B. Cells which are not able to express MHC1 C. MHC cells which express MHC2 D. Cells which are not able to express MHC Pathology mcqs Key: B

1. Function of CD4 is all except: 7. The following interleukin is characteristically A. Memory produced in a TH1 response: B. Immunoglobin production A. IL-2 C. Activation of macrophages B. IL-4 D. Cytotoxicity C. IL-5 D. IL-10 Key: B Key: A 2. A super-antigen is a bacterial product that A. Binds to B7 and CD28 co-stimulatory molecules 8. CD-95 has a major role in: B. Binds to the beta chain of TCR and MHC class II A. Apoptosis molecules of APC stimulating T cell activation B. Cell necrosis C. Binds to the CD4 + molecule causing T cell C. Interferon activation activation D. Proteolysis D. Is presented by macrophages to a larger-than- normal number of helper CD4 + lymphocytes Key: A

Key: B 9. The complement is fixed best by which of the following immunoglobulins: 3. All of the following statements about NK cells are A. IgG true except: B. IgM A. They are derived from large granular cells C. IgA B. They comprise about 5% of human peripheral D. IgD lymphoid cells C. They are MHC restricted cytotoxic cells Key: B D. They express IgG Fc receptors 10. Antigen presenting cells are which of the following: Key: C A. Astrocytes B. Endothelial cells 4. The following feature is common to both cytotoxic T- C. Epithelial cells cells and NK cells: D. Langerhan’s cells A. Synthesize antibody B. Require antibodies to be present for action Key: B C. Effective against virus infected cells D. Recognize antigen in association with HLA class 11. Antigen presenting cells are: II markers A. Langerhan’s cell B. Macrophage Key: C C. Cytotoxic T cells D. Helper T cells 5. Most potent stimulator of naive T cell is? E. B lymphocyte A. Mature dendritic cell B. Follicular dendritic cell Key: A C. Macrophages D. B cell 12. Perforins are produced by: A. Cytotoxic T cells Key: A B. Suppressor T cells C. Memory helper T cells 6. Natural killer cells attacks which of the following D. NK cells cells: A. Cells which express MHC1 Key: A

1

13. Marker for B-Lymphocyte: 20. NK cell CD marker is: A. CD34 (a) 16 B. CD33 (b) 60 C. CD19 (c) 32 D. CD20 (d) 25

Key: C Key: A

14. IL-1 causes 21. Immunity against cancer cells: A. Increased leukocyte adherence A. Basophills B. Fibroblast proliferation B. Eosinophils C. Increased collagen synthesis C. NK cells D. All of the above D. Neutrophils

Key: D Key: C

15. Antigen presenting cells present in skin are called 22. NK cells express: A. Langerhan’s cells A. CD 15, CD 55 B. Kupffer’s cells B. CD 16, CD 56 C. Microglia C. CD 16, CD 57 D. Melanocytes D. CD 21, CD 66

Key: A Key: B

16. Plasma cells 23. Which of the following immune cells have the A. Contain nucleus expression of CD8 on their surface? B. Helps in the formation of antibody A. T-cells C. Are deficient in cytoplasm B. B-cells D. Are derived from T-cells C. Null cells D. Macrophages Key: B Key: A 17. The normal ratio of CD4 to CD8 is A. 1: 1 24. Macroglobulin is derived from: B. 2: 1 A. B cells C. 8: 1 B. T cells D. 10: 1 C. Both D. Natural killer cells Key: B Key: A 18. CD4 cells is used to identify which of the following A. MHC I 25. Kupffer cells are found in: B. MHC II A. Heart C. T cells B. Lungs D. B cells C. Liver D. Spleen Key: C Key: C 19. CD3 is marker for: A. Monocyte 26. Birbeck granules are present in B. T cell A. Merkel cell C. B cell B. Langerhans cell D. none C. Langhans cell D. Melanocyte Key: B

2

Key: B Key: A 27. MHC class III genes encode: A. Complement component C3 34. Antigen presented along with HLA class II stimulate B. Tumor necrosis factor A. CD8 cell C. Interleukin 2 B. CD4 cell D. Beta 2 microglobulin C. CD2 cell D. CD19 cell Key: B Key: B 28. The HLA class III region genes are important elements in: 35. Major histocompatibility complex class I is seen on A. Transplant rejection phenomenon which of the following cell? B. Governing susceptibility to autoimmune diseases A. Macrophages only C. Immune surveillance B. All body cells D. Antigen presentation and elimination C. B cell only D. All blood cells except erythrocytes Key: B Key: D 29. HLA is located on: A. Long arm of chromosome 6 36. What type of hypersensitivity reaction is seen in B. Long arm of chromosome 3 myasthenia gravis? C. Short arm of chromosome 6 A. Type 1 hypersensitivity reaction D. Short arm of chromosome 3 B. Type 2 hypersensitivity reaction C. Type 3 hypersensitivity reaction Key: C D. Type 4 hypersensitivity reaction

30. HLA B27 is positive in: Key: B A. Ankylosing spondylitis B. Rheumatoid arthritis 37. Hemolytic disease of newborn is an example of: C. SLE A. Type 3 hypersensitivity reaction D. Behçet syndrome B. Type 2 hypersensitivity reaction C. Arthus reaction Key: A D. Type 4 hypersensitivity reaction

31. Mixed lymphocyte culture is used to identify: Key: B A. MHC class I antigen B. MHC class II antigen 38. Raji cell assays are used to quantitate: C. B lymphocytes A. Complement levels D. T helper cells B. Immune complexes C. T cells Key: B D. Interferon levels

32. HLA typing is useful in: Key: B A. Disputed paternity B. Thanatology 39. Hypersensitivity pneumonitis is classically a/an: C. Organ transplant A. Allergic reaction D. Dactylography B. Type II hypersensitivity C. Immune complex mediated hypersensitivity Key: A D. Cell mediated hypersensitivity

33. Epitope binding floor of the MHC molecule conists of Key: C A. Alpha helices B. Beta pleated structure 40. The immunoglobulin involved in type I C. Alpha and beta-1 chain hypersensitivity reaction is: D. Beta-2 microglobin A. IgE

3

B. IgM 46. Which of the following diseases is/are C. IgA mediatedthrough complement activation: D. IgG (a) Atopic dermatitis (b) Graft versus Host disease Key: A (c) Photoallergy (d) Necrotizing vasculitis 41. Arthus reaction is what type of hypersensitivity (e) Urticaria reaction: A. Localized immune complex Key: D B. Ag-Ab reaction C. Complement mediated 47. Which of following statements is not true about D. Ab mediated Mycobacterium tuberculosis infection? A. M. tuberculosis leads to development of delayed Key: A hypersensitivity B. Lymphocytes are the primary cells infected by M. 42. A 40 year old man has chronic cough with fever for tuberculosis several months. The chest radiograph reveals a diffuse C. Positive tuberculin test signifies cell mediated reticulondular pattern. Microscopically on hypersensitivity transbronchial biopsy there are focal areas of D. Tuberculin test does not differentiate between inflammation containing epitheloid cell granuloma, infection and disease. Langhans giant cells, and lymphocytes. These findings are typical for which of the following type of Key: B hypersensitivity immunologic responses: A. Type I 48. A man after consuming sea food develops rashes. It is B. Type II due to: C. Type III A. IgE mediated response D. Type IV B. Complement activation C. Cell mediated response Key: D D. None of the above

43. Patient presented with generalized edema sweating Key: A and flushing tachycardia and fever after bee sting. This is: 49. Granuloma in Sarcoidosis is called A. T cell mediated cytotoxicity A. Hard sore B. IgE mediated reaction B. Soft sore C. IgG mediated reaction C. Hard tubercle D. IgA mediated hypersensitivity reaction D. Caseating granuloma

Key: B Key: A

44. Example of Type IV Hypersensitivity is/are: 50. Myasthenia gravis may be associated with A. Farmer’s lung A. Thymoma B. Contact hypersensitivity B. Systemic lupus erythematosus C. Immediate hypersensitivity C. Hyperthyroidism D. Myasthenia gravis D. All of the above

Key: B Key: D

45. Example of Type II Hypersensitivity is/are: 51. Which of the following type of hypersensitivity A. Blood transfusion reaction reaction is found in blood transfusion reaction? B. Arthus reaction A. Anaphylactic type C. Hay Fever B. Cytotoxic type D. Post-streptococcal glomerulonephritis C. Type III hypersensitivity D. Cell mediated hypersensitivity Key: A Key: B

4

C. Liver 52. Which of the following type of hypersensitivity D. Lung reactions occurs in Farmer’s lung A. Type I Key: D B. Type II C. Type III 59. Preformed antibodies cause: D. Type IV A. Hyperacute rejection B. Acute rejection Key: D C. Chronic rejection D. Acute humoral rejection 53. Tuberculin test positivity indicates A. Good humoral immunity Key: A B. Infection with mycobacterium C. Good cell mediated immunity 60. True about graft versus host disease is: D. None A. Associated with solid organ transplantation B. Graft must contains immunocompetent T cell Key: C C. It is seen in immunosuppressed persons D. Also called as Runt disease in animals 54. Myasthenia gravis is most commonly associated with which of the following? Key: A A. Thymoma B. Thymic carcinoma 61. Acute humoral renal transplant rejection is C. Thymic hyperplasia characterized by the following, except: D. Lymphoma A. Presence of anti-donor antibodies B. Interstitial and tubular mononuclear cell infiltrate Key: C C. Necrotizing vasculitis D. Acute cortical necrosis 55. Cell mediated immunity is: A. Type I Key: B B. Type II C. Type III 62. Transfer of the graft of different species are called as D. Type IV A. Isograft B. Allograft Key: D C. Homograft D. Xenograft

56. Antibody found in patients with myasthenia gravis is Key: D directed against A. Acetylcholine 63. Acute graft versus host disease reaction occurs in all B. Acetylcholine receptors except C. Acetylcholine vesicles in nerve terminal A. Liver D. Actin-myosin complex of the muscle B. Adrenal C. Gut Key: B D. Skin

57. Hyperacute rejection is due to Key: B A. Preformed antibodies B. Cytotoxic T-lymphocyte mediated injury 64. Preformed antibodies cause: C. Circulating macrophage mediated injury A. Hyperacute rejection D. Endothelitis caused by donor antibodies B. Acute rejection C. Chronic rejection Key: A D. Acute humoral rejection

58. All are affected in Graft-Versus host reaction: Key: A A. Skin B. GIT 65. Principal cause of death in renal transplant patient is

5

A. Uraemia Key: A B. Malignancy C. Rejection 72. Tissue from rat used for detection of antinuclear D. Infection antibodies? A. Kidney Key: D B. Brain C. Stomach 66. Autoimmunity in EBV infection is the result of D. Liver A. Molecular mimicry B. Polyclonal B cell activation Key: D C. Expressing sequestrated antigens D. Antigenic cross reactivity 73. Which is not found in CNS in a case of AIDS? A. Perivascular giant cell Key: B B. Vacuolization C. Inclusion bodies 67. A 14 yrs. old girl on exposure to cold has pallor of D. Microglial nodule extremities followed by pain and cyanosis. In later ages of life she is prone to develop? Key: C A. Systemic lupus eryhtematosis B. Scleroderma 74. A person present with recurrent swelling on face and C. Rheumatoid arthritis lips due to emotional stress. Likely cause is: D. Hisiocytosis A. C1 esterase inhibitor deficiency B. Allergy Key: B C. Anaphylaxis D. None of the above 68. Which is not autoimmune disease? A. Systemic Lupus Erythematosis Key: A B. Grave’s Disease C. Myasthenia Gravis 75. Hematoxylin bodies seen in: D. Sickle Cell Disease A. SLE B. PAN Key: D C. Rheumatoid arthritis D. Wegener’s granulomatosis 69. Which among the following is seen in Antiphospholipid antibody syndrome? Key: A A. Beta 2 microglobulin antibody B. Anti nuclear antibody 76. Wire loop lesions are often characteristic for the C. Anti centromere antibody following class of lupus nephritis: D. Anti glycoprotein antibody A. Mesangial proliferative glomerulonephritis (WHO class II) Key: D B. Focal proliferative glomerulonephritis (WHO class III) 70. Necrotizing lymphadenitis is seen in C. Diffuse proliferative glomerulonephritis (WHO A. Kimura disease class IV) B. Kikuchi Fujimoto disease D. Membranous glomerulonephritis (WHO class V) C. Hodgkin disease D. Castelman disease Key: C

Key: B 77. A renal biopsy from a 56 year old woman with progressive renal failure for the past 3 years shows 71. Wire loop lesions are seen in: glomerular and vascular deposition of pink A. SLE amorphous material. It shows apple-green B. Diabetic nephropathy birefringence under polarized light after Congo red C. Benign nephrosclerosis staining. These deposits are positive for lambda light D. Wegener’s granulomatosis chains. The person is most likely to suffer from: A. Rheumatoid arthritis

6

B. Tuberculosis C. IgA C. Systemic lupus erythematosus D. IgD D. Multiple myeloma Key: C Key: D 84. Scl-70 antibody is characteristic of 78. A young lady presented with bilateral nodular lesions A. Systemic lupus erythematosus on shins. She was also found to have bi-lateral hilar B. Scleroderma lymphadenopathy on chest X-ray. Mantoux test C. Dermatomyositis reveals indurations of 5 mms. Skin biopsy would D. Sjogren’s syndrome reveal: A. Non caseating Granuloma Key: B B. Vasculitis C. Caseating Granuloma 85. Most sensitive test for screening of “Systemic Lupus D. Malignant cells Erythematosus” (SLE) is A. LE phenomenon Key: A B. Rheumatoid factor C. Anti nuclear factor (ANF) 79. Anti ds-DNA antibodies are commonly seen in: D. Double stranded DNA test A. SLE B. Scleroderma Key: C C. PAN D. Dermatomyositis 86. According to WHO, the feature of class II lupus is A. Transient proteinuria Key: A B. Massive proteinuria C. Hematuria 80. Low complement levels seen in: D. RBC casts A. PSGN B. MPGN Key: C C. Infective endocarditis. D. All 87. ANCA antibody with peripheral rim distribution is indicative of Key: D A. Antihistone antibody B. Anti smith antibody 81. Adenosine deaminase deficiency is seen in: C. Anti double stranded DNA antibody A. Severe combined immunodeficiency. D. Anti double stranded RNA antibody B. Wiskott Aldrich Syndrome C. Agammaglobulinemia as HIV Key: C D. None 88. Basic pathology in cystic fibrosis is Key: A A. Defect in the transport of chloride across epithelia B. Defect in the transport of sodium across epithelia 82. All are true regarding Hyper IgE syndrome exept: C. Defect in the transport of potassium across A. Inheritance is as a single locus autosomal epithelia dominant trait with variable expression D. Defect in the transport of bicarbonate across B. Coarse facial features epithelia C. Recurrent staphylococcal abscesses involving skin, lungs Key: A D. High serum IgE with low IgG, IgA and IgM 89. Most common viral antigen used for diagnosis of HIV Key: D in blood before transfusion is A. p24 83. Which of the following immunoglobulin is absent in B. p17 Ataxia telangiectasia: C. p7 A. IgG D. p14 B. IgM

7

Key: A C. Anticentromere D. Anti topoisomerase 90. Most common vascular tumor in AIDS patients is A. Kaposi ’s sarcoma Key: A B. Angiosarcoma C. Lymphangioma 97. Which of the following autoantibody isleast likely D. Lymphoma associated with SLE? A. Anti ds DNA Key: A B. Anti Sm C. Anti topoisomerase 91. Libman-Sacks endocarditis is seen in D. Anti histone A. Rheumatoid arthritis B. SLE Key: C C. Infective endocarditis D. Nonbacterial thrombotic endocarditis 98. Most common CNS neoplasm in HIV patient is: A. Meduloblastoma Key: B B. Astrocytoma C. Primary CNS Iymphoma 92. Anti-double stranded DNA is highly specific for: D. Ependymoma A. Systemic sclerosis B. SLE Key: C C. Polymyositis D. Rheumatic sclerosis 99. Thymic hypoplasia is seen in which of the following? A. Wiskott-Aldrich syndrome Key: B B. Digeorge syndrome C. IgA deficiency 93. Anti-topoisomerase I is marker of: D. Agammaglobulinemia A. Systemic sclerosis B. Classic polyarteritis nodosa Key: B C. Nephrotic syndrome D. Rheumatoid arthritis 100. Onion peel appearance of splenic capsule is seen in: A. SLE Key: A B. Scleroderma C. Rheumatoid arthritis 94. An 8-year-old boy presents with sarcoidosis. Which D. Sjogren syndrome of the following is correct? A. Hilar lymphadenopathy with perihilar Key: A calcification B. Basal infiltrates 101. All of the following methods are used for the C. Rubbery lymph nodes diagnosis of HIV infection in a 2months old child, D. Egg-shell-calcification except A. DNA –PCR Key: A B. Viral culture C. HIV ELISA 95. Most common site for lymphoma in AIDS patients is D. P 24 antigen assay A. CNS B. Spleen Key: C C. Thymus D. Abdomen 102. Mantoux test reading of less than 5 mm indicates: A. Tuberculous infections Key: A B. Disseminated TB C. Susceptibility to TB 96. Which of the following autoantibody is specific for D. Immunity to TB SLE? A. ds DNA Key: B B. Anti RO

8

103. Epitope spreading refers to 109. Which of the following is the characteristic of A. A type of mechanism of spread of malignant irreversible injury on electron microscopy? tumors A. Disruption of ribosomes B. One type of mechanism of HIV dissemination B. Amorphous densities in mitochondria C. A mechanism for the persistence and evolution of C. Swelling of endoplasmic reticulum autoimmune disease D. Cell swelling D. One of the mechanisms of apoptosis Key: B Key: D 110. Caspases are associated with which of the following? 104. HIV affects CD4 cells by which protein A. Hydopic degeneration A. Gp 120 B. Collagen hyalinization B. Gp 41 C. Embryogenesis C. CCR5 D. Fatty degeneration D. CXCR4 Key: C Key: A 111. Caspases are seen in which of the following? 105. Treatment for Asymptomatic HIV is done when CD4 A. Cell division count is below B. Apoptosis A. 200 C. Necrosis B. 350 D. Inflammation C. 400 D. 500 Key: B

Key: B 112. Light microscopic characteristic feature of apoptosis is: 106. Hodgkins lymphoma caused for by A. Intact cell membrane A. EBV B. Eosinophilic cytoplasm B. CMV C. Nuclear moulding C. HHV6 D. Condensation of the nucleus D. HHV8 Key: D Key: A 113. Coagulative necrosis is found in which infection? 107. CD 95 is a marker of A. TB A. Intrinsic pathway of apoptosis B. Sarcoidosis B. Extrinsic pathway of apoptosis C. Gangrene C. Necrosis of cell D. Fungal infection D. Cellular adaption Key: A, Tb > Gangrene Key: B 114. Organelle which plays a pivotal role in apoptosis is: A. Cytoplasm B. Golgi complex 108. A patient with malignancy has given C. Mitochondria chemotherapeutic agent which reduces the size of the D. Nucleus tumor. the chemotherapeutic agent works through the mechanism of Key: C A. nuclear atrophy B. dysplasia 115. All of the following statements are true regarding C. necrosis reversible cell injury, except D. Apoptosis A. Formation of amorphous densities in the mitochondrial matrix Key: D B. Diminished generation of adenosine triphosphate C. (ATP).

9

D. Formation of blebs in the plasma membrane. E. Detachment of ribosomes from the granular Key: D endoplasmic reticulum. 122. Ultra-structural finding of irreversible injury Key: A A. Ribosomal detachment from endoplasmic reticulum 116. Fibrinoid necrosis may be observed in all of the B. Amorphous densities in mitochondria following, except: C. Formation of phagolysosomes A. Malignant hypertension D. Cell swelling B. Polyarteritis nodosa C. Diabetic glomerulosclerosis Key: B D. Aschoff’s nodule 123. Caspases are involved in Key: C A. Necrosis B. Apoptosis 117. In apoptosis, Apaf-I is activated by release of which C. Atherosclerosis of the following substances from the mitochondria? D. Inflammation A. Bcl-2 B. Bax Key: B C. Bcl-XL D. Cytochrome C 124. True about Apoptosis are all except: A. Inflammation is present Key: D B. Chromosomal breakage C. Clumping of chromatin 118. Which of the following is an anti-apoptotic gene? D. Cell shrinkage A. C-myc B. p 53 Key: A C. Bcl-2 D. Bax 125. The following is an antiapoptotic gene A. Bax Key: C B. Bad C. Bcl-X 119. Annexin v on non-permeable cell is indicative of: D. Bim A. Apoptosis B. Necrosis Key: C C. Cell entering replication phase D. Cell cycle arrest 126. Cytosolic cytochrome C plays an important function in Key: A A. Apoptosis B. Cell necrosis 120. Parotid gland swelling due to obstruction will result C. Electron transport chain into ? D. Cell division A. necrosis B. Apoptosis Key: A C. hypertrophy D. hyperplasia 127. Most pathognomic sign of irreversible cell injury A. Amorphous densities in mitochondria Key: B B. Swelling of the cell membrane C. Ribosomes detached from endoplasmic reticulum 121. Promyelocytic leukemia, cells with abnormal D. Clumping of nuclear chromatin cytoplasm and rounded eosinophilic bodies, mechanism of injury. Key: A A. nuclear atrophy B. dysplasia 128. Internucleosomal cleavage of DNA is characteristic of C. cytolysis A. Reversible cell injury D. Apoptosis B. Irreversible cell injury

10

C. Necrosis D. Annexin V is a marker of apoptotic cell D. Apoptosis Key: All of the above true Key: D 135. Which of the following is the hallmark of 129. Active Programmed cell death is known as: programmed cell death? A. Cytolysis A. Apoptosis B. Apoptosis B. Coagulation necrosis C. Necrosis C. Fibrinoid necrosis D. Proptosis D. Liquefaction necrosis

Key: B Key: A

130. Ladder pattern of DNA electrophoresis in apoptosis is 136. Which of the following is an inhibitor of apoptosis? caused by the action of the following enzyme: A. Bad A. Endonuclease B. Bax B. Transglutaminase C. Bcl-2 C. DNAse D. All of the above D. Caspase Key: C Key: A 137. Inhibitor of apoptosis is: 131. Which finding on electron microscopy indicates A. p53 irreversible cell injury? B. Ras A. Dilatation of endoplasmic reticulum C. Myc B. Dissociation of ribosomes from rough D. Bcl-2 endoplasmic reticulum C. Flocculent densities in the mitochondria Key: D D. Myelin figures 138. Apoptosis is associated with all of the following Key: C features except: A. Cell shrinkage 132. True about apoptosis is all, except: B. Intact cellular contents A. Considerable apoptosis may occur in a tissue C. Inflammation before it becomes apparent in histology D. Nucleosome size fragmentation of nucleus B. Apoptotic cells appear round mass of the intensely eosinophilic cytoplasm with dense Key: C nuclear chromatin fragments C. Apoptosis of cells induce inflammatory reaction 139. Liquefactive necrosis is typically seen in D. Macrophages phagocytose the apoptotic cells and A. Ischemic necrosis of the heart degrade them B. Ischemic necrosis of the brain C. Ischemic necrosis of the intestine Key: C D. Tuberculosis

133. Morphological changes of apoptosis include Key: B A. Cytoplasmic blebs B. Inflammation 140. All of the following are morphological features of C. Nuclear fragmentation apoptosis except D. Spindle formation A. Cell shrinkage B. Chromatin condensation Key: A & C C. Inflammation D. Apoptotic bodies 134. True about apoptosis A. End products are phagocytosed by macrophage Key: C B. Intranuclear fragmentation of DNA C. Activation of caspases

11

141. Coagulative necrosis as a primary event is most often D. All of the above seen in all except: A. Kidneys Key: B B. CNS C. Spleen 148. First cellular change in hypoxia: D. Liver A. Decreased oxidative phosphorylation in mitochondria Key: B B. Cellular swelling C. Alteration in cellular membrane permeability 142. Liquefactive necrosis is seen in: D. Clumping of nuclear chromatin A. Heart B. Brain Key: A C. Lung D. Spleen 149. About apoptosis, true statement is: A. Injury due to hypoxia Key: B B. Inflammatory reaction is present C. Councilman bodies is associated with apoptosis 143. Irreversible injury in cell is D. Cell membrane is damaged A. Deposition of Ca++ in mitochondria B. Swelling Key: C C. Mitotic figure D. Ribosomal detachment 150. Fournier’s gangrene is seen in: A. Nose Key: A B. Scrotal skin C. Oral cavity 144. Apoptosis is D. All are true A. Cell degeneration B. Type of cell injury Key: B C. Cell regeneration D. Cell activation 151. Coagulative necrosis is seen in: A. Brain Key: B B. Breast C. Liver 145. Pyogenic infection and brain infarction are associated D. All with A. Coagulative necrosis Key: C B. Liquefactive necrosis C. Caseous necrosis 152. A 22 year old male patient presents to the hospital D. Fat necrosis with jaundice, right upper quadrant pain and fatigue. He tests positive for hepatitis b surface antigen. The Key: B serum bilirubin levels is 4.8mg/dl (direct is 0.8mg/dl and indirect bilirubin is 4.0mg/dl), AsT levels is 300 146. In apoptosis initiation: u/l, AlT is 325 u/l and alkaline phosphatase is within A. The death receptors induce apoptosis when it normal limits. The elevation in AsT and AlT can be engaged by fas ligand system explained by which of the following? B. Cytochrome C binds to a protein Apoptosis A. Bleb formation Activating (Apaf-1) Factor – 1 B. Cell membrane rupture C. Apoptosis may be initiated by caspase activation C. Clumping of nuclear chromatin D. Apoptosis mediated through DNA damage D. Swelling of endoplasmic reticulum

Key: A Key: B

147. Apoptosis is alternatively called as 153. A 23-year-old lady was driving her car when she had A. Ischemic cell death to apply brakes suddenly. She suffered from “steering B. Programmed cell death wheel” injury in the right breast. After 5 days of pain C. Post traumatic cell death and tenderness at the site of trauma, she noticed the

12

presence “lump” which was persistent since the day 157. A 50-year old male presented to the medicine of trauma. Dr. does an excision biopsy and observed emergency room with retrosternal chest pain of 15 the presence of an amorphous basophilic material minutes duration. He also had sweating and mild within the mass. The amorphous material is an dyspnea. The physician immediately gave him a example of nitrate tablet to be kept sublingually following which A. Apocrine metaplasia. his chest pain decreased significantly. Which of the B. Dystrophic fat necrosis following if accumulated is suggestive of reversible C. Enzymatic fat necrosis cell injury due to hypoperfusion of different organs D. Granulomatous inflammation during this duration of myocardial ischemia? A. Carbon dioxide Key: B B. Creatinine C. Lactic acid 154. A 44 yr old male patient is diagnosed with a cancer. It D. Troponin I was observed that he shows a poor response to a commonly used anti-cancer drug which acts by Key: C increasing programmed cell death. Inactivation of which of the following molecules/genes is responsible 158. A 50-year old male presented to the medicine for the resistance shown in the tumor cells? emergency room with retrosternal chest pain of 15 A. Granzyme and perforin minutes duration. He also had sweating and mild B. Bcl-2 dyspnea. The physician immediately gave him a C. p53 nitrate tablet to be kept sublingually following which D. Cytochrome P450 his chest pain decreased significantly. If we presume that the patient has experienced several similar Key: C episodes of pain over the last 10 hours, which of the following ultra-structural changes would most likely 155. Dr. Salman is carrying out an experiment in which a indicate irreversible myocardial cell injury in this genetic mutation decreased the cell survival of a cell patient? culture line. These cells have clumping of the nuclear A. Myofibril relaxation chromatin and reduced size as compared to normal B. Disaggregation of polysomes cells. Which of the following is the most likely C. Mitochondrial vacuolization involved gene in the above described situation? D. Disaggregation of nuclear granules A. Fas B. Bax Key: C C. Bcl-2 D. Myc 159. A 55-year-old man, develops a thrombus in his left anterior descending coronary artery. The area of Key: C myocardium supplied by this vessel is irreversibly injured. The thrombus is destroyed by the infusion of 156. A 50-year old male presented to the medicine streptokinase, which is a plasminogen activator, and emergency room with retrosternal chest pain of 15 the injured area is reperfused. The patient, however, minutes duration. He also had sweating and mild develops an arrhythmia and dies. An electron dyspnea. The physician immediately gave him a microscopic (eM) picture taken of the irreversibly nitrate tablet to be kept sublingually following which injured myocardium reveals the presence of large, his chest pain decreased significantly. Which of the dark, irregular amorphic densities within following best represents the biochemical change in mitochondria. What are these abnormal structures? the myocardial cells of this patient during the A. Apoptotic bodies transient hypoxia? B. Flocculent densities A. Decreased hydrogen ion concentration C. Myelin figures B. Increase in oxidative phosphorylation D. Psammoma bodies C. Loss of intracellular Na+ and water E. Russell bodies D. Stimulation of anaerobic glycolysis and glycogenolysis Key: B

Key: D 160. Which one of the listed statements best describes the mechanism through which Fas (CD95) initiates apoptosis?

13

A. BCL2 product blocks channels Key: B B. Cytochrome activates Apaf-1 C. FADD stimulates caspase 8 167. Organelle that plays a pivotal role in apoptosis: D. TNF inhibits Ikb A. Endoplasmic reticulum E. TRADD stimulates FAD most Recent Questions B. Golgi complex C. Mitochondria Key: C D. Nucleus

161. In apoptosis, cytochrome C acts through: Key: C A. Apaf 1 B. Bcl-2 168. Intracellular calcification begins in which of the C. FADD following organelles? D. TNF A. Mitochondria B. Golgi body Key: A C. Lysososme D. Endoplasmic reticulum 162. Cells most sensitive to hypoxia are: A. Myocardial cells Key: A B. Neurons C. Hepatocytes 169. Which of the following induces apoptosis in a cell? D. Renal tubular epithelial cells A. Oleic acid B. Isoprenoids Key: B C. Myristic acid D. Glucocorticoids 163. In cell death, myelin figures are derived from: A. Nucleus Key: D B. Cell membrane C. Cytoplasm 170. Which of the following is not seen is apoptosis? D. Mitochondria A. Chromatin condensation B. DNA fragmentation Key: B C. Inflammation D. Cell membrane shrinkage 164. Irreversible cell injury is characterised by which of the following? Key: C A. Mitochondrial densities B. Cellular swelling 171. Following gene when mutated protects tumor cells C. Blebs from Apoptosis D. Myelin figures A. BCL – 2 B. BRCA Key: A C. RB D. TGF – β 165. Coagulative necrosis as a primary event is most often seen in all except: Key: A A. Kidneys B. CNS 172. Following is seen in both apoptosis and necrosis: C. Spleen A. Both may be physiological D. Liver B. Both may be pathological C. Inflammation Key: B D. Intact cell membrane

166. Liquefactive necrosis is seen in: Key: B A. Heart B. Brain 173. Psammoma bodies are seen in all except: C. Lung A. Follicular carcinoma of thyroid D. Spleen B. Papillary carcinoma of thyroid C. Serous cystadenoma of ovary

14

D. Meningioma 180. The Fenton reaction leads to free radical generation Key: A when: A. Radiant energy is absorbed by water 174. True about metastatic calcification is B. Hydrogen peroxide is formed by A. Calcium level is normal Myeloperoxidase B. Occur in dead and dying tissue C. Ferrous ions are converted to ferric ions C. Occur in damaged heart valve D. Nitric oxide is converted to peroxynitrite anion D. Mitochondria involved earliest Key: C Key: D 181. Mallory hyaline is seen in: 175. Both hyperplasia and hypertrophy are seen in? A. Alcoholic liver disease A. Breast enlargement during lactation B. Hepatocellular carcinoma B. Uterus during pregnancy C. Wilson’s disease C. Skeletal muscle enlargement during exercise D. Biliary cirrhosis D. Left ventricular hypertrophy during heart failure Key: A Key: B 182. Heterotopic calcification occurs in: 176. Which of the following is not a common site for A. Ankylosing spondylitis metastatic calcification? B. Reiter’s syndrome A. Gastric mucosa C. Forrestier’s disease B. Kidney D. Rheumatoid arthritis C. Parathyroid D. Lung Key: A

Key: C 183. Wear and tear pigment in the body refers to 177. Calcification of soft tissues without any disturbance A. Lipochrome of calcium metabolism is called B. Melanin A. Inotrophic calcification C. Anthracotic pigment B. Monotrophic calcification D. Hemosiderin C. Dystrophic calcification D. Calcium induced calcification Key: A

Key: C 184. Mallory hyaline bodies are seen all except: A. HCC 178. The light brown perinuclear pigment seen on H & e B. Wilson’s disease staining of the cardiac muscle fibres in the grossly C. Alcoholic hepatitis normal appearing heart of an 83 year old man at D. Crigler-Najjar syndrome autopsy is due to deposition as: A. Hemosiderin Key: D B. Lipochrome C. Cholesterol metabolite 185. “Russell’s body” are accumulations of: D. Anthracotic pigment A. Cholesterol B. Immunoglobulins Key: B C. Lipoproteins D. Phospholipids 179. Dystrophic calcification is seen in: A. Rickets Key: B B. Hyperparathyroidism C. Atheromatous plaque 186. Dystrophic calcification is seen in: D. Vitamin A intoxication A. Atheroma B. Paget’s disease Key: C C. Renal osteodystrophy

15

D. Milk-alkali syndrome 193. Metastatic calcification occurs in all except: A. Kidney Key: A B. Atheroma C. Fundus of stomach 187. Brown atrophy is due to D. Pulmonary veins A. Fatty necrosis B. Hemosiderin Key: B C. Lipofuscin D. Ceruloplasmin 194. Dystrophic calcification is: A. Calcification in dead tissue Key: C B. Calcification in living tissue C. Calcification in dead man 188. Psammoma bodies are typically associated with all of D. None the following neoplasms except A. Medulloblastoma Key: A B. Meningioma C. Papillary carcinoma of the thyroid 195. An old man has difficulty in urination associated with D. Papillary serous cystadenocarcinoma of the ovary increased urge and frequency. He has to get up several times in night to relieve himself. There is no history Key: A of any burning micturition and lower back pain. On rectal examination, he has enlarged prostate. Which of 189. Transformation of one epithelium to other epithelium the following represents the most likely change in the is known as bladder of this patient? A. Dysplasia A. Hyperplasia B. Hyperplasia B. Atrophy C. Neoplasia C. Hypertrophy D. Metaplasia D. Metaplasia

Key: D Key: C

190. All are true about metaplasia except 196. An increase in the size of a cell in response to stress is A. Slow growth called as hypertrophy. Which of the following does B. Reverse back to normal with appropriate not represent the example of smooth muscle treatment hypertrophy as an adaptive response to the relevant C. Irreversible situation? D. If persistent may induce cancer transformation A. Urinary bladder in urine outflow obstruction B. Small intestine in intestinal obstruction Key: C C. Triceps in body builders D. None of the above 191. About hyperplasia, which of the following statement is false? Key: C A. ↑ no of cells B. ↑ size of the affected cell 197. A patient presented with complaints of slow C. Endometrial response to estrogen is an example progressive breathlessness, redness in the eyes and D. All skin lesions. His chest x-ray had bilateral hilar lymphadenopathy. His serum ACe levels were Key: B elevated. On doing Kveim test, it came out to be positive. Final confirmation was done with a biopsy 192. example of hypertrophy is: which demonstrated presence of non-caseous A. Breast in puberty granuloma. A diagnosis of sarcoidosis was B. Uterus during pregnancy established. Which of the following statements C. Ovary after menopause regarding calcification and sarcoidosis is not true? D. Liver after resection A. The calcification in sarcoidosis begins at a cellular level in mitochondria Key: B B. There is presence of dystrophic calcification

16

C. The granulomatous lesions contain macrophages A. Lymph nodes which cause activation of vitamin D precursors B. Lungs D. None of the above C. Kidney D. Liver Key: B Key: B 198. A 50-year-old male alcoholic, presents with symptoms of liver disease and is found to have mildly 203. Russell bodies are seen in: elevated liver enzymes. A liver biopsy examined with A. Lymphocytes a routine hematoxylin and eosin (H & e) stain reveals B. Neutrophils abnormal clear spaces in the cytoplasm of most of the C. Macrophages hepatocytes. Which of the following materials is most D. Plasma cells likely forming cytoplasm spaces? A. Calcium Key: D B. Cholesterol C. Hemosiderin 204. Psammoma bodies show which type of calcification: D. Lipofuscin A. Metastatic E. Triglyceride B. Dystrophic C. Secondary Key: D. All of the above

199. A 36-year-old woman, presents with intermittent Key: B pelvic pain. Physical examination reveals a 3-cm mass in the area of her right ovary. Histologic 205. Gamma Gandy bodies contain hemosiderin and: sections from this ovarian mass reveal a papillary A. Na+ tumor with multiple, scattered small, round, and B. Ca++ laminated calcifications. Which of the following is the C. Mg++ basic defect producing these abnormal structures? D. K+ A. Dystrophic calcification B. Enzymatic necrosis Key: B C. Metastatic calcification D. Viral infection 206. Oncocytes are modified form of which of the following: Key: D A. Lysososmes B. Endoplasmic reticulum 200. A 28-year-old male executive presents to the doctor C. Mitochondria with complaints of “heartburn” non-responsive to D. None of the above usual medicines undergoes endoscopy with biopsy of the distal esophagus is taken. What type of mucosa is Key: C normal for the distal esophagus? A. Ciliated, columnar epithelium 207. Which of the following is the most common fixative B. Keratinized, stratified, squamous epithelium used in electron microscopy? C. Non-keratinized, simple, squamous epithelium A. Glutaraldehyde D. Non-keratinized, stratified, squamous epithelium B. Formalin C. Picric acid Key: D D. Absolute Alcohol

201. True about psammoma bodies are all except: Key: A A. Seen in meningioma B. Concentric whorled appearance 208. The fixative used in histopathology: C. Contains calcium deposits A. 10% buffered neutral formalin D. Seen in teratoma B. Bouins fixative C. Glutaraldehyde Key: D D. Ethyl alcohol

202. Metastatic calcification is most often seen in: Key: A

17

D. Carbohydrates 209. Which is the most commonly used fixative in histopathological specimens? Key: A A. Glutaraldehyde B. Formaldehyde 216. PAs stains the following except C. Alcohol A. Glycogen D. Picric acid B. Lipids C. Fungal cell wall Key: B D. Basement membrane of bacteria

210. lipid in the tissue is detected by: Key: B A. PAS B. Myeloperoxidase 217. All are components of basement membrane except C. Oil Red O A. Nidogen D. Mucicarmine B. Laminin C. Entactin Key: C D. Rhodopsin

211. The most abundant glycoprotein present in basement Key: D membrane is: A. Laminin 218. Which of the following pigments are involved in free B. Fibronectin radical injury? C. Collagen type 4 A. Lipofuscin D. Heparan sulphate B. Melanin C. Bilirubin Key: A D. Hematin

212. enzyme that protects the brain from free radical injury Key: A is: A. Myeloperoxidase 219. True about cell ageing: B. Superoxide dismutase A. Free radicals injury C. MAO B. Mitochondria are increased D. Hydroxylase C. Lipofuscin accumulation in the cell D. Size of cell increased Key: B Key: C 213. Increased incidence of cancer in old age is due to A. Telomerase reactivation 220. Neutrophil secretes: B. Telomerase deactivation A. Superoxide dismutase C. Inactivation of protooncogene B. Myeloperoxidase D. Increase in apoptosis C. Lysosomal enzyme D. Catalase Key: A E. Cathepsin G

214. Stain not used for lipid Key: B A. Oil red O B. Congo red 221. Which of the following is a peroxisomal free radical C. Sudan III scavenger? D. Sudan black A. Superoxide dismutase B. Glutathione peroxidase Key: B C. Catalase D. All of the above 215. Acridine orange is a fluorescent dye used to bind A. DNA and RNA Key: D B. Protein C. Lipid 222. Crooke’s hyaline body is present in:

18

A. Yellow fever old man. Which of the following biochemical events B. Basophil cells of the pituitary gland in Cushing’s most likely occurred during the period of hypoxia? syndrome A. Decreased hydrogen ion concentration C. Parkinsonism B. Increase in oxidative phosphorylation D. Huntington’s disease C. Loss of intracellular Na+ and water D. Stimulation of anaerobic glycolysis and Key: B glycogenolysis

223. An autopsy is performed on a 65-year-old man, who Key: D died of congestive heart failure. Sections of the liver reveal yellow-brown granules in the cytoplasm of 228. A 45-year-old man with a long history of alcoholism most of the hepatocytes. Which of the following presents with severe epigastric pain, nausea, vomiting, stains would be most useful to demonstrate with fever, and an increase in serum amylase. During a positive staining that these yellow-brown cytoplasmic previous hospitalization for a similar episode, granules are in fact composed of hemosiderin (iron)? computed tomography scanning demonstrated A. Oil red O stain calcifications in the pancreas. A diagnosis of acute B. Periodic acid- Schiff stain pancreatitis superimposed on chronic pancreatitis was C. Prussian blue stain made. In this condition, which of the following types D. Sudan black B stain of necrosis is most characteristic? A. Caseous Key: C B. Coagulative C. Enzymatic (fat) 224. An AIDs patient Saleem develops symptoms of D. Liquefactive pneumonia, and Pneumocystis carinii is suspected as the causative organism. bronchial lavage is Key: C performed. Which of the following stains would be most helpful in demonstrating the organism’s cysts on 229. A 30 Years-old Patient hospitalized for acquired slides made from the lavage fluid? immunodeficiency syndrome (AIDS) is found to have A. Alcian blue pulmonary tuberculosis. Which type of necrosis is B. Hematoxylin and eosin found in the granulomatous lesions (clusters of C. Methenamine silver modified macrophages) characteristic of this D. Trichrome stain increasingly frequent complication of AIDS? A. Caseous Key: C B. Coagulative C. Enzymatic 225. Which process makes the bacteria ‘tasty’ to t D. Fibrinoid macrophages: A. Margination Key: A B. Diapedesis C. Opsonisation 230. A 56-year-old man recovered from a myocardial D. Chemotaxis infarction after his myocardium was entirely “saved” by immediate thrombolytic therapy. If it had been Key: C possible to examine microscopic sections of his heart during his ischemic episode, which of the following would be the most likely cellular change to be found? 226. Common intracranial tumor is: A. Karyolysis A. Glioma B. Karyorrhexis B. Madulloblastoma C. Pyknosis C. Meningioma D. Swelling of the endoplasmic reticulum D. Secondaries Key: D Key: D 231. A 64-year-old woman presents with fever, chills, 227. A Myocardial Infarction was successfully averted by headache, neck stiffness, vomiting, and confusion. thrombolytic (clot-dissolving) therapy in a 55-year- The Kernig sign and Brudzinski sign are both positive. Examination of the CSF reveals large

19

volume of leucocytes and brain imaging demonstrates C. Astrocytes a localized abscess. Which of the following types of D. Ependymal cells necrosis is most characteristic of abscess formation? A. Coagulative Key: A B. Enzymatic C. Fibrinoid 237. Gas forming bacteria D. Liquefactive A. Clostradium prefinges B. Clostradium Septitucm Key: D C. A and b both D. None of all 232. A 20-year-old man presents with yellowing of the sclerae, skin, and oral mucosa. Which of the Key: A following accumulations underlies these findings? A. Bilirubin 238. Barret Oesophagus is classical example of B. Hemosiderin A. Metaplasia C. Lead B. Dysplasia D. Melanin C. Hyperplasia D. Aplasia Key: A Key: A 233. A 16-year-old girl undergoes radiologic imaging of her abdomen and is found to have only one kidney. 239. A person having keratomalacia. Which of the one is She had been entirely unaware of this problem. Which the might be cause of this condition in eye of the Following terms is most descriptive of this A. Vitamin C deficiency finding? B. Vitamin D Deficiency A. Agenesis C. Vitamin A Deficinecy B. Atrophy D. Vitamin E Deficiency C. Hyperplasia D. Metaplasia Key: C

Key: A 240. A 77-year-old woman has chronic renal failure. Her serum urea nitrogen is 40 mg/dL. She is given a 234. In which of the following condition, vitamin K diuretic medication and loses 2 kg (4.4 lb). She deficiency is seen: reduces the protein in her diet and her serum urea A. Obstructive jaundice nitrogen decreases to 30 mg/dL. Which of the B. Prehepatic jaundice following terms best describes cellular responses to C. Hepatic jaundice disease and treatment in this woman? D. None of the above A. Adaptation B. Apoptosis Key: A, in obstructive jaundice, there is C. Necroptosis Malabsorption of fat and fat soluble vitamins such as D. Irreversible injury vitamin A, D and K Key: A 235. Glitter cells are: A. Oligodendrocytes 241. A 20-year-old woman breastfeeds her infant. On B. Phagocytes in CNS examination, her breasts are slightly increased in size. C. Epidermal cells Milk can be expressed from both nipples. Which of D. Astrocytes the following processes that occurred in her breasts during pregnancy enables her to breastfeed the infant? Key: B, Glitter cells are the macrophages found at the A. Ductal metaplasia sites of brain injury. The cells are filled with lipoid B. Epithelial dysplasia granules from phagocytosis of damaged brain cells. C. Intracellular lipid deposition D. Lobular hyperplasia 236. Phagocytes in central nervous system are: A. Microglia Key: D B. Oligodendrocytes

20

242. Myositis ossificans is the condition in which the 247. A Langhans giant cells muscle tissue changed into osseus tissue is exmple of A. Macrophages A. Metaplasia B. Mast cells B. Hyperplasia C. Neutrophils C. Dysplasia D. T lymphocytes D. Hypertrophy Key: C Key: A 248. Which of the following is not decreased in nephrotic 243. Myositis ossificans is the condition in which the syndrome: muscle tissue changed into osseus tissue is exmple of A. Ceruloplasmin A. Metaplasia B. Fibrinogen B. Hyperplasia C. Transferin C. Dysplasia D. Albumin D. Hypertrophy Key: B, Nephrotic syndrome: hyperproteinuria, Key: A hypoalbuminemia, edema, hyperlipidemia, lipiduria, hypercoaulopathy (hyperfibrinogenemia) 244. A 71-year-old man has had difficulty with urination, including hesitancy and increased frequency, for the 249. A 45-year-old woman is investigated for hypertension past 5 years. A digital rectal examination reveals that and is found to have Enlargement of the left kidney. his prostate gland is palpably enlarged to twice The right kidney is smaller than normal. Contrast normal size. A transurethral resection of the prostate studies reveal stenosis of the right renal artery. The is performed, and the microscopic appearance of the size change in the right kidney is an example of which prostate “chips” obtained is that of nodules of glands of the following adaptive changes? with intervening stroma. Which of the following A. Aplasia pathologic processes has most likely occurred in his B. Atrophy prostate? C. Hyperplasia A. Apoptosis D. Hypertrophy B. Dysplasia C. Fatty change Key: B D. Hyperplasia 250. The illustration shows a section of the heart from a Key: D 45-year-old man with long-standing hypertension whodied of a “stroke.” Which of the following 245. An 11-year-old child falls and cuts his hand. The adaptive changes is exemplified in the illustration? wound becomes infected. Bacteria extend into the The correct sequence of cell cycle is: extracellular matrix around capillaries. In the A. G0-G1-S-G2-M inflammatory response to this infection, which of the B. G0-G1-G2-S-M following cells removes the bacteria? C. G0-M-G2-S-G1 A. B lymphocyte D. G0-G1-S-M-G2 B. Fibroblast C. Macrophage Key: A D. T lymphocyte 251. Myofibroblasts are present in: Key: C A. Muscle septum B. Normal connective tissue 246. Which of the following carcinoma of lung secretes C. Bronchus PTH like substance: D. Wound margin A. Anaplastic type B. Large cell Key: D, Fibroblasts (including myofibroblasts with C. Squamous cell contractile properties) appear at the site of injury and D. Oat cell wound margins

Key: C 252. Programmed cell death is known as: A. Degeneration

21

B. Necrosis with epithelioid macrophages and Langhans giant C. Apoptosis cells. Which of the following mediators is most likely D. Calcification to contribute to giant cell formation? A. Complement C3b Key: C B. Interferon-γ C. Leukotriene B4 253. A 4-year-old child has had a high-volume diarrhea for D. Tumor necrosis factor (TNF) the past 2 days. On examination she is dehydrated. A stool sample examined by serologic assay is positive Key: B for rotavirus. She is treated with intravenous fluids and recovers. Which of the following components is 257. A 65-year-old man develops worsening congestive found on intestinal cells and recognizes double- heart failure 2 weeks after an acute myocardial stranded RNA of this virus to signal transcription infarction. An echocardiogram shows a markedly factors that upregulate interferon production for viral decreased ejection fraction. Now, capillaries, elimination? fibroblasts, collagen, and inflammatory cells have A. Caspase-1 largely replaced the infarcted myocardium. Which of B. Complement receptor the following inflammatory cell types in this lesion C. T cell receptor plays the most important role in the healing process? D. Toll-like receptor A. Eosinophils B. Epithelioid cells Key: D C. Macrophages D. Neutrophils 254. A woman who is allergic to cats visits a neighbor who has several cats. During the visit, she inhales cat Key: C dander, and within minutes, she develops nasal congestion with abundant nasal secretions. Which of 258. A 77-year-old woman experiences a sudden loss of the following substances is most likely to produce consciousness, with loss of movement on the right these findings? side of the body. Cerebral angiography shows an A. Bradykinin occlusion of the left middle cerebral artery. Which of B. Complement C5a the following mediators will be most beneficial in C. Histamine preventing further ischemic injury to her cerebral D. Interleukin-1 (IL-1) cortex? A. Leukotriene E4 Key: C B. Nitric oxide C. Platelet-activating factor 255. A 92-year-old woman is diagnosed with D. Thromboxane A2 Staphylococcus aureus pneumonia and receives a course of antibiotic therapy. Two weeks later, she no Key: B longer has a productive cough, but she still has a temperature of 38.1° C. A chest radiograph shows the 259. 35-year-old woman takes acetylsalicylic acid (aspirin) findings in the figure. Which of the following terms for arthritis. Although her joint pain is reduced with best describes the outcome of the patient’s this therapy, the inflammatory process continues. The pneumonia? aspirin therapy alleviates her pain mainly through A. Abscess formation reduction in the synthesis of which of the following B. Complete resolution mediators? C. Fibrous scarring A. Histamine D. Chronic inflammation B. Leukotriene E4 C. Nitric oxide Key: A D. Prostaglandins

256. A 9-year-old boy has had a chronic cough and fever Key: D for the past month. A chest radiograph shows enlargement of hilar lymph nodes and bilateral 260. A 54-year-old man undergoes laparoscopic hernia pulmonary nodular interstitial infiltrates. A sputum repair. In spite of the small size of the incisions, he sample contains acid-fast bacilli. A transbronchial has poor wound healing. Further history reveals that biopsy specimen shows granulomatous inflammation his usual diet has poor nutritional value and is

22

deficient in vitamin C. Synthesis of which of the following extracellular matrix components is most 264. A 24-year-old man with acute appendicitis undergoes affected by this deficiency? surgical removal of the inflamed appendix. The A. Collagen incision site is sutured. A trichrome-stained section B. Elastin representative of the site with blue appearing collagen C. Fibronectin is shown in the figure. How long after the surgery D. Integrin would this appearance most likely be seen? A. 1 day Key: A B. 4 to 5 days C. 2 weeks 261. A 37-year-old man has had midepigastric pain for the D. 1 month past 3 months. An upper gastrointestinal endoscopy shows a 2-cm, sharply demarcated, shallow ulceration Key: D of the gastric antrum. Microscopic examination of a biopsy from the ulcer base shows angiogenesis, 265. A 23-year-old woman receiving corticosteroid therapy fibrosis, and mononuclear cell infiltrates with for an autoimmune disease has an abscess on her lymphocytes, macrophages, and plasma cells. Which upper outer right arm. She undergoes minor surgery to of the following terms best describes this pathologic incise and drain the abscess, but the wound heals process? poorly over the next month. Which of the following A. Acute inflammation aspects of wound healing is most likely to be deficient B. Chronic inflammation in this patient? C. Fibrinous inflammation A. Collagen deposition D. Granulomatous inflammation B. Elaboration of VEGF C. Neutrophil infiltration Key: B D. Serine proteinase production

262. A 65-year-old man develops worsening congestive Key: A heart failure 2 weeks after an acute myocardial infarction. An echocardiogram shows a markedly 266. A 60-year-old woman with breast cancer and decreased ejection fraction. Now, capillaries, widespread bony metastases is found to have fibroblasts, collagen, and inflammatory cells have calcification of multiple organs. The calcifications are largely replaced the infarcted myocardium. Which of best described as the following inflammatory cell types in this lesion A. Dystrophic with decreased serum calcium. plays the most important role in the healing process? B. Dystrophic with increased serum calcium. A. Epithelioid cells C. Metastatic with decreased serum calcium. B. Macrophages D. Metastatic with increased serum calcium. C. Neutrophils D. Plasma cells Key: D

Key: B 267. A 56-year-old man dies 24 hours after the onset of substernal chest pain radiating down his left arm to 263. One month after an appendectomy, a 25-year-old the ulnar aspect of his fingertips. Which of the woman palpates a small nodule beneath the skin at the following morphologic myocardial findings is an site of the healed right lower quadrant sutured indicator of irreversible injury? incision. The nodule is excised, and microscopic A. Cell blebs examination shows macrophages, collagen deposition, B. Mitochondrial swelling small lymphocytes, and multinucleated giant cells. C. Myelin figures Polarizable, refractile material is seen in the nodule. D. Pyknotic nuclei Which of the following complications of the surgery best accounts for these findings? Key: D A. Abscess formation B. Chronic inflammation 268. Reversible cell injury is not characterised by : C. Granuloma formation A. Karyorrhexis D. Healing by second intention B. Fat droplets C. Cloudy swelling Key: C D. Hydrophobic degeneration

23

phagocytosis by polymorphonuclear leukocytes Key: A involves which of the following? A. Fc and C3b 269. Which of the following is true regarding irreversible B. Receptor-mediated endocytosis injury in cell: C. Respiratory burst A. Swelling D. Pseudopod extension B. Mitotic figure C. Deposition of calcium in mitochondria Key: D D. Ribosomal detachment 276. Free radicals are generated by all except Key: C A. Superoxide dismutase B. NADPH Oxidase 270. The liver change in Reye’s syndrome ( fatty liver with C. Myeloperoxidase encephalopathy) is: D. NO synthase A. Cirrhosis B. Diffuse steatosis Key: A C. Chronic hepatitis D. Acute hepatitis 277. Which among the following is the hallmark of acute inflammation? Key: B A. Vasoconstriction B. Stasis 271. Which of the following diseases characteristically C. Vasodilation and increase in permeability causes fatty changes in liver? D. Leukocyte margination A. Hepatitis B virus infection B. Wilson’s disease Key: C C. Hepatitis V virus infection D. Chronic alcoholism 278. Main feature of chemotaxis is A. Increased random movement of neutrophils Key: D B. Increase adhesiveness to intima C. Increased phagocytosis 272. Aschoff bodies are seen in: D. Unidirectional locomotion of the neutrophils A. COPD B. Rheumatic fever Key: D C. Pulmonary embolism D. Rheumatoid arthritis 279. Characteristic of acute inflammation is: A. Vasodilation and increased vascular permeability Key: B B. Vasoconstriction C. Platelet aggregation 273. Mallory body is: D. Infiltration by neutrophils A. Fat droplet in cell B. Altered mitochondrion Key: A C. Intermediate filament D. Product of lysosomal degeneration 280. Which of the following helps in generating reactive O2 intermediates in the neutrophils? Key: C A. NADPH oxidase B. SOD (superoxide dismutase) 274. in acute inflammation endothelial retraction leads to C. Catalase A. Delayed transient increase in permeability D. Glutathione peroxidase B. Immediate transient increase in permeability C. Delayed prolonged increase in permeability Key: A D. Immediate transient decrease in permeability 281. Basement membrane degeneration is mediated by: Key: C A. Metalloproteinases B. Oxidases 275. After binding of complement and antibody on the C. Elastases surface of encapsulated bacteria, the process of D. Hydroxylases

24

A. Phagocytes Key: A B. Complement C. T cell 282. Delayed prolonged bleeding is caused by: D. B cell A. Histamine B. Endothelial retraction Key: A C. IL-1 D. Direct injury to endothelial cells 289. In acute inflammation due to the contraction of endothelial cell cytoskeleton, which of the following Key: D results? A. Delayed transient increase in permeability 283. Earliest transient change following tissue injury will B. Early transient increase be: C. Delayed permanent increase A. Neutropenia D. Early permanent increase B. Neutrophilia C. Monocytosis Key: B D. Lymphocytosis 290. Diapedesis is: Key: B A. Immigration of leukocytes through the basement membrane 284. All of the following vascular changes are observed in B. Immigration of the leukocytes through the vessel acute inflammation, except wall to the site of inflammation A. Vasodilation C. Aggregation of platelets at the site of bleeding B. Stasis of blood D. Auto digestion of the cells C. Increased vascular permeability D. Decreased hydrostatic pressure Key: B

Key: D 291. Endothelium leukocyte interaction during inflammation is mediated by/due to 285. The following host tissue responses can be seen in A. Selectins acute infection, except: B. Integrins A. Exudation C. Defensins B. Vasodilation D. Endothelin C. Margination D. Granuloma formation Key: A & B

Key: D 292. In genetic deficiency of MPO the increased susceptibility to infection is due to: 286. Oxygen dependent killing is done through A. Defective production of prostaglandins A. NADPH oxidase B. Defective rolling of neutrophils B. Superoxide dismutase C. Inability to produce hydroxyl-halide radicals C. Catalase D. Inability to produce hydrogen peroxide D. Glutathione peroxidase Key: C Key: A 293. After extravasation, leukocytes emigrate in the tissue 287. Which of the following is not true? towards the site of injury. It is called as A. NADPH oxidase generate superoxide ion A. Margination B. MPO kills by OCl– B. Chemotaxis C. Chediak-Higashi syndrome is due to defective C. Diapedesis phagolysosome formation D. Pavementing D. In Bruton’s disease there is normal opsonization Key: B Key: D 294. The complex process of leukocyte movements 288. Nitroblue tetrazolium test is used for? through the blood vessels are all except

25

A. Rolling Key: D B. Adhesion C. Migration 300. Which of the following statements in context of D. Phagocytosis endothelial cell contraction in inflammation is false? A. Endothelial cell contraction is the commonest Key: D mechanism of increased permeability B. Endothelial cell contraction is responsible for 295. All are true about exudate except immediate transient response A. More protein C. It affects venules, capillaries and arterioles B. Less protein commonly. C. More specific gravity D. It is associated with the release of histamine, D. All substance P and bradykinin.

Key: B Key: C

296. All of the following are signs of inflammation except 301. A 14 month old boy Chunnu is being evaluated for A. Pain recurrent, indolent skin infections and gingivitis. On B. Swelling taking a detailed history from the mother, she tells C. Redness very valuable point that he had delayed separation of D. Absence of functional loss the umbilical cord which occurred around 9-10 weeks after his birth. Which of the following proteins is Key: D most likely under-expressed in this boy? A. Late complement components 297. Endogenous chemoattractant is: B. Transcobalamin II A. C5a C. Integrins B. Bacterial products D. a2-globulins C. Lipopolysaccharide A D. C8 Key: C

Key: A 302. A 5-year-old female Sukanya is hospitalized with fever and hemorrhagic skin lesions on her lower 298. Which of the following statements in context of the extremities. About five months ago she was enzyme ‘E’ shown in the diagram given below is successfully treated with penicillin for bacterial correct? meningitis. She likely to be suffering from which of A. It is a major mode of defense mechanism in the following immune system disorders? eosinophils A. Pure T-cell dysfunction B. Its deficiency results in Chediak Higashi B. Ineffective intracellular killing syndrome C. Insufficient IgA production C. It causes formation of a more important D. Inability to form the membrane-attack complex bactericidal agent than defensins and lysozyme D. It is required for attracting the white blood cells Key: D near a targeted organism. 303. A 3-year-old boy, presents with recurrent bacterial Key: C and fungal infections primarily involving his skin and respiratory tract. Physical examination reveals the 299. A middle aged scientist is working in the laboratory presence of oculocutaneous albinism. Examination of on the mechanisms involved in inflammation. He a peripheral blood smear reveals large granules within observes that the leucocytes leave the blood vessels neutrophils, lymphocytes, and monocytes. The total and move towards the site of bacteria. Which of the neutrophil count is found to be decreased. Further following is likely to mediate this movement of the workup reveals ineffective bactericidal capabilities of bacteria? neutrophils due to defective fusion of phagosomes A. Histamine with lysosomes. Which of the following is the most B. C3b likely diagnosis? C. C3a A. Ataxia-telangiectasia D. C5a B. Chediak-Higashi syndrome C. Chronic granulomatous disease

26

D. Ehlers-Danlos syndrome 310. All of the following are true in respect of angioneurotic edema except? Key: B A. It is caused by deficiency of complement proteins B. It is more common in females 304. All of the following are a family of selectin except C. It manifests as pitting edema A. P selectin D. It is an autosomal dominant disorder B. L selectin C. A selectin Key: C D. E selectin 311. Which of the following complement component can Key: C be activated is both common as well as alternative pathways? 305. Most important for diapedesis? A. C1 A. PECAM B. C2 B. Selectin C. C3 C. Integrin D. C4 D. Mucin like glycoprotein Key: C Key: A, PECAM-1 (platelet endothelial cell adhesion molecule) 312. Which of the following is not an inflammatory mediator? 306. In acute inflammation the tissue response consists of A. Tumor Necrosis Factor all except B. Myeloperoxidase A. Vasodilatation C. Interferons B. Exudation D. Interleukin C. Neutrophilic response D. Granuloma formation Key: B

Key: D 313. Nephrocalcinosis in a systemic granulomatous disease is due to 307. The function common to neutrophils, monocytes, and A. Over production of 1,25 dihydroxy vitamin D macrophages is B. Dystrophic calcification A. Immune response is reduced C. Mutation in calcium sensing receptors B. Phagocytosis D. Increased reabsorption of calcium C. Liberation of histamine D. Destruction of old erythrocytes Key: A

Key: B 314. Bradykinin is for: A. Pain B. Vasodilatation 308. The role of bradykinin in process of inflammation is: C. Increase vascular permeability A. Vasoconstriction D. All B. Bronchodilation C. Pain Key: D D. Increased vascular permeability 315. Most important bactericidal agent is: Key: D > C A. Cationic basic protein B. Lactoferrin 309. Which of the following is not a pyrogenic cytokine? C. Lysozyme A. IL - 1 D. Reactive O2 species B. TNF C. IFN - a Key: D D. IL - 18 316. Bradykinin causes: Key: D A. Vasoconstriction B. Pain at the site of inflammation

27

C. Bronchodilation Key: A D. Decreased vascular permeability 323. All of the following are mediators of inflammation Key: B except: A. Tumour necrosis factor-a (TNF-a) 317. Lewis triple response is caused due to: B. Interleukin-1 A. Histamine C. Myeloperoxidase B. Axon reflex D. Prostaglandins C. Injury to endothelium D. Increased permeability Key: C

Key: A 324. Interleukin secreted by macrophages, stimulating lymphocytes is: 318. Factor present in the final common terminal A. IFN alpha complement pathway is: B. TNF alpha A. C4 C. IL-1 B. C3 D. IL-6 C. C5 D. Protein B Key: C, IL -1 > IL-6

Key: C 325. Cytokines are secreted in sepsis and Systemic Inflammatory Response Syndrome (SIRS) by: 319. To which of the following family of chemical A. Neutrophils mediators of inflammation, the Lipoxins belong? B. Adrenal A. Kinin system C. Platelets B. Cytokines D. Collecting duct C. Chemokines D. Arachidonic acid metabolites Key: A & C

Key: D 326. Febrile response in CNS is mediated by A. Bacterial toxin. 320. Both antibody dependent and independent B. IL-l & Interferon complement pathway converge on which complement C. Tumor necrosis factor (TNF) component? D. All A. C3 B. C5 Key: D C. C1q D. C8 327. Cytokines: A. Includes interleukins Key: A B. Produced only in sepsis C. Are polypeptide (complex proteins) 321. C-C beta chemokines includes D. Have highly specific action A. IL-8 B. Eotaxin Key: A & C C. Lymphotactin D. Fractalkine 328. Conversion of prothrombin to thrombin requires: A. V only Key: B B. V and Ca++ C. XII 322. All of the following are mediators of acute D. X and Ca++ inflammation except A. Angiotensin Key: D B. Prostaglandin E2 C. Kallikrein 329. Which complement fragments are called D. C3a ‘anaphylatoxins’? A. C3a and C3b

28

B. C3b and C5b 336. Bleeding time assesses: C. C5a and C3b A. Extrinsic clotting pathway D. C3a and C5a B. Intrinsic clotting pathway C. Fibrinogen level Key: D D. Function of platelets

330. Cryoprecipitate is rich in which of the following Key: D clotting factors: A. Factor II 337. The estimation of the prothrombin level is useful in t B. Factor V following clotting factor deficiency, except: C. Factor VII A. II D. Factor VIII B. V C. VII Key: D D. IX

331. Most important mediator of chemotaxis is: Key: D A. C3b B. C5a 338. Which of the following is secondary mediator of C. C5-7 theanaphylaxis is: D. C2 A. Histamine B. Proteases Key: B C. Eosinophilic chemotactic factor D. Leukotriene B4 332. Histamine causes A. Hypertension Key: D B. Vasoconstriction C. Vasodilation 339. Birbeck’s granules in the cytoplasm are seen in: D. Tachycardia A. Langerhans cells B. Mast cells Key: C C. Myelocytes D. Thrombocytes 333. Which of the following is found in secondary granules of neutrophils? Key: A A. Catalase B. Gangliosidase 340. The Eosinophils secrete all except C. Proteolytic enzyme A. Major basic protein D. Lactoferrin B. Hydrolytic enzyme C. Reactive form of O2 Key: D D. Eosinophilic chemotactic factor

334. Ultra-structurally, endothelial cells contain Key: B A. Weibel Palade bodies B. Langerhan’s granules 341. In Lipooxygenase pathway of the arachidonic acid C. Abundant glycogen metabolism, which of the following products helps to D. Kallikrein promote the platelet aggregation and vasoconstriction? Key: A A. C5a B. Thromboxane A2 335. Partial thromboplastin time correlates with: C. Leukotriene B4 A. Intrinsic and common pathway D. C1 activators B. Extrinsic and common pathway C. Vessel wall integrity and intrinsic pathway Key: B D. Platelet functions and common pathway 342. Chemotactic complement components are Key: D A. C3a B. C5a

29

C. Both frequency of urine and lower backache for the past 8 D. C3b months. Digital rectal examination reveals an enlarged prostate with irregular surface. The surgeon Key: B orders for the serum PSA levels which are found to be increased and X-ray spine shows osteoblastic lesions. 343. In inflammatory process, the prostaglandin E1and E2 A diagnosis of metastatic prostate cancer is made. Mr cause Lal also complaints of significant weight loss, loss of A. Vasodilatation appetite and loss of energy over the past 45 days. His B. Increased gastric output current complaints can be attributed to which of the C. Decreased body temperature following? D. Vasoconstriction A. Fibroblast growth factor B. Interleukin-2 Key: A C. Tumor necrosis factor-a D. Vascular endothelial growth factor 344. Opsonins are A. C3a Key: C B. IgM C. Carbohydrate binding proteins 349. A 14-year-old girl Radha has high grade fever. She D. Selectins goes to a physician Dr. Jeeva Roy who orders for some blood investigations. A complete blood count Key: C with differential implies the presence of a viral infection. Which of the following best describes the 345. Inflammatory mediator of generalized systemic cells that indicate a viral etiology to her illness? inflammation is: A. They are basophilic with spherical dark-stained A. IL-1 nuclei B. IL-2 B. They are precursors of osteoclasts and liver C. Interferon alpha Kupffer cells D. TNF C. They contain a peripheral hyalomere and central granulomere Key: A D. They have azurophilic granules and multilobed nuclei 346. All are cytokines except: A. Monoclonal antibody Key: A B. Interleukin C. Chemokine 350. An 18-year-old woman, Sheila is being evaluated for D. TNF recurrent facial edema, especially around her lips. She also has recurrent bouts of intense abdo-minal pain Key: A and cramps, sometimes associated with vomiting. Laboratory examination finds decreased C4, while 347. An 8 year old girl presents to the physician with levels of C3, decay-accelerating factor, and IgE are wheezing and difficulty in breathing. The within normal limits. A deficiency of which one of breathlessness increases when she went to the fields the following substances is most likely to be to play with her friends. Her blood contains higher associated with these clinical findings? than normal concentration of IgE. The physician A. b2-integrins believes that the cell shown in the photograph below B. C1 esterase inhibitor is implicated in the pathogenesis of her condition. C. Decay-accelerating factor This cell is most similar to which of the following D. Complement components C3 and C5 white blood cells? A. Neutrophil Key: B B. Monocyte C. Basophil 351. Fever occurs due to: D. Eosinophil A. IL-1 B. Endorphin Key: C C. Enkephalin 348. A 72 year-old man presented to surgery OPD with a D. Histamine history of difficulty in micturition, increased

30

Key: A D. IL6

352. E cadherin gene deficiency is seen in: Key: B A. Gastric cancer B. Intestinal cancer 359. Both antibody dependent and independent C. Thyroid cancer complement pathway converge on which complement D. Pancreatic cancer component? A. C3 Key: A B. C5 C. C1q 353. Cell-matrix adhesions are mediated by? D. C8 A. Cadherins B. Integrins Key: A C. Selectins D. Calmodulin 360. Cryoprecipitate is rich in which of the following clotting factors? Key: B A. Factor II B. Factor V 354. Pro inflammatory Cytokines include all of the C. Factor VII following except: D. Factor VIII A. Interleukin 1 B. Interleukin-10 Key: D C. Interleukin 6 D. TNF- Alpha 361. Prostaglandins are synthesized from: A. Linoleic acid Key: B B. Linolenic acid C. Arachidonic acid 355. The most important source of histamine: D. Butyric acid A. Mast cells B. Eosinophil Key: C C. Neutrophil 362. Which chemical mediator is an arachidonic acid D. Macrophages metabolite produced by cyclo-oxygenase pathway? A. LXA4 Key: A B. LXB4 C. 5HETE 356. Following injury to a blood vessel, immediate D. PGH2 haemostasis is achieved by which of the following? A. Fibrin deposition Key: D B. Vasoconstriction C. Platelet adhesion 363. Procalcitonin is used as marker of D. Thrombosis A. Cardiac dysfunction in acute coronary syndrome B. Menstrual periodicity Key: B C. Pituitary function D. Sepsis 357. PAF causes all except A. Bronchoconstriction Key: D, Procalcitonin is an acute phase reactant B. Vasoconstriction which is now useful for being a marker of sepsis. It is C. Decreased vascular permeability in fact utilized for differentiating the bacterial and D. Vasodilation aseptic meningitis.

Key: C 364. The epithelioid cell and multinucleated giant cells of Granulomatous inflammation are derived from: 358. Eosinophils are activated by: A. Basophils A. IL1 B. Eosinophils B. IL5 C. CD4-T lymphocytes C. IL4 D. Monocytes-Macrophages

31

A. Tuberculosis Key: D B. Wegener’s granulomatosis C. Cat Scratch disease 365. Granuloma is pathological feature of all, except D. Leprosy A. Giant cell arteritis B. Microscopic polyangiitis Key: D C. Wegener’s granulomatosis D. Churg Strauss disease 372. Epithelioid granulomatous lesions are found in all of the following diseases, except: Key: B A. Tuberculosis B. Sarcoidosis 366. Granulomatous inflammatory reaction is caused by C. Berylliosis all, except: D. Pneumocystis carinii A. M. tuberculosis B. M. leprae Key: D C. Yersinia pestis D. Mycoplasma 373. Caseous granuloma is seen in A. Histoplasmosis Key: D B. Silicosis C. Sarcoidosis 367. Non-caseating granulomas are seen in all of the D. Foreign body following except A. Byssinosis Key: A B. Hodgkin’s lymphoma C. Metastatic carcinoma of lung 374. Non-caseating granuloma is characteristically seen in D. Tuberculosis A. Syphilis B. Sarcoidosis Key: C C. Tuberculosis D. Histoplasmosis 368. Epithelioid granuloma is caused by: A. Neutrophil Key: B B. Cytotoxic T-cells C. Helper T-cells 375. All are granulomatous diseases except D. NK cells A. Syphilis B. Sarcoidosis Key: C C. Schistosomiasis D. P. carinii 369. Caseous necrosis in granuloma are not found in A. Leprosy Key: D B. CMV C. Wegener’s granulomatosis 376. Which of the following is the most characteristic of D. All granuloma: A. Epithelioid cell Key: B. Giant cell C. Fibroblasts 370. The most important function of epithelioid cells in D. Endothelial cell tuberculosis is: A. Phagocytosis Key: A B. Secretory C. Antigenic 377. Caseating granuloma are seen in: D. Healing A. Histoplasmosis B. Sarcoidosis Key: A C. Coccidiodomycosis D. All 371. Necrotizing epithelioid cell granulomas are seen in all, except: Key: A

32

A. Toxoplaxmosis 378. A 28 year old young man presents to the clinic with a B. Lymphogranuloma venereum maculopapular rash on the palms and soles, oral C. Cat scratch disease ulcers, malaise, lymphadenopathy and weight loss. He D. Kikuchis lymphadenitis has a history of a painless genital lesion 2 months ago after an unprotected intercourse about 10 weeks back. Key: A Biopsy shows the presence of a granuloma. The figure shows a very important step in the pathogenesis of 383. Which of these is not a granulomatous disease this condition. Identify the cell marked ‘?’ in the A. Leprosy figure. B. Tuberculosis A. CD8 T cell C. Sarcoidosis B. TH1 D. Amebiasis C. TH2 D. Langhans cell Key: D

Key: B 384. Which one of the following statements is not correct regarding ‘Stem cell’? 379. A 45-year-old poor man has a chronic cough, a A. Developmental elasticity cavitary lesion of the lung, and is sputum positive for B. Transdifferentiation acid-fast bacilli. Which of the following is the C. Can be harvested from embryo principle form of defense by which the patient’s body D. “Knockout mice” made possible because of it fights against this infection? A. Antibody-mediated phagocytosis Key: A B. Cell-mediated immunity C. IgA-mediated hypersensitivity 385. An adult old man gets burn injury to his hands. Over D. Neutrophil ingestion of bacteria few weeks, the burned skin heals without the need for skin grafting. The most critical factor responsible for Key: B the rapid healing in this case is: A. Remnant skin appendages 380. A 36-year-old man, presents with a cough, fever, B. Underlying connective tissues night sweats, and weight loss. A chest X-ray reveals C. Minimal edema and erythema irregular densities in the upper lobe of his right lung. D. Granulation tissue Histologic sections from this area reveal groups of epithelioid cells with rare acid-fast bacilli and a few Key: A scattered giant cells. At the centre of these groups of epithelioid cells are granular areas of necrosis. What 386. Absolute lymphocytosis is seen in is the source of these epithelioid cells? A. Brucellosis A. Bronchial cells B. T.B. B. Pneumocytes C. CLL C. Lymphocytes D. All D. Monocytes Key: D Key: D 387. Which of the following is absolutely essential for 381. In a granuloma, epithelioid cells and giant cells and wound healing? derived from A. Vitamin D A. T – lymphocytes B. Carbohydrates B. Monocyte – macrophages C. Vitamin C C. B – lymphocytes D. Balanced diet D. Mast cells Key: C Key: B 388. Chronic granulomatous disease is: 382. In a lymph node showing non-necrotizing and non– A. Associated with formation of multiple caseating granuloma which of the following is granulomas suspected? B. A benign neoplastic process

33

C. A parasitic disease Key: C D. Acquired leukocyte function defect 394. Prion disease is caused by: Key: A A. Misfolding of protein B. Denaturation of proteins 389. in regeneration C. Reduced formation of proteins A. Granulation tissue D. Exces formation of proteins B. Repairing by same type of tissue C. Repairing by different type of tissue Key: A D. Cellular proliferation is largely regulated by biochemical factors 395. Maximum collagen in wound healing is seen at which stage of healing? Key: B A. End of first week B. End of second week 390. Wound contraction is mediated by: C. End of third week A. Epithelial cells D. End of 2 months B. Myofibroblasts C. Collagen Key: C D. Elastin 396. “Oval cells” are seen in the stem cells of which of the Key: B following tissues? A. Skin 391. A 45-year-old man, presents with pain in the mid B. Cornea portion of his chest. The pain is associated with eating C. Liver and swallowing food. Endoscopic examination D. Bone reveals an ulcerated area in the lower portion of his esophagus. Histologic sections of tissue taken from Key: C this area reveal an ulceration of the esophageal mucosa that is filled with blood, fibrin, proliferating 397. First sign of wound injury is: blood vessels, and proliferating fibroblasts. Mitosis is A. Epithelialization easily found, and most of the cells have prominent B. Dilatation of capillaries nucleoli. Which of the following statements best C. Leukocytic infiltration describes this ulcerated area? D. Localized edema A. Caseating granulomatous inflammation B. Dysplastic epithelium Key: B C. Granulation tissue D. Squamous cell carcinoma 398. Which of the following is the source of hepatic stem cells? Key: C A. Limbus cells B. Ito cell 392. Which of the following adhesion molecules is C. Oval cell involved in morphogenesis? D. Paneth cell A. Osteopontin B. Osteonectin SPARC Key: C C. Tenascin D. Thrombospondins 399. Vitamin used for post translational modification of glutamic acid to gamma carboxy glutamate is Key: C A. A B. D 393. When a cell transforms itself into different lineage the C. E ability us know as: D. K A. De-differentiation B. Re-differentiation Key: D C. Trans-differentiation D. Sub-differentiation

34

400. Tensile strength of wound after laparoscopic 406. Which of the following is not seen in amyloidosis of cholecystectomy in a 30 year old woman depends kidney: upon: A. Azotemia A. Replacement of type 3 collagen B. Normal size kidney B. Extensive cross-linking of tropocollagen C. Hypertension C. Macrophage activity D. Massive proteinuria D. Granulation tissue Key: C Key: B 407. Which one of the following stains is specific for 401. One of the following statements about hematopoietic amyloid? stem cell is false? A. Periodic acid- Schiff (PAS) A. Stem cells have self-renewal property B. Alzerian red B. Subset of stem cells normally circulate in C. Congo red peripheral blood D. Von Kossa C. Marrow derived stem cells can seed other tissues and develop into non-hematopoietic cells as well Key: C D. Stem cells resemble lymphoblasts morphologically 408. All of the following cause amloidosis except: A. Leprosy Key: B B. Chronic bronchitis C. Tuberculosis 402. Lardaceous spleen is found in: D. Granulomatous ileitis A. Hodgkin’s lymphoma B. CML Key: B C. Malaria D. Amyloidosis 409. MacCallum’s plaque is the diagnostic feature of: A. TOF Key: D B. MI C. Rheumatic endocarditis 403. Lardaceous spleen is seen due to deposition of D. Infective endocarditis amyloid in: A. Sinusoids of red pulp Key: C B. White pulp C. Penicillary artery 410. MacCallum’s plaques are present in: D. Splenic trabeculae A. Right ventricle B. Left atrium Key: A C. Fourth ventricle D. Right atrium 404. Amyloid (90% fibril protein and 10% glycoprotein) is a: Key: B A. Intermediate filament B. Glycoprotein Key: B, Subendocardial lesions producing a map like C. Lipoprotein thickening are found in LEFT ATRIUM in D. Lipid RHEUMATIC FEVER. They are known as MacCallum’s plaques Key: B 411. Which of the following is the most common type of 405. In primary amloidosis, the major fibril protein is: carcinoma thyroid: A. AL( amyloid light chain) A. Anaplastic B. Procalcitonin B. Medullary (5-10%) C. Transthyretin C. Follicular (20-25%) D. AA(amyloid associated) D. Papillary (60-70%)

Key: A Key: D

35

412. Most common histological type of Hodgkin’s disease is: Key: B A. Mixed cellularity type (23.39%) B. Lymphocyte predominant type (5.98%) 418. Heart failure cells have: C. Nodular sclerosis type (68.33%) A. Myoglobulin D. Lymphocyte depletion type (2.30%) B. Albumin C. Lipofuschin Key: C D. Hemosiderin

413. Cytokeratin is a marker for: Key: D A. Carcinoma B. Adenoma 419. Peripheral necrosis of liver is caused by: C. Lymphoma A. Carbontetrachloride D. Sarcoma B. Benzene C. Phosphorous Key: A D. Rifampicin

414. Rosette arrangement of cell is present in: Key: C A. Leydig cell tumor B. Retinoblastoma 420. Centrilobular necrosis of liver is seen in : C. Lymphosarcoma A. Arsenic poisoning D. Mesothelioma B. Carbon tetrachloride poisoning C. Ethanol poisoning Key: B D. Phosphorous poisoning

415. Which of the following is the earliest lesion in Key: B atherosclerosis: A. Fibrofatty plaque 421. Kaposi’s sarcoma arises from: B. Fibrous plaque A. Capillaries C. Atheroma B. Dermis D. Fatty streaks C. Connective tissue D. Fibrous tissue Key: D Key: A 416. After 72 hours of myocardial infarction, the predominant cells are: 422. In post- streptococcal glomerulonepheritis, the type of A. Mast cells hypersensitivity includes: B. Macrophages A. Type IV C. Lymphocytes B. Type III D. Leucocytes C. Type II D. Type I Key: B Key: B 417. The light microscopic picture of myocardium after 24-72hours of myocardial infarction consists of 423. A girl developed redness and swelling of ear lobes coagulative necrosis of heart muscles with loss of after wearing some earrings. This is an example of nuclei and striations. A heavy interstitial infiltrate of which of the following type of hypersensitivity? neutrophils is also present. From 3-7 days there is A. Cell mediated hypersensitivity(delayed) beginning of disintegration of dead fibers of B. Immune complex disease myocardium and resorption of sarcoplasm by C. Cytotoxic hypersensitivity MACROPHAGES. Which of the following is true D. Immediate hypersensitivity regarding heart failure cells: A. Lipofuscin granules in cardiac cells Key: A B. Pigmented alveolar macrophages C. Pigmented pancreatic aciner cells 424. Rh incompatibility involves: D. Pigmented cells seen in liver A. Type II reaction

36

B. Type I reaction C. Cholecystectomy C. Type IV reaction D. Hepatectomy D. Type V reaction Key: B Key: A 431. Which of the following is the most common site of 425. Rh incompatibility is a type of hemolytic disease of myocardial infarction: newborn hence type II reaction. Reaction found in A. Inferior wall blood transfusion is: B. Posterior wall A. Cell-mediated hypersensitivity C. Anterolateral wall B. Type III reaction D. Interventricular septum C. Cytotoxic type reaction D. Anaphylactic Key: C

Key: C 432. In an inflammation, macrophages are generally derived from: 426. Which of the following is the most common tumour A. Lymphocytes of the heart: B. Neutrophils A. Leiomyosarcoma C. Reticuloendothelial cells B. Rhabdomyosarcoma D. Monocytes C. Myxoma D. Fibroma Key: D

Key: C 433. The monocytes are actively phagocytic and peroxidase and lysosomal enzymes. 24 hours after 427. Myxomas are the most common type of primary their entry into the circulation they enter the tissues to cardiac tumour. They occur at all ages and shows no become the tissue macrophages. All tissue sex preference ,and large majority of myxomas are macrophages of the body including the Kupffer cells sporadic.The most common cause of lung abscess is : of liver and alveolar macrophages come from A. Aspirated secretions circulating monoytes. This tissue macrophage system B. Tuberculosis is also known as Reticuloendothelial system in rabies, C. Congenital most common pathological change is: D. Hematogenous A. Ventriculitis B. Cranial arteritis Key: A C. Brainstem encephalitis D. Meningitis 428. In ulcerative colitis, the site usually involved is: A. Rectum Key: C B. Ileum C. Transverse colon 434. Normocytic normochromic anemia is not seen in: D. Sigmoid colon A. Aplastic anemia B. Chronic renal disease Key: A C. Pure red cell aplasia D. Thalassemia 429. Flea bitten kidney is seen in: A. Chronic pyelonephritis Key: D, Both alpha and beta thalassemia are B. Diabetes mellitus associated with microcytosis , hypochromic anemia. C. Malignant hypertension D. Diabetes insipidus 435. Which of the following is true regarding Berry’s aneurysm: Key: C. A. It is congenital B. It is neoplastic 430. After which of the following procedure, Howell- Jolly C. Hypertensive bodies are seen: D. Mycotic A. Pancreatictomy B. Splenectomy Key: A

37

442. In which of the following organ, liquefactive necrosis 436. Which of the following is least commonly involved in is commonly found: Berry aneurysm: A. Liver A. Basilar artery B. Brain B. Vertebral artery C. Heart C. Middle cerebral artery D. Lung D. Anterior communicating artery Key: B Key: D 443. Which of the following is the most common type of 437. Deposition of which of the following element occurs cell death due to sudden cessation of blood supply: in Wilson’s disease: A. Apoptosis A. Selenium B. Coagulation necrosis B. Copper C. Cessation necrosis C. Iron D. None D. Lead Key: B Key: B 444. Pale infarct is seen in all except: 438. Which of the following is inhibited by aspirin: A. Spleen A. Cyclooxygenase B. Kidney B. Prostacyclin synthesis C. Lung C. Phospholipase A2 D. Heart D. Lipooxygenase Key: C Key: A, Aspirin, acetaminophen and NSAIDs inhibit the enzyme cyclooxygenase and, except for 445. Pulmonary infarcts are: acetaminophen, all have anti-inflammatory action. A. Yellow B. Grey 439. The most common change in atherosclerotic vessel is: C. Red( hemorrhagic infarct) A. Hemorrhage D. Green B. Aneurysm thrombosis C. Superimposed thrombosis Key: C D. Dystrophic calcification 446. Splenic infarction is not seen in: Key: D A. CML B. SABE 440. In which of the following, dystrophic calcification is C. Sickle cell anemia not seen: D. Rheumatoid arthritis A. Atheromas B. Tubercular lymph nodes Key: D C. Cardiac valve D. Kidney 447. Calcification of soft tissue without any disturbance of calcium metabolism is called: Key: D A. Ionotropic calcification B. Monotrophic calcification 441. Which of the following is the most common cause of C. Dystrophic calcification aortic aneurysm: D. Calcium induced calcification A. Syphilis B. Atherosclerosis Key: C C. Trauma D. Marfan’s syndrome 448. Gandy gamma bodies are seen in: A. Sickle cell anemia Key: B B. Hodkin’s lymphoma C. G6PD deficiency D. Hereditary spherocytosis

38

Key: D Key: A 455. Which of the following produces prostacyclin: A. Lymphocytes 449. Psammoma bodies are seen in: B. Prostate A. Papillary carcinoma of thyroid C. Vascular endothelium B. Medullary carcinoma of thyroid D. Platelets C. Follicular carcinoma of thyroid D. Anaplastic carcinoma of thyroid Key: C

Key: A 456. Prostacyclin (PGI2) are produced by blood vessel walls (vascular endothelium) and are potent inhibitors 450. Psammoma bodies are seen in: of platelet aggregation. An elderly male has anemia A. Papillary carcinoma of thyroid and splenomegaly. His peripheral blood smear reveals B. Carcinoma of ovary tear drop shaped cells. Bone marrow examination is C. Both normal. He is suffering from: D. None A. CML B. AML Key: C C. Iron deficiency anemia D. Idiopathic myelofibrosis 451. In muscular dystrophy, the characteristic finding is: A. Inflammatory cell infiltrate Key: D B. Muscle necrosis C. Heterogenicity of muscle fiber 457. Type I hypersensitivity is mediated by which of the D. Nuclear proliferation beneath sarcolemma following immunoglobulins? A. IgA Key: C B. IgG C. IgM 452. A 35 Year patient had pain in abdomen with the D. IgE distension. Hadnot passed stool since 5 days. On examination abdomen was tender and patient seems Key: D toxic. There was decrease bowel sounds and x ray reveals the dilated small and large bowels loops. What 458. Which of the following is the most common location can be cellular pathology in this condition? of hypertensive bleed in the brain? A. Cell Apoptosis A. Putamen B. Cell Necrosis B. Pons C. A & B both C. Ventricles D. None D. Lobar white matter

Key: B Key: A

453. Which of the following is false regarding IgG: 459. Which of the following conditions commonly A. J chain is absent predisposes to colonic carcinoma? B. Cross placenta A. Ulcerative colitis C. Involved in primary immune response B. Crohn’s disease D. Increased in multiple myeloma C. Diverticular disease D. Ischemic colitis Key: C Key: A 454. Which of the following HLA is important in diabetes mellitus: 460. Endoscopic biopsy from a case of Helicobacter pylori A. HLAA13 related duodenal ulcer is most likely to reveal: B. HLAB27 A. Antral predominant gastritis C. HLAB11 B. Multifocal atropic gastritis D. HLA DR3 DR4 C. Acute erosive gastritis D. Gastric atrophy

39

Key: A 467. Which of the following is the best test for assessing iron status: 461. Lung biopsy in acute hepatitis due to hepatitis B virus A. Hemoglobin is likely to show all the following, except: B. Serum iron A. Ballooning change of hepatocytes C. Transferrin B. Ground glass hepatocytes D. Ferritin C. Focal or spotty necrosis D. Acidophil bodies Key: D

Key: BThere are no ‘ground-glass’ cells or ‘sanded’ 468. Which of the following is not a characteristic feature nuclei in acute hepatitis unless the disease is in of anemia of chronic diseases? transient to chronic hepatitis. A. Decreased serum ferritin B. Decreased serum iron 462. Subdural hematoma most commonly results from : C. Decreased TIBC A. Rupture of intracranial aneurysm D. Increase macrophages in marrow B. Rupture of cerebral AVM C. Injury to cortical bridging veins Key: A D. Hemophilia 469. In which of the following carcinomas of lung, there is Key: C, It results from torn bridging veins draining ectopic production of ACTH? blood from cerebral cortex to the dura. A. Anaplastic B. Small cell 463. Most common cause of subarachnoid hemorrhage is: C. Adenocarcinoma A. Hypertension D. Squamous cell B. Aneurysm C. Arteriovenous malformation Key: B D. Bleeding disorders 470. In hepatitis B, membranous glomerulopathy is Key: B because of: A. HBeAg 464. All of the following diseases causes massive B. HBsAg splenomegaly, except: C. HBcAg A. Malaria D. Anti- HBsAg B. Kalazar C. Lymphoblastic leukemia Key: B D. Idiopathic myelofibrosis 471. Upper GI endoscopy and biopsy from lower Key: C esophagus in a 48 year-old lady with chronic heart burn shows presence of columnar epithelium with 465. Most sensitive and specific test for diagnosis of iron goblet cells. The feature is most likely consistent deficiency is: with: A. Serum iron levels A. Dysplasia B. Serum ferritin levels B. Hyperplasia C. Serum transferrin receptor population C. Carcinoma in situ D. Transferrin saturation D. Metaplasia

Key: B Key: D

466. Ferritin is decreased in: 472. Which of the following is the most common A. Sideroblastic anemia carcinoma of the breast: B. Beta thalassemia A. Sarcoma phyllodes C. Iron deficiency anemia B. Lobular carcinoma D. Anemia of chronic infection C. Infiltrative ductal carcinoma D. Colloidal carcinoma Key: C

40

Key: C A. Rheumatoid arthritis B. SLE 473. In young female, the most common type of breast C. Systemic sclerosis carcinoma is: D. Polymyositis A. Medullary B. Papillary Key: B C. Infiltrating ductal D. Lobular 480. Which of the following is the earliest response to iron therapy: Key: C A. Increased PCV B. Increase in hemoglobin 474. In cirrhosis, the splenomegaly is: C. Increased neutrophils A. Inflammatory D. Reticulocytes B. Phagocytic C. Degenerative Key: D, Reticulocytosis occurs 3 to 4 days after the D. Congestive initiation of iron therapy and reaches a peak at about 10 days Key: D, Long standing congestion in portal hypertension may cause congestive splenomegaly. 481. RBC casts in Urine analysis , most likely source is : The degree of enlargement varies upto 1 kg A. Kidney (acute nephritis) B. Bladder 475. In rheumatic fever , which of the following type of C. Ureter pericarditis is most common? D. Urethra A. Serofibrinous B. Seropurulent Key: A C. Serous D. Hemorrhagic 482. Half-life of neutrophil is: A. 6-8 days Key: A B. 2-3 days C. 6 hours 476. Egg shell calcification is seen in: D. 24 hours A. Sarcoidosis B. Silicosis Key: C C. Asbestosis D. Beryliosis 483. A child has minimal change disease which is well controlled by steroids. The most likely finding on Key: B light microscopy is: A. Severe mesangial hypercellularity 477. In polycystic kidney disease , cysts are not found in: B. Fusion of foot process’ A. Liver C. No finding B. Lung D. Hypercellular glomeruli C. Kidney D. Brain 484. Characteristic features of minimal change disease is A. Thickening of glomerular basement membrane Key: D B. Splitting of glomerular basement membrane C. IgA deposition in crescent form 478. Polycystic kidney disease is most frequently D. Loss of podocyte on electron microscope while associated with: normal in light microscope A. Liver cysts B. Cyst of pancreas Key: D C. Lung cyst D. Brain cyst 485. Which of the following is not a clinical feature of minimal change glomerulonepheritis: Key: A A. Fever B. Hematuria 479. Anti-Smith antibodies are found in: C. Hypertension

41

D. Selective proteinuria Key: B

Key: C 492. Which of the following is not a stem cell of the bone 486. Which of the following is not caused by zinc marrow? deficiency: A. Lymphoblast A. Sexual infantilism B. Myeloblast B. Growth retardation C. Myoblast C. Immunological disturbances D. Normoblast D. Cardiomyopathy Key: C Key: D 493. Which of the following surface glycoproteins is most 487. In diabetes mellitus, the most common renal lesion often expressed in human hematopoietic stem cell? is : A. CD 22 A. Diffuse thickening of basement membrane B. CD 40 B. Nodular glomerulosclerosis C. CD 15 C. Fibrin cap in the glomerulus D. CD 34 D. Papillary necrosis Key: D Key: B 494. Reticulocytosis is seen in all except: 488. Which of the following is most common site of brain A. P.N.H. abscess: B. Hemolysis A. Temporal lobe C. Nutritional anemia B. Frontal lobe D. Dyserythropoietic syndrome C. Occipital lobe D. Parietal lobe Key: C

Key: B, Frontal > =temporal >= frontoparietal> 495. Which of these are seen on Romanowsky stain: parietal> cerebellar> occipital A. Basophilic stippling B. Howell-Jolly bodies 489. Which of the following is primary pleural tumor: C. Cabot ring A. Lipoma D. All B. Mesothelioma C. Myxoma Key: D D. Fibroma 496. Which of the following surface glycoproteins is most Key: B often expressed in human hematopoietic stem cell? A. CD22 490. In apoptosis, Apaf -1 is activated by release of which B. CD40 of the following substances from mitochondria? C. CD15 A. Bcl-2 D. CD34 B. Bax C. Bcl-XL Key: D D. Cytochrome c 497. Inappropriate erythropoietin level is found in all Key: D except A. Renal cell carcinoma 491. Which of the following is associated with an intrinsic B. Lung disease defect in the RBC membrane? C. High altitude A. Autoimmune hemolytic anemia D. Benign liver tumor B. Hereditary spherocytosis C. Microangiopathic haemolytic anemia Key: D D. Thermal injury causing anemia 498. The size of the red blood cells is measured by:

42

A. MCV A. Abetalipoproteinemia B. MCHC B. Hartnup disease C. ESR C. Whipple disease D. MCH D. None

Key: A Key: A

499. Anemia which is associated with pancytopenia is 506. A 74 year-old female with renal failure presents for A. Hemolytic hemodialysis. She complains of weakness and B. Iron deficiency palpitations for about a month. On further C. Megaloblastic investigations, she is found to be anemic and is given D. All a dose of erythropoietin. Erythropoietin stimulates which of the following intermediates in Key: C hematopoiesis? A. Basophilic erythroblasts 500. Hematuria with dysmorphic RBCs are seen in: B. Colony forming units-erythroid A. Acute glomerulonephritis C. Proerythroblasts B. Renal TB D. Reticulocytes C. Renal calculi D. Chronic renal failure Key: B

Key: A 507. A 69 years old male presented with anemia with splenomegaly. Peripheral Blood Smear shows tear 501. MCHC is increased in: drop shaped cells and bone marrow examination was A. Iron deficiency anemia normal. The diagnosis is B. Spherocytosis A. Myelofibrosis C. Thalassemia B. Iron deficiency anemia D. All C. Folic acid deficiency D. CML Key: B Key: A 502. In polycythemia vera, all are raised except: A. Hematocrit 508. Pure red cell aplasia is associated with: B. Platelet count A. Thymoma C. RBCs B. Renal cell carcinoma D. Erythropoietin C. Hepatocellular carcinoma D. Prostate carcinoma Key: D Key: A 503. The type of anemia seen in chronic renal failure is: A. Microcytic 509. Vitamin B-12 malabsorption is caused by: B. Normocytic A. Ankylostoma duodenale C. Macrocytic B. Diphyllobothrium latum D. All of the above C. Giardiasis D. Taenia solium Key: D Key: A 504. Burr cell is seen in A. Uremia 510. Maturation failure in poor absorption of the vitamin B. Hepatocellular carcinoma B12 is associated with C. Gastric carcinoma A. Microcytic hypochromic anemia D. Ovarian carcinoma B. Sickle cell anemia C. Anemia occurs after 3-4 months of poor Key: A absorption D. Causes polycythemia 505. Acanthocytes are seen in:

43

Key: C afterwards is determined to be normal. Which of the following is the most likely cause of this patient’s 511. FIGLU test is done for symptoms? A. Cyanocobalamin deficiency A. Dietary cobalamin deficiency B. Folic acid deficiency B. Atrophic gastritis C. Thiamine deficiency C. Nontropical sprue D. Riboflavin deficiency D. Fish tapeworm infestation

Key: B Key: A

512. Hypersegmented neutrophils are present in which of 518. A 46-year-old male undergoing evaluation for fatigue the following anemia? and exertional dyspnea is diagnosed with macrocytic A. Hemolytic anemia. Upper gastrointestinal endoscopy is B. Iron deficiency consistent with atrophic gastritis. Some blood C. Megaloblastic parameter changes after the first dose of D. Aplastic cyanocobalamin are shown in the graph on the left side of the page. The first curve most likely Key: C corresponds to which of the following parameters? A. RBC count 513. Hypersegmented neutrophils are seen in: B. Reticulocyte count A. Thalassemia C. Haptoglobin B. Iron deficiency D. Gastrin C. Megaloblastic anemia D. All Key: B

Key: C 519. A 60-year old male patient with history of rheumatoid arthritis presents with the following: Hb: 4.5g/dL. 514. Howell-Jolly bodies are seen in: Platelet count is 2 lakh/mm3. TLC: 6000/mL, serum A. Alcoholics ferritin is 200µg/dL, serum iron 30mg/dL and TIBC B. Cirrhosis 280ng/L. Which of the following is the most likely C. Nephrotic syndrome diagnosis? D. Postsplenectomy A. Anaemia of chronic disease B. Thalassemia minor Key: D C. Iron deficiency anemia D. Autoimmune haemolytic anemia 515. Macrocytic anemia is caused by A. Hookworm infestation Key: A B. Iron deficiency C. Diphyllobothrium latum infestation 520. A 20 year old female presents with the following D. All of the above laboratory values: hemoglobin 9gm%, MCV is 55%, RBC is 4.5 million/mm3. There is no history of blood Key: C transfusion. What is the most likely diagnosis out of the following? 516. An adult who develops pure red cell aplasia should be A. Thalassemia major explicitly evaluated for which of the following? B. Thalassemia minor A. Gastric adenocarcinoma C. Iron deficiency anemia B. Pancreatic adenocarcinoma D. Anemia of chronic disease C. Papillary thyroid cancer D. Thymoma Key: B

Key: D 521. A 13 yr girl with fatigue and weakness was found to be having reduced hemoglobin. Her MCV 70fl, MCH 517. A 50-year-old female with megaloblastic anemia and 22pg and RDW was 28. What is her most likely ataxia is given radiolabeled cobalamin by mouth diagnosis? followed by an intramuscular injection of unlabeled A. Iron deficiency anemia cobalamin. The urine radioactivity level measured B. Thalassemia minor

44

C. Sideroblastic anemia D. Thalassemia major 528. In Anemia of chronic disease, what is seen? Key: A A. TIBC ↑ B. S. Iron ↑ 522. Ringed sideroblasts are seen in: C. BM iron ↓ A. Iron deficiency anemia D. S. ferritin ↑ B. Myelodysplastic syndrome C. Thalassemia Key: D D. Anemia of chronic disease 529. A 30 years old female asymptomatic not requiring Key: B blood transfusion has Hb-13 gm%, HbF-95%, HbA2 1.5%. Which of the following is the most likely 523. A 30 years old female, RBC count 4.5 million, MCV diagnosis? 55fl, TLC 8000/mm3. There is no history of blood A. Beta-Heterozygous thalassemia transfusion. What is the likely diagnosis? B. Beta-Homozygous thalassemia A. Iron deficiency anemia C. Intermediate thalassemia B. Thalassemia major D. Persistently raised HbF C. Thalassemia minor D. Megaloblastic anemia Key: D

Key: C 530. The condition which does not cause microcytic hypochromic anemia is: 524. A patient presents with increased serum ferritin, A. Iron deficiency decreased TIBC, increased serum iron, % saturation B. Hookworm infestation increased. Most probable diagnosis is: C. Absence of intrinsic factor A. Anemia of chronic disease D. Prolonged bleeding episodes B. Sideroblastic anemia C. Iron deficiency anemia Key: C D. Thalassemia minor 531. Hypochromic microcytic blood picture is seen in all Key: B of the following conditions except: A. Iron deficiency anemia 525. Anemia in CRF is due to: B. Lead poisoning A. ↓ erythropoietin &↓RBC survival C. Rheumatoid arthritis B. ↓ folate & Iron deficiency D. Sideroblastic anemia C. Bone marrow hypoplasia D. All Key: C

Key: D 532. Lead poisoning is associated with: A. Microcytic hypochromic anemia 526. Iron deficiency anemia is seen in: B. Macrocytic anemia A. Chronic renal failure & CA Cecum C. Decreased levels of zinc protoporphyrin B. Billroth II operation D. Howell-Jolly bodies C. Hookworm infection & celiac sprue D. All Key: A

Key: D 533. Microspherocytes in peripheral blood smear are seen in: 527. Bone marrow iron is increased in: A. Congenital spherocytosis A. Thalassemi(a) B. Autoimmune acquired hemolytic anemia B. Anemia in chronic disease. C. Thalassemia C. Megaloblastic anemi(a) D. All of the above D. All Key: A Key: D

45

534. “Macropolycytes” in peripheral smear is a feature of: 540. A 5 year old male child presents with episodic A. Hereditary spherocytosis jaundice since birth. He is least likely to have which B. Iron deficiency anemia of the following? C. Sickle cell anemia A. Hereditary spherocytosis D. Megaloblastic anemia B. Sickle cell disease C. G6PD deficiency Key: D D. Paroxysmal nocturnal hemoglobinuria

535. Anemia of chronic disease is characterized by of all Key: D except: A. ↓ Serum iron level 541. Thrombotic event is seen in all of following except: B. ↓ TIBC A. Paroxysmal nocturnal hemogloninuria C. ↓ Serum ferritin level B. Disseminated intravascular coagulation D. Increased macrophages iron in marrow C. Idiopathic thrombocytopenic purpura D. Heparin induced thrombocytopenia Key: C Key: C 536. Most common cause of anemia is A. Iron deficiency 542. PNH associated with somatic mutation affecting: B. Folic acid deficiency A. Decay accelerating factor (DAF) C. Sideroblastic anemia B. Membrane inhibitor of reactive lysis (MIRL) D. Pernicious anemia C. Glycosylphosphatidylinositol (GPI) D. C8 binding protein Key: A Key: C 537. A patient of anemia due to chronic inflammation, the positive finding is 543. Cold hemagglutinin is associated with: A. Serum iron is increased A. Anti IgM B. S. ferritin is decreased B. Anti IgG C. TIBC is decreased C. Anti IgA D. Presence of normal iron in blasts D. Donath-Landsteiner antibody

Key: C Key: D

538. Which of the following glycoproteins is transported in 544. The following protein defects can cause hereditary plasma in iron metabolism: spherocytosis except: A. Spectrin A. Ankyrin B. Transferrin B. Palladin C. Ferritin C. Glycophorin C D. Hemosiderin D. Anion transport protein

Key: B Key: C

539. A 23-year-old female presented with jaundice and 545. Autoimmune hemolytic anemia is seen in: pallor for 2 months. Her peripheral blood smear A. ALL shows the presence of spherocytes. The most relevant B. AML investigation to arrive at a diagnosis is which of the C. CLL following? D. CML A. Tests for PNH B. Osmotic fragility test Key: C C. Coombs test 546. Microangiopathic hemolytic anemia is seen in all of D. Reticulocyte count the following diseases except A. Antiphospholipid antibody syndrome Key: C B. Thrombotic thrombocytopenic purpura C. Microscopic polyangiitis D. Metallic cardiac valves

46

553. Cause of fragmented RBC in peripheral blood: Key: D A. Microangiopathic hemolytic anemia B. DIC & HELLP Syndrome 547. An Rh -ve woman became pregnant with Rh +ve C. Malignant hypertension fetus. Within few days after birth, the infant D. All developed jaundice, ascites, hepatomegaly and edema. The likely substance(s) deposited in skin and sclera in Key: D jaundice is/ are given below. Which is the best possible answer? 554. Intravascular hemolysis is seen in: A. Biliverdin A. Glucose-6 phosphate dehydrogenase deficiency B. Conjugated and unconjugated bilirubin B. Thalassemia C. Unconjugated bilirubin C. Sickle cell anemia D. Conjugated bilirubin D. Hemophilia

Key: B Key: A

548. Features seen in hemolytic anemia are all except 555. The peripheral smear of hereditary spherocytosis will A. Teardrop and Burr cells show spherocytes: B. ↓ Haptoglobin A. Reticulocytosis seen C. Reticulocytosis B. Smaller size D. Hemoglobinuria C. Always associated with ↑ MCHC D. (All Key: A Key: D 549. Intravascular hemolysis occurs in: A. Hereditary spherocytosis 556. Microangiopathic hemolytic anemia seen in: B. Acute G6PD deficiency A. Thrombotic thrombocytopenic purpura C. Sickle cell disease B. Hemolytic uremic syndrome D. Thalassemia C. DIC D. All Key: B Key: D 550. Intravascular hemolysis occurs in: A. Hereditary spherocytosis 557. Donath-Landsteiner antibodies are seen in: B. Sickle cell disease A. Warm agglutination C. Thalassemia B. Cold agglutination D. PNH C. Paroxysmal nocturnal hemoglobinuria D. ITP Key: D Key: B 551. Microangiopathic hemolytic anemia is seen in: A. HUS & TTP 558. In hereditary spherocytosis an inherited abnormality B. Malignant hypertension is seen in which of the following red blood cell C. Prosthetic valves component: D. All A. globin chain B. globin chain Key: D C. Phosphatidyl inositol glycan A D. Spectrin 552. Spherocytosis in blood smear is seen in: A. Hemoglobin C Key: D B. Mechanical trauma C. Hereditary spherocytosis 559. Hereditary spherocytosis is due to: D. Hereditary elliptosis A. Acquired membrane defect B. Ankyrin deficiency Key: A & C Correct C. Defective hemoglobin synthesis D. Mechanical trauma to red cells

47

anemia with target cell and reduced osmotic fragility. Key: B What is the he probable diagnosis of patient? A. Alpha thalassemia 560. Not seen in paroxysmal nocturnal hemoglobinuria is: B. Beta thalassemia A. LDH levels are raised C. Sickle cell anemia B. Increased hemosiderin in urine D. G6PD deficiency C. Decreased leukocyte alkaline phosphatase D. Increased platelets Key: B

Key: D 566. NESTROF test is a screening test for which of the following conditions? 561. ‘Warm’ autoantibodies are seen in: A. β- thalassemia A. SLE B. Hereditary spherocytosis B. Mycoplasma C. Autoimmune haemolytic anaemia C. Syphilis D. Megaloblastic anaemia D. Varicella Key: A Key: A 567. Which of the following is the cause of alpha 562. Hot agglutinin is found in all except: thalassemia? A. Mycoplasma infection A. Deletion of alpha genes B. SLE B. Deletion of beta genes C. Methyl dopa C. Excess of alpha genes D. Rheumatoid arthritis D. Single amino acid substitution in alpha chain

Key: A Key: A

563. A 20-year-old man John Abraham is transported to 568. HbH is formed due to which of the following? the emergency department within 20 minutes of A. Deletion of 4 alpha chains sustaining a road traffic accident on his bike. The B. Deletion of 3 alpha chains patient is poorly responsive. If it is presumed that he C. Deletion of 2 alpha chains may have lost about 1.5 liters of blood at the scene, D. Deletion of 1 alpha chain which of the following is the most likely finding in this patient? Key: B A. Increased mean corpuscular hemoglobin concentration 569. Mutation causing sickle cell anemia is protective for B. Decreased hematocrit which of the following? C. Decreased blood pressure A. Malaria D. Decreased red blood cell count B. Filaria C. Leishmania Key: C D. None of the above

564. Person having heterozygous sickle cell trait are Key: A protected from infection of? A. P. falciparum 570. What is affected in HbS (Hemoglobin S)? B. P. vivax A. Stability C. Pneumococcus B. Function D. Salmonella C. Affinity D. Solubility Key: A Key: D 565. A 6yrs old child belonging to Punjabi family with past history of blood transfusions presented with 571. A couple, with a family history of beta thalassemia hemoglobin 3.5 g/dl, MCV – 30 fl, MCHC – 20. major in a distant relative, has come for counseling. Peripheral smear findings of microcytic hypochromic The husband has HbA2 of 4.8% and the wife has

48

HbA2 of 2.3%. The risk of having a child with beta past medical history is significant for two prior thalassemia major is: hospitalizations for abdominal pain, which resolved A. 50% with analgesics and hydration. Evaluation today B. 25% reveals a hematocrit of 23% and reticulocyte count of C. 5% 9%. Several hours after being admitted, the patient D. 0% dies in the hospital. At autopsy, the patient’s spleen is firm and brown; this finding is most likely related to: Key: D A. Work hypertrophy B. Follicular hyperplasia 572. Sickle cell anemia is the clinical manifestation of C. Vascular occlusion homozygous genes for an abnormal haemoglobin D. Pressure atrophy molecule. The event responsible for the mutation in the b chain is Key: C A. Insertion B. Deletion 578. A 23-year-old male presents to the medicine OPD C. Non- disjunction with complaint of hematuria. There is no burning D. Point mutation sensation during urination. He also has no history suggestive of respiratory tract infection. He gives a Key: D history of two of his relatives suffering from ‘some blood disease’. His coagulation studies are within 573. Hemoglobin H disease is caused by deletion of: normal limits. The hemoglobin electrophoresis shows A. A single a globin gene the following: Hb A 60% and Hb S 40%. Which of B. Two a globin genes the following is most likely true about this patient? C. Three a globin genes A. Irreversible sickle cells are present on the D. All four a globin genes peripheral smear. B. Reticulocyte count is elevated Key: C C. He is protected from Plasmodium falciparum. D. MCHC is decreased 574. All of the following aggravate sickling phenomenon in sickle cell disease EXCEPT: Key: C A. Higher concentration of HbS B. Higher concentration of HbF 579. Which of the following manifestations is common to C. Lower concentration of HbC sickle cell anemia and thalassemia major? D. A fall in blood Ph A. Autosplenectomy B. Bone marrow expansion in the calvarium Key: B C. Ineffective erythropoiesis D. Predisposition to Hemophilus influenzae 575. Sickle cell anemia is due to: infections A. Presence of a structurally abnormal Hb B. Red cell enzyme deficiency Key: B C. Unknown multiple mechanisms D. Disturbance of proliferation and differentiation of 580. A 40 years old male had undergone splenectomy 20 stem cells years ago. Peripheral blood smear examination would show the presence of: Key: A A. Dohle bodies B. Hypersegmented neutrophils 576. In sickle cell disease, the defect is in C. Spherocytes A. chain D. Howell-Jolly bodies B. chain C. g-chain Key: D D. Hb formation 581. Spur cell anemia is caused by Key: B A. Chronic liver disease B. Acute blood loss 577. A 14-year-old male is brought to the emergency room C. Chronic blood loss with high grade fever, chest pain, and dyspnea. His D. None

49

588. Which of the following statements in context of Key: A leukemias is true? A. Chronic myeloid leukemia occurs beyond 50 582. Hypersplenism is characterized by all except: years of age A. Leukemoid reaction B. Hairy cell leukemic in less than 50 years has a B. Thrombocytopenia good prognosis C. Splenomegaly C. Acute lymphoid leukemic in less than 1 year has D. Responds to splenectomy a poor prognosis D. Chronic lymphocytic leukemia occurs in less than Key: A 50 years of age

583. The antigen lacking in Rh negative person is: Key: C A. C B. D 589. In an ablated animal, myeloid series cells are injected. C. d Which of following is seen after incubation period? D. E A. Fibroblast B. T lymphocytes Key: B C. RBC D. Hematopoetic stem cell 584. Flow cytometry is done in: A. Polycythemia Key: C B. Thrombocytosis C. Neutrophilia 590. A young boy came with dyspnea and was found to D. Lymphocytosis have a mediastinal mass. Which of the following is known to produce mediastinal lymphadenopathy? Key: D A. Diffuse large B cell Lymphoma B. B cell rich T cell lymphoma 585. Myelofibrosis leading to a dry tap on bone marrow C. Mediastinal rich B cell lymphoma aspiration is seen with which of the following D. T cell Lymphoblastic ALL conditions? A. Burkitt’s lymphoma Key: D B. Acute erythroblastic leukemia C. Acute megakaryocytic leukemia 591. Which of the following is the least likely to be a D. Acute undifferentiated leukemia preleukaemic condition? A. Paroxysmal nocturnal haemoglobinuria Key: C B. Aplastic anaemia C. Paroxysmal cold haemoglobinuria 586. Marker of myeloid cancers: D. Myelodysplastic syndrome A. S100 B. HMB45 Key: C C. Common leukocyte antigen D. Cyto-keratin 592. A 6 year old child presents with pallor that required two blood transfusions previously. He has now Key: C developed fever and petechial haemorrhages. His hemoglobin is is 9 g/dL, platelet count is 20,000/mm3 587. Adult patient presents with generalized and TLC is 60,000/ mm3. Flow cytometry reveals the lymphadenopathy and blood film shows 70% cells to be CD10+ve, MPO+ ve, CD 19 + ve, CD 33 – immature looking lymphocytes. What should be the ve, CD 117 + ve, and CD3 – ve. Which of the next best investigation? following is the most likely diagnosis? A. Genotyping/karyotyping A. ALL B. Immunophenotyping B. AML C. Bone marrow C. Mixed phenotypic leukaemia D. Peripheral smear study D. Undifferentiated leukaemia

Key: B Key: C

50

593. Poor prognostic factor for ALL is B. Blasts of acute lymphoblastic leukemia are A. Hyperdiploidy typically myeloperoxidase positive B. t(9;22) t(4;11) C. Low leucocyte alkaline phosphatase score is C. Age at presentation is 2-8 yrs characteristically seen in blastic phase of chronic D. Total Leucocyte count <50000 myeloid leukemia D. Tartarate resistant acid phosphatase positivity is Key: B typically seen in hairy cell leukemia

594. 1All the following are poor prognostic indicators in Key: D AML except A. Inv 16 600. Which is the most common cytogenetic abnormality B. Complex karyotype in adult myelodysplastic syndrome (MDS)? C. AML M7 A. Trisomy 8 D. Deletion 7q B. 20q– C. 5 q– Key: A D. Monosomy 7

595. Most specific marker for myeloid series is Key: C A. CD 34 B. CD 45 601. Which of the following is a pan-T lymphocyte C. CD 99 marker? D. CD 117 A. CD2 B. CD3 Key: D C. CD19 D. CD25 596. t (2,8) is associated with: A. T cell ALL Key: B B. B cell ALL C. CML 602. B cell marker are all except: D. CLL A. CD 19 B. CD 20 Key: B C. CD 10 D. CD135 597. ALL L3 morphology is a malignancy arising from which cell lineage? Key: D A. Mature B-cell B. Precursor B-cell 603. Which of the following is having poor prognosis in C. Immature T-cell ALL: D. Mixed B cell and T-cell A. TLC 4000-10000 B. Age < 2 yrs Key: A C. Presence of testicular involvement at presentation D. Presence of blasts in peripheral smear 598. Non-specific esterase is positive in all the categories of AML except Key: C A. M3 B. M4 604. All of the following are good prognostic factors for C. M5 acute lymphoblastic leukemia except D. M6 A. Age of onset between 2-8 years B. Initial WBC count less than 50000 Key: D C. Hyperdiploidy D. t(9:22), t(8:14), t(4:11) 599. Which of the following statements pertaining to leukemia is correct? Key: D A. Blasts of acute myeloid leukemia are typically Sudan black negative 605. AML with gum infiltration, hepato- splenomegaly is most likely to be:

51

A. ALL A. No surface antigens (null phenotype) B. M3 B. An immature T-cell phenotype (Tdt/CD34/CD7 C. M2 positive) D. M4 C. Myeloid markers, such as CD13, CD33 and CD15 Key: D D. B cell markers, such as CD19, CD20 and CD22

606. Marker for granulocytic sarcoma: Key: B A. CD33 B. CD38 612. A 15-year-old boy presented with one day history of C. CD117 bleeding gums, subconjunctival bleed and Purpuric D. CD137 rash. Investigations revealed the following results: Hb-6.4 gm/dL; TLC-26,500/mm3 Platelet 35,000 Key: C mm3; prothrombin time-20 sec with a control of 13 sec; partial thromboplastin time-50 sec; and 607. Pancytopenia with a cellular marrow is seen in all Fibrinogen 10mg/dL. Peripheral smear was except suggestive of acute myeloblastic leukemia. Which of A. PNH the following is the most likely? B. Megaloblastic anemia A. Myeloblastic leukemia without maturation C. Myelodysplastic syndrome B. Myeloblastic leukemia with maturation D. Congenital dyserythropoietic anemia C. Promyelocytic leukemia D. Myelomonocytic leukemia Key: D Key: C 608. All are B-cell marker except: A. CD-15 613. In a patient with acute leukemia, immunophenotype B. CD-19 pattern is CD 19+ve, CD 10+ve, CD33+ve, CD C. CD-21 13+ve. He may probably have (AIIMS May 2004) D. CD-24 A. Biphenotypic leukemia B. ALL Key: A C. AML-M2 D. AML-M0 609. Acid phosphatase is specific to which of the following cells Key: A A. Monocyte B. T-lymphocyte 614. Which of the following is not compatible with a C. B-lymphocyte diagnosis of chronic myelomonocytic leukemia? D. Myelocytes A. Peripheral blood monocytosis more than 1×109/L B. Absence of Philadelphia chromosome Key: A C. More than 20% blasts in blood or bone marrow D. Absent or minimal dysplasia in myeloid lineages 610. A peripheral smear with increased neutrophils, basophils, eosinophils, and platelets is highly Key: C suggestive of: A. Acute myeloid leukemia 615. A 60 year old man presented with fatigue, weight loss B. Acute lymphoblastic leukemia and heaviness in left hypochondrium for 6 months. C. Chronic myelogenous leukemia The hemogram showed Hb, 10gm/dL, TLC 5 D. Myelodysplastic syndrome lakhs/mm3, platelet count 4 lakhs/mm3, DLC, neutrophil 55%, lymphocytes 4%, monocytes 2%, Key: C basophils 6%, metamyelocytes 10%, myelocytes 18%, promyelocytes 2% and blasts 3%. The most 611. A 17-year-old boy presented with TLC of 138 × likely cytogenetic abnormality in this case is 109/L with 80% blasts on the peripheral smear. Chest A. t (1:21) X-ray demonstrated a large mediastinal mass. B. t (9:22) Immunophenotyping of this patient’s blasts would C. t (15, 17) most likely demonstrate: D. Trisomy 21

52

Key: B Key: D

616. A 42-year old man was referred with a 2 week history 622. Absolute monocytosis is seen in: of fever weakness and bleeding gum. Peripheral A. Brucellosis smear showed pancytopenia. The bone marrow B. Kala-azar examination revealed 26% blasts frequency exhibiting C. TB Auer rods and mature myeloid cells. An occasional D. All neutrophil with pseudo Pelger-Huet anomaly was also detected. Which of the following cytochemical stains Key: D is most likely to be positive? A. Acid phosphatase 623. Aplastic anemia can progress to: B. Non-specific esterase A. AML C. Myeloperoxidase B. Myelodysplastic syndrome D. Toluidine blue C. PNH D. All Key: C

617. AML with worst prognosis Key: D A. 8/21 translocation B. Inversion 16 624. True about aplastic anemia: C. Normal cytogenetics A. Reticulocytopenia D. Monosomy 7 B. Thrombocytopenia C. Neutropenia Key: D D. All

618. Pancytopenia with cellular marrow is seen in all Key: All except A. Megaloblastic anemia 625. Leucocytosis is seen in all except: B. Myelodysplasia A. Brucellosis C. Paroxysmal nocturnal hemoglobinuria B. Acute MI D. G6PD deficiency C. Typhoid D. Diphtheria Key: D Key: C 619. Highest LAP score is seen in A. CML 626. The blast cells of acute lymphocytic leukemia in B. Polycythemia vera childhood contain: C. PNH A. Surface antigen D. Lymphoma B. CALLA Ag C. Antibodies to WBC Key: B D. Thrombocytosis

620. Causes of eosinophilia are: Key: B A. Hodgkin’s disease B. Filariasis 627. “Smudge cells” in the peripheral smear are C. MI characteristic of: D. HIV infection A. Chronic myelogenous leukemia B. Chronic lymphocytic leukemia Key: A C. Acute myelogenous leukemia D. Acute lymphoblastic leukemia 621. Sideroblasts are seen in A. Iron overload Key: B B. Myelofibrosis C. Alcoholism 628. Chromosomal translocation characteristic in acute D. All promyelocytic leukemia is

53

A. t ( 15: 17) 635. All are causes of splenomegaly except B. t ( 22: 9) A. Malaria C. t ( 21: 17) B. Kala azar D. t ( 8: 21) C. Hemolytic anemia D. Aplastic anemia Key: A Key: D 629. TRUE abut acute myelogenous leukemia A. Philadelphia chromosome is seen 636. In myelodysplastic syndrome, the following statement B. Auer bodies are seen is incorrect C. Common in childhood A. Platelet counts are normal or elevated D. Peroxidase negative granules B. Leucocyte counts are normal or elevated C. Hypocellular bone marrow Key: B D. Refractory anemia

630. In CML, serum vitamin B12 level is Key: C A. Slightly decreased B. Normal 637. Leukoerythroblastic picture is seen in all except C. Markedly decreased A. Myelofibrosis D. Increased B. Secondary malignancy of bone marrow C. Thalassemia Key: D D. Gaucher disease

631. BCR-ABL hybrid gene is present in Key: C A. Burkitt’s lymphoma B. Retinoblastoma 638. A round cell having, fine nuclear chromatin, C. Breast carcinoma prominent nucleoli and fine azurophillic granule, cell D. CML is: A. Myeloblast Key: D B. Lymphoblast C. Monoblast 632. The difference between leukemia and Leukemoid D. None reaction is done by: A. Total leukocyte count Key: A B. Leucocyte alkaline phosphatase C. Erythrocyte sedimentation rate 639. Autoimmune hemolytic anemia is seen in: D. Immature cells A. ALL B. AML Key: B C. CLL D. CML 633. Neutropenia is caused by all except: A. Typhoid fever Key: C B. Viral infection C. Brucellosis 640. Reed Sternberg cells are found in: D. Glucocorticoids A. Hodkin’s disease B. Sickle cell anaemia Key: D C. Thalassemia D. CML 634. Basophilic leucocytosis occurs in A. AML Key: A B. ALL C. CML 641. Specific stain for myeloblasts is: D. CLL A. Sudan black B. PAS Key: C C. Myeloperoxidase (MPO) D. LAP

54

D. Megakaryoblast Key: C Key: B 642. Dohle bodies are seen in which of the following? A. Multiple myeloma 649. The peripheral blood eosinophil count in Eosinophilia B. May-Heggline anomaly myalgia syndrome is usually C. Waldenstorm Macroglobulinemia A. Between 500 to 2000 cells microilter D. Lymphoma B. 2000 to 5000 cells/microliter C. Less than 500 cells/microliter Key: B D. More than 5000 cells/microliter

643. Dohle bodies in neutrophils are comprising of: Key: D A. Mitochondria B. Golgi apparatus 650. Most common ALL subtype? C. Lysosomes A. Pre B cell D. Dilated endoplasmic reticulum B. Pre T cell C. T cell Key: D D. B cell

644. What is the chromosomal translocation in AML M3? Key: A A. t (18, 21) B. t (15, 17) 651. Progressive transformation of germinal centres C. t (8, 21) (PTGC) is a precursor lesion of: D. t (9, 11) A. Hodgkin’s Lymphoma, nodular sclerosis B. Hodgkin’s Lymphoma, mixed cellularity Key: B C. Anaplastic large cell Lymphoma D. Peripheral T cell Lymphoma 645. Which of the following is associated with good prognosis in ALL? Key: A A. T cell line B. Philadelphia chromosome 652. Eosinophilic Abscess in lymph node is C. Hyperdiploidy characteristically seen in: D. Hypodiploidy A. Kimura’s disease B. Hodgkin’s Lymphoma Key: C C. Tuberculosis D. Sarcoidosis 646. B cell ALL is due to which of the following? A. T cells Key: A B. Immature B cells C. Immature T cells 653. A 50 years old male presents with massive D. Both T and B cells splenomegaly. His differential diagnosis will include all, except: Key: B A. Chronic myeloid leukemia B. Polycythemia rubra vera 647. CD-10 is seen in: C. Hairy cell leukemia A. ALL D. Aplastic anemia B. CLL C. GCL Key: D D. CML 654. Burkitt’s lymphoma is associated with: Key: A A. t (8:14) B. t (9:22) 648. Auer rods are seen in C. t (11; 14) A. Lymphoblast D. t (8:21) B. Myeloblast C. Erythroblast Key: A

55

D. Small lymphocytic lymphoma 655. All of the following immunohistochemical markers are positive in the neoplastic cells of granulocytic Key: B sarcoma, except: A. CD 45 RO 661. ‘Starry sky’ appearance is seen in B. CD 43 A. Burkitt’s lymphoma C. Myeloperoxidase B. Mantle cell lymphoma D. Lysozyme C. Extra nodal marginal zone B-cell lymphoma of MALT type Key: A D. Chronic myeloid leukemia

656. Mantle cell lymphomas are positive for all of the Key: A following, except: A. CD 23 662. A 21-year-old male with fatigue, recurrent fever, and B. CD 20 enlarged cervical lymph nodes has numerous atypical C. CD 5 lymphocytes in his peripheral blood smear. Lymph D. CD 43 node biopsy shows expansion of lymphoid follicles with preservation of the underlying architecture. Key: A Numerous atypical lymphocytes are present in the paracortical areas. This patient most likely has 657. Post-transplant lymphoma occurs due to proliferation A. AIDS of which of the following cells B. Burkitt’s lymphoma A. T-cell C. Hodgkin’s Disease B. B-cell D. Infectious mononucleosis C. NK cell D. Monocyte Key: D

Key: B 663. A 35-year-old man is diagnosed with non-Hodgkin lymphoma. Even without knowing the specific 658. Which of the following statements on lymphoma is diagnosis, it can safely be said that this patient’s not true? lymphoma is characterized by A. A single classification system for Hodgkin’s A. B-lymphocytic origin disease (HD) is almost universally accepted B. Histiocytic origin B. HD more often tends to remain localized to a C. Lymph node localization single group of lymph nodes and spreads by D. Monoclonal origin contiguity C. Several types of non-Hodgkin’s lymphoma Key: D (NHL) may have a leukemic phase D. In general follicular (nodular) NHL has worse 664. A 26-year-old man Ronit has progressive, painless prognosis compared to diffuse NHL enlargement of neck lymph nodes. Routine chest film and CT scan show marked enlargement of mediastinal Key: D nodes. No nodules are seen in the liver or lungs. When evaluating the biopsy of one of the involved 659. Mantle cell lymphomas are positive for all of the nodes, Dr. Ali, a pathologist would find which of the following except: following? A. CD23 A. Abnormal plasma cells B. CD20 B. Giant platelets C. CD5 C. Immature neutrophil precursors D. Cyclin D1 D. Reed-Sternberg cells

Key: B Key: D

660. Over-expression of BCL-2 proteins occurs in 665. Classical markers for Hodgkin’s disease are: A. Burkitt’s lymphoma A. CD 15 and CD 30 B. Follicular lymphoma B. CD 15 and CD 22 C. Diffuse large B-cell lymphoma C. CD 15 and CD 20

56

D. CD 20 and CD 30 672. Lacunar cells are seen in which type of Hodgkin’s Key: A lymphoma A. Nodular sclerosis 666. The subtype of Hodgkin’s disease, which is B. Mixed cellularity histogenetically distinct from all the other subtypes, C. Lymphocyte depletion is: D. Lymphocyte predominant A. Lymphocyte predominant B. Nodular sclerosis Key: A C. Mixed cellularity D. Lymphocyte depleted 673. Lacunar cells are present in which Hodgkin’s lymphoma? Key: A A. Nodular sclerosis B. Lymphocyte predominant 667. All of the following are the good prognostic features C. Mixed cellularity for Hodgkin’s disease except: D. All A. Hemoglobin > 10 gm/dl B. WBC count < 15000/mm3 Key: A C. Absolute lymphocyte count < 600/µl D. Age < 45 years 674. ‘Popcorn cells’ are seen in which type of Hodgkin’s disease? Key: C A. Lymphocyte dominant B. Lymphocyte depleted 668. The lymphocytic and histiocytic variant of C. Nodular sclerosis ReedSternberg cell is seen in D. Mixed type A. Follicular center lymphoma B. Lymphocyte depleted Hodgkin’s disease Key: A C. Nodular sclerosis Hodgkin’s disease D. Lymphocyte predominant Hodgkin’s disease 675. An elderly patient presented with hypercellular bone marrow, peripheral blood smear shows pancytopenia, Key: D and 15% myeloblast cells. Most likely diagnosis is A. Myelodysplastic syndrome 669. Which cell is not seen in Hodgkins lymphoma B. Blast crisis in CML A. Reed Sternberg cell C. AML B. Lacunar cell D. Polycythemia vera C. L and H cell D. Langerhan’s cell Key: A

Key: D 676. Splenomegaly is associated with all except: A. CML 670. Lacunar type of Reed Sternberg cells are seen in: B. Polycythemia vera A. Mixed cellularity Hodgkin’s lymphoma C. Essential thrombocythemia B. Nodular sclerosis Hodgkin’s lymphoma D. Primary myelofibrosis C. Lymphocyte depleted Hodgkin’s lymphoma D. Lymphocyte predominant Hodgkin’s lymphoma Key: C

Key: B 677. A 70-year-old male has a pathologic fracture of femur. The lesion appears a lytic on X-rays film with 671. The sub-type of Hodgkin’s lymphoma characterized a circumscribed punched out appearance. The by L and H cells is: curetting from fracture site is most likely to show A. Nodular sclerosis which of the following? B. Mixed cellularity A. Diminished and thinned trabecular bone C. Lymphocyte depletion B. Sheets of atypical plasma cells D. Lymphocyte predominant C. Metastatic prostatic adenocarcinoma D. Malignant cells forming osteoid bone Key: D

57

Key: B A. Megakaryocytic thrombocytopenia B. Amegakaryocytic thrombocytopenia 678. Hyperviscosity is seen in C. Platelet function defects/Functional platelet A. Cryoglobulinemia defect B. Multiple myeloma & Lymphoma D. Acquired Factor VIII inhibitors C. Macroglobulinemia D. All Key: D

Key: D 684. Patient with bleeding due to platelet function defects has which of the following features? 679. Hyperviscosity syndrome is seen in: A. Normal platelet count and normal bleeding time A. NHL B. Normal platelet count and increased bleeding B. Waldenstrom’s macroglobulinemia time C. Hodgkin’s lymphoma C. Decreased platelet count and increased bleeding D. Acute promyelocytic leukemia time D. Normal platelet count and decreased bleeding Key: B time

680. A newborn baby presented with profuse bleeding Key: B from the umbilical stump after birth. Rest of the examination and PT, APTT are within normal limits. 685. A 9-year-old boy presents with elevation in both PT Most likely diagnosis is which of the following? and aPTT. What is the diagnosis? A. Factor X deficiency A. Defect in extrinsic pathway B. Glanzmann’s thrombasthenia B. Defect in intrinsic pathway C. von Willebrand disease C. Platelet function defect D. Bernard Soulier disease D. Defect in common pathway

Key: B, Glanzmann’s thrombasthenia > Bernard Key: D Soulier disease 686. All are true about thrombotic thrombocytopenic 681. A 25 years old asymptomatic female underwent a purpura except? preop coagulation test. Her bleeding time is 3minutes, A. Microangiopathic hemolytic anemia PT is 15/14sec, a PTT is 45/35 sec, platelet count is B. Thrombocytopenia 2.5 lac/ mm3 and factor VIII levels were 60IU/dL. C. Normal complement level What is her most likely diagnosis? D. Grossly abnormal coagulation tests A. Factor IX deficiency B. Lupus anticoagulant Key: D C. Factor VIII inhibitors D. VWD – Type III 687. D.I.C. is seen in: A. Acute promyelocytic leukemia Key: C B. Acute myelomonocytic leukemia C. CMC 682. True about prothrombin time to D. Autoimmune hemolytic anemia A. Immediate refrigeration to preserve factor viability Key: A B. Platelet-rich plasma is essential C. Done within 2 hours 688. All of the following can cause megakaryocytic D. Activated with kaolin thrombocytopenia, except A. Idiopathic thrombocytopenia purpura Key: C B. Systemic lupus erythematosus C. Aplastic anemia 683. A 22 year old female having a family history of D. Disseminated intravascular coagulation (DIC) autoimmune disease presents with the complaints of recurrent joint pains. She has now developed Key: C petechial hemorrhages. She is most likely to have which of the following disorders?

58

689. A patient with cirrhosis of liver has the following C. Defective platelet adhesion coagulation parameters, Platelet count 2,00,000, D. All of the above Prothrombin time 25s/12s, Activated partial thromboplastin time 60s/35s, thrombin time 15s/15s. Key: D In this patient A. D-dimer will be normal 696. Thrombospondin is B. Fibrinogen will be < 100 mg A. Coagulation protein C. ATIII will be high B. Coagulation promoting protein D. Protein C will be elevated C. Contractile protein D. Angiogenesis inhibitory protein Key: A Key: D 690. The presence of small sized platelets on the peripheral smear is characteristic of: 697. Which is must for prothrombins time (PT)? A. Idiopathic thrombocytopenia purpura (ITP) A. Thromboplastin B. Bernard Soulier syndrome B. Prothrombin C. Disseminated intravascular coagulation C. Fibrin D. Wiskott Aldrich syndrome D. Fibrinogen

Key: D Key: A

691. Platelet aggregation in vivo is mediated by 698. Thrombocytosis is seen in: A. Serotonin & Ig mediators. A. Myelofibrosis B. Interaction among the platelets B. SLE C. Macromolecules. C. Azidothymidine therapy D. All D. Myelodysplastic syndrome

Key: D Key: A

692. Conditions associated with incoagulable state: 699. All of the following are true about Willebrand factor A. Abruption placentae & Heparin overdose except: B. Acute promyelocytic leukemia A. Synthesized by hepatocytes C. Severe falciparum malaria & snake envenomation B. Its deficiency can cause factor 8 defect also D. All C. Its deficiency may cause problem with platelet adhesion Key: D D. It serves as carrier for the factor eight

693. In DIC, which is/are seen: Key: A A. Increased PT B. Decreased fibrinogen 700. All of the following clotting factors are completely C. Decreased platelets synthesized from liver except D. All A. II B. V Key: D C. VII D. VIII 694. Platelet function defect is seen in: A. Glanzmann syndrome & Von-Willebrand disease Key: D B. Bernard Soulier syndrome C. Wiskott Aldrich syndrome 701. Cryoprecipitate contain all except D. All A. Fibrinogen B. Factor VIII Key: D C. von Willebrand factor D. Antithrombin 695. VWF factor deficiency causes: A. ↓ Platelet aggregation Key: D B. ↓ Factor VIII in plasma

59

702. Bleeding time is abnormal in: 706. Which one of the following is not included as major A. Hemophilia criteria in Jones criteria? B. Christmas disease A. Pancarditis C. von Willebrand disease B. Arthritis D. Vitamin K-deficiency C. Subcutaneous nodules D. Elevated ESR Key: C Key: D 703. A 28-year-old woman Salma presents complaining of nosebleeds. She also has easy bruising and 707. The mechanism of the development of Acute excessively heavy bleeding during her periods. There Rheumatic Fever is which of the following? is no history of drug intake. Physical examination A. Cross reactivity with exogenous antigen shows scattered petechiae with normal sized spleen. B. Innocent bystander effect Laboratory examination shows platelet count of C. Due to toxin secretion by streptococci 37000/microliter and a bleeding time of 16 minutes. D. Release of pyrogenic cytokines The bone marrow shows an increased number of megakaryocytes. Antinuclear antibody is negative. Key: A Autoantibodies directed against which of the following antigens would likely be found in this 708. Cardiac involvement in carcinoid syndrome is patient’s serum? characterized by: A. Acetylcholine receptor A. Calcification tricuspid valve B. Erythrocyte membrane protein B. Intimal fibrosis of right ventricle, tricuspid and C. Glycoprotein IIb/IIIa pulmonary valve. D. Intrinsic factor C. Involvement of the major blood vessels is commonly seen Key: C D. Equal involvement of both the sides of the heart

704. A young female Vibhuti presents with a several Key: B month history of easy bruising and increased menstrual flow is evaluated for a bleeding disorder. 709. Most friable vegetation is seen in: She has idiopathic thrombocytopenic purpura (ITP). A. Infective endocarditis In this disorder, the low platelet count is due to which B. Libman Sacks endocarditis of the following? C. Rheumatic heart disease A. Antiplatelet antibodies D. Rheumatoid heart disease B. Defective platelet aggregation C. Hypersplenism Key: A D. Ineffective megakaryopoiesis 710. Aschoff’s nodules are seen in: Key: A A. Subacute bacterial endocarditis B. Libman-Sacks endocarditis C. Rheumatic carditis 705. A 45 yrs old male had severe chest pain and was D. Non-bacterial thrombotic endocarditis admitted to the hospital with a diagnosis of acute myocardial infarction. Four days later he died and Key: C autopsy showed transmural coagulative necrosis. Which of the following microscopic features will be 711. Which of the following is not a complication of seen on further examination? infective endocarditis? A. Fibroblasts and collagen A. Myocardial ring abscess B. Granulation tissue B. Suppurative pericarditis C. Neutrophilic infiltration surrounding Coagulative C. Myocardial infarction necrosis D. Focal and diffuse glomerulonephritis D. Granulomatous inflammation Key: C Key: C 712. Aschoff bodies in Rheumatic heart disease show all of the following features, except:

60

A. Anitschkow cells A. Rheumatic heart disease B. Epithelioid cells B. Infective-endocarditis C. Giant cells C. Diabetes mellitus D. Fibrinoid necrosis D. Congenital

Key: B Key: A

713. Pathognomic feature of acute rheumatic fever is: 720. Calcification of aortic valve is seen in: A. Pericarditis A. Hurler’s syndrome B. Myocarditis B. Marfan’s syndrome C. Mitral stenosis C. Syphilis D. Aschoff’s nodules D. None

Key: D Key: C

714. Vegetations on under surface of cusps are found in: 721. Most common cause of left sided cardiac failure is: A. Infective endocarditis A. Myocardial infarction B. Libman-Sacks endocarditis B. Systemic hypertension C. SABE C. Rheumatic heart disease D. Rheumatic fever D. Infective endocarditis

Key: B Key: A

715. Aschoff’s nodules are seen in: 722. Libman-Sacks endocarditis is found in: A. Acute rheumatic fever A. Rheumatoid arthritis B. Bacterial endocarditis B. SLE C. Pneumoconiosis C. Syphilis D. Asbestosis D. Lymphoma

Key: A Key: B

716. Anitschkow cells are pathognomonic for: 723. Chronic constrictive pericarditis is most commonly (a) Acute rheumatic fever caused by: (b) Yellow fever A. Staphylococcus (c) Malarial spleen B. TB (d) ITP C. Viral D. Autoimmune Key: A Key: B 717. All are the causes of myocarditis except: A. Trichinosis 724. Aschoff’s bodies are seen in B. Mycobacterium tuberculosis A. Acute rheumatic fever C. Corynebacterium diphtheriae B. SLE D. Systemic lupus erythematosus C. SABE D. TB Key: B Key: A 718. Disarrangement of myofibrils is found in: A. Dilated cardiomyopathy 725. Diagnostic feature of rheumatic fever is: B. Constrictive cardiomyopathy A. Antischkow cells C. Fibroelastic cardiomyopathy B. Aschoff’s nodule D. Hypertrophic cardiomyopathy C. MacCallum’s patch D. Epithelioid cells Key: D Key: B 719. Most common cause of mitral stenosis is:

61

726. Rheumatoid factor is A. lgM directed against lgG 732. Heart failure cells are seen in which of the following B. lgE directed against lgM organs? C. lgG directed against lgM A. Kidney D. None B. Heart C. Lungs Key: A D. Brain

727. Major criteria for rheumatic fever, consists of all Key: C except: A. Pancarditis 733. Tigered effect in myocardium is due to: B. Arthritis A. Malignant change C. Subcutaneous nodule B. Fat deposition D. Erythema nodosum C. Seen in rheumatic fever D. Associated with myocarditis Key: D Key: B 728. An 8 year old girl, had sore throat following which she developed severe joint pains. She has been 734. ASLO titers are used in the diagnosis of: diagnosed with acute rheumatic fever. Instead of A. Acute rheumatoid arthritis recovering as expected, her condition worsened, and B. Acute rheumatic fever she died. Which of the following is the most likely C. Ankylosing spondylitis cause of death? D. Osteoarthritis A. Central nervous system involvement B. Endocarditis Key: B C. Myocarditis D. Streptococcal sepsis 735. Mitral valve vegetations do not embolise usually to: A. Brain Key: C B. Liver C. Spleen 729. Which of the following is the feature of vegetations in D. Lung Libmann Sacks endocarditis? A. Large and fragile Key: D B. Small warty along the line of closure of valve C. Small or medium sized on either or both sides of 736. Which of the following cardiac valves is not valve commonly involved in rheumatic fever? D. Small bland vegetations A. Mitral B. Aortic Key: C C. Pulmonary D. Tricuspid 730. Which type of endocarditis has vegetation on both sides of the valves? Key: C A. Infective endocarditis B. Libman Sack’s endocarditis 737. Most common heart valve involved in IV drug user is C. Rheumatic fever A. Mitral valve D. Nonbacterial thrombotic enodcarditis B. Aortic valve C. Pulmonary valve Key: B D. Tricuspid valve

731. Mc Callum’s patch is diagnostic of: Key: D A. Infective endocarditis B. Rheumatic endocarditis 738. A 70-year-old male with advanced visceral cancer C. Myocardial infarction dies of extensive myocardial infarction. Autopsy also D. Tetralogy of Fallot (ToF) reveals sterile non-destructive vegetations along the mitral leaflet edges. The pathogenesis of this patient’s Key: B vegetations is most similar to that of:

62

A. Hypercalcemia of malignancy C. Cirrhosis of liver B. Distant metastases D. Myocardial infarction C. Trousseau syndrome D. Raynaud’s phenomenon Key: D

Key: C 744. What heart condition is Marfan’s syndrome associated with? 739. A 56-years-old male presented with sudden substernal A. Endocarditis pain, impending doom and died 4 days after. On B. Restrictive cardiomyopathy autopsy, there was a large transmural anterior wall C. Arrhythmia infarction. It would be associated with: D. Aortic dissection A. Presence of collagen and fibroblasts B. Presence of neutrophils Key: D C. Granulomatous inflammation D. Granulation tissue 745. What gross histological change correlates with white blood cells’ (WBCs) invasion into cardiac tissue Key: B during the first week after an MI? A. Yellow pallor 740. A 60-year-old male presented with acute chest pain of B. Dark discolouration 4 hours duration. Electrocardiographic examination C. White scar revealed new Q wave with ST segment depression. D. Red border around yellow pallor He succumbed to his illness within 24 hours of admission. The heart revealed presence of a Key: A transmural hemorrhagic area over the septum and anterior wall of the left ventricle. Light microscopic 746. What is the key complication in the first 24 hours of examination is most likely to reveal: an MI? A. Edema in between normal myofibers A. Fibrinous pericarditis B. Necrotic myofibers with presence of neutrophils B. Coronary artery aneurysm C. Coagulative necrosis of the myocytes with C. Arrhythmia presence of granulation tissue D. Mitral insufficiency D. Infiltration by histiocytes with hemosiderin laden Macrophages Key: C

Key: B 747. What is the most sensitive and specific marker for a myocardial infarction (MI)? 741. Which of the following increases the susceptibility to A. AST coronary artery disease? B. LDH A. Type V hyperlipoproteinemia C. Troponin I B. Von Willebrand’s disease D. CK-MB C. Nephrotic syndrome D. Systemic lupus erythematosus Key: C

Key: C 748. What type of cardiomyopathy is seen in the sudden death of young athletes? 742. A myocardial infarct showing early granulation tissue A. Hypertrophic cardiomyopathy has most likely occurred: B. Restrictive cardiomyopathy A. Less than 1 hour C. Dilated cardiomyopathy B. Within 24 hours D. Obstructive cardiomyopathy C. Within 1 week D. Within 1 month Key: A

Key: C 749. What is the most common cause of mitral stenosis? A. Chronic rheumatic valve disease 743. Troponin-T is a marker of: B. Acute rheumatic fever A. Renal disease C. Congestive heart failure B. Muscular dystrophy D. Infective endocarditis

63

756. What are the characteristics of stable angina? Key: A A. Chest pain that occurs with exertion and/or emotional stress 750. What does the ECG show in prinzmetal angina? B. Severe and crushing chest pain (>20 mins) A. ST segment elevation C. Chest pain that occurs at rest B. ST segment depression D. Bradycardia C. Absent P waves D. Prolonged PR interval Key: A

Key: A 757. What is the main complication of the macrophage phase (4 to 7 days) after an MI? 751. What heart condition is Turner’s syndrome associated A. Fibrinous pericarditis with? B. Arrhythmia A. Tricuspid atresia C. Aneurysm / Mural thrombus / Dressler syndrome B. Truncus arteriosus D. Cardiac tamponade / Shunt through the C. Coarctation of the aorta ventricular wall / Mitral insufficiency D. Patent ductus arteriosus Key: D Key: C 758. What is the most common cause of sudden cardiac 752. What is the most common cause of right sided heart death (SCD)? failure? A. Cocaine abuse A. Left sided heart failure B. Mitral valve prolapse B. Chronic lung disease (Cor Pulmonale) C. Cardiomyopathy C. Hypothyroidism D. Ventricular arrhythmia D. Liver cirrhosis Key: D Key: A 759. What is the most common cause of cardiomyopathy? 753. What is the most frequent etiologic agent of acute A. Smoking infective endocarditis in IV drug abusers? B. systolic HTN A. Streptococcus viridans C. aging B. Staphylococcus aureus D. idiopathic C. Staphylococcus epidermidis D. Streptococcus bovis Key: D

Key: B 760. Which of the following is not a risk factor for developing CHF? 754. What is the most commonly involved coronary artery A. high salt diet in myocardial infarction (MI)? B. smoking A. Right coronary artery (RCA) C. HTN B. Left anterior descending artery (LAD) D. high HDL C. Left circumflex artery (LCA) D. Posterior descending artery (PDA) Key: D

Key: B 761. Which of the following drugs may worsen the obstruction in hypertrophic cardiomyopathy? 755. What are the classic signs of a cardiac tamponade? A. beta blockers A. Hypotension, muffled heart sounds, increased B. CCB's jugular venous distension (JVD) C. digoxin B. Tachycardia, dyspnoea, fever D. diuretics C. Bradycardia, weakness in arms, diaphoresis D. Hypertension, palpitations, chest pain Key: C

Key: A 762. Autopsy finding after 12 hrs in a case of death due to M.I. is

64

A. Caseous pecrosis B. Coagulative necrosis Key: D C. Fat necrosis D. Liquefactive necrosis 769. Heart muscle contains the isoenzymes: A. MM Key: B B. MB C. MM and MB 763. In MI with hypothyroidism, what is the marker of D. BB Choice? A. LDH Key: C B. CPK-MB C. Aldolase 770. Enzyme elevated in first 2 hours of MI is: D. Troponin-I A. CPK MB B. LDH Key: D C. SGPT D. Acid phosphatase 764. What is the investigation for second MI after 1 week of previous MI? Key: A A. Troponin I B. Troponin T 771. A 70 year old male presents to your OPD with C. CPK-MB epigastric pain that typically starts about 30 minutes D. LDH after meals and does not respond to antacids. He lost almost 3-4 kilograms over the last few weeks because Key: C he eats less for fear of pain. His past medical history is significant for hypertension, hyperlipidemia, 765. Earliest light microscopic change in myocardial coronary artery bypass grafting, and right-sided infarction is: carotid endarterectomy. Upper gastrointestinal A. Waviness of the fibers endoscopy does not reveal any abnormalities. The B. Neutrophilic infiltration pathophysiology of this patient’s symptoms is most C. Phagocytic infiltration close to D. Coagulative necrosis A. Peptic ulcer disease B. Esophageal spasm Key: A C. Pulmonary embolism D. Stable angina 766. Most common artery involved in myocardial infarction is: Key: D A. Right coronary artery B. Left coronary artery 772. A 60 year old man is discharged after being observed C. Left anterior descending coronary artery in the hospital for 4 days following a myocardial D. Left circumflex coronary artery infarction. He returns to his normal activities, which include sedentary work only. This point in time Key: C following a myocardial infarct is noteworthy for the special danger of which of the following? 767. In myocardial infarction scarring completes by: A. Arrhythmia A. 1 day B. Ventricular aneurysm B. 1 week C. Myocardial (pump) failure C. 1 month D. Myocardial rupture D. 3 months Key: D Key: D 773. A 62 year-old male is admitted following an acute 768. Dressler’s syndrome is: ST-segment elevation myocardial infarction A. Viral experiences chest pain on day four of his B. Bacterial hospitalization. He describes the pain as sharp in C. Fungal quality, and adds that it increases with coughing and D. Autoimmune swallowing and radiates to his neck. The blood

65

pressure is 130/80 mmHg, pulse is 90 beats per B. Monocytes minute temperature is 38.3°C (101°F) and respirations C. Eosinophils are 20 per minute. Which of the following is the most D. Free radicals likely cause of this patient’s chest pain? A. Recurrent thrombosis of the affected coronary Key: D vessel B. Thrombosis of a new coronary vessel 779. In myocardial infarctions, microscopes picture of C. Pericardial inflammation overlying the necrotic coagulation necrosis with neutrophilic infiltration is segment of myocardium seen after: D. Pericardial inflammation due to autoimmune A. 4-12 hr reaction to necrotic tissue B. 12-24 hr C. 1-3 days Key: C D. 3-7 days

774. 60 year-old male smoker develops severe chest pain. Key: C He is diagnosed with MI based on his electrocardiogram and serial CK-MB levels. One 780. Myocarditis is most commonly caused by week later he again complains of precordial pain and A. Influenza develops a fever of 101.5°F. Physical examination is B. Measles virus remarkable for a loud friction rub. Which of the C. Coxsackie virus following is the most likely diagnosis? D. Epstein barr virus A. Caseous pericarditis B. Fibrinous pericarditis Key: C C. Hemorrhagic pericarditis D. Purulent pericarditis 781. Which malignancy metastasizes to heart? A. Bronchial carcinoma Key: B B. Prostate carcinoma C. Breast carcinoma 775. 7 day old MI the most sensitive biochemical marker: D. Wilms’ tumor A. Troponin T B. CPK MB Key: A C. LDH D. Myoglobin 782. Most common benign heart tumor is: A. Rhabdomyoma Key: A B. Hemangioma C. Lipoma 776. Post MI day 10 which enzyme is raised: D. Myxoma A. CPK B. Troponin Key: D C. LDH D. Myoglobin 783. Most common tumour of heart is: A. Myxoma Key: C B. Rhabdomyosarcoma C. Fibroma 777. The cells seen after 72 hours in the infarcted area in D. Leiomyosarcoma MI are: A. Neutrophils Key: A B. Lymphocytes C. Macrophages 784. Atrial myxoma commonly arises from: D. Monocytes A. Left ventricle B. Left atrium Key: C C. Right ventricle D. Right atrium 778. In myocardial reperfusion injury, the maximum effect is caused due to which of the following? Key: B A. Neutrophil

66

785. In 2 patients with atherosclerosis, one is diabetic and D. Hyperplastic arteriosclerosis the other is non-diabetic. In relation to the non- diabetic, the diabetic patient has 100 times risk of Key: A which of the following? A. MI 791. All are seen in malignant hypertension, except: B. Stroke A. Fibrinoid necrosis C. Lower limb ischemia B. Hyaline arteriosclerosis D. Vertebrobasilar insufficiency C. Necrotizing glomerulonephritis D. Hyperplastic arteriosclerosis Key: C Key: B 786. ALL of the following statements regarding atherosclerosis are true except: 792. Recurrent ischemic events following thrombolysis has A. Omega-3 fatty acid (abundant in fish oil) been pathophysiologically linked to which of the decrease following factors: B. LDL A. Antibodies to thrombolytic agents C. Atherosclerosis in less important in age more B. Fibrinopeptide A than 45 years age C. Lipoprotein (A) D. Cigarette smoking is independent risk factor for D. Triglycerides M.I E. C-reactive protein is independent risk factor for Key: C M.I 793. 70-year-old man has abdominal pain with mass in Key: B abdomen. Angiography reveals aneurysm of aorta. Most likely cause is: 787. Which of the following is the commonest histological A. Trauma finding in benign hypertension? B. Atherosclerosis A. Proliferative end arteritits C. Syphilis B. Necrotizing arteriolitis D. Congenital C. Hyaline arteriosclerosis D. Cystic medial necrosis Key: B

Key: C 794. CAD predisposing factors: A. Homocysteinemia 788. The presence of stroke, peripheral vascular disease B. Increased fibrinogen and atherosclerosis is associated with which C. Increased plasminogen activator inhibitors hormone? D. All A. Insulin deficiency B. Hyperestrogenemia Key: D C. Hypothyroidism D. Progesterone 795. Features of essential hypertension: A. Concentric hypertrophy of LV Key: A B. Increased heart size C. Increased size of the heart muscles 789. Most common cause of abdominal aortic aneurysm is: D. All A. Atherosclerosis B. Syphilis Key: D C. Trauma D. Congenital 796. In atherosclerosis, increased LDL in monocyte macrophage is due to: Key: A A. LDL receptors on macrophage B. LDL receptors on endothelium 790. Hallmark feature of benign HTN is C. Lipids in LDL get auto-oxidized A. Hyaline arteriosclerosis D. All of the above B. Cystic medial necrosis C. Fibrinoid necrosis Key: C

67

Key: A 797. Most common site of atherosclerotic aneurysm is: A. Coronary artery 803. Atheromatous changes of blood vessels affects early B. Renal artery in ? C. Arch of aorta A. Kidney D. Abdominal aorta B. Heart C. Liver Key: D D. Spleen

798. A 52 year old male, presents to the emergency of a Key: B tertiary care hospital with chest pain and syncope. The physician suspects a coronary pathology. Coronary 804. Most common cause of aortic aneurysm is: arteriography demonstrates significant atherosclerotic A. Syphilis involvement of the left anterior descending and B. Marfan’s syndrome circumflex arteries. Which of the following cells C. Atherosclerosis provides major proliferative stimuli for the cellular D. Congenital components of atherosclerotic plaques? A. Neutrophils Key: C B. Eosinophils C. Platelets 805. Visceral aneurysm is most commonly seen in: D. Erythrocytes A. Splenic B. Renal Key: C C. Hepatic D. Coronary 799. Most common site of artery of atherosclerosis: A. Right coronary artery Key: A B. Left anterior descending coronary artery C. Left circumflex artery 806. Medial calcification is seen in: D. Diagonal branch of LAD A. Atherosclerosis B. Arteriolosclerosis Key: B C. Monckeberg’s sclerosis D. Dissecting aneurysm 800. Malignant hypertension causes which of the following changes in the kidney? Key: C A. No change in kidney B. Flea bitten kidney 807. Ascending aorta involvement is the commonest site of C. Irregular granular contracted kidney which aneurysm: D. Large white kidney A. Syphilitic B. Atherosclerotic Key: B C. Berry aneurysm D. Traumatic 801. Cystic medical necrosis is seen in: A. Marfan syndrome Key: A B. Friedrichs ataxia C. Down syndrome 808. Onion skin thickening of arteriolar wall is seen in: D. Kawasaki disease A. Atherosclerosis B. Median calcific sclerosis Key: A C. Hyaline arteriosclerosis D. Hyperplastic arteriosclerosis 802. Most common cause of dissecting hematoma is because of: Key: D A. Hypertension B. Marfan syndrome 809. Atherosclerosis is seen with which bacteria – C. Iatrogenic A. Staph aureus D. Kawasaki B. Streptococcus pneumonia C. Chlamydia pneumoniae

68

D. Chlamydia trachomatis A. Rotor’s syndrome B. Criggler Najjar syndrome Key: C C. Gilbert syndrome D. Hereditary spherocytosis 810. Commonest histological finding in benign hypertension is: Key: A A. Proliferating endarteritis B. Necrotising arteriolitis 816. Primary biliary cirrhosis is positive for: C. Hyaline arteriosclerosis A. p-ANCA D. Cystic medial necrosis B. Anti nuclear antibody C. Anti-microsomal antibody Key: C D. Anti-mitochondrial antibody

811. Which of the following condition is associated with Key: B unconjugated hyperbilirubinemia? A. Dubin-Johnson syndrome 817. Which of the following is not a function of liver: B. Rotor syndrome A. Production of vitamin K C. Gilbert syndrome B. Production of albumin D. Gall stones C. Detoxification of ammonia D. Metabolism of drugs Key: C Key: A 812. A patient with unconjugated bilirubinemia has increased excretion of urobilinogen in his urine. This 818. A 30 years old man visits his physician because he can be seen in all of the following conditions, except: noticed the development of yellowish skin during last A. G6 PD deficiency 5 days. His physical examination has absence of B. Hemolytic anemia abdominal pain or tenderness. His blood reports are as C. Hereditary spherocytosis follows: Haemoglobin 11.5 g/dL, MCV 94µm3, D. Biliary cirrhosis platelet count 1,80,000/mm3, WBC count 6930/mm3, albumin 3.7g/dL, total protein 5.6 g/dL, total bilirubin Key: D 8.2 mg/ dL, direct bilirubin, 0.5 mg/dL, AST, 45 U/L, ALT 32 U/L, and alkaline phosphatase, 340U/L. 813. In post-hepatic jaundice, the concentration of What of the following is the most likely diagnosis? conjugated bilirubin in the blood is higher than that of A. Cholelithiasis unconjugated bilirubin because: B. HAV infection A. There is an increased rate of destruction of red C. Micronodular cirrhosis blood cells D. Hemolytic anemia B. The unconjugated bilirubin is trapped by the bile stone produced in the bile duct. Key: D C. The conjugation process of bilirubin in liver remains operative without any interference. 819. ‘Nutmeg liver’ is seen in D. The UDP glucuronyl transferase activity is A. Portal cirrhosis increased manifold in obstructive jaundice B. Biliary cirrhosis C. Chronic venous congestion of liver Key: C D. Fatty liver

814. Function of hepatic stellate cells is/are: Key: C A. Formation of sinusoids B. Vitamin A storage 820. Commonest site of varices in portal hypertension is C. Increases blood perfusion A. Esophagus D. Phagocytosis B. Anal canal C. Periumbilical Key: B D. Liver

815. Which of the following diseases is not a cause of Key: A indirect hyperbilirubinemia?

69

821. In cirrhosis of liver collagen is laid down by Key: B A. Hepatocytes B. Hepatic stellate cells 827. A 20 yr old man with HBs Ag +ve, HbeAg –ve with C. Biliary epithelial cells SGOT and SGPT raised 5 times the normal value. D. Kupffer cells The HBV DNA copies are 1, 00,000/ml. Which is the likely diagnosis? Key: B A. Wild type HBV B. Surface mutant HBV 822. A 50-year-old chronic alcoholic with jaundice and C. PreCore mutant HBV ascites secondary to known cirrhosis becomes D. Inactive HBV carrier disoriented and confused. Asterixis (flapping tremor) can be demonstrated. Which of the following is not Key: C associated with the development of ascites? A. Hypoalbuminemia 828. Which one of the following diseases characteristically B. Increased hepatic lymph formation causes fatty change in liver? C. Increased portal venous pressure A. Hepatitis B virus infection D. Portal-systemic venous shunting B. Wilson’s disease C. Hepatitis C infection Key: D D. Chronic alcoholism

823. A 42-year-old woman Kiran with polycythemia vera Key: D develops progressive severe ascites and tender hepatomegaly over a period of several months. Liver 829. Councilman bodies are seen in: function tests are near normal. Which of the following A. Wilson disease tests would be most likely to establish the probable B. Alcoholic hepatitis diagnosis? C. Acute viral hepatitis A. Endoscopic retrograde cholangiopancreatography D. Auto immune hepatitis B. Hepatic venography C. Serum alpha fetoprotein Key: C D. Serum iron 830. in Chronic Viral Hepatitis Key: B A. Hepatitis A virus infection is a common cause in children 824. Nutmeg liver is seen in which of the following B. Morphological classification into Chronic Active conditions? Hepatitis and Chronic Persistent Hepatitis are A. Right sided heart failure important B. Left sided heart failure C. Fatty change is pathognomic of Hepatitis C virus C. Increased pulmonary pressure infection D. Decreased pulmonary pressure D. Grading refers to the extent of necrosis and Inflammation Key: A Key: D 825. Nutmeg liver is seen in: A. Right sided heart failure 831. The liver biopsy in acute hepatitis due to hepatitis B B. Left sided heart failure virus is likely to show all of the following, except C. Increased pulmonary pressure A. Ballooning change of hepatocytes D. Decreased pulmonary pressure B. Ground glass hepatocytes C. Focal or spotty necrosis Key: A D. Acidophil bodies

826. Micronodular cirrhosis is seen in all except: Key: B A. Alcoholic cirrhosis B. Viral hepatitis 832. All are correctly matched except: C. Budd-Chiari syndrome A. Hepatitis B - Ground glass hepatocytes D. Indian childhood cirrhosis B. Reye’s syndrome - Ground glass hepatocytes C. Alcohol & Wilson disease - Mallory bodies

70

D. Acute hepatitis - councilman bodies B. Chronic active hepatitis C. Toxic hepatitis Key: B D. Wilson disease

833. Centrilobular necrosis of liver occurs in Key: B A. Phosphorus B. Phenol 840. Hepatitis more common in pregnant women C. Arsenic A. Hepatitis-A D. Mercury B. Hepatitis-B C. Hepatitis-C Key: B D. Hepatitis-E

834. Most common Pathological change seen in acute viral Key: A hepatitis is A. Ballooning degeneration 841. Hepatitis most lethal in pregnant women B. Neutrophilic infiltration A. Hepatitis-A C. Piece meal necrosis B. Hepatitis-B D. Periportal fatty change C. Hepatitis-C D. Hepatitis-E Key: A Key: D 835. Steatosis is NOT seen in A. Hepatitis-B infection 842. Which of following is sign of chronicity in patient B. Hepatitis-C infection with chronic HCV? C. Alcoholic person A. Councilman bodies D. Protein malnutrition B. Lymphocytes C. Fibrosis Key: A D. Neutrophilia

836. Piece meal necrosis is seen in Key: D A. Alcoholic hepatitis B. Toxic hepatitis 843. Hepatitis E is transmitted by C. Chronic active hepatitis A. Blood D. Malignancy B. Feco-oral C. Venereal Key: C D. All of the above

837. In pregnancy, which viral infection has maximum Key: B mortality? A. Hepatitis A Virus 844. Incubation period of hepatitis B is B. Hepatitis B Virus A. 6 weeks to 6 months C. Hepatitis C Virus B. 6 days to 6 weeks D. Hepatitis E Virus. C. 6 months to 6 years D. More than 6 years Key: D Key: A 838. Hepatitis B virus is not associated with A. Fulminant hepatitis 845. Most prolong incubation period is of which of B. Chronic active hepatitis following virus? C. Hepatocellular carcinoma A. Hepatitis A D. Cholangiocarcinoma B. Hepatitis B C. Hepatitis C Key: D D. Hepatitis D

839. Piece meal necrosis is pathognomic of Key: B A. Alcoholic Liver disease

71

846. Indicator of active multiplication of hepatitis B virus is: Key: A A. HBs Ag B. HBc Ag 852. Hepatitis B marker which shows active transmission C. Hbe Ag phase is: D. Anti-HBs Ab A. HbeAg B. HBsAg Key: C C. Anti-Hepatitis B core antibody D. Hepatitis B DNA levels 847. Chronic carrier stage is not found in A. Hepatitis B Virus Key: A B. Hepatitis C Virus C. Both a and b 853. Which is required for infection of hepatitis D? D. Hepatitis A Virus A. Hepatitis A B. Hepatitis B Key: D C. Hepatitis C D. Hepatitis E 848. A 30 year old woman goes to her gynecologist for a pre-pregnancy examination. Routine prenatal Key: B laboratory testing demonstrates normal hematological profile with controlled sugar as well negative TORCH 854. Which of the following is defective virus infections. She normal liver function tests with the A. Hepatitis A following profile: HBsAg negative, antiHBcAg (-), B. Hepatitis B anti- HBeAg (-), HBV DNA polymerase (-) but anti- C. Hepatitis C HBsAg is positive. Which of the following likely D. Hepatitis D represents the status of the patient? A. Hepatitis B carrier Key: D, Hepatitis-D is a defective virus (dormant), it B. Recently infected with hepatitis B is the only infection that occurs in the presence of C. Immunized against hepatitis B HBV D. Infected with hepatitis B and highly transmissible 855. Which is transmitted most commonly through blood? Key: C E. Hepatitis A F. Hepatitis B 849. In a chronic alcoholic all the following may be seen in G. Hepatitis C the liver except H. Hepatitis D A. Fatty degeneration B. Chronic hepatitis Key: C, The route of transmission of HCV is C. Granuloma formation considered by parenteral exposure via blood or blood D. Cholestatic hepatitis products and also the majority of intravenous drug users become infected by repetitive exposure to Key: C contaminated injection equipment. Hepatitis B is spread when blood, semen, or other body fluid 850. Nodular regenerative changes in liver most commonly infected with the HBV enters the body of a person occur in: who is not infected. HCV doesn't spread through A. Drugs induced hepatitis sexual route commonly as compared to HBV and B. Alcoholic hepatitis HIV. C. Hepatitis B D. Autoimmune hepatitis 856. Mallory hyaline is seen in: A. Alcoholic liver disease Key: A B. Hepatocellular carcinoma C. Wilson’s disease & biliary cirrhosis 851. Hepatitis B infection is monitored by? D. All A. Surface antigen B. Surface antibody Key: D C. Core antibody D. E antibody

72

857. A chronic alcoholic has an elevated serum alpha patient’s liver reveals irregular eosinophilic hyaline fetoprotein levels. Which of the following neoplasms inclusions within the cytoplasm of the hepatocytes. is most likely seen? These eosinophilic inclusions are composed of which A. Prostatic adenocarcinoma of the following substances? B. Multiple myeloma A. Immunoglobulin C. Hepatocellular carcinoma B. Excess plasma proteins D. Glioblastoma multiforme C. Prekeratin intermediate filaments D. Lipofuscin Key: C Key: C

858. Mallory bodies are composed of: 864. Mallory bodies contain: A. Fat droplets A. Vimentin B. Mitochondria B. Cytokeratin C. Lysosomal enzymes C. Keratin D. Intermediate filaments D. Collagen

Key: D Key: B

859. Alcoholic hyaline seen in alcoholic liver disease is 865. Which of the following may not cause microvesicular composed of steatosis? A. Lipofuschin A. Alcoholic fatty liver B. Eosinophilic intracytoplasmic inclusions B. Tetracycline toxicity C. Basophilic intracytoplasmic inclusions C. Acute fatty liver of pregnancy D. Hemazoin D. Reye’s syndrome

Key: B Key: A

860. In Alcoholic liver disease, which of the following 866. The following are true attributes of hepatitis B pigments is deposited in the hepatocytes? infection except: A. Hemosiderin A. Infants develop chronic infections B. Hemoglobin B. HBc Ag in serum is indicative of active infection C. Lipofuschin C. Can cause hepatocellular cancer D. Melanin D. Interferons are used for treatment

Key: A Key: B

861. Mallory bodies are seen is 867. Which of the following most significantly increases A. Viral hepatitis the risk of hepatocellular cancer? B. Toxic hepatitis A. Hep A C. Alcoholic hepatitis B. Hep B D. All C. CMV D. EBV Key: C Key: B 862. Mallory bodies are seen in all except A. Alcoholic cirrhosis 868. Most common primary malignant tumour of liver in B. Biliary cirrhosis adult is C. Cardiac cirrhosis A. Squamous cell carcinoma D. Wilson disease B. Hepatoblastoma C. Hepatocellular carcinoma Key: C D. Hepatoma

863. A 46-year-old man, who has a long history of Key: C excessive drinking presents with signs of alcoholic hepatitis. Microscopic examination of a biopsy of this 869. Thorium induced tumor:

73

A. Angiosarcoma of liver A. Primary biliary cirrhosis B. Renal cell carcinoma B. Primary sclerosing cholangitis C. Lymphoma C. Extrahepatic biliary fibrosis D. Astrocytoma D. Congenital hepatic fibrosis

Key: A Key: B

870. Commonest benign tumor of liver is: 877. Histological finding in Reye’s syndrome is A. Hamartoma A. Budding and branching of mitochondria B. Hemangioma B. Swelling of endoplasmic reticulum C. Adenoma C. Para-nuclear micro-dense deposits D. Nodular focal hyperplasia D. Glycogen depletion

Key: B Key: D

871. Most common site of Cholangiocarcinoma is? 878. Finding on histopathological examination of liver in A. Distal biliary tree case of malaria is B. Hilum A. Microabscess formation C. Intrahepatic biliary duct B. Kupffer’s cell hyperplasia with macrophage D. Multifocal infiltration around periportal area laden with pigments. Key: B C. Non caseating granuloma D. Nonspecific finding of neutrophilic infiltration 872. Cholangiocarcinoma of liver is caused by A. Hepatitis B infection Key: B B. Cirrhosis of liver C. Antitrypsin deficiency 879. “Kayser-Fleischer ring” is seen in D. Clonorchis sinensis infection A. Wilson’s disease B. 1 antitrypsin deficiency Key: D C. Hemochromatosis D. Primary biliary cirrhosis 873. Most common bile duct tumor is A. Adenocarcinoma Key: A B. Squamous cell cancer C. Transitional cell carcinoma 880. All are true about Wilson’s disease except D. All A. ↑Liver Cu B. ↑Urine Cu Key: A C. ↑Ceruloplasmin D. ↑Serum Cu 874. Which is risk factor for cholangiocarcinoma: A. Obesity Key: C B. Primary sclerosing cholangitis C. Salmonella carrier state 881. α-1 antitrypsin deficiency causes D. HBV infection A. Congenital cystic fibrosis B. Neonatal hepatitis Key: B C. Pulmonary fibrosis D. All of the above 875. Klatskin tumor is: A. Nodular type of cholangiocarcinoma Key: B B. Fibrolamellar hepatocellular carcinoma C. Gall bladder carcinoma 882. Centrilobular necrosis is seen in D. Hepatocellular carcinoma A. CCl4 B. White phosphorus Key: A C. Yellow fever D. Eclampsia 876. Onion skin fibrosis of the common bile duct is:

74

Key: A

883. Liver in hemochromatosis is stained by which of the following stain? A. Perls iron stain B. Alcian blue C. Congo Red D. Masson trichome

Key: A

884. Bronze diabetes is seen in: A. Wilson’s disease B. Sarcoidosis C. Lead intoxication D. Hemochromatosis

Key: D

885. Copper is mainly transported by: A. Albumin B. Haptoglobin C. Ceruloplasmin D. Globulin

Key: C

886. Gene of Wilsons disease is: A. ATP 7A B. ATP 7B C. ADP 7A D. ADP 7B

Key: B

887. The most common cause of Ascites is: A. Myocardial infarction B. Cerebral haemorrhage C. Liver cirrhosis D. RCC

Key: C

75