PATHOLOGY BOARD EXAM QUESTIONS
MULTIPLE CHOICE:
1. The hallmark of acute inflammation is:
A. Increased blood flow
B. Rubor, calor, dolor increased permeability of microcirculation
C. Increased vascular permeability
D. Vascular stasis
2. The most efficient bactericidal compound present in neutrophils is the:
A. Arachidonic acid metabolites C. Lysosomal enzymes
B. H202-MPO-Halide system D. Hydrogen peroxide
3. Leukotrienes are derived from arachidonic acid through the help of this enzyme:
A. Phospholipase C. Cyclooxygenase
B. Lipooxygenase D. Lipoxins
4. The hallmark of chronic inflammation is:
A. Increased permeability of microcirculation
B. Migration of macrophages at site of injury
C. Tissue destruction
D. Mononuclear cell infiltration
5. An example of tumor suppressor gene:
A. p53 C. ras
B. C-myc D. bcr
6. A lymph node biopsy was diagnosed as tuberculosis. This type of necrosis is
characteristic of:
A. Coagulative C. Caseous
B. Liquefactive D. Gangrenous
7. Which of the following substances accumulates in atherosclerotic blood vessels?
A. Fatty acids C. Tryglicerides
B. Cholesterol esters D. Phospholipids
8. "Heart failure cells" found in the lungs in Chronic Passive Congestion are actually….
A. Lymphocytes C. Neutrophils
B. Eosinophils D. Macrophages
9. The outcome of thrombosis wherein the thrombi tends to GROW due to deposition of
additional platelets, fibrin and red blood cells:
A. Resolution C. Propagation
B. Organization D. Recanalization
10. Most common cause of death in burn patients who got into shock is:
A. Sepsis C. Dehydration
B. CHF D. Hemorrhage
11. This type of hypersensitivity reaction is mediated by IgE:
A. Type I C. Type III
B. Type II D. Type IV
12. One of the three major components of acute inflammation include:
A. Alteration in vascular caliber that leads to a decrease in blood flow
B. Structure changes in the microvasculature permitting plasma proteins and leukocytes to leave the circulation
C. Tissue destruction
D. Healing by connective tissue
13. Heat and redness in acute inflammation is due to the following pathogenetic
mechanism:
A. Increased vascular permeability C. Stasis
B. Increased blood flow D. Leukocytic margination
14. The uterine endometrial lining thickens during the proliferative phase of the
menstrual cycle. This is due to:
A. Hypertrophy C. Hyperplasia
B. Dysplasia D. Metaplasia
1
,15. Which of the following disorders is most likely to be associated with an exudates rather than a transudate?
A. Congestive heart failure C. Suppurative inflammation
B. Nephrotic syndrome D. Peritonitis
16. Which of the following conditions will NOT cause edema?
A. Sodium retention C. Obstruction of lymph flow
B. Increased hydrostatic pressure D. Increased oncotic pressure
17. The role of histamine in acute inflammatory response include:
A. Platelet release and aggregation
B. Increased vascular permeability of the venules
C. Increased vascular permeability of the arterioles
D. Membrane lysis
18. The central figure in chronic inflammation is the Macrophage because of its role in:
A. Breakdown of collagen and fibronectin
B. Production of 02 and Nitric oxide metabolites
C. Emigration from the blood stream to site of injury
D. Inhibition by cytokines and oxidized lipids
19. A biopsy of the stomach reveal an area of malignant change characterized by
varisized, compactly arranged neoplastic glands lined by moderately differentiated
cells. Which of the following terms refer to malignant tumor of glandular epithelium?
A. Sarcoma C. Teratoma
B. Choristoma D. Adenocarcinoma
20. Which of the following statements in NOT true of red infarcts?
A. It occurs in organs with double blood supply
B. Commonly found in the heart and kidneys
C. Seen in venous occlusion with infarction
D. Seen in organs with well developed anastomosis
21. Which of the following conditions is a complication of both direct injuries to the lungs
and systemic disorders?
A. Atelectasis C. Diffuse alveolar damage
B. Pulmonary edema D. Pulmonary congestion
22. Which of the following conditions of the lung is characterized by abnormal permanent
enlargement of the air space distal to the terminal bronchiole accompanied by
destruction of their walls without obvious fibrosis?
A. Emphysema C. Chronic bronchitis
B. Bronchial asthma D. Bronchiectasis
23. A spectrum of immunologically mediated predominantly interstitial lung disorders
caused by intense often prolonged exposure to inhaled organic dusts and
occupational antigens is:
A. Pulmonary alveolar proteinosis
B. Bronchiolis obliterans-organizing pneumonia
C. Desquamative interstitial pneumonitis
D. Hypersensitivity pneumonitis
24. An acute febrile respiratory disease characterized by patchy inflammatory changes
in the lungs confined to the alveolar septa and pulmonary interstitium:
A. Primary atypical pneumonia C. Bronchopneumonia
B. Lobar pneumonia D. Lobular bronchopneumonia
25. A systemic disease of unknown cause characterized by non-caseating granuloma in
many tissues and organs particularly in the hilar lymph nodes, lungs, eye, and skin
is:
A. Silicosis C. Idiopathic pulmonary fibrosis
B. Sarcoidosis D. Asbestosis
26. Most common benign tumor of the lung discovered incidentally as a coin lesion on
routine X-Ray examination is:
A. Bronchial carcinoids C. Hamartoma
B. Thymoma D. Bronchogenic cyst
27. Most common cause of aspiration pneumonia is hospitalized patients:
A. Streptococcus pneumonia C. Haemophilus influenzae
B. Staphylococcus aureus D. Pseudomonas aeroginosa
28. Most common type of asthma that begins in childhood and triggered by
2
, environmental antigens such as dust, pollens and food is:
A. Non-atopic asthma C. Atopic asthma
B. Drug induced asthma d. Occupational Asthma
29. Most common manifestation of asbestos exposure often containing calcium seen on
the anterior and posterior aspect of the parietal pleura:
A. Asbestos body C. Ferruginous bodies
B. Plaques D. Amphibole
30. Which of the following syndrome is characterized by the appearance of proliferative
glomerulonephritis and necrotizing hemorrhagic interstitial pneumonitis?
A. Goodpasture syndrome C. Karteagner syndrome
B. Paraneoplastic syndrome D. Lambert-Eaton myasthenic syndrome
31. Most common location of secondary tuberculosis in the lung:
A. Hilar area C. Peripheral
B. Base D. Apex
32. A fatal complication of ruptured aortic aneurysm and vascular trauma:
A. Chylothorax C. Hydrothorax
B. Hemothorax D. Empyema
33. Mang Juanito, 60-year-old man, has been smoking for many years, he experienced
chronic cough and weight loss for the past 6 months, no fever no nausea and
vomiting. He had one bout of hemoptysis and went to the ER for consultation. X-ray
shows a 6 cm mass on the medial upper lobe. Bronchoscopy shows a mass on the
segmental bronchus. Which of the following cytologic findings is likely to be found in
this patient?
A. Presence of acid fast organism on sputum exam
B. Presence of malignant squamous cells in sputum
C. Presence of numerous necrotic debris and inflammatory cells in sputum
D. Presence of reactive mesothelial cells in pleural fluid exam
34. Mang Juan, 65-year-old male with a history of smoking with productive cough for
many years came in at the emergency room with difficulty of breathing. Chest X-ray
shows prominent blood vessels and large heart. Patient went into cardiorespiratory
arrest. Resuscitation done but to no avail. Histologic section taken from the lung at
autopsy shows enlargement of the mucus secreting glands of the trachea and
bronchi. What is the most likely diagnosis?
A. Emphysema C. Chronic bronchitis
B. Bronchial asthma D. Bronchiectasis
35. Mang Tony, 55-year-old man has no major medical problems in the past year, 4
months prior to consultation the patient experience malaise and weight loss of 10 kg.
The patient is a non-smoker, no fever, no difficulty of breathing. Chest X-ray shows a
multiple solid nodules scattered throughout the lung fields. What is the most likely
diagnosis?
A. Bronchogenic carcinoma C. Malignant mesothelioma
B. Metastatic carcinoma D. Bronchioalveolar carcinoma
36. Mang Tomas, 45-year-old man had an episode of myocardial infarction he was
brought to the emergency room and was intubated. Upon intubation he suffers
aspiration of gastric contents. For the next 5 days he develops non-reproductive
cough and fever. Chest X-ray shows a 3 cm mass in the right lung with elevated air
fluid level. What is the most likely diagnosis?
A. Bronchopulmonary sequestration C. Atelectasis
B. Bronchiectasis D. Lung abscess
37. Hemodynamic pulmonary edema seen in congestive heart failure is due to:
A. Increased oncotic pressure C. Increased hydrostatic pressure
B. Decreased interstitial osmotic pressure D. Increased albumin
38. Sudden death in patients with pulmonary embolism is caused by:
A. Blockage of blood flow through the lungs
3
, B. Atelectasis
C. Development of chronic obstructive pulmonary disease
D. Development of pulmonary hypertension
39. A lymphohematogenous dissemination of pulmonary tuberculosis would give rise to:
A. Vacitary fibrocaseous tuberculosis C. Tuberculous bronchopneumonia
B. Potts disease D. Miliary tuberculosis
40. The plausible mechanism in the development of emphysema is:
A. Increase release of elastase in neutrophils and macrophages
B. Increase alpha-1 anti-trypsin enzyme
C. Presence of obstruction of a tumor of foreign body with concomitant infection
D. Increase responsiveness of the bronchial tree
41. The major cause of celiac sprue is:
A. Bacterial infection
B. Deficiency of Vitamin B12
C. Hypersensitivity to gliadin fraction of wheat gluten
D. Lymphatic obstruction
42. Which of the following statements is NOT a characteristic of Whipple's Disease?
A. Caused by a gram-positive actinomycete
B. It is a systemic condition that may involve any organ of the body
C. There is an increased incidence of small intestinal adenocarcinoma
D. Villi expanded by the dense infiltrate of macrophages imparts a shaggy gross appearance to the intestinal
mucosal surface
43. The histologic criterion for the diagnosis of acute appendicitis is based on finding this
type of cell infiltrating the muscularis propia:
A. Histiocytes C. Lymphocytes
B. Monocytes D. Neutrophils
44. Which of the following statements is NOT a characteristic of Crohn's Disease?
A. Associated with extraintestinal manifestations like migratory polyarthritis and ankylosing spondylitis
B. Granulomatous reaction in all layers of involved intestine
C. Response to surgery is good
D. Skip areas are seen between involved segments of intestine
45.Disaccharidase deficiency is classified under which of the following major causes of
malabsorption syndrome:
A. Defective Intraluminal digestion
B. Lymphatic obstruction
C. Primary mucosal cell abnormalities
D. Reduced small intestinal surface area
46. In ulcerative colitis, inflammation is limited to the:
A. Mucosa C. Serosa
B. Submucosa D. Transmural layer
47. Large areas of hemorrhagic green ulceration of the mucosa and green-black
necrosis through the wall, extending to the serosa of the appendix is most likely
associated to which of the following stages of acute appendicitis?
A. Acute gangrenous appendicitis C. Acute suppurative appendicitis
B. Early acute appendicitis D. Ruptured acute appendicitis
48. Leon, 25-year-old male complained of intermittent diarrhea and lower abdominal
pain. An upper G-I series showed segmental narrowing in the ileum. Microscopic
findings of the lesion showed inflammation from the mucosa to the serosa with the
presence of non-caseating granulomas. The most likely diagnosis is:
A. Celiac sprue C. Crohn's disease
B. Tropical sprue D. Whipple's disease
49. Henry, 45-year-old, male suffers from episodic abdominal bloating with flatulence
and explosive diarrhea after attending a week-long community celebration of the
dairy industry during the rest of the year, he does not consume milk shakes or ice
cream and is not symptomatic. Which of the following conditions best accounts for
these findings?
A. Celiac sprue C. Disaccharidase deficiency
B. Ulcerative colitis D. Whipple's disease
50. Josie, 40-year-old female, has a total serum bilirubin concentration of 8. 9 mg/dl and
a direct bilirubin level of 6.8 mg/dl. The serum Alanine aminotrasferase (ALT) level is
125 U/L, and the aspartate aminotransferase (AST) level is 108 U/L. A liver biopsy
shows histologic findings characteristic for Sclerosing cholangitis. Which of the
4
MULTIPLE CHOICE:
1. The hallmark of acute inflammation is:
A. Increased blood flow
B. Rubor, calor, dolor increased permeability of microcirculation
C. Increased vascular permeability
D. Vascular stasis
2. The most efficient bactericidal compound present in neutrophils is the:
A. Arachidonic acid metabolites C. Lysosomal enzymes
B. H202-MPO-Halide system D. Hydrogen peroxide
3. Leukotrienes are derived from arachidonic acid through the help of this enzyme:
A. Phospholipase C. Cyclooxygenase
B. Lipooxygenase D. Lipoxins
4. The hallmark of chronic inflammation is:
A. Increased permeability of microcirculation
B. Migration of macrophages at site of injury
C. Tissue destruction
D. Mononuclear cell infiltration
5. An example of tumor suppressor gene:
A. p53 C. ras
B. C-myc D. bcr
6. A lymph node biopsy was diagnosed as tuberculosis. This type of necrosis is
characteristic of:
A. Coagulative C. Caseous
B. Liquefactive D. Gangrenous
7. Which of the following substances accumulates in atherosclerotic blood vessels?
A. Fatty acids C. Tryglicerides
B. Cholesterol esters D. Phospholipids
8. "Heart failure cells" found in the lungs in Chronic Passive Congestion are actually….
A. Lymphocytes C. Neutrophils
B. Eosinophils D. Macrophages
9. The outcome of thrombosis wherein the thrombi tends to GROW due to deposition of
additional platelets, fibrin and red blood cells:
A. Resolution C. Propagation
B. Organization D. Recanalization
10. Most common cause of death in burn patients who got into shock is:
A. Sepsis C. Dehydration
B. CHF D. Hemorrhage
11. This type of hypersensitivity reaction is mediated by IgE:
A. Type I C. Type III
B. Type II D. Type IV
12. One of the three major components of acute inflammation include:
A. Alteration in vascular caliber that leads to a decrease in blood flow
B. Structure changes in the microvasculature permitting plasma proteins and leukocytes to leave the circulation
C. Tissue destruction
D. Healing by connective tissue
13. Heat and redness in acute inflammation is due to the following pathogenetic
mechanism:
A. Increased vascular permeability C. Stasis
B. Increased blood flow D. Leukocytic margination
14. The uterine endometrial lining thickens during the proliferative phase of the
menstrual cycle. This is due to:
A. Hypertrophy C. Hyperplasia
B. Dysplasia D. Metaplasia
1
,15. Which of the following disorders is most likely to be associated with an exudates rather than a transudate?
A. Congestive heart failure C. Suppurative inflammation
B. Nephrotic syndrome D. Peritonitis
16. Which of the following conditions will NOT cause edema?
A. Sodium retention C. Obstruction of lymph flow
B. Increased hydrostatic pressure D. Increased oncotic pressure
17. The role of histamine in acute inflammatory response include:
A. Platelet release and aggregation
B. Increased vascular permeability of the venules
C. Increased vascular permeability of the arterioles
D. Membrane lysis
18. The central figure in chronic inflammation is the Macrophage because of its role in:
A. Breakdown of collagen and fibronectin
B. Production of 02 and Nitric oxide metabolites
C. Emigration from the blood stream to site of injury
D. Inhibition by cytokines and oxidized lipids
19. A biopsy of the stomach reveal an area of malignant change characterized by
varisized, compactly arranged neoplastic glands lined by moderately differentiated
cells. Which of the following terms refer to malignant tumor of glandular epithelium?
A. Sarcoma C. Teratoma
B. Choristoma D. Adenocarcinoma
20. Which of the following statements in NOT true of red infarcts?
A. It occurs in organs with double blood supply
B. Commonly found in the heart and kidneys
C. Seen in venous occlusion with infarction
D. Seen in organs with well developed anastomosis
21. Which of the following conditions is a complication of both direct injuries to the lungs
and systemic disorders?
A. Atelectasis C. Diffuse alveolar damage
B. Pulmonary edema D. Pulmonary congestion
22. Which of the following conditions of the lung is characterized by abnormal permanent
enlargement of the air space distal to the terminal bronchiole accompanied by
destruction of their walls without obvious fibrosis?
A. Emphysema C. Chronic bronchitis
B. Bronchial asthma D. Bronchiectasis
23. A spectrum of immunologically mediated predominantly interstitial lung disorders
caused by intense often prolonged exposure to inhaled organic dusts and
occupational antigens is:
A. Pulmonary alveolar proteinosis
B. Bronchiolis obliterans-organizing pneumonia
C. Desquamative interstitial pneumonitis
D. Hypersensitivity pneumonitis
24. An acute febrile respiratory disease characterized by patchy inflammatory changes
in the lungs confined to the alveolar septa and pulmonary interstitium:
A. Primary atypical pneumonia C. Bronchopneumonia
B. Lobar pneumonia D. Lobular bronchopneumonia
25. A systemic disease of unknown cause characterized by non-caseating granuloma in
many tissues and organs particularly in the hilar lymph nodes, lungs, eye, and skin
is:
A. Silicosis C. Idiopathic pulmonary fibrosis
B. Sarcoidosis D. Asbestosis
26. Most common benign tumor of the lung discovered incidentally as a coin lesion on
routine X-Ray examination is:
A. Bronchial carcinoids C. Hamartoma
B. Thymoma D. Bronchogenic cyst
27. Most common cause of aspiration pneumonia is hospitalized patients:
A. Streptococcus pneumonia C. Haemophilus influenzae
B. Staphylococcus aureus D. Pseudomonas aeroginosa
28. Most common type of asthma that begins in childhood and triggered by
2
, environmental antigens such as dust, pollens and food is:
A. Non-atopic asthma C. Atopic asthma
B. Drug induced asthma d. Occupational Asthma
29. Most common manifestation of asbestos exposure often containing calcium seen on
the anterior and posterior aspect of the parietal pleura:
A. Asbestos body C. Ferruginous bodies
B. Plaques D. Amphibole
30. Which of the following syndrome is characterized by the appearance of proliferative
glomerulonephritis and necrotizing hemorrhagic interstitial pneumonitis?
A. Goodpasture syndrome C. Karteagner syndrome
B. Paraneoplastic syndrome D. Lambert-Eaton myasthenic syndrome
31. Most common location of secondary tuberculosis in the lung:
A. Hilar area C. Peripheral
B. Base D. Apex
32. A fatal complication of ruptured aortic aneurysm and vascular trauma:
A. Chylothorax C. Hydrothorax
B. Hemothorax D. Empyema
33. Mang Juanito, 60-year-old man, has been smoking for many years, he experienced
chronic cough and weight loss for the past 6 months, no fever no nausea and
vomiting. He had one bout of hemoptysis and went to the ER for consultation. X-ray
shows a 6 cm mass on the medial upper lobe. Bronchoscopy shows a mass on the
segmental bronchus. Which of the following cytologic findings is likely to be found in
this patient?
A. Presence of acid fast organism on sputum exam
B. Presence of malignant squamous cells in sputum
C. Presence of numerous necrotic debris and inflammatory cells in sputum
D. Presence of reactive mesothelial cells in pleural fluid exam
34. Mang Juan, 65-year-old male with a history of smoking with productive cough for
many years came in at the emergency room with difficulty of breathing. Chest X-ray
shows prominent blood vessels and large heart. Patient went into cardiorespiratory
arrest. Resuscitation done but to no avail. Histologic section taken from the lung at
autopsy shows enlargement of the mucus secreting glands of the trachea and
bronchi. What is the most likely diagnosis?
A. Emphysema C. Chronic bronchitis
B. Bronchial asthma D. Bronchiectasis
35. Mang Tony, 55-year-old man has no major medical problems in the past year, 4
months prior to consultation the patient experience malaise and weight loss of 10 kg.
The patient is a non-smoker, no fever, no difficulty of breathing. Chest X-ray shows a
multiple solid nodules scattered throughout the lung fields. What is the most likely
diagnosis?
A. Bronchogenic carcinoma C. Malignant mesothelioma
B. Metastatic carcinoma D. Bronchioalveolar carcinoma
36. Mang Tomas, 45-year-old man had an episode of myocardial infarction he was
brought to the emergency room and was intubated. Upon intubation he suffers
aspiration of gastric contents. For the next 5 days he develops non-reproductive
cough and fever. Chest X-ray shows a 3 cm mass in the right lung with elevated air
fluid level. What is the most likely diagnosis?
A. Bronchopulmonary sequestration C. Atelectasis
B. Bronchiectasis D. Lung abscess
37. Hemodynamic pulmonary edema seen in congestive heart failure is due to:
A. Increased oncotic pressure C. Increased hydrostatic pressure
B. Decreased interstitial osmotic pressure D. Increased albumin
38. Sudden death in patients with pulmonary embolism is caused by:
A. Blockage of blood flow through the lungs
3
, B. Atelectasis
C. Development of chronic obstructive pulmonary disease
D. Development of pulmonary hypertension
39. A lymphohematogenous dissemination of pulmonary tuberculosis would give rise to:
A. Vacitary fibrocaseous tuberculosis C. Tuberculous bronchopneumonia
B. Potts disease D. Miliary tuberculosis
40. The plausible mechanism in the development of emphysema is:
A. Increase release of elastase in neutrophils and macrophages
B. Increase alpha-1 anti-trypsin enzyme
C. Presence of obstruction of a tumor of foreign body with concomitant infection
D. Increase responsiveness of the bronchial tree
41. The major cause of celiac sprue is:
A. Bacterial infection
B. Deficiency of Vitamin B12
C. Hypersensitivity to gliadin fraction of wheat gluten
D. Lymphatic obstruction
42. Which of the following statements is NOT a characteristic of Whipple's Disease?
A. Caused by a gram-positive actinomycete
B. It is a systemic condition that may involve any organ of the body
C. There is an increased incidence of small intestinal adenocarcinoma
D. Villi expanded by the dense infiltrate of macrophages imparts a shaggy gross appearance to the intestinal
mucosal surface
43. The histologic criterion for the diagnosis of acute appendicitis is based on finding this
type of cell infiltrating the muscularis propia:
A. Histiocytes C. Lymphocytes
B. Monocytes D. Neutrophils
44. Which of the following statements is NOT a characteristic of Crohn's Disease?
A. Associated with extraintestinal manifestations like migratory polyarthritis and ankylosing spondylitis
B. Granulomatous reaction in all layers of involved intestine
C. Response to surgery is good
D. Skip areas are seen between involved segments of intestine
45.Disaccharidase deficiency is classified under which of the following major causes of
malabsorption syndrome:
A. Defective Intraluminal digestion
B. Lymphatic obstruction
C. Primary mucosal cell abnormalities
D. Reduced small intestinal surface area
46. In ulcerative colitis, inflammation is limited to the:
A. Mucosa C. Serosa
B. Submucosa D. Transmural layer
47. Large areas of hemorrhagic green ulceration of the mucosa and green-black
necrosis through the wall, extending to the serosa of the appendix is most likely
associated to which of the following stages of acute appendicitis?
A. Acute gangrenous appendicitis C. Acute suppurative appendicitis
B. Early acute appendicitis D. Ruptured acute appendicitis
48. Leon, 25-year-old male complained of intermittent diarrhea and lower abdominal
pain. An upper G-I series showed segmental narrowing in the ileum. Microscopic
findings of the lesion showed inflammation from the mucosa to the serosa with the
presence of non-caseating granulomas. The most likely diagnosis is:
A. Celiac sprue C. Crohn's disease
B. Tropical sprue D. Whipple's disease
49. Henry, 45-year-old, male suffers from episodic abdominal bloating with flatulence
and explosive diarrhea after attending a week-long community celebration of the
dairy industry during the rest of the year, he does not consume milk shakes or ice
cream and is not symptomatic. Which of the following conditions best accounts for
these findings?
A. Celiac sprue C. Disaccharidase deficiency
B. Ulcerative colitis D. Whipple's disease
50. Josie, 40-year-old female, has a total serum bilirubin concentration of 8. 9 mg/dl and
a direct bilirubin level of 6.8 mg/dl. The serum Alanine aminotrasferase (ALT) level is
125 U/L, and the aspartate aminotransferase (AST) level is 108 U/L. A liver biopsy
shows histologic findings characteristic for Sclerosing cholangitis. Which of the
4
