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2026 Robbins Pathology 10th Edition Final Test
Bank Exam: 400 Practice Questions with Verified
Answers and Detailed Rationales, Most Recent
Update, Already Graded A+, Comprehensive Study
Guide for Pathology Board Review
SECTION 1: CELL INJURY, CELL DEATH, AND ADAPTATION
Question 1
A 54-year-old man undergoes laparoscopic hernia repair. Despite the small
size of the incisions, he has poor wound healing. Further history reveals that
his usual diet has poor nutritional value and is deficient in vitamin C. Synthesis
of which of the following extracellular matrix components is most affected by
this deficiency?
A. Elastin
B. Collagen
C. Fibronectin
D. Integrin
E. Laminin
Answer: B
Rationale: Vitamin C (ascorbic acid) is required for the hydroxylation of
proline and lysine residues in procollagen. Without adequate vitamin C,
collagen synthesis is impaired, leading to poor wound healing, fragile blood
vessels, and poor tissue repair. This condition is known as scurvy.
,2
Question 2
In an experiment, glass beads are embolized into the coronary arteries of rats,
resulting in myocardial injury. After 7 days, sections of the myocardium are
studied using light microscopy. The microscopic appearance shows
granulation tissue with new capillary formation. Which of the following
mediators is most likely being expressed to produce this appearance?
A. Epidermal growth factor
B. Interleukin-2
C. Leukotriene B4
D. Thromboxane A2
E. Tumor necrosis factor
F. Vascular endothelial growth factor
Answer: F
Rationale: Vascular endothelial growth factor (VEGF) is the most important
growth factor for angiogenesis. It promotes the proliferation and migration of
endothelial cells to form new blood vessels in healing tissue. The granulation
tissue seen at 7 days post-injury is characterized by new capillary formation
driven by VEGF.
,3
Question 3
A 48-year-old man has ill-fitting shoes and develops a local injury to the sole
of his foot that fails to heal after 3 months. On examination there is loss of the
overlying epithelium in a 2-cm area on the ball of his left foot, with excavation
0.5 cm below the surface, filled with dark, soft material mixed with yellow
exudate. His past history is significant for worsening renal function and for a
myocardial infarction. Which of the following laboratory test findings is most
likely indicative of the underlying disease that is responsible for the delayed
healing?
A. Decreased cortisol
B. Decreased lactic acid
C. Decreased vitamin D
D. Increased albumin
E. Increased C-reactive protein
F. Increased hemoglobin A1c
Answer: F
Rationale: The patient has diabetes mellitus, indicated by the non-healing foot
ulcer, history of renal dysfunction, and myocardial infarction. Elevated
hemoglobin A1c indicates poor long-term glycemic control, which impairs
wound healing through multiple mechanisms including impaired neutrophil
function, decreased collagen synthesis, and microvascular disease.
, 4
Question 4
A 24-year-old man has marked abdominal pain for 6 hours. He is diagnosed
with acute abdomen and undergoes surgical removal of an inflamed appendix.
The incision site is sutured. A trichrome-stained section shows blue appearing
collagen. How long after the surgery would this appearance most likely be
seen?
A. 1 day
B. 2 to 3 days
C. 4 to 5 days
D. 2 weeks
E. 1 month
Answer: E
Rationale: The trichrome stain shows abundant blue collagen deposition,
which indicates mature scar tissue. Collagen synthesis begins around day 3-5
but reaches significant levels with mature cross-linking by 2-4 weeks. At 1
month, the wound has substantial collagen deposition with increasing tensile
strength, which would appear blue on trichrome stain.
Question 5
A 40-year-old man underwent laparotomy for a perforated sigmoid colon
diverticulum. A wound infection complicated the postoperative course, and
2026 Robbins Pathology 10th Edition Final Test
Bank Exam: 400 Practice Questions with Verified
Answers and Detailed Rationales, Most Recent
Update, Already Graded A+, Comprehensive Study
Guide for Pathology Board Review
SECTION 1: CELL INJURY, CELL DEATH, AND ADAPTATION
Question 1
A 54-year-old man undergoes laparoscopic hernia repair. Despite the small
size of the incisions, he has poor wound healing. Further history reveals that
his usual diet has poor nutritional value and is deficient in vitamin C. Synthesis
of which of the following extracellular matrix components is most affected by
this deficiency?
A. Elastin
B. Collagen
C. Fibronectin
D. Integrin
E. Laminin
Answer: B
Rationale: Vitamin C (ascorbic acid) is required for the hydroxylation of
proline and lysine residues in procollagen. Without adequate vitamin C,
collagen synthesis is impaired, leading to poor wound healing, fragile blood
vessels, and poor tissue repair. This condition is known as scurvy.
,2
Question 2
In an experiment, glass beads are embolized into the coronary arteries of rats,
resulting in myocardial injury. After 7 days, sections of the myocardium are
studied using light microscopy. The microscopic appearance shows
granulation tissue with new capillary formation. Which of the following
mediators is most likely being expressed to produce this appearance?
A. Epidermal growth factor
B. Interleukin-2
C. Leukotriene B4
D. Thromboxane A2
E. Tumor necrosis factor
F. Vascular endothelial growth factor
Answer: F
Rationale: Vascular endothelial growth factor (VEGF) is the most important
growth factor for angiogenesis. It promotes the proliferation and migration of
endothelial cells to form new blood vessels in healing tissue. The granulation
tissue seen at 7 days post-injury is characterized by new capillary formation
driven by VEGF.
,3
Question 3
A 48-year-old man has ill-fitting shoes and develops a local injury to the sole
of his foot that fails to heal after 3 months. On examination there is loss of the
overlying epithelium in a 2-cm area on the ball of his left foot, with excavation
0.5 cm below the surface, filled with dark, soft material mixed with yellow
exudate. His past history is significant for worsening renal function and for a
myocardial infarction. Which of the following laboratory test findings is most
likely indicative of the underlying disease that is responsible for the delayed
healing?
A. Decreased cortisol
B. Decreased lactic acid
C. Decreased vitamin D
D. Increased albumin
E. Increased C-reactive protein
F. Increased hemoglobin A1c
Answer: F
Rationale: The patient has diabetes mellitus, indicated by the non-healing foot
ulcer, history of renal dysfunction, and myocardial infarction. Elevated
hemoglobin A1c indicates poor long-term glycemic control, which impairs
wound healing through multiple mechanisms including impaired neutrophil
function, decreased collagen synthesis, and microvascular disease.
, 4
Question 4
A 24-year-old man has marked abdominal pain for 6 hours. He is diagnosed
with acute abdomen and undergoes surgical removal of an inflamed appendix.
The incision site is sutured. A trichrome-stained section shows blue appearing
collagen. How long after the surgery would this appearance most likely be
seen?
A. 1 day
B. 2 to 3 days
C. 4 to 5 days
D. 2 weeks
E. 1 month
Answer: E
Rationale: The trichrome stain shows abundant blue collagen deposition,
which indicates mature scar tissue. Collagen synthesis begins around day 3-5
but reaches significant levels with mature cross-linking by 2-4 weeks. At 1
month, the wound has substantial collagen deposition with increasing tensile
strength, which would appear blue on trichrome stain.
Question 5
A 40-year-old man underwent laparotomy for a perforated sigmoid colon
diverticulum. A wound infection complicated the postoperative course, and
