Actual Exam 2026/2027 | Questions with Verified
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SECTION 1: Cellular & Genetic Foundations (15 Questions)
Q1: A 55-year-old male with chronic hepatitis C develops hepatomegaly. Biopsy shows
enlarged hepatocytes with abundant smooth endoplasmic reticulum. This cellular
adaptation is:
A. Atrophy
B. Hypertrophy
C. Hyperplasia
D. Metaplasia
Correct Answer: C
Rationale: Pathophysiological Sequence: Chronic hepatitis C (etiology) → induces
cytochrome P450 enzymes → smooth ER proliferation (pathogenesis) → hyperplasia
(increase in cell number).
Clinical Correlation: Explains why chronic liver disease shows organ enlargement.
Distractor Analysis: Hypertrophy (B) is increased cell size, not number.
,Q2: Which genetic disorder demonstrates autosomal dominant inheritance with
complete penetrance?
A. Cystic fibrosis
B. Sickle cell disease
C. Huntington disease
D. Phenylketonuria
Correct Answer: C
Rationale: Genetic Mechanism: Huntington disease is caused by trinucleotide repeat
expansion on chromosome 4 with complete penetrance - if gene present, disease
manifests.
NP Application: 50% transmission risk to offspring.
Comparison: Others are autosomal recessive.
Q3: A tumor suppressor gene mutation leads to uncontrolled cell growth. Which gene
fits this description?
A. TP53
B. RAS
C. MYC
D. BCR-ABL
Correct Answer: A
, Rationale: Molecular Pathophysiology: TP53 (tumor suppressor) → "guardian of
genome" → regulates cell cycle checkpoints. Mutation → loss of growth inhibition →
carcinogenesis.
Clinical Correlation: Found in >50% of human cancers.
Distractor Analysis: RAS, MYC, BCR-ABL are oncogenes (gain-of-function).
Q4: In sickle cell disease, the primary pathophysiological mechanism involves:
A. Single amino acid substitution (valine for glutamic acid at position 6 of β-globin)
B. Decreased α-chain production
C. Abnormal heme synthesis
D. Iron overload
Correct Answer: A
Rationale: Genetic Basis: Point mutation in HBB gene → Glu6Val → HbS formation →
polymerization under hypoxia → sickling → vaso-occlusion.
Diagnostic Correlation: Electrophoresis shows HbS band.
Treatment Implication: Hydroxyurea increases HbF production.
Q5: Which cellular change represents dysplasia?
A. Bronchial epithelium showing loss of polarity and nuclear pleomorphism
B. Gastric metaplasia in esophagus
C. Cardiac myocyte enlargement