GENERAL PATHOLOGY 1st BIMONTHLY
BIMONTHLY EXAM
1. A 2-year-old boy presents with Chronic granulomatous disease (CGD) is a genetic disorder
recurrent infections involving multiple in which white blood cells called phagocytes are unable to kill
organ systems. Extensive investigation certain types of bacteria and fungi. People with CGD are highly
results in a diagnosis of chronic susceptible to frequent and sometimes life-threatening bacterial
granulomatous disease of childhood. and fungal infections.
Which of the following most closely
characterizes the abnormality in this CGD is caused by defects in an enzyme, NADPH oxidase,
patient’s phagocytic cells? that phagocytes need to kill certain bacteria and fungi.
Mutations in one of five different genes can cause these
A. Deficiency of NADPH oxidase defects.
activity
B. Increased myeloperoxidase– The H2O2-MPO-halide system is the most potent bactericidal
halide- mediated killing of system of neutrophils. Myeloperoxidase (MPO) in the presence
catalase-positive organisms
when compared with catalase- of a halide such as Cl− , converts H2O2 to hypochlorite (HOCl )
negative organism which is a potent antimicrobial agent that destroys microbes by
C. Impaired chemotaxis and
migration caused by abnormal halogenation or or by oxidation of proteins and lipids (lipid
microtubule formation peroxidation)
D. Decreased killing of
microorganisms because of Cytoskeletal structures are constantly elongating and shrinking;
enhanced production of assembly and disassembly of microfilaments and microtubules
hydrogen peroxide drive cell migration and does not characterize CGD
E. Inability to kill streptococci
Hydrogen Peroxide is a peroxide and oxidizing agent with
ANSWER: A disinfectant, antiviral and anti-bacterial activities. An enhanced
production of H2O2 would increase killing of microbes but it
does not also characterize CGD
-
2. A 45 year old man underwent
laparotomy for a perforated sigmoid
colon diverticulum. A wound infection
complicated the postoperative course
and surgical wound dehiscence
occurred. Six weeks later the wound is
only 10% of its original size. Which of the
following processes best accounts for the
decrease in wound size over the past 6
weeks?
A. Increase in synthesis of collagen
B. Inhibition of metalloproteinases
C. Myofibroblast contraction
D. Resolution of subcutaneous edema
E. Elaboration of adhesive
glycoproteins
ANSWER: D
,3. A 25-year-old woman with membranous Lymphocytes - Acute cellular rejection is characterized by an infiltrate
glomerulonephritis receives a kidney of both CD4+ and CD8+ lymphocytes. Acute rejection occurs over a
transplant. The donor is her HLA-matched variable time period, ordinarily days to weeks to mths after transplant.
sister. She does well initially, but after several
weeks, there is a progressive increase in
serum creatinine. Assuming that this
represents acute cellular rejection, an
infiltrate with which of the following types of
inflammatory cells is most likely to be a
prominent finding on renal biopsy?
A. Mast cells
B. Lymphocytes
C. Basophils
D. Monocytes-macrophages
E. Neutrophils
ANSWER: B
4. A 22-year-old woman with acute Graft-versus-host disease is most often manifested by clinical
myeloblastic leukemia receives an allogeneic findings related to the three principal target organs: the skin,
bone marrow transplant with apparent liver, and gastrointestinal tract. The skin manifestations are often
successful engraftment. Three weeks later, initiated by a pruritic rash. Elevation of bilirubin and liver
early jaundice, as well as a generalized enzymes signals the hepatic involvement. Effects on the ileum
maculopapular rash, is noted. Profuse and colon present as diarrhea and abdominal pain. The lesions
diarrhea follows. A skin biopsy reveals are caused by donor lymphocytes, with targeting of host
vacuolar changes, necrotic epidermal cells, epithelial cells by CD8+T cells.
and a lymphocytic infiltrate. These findings
are most likely caused by
A. attack on host epithelial cells by
donor CD8+ T cells
B. IgE and mast cell–mediated
anaphylactic hypersensitivity
C. antibody-dependent cellular
cytotoxicity.
D. secretion of IL-2 and interferon-γ by
TH1 cells
ANSWER: A
,5. A 5 year old child with this histologic
findings in the liver. This is an example of cell
injury which is
A. Reversible
B. Irreversible
ANSWER: A
, Source:
Liver and Biliary Tract Diseases Trans, 02/11/2021, page 2
6. A 45-year-old woman is investigated for Atrophy is shrinkage in the size of cells by the loss of cell
hypertension and is found to have substance. When a sufficient number of cells are involved, the
enlargement of the left kidney. The right entire tissue or organ is reduced in size. Causes include
kidney is smaller than normal. Contrast diminished blood supply and nutrition (ie. due to stenosis of the
studies reveal stenosis of the right renal right renal artery), loss of innervation, loss of endocrine
artery. The size change in the right kidney is stimulation and aging.
an example of which of the following adaptive
changes?
A. Hyperplasia
B. Hypertrophy
C. Atrophy SOURCE:
D. Aplasia Robbins Basic Pathology 10th Edition, page 50
E. Metaplasia
ANSWER: C
7. A 35 year old male who underwent
emergency surgery secondary to acute
abdomen. Operative findings show bowel
constriction due to adhesions. Grossly, the
affected intestine appears reddish brown
which corresponds to the histologic findings
below. This case is an example of
A. White/pale infarct
B. Hemorrhagic/red infarct
ANSWER: B
SOURCE: https://www.researchgate.net/figure/Histopathology-
signs-of-ischemic-intestine-of-the-resected-small-bowel-show-
diffuse_fig1_2358132
8. A 3-year-old boy, presents with recurrent
bacterial and fungal infections primarily
involving his skin and respiratory tract.
Physical examination reveals the presence of
oculocutaneous albinism. Examination of a
peripheral blood smear reveals large
granules within neutrophils, lymphocytes, and
monocytes. The total neutrophil count is
found to be decreased. Further workup
reveals ineffective bactericidal capabilities of
neutrophils due to defective fusion of
phagosomes with lysosomes. Which of the
following is the most likely diagnosis?
A. Chediak-Higashi syndrome
BIMONTHLY EXAM
1. A 2-year-old boy presents with Chronic granulomatous disease (CGD) is a genetic disorder
recurrent infections involving multiple in which white blood cells called phagocytes are unable to kill
organ systems. Extensive investigation certain types of bacteria and fungi. People with CGD are highly
results in a diagnosis of chronic susceptible to frequent and sometimes life-threatening bacterial
granulomatous disease of childhood. and fungal infections.
Which of the following most closely
characterizes the abnormality in this CGD is caused by defects in an enzyme, NADPH oxidase,
patient’s phagocytic cells? that phagocytes need to kill certain bacteria and fungi.
Mutations in one of five different genes can cause these
A. Deficiency of NADPH oxidase defects.
activity
B. Increased myeloperoxidase– The H2O2-MPO-halide system is the most potent bactericidal
halide- mediated killing of system of neutrophils. Myeloperoxidase (MPO) in the presence
catalase-positive organisms
when compared with catalase- of a halide such as Cl− , converts H2O2 to hypochlorite (HOCl )
negative organism which is a potent antimicrobial agent that destroys microbes by
C. Impaired chemotaxis and
migration caused by abnormal halogenation or or by oxidation of proteins and lipids (lipid
microtubule formation peroxidation)
D. Decreased killing of
microorganisms because of Cytoskeletal structures are constantly elongating and shrinking;
enhanced production of assembly and disassembly of microfilaments and microtubules
hydrogen peroxide drive cell migration and does not characterize CGD
E. Inability to kill streptococci
Hydrogen Peroxide is a peroxide and oxidizing agent with
ANSWER: A disinfectant, antiviral and anti-bacterial activities. An enhanced
production of H2O2 would increase killing of microbes but it
does not also characterize CGD
-
2. A 45 year old man underwent
laparotomy for a perforated sigmoid
colon diverticulum. A wound infection
complicated the postoperative course
and surgical wound dehiscence
occurred. Six weeks later the wound is
only 10% of its original size. Which of the
following processes best accounts for the
decrease in wound size over the past 6
weeks?
A. Increase in synthesis of collagen
B. Inhibition of metalloproteinases
C. Myofibroblast contraction
D. Resolution of subcutaneous edema
E. Elaboration of adhesive
glycoproteins
ANSWER: D
,3. A 25-year-old woman with membranous Lymphocytes - Acute cellular rejection is characterized by an infiltrate
glomerulonephritis receives a kidney of both CD4+ and CD8+ lymphocytes. Acute rejection occurs over a
transplant. The donor is her HLA-matched variable time period, ordinarily days to weeks to mths after transplant.
sister. She does well initially, but after several
weeks, there is a progressive increase in
serum creatinine. Assuming that this
represents acute cellular rejection, an
infiltrate with which of the following types of
inflammatory cells is most likely to be a
prominent finding on renal biopsy?
A. Mast cells
B. Lymphocytes
C. Basophils
D. Monocytes-macrophages
E. Neutrophils
ANSWER: B
4. A 22-year-old woman with acute Graft-versus-host disease is most often manifested by clinical
myeloblastic leukemia receives an allogeneic findings related to the three principal target organs: the skin,
bone marrow transplant with apparent liver, and gastrointestinal tract. The skin manifestations are often
successful engraftment. Three weeks later, initiated by a pruritic rash. Elevation of bilirubin and liver
early jaundice, as well as a generalized enzymes signals the hepatic involvement. Effects on the ileum
maculopapular rash, is noted. Profuse and colon present as diarrhea and abdominal pain. The lesions
diarrhea follows. A skin biopsy reveals are caused by donor lymphocytes, with targeting of host
vacuolar changes, necrotic epidermal cells, epithelial cells by CD8+T cells.
and a lymphocytic infiltrate. These findings
are most likely caused by
A. attack on host epithelial cells by
donor CD8+ T cells
B. IgE and mast cell–mediated
anaphylactic hypersensitivity
C. antibody-dependent cellular
cytotoxicity.
D. secretion of IL-2 and interferon-γ by
TH1 cells
ANSWER: A
,5. A 5 year old child with this histologic
findings in the liver. This is an example of cell
injury which is
A. Reversible
B. Irreversible
ANSWER: A
, Source:
Liver and Biliary Tract Diseases Trans, 02/11/2021, page 2
6. A 45-year-old woman is investigated for Atrophy is shrinkage in the size of cells by the loss of cell
hypertension and is found to have substance. When a sufficient number of cells are involved, the
enlargement of the left kidney. The right entire tissue or organ is reduced in size. Causes include
kidney is smaller than normal. Contrast diminished blood supply and nutrition (ie. due to stenosis of the
studies reveal stenosis of the right renal right renal artery), loss of innervation, loss of endocrine
artery. The size change in the right kidney is stimulation and aging.
an example of which of the following adaptive
changes?
A. Hyperplasia
B. Hypertrophy
C. Atrophy SOURCE:
D. Aplasia Robbins Basic Pathology 10th Edition, page 50
E. Metaplasia
ANSWER: C
7. A 35 year old male who underwent
emergency surgery secondary to acute
abdomen. Operative findings show bowel
constriction due to adhesions. Grossly, the
affected intestine appears reddish brown
which corresponds to the histologic findings
below. This case is an example of
A. White/pale infarct
B. Hemorrhagic/red infarct
ANSWER: B
SOURCE: https://www.researchgate.net/figure/Histopathology-
signs-of-ischemic-intestine-of-the-resected-small-bowel-show-
diffuse_fig1_2358132
8. A 3-year-old boy, presents with recurrent
bacterial and fungal infections primarily
involving his skin and respiratory tract.
Physical examination reveals the presence of
oculocutaneous albinism. Examination of a
peripheral blood smear reveals large
granules within neutrophils, lymphocytes, and
monocytes. The total neutrophil count is
found to be decreased. Further workup
reveals ineffective bactericidal capabilities of
neutrophils due to defective fusion of
phagosomes with lysosomes. Which of the
following is the most likely diagnosis?
A. Chediak-Higashi syndrome
