1.

Which one of the listed changes correctly describes the pathophysiology involved in the production of
pulmonary edema in patients with congestive heart failure?

a. Decreased plasma oncotic pressure

b. Endothelial damage

c. Increased hydrostatic pressure

d. Increased vascular permeability

e. Lymphatic obstruction

2.Oedema may be caused by any of the following EXCEPT:

a.An increase in plasma protein concentration

b.An increase in capillary hydrostatic pressure

c.An increase in capillary permeability

d.Lymphatic obstruction

3.The most common site of origin for venous thrombi leading to pulmonary embolism is:

a.Ascending aorta

b.Portal vein

c.Deep leg veins

d.Right atrium

4.which of the following predisposes to thrombogenesis?

a.Stasis of blood

b.Endothelial injury

c.Turbulence of blood

d.All of the above

5.Caissons diesease is caused by :

a.Amniotic fluid embolism

b.Tumor embolism

c.Hypercoagulability

d.Air or gas embolism

6.Gamna gandy bodies are seen in:

a.Lung

b.Kidney

c.Liver

d.Spleen

7.A 21-year-old woman sustains multiple injuries, including fractures of the right femur and tibia and the left
humerus, in amotor vehicle collision. She is admitted to the hospital, and the fractures are stabilized surgically.
Soon after admission tothe hospital, she is in stable condition. She suddenly becomes severely dyspneic, however,
2 days later. Which of thefollowing complications is the most likely cause of this sudden respiratory difficulty?

a. Right hemothorax

b. Pulmonary edema

c. Fat embolism

d. Cardiac tamponade

e. Pulmonary infarction

8.A 35-year-old man asks for advice regarding seasonal eyeitching and runny nose. Recurrent conjunctivitis in this
patientis most likely caused by which of the following mechanisms of disease?

a. Autoimmunity
b. Bacterial infection
c. Chemical toxicity
d. Hypersensitivity
e. Viral infection

9.What type of antibody is produced first against a bacterial infection, isvery effective at activating complement,
and is too large to cross the placenta?

a. IgG

b. IgM

c. IgD

d. IgE

e. IgA

10. Ten minutes after being stung by a wasp, a 30-year-old male developsmultiple patches of red, irregular skin
lesions over his entire body. Theselesions (urticaria) are pruritic, and new crops of lesions occur every day.This
response is primarily the result of liberation of specific vasoactive substances by the action of

a. Activated T lymphocytes on smooth muscle cells

b. IgA on basophils and mast cells

c. IgA on lymphocytes and eosinophils

d. IgE on basophils and mast cells

e. IgE on lymphocytes and eosinophils

11.Which one of the following histologic or immunofluorescent findingsis most indicative of a delayed type
hypersensitivity reaction?

a. A linear immunofluorescence pattern in the wall of the esophagus

b. Caseating granulomas in hilar lymph nodes

c. Councilman (apoptotic) bodies in the liver

d. Fibrinoid necrosis around dermal blood vessels

e. Numerous eosinophils in a nasal polyp

12.An allograft is a graft between

a. A human and an animal

b. Two individuals of different species

c. Two individuals of the same species

d. Two individuals of the same inbred strain

e. Identical twins

13.An 87-year-old male develops worsening heart failure. Workup revealsdecreased left ventricular filling due to
decreased compliance of the leftventricle. Two months later the patient dies, and postmortem sectionsreveal
deposits of eosinophilic, Congo red–positive material in the interstitium of his heart. When viewed under
polarized light, this material displays an apple-green birefringence. What is the correct diagnosis?

a. Amyloidosis

b. Glycogenosis

c. Hemochromatosis

d. Sarcoidosis

e. Senile atrophy

14. A 35-year-old male presents with the new onset of a “bulge” in his leftinguinal area. After performing a
physical examination, you diagnose thebulge to be an inguinal hernia. You refer the patient to a surgeon,
whorepairs the hernia and sends the resected hernia sac to the pathology laboratory along with some adipose
tissue, which he calls a “lipoma of thecord.” The pathology resident examines the tissue grossly and
microscopically and decides that it is not a neoplastic lipoma, but instead is nonneoplastic normal adipose tissue.
Which one of the following features wouldhave been present had the lesion been a lipoma rather than normal
adiposetissue?

a. Anaplasia

b. Fibrous capsule

c. Numerous mitoses

d. Prominent nucleoli

e. Uniform population of cells

15.A 65-year-old man complains of muscle weakness and a drycough for 4 months. He has smoked two packs of
cigarettesdaily for 45 years. A chest X-ray shows a 4-cm central, left lung mass. Laboratory studies reveal
hyperglycemia andhypertension. A transbronchial biopsy is diagnosed as smallcell carcinoma. Metastases to the
liver are detected by CT scan. Which of the following might account for the development ofhyperglycemia and
hypertension in this patient?

a. Adrenal metastases
b. Paraneoplastic syndrome
c. Pituitary adenoma
d. Pituitary metastases
e. Thrombosis of the renal artery

16.A 60-year-old man who worked for 30 years in a chemical factory complains of blood in his urine. Urine
cytologydiscloses dysplastic cells. A bladder biopsy demonstratestransitional cell carcinoma. Which of the
following carcinogens was most likely involved in the pathogenesis of bladdercancer in this patient?
a. Aniline dyes
b. Arsenic
c. Benzene
d. Cisplatinum
 e. Vinyl chloride

17.A 58-year-old woman with colon cancer presents with3 months of increasing shortness of breath. A chest X-
rayreveals numerous, bilateral, round masses in both lungs. Histologic examination of an open-lung biopsy
discloses malignant gland-like structures, which are nearly identical to thecolon primary. Which of the following
changes in cell behaviour was the first step in the process leading to tumor metastasis from the colon to the lung
in this patient?

a. Arrest within the circulating blood or lymph

b. Exit from the circulation into a new tissue
c. Invasion of the underlying basement membrane
d. Penetration of vascular or lymphatic channels
e. Stimulation of angiogenesis within the pulmonary Metastases

18.A 35-year-old woman complains of nipple discharge andirregularmenses of 5 months duration. Physical
examination reveals amilky discharge from both nipples. MRI shows an enlargement of the anterior pituitary.
Which of the following is the most likelyhistologic diagnosis of this patient’s pituitary tumor?

a. Adenoma
b. Choristoma
c. Hamartoma
d. Papilloma
e. Teratoma

19.Which is the guardian gene?

A.P53 gene

B.Myc proto-oncogene

C.Erb-B

D.Cyclin D

20.Viruses that have been associated with malignancy include all of the following EXCEPT:

a.Rhinovirus

b- Hepatitis B virus

c- Human immunodeficiency d- human papilloma virus

d- Human T-lymphocyte virus, type I