Cardiovascular Exam, 2nd year Pathology Cardiovascular Exam, 2nd year Pathology

Q1: Select the ONE appropriate answer (0.5 for each): Q3: Enumerate the histomorphological types of myocarditis.
1- one hemodynamic abnormality in pathophysiology of mitral valve stenosis is:
a. increased left ventricular filling
b. increased left atrial pressure
c. increased forward cardiac output
d. decreased right ventricular pressure
2- of the following, a major constituent of atherosclerotic plaque is:
a. smooth muscle cells
b. red blood cells
c. platelets
d. fibroblasts
e. leukocytes
3- all of the following factors contribute to an increased risk for the development
of hypertension EXCEPT:
a. diabetes mellitus
b. high levels of high density lipoprotein (HDL)
c. hypertension
d. family history
e. cigarette smocking
4- rheumatic valvular disease results from
a. rheumatic endocarditis
b. rheumatic myocarditis
c. rheumatic pericarditis
d. bacterial endocarditis
e. mural thrombosis
5- the most common cause of aortic stenosis is:
a. bacterial infection
b. systemic hypertension
c. left side heart failure
d. rheumatic fever
e. congenital
6- the most common and most frequent complication of myocardial infarction is:
a. arrhythmias
b. myocardial rupture
c. cardiac tamponade
d. mural thrombosis
e. pericarditis
7- regarding periarteritis nodosa, all are true EXCEPT:
a. more commonly affecting adults males.
b. the pathogenesis involving immune complex deposition
c. affecting medium sized and small arteries
d. associated with multiple microaneurysms
e. mainly affect renal and pulmonary arteries
Q2: Mark (T) for true statement and (F) for false one (0.5 for each).
a. Secondary hypertension is caused by diseases of the kidneys or
endocrine glands ( )
b. Right side heart failure is most commonly due to left side heart failure or
primary pulmonary disease ( )
c. Myxomas are the most common primary tumor of adult heart ( )
 Female Genital System Pathology Exam/ Part 2 Female Genital System Pathology Exam/ Part 2

Female Genital System Pathology Exam/ Part 2 Female Genital System Pathology Exam/ Part 2
I- Select the one most appropriate answer I- Select the one most appropriate answer

1. A female patient develops abortion and postabortion hemorrhage. She seeks 1. A female patient develops abortion and postabortion hemorrhage. She seeks
medical advice. Her HCG was 400000IU/ml. Diagnostic D&C revealed medical advice. Her HCG was 400000IU/ml. Diagnostic D&C revealed
amixture of cytotrophoblast and syncitiotropholblast amid areas of amixture of cytotrophoblast and syncitiotropholblast amid areas of
hemorrhage and necrosis without any chrionic villi. This patient has: hemorrhage and necrosis without any chrionic villi. This patient has:
a. Teratoma a. Teratoma
b. Vesicular mole b. Vesicular mole
c. Choriocarcinoma c. Choriocarcinoma
d. Remnants of conception. d. Remnants of conception.
2. A black woman 35 year-old with huge pelvic tumor. Grossly: this tumor is 2. A black woman 35 year-old with huge pelvic tumor. Grossly this tumor is
complex solid cystic with yellow tinge and microscopically composed of cystic with sebaceous material and hairs inside. Microscopically it is lined by
cuboidal cells with Call-Exner rosettes. Mitotic activity is normal. This tumor keratinized squamous epithalamium with hair follicles and sebaceous glands
is most likely: as well as areas containing cartilage and bone. This tumor is most likely:
a. Cystic hyperplasia a. Mature cystic teratoma (Dermoid cyst)
b. Cervical adenocarcinoma b. Cervical adenocarcinoma
c. Uterine leiomyoma c. Uterine leiomyoma
d. Granulosa cell tumor. d. Placenta
3. A young female with multiple warty lesions at the vulva. Histologically, they 3. A young female with multiple warty lesions at the vulva. Histologically, they
are composed of papillary lesion with multiple layers of stratified squamous are composed of papillary lesion with multiple layers of stratified squamous
epithelium and Koliocytosis. This patient is sexually active. The most likely epithelium and Koliocytosis. This patient is sexually active. The most likely
diagnosis is: diagnosis is:
a. Syphilis a. Syphilis
b. Condyloma accuminata b. Condyloma accuminata
c. Lymphogranuloma venerium c. Lymphogranuloma venerium
d. Herpes simplex type II d. Herpes simplex type II

II- Select (T) for true statement and (F) for false one: II- Select (T) for true statement and (F) for false one:
1. The most common uterine tumors are fibroids ( ) 1. Chocolate cyst represent ectopic endometrium in ovary forming cystic lesion
2. Karytyping revealed 69XXX is likely from complete vesicular mole ( ) ( )
3. Herpes virus type II related to cervical cancer ( ) 2. Karytyping revealed 69XXX is likely from vesicular mole ( )
4. The most common site for female genital system tuberculosis is fallopian 3. Herpes virus type II not related to cervical cancer ( )
tubes ( ) 4. Simple endometrial hyperplasia carries a greater risk for malignancy than
5. Adenomyosis is presence of endometrial tissue outside the uterus e.g the complex endometrial hyperplasia ( )
ovaries ( ) 5. The most common site for female genital system tuberculosis is the
6. Endometriois may be complicated by obstructive infertility ( ) endometrium ( )
7. Malignant transformation in leiomyoma to leiomyosarcoma approximately 3% 6. The incidence of leiomyosarcoma increases with multiple leiomyomas than
( ) solitary myoma ( )
7. Endometriois may be complicated by obstructive infertility ( )
III- Give an account on Endometrial hyperplasia 8. Malignant transformation in leiomyoma to leiomyosarcoma approximately 3%
( )

III- Write short notes on:

1. Cervical intraepithelial neoplasia (CIN)
2. Classification of ovarian tumors

Dr. Fayed Al-Yousofy Dr. Fayed Al-Yousofy

Female Genital System Pathology Exam/ Part 2

Female Genital System Pathology Exam/ Part 2 Pathology exam 3rd year Medical students
I- Select the one most appropriate answer

1. A female patient develops abortion and postabortion hemorrhage. She seeks

medical advice. Her HCG was 400000IU/ml. Diagnostic D&C revealed Local accumulation of blood within a dilated vein in the spermatic
amixture of cytotrophoblast and syncitiotropholblast amid areas of cord:
hemorrhage and necrosis without any chrionic villi. This patient has: A.hematocele
a. Teratoma B.hydrocele
b. Vesicular mole C.chylocele
c. Choriocarcinoma D.vericocele (venous varix)
d. Remnants of conception.
2. A black woman 35 year-old with huge pelvic tumor. Grossly: this tumor is nodular gummas are associated with?
complex solid cystic with yellow tinge and microscopically composed of A.TB
cuboidal cells with Call-Exner rosettes. Mitotic activity is normal. This tumor B.gonorrhea
C.syphilis
is most likely:
D.mumps
a. Cystic hyperplasia
Cerebral infarcts due to focal obstruction of blood flow may arise
b. Cervical adenocarcinoma
from either thrombotic or embolic arterial occlusion
c. Uterine leiomyoma
A.true
d. Granulosa cell tumor.
B.false
3. A young female with multiple warty lesions at the vulva. Histologically, they
are composed of papillary lesion with multiple layers of stratified squamous
epithelium and Koliocytosis. This patient is sexually active. The most likely
diagnosis is:
a. Syphilis Hydrocele, hematocele, chylocele, spermatocele, and vericocele are all
b. Condyloma accuminata lesions of the:
c. Lymphogranuloma venerium
d. Herpes simplex type II A.tunica vaginalis

II- Select (T) for true statement and (F) for false one: B.tunica albicans
1. The most common uterine tumors are fibroids ( )
C.glans penis
2. Karytyping revealed 69XXX is likely from complete vesicular mole ( )
3. Herpes virus type II related to cervical cancer ( ) D.testis
4. The most common site for female genital system tuberculosis is fallopian
tubes ( )
5. Adenomyosis is presence of endometrial tissue outside the uterus e.g the An autopsy study reveals that evidence for atheroma formation can begin
ovaries ( ) even in children. The gross appearances of the aortas are recorded and
6. Endometriois may be complicated by obstructive infertility ( )
compared with microscopic findings of atheroma formation. Which of the
7. Malignant transformation in leiomyoma to leiomyosarcoma approximately 3%
( ) following is most likely to be the first visible gross evidence for the formation
of an atheroma?
III- Give an account on Endometrial hyperplasia
A Thrombus

B Fatty streak

C Calcification

Dr. Fayed Al-Yousofy

D Hemorrhage

E Exudate

F Ulceration

On sectioning of an organ from a 60-year-old man at the time of autopsy, a

focal, wedge-shaped area that is firm is accompanied by extensive
hemorrhage, giving it a red appearance. The lesion has a base on the surface
of the organ. In which of the following situations will this lesion most likely
occur?

A Lung with pulmonary thromboembolism

B Heart with coronary thrombosis

C Liver with hypovolemic shock

D Kidney with septic embolus

E Spleen with embolized mural thrombus

F Brain with cerebral arterial aneurysm

Pathology Exam-Urogenital System

-( )- • Questions 1-3: Read carefully the clinical case and select one
appropriate answer (1 mark for each):
1- A 50-year-old man has noted passing darker urine for the past week. On
physical examination there are no abnormal findings. A urinalysis shows 2+
blood, no protein, and no glucose. A urine cytology is performed and there are
atypical uroepithelial cells seen. Aurologist performs a cystoscopy, but no
mucosal lesions are noted. He has a 60 pack year history of smoking cigarettes.
Which of the following is the most likely diagnosis?
A- Adenocarcinoma of prostate
B-Urothelial carcinoma of renal pelvis
C- Acute interstitial nephritis
D- Nodular glomerulosclerosis
) E- Squamous cell carcinoma of penis

2- A 72-year-old man has been feeling tired and lethargic for 5 months. He has
( noted increasing hesitancy with urination. On physical examination his prostate is
diffusely enlarged. Laboratory studies show creatinine 1.9 mg/dL, and glucose 81
mg/dL.
Which of the following renal abnormalities is most likely to be present in this man?
A- Cortical atrophy
B- Glomerulonephritis
C- Papillary necrosis
D- Polycystic changes
E- Renal cell carcinoma

3- A 50-year-old man with diabetes mellitus. He has an increasing serum urea

nitrogen and a urinalysis shows sp gr 1.012, pH 6.5, 1+ protein, no blood, 1+
glucose, negative leukocyte esterase, negative nitrite, and no ketones.
Which of the following renal diseases is he most likely to have?
A- Nodular glomerulosclerosis
B- Hyperplastic arteriolosclerosis
C- Papillary necrosis
D- Crescentic glomerulonephritis
E- Pyelonephritis

Questions 4-9 : Select one answer of the following (0.5 mark for each):
4- The most common features of nephritic syndrome include the folloing except:
A-heavy proteinuria B- Hypertension
C- Oliguria D-Microscopic hematuria
5- The most common form of glomerulonephritis (GN) in adults is:
A-Minimal change disease B- Membranous GN
B-Membranoproliferative GN C- Focal segmental GN
6- Acute post-streptococcal GN is characterized by proteinuria of:
A-Selective B- Non-selective
C-Albuminuria only D-Low molecular weight only

1 Dr. Fayed Al-Yousofy

 Pathology Exam-Urogenital System Pathology Exam-Urogenital System

7- The most common and most severe form of lupus nephritis is: Pathology exam Genitourinary system
A-Mesangeal lupus nephritis B- Focal segmental lupus nephritis
C-Diffuse proliferative GN D- Membranous GN I- Select the most appropriate answer (1 mark for each selection):
8- The following type of renal calculi are infection-induced: 1- A 55-year-old man has developed progressive renal failure for the past 5
A- Calcium oxalate C- Struvite years. Microscopic examination of a renal biopsy shows extensive glomerular
B- Uric acid D- Calcium phosphate and vascular deposition of pink amorphous material on H&E staining. This
9- All are true about prostatic carcinoma except: material demonstrates apple-green birefringence under polarized light after
A- We use Gleason system for staging Congo red staining. Immunohistochemical staining of these deposits is
B- Prostatic specific antigen is important for diagnosis and follow up positive for lambda light chains. Which of the following conditions is most
C- Serum acid phosphatase increased likely to be present in this man?
D- Produce osteosclerotic boney metastasis a. Rheumatoid arthritis d- Tuberculosis
E- Mostly originate from the peripheral part of prostate. b. Alzheimer disease e- Multiple myeloma
c. Systemic lupus erythematosus
Question 10: Enumerate the pathological lesions in the kidney that can be seen in 2- A 9-year-old boy has a sore throat. A throat culture grows group A hemolytic
patient with diabetes mellitus. (3 marks) streptococcus. He receives antibiotic therapy. However, 17 days later he
develops dark-colored urine. Laboratory studies show 3+ blood on urinalysis.
A renal biopsy is performed. On immunofluorescence staining the biopsy
The fate of acute post streptococcal glomerulonephritis is usually shows granular deposition of IgG and complement around glomerular
capillary loops. Which of the following immune hypersensitivity mechanisms
a) Development of chronic glomerulonephritis is most likely responsible for this pattern of findings?
a. Type I c- Type III
b) Development of membranous glomerulonephritis
b. Type II d- Type IV
c) Development of lobular glomerulonephritis 3- A 55-year-old woman has had increasing difficulty with swallowing over the
past year. On physical examination her blood pressure is 210/110 mm Hg.
d) Development of sub acute glomerulonephritis Laboratory testing reveals a positive antinuclear antibody test with a nucleolar
pattern on immunofluorescence. Her serum complement levels are normal.
e) Complete recovery Which of the following lesions is most likely to be seen in her kidneys with
renal biopsy?
a. Renal cell carcinoma d- Nodular glomerulosclerosis
b. Acute glomerulonephritis e- Hyperplastic arteriolosclerosis
c. Polycystic change
II- Select the most appropriate answer (0.5 mark for each):
1- Hematuria is least likely to occur in:
a. Renal cell carcinoma
b. Transitional cell carcinoma of renal pelvis and ureter
c. Acute post infectious glomerulonephritis
d. Urine lithiasis
e. Minimal change glomerulonephritis
2- In polycystic kidney which of the following is false:
a. It is familial disease e. Enlarged kidneys
b. The renal involvement is occasional unilateral
c. The disease is usually asymptomatic until early adult or middle life
d. Renal failure late in the course

2 Dr. Fayed Al-Yousofy 3 Dr. Fayed Al-Yousofy

Pathology Exam-Urogenital System Pathology Exam-Urogenital System

3- Which of the following is not a feature of Kimmelstiel-Wilson disease?

a. Occurs in diabetes e. Nodular glomerulosclerosis
b. Hyalinization of efferent arteriole
c. Thickened basement membrane
d. Subepithelial glomerular deposits
4- The most characteristic feature of rapidly progressive glomerulonephritis is
a. Crescent formation d. Hyaline nodules
b. Sub-epithelial dense deposits e. Wire-loop lesions
c. Thickened capillary loops
5- Nephritic edema differs from nephritic edema in having:
a. Mild edema c. Distributed on face and eyes
b. Heavy proteinuria d. Occurs in acute glomerulonephritis
6- Which of the following conditions does not predispose to urolithiasis?
a. Hydronephrosis c. Chronic pyelonephritis
b. Hypercalcemia d. Hydrocele e. cystitis

III- Write short notes on the following: the answer on the question paper!
7- Classification of testicular tumors and discuss one of them.
8- Genitourinary TB?

4 Dr. Fayed Al-Yousofy 5 Dr. Fayed Al-Yousofy

 Pathology exam GIT course
I- Encircle the single most appropriate answer in each of the
following (0.5 mark for each): 3) Essential features of nephrotic syndrome includes all except
1- Which of the following tumors occurs almost exclusively in parotid gland. Increased Urinary excreti
a. Pleomorphic adenoma c. Warthin's tumor Hypoalbuminemia
b. Adenoid cystic carcinoma d. Myoepithelioma c) Peripheral edema
2- The most common malignancy of appendix is:
d) Decreased serum cholesterol
a. Carcinoid c. Non-Hodgkin's lymphoma
b. Gastrointestinal stromal tumor (GIST) d. Squamous cell carcinoma
3- The most common lymphoma in small intestine is: 1. A 7 year old child presents with hypoalbuminemia, edema, hyperlipidemia, and
a. Non-Hodgkin's lymphoma (MALT oma). c. Burkitt's lymphoma proteinuria. The edema is in the periorbital region initially and eventually spreads to the
rest of the body. The patient is given steroid therapy and the disease goes away. What
b. Hodgkin's lymphoma mixed cellularity d. Adenocarcinoma is a key morphological feature of the patients disease?
4- The most common site of peptic ulcer is: A.Fusion of the foot processes
a. Esophagus b. Stomach c. Duodenum d. Meckel's diverticulum. B.Destruction of the basement membrane
5- All are true about hepatointestinal bilharziasis except: C.Destruction of the glomerulus
D.Hemosiderin laden macrophages in the kidney
a. Bilharizal colonic polyps are common c. It cause periportal fibrosis
E.None of the above
b. Bilharzial polyps are precancerous lesions d. Huge spleen is common.
6- A 57 year old woman with anemia is found to have a decreased Vitamin B12 level.
Antibodies to intrinsic factor are identified. Levels of all other vitamins are within
normal limits. Which of the following is most likely to be associated with this
condition? 2. A patient presents with symptoms of nephrotic syndrome. The disease is immune
complex mediated and is known to create an increase in glomerular basement
a. Duodenal ulcer c. Ulcerative colitis e. Angiodysplasia membrane size. IgG and C3 levels are deposited on subepithelial side of the basement
b. Dietary Vit. B12 de ciency d. Atrophic gastritis membrane. Which of the following would best describe the morphology of the disease?
7- Which of the following is a major predisposing factor for the development of A.Proliferation of new basement membrane between complexes
pseudomembranous colitis? B.spike and Hair-comb pattern
C.infiltration of the area with lymphocytes
a. Young age c. Malnutrition e. Antibiotic use
D.A and B
b. Refined diet d. Obesity E.B only
8- Classic lesion of crohns disease is
a. Skip lesion c. Flask shaped ulcer e. Pseudopolyps
b. Crypt abscess d. Macrophages laden lamina propria 7. Rapidly progressive glomerulonephritis is a group of disorders associated with severe
oliguria and death from renal failure within weeks and is commonly associated with _
II- Discuss the pathology of chronic hepa s (3 marks). formation

Obstructive uropathy will cause dilation of renal pelvises and calyses also known
as

2.Hematuria is least likely to occur in:

A. papillary transitional cell carcinoma of renal pelvis, ureter or bladder

B. renal tubular adenocarcinoma

Dr. Fayed Al-Yousofy

C. acute post-infectious glomerulonephritis

D. urinary lithiasis 19.The majority of patients with acute post-streptococcal glomerulonephritis:

E. minimal change disease A. die from congestive heart failure in a few weeks

B. die from renal failure in a few weeks

4.Red cell casts in the urine would be compatible with:
C. pass through a latent period but eventually develop chronic glomerulonephritis
A. a ureteral calculus
D. progress through subacute phase to chronic glomerulonephritis
B. a transitional cell carcinoma of the renal pelvis
E. recover completely
C. anti-glomerular basement membrane antibody induced renal lesion

D. a foreign body in the urinary bladder

20.Which is not a feature of Kimmelstiel-Wilson disease?

8.Typical features of adult polycystic kidney disease include: A. occurs in diabetes

A. involvement of both kidneys B. nodular glomerulosclerosis

B. autosomal dominant inheritance C. hyalinization of efferent arteriole

C. enlarged kidneys D. subepithelial glomerular deposits

D. cysts in the liver E. thickened basement membrane

E. all of the above

22.Membranous glomerulopathy and post-streptococcal glomerulonephritis are

similar in

that they both:

18.Each of the following is true of acute poststreptococcal glomerulonephritis except:
A. are self-limiting and transient renal diseases
A. becomes rapidly progressive glomerulonephritis in 50% of children
B. are commonly associated with the nephrotic syndrome
B. is a proliferative glomerulonephritis
C. are most commonly seen in children
C. preceded by infective episode
D. have glomerular immune complex deposits
D. shows dome-shaped subepithelial humps
E. occur most frequently following an infectious disease
E. usually affects children
24.A patient with hemoptysis and renal failure has a renal biopsy which reveals 6.Which testicular tumor is most likely to contain a variety of tissue patterns?
crescentic
A. seminoma
proliferative glomerulonephritis. Immunofluorescence reveals linear deposits of IgG
B. interstitial cell tumor
and
C. embryonal carcinoma
C3. The diagnosis is:
D. teratocarcinoma
A. acute post-infectious glomerulonephrities
E. choriocarcinoma
B. membranous nephropathy

C. Goodpasture’s syndrome

D. minimal change disease

7.Production of gonadotropins is most characteristic of:

A. adenocarcinoma of the prostate

B. seminoma of the testis

25.The most characteristic feature of rapidly progressive glomerulonephritis is
C. embryonal carcinoma of the testis
A. crescent formation
D. choriocarcinoma of the testis
B. hyaline nodules
E. teratoma of the testis
C. sub-epithelial dense deposits

D. thickened capillary loops

V
E. wire-loop lesions

12.Painless enlargement of the testis without involvement of the epididymis is most

31.A patient with minimal change disease is least likely to have: characteristic of:
A. hypoproteinemia A. torsion of the testis
B. edema B. germ cell tumor
C. massive albuminuria C. hydrocele
D. hypertension D. spermatocele
E. hyperlipemia E. orchitis

14.The most frequent cause of urinary obstruction in the male is: Respiratory MCQ s Di Flood

A. benign prostatic hypertrophy RESPIRATORY SUSAN TUCKER

B. carcinoma of prostate 1.Which is the most common organism causing community acquired pneumonia?
a) pneumococcus
C. staghorn calculus b) hemophilus influenzi
c) viral
D. hydronephrosis d) gm negatives
e) mycoplasma
E. pyelonephritis
2.which organism causing pneumonia has an increased association with COPD
a) pneumococcus
b) hemophilus influenzi
c) viral
d) gm negatives
e) mycoplasma

3.Which organism causing pneumonia has an increased incidence in IV drug users

and those post-influenza?
a) pneumococcus
b) staph aureus
c) viral
d) gm negatives
e) mycoplasma

4.Which drug/s should be used in adult mild-mod. Community acquired pneumonia?

a) amoxycillin
b) doxycycline
c) rulide
d) any of the above as a single drug
e) amoxycillin and rulide

5.Which drug regimen is suggested for severe community acquired pneumonia

initially?
a) benzyl penicillin and gentamicin and erythromycin
b) benzyl penicillin and gentamicin
c) ceftriaxone and gentamicin
d) gentamicin and erythromycin
e) flucloxacillin and gentamicin

6.Which bug makes up 50% of hospital acquired pneumonia?

a) pneumococcus
b) staph aureus
c) gm ve bacilli
d) legionella
e) chlamydia psittici
7.What is the largest size spontaneous primary pneumothorax that can be managaed d) Cirrhosis
without aspiration or thoracostomy? e) Nephritic syndrome
a) 10%
b) 15% 14.Which is not a possible cause of haemoptysis?
c) 20% a) PE
d) 30% b) Mitral stenosis
e) 35% c) Pneumonia
d) Aortic stenosis
8.In which sort of pneumoathorax is aspiration likely to be most successful? e) Neoplasm
a) traumatic
b) secondary 15.Which statement is false about haemoptysis?
c) primary a) massive haemoptysis is greater than 600ml in 24 hours
d) iatrogenic b) a CXR is normal in about 25 % of cases
e) equally effective in all of the above c) in any four cases, one is likely to be due to nonteuberculous infection, one due
to neoplasia, one due to rarer causes and one idiopathic
9.What if the role of aspiration in traumatic pneumothoraces? d) in massive hemoptysis the pt should be nursed bleeding lung up
a) there is no role e) if possible a double lumen tube should be reserved for post brochoscopy as a
b) first line management in small pneumathoraces only rigid bronchoscope cannot be passed down it
c) it should be tried in all pneumathoraces as long as there is no respiratory
compromise 16.Which drug/intervention is of no proven benefit in management of acute severe
d) it can be repeated twice before thoracostomy tube is considered asthma in adults?
e) none of the above a) steroids
b) magnesium
10.Whatis the recurrence rate of primary spontaneous pneumathoraces? c) steroids
a) 10% d) CPAP
b) 20% e) Aminophylline
c) 30%
d) 40% 17.As a generalization, at what PEFR should someone be admitted?
e) 50% a) PEFR<25% pretreatment and <40% posttreatment
b) PEFR<10% pretreatment and <20% posttreatment
11.Which is not a biochemical feature of transudative pleural effusions? c) PEFR<40% pretreatment and <60% posttreatment
a) protein<30g/l d) PEFR<50% pretreatment and <70% posttreatment
b) pleural protein:serum protein <0.5 e) PEFR is of no value in this decision
c) pleural LDH : seurm LDH < 0.6
d) pleural glucose< serum glucose 18.Which statement is false?
e) none of the above are biochemical features a) Ipratropium is of definite proven benefit in asthma when used with B agonists
b) Ketamine is the intubation agent of choise but in ongoing therapy in acute
12.Which of the list below is not the cause of an exudative pleural effusion? asthma no benefit has yet been proven in the few studies done
a) viral pneumonia c) Oral steroids are as effective as parenteral steroids
b) pancreatitis d) Aminophylline may have a role in acute treatment in children but not in adults
c) TB e) No studies have been done to see whether adrenaine is better than parenteral
d) Malignancy salbutamol
e) Nephrotic syndrome 19.Which is FALSE regarding CPAP in acute asthma?
a) it decreases the work of breathing
b) it causes bronchodilation and decreases airway resistance
c) it improves gas exchange if used alone in severe asthma
13.Which of the list below is not a cause of a transudative pleural effusion? d) it may be an effective alternative to ETT when maximal pharmacotherapy is
a) CCF used
b) PE e) it reduces the cardiovascular impact of changes in pressures caused by asthma
c) SLE/RA

20.Which drug/intervention is rarely used acutely in the acute setting of exacerbation 13)C 14)D 15)D 16)E 17)A 18)A
of COAD?
a) salbutamol
b) CPAP
c) Aminophylline 19)C 20)C 21)D 22)D 23)C
d) Steroids
e) Ipratropium

21.Which statement is incorrect regarding the acute management of exacerbation of 1. Which is true regarding community acquired pneumonia?
COAD? a. Use of high dose penicillin in penicillin resistant Strep pneumoniae is
a) support for the widespread use of steroids is limited rarely successful in treating the pneumonia.
b) support for the use of salbutamol combined with ipratropium is limited b. Mycoplasma pneumoniae is more commonly seen in elderly patients.
c) B agonists are widely used assuming the possiblility of a small reversible c. Leigonella spp pneumonia is usually moderately severe and can cause
component to the airflow obstruction pancreatitis, and myocarditis.
d) Support for the widespread use of CPAP and BiPAP is minimal d. H. influenzae is more commonly seen in young, otherwise well
e) Theophylline is rarely used acutely patients.
e. Klebsiella pneumoniae is an aerobic gram positive bacillus.
22.Regarding pulmonary emboli, which statement is correct?
a) a normal Aa gradient excludes a PE
b) a paO2>80 excludes a PE 2. Which statement regarding pneumonia in INCORRECT?
c) a normal CXR excludes a PE a. In patients with AIDS once the CD4 count reaches 800 they are at high
d) anticoagulation reduces mortality from PE from 30% to 10% risk of PCP.
e) all of the above are correct b. Mild PCP can be treated with oral cotrimoxazole for 21 days.
c. Transplant patients are most at risk of opportunistic infections between
23.With regards to PE which statement is CORRECT? days 30 and 120 post transplant.
a) embolectomy has a better outcome than thrombolysis in massive PE d. Gram ve organism s account for 50% of all hospital acquired
b) streptokinase is more effective with lower side effects than tPA in massive PE pneumonias.
c) LMWH is probably as effective as unfractionated heparin e. Only 40% of patients who aspirate will develop pneumonia.
d) TOE is sensitive for peripheral emboli
e) Spiral CT angiography is better at detecting peripheral clots than central
3. Which is INCORRECT regarding lung abscess?
a. 90% of patients will have evidence of periodontal disease or some
predisposition to aspiration.
b. Staph aureus is the most common cause.
c. Sputum examination is often unhelpful in identifying the organism
involved.
d. Medical management with antibiotics for up to 2 months is the
treatment of choice.
e. Non infectious causes of lung abscess include rheumatoid nodules and
pulmonary infarction.
ANSWERS
1)A 2)B 3)B 4)D 5)A 6)C
4. A patient with pneumonia develops a pleural effusion, which you aspirate.
Which of the following is supportive of an empyema on examining the fluid?
7)C 8)C 9)A 10)E 11)D 12)E a. Pleural protein <30g/l
b. Pleural glucose: plasma glucose > 1.0
c. Pleural LDH : serum LDH ratio < 0.6
d. pH 7.15
e. RBC > 100,000 mm3.
1=C 2=A 3=B 4=D
5. Which of the following is incorrect regarding pneumothorax?
a. 70% of patients with pneumothorax are smokers.
b. Catamenial pneumothorax may occur probably secondary to
endometrial metastases to lungs.
c. Oxygen treatment will increase rate of pleural air resorption 4 times
and should be given to all patients with pneumothorax.
d. A patient with calculated average interpleural distance of 1cm can be
managed conservatively.
e. The recurrence rate of pneumothorax is approx 15% with half of those
occurring in the first year.
6. A 50 year old male presents with haemoptysis of approx 700 mls over 24
hours. Which is true regarding this man?
a. The bleeding is most likely secondary to pulmonary vessels.
b. The preferred position for this patient is with the affected lung up.
c. Placement of an ETT will prevent possible contamination of the good
lung with blood.
d. Placement of a Robertshaw ETT will protect the good lung and allow
passing of a fiberoptic bronchoscope.
e. Bronchial artery embolization has an 80% chance of stopping the
bleeding.
7. Regarding treatment of asthma in adults which is the correct answer.
a. Intravenous hydrocortisone will have faster onset of anti-inflammatory
action than oral prednisolone.
b. Nebulized ipatropium bromide in combination with salbutamol has
been shown to have a better clinical outcome than salbutamol used
alone.
c. It has been shown that IV aminophylline use in severe asthmatics with
optimal beta agonist and corticosteroid therapy will confer benefit.
d. Magnesium has been shown in severe asthma to reduce admission rates
and improve FEV1.
e. Long acting beta agonist have been shown to be beneficial in acute
exacerbations of asthma.
5=E 6=E 7=D 8=E
9. Which is not true of lung transplant patients.
a. Early rejection may present as cough, chest tightness and decline in
FEV1 by greater than10%.
b. Lung transplant patients do not require prophylaxis for endocarditis.
c. Post transplant lymphoproliferative disease is usually fatal is occurring
greater than one year post transplant.
d. Obliterative bronchiolitis is the most common cause of death 2 years
plus after transplant.
e. CMV infection will usually cause neutropenia..
10. What is the overall probability of PE in a patient with a normal V:Q scan ?
a. 0%
b. 4%
c. 8%
d. 10%
e. none of the above.
11. Which is incorrect regarding acute respiratory distress syndrome?
a. Reduced compliance of lungs due to increased collagen and fibroblast
activity is an early stage of ARDS.
b. Severe hypoxaemia despite normal or low PaC02 occurs early.
c. ARDS usually develops 12-72 hrs post triggering event.
d. Mechanical ventilation can sometimes worsen oxygen delivary to
tissues secondary to reduced cardiac output.
e. Inhalational nitric oxide has been used in the treatment but is at present
experimental due to unknown long term effects and clinical relevance
of improvement.
12. which is not a recognized sign on lateral neck xray of adult epiglottitis?
a. Blunted swollen epiglottis
b. Supraglottic haze
c. Prevertebral swelling
d. Swelling aryepiglottic folds
e. All of the above.

8. Which is true of COAD?

a. 100 % of patients with homozygous alpha-1 antitrypsin deficancy
patients will exhibit evidence of emphysema eventually.
b. pink puffers have predominantly chronic bronchitis. 9=B 10=B 11=A 12=E
c. Use of longterm inhaled steroids has been shown to decrease morbidity.
d. Use of CPAP in acute exacerbations will improve gas exchange.
e. All of above are incorrect.

Respiratory MCQs 38A patient has known small cell bronchogenic carcinoma. He has no other medical
history, and is on no medications. He presents with a serum Na of 126 (measured by
1. Which of the following is most correct about respiratory infections in patients ion sensitive electrode), and is clinically euvolaemic. Investigations will also reveal:
with HIV?
a. CMV is a common cause of clinically significant disease f) Normal serum osmolarity
b. CAP pneumonias are more common than PCP in patients with HIV g) Urine osmolarity less than plasma osmolarity
c. PCP occurs when the CD4 count is between 800 and 1000 h) Urinary Na less than 10mmol/L
i) Low serum thyroxine
d. Mortality from bacterial pneumonia is higher in patients with HIV than j) None of the above
in patients who are HIV-negative
e. Pulmonary aspergillosis is not a life threatening illness.
2. With regard to aspiration pneumonia, which of the following is incorrect? 43An adult with severe asthma has been intubated. Mechanical ventilation should:
a. The right lower lobe is the commonest area for aspiration in the erect
position k) Deliver high minute volumes
b. pH less than 2.0 is associated with a higher mortality l) Be set at a high inspiratory flow rate
c. Many of the symptoms of aspiration are due to the body s m) Be adjusted to maintain a normal PaCO2
inflammatory response to the infectious or irritative material. n) Employ a high PEEP
o) Have a short expiratory time (TE)
d. Streptococcus species are the commonest infecting organism
e. All patients who aspirate should be commenced on broad spectrum
antibiotics.
3. In patients with Tuberculosis, which of the following is incorrect? 20 Regarding COPD which is correct
a. Aerosolised saliva and sputum are the commonest modes of
transmission. A >50% is caused by smoking
b. Interferon 8 levels increase in patients who are responding to treatment. B. 10% is caused by alpha-1- antitrypsin deficiency
c. Pulmonary TB is an AIDS-defining illness. C. may be related to childhood respiratory illnesses
d. Extra-pulmonary manifestations are unlikely in HIV patients.
e. Initial therapy is with isoniazid, rifampicin, ethambutol and
pyrazinamide for 2 months. 23. Massive haemoptysis is an occasional complication of
a) aortic stenosis
4. In spontaneous pneumothorax, which is incorrect? b) aortic incompetence
a. 95% will have pleuritic chest pain on the side of the pneumothorax c) mitral stenosis
b. Only 5% with be tachypnoeic or tachycardic d) mitral incompetence
c. Spontaneous pneumothoraces of 35% deflation can be managed e) right sided valve lesions
conservatively
d. CT scan is the current gold standard for measuring deflation c [rosen ch.78, tintin p379] from rupture of pulmonary bronchial venous connection
e. Spontaneous pneumothorax in HIV patients suggests PCP infection
and carries a high mortality 24. Clubbing is commonly associated with all but which of the following?
a) bronchiectasis
b) asbestosis
1B 2E 3D 4C c) COAD
d) congenital heart dis
e) idiopathic pulmonary fibrosis

23Which of the following is LEAST likely to cause upper lobe pulmonary fibrosis?

a) Tuberculosis c [dunn p 803, T+O C p34] other common causes: IE, lung abscess, ca lung
b) Asbestosis
c) Sarcoidosis
25. Pleural exudates are characterised by
d) Silicosis a) protein > 50% serum
e) Ankylosing Spondylitis b) LDH > 60% serum
c) cholesterol > 30% serum
d) pleural fluid cholesterol >1.5 mmol/L
e) all of the above
 a) insufficient muscle paralysis
e [dunn p806] Light s criteria b) increased tidal volume
26. Regarding lung volumes which is true c) bronchospasm
a) Total Lung Capacity = Vital Capacity + Tidal Volume d) pneumothorax
b) Inspiratory Reserve = TV + Residual Volume e) increased I:E ratio
c) Tidal Volume = 1L in 70kg male
d) Vital Capacity = 5L in 70 kg male
E
e) none of the above

9Severe Asthma is indicated by all of the following except

d [dunn p769] a. Pt talking in words
b. Silent chest
27. Common causes of lower lobe pulmonary fibrosis include
a) bronchiectasis c. PCO2 44mmHg
b) silicosis d. PO2 89mmHg
c) coalminer s lung e. Pulsus paradoxus
d) allergic alveolitis
e) TB
47All of the following may have a role in the acute management of severe asthma
EXCEPT
A. magnesium
the rest are upper lobe + aspergillosis, sarcoid, ank spon B. salmeterol
C. halothane
D. helium
38. Which of the following indicates severe asthma?
E. ketamine.
a) Pulsus paradoxus < 20 mmHg
b) Pulsus paradoxus < 10 mmHg
c) Pulsus paradoxus > 20 mmHg 50Symptoms heralding respiratory arrest during an asthma exacerbation
d) Pulsus paradoxus > 10 mmHg include all of the following EXCEPT
e) Pulsus paradoxus < 30 mmHg F. lethargy
G. severe respiratory alkalosis and the use of accessory muscles of
respiration
Pulsus paradoxus is an accentuation of the decrease in systolic blood pressure that normally H. a normal pCO2 on arterial blood gas
occurs during inspiration. A drop in blood pressure of greater than 20 mm Hg (i.e., pulsus
I. a silent chest on auscultation
paradoxus > 20 mm Hg) indicates excessive negative intrathoracic pressure and correlates
with severe asthma. In this situation, left ventricular after load and venous return to the right J. agitation.
heart are increased, thereby causing a transient reduction in cardiac output and systolic blood
pressure.
51Complications of Mycoplasma pneumonia infection include all of the
following EXCEPT
58. What is the best position in which to place patient with massive haemoptysis? K. Guillain-Barré syndrome
a) Affected side up L. aseptic meningitis and encephalitis
b) Affected side down M. haemolytic anaemia
c) Trendelenburg N. pericarditis and myocarditis
d) Reverse Trendelenburg O. septic arthritis
e) None of the above
Tint chap 63 52Which of the following is the BEST view to request when assessing for the
presence of pneumothorax on chest x-ray?
B P. Supine anteroposterior
Q. Upright posteroanterior (PA)
60. The following can cause a rise in peak inspiratory pressure (PIP) in a mechanically
ventilated patient EXCEPT: R. Inspiratory PA

S. Lateral decubitus with the patient lying on the unaffected side

C
T. Expiratory PA
9. All of the following drugs can be used in rapid sequence induction
EXCEPT:
10. Bronchiolitis a) atropine
a) CRX: hyperinflation
b) Bronchodilators are controversial
b) fentanyl
c) WBC usually normal c) isoflurane
d) Steroids contraindicated d) atracurium
e) ketamine
CXR: hyperinflation without infiltrates, peribronchial cuffing, atelectasis
Steroids possible beneficial for mild to moderate, definitely not contra-indicated
Adrenaline most effective therapy C
Bronchodilators may help, are controversial
WCC doesn t help assessment 47. In asthma:

1. A 43 year old man is receiving positive pressure ventilation on a a) the white blood cell count will often be elevated
respirator following a road traffic crash. His ABG shows a pH b) the ECG may show signs of acute left heart strain
7.54, PC02 28mmHg, P02 87mmHg, Bic 16 mmol/L. c) a CXR should be routine in all patients admitted
d) blood gas results correlate well with pulmonary function testing
This blood gas shows: e) theophylline dosing needs to be increased if erythromycin is given
a) pure respiratory alkalosis
b) respiratory alkalosis and hypoxaemia
c) respiratory alkalosis and metabolic acidosis A
d) mixed respiratory and metabolic alkalosis
49. Regarding pleural effusion all of the following are true
e) metabolic alkalosis with partial respiratory compensation
EXCEPT:
C
a) can be tapped to make a diagnosis of pancreatitis
6. Uncuffed endotracheal tubes should be used for:
b) can be detected radiographically when 10 ml of fluid is present
c) is most commonly caused by congestive cardiac failure
a) tube sizes less than 6mm
d) can result from rheumatoid arthritis
b) acute epiglottis
e) will not produce mediastinal shift
c) blind nasotracheal intubation
d) intubations with a Macintosh blade
E
e) known fractured base of skull
50. Sore throat is caused by all of the following
A
7. Cricoid pressure was first described by: a) neisseria gonorrheae
b) mycoplasma pneumoniae
a) Mendelson c) bacteroides fragilis
b) Danzi d) cytomegalovirus
c) Sellick e) corynebacterium diptheriae
d)Tintinalli
e)Meller
 Pathology exam Dr. Fayed Al-Yousofy

C Pathology exam GIT course

51. Regarding empiric antibiotic therapy in pneumonia: I- Encircle the single most appropriate answer in each of the
following (0.5 mark for each):
a) cetazidime is used for atypical pneumonia 1- Duke's staging system is used for :
b) clindamycin is used for aspiration pneumonia a. Cancer stomach c. Cancer tongue
c) acyclovir is used for post influenza pneumonia
b. Cancer colon d. Cancer esophagus
d) erythromycin is used for PCP pneumonia 2- Multiple gut ulcerations is associated with which of the following disorders:
e) amoxycillin alone is used for neonates with pneumonia
a. Peutz Jegher's c. Plummer-Vinson syndrome
syndrome d. Zollinger Ellison syndrome
86. The patient with normal lungs and pulmonary gas exchange b. Turcott's syndrome
breathing 40% oxygen at sea level and breathing normally could be 3- All are true about celiac disease except:
expected to achieve an arterial oxygen tension of about: a. Entropathic associated d. The duodenal villi are flat
lymphoma is a complication on histology
a) 180 mm Hg b. Gluten hypersensitivity e. It is a chronic
b) 210 mm Hg c. The patient is presented by granulomatous disease.
c) 235 mm Hg malabsorption
d) 260 mm Hg 4- The type of carcinoma associated with Barrett's esophagus is:
e) 290 mm Hg a. Adenocarcinoma d. Epidermoid carcinoma
b. Squamous cell e. Mucoepidermoid
11) Regarding aspiration pneumonitis which is true carcinoma carcinoma
a. Should be treated with high dose IV steroids c. Malignant lymphoma f. Small cell carcinoma
b. Commonest organisms involved in community acquired are anaerobes and 5- The development of peptic ulceration associated with all of the following except:
GNB c. Caffeine c. H. pylori
c.
d. d. Mallory-Weiss syndrome a. Zollinger Ellison syndrome
e. e. Alcohol b. Asprin
6- Which of the following have malignant potential for colon cancer:
a. Should be treated with high dose steroids. Can t find evidence for this a. Leiomyoma c. Hamartomatous polyp
b. *Commonest organisms are GNB and anaerobes. Staph aureus also common
in mouth but more so in aspirated saliva than vomit b. Adenomatous polyp d. Juvenile (retention) polyp
7- In which of the following disorders there is an increased risk for cancer colon:
55) Which of the following is true of COPD c. Chronic ulcerative colitis a. Granulomatous disease of
a. Associated with decreased compliance d. Chronic diverticulitis colon
b. Associated with low output cardiac failure
e. Peutz Jegher's syndrome b. Peri rectal abscess and
c. Associated with reduced FVC but normal FEV1
d. fistula.
e. 8- Segmoidoscopy will reveal what typical findings in patient with Crohn's disease:
a. Sheets of white blood cells with inflammaed mucosa c. Fungating mass
55) Which of the following is true of COPD
a. Associated with decreased compliance false….increased compliance b. Mucosal ulcers and fissures adjacent to normal- d. Psedopolyps
b. *Associated with low output CCF. Pulmonary HPT with RV hypertrophy and
appearing mucosa.
then dilation with cor pulmonale (LVF) and low LV output
c. Associated with decreased FVC but normal FEV1. both reduced FEV1 > FVC II- Very short assay about the fate of acute viral hepatitis C?

Pathology exam Dr. Fayed Al-Yousofy

Pathology exam GIT course Pathology exam GIT course

I- Encircle the single most appropriate answer in each of the I- Encircle the single most appropriate answer in each of the
following (0.5 mark for each): following (0.5 mark for each):
1- Duke's staging system is used for : 1- Esophageal webs have the following features except:
a. Cancer stomach c. Cancer tongue a. They are located at the lower esophagus
b. Cancer colon d. Cancer esophagus b. They are associated with dysphagia
2- Multiple gut ulcerations is associated with which of the following disorders: c. They are associated with chronic atrophic glossitis
a. Peutz Jegher's c. Plummer-Vinson syndrome d. They are associated with iron deficiency anemia
syndrome d. Zollinger Ellison syndrome 2- Barrett's esophagus is:
a. Congenital anomaly
b. Turcott's syndrome
b. Inflammatory disease
3- All are true about celiac disease except:
c. Metaplastic process
a. Entropathic associated d. The duodenal villi are flat
d. Neoplastic lesion
lymphoma is a complication on histology 3- Barrett's esophagus predisposes to development of:
b. Gluten hypersensitivity e. It is a chronic a. Reflux esophagitis
c. The patient is presented by granulomatous disease. b. Esophageal varices
malabsorption c. Squamous cell carcinoma
4- The type of carcinoma associated with Barrett's esophagus is: d. Adenocarcinoma
a. Adenocarcinoma d. Epidermoid carcinoma 4- The following features characterized ulcerative colitis except:
b. Squamous cell e. Mucoepidermoid a. Formation of crypt abscess and cryptitis
carcinoma carcinoma b. Superficial mucosal ulceration
c. Malignant lymphoma f. Small cell carcinoma c. Depletion of goblet cells
5- The development of peptic ulceration associated with all of the following except: d. Stricture formation in chronic cases.
c. Caffeine c. H. pylori 5- Typhoid ulcers in bowel have the following features except:
a. They begin in Peyer's patches
d. Mallory-Weiss syndrome a. Zollinger Ellison syndrome
b. The are transverse to the long axis
e. Alcohol b. Asprin
c. Usually occurs in the 3rd or 4th week.
6- Which of the following have malignant potential for colon cancer:
d. Often cause intestinal perforation
a. Leiomyoma c. Hamartomatous polyp 6- The following type of colorectal polyps has highest malignant transformation:
b. Adenomatous polyp d. Juvenile (retention) polyp a. Hyperplastic polyp
7- In which of the following disorders there is an increased risk for cancer colon: b. Adenomatous plyp
c. Chronic ulcerative colitis a. Granulomatous disease of c. Villous adenoma
d. Chronic diverticulitis colon d. Tubulovillous adenoma
e. Peutz Jegher's syndrome b. Peri rectal abscess and II- Discuss the pathology of colonic carcinoma.
fistula. III- Discuss Barrett's esophagus.
8- Segmoidoscopy will reveal what typical findings in patient with Crohn's disease:
a. Sheets of white blood cells with inflammaed mucosa c. Fungating mass

b. Mucosal ulcers and fissures adjacent to normal- d. Psedopolyps

appearing mucosa.
II- Very short assay about the fate of acute viral hepatitis C?

Dr. Fayed Al-Yousofy

Pathology exam Dr. Fayed Al-Yousofy Pathology exam Dr. Fayed Al-Yousofy

10- Barrett's esophagus predisposes to development of:

a. Reflux esophagitis
b. Esophageal varices
Pathology exam GIT course
c. Squamous cell carcinoma
d. Adenocarcinoma
I- Encircle the single most appropriate answer in each of the
11- The following features characterized ulcerative colitis except:
following (0.5 mark for each): a. Formation of crypt abscess and cryptitis
1- The most common malignancy of appendix is: b. Superficial mucosal ulceration
a. Carcinoid c. Non-Hodgkin's lymphoma c. Depletion of goblet cells
b. Gastrointestinal stromal tumor (GIST) d. Squamous cell carcinoma d. Stricture formation in chronic cases.
2- The most common lymphoma in small intestine is: 12- Tuberculous ulcers in bowel have the following features except:
a. Non-Hodgkin's lymphoma (MALT oma). c. Burkitt's lymphoma a. They begin in Peyer's patches
b. Hodgkin's lymphoma mixed cellularity d. Adenocarcinoma b. The are transverse to the long axis
3- The most common site of peptic ulcer is: c. Advanced cases may cause intestinal obstruction
a. Esophagus b. Stomach c. Duodenum d. Meckel's diverticulum. d. Often cause intestinal perforation
4- All are true about hepatointestinalbilharziasis except: 13- The following type of colorectal polyps has highest malignant transformation:
a. Bilharizal colonic polyps are common c. It cause periportal fibrosis a. Hyperplastic polyp
b. Bilharzial polyps are precancerous lesions d. Huge spleen is common. b. Adenomatous plyp
5- A 57 year old woman with anemia is found to have a decreased Vitamin B12 level. c. Villous adenoma
Antibodies to intrinsic factor are identified. Levels of all other vitamins are within d. Tubulovillous adenoma
normal limits. Which of the following is most likely to be associated with this
IV- Discuss the pathology of peptic ulcer?
condition?
a. Duodenal ulcer c. Ulcerative colitis e. Angiodysplasia V- Inumerate the pathological lesions of hepatointestinalbilharziasis?
b. Dietary Vit. B12 de ciency d. Atrophic gastritis
6- Which of the following is a major predisposing factor for the development of
pseudomembranous colitis?
a. Young age c. Malnutrition e. Antibiotic use
b. Refined diet d. Obesity
7- Classic lesion of crohns disease is
a. Skip lesion c. Flask shaped ulcer e. Pseudopolyps
b. Crypt abscess d. Macrophages laden lamina propria
II- Discuss the pathology of chronic hepa s (3 marks).
III- Encircle the single most appropriate answer in each of the
following (0.5 mark for each):
8- Esophageal webs have the following features except:
a. They are located at the lower esophagus
b. They are associated with dysphagia
c. They are associated with chronic atrophic glossitis
d. They are associated with iron deficiency anemia
9- Barrett's esophagus is:
a. Congenital anomaly Pathology exam GIT course
b. Inflammatory disease
c. Metaplastic process VI- Encircle the single most appropriate answer in each of the
d. Neoplastic lesion following (0.5 mark for each):

Pathology exam Dr. Fayed Al-Yousofy Pathology exam Dr. Fayed Al-Yousofy

1- Duke's staging system is used for : b. They are associated with dysphagia
a. Cancer stomach c. Cancer tongue c. They are associated with chronic atrophic glossitis
b. Cancer colon d. Cancer esophagus d. They are associated with iron deficiency anemia
2- Multiple gut ulcerations is associated with which of the following disorders: 15- Barrett's esophagus is:
a. PeutzJegher's c. Plummer-Vinson syndrome a. Congenital anomaly
syndrome d. Zollinger Ellison syndrome b. Inflammatory disease
c. Metaplastic process
b. Turcott's syndrome
d. Neoplastic lesion
3- All are true about celiac disease except:
16- Barrett's esophagus predisposes to development of:
a. Entropathic associated d. The duodenal villi are flat
a. Reflux esophagitis
lymphoma is a complication on histology b. Esophageal varices
b. Gluten hypersensitivity e. It is a chronic c. Squamous cell carcinoma
c. The patient is presented by granulomatous disease. d. Adenocarcinoma
malabsorption 17- The following features characterized ulcerative colitis except:
4- The type of carcinoma associated with Barrett's esophagus is: a. Formation of crypt abscess and cryptitis
a. Adenocarcinoma d. Epidermoid carcinoma b. Superficial mucosal ulceration
b. Squamous cell e. Mucoepidermoid c. Depletion of goblet cells
carcinoma carcinoma d. Stricture formation in chronic cases.
c. Malignant lymphoma f. Small cell carcinoma 18- Typhoid ulcers in bowel have the following features except:
5- The development of peptic ulceration associated with all of the following except: a. They begin in Peyer's patches
c. Caffeine c. H. pylori b. The are transverse to the long axis
c. Usually occurs in the 3rd or 4th week.
d. Mallory-Weiss syndrome a. Zollinger Ellison syndrome
d. Often cause intestinal perforation
e. Alcohol b. Asprin
19- The following type of colorectal polyps has highest malignant transformation:
6- Which of the following have malignant potential for colon cancer:
a. Hyperplastic polyp
a. Leiomyoma c. Hamartomatous polyp b. Adenomatous plyp
b. Adenomatous polyp d. Juvenile (retention) polyp c. Villous adenoma
7- In which of the following disorders there is an increased risk for cancer colon: d. Tubulovillous adenoma
c. Chronic ulcerative colitis a. Granulomatous disease of
IX- Discuss the pathology of colonic carcinoma.
d. Chronic diverticulitis colon
X- Discuss Barrett's esophagus.
e. PeutzJegher's syndrome b. Peri rectal abscess and
fistula.
8- Segmoidoscopy will reveal what typical findings in patient with Crohn's disease:
a. Sheets of white blood cells with inflammaed mucosa c. Fungating mass

b. Mucosal ulcers and fissures adjacent to normal- d. Psedopolyps

appearing mucosa.
VII- Very short assay about the fate of acute viral hepatitis C?

VIII- Encircle the single most appropriate answer in each of the

following (0.5 mark for each):
14- Esophageal webs have the following features except: Pathology exam GIT course
a. They are located at the lower esophagus
 Pathology exam Dr. Fayed Al-Yousofy Pathology exam Dr. Fayed Al-Yousofy

XI- Encircle the single most appropriate answer in each of the Pathology exam GIT course
following (0.5 mark for each):
20- Esophageal webs have the following features except: I- Encircle the single most appropriate answer in each of the
a. They are located at the lower esophagus following (0.5 mark for each):
b. They are associated with dysphagia 1- Duke's staging system is used for :
c. They are associated with chronic atrophic glossitis a. Cancer stomach c. Cancer tongue
d. They are associated with iron deficiency anemia b. Cancer colon d. Cancer esophagus
21- Barrett's esophagus is: 2- Multiple gut ulcerations is associated with which of the following disorders:
a. Congenital anomaly a. Peutz Jegher's c. Plummer-Vinson syndrome
b. Inflammatory disease
syndrome d. Zollinger Ellison syndrome
c. Metaplastic process
b. Turcott's syndrome
d. Neoplastic lesion
3- All are true about celiac disease except:
22- Barrett's esophagus predisposes to development of:
a. Reflux esophagitis
a. Entropathic associated d. The duodenal villi are flat
b. Esophageal varices lymphoma is a complication on histology
c. Squamous cell carcinoma b. Gluten hypersensitivity e. It is a chronic
d. Adenocarcinoma c. The patient is presented by granulomatous disease.
23- The following features characterized ulcerative colitis except: malabsorption
a. Formation of crypt abscess and cryptitis 4- The type of carcinoma associated with Barrett's esophagus is:
b. Superficial mucosal ulceration a. Adenocarcinoma d. Epidermoid carcinoma
c. Depletion of goblet cells b. Squamous cell e. Mucoepidermoid
d. Stricture formation in chronic cases. carcinoma carcinoma
24- Tuberculous ulcers in bowel have the following features except: c. Malignant lymphoma f. Small cell carcinoma
a. They begin in Peyer's patches
5- The development of peptic ulceration associated with all of the following except:
b. The are transverse to the long axis
c. Caffeine c. H. pylori
c. Advanced cases may cause intestinal obstruction
d. Mallory-Weiss syndrome a. Zollinger Ellison syndrome
d. Often cause intestinal perforation
25- The following type of colorectal polyps has highest malignant transformation:
e. Alcohol b. Asprin
a. Hyperplastic polyp 6- Which of the following have malignant potential for colon cancer:
b. Adenomatous plyp a. Leiomyoma c. Hamartomatous polyp
c. Villous adenoma b. Adenomatous polyp d. Juvenile (retention) polyp
d. Tubulovillous adenoma 7- In which of the following disorders there is an increased risk for cancer colon:
XII- Discuss the pathology of peptic ulcer? c. Chronic ulcerative colitis a. Granulomatous disease of
d. Chronic diverticulitis colon
XIII- Inumerate the pathological lesions of
e. Peutz Jegher's syndrome b. Peri rectal abscess and
hepatointestinalbilharziasis? fistula.
8- Segmoidoscopy will reveal what typical findings in patient with Crohn's disease:
a. Sheets of white blood cells with inflammaed mucosa c. Fungating mass

b. Mucosal ulcers and fissures adjacent to normal- d. Psedopolyps

appearing mucosa.
II- Very short assay about the fate of acute viral hepatitis C?

1 2

Pathology exam Genitourinary system a. Occurs in diabetes e. Nodular glomerulosclerosis

b. Hyalinization of efferent arteriole
I- Select the most appropriate answer (1 mark for each selection): c. Thickened basement membrane
1- A 55-year-old man has developed progressive renal failure for the past 5 d. Subepithelial glomerular deposits
years. Microscopic examination of a renal biopsy shows extensive glomerular 4- The most characteristic feature of rapidly progressive glomerulonephritis is
and vascular deposition of pink amorphous material on H&E staining. This a. Crescent formation d. Hyaline nodules
material demonstrates apple-green birefringence under polarized light after b. Sub-epithelial dense deposits e. Wire-loop lesions
Congo red staining. Immunohistochemical staining of these deposits is c. Thickened capillary loops
positive for lambda light chains. Which of the following conditions is most 5- Nephritic edema differs from nephritic edema in having:
likely to be present in this man? a. Mild edema c. Distributed on face and eyes
a. Rheumatoid arthritis d- Tuberculosis b. Heavy proteinuria d. Occurs in acute glomerulonephritis
b. Alzheimer disease e- Multiple myeloma 6- Which of the following conditions does not predispose to urolithiasis?
c. Systemic lupus erythematosus a. Hydronephrosis c. Chronic pyelonephritis
2- A 9-year-old boy has a sore throat. A throat culture grows group A hemolytic b. Hypercalcemia d. Hydrocele e. cystitis
streptococcus. He receives antibiotic therapy. However, 17 days later he
develops dark-colored urine. Laboratory studies show 3+ blood on urinalysis.
A renal biopsy is performed. On immunofluorescence staining the biopsy III- Write short notes on the following: the answer on the question paper!
shows granular deposition of IgG and complement around glomerular 7- Classification of testicular tumors and discuss one of them.
capillary loops. Which of the following immune hypersensitivity mechanisms 8- Genitourinary TB?
is most likely responsible for this pattern of findings?
a. Type I c- Type III
b. Type II d- Type IV
3- A 55-year-old woman has had increasing difficulty with swallowing over the
past year. On physical examination her blood pressure is 210/110 mm Hg.
Laboratory testing reveals a positive antinuclear antibody test with a nucleolar
pattern on immunofluorescence. Her serum complement levels are normal.
Which of the following lesions is most likely to be seen in her kidneys with
renal biopsy?
a. Renal cell carcinoma d- Nodular glomerulosclerosis
b. Acute glomerulonephritis e- Hyperplastic arteriolosclerosis
c. Polycystic change
II- Select the most appropriate answer (0.5 mark for each):
1- Hematuria is least likely to occur in:
a. Renal cell carcinoma
b. Transitional cell carcinoma of renal pelvis and ureter
c. Acute post infectious glomerulonephritis
d. Urine lithiasis
e. Minimal change glomerulonephritis
2- In polycystic kidney which of the following is false:
a. It is familial disease e. Enlarged kidneys
b. The renal involvement is occasional unilateral
c. The disease is usually asymptomatic until early adult or middle life
d. Renal failure late in the course
3- Which of the following is not a feature of Kimmelstiel-Wilson disease?

Dr. Fayed Al-Yousofy Dr. Fayed Al-Yousofy