Male genital tract

1) Which of the following features is not consistent with the diagnosis of a classic Seminole?
A. Middle aged man (F)
B. Presence of lung metastases (F)
C. Enlargement of para-aortic nodes (F)
D. Elevations in HCG and AFP levels (T)
E. No history of cryptorchidism (F)

2) A 65 year old male with recurrent urinary tract infections including acute cystitis and
pyelonephritis would be likely to have
A. Gonorrhoeae (F)
B. Prostatic nodular hyperplasia (T)
C. Phimosis (F)
D. Epispadias (F)
E. Adenocarcinoma of the prostate (F)

3) An elevated serum AFP level in a 32 year old male with an enlarged testis most strongly
suggests the presence of which of the following cellular components in the mass?
A. Yolk sac cells (T)
B. Leydig cells (F)
C. Seminoma cells (F)
D. Cytotrophoblasts (F)
E. Embryonal carcinoma cells (F)

4) Carcinoma of penis
A. Is associated with HPV type 16, 18 (T)
B. May be associated with cigarettes smoking (T)
C. Usually reveals Adenocarcinoma (F)
D. Is a rapid growing tumour (F)
E. Widespread metastasis is extremely uncommon (T)

5) The most frequent organisms for nonspecific epididymitis under age 35 year include
A. Chlamydia trachomatis (T)
B. Neisseria gonorrhoeae (T)
C. E coli (F)
D. Pseudomonas (F)
E. None of these (F)

6) Germ cell tumours of testis include

A. Spermatocytic seminoma (T)
B. Embryonal carcinoma (T)
C. Granulosa cell tumours (F)
D. Choriocarcinoma (T)
E. Leydig cell tumour (F)

7) Seminoma (All T)
A. Is the most common type GCT
 B. Almost never occurs in infants
C. Peaks in the thirties
D. Is nearly identical to dysgerminoma in ovary
E. May produce bulky masses

8) Classic seminoma
A. Shows lobulated cut surface (T)
B. Is usually associated with haemorrhage and necrosis (F)
C. Reveals seminoma cells which contain glycogen (T)
D. Contains cells which are AFP positive immunohistochemically (T)
E. Shows infiltration with T lymphocytes and prominent granulomas (T)

9) Embryonal carcinoma
A. Is common in 20-30 year age group (T)
B. Is less aggressive than seminoma (F)
C. Show foci of haemorrhage and necrosis on cut section (T)
D. Shows cells containing HCG or AFP (T)
E. Shows rare mitoses histologically (F)

10) The most common testicular tumour in infant is

A. Embryonal carcinoma (F)
B. Choriocarcinoma (F)
C. Yolk sac tumour (T)
D. Seminoma (F)
E. Teratoma (F)

11) Regarding yolk sac tumours

A. They usually occur in combination with embryonal carcinoma in adults (T)
B. They show primitive glomeruli-like structures histologically (T)
C. The cells show AFP with IHC staining (T)
D. They show negative staining for alpha antitrypsin (F)
E. They have a bad prognosis up to 3 years of age (F)

12) Biologic markers for germ cell tumours of the testis include (All T)
A. HCG
B. AFP
C. Placental alkaline phosphatase
D. Placental lactogen
E. Lactate dehydrogenase

13) The first to be involved for lymphatic spread of testicular tumours are
A. Para-aortic nodes (T)
B. Mediastinal nodes (T)
C. Supraclavicular nodes (F)
D. Superficial inguinal nodes (F)
E. Deep inguinal nodes (F)

14) The following matching/s is/are true

 A. Yolk sac tumour 》AFP (T)
B. Choriocarcinoma 》HCG (T)
C. Seminoma 》haematogenous spread
initially (F)

D. Non seminomatous 》late metastasis

germ cell tumour (F)

E. Seminoma 》extremely radio resistant (F)

15) Benign prostatic hyperplasia

A. Develops with ageing (T)
B. Is characterised by hyperplasia of epithelial cells alone (F)
C. Is associated with reduced estradiol levels (F)
D. Is usually seen after castration (F)
E. Is associated with the synthesis of dihydrotestosterone in the stromal cells (T)

16) Nodular hyperplasia of prostate

A. Usually originate in the transitional and periurethral zones (T)
B. Usually involves the posterior lobe (F)
C. Reveals hyperplastic glands with inner cuboidal and outer columnar epithelial lining
(F)
D. May reveal foci of metaplasia (T)
E. May reveal small areas of infarction (T)

17) Complications of BPH (All T)

A. Cystitis
B. Bladder stone
C. Pyelonephritis
D. Hydronephrosis
E. Uraemia

18) Regarding carcinoma of the prostate

A. Approximately 90%of cases do not cause trouble in the lifetime of the host (T)
B. Most cases are diagnosed before 50 years of age (F)
C. It is common in Asians (F)
D. It usually arises in the periurethral zone of the gland (F)
E. Blood spread chiefly involves the bones (T)

19) Histological features of carcinoma of prostate

A. Most lesions are Adenocarcinoma (T)
B. Pleomorphism is marked (F)
C. Mitoses are common (F)
D. There may be clear evidence of invasion of the capsule (T)
E. The malignant acidic are smaller and closed spaced in contrast to nodular
hyperplasia and are lined by a single layer of cells (T)
20) Regarding carcinoma of the bladder
A. Females are more affected than males (F)
B. It is most commonly associated with smoking in males (T)
C. 70% of adenocarcinoma are associated with Schistosomiasis (F)
D. Long term use of cyclophosphamide can prevent neoplastic change (F)
E. It may appear 15-40 yrs after first exposure to naphthylamine (T)

21) Direct spread from carcinoma of bladder may involve (All T)

A. Prostate
B. Seminal vesicles
C. Vagina
D. Rectum
E. Ureters

22) Clinical course of carcinoma of bladder reveals (All T)

A. Painless hematuria
B. Frequency
C. Urgency
D. Dysuria
E. Pyelonephritis and hydronephrosis

Gastrointestinal system

24) Glossitis may be associated with

A. B12 deficiency (T)
B. Pyridoxine deficiency (T)
C. Iron deficiency (T)
D. Plummer-Vinson syndrome (T)
E. သ H pylori infection (F)

25) The commonest benign tumour of salivary gland is

A. Warthin tumour (F)
B. Pleomorphic adenoma (T)
C. Duct papilloma(F)
D. Haemangioma(F)
E. Fibroma(F)

26) Esophageal varices are associated with

A. Cirrhosis of liver (T)
B. Portal vein thrombosis (T)
C. Hepatic vein thrombosis (T)
D. Amyloidosis (T)
E. superior mesenteric vein thrombosis (F)

27) Regarding Mallory Weiss syndrome

A. There are transverse tears in oesophagus (F)
B. It is seen only in alcoholics(F)
 C. There is normal reflex relaxation (F)
D. It may be associated with bleeding (T)
E. It is not associated with vomiting (F)

28) Causes of esophagitis include (All T)

A. Smoking
B. Herpes infection
C. Uraemia
D. Hypothyroidism
E. GVHD

29) Barrett oesophagus

A. Is a complication of gastroesophageal reflux (T)
B. Is associated with squamous metaplasia (F)
C. May be a gastric type epithelium (T)
D. May have intestinal type epithelium (T)
E. Complicates in bleeding, stricture and increased incidence of squamous cell
carcinoma (F)

30) The aetiology of squamous cell carcinoma of the oesophagus includes

A. Achalasia (T)
B. Deficiency of riboflavin (T)
C. Low dietary content of nitrosamines(F)
D. Human papillomavirus DNA (T)
E. Fusel oils in alcohol drink (T)

31) Regarding SCC of oesophagus

A. It is most common in lower ⅓ of oesophagus (F)
B. The commonest type is protruded (polypoid) exophytic lesion (T)
C. Aspiration of food may be the first alarming symptom (T)
D. Haemorrhage and sepsis are common in ulcerative lesions (T)
E. It is usually associated with Barrett oesophagus (F)

32) Causes of dysphagia include

A. Dilated left atrium (T)
B. Aortic aneurysms (T)
C. Mucosal rings (T)
D. Achalasia (T)
E. None of these (F)

33) Acute gastritis may be associated with (All T)

A. Alcoholism
B. Uremia
C. Salmonella infection
D. Stress
E. Shock

34) Autoimmune gastritis is associated with

 A. B12 deficiency anaemia (T)
B. Hashimoto's thyroiditis (T)
C. Hypogastrinemia(F)
D. Reduced incidence of gastric carcinoma (F)
E. Increased in parietal cell mass(F)

35) H pylori
A. Has a strong causal association with peptic ulcer (T)
B. Is curvilinear gram-negative rod (T)
C. Is found in superficial mucous layer in areas of intestinal metaplasia (F)
D. Is seen in areas of pyloric metaplasia in duodenum (T)
E. Invades the mucosa (F)

36) H pylori secretes

A. Urease (T)
B. Protease (T)
C. Phospholipases (T)
D. Myeloperoxidase (F)
E. Hypochlorous acid (F)

37) The most frequent site of peptic ulcer is

A. First part of duodenum (T)
B. Pyloric antrum (F)
C. Barrett mucosa (F)
D. Within Meckel’s diverticulum (F)
E. In the margin of gastroenterostomy (F)

38) Pathogenesis of peptic ulcer is enhanced by

A. Zollinger-Ellison syndrome (T)
B. Cigarette smoking (T)
C. Steroid (T)
D. Increased mucosal prostaglandin synthesis (F)
E. Hypocalcaemia(F)

39) The following statement/s is/are true about peptic ulcer

A. Heaping up of the margin is rare in malignant ulcer (F)
B. Base is usually smooth and clean (T)
C. Puckering of the mucosa in spoke-like fashion indicates acute gastric ulcer(F)
D. H pylori infection after the ulcer has healed (T)
E. Posterior wall of the duodenum is more affected than anterior wall (F)

40) The commonest cause of haematemesis is

A. Esophageal varices (F)
B. Acute peptic ulcer (F)
C. Chronic peptic ulcer (T)
D. Multiple erosions (F)
E. Carcinoma of the stomach (F)
41)Factors associated with increased incidence of gastric cancer include
A. Vitamin C and beta carotene (F)
B. Smoked foods (T)
C. Partial gastrectomy (T)
D. H pylori infection (T)
E. Blood group O (F)

42) The commonest site for carcinoma of the stomach is

A. Pylorus and antrum (T)
B. Fundus (F)
C. Greater curvature (F)
D. Cardia(F)
E. Body(F)

43) The malignant ulcer of the stomach may reveal

A. Heaped up, beaten margin (T)
B. Clean base (F)
C. Limitia plastica (T)
D. Metastasis to breast (T)
E. Metastasis to lung (T)

44) The following statement/s is/are true

A. H pylori infection is sufficient for gastric carcinogenic(F)
B. Autoimmune gastritis carries no risk (T)
C. Most persons infected with H pylori never develop gastric cancer (T)
D. Previous peptic ulcer disease per se imparts increased risk (F)
E. 40% of gastric adenomas harbour cancer at the time of diagnosis (T)

45) The features of advanced CA stomach include (All T)

A. New Dyspepsia
B. Vomiting
C. Dysphagia
D. Deep vein thrombosis
E. Anaemia

46) Enteroinvasive organisms which proliferate, invade and destroy mucosa include
A. E coli (T)
B. Shigella (T)
C. Salmonella (T)
D. Vibrio cholera (F)
E. Vibrio eltor (F)

47) Usual complications of Crohn’s disease include the following except

A. Toxic megacolon (T)
B. Protein-losing enteropathy (T)
C. Malabsorption (T)
D. Pernicious anaemia (F)
E. Steatorrhoea (T)
48) Regarding clinical course of ulcerative colitis, there are
A. Bloody mucoid diarrhoea (T)
B. Toxic megacolon (T)
C. Perforation (T)
D. No risk of cancer (F)
E. Fluid and electrolyte imbalance (T)

49) The common features of ulcerative colitis include

A. Skin lesions (F)
B. Transmural inflammation and fissure (F)
C. Pancolitis in severe cases (T)
D. Pseudopolyp (T)
E. Ulcer (T)

50) The following statement/s is are true

A. Small hyperplastic polyps usually have malignant potential (F)
B. Juvenile polyposis syndrome carries a risk of adenocarcinoma (T)
C. Hamartomatous polyps themselves have malignant potential (F)
D. All adenomatous lesions arise as the result of epithelial proliferative dysplasia (T)
E. Colorectal adenomas may be asymptomatic (T)

51) The following factors involve in the pathogenesis of colorectal carcinoma

A. High content of unabsorbable vegetable Fibre (F)
B. Refined carbohydrates (T)
C. Red meat (T)
D. Excess energy intake (T)
E. Micronutrients (T)

52) The most affected site of colorectal carcinoma is

A. Caecum and ascending colon (T)
B. Transverse colon (F)
C. Sigmoid colon (F)
D. Descending colon (F)
E. Rectum (F)

53) The following statement/s is/are true

A. Obstruction is common due to tumour in the proximal colon(F)
B. Virtually 98% of all cancers in the large intestine are adenocarcinoma (T)
C. Napkin ring constrictions of the bowel are more common in the proximal colon (F)
D. Microscopic characteristics of right sided and left sided colonic adenocarcinoma are
different (F)
E. Iron deficiency anaemia in an older man means (T)

54) Regarding carcinoid syndrome

A. Peak age is in the fifties (T)
B. There is no malignant potential (F)
C. It gives a solid, yellow tan appearance on transaction (T)
 D. Rectal and appendiceal carcinoid usually metastasize (F)
E. There can be hyperinsulinism (T)

55) Carcinoid syndrome usually exhibits

A. Cutaneous flushes (T)
B. Constipation (F)
C. Cough (T)
D. Hepatomegaly (T)
E. Nausea and vomiting (T)

56) Primary gastrointestinal lymphomas frequently occur in (All T)

A. Patients with Helicobacter gastritis
B. Patients with congenital immunodeficiency states
C. HIV infected individual
D. individuals undergoing immunosuppressive therapy
E. Patients with sprue

57) The most common cause of appendiceal inflammation is

A. Faecolith (T)
B. Gallstone (F)
C. Tumours(F)
D. Ball of worms(F)
E. None of these(F)

58) Which one of the following is not a predisposing factor for peptic ulcer
A. Achlorhydria (T)
B. Blood group O (F)
C. Cigarette smoking (F)
D. High gastrin secretion (F)
E. Ingestion of a spring (F)

59) Which one of the following predispose to colonic carcinoma

A. Bacillary dysentery (F)
B. Crohn’s disease (F)
C. Diverticular disease (F)
D. Ischemic colitis (F)
E. Ulcerative colitis (T)

60) Which one of the following polyps of the colon and rectum is most likely to be
premalignant
A. Villous adenoma (T)
B. Juvenile polyp (F)
C. Tubular polyp (F)
D. Inflammatory polyp (F)
E. Hyperplastic polyp (F)

61) The risk of esophageal cancer increases with of all the following except
A. Alcohol (F)
 B. Tobacco (F)
C. Chronic ingestion of hot beverages (F)
D. Aflatoxin (T)
E. Poor oral hygiene (F)

62) Achalasia is associated with all the following except

A. Trypanosoma cruzi (F)
B. Dysphagia (F)
C. Weight Loss (F)
D. Relaxation of the lower esophageal sphincter with swallowing (T)
E. Aspiration pneumonia which may cause lung abscesses (F)

63) Compare to duodenal ulcers, gastric ulcers have all of the following characteristics
except they
A. Occur later in life (F)
B. Are more frequent malignant (T)
C. Heal slowly (F)
D. Have a slow rate of recurrence (F)
E. Are not as closely associated with hyperacidity (F)

64) Common causes of UGI bleeding include all of the following except
A. Esophageal varices (F)
B. Gastric polyp (T)
C. Gastric ulcers (F)
D. Gastritis (F)
E. Duodenal ulcers (F)

65) Conditions associated with gastric cancer include all of the following except
A. Higher socioeconomic groups (T)
B. Pernicious anaemia (F)
C. Chronic atrophic gastritis (F)
D. Adenomatous polyps(F)
E. A high intake of dietary nitrates (F)

66) Patients with right sides colon cancer are more likely than patients with left sided cancer
to
A. Have obstructive signs(F)
B. Show bright blood in stool (F)
C. Present with anaemia (T)
D. Have constipation (F)
E. Have lower abdominal pain (F)

Breast

67) The following matching/s is/are true

A. Non-proliferative change 》cyst and fibrosis (T)
B. Proliferative change 》epithelial hyperplasia and sclerosing adenosis (T)
 C. Epithelial hyperplasia 》clinically large breast mass (T)
D. Atypical lobular hyperplasia 》cells filled more than 50%of terminal duct units (F)
E. Sclerosing adenosine 》 slightly increased risk of progression to carcinoma (F)

68) The following conditions have slightly to significantly increased risk of progression to
carcinoma
A. Fibrosis and cystic changes (F)
B. Fibroadenomas associated with fibrocystic changes (T)
C. Atypical hyperplasia, ductal or lobular (T)
D. Family history of breast cancer (T)
E. Apocrine metaplasia (F)

69) The following matching/s is/are true

A. Acute mastitis 》Staphylococci (T)
B. Mammary duct ectasia 》bacterial inflammation (F)
C. Fibroadenoma 》Peak incidence in third decade of life (T)
D. Phyllodes tumours 》always malignant (F)
E. Intraductal papilloma 》 serious or bloody nipple discharge (T)

70) Regarding risk factors of breast cancer, the following have well established influences
A. Age after 30 years (T)
B. Early menarche and late menopause (T)
C. Nulliparous women (T)
D. Proliferative breast disease (T)
E. Oral contraceptive, obesity and high fat diets (F)

71) Paget disease of the nipple

A. Is caused by extension of DCIS upto the lactiferous ducts (T)
B. Presents as a unilateral crusting exudate over the nipple and areola (T)
C. May be associated with underlying invasive carcinoma (T)
D. Alone worsen the prognosis (F)
E. Is characterised by Paget cells with scanty eosinophilic cytoplasm and pleomorphism
nuclei (F)

72) LCIS is characterised by

A. A uniform appearance (T)
B. Cohesive clusters (T)
C. Absence of signet ring cells (F)
D. Arising in either breast at equal frequency (F)
E. No risk of breast cancer in either breast(F)

73. The following matching/s is/are true regarding breast cancer

A. Inflammatory carcinoma 》 generally of no atypical type (T)
B. Invasive lobular carcinoma 》strands and bull's eye patterns (T)
C. Medullary carcinoma 》mucin dissenting into the stroma(F)
 D. Colloid carcinoma 》pronounced lymphoplasmacytic infiltrate (F)
E. Tubular carcinoma 》excellent prognosis (T)

74. The following histologic types of cancer usually have a good prognosis except
A. Tubular carcinoma (F)
B. Medullary carcinoma (F)
C. Lobular carcinoma (F)
D. Papillary carcinoma (F)
E. Ductal carcinoma (T)

75. The followings are associated with poor prognosis for breast carcinoma
A. Increased tabular formation (T)
B. Absence of lymphovascular invasion (F)
C. Presence of oestrogen progesterone receptors (T)
D. Aneuploidy (T)
E. Overexpression of ERBB (T)

76. Gynaecomastia
A. Occurs in response to oestrogen excess (T)
B. Is the male analogue of proliferative breast disease in the female (F)
C. Is most commonly caused by oestrogen therapy (F)
D. Is not associated with Klinefelter syndrome (F)
E. Shows intraductal hyperplasia histologically (T)

77. The most likely cause of a 1 Xmas mass in outer quadrant of the breast of 65 years old
woman is
A. Fibrocystic change (F)
B. Acute mastitis (F)
C. Fibroadenoma (F)
D. Carcinoma (T)
E. Paget's disease of the breast (F)

78. All of the followings are associated with carcinoma of the breast except
A. High fat diet(F)
B. Positive family history (F)
C. Obesity (F)
D. Early menarche(F)
E. Multiparity (T)

Respiratory system

79. The spectrum of chronic obstructive pulmonary disease consists of

A. Emphysema (T)
B. Chronic bronchitis (T)
C. Bronchial asthma (T)
D. Bronchiectasis (T)
E. Pulmonary edema (F)
80. Centrilobular emphysema
A. Involves the distal alveoli (F)
B. Both emphysematous and normal air spaces (T)
C. The lesions are more severe in the upper lobes (T)
D. Is most commonly seen in cigarette smokers (T)
E. The patients have congenital deficiency of Alpha-1 antitrypsin (F)

81. Panacinar emphysema

A. Involves the acini from the level of the respiratory bronchiole to the terminal blind
alveoli (T)
B. Occurs commonly in the upper lung zones (F)
C. Occurs in Alpha-1 antitrypsin deficiency (T)
D. Is more striking adjacent to the pleura (F)
E. Is the commonest cause of spontaneous pneumothorax in young adults (F)

82. Clinical course of emphysema (All T)

A. Dyspnoea is usually the first symptom
B. Weight loss
C. Reduced FEV1
D. Cough
E. Wheezing

83. The following matching/s is/are true

A. Emphysema 》 pick puffers (T)
B. Panacinar emphysema 》occurs in Alpha-1 antitrypsin deficiency (T)
C. Senile emphysema 》overdistended lungs of elders (T)
D. Mediastinal emphysema 》vomiting and violent coughing (T)
E. Chronic bronchitis 》blue bloaters (T)

84. Chronic bronchitis is characterised by

A. Pale mucosal lining of the larger airways (T)
B. Enlargement of the mucous secreting glands (T)
C. Reduced number of goblet cells (F)
D. Increased ciliated epithelial cells (F)
E. Absence of mononuclear cells (F)

85. Aetiology of bronchiectasis involves (All T)

A. Bronchial obstruction by tumours
B. Cystic fibrosis
C. Kartagener syndrome
D. Tuberculosis
E. Necrotizing pneumonia with Klebsiella spp

86. Clinical features and Complications of bronchiectasis are (AllT)

A. Severe paroxysmal and persistent cough
 B. Foul-smelling copious sputum
C. Secondary amyloidosis
D. Left sided cardiac failure
E. Metastatic abscess formation

87. Clinical course of chronic bronchitis (All T)

A. Hypercapnia
B. Hypoxia
C. Cyanosis
D. Pulmonary hypertension and cardiac failure
E. Recurrent infections and respiratory failure

88. The common causes of acute lung injury and acute respiratory distress syndrome are
the followings except
A. Pneumonia (F)
B. Aspiration of gastric contents (F)
C. Fat embolism (T)
D. Sepsis (F)
E. Severe trauma with shock (F)

89. Chronic interstitial lung disease associated with granulomas formation include
A. Asbestosis(F)
B. Silicosis (F)
C. Hypersensitivity pneumonitis (T)
D. Sarcoidosis (T)
E. Wegener granulomatosis (T)

90. Clinical consequences of pulmonary thromboembolism include

A. Acute left sided heart failure (F)
B. Cardiovascular collapse (T)
C. Pulmonary infarction (T)
D. Chronic cor pulmonale (T)
E. Pulmonary vascular sclerosis (T)

91. Complications of pneumonia include (All T)

A. Abscess
B. Empyema
C. Meningitis
D. Arthritis
E. Infective endocarditis

92. Isolated-organ tuberculosis typically involves

A. Meninges (T)
B. Kidneys (T)
C. Adrenals (T)
D. Bones (T)
E. Intestine (F)
93. Complications of lung abscess (All T)
A. Pneumothorax
B. Empyema
C. Meningitis
D. Brain abscess
E. Amyloidosis

94. Pneumocystis pneumonia

A. Is common in patients with CD4 count less than 500/mm3 (F)
B. Demonstrate cotton candy exudate (T)
C. Reveals cup-shaped cyst walls with silver stains (T)
D. Doesn't have trophozoites form of the organisms in the sputum (F)
E. Usually shows normal chest radiograph(F)

95. The following statements are true for bronchogenic carcinoma

A. Asbestos workers with smoking have higher risk (T)
B. Scar cancers are adenocarcinoma (T)
C. More than half of the cases spread to adrenals (T)
D. Oat cell carcinoma is the most aggressive tumour (T)
E. Dense core neurosecretory granules are present in some larger cell carcinomas(F)

96. Small cell lung carcinoma (SCLC) is characterised by

A. Absence of neuroendocrine and epithelial markers (T)
B. Absence of mucin production (F)
C. Production of parathyroid hormone-related peptide (PTH-rp)(F)
D. Often complete response to chemotherapy and radiotherapy (T)
E. Glandular or squamous architecture in histology (F)

97. Non-small cell lung carcinoma (NSCLC) produces the following peptide hormone
A. Adrenocorticotropic hormone (ACTH)(F)
B. Antidiuretic hormone (ADH)(F)
C. Gastrin releasing peptide (F)
D. Calcitonin(F)
E. PTH-rp (T)

98. Squamous cell carcinoma of the lung

A. Are more common in men than women (T)
B. Arises in peripheral long scars(F)
C. Usually disseminated outside the thorax earlier than other histologic types(F)
D. Complicates in atelectasis and infection (T)
E. Are composed of neoplastic cells usually twice the size of resting lymphocytes (F)

99. Adenocarcinoma of the lung

A. Have the strongest association with a previous history of smoking (F)
B. Grow slowly (T)
C. Form smaller masses than do the other subtypes (T)
D. Metastasize widely at an early stage (T)
E. Grow along preexisting structures and preserve alveolar architecture (F)
100. Small cell carcinoma
A. Appears as centrally located masses (T)
B. Show rare mitotic figures (F)
C. Reveals markedly fragile tumour cells (T)
D. Are rarely associated with paraneoplastic syndromes(F)
E. Are characterised by keratin pearls and intercellular bridges histologically (F)

101. All of the following disorders are correctly paired with related characteristics except
A. Atelectasis 》Bronchial obstruction (F)
B. ARDS 》hyaline membranes (F)
C. Cystic fibrosis 》Alpha-1 antitrypsin deficiency (T)
D. Acute epiglottitis 》H influenzae (F)
E. Asbestosis 》ferruginous bodies (F)

102. ARDS is caused by all of the following conditions except

A. Shock(F)
B. Sepsis(F)
C. Inhalation of toxic irritants(F)
D. Bronchial obstruction by foreign bodies (T)
E. Head injury (F)

103. A patchy distribution of lesions throughout the lungs is characteristic of pneumonia

caused by all of the following agents except
A. S aureus (F)
B. Virus(F)
C. M pneumoniae (F)
D. S pneumoniae (T)
E. H influenzae (F)

104. Which of the following changes does not occur in primary tuberculosis
A. Calcification (F)
B. Caseating granulomas (F)
C. Cavitation (T)
D. Langhans giant cell(F)
E. Positive tuberculin test (F)

105. All of the following phenomena related to lung cancer are correctly matched with the
appropriate association except
A. Bronchial squamous metaplasia 》cigarette smoking (F)
B. Facial swelling and cyanosis 》 recurrent laryngeal nerve (T)
C. Pancoast's tumour 》superior success (F)
D. Ptosis, miosis, anhidrosis 》 Horner's syndrome (F)
E. Paraneoplastic syndrome 》small cell carcinoma (F)
106. Which one of the following is not a histological feature of chronic bronchitis
A. Calcification of bronchial cartilage(F)
B. Goblet cell metaplasia (F)
C. Hypertrophy of smooth muscle (T)
D. Mucous gland hyperplasia (F)
E. Squamous metaplasia of respiratory epithelium (F)

107. Panacinar emphysema shows

A. Air in the interlobular septa(F)
B. Enlargement of alveolar ducts, spaces and respiratory bronchioles (T)
C. Enlargement of centrilobular air spaces (F)
D. Fusiform dilatation of alveolar ducts surrounded by coal dust (F)
E. Normal respiratory bronchioles with enlarged ducts and alveoli (F)

108. In chronic obstructive pulmonary disease (COPD)

A. Emphysema is associated with loss of elastic recoil (T)
B. Patients with Alpha-1 antitrypsin deficiency frequently develop centrilobular
emphysema (T)
C. A Reid index of less than 0.5 is histologically diagnostic of chronic bronchitis (F)
D. The pO2 will fall on exercise (F)
E. A raised pCO2 indicates a chronic hypoventilatory state (F)

109. Clinically overt paraneoplastic syndrome include (All T)

A. Hypercalcemia
B. SIADH
C. Peripheral neuropathy
D. Finger clubbing
E. DIC

Cardiovascular system

110. Diseases of the aorta contain

A. Dissecting hematoma (T)
B. Atherosclerosis (T)
C. Temporal arteritis (T)
D. Wegener granulomatosis (F)
E. Berry aneurysm/polyarteritis nodosa(F)

111. Immediate causes of death in myocardial infarction include

A. Heart failure/cardiac tamponade (T)
B. Pericarditis (F)
C. Ventricular aneurysm (F)
D. Mural thrombosis and thromboembolism (F)
E. Ventricular arrhythmia (T)

112. Cor pulmonale is associated with (AllT)

A. Bronchiectasis
 B. Chronic bronchitis
C. Pulmonary embolism
D. Pickwickian syndrome
E. Primary pulmonary hypertension

113. Disorders which lead to cor pulmonale contain

A. Myocardial infarction (F)
B. Pickwickian syndrome (T)
C. Bronchiectasis (T)
D. Portal hypertension (F)
E. Recurrent pulmonary thromboembolism (T)

114. Which one of the following is not a predisposing factor for Atherosclerosis
A. Cigarette smoking (F)
B. High level of serum HDL (T)
C. High level of serum LDL(F)
D. Male sex(F)
E. Systemic hypertension (F)

115. Which one of the following is not involved in the aetiology of systemic hypertension
A. Arteriosclerosis (T)
B. Chronic glomerulonephritis (F)
C. Conn's syndrome (F)
D. Pheochromocytoma(F)
E. Hyperthyroidism (F)

116. Which one of the following is least likely to be found in a child of acute rheumatic fever
A. Aschoff bodies(F)
B. Bread and butter pericarditis (F)
C. History of recent sore throat (F)
D. Large crumbling vegetations on the mitral valve (T)
E. Raised ASO titre(F)

117. Aortic dissection is most commonly associated with

A. Carcinoid syndrome (F)
B. Hypertension (T)
C. Mitral stenosis (F)
D. Rheumatic endocarditis (F)
E. Atherosclerosis (F)

118. Subacute bacterial endocarditis is a characteristic complication of

A. Congenital heart disease (TOF, VSD) (T)
B. Rheumatic heart disease (T)
C. Mitral valve prolapse;artificial valves (T)
D. Lobar pneumonia (F)
E. Cardiac surgery (valvectomy)(F)

119. Acute Infective endocarditis

 A. Has an abrupt onset and short course (T)
B. Affects previously abnormal heart valves (F)
C. Does not occur in IVDU(F)
D. Is most commonly caused by S aureus (T)
E. Is associated with well defined extracardiac focus of infection (T)

120. Subacute bacterial endocarditis is most commonly caused by

A. S aureus (F)
B. S pyogenes (F)
C. S viridans (T)
D. H influenzae (F)
E. Candida albicans (F)

121. Extracardiac manifestations of infective endocarditis include (All T)

A. Fever
B. Skin and mucosal haemorrhage
C. Embolisation and infarction
D. Haematuria
E. Splenomegaly

122. Which of the following/s is/are frequently involved in rheumatic heart disease
A. Aortic valve (T)
B. Tricuspid valve (F)
C. Mitral valve (T)
D. Pulmonary valve (F)
E. Tricuspid and pulmonary valves (F)

123. Marfan's syndrome is characterised by

A. Aortic valve disease (T)
B. Mitral valve disease (F)
C. Cystic medial degeneration of the aorta (T)
D. Atrial myxomas(F)
E. Pericarditis (F)

124. Statistically which of the following risk factors increase the myocardial infarction
A. Cigarette smoking (T)
B. Hypertension (T)
C. Hypercholesterolemia (T)
D. Hyperlipidemia (T)
E. Moderate alcohol consumption (F)

125. Tetralogy of Fallot includes each of the following except

A. Right ventricle hypertrophy (F)
B. Subaortic VSD(F)
C. Dextroposition of the aorta (F)
D. Obstruction to pulmonary flow(F)
E. Aortic stenosis (T)
126. Cardiac involvement in acute rheumatic heart disease is most accurately characterised
by which of the following
A. Pancarditis (T)
B. Pericarditis (F)
C. Myocarditis (F)
D. Endocarditis (F)
E. Valvulitis(F)

127. The features of acute rheumatic fever include

A. Aschoff bodies, often perivascular (T)
B. Verrucous vegetations (T)
C. Bread and butter pericarditis (T)
D. Fish Mouth or buttonhole stenosis of mitral valve (F)
E. Right ventricular hypertrophy (F)

128. Features of chronic rheumatic heart disease (All T)

A. Thromboembolism
B. Infective endocarditis
C. Acute pulmonary edema
D. Dysphagia
E. Left ventricular dilatation and hypertrophy

129. The characteristic microscopic lesion in syphilitic cardiovascular disease is

A. Obliterative endarteritis of the small arteries of the myocardium (F)
B. Obliterative endophlebitis(F)
C. Obliterative endarteritis of the large arteries (F)
D. Obliterative endarteritis of the vasa vasorum of aorta (T)
E. Gummas of myocardium(F)

130. Factors predisposing development of bacterial endocarditis include

A. Dental extraction (T)
B. Valvular disease (T)
C. DM (T)
D. Organ transplants (T)
E. Platelets deficiency (F)

131. Carcinoid heart disease is characterised by each of the following except

A. Pulmonary and tricuspid stenosis (F)
B. Endocardial fibrosis (F)
C. Predominantly affects left heart valves (T)
D. Increased 5 hydroxytryptamine in serum (F)
E. Increased 5-hydroxyindoleacetic acid (5-HIAA) in urine (F)

132. Cardiac causes of sudden death include (All T)

A. Coronary atherosclerosis
B. Coronary artery embolism
C. Myocarditis
D. Mitral valve prolapse
 E. Endocarditis

133. The most common serious complication of systemic hypertension is

A. Cerebral haemorrhage (T)
B. Glomerulosclerosis (F)
C. Myocardial infarction (F)
D. Atherosclerosis (F)
E. Pulmonary hypertension (F)

134. By 18-24 hours, the morphology of a myocardial infarction includes each of the
following except
A. Slightly pallor or mottling(F)
B. Coagulation necrosis (F)
C. Contraction band necrosis (F)
D. Neutrophils infiltrate (F)
E. Prominent granulation tissue and fibrosis (T)

135. The most common complication and cause of death in myocardial infarction is
A. Cardiac arrhythmia (T)
B. Left ventricular failure (F)
C. Cardiogenic shock(F)
D. Rupture of free wall,septum or papillary muscle (F)
E. Thromboembolism (F)

136. The various myocardial markers used to monitor the evaluation of MI are
A. CK-MM(F)
B. CK-MB (T)
C. CK-BB(F)
D. Troponins (T)
E. Lactate dehydrogenase (T)

137. The early Coagulation necrotic changes in myocardial infarct can be seen under light
microscope in
A. 0-3 min(F)
B. 1-2 hr(F)
C. 4-12 hr (T)
D. 18-24 hr(F)
E. 24-72 hr(F)

138. Atherosclerotic aneurysms are most commonly located in the

A. Circle of Willis(F)
B. Abdominal aorta (T)
C. Thoracic aorta (F)
D. Ascending aorta(F)
E. Left anterior descending coronary artery(F)

139. Hypertensive arteriosclerosis is characterised by

A. Hyaline arteriosclerosis (T)
 B. Lack of extracellular matrix production (F)
C. Loss of nephrons (T)
D. Onion-skin thickening of the walls of the arterioles in malignant hypertension (T)
E. Necrotizing arteriolitis in malignant hypertension (T)

140. A myocardial infarct that exhibits early granulation tissue has most likely occurred
A. Less than 1 hour (F)
B. Within 24 hour(F)
C. 4-7 days (T)
D. Within 1 month (F)
E. Within 3 months (F)

141. Clinical features related to acute rheumatic carditis include

A. Pericardial friction rubs (T)
B. Loud heart sounds (F)
C. Bradycardia (F)
D. Arrhythmias (T)
E. Features of congestive heart failure (T)

142. Manifestations of acute rheumatic fever include all of the following conditions except
A. Mitral stenosis (T)
B. Pancarditis (F)
C. Subcutaneous nodules (F)
D. Erythema marginatum (F)
E. Chorea (F)

143. Non-bacterial thrombotic endocarditis is most frequently associated with which of the
following conditions
A. Malignancy, particularly adenocarcinoma (T)
B. SLE (F)
C. Old rheumatic endocarditis (F)
D. Subdiaphragmatic abscess (F)
E. Congenital heart disease (F)

144. Which of the two valves listed below is least commonly associated with rheumatic heart
disease
A. Aortic and pulmonary (F)
B. Mitral and tricuspid (F)
C. Aortic and Mitral (F)
D. Pulmonary and tricuspid (T)
E. Aortic and tricuspid (F)

145. Mitral stenosis most often results from

A. Rheumatic endocarditis (T)
B. Bacterial endocarditis (F)
C. Congenital heart disease (F)
D. Marfan's syndrome (F)
E. Syphilitic heart disease (F)
146. The followings are associated with a left to right shunt
A. Atrial septal defects (ASDs) (T)
B. Ventricular septal defects (VSDs) (T)
C. Patent ductus arteriosus (PDA) (T)
D. Tetralogy of Fallot (F)
E. Transposition of great vessels (F)

147. Which one of the following conditions is associated with paradoxical embolism
A. Rheumatic heart disease (F)
B. Pulmonary stenosis (F)
C. Pulmonary hypertension (F)
D. Atrial septal defects (T)
E. Infective endocarditis (F)

148. The most common cardiac malformation at birth is

A. VSD (T)
B. Atrial septal defect (F)
C. PDA (F)
D. Pulmonary stenosis (F)
E. Coarctation of the aorta (F)

149. The most common cause of restrictive cardiomyopathy is

A. Endomyocardial fibrosis (T)
B. Cardiac amyloidosis (F)
C. Endocardial fibroelastosis (F)
D. Hemochromatosis (F)
E. Radiation injury (F)

150. Major cases of aortic regurgitation include (All T)

A. Rheumatic heart disease
B. Infective endocarditis
C. Syphilitic aortitis
D. Ankylosing spondylitis
E. Marfan's syndrome

Bone

151. The following commonly occur around the knee joint

A. Osteoid osteoma in the young (T)
B. Osteosarcoma in the young (F)
C. Chondrosarcoma (F)
D. Enchondroma (F)
E. Chondroblastoma (T)

152. Paget's disease of the bone is associated with the following

A. Increased osteoclastic activity(T)
B. Increased osteoblastic activity (T)
 C. Exuberant bone formation (T)
D. Skeletal deformity and chalkstick fracture (T)
E. Reduced serum alkaline phosphatase (F)

153. Bone forming tumours include

A. Osteoma (T)
B. Osteoid osteoma (T)
C. Osteoblastoma (T)
D. Osteosarcoma (T)
E. Giant cell tumour (F)

154. Primary osteosarcoma

A. Most commonly affects 10-20 years of age (T)
B. Is common in metaphysis of distal femur,proximal tibia and humerus (T)
C. Grows outward and lifts periosteum (T)
D. Is characterised by formation of osteoid by malignant cells (T)
E. Most commonly develop in the setting of Paget cells (F)

155. Generalised osteoporosis is associated with (All T)

A. Hyperparathyroidism
B. Hyperthyroidism
C. Hypothyroidism
D. SLE
E. Addison disease, Cushing syndrome

156. Bone tumour of Hyperparathyroidism

A. Reduced bone resorption (F)
B. Increased synthesis of vitamin D (T)
C. Increased number of osteoclasts (T)
D. Reactive giant cells (T)
E. Absence of hemosiderin deposits (F)

157. Rickets is characterised by

A. Normal growth (F)
B. Looser's zone radiologically (T)
C. Bow leg or knock knee (F)
D. Rachitic rosary (F)
E. Harrison's groove at costal margins (F)

158. Paget's disease of bone is best associated with

A. Collections of eosinophils (F)
B. Decreased in amount of bone with normal mineralization (T)
C. Fibrous tissue around and within trabeculae of matrix (T)
D. High proportion of woven to lamellar bone (F)
E. Mosaic pattern of cement lines (F)

159. Which of the following is the commonest tumour in bone

A. Chondroblastoma (F)
 B. Chondrosarcoma (F)
C. Giant cell tumour (F)
D. Secondary carcinoma (T)
E. Osteosarcoma (F)

160. Which one of the following is not a feature of osteosarcoma

A. Almost 50% occur around the knee (F)
B. Lung secondaries are common (F)
C. May be associated with Paget's disease of bone (F)
D. Peak incidence between 10-20 years of age (F)
E. Usually metastasize to lymph nodes (T)

161. Ewing sarcoma

A. Is primary malignant small round cell tumour of the bone (T)
B. Most commonly affects 70-80 years of age (F)
C. May reveal Homer-Wright rosettes (T)
D. Present with painful enlarging mass at the diaphysis of the bone (T)
E. Is associated with elevated urinary catecholamines (F)

162. The following matching/s is/are true

A. Osteosarcoma 》osteoclastoma (F)
B. Giant cell tumour 》 osteoid formation (F)
C. Osteitis fibrosa 》Paget's disease of bone (F)
D. Osteitis deformans 》 renal osteodystrophy (F)
E. Malignant fibrous histiocytoma 》herringbone pattern of malignant (T)

163. Osteosarcoma is characterised by

A. A bimodal age of distribution (T)
B. Absence of tumour giant cells (F)
C. Absence of mitoses (F)
D. Island of primitive bony trabeculae (T)
E. Codman triangle radiologically (T)

164. Paget's disease is characterised by (All T)

A. Accelerated bone resorption
B. Accelerated bone formation
C. Frequent skull involvement
D. Woven bone
E. Mosaic pattern of cement lines

165. The deficient of which vitamin results in disturbance in the formation matrix of normal
cartilage and bone
A. Vitamin A (F)
B. Vitamin B complex (F)
C. Vitamin C (T)
D. Vitamin D (F)
 E. Vitamin E (F)

166. Osteomalacia is concerned with

A. Vitamin D deficiency in children (F)
B. Increased demineralization (F)
C. Osteopenia (T)
D. Kyphoscoliotic deformity (T)
E. Craniotabes and frontal bossing (F)

167. The malignancy most often complicating Paget's disease of the bone is
A. Synovial sarcoma (F)
B. Chondrosarcoma (F)
C. Malignant giant cell tumour (F)
D. Osteogenic sarcoma (T)
E. Fibrosarcoma (F)

168. A young male patient with an osteogenic sarcoma of the right tibia is to be studied for
metastasis. The investigation should begin with the study of
A. Local lymph nodes (F)
B. Lungs (T)
C. Brain (F)
D. Liver (F)
E. Adrenal glands (F)

169. The primary bone tumour often seen with irradiation is

A. Osteoma (F)
B. Osteogenic sarcoma (T)
C. Chondroma (F)
D. Chondrosarcoma (F)
E. Chondromyxoid sarcoma (F)

170. Synovial sarcoma characteristically shows which pattern

A. Giant cell (F)
B. Biphasic cell (T)
C. Spindle cell (F)
D. Small cell (F)
E. Columnar cell (F)

171. Characteristics of osteosarcoma include all of the followings except

A. High incidence occurs in teenagers with preexisting Paget's disease of bone (T)
B. It can occur in cases of familial retinoblastoma (F)
C. It is the most common malignant primary tumour of bone(F)
D. It is more common in males(F)
E. Early haematogenous spread into the lungs, liver and brain (F)

172. All of the followings are characteristics of gout

A. Higher incidence in women (F)
B. Hyperuricemia (T)
 C. Involvement of great toe (T)
D. Tophi (T)
E. Urate urolithiasis (T)

Endocrine

173. Thyroid conditions showing follicular cell hypertrophy and hyperplasia include
A. Hashimoto's thyroiditis (F)
B. Grave's disease (T)
C. Diffuse non-toxic goitre (T)
D. Adenoma (T)
E. Medullary carcinoma (F)

174. The followings produce endocrine effects (AllT)

A. Medullary carcinoma of thyroid
B. Pheochromocytoma
C. Neuroblastoma
D. Gastrinoma
E. Small cell carcinoma of the lung

175. Hypothyroidism is best associated with

A. Adenoma (F)
B. Autoimmune disease (T)
C. Dyshormonogenesis (T)
D. Grave's disease (F)
E. Iodine deficiency (T)

176. Which one of the following is most likely to lead to blood borne metastases
A. Follicular carcinoma of thyroid (T)
B. Giant cell carcinoma of thyroid (F)
C. Medullary carcinoma of thyroid(F)
D. Papillary carcinoma of thyroid(F)
E. Anaplastic carcinoma of thyroid(F)

177. Hypothyroidism is caused by

A. Surgery or radioiodine therapy (T)
B. Hashimoto's thyroiditis (T)
C. Iodine deficiency (T)
D. Dyshormonogenetic goitre (T)
E. Adenoma (F)

178. Causes of goitrous hypothyroidism include

A. Primary idiopathic hypothyroidism (F)
B. Hashimoto's thyroiditis (T)
C. Iodine deficiency (T)
D. Congenital biosynthetic defect (T)
E. Grave's disease (F)
179. All of the followings characteristics are associated with Hashimoto's thyroiditis
A. Mononuclear inflammatory infiltrate and germinal centres (T)
B. Increased risk for development of Hodgkin's lymphoma (F)
C. Antithyroglobulin and anti- TSR receptor antibodies (T)
D. Increased incidence in association with HLA DR3 and DR5 (T)
E. Infiltration by CD8+ cytotoxic T cells (T)

180. Which of the following/s is/are true of medullary carcinoma of the thyroid
A. Increased blood levels of calcitonin can occur (T)
B. Contain deposits of amyloid (T)
C. Derived from C cells found between follicles (T)
D. Familial form may be associated with pheochromocytoma (T)
E. Vascular and lymphatic invasion is most common among the malignant thyroid
tumours (F)

181. The single most significant laboratory finding in primary hypothyroidism is

A. Low T4 (F)
B. Elevated TSH (T)
C. Increased T3 resin uptake (F)
D. High antithyroid antibodies (F)
E. Elevated serum cholesterol (F)

182. The manifestations found in diffuse Hyperthyroidism (Grave's disease) is not related to
A. Excessive TSH production by pituitary (T)
B. Ophthalmopathy (F)
C. Dermopathy, pretibial myxoedema (F)
D. Proptosis (F)
E. Diffuse uptake of Iodine in a radioiodine scans (F)

183. Causes of primary hyperthyroidism include

A. Grave's disease (T)
B. TSH-secreting pituitary adenoma (F)
C. Toxic multinodular goitre (T)
D. Toxic adenoma (T)
E. Struma ovarii (F)

184. The clinical manifestations of thyrotoxicosis include

A. Cold intolerance (F)
B. Weight loss despite increased appetite (T)
C. Constipation (F)
D. Muscle weakness (T)
E. Thyroid storm and apathetic hyperthyroidism (T)

185. A triad of manifestations in Grave's disease include

A. Thyrotoxicosis (T)
B. Infiltrative ophthalmopathy (T)
C. Infiltrative dermopathy, pretibial myxoedema (T)
D. Hashi thyrotoxicosis (F)
 E. Plummer syndrome (F)

186. The following matching/s is/are true

A. Endemic goitre 》more than 40% of the population affected (F)
B. Colloid goitre 》lining by crowded columnar cells (F)
C. Multinodular goitre 》fibrosis, haemorrhage and calcification (T)
D. Toxic nodule within MNG 》Plummer syndrome (T)
E. Hashimoto's thyroiditis 》Hurthle cells (T)

187. Manifestations of adenoma of thyroid

A. Painless nodules (T)
B. Dysphagia (T)
C. Cold nodules (T)
D. Warm and hot nodules (T)
E. Differentiation from carcinoma by FNAC (F)

188. Papillary carcinoma of the thyroid

A. It is the most common common form of thyroid cancer (T)
B. The diagnosis is based on nuclear features (T)
C. A papillary architecture is present in all cases (F)
D. Psammoma bodies are often present outside the papillae (F)
E. Invasion of blood vessels is common in smaller lesions (F)

189. Neoplastic thyroid lesions with a follicular architecture can be

A. Hyperplastic nodule in goitre (F)
B. Follicular adenoma (T)
C. Follicular carcinoma (T)
D. Follicular variant of papillary carcinoma (T)
E. Anaplastic carcinoma (F)

190. Papillary carcinoma

A. Are nonfunctional tumour (T)
B. Present most often as a painless mass (T)
C. Present as metastasis in a cervical lymph node (T)
D. May reveal haematogenous metastases in the lung (T)
E. Give a favourable prognosis in elderly patients (F)

191. The characteristic features of follicular carcinoma include

A. Capsular invasion (T)
B. Vascular invasion (T)
C. Orphan Annie-eye nuclei (F)
D. Psammoma bodies (F)
E. Haematogenous metastasis to lungs, bone and liver (F)

192. Medullary carcinoma of the thyroid

A. Are derived from parafollicular cells of the thyroid (T)
 B. Can secrete serotonin and vasoactive intestinal peptide (T)
C. Shows multicentricity in Familial cases (T)
D. May reveal a cellular Amyloid deposits derived from altered calcitonin molecules (T)
E. Are not associated with multiple endocrine neoplasia (MEN) syndromes (F)

193. Anaplastic carcinoma of the thyroid

A. Are among the most aggressive neoplasm (T)
B. Occur in middle aged patients (F)
C. May show giant cells, spindle cells or squamoid cells microscopically (T)
D. Are rarely associated with distant metastases (F)
E. Gives 5 years survival rate in 85% of cases (F)

194. Causes of hypercalcemia include

A. Hypoparathyroidism (F)
B. Vitamin D toxicity (T)
C. Immobilization (T)
D. Sarcoidosis (T)
E. Malignancy (T)

195. Causes of chronic adrenal insufficiency include

A. Waterhouse-Friderichsen syndrome (F)
B. Autoimmune adrenalitis (T)
C. Tuberculosis (T)
D. AIDS (T)
E. Metastatic disease (T)

196. Multiple endocrine neoplasia (MEN) Type 1 includes

A. Primary Hyperparathyroidism (T)
B. Gastrinoma and Zollinger-Ellison syndrome (T)
C. Hyperglycemia related to glaucoma (F)
D. Prolactin secreting pituitary tumour (T)
E. Pheochromocytoma (F)

Liver biliary tract and pancreas

197. In which one of the following conditions is fatty change of liver not a feature
A. Alcohol abuse (F)
B. Kwashiorkor (F)
C. Obesity (F)
D. Starvation (F)
E. Viral hepatitis (T)

198. The following matching/s is/are true (AllT)

A. Postnecrotic cirrhosis 》macronodular
B. Primary biliary cirrhosis 》antimitochondrial antibodies
C. Secondary biliary cirrhosis 》extrahepatic biliary obstruction
D. Haemochromatosis 》diabetes mellitus
 E. Wilson's Disease 》Kayser-Feischer ring/Reduced ceruloplasmin

199. Metastatic tumour of the liver (All T)

A. Less common than primary carcinoma
B. Tendency to develop central umbilication
C. Common initial presentation of liver failure
D. Early diagnosis by LFT
E. Rare tendency for carcinoma of breast and lung to metastasize to liver

200. Fatty liver may result from (AllT)

A. Hypoxia
B. Malnutrition
C. Obesity
D. Effects of alcohol
E. Pregnancy

201. Acute pancreatitis may be triggered by (All T)

A. Alcohol
B. Hyperlipoproteinemia, hypercalcemia
C. Gallstones
D. Shock
E. Coxsackievirus

202. Absence of urobilinogen in the stool suggests

A. Hemolytic anaemia(F)
B. Hepatocellular jaundice (F)
C. Fulminant hepatic failure (F)
D. Total mechanical biliary obstruction (T)
E. Viral hepatitis (F)

203. Hepatorenal syndrome

A. Kidney function promptly improves if hepatic failure is reversed (T)
B. Normal urine output (F)
C. Rising blood urea nitrogen and creatinine values (T)
D. Retaining the ability to concentrate urine (T)
E. Low urinary sodium (T)

204. Cirrhosis of liver is association with (All T)

A. Alcoholic liver disease
B. Biliary disease
C. Hereditary hemochromatosis
D. Wilson's disease
E. Alpha-1 antitrypsin deficiency

205. Massive hepatic necrosis is associated with (All T)

A. HEV infection in pregnancy
B. Heat stroke
 C. HBV
D. HDV-HBV
E. HAV

206. Impaction of a gallstone in the cystic duct will usually result in

A. Carcinoma of gallbladder (F)
B. Jaundice (F)
C. Hydrops of the gallbladder (T)
D. Cholesterolosis of the gallbladder (F)
E. Gangrenous cholecystitis (F)

207. Approximately what proportion of gallbladder carcinoma are associated with preexisting
gallstones
A. 3-10%(F)
B. 25-30%(F)
C. 60-90% (T)
D. 50%(F)
E. Almost 100% (F)

208. Carcinoma of the pancreas

A. Migratory thrombophlebitis (Trousseau sign) usually as the first symptom (F)
B. Obstructive jaundice is associated with most cases of carcinoma of the body of the
pancreas (F)
C. Elevated carcinoembryonic antigen (T)
D. Peak incidence between 60-80 years (T)
E. Association of coffee drinking with pancreatic cancer (F)

209. Intracytoplasmic eosinophilic hyaline inclusion within hepatocytes are most suggestive
of chronic exposure to which of the following agents
A. Carbon tetrachloride (F)
B. Tetracycline (F)
C. Polyvinyl Chloride (F)
D. Ethyl alcohol (T)
E. Phosphorous (F)

210. Clinical manifestations of alcoholic cirrhosis include all of the followings except
A. Hypoalbuminemia (F)
B. Hypoestrinism (T)
C. Portal hypertension (F)
D. Coagulation factor deficiency (F)
E. Encephalopathy (F)

211. The most common hepatic malignancy is

A. Hepatocellular carcinoma (F)
B. Cholangiocarcinoma (F)
C. Hemangiosarcoma (F)
D. Adenocarcinoma (F)
E. Metastatic tumour (T)
212. Which of the following factors is associated with cholangiocarcinoma of the liver
A. Alpha- fetoprotein increases (F)
B. Clonorchis sinensis infection (T)
C. Cirrhosis (F)
D. Hepatitis B virus infection (F)
E. Intraperitoneal bleeding (F)

213. Complications or well-established association of gallstones include all of the following

except
A. Biliary obstruction (F)
B. Cholesterolosis (T)
C. Pancreatitis (F)
D. Intestinal obstruction (F)
E. Malignancy (F)

214. All of the following etiologic characteristics or manifestations are suggestive of acute
pancreatitis except
A. Fat necrosis (F)
B. Tetracycline toxicity (T)
C. Gallstones (F)
D. Alcoholism (F)
E. Hypocalcaemia (F)

215. Migratory Thrombophlebitis is associated with which one of the following disease
A. DM (F)
B. Cystic fibrosis (F)
C. Acute pancreatitis (F)
D. Chronic pancreatitis (F)
E. Pancreatic carcinoma (T)