REFRES~6

Angeles University COLLEGE OF MEDICINE REFRESHER COURSE EXAMINATION PATHOLOGY January 05, 2004 Name: _________________________________

SCORE: ________________

I. CHOOSE THE CORRECT ANSWER. _____ 1.

The most common mechanism of exudation of proteins during inflammation is: A. Endothelial retraction C. Endothelial contraction B. Direct endothelial injury D. Newly formed blood vessels

_____ 2.

Vascular leakage with an immediate sustained response is exemplified by: A. Severe burns C. Multiple abrasions B. Multiple stab wounds D. Clean surgical wound

_____ 3.

A good example of chemotactic agent is: A. C3b C. Collectins B. C5a D. Histamines

_____ 4.

Oxygen dependent bacterial killing is accomplied by: A. Lyzozymes C. H2O2-Halide system B. Bacterial permeability increasing protein D. Lactoferrin

_____ 5.

Vascular leakage in sun burn is usually due to what mecanism: A. Endothelial retraction C. Delayed prolonged leakage B. Leakage from new blood vessels D. Direct endothelial injury

_____ 6.

Example of stable cells: A. Gastric mucosa B. Brain cells

C. Skin D. Liver cells

_____ 7.

Margination, rolling and adhesion is mediated by: A. Selectins and integrins C. Cytokines B. Histamines and serotonin D. Growth factors

_____ 8.

Preformed chemical mediators of acute inflammation: A. Histamiens C. Leukotrienes B. Nitric oxide D. Cytokines

_____ 9.

Arteriolar vasoconstriction as the immediate response to a vascular injury is brought about by: A. Platelet C. Coagulation cascade B. Endothelial matrix D. Neurogenic

_____10.

Extrinsic pathway is activated specifically by: A. Tissue factor C. Endothelin B. Hageman factor D. Factor XIIa

_____11.

VWF binds to platelet to: A. Other platelets B. Collagen

_____12.

C. Fibrin D. Plasminogen

The following cause hypercoagulability by certain mechanisms, which of them is NOT TRUE? A. Pregnancy – increased synthesis of coagulation factors B. Obesity – inhibitory effect of antithrombin C. Cancer – release procoagulant products D. Old age – increase platelet aggregation

_____13.

The most vulnerable tissue of infarction: A. Cardiac C. Neuron B. Fibroblast D. Renal tubules

_____14.

The principal cell involves in immunity: A. Red blood cell B. Lymphocyte C. Endothelial cell

D. Pancreatic acinar cell E. Adipose cell

_____15.

Which of the following is TRUE regarding T-cell? A. Not found in the peripheral circulation D. Mature into plasma cell B. Unable to bind to sheep erythrocytes E. Have a receptor for Fc fragment C. Play key a role in cellular immunity

_____16.

Cell-mediated immunity is important against all of the following, EXCEPT: A. Deep-seated mycotic infection D. Schistosomiasis B. Pyogenic bacterial infections E. Measles C. Mycobacterium tuberculosis

_____17.

The ultimate result of the complement pathway is: A. Mitosis D. Immunoglobulin synthesis B. Immunocompetency E. Immune tolerance C. Lysis

_____18.

A graft transplanted between genetically non-identical members of the same species is: A. An allograft D. A synograft B. An autograft E. A xenograft C. A heterograft

_____19.

Acquired immunodeficiency syndrome (AIDS) should immediately be suspected in any patient with: A. Pneumonia due to Pneumocystic carinii B. Meningitis due to Neisseria meningitides C. Pneumonia due to Streptococcus pneumoniae D. A skin abscess due to Staphylococcus aureus E. A positive skin test for tuberculosis

_____20.

Largest group that has the risk for developing AIDS: A. Newborn born with infected mother D. Drug addicts B. Hemophiliacs E. Recipients of blood and its components C. Bisexual men

_____21.

Responsible for tropism of HIV is/are: A. CD4 + receptors B. CD8 + receptors D. Fc ligands present in T-helper cells

D. A and C only E. None of the above

_____22.

Arthus reaction is localized presentation of: A. Type I hypersensitivity reaction D. Type IV hypersensitivity reaction B. Type II hypersensitivity reaction E. Type V hypersensitivity reaction C. Type III hypersensitivity reaction

_____23.

The caseation necrosis seen in tuberculosis is mainly because of the action of: A. B-lymphocytes D. Macrophages B. T-helper lymphocytes E. Langerhans giant cells C. T-suppressor lymphocytes

_____24.

Good pasture syndrome is an example of: A. Type I hypersensitivity reaction D. Type IV hypersensitivity reaction B. Type II hypersensitivity reaction E. Type V hypersensitivity reaction C. Type III hypersensitivity reaction

_____25.

The following are responsibilities of the Clinical Pathologist, EXCEPT: A. Interpret chemistry results C. Interpret Paps smears B. Interpret peripheral blood smears D. Interpret bone marrow smears

_____26.

The regulating body for the practice of pathology in the Philippines: A. Professional Regulation Commission C. Philippine Society of Pathologist B. Department of Pathology D. Philippine College of Pathologist

_____27.

The ideal blood container for serum glucose determination: A. Red top C. Black top B. Lavender top D. Blue top

_____28.

The artery favored for arterial blood gases: A. Brachial C. Femoral B. Radial D. Aorta

_____29.

The best sample for routine urinalysis: A. Random sample B. First morning urine

C. 24 hour urine sample d. 12 hour urine sample

_____30.

In CSF examination, which tube should you submit for bacteriological analysis? A. First tube C. Third tube B. Second tube D. Any of the above

_____31.

Which reference laboratory is authorized by the government of the Philippines to confirm screening test for HIV? A. Angeles University Foundation Medical Center B. Jose B. Lingad Memorial Hospital C. Regional Health Office D. Research Institute for Tropical Medicine

_____32.

Section of the laboratory handling determination of hemoglobin and hematocrit: A. Hematology C. Immunology B. Blood bank D. Histopathology

_____33.

Which finger is recommended for capillary blood sampling? A. Thumb C. Ring finger B. Middle finger D. Small finger

_____34.

Which procedure requires a written consent from the patient? A. HIV testing C. Lumbar puncture B. Bone marrow extraction D. All of the above

_____35.

A congenital anomaly characterized by failure of the abdominal musculature to develop resulting in herniation of abdominal contents into a ventral membranous sac: A. Duplication of intestine C. Omphalocele B. Malrotation D. Gastroschisis

_____36.

True of Meckel’s diverticulum, EXCEPT: A. A true diverticulum B. Usually located two feet from the ileocecal valve C. Results from failure of involution of the vitelline duct D. Wall contains only the mucosa and serosa

_____37.

Usual causes of infectious enterocolitis: A. Rotavirus C. Enterotoxigenic E. coli B. Norwalk virus D. All of the above

_____38.

Most common virus causing enteritis: A. Norwalk virus B. Rotavirus

C. Astrovirus D. Adenovirus

_____39.

_____40.

Antibiotic associated colitis is due to: A. Clostridium perfringes B. Clostridium tetani

C. Clostridium difficile D. Staphylococcus aureus

Causes of enteritis: A. Drugs B. Radiation

C. Ascaris D. All of the above

_____41.

A malabsorption condition characterized by the presence of PAS laden macrophages in lamina propria of small intestine: A. Celiac sprue C. Whipple disease B. Tropical sprue D. None of the above

_____42.

Characteristic of celiac disease, EXCEPT: A. Patient is sensitive to gluten B. Humoral immunity is main cause of pathology C. Presence of antiendomesial antibody D. Loss of intestinal villi

_____43.

Factor/s predisposing to ischemic bowel disease: A. Oral contraceptives C. Angiographic procedures B. Antithrombin III deficiency D. All of the above

_____44.

Condition where the abdominal cavity is filled with mucnous secretions and mucin secreting cells: A. Mucinous cystadenoma C. Carcinoid syndrome B. Pseudomyxoma peritonei D. None of the above

_____45.

Cholesterol gallstones are characterized by: A. Common in Asian C. Supersaturation of bile with cholesterol B. Associated with biliary infection D. More common in male

_____46.

The following is/are complication/s of gallstone: A. Cholecystitis C. Cholangitis B. Gallstone ileus D. All of the above

_____47.

The appearance of jaundice with no other associated signs and symptoms in a patient with a gallstone implies: A. Ascending cholangitis C. Gallstone ileus B. Obstruction of common bile duct D. Pancreatic carcinoma

_____48.

Rokitansku Aschoff sinuses are seen in: A. Choledochal cysts C. Chronic cholecystitis B. Acute hemorrhagic pancreatitis D. Cholesterolosis

_____49.

Patient with biliary atreasia usually dies of: A. Ascending cholangitis C. Shock B. Bacterial infection D. Cirrhosis

_____50.

Periampullary carcinoma may involve the following organs, EXCEPT: A. Duodenum, second portion C. Pancreatic tall B. Common bile duct D. Ampulla of Vater

_____51.

Pancreatic tissues encircling the duodenum is known as: A. Agenesis C. Annular B. Divisum D. Aberrant

_____52.

The most common causes of pancreatitis: A. Drugs and infection C. Infection and alcoholism B. Alcoholism and gallstone D. Mumps and biliary diseases

_____53.

The following are implicated in the development of pancreatic injury, EXCEPT: A. Activation of enzymes C. Impaction of the pancreatic duct B. Toxic effect to the acini D. Fibrinoid necrosis of the parenchyma

_____54.

Malabsorption, steatorrhea, diabetes and pseudocyst are considered late complications of: A. Chronic pancreatitis C. Periampullary carcinoma B. Gallstone D. Biliary atresia

_____55.

Pancreatic carcinoma are derived from: A. Pancratic islet C. Acini B. Ductal epithelium D. Ampullary of Vater

_____56.

Carcinoma of pancreas is usually seen in most cases in: A. Head C. Tail B. Body D. Diffuse

_____57.

Most common pancreatic carcinoma: A. Adenocarcinoma B. Adenosquamous

C. Anaplastic D. Acinic cell carcinoma

_____58.

Prognosis of pancreatic carcinoma: A. 5 yr mortality rate of more than 90% C. 5 yr survival rate of 100% B. 5 yr mortality rate of less then 50% D. 5 yr survival rate of 75%

_____59.

Epigastric pain radiating to the back may be due to: A. Acute pancreatitis C. Periampullary carcinoma B. Gallstone ileus D. Biliary atresia

_____60.

Pseudocysts are most frequently due to: A. Pancreatitis C. Choledochal cysts B. Cholelithiasis D. Carcinoma of the gallbladder

_____61.

Acalcilous cholecystitis is brought about by: A. Trauma C. Sepsis B. Post operative state D. All of the above

_____62.

Most common etiologic agent of ascending cholagitis: A. Tuberculosis C. Fungal B. Gram negative bacilli D. Viral

_____63.

Most common type of biliary atresia: A. Type I B. Type II

_____64.

C. Type III D. None of the above

Carcinoma of the gallbladder are usually: A. Adenocarcinoma C. Squamous B. Undifferentiated D. Adenosquamous

_____65.

A 39-year-old man had an acute febrile illness with fever, pharyngitis, lymphadenopathy, and malaise following a trip to a city known for is commercial sex workers. In how many years would you predict that his peripheral blood CD4 lymphocyte count will drop below 200/microliter: A. 1 year C. 10 years B. 5 years D. 30 years

_____66.

A 30-year-old patient has a CD4 lymphocyte count of 152/microliter. Physical examination reveals oral thrush. There has been a 10% loss of body weight over the past month. These findings are LEAST likely to have resulted from: A. Sexual intercourse with an HIV-infected person B. Sharing a needle for drug injection from an HIV-infected person C. Transplacental spread from an HIV-infected mother D. Cleaning up a spill of HIV-infected blood without gloves

_____67.

A 41-year-old man has a 0.4 cm diameter firm reddish area on the glans of his penis that has surface ulceration. This has developed over the past week. It is not particularly painful. This lesion subsides, but then a month later he develops a bilateral palmar maculopapular rash. The rash subsides in a few weeks. Which of the following infectious agents is most likely to produce these findings: A. Treponema pallidum C. Human papillomavirus B. Hemophilus ducreyi D. Nesseria gonorrhea

_____68.

A 20-year-old commercial sex worker has lower abdominal pain of 24 hours duration. There is no previous history of pain. She is febrile, her total WBC is 29,000/mm3 with 85% neutrophils. She has a markedly tender lower abdomen on palpation. Laparotomy reveals a distended, fluid-filled reddened left fallopian tube that is about to rupture. The tube is removed. A culture of the fluid from the tube is most likely to grow: A. Treponema pallidum C. Human papillomavirus B. Hemophilus ducreyi D. Neisseria gonorrheae

_____69.

A 19-year-old student has noted fever for one week with foul smelling urethral discharge. A history of unprotected sexual intercourse with female partners was obtained. A grams stain of the discharge will revealed: A. Intracellular gram positive diploccoci C. Gram positive spirochete B. Intracellular gram negative diplococci D. Gram positive cocci in clusters

_____70.

A 30-year-old HIV-infected man has a CD4 count of 125/microliter. He now has a profuse watery diarrhea. Which of the following infections is he most likely to have: A. Cytomegalovirus C. Cryptosporidium B. Pneumocystis carinii D. Mycobacterium tuberculosis

_____71.

A 20-year-old healthy woman is sexually active. She has noted multiple painful genital epithelial vesicles ranging in size from 0.1 to 0.3 cm that have occurred sporadically over months. A. Staphylococcus aureus C. Treponema pallidum B. Calymmatobacterium sp D. Herpes simplex virus

_____72.

Ulceration of the male external genitalia is LEAST likely with infection by: A. Human papillomavirus C. Calymmatobacterium granulomatis B. Treponema pallidum D. Hemophilus ducreyi

_____73.

Urethritis with pain and a burning sensation on urination is present in a 30-year-old sexually active man. The most likely organism associated with this finding is: A. Herpes simplex virus C. Treponema pallidum B. Chlamydia trachomatis D. Hemophilus ducreyi

_____74.

A 21-year-old man was notified by the health department that his last sexual contact 3 weeks prior was VDRL positive. The best indicator of the same infection in him is: A. Positive VDRL in the CSF C. Testicular gumma on biopsy B. Mucocutaneous rash D. Genital condyloma lata

_____75.

Pearly penile papules at the edge of the glans penis in a healthy 27-=year-old sexually active male represent: A. Premalignant change C. Infection with human papillomavirus B. Infection with H. ducreyi D. A finding associated with phimosis

_____76.

The best way to diagnose infection with Primary syphilis A. Darkfield microscopic examination of exudates or secretion B. Cytologic smear C. ELISA performed on serum D. Microbiolgoc culture

_____77.

The best way to diagnose infection with Secondary syphilis A. Darkfield microscopic examination of exudates or secretion B. Cytologic smear C. ELISA performed on serum D. Microbiologic culture

_____78.

A 45-year-old sexually active man complain of dysuria. Examination of the uncircumcised penis reveals erythema and edema of the urethral meatus. Which of the following infectious agents is most likely to be associated with these findings: A. Human papillomavirus C. Chlamydia trachomatis B. Herpes simplex virus D. Treponema pallidum

_____79.

Dengue virus can produce: A. Transient bone marrow suppression D. Decreased platelet count B. Shock E. All of the above C. DIC

_____80.

The predominant pathology is Rickettsial infection: A. Widespread granulamatous formation B. Suppurative inflammation at the portal of entry C. Endothelial cell damage D. Exotoxin elaboration E. None of the above

_____81.

True of Chlamydia trachoma infection: A. Produces a chronic suppurative ocular infection B. Very common among poor people and nomads C. Infection can be self-limiting D. There can be superimposed bacterial infection E. All of the above

_____82.

True of Mycobacterium leprae: A. Produces granulomatous inflammation in the cerebrum B. Acid fast obligate intracellular parasite C. Elaborates exotoxins D. Elaborates endotoxins E. Grow best at 32 to 34oC

_____83.

Schistosoma produces pathology by: A. Elaborating substances which are directly hepatotoxic B. Carbohydrate antigens induce macrophage accumulation C. Eggs release factors that stimulate lymphocyte to secrete chemical mediators D. All of the above E. None of the above

_____84.

Effects of schistosoma infections, EXCEPT: A. Pipestem fibrosis of the liver D. All of the above B. Urinary bladder granulomas E. None of the above D. Portal hypertension

_____85.

Characteristic/s of ancylostoma duodenale infection: A. Severe anemia B. Infects man by ingestion of uncooked food C. Larva settles in the intestinal wall D. Caused by ingestion of tapeworm eggs E. Wall contains a protein called antigen B

_____86.

True of staphylococcal organisms, EXCEPT: A. Can produce food poisoning D. Can produce pimple infection B. Can produce skin exfoliation E. None of the above C. Can produce titanic contractions

_____87.

Most common cause of nosocomial infections: A. Staphylococcus aureus D. Escherichia coli B. Staphylococcus epidermidis E. Bacteroides fragilis

_____88.

Organism usually implicated in the development of dental caries: A. Staphylococcus aureus D. Streptococcus mutans B. Staphylococcus epidermidis E. Clostridium botulinum C. Streptococcus pneumonia

_____89.

Virulence factors elaborated by staphylococci A. Hemolysins D. Enterotoxins B. Exfoliatins E. All of the above C. Leukocidin

_____90.

Cause of toxic shock syndrome of women using vaginal tampons: A. Staphylococcus aureus D. Peptostreptococcus B. Streptococcus viridans E. Bacteroides fragilis C. Clostridium perfringers

_____91.

Variant of streptococcus that causes rheumatic fever: A. Group A D. All of the above B. Group B E. None of the above C. Group C

_____92.

Virulence factor of streptococcus which prevent them from being phagocytosed: A. Lipotechoic acid D. Exotoxins B. M Protein E. None of the above C. Pneumolysin

_____93.

In streptococcal pharyngitis, the predominant inflammatory infiltrate would be: A. Lymphocytes D. Macrophages B. Plasma cells E. Polymorphonuclear leukocytes C. Histiocytes

_____94.

Clostridial perfringen infection is characterized by the following, EXCEPT: A. Gas formation D. Plenty of PMN infiltrates B. Muscle fiber necrosis (myonecrosis) E. None of the above C. RBC hemolysis

_____95.

Usual cause of periodontal abscess: A. Prevotella B. Propionebacterium acnes C. bacteroides fragilis

_____96.

D. Fusobacterium E. Actinomyces

True of measles virus infection, EXCEPT: A. Spread by respiratory droplets B. Characterized by transient viremia C. Koplik’s spot herald the onset of rash D. Rash is due to humoral immunity E. T cell mediated immunity controls the viral infection

_____97.

True of mumps infection: A. Affects salivary gland tissue only B. Can cause male sterility C. Affects both parotids in 70% of cases D. Can involve submandibular and submaxillary glands E. Produces interstitial mononuclear cell infiltration in the parotid gland

_____98.

True of infectious mononucleosis: A. Self limiting B. Cause by CMV organism C. Occur usually among newborns and infants D. Transmissible only kissing E. All of the above

_____99.

Characteristics of Infectious mononucleosis, EXCEPT: A. Lymphocytosis B. Enlarged lymph nodes C. Atypical lymphocytes D. Moderate hepatomegaly E. Preponderance of monocytes

_____100.

The diagnosis of Infectious mononucleosis, depends on: A. Lymphocytosis with on the following page B. Monospot test C. Specific antibodies for EBV virus D. All of the above E. None of the above -end-