Download MBBS UHS Lahore 3rd Year Special Pathology MCQ Question Paper

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MBBS THIRD PROFESSIONAL

MODEL QUESTIONS FOR ANNUAL 2009

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Special Pathology

(Multiple Choice Questions)

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Q.1

A 58 -year-old man died after an episode of severe chest pain that radiated

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to the back. Autopsy showed an intimal tear in the aortic wall 5cm from the

aortic valve with intramural aortic hematoma. Elastic tissue fragmentation

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is noted in the aortic wall. What is the major risk factor predisposing to this

condition:

a) Hyperlipidemia

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b) Cigarette smoking

c) Alcohol consumption

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d) Hypertension

e) Defects in lipid metabolism

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Q.2

A patient who is a known case of hypertension and coronary artery disease

complains of severe chest pain radiating to left arm, while admitted to the

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CCU for worsening angina. The pain does not subside with sublingual

nitroglycerine. ECG shows ST segment elevation. The registrar institutes

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thrombolytic therapy within 20 minutes of onset of symptoms. What is the

most likely outcome if successful thrombolysis is achieved in this patient:

a) More than 80% of the myocardium at risk will be salvaged

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b) Myocardial death will be prevented

c) More than 50% of the myocardium at risk would be salvaged

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d) Reperfusion injury would be minimized

e) Complete infarction of the myocardium at risk

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Q.3

Four months following a dental surgery a 65-year old man develops flu-like

symptoms with fatigue and weight loss. Chest auscultation reveals an

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aortic murmur and Echocardiography shows calcific stenosis of the aortic

valve with large vegetations. A blood culture in this patient is likely to be

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positive for:

a) Staphylococcus aureus

b) Group B beta hemolytic streptococci

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c) Staphylococcus epidermidis

d) Streptococcus viridans

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e) Gram negative bacilli


Q.4

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Bone marrow examination of a patient presenting with severe anemia and

jaundice reveals increased number of normoblasts and a reticulocyte count

of 10%. Bilirubin is 8mg/dl and predominantly unconjugated. If the patient

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has no hemoglobinuria or hemoglobinemia, what is the most likely cause of

anemia:

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a) Iron deficiency

b) Cobalamine deficiency

c) Intravascular hemolysis

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d) Aplastic anemia

e) Extravascular hemolysis

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Q.5

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A traveller from Europe is given antimalarial prophylaxis before he

travelled to Pakistan. He presented to a local hospital with lethargy, anemia

and jaundice. Urine routine examination shows hemoglobinuria. A

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peripheral smear shows bite cells and membrane-bound precipitates in red

blood cells which stain as dark inclusions on cresyl violet staining. What

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enzyme deficiency is likely to be present in this patient:

a) Phosphofructokinase

b) Glucose 6-phosphate dehydrogenase (G6PD)

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c) Alpha 1 antitrypsin

d) Glutathione reductase

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e) Glutathione peroxidase



Q.6

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A patient presents with weakness, pallor and repeated episodes of fever

and chills 2 months after he recovered from an episode of viral hepatitis.

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Blood CP shows pancytopenia. Bone marrow biopsy shows fatty infiltration

of marrow with marked hypocellularity. The findings are most consistent

with a diagnosis of:

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a) Myelodysplastic syndrome

b) Acute leukemia

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c) Aplastic anemia

d) Non Hodgkin's Lymphoma

e) Chronic leukemia

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Q.7

A 30-year-old female presenting with insidious onset of shortness of breath

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associated with dry cough is found to have bilateral hilar lymphadenopathy

with pulmonary infiltrates. Bronchoscopic biopsy shows non-caseating

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granulomas with giant cells containing Schaumann bodies and asteroid

bodies. These features are most consistent with a diagnosis of:

a) Tuberculosis

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b) Silicosis

c) Interstitial pneumonitis

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d) Sarcoidosis

e) Fungal infection

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Q.8

A 45-year-old woman presents with anemia and fatiguability. She has mild

jaundice on clinical examination. Blood CP shows a raised MCV of 105fl and

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leucopenia. Peripheral smear shows macrovalocytes and hypersegmented

neutrophils. Schilling test for absorption of orally administered cobalamin is

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positive. What is a gastric biopsy from this patient likely to show:

a) H. pylori infection

b) Chronic non specific gastritis

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c) Peptic ulceration

d) Hypertrophic gastritis

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e) Atrophy of fundic glands with intestinalization


Q.9

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A 40-year-old male develops chronic diarrhea following antibiotic therapy

for enterocolitis. Sigmoidoscopy reveals plaques of yellow fibrin and

inflammatory debris adherent to colonic mucosa. Histologic examination of

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biopsy material reveals a plaque-like adhesion of fibrinopurulent necrotic

debris and mucous to damaged colonic mucosa. Diagnosis is confirmed by

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finding of which bacterial toxin in stool:

a) Shiga toxin

b) C. difficile cytotoxin

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c) Vibrio cholera enterotoxin

d) Campylobacter enterotoxin

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e) E. coli enterotoxin


Q.10 A 30-year-old female has attacks of bloody mucoid diarrhea lasting a week

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to 10 days with symptom free intervals of 3-4 months in between.

Sigmoidoscopy shows uninterrupted mucosal inflammation from rectum to

splenic flexure. Biopsy material shows mucosal ulceration, cryptitis and

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crypt abscess formation, pseudopolyps and mild epithelial dysplasia. No

granulomas are seen. What morphologic feature is the most important

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predictor of long-term prognosis of this patient:

a) Absence of granulomas

b) Ulceration

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c) Cryptitis

d) Dysplasia

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e) Pseudopolyps

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