10.

The most common cause of myocarditis is:

a. bacteria
TOPICS: COMPILED BR QUESTIONS + BCA 2020 b. virus
c. fungi

11. What are the most frequent types of pericarditis?

WEEK 1 a. Fibrinous and Serofibrinous
HEART
1. The most common cause of right sided heart failure is: 12. What is the most common primary adult tumor of the heart?
a. primary lung disorder Myxoma
b. left sided heart failure
c. ischemic heart disease LUT AND MALE GENITAL TRACT
d. none of the above
1. What is the most common cause of hydronephrosis in infants?
a. Double ureters.
2. What is Eisenmenger syndrome? It is a reversal of shunt of an
b. Diverticula
initially….
c. Ureteropelvic junction obstruction
a. right to left
d. Hydroureter
b. left to right….shunts
2. Ureteritis follicularis is described as follows:
3. Majority of ischemic heart disease is due to:
a. Cystic mucosa is present
a. vasospasm
b. Aggregates of lymphocytes in subepithelial region
b. coronary artery atherosclerosis
c. Smooth mucosa
c. vasculitis
d. None of the above
d. embolism
3. Which of the ff. is TRUE?
4. Myocardial necrosis in MI is observed in:
a. Mortality rate in urothelial CA is increased with
a. 1-2 minutes
muscularis propria invasion
b. 4-5 minutes
b. Carcinoma in situ is a flat invasive CA
c. 20-40 minutes
c. Squamous cell CA is the most predominant urinary bladder
d. 1 hour ….of ischemia
CA
d. Leiomyosarcoma is the most common bladder tumor in
5. Which of the ff. characterizes acute cor pulmonale?
infancy
a. dilated right ventricle
b. hypertrophied right ventricle
4. Which of the ff. are parts of Reiter syndrome?
c. due to massive pulmonary embolism
a. arthritis, conjunctivitis, and cystitis
d. A & C
b. arthritis, conjunctivitis, and urethritis
e. A, B, C
c. chorea, conjunctivitis, and urethritis
d. D. tenosynovitis, conjunctivitis, and cystitis
6. Which NOT true of functional regurgitation?
a. due to a primary valve defect
5. Which of the ff. is TRUE?
b. there is abnormality in valve support structures
a. Epispadia is more common than hypospadia.
c. can be seen in dilated cardiomyopathy
b. The abnormal opening in epispadia & hypospadia is
d. none of the above
constricted
c. There is increased risk of UTI through hematogenous route.
7. Which valve is most commonly affected by RHD?
d. All of the above.
a. pulmonic
b. aortic
6. Condyloma acuminatum of the penis:
c. mitral
a. is caused by poxvirus
d. tricuspid
b. has koilocytosis
c. The basement membrane is destroyed.
8. Which commonly affects previously abnormal valves?
d. all of the above
a. acute infective endocarditis
b. subacute infective endocarditis
7. Which of the ff. is NOT associated with HPV?
a. Bowen’s disease
9. Which of the ff. Cardiomyopathies results to heart failure
b. Bowenoid papulosis
secondary to systolic dysfunction?
c. Erythroplasia of Queyrat
a. dilated
d. None of the above
b. hypertrophied
c. restrictive
8. Fusion of testes is known as:
d. A & B
a. Cryptochidism
e. B & C
b. Balanoposthisis
c. Synorchism

TRANSCRIBER: VISION 1 OF 21

VICTORUM – CONQUER!
 d. Exstrophy d. formation of free radicals
e. cell membrane damage
9. Testicular atrophy is observed in which condition?
a. Old age 3. Apoptosis rather than tissue necrosis is more likely involved in
b. Cachexia which of the following disorders or physiologic events?
c. Administration of oxygen a. Involution of the thymus
d. All of the above b. Abnormal mitochondrial structure
c. Widespread tissue necrosis
10. Which of the ff. is NOT a germ cell tumor of the testis? d. Inflammatory infiltrates
a. Leydig e. Faint cytoplasmic staining
b. Seminoma
c. Yolk sac tumor
4. The pathologic process in acute suppurative appendicitis is the
d. Choriocarcinoma
same process that is primarily involved in
a. acute MI
11. Characteristic/s of classic seminoma:
b. immune vasculitis
a. Large & round nucleus
c. dry gangrene
b. Watery appearance cytoplasm
d. brain infarction
c. Prominent nucleoli
e. apoptosis
d. All of the above

12. Presence of Schiller Duval bodies is seen in 5. Metastatic rather than dystrophic calcification is primarily
a. Embryonal CA represented by
b. Yolk sac tumor a. calcific aortic stenosis in a patient with a bicuspid aortic
c. Choriocarcinoma valve
d. Seminoma b. calcified atherosclerotic plaques in the aorta
c. calcification of the pineal gland in elderly
13. Teratoma in postpubertal male d. calcification of renal tubular basement membranes in
a. Considered malignant primary hyperparathyroidism
b. Derived from one germ cell layer
c. Usually pure 6. A 20 year old female went to Boracay and did sunbathing for 3 days
d. D. None of the above without using a sun block. What possible cell injury would occur?
a. Depletion of ATP
14. Which is the most potent b. Mutation of DNA
growth stimulus in benign c. Mitochondrial rupture
prostatic hyperplasia? d. Injury to lysosomal membrane
a. Testosterone e. Formation of free radicals
b. Estrogen
c. Dihydrotestosterone
INFLAMMATION AND REPAIR
d. Peptide growth factor
1. A clinical study is performed of patients with pharyngeal
infections. The most typical clinical course averages 3 days from
15. Most prostatic CA is located in
the time of onset until the patient sees the physician. Most of these
a. Peripheral zone
patients experience fever and chills. On physical examination, the
b. Anterior region
most common findings include swelling, erythema, and
c. Centralregion
pharyngeal purulent exudate. Which of the following types of
d. Inferior aspect
inflammation did these patients most likely have?
a. Granulomatous
WEEK 2 b. Acute
CELL INJURY c. Gangrenous
1. The growth alteration in LVH is most closely related to which one d. Resolving
of the following growth alterations? e. Chronic
a. lactation in breast tissue
b. degeneration of liver tissue after injury 2. A 22-year-old man develops marked right lower quadrant
c. denervation of skeletal muscle abdominal pain over the past day. On physical examination there
d. skeletal muscle of weight lifter is rebound tenderness on palpation over the right lower quadrant.
e. bladder smooth muscle reaction to urethral obstruction Laparoscopic surgery is performed, and the appendix is swollen,
erythematous, and partly covered by a yellowish exudate. It is
2. From the following list of alterations, select an early event in removed, and a microscopic section shows infiltration with
hypoxic cell injury that is directly related to ATP deficiency. numerous neutrophils. The pain experienced by this patient is
a. lipid peroxidation predominantly the result of which of the following two chemical
b. nuclear pyknosis mediators?
c. cellular swelling a. Complement C3b and IgG

TRANSCRIBER: VISION 2 OF 21

VICTORUM – CONQUER!
 b. Interleukin-1 and tumor necrosis factor b. Immunogloblulin G
c. Histamine and serotonin c. Complement component C3b
d. Prostaglandin and bradykinin d. Leukotriene B4
e. Leukotriene and HPETE e. Vascular endothelial growth factor

3. A 58-year-old woman has had a cough with fever for 3 days. A chest 8. A 94-year-old woman has developed a fever and cough over the
radiograph reveals infiltrates in the right lower lobe. A sputum past 2 days. Staphylococcus aureus is cultured from her sputum.
culture grows Streptococcus pneumoniae. The clearance of these She receives a course of antibiotic therapy. Two weeks later she no
organisms from the lung parenchyma would be most effectively longer has a productive cough, but she still has a fever. A chest
accomplished through generation of which of the following radiograph reveals a 3 cm rounded density in the right lower lobe
substances by the major inflammatory cell type responding to this whose liquefied contents form a central air-fluid level. There are no
infection? surrounding infiltrates. Which of the following is the best
a. Platelet activating factor description for this outcome of her pneumonia?
b. Prostaglandin E2 a. Hypertrophic scar
c. Kallikrein b. Abscess formation
d. Leukotriene B4 c. Regeneration
e. Hydrogen peroxide d. Bronchogenic carcinoma
e. Chronic inflammation
4. A 56-year-old man has had increasing dyspnea for 6 years. He has f. Granulomatous cavitation
no cough or fever. He had chronic exposure to inhalation of silica
dust for many years in his job. A chest x-ray now shows increased 9. A 36-year-old woman has been taking acetylsalicylic acid (aspirin)
interstitial markings and parenchymal 1 to 3 cm solid nodules. His for arthritis for the past 4 years. Her joint pain is temporarily
pulmonary problems are most likely to be mediated through reduced via this therapy. However, radiographs of her knees
which of the following inflammatory processes? reveals continuing joint destruction with loss of articular cartilage
a. Neutrophilic infiltrates producing leukotrienes and joint space narrowing. This pain reduction is most likely to be
b. Foreign body giant cell formation the result of diminishing which of the following chemical
c. Plasma cell synthesis of immunoglobulins mediators?
d. Mast cell histamine release a. Leukotriene B4
e. Macrophage elaboration of cytokines b. Interleukin-1
c. Prostaglandin
5. A 43-year-old woman has had a chronic cough with fever and d. Bradykinin
weight loss for the past month. A chest radiograph reveals multiple e. Hageman factor
nodules from 1 to 4 cm in size, some of which demonstrate
cavitation in the upper lobes. A sputum sample reveals the 10. A small sliver of wood becomes embedded in the finger of a 25-
presence of acid fast bacilli. Which of the following cells is the most year-old man. He does not remove it, and over the next 3 days the
important in the development her lung lesions? area around the sliver becomes red, swollen, and tender.
a. Macrophage Neutrophils migrate into the injured tissue. Expression of which of
b. Fibroblast the following substances on endothelial cells is most instrumental
c. Neutrophil in promoting this inflammatory reaction?
d. Mast cell a. Interferon gamma
e. Platelet b. Hageman factor
c. Lysozyme
6. A 20-year-old man has experienced painful urination for 4 days. A d. E-selectin
urethritis is suspected, and Neisseria gonorrheae is cultured. e. Prostacyclin
Numerous neutrophils are present in a smear of the exudate from
the penile urethra. These neutrophils undergo diapedesis to reach 11. An inflammatory process that has continued for 3 months includes
the organisms. Release of which of the following chemical the transformation of tissue macrophages to epithelioid cells.
mediators is most likely to drive neutrophil exudation? There are also lymphocytes present. Over time, fibroblasts lay
a. Histamine down collagen as the focus of inflammation heals. These events
b. Prostaglandin are most likely to occur as an inflammatory response to which of
c. Hageman factor the following infectious agents?
d. Bradykinin a. Mycobacterium tuberculosis
e. Complement b. Pseudomonas aeruginosa
c. Cytomegalovirus
7. An episode of marked chest pain lasting 4 hours brings a 51-year- d. Giardia lamblia
old man to the emergency room. He is found to have an elevated e. Treponema pallidum
serum creatine kinase. An angiogram reveals a complete blockage
of the left circumflex artery 2 cm from its origin. Which of the 12. A 37-year-old man has had nausea and vomiting for 5 weeks. He
following substances would you most expect to be elaborated experienced an episode of hematemesis yesterday. On physical
around the region of tissue damage in the next 3 days as an initial examination he has no abnormal findings. Upper GI endoscopy is
response to promote healing? performed, and there is a 1.5 cm diameter lesion in the gastric
a. Histamine

TRANSCRIBER: VISION 3 OF 21

VICTORUM – CONQUER!
 antrum with loss of the epithelial surface. These findings are most TISSUE REPAIR
typical for which of the following pathologic processes? 1. Arrange the following events in healing by primary intention into
a. Abscess the proper sequence.
b. Serositis 1. peak granulation tissue forms
c. Granuloma 2. macrophages replace neutrophils
d. Gangrene 3. tensile strength is 10%
e. Ulcer 4. continuous epithelial lining seals the wound
a. 2-3-4-1
13. A 45-year-old woman has had a chronic, non-productive cough for b. 4-1-2-3
3 months, along with intermittent fever. She has a chest c. .2-4-3-1
radiograph that reveals multiple small parenchymal nodules along d. 4-2-1-3
with hilar and cervical lymphadenopathy. A cervical lymph node e. 2-4-1-3
biopsy is performed. Microscopic examination of the biopsy shows
noncaseating granulomatous inflammation. Cultures for bacterial, 2. Which of the following is/are stable tissue/s?
fungal, and mycobacterial organisms are negative. Which of the a. Endothelial cells
following chemical mediators is most important in the b. Neural cells
development of her inflammatory response? c. Endometrium
a. Interferon gamma d. A & B only
b. Bradykinin e. A, B & C
c. Complement C5a
d. Histamine
3. Which of the following growth factors is the most potent
e. Prostaglandin E2
fibrogenic agent?
a. TNF
14. A 15-year-old girl has had episodes of sneezing with watery eyes
b. TGF-β
and runny nose for the past 2 weeks. On physical examination she
c. EGF
has red, swollen nasal mucosal surfaces. She has had similar
d. PDGF
episodes each Spring and Summer when the amount of pollen in
e. VEGF
the air is high. Her symptoms are most likely to be mediated by the
release of which of the following chemical mediators?
a. Complement C3b 4. Receptors lacking intrinsic tyrosine kinase activity, transmit signals
b. Platelet activating factor (PAF) to the nucleus by:
c. Tumor necrosis factor (TNF) a. cAMP pathway
d. Histamine b. MAP-kinase pathway
e. Immunoglobulin G c. IP3 pathway
d. JAK/STAT pathway
15. A 72-year-old woman did not get a 'flu' shot in the fall as
recommended for older persons. In the wintertime, she became ill, 5. Excessive formation of repair components may result to:
as many people in her community did, with a respiratory illness a. Keloid
that lasted for 3 weeks. During this illness, she had a fever with a b. Hypertrophic scar
non-productive cough, mild chest pain, myalgias, and headache. c. Wound dehiscence
What was her chest radiograph most likely to have shown during d. A and B only
this illness? e. A, B & C
a. Hilar mass 6. Most abundant collagen in the basement membrane
b. Interstitial infiltrates a. A.I
c. Hilar lymphadenopathy b. II
d. Lobar consolidation c. III
e. Pleural effusions d. IV
e. V
16. A 17-year-old truck driver is involved in a collision.He incurs blunt
force abdominal trauma. In response to this injury, cells in tissues 7. A 31-year-old woman has a laparotomy performed for removal of
of the abdomen are stimulated to enter the G1 phase of the cell an ovarian cyst. She recovers uneventfully, with no complications.
cycle from the G0 phase. Which of the following cell types is most At the time of surgery, a 12 cm long midline abdominal incision
likely to remain in G0 following this injury? was made. The tensile strength in the surgical scar will increase so
a. Smooth muscle her normal activities can be resumed. Most of the tensile strength
b. Endothelium will likely be achieved in which of the following time periods?
c. Skeletal muscle a. One week
d. Fibroblast b. One month
e. Hepatocyte c. Three months
d. Six months
e. One year

TRANSCRIBER: VISION 4 OF 21

VICTORUM – CONQUER!
 8. In an experiment, surgical wound sites are observed following a. Heart failure
suturing. An ingrowth of new capillaries is observed to occur b. Malabsorption
within the first week. A substance elaborated by macrophages is c. Peripheral neuropathy
found at the wound site to stimulate this capillary proliferation. d. Skin rash
Which of the following substances is most likely to have this e. Renal failure
function?
a. Platelet-derived growth factor 4. A male infant is born at term. No congenital anomalies are noted
b. Phospholipase C-gamma on examination. A year later he now has failure to thrive and has
c. Fibronectin been getting one bacterial pneumonia after another with both
d. Fibroblast growth factor Hemophilus influenzae and Streptococcus pneumoniae cultured
e. Epidermal growth factor from his sputum. Which of the following diseases is he most likely
to have?
9. A 19-year-old man incurs a stab wound to the chest. The wound is a. DiGeorge syndrome
treated in the emergency room. Two months later there is a firm, 3 b. Selective IgA deficiency
x 2 cm nodular mass with intact overlying epithelium in the region c. Epstein-Barr virus (EBV) infection
of the wound. On examination the scar is firm, but not tender, with d. Acute leukemia
no erythema. This mass is excised and microscopically shows e. X-linked agammaglobulinemia
fibroblasts with abundant collagen. Which of the following
mechanisms has most likely produced this series of events?
5. The second pregnancy for a 23-year-old woman appears
a. Keloid formation
uncomplicated until ultrasound performed at 19 weeks shows
b. Development of a fibrosarcoma
hydrops fetalis. The fetal organ development is consistent for 19
c. Poor wound healing from diabetes mellitus
weeks, and no congenital anomalies are noted. Her first pregnancy
d. Foreign body response from suturing
was uncomplicated and resulted in the birth of a normal girl at
e. Staphyloccocal wound infection
term. The current pregnancy ends with birth of a baby boy at 32
weeks gestation. On examination the baby has marked icterus.
IMMUNE SYSTEM
Laboratory studies show a hemoglobin of 7.5 g/dL, and neonatal
1. A 55-year-old man has developed progressive renal failure for the
exchange transfusion is performed. Which of the following
past 5 years. Microscopic examination of a renal biopsy shows
immunologic mechanisms best explains this infant's findings?
extensive glomerular and vascular deposition of pink amorphous
a. Anti-receptor antibody
material on H&E staining. This material demonstrates apple-green
b. Loss of self tolerance
birefringence under polarized light after Congo red
c. Immune complex formation
staining.Immunohistochemical staining of these deposits is
d. Delayed type hypersensitivity
positive for lambda light chains. Which of the following conditions
e. Complement mediated cell destruction
is most likely to be present in this man?
a. Rheumatoid arthritis
b. Tuberculosis HEAD AND NECK
c. Systemic lupus erythematosus 1. A 50 year old man notes a slowly enlarging lump on the left side of
d. Multiple myeloma his face for several years. On physical examination, there is a firm,
e. Alzheimer disease mobile mass anterior to the left ear and above the angle of the
mandible. The mass is removed and is grossly 3 cm in diameter
with discreet borders and a grey-white cut surface. Microscopically
2. A 22-year-old woman has experienced episodes of myalgias, chest
it is composed of epithelial elements dispersed throughout a
pain, and arthralgias for the past 3 years. On examination a friction
matrix of mucoid, myxoid, and chondroid tissue. Around the mass
rub is audible on chest auscultation and there is dullness to
are serous glands. This lesion is most likely to be a(an):
percussion at posterior lung bases. No joint deformity is noted. She
a. Warthin's tumor
has continued working at her job. She has a mild normocytic
b. Pleomorphic adenoma
anemia. A chest x-ray shows bilateral pleural effusions. Which of
c. Adenoid cystic carcinoma
the following laboratory screening tests is most appropriate to
d. Teratoma
begin the workup for her condition?
e. Mucoepidermoid carcinoma
a. CD4 lymphocyte count
b. Blood culture
c. Antinuclear antibody test 2. A 56-year-old male has a slow-growing mass involving the right
d. Sedimentation rate parotid region that he has noticed for the past year. For several
e. Creatine phosphokinase months he has experienced pain in this area. Surgical excision is
undertaken and the mass is 4 cm in diameter and found to be
invading surrounding structures, including the facial nerve. This
3. A 20-year-old woman has had symmetrical, proximal muscle
neoplasm is probably a(an):
weakness for 6 months. On exam she has 4/5 motor strength in all
a. Adenoid cystic carcinoma
extremities. A deltoid biopsy shows a neutrophilic infiltrate with
b. Squamous cell carcinoma
focal necrosis of the muscle fibers. Her antinuclear antibody test is
c. Warthin's tumor
negative, but she has histidyl-tRNA synthetase (Jo-1) antibody in
d. Pleomorphic adenoma
her serum. Which of the following additional findings would be
e. Metastatic laryngeal carcinoma
most likely be present in this patient?

TRANSCRIBER: VISION 5 OF 21

VICTORUM – CONQUER!
 These plaques cannot be removed by scraping. His dentist advises
3. A 21-year-old male gives a history of hay fever all his life. He has him that he is at risk for development of:
noted increasing difficulty breathing through his nose for the past a. Squamous cell carcinoma of the mouth
several years. This is due to nasal obstruction with a feeling of nasal b. Salivary gland duct lithiasis
stuffiness but no bleeding or pain. On physical examination, you c. Sjogren's syndrome
find bilateral soft, pale, glistening, rounded masses filling the nasal d. Pleomorphic adenoma
cavities. The most likely diagnosis is: e. Mucocele
a. Wegener's granulomatosis
b. Sarcoidosis 9. Examination of the oral cavity of a 42 year old male reveals a
c. Squamous papillomatosis reddish-blue, circumscribed, papular lesion with superficial
d. Angiofibromas ulceration that is located on the left anterior gingival ridge above
e. Benign nasal polyps the mandible. This lesion is most likely to be a(an):
a. Thyroglossal duct cyst
4. A 55-year-old male with a 100 pack year smoking history has had a b. Ameloblastoma
chronic cough for years. However, he has noticed increasing c. Cholesteatoma
hoarseness for several months. Recently, his sputum has been d. Mucocele
blood-streaked after coughing. You most strongly suspect that he e. Pyogenic granuloma
has:
a. Singer's nodules 10. A 14 year old male notes a "bump" on his neck that has been slowly
b. Herpes simplex virus infection enlarging for the past two years. On physical examination, there is
c. Laryngeal carcinoma a 2 cm diameter discreet mass in the anterior midline of the neck
d. Sjogren's syndrome above the thyroid cartilage. On head CT scan, this mass is cystic
e. Laryngeal papillomatosis with a thin wall and smooth border. Which of the following entities
does this lesion most likely represent:
5. A 71 year old male has noted a small bump on the left lower side a. A malignant neoplasm
of his mouth which he can feel with his tongue. On physical b. An embryologic remnant
examination, this small firm mass is 0.7 cm in diameter with no c. A granuloma
overlying erythema or ulceration. The lesion is excised and appears d. A benign neoplasm
microscopically to have been produced by obstruction of a minor e. An abscess
salivary gland duct. This lesion is most likely to be a: - (B) CORRECT. This is a thyroglossal duct cyst, left over from
a. Calculus embryologic migration of thyroid tissue from foramen cecum to
b. Mucocele the final location over the trachea. The cyst is lined by squamous
c. Mucoepidermoid carcinoma or respiratory epithelium and may have thyroid follicles and
d. Squamous papilloma lymphoid aggregates.
e. Hematoma
11. A 40 year old female has seropositivity for both SS-A and SS-B
6. A 44-year-old basketball coach has been screaming at players, autoantibodies. Her antinuclear antibody test is negative. Of the
assistant coaches, referees, and the media for years. He is at most following features, the one that is NOT characteristic of her
risk for development of: underlying condition is:
a. Chronic sinusitis a. Keratoconjunctivitis sicca
b. Laryngeal papilloma b. Xerostomia
c. Mucocele c. Mucormycosis
d. Laryngeal nodule d. Lymphocytic infiltrates of salivary gland
e. Laryngeal granuloma e. Risk for B-cell lymphoma

7. A 15 year old male has had problems with hoarseness for the past EYE
8 years and rare episodes of hemoptysis. He has had multiple 1. Neoplasms of the eyelid (basal cell carcinoma, squamous cell
resections of small nodular masses on the vocal folds. carcinoma, melanoma) are etiologically related most closely to:
Microscopically, these masses are composed of finger-like a. Use of mascara
projections of fibrovascular cores covered by squamous b. A hereditary condition
epithelium. These lesions are most likely to: c. Recurrent herpes infection
a. Respond to radiation therapy d. Sunlight exposure
b. Stem from human papillomavirus infection e. Glaucoma
c. Be solitary lesions
d. Become malignant 2. A 60 year old male has noted decreasing vision on the right for the
e. Spontaneously regress past year. Funduscopic examination reveals a darkly pigmented
uveal mass. These findings most strongly suggest a diagnosis of:
8. A 49-year-old male has a long history of use of chewing tobacco. a. Diabetic retinopathy
His dentist notes the presence of several 0.5 cm white plaques on b. Retinoblastoma
the oral mucous membrane just lateral to the left lower teeth. c. Melanoma
d. Tay-Sachs disease

TRANSCRIBER: VISION 6 OF 21

VICTORUM – CONQUER!
 e. Cytomegalovirus retinopathy a. Capillary microaneurysms
b. Dot and blot hemorrhages
3. A 56 year old female has noted increasingly frequent headaches c. Neovascularization
for the past year. She recently had her vision checked, and her d. Flame-shaped hemorrhages
intraocular pressure was found to be increased. The most e. Hard exudates Incorrect.
significant result of this condition, if not treated, is:
a. Cataract formation
KIDNEY
b. Conjunctivitis
1. A 62-year-old man has had back pain for the past 8 months. He has
c. Hypertensive retinopathy
had a productive cough for the past 2 days. On physical
d. Optic nerve damage
examination his temperature is 39°C and there is dullness to
e. Strabismus
percussion at the right lung base. Laboratory studies show 4+
gram-positive diplococci in the sputum. A chest radiograph shows
4. A 3-year-old child, who had been born prematurely at 30 weeks
right lower lobe consolidation. An abdominal CT scan shows
gestation and then developed hyaline membrane disease at birth,
multiple lytic lesions of the vertebrae. On the day prior to death his
is found to be visually impaired. Funduscopic examination reveals
serum urea nitrogen was 63 mg/dL with creatinine 7.1 mg/dL. A
retinal detachment on the left. The most likely pathogenesis of this
dipstick urinalysis was normal. At autopsy, his kidneys are firm and
condition is:
pale. Microscopically, there is abundant pink hyaline material in
a. Retinal damage by oxygen species of free radicals
glomeruli and around small vessels. This material stains positively
b. Hereditary hexosaminidase A deficiency
with Congo red. Which of the following laboratory findings was
c. Germinal matrix hemorrhage at birth
most likely to have been present in this patient in the week prior to
d. Alobar holoprosencephaly
death?
e. Absence of tumor suppressor gene on chromosome 13
a. Positive antinuclear antibody test
b. Serum glucose of 210 mg/dL
5. A 70 year old female has noted the appearance of a "spot" c. CD4 lymphocyte count of 110/microliter
discoloring the sclera of her right eye. Her physician notes a 0.3 cm d. Total serum protein of 9.2 g/dL
raised yellowish-white lesion near the limbus. This lesion is LEAST e. Serum prostate specific antigen of 11.8 ng/mL
likely to:
a. Appear more often in older persons 2. A 52-year-old previously healthy man has experienced episodes of
b. Decrease visual acuity discomfort with urination for 3 months. There are no remarkable
c. Increase in size very slowly over time findings on physical examination. Laboratory studies include a
d. Show elastosis of collagen histologically urinalysis that reveals 1+ blood. Microscopic urine examination
e. Have an association with sunlight exposure shows numerous RBCs, a few WBCs, and no casts. A urine culture is
negative. A plain film radiograph of the pelvis shows a rounded, 1
6. A 4 year old boy has lost vision in the right eye. Other children in cm radiopaque lesion in the region of the bladder. Which of the
his family have had a similar problem, with many losing vision in following laboratory test findings is most likely to be present in this
both eyes. A presumptive diagnosis of an intraocular tumor is man?
made. Which of the following statements is LEAST appropriate for a. Albuminuria
this condition: b. Hypercalciuria
a. Leukocoria is often noted on physical examination c. Transaminasemia
b. The patient may have inherited a faulty tumor d. Hemoglobinuria
suppressor gene e. Hyperuricemia
c. The tumor is composed of small blue cells that form
rosettes 3. A 72-year-old man has been feeling tired and lethargic for 5
d. Dystrophic calcification is often seen histologically months. He has noted increasing hesitancy with urination. On
e. The tumor often spreads via scleral vascular channels physical examination his prostate is diffusely enlarged. Laboratory
studies show sodium 139 mmol/L, potassium 4.0 mmol/L, chloride
104 mmol/L, CO2 25 mmol/L, creatinine 1.9 mg/dL, and glucose 81
7. A 41 year old female with a history of intravenous drug abuse
mg/dL. Which of the following renal abnormalities is most likely to
presents with a 1 day history of severe headache and high fever.
be present in this man?
She has marked nuchal rigidity. You suspect that her intracranial
a. Cortical atrophy
cerebrospinal fluid pressure is increased. Which of the following
b. Glomerulonephritis
funduscopic examination findings is most likely to be present:
c. Papillary necrosis
a. Deepening of the optic cup with excavation
d. Polycystic change
b. Arteriolar narrowing
e. Renal cell carcinoma
c. Neovascularization of the optic nerve
d. An elevation and swelling of the optic nerve
4. A 36-year-old woman has urinary frequency with dysuria for the
e. Flame-shaped hemorrhages
past 4 days. On physical examination she has no flank pain or
8. An obese 50 year old male has a serum glucose of 171 mg/dL and
tenderness. A urinalysis reveals sp. gr.1.014, pH 7.5, no glucose, no
a hemoglobin A1C that is increased. He has decreased visual
protein, no blood, nitrite positive, and many WBC's. She has a
acuity. A funduscopic examination reveals a proliferative
serum creatinine of 0.9 mg/dL. Which of the following is the most
retinopathy. Which of the following findings is most characteristic
likely diagnosis?
for this process:
a. Lupus nephritis

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 b. Urinary lithiasis surfaces. Microscopically they show hyperplastic arteriolosclerosis
c. Acute cystitis with fibrinoid necrosis, petechial hemorrhages, and microinfarcts
d. Malakoplakia in the cortices. Which of the following conditions is most likely to
e. Urothelial carcinoma be her underlying cause of death?
a. Diabetes mellitus, type II
5. A 69-year-old man incurs blunt force trauma from a fall. On b. Fibromuscular dysplasia
physical examination he has a contusion on his lower back. An c. Factor V Leiden mutation
abdominal CT scan shows 3 peripheral 1 to 2 cm cysts in his d. Analgesic abuse
kidneys. The kidneys are normal in size. Laboratory studies show a e. Systemic sclerosis
serum urea nitrogen of 16 mg/dL and creatinine of 1.1 mg/dL. A
urinalysis reveals no blood, ketones, protein, or glucose. 10. A 3-year-old child has become more irritable over the past two
Microscopic urinalysis reveals a few oxalate crystals. Which of the months and does not want to eat much at meals. On physical
following is the most likely diagnosis? examination the pediatrician notes an enlarged abdomen and can
a. Polycystic kidney disease palpate a mass on the right. An abdominal CT scan reveals a 10 cm
b. Hydronephrosis solid mass involving the right kidney. The resected mass has a
c. Renal atherosclerosis microscopic appearance with sheets of small blue cells along with
d. Simple cortical cysts primitive tubular structures. The child receives chemotherapy and
e. Recurrent pyelonephritis infection radiation therapy, and there is no recurrence. Which of the
following neoplasms is this child most likely to have had?
6. A clinical study is performed with pediatric subjects who had a a. Angiomyolipoma
diagnosis of minimal change disease. These patients were b. Renal cell carcinoma
observed to have prominent periorbital edema at diagnosis. c. Urothelial carcinoma
Laboratory test findings from serum and urine tests were analyzed. d. Wilms tumor
Which of the following urinalysis test findings is most likely to have e. Medullary fibroma
been consistently present in these subjects?.
a. Nitrite positive 11. A 5-year-old boy is noted to have increased puffiness around his
b. Proteinuria >3.5 gm/24 hours eyes for the past week, and he has been less active than normal. On
c. Hematuria with >10 RBC/hpf physical examination he has periorbital edema. Vital signs include
d. Calcium oxalate crystsls T 37°C, P 75/minute, RR 22/minute, and BP 140/90 mm Hg. A
e. Renal tubular epithelial cells and casts urinalysis reveals sp. gr. 1.010, pH 6.5, no glucose, 4+ protein, no
blood, no casts, and no ketones. Microscopic urinalysis reveals oval
7. A 12-year-old boy is a member of a family with a history of renal fat bodies, but no WBC's or RBC's. He improves following a course
disease, with males more severely affected than females. He is of corticosteroid therapy. Which of the following renal lesions is
found to have auditory nerve deafness, corneal dystrophy, and most likely to have been present in this boy?
ocular lens dislocation. A urinalysis shows microscopic hematuria. a. Glomerular crescent formation
A renal biopsy is performed. Microscopically, the glomeruli show b. Podocyte foot process effacement
glomerular capillaries with irregular basement membrane c. Patchy acute tubular necrosis
thickening and attenuation with splitting of the lamina densa. The d. Hyperplastic arteriolosclerosis
mesangial matrix is increased and epithelial cells may appear e. Mesangial immune complex deposition
foamy. Which of the following is the most likely diagnosis?
a. Goodpasture syndrome 12. A clinical study is performed involving subjects with
b. IgA nephropathy glomerulonephritis. One group of subjects has a diagnosis of
c. Alport syndrome crescentic glomerulonephritis and another group has
d. Dominant polycystic kidney disease membranous nephropathy. Which one of the following laboratory
e. Diabetes mellitus, type I findings is most likely to be found in the absence of other findings
in subjects with membranous nephropathy?
8. A clinical study is performed of laboratory findings in subjects with a. Rapid onset
renal diseases. Loss of physiologic function accompanies many b. Red blood cell casts
diseases. One renal physiologic function affects thirst. Loss of c. Oliguria
which of the following renal functions is most likely to be identified d. Albuminuria
by laboratory measurement of the urine specific gravity following e. Hypertension
water deprivation?
a. Filtration 13. A 51-year-old man is hospitalized for acute myocardial infarction.
b. Reabsorption He has decreased cardiac output with hypotension requiring
c. Secretion multiple pressor agents. His urine output drops over the next 3
d. Concentration days. His serum urea nitrogen increases to 59 mg/dL, with
e. Blood flow creatinine of 2.9 mg/dL. Urinalysis reveals no protein or glucose, a
9. A 45-year-old woman has had increasing malaise for the past year. trace blood, and numerous hyaline casts. Five days later, he
On physical examination her blood pressure is 265/150 mm Hg. develops polyuria and his serum urea nitrogen declines. Which of
Laboratory studies show a plasma renin activity of 9 ng/mL/hr. She the following pathologic findings in his kidneys is most likely to
then suffers a 'stroke' with a right basal ganglia hemorrhage and have caused his azotemia?
dies. At autopsy the kidneys are bilaterally small with granular a. Patchy tubular necrosis

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 b. Podocyte foot process effacement 4. The sudden disruption of neurologic function probably involves
c. Glomerular crescent formation dysregulation of reticular activating system:
d. Hyperplastic arteriolosclerosis a. Contusion
e. Mesangial immune complex deposition b. laceration
c. concussion
14. A clinical study is performed to determine the value of d. diffuse axonal damage
percutaneous renal biopsy. The medical records of subjects with
renal diseases are analyzed to note the circumstances in which the 5. Increased rate of subdural hematoma among older patients with
results of a renal biopsy facilitated choice of therapy that improved brain atrophy is due to bridging veins:
prognosis. In which of the following situations is a percutaneous a. thin-walled
needle biopsy of the kidney most useful? b. Stretched
a. Fever and flank pain with suspected acute c. compressed
pyelonephritis d. thrombosed
b. Prostatic hyperplasia with suspected hydronephrosis
c. Premature neonate with suspected polycystic kidney 6. In the cerebral hemispheres, the border zone between what artery
disease distributions is at greatest risk of infarct?
d. Abdominal pain with suspected renal cyst a. Anterior and middle cerebral
e. Acute renal failure with suspected systemic lupus b. Anterior and anterior communicating
erythematosus c. middle and posterior cerebral
d. carotid and middle
15. A 43-year-old man has had increasing malaise for the past 3 weeks.
On physical examination he has a blood pressure of 150/95 mm Hg
and 1+ pitting edema of the lower extremities to the knees.
Dipstick urinalysis shows no glucose, blood, ketones, nitrite, or 7. Which of the following causes of cerebral embolism is the most
urobilinogen, and the microscopic urinalysis reveals no RBC/hpf common culprit?
and only 1 WBC/hpf. Additional laboratory studies show a 24 hour a. Fat from fractured bone
urine protein of 4.1 gm. His serum creatinine is 3.5 mg/dL with urea b. Cardiac mural thrombi
nitrogen of 38 mg/dL. His hepatitis B surface antigen is positive. c. carotid artery thromboemboli
Which of the following is the most likely diagnosis? d. deep vein thrombosis
a. Membranous nephropathy
b. Systemic lupus erythematosus 8. Embolic occlusion of the carotid bifurcation will lead to which of
c. Acute tubular necrosis the following gross morphologic findings?
d. Diabetic nephropathy a. Non-hemorrhagic infarct
e. Post-streptococcal glomerulonephritis b. Hemorrhagic infarct
c. both
WEEK 3 d. neither
CNS, BONES, WBC, PNS, LUNGS
9. The most frequent cause of clinically significant subarachnoid
1. Which of the following is a cause of communicating form of hemorrhage is a ruptured:
hydrocephalus?
a. A-V malformation
a. meningioma
b. Charcot-Bouchard aneurysm
b. Blood clot in the third ventricle
c. saccular aneurysm
c. tuberculous meningitis d. cavernous malformation
d. loss of brain parenchyma
10. Patient was a diagnosed case of meningitis. Autopsy revealed
2. Patient sustained head injury from a motorcycle accident. Cranial
dense exudates in the cerebral convexities. The etiologic agent is
MRI revealed third cranial nerve compression by the medial aspect most probably.
of the temporal lobe. The type of herniation associated is:
a. H. influenzae
a. Subfalcine
b. Strep pneumoniae
b. Tonsillar
c. E. coli
c. cingulate d. N. meningitidis
d. transtentorial
11. Autopsy revealed necrotizing and hemorrhagic inflammation of
3. Patient presented with motor and sensory deficits in the lower
the inferior and medial regions of the temporal lobes and orbital
extremities as well as disturbances of bladder and bowel habits. gyri of the frontal lobes. You will look for:
Which of the following neural tube defects will show the above
a. Intranuclear and intracytoplasmic inclusion
findings?
b. Round to oval eosinophilic cytoplasmic inclusion
a. Anencephaly
c. Intranuclear inclusion
b. Spina bifida
c. encephalocele
12. The two pathologic hallmarks of this lesions are plaques & tangles:
d. myelomeningocele
a. Alzheimer disease
b. Parkinson disease

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 c. Multiple sclerosis b. Osteoblastoma
d. Huntington disease c. Osteosarcoma
d. Osteochondroma
13. Which of the following infiltrating gliomas is characterized by
mutations of PTEN tumor suppressor gene, deletions of 22. Common sites affected by chondrosarcoma EXCEPT:
chromosome 10, and amplification of the EGFR oncogene? a. Pelvis
a. Glioblastoma b. Shoulder
b. Oligodendroglioma c. ribs
c. ependymoma d. femur
d. subependymoma
23. Of all bone sarcomas, it have the youngest average age at
presentation.
a. Osteoclastoma
14. Bilateral acoustic schwannoma is commonly associated with: b. Osteosarcoma
a. NF1 c. Chondrosarcoma
b. NF2 d. Ewing sarcoma family tumors
c. Tuberous sclerosis
d. Von-Hippel Lindau 24. CT or MRI may demonstrate internal septa and characteristic fluid-
fluid levels:
15. This malignant brain tumor occurs predominantly in children and a. Aneurysmal bone cyst
exclusively in the cerebellum: b. Fibrous dysplasia
a. Atypical teratoid/rhabdoid tumor c. giant cell tumor
b. Medulloblastoma d. non-ossifying fibroma
c. meningioma
d. neurofibroma 25. Loose bodies (joint mice) are seen in:
a. Rheumatoid arthritis
16. The most common cause of dwarfism is: b. Osteoarthritis
a. Achondroplasia c. gouty arthritis
b. Thanatophoric dysplasia d. infectious arthritis
c. osteogenesis imperfecta
d. osteopetrosis 26. The pathognomonic hallmark of gout is:
a. Pannus
17. Post menopausal osteoporosis affects mainly the: b. Tophi
a. Femoral neck c. Heberden nodes
b. Pelvis d. joint exudate
c. Spine
d. Ribs 27. The most common disease of joints is:
a. Gout
18. The histologic hallmark of this bone lesion is a mosaic pattern of b. Pseudogout
lamellar bone: c. Rheumatoid arthritis
a. Osteoporosis d. osteoarthritis
b. Osteopetrosis
c. Paget disease 28. Reactive arthritis is compose of the following EXCEPT:
d. osteomalacia a. Arthritis
b. Non-gonococcal urethritis or cervicitis
19. About 80% to 90% of the cases of culture-positive pyogenic c. conjunctivitis
osteomyelitis is caused by: d. enteritis
a. E. coli
b. Pseudomonas 29. Grape-like lesions were seen protruding out from the vagina of a
c. Klebsiella young child. It is most probably.
d. S. aureus a. Liposarcoma
b. Rhabdomyosarcoma
20. Benign bone forming tumor more than 2cm diameter involving the c. leiomyosarcoma
posterior spine: d. synovial sarcoma
a. Osteoid osteoma
b. Osteoblastoma
c. osteosarcoma
d. osteochondroma 30. This tumor may show either a monophasic or biphasic type
forming gland-like structures:
21. The formation of neoplastic bone with a fine, lace-like architecture a. Liposarcoma
by the anaplastic tumor cells is diagnostic of: b. Rhabdomyosarcoma
a. Osteoid osteoma c. leiomyosarcoma

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 d. synovial sarcoma c. Nodular sclerosis
d. lymphocyte depletion
31. The most common cause of agranulocytosis is:
a. Aplastic anemia 41. Distinctive needle-like azurophilic granules are seen in the
b. Severe sepsis cytoplasm in many cases:
c. metastatic cancer to marrow a. AML
d. drug toxicity b. ALL
c. CML
32. This form of hyperplasia may be particularly prominent in lymph d. CLL
nodes draining cancers such as carcinoma of the breast.
a. Follicular 42. Philadelphia chromosome can be demonstrated in more than 90%
b. Paracortical of cases.
c. reticular a. AML
d. medullary b. ALL
c. CML
33. The most common cancer of children is: d. CLL
a. ALL
b. AML 43. The presence of Birbeck granules in the cytoplasm is
c. CLL/SLL characteristic:
d. CML a. Primary myelofibrosis
b. Essential thrombocytosis
34. Proliferation centers are pathognomonic for: c. Langerhans cell histiocytosis
a. ALL d. Multiple myeloma
b. AML
c. CLL/SLL 44. Nonspecific acute splenitis can be seen in the following EXCEPT:
d. CML a. TB
b. Typhoid
35. The most common form of NHL is: c. IM
a. Follicular d. Gonorrhea
b. Burkitt
c. Small lymphocytic 45. Myasthenia gravis is seen in 30-45% of patients with:
d. Diffuse large B cell a. Lymphoma
b. Thymoma
36. Which of the following is not seen in multiple myeloma? c. congestive splenomegaly
a. Smudge cells d. splenic rupture
b. Mott cells
c. Russell bodies 46. Infections with the following, have significant epidemiologic
d. Dutcher bodies associations with GuillainBarré syndrome EXCEPT.
a. Campylobacter jejuni
37. . This rare but distinctive B-cell neoplasm shows fine threadlike b. Epstein-Barr virus
cytoplasmic extensions: c. Cytomegalovirus
a. Anaplastic large-cell lymphoma d. Streptococcus pneumoniae
b. Hairy cell leukemia
c. Mycosis fungoides 47. Painful, vesicular skin eruption (shingles) in a distribution that
d. large granular lymphocytic leukemia follows sensory dermatomes most commonly involvement the
nerve dermatomes.
a. Facial
38. The R-S cells are infected with EBV in about 70% of cases: b. Trigeminal
a. Nodular sclerosis c. auditory
b. Mixed-cellularity d. throchlear
c. Lymphocyte-rich
d. lymphocyte depletion

48. About 85% of patients with myasthenia gravis have autoantibodies

39. This is the most common form of HL:
against:
a. Nodular sclerosis
a. postsynaptic acetylcholine receptors
b. Mixed-cellularity
b. sarcolemmal protein muscle-specific receptor tyrosine
c. Lymphocyte-rich
kinase
d. lymphocyte depletion
c. Acetylcholinesterase
d. Acetylcholine
40. L & H variants are seen in:
a. Lymphocyte predominant
b. Lymphocyte-rich

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 49. This muscular dystrophy is typically associated with deletions or c. hemorrhage
frame shift mutations that result in total absence of dystrophin. d. edema
a. Duchenne
b. Becker
57. Gram-stained sputum reveal presence of numerous neutrophils
c. Myotonic
containing typical gram-positive, lancet-shaped diplococci supports the
d. Limb-Girdle
diagnosis of community-acquired acute pneumonia caused by.

50. The most common cause of peripheral neuropathy is. a. Haemophilus influenza
a. Uremia b. Streptococcus pneumoniae
b. Thyroid dysfunction c. Mycoplasma pneumoniae
c. infections d. Klebsiella pneumonia
d. Diabetes
58. Severe acute respiratory syndrome (SARS) is caused by:
51. Patient diagnosed of bronchial asthma showed atelectasis on CXR of
which type? a. Influenza
a. Adhesion b. Paramyxovirus
b. Compression c. Corona virus
c. contraction d. Pseudomonas aeroginosa
d. Resorption
59. Which of the following histologic type of lung cancer shows the
52. It is characterized by the abrupt onset of significant hypoxemia and strongest association with smoking?
bilateral pulmonary infiltrates in the absence of cardiac failure. a. Adenocarcinoma
a. Acute lung injury/ARDS b. Squamous
b. Pulmonary embolism c. Small cell
c. Pulmonary edema d. Large cell
d. Acute Interstitial pneumonia
- The radiographic and pathologic features are identical to those 60. Increased incidence is seen among people with heavy exposure to
of the organizing stage of ALI. asbestos:

53. It is characterized by irreversible enlargement of the airspaces distal a. Solitary fibrous tumor of pleura
to the terminal bronchiole, accompanied by destruction of their walls b. Malignant mesothelioma
without obvious fibrosis. c. carcinoid tumor
d. metastatic tumor
a. Bronchial asthma
b. Bronchiectasis 61. This type of atelectasis is irreversible.
c. Chronic bronchitis A. Irregular C. compression
d. Emphysema
B. Resorption D. contraction

54. The earliest feature of this COPD is hypersecretion of mucus in the

62. Dyspnea is usually the first symptom of this COPD
large airways, associated with hypertrophy of the submucosal glands in
A. Asthma C. Chronic bronchitis
the trachea and bronchi.
B. Bronchiectasis D. Emphysema
a. Bronchial asthma
b. Bronchiectasis 63. In this type of emphysema, the proximal parts are affected while the
c. Chronic bronchitis distal alveoli are spared.
d. Emphysema A. Panacinar C. Centriacinar
B. Paraseptal D. Irregular
55. Involved tissues contain well-formed nonnecrotizing granulomas
enclosed within fibrous rims with laminated concretions composed of
64. Airway resistance is increased but elastic recoil is normal:
calcium and proteins and stellate inclusions.
A. Bronchial asthma C. Chronic bronchitis
a. Asbestosis B. Bronchiectasis D. Emphysema
b. Sarcoidosis
c. silicosis 65. Fibrotic lesions in the hilar lymph node produces “eggshell”
d. anthracosis calcification on CXR:
A. Asbestosis C. silicosis
56. Goodpasture syndrome is an uncommon autoimmune disease in B. Anthracosis D. Sarcoidosis
which kidney and lung injury are caused by circulating autoantibodies
against the noncollagenous domain of the a3 chain of collagen IV. The 66. In most cases of pulmonary thromboembolism, the risk factor is:
lung injury usually present as: A. Cancer C. immobilization
B. Hypercoagulable state D. cardiac disease
a. Embolism
b. Infarction

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 67. The most common cause of community acquired acute pneumonia polychromatophilic RBCs, low platelet count and splenomegaly.
is: Anemia in this patient can be corrected by:
A. Strep pneumoniae C. Kleb. pneumoniae a. Iron supplementation
B. H. influenzae D. Pseudomonas aeruginosa b. Frequent blood transfusion
c. Splenectomy
68. This virus bind the ACE2 in the surface of pulmonary alveolar d. Hematopoietic Stem Cell Transplantation
epithelial cells causing severe, often fatal pneumonia. 5. A 13-year-old female was brought in for consult due to pallor and
A. Influenza C. SARS-CoV-2 tea-colored urine. She sought consult 3 days ago complaining of
B. Human metapneumovirus D. CMV dysuria and was given nitrofurantion. Laboratory workup showed
normocytic anemia, elevated bilirubin and peripheral blood smear
69. The most common form of lung cancer in women and men. showed Heinz bodies & bite cells. What is the mechanism of
A. Adenocarcinoma C. squamous cell carcinoma hemolysis?
B. Small cell carcinoma D. Large cell carcinoma a. Enzyme deficiency
b. Structurally abnormal globins
70. Malignant mesothelioma will be positive for: c. Antibody-mediated destruction
A. CEA and TTF1 C. CD34 and stat 6 d. Acquired genetic defects
B. CK and Calretenin D. LCA and vimentin
6. A 25-year-old female came in for consult due to undocumented
BCA (APRIL 2020) fever, cough and chest pain. History revealed a hereditary
GIT, LIVER, RBC hematologic condition. Chest x-ray showed pulmonary infiltrates.
Peripheral blood smear showed RBCs with a holly-leaf shape and
1. An 8-month old female was brought in for consult due to
some having round, dark purple inclusions which are peripherally
progressive abdominal enlargement. Upon PE, she was noted to
located. The genetic basis of the patient’s hematologic condition is
be pale. Hepatosplenomegaly, frontal & parietal bossing were
a point mutation in the 6th codon of 𝛃-globin leading to
likewise noted. Laboratory work up showed hgb of 5 g/dL and
replacement of:
markedly hypochromic erythrocytes with marked anisocytosis and
a. glutamine with valine
poikilocytosis. What is the possible genotype of the patient?
b. glutamine with lysine
a. -/𝛂 𝛂/𝛂
c. valine with glutamine
b. -/- 𝛂/𝛂
d. lysine with glutamine
c. 𝛃+/𝛃
d. 𝛃+ /𝛃o
7. Which of the following features differentiate anemia due to
vitamin B12 deficiency from folic acid deficiency?
2. A 40-year-old G3P2 39 weeks AOG was admitted for elective repeat
a. Increased homocysteine level
caesarean section. She is hypertensive & is maintained on
b. Presence of neurologic changes
methyldopa 500 mg BID since 24th week AOG. Lab workup
c. Nuclear hypersegmentation of neutrophils
showed microcytic hypochromic anemia, hgb 8.0 g/ dL,
d. Marrow hyperplasia
reticulocyte production index of 2.9. A healthy female newborn
with Apgar scores of 9 and 10 at the 1st & 5th minutes, respectively,
8. This is an unusual form of disseminated intravacular coagulation
was delivered. The neonate also had unremarkable PE findings. A
which occurs in patients with giant hemangiomas, wherein
few hours after delivery, the mother’s hemoglobin level decreased
thrombi form within the neoplasm because of stasis and
to 7 g/dL. No signs of hemorrhage from the surgical field was
recurrent trauma to fragile blood vessels.
noted. The hemoglobin further decreased to 6 g/dL after 2 days.
a. Gaisbock syndrome
The mother and neonate’s blood type were both “O” positive. What
b. Kasabach-Merritt Syndrome
type of antibody could have caused the patient’s condition?
c. Waterhouse-Friderichsen Syndrome
a. IgD
d. Bernard-Soulier Syndrome
b. IgG
c. IgM
9. A 50-year-old female presents with joint pains, purpuric rash in her
d. IgE
lower extremities, colicky abdominal pain. She reported a recent
history of upper respiratory tract infection for which she was
3. Which of these condition/s confer/s protection against malarial
prescribed with unrecalled antibiotics. Urinalysis showed
infection?
microscopic hematuria. The pathogenesis of this disease is:
a. G6PD Deficiency
a. Mutations in genes regulating TGF-B signaling
b. Sickle Cell Disease
b. Accumulation and deposition of abnormal protein
c. Thalassemia
c. Deposition of circulating immune complexes
d. A and B only
d. Defective collagen synthesis
e. B and C only
f. All of the above
10. Deficiency with ADAMTS13 is associated with
a. Hemolytic Uremic Syndrome
4. 4. A 9 year old boy was brought for consult due to yellowish
b. Immune Thrombocytopenic Purpura
discoloration of the skin associated with abdominal enlargement.
c. Glazmann Thrombasthenia
Upon PE, he was also noted to have pale palpebral conjunctivae.
d. Thrombotic Thrombocytopenic Purpura
Laboratory workup showed decreased hemoglobin levels,
hyperchromatic RBCs lacking the central pallor,

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 11. A 50-year-old male who underwent partial hepatectomy and had This condition is called:
thrombocytopenia was transfused with 6 units of platelet a. Autoimmune gastritis
concentrate. During transfusion, he suddenly developed difficulty b. Dieulafoy lesion
of breathing. His BP dropped to 80/50, T 38.1C and O2 saturation c. Helicobacter pylori gastritis
of 88%. What is the cause of the patient’s condition? d. Gastric antral vascular ectasia
a. IgM antibodies against donor red cells
b. IgA deficiency 18. All are characteristics of Helicobacter pylori gastritis, EXCEPT:
c. Antibodies against MHC class I antigens a. Multifocal disease is associated with an increased risk of
d. Bacterial contamination gastric adenocarcinoma.
b. H. pylori organisms are most often found in the antrum.
12. A 3-year-old boy was brought to the ER for persistent bleeding of c. Gastrin production is usually increased.
a lacerated wound in his mouth incurred after a fall about 5 hours d. Inflammatory infiltrates consist of neutrophils &
ago. He is currently given antibiotics for otitis media. There was no subepithelial plasma cells.
history of hematomas or bruising. There is also no known of family
history of bleeding disorders. PE revealed 2 small lacerations in the 19. A 60-year-old female who was previously diagnosed with
oral mucosa. Laboratory results showed normal platelet counts, Hashimoto’s thryoiditis came in for consult due to tingling
normal PT and slightly prolonged PTT. What is the most likely sensation and numbness in her distal extremities. Upon PE, she
diagnosis? was noted to have pallor and a smooth, beefy red tongue.
a. Hemophilia A Serologic tests reveal the presence of autoantibodies against
b. Hemophilia B H+,K+-ATPase. What do you expect to see in the gastric biopsy of
c. Von Willebrand Disease this patient?
d. Drug-Induced Thrombocytopenia a. Diffuse mucosal damage of the oxyntic mucosa within
the body and fundus. (AUTOIMMUNE GASTRITIS)
13. All are characteristic features of Plummer-Vinson syndrome, b. Dense infiltrates of eosinophils in the mucosa and muscularis
except: layers of the antral and pyloric regions. (EOSINOPHILIC
a. Glossitis GASTRITIS)
b. Cheilosis c. Moderate edema and slight vascular congestion in the
c. Iron deficiency anemia lamina propria with intact surface epithelium and foveolar
d. Esophageal rings cell hyperplasia. (GASTROPATHY & ACUTE GASTRITIS)
d. Granulation tissue filtrated with mononuclear leukocytes
14. All of these serve as risk factors for developing esophageal and fibrous scar. (PEPTIC ULCERS)
adenocarcinoma, EXCEPT
a. Helicobacter pylori infection 20. Familial gastric cancers are associated with mutations in
b. Smoking a. APC
c. Radiation exposure b. CDKN2A
d. Gastroesophageal reflux c. B-catenin
d. CDH1
15. A 28-year-old male African who is fond of consuming mursik
developed difficulty of swallowing. An exophytic mass was noted 21. Carney triad is comprised of which of the following?
in the esophagus. Biopsy revealed a malignant neoplasm 1. Pulmonary chondroma 3. Gastric GIST
composed of nests of tumor cells with abundant eosinophilic 2. Atrial myxoma 4. Paraganglioma
cytoplasm and large nuclei. This tumor is most commonly located a. 1, 2 and 3
at the of the esophagus b. 1, 3 and 4
a. Proximal third c. 2, 3 and 4
b. Middle third d. 1, 2 and 4
c. Distal third
d. No specific predilection 22. A caucasian male who complains of chronic diarrhea underwent
endoscopy with small intestinal biopsy. Microscopic findings
16. A 30-year-old female patient sought consult due to generalized revealed dense accumulation of foamy macrophages in the lamina
dull headaches of moderate intensity which was worse in the propria. Macrophages contain PAS-positive, diastase resistant
morning. Other symptoms reported by the patient include blurring granules. AFB staining showed a negative result. What is the
of vision and sharp epigastric pain. Cranial CT scan revealed a causative agent?
spherical, dural-based mass in the frontal region, most likely a a. Clostridium difficile
meningioma. The epigastric pain felt by the patient is due to b. Salmonella enterica
a. Stress ulcers c. Yersinia enterocolitica
b. Cushing ulcers d. Tropheryma whippelii
c. Curling ulcers
23. Features of ulcerative colitis, EXCEPT:
17. A 73-year-old female was brought for consult due to pallor and a. Fibrosing strictures
easy fatigability. CBC showed low hemoglobin and decreased RBC b. Skip lesions
count. Fecal occult blood test was positive. She underwent c. Broad-based ulcers
endoscopy which revealed a characteristic “watermelon stomach”. d. Inflammation of the mucosa and superficial submucosa

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 31. Mallory-Denk bodies can be seen in which of the following
24. A colonic polyp was described to have an arborizing pattern of conditions?
connective tissue, smooth muscle, lamina propria & glands lined by a. Alcoholic liver disease
normal-appearing intestinal epithelium. b. Wilson disease
a. Juvenile Polyp c. Large bile duct obstruction
b. Inflammatory Polyp d. A and B only
c. Peutz-Jeghers Polyp e. All of the above
d. Sessile Serrated Adenoma
32. An individual who has an HFE gene mutation may present with all
25. What is the most important characteristic of colorectal adenoma of the following clinical features, EXCEPT:
that correlates with the risk of malignancy? a. Skin pigmentation in sun exposed areas
a. Location b. Diabetes mellitus
b. Size c. Kayser-Fleischer rings
c. Degree of epithelial stratification d. Cardiac dysfunction
d. Intensity of inflammation
33. All of the following are changes seen in alcoholic liver disease,
26. Majority of sporadic colorectal adenocarcinomas have early EXCEPT:
mutations in this gene, which is a negative regulator of B-catenin. a. Hepatocytes with swelling and necrosis.
a. MSH2 b. Ballooned hepatocytes containing Mallory-Denk bodies.
b. MLH1 c. Fibrous scars surrounding individual or small clusters of
c. BRAF hepatocytes.
d. APC d. Accumulation of mononuclear cells around
degenerating hepatocytes.
27. A 25-year-old female was brought in the emergency department
due to a 3-day history of nausea and vomiting. A few hours prior to 34. This disease is caused by absent UGT1A1 activity and is associated
consult, she also complained of abdominal pain. Physical with unconjugated hyperbilirubinemia.
examination revealed generalized jaundice and right upper a. Crigler-Najjar syndrome type I
quadrant abdominal tenderness. It was later on discovered that b. Gilbert syndrome
she intentionally took 50 paracetamol tablets prior to the c. Crigler-Najjar syndrome type II
appearance of symptoms. Which of the following is expected in d. Dubin-Johnson syndrome
the patient’s liver biopsy?
a. Presence mixed inflammatory infiltrates in portal tracts 35. A liver biopsy showed inflammation of large ducts and
b. Fibrous septae linking portal tracts with each other and with circumferential “onion skin” fibrosis of the smaller ducts.
central veins a. Primary hepatolithiasis - pigmented calcium bilirubinate
c. Hepatocytes containing large, round, clear vacuoles within stones in distended intrahepatic bile ducts. Ducts show
the cytoplasm chronic inflammation, mural fibrosis, and peribiliary gland
d. Widespread hepatocyte necrosis hyperplasia in the absence of extrahepatic duct obstruction.
b. Primary sclerosing cholangitis
28. The dominant intrahepatic cause of portal hypertension is: c. Primary biliary cirrhosis - interlobular bile ducts are actively
a. Massive fatty change destroyed by lymphoplasmacytic inflammation with or
b. Schistosomiasis without granulomas.
c. Cirrhosis d. Biliary atresia - inflammation and fibrosing stricture of the
d. Hepatocellular carcinoma hepatic or common bile ducts

29. A 50-year old male came in for consult due intermittent 36. Classic triad of Budd-Chiari syndrome, except:
appearance of fever, joint pains, abdominal pains and urine for the a. Jaundice
past 2 years. Serologic testing result revealed (-) HBsAg, (+) Anti- b. Liver enlargement
HBs, (+) HCV RNA. Which of the following is/are possible c. Pain
histopathologic finding/s in the liver biopsy? d. Ascites
a. Lymhpoid follicles
b. Steatosis 37. Kasai procedure is warranted in a patient who presents with this
c. Ground glass hepatocytes histomorphologic findings in a liver biopsy.
d. A and B only a. Inflammation and fibrosing stricture of the hepatic or
e. All of the above common bile ducts.
b. Hepatic lobular disarray with focal liver cell apoptosis and
30. Persistence of which of these markers indicate continued viral necrosis, giant-cell transformation, prominent hepatocellular
replication, infectivity & probably progression to chronic hepatitis? and canalicular cholestasis and mild mononuclear portal
a. HBV-DNA inflammation.
b. DNA polymerase c. Acute and chronic inflammation of large ducts with minimal
c. HBcAg inflammation and circumferential “onion skin” fibrosis of
d. HBeAg small ducts.
d. Pigmented calcium bilirubinate stones in distended

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 intrahepatic bile ducts. c. Sclerosing adenosis
d. Staphylococcus aureus
38. All of the following are features of preeclampsia, EXCEPT: e. Fat necrosis
a. BP = 160/100
b. Knee jerk reflex ++++ 5. A bloody nipple discharge is most often a consequence from
c. Platelet count = 110 x 109/L which of the following lesions in a 31-year-old female?
d. Urine Protein ++ a. Mastitis
b. Intraductal papilloma
39. A 30-year-old male patient underwent excision biopsy of a hepatic c. Trauma
mass which grossly appears tan-yellow with a central gray-white d. Infiltrating ductal carcinoma
stellate scar. The lesion is most likely a e. Tuberculosis.
a. Hepatocellular adenoma
b. Focal nodular hyperplasia 6. Of the following findings among women worldwide, which
c. Hepatocellular carcinoma one is associated with the LEAST risk for breast carcinoma?
d. Angiosarcoma a. Previous history of endometrial adenocarcinoma
b. United States birth certificate
40. What is the most common malignancy of the liver? c. High fat diet
a. Angiosarcoma d. Multiparity
b. Hepatocellular carcinoma e. Late menopause.
c. Cholangiocarcinoma
d. Metastatic neoplasm 7. A 41-year-old female with a 9-cm soft, fleshy breast neoplasm
that microscopically has a lymphoid stroma with little fibrosis
41. This is associated with increased incidence of associated cancer. surrounding sheets of large vesicular cells with frequent
a. Hydrops of the gallbladder mitoses is most likely which of the following?
b. Porcelain gallbladder a. Infiltrating ductal carcinoma
c. Xanthogranulomatous cholecystitis b. Paget's disease of breast
d. Gangrenous cholecystitis c. Medullary carcinoma
d. Lobular carcinoma
PNS, LUNGS, BREAST&SKIN (ANS FROM “SANA SAMPLEX 2020”) e. Cystosarcoma phyllodes
BREAST AND SKIN
8. A 51-year-old male is found to have bilateral gynecomastia on
1. Which of the following statements regarding fibrocystic
physical examination. He is most likely to have which of the
disease (change) of the breast is INCORRECT?
following?
a. It generally develops after the age of 30 and before
a. Proliferation of breast lobules
menopause.
b. 47, XXY karyotype
b. Ductal epithelial proliferation is often present.
c. Increased risk for breast carcinoma
c. There is no increased risk for carcinoma of the breast.
d. Seminoma of the testis
d. It occurs with an absolute estrogen increase.
e. Increased testosterone levels.
e. It is the most common breast disorder.

9. The major distinguishing feature between a phyllodes tumor

2. A 12-cm mass of the right breast that microscopically includes
of the breast and a fibroadenoma is which of the following
a stromal component along with an epithelial component in a
features?
49-year-old female is most likely which of the following?
a. Stromal cellularity
a. Fibroadenoma
b. Size of the tumor
b. Phyllodes tumor
c. Patient age
c. Sclerosing adenosis
d. Location within the breast
d. Hamartoma
e. Mammographic appearance
e. Medullary carcinoma

10. An elderly male has several slowly enlarging, coin-like, lightly

3. Which of the following features of a breast carcinoma suggests
pigmented, velvety-surfaced lesions on the face and upper
a worse prognosis?
chest. These are probably which of the following?
a. Presence of estrogen receptors
a. Intradermal nevi
b. Positive BRCA-1 or BRCA-2 marker
b. Epidermal inclusion cysts
c. Presence of an in-situ component
c. Seborrheic keratoses
d. Axillary lymph node metastases
d. Impetigo
e. Presence of progesterone receptors.
e. Actinic keratoses.
4. During the postpartum period, a 20-year- old female develops
11. A 39-year-old male has a slightly raised, pigmented lesion on
a tender 3-cm mass in the left breast beneath a nipple that
the chest which has recently become darker and enlarged,
shows several painful fissures. Which of the following
with irregular borders present. This should suggest that it is
pathologic findings is most likely to be present in this breast?
which of the following?
a. Infiltrating ductal carcinoma
a. Lentigo nevus
b. Numerous plasma cells

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 b. Malignant melanoma d. Vitiligo.
c. Intradermal nevus
d. Hemangioma 18. Most common tumor in sun exposed skin characterized by
e. Basal cell carcinoma. pearly papules with dilated subepidermal blood vessels is
which of the following?
12. A 55 year old diving instructor from Boracay, has a number of a. Malignant melanoma
0.5 to 1 cm rounded, flat, tan-brown to slightly erythematous b. Basal cell carcinoma
lesions with a rough, sandpaper-like consistency on the face, c. Squamous cell carcinoma
arms, and dorsa of both hands. Which of the following d. Mycosis fungoides.
statements is LEAST likely to be correct?
a. The lesions are probably related to his job 19. True of mycosis fungoides, EXCEPT:
b. He has a risk for development of squamous cell carcinoma a. Cutaneous B-cell lymphoma
c. One of the features on biopsy will be upper dermal elastosis b. shows Sezary-Lutzner cells
d. The lesions are infectious to others c. Pautrier microabscess may be present
e. It took years for these lesions to develop. d. associated with erythroderma.

13. Which of the following parameters is most important in 20. Tumor composed of fibroblast and histiocytes which dimple
determination of the prognosis in a patient with malignant inward on lateral compression is seen in which of the
melanoma? following?
a. Age of the patient a. Acrochordon
b. Diameter of the lesion b. Dermatofibroma
c. History of sun exposure c. Dermatofibrosarcoma protruberans
d. Location on the skin d. Xanthomas.
e. Depth of the lesion.
21. The following findings are seen in psoriasis, EXCEPT:
14. A tan, flat, 1 cm rough-surfaced papule on the dorsal surface of a. Auspitz sign
the hand of a 19-year-old male is most likely which of the b. Nail changes
following? c. Silver white scales
a. Herpetic dermatitis d. Pautrier microabscesses.
b. Syphilitic chancre
c. Tinea versicolor PNS
d. Verruca vulgaris 1. A 40-year-old female sought admission because of difficulty of
e. Seborrheic keratosis. breathing of few hours duration. She had a flu-like symptoms
the week before when she noticed weakness in her legs and
15. A 25-year-old female has an erythematous malar skin rash thighs followed by difficulty of breathing. Pertinent physical
along with a positive anti-nuclear antibody (ANA) test at a examination findings include absent deep tendon reflex. Her
1:256 titer. Immunofluorescence staining on a biopsy of nerve conduction velocity is slow. Which of the following is the
normal skin reveals band-like deposition of IgG and C3 at the primary lesion in this condition?
dermal-epidermal junction. This is most typical for which of a. Axonal damage
the following conditions? b. Inflammation
a. Polymyositis-dermatomyositis c. Segmental demyelination
b. Discoid lupus erythematosus (DLE) d. Well-developed onion bulbs
c. Progressive systemic sclerosis (PSS)
d. Systemic lupus erythematosus (SLE) 2. The electrophysiologic hallmark of axonal neuropathy is which
e. Graft versus host disease (GVHD). of the following?
a. reduction in signal strength
16. A dome-shaped, flesh-colored nodule is present on the cheek b. slowed nerve conduction velocity
of a 55-year-old male. While waiting several months for a c. increased signal strength
referral in his managed care health plan, the lesion disappears. d. increased nerve conduction velocity
It is most likely which of the following?
a. Skin tag 3. A 45- year-old female with nodules in the face and upper and
b. Keratoacanthoma lower extremities sought consult because of a bleeding incised
c. Dermatofibroma wound in her forearm. She claims that she did not even feel
d. Epidermal inclusion cyst that she was wounded while chopping a tree in their back
e. Hemangioma. yard. The doctor noticed that she has a leonine facie. What is
the mechanism of the absence of
17. A 48 year old, woman sought consult because of complete loss sensation present in this patient?
of pigment producing melanocytes in her chin and face. The a. the etiology of her skin lesion produces toxins that destroys
most probable diagnosis is which of the following? nerve
a. Basal cell carcinoma b. her skin lesions compress on the nerves causing atrophy
b. Melasma c. the etiology of her lesion brings about vasculitis and
c. Ephelis necrosis of the nerve

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 d. the etiology of her lesion invades the Schwann cells c. Presence of rimmed vacuoles, cytoplasmic inclusions, and
endomysial fibrosis and fatty replacement
4. Diseases of the neuromuscular junction usually manifest as d. Ragged red fibers due to myofibril distortion and parking lot
which of the following? Inclusions on EM
a. Painless weakness
b. Paralysis 11. A 45-years-old male sought consult because of skeletal muscle
c. Spasm of lower extremities weakness of three months duration. He also complained of
d. Tingling sensation involuntary muscle contractions. He had a cousin who had the
same condition and also manifest when his cousin was 39
5. A 35-year-old female sought consult because of ocular years old. This condition is associated with which of the
disturbance and body weakness which worsens during the following abnormality?
course of the day. She has ptosis and diplopia. This disease is a. Genomic imprinting
caused by antibodies against which of the following? b. Gonadal mosaicism
a. Acetylcholine c. Mitochondrial gene mutation
b. Acetylcholine receptors d. Triplet repeat mutation
c. Skeletal muscles
d. Schwann cells 12. Which of the following refers to the conditions that arise from
destruction of neurons with secondary degeneration of axonal
6. Rhabdomyolysis, myoglobinuria and renal failure is processes?
associated with which of the following toxic myopathies? a. Axonal neuropathies
a. Chloroquine b. Demyelinating neuropathies
b. Ethanol c. Neurogenic myopathies
c. ICU-associated d. Neuronopathies
d. Steroid-induced
MATCHING TYPE: Match the category of the disease in col. I with the
7. A 10-year-old wheelchair dependent male child who was example in col. II.
normal at birth, had delayed walking and developed 13. Denervation atrophy C a. Limb Girdle Muscular
weakness of the pelvic and girdle muscle is probably 14. X-linked muscular dystrophy Dystrophy
suffering from which of the following conditions? Similar D b. Nemaline myopathy
males in the family suffer from the same condition. 15. Autosomal muscular c. Spinal muscular atrophy
a. Becker muscular dystrophy dystrophy A d. Duchenne Muscular
b. Duchenne muscular dystrophy 16. Congenital myopathy B Dystrophy
c. Limb-girdle muscular dystrophy 17. Inflammatory myopathy E e. Dermatomyositis
d. Myotonic dystrophy 18. Inborn errors of metabolism F f. Lipid myopathies

8. A 45- year-old male underwent excision biopsy of a mass in the LUNGS

forearm. Histologic sections revealed tumor composed of 1. Which of the following is a developmental lung anomaly that
intersecting fascicles of spindle cells with cellular and lacks connection to the airway system?
hypocellular areas and nuclear palisading with a central a. Foregut cyst
nuclear free zone. Based on the histologic findings, what is b. Pulmonary hypoplasia
your diagnosis? c. Pulmonary sequestration
a. Dermatofibroma d. Pulmonary hamartoma
b. Neurofibroma
c. Malignant peripheral nerve sheath tumor 2. Which of the following results from complete obstruction of an
d. Schwannoma airway which shifts the mediastinum towards the atelectatic
lung?
9. Polyradiculopathy involving the lower extremities is seen in a. Contraction atelectasis
which of the following tumor infiltrations? b. Compression atelectasis
a. Brachial plexopathy c. Resorption atelectasis
b. Cauda equina involvement 3. Which of the following does NOT cause hemodynamic
c. Cranial nerve involvement pulmonary edema?
d. Obturator palsy a. Left sided heart failure
b. Primary injury to vascular endothelium
10. A 65-year-old, male sought consult because of periorbital c. Pulmonary vein obstruction
edema with lilac discoloration of the upper eyelids, dusky red d. Liver disease
patches over knuckles, elbows and knees and bilateral
muscle weakness. Which of the following findings on biopsy 4. A 65-year-old male, known hypertensive was admitted
is seen in this lesion? because of left hemiparesis. Patient developed severe
a. Deposition of C5b – 9 within capillary beds of skin and dyspnea on the second hospital day which did not improve
muscles with O2 administration. He had bouts of vomiting after dinner
b. Inflammatory cells in endomysium, patchy degenerating, the night before. Chest X-ray revealed reticular densities
regenerating, and atrophic muscle fibers bilaterally. Which of the following morphologic findings in the

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 lungs is responsible for his condition? developed pneumonia which was not noted on admission.
a. Fibrinosuppurative exudate in the alveoli What is the most common cause of his pneumonia?
b. Neutrophils in the bronchi and adjacent lung parenchyma a. Klebsiella pneumoniae
c. Widened alveolar septae with edema and hyaline b. Pseudomonas aeruginosa
membrane c. Streptococcus pneumoniae
d. Diffuse pulmonary edema with microhemorrhages d. Staphylococcus aureus

5. Which of the following obstructive pulmonary disease is 13. Patchy consolidation of the lungs is a feature of which of the
characterized by mucus gland hyperplasia and following?
hypersecretion? a. Lobar pneumonia
a. Emphysema b. Interstitial pneumonia
b. Bronchiectasis c. Bronchopneumonia
c. Chronic bronchitis
d. Asthma 14. A 75-year-old, 45 pack-year male cigarette smoker sought
admission because of cough not responsive to antibiotics,
6. Cigarette smoking in the presence of chronic bronchitis causes weight loss and difficulty of breathing. CT scan revealed a hilar
which of the following type of emphysema? mass measuring 6x5x3 cm. CT scan-guided biopsy revealed
a. Centriacinar lymphocyte-like cells with salt and pepper chromatin pattern
b. Distal acinar and nuclear molding. Which of the following IHC stain will
c. Irregular confirm the diagnosis?
d. Panacinar a. TTF-1 - adenocarcinoma
b. Calretinin - mesothelioma
7. A 25-year-old female was admitted because of chest tightness, c. Chromogranin – small cell carcinoma
dyspnea, coughing and wheezing. She had been having d. Cytokeratin – squamous cell carcinoma
similar on and off symptoms like this since childhood. Her
mother and maternal grandmother had similar 15. Which lung malignancy is more commonly associated with
manifestations. Which of the following is responsible for her non-smokers?
condition? a. Adenocarcinoma
a. TH1-IL secretion b. Squamous cell carcinoma
b. TH2-IL secretion c. Small cell carcinoma
c. Protease-anti-protease imbalance d. Large cell carcinoma
d. Primary ciliary dyskinesia
16. Hormone/s elaborated in small cell carcinoma associated with
8. Which of the following diseases is not a cause of restrictive paraneoplastic syndrome:
lung disease? a. ACTH and ADH
a. Pneumoconioses b. Hypercalcemia
b. Severe obesity c. Parathormone
c. Kyphoscoliosis d. Serotonin and bradykinin
d. Emphysema
9. Which of the following disorders causes a non-caseating 17. The gross lesion called “collar-button” is attributed to which of
granuloma in the lungs? the following tumor?
a. Farmer’s lung a. Adenocarcinoma
b. Sarcoidosis b. Carcinoid tumor
c. Pigeon breeder’s lung c. Large cell carcinoma
d. All of these d. Squamous cell carcinoma

10. Which of the following statements is TRUE of pulmonary 18. Which of the following is TRUE of malignant mesothelioma?
embolism? a. higher risk in persons who smoke and are exposed to
a. Majority of cases is clinically silent asbestos
b. The usual source is a mural thrombus from the heart b. it is an inner lung tumor near the bronchus
c. The risk of recurrence is low c. immunohistochemical stain positive for TTF-1
d. Usually associated with left-sided heart failure d. most common malignant tumor of the pleura

11. Which of the following commonly give rise to pulmonary KIDNEYS

hypertension? 1. Which of the ff. glomerular syndromes is associated with severe
a. Thrombophilia proteinuria?
b. Right sided heart failure a. nephritic
c. Massive thromboembolism b. nephrotic
d. Chronic obstructive lung disease c. RPGN
d. CRF
12. A 65-year-old male was admitted because loss of sensation e. isolated urinary abnormalities
and paralysis of the right side of the body. Five days later, he

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 2. Immune complexes in the glomeruli involve: 2. A 50-year old male with malignant hypertension has concentric,
a. exogenous antigens laminated thickening of the walls with luminal narrowing of renal
b. endogenous antigens vessels. These findings are compatible with:
c. both a. Atherosclerosis
d. neither b. Mönckeberg medial sclerosis
3. What is the most common cause of nephrotic syndrome in c. Hyaline arteriolosclerosis
children? d. Hyperplastic arteriolosclerosis
a. minimal change disease
b. membranous nephropathy 3. The following are constitutional risk
c. focal segmental glomerulosclerosis factors of atherosclerosis, EXCEPT:
d. membranoproliferative glomerulonephritis a. Familial hypercholesterolemia
b. Inflammation
4. What is the most common cause of acute kidney injury/ acute renal c. Age
failure? d. Gender
a. Acute tubular injury/necrosis 4. A 5 year old female with Marfan Syndrome has diffuse,
circumferential dilation of the aorta. The finding is compatible with:
5. Ascending infection is a common cause of: a. Saccular aneurysm
a. acute pyelonephritis b. Fusiform aneurysm
b. chronic pyelonephritis c. Pseudo-aneurysm
c. both d. Dissection
d. neither
5. A 60-year old male with hypertension was diagnosed of having a
6. What is the second most common cause of acute kidney injury/ blood-filled channel within the wall of the ascending and
acute renal failure? descending aorta due to the separation of the laminar planes of
a. Drug induced tubulointerstitial nephritis the media by blood. This finding is compatible with what type of
dissection?
7. Which condition is associated with systolic pressures of >200 a. DeBakey type I
mmHg, papilledema, retinal hemorrhages, and “onion skinning” of b. DeBakey type II
renal arterioles? c. DeBakey type III
a. benign nephrosclerosis d. DeBakey type IV
b. malignant nephrosclerosis
6. A 70-year old American male has a thickened, nodular and tender
8. Abnormalities of the cilium-centrosome complex is the major segment of a blood vessel on the surface of leh side of the head.
underlying reason for Fatigue, weight loss and frequent headache are also noted. Biopsy
a. Autosomal recessive polycystic kidney disease of the segment of the blood vessel shows intimal thickening, with
b. Autosomal dominant polycystic kidney disease thrombosis and narrowing of the luminal diameter. Also seen is
c. both medial granulomatous inflammation. These findings are
d. neither compatible with:
a. Buerger disease
9. What is the most common renal stone? b. Polyarteritis nodosa
a. uric acid c. Giant cell arteritis
b. magnesium ammonium PO4 d. Takayasu arteritis
c. calcium oxalate/phosphate
d. cystine 7. A 4-year old female presents with fever, edema of the hands and
feet, erythema of the palms and soles, a desquamative rash and
10. What gene is commonly involved in the most common cervical lymphnode enlargement. These findings are compatible
type of renal cell CA? with:
a. MET protooncogene a. Microscopic polyangiitis
b. VHL tumor suppressor gene b. Churg-Strauss syndrome
c. p53 c. Kawasaki disease
d. Rb d. Wegener granulomatosis

BLOOD VESSELS, LUT, MALE AND FEMALE GENITAL LUT AND MALE GENITAL
BLOOD VESSELS 1. Which of the following is an extrinsic cause of ureteral
1. The blood vessel that has the most effect on blood pressure when obstruction?
there is vasoconstriction on narrowed structural changes is the: a. Calculi
a. Elastic arteries b. Blood clots
b. Muscular arteries c. Fibroepithelial polyp
c. Arterioles d. Benign prostatic hyperplasia
d. Capillaries
e. Vein 2. Majority of urinary bladder neoplasms are:
a. Squamous cell carcinoma

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 b. Adenocarcinoma b. Ureaplasma urealyticum
c. Transitional cell carcinoma c. Trichomonas vaginalis
d. Mesenchymal tumors d. Mycoplasma hominis

3. A 6-month old boy has an abnormal urethral opening on the dorsal 3. A 40-year old woman presents with opaque, white, plaque-like
surface of the penis. Bothe testis are undescended. These findings epithelial thickening on the vulva resulting from rubbing or
are compatible with: scratching of the skin to relieve pruritus. Histologic examination of
a. Hypospadias this lesion shows acanthosis, hyperkeratosis and scattered
b. Epispadias lymphocytic infiltrates in the dermis. What is the most likely
c. Phimosis diagnosis?
d. Balanoposthitis a. Condyloma acuminatum
b. Paget disease
4. A 40-year old male has a red papillary lesion on the penis that is c. Lichen sclerosus
associated with HPV type 6. This lesion is: d. Squamous cell hyperplasia
a. Peyronie disease
b. Condyloma acuminatum 4. A 2-year old girl presents with a polypoid mass protruding from
c. Bowenoid papulosis the vagina. Biopsy of the mass shows small malignant cells with
d. Squamous cell carcinoma oval nuclei. Some cells have small protrusions of cytoplasm from
one end, resembling a tennis racket and some have striations
5. A 70-year old male presents with a mass in the right testis. Biopsy within the cytoplasm. These are features of which subtype of
shows a tumor composed of mixture of medium-sized cells Rhabdomyosarcoma?
containing round nuclei and eosinophilic cytoplasm, smaller cells a. Embryonal
with narrow rim of eosinophilic cytoplasm resembling secondary b. Alveolar
spermatocytes and scattered multinucleated giant cells. These c. Pleomorphic
findings are compatible with: d. Dedifferentiated
a. Classic seminoma
b. Spermatocytic seminoma 5. A 55-year old woman presents with a fungating mass in the cervix.
c. Embryonal carcinoma Biopsy of the mass shows a nest of malignant keratinized
d. Endodermal sinus tumor squamous cells which invades the underlying cervical stroma (2.5
mm deep and 6 mm wide). What is the stage of cervical carcinoma?
6. A 3-year old boy was diagnosed with Yolk sac tumor. Which of the a. Stage 0
following is seen in this tumor? b. Stage Ia1
a. Syncytiotrophoblasts c. Stage Ia2
b. Homer-Wright rosettes d. Stage Ib
c. Molluscum bodies
d. Schiller-Duval bodies

7. A 70-year old male presents with urinary frequency, nocturia,

difficulty in starting and stopping the stream of urine, overflow
dribbling and dysuria. His PSA is elevated. Which of the following
is associated with high PSA levels?
a. Benign prostatic hyperplasia
b. Prostate adenocarcinoma
c. Both
d. Neither

FEMALE GENITAL SYSTEM

1. A 15-year old female has a cyst in the cervix and diagnosed by her
gynecologist as Gartner duct cyst. This cyst is a remnant of
that failed to regress and persist into adult life as epithelial
inclusions.
a. Paramesonephric duct
b. Müllerian duct
c. Urogenital sinus
d. Wolffian duct

2. A 25-year old woman presents with yellowish, frothy vaginal

discharge, vulvovaginal discomfort, dysuria and dyspareunia.
Colposcopic examination shows “strawberry cervix” and Pap
smear reveals large, flagellated, ovoid organisms. These organisms
are most likely:
a. Gardnerella vaginalis Source: Lecture PPTs, BCA 2020

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