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General Pathology and Microbiology Model Paper King Edward Medical University

DEPARTMENT OF PATHOLOGY, KING EDWARD MEDICAL UNIVERSITY, LAHORE
MODEL PAPER, SPECIAL PATHOLOGY
3RD PROFESSIONAL MBBS EXAMINATION
PART - II
Total Marks: 90, Qualifying Marks: 50% Time Allowed: Two Hours & 20 Minutes
Short Essay Questions

Q.1
Describe the Laboratory Diagnosis of a patient suspected to be suffering from lobar pneumonia
10
Q.2.
Describe in brief the pathogenesis of Typhoid Fever.
10
Q.3
Describe the morphological features and cultural characteristics of Mycobacterium TB.
10
Long Essay Question

Q.4.A
Draw and label the life cycle of ancylostoma duodenale. Give its Lab. Diagnosis. Clarify your points with the help of diagram /diagrams.
15
Q.4. B
Name the chemical mediaters involved in different stages of acute inflammatory response. Describe the healing of a surgically incised clean wound.
15
Problem Based Learning
Q5.A
A 70 years old man is brought to Emergency with sudden onset of left sided chest pain increasing on inspiration. The patient is dyspneic and ferbrile. A friction rub is audible on lateral side of left chest. The left leg is markedly edematous with positive homan’s sign. X-Rays reveals a left sided pleural effusion.
i).
What is the most likely diagnosis?
2
ii).
Describe the pathogenesis of thrombosis.
8
iii).
Write short note on hypovolemic shock.
5
Q5.B
A five year old child presented in outdoor with visual loss of his left eye. There was a positive history of similar visual loss in one of his grand parents.
i).
Name at least two neoplasm of the eye.
2
ii).
Enumerate the characteristics of malignancy.
5
iii).
Describe the role of oncogenic viruses and radiations in the pathogenesis of neoplasm.
8
DEPARTMENT OF PATHOLOGY, KING EDWARD MEDICAL UNIVERSITY, LAHORE
MODEL PAPER, SPECIAL PATHOLOGY
3RD PROFESSIONAL MBBS EXAMINATION
PART - I (Multiple Choice Questions)
Total Marks: 30, Time Allowed: 40 Minutes
Choose the Best option


Multiple Choice Questions
Q.1
In acute inflammation, two main functions of leucocytes are:
Ans
A)
Hemostasis and coagulation
B).
Apoptosis and necrosis
C).
Carrying of oxygen and food
D).
Formation of epitheloid Cells.
E).
Phagocytosis and chemotaxis
Q.2
Peritoneal, pleural and pericardial effusion are example of :
A).
Fibrinous inflammation
B).
Suppurative Inflammation
C).
Serous inflammation
D).
Mucinous inflammation
E.
Purulent Inflammation
Q.3
A CT scan of a 40 years old women with parathyroid adenoma and hyperparathyroidism reveals extensive calcium deposit in the lung and kidney parenchyma. These radiologic findings are best explained by which of the following mechanisms of disease.
A).
Arteriosclerosis
B).
Dystrophic calcification
C).
Granulomatous inflammation
D).
Metastatic calcification
E).
Tumour embolism
Q.4
Karyorrhexis is
A).
The fading of chromatin basophilia
B).
Condensation of DNA into shrunken mass
C).
Fragmentation of pyknotic or partially pyknotic nucleus
D).
Increase in chromatin basophilia
E).
Cell membrane damage
Q.5
At autopsy, the heart of 60 years old man weighs only 245 g and has small ventricles. The myocardium is firm with dark chocolate brown color. The coronary arteries show slight atherosclerosis. Which of the following substances is most likely to be found in myocardial fibres in this heart in excess.
A).
Melanin
B).
Hemosidrin
C).
Glycogen
D).
Lipofuscin
E).
Bilirubin
Q.6
Which of the following changes best describes pathophysiology involved in the causation of pulmonary oedema in patients with congestive heart failure.
A).
Decreased plasma oncotic pressure.
B).
Widespread endothelial damage.
C).
Increased hydrostatic pressure
D).
Increased vascular permeability
E).
Acute lymphatic obstruction.
Q.7
The infarct of following organ is invariably hemorrhagic.
A).
Kidney
B).
Lung
C).
Spleen
D).
Heart
Q.8
Teratogens are defined as agents which induce.
A).
Mitosis
B).
Carcinogensis
C).
Birth Defects
D).
Fallot’s Tetrology
Q.9
Drugs reaction are mediated by which type of hypersensivitity
A).
Type - I
B).
Type –II
C).
Type - III
D).
Type – IV
Q.10
The following form of ionizing radiation exposure is associated with highest risk of cancer.
A).
α-Rays
B).
β-Rays
C).
γ-Rays
D).
X-Rays.
Q.11
Grading of tumour depends upon the following except:
A).
Degree of anaplasia
B).
Metastatic spread
C).
Rate of growth of cells.
D).
Degree of differentiation
Q.12
A 60 years old man with history of alcoholism has noted a 6 kg weight loss over the past 5 months. Physical examination shows no masses or palpable lymphadenopathy. Laboratory studies include an elevated serum α-fetoprotein level. Stool guaiac test result is negative. Which of the following is most likely diagnosis.
A).
Prostatic adenocarcinoma
B).
Pulmonary squamous cell carcinoma
C).
Multiple myeloma
D).
Pancreatic adenocarcinoma
E).
Hepatocellular carcinoma.
Q. 13
Gas gangrene is a form of necrosis associated with
A)
Mycotic infections
B)
Emphysema
C)
Tuberculosis
D)
Infections with Clostridium
E).
Muscle trauma
Q. 14
Pain Associated with acute inflammation is thought to be caused by:
A)
Pressure effects of exudates fluid
B)
Histamine
C)
Serotonin
D)
Kinins
E)
All of the above
Q. 15
Hypostatic pneumonia is:
A)
Usually caused by a virus
B)
Secondary infection of chronic pulmonary edema
C)
Associated with low blood pressure
D)
Associated with low electrical charges
E)
Infections of the legs with pulmonary complications
Q.16
.Each of the following statements concerning peptidoglycan is correct EXCEPT:
A.
It has a backbone composed of alternating units of muramic acid and acetylglucosamine
B.
Cross-links between the tetrapeptides involve D-alanine
C.
It is thinner in gram-positive than in gram-negative cells
D.
It can be degraded by lysozyme
Q.17
Each of the following is a typical property of obligate anaerobes EXCEPT:
A.
They generate energy by using the cytochrome system
B.
They grow best in the absence of air
C.
They lack superoxide dismutase
D.
They lack catalase
Q.18.
During an outbreak of gastrointestinal disease caused by an Escherichia coli strain sensitive to ampicillin, tetracycline, and chloramphenicol, a stool sample from one patient yields E. coli with the same serotype resistant to the three antibiotics. What is the mechanism by which the genes for resistance to these antibiotics has been transferred.
A.
Transduction
B.
Conjugation
C.
DNA transformation
D.
Transposition
Q.19.
Enveloped RNA virus that is the most common cause of non-A, non-B hepatitis
A.
Hepatitis A virus
B.
Hepatitis B virus
C.
Hepatitis C virus
D.
Hepatitis D virus
Q.20.
The ability of a virus to produce disease can result from a variety of mechanisms. Which one of the following mechanisms is LEAST likely?
A.
Cytopathic effect in infected cells
B.
Malignant transformation of infected cells
C.
Immune response to virus-induced antigens on the surface of infected cells
D.
Production of an exotoxin that activates adenylate cyclase
Q.21.
Your patient is a woman with a vaginal discharge. You suspect, on clinical grounds, that it may be due to Candida albicans. Which one of the following statements is LEAST accurate or appropriate?
A.
A Gram stain of the discharge should reveal budding yeasts
B.
Culture of the discharge on Sabouraud's agar should produce a white mycelium with aerial conidia
C.
To identify the organism, you should determine whether germ tubes are produced
D.
You should ask her whether she is taking antibiotics
Q.22
Laboratory diagnosis of a patient with a suspected liver abscess due to Entamoeba histolyticashould include
A.
Stool examination and indirect hemagglutination test
B.
Stool examination and blood smear
C.
Indirect hemagglutination test and skin test
D.
Xenodiagnosis and string test
Q.23
Which one of the following agents is used to prevent malaria?
A.
Mebendazole
B.
Chloroquine
C.
Inactivated vaccine
D.
Praziquantel
Q.24
Each of the following statements concerning sleeping sickness is correct EXCEPT:
A.
Sleeping sickness is caused by a trypanosome
B.
Sleeping sickness is transmitted by tsetse flies
C.
Sleeping sickness can be diagnosed by finding eggs in the stool
D.
Sleeping sickness occurs primarily in tropical Africa
Q.25
Each of the following statements concerning Pneumocystis carinii is correct EXCEPT:
A.
P. carinii infections primarily involve the respiratory tract
B.
P. carinii can be diagnosed by seeing cysts in tissue
C.
P. carinii infections are symptomatic primarily in immunocompromised patients
D.
P. carinii symptomatic infections can be prevented by administering penicillin orally
Q.26
Each of the following agents is a recognized cause of diarrhea EXCEPT:
A.
Clostridium perfringens
B.
Enterococcus faecalis
C.
Escherichia coli
D.
Vibrio cholerae
Q.27
Which one of the following zoonotic illnesses has NO arthropod vector?
A.
Plague
B.
Lyme disease
C.
Brucellosis
D.
Epidemic typhus
28.
Which one of the following illnesses is NOT a zoonosis?
A.
Typhoid fever
B.
Q fever
C.
Tularemia
D.
Rocky Mountain spotted fever
Q.29
.Each of the following statements concerning neisseriae is correct EXCEPT:
A.
They are gram-negative diplococci
B.
They produce IgA protease as a virulence factor
C.
They are oxidase-positive
D.
They grow best under anaerobic conditions
Q.30.
Is an acid-fast rod
A.
Mycobacterium avium-intracellulare
B.
Treponema pallidum
C.
Rickettsia prowazekii
D.
Mycoplasma pneumoniae
Q 31
A 60-year-old man who has a 90 pack year history of cigarette smoking has had a chronic cough for the past 10 years. He has begun to lose weight (3 kg) during the past year. No abnormal findings are noted on physical examination. He has a chest radiograph that reveals a right hilar mass. A sputum cytology shows atypical, hyperchromatic squamous cells. What is the most common initial pathway for metastases from this lesion?
A.
Bloodstream
B.
Pleural cavity
C.
Contiguous spread to chest wall
D.
Lymphatics
Q 32
A 55-year-old man dies after a year-long illness. At autopsy her liver contains multiple tumor masses from 2 to 5 cm in size that are firm and tan and that grossly exhibit umbilication with central necrosis. The surrounding hepatic parenchyma appears normal. Which of the following characteristics of neoplasia is best illustrated by these findings?
A.
Multicentric origin
B.
High tumor grade
C.
Primary neoplasm in the stomach
D.
Exposure to a carcinogen
E.
Advanced stage
Q 33
A 66-year-old woman has noted increasing abdominal girth for 3 months. On examination there is a fluid wave. Paracentesis yields cloudy fluid that cytologically contains clusters of malignant cells. An abdominal CT scan shows bilateral cystic and solid pelvic masses and multiple peritoneal nodules. She is treated with chemotherapy with an initial response, but a year later there is still residual tumor. Which of the following parameters of the neoplastic cells best predicts her diminished chemotherapy response?
A.
Doubling time
B.
Extent of apoptosis
C.
Gene amplification
D.
Growth fraction
E.
Telomerase expression
Q 34
A 15-year-old girl has had episodes of sneezing with watery eyes and runny nose for the past 2 weeks. On physical examination she has red, swollen nasal mucosal surfaces. She has had similar episodes each Spring and Summer when the amount of ragweed pollen in 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
B.
Platelet activating factor (PAF)
C.
Tumor necrosis factor (TNF)
D.
Histamine
E.
Immunoglobulin G
Q 35
A 20-year-old woman sustains an injury to her right calf in a mountain biking accident near Moab. On physical examination she has a 5 cm long laceration on the right lateral aspect of her lower leg. This wound is closed with sutures. Wound healing proceeds over the next week. Which of the following factors will be most likely to aid and not inhibit wound healing in this patient?
A.
Secondary wound infection
B.
Poor tissue perfusion
C.
Presence of sutures
D.
Corticosteroid therapy
E.
Hypoalbuminemia
Q 36
A 48-year-old woman has a malignant lymphoma involving lymph nodes in the para-aortic region. She is treated with a chemotherapeutic agent which results in the loss of individual neoplastic cells through fragmentation of individual cell nuclei and cytoplasm. Over the next 2 months, the lymphoma decreases in size, as documented on abdominal CT scans. By which of the following mechanisms has her neoplasm primarily responded to therapy?
A.
Coagulative necrosis
B.
Mitochondrial poisoning
C.
Phagocytosis
D.
Acute inflammation
E.
Apoptosis
Q 37
A 43-year-old man has complained of mild burning substernal pain following meals for the past 3 years. Upper GI endoscopy is performed and biopsies are taken of an erythematous area of the lower esophageal mucosa 3 cm above the gastroesophageal junction. There is no mass lesion, no ulceration, and no hemorrhage noted. The biopsies show the presence of columnar epithelium with goblet cells. Which of the following mucosal alterations is most likely represented by these findings?
A.
Dysplasia
B.
Hyperplasia
C.
Carcinoma
D.
Ischemia
E.
Metaplasia
Note: In Final Examination there will be 30 M.C.Q s of one Best Type having Four-Five options. Also there will be 3 Short essay questions One Long essay question having Two Parts a and b and one Problem based learning question may or may not having two parts a and b.
Note: Books advised
Robbins (small) - Pathology
Levinson - Microbiology
MRSA - Microbiology

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