Master General Pathology I. Understand disease causes, cellular injury, inflammation, and repair. Essential for Year 3 medical students. Learn key concepts.
SCHOOL OF CLINICAL MEDICINE - DEPARTMENT OF CLINICAL SCIENCES BACHELOR OF SCIENCE IN CLINICAL MEDICINE AND COMMUNITY HEALTH (REGULAR) --- UNIT CODE: BPA1201/BPA3101 UNIT TITLE: GENERAL PATHOLOGY I DATE: TUESDAY 19TH APRIL, 2022 - 2:00 PM EXAM TYPE: MAIN EXAM TIME: 2 HOURS --- INSTRUCTIONS - THIS PAPER HAS THREE SECTIONS - ANSWER ALL QUESTIONS - DO NOT WRITE ANYTHING ON THE QUESTION PAPER --- SECTION A: MULTIPLE CHOICE QUESTIONS CHOOSE THE SINGLE BEST ANSWER TO EACH QUESTION Question 1 Name the response that best categorizes cells: - a) Labile cells - b) Stable cells - c) Permanent cells - d) Semi permeable cells - e) A, B, and C Answer: e) A, B, and C Explanation: Cells are categorized into three types based on their proliferative capacity: labile cells (continuously dividing), stable cells (divide when stimulated), and permanent cells (non-dividing post-mitotic cells). --- Question 2 All the granulomatous diseases EXCEPT: - a) Tuberculosis - b) Sarcoidosis - c) Schistosomiasis - d) Syphilis - e) Asthma Answer: e) Asthma Explanation: Asthma is a chronic inflammatory airway disease characterized by eosinophilia and smooth muscle hypertrophy, not granulomatous inflammation. The others all cause granulomatous reactions. --- Question 3 The following are chemical mediators of chronic inflammation EXCEPT: - a) Leukotrienes - b) Complement proteins - c) Interleukins - d) Cytokines - e) Hormones Answer: e) Hormones Explanation: While hormones can modulate inflammatory responses, they are not considered primary chemical mediators of chronic inflammation. Leukotrienes, complement, interleukins, and cytokines are key inflammatory mediators. --- Question 4 The most important cell in chronic inflammation is: - a) Macrophages - b) Monocyte - c) Lymphocyte - d) Fibroblast - e) Smooth Muscle Cell Answer: a) Macrophages Explanation: Macrophages are the hallmark cells of chronic inflammation, responsible for phagocytosis, antigen presentation, and secretion of inflammatory mediators and growth factors. --- Question 5 The following are causes of pathological atrophy EXCEPT: - a) Reduced nervous supply - b) Ischaemia - c) Malnutrition - d) Muscle disease - e) None of the above Answer: e) None of the above Explanation: All listed options (denervation, ischemia, malnutrition, and muscle disease) are valid causes of pathological atrophy - reduction in cell size and organ mass. --- Question 6 The following are functions of cellular adaptations EXCEPT: - a) Phagocytosis - b) Antigen processing - c) Secretion of inflammatory substances - d) Lysis - e) None of the above Answer: e) None of the above Explanation: All listed functions can be part of cellular adaptations. Cells can adapt to perform various functions including phagocytosis, antigen processing, secretion, and lysis in response to environmental changes. --- Question 7 Mechanisms of cell injury include all EXCEPT: - a) Damaged mitochondrial functions - b) Leaky cell membrane - c) Normal protein synthesis - d) Deranged calcium homeostasis - e) Leakage of lysosomal enzymes Answer: c) Normal protein synthesis Explanation: Normal protein synthesis is a sign of cellular health, not injury. Cell injury involves mitochondrial dysfunction, membrane damage, calcium dysregulation, and lysosomal enzyme leakage. --- Question 8 A tuberculous granuloma is comprised of: - a) Fibroblasts and capillaries - b) Capillaries and giant cells - c) Endothelial cells and neutrophils - d) Young capillaries - e) Central necrotic area, epithelioid cells and lymphocytes Answer: e) Central necrotic area, epithelioid cells and lymphocytes Explanation: Tuberculous granulomas are characterized by central caseating necrosis surrounded by epithelioid cells, Langhans giant cells, and a peripheral layer of lymphocytes and plasma cells. --- Question 9 Events surrounding chronic inflammation include all EXCEPT: - a) Infiltration with macrophages - b) Angiogenesis - c) Attempts at repair - d) Tissue destruction - e) Infiltration with neutrophils Answer: e) Infiltration with neutrophils Explanation: Neutrophil infiltration is characteristic of acute inflammation. Chronic inflammation is characterized by macrophage infiltration, angiogenesis, repair attempts, and tissue destruction. --- Question 10 The heart and kidneys are prone to this type of cellular adaptation: - a) Dysplasia - b) Hyperplasia - c) Hypertrophy - d) Atrophy - e) Anaplasia Answer: c) Hypertrophy Explanation: Heart and kidney cells are primarily post-mitotic, so they respond to increased workload by increasing cell size (hypertrophy) rather than cell number (hyperplasia). --- Question 11 Low albumin results in: - a) Increased interstitial hydrostatic pressure - b) Decreased colloid osmotic pressure - c) Decrease in capillary hydrostatic pressure - d) Decrease in interstitial pressure - e) None of the above Answer: b) Decreased colloid osmotic pressure Explanation: Albumin is the major contributor to plasma oncotic pressure. Low albumin (hypoalbuminemia) decreases colloid osmotic pressure, leading to fluid extravasation and edema. --- Question 12 White blood cells attach to endothelial cells in the inflammatory process using their surface receptors called: - a) Integrins - b) E-Selection - c) P-Selection - d) XCAMS - e) CD35 Answer: a) Integrins Explanation: Integrins on leukocytes bind to adhesion molecules (like ICAM-1) on endothelial cells, allowing firm adhesion before transmigration. Selectins mediate rolling, not firm adhesion. --- Question 13 A white blood cell that is involved in the acute inflammatory response is: - a) Neutrophil - b) T-lymphocyte - c) B-lymphocyte - d) Fibroblast - e) Platelet Answer: a) Neutrophil Explanation: Neutrophils are the first and most numerous leukocytes recruited during acute inflammation, arriving within hours to perform phagocytosis and antimicrobial functions. --- Question 14 In the process of phagocytosis, the oxidative arm produces the following EXCEPT: - a) Collagenases - b) Elastases - c) O2- - d) NO3 - e) Iodine Answer: a) Collagenases Explanation: Collagenases are non-oxidative enzymes. The oxidative arm of phagocytosis produces reactive oxygen species like superoxide (O2-), nitrates, and hypohalites (including iodine compounds). --- Question 15 Wound healing involves all the processes outlined below EXCEPT: - a) Induction of an acute inflammatory response - b) Parenchymal cell regeneration - c) Migration and proliferation - d) Synthesis of intracellular proteins (ICM) - e) Remodeling of parenchymal elements to restore function and strength Answer: d) Synthesis of intracellular proteins (ICM) Explanation: Wound healing involves extracellular matrix (ECM) synthesis, not intracellular proteins. The process includes inflammation, cell regeneration, migration/proliferation, and tissue remodeling. --- Question 16 Which of the following is the correct response to describe how secondary healing differs from primary healing: - a) Large tissue defects in secondary healing - b) Inflammatory response is more intense - c) Larger amounts of granulation tissues are observed - d) Wound contraction is a distinguishing feature - e) All of the above Answer: e) All of the above Explanation: Secondary healing (healing by second intention) involves all these features compared to primary healing: larger defects, more intense inflammation, extensive granulation tissue, and significant wound contraction. --- Question 17 Wound healing is affected by all of the following EXCEPT: - a) Infection - b) Malnutrition - c) Poor blood vessel supply - d) Absence of glucocorticoids - e) Type and location of tissue Answer: d) Absence of glucocorticoids Explanation: The absence of glucocorticoids would actually improve wound healing, as glucocorticoids impair healing by suppressing inflammation and collagen synthesis. The other factors all negatively affect healing. --- Question 18 Haemorrhage can result in one of the following: - a) Cardiogenic Shock - b) Septic Shock - c) Neurog