Explore general pathology principles: disease causes (etiology), mechanisms (pathogenesis), cellular changes, and adaptation. Master foundational concepts for m
SECTION A: MULTIPLE CHOICE QUESTIONS 1. Vasoactive amines responsible for vasodilatation during inflammation are released from which cell type? a) Plasma cells b) Lymphocytes c) Monocytes d) Mast cells Answer: d) Mast cells Explanation: Mast cells contain preformed vasoactive mediators including histamine, which causes immediate vasodilation and increased vascular permeability during the early phase of acute inflammation. 2. Bradykinin causes all the following during inflammation EXCEPT: a) Smooth muscle contraction b) Pain c) Dilatation of blood vessels d) Opsonisation and Chemotaxis Answer: d) Opsonisation and Chemotaxis Explanation: Bradykinin is a vasoactive peptide that causes vasodilation, increased vascular permeability, smooth muscle contraction, and pain. It does not directly cause opsonization or chemotaxis. 3. Granulomas are characterised by all of the following EXCEPT: a) Features of chronic inflammation b) Accumulation of modified macrophages, lymphocytes and plasma cells c) Initiation by both infectious and non-infectious agents d) Acute inflammatory reaction Answer: d) Acute inflammatory reaction Explanation: Granulomas are a form of chronic inflammation characterized by collections of epithelioid cells, lymphocytes, and sometimes giant cells. 4. During acute inflammation, tissue oedema occurs due to: a) Increased capillary permeability b) Decreased capillary permeability c) Decreased interstitial fluid d) Decreased blood flow Answer: a) Increased capillary permeability Explanation: Tissue edema results from increased vascular permeability, allowing plasma proteins and fluid to leak into the interstitial space. 5. The process by which white blood cells migrate from blood vessels through widened inter-endothelial junctions is referred to as: a) Pavementing b) Diapedesis c) Rouleaux formation d) Chemotaxis migration Answer: b) Diapedesis Explanation: Diapedesis (transmigration) is the process by which leukocytes migrate between endothelial cells to exit the vascular compartment. 6. During acute inflammation, Interleukin-1 (IL-1) helps in: a) Stimulation of T-lymphocytes b) Inhibiting B-lymphocytes c) Inhibiting chemotaxis of neutrophils and macrophages d) Decreasing fibroblast and bone resorption activity Answer: a) Stimulation of T-lymphocytes Explanation: IL-1 is a pro-inflammatory cytokine that stimulates T-lymphocyte activation and proliferation. 7. The following are mediators of inflammation EXCEPT: a) Interferons b) Prostaglandins c) Tumor Necrosis Factor (TNF) d) Myeloperoxidase enzyme Answer: d) Myeloperoxidase enzyme Explanation: Myeloperoxidase is an enzyme in neutrophil granules used for antimicrobial activity, not a primary mediator of inflammation. 8. Caseating type granulomas are usually seen in: a) Viral infections b) Tuberculosis c) Pyogenic bacterial infections d) Meningitis Answer: b) Tuberculosis Explanation: Caseating granulomas with central necrosis are characteristic of mycobacterial infections, particularly tuberculosis. 9. In granulomas, epithelioid and giant cells are derived from: a) T-lymphocytes b) B-lymphocytes c) Plasma cells d) Circulating monocytes Answer: d) Circulating monocytes Explanation: Epithelioid cells and multinucleated giant cells are derived from activated macrophages, which originate from circulating monocytes. 10. The characteristic cells of chronic inflammation are all EXCEPT: a) Plasma cells b) Macrophages c) Lymphocytes d) Polymorphonuclear cells (PMNs) Answer: d) Polymorphonuclear cells (PMNs) Explanation: PMNs (neutrophils) are the hallmark of acute inflammation; chronic inflammation involves mononuclear cells. 11. The following vascular changes are observed in acute inflammation EXCEPT: a) Vasodilation b) Stasis of blood c) Increased vascular permeability d) Decreased blood flow Answer: d) Decreased blood flow Explanation: Acute inflammation initially causes increased blood flow due to vasodilation. 12. The most common fixative used to preserve tissue in histopathology is: a) 10% Formalin b) Ethylene glycol c) Haematoxylin d) 95% Ethanol Answer: a) 10% Formalin Explanation: 10% neutral buffered formalin is the standard fixative used to cross-link proteins and preserve morphology. 13. Cells which have the capacity to multiply throughout their lifespan are referred to as: a) Stable cells b) Permanent cells c) Labile cells d) None of the above Answer: c) Labile cells Explanation: Labile cells (e.g., skin, GI epithelium) continuously divide to replace lost cells. 14. The following cells have LEAST capacity for regeneration: a) Cardiac muscle b) Skeletal muscle c) Neuronal cells d) Liver cells Answer: c) Neuronal cells Explanation: Neurons are permanent cells with minimal to no regenerative capacity in the adult CNS. 15. The FIRST event in primary wound healing is: a) Epithelial changes b) Organization c) Formation of blood clot d) Acute inflammatory response Answer: c) Formation of blood clot Explanation: Hemostasis and clot formation occur immediately to stop bleeding and provide a scaffold. 16. Clean, uninfected, surgically incised wounds whose edges are approximated by surgical sutures heal by: a) Primary intention b) Secondary intention c) Cauterisation d) Regeneration Answer: a) Primary intention 17. Large open wounds characterised by tissue loss and repaired by granulation tissue in the floor heal by: a) Secondary intention b) Primary intention c) Cauterisation d) Regeneration Answer: a) Secondary intention 18. The following events are common to primary and secondary wound healing EXCEPT: a) Formation of blood clot b) Inflammatory response c) Epithelial changes d) Wound contraction Answer: d) Wound contraction Explanation: Wound contraction is primarily a feature of secondary intention healing. 19. The following factors inhibit wound healing EXCEPT: a) Infection b) Cortisol c) Foreign bodies d) Proteins Answer: d) Proteins Explanation: Proteins are essential building blocks for repair and collagen synthesis. 20. Granulation tissue consists of the following EXCEPT: a) Fibroblasts b) Macrophages c) Polymorphonuclear cells d) Budding young blood vessels Answer: c) Polymorphonuclear cells 21. The correct sequence of the cell cycle is: a) G0 – G1 – S – G2 – M b) G0 – G1 – G2 – S – M c) G0 – M – G2 – S – G1 d) G0 – G1 – S – M – G2 Answer: a) G0 – G1 – S – G2 – M 22. The following local factors influence wound healing EXCEPT: a) Nutrition b) Adequate blood supply c) Size and location of wound d) Presence of infection Answer: a) Nutrition Explanation: Nutrition is a systemic factor, not a local factor. 23. The term Metaplasia refers to: a) Irregular, atypical proliferative changes b) Loss of cell substance producing shrinkage c) Replacement of one type of adult cell by another d) None of the above Answer: c) Replacement of one type of adult cell by another 24. Malignant neoplasms show all the following features EXCEPT: a) Disorganized cell structure b) Capsulation c) Invasion of local and distant tissues d) Rapid, erratic growth Answer: b) Capsulation Explanation: Malignant tumors typically lack a capsule and are invasive. 25. The increase in size of individual cells within an organ is referred to as: a) Hypertrophy b) Hyperplasia c) Atrophy d) Differentiation Answer: a) Hypertrophy 26. The following is classified as a tumor suppressor gene: a) C-Myc b) p53 c) RAS d) BCR Answer: b) p53 27. Burkitt's lymphoma is associated with proliferation of: a) T-lymphocyte cells b) B-lymphocyte cells c) Lymph vessels d) Lymph nodes Answer: b) B-lymphocyte cells 28. The following are oncogenic viruses in humans EXCEPT: a) Human Papilloma Virus (HPV) b) Epstein-Barr Virus (EBV) c) Hepatitis B virus d) Polio virus Answer: d) Polio virus 29. Which of the following is TRUE regarding pathologic assessment of tumours? a) Grading is the degree of microscopic differentiation b) Staging is the extent of spread c) TNM and AJCC systems are used for staging d) All of the above Answer: d) All of the above 30. Immune