Test your knowledge of General Pathology with this July 2021 continuous assessment. Covers MCQs and short answer questions on inflammation, oncology, cell injur
Pathology Continuous Assessment July 2021 SECTION A: MULTIPLE CHOICE QUESTIONS Question 1 Malignant neoplasms show all the following features EXCEPT: a) Disorganized cell structure b) Encapsulation c) Invasion of local and distant tissues d) Rapid, erratic growth Answer: b) Encapsulation Question 2 ONE of the following cells have LEAST capacity for regeneration : a) Cardiac muscle b) Skeletal muscle c) Neuronal cells d) Liver cells Answer: c) Neuronal cells Question 3 The following are mediators of inflammation EXCEPT: a) Interferons b) Prostaglandins c) Tumor Necrosis Factor (TNF) d) Myeloperoxidase enzyme Answer: d) Myeloperoxidase enzyme Question 4 Metaplasia refers to: a) Irregular, atypical proliferative changes in epithelial or mesenchymal cells b) Loss of cell substance producing shrinkage of the cells c) Replacement of one type of adult cell by another type of adult cell d) None of the above Answer: c) Replacement of one type of adult cell by another type of adult cell Question 5 Metastatic calcification is associated with: a) Dead or dying tissues b) Atherosclerosis c) Abnormal calcium metabolism d) Damaged heart valves Answer: c) Abnormal calcium metabolism Question 6 Which of these is an endogenous pigment : a) Melanin b) Coal c) Tattooing d) Lipid Answer: a) Melanin Question 7 Phagocytes include the following EXCEPT: a) Neutrophils b) Macrophages c) Osteoclasts d) Lymphocytes Answer: d) Lymphocytes Question 8 Which of these is the commonest cause of infectious granulomas : a) Tuberculosis b) Fungal infections c) Viral infections d) Toxins Answer: a) Tuberculosis Question 9 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 Question 10 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 Question 11 RB gene , 'the guardian of the genome' regulates the cell cycle at: a) G1/S Checkpoint b) G2 Checkpoint c) G0 restriction checkpoint d) Intra-S Checkpoint Answer: a) G1/S Checkpoint Question 12 TP53 is regulated and scavenged after completing its action by: a) CDKN1A b) MDM2 c) RAS d) E6 Answer: b) MDM2 Question 13 Mutations in the TGF-Beta signaling pathway involving SMAD molecules usually result in the following type of cancer: a) Colon Cancer b) Stomach Cancer c) Lung Cancer d) Pancreatic cancer Answer: d) Pancreatic cancer Question 14 The most commonly mutated oncoprotein in all tumors and a key participant in abnormal signal transduction pathways is: a) APC b) TP53 c) BRAF d) RAS Answer: d) RAS Question 15 The ' Warburg ' effect in tumor cellular metabolism refers to: a) Oxidative phosphorylation in tumor cells b) Aerobic glycolysis in tumor cells c) Mutations and defects in enzymes that regulate the Krebs cycle d) Defective Mitochondrial ATP synthesis Answer: b) Aerobic glycolysis in tumor cells Question 16 A Granuloma is comprised of: a) Fibroblasts and capillaries b) Capillaries and giant cells c) Endothelial cells and neutrophils d) Central necrotic area, epithelioid cells and lymphocytes Answer: d) Central necrotic area, epithelioid cells and lymphocytes Question 17 During autopsy ONE of the following is NOT the role of the medical officer: a) Identify the decedent b) Ascertain the cause of death c) Document evidence d) Request for autopsy Answer: d) Request for autopsy Question 18 The postmortem interval can be estimated using the below EXCEPT: a) Rigor Mortis b) Algor Mortis c) Mummification d) Cadaveric spasms Answer: d) Cadaveric spasms Question 19 Exhumation of human remains may ONLY proceed on the authority of: a) Valid Court Orders b) The National Police Service c) The Chief Government Pathologist d) The Medical Superintendent Answer: a) Valid Court Orders Question 20 The following are chemical mediators of acute inflammation EXCEPT: a) Leukotrienes b) Complement proteins c) Interleukins d) Hormones Answer: d) Hormones Question 21 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) Question 22 Which of the following is TRUE regarding the pathologic assessment of tumours : a) Grading is the degree of macroscopic and microscopic differentiation b) Staging is the extent of spread of tumours c) TNM and AJCC systems can be used for staging malignant tumours d) All of the above Answer: d) All of the above Question 23 Complications of cutaneous wound healing include ONE of the following: a) Wound dehiscence b) Ulceration c) Formation of contractures d) Deficient scar formation Answer: a) Wound dehiscence Question 24 ONE of the following statements is TRUE: a) Large cutaneous wounds heal by first intention b) Hormones such as glucocorticoids inhibit collagen synthesis c) Defective inflammation may cause increased susceptibility to infection d) Atherosclerosis is a chronic inflammatory process Answer: d) Atherosclerosis is a chronic inflammatory process Question 25 The following statements are TRUE of ischaemia : a) Results from critical lack of blood supply to an area b) May occur in atherosclerosis c) May be reversible when blood supply is restored d) All the above Answer: d) All the above SECTION B: SHORT ANSWER QUESTIONS 1. Define: An oncogene is a mutated proto-oncogene that promotes uncontrolled cell growth. An oncoprotein is the abnormal protein product of an oncogene. A proto-oncogene is a normal gene that regulates cell growth. 2. Amyloidosis is characterized by the extracellular deposition of misfolded proteins arranged in beta-pleated sheets . Diagnosis is typically made using a Congo red stain , which reveals apple-green birefringence under polarized light. 3. Key mediators of acute inflammation include Histamine , Prostaglandins , Leukotrienes , Complement proteins (specifically C3a and C5a), Cytokines (such as IL-1 and TNF), and Nitric Oxide . 4. Malignant cytomorphology refers to the characteristic cellular changes seen in malignancy. These include nuclear pleomorphism (variation in nuclear size and shape), an increased nuclear-to-cytoplasmic (N:C) ratio , hyperchromatism (darkly stained nuclei due to increased DNA content), prominent nucleoli , and the presence of abnormal mitoses . SECTION C: LONG ANSWER QUESTIONS 1. The process of malignant transformation involves several distinct stages. It begins with Initiation , where cells acquire DNA damage from carcinogens. This is followed by Promotion , which involves the clonal expansion of these initiated cells. The next stage, Progression , sees the accumulation of further mutations , leading to increased genomic instability and more aggressive tumor behavior. Finally, Metastasis occurs when malignant cells spread from the primary tumor to distant sites in the body. 2. The vascular events of acute inflammation are crucial for delivering immune cells and mediators to the site of injury. These events begin with vasodilation , an increase in the diameter of blood vessels, leading to increased blood flow and warmth and redness at the inflamed site. This is followed by increased vascular permeability , primarily due to the formation of endothelial gaps , allowing fluid and plasma proteins to leak into the extravascular tissue, causing edema. Concurrently, there are significant changes in blood flow , including stasis (slowing of blood flow), margination (leukocytes moving to the periphery of the vessel lumen), and transmigration (leukocytes actively moving through the endothelial gaps into the interstitial tissue).