Pathology Continuous Assessment July 2021 | Essay Questions | Ompath Study

Practice 7 structured short- and long-answer medical questions on Pathology Continuous Assessment July 2021. Review model answers for exam revision.

Essay Questions and Answers

1. Q1. ## Pathology Continuous Assessment July 2021

   Answer: ## 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

2. Q2. **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.

   Answer: Model answer pending

3. Q3. **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.

   Answer: Model answer pending

4. Q4. 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**.

   Answer: Model answer pending

5. Q5. 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.

   Answer: Model answer pending

6. Q6. 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).

   Answer: Model answer pending

7. Q7. **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**.

   Answer: ## SECTION C: LONG ANSWER QUESTIONS