General Pathology I – 21 MCQs | Kenya MBChB

21 Year 3: General Pathology exam questions on General Pathology I for medical students. Includes MCQs, answers, explanations and written questions. Sample: Nam

This MCQ set contains 21 questions on General Pathology I in the Year 3: General Pathology unit. Each question includes the correct answer and a detailed explanation for active recall and exam preparation.

Q1: Name the response that best categorizes cells:

  1. A. Labile cells
  2. B. Stable cells
  3. C. Permanent cells
  4. D. Semi permeable cells
  5. E. A, B, and C

Correct answer: E – A, B, and C

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). ---

Q2: All the granulomatous diseases EXCEPT:

  1. A. Tuberculosis
  2. B. Sarcoidosis
  3. C. Schistosomiasis
  4. D. Syphilis
  5. E. Asthma

Correct answer: E – Asthma

Asthma is a chronic inflammatory airway disease characterized by eosinophilia and smooth muscle hypertrophy, not granulomatous inflammation. The others all cause granulomatous reactions. ---

Q3: The following are chemical mediators of chronic inflammation EXCEPT:

  1. A. Leukotrienes
  2. B. Complement proteins
  3. C. Interleukins
  4. D. Cytokines
  5. E. Hormones

Correct answer: E – Hormones

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. ---

Q4: The most important cell in chronic inflammation is:

  1. A. Macrophages
  2. B. Monocyte
  3. C. Lymphocyte
  4. D. Fibroblast
  5. E. Smooth Muscle Cell

Correct answer: A – Macrophages

Macrophages are the hallmark cells of chronic inflammation, responsible for phagocytosis, antigen presentation, and secretion of inflammatory mediators and growth factors. ---

Q5: The following are causes of pathological atrophy EXCEPT:

  1. A. Reduced nervous supply
  2. B. Ischaemia
  3. C. Malnutrition
  4. D. Muscle disease
  5. E. None of the above

Correct answer: E – None of the above

All listed options (denervation, ischemia, malnutrition, and muscle disease) are valid causes of pathological atrophy - reduction in cell size and organ mass. ---

Q6: The following are functions of cellular adaptations EXCEPT:

  1. A. Phagocytosis
  2. B. Antigen processing
  3. C. Secretion of inflammatory substances
  4. D. Lysis
  5. E. None of the above

Correct answer: E – None of the above

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. ---

Q7: Mechanisms of cell injury include all EXCEPT:

  1. A. Damaged mitochondrial functions
  2. B. Leaky cell membrane
  3. C. Normal protein synthesis
  4. D. Deranged calcium homeostasis
  5. E. Leakage of lysosomal enzymes

Correct answer: C – Normal protein synthesis

Normal protein synthesis is a sign of cellular health, not injury. Cell injury involves mitochondrial dysfunction, membrane damage, calcium dysregulation, and lysosomal enzyme leakage. ---

Q8: A tuberculous granuloma is comprised of:

  1. A. Fibroblasts and capillaries
  2. B. Capillaries and giant cells
  3. C. Endothelial cells and neutrophils
  4. D. Young capillaries
  5. E. Central necrotic area, epithelioid cells and lymphocytes

Correct answer: E – Central necrotic area, epithelioid cells and lymphocytes

Tuberculous granulomas are characterized by central caseating necrosis surrounded by epithelioid cells, Langhans giant cells, and a peripheral layer of lymphocytes and plasma cells. ---

Q9: Events surrounding chronic inflammation include all EXCEPT:

  1. A. Infiltration with macrophages
  2. B. Angiogenesis
  3. C. Attempts at repair
  4. D. Tissue destruction
  5. E. Infiltration with neutrophils

Correct answer: E – Infiltration with neutrophils

Neutrophil infiltration is characteristic of acute inflammation. Chronic inflammation is characterized by macrophage infiltration, angiogenesis, repair attempts, and tissue destruction. ---

Q10: The heart and kidneys are prone to this type of cellular adaptation:

  1. A. Dysplasia
  2. B. Hyperplasia
  3. C. Hypertrophy
  4. D. Atrophy
  5. E. Anaplasia

Correct answer: C – Hypertrophy

Heart and kidney cells are primarily post-mitotic, so they respond to increased workload by increasing cell size (hypertrophy) rather than cell number (hyperplasia). ---

Q11: Low albumin results in:

  1. A. Increased interstitial hydrostatic pressure
  2. B. Decreased colloid osmotic pressure
  3. C. Decrease in capillary hydrostatic pressure
  4. D. Decrease in interstitial pressure
  5. E. None of the above

Correct answer: B – Decreased colloid osmotic pressure

Albumin is the major contributor to plasma oncotic pressure. Low albumin (hypoalbuminemia) decreases colloid osmotic pressure, leading to fluid extravasation and edema. ---

Q12: White blood cells attach to endothelial cells in the inflammatory process using their surface receptors called:

  1. A. Integrins
  2. B. E-Selection
  3. C. P-Selection
  4. D. XCAMS
  5. E. CD35

Correct answer: A – Integrins

Integrins on leukocytes bind to adhesion molecules (like ICAM-1) on endothelial cells, allowing firm adhesion before transmigration. Selectins mediate rolling, not firm adhesion. ---

Q13: A white blood cell that is involved in the acute inflammatory response is:

  1. A. Neutrophil
  2. B. T-lymphocyte
  3. C. B-lymphocyte
  4. D. Fibroblast
  5. E. Platelet

Correct answer: A – Neutrophil

Neutrophils are the first and most numerous leukocytes recruited during acute inflammation, arriving within hours to perform phagocytosis and antimicrobial functions. ---

Q14: In the process of phagocytosis, the oxidative arm produces the following EXCEPT:

  1. A. Collagenases
  2. B. Elastases
  3. C. O2
  4. D. NO3
  5. E. Iodine

Correct answer: A – Collagenases

Collagenases are non-oxidative enzymes. The oxidative arm of phagocytosis produces reactive oxygen species like superoxide (O2-), nitrates, and hypohalites (including iodine compounds). ---

Q15: Wound healing involves all the processes outlined below EXCEPT:

  1. A. Induction of an acute inflammatory response
  2. B. Parenchymal cell regeneration
  3. C. Migration and proliferation
  4. D. Synthesis of intracellular proteins (ICM)
  5. E. Remodeling of parenchymal elements to restore function and strength

Correct answer: D – Synthesis of intracellular proteins (ICM)

Wound healing involves extracellular matrix (ECM) synthesis, not intracellular proteins. The process includes inflammation, cell regeneration, migration/proliferation, and tissue remodeling. ---

Q16: Which of the following is the correct response to describe how secondary healing differs from primary healing:

  1. A. Large tissue defects in secondary healing
  2. B. Inflammatory response is more intense
  3. C. Larger amounts of granulation tissues are observed
  4. D. Wound contraction is a distinguishing feature
  5. E. All of the above

Correct answer: E – All of the above

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. ---

Q17: Wound healing is affected by all of the following EXCEPT:

  1. A. Infection
  2. B. Malnutrition
  3. C. Poor blood vessel supply
  4. D. Absence of glucocorticoids
  5. E. Type and location of tissue

Correct answer: D – Absence of glucocorticoids

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. ---

Q18: Haemorrhage can result in one of the following:

  1. A. Cardiogenic Shock
  2. B. Septic Shock
  3. C. Neurogenic Shock
  4. D. Anaphylactic Shock
  5. E. Hypovolaemic Shock

Correct answer: E – Hypovolaemic Shock

Hemorrhage leads to blood volume loss, resulting in hypovolemic shock. The other shock types have different etiologies: cardiac dysfunction, infection, neurological injury, and allergic reactions respectively. ---

Q19: The most common cause of oedema in the developing world secondary to reduced plasma colloid oncotic pressure is:

  1. A. Protein losing renal syndrome
  2. B. Liver cirrhosis
  3. C. Excessive protein loss from the gut
  4. D. Malnutrition
  5. E. Acute and chronic inflammatory

Correct answer: D – Malnutrition

In developing countries, protein-energy malnutrition (kwashiorkor) is the most common cause of hypoproteinemic edema due to inadequate protein intake leading to low albumin synthesis. ---

Q20: One of the following is not associated with the pathophysiology of oedema:

  1. A. Increased Hydrostatic Pressure
  2. B. Reduced Plasma Oncotic Pressure
  3. C. Lymphatic obstruction
  4. D. Potassium retention
  5. E. Inflammation

Correct answer: D – Potassium retention

Potassium retention doesn't directly cause edema. Edema results from increased hydrostatic pressure, decreased oncotic pressure, lymphatic obstruction, increased vascular permeability (inflammation), and sodium retention. --- SECTION B: SHORT ANSWER QUESTIONS (5 MARKS EACH)

Q21: : Define the following terms

  1. A. Hypoxia: Reduced oxygen availability to tissues despite adequate perfusion. Can result from respiratory disease, anemia, carbon monoxide poisoning, or
  2. B. Cells switch to anaerobic metabolism leading to lactic acidosis.
  3. C. Necrosis: Pathological cell death characterized by cellular swelling, membrane disruption, organelle destruction, and inflammatory respons
  4. D. Results from severe cell injury and is irreversible, unlike apoptosis.

Correct answer: A – Hypoxia: Reduced oxygen availability to tissues despite adequate perfusion. Can result from respiratory disease, anemia, carbon monoxide poisoning, or

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