MBR Pathology Mock Exam 2021
MBR Pathology Mock Exam 2021
MBR Pathology Mock Exam 2021
Department of Pathology
5. The heart of a 35 year old male with a 10. Which characterizes a transudative type
history of chronic rheumatic heart disease of fluid?
exhibits the so-called “bread and butter” A. High protein concentration
type of pericarditis. The patient ultimately B. High cellular debris
died of cardiac failure. The cause of death C. Low specific gravity
is most likely due to: D. None of the above
A. Caseation necrosis of the adjacent KEY: C
myocardium
B. Decreased cardiac output secondary to 11. What mediator is primarily involved in
pericardial fibrosis vasodilation?
C. Myocardial rupture A. Histamine
D. Liquefactive necrosis of the cardiac wall B. Endothelin
KEY: B C. Leukotriene
D. Prostaglandin
KEY: A
12. What is the most common mechanism 19. Which is the likely type of shock
of vascular leakage in acute inflammation? produced by pulmonary embolism?
A. Endothelial injury A. Anaphylactic
B. Increased fluid transport through B. Cardiogenic
transcytosis C. Hypovolemic
C. Contraction of endothelial cells D. Septic
D. Opening of transcellular channels KEY: B
KEY: C
20. Atherosclerotic coronary artery may
13. Which of the following is true of Lyon form thrombus thru which major cause?
Hypothesis? A. Hypercoagulability of blood
A. Normal males are mosaics B. Endothelial injury
B. Random inactivation of the X C. Stasis
chromosome occurs in mid-embryogenesis D. Turbulence of blood flow
C. One X chromosome is active KEY: B
D. All paternal X chromosome is inactivated
KEY: C 21. Patients with renal hypoperfusion
develop edema because of:
14. This abnormality involves inability to A. Hormone secretion
catabolize GM2 gangliosides: B. Excessive protein is lost in urine
A. Lysosomal Storage Disease C. Damage to the excretory ductules
B. Tay Sachs Disease D. Sodium and water retention
C. Gaucher’s Disease KEY: D
D. Alkaptonuria
KEY: B 22. Which is a common feature of
hyperemia and congestion?
15. The second number/item in karyotyping A. Increased arterial flow
nomenclature corresponds to which of the B. Bright red discoloration
following? C. Decreased venous flow
A. Bands involved D. Increased blood volumes
B. Chromosome number KEY: D
C. 23rd pair of chromosome
D. Description of the genetic abnormality 23. Sterile, verrucous (Libmann Sacks)
KEY: C endocarditis is commonly seen in which
setting?
17. Which chromosomal translocation is A. Previously damaged valve
seen in mantle cell lymphoma? B. Cancer
A. 11;18 translocation C. Infective endocarditis
B. 8;14 translocation D. Systemic lupus erythematosus
C. 11;14 translocation KEY: D
D. 14;18 translocation
KEY: C 24.Which heart disease occurs in early
adults with a history of viral infection
18. Which of the following changes best resulting to four
describes the pathophysiology involved in chamber dilatation of the heart?
the production of lung edema in patients A. Viral myocarditis
with congestive heart failure? B. Bacterial myocarditis
A. Acute lymphatic obstruction C. Congestive cardiomyopathy
B. Decreased plasma oncotic pressure D. Hypertrophic cardiomyopathy
C. Increased hydrostatic pressure KEY: C
D. Widespread endothelial damage
KEY: C
25. The pathologic changes of heart valves 30. A 29 year old nulliparous woman
in rheumatic heart disease is due to which requests a routine mammogram because
morphologic finding? both her mother
A. Acute inflammation an older sister of 10 years died of
B. Damage to collagen that weakens the metastatic breast cancer before 40 years of
leaflets age. Which of the
C. Nodular calcification beginning in ff. would add to this patient’s risk factors for
interstitial cells breast cancer?
D. Fibrotic thickening A. BRCA1 mutation
KEY: D B. High fiber diet
C. Nulliparity
26. A 63 year old male patient was brought D. Oral contraceptive use
to the ER due to prolonged chest heaviness KEY: A
5hours
prior to consult. His CK-MB is slightly 31. A newborn has ambiguous genitalia.
elevated. Which would be the likely What appears to be a vagina is
histologic feature of the myocardium associated with a significantly enlarged
affected? clitoris resembling a penis. Laboratory
A. Cytomyolysis and macrophages findings show
B. Dense fibrosis hyponatremia and hyperkalemia, and
C. Loss of striations and heavy neutrophilic hypotension. Deficiency of which of the ff.
infiltration rate limiting
D. Myocardial waviness enzymes is suggested by these findings?
KEY: D A. 1α-Hydroxylase
B. 11-Hydroxylase
27. Eisenmenger syndrome occurring in a C. 17-Hydroxylase
setting of VSD is characterized by: D. 21-Hydroxylase
A. Left to right shunt KEY: D
B. Cyanosis
C. Left ventricular hypertrophy 32. A 35-year old elderly primigravid is seen
D. Systemic hypertension 7 months after giving birth to a normal
KEY: B healthy infant. Her
obstetric history reveals that she suffered
28. Which is the pathology caused by drugs severe haemorrhagic shock with a near-
such as aminoglycoside antibiotics, fatal scenario
cyclosporin, due to abruption placenta. Following
amphotericin B to the kidneys? massive blood transfusion and emergency
A. Glomerulonephritis hysterectomy,
B. Acute tubular necrosis post-partum recovery has so far been
C. Tubulointerstitial disease uneventful. She presently complaints of
D. Lipoid nephrosis continued
KEY: B amenorrhea, significant weight loss, body
malaise and muscular weakness. Further
29. The characteristic peau d’orange skin investigation might be expected to
change seen in inflammatory breast demonstrate which of the ff. findings?
carcinoma is due to: A. Decreased serum cortisol
A. Contraction of the supporting fibroelastic B. Hyperestrinism
fibers of the breast C. Hyperglycemia
B. Fat necrosis with secondary inflammatory D. Increased serum free T4
reaction KEY: A
C. Obstruction of the dermal lymphatics by
tumor emboli
D. Marked interstitial edema
KEY: D
51. A 20-yr-old exhibits vascular collapse 56. Which of the following statements is
several minutes after injection of an IV TRUE?
antibiotic A. The presence of many mitoses in a
for which he was not subjected to a skin neoplasm always indicates that a tumor is
test. What is the responsible immune malignant.
reactant? B. In benign neoplasms, nuclear to
A. IgA cytoplasmic ratio is increased.
B. IgD C. Nuclei of malignant cells are more lightly
C. IgG stained and hypochromatic.
D. IgE D. Abnormally large nucleoli are commonly
KEY: D seen in malignant cells.
KEY: D
52. Autoreactive T and B cells are removed
or neutralized through: 57. Which of the following statements about
A. Negative selection the hematogenous spread of cancer is
B. Action of a super set of killer T cells FALSE?
C. Splenic filtration A. Arteries are less readily penetrated by
D. Lymphoid maturation arrest cancer cells because of their thicker walls
KEY: A B. This is seen only in sarcomas and never
in carcinomas
53. A 42-year-old man reports recurrent C. Arterial spread may occur when tumor
diarrhea and respiratory tract infections for cells pass through the pulmonary capillary
most of his beds or pulmonary AV shunts
life. Following injuries sustained in a motor D. Vertebral metastases are more
vehicle accident, he is transfused whole frequently seen in cancers found in thyroid
blood and and prostate because are close to the
blood components. During the transfusion vertebral column.
he develops a transfusion reaction. Which of KEY: B
the
following diseases is he most likely to have? 58. Hypercalcemia is a paraneoplastic
A. Graft versus host disease syndrome often seen in patients with:
B. Common variable immunodeficiency A. Fibrosarcoma of soft tissue
C. Acquired immunodeficiency syndrome B. Small cell carcinoma of the lung
D. Selective IgA deficiency C. Squamous cell carcinoma of the lung
KEY: D D. Adenocarcinoma of the prostate
KEY: C
54. Which of the following is important in
discriminating between self- and non-self 59. After modified radical mastectomy, a 55
cells? year old woman was diagnosed to have
A. Mitochondrial DNA Invasive Ductal Carcinoma, Grade 1, Stage
B. Majorhistocompatibility complex 1. Which of the following is the best
C. Phospholipid bilayer cell membrane interpretation of this diagnosis?
D. Cell adhesion molecules A. The patient’s tumor is well-differentiated
KEY: B and localized to the breast
B The patient has axillary lymph nodes
55. Biopsy of a lung mass in 60 year old positive for tumor metastasis.
female showed back-to-back glands lined by C. The patient’s tumor is benign.
epithelial cells with hyperchromatic, D. The patient has in-situ carcinoma only.
pleomorphic nuclei, prominent nucleoli, and KEY: A
scant cytoplasm. What is the most likely
diagnosis?
A. Adenocarcinoma
B. Adenoma
C. Squamous cell carcinoma
D. Squamous papilloma
KEY: A
60. On Pap smear, a 37 year old female is 66. Which immature element is the basis for
found to have an infection with Human grading immature teratoma?
Papillomavirus. Which of the following is the A. Rhabdomyoblast
pathognomonic feature found on her B. Fetal cartilage
smear? C. Primitive neuroepithlium
A. Parakeratosis D. Osteoblast
B. Koilocytosis KEY: C
C. Acanthosis
D. Apoptosis 67. What proportion of solid nests in
KEY: B endometrioid carcinoma will merit FIGO
Grade 3?
61. If an ovarian mass is solid and necrotic A. > 50%
and microscopy reveals complex delicate B. > 90%
papillae and psammoma bodies, it is: C. > 40%
A. Serous carcinoma D. > 75%
B. Mucinous carcinoma KEY: A
C. Yolk sac tumor
D. Endometrioid carcinoma 68. An 82-year-old man has had
KEY: A progressively worsening lower back,
bilateral hip, and right shoulder pain for the
62. Which is a characteristic of partial mole past 6 years. Imaging showed narrowing of
that a complete mole does not have? joint spaces with adjacent bony sclerosis. A
A. With an embryo biopsy of the iliac crest was done. This
B. Trophoblastic proliferation showed sclerotic bone with unusually
C. Hydropic villi prominent cement lines, appearing like a
D. Trophoblastic atypia jigsaw puzzle. What is the most likely
KEY: A diagnosis?
A. Osteosarcoma
63. Which ovarian benign epithelial B. Osteoblastoma
neoplasm is solid? C. Paget Disease
A. Mucinous. D. Langerhans Cell Histiocytosis
B. Seromucinous. KEY: C
C. Serous
D. Brenner 69. A 75-year-old woman loses her balance
KEY: D and falls to the floor. She immediately has
marked pain in the right hip. Imaging on
64. Which of the following is most likely to admission shows a right femoral neck
present as bilateral solid adnexal masses? fracture. Bone mass is shown to be 2.5
A. Krukenberg tumor standard deviations below mean peak bone
B. Fibroma mass in young adults. What would be the
C. Granulosa cell tumor expected mineral content of the bony
D. Dysgerminoma trabeculae of these patients?
KEY: A A. Increased
B. Decreased
65. Which of the following ovarian tumors is C. Normal
most likely to be associated with D. Indeterminate
endometrial hyperplasia or carcinoma? KEY: C
A. Immature teratoma
B. Dysgerminoma
C. Granulosa cell tumor
D. Mucinous cystadenoma
KEY: C
70. A 75 year old male noticed slowly 74. If a child suddenly develops edema,
enlarging dark brown patches and macules hematuria, proteinuria, and high systemic
on his trunk over the past 20 years. One of blood pressure two weeks after a throat
the lesions is excised, and microscopic infection by a strain of nephritogenic
examination shows sheets of basaloid cells streptococcus, what mechanism of immune
which surround keratin-filled cysts. This tissue destruction would you expect:
lesion is sharply demarcated from the A. Membrane attack complex formation
surrounding epidermis. What is the most B. Killer lymphocyte activation
likely diagnosis? C. Complement activation
A. Melanoma D. Molecular mimicry
B. Seborrheic keratosis KEY: C
C. Actinic keratosis
D. Dysplastic nevus 75. “Wire-loop” lesions seen in the renal
KEY: B biopsy of a known lupus patient result from:
A. Glomerular hypercellularity
71. A 39 year old female comes in for B. Diffuse subendothelial immune deposits
consult multiple pruritic papules that are C. Mesangial expansion
purple in color on both elbows. Skin biopsy D. Parietal epithelial cell proliferation
showed a bandlike infiltrate of lymphocytes KEY: B
at the dermoepidermal junction, which was
noted to have sawtooth-like appearance, 76. A patient experiencing sudden
and associated with degeneration of basal development of gross hematuria (with red
keratinocytes. What is the most likely cell urine casts and 1+ proteinuria),
diagnosis? hypertension, oliguria and azotemia most
A. Lichen planus probably has:
B. Psoriasis A. Nephritic syndrome
C. Pemphigus vulgaris B. Nephrotic syndrome
D. Actinic keratosis C. Chronic renal failure
KEY: A D. End-stage renal disease
KEY: A
72. A 6-year-old boy with generalized
edema passes smoky urine. A subsequent 77. A 30-year-old female who complains of
renal biopsy is largely unremarkable. No dysuria and frequency is noted to be slightly
deposits are found on immunofluorescence. febrile with right costovertebral
This is most probably a case of: angle tenderness. Urinalysis showed
A. Post-streptococcal GN numerous pus cells and microscopic
B. IgA nephropathy hematuria. Without proper treatment, the
C. Minimal change disease course of this condition is:
D. Membranous GN A. Spontaneous remission
KEY: C B. Unavoidable bilateral kidney involvement
C. Potential kidney scarring
73. A 15-year-old patient with chronic active D. Recurrent gross hematuria
hepatitis (positive serum HBeAg) developed KEY: C
rapid decline in renal function. A renal
biopsy showed more than 50% of glomeruli 78. Which of the following is the most likely
with epithelial crescents. This is obviously a cause of hepatocellular carcinoma?
case of: A. Chronic hepatitis B infection
A. Rapidly progressive GN B. Smoking
B. IgA nephropathy C. Aflatoxin
C. Post-infectious GN D. Nitrates
D. Membranoproliferative GN KEY: A
KEY: A
79. Which of the following microscopic 85. In beta thalassemia, which of the
evidence of hepatic injury is considered following chains tend to form tetramers and
potentially reversible? appear as inclusions in the red blood cells
A. Apoptotic hepatocytes when subjected to special staining?
B. Bridging necrosis A. Alpha
C. Fibrosis connecting portal tracts B Beta
D. Bile accumulation in hepatocytes C. Delta
KEY: D D. Gamma
KEY: A
80. The initial effect of alcoholism in the
liver is: 86. TRUE of cherry red spot in Tay Sachs
A. Fatty change disease:
B. Hepatitis A. Hemorrhage in the choroid layer
C. Cirrhosis B. Telangiectatic changes in the choroid
D. Hepatoma layer
KEY: A C. Normal choroid layer
D. Normal ganglion cell layer
81. Which of the following markers would KEY: C
suggest that the patient is a chronic
hepatitis B carrier? 87. Which vitamin/mineral deficiency is
A. Hepatitis B surface antigen correctly paired?
B. Hepatitis B core antigen A. Vitamin A – osteomalacia
C. Hepatitis E antigen B. Iodine – dental caries
D. Hepatitis B surface antibody C. Vitamin D – scurvy
KEY: A D. Copper – muscle weakness
KEY: D
82. Von Recklinghausen’s disease is
characterized microscopically by 88. Exogenous chemicals in the
proliferation of this element in skin and environment in air, water, food, and soil
subcutaneous tissues that may be absorbed into the body through
A. Microfibrils inhalation, ingestion, and skin contact are
B. Elastin called:
C. Collagen A. Solvents
D. Fibroblast B. Xenobiotics
KEY: D C. Toxic metabolites
D. Poison
83. This feature can be used to differentiate KEY: B
Type 2 from Type 1 neurofibromatosis:
A. Neural tumors 89. The infiltration of inflammatory cell
B. Lisch nodules infiltrates beyond the limiting plate into the
C. Cafe au lait spots hepatic lobule is termed:
D. Increased risk of tumors A. Lobular hepatitis
KEY: B B. Confluent necrosis
C. Interface hepatitis
84. Inflammatory carcinoma of the breast is D. Bridging necrosis
a consequence of: KEY: C
A. Granulomatous inflammation secondary
to fat necrosis
B. Obstruction of the dermal lymphatics
C. Secondary bacterial infection
D. Release of tumor necrotic factor
KEY: B
90. A 60 year old male died due to massive 93. Which of the following statements about
hematemesis. He had jaundice, palmar achondroplasia is TRUE?
erythema and a known alcoholic. Liver A. This leads to an underdeveloped thoracic
biopsy will most likely show: cavity, so individuals die at birth due to
A. Thickened hepatic plates with loss of respiratory insufficiency
reticulin framework B. This is a type I collagen disease that
B. Hepatic nodules separated by bands of leads to affected individuals having too little
fibrosis bone and extreme skeletal fragility
C. Confluent necrosis and severe periportal C. This condition is associated with changes
inflammation in longevity, intelligence, and reproductive
D. Interface hepatitis with predominance of status in affected individuals
plasma cells D. This is an autosomal dominant disorder
KEY: B that causes reduction in the proliferation of
the chondrocytes in the growth plate
91. Which of the following is consistent with KEY: D
a diagnosis of osteochondroma?
A. Mosaic pattern of bone trabeculae 94. Which of the following is most
B. Randomly interconnecting trabeculae of suspicious for a melanoma?
woven bone prominently rimmed by a single A. Symmetrical lesion, diameter of 4 mm
layer of osteoblasts B. Pigmented lesion with regular borders
C. Cap composed of benign hyaline cartilage C. Homogenously dark brown in color
with newly made bone forming the inner D. Present at birth, but noticed a recent
portion of the head and stalk of the lesion change in appearance and size
D. Curvilinear trabeculae of woven bone KEY: D
with a “Chinese character” appearance and
lacks osteoblastic rimming 95. A 38 year old male noted a small, flesh-
KEY: C colored nodule on his upper trunk, since 6
weeks prior to consult. The lesion is
92. A 75-year-old woman loses her balance umbilicated, and a curdlike material can be
and falls to the floor. She immediately has expressed from the center. Skin biopsy
marked pain in the right hip. Imaging on showed ellipsoid, homogeneous,
admission shows a right femoral neck cytoplasmic inclusion in cells of the stratum
fracture. Bone mass is shown to be 2.5 granulosum and the stratum corneum.
standard deviations below mean peak bone Which of the following infectious agents
mass in young adults. What would be the most likely produced this lesion?
expected mineral content of the bony A. Molluscum contagiosum
trabeculae of these patients? B. Human papillomavirus
A. Increased C. Staphylococcus aureus
B. Decreased D. Histoplasma capsulatum
C. Normal KEY: A
D. Indeterminate
KEY: C 96. Which histomorphologic changes can
commonly be seen in both asthma and
chronic bronchitis?
A. Mucus gland hyperplasia
B. Severe airway remodeling
C. Airway scarring
D. Obliteration of bronchioles
KEY: A