Monday, July 25, 2016

General Pathology Multiple choice questions (MCQ)



1. Regarding cell injury and death
a)       Initially there is a reduction in cell size during cell necrosis
b)      Apoptosis is associated with an inflammatory response
c)       Necrosis results from caspases sequestered in mitochondrial membranes
d)      Cellular swelling and fatty change indicate reversible cell injury
2. In which of the following organs is steatosis NOT seen
a)       Heart
b)      Kidney
c)       Lung
d)      Liver

3. Dystrophic calcification can occur in
a)       Coagulative necrosis
b)      Caseous necrosis
c)       Enzyme necrosis of fat
d)      All the above

4. Cholesterol and its esters are
a)       Metabolised in a loosely regulated system within cells
b)      Are seen as xanthomas within monocytes in tendons
c)       Accumulate in macrophages in the gallbladder known as cholesterosis
d)      Are seen in the media propria of the aorta in atherosclerosis

5. Progressive atrophy of the brain in later adult life is thought to be part due to
a)       Decreased workload
b)      Loss of innervation
c)       Diminished blood supply
d)      Loss of endocrine stimulation

6. Inflammation is
a)       Fundamentally a destructive response acutely
b)      Is characterised by exudation of fluid and migration of neutrophils
c)       Results in scarring thru regeneration of native parenchymal cells
d)      Is activated by Toll like receptors on microbes

7. The most common mechanism for the formation of leaky endothelium in inflammation is
a)       Endothelial retraction
b)      Direct endothelial injury
c)       Leukocyte mediated endothelial injury
d)      Endothelial cell contraction

8,Regarding mediators of inflammation
a)       Histamine is a preformed vasoactive mediator causing arteriole vasoconstriction
b)      Histamine is considered to be the principle mediatory of the immediate transient phase of increased vascular permeability
c)       Nitric oxide has dual actions in inflammation, it relaxes vascular smooth muscle and also promotes the cellular response in the inflammatory response
d)      Platelet activating factor is found unique to platelets

9. In leukocyte migration thru blood vessels in inflammation
a)       Extravasation of the leukocyte occurs in the order of: adhesion to the wall, margination and then rolling of the leucocyte across the endothelial wall.
b)      Selectins are the primary molecule who play roles with neutrophil activation
c)       Integrins are  involved in firm adhesion of the leucocyte to the cell wall
d)      Endothelial cells will take 6-12hrs before they express their selctin ( E selectin ) in inflammation

10. Regarding some inflammatory patterns
a)       When mesothelial cells of the peritoneum, pleural and pericardial linings secrete fluid it is usually of a fibrinous nature
b)      A serous exudation consists primarily of neutrophils, liquefactive necrosis and oedematous fluid
c)       When there are large vascular leaks or an associated procoagulant stimulus you commonly see a suppurative exudate
d)      Ulcers can only occur when tissue necrosis and the resultant inflammation is on or near a surface

11.In chronic inflammation, all are true except
a)       It can be caused by prolonged exposure to toxic agents
b)      It involves mononuclear inflammatory cells
c)       It may contribute to the formation of atherosclerosis
d)      It primarily involves tissue destruction

12. The complement system
a)       Most critical step is the proteolysis of the 3rd component C3 to C3a
b)      Is only involved in innate immunity reactions
c)       Causes decreased vascular permeability, chemotaxsis and opsonization of leukocytes
d)      Is a loosely controlled pathway

13, Regarding wound healing,
a)       The inflammatory response in primary healing is more intense than in secondary healing 
b)      At 1 week , the wound strength is 20% of that of unwounded skin
c)       Wound contraction is due in part to fibroblast contraction
d)      In primary union, collagen fibres appear with granulation tissue

14.The most important cause of delay of healing is
a)       Inadequate blood supply
b)      Infection
c)       Foreign body presence
d)      Poor nutritional state of the patient

15. Regarding the extracellular matrix, which is NOT CORRECT?
a)       Fibronectin in its plasma form is involved in blood clot stabilisation
b)      Laminin is the most abundant glycoprotein in the extracellular matrix
c)       Vit D is required for the hydroxylation of procollagen to collagen
d)      The cross linking of collagen is important in providing tensile strength to a wound

16. The causes of liver steatosis do not include:
a)       Alcohol abuse
b)      Protein malnutrition
c)       XI-antitrypsin deficiency
d)      CCl4

17.Regarding metastatic calcification, which of the following is not a cause?
a)       Renal failure
b)      Paget’s disease
c)       Sarcoidosis
d)      Hypoparathyroidism

18. Depletion of AtP cause all EXCEPT

a)                 efflux of Ca2+
b)      efflux of K
c)       influx of Na+
d)      decrease pH cells

19.The most common causes of fatty liver in the developed world  are
a)       Hypercholesterolaemia and lipid storage diseases
b)      Alcohol abuse and hypercholesterolaemia
c)       NAFLD and alcohol abuse
d)      NAFLD and hypercholesterolaemia


20   .Examples of intracellular accumulations of lipid do NOT include
a)       Niemann-Pick disease type C
b)      Atherosclerosis
c)       Xanthomas
d)      Amyloidosis

21. .Regardig white cell extravasation in acute inflammation which of the following pairs are incorrect
a)       P selectin: neutrophil rolling
b)      ICAM: neutrophil rolling
c)       E selectin neutrophil rolling
d)      CD34: neutrophil rolling
22.Which of the following disorders are examples of chronic leukocyte induced injury
a)       Arthritis
b)      Asthma
c)       Atherosclerosis
d)      Septic  shock

23.Leukotrienes does not mediate the following actions
a)       Vasoconstriction
b)      Chemotaxis
c)       Increased vascular permiability
d)      Vasodilatation

24.Which is NOT true regarding blood clot formation?
a)       The clot contains red cells, fibrin, fibronectin and complement
b)      Within 24 hours of injury, macrophages migrate in along the fibrin scaffold
c)       Neutrophils release proteolytic enzymes that clean out debris and bacteria
d)      Platelet adhesion and aggregation, and formation of the clot leads to inflammation

25.          Which of the following is true about formation of granulation tissue:
a)       Granulation tissue forms around day 6 from proliferation of fibroblasts and vascular endothelial cells
b)      Characteristic histological feature is presence of new small blood vessels (angiogenesis) and proliferation of fibroblasts
c)       The new vessels in angiogenesis are tight and restrict passage of plasma proteins.
d)      There is a similar amount of granulation tissue in wounds healing by both primary and secondary intention

26.          The following complications of healing are true, except:
a)       Hypertrophic scars result from accumulation of granulation tissue
b)      Keloid scars grow beyond the boundaries of the original wound and don't regress
c)       Dehiscence, common after abdominal surgery, is due to increased abdominal pressure
d)      Wounds can ulcerate because of inadequate vascularisation
27.          Which is NOT true regarding wound healing?
a)       A scar is composed of fibroblasts, collagen, elastic tissue and other ECM components.    
b)      Wound contraction is important in healing by secondary intention.
c)       The initial matrix of fibrin, fibronectin and type I collagen is ultimately replaced by type III collagen.
d)      The tensile strength after one week in an incisional surgical wound is about 10% of unwounded skin.

28. Which of the following is not an example of peripheral immunologic tolerance?
a)       Anergy
b)      Thymic deletion
c)       Suppression by regulatory T-cells
d)      Antigen sequestration


29. Regarding mitochondrial alterations, which is true?

a)       In cell hypertrophy, there is corresponding increase in mitochondrial size.
b)      Mitochondrial myopathies are associated with increased numbers of morphologically abnormal mitochondria
c)       Oncocytomas are malignant tumours consisting of cells with abundant enlarged mitochondria
d)      Hepatocytes in alcoholic liver disease assume megamitochondria -> extremely large, normally shaped mitochondria (abnormal shapes)

30.Regarding lysosomes which is incorrect?

a)       Primary lysosomes are membrane bound
b)      Contain hydrolytic enzymes
c)       Are synthesised in the smooth endoplasmic reticulum
d)      May persist in the cell as residual bodies




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Friday, July 22, 2016

Acute inflammation - General Pathology Multiple Choice Questions (MCQ) - With Answers

       

    True and False type MCQ's

     01.Acute inflammation
a.     Heal by suppuration with abscess formation
b.     Completely heal by resolution
c.      Heal with fibrosis
d.     Heal with regeneration
e.     Leads to amyloidosis
        
02  Regarding acute inflammation
a. Active hyperaemia is due to increased venous pressure
b. Increased pressure is due to gaps in basement membrane
c. Prostaglandin is an endogenous mediator of increased venous pressure
d. Excess proteins are removed by lymph
e. Cellular inflammatory exudates has low O2 tension

03. Regarding acute inflammation
a. Active hyperaemia is due to arteriolar relaxation
b. Angiotensin is an endogenous mediator causing increase in permeability
c. Monocyte infiltration is an active process
d. Increased permeability is due to gaps in the basement membrane
e. Proteins are taken into the lymphatics by pinocytosis

04. Regarding acute inflammation
a. It does not depend on the structure of the tissue affected
b. Mild acute inflammation is healed by the granulation tissue formation
c. In mild acute inflammation the cardinal signs of inflammation cannot be seen
d. Dilation of blood vessels are due to stimulation of autonomic innervation of arterioles
e. In severe inflammation cell necrosis may occur

05. Regarding acute inflammation
a. Migration of monocytes is a passive process
b. Fibrin network forms a mechanical barrier to the spread of bacteria
c. Promotion of immunity is due to antibody mediated immunity as well as cell mediated immunity
d. Slowing of blood flow preceded by active hyperaemia
e. Formation of granulation tissue leading to fibrosis is a recognized sequale

06. “Triple response” of acute inflammation is characterized by
a. Redness of the injury followed by reflex vasodilation
b. Local tissue wheal representing swelling
c. Development of heat
d. Involvement of both a local nerve reflex and a histamine response
e. Increased reaction due to a mixture of polypetides

07. Effects of acute inflammation include
a. Prevention of local tissue injury by dilution of the toxin
b. Prevention of spread of organism by forming a fibrin network
c. Maintaining long term immunity by promoting antibody formation
d. Destruction of microorganisms due to heat
e. Healing of the injury by promoting immobility due to pain

08. Cells that take part in acute inflammation include
a. Plasma cells
b. Mast cells
c. Lymphocytes
d. Polymorphonuclear leucocytes
e. Macrophages

09. Exudate occurs as a result of
a. Increased capillary permeability
b. Direct action of prostacycline and complement
c. Chemical mediators
d. Axonal reflex via substance P
e. Prostaglandin action

10. In acute inflammation oedema is produced by
a. increased capillary permeability
b. Direct reflex
c. Neural reflex
d. Antibody reactions
e. Increased intravascular pressure

11. Substances important in the increased vascular permeability of acute inflammation include
a. Globulin permeability factor
b. Cortisol
c. Histamine
d. Plasma kinines
e. Seratonin

12. Essential features of abscess formation are
a. Eosinophil leucocytosis
b. Destruction of tissue
c. Pyaemia
d. Septicaemia
e. Neutrophil leucocytosis

13. Regarding chronic inflammation
a. Important feature is production of vascular granulation tissue
b. Nature of the lesion depend on the intensity and persistence of the stimulation
c. Most of the migrating cells into the injured tissue are mononuclear cells
d. It gives rise to serious effects by narrowing orifices and tubes
e. Fibrosis tissue formation always have harmful effects

14. Regarding chronic inflammation
a. Microorganisms ingested by macrophages are destroyed by it
b. In autoimmune thyroiditis it serves a useful function
c. In arteritis, fibrous tissue formation strengthens the arterial wall
d. Presence of large numbers of lymphocytes suggest hypersensitivity
e. Production of vascular granulation tissue is important feature

15. Malignant disease may complicate the chronic inflammatory conditions
a. Sarcoidosis
b. Ulcerative colitis
c. Chronic osteomyelitis
d. Asbestosis
e. Schistosomiasis

16. Granulomas are characteristically found in
a. Beryllium pneumonitis
b. Leprosy
c. Tuberculosis
d. Syphilis
e. Coccidiodomycosis

17. Granuloma is a type of inflammatory reaction characteristic of
a. Tuberculosis
b. Rheumatoid arthritis
c. Regional ileitis
d. Staphylococcal pyaemia
e. Sarcoidosis

18. Cells which may be found in granulomas
a. Plasma cells
b. Giant cells
c. Lymphocytes
d. Epithelioid cells
e. Macrophages

19. Epithelial cell granulomas are seen in
a. Typhoid fever
b. Crohn’s disease
c. Foerign body reactions
d. Tuberculosis
e. Alcoholic hepatitis

20. Caseous granuloma are seen in
a. Tuberculosis
b. Lupus vulgaris
c. Sarcoidosis
d. Foreign body granulomas
e. Inflammatory bowel disease

 Answers will be Uploaded soon






Tuesday, July 19, 2016

Answers for RESPIRATORY SYSTEM PHYSIOLOGY-MULTIPLE CHOICE QUESTIONS (MCQ) - LUNG MECHANICS


01.  Increased respiratory minute volume occurs with

a. F - 100mmHg is the normal arterial partial pressure of oxygen

b. T - This is prominent in animals as a thermo regulatory mechanism

c. F - Brain damage suppress the respiratory center

d. T - As a compensatory mechanism

e. T - Reduction in P O2


02. Increased in respiratory minute volume at rest occurs with

a. T

b. T - Increase is marked in P O2 lower than 60 mm Hg

c. Haemoglobin does not affect the partial pressure and partial pressure is due to dissolved oxygen

d. CO2 is a activator of central chemo receptors. But CO2 concentration more than 7% causes respiratory center inhibition due to CNS suppression.

e. F - Inhibit respiration


03. Airway resistance to air flow

a. F

b. T

c. T - Haeliox a treatment for asthma

d. T - As density of air reduces

e. T - Obstructive pulmonary disorder


04. During quite respiration

a. T

b. F - During expiration it becomes positive

c. F - Functional residual capacity

d. F

e. T


05. During maximal inspiration in a healthy adult

a. F -20mmHg

b. F - Increases

c. F - Contracts

d. T

e. F


06. During inspiration there is an increase in

a. T

b. F

c. F - Reduction

d. F - Reduction

e. F- Reduction


07. Regarding pressure changes during respiration

a. F

b. F- 5mmHg

c. T

d. T

e. F- Never Rises


08. Intra- pleural pressure

a.T

b. T

c. F

d. F.

e. T

Sunday, July 17, 2016

Respiratory system Physiology-Multiple choice Questions (MCQ) - Lung Mechanics


Please Mark True or False

01.  Increased respiratory minute volume occurs with

a. Arterial pO2 of 100mmHg

b. Rise in body temperature

c. Brain damage

d. Renal tubular acidosis

e. Lowered barometric pressure


02. Increased in respiratory minute volume at rest occurs with

a. Acute rise in arterial pCO2

b. Arterial pO2 of 65 mmHg

c. Haemoglobin of 5g/dl

d. Breathing air containing 5% CO2

e. Rise in arterial blood pressure


03. Airway resistance to air flow

a. Varies directly with the velocity of flow

b. Varies directly with the fourth power of the radius

c. Is reduced when breathing helium – oxygen gas mixture

d. Is decreased at high altitude

e. Is increased in asthma


04. During quite respiration

a. Intra- pleural pressure is always sub atmospheric

b. Intra-alveolar pressure is always sub atmospheric

c. Volume of air left in the lungs at the end of expiration constitutes the residual volume

d. Volume of air left in the lungs at the end of inspiration constitutes the vital capacity

e. External intercostal muscles contract in the inspiratory phase


05. During maximal inspiration in a healthy adult

a. Intra pleural pressure rises to about 2 mm Hg

b. Venous return decreased

c. Skeletal muscles of the diaphragm relaxes

d. Alveolar ventilation increases

e. Heart rate is reduced


06. During inspiration there is an increase in

a. Intra-abdominal pressure

b. Intra- pulmonary

c. Intra- pleural pressure

d. Intra- oesophageal pressure

e. Intra thoracic pressure


07. Regarding pressure changes during respiration

a. Intra- pleural pressure is nearly equal to intra oesophageal pressure

b. During quite inspiration in an adult intra pleural pressure is about 6 mm Hg

c. During quite expiration the intra pleural pressure is slightly below atmospheric pressure

d. During quite expiration the intra pulmonary pressure is slightly above atmospheric pressure

e. Intra pleural pressure rises above atmospheric pressure with a forced expiration


08. Intra- pleural pressure

a. Is subatmospheric throughout normal inspiration and expiration

b. Becomes more subatmospheric with inspiration

c. Can be assessed by measuring intra gastric pressure

d. Become less subatmospheric during inspiration with a high air way resistane.

e. Rises above atmospheric pressure with a forced expiration against resistance.

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