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A 45 year old woman presents to the ER with severe upper abdominal pain with vomiting. The pain is focused in epigastrium radiating to the back. There is no history of chronic epigastric pain. hich of the following are the most likely predisposing factors for this condition! a. ". pylori infection and e#cess gastric acid secretion b. Gallstone or alcohol use [ as diagnosis is acute pancreatitis] c. $besity and high serum cholesterol d. %tress and cigarette use e. "epatitis & and ' co(infection A 5* year old obese female presents to ER after being found unconscious by her daughter. +aramedics report that the female is found in stuporous condition covered with vomit. $n arrival at ER, she is clammy and her &+ is -5.5/mm"g. "er serum amylase is raised. hich of the following is the most likely cause of hypotension! a. Alpha cell tumor of pancreas b. Ectopic pancreas c. Acute hemorrhagic pancreatitis d. +ancreatic adenocarcinoma e. 0ystic fibrosis A 51 year old male diagnosed with 'ecompensated 0hronic 2iver 'isease suddenly starts vomiting blood and eventually loses consciousness. "is wife finds him lying on the bedroom floor. "e has no prior history of hematemesis, bleeding diathesis and had not been vomiting prior to the appearance of the blood. hich of the following is the most likely cause of this man3s presentation! a. Achalasia b. Esophageal varices c. 4allory weiss tear d. +lummer inson syndrome e. 5enker3s diverticulum A 45 year old man presents with malaise,anore#ia and vomiting to emergency room. The physician notices slight 6aundice. &lood e#amination shows marked elevation of A2T and A%T with A%T.A2T ratio being ).5. Alkaline phosphatase is near normal. %erum 0opper and 7ron are normal.histopathological reports show 4allory bodies in hepatocytes. 2iver damage from which of the following diseases most likely accounts for these findings! a. &iliary cirrhosis b. 8iral hepatitis c. Alcoholic hepatitis d. "emochromatosis e. ilson3s disease A 1/ year old married woman presents to gynaecology $+' for routine checkup. %he is taking $ral 0ontraceptive +ills for contraception for the last 4 years. %he reports slight discomfort in the right hypochrondrium. Alpha protein level is essentially within normal limits. 9ltrasound shows a space occupying lesion. %he is physically fine otherwise. This lesion is most likely a. "epatocellular carcinoma b. Hepatic adenoma c. Angiosarcoma d. "epatic amebiasis e. Echinococcus granulosus cyst A *5 year old male presents with complaint of right upper :uadrant pain. "e was diagnosed "08 )/ years back. "e also gives a history of ill health, fever, decreased appetite and fatigue. &iopsy specimen shows presence of bile and atypical lymphocytes. Apart from 0T scan and other tests which tumor marker you will order to support your diagnosis! a. &eta "0; b. 0arcino(embryonic antigen c. Alpha feto protein d. 0A(1)5 e. 0A(15 A 1) year old male child presents with pitting edema, ascites and prolonged bleeding from wound sites. "is biological parents are not known and he was adopted from orphanage. "is abdominal 9ltrasound reveals cirrhosis and viral serology for "&8 and "08 comes out as negative. hat is the most likely cause of cirrhosis in children of his age! a. Wilsons disease [ as no bronze diabeties(e ! emph"sema#! adult female (d ! hepatospleenomegal"$ cerebral s$s of l"sosomal storage disorder(b ] b. ;aucher3s disease c. Alpha 1 Antitrypsin deficiency d. +rimary &iliary cirrhosis e. "emochromatosis A 1/ year old male presents with dementia, "emiballism and de(arranged liver en=ymes. $n further evaluation his abdominal 9ltrasound shows cirrhosis of the liver. "is 8iral serology is negative. hat is the most likely ne#t finding in this patient!

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a. +eriodic Acid %chiff %tain shows red cytoplasmic granules in hepatocytes. b. %a"ser &leisher rings in cornea c. "ighly increased Alpha feto proteins d. Antimitochondrial antibodies in blood e. 0entral cyanosis A 1 year old boy is brought to ER in a comatose condition. "e had an episode of viral infection for which he was given aspirin by his mother to relieve fever. &ut his condition deteriorated and later he was brought to ER. "is blood samples are taken and deranged liver en=ymes are found. 4ost probably his diagnosis is? a. Alpha 1 anti(trypsin deficiency b. 'e"e ("ndrome c. ilson3s disease d. @eonatal cholestasis e. +rimary &iliary 0irrhosis A )* year old malnourished female presents to medicine $+' with mild abdominal discomfort in Right hypochondrium. $n taking further history,she has had diarrhea for ) weeks. 9ltrasound abdomen shows space occupying lesion. &iopsy specimen shows abscess. 4ost likely cause of this liver abscess is? a. E. coli b. Alebsiella sp. c. Entamoeba histol"tica. d. Acute hepatitis e. Echinococcus granulosus cyst A )5 year old man had been e#periencing intermittent diarrhea which, over years, progressed to severe diarrhea, alternating with constipation, rectal bleeding, and passage of mucus. $n physical e#amination, the abdomen is tender over the left iliac fossa . %tools e#amination fails to reveal parasites. 0olonoscopy demonstrates inflammation limited to the rectum, with no higher lesions. hich of the following is the most likely diagnosis! a. 0eliac 'isease b. 0rohn 'isease c. "irschprung 'isease d. Tropical sprue e. )lcerative colitis E#ploratory laparotomy of a patient with an acute abdomen demonstrates a several foot long loop of small intestine with a dark red(to(brown, edematous appearance.The patient has a history of atrial fibrillation. The lesion ends abruptly on both the distal and pro#imal edges. hich of the following diagnosis is suggested by this appearance! a. Adenocarcinoma of the colon b. 0rohn disease c. 9lcerative colitis d. *schemic bo+el disease [as A.fab +ill dislodge the mural thrombi] e. Tuberculosis A */ year old man presents to his physician because of progressive dysphagia, first to solids and then to li:uids. Endoscopy reveals a large fungating mass )cm above the ;astroesophageal 6unction. &iopsy of the mass shows that the glands have e#tended into muscular layer and contain large hyperchromatic nuclei. A diagnosis of esophageal adenocarcinoma is made. hich of the following conditions can result in the development of this lesion! a. Esophageal rings b. Esophageal webs c. 'eflu, esophagitis d. %cleroderma e. %liding hiatal hernia A *5 year old man develops peri(umbilical pain which then shifted to the right iliac fossa. $n physical e#amination, his temperature is 1-0 rectally and his abdomen is tender. hich of the following is the most likely diagnosis! a. Acute Appendicitis b. 'iverticulitis c. "emorrhoids d. +ancreatitis e. +yelonephritis A 5< year old woman with anemia is found to have a decreased 8itamin &1) level. Antibodies to intrinsic factor are identified. 2evels of all other vitamins are within normal limits. hich of the following is most likely to be associated with this condition! a. 'uodenal ulcer b. 9lcerative colitis c. 'ietary 8it. &1) deficiency d. Atrophic gastritis e. Angiodysplasia A 54 year old woman complains of burning pain in her epigastrium and vomiting a few days after she started taking medication for her rheumatoid arthritis. hich of the following forms of gastritis would most likely be found in this patient!

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a. Acute gastritis b. 0hronic antral gastritis c. 0hronic fundal gastritis d. "ypertrophic gastritis e. 2ympocytic gastritis A 1) year old woman presents with complaints of several months of burning substernal chest pain e#acerbated by large meals, cigarettes and caffeine. "er symptoms are worse when she lies on her back, especially while sleeping at night. Antacids often improve her symptoms. This patient is at risk for which of the following conditions! a. 0ardiac ischemia b. -olumnar metaplasia of distal esophagus c. Esophageal web d. 2eiomyoma of the esophagus e. 4allory eiss lesion in the esophagus A patient develops anemia and weight loss and slight abdominal discomfort. $n :uestioning, the patient is a known case of chronic gastritis. hich of the following type of malignancy is most strongly associated with this patient3s condition! a. ;astric lymphoma b. 7ntestinal type of gastric adenocarcinoma c. .iffuse t"pe of gastric adenocarcinoma [ as anemia is there! this tumor is a conse/uence of chronic atrophic autoimmune t"pe gastritis] d. %:uamous type of oesophageal carcinoma e. Adenocarcinoma of oesophagus A 5/ year old man with a history of alcohol abuse is found to have elevated liver en=ymes. A liver biopsy shows the microscopic features of fatty change BsteatosisC. 7f the patient abstains from further drinking, this condition will most likely evolve into which of thee following! a. Acute hepatitis b. 0hronic hepatitis c. -omplete regression d. "yperplastic nodules e. 4alignant degeneration A patient presents to a physician complaining of recurrent episodic diarrhea, triggered by eating too much or drinking alcohol. "is wife states that Dhe turns as red as a beet and starts whee=ingE during these episodes. 0hest F(Ray demonstrates a lung mass. hich of the following would be the most likely cause of his symptoms! a. -arcinoid tumor b. +rimary T& c. Recurrent T& d. 2ung cancer e. %uperior vena cava syndrome A 4/ year old woman with polycythemia vera develops progressive severe ascites and tender hepatomegaly over a period of several months. 2iver function tests are near normal. hich of the following is the most likely diagnosis! a. Acute hepatitis b. Hepatic vein obstruction c. "emochromatosis d. 0hronic hepatitis.cirrhosis e. 0arcinoid syndrome A 1/ year old boy complains of intermittent abdominal pain. Endoscopy fails to demonstrate peptic ulcer or chronic gastritis. The clinician suspects that the patient may have a heterotopic rest of gastric mucosa that is producing enough acid to cause ulceration of ad6acent mucosa. hich of the following is the most likely diagnosis! a. Ectopic pancreatic tissue b. 0ec1els diverticulum c. Galse diverticulum d. Appendicitis e. 0ancer of the cecum A *5 year old woman dies of metastatic liver cancer. The liver at autopsy shows a multinodular vascular tumor that histologically is composed of anastomosing channels lined by anaplastic endothelial cells. The liver parenchyma between tumor nodules appears normal. The histopathologist gives a preliminary diagnosis of angiosarcoma of the liver. hich of the following risk factors is associated with this form of liver cancer! a. 0irrhosis b. "emochromatosis c. E,posure to vin"l chloride d. "epatitis & virus infection e. $ral contraceptive use

)4. A *5 year old man presents to a physician because of a palpable mass immediately above the left clavicle. &iopsy of the mass demonstrates metastatic adenocarcinoma in a lymph node. hich of the following organs should be most strongly suspected as containing the primary tumor! a. &ladder b. 2arge bowel c. 2iver d. (tomach e. +ancreas )5. 0hronic ;astritis is associated with? a. Helicobacter p"lori b. 0ontaminated food c. 'rug poisoning d. Trauma e. %chistosoma infection )*. 4a6or site of +eptic 9lcer is ? a. 7leum b. .uodenum c. Esophagus d. +ancreas e. 0ecum )<. 7nflammatory bowel diseases are associated with? a. 8iruses b. Autoimmune disorders c. Refined diet d. +sycho H somatic factors e. Elderly age )-. The granulomas of 0rohns3s disease are differentiated from granulomas of tuberculosis due to? a. +resence of necrosis b. 2resence of casseation [ absent in crohns disease.] c. +resence of giant cells d. +resence of lymphocytes e. +resence of epitheloid cells )>. hich of the following features of the polyps of the colon indicates a better prognosis! a. 8illous histology b. 2arge si=e c. "igher degrees of dysplasia d. 2edunculated e. +ro#imal location 1/. hich of the following is a ma6or predisposing factor for the development of pseudomembranous colitis! a. Ioung age b. 4alnutrition c. Antibiotic use d. Refined diet e. $besity 11. A * year old boy presents with abdominal pain and vomiting. The pain first started in the peri umbilical region and then shifted to the right lower :uadrant. "is temperature is 1/)G and pulse is 11/. A laparotomy is performed and his appendi# is removed. hat will be observed if the appendi# is e#amined by the histopathologist! a. 2ymphocytic infiltrate b. @ecrosis c. 3eutrophilic infiltrate d. +erforation of the appendi# e. Adhesions 1). %chistosoma hematobium is associated with? a. Adenocarcinoma of the kidney b. (/uamous cell carcinoma of the bladder c. "epatocellular carcinoma d. 0olon cancer e. 9reteric colic 11. &arrets esophagus is a predisposing factor of a. %:uamous cell carcinoma b. Adeno carcinoma c. &asal cell carcinoma d. ;astric carcinoma e. Esophagus refle# disease

14. A 5/yr old man who is on @%A7's for his heart problem for last 4yrs and smokes ) pack cigarette per day last 1/(15yrs presents in $+' with the c.o recurrent epigastric pain 15()/ min after taking meal which is relieved by vomiting. hat is the diagnosis! a. 0oelic disease b. 2eptic ulcer disease [nsaids and smo1ing..] c. ;astric ca d. ;astro Esophageal Reflu# 'isease e. 0holecystitis 15. A 4)yrs old man presents in $+' with the complaints of passage of abnormally bulky, frothy, greasy, yellow stools for 1 days accompanied by weight loss anore#ia, abdominal distention and flatus. $n biopsy small intestine was found to be laden with distended macrophages in the lamina propria. hat is the most likely diagnosis! a. Whipples disease b. Tropical sprue c. 0eliac disease d. ;iardiasis e. 0holera 1*. hat is another name for apthous ulcer! a. 2eukoplakia b. Erythroplakia c. &ed sore d. -an1er sores e. $ral candidiasis 1<. A */yrs old lady presents with a small swelling at the angle of the 6aw for last ) years which is painless. $n e#am it is non(tender and palpated as discrete mass. %urgeon wants to e#cise the lesion but he is worried about the facial nerve that may get damaged during the e#cision. hat is most likely the diagnosis! a. %aladenitis b. arthin tumor c. +arotitis d. +apillary cystadenoma e. 2leomorphic adenoma 1-. 0lassic lesion of crohns disease is a. (1ip lesion b. Glask shaped ulcer c. +seudopolyps d. 0rypt abscess e. 4acrophages laden lamina propria 1>. 'eep ulcers, marked lymphoid reaction, fibrosis, serositis, granuloma mass and fistulas are the features of a. 9lcerative colitis b. -rohns disease c. 7ntestinal polyposis d. 4alabsorbtion syndrome e. 0olorectal carcinoma 4/. 4ost common colorectal carcinoma is a. %:uamous carcinoma b. &asal cell carcinoma c. Adenoma d. Adenocarcinoma e. 4ucinous carcinoma 41. A </yrs old lady who is case of colon cancer. $n biopsy, her cancer as invaded the muscularis propria. Two pericolic nodes are involved with no metastasis. hat is the T@4 stage of her colon cancer! a. 453607 b. T1@)4/ c. T)@)4/ d. T)@141 e. T)@/4/ 4). hat is the histological criteria for the diagnosis of acute appendicitis a. 0ytological atypia b. Grond like villiform e#tensions of mucosa c. 4ucosal atrophy d. %ubmucosal fibrosis e. 3eutrophilic infiltration of muscularis propria 41. 7dentify the risk factors associated with gastric carcinoma a. Gamily history b. H.p"lori c. Gatty food d. %edentary life style e. 4ore use of fruits in diet

44. The most common fungal infection of the oral cavity in immunocompromised individuals is? a. 4hrush (candidiasis [ aspergillus and mucorm"cosis follo+] b. &lastomycosis c. "istoplasmosis d. 4ucormycosis e. 0occidioidomycosis 45. A department of pathology reviews pathology reports of colorectal adenomas over the past 15 years and correlates them with clinical data. hat set of factors is most likely to correlate with the risk of developing colorectal carcinoma! a. 2ol"p size! histologic t"pe! severit" of d"splasia b. +olyp si=e and anatomic location c. +atient age, polyp si=e d. +olyp si=e and gender of patient e. +atients age and histologic type 4*. 'uring the pathogenesis of +ancreatitis which en=yme after activation from its proen=yme form can activate other en=ymes and clotting, Ainin and compliment systems! a. 2ipase b. +hospholipase c. 4r"psin d. Elastase e. Alpha amylase 4<. An outbreak of acute hepatitis in the months of July and August is traced to the mi#ing of sewage with drinking water. The patients had 6aundice, arthralgias and low(grade fever. Transaminases were markedly raised. @one of the patients developed chronic disease. $nly two patients died during the outbreak, both were pregnant females. hat is the likeliest cause of this outbreak! a. "A8 b. HE8 c. "&8 d. "'8 e. "08 4-. A 41year old man presents to his physician complaining of swollen ankles. "e states that he never had this problem before. +hysical e#amination demonstrates marked lower e#tremity edema and periorbital swelling. "is pulse is strong and regular. 9rine dipstick is 4K positive for protein but negative for blood and glucose. A )4 hour urine collection demonstrates proteinuria if * gm . day.%pike like protrusion of ;&4 matri# is seen on histology hich of the following is the most likely cause of this man3s problem! a. &erger3s disease b. 'iabetic nephropathy c. 4embranoproliferative glomerulonephritis d. 0embranous glomerulonephritis e. 4inimal change disease 4>. A * year old child develops a large erythematous rash around the site of mos:uito bite. $ne month later she is taken to a pediatrician because of a puffy face and swollen ankles. The scanty urine sample has a reddish brown hue and contains both Red &lood 0ells and proteins. hich of the following distinctive features will be most likely to be seen on renal biopsy! a. Gusion of podocyte foot processes b. 7gA in the mesangium c. 2inear 7g; deposits d. $nion skinning of renal arterioles e. (ub epithelial electron dense humps 5/. An 78 drug abuser develops an aggressive form of nephrotic syndrome that does not respond to steroids. A renal biopsy is performed. hich of the following histological diagnosis will most likely be made from the biopsy tissue! a. &ocal segmental glomerulosclerosis b. 7gA nephropathy c. 2ipoid nephrosis d. 4embranoproliferative glomerulonephritis e. 4embranous glomerulonephritis

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