MBBS THIRD PROFESSIONAL EXAMINATION 2007 SPECIAL PATHOLOGY MCQs

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MBBS THIRD PROFESSIONAL EXAMINATION 2007

SPECIAL PATHOLOGY (MCQs)

Model Paper

Total No. of MCQs 65
Marks 65 Time 1 hour 5 minutes

01. A mother brought her infant to the pediatrician for delayed
milestones, hepatosplenomegaly and pallor. Another sibling
had similar problems for which repeated blood transfusions
was advised. Confirmation of the diagnosis can be made by:
A. Complete blood picture.
B. Iron studies.
C. Hemoglobin electrophoresis.
D. Bone marrow examination.
E. Liver biopsy.
Key: C

Topic: Hematology

02. Young female complains of episodic breath-lessness, cough,
wheezing and chest tightness, worse during spring season.
Pathological findings will include:
A. Permanent enlargement of distal air spaces.
B. Mast cell activation.
C. Haemoptysis.
D. Excessive lysis of elastin.
E.
1
antiprotease deficiency.
Key: B

Topic: Respiratory System

03. During a routine pelvic examination, a 25 year old female was
found to have an enlarged uterus. Ultrasound showed a
multiloculated cystic structure in the uterine cavity. The mass
was removed by dilatation curettage of the uterus and it
showed placental like tissue. Which tumor marker is helpful in
diagnosis and prognosis?
A. CEA.
B. PSA.
C. S-100.
D. Beta-HCG.
E. CA-125.
Key: D

Topic: Female Genital Tract

04. In which of the following breast lesions is there a prominent
giant cell reaction?
A. Acute mastitis.
B. Fat necrosis.
C. Fibro adenoma.
D. Fibrocystic changes.
E. Sclerosing adenosis.
Key: B
Page 2 of 17

Model Paper

Topic: Breast
05. A 41 year old man complained of swollen ankles. Physical
examination revealed marked lower extremity edema and
periorbital swelling. Urine dipstick was 4+ positive for protein
but negative for blood and glucose. 24 hour urine collection
showed proteinuria of 6 GM/day. The diagnosis is:
A. Diabetic nephropathy.
B. Membranoproliferative glomerulonephritis.
C. Membranous glomerulonephritis.
D. Minimal change disease.
E. Berger disease.
Key: C

Topic: Urinary System

06. A middle aged man consulted a physician for a lesion on his
nose. On examination a flesh-colored lesion about 1 cm in
diameter, with a rolled edge and central ulceration was seen.
The most likely diagnosis is:
A. Eczema.
B. Psoriaris.
C. Urticaria.
D. Verruca vulgaris.
E. Basal cell carcinoma.
Key: E

Topic: Skin

07. The leading cause of mortality in ischaemic heart disease is
sudden death which is due to:
A. Atrial fibrillation.
B. Ventricular fibrillation.
C. Myocardial ischaemia.
D. Hypotension.
E. Coagulation necrosis.
Key: B

Topic: Cardiovascular System

08. Wedge shaped shadow on chest X-ray indicates:
A. Pneumonitis.
B. Pulmonary edema.
C. Pulmonary infarction.
D. Ards.
E. Pulmonary hemorrhage.
Key: C

Page 3 of 17

Model Paper

09. A gastroenterologist performs a colonoscopy on a patient with
a family history of gastric and color cancer and discovers
multiple polyps. Biopsy of one lesion reveals benign
hamartoma. On physical examination the patient is noted to
have dark pigmentation of the buccal mucosa and lips. What is
the diagnosis:
A. Peutz Jeghers syndrome.
B. Gardners syndrome.
C. Adenomatous polyposis coli.
D. Turcots syndrome.
E. Helicobacter pylori infection.
Key: A

Topic: GIT

10. An infant presented with mild anemia, jaundice and
splenomegaly. CBC revealed spherocytosis with raised
reticulocyte count. The condition is most likely caused by
defective:
A. Clathrin.
B. Connexon.
C. Spectrin.
D. Tubulin.
E. Dyenin.
Key: C

Topic: Hematology (Hereditary Spherocytosis)

11. A 54 year old female with an abdominal mass undergoes
exploration laparoscopy. Both ovaries are enlarged hence
resected. Pathology report is Krukenberg tumor, indicating
which of the following:
A. Ectopic pregnancy.
B. Endometriosis.
C. Hyperestrogenic state.
D. Immunosuppresion.
E. Metastatic carcinoma.
Key: E


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Model Paper

12. A 60 year old man presented with progressive dysphagia. First
for solids, then for liquids. Endoscopy revealed a large
fungating mass 2 cm above gastroesophageal junction which
was malignant on biopsy report. Which condition is associated
with this development?
A. Carcinoma stomach.
B. Scleroderma.
C. Esophageal webs.
D. Sliding hiatal hernia.
E. Barretts esophagus
Key: E

Topic: GIT

13. A 70 year old man presented with left ventricular failure and a
harsh systolic murmur. Echocardiography revealed stenosis of
aortic valve as well as hypertrophy and dilatation of the left
ventricle. Which additional change would also be expected:
A. Dilatation of ascending aorta.
B. Dissection of ascending aorta.
C. Calcification of aortic valve.
D. Rupture of aortic valve.
E. Vegetations on the aortic valve.
Key: C

Topic: Cardiovascular System

14. A 40 year old man developed gynecomastia. On examination
he was found to have enlarged right testicle. Orchiectomy was
done and biopsy revealed homogenous population of large
polygonal cells with abundant eosinophilic cytoplasm and
round central nuclei. Which is the most likely diagnosis:
A. Immature teratoma.
B. Sertoli cell tumor.
C. Spermatocytic seminoma.
D. Leydig cell tumor.
E. Teratoma with malignant transformation.
Key: D
Topic: Male Genital System

15. A patient presented with a lump in his neck. Physical
examination revealed a solitary firm thyroid nodule on the left
side. The nodule does not enhance during 99 mTc imaging.
Serum T
3
, T
4
and TSH are normal, but serum calcitonin is
elevated. Biopsy will reveal which of the following:
A. Parathyroid adenoma.
B. Follicular carcinoma thyroid.
C. Medullary carcinoma thyroid.
D. Parathyroid carcinoma.
E. Hashimoto thyroiditis.
Key: C

Topic: Endocrines
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Model Paper

16. Predisposing factors for carcinoma of the urinary bladder
include:
A. Diabetes.
B. Hypertension.
C. Smoking.
D. Hypercholesterolemia.
E. Obesity.
Key: C

Topic: Urinary System (urinary bladder)

17. A child develops a tumor of the brainstem, which on biopsy
demonstrates bizarre, pleomorphic tumor cells accompanied
by necrosis and heamorrage. Which of the following is the
most likely diagnosis?
A. Glioblastoma Multiforme.
B. Ependymoma.
C. Astrocytoma.
D. Oligodendroglioma.
E. Pilocytic astrocytoma.
Key: A

Topic: CNS

18. A 60 year old male patient presented with bilateral cervical
and axillary lymphadenopathy which develop over the last one
year. Blood examination revealed TLC of 120 x 10
9
/l with
normal platelet count and hemoglobin 9Gm/dl. Differential
count showed 92% lymphocytes. Bone marrow examination
will show:
A. Hypocellular fragments with increased lymphocyes.
B. Hypercellular fragments with increased lymphocytes.
C. Hypercellular fragments with increased myeloid cells.
D. Hypercellular fragments with increase in all cell lines.
E. Moderately cellular fragments with normal lymphocytes.
Key: B

Topic: Hematology

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Model Paper

19. A 15 year old girl was brought to the emergency in coma. Her
breath smelt like acetone. Diagnosis would be most likely
consistent with:
A. Alcohol intoxication.
B. Heroin overdose.
C. Profound hypoglycemia.
D. Diabetic ketoacidosis.
E. Diazepam overdose.
Key: D

Topic: Chemistry

20. Physical examination of a 45 year old man revealed thin arms
and legs, a swollen abdomen, red tongue, dry and slightly
yellow skin, gynecomastia, testicular atrophy, multiple spider
angiomas, tremor and short-term memory loss. Which of the
following conditions can be associated with this:
A. Bronchogenic carcinoma.
B. Colon carcinoma.
C. Hepatic cirrhosis.
D. Glomerulonephritis.
E. Congestive heart failure.
Key: C

Topic: Liver

21. A 47 year old man presented to the emergency with sudden
onset of severe upper abdominal pain with vomiting. Pain was
in epigastrium radiating to the back. Serum amylase level was
2000 u/l. Which of the following are predisposing factors for
his condition?
A. Helicobacter pylori infection and excess gastric acid secretion.
B. Hepatitis B infection and iron overload.
C. Obesity and high serum cholesterol.
D. Stress and cigarette use.
E. Alcohol use and gallstones.
Key: E

Topic: GIT

22. Which of the following locations is most likely for the
development of carcinoma in a person who has chewed
tobacco for 15 years?
A. Floor of the mouth.
B. Lower lip.
C. Tongue.
D. Tonsils.
E. Upper lip.
Key: B

Topic: Oral Cavity
Page 7 of 17

Model Paper

23. A 49 year old female presented to her physician with a lump in
her breast. Biopsy of the lump showed invasive ductal
carcinoma. The connective tissue adjacent to the tumor was
densely collagenous. This is an example of:
A. Anlaplasia.
B. Dysplasia.
C. Desmoplasia.
D. Carcinoma in SITU.
E. Metaplasia.
Key: C

Topic: Breast

24. A 61 year old male develops severe chest pain. He is
diagnosed as a case of myocardial infarction after
investigations. One week later he again complains of
precordial pain, this time with fever and a loud friction rub.
What is the most likely diagnosis?
A. Caseous pericarditis.
B. Fibrinous pericarditis.
C. Hemorrhagic pericarditis.
D. Purulent pericarditis.
E. Serous pericarditis.
Key: B

Topic: CVS

25. Which of the following statements is correct for hepatocellular
carcinoma:
A. Strong tendency for invasion of vascular channels.
B. Strongly associated with hepatitis A.
C. Females are more affected as compared to males.
D. Morphology of hepatocellular carcinoma is usually of squamous
cell carcinoma.
E. Alpha-I antitrypsin deficiency predisposes to hepatocellular
carcinoma.
Key: A

Topic: Heptobiliary System

26. Which of the following types of hepatitis is associated with an
immune mediated vasculitis characterized by p-ANCA
antibodies?
A. Hepatitis A.
B. Hepatitis B.
C. Hepatitis C.
D. Hepatitis D.
E. Hepatitis E.
Key: B

Topic: Liver
Page 8 of 17

Model Paper

27. Fine, radiographically dense crystals in the tissues of a knee
joint is associated with which of the following types of
arthropathy?
A. Gonococcal arthritis.
B. Gouty arthritis.
C. Osteoarthritis.
D. Pseudogout.
E. Rheumatoid arthritis.
Key: D

Topic: Bones & Joints.

28. A patient presents to a physician complaining of recurrent
episodic diarrhea triggered by eating too much or drinking
alcohol. He also starts wheezing and is flushed during the
episodes. Chest X-ray shows a lung mass. Biopsy of the mass
would reveal:
A. Bronchio alveolar carcinoma.
B. Squamous cell carcinoma.
C. Carcinoid tumor.
D. Primary tuberculosis.
E. Recurrent tuberculosis.
Key: C


29. Electron microscopy showing prominent deposits between the
podocytes and the basement membrane of the glomerular
capillaries are releted to infection with:
A. Escherichia
B. Klebsiella.
C. Neisseria.
D. Pseudomonas.
E. Streptococcus.
Key: E

Topic: Kidney

30. Oral examination of a 57 year old woman revealing a 1cm flat
white patch on the buccal mucosa leading to oral malignancy
would be:
A. Leukoplakia.
B. Hairy leukoplakia.
C. Lichen planus.
D. Oral thrush.
E. Squamous papilloma.
Key: A

Topic: Oral Cavity

Page 9 of 17

Model Paper

31. The testicular tumor occurring in young males and responsive
to radiotherapy is:
A. Teratoma.
B. Choriocarcinoma.
C. Yolk sac tumor.
D. Embryonal carcinoma.
E. Seminoma.
Key: E


32. Which of the following CNS tumors has the best prognosis:
A. Anaplastic astrocytoma (who grade III)
B. Glioblastoma multforme.
C. Well differentiated astrocytoma (who grade II)
D. Medulloblastoma.
E. Oligodendroglioma
Key: E

Topic: CNS Tumors

33. A large fungating mass protruding into the rectal lumen which
on biopsy turns out to be an invasive malignant tumor
composed of glandular structures is associated with:
A. Diverticulitis.
B. Diverticulosis.
C. Juvenile polyposis syndrome.
D. Crohns disease.
E. Ulcerative colitis.
Key: E

Topic: GIT

34. An 18 year old boy has an automobile accident. Serum enzyme
studies reveal a thousand fold increase in creatine kinase.
Which tissue is the source of the enzyme?
A. Heart.
B. Skeletal muscle.
C. Bone.
D. Brain.
E. Kidney.
Key: B

Topic: Musculoskeletal System

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Model Paper

35. A 54 year old man comes to the emergency four hours after
the onset of severe chest pain radiating to the left arm.
Examination of which serum marker would best help in
diagnosis:
A. Aspartate aminotransferase.
B. Creatine kinase-MB isoenzyme.
C. Lactate dehydrogenase-I isoenzyme.
D. Troponin.
E. Total creatine kinase.
Key: D

Topic: Chemistry

36. A woman smokes one pack/ day, she drinks at least 5 cups of
coffee/ day, she has no children and she takes birth control
pills. Her mother died of breast cancer. Which is the greatest
risk factor for breast cancer in this patient?
A. Birth control pills.
B. Cigarette smoking.
C. Family history.
D. Caffeine intake.
E. Nulliparity.
Key: C

Topic: Breast

37. A 62 year old female is evaluated for uterine bleeding.
Endometrial biopsy reveals marked endometrial hyperplasia. A
left ovarian mass is noted which is solid and about 4cm in
diameter. The ovarian tumor is:
A. Corpus albicans.
B. Endometrioid carcinoma.
C. Endometroitic cyst.
D. Granulosa cell tumor.
E. Teratoma.
Key: D


38. A woman with metastatic lung cancer develops profound
weakness with alternating diarrhea and constipation. Physical
examination shows hyperpigmentation of skin even in areas
protected from the sun. Which endocrine organ is involved in
the tumor?
A. Pituitary gland.
B. Adrenal gland.
C. Endocrine pancreas.
D. Ovaries.
E. Thyroid gland.
Key: B
Topic: Endocrines
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Model Paper

39. A 45 year old male patient presented with fever, cough,
dyspnoea, sweats and rigors. Chest X-ray showed
parenchymal infiltrate. On auscultation bronchial breath
sounds were heard. Diagnosis can be confirmed by:
A. CBC.
B. Gram stain and culture of sputum.
C. Sputum for AFB.
D. Blood gases.
E. Bronchoscopy.
Key: B


40. A 21 year old girl complained of weakness, exertional
dyspnoea and bleeding from the gums. On examination she
was pale, febrile and showed gum hypertrophy along with
hepatosplenomegaly. CBC showed HB 6.7 Gm/dl, TLC of
35,000/mm
3
, platelets were 20,000/mm
3
and DLC revealed
6% blast cells. Diagnosis is:
A. Immune thrombocytopenia.
B. Factor IX deficiency.
C. Acute lymphoblastic leukemia.
D. Acute myeloblastic leukemia.
E. Chronic myeloid leukemia.
Key: D

Topic: Hematology

41. Biopsy of a testicular mass revealed different tissues including
cartilage, thyroid and neural tissue. A small focus of squamous
cell carcinoma is also seen. Which appropriate type of tumor is
it?
A. Dermoid cyst.
B. Embryona carcinoma.
C. Immature teratoma.
D. Solid mature teratoma.
E. Teratoma with malignant transformation.
Key: E


42. A 65 year old man presented with a palpable lymph node
below the left clavicle. Biopsy report was metastatic
adenocarinoma. The primary tumor was most probably in:
A. Liver.
B. Colon.
C. Stomach.
D. Pancreas.
E. Bladder.
Key: C
Topic: GIT
Page 12 of 17

Model Paper

43. X-ray of a patient show skull thickening with narrowing of
foramina. There is bowing of femur and tibia as well and
raised alkaline phosphates. Bone biopsy reveals mosaic
pattern of bone spicules with prominent osteoid seams. Which
neoplasm will it be?
A. Astrocytoma.
B. Osteosarcoma.
C. Meningioma.
D. Hodgkins lymphoma.
E. Non-hodgkens lymphoma
Key: B

Topic: Musculo-skeletal system

44. A biopsy of a very large neck mass shows a benign thyroid
lesion composed of colloid filled follicles separated by fibrous
scars. The most likely diagnosis is:
A. Multinodular goiter.
B. Diffuse non-toxic goiter.
C. Subacute thyroiditis.
D. Thyroid adenoma.
E. Thyroid cyst.
Key: A

Topic: Endocrines

45. A 65 year old woman presents with a pathologic fracture of
the shaft of humerus. X-ray shows multiple lytic and blastic
bone lesions. Biopsy of lesion reveals adenocarcinoma. Which
is the site of primary tumor?
A. Breast.
B. Thyroid
C. Colon.
D. Kidney.
E. Lung.
Key: A

Topic: Breast

46. A 60 year old man develops increased frequency of
micturation, nocturia, dysuria, and difficulty in starting and
stopping the flow of urine. Prostate specific antigen is normal
and biopsy reveals benign tissue. The lesion is located in:
A. Peri-urethral prostate.
B. Posterior prostate.
C. Penile urethra.
D. Bladder neck
E. Ureter.
Key: A

Page 13 of 17

Model Paper

47. Acute nephritic syndrome is characterized by:
A. Proteinuria.
B. Haematuria.
C. Oedema.
D. Hypertension.
E. Hypoproteinemia.
Key: B

Topic: Kidney

48. Which of the following statements is true for hepatitis A
infection:
A. A carrier stat is common following initial infection.
B. Mortality rate is about 10%.
C. Infection is transmitted mainly by parenteral route.
D. Incubation period is 2 4 weeks.
E. Infective units are called dane particles.
Key: D

Topic: Liver

49. Benign prostatic hyperplasia originates in the:
A. Transitional zone of prostate.
B. Peripheral zone of prostate.
C. Central zone of prostate.
D. Periurethral zone of prostate.
E. Capsule of the prostate.
Key: C


50. The most common tumor of the appendix is:
A. Adenoma.
B. Mucinous adenocarcinoma.
C. Mesothelioma.
D. Squamous cell carcinoma.
E. Carcinoid tumor.
Key: E

Topic: GIT

51. The most common cause of abdominal aortic aneurysm is:
A. Trauma.
B. Syphilis.
C. Atherosclerosis.
D. Vasculitides.
E. Hypertension.
Key: C
Topic: CVS
Page 14 of 17

Model Paper

52. A 6 year old boy presents with fever, an abdominal mass
which has grown rapidly over the last four months
accompanied by weight loss. Ultrasound confirms a solid
space occupying lesion in the kidney. The diagnosis is:
A. Renal cell carcinoma.
B. Transitional cell carcinoma of kidney.
C. Squamous cell carcinoma of renal pelvis.
D. Wilms tumor.
E. Hydronephrosis.
Key: D

Topic: Kidney

53. A female patient was operated for breast cancer. During the
procedure mobile axillary nodes were found on the same side
of the tumor which showed malignant cells. The size of the
primary tumor was 2cm and no distant metastases was seen.
The tumor will be staged as:
A. Stage I.
B. Stage II.
C. Stage III.
D. Stage III b.
E. Stage IV.
Key: B

Topic: Breast
54. A 55 year old man has persistent cough, weight loss and
clubbing of fingers. X-ray of hand shows new bone formation
beneath the periosteum. Which of the following condition is
associated with it?
A. Chronic renal failure.
B. Colon cancer.
C. Endocrine adenoma.
D. Profound anemia.
E. Lung cancer.
Key: E


55. Biopsy of the synovium of the knee joint in rheumatoid
arthritis would reveal?
A. A nearly normal synovium with scattered inflammatory cells.
B. A non-proliferative synovitis with abscess formation.
C. A non-proleferative synovitis with many neutrophils.
D. A proliferative synovitis with many eosinophils, neutrophils,
plasma cells.
E. A proliferative synovitis with many lymphocytes, macrophages,
plasma cells.
Key: E

Page 15 of 17

Model Paper

56. A pap-smear is graded as cervical intra-epithelial neoplasia,
grade II (CIN II). Which of the following viruses is related to
this neoplastic growth?
A. Epstein Barr virus.
B. Hepatitis B virus.
C. Human papilloma virus.
D. Human herpes virus 8.
E. Human T-cell lymphotropic virus.
Key: C


57. A patient has enlarged thyroid gland which on needle
aspiration showed cell clusters suspicious for papillary
carcinoma of the thyroid. Which of the following findings will
support the diagnosis?
A. Anitschkow cells.
B. Psammoma bodies.
C. Auer rods.
D. Reed Sternberg cells.
E. Roths spots.
Key: B

Topic: Endocrines

58. Conjugated hyperbilirubinemia is seen in:
A. Hemolytic anemia.
B. Physiologic jaundice of the newborn.
C. Crigler-Najjar syndrome.
D. Dubin-Johnson syndrome.
E. Viral hepatitis.
Key: D

Topic: Hepatobiliary System

59. The most sensitive test to assess renal failure is:
A. Serum sodium.
B. Serum potassium.
C. Serum urea.
D. Serum creatinine.
E. Creatinine clearance.
Key: E

Topic: Chemistry

Page 16 of 17

Model Paper

60. A young boy presented with petechiae, haematuria, bleeding
from gums and epistaxis. History was given of a snake bite.
Blood examination will show decreased level of:
A. Platelets.
B. Factor VIII.
C. Prothrombin time.
D. Activated partial thromboplastin time.
E. Fibrin degradation products.
Key: A

Topic: Hematology

61. Aschoffs nodule shows the presence of:
A. Coagulation necrosis.
B. Aggregates of lymphocytes.
C. Multinucleated giant cells.
D. Numerous plasma cells.
E. Marked fibrosis.
Key: C

Topic: CVS

62. A 61 year old diabetic female patient presents with bleeding
per vaginum. On investigation she admitted to being childless
and became menopausal at age 58, after which she started
taking hormone replacement therapy and has gained weight
by 10 kg. Ultrasound revealed a mass which turned out to be
malignant. Diagnosis is:
A. Carcinoma cervix.
B. Carcinoma ovary.
C. Carcinoma fallopian tume.
D. Granulosa cell tumor.
E. Carcinoma endometrium.
Key: E


63. Gastric ulcers are characterized by:
A. Males are affected more than females.
B. Seen in younger age group.
C. It is not associated with smoking.
D. Common site is lesser curvature of stomach.
E. Common site is greater curvature of stomach.
Key: D

Topic: GIT

Page 17 of 17

Model Paper

64. Cushing disease is a feature of:
A. Chromophobe adenoma of pituitary gland.
B. Acidophilic adenoma of pituitary gland.
C. Basophilic adenoma of pituitary gland.
D. Non-secreting adenoma of pituitary gland.
E. Microprolactinoma.
Key: C

Topic: Endocrines

65. A male patient presented with pseudo-hypertrophy of the
muscles. Work up of the patient revealed elevated creatinine
kinase levels with disturbance in dystrophin action.
Chromosomal studies showed abnormal gene located at Xp21.
The most likely diagnosis is:
A. Duchenne muscular dystrophy.
B. Beckers muscular dystrophy.
C. Thyrotoxic myopathy.
D. Dermatomyositis.
E. Polymyositis
Key: A


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MBBS THIRD PROFESSIONAL EXAMINATION 2007

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