GP FE S

1. Pathogenesis of granulomatous inflammation:     a. Leukocyte infiltration     b. Viral transformation of cells     c. Formation of granulomata     d. Loss of normal parenchyma

c. Formation of granulomata

2. An 18-year-old woman presented with skin lesions that appeared centrifugally from the torso then the head and extremities. The lesion progressed from a macule to a vesicle. What virus caused this?     a. Varicella-Zoster virus     b. Cytomegalovirus     c. HSV-2     d. HSV-1

a. Varicella-Zoster virus

3. A 12-year-old girl is brought to the physician because of a history of coughing and wheezing and repeated attacks of difficulty breathing. The attacks are particularly common in the spring. During an episode of acute respiratory difficulty, a physical examination shows that she is afebrile. Her lungs are hyperresonant, and a chest radiograph shows increased lucency of all lung fields. Laboratory tests show an elevated serum IgE level and peripheral blood eosinophilia. A sputum sample examined microscopically also has increased numbers of eosinophils. Which of the following histologic features is most likely to characterize the lung in this patient’s acute condition?     a. Thickening of bronchial epithelial basement membrane and hypertrophy of bronchial smooth muscle     b. Dilation of bronchi with inflammatory destruction of walls     c. Interstitial and alveolar edema with presence of hyaline membranes that line alveoli     d. Patchy areas of consolidation surrounding bronchioles and neutrophilic exudate in affected alveoli

a. Thickening of bronchial epithelial basement membrane and hypertrophy of bronchial smooth muscle

4. The predilection for viruses to infect certain cells and not others is called tropism. The major determinant of tissue tropism is:     a. All of the choices     b. Complement defects     c. Defects in TLR signaling pathways     d. Presence of viral receptors

d. Presence of viral receptors

5. What is the BEST measure of hypertrophy in dilated hearts?     a. Weight     b. Blood vessel diameter     c. Wall thickness     d. Length

a. Weight

6. A 35-year-old African-American man is transported to the emergency department because of an unrelenting, severe, excruciating headache. His blood pressure is 245/150 mm Hg, and bilateral papilledema is evident on ophthalmoscopic examination of the retina. Despite all interventions, including administration of nitroprusside, the patient dies. At autopsy, which of the following is a likely finding?     a. Multiple punctuate hemorrhages on the surface of both kidneys (“flea-bitten kidneys”)     b. Longitudinal intraluminal tears of the ascending aorta     c. Immune complex vasculitis of the glomeruli     d. Unilateral renal artery stenosis

a. Multiple punctuate hemorrhages on the surface of both kidneys (“flea-bitten kidneys”)

7. Which of the following will MOST LIKELY have chronic cor pulmonale?     a. Professional tennis player     b. A child with leukemia     c. Elderly patient with multiple myeloma     d. 30-year chronic smoker

d. 30-year chronic smoker

8. A 40-year-old man has been smoking 1.5 packs of cigarettes per day for 20 years. For the past 4 years, he has had a chronic cough with copious mucoid expectoration. During the past year, he has had several episodes of respiratory tract infections known to be viral and he developed difficulty breathing, tightness of the chest, and audible wheezing. His dyspnea was relieved by inhalation of a B-adrenergic agonist and disappeared after the chest infection had resolved. Which of the following pathologic conditions best describes these clinical findings?     a. Chronic bronchitis with cor pulmonale     b. Chronic bronchitis with asthmatic bronchitis     c. Chronic bronchitis with emphysema     d. Bronchiectasis

b. Chronic bronchitis with asthmatic bronchitis

9. A 59-year-old man experiences sudden severe chest pain that radiates to his back. On physical examination his blood pressure is 170/110 mm Hg. Heart sounds are distant. Pulsus paradoxus is observed. A pericardiocentesis is performed and yields blood. Which of the following pathologic findings has most likely occurred in his aorta?     a. Dissection     b. Arteriolosclerosis     c. Thrombosis     d. Aneurysm

a. Dissection

10. Angina pectoris from the sudden spasm of the right coronary artery is MOST LIKELY:     a. Prinzmetal     b. Unstable     c. MI     d. Stable

a. Prinzmetal

11. A 16 year old female with beta-thalassemia is in need of regular transfusions. Which cardiomyopathy is she MOST LIKELY to develop?     a. Dilated     b. Arrhythmogenic     c. Restrictive     d. Hypertrophic

a. Dilated

12. A 74-year-old woman presents to her primary care physician with malaise, proximal muscle pain, morning stiffness, and claudication of the jaw, along with occasional visual impairment. On examination, palpation along the lateral aspect of the head elicits tenderness. This is likely a result of     a. Kawasaki disease     b. giant cell arteritis     c. hypersensitivity vasculitis     d. Takayasu arteritis

b. giant cell arteritis

13. Which of the following is true regarding dilated cardiomyopathy?     a. Primary valvular abnormalities common     b. Mutations in myosin-binding protein     c. Progressive and fatal     d. Majority of cases are in pregnant patients

c. Progressive and fatal

14. A 18-year-old young woman who emigrated from Taiwan 8 years ago presents with fever, malaise, myalgias, and arthritis and coldness in her upper extremities. She has a weak radial pulse bilaterally, and a magnetic resonance angiogram demonstrates nearly 75% stenosis of the main arteries originating from the aorta. She likely has which of the following rheumatologic conditions?     a. Buerger disease     b. Kawasaki disease     c. Takayasu arteritis     d. Raynaud disease

c. Takayasu arteritis

15. The appearance of spider cells is due to the artifactual shrinking of which myocyte component?     a. Nucleolus     b. Nucleus     c. Cytoplasm     d. Cell membrane

c. Cytoplasm

16. For the past 5 years, a 45-year-old woman has had increasing respiratory difficulty that limits her activities. She does not smoke. On physical examination, she is afebrile and normotensive. Her lungs are hyper resonant. A chest radiograph shows flattening of the diaphragmatic leaves. Laboratory studies show the PiZZ phenotype of a1-antitrypsin deficiency. Which of the following is most likely present in the lungs?     a. Panacinar emphysema     b. Bronchiectasis     c. Interstitial fibrosis     d. Sarcoidosis

a. Panacinar emphysema

17. A 58-year-old man had a myocardial infarction 1 year ago, which was the first major illness in his life. He now wants to prevent another acute coronary event and is advised to begin a program of exercise and to change his diet. A reduction in the level of which of the following serum laboratory findings 1 year later would best indicate the success of his diet and exercise regimen?     a. Glucose     b. Cholesterol     c. Calcium     d. Potassium

b. Cholesterol

18. A 3-day old baby boy was born with cyanosis and failure to thrive. Echocardiography revealed that his aorta is continuous with his right ventricle. What is the pathogenesis of this condition?     a. Failure to separate of midline raphae     b. Abnormal formation of the major vessel septae     c. Subpulmonic stenosis     d. Decline in levels of prostaglandin E2

b. Abnormal formation of the major vessel septae

19. A 4-year-old boy has had a cough, headache, and slight fever for 5 days. His mother becomes concerned because he is now having increasing respiratory difficulty. On physical examination, his respirations are 25/min, and blood pressure is 90/55 mm Hg. On auscultation, there are inspiratory crackles, but no dullness to percussion or tympany. Respiratory syncytial virus is isolated from a sputum sample. Which of the following chest radiographic patterns is Most likely to be present?     a. Upper lobe cavitation     b. Lobar consolidation     c. Large pleural effusions     d. Interstitial infiltrates

d. Interstitial infiltrates

20. What do you expect to see in Frank-Starling mechanism?     a. Release of ANP     b. Fibrous tissue deposition     c. Increased actin-myosin cross-bridge     d. Catecholamine increase

c. Increased actin-myosin cross-bridge

21. A 26-year-old woman with postpartum sepsis is afebrile on antibiotic therapy, but she has had worsening oxygenation over the past 3 days. Her chest x-ray shows scattered bilateral pulmonary opacifications. A ventilation perfusion scan shows areas of mismatch. This process is developing from upregulation of nuclear factor kappa-B that promotes interleukin-a and tumor necrosis factor release, with damage to endothelium and type I cells. Which of the following microscopic findings is most likely to be present in her lungs?     a. Lymphocytic infiltrates     b. Interstitial fibrosis     c. Arterial plexiform lesions     d. Alveolar hyaline membranes

d. Alveolar hyaline membranes

22. A 55-year-old man has a history of chronic alcoholism. He is found in a stuporous condition after 7 days of binge drinking. On physical examination, his temperature is 40.0°C. A few crackles are heard on auscultation of the right lung base. A chest radiograph shows a 4-cm lesion with an air-fluid level in the right lower lobe. Which of the following organisms are most likely to be detected in bronchoalveolar lavage fluid?     a. Staphylococcus aureus and Bacteroides fragilis     b. Cytomegalovirus and Pneumocystis carinii     c. Mycobacterium tuberculosis and Aspergillus fumigatus     d. Nocardia asteroides and Actinomyces israelii

a. Staphylococcus aureus and Bacteroides fragilis

23. A 46-year-old woman goes to the physician for a routine health maintenance examination. On physical examination, there are no remarkable findings. Her body mass index is 22. She does not smoke. A tuberculin skin test is positive. A chest radiograph shows a solitary, 3-cm left upper lobe mass. The mass is removed at thoracotomy by wedge resection. The microscopic appearance of this lesion is showed Langhans type multinucleated giant cells. Which of the following is the most likely diagnosis?     a. Pulmonary hamartoma     b. Pulmonary infarction     c. Mycobacterium tuberculosis infection     d. Lung abscess

c. Mycobacterium tuberculosis infection

24. A 48-year-old man presents with abdominal pain and hypertension. On physical examination, he is found to have an abdominal mass. Further workup confirms the diagnosis of adult polycystic kidney disease. Which of the following vascular complications is associated with this condition?     a. Arteriovenous fistula     b. Atherosclerotic aneurysm     c. Berry aneurysm     d. Dissecting aneurysm

c. Berry aneurysm

25. A 27-year-old man presents with fever, weight loss, malaise, abdominal pain, and myalgias. Workup reveals that the patient has polyarteritis nodosa. Which of the following is associated with this form of vasculitis?     a. Hepatitis B virus     b. Chlamydia pneumonia     c. Human herpesvirus 8     d. Arsenic

a. Hepatitis B virus

26. A 58-year-old woman has experienced chest pain at rest for the past year. On physical examination, her pulse is 80/min and irregular. Microscopic examination of her left anterior descending artery showed 90% obstruction with atherosclerotic plaque complicated by calcification. Which of the following laboratory findings is most likely to be involved in the pathogenesis of the process illustrated?     a. Low plasma homocysteine     b. Elevated platelet count     c. Low HDL cholesterol     d. Low Lp(a)

c. Low HDL cholesterol

27. Influenza viruses breach local defense by:     a. Resistance to killing by phagocytes     b. Attaching and proliferating in the cilia     c. All of the choices     d. Causing ciliary paralysis

d. Causing ciliary paralysis

28. Reversible ischemic injury of the myocardium is seen up to how many hours of from injury? Choose the best answer.     a. 2     b. 4     c. 0.5     d. 1

c. 0.5

29. A 30-year-old man suddenly develops severe dyspnea with wheezing and is taken to the E.R. On P.E., his vital signs are Temp. 37.0 C; PR, 93/min; RR, 16/min; and BP, 140/80 mm Hg. A chest radiograph shows increased lucency in all lung fields. A sputum cytologic specimen shows Curschmann spirals, Charcot-Leyden crystals, and acute inflammatory cells in a background of abundant mucus. Many of the inflammatory cells are eosinophils. What is the most likely diagnosis?     a. Bronchial asthma     b. Aspiration     c. Centrilobular emphysema     d. Bronchiectasis

a. Bronchial asthma

30. Mycobacterium tuberculosis breaches local defense by:     a. Attaching and proliferating in the cilia     b. Causing ciliary paralysis     c. All of the choices     d. Resistance to killing by phagocytes

d. Resistance to killing by phagocytes

31. Microbes have strategies to allow them to change their coats by expressing different surface antigens. This is called:     a. Resistance to antimicrobial peptides     b. Evasion of apoptosis     c. Antigenic variation     d. Immunoregulatory mechanisms

c. Antigenic variation

32. 26-year-old woman from East Asia developed a fever with chills over the past 4 days. Yesterday, she had increasing shortness of breath and a nonproductive cough. On physical examination, her temper shows right lower lobe infiltrates. Laboratory studies show hemoglobin, 13.4 g/dl; hematocrit, 40.2%; platelet count, 78,400/mm3; and WBC count, 3810/mm3 with 77% segmented neutrophils, 2% bands, 5% lymphocytes, and 16% monocytes. Over the next 2 days, she has increasing respiratory distress requiring intubation and mechanical ventilation. A repeat chest radiograph shows worsening bilateral infiltrates. Her oxygen saturation has decreased to 90%. Infection with which of the following is most likely to have caused this patient’s illness?     a. Cytomegalovirus     b. Coronavirus     c. Ebola virus     d. Respiratory syncytial virus

b. Coronavirus

33. An 8 year old girl presented with vesicular eruption in the tongue and oral cavity. What virus caused this?     a. HSV-2     b. Varicella-Zoster virus     c. Cytomegalovirus     d. HSV-1

d. HSV-1

34. This inflammatory response is toxin-mediated and causes rapid damages to the tissue.     a. Chronic inflammation     b. No reaction     c. Tissue necrosis     d. Cytopathic-cytoproliferative reactions

c. Tissue necrosis

35. A 60-year-old woman noted a distinct complete pallor of her most distal phalanx of her finger of her right hand while she was driving to work one morning. There was associated pain and numbness. Within 20 minutes after entering the warm office building, these problems disappeared. What pathologic process has most likely led to these findings?     a. Calcification     b. Thrombosis     c. Hypertension     d. Vasoconstriction

d. Vasoconstriction

36. A 46-year-old man has had increasing dyspnea with nonproductive cough for the past year. On physical examination he is afebrile and has clubbing of digits. Pulmonary function testing reveals a mild restrictive abnormality along with reduced diffusing capacity of carbon monoxide. A transbronchial biopsy is performed and microscopic examination shows numerous alveolar macrophages, plump epithelial cells, mild interstitial fibrosis, and loss of respiratory bronchioles. Lamellar bodies and iron pigment are present within these macrophages. Which of the following is the most likely etiology for his pulmonary disease?     a. Cigarette smoking     b. Atopy     c. Ciliary dyskinesia     d. Mold spores

a. Cigarette smoking

37. Cells infected by this virus are strikingly enlarged, often to a diameter of 40 micrometers. It also shows cellular and nuclear pleomorphism with prominent intranuclear basophilic inclusions. Marked out of     a. HSV-2     b. Cytomegalovirus     c. HSV-1     d. Varicella-Zoster virus

b. Cytomegalovirus

38. A 32-year-old woman returns to her physician for follow-up of hypertension that has been poorly controlled in spite of numerous antihypertensive medications. It is decided to evaluate the patient for possible secondary hypertension. Which of the following is a well-known cause of secondary hypertension?     a. Smoking     b. Ethnicity     c. Renal artery stenosis     d. Obesity

c. Renal artery stenosis

39. A 65-year-old man worked in a shipyard for 10 years, and then he worked for 5 years for a company that installed fire retardant insulation. He experienced increasing dyspnea for several years and eventually died of progressive respiratory failure with hypoxemia. At autopsy, a firm, tan mass encased the left lung. Within the lung parenchyma adjacent to the mass, many ferruginous bodies were identified on microscopic examination. Which of the following findings is most likely to have been seen on a chest radiograph?     a. Diaphragmatic pleural calcified plaques     b. Bilateral upper lobe cavitation     c. Bilateral fluffy infiltrates     d. Left main bronchus, 1.5-cm endobronchial mass

a. Diaphragmatic pleural calcified plaques

40. In a partially obstructed left anterior descending artery, which of the following shows signs of ischemic injury first?     a. Pericardium     b. Subendocardium     c. Epicardium     d. Myocardium

b. Subendocardium

41. Which of the anatomic patterns of cardiomyopathies will have the LOWEST left ventricular ejection fraction?     a. Restrictive     b. Dilated     c. All types have equal ejection fraction     d. Hypertrophic

b. Dilated

42. A 6 year old girl presented with blotchy, reddish brown rash on the face, trunk and proximal extremities. On physical examination, an ulcerated mucosal lesion in the oral cavity is noted, near the opening of the Stensen duct. What is the diagnosis?     a. Measles     b. Chickenpox     c. German measles     d. Oral herpes

a. Measles

43. A 70-year-old man has experienced increasing dyspnea for the past 4 years. On physical examination, he is afebrile, with a pulse of 70/min, respirations 20/min, and blood pressure 120/75 mm Hg. A chest radiograph shows increased interstitial markings, but no effusions. The right border of the heart and the pulmonary arteries are prominent. A transbronchial biopsy is performed; a ferruginous body with a beading and knobbed end when stained with Prussian blue. Which of the following is the most likely diagnosis?     a. Anthracosis     b. Berylliosis     c. Silicosis     d. Asbestosis

d. Asbestosis

44. A study is conducted involving persons with LDL cholesterol levels above 160 mg/dl. They are found to have increased oxidized LDL deposited in their arteries. As a consequence, the arterial lumen, particularly at branch points, is decreased in size. Which of the following is the most likely pathologic change that develops initially in these areas of arterial narrowing?     a. Endothelial cell disruption     b. Lymphocytic infiltrates     c. Intimal thickening     d. Platelet aggregation

c. Intimal thickening

45. A 20-year old female developed chest pain a month after she had a bout of sore throat and fever. If vegetations are present on her mitral valve, which of the following would BEST describe their location     a. On the papillary muscles     b. Along the lines of closure     c. Valve cusps extending into chordae     d. On both sides of valve leaflets

b. Along the lines of closure

46. A 52-year-old woman has had an increasingly severe cough productive of yellowish sputum for several days. On physical examination, her temperature is 39.9-c. and diffuse crackles are heard in the left lower lung. A chest radiograph shows left lower lung consolidation. Laboratory studies show a WBC count of 12,000/mm3 with 75% segmented neutrophils, 8% bands, 19% lymphocytes, and 4% monocytes. Which of the following pathogens is most likely to be cultured from the patient’s sputum?     a. Streptococcus pneumoniae     b. Mycoplasma pneumoniae     c. Pneumocystis jiroveci     d. Cryptococcus neoformans

a. Streptococcus pneumoniae

47. A 63-year-old man who has a long history of hypertension presents to the emergency department with tearing chest pain that radiates to the back. An electrocardiogram is normal, as are cardiac enzymes. A “stat” chest radiograph demonstrates widening of the mediastinum. Which of the following is the most likely?     a. Atherosclerotic aneurysm     b. Arteriovenous fistula     c. Dissecting aneurysm     d. Berry aneurysm

c. Dissecting aneurysm

48. A population health study shows that the prevalence of essential hypertension has been increasing for the past 10 years and now is found in one fourth of all adults. A strategy is adopted to decrease the prevalence of hypertension through lifestyle changes. A policy to reduce dietary intake of which of the following is most likely to support this goal?     a. Salt     b. Alcohol     c. Coffee     d. Animal protein

a. Salt

49. Pathogenesis of suppurative infection:     a. Loss of normal parenchyma     b. Leukocyte infiltration     c. Formation of granulomata     d. Viral transformation of cells

b. Leukocyte infiltration

50. What is the most common extrasalivary gland complication of mumps?     a. both     b. Neither     c. Meningitis     d. Orchitis

c. Meningitis

51. A 40-year-old man has had increasing dyspnea for the past 5 years. He has an occasional cough with minimal sputum production. On physical examination, his lungs are hyperresonant with expiratory wheezes. Pulmonary function tests show increased total lung capacity (TLC) with slightly increased FVC and decreased FEV1 and FEV1/FVC ratio. Which of the following disease processes should most often be suspected as a cause of these findings?     a. Primary adenocarcinoma     b. Centrilobular emphysema     c. Diffuse alveolar damage     d. Chronic pulmonary embolism

b. Centrilobular emphysema

52. A newborn baby was very frail, with a dusky skin color. If a congenital heart failure is suspected, which of the following is the MOST LIKELY?     a. MVP     b. ASD     c. TOF     d. VSD

c. TOF

53. Which statement is incorrect?     a. Infectious agents can induce host immune responses that cause additional tissue damage     b. Infectious agents release toxins that kills cells at a distance     c. None of the choices     d. Infectious agents establish infection by entering host cells and cause cell death directly

c. None of the choices

54. Vibrio cholerae breach local defense by:     a. Acid resistant cysts     b. Local proliferation of microbes     c. Resistant microbial external coats     d. Invasion of microbes

b. Local proliferation of microbes

55. A 12-year-old girl undergoes bone marrow transplant as part of therapy for ALL. She subsequently presents with pulmonary complaints and neurologic findings. Lung biopsy reveals a granulomatous vasculitis with associated atypical lymphocytes. Clonality studies reveal a monoclonal B cell population with associated polyclonal T cells. What infectious agent is related to this diagnosis?     a. Cytomegalovirus (CMV)     b. Human Papilloma Virus (HPV)     c. Human Herpes virus-8 (HHV-8)     d. Epstein-Barr Virus (EBV)

d. Epstein-Barr Virus (EBV)

56. A 35-year-old man is hospitalized after a motor vehicle accident in which he sustains blunt trauma to the chest. On physical examination, there are contusions to the right side of the chest, but no lacerations. Within 1 hour after the accident, he develops sudden difficulty breathing and marked pain on the right side. Vital signs now show that he is afebrile; his pulse is 80/min, respirations are 24/min, and blood pressure is 100/70 mm Hg. Breath sounds are not audible, and there is tympany to percussion on the right side. Which of the following radiographic findings is most likely to be present?     a. Right rib fractures with pneumothorax on chest radiograph     b. High probability of pulmonary embolus on ventilation/perfusion scan     c. Large bilateral pleural effusions on chest radiograph     d. Extensive centrilobular emphysema on chest CT scan

a. Right rib fractures with pneumothorax on chest radiograph

57. A 3-year-old boy is brought by his parents to the emergency department because they are concerned that he has had a high fever for several days. On examination, the boy has conjunctival and oral erythema. He has palpable cervical lymphadenopathy and erythema of his palms and soles. What is a potential life-threatening complication of this disorder?     a. Dissection of the thoracic aorta     b. Aneurysm of the abdominal aorta     c. Aneurysm of the coronary arteries     d. ischemia and gangrene of the extremities

c. Aneurysm of the coronary arteries

58. Which of the following is most commonly associate with connective tissue disorders?     a. Mitral valve prolapse     b. Marantic endocarditis     c. Mitral valve stenosis     d. Rheumatic heart disease

a. Mitral valve prolapse

59. Which organism is responsible for the most cases of infectious endocarditis on previously damaged valves?     a. S. viridans     b. S. epidermidis     c. s. aureus     d. S. agalactiae

a. S. viridans

60. Staphylococcus aureus breach local defense by:     a. Animal bites     b. All of the choices     c. Mechanical defects     d. Arthropod bites

c. Mechanical defects

61. Involves only the colon     a. Crohns disease     b. Both of the choices     c. None of the choices     d. Ulcerative colitis

d. Ulcerative colitis

62. The condition is accompanied by severe fibrosis     a. Both of the choices     b. None of the choices     c. Crohns disease     d. Ulcerative colitis

c. Crohns disease

63. Presence of skin lesion grossly     a. Ulcerative colitis     b. Crohns disease     c. None of the choices     d. Both of the choices

b. Crohns disease

64. High incidence of malignant degeneration     a. Both of the choices     b. None of the choices     c. Crohns disease     d. Ulcerative colitis

d. Ulcerative colitis

65. It is a granulomatous lesion histologically     a. Ulcerative colitis     b. Crohns disease     c. None of the choices     d. Both of the choices

b. Crohns disease

66. It has a genetic predisposition     a. Both choices     b. Duodenal ulcer     c. None of the choices     d. Gastric ulcer

d. Gastric ulcer

67. Obstruction, bleeding, rupture are possible complications     a. Gastric ulcer     b. Both choices     c. None of the choices     d. Duodenal ulcer

b. Both choices

68. Histologically presented as acute and chronic inflammation     a. Gastric ulcer     b. Duodenal ulcer     c. Both choices     d. None of the choices

c. Both choices

69. Vagal stimulation is not related to the genesis of lesion     a. Gastric ulcer     b. None of the choices     c. Duodenal ulcer     d. Both choices

a. Gastric ulcer

70. There is high HCl gastric secretion or content     a. None of the choices     b. Both choices     c. Duodenal ulcer     d. Gastric ulcer

c. Duodenal ulcer

71. Signs and symptoms are food-related and hunger     a. Gastric ulcer     b. Duodenal ulcer     c. Both choices     d. None of the choices

b. Duodenal ulcer

72. Associated with chronic antral gastritis     a. Duodenal ulcer     b. Both choices     c. Gastric ulcer     d. None of the choices

a. Duodenal ulcer

73. There is a mucosal defect with increased back diffusion of gastric contents     a. Duodenal ulcer     b. Gastric ulcer     c. None of the choices     d. Both choices

b. Gastric ulcer

74. A form of malabsorption syndrome     a. Whipple’s disease     b. All of the choices     c. Celiac sprue     d. Tropical sprue

b. All of the choices

75. Gluten-sensitive enteropathy     a. All of the choices     b. Celiac sprue     c. Whipple’s disease     d. Tropical sprue

b. Celiac sprue

76. A 1 year old boy with progressive dysphagia, nocturnal regurgitation and aspiration of undigested food     a. Achalasia     b. Acute Gastric Ulcer     c. Chronic Gastritis     d. Hirschsprung’s disease

a. Achalasia

77. A 30 year old male with explosive vomiting with hematemesis provoked by alcohol intake     a. Mallory-Weiss Syndrome     b. Achalasia     c. Acute Gastric ulcer     d. Megacolon

a. Mallory-Weiss Syndrome

78. A 40 year old female with signs and symptoms of pernicious anemia accompanied by nausea, vomiting and abdominal discomfort     a. Hirschsprung’s disease     b. Acute Gastric Ulcer     c. Mallory-Weiss Syndrome     d. Chronic Gastritis

d. Chronic Gastritis

79. A 50 year old female with chronic arthritis relieved by massive and prolonged use of aspirin. The patient suddenly developed massive vomiting of fresh blood.     a. Megacolon     b. Acute Gastric ulcer     c. Achalasia     d. Mallory-Weiss Syndrome

b. Acute Gastric ulcer

80. Newborn male with Down syndrome with failure to pass out meconium followed by obstructive constipation     a. Chronic Gastritis     b. Acute Gastric Ulcer     c. Hirschsprung’s disease     d. Mallory-Weiss Syndrome

c. Hirschsprung’s disease

81. A 53-year old male with a known history of Hepatitis B presented with easy fatigability and hematemesis. An endoscopic test showed dilated tortuous vessels in his distal esophagus. Which of the following BEST explains this:     a. Poor intrinsic quality of the vascular wall     b. Genetic mutations     c. Congenital vascular malformation     d. Opening of portocaval anastomosis

d. Opening of portocaval anastomosis

82. A disease flare up in a previously HBV-infected individual when infected with HDV is called?     a. Healthy carrier     b. Superinfection     c. Co-infection     d. Reactivation

b. Superinfection

83. Which of the following morphologic findings is MOST consistent with a chronic liver disease?     a. Steatosis     b. Necrosis     c. Fibrosis     d. Apoptosis

c. Fibrosis

84. Which among the following statements about fatty liver disease is correct?     a. Steatosis is reversible     b. Alcohol is the sole cause     c. All answers are wrong     d. Risk factor of developing cholangiocarcinoma

a. Steatosis is reversible

85. A 75-year old male is a known hypertensive who progressively had shortness of breath and bipedal edema. Echocardiography shows his ejection fraction to be <20%. What will be the MOST LIKELY histologic appearance of the liver?     a. Bridging fibrosis     b. Ground glass hepatitis     c. Proliferative biliary reaction     d. Centrilobular necrosis

d. Centrilobular necrosis

86. A patient with beta-thalassemia and history of multiple blood transfusions will MOST LIKELY have which of the following liver findings?     a. Pink globular inclusions     b. Moderate steatosis     c. Ground glass hepatocytes     d. Golden yellow cytoplasmic granules

d. Golden yellow cytoplasmic granules

87. Cholesterol gallbladder stone formation is favorable in the following conditions EXCEPT:     a. Cholangitis     b. Poorly contractile gallbladder     c. Bile stasis     d. Supersaturation of cholesterol

a. Cholangitis

88. Which of the following is part of the tetrad of hemochromatosis?     a. Neurologic movement disorder     b. Atypical arthritis     c. Hypogonadism     d. Abnormal skin pigmentation

d. Abnormal skin pigmentation

89. A 30-year old female on oral contraceptives was noted to have right upper quadrant pain. Ultrasound reveals a fairly-circumscribed liver mass. Biopsy was performed which showed atypical hepatocytes. Molecular studies showed that the liver cells are positive for beta-catenin mutation. Which of the following is true?     a. This signifies impending acute liver failure     b. No further intervention needed     c. High risk for malignant transformation     d. Obesity is usually associated

c. High risk for malignant transformation