Home/Quiz/Pathology MCQs : Haemodynamic Disorders, Neoplasia & Immunopathology Pathology MCQs : Haemodynamic Disorders, Neoplasia & Immunopathology Welcome to your Pathology MCQs : Haemodynamic Disorders, Neoplasia & Immunopathology 1. A 67-year-old man with chronic left-sided heart failure develops bilateral ankle edema. Which change most directly promotes movement of fluid from capillaries into the interstitium? Increased capillary hydrostatic pressure Increased plasma oncotic pressure Decreased venous pressure Increased lymphatic drainage Decreased sodium retention None Hint 2. A patient with severe cirrhosis develops generalized edema and ascites. Which change is a major contributor? Increased plasma albumin Reduced plasma oncotic pressure Increased capillary oncotic pressure Reduced aldosterone activity Increased lymphatic return None Hint 3. A patient with bacterial pneumonia develops a pleural effusion containing abundant protein and leukocytes. How is this fluid best classified? Transudate Exudate Pure ultrafiltrate Chyle Hematoma None Hint 4. A healthy student develops flushed, warm skin during vigorous exercise. Which vascular process explains this finding? Passive congestion Active hyperemia Venous thrombosis Infarction Lymphatic obstruction None Hint 5. A patient with chronic right-sided heart failure has hepatomegaly and a mottled red-brown liver. Which process is primarily responsible? Arterial hyperemia Passive venous congestion Lymphatic obstruction Arterial embolism Vasculitis None Hint 6. A patient loses 2 liters of blood after trauma and becomes tachycardic and hypotensive. Which immediate complication is most concerning? Hypovolemic shock Chronic pulmonary hypertension Nephrotic syndrome Chronic passive congestion Disseminated calcification None Hint 7. A hospitalized patient develops a deep venous thrombosis after prolonged immobilization. Which component of Virchow triad is directly promoted by immobility? Endothelial denudation Abnormal blood flow Severe thrombocytopenia Hypercalcemia Reduced blood viscosity None Hint 8. A thrombus forms over an atherosclerotic plaque after endothelial disruption. Which event is most important in initiating thrombosis? Exposure of thrombogenic subendothelial components Reduced platelet adhesion Suppression of tissue factor Increased antithrombin activity Increased fibrinolysis None Hint 9. A patient with prolonged immobilization develops a thrombus in the femoral vein. Which description best fits a typical venous thrombus? Predominantly platelet with little fibrin Rich in red cells and fibrin Composed entirely of cholesterol Always sterile pus Made mainly of calcium None Hint 10. A patient with a proximal lower-limb DVT suddenly develops dyspnea and pleuritic chest pain. What complication should be suspected? Pulmonary embolism Aortic dissection Renal infarction Splenic rupture Cardiac tamponade None Hint 11. A young adult sustains multiple long-bone fractures and 36 hours later develops respiratory distress, neurologic symptoms, and petechiae. Which complication is most likely? Fat embolism syndrome Septic shock Air embolism Tumor embolism Amniotic fluid embolism None Hint 12. A diver rapidly ascends from deep water and develops joint pain and neurologic symptoms. What mechanism is responsible? Nitrogen gas emboli Fat droplets Cholesterol crystals Platelet emboli Tumor fragments None Hint 13. A renal arterial branch is suddenly occluded, producing a pale wedge-shaped lesion. What is this lesion? Abscess Infarct Granuloma Aneurysm Hematoma None Hint 14. A patient develops an arterial infarct in the spleen. What gross appearance is expected? Pale wedge-shaped lesion Black hemorrhagic cavity Diffuse purulent lesion Ring-enhancing mass Multiple calcified nodules None Hint 15. A patient develops severe hypotension after massive gastrointestinal hemorrhage. Which shock category applies? Hypovolemic Cardiogenic Septic Neurogenic Anaphylactic None Hint 16. A patient develops profound hypotension after a large myocardial infarction despite adequate blood volume. Which type of shock is most likely? Hypovolemic Cardiogenic Septic Anaphylactic Neurogenic None Hint 17. A patient with severe bacterial sepsis develops hypotension, tissue hypoperfusion, and disseminated microvascular abnormalities. Which type of shock is present? Cardiogenic Hypovolemic Septic Obstructive Neurogenic None Hint 18. A critically ill patient develops widespread bleeding from venipuncture sites while laboratory tests show thrombocytopenia and prolonged clotting times. Which process is likely? Disseminated intravascular coagulation Isolated hemophilia Simple dehydration Iron deficiency Immune thrombocytopenia only None Hint 19. A patient with DIC has markedly elevated fibrin degradation products. Which process does this finding reflect? Increased fibrinolysis Suppressed coagulation Increased platelet production Reduced fibrin formation Increased albumin synthesis None Hint 20. A patient with long-standing hypertension has a localized dilation of the abdominal aorta. What is the lesion called? Aneurysm Thrombus Infarct Embolus Hematoma None Hint 21. A slowly enlarging, well-circumscribed thyroid mass remains localized and resembles normal thyroid tissue. Which feature favors a benign neoplasm? Metastasis Infiltrative invasion Well-circumscribed localized growth Marked anaplasia Vascular invasion None Hint 22. A tumor is found in the liver after having originated in the colon. Which finding provides definitive evidence that the primary tumor is malignant? Slow growth Encapsulation Metastasis Small size High cellularity alone None Hint 23. A biopsy from a colonic mass shows malignant gland-forming epithelial cells. What is the most appropriate classification? Sarcoma Adenocarcinoma Lymphoma Leukemia Glioma None Hint 24. A malignant tumor of skeletal muscle shows primitive mesenchymal cells. Which broad category does it belong to? Carcinoma Sarcoma Lymphoma Melanoma Papilloma None Hint 25. A tumor closely resembles the mature cells of the tissue from which it arose. What term describes this feature? Differentiation Anaplasia Metastasis Dysplasia Necrosis None Hint 26. A biopsy shows pleomorphic cells, hyperchromatic nuclei, abnormal mitotic figures, and loss of normal tissue organization. What term best describes these features? Hypertrophy Anaplasia Hyperplasia Metaplasia Atrophy None Hint 27. A pathologist estimates tumor grade primarily by evaluating cellular differentiation and mitotic activity. What does tumor grading assess? Extent of anatomical spread Histologic aggressiveness Patient age Treatment cost Serum electrolyte balance None Hint 28. A patient with carcinoma undergoes imaging and lymph-node evaluation to determine the extent of disease. What is being assessed? Tumor grade Tumor stage Cell differentiation only Histologic subtype only DNA repair capacity None Hint 29. In the TNM system, the N component primarily describes what? Primary tumor size Regional lymph-node involvement Distant metastasis Tumor differentiation Mutation burden None Hint 30. A cancer cell contains an activating mutation in RAS that causes persistent downstream growth signaling. RAS is best classified as a: Tumor suppressor gene Proto-oncogene DNA repair gene Structural gene Housekeeping gene None Hint 31. A tumor cell loses both functional copies of a gene that normally restrains G1-to-S progression. Which tumor suppressor is classically involved? RB RAS MYC HER2 BCR-ABL None Hint 32. A cell with severe DNA damage normally activates a protein that can induce cell-cycle arrest or apoptosis. Which protein is this? p53 RAS MYC Cyclin D only VEGF None Hint 33. A malignant tumor continues proliferating despite signals that normally inhibit cell division. Which cancer capability does this represent? Evading growth suppressors Reduced angiogenesis Enhanced normal apoptosis Loss of invasion Reduced metabolic adaptation None Hint 34. A solid tumor grows beyond a few millimeters and develops numerous new blood vessels. Which factor is particularly important? VEGF Erythropoietin Insulin only C3b Albumin None Hint 35. A carcinoma first reaches regional lymph nodes before distant organs are involved. Which route is particularly common for epithelial malignancies? Lymphatic dissemination CSF dissemination Direct arterial spread only Transplacental spread Biliary spread None Hint 36. A sarcoma produces multiple pulmonary metastases. Which route of dissemination is particularly characteristic of sarcomas? Lymphatic only Hematogenous spread CSF only Transcoelomic spread only Surface implantation only None Hint 37. A chemical carcinogen produces a permanent DNA mutation in a previously normal cell. Which stage of carcinogenesis has occurred? Initiation Promotion Progression Metastasis Angiogenesis None Hint 38. An initiated cell undergoes clonal expansion after repeated exposure to a nonmutagenic stimulus. Which stage is this? Initiation Promotion Invasion Metastasis Differentiation None Hint 39. A compound requires metabolic conversion by hepatic enzymes before becoming carcinogenic. What is such a compound called? Direct-acting carcinogen Indirect-acting carcinogen Tumor suppressor Growth inhibitor Oncogene None Hint 40. A patient with a lung tumor develops hypercalcemia caused by tumor production of a hormone-like substance. What category of cancer-related manifestation is this? Paraneoplastic syndrome Metastatic syndrome Direct invasion Tumor grading Dysplasia None Hint 41. A patient develops wheezing and generalized urticaria within minutes after peanut exposure. Which antibody is central to this reaction? IgA IgG IgM IgE IgD None Hint 42. A patient develops bronchospasm immediately after allergen exposure. Which preformed mast-cell mediator contributes to the early response? Histamine TGF-beta IFN-gamma IL-2 C3b None Hint 43. A patient develops autoimmune hemolytic anemia because antibodies bind antigens on red blood cells. Which hypersensitivity mechanism is involved? Type I Type II Type III Type IV Type V only None Hint 44. A patient develops vasculitis after deposition of circulating antigen-antibody complexes in vessel walls. Which mechanism is responsible? Type I Type II Type III Type IV T-cell exhaustion None Hint 45. A patient develops an indurated skin reaction 48 hours after tuberculin exposure. Which immune mechanism is responsible? IgE-mediated mast-cell activation IgG-mediated cytotoxicity Immune-complex deposition T-cell-mediated delayed hypersensitivity Complement deficiency None Hint 46. A patient develops antibodies against nuclear antigens and immune-complex-mediated tissue injury. Which category of disease does this represent? Autoimmune disease Primary immunodeficiency Immediate allergy Transfusion reaction only Neoplastic disease None Hint 47. A woman has photosensitive rash, arthritis, and renal disease with circulating antinuclear antibodies. Which disease is most likely? Systemic lupus erythematosus Myasthenia gravis Type 1 diabetes only Multiple myeloma Hereditary angioedema None Hint 48. A child has recurrent infections caused by multiple classes of pathogens beginning early in life. Which broad category should be considered? Primary immunodeficiency Type I hypersensitivity Paraneoplastic syndrome Autoimmune disease Metastatic disease None Hint 49. A kidney-transplant recipient develops graft dysfunction months after transplantation with vascular changes and chronic interstitial fibrosis. Which type of rejection is suggested? Hyperacute rejection Acute rejection only Chronic rejection No immune reaction Type I allergy None Hint 50. A transplanted kidney becomes cyanotic and stops functioning within minutes of reperfusion. Which mechanism is most likely? Preformed recipient antibodies Newly generated T cells only Chronic fibrosis Delayed hypersensitivity IgE-mediated allergy None Hint 1 out of 25 Time's up
