IDEAS (Institute for MD/MS/MDS Entrance) PATHOLOGY WTS-MDS Answers 2008

1. A. Pseudomonas 17. C. Anti SSA

2. C.Varmus & bishop 18. A. Alpha-methyldopa

A proto-oncogene is a normal gene that can become an An alpha-2 adrenergic agonist that has both central and
oncogene due to mutations or increased expression. J. peripheral nervous system effects. Its primary clinical use is
Michael Bishop and Harold E. Varmus demonstrated that as an antihypertensive agent.
oncogenes were defective proto-oncogenes, found in many Methotrexate, alpha methyldopa, amiodarone can induce
organisms including humans. liver diseases and even cirrhosis

3.B. Non receptor tyrosine kinase 19.D. Hepatitis B

Three major classes of non-receptor tyrosine kinases have
been identified: Src, Abl and Jak. 20.C. Popliteal vein
Generally, most aneurysms of the venous system are
4.B. Inactivation ras probably congenital and rarely have clinical significance.
Ras is a G protein (specifically a small GTPase): a regulatory Popliteal aneurysms are an exception of this rule and are
GTP hydrolase that cycles between two conformations an known to be a source of recurrent pulmonary emboli
activated or inactivated form, respectively RAS-GTP and
RAS-GDP. It is activated by guanine exchange factors 21.A. Interstitial fatty infiltration
(GEFs, eg. CDC25, SOS1 and SOS2, SDC25 in yeast),
which are themselves activated by mitogenic signals and 22.C. Gingivostomatitis
through feedback from Ras itself. A GEF usually heightens Gingivostomatitis is similar to cold sores which are caused
the dissociation rate of the nucleotide while not changing by the Herpes Simplex Virus 1. It is a combination of
the association rate (effectively lower the affinity of the gingivitis and stomatitis. Gingivostomatitis is caused by the
nucleotide) thereby promoting its exchange. The cellular primary infection of the virus,
concentration of GTP is much higher than that of GDP so the HSV1 is associated mainly with orofacial disease.
exchange is usually GDP vs. GTP. 23. D.WT
It is inactivated by GTPase-activating proteins (GAPs, the 24. A. Amyloidosis
most frequently cited one being RasGAP), which increase the Amyloid deposits can be identified histologically by Congo
rate of GTP hydrolysis, returning RAS to its GDP-bound red staining and viewing under polarized light where amyloid
form, simultaneously releasing an inorganic phosphate deposits produce a distinctive 'apple green birefringence'.
5.B. Thymus 25.C. p73
6. D. Liver In 1997 with the discovery of the p73 gene, dubbed the "Big
Ito cells, also known as hepatic stellate cells or fat-storing Brother" of p53. Located on 1p36, this gene encodes a
cells, are pericytes found in the perisinusoidal space (a small protein similar to the p53 protein, its talents including cell
area between the sinusoids and hepatocytes) of the liver cycle arrest and apoptosis. Deletions of the gene locus for
7. A. C2, C4 and C3 decreased p73 are common in a variety of tumors, including
8. D. Cardiogenic shock neuroblastoma and colon and breast cancers.
9.C. Lymphocyte 26. A. Lipochrome
10. C. Haemophilus A term sometimes used to designate the wear-and-tear
Removal of the spleen is associated with an increased risk of pigments, e.g., lipofuscin, haemofuscin, ceroid. More
infections, more vulnerably Haemophilus influenzae type b precisely, lipochrome's are yellow pigments that seem to be
(Hib) other risk of infections are , meningococcal and identical to carotene and xanthophyll and are frequently
Escherichia coli infection. In particular, there is a risk of fatal found in the serum, skin, adrenal cortex, corpus luteum, and
pneumococcal pneumonia 2.5 per cent of patients die of arteriosclerotic plaques, as well as in the liver, spleen, and
pneumococcal pneumonia within five years of spleen adipose tissue; lipochrome's do not stain with the ordinary
removal. Because of this, patients with splenectomies are dyes for fat.
often advised to have a pneumococcal vaccine (with
revaccination every six years) as well as long term antibiotic 27. D. Cancer giant cell
treatment In the cancer giant cell, the nucleus is hyperchromatic and is
very large in relation to the cell.
11. C. Superficial thrombophlebitis
12.C. Osteitis deformans 28. A. Carcinoid tumor
13. C.t (14;18) Definitive diagnosis of carcinoid tumors is based on
14.A. Edema of alveolar walls and heart failure cells histologic features, immunostaining for secretory products
15.C. Cytoskeleton such as chromogranin, and ultrastructural identification of
Neurofibromin 2 (NF2) is a cytoskeletal protein. In humans, neuroendocrine secretory
it is a tumor suppressor protein involved in granules.
Neurofibromatosis type II.
Cytogenetic Location: 22q12.2 29.A. Carcinogenesis
Molecular Location on chromosome 22: base pairs Low dose radiationinduced cancer in humans
28,329,564 to 28,424,586
30. C. Fernandez reaction is read in 24/48 hours
16. D. Pleiotropism The lepromin test is useful in determining the extent of host
Converse is genetic heterozygocity: Multiple mutation with immune reactivity to Mycobacterium leprae.
same trait. 0.1 ml of lepromin, prepared from a crude extract of

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organisms, is injected intradermally. The reaction is read at The first category, alterations in normal blood flow, refers to
24/48 hours (Fernandez) or at 3 to 4 weeks (Mitsuda). several situations. These include turbulence, stasis, mitral
stenosis, and varicose veins. The second category, injuries
31. B. Staphylococcal food poisoning and/or trauma to endothelium includes damage to the veins
Staphylococcal food poisoning is a gastrointestinal illness. It arising from shear stress, hypertension. The last category,
is caused by eating foods contaminated with toxins produced alterations in the constitution of blood, has numerous
by Staphylococcus aureus As the germ multiplies in food, it possible risk factors such as hyperviscosity, deficiency of
produces toxins that can cause illness. Staphylococcal toxins antithrombin III, nephrotic syndrome, changes after severe
are resistant to heat and cannot be destroyed by cooking. trauma or burn, disseminated cancer, late pregnancy and
Antibiotics are not useful in treating this illness. The toxin is delivery, race, age, whether the patient is a smoker, and
not affected by antibiotics. Patients with this illness are not obesity. All of these risk factors cause the situation called
contagious. Toxins are not transmitted from one person to hypercoagulability.
another.
41.D. Mucous patches
32. B. Candida albicans
Candida albicans is a diploid fungus (a form of yeast), which 42.B. Type II hypersensitivity reaction
is capable of mating but not of meiosis, and a causal agent of Goodpastures syndrome (also known as Goodpastures
opportunistic oral and genital infections in humans. Systemic disease and anti-glomerular basement membrane disease)
fungal infections (fungemias) have emerged as important is a rare condition characterised by rapid destruction of the
causes of morbidity and mortality in immunocompromised kidneys and haemorrhaging of the lungs. Although many
patients (e.g., AIDS, cancer chemotherapy, organ or bone diseases can present with these symptoms, the name
marrow transplantation). Goodpastures syndrome is usually reserved for the
autoimmune disease produced when the patients immune
33.C. Stromal proliferation system attacks cells presenting the Goodpasture antigen (a
type II hypersensitivity reaction), which are found in the
34.A. Interferon kidney and lung, causing damage to these organs.
35.A. Niemann-pick disease
Palisaded lamellar structure of lysosome, seen in electron 43. D.GP 120
microscopy. Also seen in mucopolysaccharidoses.
44.B. Promyelocytic AML
36.C. Contamination of trauma or surgical site with DIC is a thrombotic disorder initiated by overwhelming
endogenous organisms stimulation of the clotting system. In acute DIC, coagulation
Actinomycosis may be seen in the tonsils, tongue, cheek or is stimulated within the blood vessels at multiple locations
lips where it is usually implanted by trauma. The organisms throughout the body
that cause Actinomycosis are members of the families
Actinomycetaceae, Streptomycetaceae, and Actinoplanaceae. 45. A. Aspergillosis
The organisms are gram-positive, branching, nonspore- The diagnosis of allergic bronchopulmonary aspergillosis
forming bacilli. They are anaerobic or microaerophilic. They (ABPA) usually is based on the presence of asthma,
are very difficult to grow in culture, and the culture-recovery peripheral blood eosinophilia, markedly elevated IgE levels,
rate from active infection is only approximately 30%. The immediate skin test reactivity to Aspergillus antigen, and
organisms responsible for infection in man are thought to be precipitating antibodies to Aspergillus species in the serum
Actinomyces israelii, naeslundii, viscosus, and odontolyticus;
of these israelii is most common. Actinomyces bovis has not 46.B. CCR5, CXCR4
been isolated in man, and is felt to be the organism They are called as co-receptors and required for binding of
responsible for "lumpy jaw" in cattle. gp120 with CD4 receptors.

37. C. Thromboembolism 47. D. Intracytoplasmic microorganisms in the RE system

38.C. Fragile x syndrome 48.C. Cartilage

Fragile X syndrome (also called Fragile X) is the most
common inherited form of mental retardation.It is a genetic 49. A. Bronchogenic carcinoma
disorder caused by mutation of the FMR1 gene on the X 50. C. Because of the great number of WBCs infections
chromosome. Mutation at that site is found in 1 out of about are uncommon
every 2000 males and 1 out of about every 259 females. Although WBC count is increased, they are functionally
(Incidence of the disease itself is about 1 in every 4000 abnormal, so infections are common.
females.)Normally, the FMR1 gene contains between 6 and
55 repeats of the CGG codon (trinucleotide repeats). In 51. A. Nuclear atypia
people with the fragile X syndrome, the FMR1 allele has
over 230 repeats of this codon 52.C. Neuroblastoma
Neuroblastoma is one of the rare human malignancies known
39. D. Type IV to demonstrate spontaneous regression from an
Reversal reactions are a shift toward the tuberculoid pole undifferentiated state to a completely benign cellular
after the start of therapy, and they are type IV cell-mediated appearance
allergic hypersensitivities.
53.C. Repletion of glycogen stores
40.D. Changes in amount of fluid
54.A. Hamartoma

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55.D. Type-IV 65.B. BRCA 1 gene
Type IV reaction induces granuloma formation A breast cancer (BRCA) gene test is a blood test to check for
specific changes (mutations) in genes that help control
56.B. RER aggregate normal cell growth. Finding changes in these genes, called
Dhle bodies are light blue-gray, oval, basophilic, leukocyte BRCA1 and BRCA2, can help determine your chance of
inclusions located in the peripheral cytoplasm of neutrophils. developing breast cancer and ovarian cancer. A BRCA gene
They measure 1-3 m in diameter. Not much is known about test does not test for cancer itself. This test is only done for
their formation, but are thought to be remnants of the RER- people with a strong family history of breast cancer or
rough endoplasmic reticulum. ovarian cancer, and sometimes for those who already have
one of these diseases
57.B. Rapidly developing tuberculosis
Galloping consumption term refers to tuberculosis, or some 66. D. Coagulative necrosis
virulent strain of TB. Consumption was a common word for Coagulative Necrosis is a type of accidental cell death
tuberculosis many years ago (consuming the lung tissue). typically caused by ischemia or infarction.
Galloping refers to the speed at which the disease It is characterised by the 'ghostly' appearance of cells under
progresses. light microscopy in the affected area of tissue. Like most
types of necrosis if enough labile cells are present around the
58.D. Emphysema affected area regeneration can occur
Direct causes of left-sided failure include the
following:Rheumatic heart disease,Chronic blockages of the 67. B. Urinary retention
heart arteries ,Hypertension ,Aortic stenosis Benign prostatic hyperplasia (BPH) also known as
nodular hyperplasia, benign prostatic hypertrophy or
59. A. Seen in papillary carcinoma of thyroid benign enlargement of the prostate (BEP) refers to the
Psammoma bodies are commonly seen in certain tumors such increase in size of the prostate. To be accurate, the process is
as: one of hyperplasia rather than hypertrophy, but the
papillary thyroid carcinoma,papillary renal cell nomenclature is often interchangeable, even amongst
carcinoma,serous papillary ovarian adenocarcinoma urologists. It is characterized by hyperplasia of prostatic
(cystadenocarcinoma),endometrial stromal and epithelial cells, resulting in the formation of
adenocarcinomas(Papillary serous carcinoma ~3%-4%) large, fairly discrete nodules in the periurethral region of the
meningioma,mesothelioma prostate. When sufficiently large, the nodules compress the
60.A. Venules urethral canal to cause partial, or sometimes virtually
complete, obstruction of the urethra which interferes the
61.C. Histoplasmosis normal flow of urine. It leads to symptoms of urinary
The histopathological picture in acute disseminated hesitancy, frequent urination, increased risk of urinary tract
histoplasmosis is different from that seen in the more chronic infections and urinary retention
disease, and in solitary pulmonary nodules ("coin lesion"). In
the first entity, the organisms are localized in histiocytes and 68. A. St. Louis encephalitis
reticuloendothelial cells. The cells enlarge, but with no St. Louis encephalitis is a serious viral disease that is spread
evidence of inflammation. The intracellular budding yeasts by infected mosquitoes
are approximately 3 m in diameter, similar to Leishmania 69. B. Multiple myeloma
sp., but do not contain a kinetoplast. In addition, Leishmania Multiple myeloma is an example for primary amyloidosis
does not stain with the special stains used for fungi. Older Secondary amyloidosis (AA) develops along with a chronic
lesions show well-developed granulomata and have a central infectious or inflammatory disease, such as
area of caseation resembling tuberculosis. The solitary tuberculosis,osteomyelitis or rheumatoid arthritis. People
pulmonary nodules are well organized and usually have a with multiple myeloma(feature of primary amyloidosis) are
circumferential rim of calcification accounting for their at increased risk for developing secondary amyloidosis
visibility on chest X-ray. Fungi within these nodules are
usually dead. Histoplasma capsulatum yeast are found in the 70.C. Budding ends of capillaries
center of the lesions.
71.A. Carcinoma
62.D. Are arranged around the periphery 72. C. CREST syndrome
A subset of patients with scleroderma, a systemic
63. C. Mesangial deposits autoimmune disorder that causes fibrosis, can have several
Bergers disease or primary IgA nephropathy, associated conditions and symptoms that are collectively
glomerulonephritis with IgA and IgG deposits and IgA . known as CREST syndrome A subset of patients with
Extensive mesangial IgA deposits (the characteristic scleroderma, a systemic autoimmune disorder that causes
pathologic feature of Berger disease), may also occur in a fibrosis, can have several associated conditions and
variety of multisystem, neoplastic and infectious diseases symptoms that are collectively known as CREST syndrome
mesangial nephropathy Lab changes in CREST syndrome are similar to those seen in
64.B. Non-caseating granuloma patients with limited cutaneous scleroderma. The ANA test is
Hilar lymphadenopathy, pulmonary symptoms and skin positive, showing a pattern of anticentromere antibodies.
nodules and Non-caseating granulomas in skin biopsy are 73.D. Nephrosclerosis
features of Sarcoidosis. Caseating granulomas produced by Benign nephrosclerosis may naturally occur with age as a
other diseases, especially tuberculosis result of years of mild high blood pressure (chronic
hypertension). Malignant nephrosclerosis is caused by severe

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high blood pressure that is not controlled. It can also be Minor diagnostic criteria-Fever,Arthralgia,Prolonged PR
caused by conditions such as chronic kidney failure, interval on electrocardiogram
glomerulonephritis, renal vasculitis, and renal vascular Elevated acute-phase reactants (APRs), which are erythrocyte
hypertension sedimentation rate and C-reactive protein

74.A. Adenoma 91. C. Replacement of columnar cells by stratified

squamous epithelium
75. C. Typhoid
92. A. < 1012
76. C. Both commonly occur in the oral cavity Transudate is extravascular fluid with low protein content
basal cell carcinoma occur on skin and a specific gravity <1012. It has low nucleated cell counts
(less than 500 to 1000 /microlit) and the primary cell types
77. D. Detachment of ribosome from PER are mononuclear cells: macrophages, lymphocytes and
78.B. Megalo blastic anemia mesothelia cells.
Megaloblastic anemia is an anemia (of macrocytic 93. A. Adult T-cell leukemia
classification) which results from inhibition of DNA
synthesis in red blood cell production. It is often due to 94. C. 2:1
deficiency of vitamin B12 and/or folic acid. It can be the
result of a lack of intrinsic factor (which lack interferes with 95.B. Superoxide dismutase
B12 absorption), causing pernicious anemia, or with other Superoxide dismutase
antimetabolites which poison DNA production, such as 1.Reduces ishemia reperfusion injury
chemotherapeutic agents. 2. Protects against ishemic brain injury
It is characterized by many large immature and dysfunctional 3. Helps heal corneal ulcers
red blood cells (megaloblasts) in the bone marrow, and also 4. Reduces brain swelling after traumatic brain injury
by hypersegmented or multisegmented neutrophils. 5. Protects organs following burn injury
6. Speeds healing following burn injury
79. C. 11 and 13
96. A. Carcinoma of the prostate gland
80. B. Lung
Leukocyte extravasation occurs mainly in post-capillary 97.B. Defective phagocytosis
venules, where haemodynamic shear forces are minimized.
98. B. Macrophage
81. C. Lower specific gravity Anitschkow (or Anichkov cells are cells associated with, and
pathognomonic for, rheumatic heart disease.They are also
82. D. Necrotic focus called caterpillar cells, as these cells have a large amount of
clear cytoplasm surrounding a rod-shaped nucleus that to
83. A. Poisonous products from saprophytes, in blood some resembles a caterpillar. Anitschkow cells are enlarged
Blood poisoning caused by putrefactive bacteria or macrophages found within granulomas (called Aschoff
Septicemia caused by a saprophytic organism; results from bodies) associated with the disease. Larger Anitschkow cells
eating putrified matter. may coalesce to form multinucleated Aschoff giant
84. A. CD2 cells.Anitschkow cells were named after the Russian
pathologist Nikolai Nikolajewitsch Anitschkow
85. A. Hepatocytes
Labile cells are dividing all the time--always in the cell cycle. 99. A. Measles
Examples include cells in the digestive tract, skin, respiratory Multinucleated giant cells seen in the lymphoid tissues of
tract, and stem cells in the bone marrow producing blood patients with measles.
cells. 100. D. ITP
86.D. Cicatrization and healing Idiopathic thrombocytopenic purpura (ITP) is the
condition of having a low platelet count (thrombocytopenia)
87. B. Lipochrome of no known cause (idiopathic). As most causes appear to be
Lipochrome, aging pigment, derived from lipid peroxidation, related to antibodies against platelets, it is also known as
mainly seen in heart. immune thrombocytopenic purpura. Although most cases
are asymptomatic, very low platelet counts can lead to a
88. B. Langerhans cells bleeding diathesis and purpura. Bleeding time is prolonged
Langerhans' cells are dendritic cells abundant in epidermis, in ITP patients
containing large granules called Birbeck granules. They are
normally present in lymph nodes, and can be found in other 101. A. Fibroblasts
organs in the condition Histiocytosis.
102. B. 2 integrins
89. D. All nucleated cells
103. B. Sex linked recessive
90. C. Fever
Fever is one of the minor diagnostic criteria 104. A.Involves the death of large contiguous areas of
Major diagnostic criteria- cells
Carditis,Polyarthritis,Chorea,Subcutaneous Can involve single cells or clusters of cells.
nodules,Erythema marginatum

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105. A. Well differentiated 119. D. Hyperparathyroidism
The most frequent complication of hyperparathyroidism is
106.B. Brain nephrolithiasis, which occurs in about 20% of patients .
Autopsy studies have found lung cancer metastases in Renal effects of the disease also include decreased
virtually every organ system. Metastatic disease is found at glomerular filtration rate. Hypercalciuria (>300 mg daily
autopsy in over 50% of patients with epidermoid carcinoma, calcium excretion) is observed in a significant subset (up to
80% of patients with adeno and large cell carcinoma and over 30%) of patients.
95% of patients with small cell cancer. Commonly
bronchogenic carcinoma metastasizes to brain with 120. C. Basophills
neurologic deficits.
121. A. Legionella
107.B. Invasive form develops in individuals with severe Pontiac fever, an influenza-like illness characterized by fever,
impaired resistance headache, and muscle pain, represents a milder form of
Invasive aspergillosis normally only occurs in severely Legionella infection
immune-compromised patients and has a high mortality rate
(25-90%). Invasive disease is most commonly seen in the 122. C.Macrophage
lungs, which is called pulmonary aspergillosis, but although
less common, dissemination of aspergillus to other tissues 123. A. Staph. aureus
including the central nervous system, sinuses, bone, heart, 124. A. Large mononuclear phagocytes
kidney, eye, blood and skin have been reported disease
125. D. Coralline thrombus
108. B. Micro vascular occlusion
Diffuse cerebral edema was the most common abnormality 126. A. Neutofibromatosis
seen in patients with cerebral malaria.
Cerebral edema is believed to be both vasogenic and 127.B. Ingestion of alcohol
cytotoxic in origin. The cause of edema probably is an Pain in involved lymph nodes immediately after the ingestion
increase in the intracerebral blood volume, which results of alcohol is a curious complaint that is nearly specific to
from sequestration of the parasitized erythrocytes and Hodgkins Disease
compensatory vasodilatation, damage to cerebral capillary
endothelium, and cerebral microvascular occlusion 128. A. Urease
Helicobacter is a spiral shaped organism with flagella. It has
109. D. CPD A a potent multisubunit urease enzyme that enables it to survive
Citrate-phosphate-dextrose-adenine; an anticoagulant used in in acidic pH conditions and colonize the gastric environment
blood collection bags. . H. pylori utilizes the enzyme urease to convert urea into
110.A. Lung bicarbonate and ammonia to combat the low acidity of the
Lungs are the common sites for hydrated cysts but the stomach. The mixing of the two extreme pH levels creates a
hydatid cyst in lungs never calcifies. neutralized protective cloud around the H. pylori, allowing it
to survive in the stomach
111. C. Microscopic polyangitis
129. C. Arch of the aorta
112. D. Asbestosis
130.B. Dust from vegetable matter
113. A. Hamartoma Phytopneumoconiosis: A chronic fibrous reaction in the
A hamartoma is a focal malformation that resembles a lungs due to the inhalation of dust particles of vegetable
neoplasm in the tissue of its origin. This is not a malignant origin.
tumor, and it grows at the same rate as the surrounding
tissues 131.C. Microthrombi in arteriole

114.C. Pseudomonas 132.B. Prostate carcinoma with bone metastasis

Ecthyma gangrenosum is an infection of the skin typically
caused by Pseudomonas aeruginosa that is a round or oval 1- 133. C. Monckebergs sclerosis
to 15-cm lesion with a halo of erythema and usually with a Monckeberg's sclerosis is a disease of unknown aetiology
necrotic center representing where the organism has invaded characterised by dystrophic calcification of the media of
blood vessels and produced hemorrhagic infarctions. arteries. This condition is usually seen in the major lower
limb arteries of elderly patients, and may also be seen in the
115. A. Clonal selection head, neck and pelvis, especially the uterine arteries. Stenosis
and atheroma may occur but the lumen usually remains
116. C. white blood cells migration patent, leading to "pipe-stem" rigidity.
The blood vessels are lined with the endothelium, a layer of
cells that tends to protect blood cell migration outside of the 134. C. Cervical cancer
cells. However, injury or trauma can cause white blood cells Both are squamous cell carcinoma and both start with
to migrate across the endothelium. This process is called Carcinoma in situ
diapedesis.
135. A. Patchy, inflammatory distribution
117. D. Acute liver failure Pathology of bronchopneumonia Patchy distribution in and
around small airways,Dense acute inflammatory exudate of
118. C. Autoimmune diseases are usually associated with PMNs, fibrin and blood in bronchi, bronchioles and adjacent
DR

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alveoli,FOCAL destruction of alveolar walls (you can see Von Willebrand factor is not an enzyme and therefore has no
normal parenchyma in other areas adjacent) catalytic activity. Its primary function is binding to other
proteins, particularly Factor VIII and it is important in
136. B. Coagulative necrosis platelet adhesion to wound sites.
Coagulative necrosis is typically seen in hypoxic
environments (e.g. myocardial infarction, infarct of the 150. A. Cause only small lesions where they enter the
spleen). Cell outlines remain after cell death and can be body
observed by light microscopy.It is characterizes by it its
tombstone form 151.A. Decrease basophilia
A feature of cells undergoing necrosis, or cell death caused
137. D. Each of the above by irreversible cell damage. The sequential descriptive order
Polycythemia is an acquired disorder of the bone marrow of events: Pyknosis, Karyorrhexis, Karyolysis.
that causes the overproduction of white blood cells, red blood Pyknosis: CONDENSATION of nuclear chromatin.
cells, and platelets. Basophilia increases, cell shrinks.
Karyorrhexis: FRAGMENTATION of nuclear chromatin.
138.C. Curling ulcer Karyolysis: LYSIS via DNAase activity. Basophilia
Curling's ulcer is an acute peptic ulcer of the duodenum decreases.
resulting as a complication from severe burns when reduced
plasma volume leads to sloughing of the gastric mucosa. The 152. C. Impair collagen formation
condition was first described in 1823 and named for a doctor,
Thomas Blizard Curling, who observed ten such patients in 153. D. Rhabdomyoma
1842. A rhabdomyoma is a benign tumor of striated muscle.
Cardiac rhabdomyomas occur most frequently in infants and
139. C. Nuclear bindings protein young children and have an association with tuberous
sclerosis.
140. B. Basement membrane It is most commonly associated with the tongue and heart,
but can also occur in other locations.
141. D. Typhoid The malignant form of rhabdomyoma is called
142. D. Mucormycosis rhabdomyosarcoma.
Mucormycosis (also known as zygomycosis or 154. A. Endothelial injury
phycomycosis) is a serious infection of fungi, usually 155. C. Lipofuschin
affecting the face or oropharyngeal cavity. Occasionally, 156.C. Tongue
when caused by Pythium or other similar fungi, the condition 157. B. Breast carcinoma
may affect the gastrointestinal tract or the skin. It usually 158.D. All of the above
begins in the nose and paranasal sinuses and is one of the 159. A. Respiratory tract
most rapidly spreading fungal infections in humans. The Psittacosis is an infectious disease in humans that has mild,
most common fungi responsible for mucormycosis in humans non-specific flu-like symptoms. Psittacosis refers to any
are Mucor and Rhizopus. It usually affects patients who are infection or disease caused by Chlamydia psittaci, one of
immunocompromised. Some 50-75% of patients diagnosed several microorganisms in the genus Chlamydia. This disease
with mucormycosis are estimated to have underlying poorly can be transmitted from infected birds to humans. Parrot
controlled diabetes mellitus and ketoacidosis. disease, ornithosis, and chlamydiosis are other names for
143. A. Secreted by platelets psittacosis. Human can become infected with Chlamydia
Thromboxane A2 is generated from prostaglandin H2 by psittaci by breathing in the organism when the urine,
thromboxane-A synthase. It is also a major component of respiratory secretion, or dried feces of infected birds is
blood clots. Aspirin irriversibly inhibits platelet aerosolized
cyclooxygenase preventing the formation of prostaglandin
H2. 160. C. Brilliant pink color
161.A. Accumulation of water intracellulary
144. B. Forms surface pellicle 162. C. 80-90%
163. A. HbA2
145.B. Left anterior descending artery 164.D. Cardiac muscle
left anterior descending coronary artery, implicated in about 165. D. Monocytes-Macrophages
50% of cases of artherosclerosis thats why it is also known 166.A. Lead poisoning
as widows artery. 167. B. Basal cell carcinoma

146. A. Elevated serum lipase 168. B. Tay-Sachs disease

Serum Lipase is elevated with amylase in acute pancreatitis, All patients with Tay-Sachs disease have a "cherry-red" spot,
but the elevation of lipase is more prolonged easily observable by a physician using an ophthalmoscope, in
the back of their eyes (the retina). This red spot is the area of
147. D. Upper respiratory infections due to hemolytic the retina which is accentuated because of gangliosides in the
streptococci surrounding retinal ganglion cells (which are neurons of the
central nervous system). The choroidal circulation is showing
148. D. Media of Monckebergs degeneration through "red" in this region of the fovea where all of the
149. A. VWF retinal ganglion cells are normally pushed aside to increase
visual acuity. Thus, the cherry-red spot is the only normal
part of the retina seen.

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169. D. 3 months a year for 2 years 182.B. Pulmonary emphysema
Pulmonary Emphysema is a chronic obstructive pulmonary
170. A. Villous adenoma disease (COPD), It is often caused by exposure to toxic
Villous adenoma is a type of polyp that grows in the colon chemicals or long-term exposure to tobacco smoke.
and other places in the gastrointestinal tract and sometimes in Emphysema is caused by loss of elasticity (increased
other parts of the body. These adenomas may become compliance) of the lung tissue, from destruction of structures
malignant (cancerous) supporting the alveoli, and destruction of capillaries feeding
the alveoli. Thus the small airways collapse during
171.A. Tuberculosis exhalation, although alveolar collapsibility has increased.
Langhans giant cells are large cells found in granulomatous This impedes airflow and traps air in the lungs, as with other
conditions. They are formed by the fusion of epithelioid cells obstructive lung diseases. Symptoms include shortness of
(macrophages), and contain nuclei arranged in a horseshoe- breath on exertion and later at rest, hyperventilation, and an
shaped pattern in the cell periphery. Their presence could expanded chest.
indicate tuberculosis or other mycobacterial infection
183. C. Amyotrophic lateral sclerosis
172. C.Acute ischaemia Amyotrophic Lateral is a progressive, usually fatal,
173. B. T-cell neurodegenerative disease caused by the degeneration of
motor neurons, the nerve cells in the central nervous system
174. D. Lipofuscin that control voluntary muscle movement. As a motor neuron
Lipofuscin is the name given to finely granular yellow disease, the disorder causes muscle weakness and atrophy
brown pigment granules composed of lipid-containing throughout the body as both the upper and lower motor
residues of lysosomal digestion. It is considered one of the neurons degenerate, ceasing to send messages to muscles.
aging or "wear and tear" pigments; found in the liver, kidney,
heart muscle, adrenals, nerve cells, and ganglion cells. It is 184. D.Cardiac tamponade
specifically arranged around the nucleus. "Liver spots" Cardiac tamponade is the compression of the heart caused by
commonly associated with aging are superficial dermal blood or fluid accumulation in the space between the
lipofuscin deposits. myocardium (the muscle of the heart) and the pericardium
(the outer covering sac of the heart).
175. C. Bone marrow The outer pericardium is made of fibrous tissue which does
not easily stretch, and so once fluid begins to enter the
176. B. An osteochondroma pericardial space, pressure starts to increase.
An osteochondroma is a cartilage covered bony excrescence If fluid continues to accumulate, then with each successive
(exostosis) that arises from a surface of a bone In adults, the diastolic period, less and less blood enters the ventricles, as
cartilage cap often contains flecks of calcification. the increasing pressure presses on the heart and forces the
Osteochondromas arise from the surface of the bones contain septum to bend into the left ventricle, leading to decreased
spongiosa and cortex that appear continuous with the parent stroke volume. This causes obstructive shock to develop, and
bone; this is particularly obvious in long bones if left untreated then cardiac arrest may occur A thrombus
formed on and attached to a diseased patch of endocardium,
177.A. No basement membrane involvement not on a valve or on one side of a large blood vessel.
Carcinoma in situ is malignant epithelium that has not 185.A. Mural thrombus
penetrated the basement membrane,that is ,it is not invasive
cancer and cannot reached blood vessels or lymphatic which 186. D. Diphtheria
lies beneath the basement membrane
187. B. Streptococcus viridans
178. B. Clindamycin The subacute bacterial endocarditis (SBE) is due to
Hypersensitivity to clindamycin or any component of the streptococci of low virulence like Streptococcus viridans
formulation or a prolonged therapy have major adverse effect Where as acute bacterial endocarditis (ABE) is a fulminant
like pseudomembranous colitis; regional enteritis, ulcerative illness over days to weeks, and is more likely due to
colitis. Staphylococcus aureus which has much greater virulence, or
disease-producing capacity and frequently causes metastatic
179. B. Blood viscosity infection.
180. C. Mydriasis
A pancoast tumor, also pancoast tumour (UK) or superior 188.B. Mitochondria
sulcus tumor, is a tumor of the pulmonary apex i.e. a type of
lung cancer defined primarily by its location situated at the 189. C. Poliomyelitis
top end of either the right or left lung. Symptoms can include poliomyelitis is a disease of the anterior horn motor neurons
miosis (constriction of the pupils), anhidrosis (lack of of the spinal cord and brain stem caused by poliovirus.
sweating), ptosis (drooping of the eyelid), and in severe Flaccid asymmetric weakness and muscle atrophy are the
cases, a complete Horner's syndrome. hallmarks of its clinical manifestations, due to loss of motor
neurons and denervation of their associated skeletal muscles.
181. B. Parathormone
Parathyroid hormone (PTH), or parathormone, is secreted 190.D. All are true
by the parathyroid glands as a polypeptide containing 84
amino acids. It acts to increase the concentration of calcium 191. C. Congenital heart disease
(Ca2+) in the blood, whereas calcitonin (a hormone produced Kartagener's Syndrome is a chronic lung disease that occurs
by the parafollicular cells (C cells) of the thyroid gland) acts when cilia are unable to move
to decrease calcium concentration.

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IDEAS (Institute for MD/MS/MDS Entrance) PATHOLOGY WTS-MDS Answers 2008
Kartagener's syndrome include -chronic rhinitis,recurrent or
chronic sinusitis,recurrent or chronic bronchitis
Bronchiectasis,and dextrocardia

192. B. Complement complex C5-9

193. D. Ischemia
Decubitus ulcer: A bed sore, a skin ulcer that comes from
lying in one position too long so that the circulation in the
skin is compromised by the pressure, particularly over a bony
prominence such as the sacrum (sacral decubitus) ulcer is
caused by ischemia of the underlying structures of the skin,
fat, and muscles as a result of the sustained and constant
pressure.

194. A. Bronchiectasis

195. C. Mumps
Orchitis is an inflammation of one or both of the testicles,
often caused by infection
It is usually a result of epididymitis, inflammation of the tube
that connects the vas deferens and the testicle.
The most common viral cause of orchitis is mumps.
Approximately 30% of patients who have mumps will
develop orchitis during the course of the illness.

196.C. Fibrinoid change

197. C. Damage to liver cells

Hepatic jaundice causes include acute hepatitis,
hepatotoxicity and alcoholic liver disease, whereby damage
to liver cell reduces the liver's ability to metabolise and
excrete bilirubin leading to a buildup in the blood

198. A. A long bone fracture

The most common sources of embolism are pelvic vein
thromboses or proximal leg deep venous thromboses (DVTs)
In other, rarer forms of pulmonary embolism, material other
than a blood clot is responsible; this may include fat or bone
(usually in association with significant trauma), air (often
when diving), clumped tumor cells, and amniotic fluid
(affecting mothers during childbirth).

199. A. Acute tubular necrosis

Any condition that causes a reduction in the amount of blood
being pumped by the heart may cause ATN.
Risks for acute tubular necrosis include injury or trauma with
resulting damage to the muscles, recent major surgery, blood
transfusion reaction, septic shock or other forms of shock,
and severe hypotension (low blood pressure) that lasts longer
than 30 minutes.

200. D. Antimitochondiral antibody-PBC

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