ABPath Pathology MCQ 1 — Questions and Answers
Question 1: Which of the following is a common histologic feature of chronic inflammation?
- Neutrophil infiltration
- Granuloma formation (Correct answer)
- Eosinophil infiltration
- Hyperemia
Correct answer: Granuloma formation
Chronic inflammation is characterized by the prolonged presence of inflammatory cells, tissue destruction, and attempts at repair. Granuloma formation, a specific type of chronic inflammation, involves aggregates of activated macrophages (epithelioid cells) often surrounded by lymphocytes, and is a hallmark response to persistent irritants or certain microorganisms like Mycobacterium tuberculosis. While neutrophils are key in acute inflammation, granulomas are distinctive for chronic processes.
Question 2: What is the most common cause of iron deficiency anemia worldwide?
- Blood loss (Correct answer)
- Malabsorption
- Vitamin B12 deficiency
- Chronic inflammation
Correct answer: Blood loss
Iron deficiency anemia occurs when the body lacks sufficient iron to produce hemoglobin. Globally, chronic blood loss, particularly from the gastrointestinal tract (e.g., peptic ulcers, colon cancer, hookworm infection) or gynecological sources (e.g., menorrhagia), is the predominant cause. This consistent depletion of iron stores through blood loss is the leading factor worldwide.
Question 3: In which condition would you most likely find hyperkalemia?
- Chronic kidney disease (Correct answer)
- Acute myocardial infarction
- Hyperparathyroidism
- Addison’s disease
Correct answer: Chronic kidney disease
Hyperkalemia, an elevated potassium level in the blood, is commonly seen in chronic kidney disease (CKD). The kidneys are primarily responsible for excreting excess potassium from the body. As kidney function declines in CKD, the ability to excrete potassium is impaired, leading to its accumulation in the bloodstream.
Question 4: What is the key difference between malignant and benign tumors?
- Benign tumors grow slowly, while malignant tumors grow rapidly (Correct answer)
- Malignant tumors are encapsulated, while benign tumors are not
- Malignant tumors are always larger than benign tumors
- Benign tumors can invade surrounding tissues, while malignant tumors do not
Correct answer: Benign tumors grow slowly, while malignant tumors grow rapidly
The fundamental difference between benign and malignant tumors lies in their biological behavior and potential for harm. Malignant tumors (cancers) exhibit uncontrolled, rapid growth, invade surrounding tissues, and have the capacity to metastasize to distant sites. Benign tumors, in contrast, typically grow slowly, remain localized, and do not invade or metastasize.
Question 5: Which of the following is a characteristic feature of retinoblastoma on histopathology?
- Homer-Wright rosettes
- Flexner-Wintersteiner rosettes (Correct answer)
- Pseudoepitheliomatous hyperplasia
- Microcytic hypochromic cells
Correct answer: Flexner-Wintersteiner rosettes
Retinoblastoma is a malignant tumor of the retina, primarily affecting young children. On histopathological examination, a characteristic feature is the presence of Flexner-Wintersteiner rosettes. These are true rosettes formed by columnar tumor cells arranged around a central lumen, representing an attempt at photoreceptor differentiation, and are highly specific for retinoblastoma.
Question 6: What is the most common cause of myocardial infarction?
- Coronary artery spasm
- Atherosclerosis and thrombosis (Correct answer)
- Hypertension
- Endocarditis
Correct answer: Atherosclerosis and thrombosis
Myocardial infarction (heart attack) is most commonly caused by the rupture of an atherosclerotic plaque in a coronary artery, followed by the formation of a thrombus (blood clot) at the site of rupture. This thrombus then completely or severely obstructs blood flow to a portion of the heart muscle, leading to ischemia and necrosis. Atherosclerosis is the underlying disease, and thrombosis is the acute event.
Question 7: Which of the following is the hallmark feature of a fibroid (leiomyoma) on histology?
- Sheets of malignant cells
- Spindle-shaped smooth muscle cells (Correct answer)
- Cystic spaces with blood-filled cavities
- Presence of keratin pearls
Correct answer: Spindle-shaped smooth muscle cells
A uterine fibroid, or leiomyoma, is a benign tumor originating from the smooth muscle cells of the myometrium. Histologically, it is characterized by well-demarcated, whorled bundles of uniform, elongated spindle-shaped smooth muscle cells with bland nuclei and minimal mitotic activity. This distinct cellular arrangement and morphology are diagnostic for leiomyomas.
Question 8: What is the most common presenting symptom of acute leukemia?
- Abdominal pain
- Severe anemia
- Fever and infections (Correct answer)
- Weight loss
Correct answer: Fever and infections
Acute leukemia is characterized by the rapid proliferation of immature white blood cells (blasts) in the bone marrow, which suppresses the production of normal blood cells. This leads to pancytopenia, including neutropenia (low neutrophils). Consequently, patients often present with fever and recurrent infections due to a compromised immune system, as their body cannot effectively fight pathogens.
Question 9: What is the primary molecular alteration in the pathogenesis of chronic myelogenous leukemia (CML)?
- BCR-ABL fusion gene (Correct answer)
- TP53 mutation
- EGFR amplification
- MYC oncogene activation
Correct answer: BCR-ABL fusion gene
Chronic myelogenous leukemia (CML) is definitively characterized by a specific chromosomal translocation, t(9;22), which results in the formation of the Philadelphia chromosome. This translocation creates the BCR-ABL fusion gene, encoding a constitutively active tyrosine kinase. This abnormal kinase drives the uncontrolled proliferation of myeloid cells, which is the hallmark of CML.
ABPath Pathology MCQ 1
Which of the following is a common histologic feature of chronic inflammation?