Free Printable FM A/L 2020 - Formative Assessment

1.

The laboratory result that would be seen in a 20 year old patient diagnosed to have acute bacterial meningitis

prominent toxic granules in neutrophils in blood picture

a)

True

b)

False

2.

The laboratory result that would be seen in a 20-year-old patient diagnosed with acute bacterial meningitis

increased protein content in cerebrospinal fluid

a)

True

b)

False

3.

The laboratory result that would be seen in a 20-year-old patient diagnosed with acute bacterial meningitis

increased C-reactive protein levels in serum

a)

True

b)

False

4.

The laboratory result that would be seen in a 20-year-old patient diagnosed with acute bacterial meningitis

increased eosinophil count in peripheral blood

a)

True

b)

False

5.

The laboratory result that would be seen in a 20-year-old patient diagnosed with acute bacterial meningitis

increased lymphocyte count in peripheral blood

a)

True

b)

False

6.

In a 15 year old boy with acute septic arthritis, the swelling of the knee joint is due to:

Dilation of vessels in joint capsule

a)

True

b)

False

7.

In a 15 year old boy with acute septic arthritis, the swelling of the knee joint is due to:

Increased permeability of vessels in joint capsule

a)

Yes

b)

No

8.

In a 15 year old boy with acute septic arthritis, the swelling of the knee joint is due to:

Leakage from newly formed blood vessels in joint capsule

a)

True

b)

False

9.

In a 15 year old boy with acute septic arthritis, the swelling of the knee joint is due to:

Emigration of neutrophils in to joint space

a)

True

b)

False

10.

In a 15 year old boy with acute septic arthritis, the swelling of the knee joint is due to:

Lymphatic obstruction in joint capsule

a)

True

b)

False

11.

A patient develops a chronic non-healing wound on his left leg following a road traffic accident six months ago. He has been bed ridden from the date of the accident and has been taken to the operating theatre several times for wound cleaning.

A pathological change likely to be seen include:

atrophy of the skeletal muscle fibres adjacent to the wound

a)

True

b)

False

12.

A patient develops a chronic non-healing wound on his left leg following a road traffic accident six months ago. He has been bed ridden from the date of the accident and has been taken to the operating theatre several times for wound cleaning.

A pathological change likely to be seen include:

dysplastic changes in the squamous epithelium

a)

True

b)

False

13.

A patient develops a chronic non-healing wound on his left leg following a road traffic accident six months ago. He has been bed ridden from the date of the accident and has been taken to the operating theatre several times for wound cleaning.

A pathological change likely to be seen include:

fibrosis in the wall of the ulcer

a)

True

b)

False

14.

A patient develops a chronic non-healing wound on his left leg following a road traffic accident six months ago. He has been bed ridden from the date of the accident and has been taken to the operating theatre several times for wound cleaning.

A pathological change likely to be seen include:

hyperplasia of the squamous epithelium surrounding the wound

a)

True

b)

False

15.

A patient develops a chronic non-healing wound on his left leg following a road traffic accident six months ago. He has been bed ridden from the date of the accident and has been taken to the operating theatre several times for wound cleaning.

A pathological change likely to be seen include:

resolution at the centre of the ulcer base

a)

True

b)

False

16.

Chronic inflammation with organization can occur following multiple episodes of acute inflammation.

Chronic pyelonephritis in a patient with urinary tract infection is an example for that.

a)

True

b)

False

17.

Chronic inflammation with organization can occur following multiple episodes of acute inflammation.

Excess granulation tissue formation during healing of a surgical scars is an example for that.

a)

True

b)

False

18.

Chronic inflammation with organization can occur following multiple episodes of acute inflammation.

Foreign body granuloma reaction occurring around a piece of suture materialIs is an example of that.

a)

True

b)

False

19.

Chronic inflammation with organization can occur following multiple episodes of acute inflammation.

Lung abscess formation as a complication of lobar pneumonia is an example of that.

a)

True

b)

False

20.

Chronic inflammation with organization can occur following multiple episodes of acute inflammation.

Chronic cholecystitis in a patient who had acute episodes previously is an example for that.

a)

True

b)

False

21.

This feature of a tumour can be assessed by histology, but not by cytology examination:

Nuclear pleomorphisms of tumour cells

a)

True

b)

False

22.

This feature of a tumour can be assessed by histology, but not by cytology examination:

Extent of local invasion of a tumour

a)

True

b)

False

23.

This feature of a tumour can be assessed by histology, but not by cytology examination:

Immunohistochemical analysis of prognostic markers of a tumor

a)

True

b)

False

24.

This feature of a tumour can be assessed by histology, but not by cytology examination:

The count of the mitotic figures of a tumor

a)

True

b)

False

25.

This feature of a tumour can be assessed by histology, but not by cytology examination:

Capsular invasion by a tumour

a)

True

b)

False

26.

A previously healthy female suffered a fracture neck of femur following a motor-cycle accident. The fractured limb was immobilized and bed rest was ordered. On the 7^th day of her hospital stay she developed an acute pulmonary embolism.

Which of the following is the most likely cause for the embolus?

a)

Air embolism during the traffic accident

b)

Cholesterol embolism from an atherosclerotic plaque

c)

Fat embolism from the fracture of the femur

d)

Thromboembolism from a lower limb deep vein

e)

Thromboembolism from an intra-cardiac mural thrombus

27.

Supra-clavicular lymph node enlargement is seen in a patient with gastric adenocarcinoma.

From the items listed below, select the most appropriate reason for the given clinical presentation.

a)

Lymphatic spread of gastric tumour

b)

Haematogenous spread of gastric tumour of

c)

Local infiltration of gastric tumour

d)

Paraneoplastic effect of the gastric tumour

e)

Trans coelomic spread of the gastric tumour

28.

A 65 year old man with a past history of prostatic adenocarcinoma presents with severe back pain. X ray of the spine shows sclerotic lesions in vertebral bodies suggestive of carcinoma metastasis.

Which of the following is the most likely route of spread of the prostatic adenocarcinoma to vertebral body ?

a)

Local infiltration of tumour posteriorly

b)

Perineural spread along spinal nerve roots

c)

Retrograde venous spread through paraveretebral venous plexus

d)

Spread along the spinal canal

e)

Systemic haematogenous spread

29.

A patient with small cell carcinoma of lung presents with Cushing’s syndrome. From the items listed below, select the most appropriate explanation for the given clinical presentation.

a)

Local infiltration to adrenal

b)

Endogenous hormone secretion

c)

Haematogenous spread to adrenal

d)

Paraneoplastic effect

e)

Pressure effects on adrenal

30.

A patient with pancreatic adenocarcinoma has features of obstructive jaundice. From the items listed below, select the most likely reasons for the given clinical presentation.

a)

Local pressure effects on CBD

b)

Bleeding into the tumour

c)

Enzyme secretion by the tumour

d)

Haematogenous spread to liver

e)

Local infiltration to CBD

31.

The following are features of irreversible cell injury.

Select all correct answers.

a)

Fatty change

b)

Degradation of lysosomes

c)

Cytoplasmic vacuole formation

d)

ATP depletion

e)

Nuclear pyknosis

32.

Select all correct answers.

Dysplasia differs from metaplasia by having

a)

Rapid cell proliferation

b)

Nuclear abnormalities

c)

Premalignant potential

d)

Reversibility

e)

Nuclear enlargement

33.

A surgeon requires an intra-operative assessment of a sentinel lymph node excision in a breast cancer patient.

As the histopathologist of the laboratory, what is the best action you could take?

a)

A. Perform routine processing and issue a histology report

b)

B. Assess macroscopic appearance of the lymph node and provide a report

c)

C. Perform a frozen section of the lymph node and issue a report

d)

D. Perform imprint smears for cytology and provide results

e)

E. Aspirate some cells for cytology from the node

34.

Which of the following is the most likely histological feature mediated via alternatively activated macrophages?

a)

A. Focal collection of neutrophils in the dermis

b)

B. Fibrosis of the deep dermis

c)

C. Perivascular heavy chronic inflammatory cell infiltration

d)

D.Macrophages laden with debris

e)

E.Ulceration of the epidermis

35.

A 30-year-old female presents with a slow-growing painless lump on the right index finger for one-month duration. She gives a history of minor surgery at the same site two months back lump is resected, and the histology shows an ill-defined lesion in the deep dermis containing sheets of histiocytes admixed with lymphocytes and a few scattered neutrophils. There are aggregates of histiocytes with foreign body type multinucleated giant cells.

Which of the following process best explains the underlying pathology of this lesion?

a)

A. Acute on chronic inflammation

b)

B. Immune granulomatous inflammation .

c)

C. Non-immune granulomatous inflammation

d)

D. Non-specific chronic inflammation

e)

E.Granulation tissue formation

36.

A 55-year-old female presented with a right sided pleural effusion and past history of breast and ovarian cancers. She underwent a pleural tap and 10 ml of pleural fluid was aspirated. What is the most appropriate step you would take with regard to pleural fluid?

a)

A. send pleural fluid for cytology

b)

B. send to genetic lab to perform TB PCR

c)

C. send for pleural fluid full report

d)

D. discard the fluid

e)

E. aspirate a larger volume for investigations

FM A/L 2020 - Formative Assessment

Total questions: 36

Worksheet time: 28mins

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