Pathophysiology-MCQ PDF

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Pathophysiology MCQ1. Cerebrovascular accidents (CVA) are:a) unilateral neurological deficits that slowly resolveb) generalised neurological deficits that clear in 24 hours c) sudden focal neurological deficits, lasting for several minutes only.d) neurological deficits that slowly evolve and which c...

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Pathophysiology MCQ 1. Cerebrovascular accidents (CVA) are: a) unilateral neurological deficits that slowly resolve b) c) d) e)

generalised neurological deficits that clear in 24 hours sudden focal neurological deficits, lasting for several minutes only. neurological deficits that slowly evolve and which can develop into CVA. sudden focal neurological deficits lasting for longer than 24 hours.

2. confirmed by presence of blood in cerebrospinal fluid (CSF). a) transient ischaemic attack (TIA) b) lacunar infarcts c) thrombotic stroke d) haemorrhagic stroke e) petechial haemorrhage 3. Following head injury, this is a positive sign of transtentorial herniation. a) frontal headache b) swelling of the head at the site of injury c) increased pulse and respiratory rate d) unequal pupillary reflex and decreasing level of consciousness e) decreased blood pressure and increased pulse 4. Structural changes in the brain in Alzheimer's disease are due to: a) deposition of amyloid plaques and neurofibrillary tangles b) degeneration of the basal ganglia c) hypertrophy of the frontal lobe neurons d) demyelination of the central nervous system e) degeneration of dopamine receptors 5. Which of these definitions describe Multiple Sclerosis? a) disorder involving destruction of the myelin sheath predominantly in the in the white matter of the CNS b) resting tremor, muscle stiffness, akinesia, forward leaning posture c) degenerative disease of the basal ganglia involving failure of the dopaminergic nigrostriatal pathway d) hereditary, degenerative disorder involving the basal ganglia and cerebral cortex featuring involuntary movements (chorea) e) weakness in all muscles of the body but with normal intellect and sensory functions.

6. Bill has an injury of the cervical spinal cord. Cord swelling in this region may be life-threatening because: a) increased intracranial pressure may occur b) reflexes may be disrupted c) diaphragmatic function may be impaired d) bladder emptying will not occur e) decreased intracranial pressure may occur

7. Osteogenesis imperfecta is characterised by all of the following features EXCEPT: a) bone fragility and susceptibility to multiple #s b) ocular changes affecting the sclera c) hearing loss which may lead to profound deafness. d) dentinogenesis imperfecta. e) increased bone density & lack of funnelisation

8. Factors contributing to the cause of rheumatoid arthritis are all of the following EXCEPT: a) hormone-related (decreased during pregnancy and increased after childbirth) b) conversion of normal antibodies to autoantibodies c) seasonal variations: worse in hot climates d) infectious microbes such as bacteria, mycoplasmas & viruses e) long term smoking 9. Nodules invading various systems of the body e.g. heart, lungs, spleen are characteristic of this skeletal condition: a) rheumatoid arthritis b) osteoarthritis c) ankylosing spondylitis d) osteoporosis e) osteopetrosis 10. Which of the following definitions describe Paget's Disease? a) symmetric inflammation of the joints with formation of a pannus b) also known as osteitis deformans, featuring disordered bone modelling c) seronegative arthropathy with fusion of the spine and sacro-iliac joints d) malignant destructive tumour often found in the bone marrow e) degenerative changes in the articular cartilage with cyst and osteophyte formation 11. All of the following features are seen in osteoarthritis except: a) bony spurs b) destruction of the synovial membrane with pannus formation c) fissuring of the articular cartilage d) presence of subchondral bone cysts e) fragments of articular cartilage in joint space

12. Which of these definitions describe osteopetrosis? a) reduction in bone mass resulting in increased porosity of skeleton b) inheritable disorder of connective tissue which affects the skeleton, joints, ears, ligaments, teeth, sclerae and skin. c) slow progressive degeneration of the articular cartilage d) chronic condition of disordered bone remodelling e) autosomal recessive disorder featuring increased bone density and lack of funnelisation.

13. Ankylosing spondylitis: 1) is a systemic immune inflammatory disease 2) is characterised by stiffening or fusion of the spine 3) causes instability of synovial joints 4) begins with inflammation of fibrocartilage 5) is manifested early by low back pain and stiffness. a) 1,2 b) 1,2,5 c) 2,5 d) 1,2,4,5 e) 3,4,5

14. In reversible cell injury, all of the following occur except: a) reduction in the activity of the ATP-driven sodium pump b) detachment of the ribosomes and reduction of protein synthesis c) leakage of lysosomal enzymes and autodigestion d) net gain of sodium intracellularly e) increase in intracellular calcium

15. Components of the complement system play a role in the inflammatory process by: 1) acting as chemotactic agents 2) enhancing inflarnmation 3) promoting haemostasis 4) ingesting bacteria 5) boring holes in target cells a) 1,3

b) 1,2and5 c) 3,4 d) 2,3, and 4 e) 4 only 16. Excessive secretion of hGH (growth hormone) in an adult may cause:

a) b) c) d) e)

acromegaly giantism dwarfism myxoedema decreased metabolic rate

17. What is the most common cause of acromegaly? a) overproduction of human growth hormone (hGH) b) overproduction of adrenocorticotrophic hormone (ACTH) c) overproduction of thyroid stimulation hormone (TSH) d) underproduction of human growth hormone (hGH) e) underproduction of adrenocorticotrophic hormone (ACTH)

18. When the body produces antibodies against its own tissue, it is alan: a) hypersensitivity b) cell-mediated immunity c) autoirrlmune disease d) antibody reaction e) opsonization

19. Characteristics of unwanted or inappropriate immune response are all EXCEPT: a) the body's immune system responds against own components b) it is antibody or cell-mediated c) normal mechanisms break down d) it has a genetic or microbial trigger e) the immune protective role is amplified to the point of damage occurring

20. The complication most likely to occur with an open fracture is: a) peripheral nerve loss b) osteomyelitis c) anaemia from blood loss d) skin atrophy e) bone atrophy 21. Compartment syndromes: a) involve large compartments of haemorrhage b) bleed into joints c) lead to ischaemic contracture in muscles d) may lead from myoglobinuria e) both b and c are correct

22. While skiing, the tip of John's right ski became lodged in a snowbank and his ski twisted around until his right tibia was 'fractured. The most likely fracture he sustained was: a) transverse b) oblique c) comminuted

d) segmental e) spiral

23. Mrs. Aguardo is admitted to the hospital with a compound, oblique 'fracture of the femur. Which of the following is true? a) the fracture line runs parallel to the bone b) the fracture line runs diagonally to the shaft of the bone c) the fracture line runs perpendicular to the bone d) the fracture line runs vertically to the shaft of the bone e) none of the above are correct.

24. fractures usually occur in individuals who engage in a new activity that is both strenuous and repetitive. a) oblique b) fatigue/stress c) greenstick d) compound e) spiral 25. Myasthenia Gravis is defined as: a) a disease caused by an infection which spreads from bone to adjacent soft tissues. b) a disease caused by an infection entering from outside which spreads from soft tissues into adjacent bone. c) Relapsing, remitting neuromuscular disorder featuring generalised weakness and fatiguability of muscles d) leakage of potentially toxic cellular contents into systemic circulation e) bone formation within muscle at site of haematoma 26. Crepitus indicates the presence of a fracture. It describes: a) massive blood loss b) sound generated by the rubbing of fracture fragn1ents together c) broken tissue in the area of the fracture d) an accompanying dislocation e) pain and swelling at the fracture site 27. Coronary artery disease can diminish the myocardial blood supply until deprivation impairs myocardial metabolism a) myocardial ischaemia b) myocardial infarction c) pulmonary embolism d) musculoskeletal strain e) overexertion 28. The possible cause/s of varicose veins are all of the following EXCEPT: a) crossing legs at the knees b) long periods of standing c) long periods of sitting

d) constricting garments e) none of the above

29. Of the following risk factors for coronary artery disease, which is the most predictive of the disease? a) diabetes mellitus b) obesity c) hypertension d) high alcohol consumption e) smoking 30. The presence of ischaemia is characterised by all of the following EXCEPT: a) calor b) pulselessness c) pallor d) paralysis e) pain 31. Serum cardiac enzymes are done on patients with recent myocardial infarction to determine the: a) location of necrotic tissue in the myocardium b) degree of cardiac irritability c) electrical potential of cardiac muscle d) intensity of myocardial oxygen demand e) presence of myocardial damage 32. Left-sided heart failure initially may lead to: a) increased coronary artery perfusion b) pulmonary emboli c) increased peripheral resistance d) pulmonary oedema e) ankle oedema

33. Right heart failure initiated by a chronic pulmonary disorder is called: a) congestive heart failure b) restrictive heart failure c) high output heart failure d) cor pulmonale e) low output heart failure 34. Clinical manifestations that characterize asthma include both: a) barrel chest appearance and bronchodilation b) inspiratory wheeze and dyspnoea c) expiratory wheeze and dyspnoea

d) expiratory wheeze and anaemia e) inspiratory wheeze and anaemia

34. This clinical feature indicates that patient has severe asthma: a) ability to talk in phrases; pulse 100-200 beats per minute b) ability to talk in sentences c) loud wheezing d) silent chest e) moderate wheezing 35. Polycythaemia in "blue-bloater' bronchitis is due to: a) early destruction of red blood cells (RBCs) b) the affected individuals having 'pink complexion' and are puffing. c) oversupply of defective RBCs that carry oxygen in small amounts d) loss of blood volume secondary to dehydration e) overproduction of red blood cells stimulated by chronic hypoxia 36. A pulmonary embolus typically occurs when: a) thrombus breaks loose from the coronary arteries and occludes the pulmonary venous system b) blood clot detaches itself from a deep venous thrombosis and lodges in the pulmonary venous system. c) fat emboli develop secondary to a bone fracture and lodge in alveolar bronchioles d) blood clot detaches itself from a deep venous thronlbosis and lodges in the pulmonary arterial system e) mural thrombus in the left ventricle of the heart breaks off. 37. Cystic fibrosis is characterized by: 1. changes in electrolyte composition of perspiration 2. dysfunction of exocrine glands 3. thickened mucous secretions of the bronchioles 4. fibrotic changes in the lungs and pancreas a) 1,2,3 b) 1,3 c) 2,4 d) 1,2,3,4 e) 4

38. A person with inflammatory polyarthritis is found to have high level of anti-dsDNA in blood. This strongly indicates the possibility of A. polymyositis B. SLE C. Paget's disease D. reactive arthritis E. gouty arthritis

39. Which of the following statements about berry aneurysms in the brain is not true? A. when rupture they cause intracerebral haematoma B. following rupture there is sudden onset headache C. they are usually asymptomatic for many years D. following rupture, blood appears in the subarachnoid space E. they usually develop at points of bifurcation in the circle of Willis

40. A 70-year-old female with osteoporosis fractures her leg at a location of pre-existing abnormality. She reports that the fracture occurred following a minor fall. Which of the following best describes the fracture? A. pathological fracture B. complicated fracture C. iatrogenic fracture D. greenstick fracture

E. idiopathic fracture

41. A 50-year-old male is diagnosed with pulmonary embolism. Which of the following symptoms were the most likely on his arrival to hospital? A. copious mucopurulent sputum B. shallow respirations and wheezing C. barrel chest and reduced respiratory rate D. dry cough and inspiratory crackles E. chest pain and tachypnoea

42.The most common primary intracerebral CNS tumour in adults is A. angioma B. medulloblastomas C. astrocytoma D. meningioma E. neuroma

43.Lung infarction is not very common during pulmonary embolism because of A. reduced venous return in such event B. compensatory vasodilation in hypoperfused area C. compensatory reduction in right ventricular output D. lung tissue also receiving blood from bronchial arteries E. compensatory increase in left ventricular output

44. A 33-year-old male is brought to emergency for treatment of injuries received in a motor vehicle accident. An MRI reveals an injury of the cervical cord. Cord injury and swelling in this region may be life threatening because A. increased intracranial pressure may occur B. bladder emptying will not occur C. respiratory muscles function may be impaired D. somatomotor reflexes will be disrupted E. heart will not receive sympathetic stimulation

45. Why does vomiting occur in a patient who has increased intracranial pressure?

A. stimulation of the hypothalamic centre for hunger B. pressure on the emetic centre in the medulla C. pressure extending to spinal nerves controlling swallowing D. chemoreceptors responding to changes in the blood flow E. reduced blood flow to the GIT

46. Which of the following is a true statement about transient ischemic attacks? A. they may be caused by rupture of a cerebral aneurysm B. they produce transient demyelination in the CNS C. they usually cause diffuse axonal injury D. they only occur in people with marked hypertension E. they can warn of potential cerebrovascular accidents

47. How is the articular cartilage damaged in rheumatoid arthritis? A. blood supply to the cartilage is lost B. deposition of toxic immune complexes in the cartilage C. blood clotting occurring in the cartilage D. by enzymes released from leukocytes and synovial cells E. immune system directly attacking chrondrocytes

48. Which of the following is true about Duchenne’s muscular dystrophy?

A. it is caused by genetic absence of nicotinic receptors at neuromuscular junctions B. it involves only muscle of legs and pelvis C. it can be diagnosed with anticholinesterase test D. there is difficulty climbing stairs or standing up at 2 to 3 years of age E. it can only be inherited if one parent has Duchenne’s dystrophy

49. What limits joint movement in osteoarthritis?

A. wider joint space B. significant swelling of joint capsule C. fibrosis involving the joint ligaments D. osteophytes and irregular cartilage surface

E. decreased amount of synovial fluid in the cavity

50.What is a common adverse effect of long-term use of glucocorticoids to treat rheumatoid arthritis?

A. hypotension B. skin allergy C. osteoporosis D. weight loss E. aplastic anaemia

51. Which of the following describes lobar pneumonia best?

A. sudden onset of fever and chills, coughing and rusty sputum B. dyspnoea, wheezing, indrawing of intercostal spaces C. slow development of malaise, anorexia, weight loss and low grade fever D. barking cough, hoarseness of voice, inspiratory stridor, dyspnoea E. insidious onset, mild fever, dry cough

52. All of the following can occur in Duchene muscular dystrophy except

A. delayed relaxation of muscles after contraction B. cardiomyopathy C. enlargement of calf and deltoid muscles D. elevated CK level in blood E. muscle contractures in the heels

53. When does secondary tuberculosis with tissue destruction occur? A. when Ghon complexes form in the lungs B. when type I hypersensitivity reaction develops in response to M.tuberculosis C. when there is prolonged exposure to cigarette smoke D. when a person become immunocompromised for some reason E. when the BCG vaccine is not administered immediately following exposure to the microbe

54. Which of the following is the most likely in a patient presenting with fatigue and haemoptysis? A. hyperventilation B. pneumothorax C. atypical pneumonia

D. secondary tuberculosis E. serious asthmatic episode

55. Where does inflammation usually begin in an individual with ankylosing spondylitis? A. hips first and then thoracic spine B. peripheral joints and then proceeds to the vertebrae C. sacroiliac joints with progression up the spine D. costovertebral joints with progression down the spine E. cervical and thoracic vertebrae, causing kyphosis

56. Which of the following is unlikely cause of embolic cerebral infarction? A. thrombosis in common carotid artery B. aortic arch atherosclerosis/thrombosis C. deep leg vein thrombosis D. mural thrombus in the left ventricle E. left atrial thrombosis

57. Paroxysmal nocturnal dyspnoea A. is highly suggestive of lung cancer B. occurs in association with tuberculosis C. is a manifestation of pulmonary fibrosis D. is a typical symptom of obstructive lung disease

E. generally accompanies pulmonary oedema

58. What is the distinguishing feature of primary fibromyalgia syndrome? A. specific trigger points for pain and tenderness B. degeneration and atrophy of skeletal muscles C. joint pain throughout the body D. autoimmunity targeting connective tissue E. marked inflammatory process affecting skeletal muscles

59. Classic amyotrophic lateral sclerosis presents with A. paresthesia and hypoesthesia B. progressive dementia and behavioural changes C. recurrent visual hallucinations D. autonomic dysfunction E. muscle weakness and atrophy

60. The inflammation surrounding a fracture site during the first few days may complicate healing by causing A. ischeamia and tissue necrosis B. formation of a cartilage scar C. transformation of osteocytes to fibroblasts D. excessive bone movement E. increased proliferation of osteoblasts

61. A person who suffered mild concussion would typically present with A. vomiting without nausea B. a brief loss of consciousness C. significant behavioural changes D. gradually increasing headache E. retrograde amnesia

62. A 23-year-old female begins having problems with tiredness, weakness and visual changes. Her diagnosis is multiple sclerosis. The main abnormality is A. demyelination of axon tracts in the CNS B. loss of motor neurons in anterior horns of spinal cord C. reduced activity of acetylcholine at the neuromuscular junctions D. depletion of dopamine in the CNS E. formation of amyloid plaques and neurofibrillary tangles

63. A patient is experiencing respiratory failure. Which of the following lab values would be expected? A. low haematocrit B. anaemia C. reduced blood pH D. low PaCO2 E. hypoproteinaemia

64. A person presented with low back pain spreading along the distribution of S1 spinal nerve on the left. Which of the following statements is most likely to be correct? A. he is showing early manifestations of Brown-Sequard's syndrome B. he probably has a lesion of the spinothalamic tract on the opposite side C. this is to be expected in early stage of ankylosing spondylitis D. he most likely has diabetic neuropathy E. he is likely to show weakness of plantar flexion

65. Pulse oximetry has shown 90%. Which of the following conditions is unlikely? A. widespread bronchopneumonia B. significant pulmonary embolism C. pulmonary oedema D. serious anaemia E. status asthmaticus

66. A one-year-old child is diagnosed with croup. Which of the following symptoms is most likely present? A. high fever and occasional dry cough B. respiratory stridor and barking cough C. pleuritic chest pain D. haemoptysis and mucous production E. fatigue and weight loss

67. A massive pulmonary emb...