FIRST MCQ TEST ANSWER - PART III

11. Pick the wrong statement

a.       Hyperemia is due to increased blood flow

b.      Congested tissues are bright red in appearance

c.       Periorbital edema is usually due to renal failure

Hyperemia in a tissue is due to increased active inflow of blood from the arteries. So oxygenated blood accumulates in the tissue and the tissue appears bright red in colour (erythema).

 Congestion is due to decreased outflow of blood from tissue in veins. So more venous blood (deoxygenated blood) accumulates in the tissue. Because the blood is deoxygenated, blood is reddish-BLUE in colour (cyanosis)

So option B is the wrong statement

12. False about red infarcts

a.       Occurs in loose tissues

b.      Occurs in tissues with dual circulation

c.       Occurs with arterial occlusion

First two statements are right. But the third statement is wrong. Arterial occlusion causes white infarcts. Red infarcts are seen in venous occlusion

13. What is a saddle embolus?

a.       Saddle shaped emboli

b.      Emboli in the saddle area of liver

c.       Emboli in bifurcation of pulmonary vein

d.      None of the above

Option D is the correct answer

14. Antiphospholipid antibody syndrome does not show

a.       Recurrent abortions

b.      Repeated thrombosis

c.       Reduced prothrombin time

d.      Pulmonary hypertension

Antiphospholipid antibody syndrome is an autoimmune disorder where antibodies are produced against our own body proteins and phospholipids. This disorder is common in young females and shows recurrent abortions, repeated thrombosis, pulmonary hypertension etc. So options A, B,D are correct.

Prothrombin time (PT) and Partial thromboplastin time (PTT) are tests for coagulation i.e time taken for clot formation.  
Prothrombin time tests the extrinsic pathway of coagulation whereas PTT tests the intrinsic pathway of coagulation.

As i said, these tests basically measure the time taken for clot formation. So by simple logic, u tend to think that in thrombotic disorders like Antiphospholipid antibody syndrome coagulation occurs easily and time taken for clot formation will be less. But that doesnt happen in Antiphospholipid antibody syndrome. Coagulation tests are actually prolonged in this disorder, particularly PTT.

15. Pick the right answer

a.       Postmortem thrombi show lines of zahn

b.      Arterial thrombi progress in retrograde direction

c.       Arterial thrombi show chicken fat appearance

d.      Postmortem thrombi are attached to blood vessel

Differences between antemortem and postmortem thrombi is an important question. So dont forget to read that. If u make a tabular column and read it will be easy.

Among the options here, only B is correct. All thrombi whether arterial or venous progress towards heart.
So venous thrombi spread in a forward direction in the direction of blood flow itself towards the heart.
Arterial thrombi also move towards the heart, that is in a direction opposite to their normal blood flow. (arteries normally take blood away from heart). so arterial thrombi spread is called retrograde spread.

Options A, B and D are wrong.

Antemortem thrombi shows lines of zahn and is attached to blood vessel. These features are not seen in postmortem thrombi. So options A and D are wrong.

Postmortem thrombi shows chicken-fat appearance but not antemortem thrombi. So option C is also wrong

FIRST MCQ TEST ANSWER - PART II

6. Microscopic appearance of chronic venous congestion of liver:

a.       Periportal necrosis

b.      Centilobular necrosis

c.       Bridging necrosis

d.      All the above

 Blood supply to the liver is from hepatic artery and portal vein which are located in the portal triad. The centrilobular region, because it is far away from the portal triad receives less oxygen supply than the periportal region which is near to the portal triad and receives more oxygen supply.

During chronic venous congestion (CVC) there is accumulation of venous blood. Since the venous blood is deoxygenated liver undergoes hypoxic injury. The centrilobular region which normally itself receives less oxygen supply is more affected now and undergoes necrosis. Thus centrilobular necrosis occurs in chronic venous congestion of liver.

During CVC, the periportal region also undergoes hypoxic injury because of accumulation of venous blood. However since the periportal region is close to hepatic artery it receives some oxygen, escapes from necrosis but undergoes fatty change alone. 

So the correct answer is option B

7. Which among the following tissues is more prone for infarction?

a.       Lung

b.      Kidney

c.       Liver

d.      Forearm

 Lung, liver and forearm have dual blood supply. (Find out how and enter the answer in comments box) . so even if one blood supply is blocked the other will still supply blood and the organ will survive. However kidney has blood supply only from renal artery. Because of the single blood supply kidney is more prone for infarction.

So the correct answer is option B

8. The most common organisms that cause septic shock is

a.       Gram positive bacteria

b.      Gram negative bacteria

c.       Fungi

d.      Parasites

 The correct answer is option A - gram positive bacteria

9. Chokes and bends are associated with

a.       Fat embolism

b.      Air embolism

c.       Marrow embolism

d.      Amniotic fluid embolism

 The correct answer is option B - Air embolism

10. Primary hemostasis is

a.       The conversion of fibrin to fibrinogen

b.      The conversion of fibrinogen to fibrin

c.       The formation of platelet plug

d.      None of the above

 The correct answer is option C - the formation of platelet plug. This has already been explained in MCQ answers - Part 1.
 

MCQ TEST ANSWERS - PART I

I am providing the answers of questions asked in MCQ test. If you have not done the test so far, first write the test, send the answers to me and then see these correct answers

LEVEL ONE

1.Which among the following does not cause edema?

a.       Increased hydrostatic pressure

b.      Increased protein in blood

c.       Lymphatic obstruction

d.      Inflammation

Question 1:
 Hydrostatic pressure is because of the fluid component of blood. It tries to push the fluid out of the vessels.
 So increase in hydrostatic pressure will push more fluid out of the vessel. Hence more fluid will accumulate in the interstitium resulting in edema.

Osmotic pressure (Oncotic pressure) is due to the solutes like protein in the blood. Osmotic pressure tends to pull the blood back into the blood vessels.. 
If protein level increases in blood, osmotic pressure will also increase. so more blood will be pulled back into the blood vessel from interstitium. Fluid in interstitium will become less. Hence there is no edema.

Normally lymphatics remove whatever fluid is collected in interstitium. So if lymphatics are blocked, fluid cannot be removed from interstitium. Hence more fluid accumulates in interstitium resulting in edema.

Inflammation is associated with an increase in vascular permeability. Hence more fluid accumulates in the interstitium resulting in edema.

So the right answer is OPTION B.


2. Which is not a clinical manifestation of shock?

a.       Hypotension

b.      Weak pulse

c.       Bradycardia

d.      Cool skin

Direct answer. Refer to the clinical consequences of shock in your text book. Shock is associated with hypotension, weak pulse and cool skin.

To compensate for the hypotension heart rate will increase. Hence tachycardia is usually seen in shock and not bradycardia. Hence option C is the answer.

3. Which among the following leads to prolonged prothrombin time?

a.       Factor VIII deficiency

b.      Factor IX deficiency

c.       Factor VII deficiency 

Prothrombin time is an investigation used to assess the extrinsic pathway. It is prolonged if there is deficiency of a factor involved in extrinsic pathway. Of the given options, only Factor VII belongs to extrinsic pathway. Hence that is the answer.

4.Arrange the following events in the correct order of their occurrence

1) Platelet aggregation

2) Platelet adhesion

3) Clot formation

4) vasoconstriction

a.       1,2,3,4

b.      2,1,3,4

c.       4,1,2,3

d.      4,2,1,3

After injury to a vessel, an initial vasoconstriction happens so that less blood is lost. This is followed by two steps, primary hemostasis and secondary hemostasis. 

Primary hemostasis is nothing but the formation of a platelet plug which plugs the injured site in the vessel. Primary hemostasis involves two substeps.
1. Platelet adheres to the vessel wall at the site of injury (Platelet adhesion)
2. After platelet adhesion to the vessel wall, numerous platelets aggregate together so that the injured site is completely sealed (platelet aggregation)

But the platelet plug is not strong enough to last for a long time.  A clot has to be formed to seal the injured site permanently. So coagulation system is activated resulting in clot formation. This step is called secondary hemostasis.

So the order of events is vasoconstriction followed by platelet adhesion, next platelet aggregation and then clot formation. Option D is the right answer

5. Which among the following is not a hypercoagulable state?

a.       Oral contraceptive use

b.      Cancer

c.       Exercise

Obviously answer C is the right answer. you can refer the table of hypercoagulable states in your textbook

MCQ TEST REMINDER - IMPORTANT

Dear students, Thanks for the wonderful response.. There were 819 pageviews yesterday.. As i am repeatedly saying, these exercises are to train you for the future exams.. So nothing to worry even if u had done badly.. PREPARE THE CORRECT ANSWERS FOR YESTERDAY'S TEST BY REFERRING ROBBINS AND SEND TO ME TODAY ITSELF. OTHERWISE WE WILL NEITHER GIVE YOU THE RIGH ANSWERS NOR TELL THE MARKS. That is important..Half-reading is equal to zero.. So prepare the answers..

Also need suggestions for the next MCQ test.. Subject and chapter is of your choice.. Test date also you decide keeping in mind Christmas,, I dont want to disturb people celebrating it.. Should keep the test either two days before or after Christmas.. All of you pls give your suggestions in the comments box.. Some students have asked for genetics..

Also i want to know how many of you are following our blog. So pls submit your email id in the box FOLLOW BY E-MAIL (given in home page on the right side). You will also receive alerts regularly..

PATHOLOGY MCQ TEST

PATHOLOGY MCQ TEST QUESTIONS WILL BE DISPLAYED IN THIS BLOG ON MONDAY, 17th DECEMBER.

•  Portion - Hemodynamic disorders (Read both Robbins & Harshmohan)
•  Time - 6pm
•  How to answer -Enter your answers in comments box along with question number. Submit the comment (answer) before 6.30 pm..
• Follow up - after submitting the answers at 6.30 pm, go through the book, find the answers and resubmit the correct answer within 24 hrs (18th December , 6 pm). THIS IS A MUST
• Results - 18th DECEMBER 6.00 pm after submission of correct answers