Which of the following best explains the meaning of cretinism?

(a) Is a hyperthyroidism in children and infancy

(b) Is a hypothyroidism in children and infancy

(c) Is a dietary iodine deficiency and thyroxine hormone

(d) Is excessive production of T3 and T4 hormones

(e) Is also called Hashimoto’s thyroiditis


2. The risk factor for developing cervical intra-epithelial neoplasm is

(a) Monogamy

(b) Late age at first intercourse

(c) Multiple sexual partners

(d) Excessive alcoholism

(e) Female genital mutilation





3. The endometriosis is well defined as

(a) Inflammation of endometrial layer

(b) Endometrial mass within the uterus

(c) Endometrial tissues outside endomyometrium

(d) Is the early stage of cervical intra-epithelial neoplasm stage iii

(e) Is also known as endometrial hyperplasia


4. Fournier’s Gangrene  best matches with the following statement

(a) necrotizing infection or gangrene usually affecting the perineum

(b) is the neoplasm of the penile meatus

(c) it is caused by aerobic type of bacteria

(d) necrotizing fasciitis of the anterior abdomen

(e) This is accumulations of blood the tunica vaginalis


5. The pathophysiology of  septic shock is accounted by the following statement

A. Sepsis leads to vasoconstriction of the blood vessel endothelial pores

B. Sepsis leads to bursting of mast cells releasing leukotriene cytokines

C. Sepsis leads to vasodilatation of the blood vessel endothelial pores

D. Sepsis leads to the binding of immunoglobulin E to the  mast cells

E. Sepsis leads to inability of the cardiac muscles to contract well


6. Which of the following is the function of the insulin

A. Accelerates lipolysis

B. Inhibit uptake of amino acids by the cells

C. Accelerate glycogenolysis

D. Increases digestion and gluconeogenesis

E. Accelerate uptake of amino acids by the cells


7. A 45yrs man who is a smoker reported at the health center complaining of recurrent irritant cough, on and off for the past 3years, each episode of cough last two to three month. What is the most likely diagnosis:

(a) Recurrent Respiratory tract infection

(b) Pulmonary tuberculosis

(c) Chronic bronchitis

(d) chronic bronchiectasis

(e) Acute bronchitis


8.  Regarding carcinoma of the prostate, the following statement is true

(a) Less than 50% of men above 80 years have asymptomatic (latent) carcinomas of prostate.

(b) Occult carcinoma  is the type in which the patient has symptoms of prostatic carcinoma but shows evidence of metastases on clinical examination and investigations

(c) Androgens are considered essential development prostatic cancer

(d) Excessive alcoholism and Cigarrate smoking is a direct cause

(e) The Aetiology is human papilloma virus type 8


9. A 17yrs old boy while playing with his fellow friends after school hours, he sustained a wide cut wound on the lateral distal one third of the leg, after 12hrs he was sent to the hospital for treatment. His wound healing will be by

(a)  Primary intention

(b)  Delayed primary intention

(c) Secondary intention

(d) Delayed secondary intension

(e)  Proper apposition of wound roof


10. Mwanaheri has received several drips of 5% dextrose following her history of frequent hypoglycemia, but still her blood glucose is low, on laboratory hormonal assay study showed that she has low level of cortisol hormone, she is likely to have? 
a) cretinism
b) diabetes mellitus
c) Cushing syndrome
d) Addison’s disease 
e) Grave’s disease











Ø Write the word “(TRUE)” for a true statement(s) and “( FALSE)” for a wrong statements(s) on the space provided


1.   With respect to hypersensitivity reaction

A. …F…When the antibodies bind to a fixed cell surface antigen is hypersensitivity type I

B. …F…When environmental antigen activate CD4 to cause IgE to bind mast cell is called hypersensitivity type ii

C.  …T… When environmental antigen binds to antibody to form complex is hypersensitivity type iii

D.  …T…… When T lymphocytes causes tissue injury is called hypersensitivity type iv

E. …T…….can lead to irreversible dilatation of the bronchial wall and necrosis






2. Fatty streaks found in a certain blood vessel, the following isn’t  a correct statement

A. -----F------- they occur commonly in childhood

B. ------F----  they may be precursor lesions to atherosclerotic plaques

C. -----T-----  they are composed of large number of fibrous cap and intracellular lipids

D. -----T-----  they are found in the thoracic aorta of the children

E. ----F-----  they tend to occur in both male and females


3. An 18 years old student sustained an injury on the proximal a half of the right leg 3hours ago, what would you expect to find on her right leg?

A. --------F------- non tender  and hot per injured sites

B. -----T--------  tender and loss of function to the injured sites

C. ----F------- red , tender and functional injured sites

D. ----T------ swollen, red, tender and very hot per injured sites

E. ------F----  edematous, red, tender and hot per injured sites

4.   Concerning the thrombosis and embolism

A. ……T……Massive proteinuria causes thrombosis

B. ……F……..Trauma is a not a risk factor for thrombosis

C. ……T…….Mural thrombi is the one occurring in heart lumen

D. ……T………Thrombi in heart valves are called vegetations

E. ……T………. Cerebral embolism is the leading cause of stroke






SECTION C:  MATCHING ITEM QUESTIONS                                 (10 marks)


1. Match the lettered item from column B to the numbered in column A, Each Item to be used once.






A. Decreased of all cell lines

ii)……C….   Cytopathology


B. Dissemination of malignant tumour



C. Study of cells shade off from lesion

iv)……B…..    Metastasis


D. Events in response to tissue injury

v)……A……aplastic anaemia


E. Study of tissues removed from living body


F. Increased of all cell lines

G. Is the new mass which is anaplastic

H. Localized new mass at the site of origin








           (i)………E….megaloblastic anaemia


A. Abnormal dilatation of blood vessel

           (ii)……C……acute reticulocytosis



B. A new growth around a blood vessel




C. Indicate hemorrhagic anaemia




D. Circumscribed tiny lesion about 1mm


          (v)………F……cause of spinal injury


E. Lack of folic acid or vitamin B12


F. Lack of iron from the body


G. Circumscribed tiny lesion about 1cm

H. Indicate chronic anaemia



SECTION   D.  SHORT ANSWERS QUESTIONS                                           (40 MARKS)



1. List the five causes of cell injury

a. Oxygen deprivation 

b. Chemical agents

c. Infectious agents

d. Immunologic reactions

e. Genetic defects


2. Enumerate the five roles of the extracellular matrix


Ø Mechanical support for cell anchorage, cell migration, and maintenance of cell polarity.

Ø Control of cell growth.

Ø ECM components can regulate cell proliferation by signaling through cellular receptors of the integrin family.

Ø Maintenance of cell differentiation.

Ø  Storage and presentation of regulatory molecules. For example, growth factors like FGF and HGF are excreted and stored in the ECM in some tissues.

Ø Scaffolding for tissue renewal.

Ø The maintenance of normal tissue structure requires a basement membrane or stromal scaffold.






3. Mention the five causes of extrahepatic obstructive jaundice

a. Gall stone in large bile duct

b. Tumour compressing the billiary flow

c. Pancreatic cancer in the head of pancreas

d. Cancer of the bile duct

e. Cancer gut nearby the bile duct opening

f. Wandering worm – Ascaris lumbricoides (rare cause)


4. Enumerate any of the five factors in the disease causation

Ø Environmental factors

Ø Genetic factors

Ø Dietary factors

Ø Immunological factors

Ø aging

5. Important five risk factors for the development of CIN( cervical intra-epithelial neoplasm) and invasive carcinoma are

a. Early age at first intercourse

b. Multiple sexual partners

c. A male partner with multiple previous sexual partners.

d. Cigarette smoking

e. Immunodeficiency

f. Persistent infection by ‘high-risk’ papillomaviruses


6. Define each of the following terms as used in pathology

(a) Histopathology - deals with study of tissues removed from the living body.

(b) Cytopathology- includes study of cells shade off from lesions (exfoliative cytology and fine needle aspiration cytology of official and deep seated lesion for diagnosis

(c) Adaptive immunity –Is an immunity acquired after exposure to an allergen

(d) Frame shift mutation -- occur when the insertion or deletion of one or two base pairs alters the reading frame of the DNA strand.


(e) Point mutation --- result from the substitution of a single nucleotide base by a different base, resulting in the replacement of one amino acid by another in the protein product


7. Write short notes on the diabetic ketoacidosis

· - Absence of glucose in the tissues/cells for production of required energy, due to lack of insulin, stimulates the body to find the alternative source of energy.

· The other food substrate which is readily available as an alternative source is fats.

· Thus in the absence of insulin there is increased fat breakdown (lipolysis) in the effort to produce the required energy.

· Fatty acids are degraded in the liver, and in this process some of the by-products formed are ketone bodies.

· Ketone bodies (B-hydroxybutyric acid and aceto – acetic acid) in low concentration can be oxidized to produce energy.

· But in the absolute absence of insulin the rate of ketone bodies production exceeds the rate of their utilization and their levels rise in blood causing ketonaemia (hyperketonaemia).

· Ketone bodies further increase the plasma osmolarity causing cell dehydration and more thirst.

· They are acidic in nature and therefore offset body pH balance mechanism. This can result in severe ketoacidosis and often ketoacidotic coma



8. Define the following pathological terminology

(a) Balanoposthitis --- The term balanoposthitis refers to local inflammation of the glans penis and the overlying prepuce.


(b) Hypospadias - Hypospadias results from incomplete closure of urethral folds on the underside of the penis during embryological development.


(c) Epispadias -- The term epispadias indicates the presence of the urethral orifice on the dorsal aspect of the penis.


1. Write an essay on the epididymorchitis basing on the definition, causes and clinical presentation


  The epididymorchitis is general term used to denote inflammation of epididymis and testis.

The involved testis is typically swollen and tender and contains inflammatory infiltrate.

The affected testis is oedematous and congested and contains a predominantly inflammatory infiltrate.

Severe cases may be associated with considerable loss of seminiferous epithelium with resultant tubular atrophy, fibrosis, and sterility.

Testicular tuberculosis generally begins as an epididymitis, with secondary involvement of the testis.

The histological changes include granulomatous inflammation and caseous necrosis, identical to that seen in active tuberculosis in other sites.

Sexually transmitted diseases.

§ Chlamydia, gonorrhea, acquired immunodeficiency syndrome (AIDS), syphilis, and hepatitis B






2. Write an assay on the pathogenesis of benign prostate hypertrophy basing on the following factors

· Androgens (testosterone and related hormones) are considered to play a permissive role in BPH.  This means that androgens have to be present for BPH to occur, but do not necessarily directly cause the condition.

· Dihydrotestosterone (DHT), a metabolite of testosterone, is a critical mediator of prostatic growth. This is synthesized in the prostate from circulating testosterone by the action of the enzyme 5α-reductase, type 2.

· This enzyme is localized principally in the stromal cells, hence, those cells are the main site for the synthesis of DHT.

· DHT binds to nuclear androgen receptors and signals the transcription of growth factors that are mitogenic to the epithelial and stromal cells.

· The importance of DHT in causing nodular hyperplasia is supported by clinical observations in which an inhibitor of 5α-reductase reduces prostate volume.

· Estrogens also play a role in the etiology of BPH.

This is based on the fact that BPH occurs when men have, in general, elevated estrogen levels and relatively reduced free testosterone levels, and when prostate tissue becomes more sensitive to estrogens and less responsive to DHT.



3. Describe the types of wound healing

· It is a complex and dynamic process of restoring cellular structures and tissue layers.

· Wound healing process can be divided into 3 distinct phases

Inflammatory phase

Proliferative phase

Remodelling phase

· Within these three broad phases is a complex and coordinated series of events that includes chemotaxis, phagocytosis, granulation, collagen degradation, and collagen remodeling.

· In addition, angiogenesis, epithelization, and the production of new glycosaminoglycans and proteoglycans are vital to the wound healing.


Types of Wound Healing

There are three categories of wound healing which are:

· Primary wound healing

This is also known as healing by first intention.

Occurs within hours of repairing a full-thickness surgical incision when edges of the wound are in aposition.

· Delayed primary wound healing

Occurs if the wound edges are not reapproximated immediately.

By the fourth day, phagocytosis of contaminated tissues is well underway, and the processes of epithelialisation, collagen deposition, and maturation are occurring.

Foreign materials are walled off by macrophages that may metamorphose into epithelioid cells, which are encircled by mononuclear leukocytes, forming granulomas.

Chronic inflammation can ensue, resulting in prominent scarring.

· Secondary healing

This is also known as healing by secondary intention.

Secondary healing results in an inflammatory response that is more intense than with primary wound healing.

In addition, a larger quantity of granulomatous tissue is fabricated because of the need for wound closure

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