1
Q
Which of the following is true regarding organ specific autoimmune diseases?
A. Damage to target cells is usually done
via endotoxins
B. Aside from destruction of target
organ cells, antibodies can
overstimulate target cells as well
C. All of the above
D. The target antigen is generalized in
different organs, so there is usually a
systemic response
A
B. Aside from destruction of target
organ cells, antibodies can
overstimulate target cells as well
2
Q
Wheal formation during allergy tests are due
to:
A. Arteriolar dilatation
B. Venous dilatation
C. Capillary dilatation
D. Exudation of fluid
A
D. Exudation of fluid
3
Q
Primary Hyperaldosteronism is characterized by what? (select all answers that apply.)
A. High Aldosterone/Renin Ratio (>50)
B. Potassium retention
C. Hypertension
D. Commonly have severe hyponatremia
A
A. High Aldosterone/Renin Ratio (>50)
C. Hypertension
4
Q
- Which of the following is true regarding
Graves’ Disease?
A. Patient’s present with heat
intolerance among other symptoms
B. Mediated by destruction and loss of
function of thyrocytes
C. Granuloma formation is mandatory for
the diagnosis
D. All of the above
A
A. Patient’s present with heat
intolerance among other symptoms
5
Q
After eating a meal, a man develops hives all over the body, and has difficulty breathing. The mechanism behind this particular reaction is mediated by:
A. IgE
B. IgG
C. IgA
D. IgM
A
A. IgE
6
Q
- A patient consults you with a thyroid tumor. It is removed and the pathologist diagnoses it as a Medullary Thyroid Carcinoma. Which of the following statements are true?
A. if both basal and postpentagastrin or
calcium-stimulating calcitonin are
undetectable, residual tissue can be
determined via calcitonin levels
B. MTC can be part of a Multiple Endocrine
Neoplasm (MEN) syndrome
C. Is higher in children <3 years of age.
D. All of the above
A
D. All of the above
7
Q
When and under what circumstances is it best
to measure phosphorus in a patient?
A. In the evening, after dinner
B. During a fasting specimen in the
morning
C. Any time of the day is optimal
D. During the afternoon, before dinner
A
B. During a fasting specimen in the
morning
8
Q
- Most of the calcium in the human body is contained in the:
A. Skeleton
B. Serum
C. Liver
D. Skin
A
A. Skeleton
9
Q
- This patient is an adult. He has:
A. Osteoporosis
B. Osteomalacia
C. Osteitis Cystica
D. Rickets
A
B. Osteomalacia
10
Q
- In Myasthenia Gravis, which of the following is
true?
A. The disease can be treated in a number
of different ways
B. Manifests as progressive weakness
C. Mediated by antibodies blocking
acetylcholine receptors
D. All of the above
A
D. All of the above
11
Q
- You do a skin prick test on a patient with a
suspected allergy to hayseed. After a few
minutes, a wheal and flare reaction appears
on the skin. Which of the following is true?
A. If the reaction measures 2mm, this is
considered positive
B. Measuring the wheal and flare increases
reproducibility
C. This test must be conducted with a
positive and negative control
D. Recording the exact reaction size is not
necessary
A
C. This test must be conducted with a
positive and negative control
12
Q
- This structure labeled “B” is called:
A. Osteate Bone
B. Compact Bone
C. Spongy Bone
D. Cortical Bone
A
C. Spongy Bone
13
Q
- Attaching to a poly-immunoglobulin receptor, secretory IgA finds its way into the lumens of glands via:
A. Transcytosis
B. Degranulation
C. Phagocytosis
D. Osmosis
A
A. Transcytosis
14
Q
- Involved in the creation of protective barriers, the predominant Immunoglobulin in secretions is:
A. IgM
B. IgA
C. IgE
D. IgG
A
B. IgA
15
Q
- A patient is highly suspected to have an allergy, but his skin prick test is negative. What could be the cause of this?
A. The allergen concentration is too high
B. The patient may be taking drugs that
blunt the immune response
C. There is nothing wrong, do a serum IgE
immediately
D. There are impurities that cause an
allergenic reaction
A
B. The patient may be taking drugs that
blunt the immune response
16
Q
- Most sensitive metabolite in detecting
pheochromocytoma:
A. HVA
B. L-dopa
C. VMA
D. Metanephrine (plasma or urine)
A
D. Metanephrine (plasma or urine)
17
Q
- In an intradermal test for allergens:
A. Allergen preparations can be stored at
room temperature
B. None of the given choices are true
C. Can be preserved with 50% glycerine
D. The preparation has the same
concentration as that used for skin tests.
A
B. None of the given choices are true
18
Q
- A 52-year-old asian female consults at your clinic, with a chief complaint of diffuse bone pain over the past several years after menopause. Any weight-bearing activity causes her severe discomfort. She admits to eating a vitamin-poor diet. Lately the patient experiences severe back pain and the inability to do simple chores such as lifting grocery bags and her grandchild without pain. PE shows guarding and tenderness in the cervical, thoracic and lumbar spine with limited range of motion. There is also noticeable guarding with some limitation of movement at the cervical spine area. What is a defining characteristic of this illness?
A. “softening” of the bones due to a lack of
mineralization
B. PTH dysfunction
C. Microarchitectural deterioration of
bone tissue
D. A paramyxovirus-related dysfunction of
osteoclasts
A
C. Microarchitectural deterioration of
bone tissue
19
Q
- The reference method for calcium
determination is:
A. Gas Chromatography (non tandem)
B. Atomic absorption
spectrophotometry
C. Indirect Potentiometry
D. GC-MS (Gas Chromatography-Mass
Spectrophotometry)
A
B. Atomic absorption
spectrophotometry
20
Q
- True regarding Autoimmune Hemolytic
Anemia:
A. Leads to lysis of RBCs
B. May be induced by drugs
C. Autoantibodies against RBCs are
formed
D. All of the above.
A
D. All of the above.
21
Q
- True regarding Phosphorus:
A. Is mostly absorbed in the stomach by
osmosis
B. Is normally unavailable in the diet
C. Is excreted mainly in the proximal
collecting tubules
D. None of the given statements are true
A
C. Is excreted mainly in the proximal
collecting tubules
22
Q
- When a person is first infected with something, the primary Immunoglobulin in this initial response is:
A. IgM
B. IgA
C. IgE
D. IgG
A
A. IgM
23
Q
- 29/M presents with hemoptysis and hematuria
with glomerular inflammation, pulmonary
infiltrates and electron dense humps on the
epithelial side of the basement membrane.
What does he have?
A. Wegener Granulomatosis
B. MPGN
C. Goodpasture’s Syndrome
D. Idiopathic Thrombocytopenic Purpura
A
C. Goodpasture’s Syndrome
24
Q
- Which of the following statements correctly
describe the action of PTH?
A. In the context of a high serum calcium,
PTH stimulates RANKL to increase
bone resorption
B. PTH acts on the liver to create enzymes
that cleave protein-bound calcium
C. In the context of a low serum
calcium, PTH acts on the kidney to
increase calcium reabsorption
D. PTH acts on the bone to decrease
serum calcium concentration
A
C. In the context of a low serum
calcium, PTH acts on the kidney to
increase calcium reabsorption
25
25. The Nasal Provocation test:
A. None of the given choices are true
B. Is non-invasive
C. Is an example of an In Vitro test
D. Should be done as a first line test for all
allergic patients
A. None of the given choices are true
26
26. True regarding Hashimoto Thyroiditis
A. ultimately leads to decreased thyroid
function
B. characterized by a delayed type
hypersensitivity response
C. occurs more in women
D. All of the above
D. All of the above
27
27. Which of the following is NOT used to
measure phosphorus?
A. Reacting phosphorus to create a
picrate solution
B. Indirect Potentiometry
C. Atomic Absorption Spectrophotometry
D. Reacting phosphorus to create a
phosphomolybdate complex
A. Reacting phosphorus to create a
picrate solution
28
28. This IgG type CANNOT easily cross the placenta:
A. IgG3
B. IgG1
C. IgG4
D. IgG2
D. IgG2
29
29. The physiologically active form of calcium:
A. Is bound to plasma proteins
B. Is bound to anions
C. Comprises around 10% of the total
serum calcium in the body
D. Is the free or ionized form
D. Is the free or ionized form
30
30. Goodpasture syndrome involves which of the following? (select all the correct answers)
A. Anti-glomerular basement membrane
(anti-GBM) antibodies
B. Pulmonary hemorrhage
C. low amounts of urea in the serum
D. Rapidly progressive
glomerulonephritis
A. Anti-glomerular basement membrane
(anti-GBM) antibodies
B. Pulmonary hemorrhage
D. Rapidly progressive
glomerulonephritis
31
31. When measuring for serum calcium, aside from a serum separator or lithium tube, one can use this type of vial for blood extraction:
A. Gray Top
B. Red Top
C. Blue Top
D. Violet top
B. Red Top
32
32. This test injects the fluid into the:
A. Epidermis
B. Dermis
C. blood vessels
D. capillaries
B. Dermis
Description: The dermis lies beneath the epidermis and contains tough connective tissue, hair follicles, and sweat glands. It also contains more blood vessels than the epidermis, which is crucial for the immune response needed in the PTB test.
Why this choice: The PTB test requires the injection to be placed in the dermis to ensure that the immune cells can react if tuberculosis bacteria have sensitized the person. This reaction is critical for the test's effectiveness.
33
33. The resorption of bone is primarily due to the action of osteoclasts. What is the expected serum calcium level in conditions with extremely high osteoclast activity?
A. High
B. Normal
C. Low
A. High
34
34. In what conditions can conventional Calcium measurements be inaccurate, necessitating a correction?
A. Nephrotic Syndrome
B. Liver Disease
C. Chronic Lymphocytic Leukemia
D. All of the above
D. All of the above
35
35. What can be expected in a patient with
adrenal crisis?
A. Confusion
B. vomiting and/or diarrhea
C. Severe weakness
D. All of the above
D. All of the above
36
36. You are ordered to extract blood for a calcium test. Which tube should you use for this test?
A. D
B. A
C. B
D. C
C. B
37
37. Of the IgG types, ______ is the most effective complement activator
A. IgG1
B. IgG2
C. IgG4
D. IgG3
D. IgG3
38
38. A man with a diagnosed parathyroid adenoma consults you for concerning x-ray results. There seem to be lots of deposits of dense material in his lungs and soft tissues. Given his condition, these dense materials may likely be:
A. Metastatic cancer
B. Solidified mucuous deposits
C. Granulomas formed by an immunologic
process
D. Due to very high calcium levels in the
blood
D. Due to very high calcium levels in the
blood
39
39. Cancellous bone has the following functions:
A. All of the given statements are true
B. Provides a large surface area for
mineral exchange
C. Houses the structures needed for the
creation of blood elements
D. Responsible for around half of bone
turnover
A. All of the given statements are true
40
40. Which of the following is true regarding
Addison's disease?
A. can not be related to other organ
specific autoimmune disorders
B. Due to a hypersecreting tumor
C. Can be due to autoimmune
destruction (a majority is) but can
also be due to other causes
D. None of the above
C. Can be due to autoimmune
destruction (a majority is) but can
also be due to other causes
41
41. Is this patient allergic to Progesterone?
A. Yes
B. The result is equivocal
C. No
D. This is an invalid test
A. Yes
42
42. True regarding Pernicious Anemia:
A. All of the above
B. Low RBC count due to autoimmune
lysis of RBCs
C. Can be due to an autoimmune attack
of gastric epithelium
D. Due to a deficiency of Thiamine.
C. Can be due to an autoimmune attack
of gastric epithelium
43
43. This cell (red arrow) is involved in the resorption of bone. If these cells are very active, the calcium levels in the bloodstream should be expected to:
A. Stay the Same
B. Increase
C. Decrease
D. I don't know
B. Increase
When osteoclasts are active and bone resorption is heightened, more calcium is released from the bone into the bloodstream. This would naturally lead to an increase in the calcium levels in the blood, which is what the question is suggesting.
44
44. An antibody that is digested by papain creates which of the following products?
A. C
B. B
C. D
D. A
A. C
45
45. What is the action of calcitonin in the bone?
A. blocks osteoblasts -> less bone buildup
-> more calcium in serum
B. blocks osteoclasts -> less bone
resorption -> less calcium in serum
C. blocks osteoblasts -> more bone buildup -> less calcium in serum
D. blocks osteoclasts -> more bone
resorption -> more calcium in serum
B. blocks osteoclasts -> less bone
resorption -> less calcium in serum
Calcitonin reduces the activity of osteoclasts, the cells responsible for bone resorption. By inhibiting osteoclast activity, less bone is broken down, which means less calcium is released from the bones into the bloodstream, resulting in lower serum calcium levels. This choice correctly describes the action of calcitonin.
46
46. The most abundant immunoglobulin in the serum:
A. IgG
B. IgA
C. IgM
D. IgE
A. IgG
47
47. This phenomenon is called:
A. Reynaud’s phenomenon
B. Urticarial markings
C. Dermatographism
D. Erythematosus migrans
C. Dermatographism
48
48. You are consulted by a young patient
diagnosed with Type I diabetes mellitus.
Which of the following applies to her
condition?
A. Infiltration of the pancreas by massive
amounts of primarily B Lymphocytes
B. People with her condition usually
present at an elderly age
C. Patients with her condition are always
obese
D. All of the above
E. None of the above
E. None of the above
49
49. Antibodies are made up of:
A. 2 light chains, a hinge region, one
medium chain, and one heavy chain
B. 4 light chains
C. 2 light chains and 2 heavy chains
D. 3 heavy chains and 1 light chain
C. 2 light chains and 2 heavy chains
50
50. A patient taking lithium for symptoms of
Bipolar type I can develop what?
A. Hypercortisolism
B. SIADH
C. Hyperprolactinemia
D. Hypothyroidism
D. Hypothyroidism
Clin Path
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