AMREF INTERNATIONAL UNIVERSITY
SCHOOL OF MEDICAL SCIENCES
DEPARTMENT OF NURSING AND MIDWIFERY SCIENCES
BACHELOR OF SCIENCE IN NURSING UPGRADING
END OF SEMESTER EXAMINATIONS NOVEMBER/DECEMBER 2021
FOR BSN BSC NURSING APRIL 2021SEPT 2020 PRE-SERVICE CLASS
UNIT CODE: BSN 214
UNIT NAME: HUMAN PATHOLOGY
DATE: TUESDAY, 23RD NOVEMBER, 2021
TIME: 2 Hours Start: 9.00AM Finish: 11.00AM
INSTRUCTIONS
1. This exam will be marked out of 100 marks
2. All questions are compulsory
3. For section A (MCQs), chose the most correct response and write your answers in capital
letters, e.g ‘A’ and NOT ‘a’
4. Section B is short answer questions, answer them in the answer booklet provided
5. Section C has long Answer Questions, answer them in the answer booklet provided
6. All answers must be written in blue/black ink
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SECTION A: MULTIPLE CHOICE QUESTIONS (MCQS) 20 MARKS
1. Regarding cell injury and death:-
A. Initially there is a reduction in cell size during cell necrosis
B. Apoptosis is associated with an inflammatory response
C. Necrosis results from caspases sequestered in mitochondrial membranes
D. Cellular swelling and fatty change indicate reversible cell injury
2. In which of the following organs is steatosis NOT seen:-
A. Heart
B. Kidney
C. Lung
D. Liver
3. Progressive atrophy of the brain in later adult life is thought to be part due to:-
A. Decreased workload
B. Loss of innervation
C. Diminished blood supply
D. Loss of endocrine stimulation
4. Inflammation isis: -
A. Fundamentally a destructive response acutely
B. Is characterisedcharacterized by exudation of fluid and migration of neutrophils
C. Results in scarring thru regeneration of native parenchymal cells
D. Is activated by Toll like receptors on microbes;-
E.
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5. The most common mechanism for the formation of leaky endothelium in inflammation
is:-
A. Endothelial retraction
B. Direct endothelial injury
C. Leukocyte mediated endothelial injury
D. Endothelial cell contraction
6. Regarding mediators of inflammation
A. Histamine is a preformed vasoactive mediator causing arteriole vasoconstriction
B. Histamine is considered to be the principle mediatory of the immediate transient
phase of increased vascular permeability
C. Nitric oxide has dual actions in inflammation, it relaxes vascular smooth muscle and
also promotes the cellular response in the inflammatory response
D. Platelet activating factor is found unique to platelets
7. Regarding some inflammatory patterns:-
A. When mesothelial cells of the peritoneum, pleural and pericardial linings secrete fluid
it is usually of a fibrinous nature
B. A serous exudation consists primarily of neutrophils, liquefactive necrosis and
oedematous fluid
C. When there are large vascular leaks or an associated procoagulant stimulus you
commonly see a suppurative exudate
D. Ulcers can only occur when tissue necrosis and the resultant inflammation is on or
near a surface
8. In chronic inflammation, all are true EXCEPT:-
A. It can be caused by prolonged exposure to toxic agents
B. It involves mononuclear inflammatory cells
C. It may contribute to the formation of atherosclerosis
D. It primarily involves tissue destruction
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E.
9. Regarding wound healing:-,
A. The inflammatory response in primary healing is more intense than in secondary
healing
B. At 1 week ,week, the wound strength is 20% of that of unwounded skin
C. Wound contraction is due in part to fibroblast contraction
D. In primary union, collagen fibres appear with granulation tissue
10. The most important cause of delay of healing is:-
A. Inadequate blood supply
B. Infection
C. Foreign body presence
D. Poor nutritional state of the patient
11. Which of tThe following is true about formation of granulation tissue:-
A. Granulation tissue forms around day 6 from proliferation of fibroblasts and vascular
endothelial cells
B. Characteristic histological feature is presence of new small blood vessels
(angiogenesis) and proliferation of fibroblasts
C. The new vessels in angiogenesis are tight and restrict passage of plasma proteins.
D. There is a similar amount of granulation tissue in wounds healing by both primary
and secondary intention
12. The most common predisposing factor for developing thromboembolism is:-
A. Immobility
B. Post-surgery status
C. Malignancy
D. Coronary artery disease
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13. Which The factors that determines the severity of a pulmonary embolus:-?
A. Type of embolism
B. Degree of obstruction
C. Speed of onset
D. General health of the patient
14. When a person sustains injury the first line of defense that is initiated immediately to
prevent further injury is:-
A. Walling off the injured area
B. Tissue macrophage invasion
C. Neautrophil invasion of the inflammed area
D. Increased production of granulocytes and monocytes
15. The following processes aoccuroccur when tissues heal by secondary intention
EXCEPT:-
A. Occurs in injuries with loss of significant tissue
B. The process is fast with no scar formation
C. Heals by granulation tissue proliferation and filling the injured area
D. Re-epithelialization occurs beginning from the edges towards the centre
16. The infarct of which organ is invariably haemorrhagic:-
A. Kidney infarct
B. Splenic infarct
C. Lung infarct
D. Heart infarct
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17. The following type of oedema is characteristically dependent oedema
A. Nephrotic oedema
B. Nephritic oedema
C. Pulmonary oedema
D. Cardiac oedema
18. The following are types of tissue macrophages EXCEPTEXCEPT: -
A. Littoral cells
B. Hoffbauer cells
C. Osteoclasts
D. Osteoblasts
19. Nephritic oedema differs from nephrotic oedema in having the following
EXCEPTEXCEPT: -
A. Mild oedema
B. Distributed on face, eyes
C. Heavy proteinuria
D. Occurs in acute glomerulonephritis
20. The major mechanism of damage to cell membrane in ischaemia is
A. Reduced intracellular PH
B. Increased intracellular accumulation of sodium
C. Increased calcium ions in the cytosol
D. Reduced aerobic respiration
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SECTION B: SHORT ANSWER QUESTIONS (SAQ) 40 MARKS
Answer all questions
1. Describe the various types of necrosis. (8 Marks)
2. Discuss the differences between malignant and benign tumors (8 marks marks)
3. Describe the cytological characteristics seen under the light microscope that indicate
malignancy of cells (8 marks)
4. Explain the stages of hypovolemic shock (8 marks)
5. Explain pathogenesis of oedema (8 marks)
SECTION C: LONG ANSWER QUESTIONS (LAQ) 40 MARKS
Answer any two questions
1. Explain the various cellular adaptations. (20 Marks)
2. Discuss the mediators of inflammation (20 marks)
3. Discuss wound healing (primary and secondary intention) ( 20 marks)
