FCPS Part 1 Pathology: Neoplasia & Immunopathology MCQs — High-Yield Concepts

Practice MCQs on oncogenes, tumour markers, hypersensitivity and transplant rejection for FCPS Part 1 Pathology, with the reasoning behind each answer.

Neoplasia (about 165 questions) and immunopathology and transplantation (about 145) are two of the most concept-driven blocks in the Pathology bank. They reward knowing a short list of facts well. Here is a sample set.

Neoplasia

1. The tumour marker most closely associated with hepatocellular carcinoma is:

A) CEA
B) Alpha-fetoprotein ✅
C) CA-125
D) PSA

AFP is also raised in yolk sac tumours; CEA is used in colorectal cancer follow-up and CA-125 in ovarian cancer.

2. Which gene product is the "guardian of the genome"?

A) RAS
B) MYC
C) p53 ✅
D) BCL-2

p53 halts the cell cycle at G1 for DNA repair or triggers apoptosis; loss of it lets damaged cells survive and is the commonest mutation in human cancer.

3. N-myc amplification is a poor prognostic marker in:

A) Neuroblastoma ✅
B) Wilms tumour
C) Burkitt lymphoma
D) Retinoblastoma

c-myc is activated by t(8;14) in Burkitt lymphoma, while N-myc amplification marks aggressive neuroblastoma.

4. Aflatoxin B1 is a recognised cause of:

A) Hepatocellular carcinoma ✅
B) Bladder carcinoma
C) Lung carcinoma
D) Angiosarcoma

Aflatoxin from contaminated stored grains causes p53 mutations; vinyl chloride causes hepatic angiosarcoma and aromatic amines cause bladder cancer.

Immunopathology and Transplantation

5. Goodpasture syndrome is an example of which hypersensitivity type?

A) Type I
B) Type II ✅
C) Type III
D) Type IV

Antibodies against the glomerular basement membrane cause linear IgG deposition; immune-complex diseases such as SLE are type III.

6. The tuberculin skin test is an example of:

A) Type I hypersensitivity
B) Type II hypersensitivity
C) Type III hypersensitivity
D) Type IV hypersensitivity ✅

It is a delayed, T-cell and macrophage-mediated reaction, peaking at 48 to 72 hours.

7. Rejection of a kidney graft within minutes of anastomosis is caused by:

A) Pre-formed antibodies ✅
B) Cytotoxic T cells
C) Chronic vascular fibrosis
D) Donor T cells

Hyperacute rejection reflects pre-formed anti-HLA or ABO antibodies causing thrombosis; acute cellular rejection occurs after days to weeks and chronic rejection after months.

8. The most sensitive screening test for SLE is:

A) Anti-dsDNA
B) Anti-Smith antibody
C) ANA ✅
D) Anti-histone antibody

ANA is sensitive but not specific; anti-dsDNA and anti-Smith are the specific tests.

How to Revise These Blocks

For neoplasia, make a one-page table of oncogenes, tumour suppressors, translocations and markers. For immunopathology, learn the four hypersensitivity types with one example each, then the rejection timeline. Practise by subject on the Neoplasia and Immunopathology & Transplantation pages.

Practise With Explanations

HighYield's FCPS Part 1 Pathology QBank has 3,800+ MCQs across general and systemic pathology, haematology, microbiology and immunology, plus the shared basic sciences (anatomy, physiology, biochemistry, pharmacology and forensic medicine). Every question has a written explanation, four full-length mock tests mirror the two-paper layout, and subject analytics show which area needs another pass. Your first 20 questions are free, no card required.

Frequently Asked Questions

What is the difference between grading and staging?

Grading describes how differentiated the tumour cells look; staging describes how far the tumour has spread. Staging is the stronger predictor of outcome.

Which hypersensitivity type is serum sickness?

Type III, caused by immune-complex deposition.