FCPS Part 1 Pathology: Systemic Pathology MCQs — Cardiovascular, GIT, Endocrine & Renal

Practice MCQs on cardiovascular, hepatobiliary, endocrine and renal pathology for FCPS Part 1, each with a short explanation.

Systemic pathology is spread across many smaller blocks in the bank (cardiovascular, gastrointestinal and hepatobiliary, endocrine, renal, nervous and others), so it is easy to under-revise. Here is a sample across four of them.

Cardiovascular Pathology

1. The earliest and most specific cardiac marker for myocardial infarction is:

A) Troponin ✅
B) LDH
C) AST
D) CK-MM

Troponins I and T rise within hours and stay elevated for days; myoglobin rises earlier but is non-specific.

2. Aschoff bodies are characteristic of:

A) Infective endocarditis
B) Rheumatic heart disease ✅
C) Libman-Sacks endocarditis
D) Dilated cardiomyopathy

They are granulomas with Anitschkow cells, found in all layers of the heart in rheumatic carditis.

Gastrointestinal and Hepatobiliary Pathology

3. Kayser-Fleischer rings are a feature of:

A) Haemochromatosis
B) Wilson disease ✅
C) Primary biliary cholangitis
D) Alpha-1 antitrypsin deficiency

Copper deposits in Descemet membrane because of defective ATP7B-mediated biliary copper excretion.

4. Barrett oesophagus predisposes to:

A) Squamous cell carcinoma
B) Adenocarcinoma ✅
C) Lymphoma
D) Leiomyosarcoma

Chronic reflux replaces squamous epithelium with intestinal-type columnar epithelium, which can progress through dysplasia to adenocarcinoma.

Endocrine Pathology

5. Psammoma bodies and "Orphan Annie eye" nuclei are seen in:

A) Follicular carcinoma
B) Medullary carcinoma
C) Papillary carcinoma ✅
D) Anaplastic carcinoma

Papillary carcinoma is the commonest thyroid cancer, spreads through lymphatics and has an excellent prognosis; medullary carcinoma arises from C cells and secretes calcitonin.

6. Hypertension with hypokalaemia suggests:

A) Addison disease
B) Conn syndrome ✅
C) Pheochromocytoma
D) Hypothyroidism

Primary hyperaldosteronism causes sodium retention and potassium loss with suppressed renin.

Renal Pathology

7. The commonest cause of nephrotic syndrome in children is:

A) Membranous nephropathy
B) Minimal change disease ✅
C) FSGS
D) IgA nephropathy

Foot-process effacement on electron microscopy with a normal light-microscopy appearance, and an excellent response to steroids.

8. Post-streptococcal glomerulonephritis typically shows on immunofluorescence:

A) Linear IgG deposits
B) Granular "lumpy-bumpy" IgG and C3 deposits ✅
C) No deposits
D) Mesangial IgA only

Subepithelial immune-complex "humps" appear 1 to 3 weeks after streptococcal infection; linear staining indicates anti-GBM disease.

Revision Tip

For each organ system, learn four things: the commonest cause, the pathognomonic histology, the key marker and the classic complication. Subject pages such as Cardiovascular Pathology, Endocrine Pathology and Gastrointestinal & Hepatobiliary Pathology let you drill one system at a time.

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.