🧬 NCLEX Pathology MCQs (Part 2: Q.51–100)
Preparing for the NCLEX exam or international nursing and medical tests requires strong command over pathology concepts. In this Part 2 of NCLEX Pathology MCQs (Q.51–100), we cover essential topics like types of necrosis, hematological malignancies, tumor markers, anemias, and cancer genetics.
Each MCQ is presented with the correct answer and explanation so you don’t just memorize — you actually understand the underlying concepts. Whether you’re in the USA, UK, Canada, Australia, New Zealand, or Europe, these high-quality practice questions will help you strengthen your foundation and improve your exam performance.
51. Which leukemia is most common in adults?
A) AML
B) ALL
C) CML
D) CLL
Answer: D. CLL
👉 Chronic lymphocytic leukemia (CLL) is the most common adult leukemia.
52. Which infection is most associated with Burkitt’s lymphoma?
A) Hepatitis B
B) EBV
C) HPV
D) HIV
Answer: B. EBV
👉 Burkitt’s lymphoma is strongly linked with Epstein-Barr virus.
53. Which type of necrosis is typical of TB?
A) Liquefactive
B) Caseous
C) Fat
D) Fibrinoid
Answer: B. Caseous
👉 TB shows caseous necrosis (cheese-like).
54. Coagulative necrosis is most commonly seen in:
A) Brain infarct
B) Liver infarct
C) Kidney infarct
D) Heart infarct
Answer: D. Heart infarct
👉 Myocardial infarction → coagulative necrosis.
55. Liquefactive necrosis is characteristic of:
A) Brain infarction
B) TB
C) Pancreatitis
D) Spleen infarction
Answer: A. Brain infarction
👉 Brain infarcts → liquefactive necrosis.
56. Fat necrosis is commonly seen in:
A) Brain infarcts
B) Acute pancreatitis
C) TB
D) Hepatitis
Answer: B. Acute pancreatitis
👉 Fat necrosis occurs in acute pancreatitis due to lipase activity.
57. Fibrinoid necrosis is seen in:
A) Hypertension and vasculitis
B) Brain infarcts
C) Fat necrosis
D) TB
Answer: A. Hypertension and vasculitis
👉 Immune complexes in vessels → fibrinoid necrosis.
58. Which cellular change is reversible?
A) Apoptosis
B) Necrosis
C) Fatty change
D) DNA fragmentation
Answer: C. Fatty change
👉 Fatty change = reversible injury, unlike necrosis.
59. Which enzyme is most specific for myocardial infarction?
A) CK-MB
B) AST
C) LDH
D) Troponin I
Answer: D. Troponin I
👉 Troponin I is most specific for MI.
60. Which organ is most often affected by metastasis?
A) Lung
B) Liver
C) Brain
D) Bone
Answer: B. Liver
👉 Liver is the most common site of hematogenous metastasis.
61. Which is the most common primary bone tumor in adults?
A) Osteosarcoma
B) Chondrosarcoma
C) Multiple myeloma
D) Ewing sarcoma
Answer: C. Multiple myeloma
👉 Multiple myeloma is the commonest bone tumor in adults.
62. Which bone tumor is common in teenagers?
A) Osteosarcoma
B) Chondrosarcoma
C) Multiple myeloma
D) Fibrosarcoma
Answer: A. Osteosarcoma
👉 Osteosarcoma peaks in adolescence.
63. “Onion-skin” periosteal reaction is seen in:
A) Osteosarcoma
B) Ewing’s sarcoma
C) Chondrosarcoma
D) Multiple myeloma
Answer: B. Ewing’s sarcoma
👉 Ewing’s sarcoma → onion-skin periosteum.
64. Which skin cancer is most common?
A) Melanoma
B) Squamous cell carcinoma
C) Basal cell carcinoma
D) Sarcoma
Answer: C. Basal cell carcinoma
👉 Basal cell carcinoma is most common, but rarely metastasizes.
65. Which skin cancer is most aggressive?
A) Melanoma
B) Basal cell carcinoma
C) Squamous cell carcinoma
D) Keratoacanthoma
Answer: A. Melanoma
👉 Melanoma is the most aggressive skin tumor.
66. Which marker is most associated with prostate cancer?
A) AFP
B) CEA
C) PSA
D) CA-125
Answer: C. PSA
👉 Prostate-specific antigen (PSA) is used for screening.
67. Which marker is raised in hepatocellular carcinoma?
A) CA-125
B) CEA
C) AFP
D) PSA
Answer: C. AFP
👉 Alpha-fetoprotein (AFP) rises in HCC.
68. Which marker is associated with ovarian cancer?
A) CA-19-9
B) CA-125
C) CEA
D) PSA
Answer: B. CA-125
👉 CA-125 is used in ovarian cancer.
69. Which tumor marker is raised in colorectal carcinoma?
A) CEA
B) PSA
C) AFP
D) CA-125
Answer: A. CEA
👉 Carcinoembryonic antigen (CEA) = colorectal cancer marker.
70. Which blood disorder shows “Reed-Sternberg cells”?
A) Hodgkin’s lymphoma
B) Burkitt’s lymphoma
C) Multiple myeloma
D) CLL
Answer: A. Hodgkin’s lymphoma
👉 Reed-Sternberg cells = diagnostic of Hodgkin’s.
71. Which leukemia shows “smudge cells”?
A) AML
B) ALL
C) CLL
D) CML
Answer: C. CLL
👉 CLL blood smear shows smudge cells.
72. The Philadelphia chromosome is most associated with:
A) AML
B) CML
C) ALL
D) CLL
Answer: B. CML
👉 t(9;22) = CML.
73. Which clotting factor is deficient in hemophilia A?
A) Factor VIII
B) Factor IX
C) Factor XI
D) Factor VII
Answer: A. Factor VIII
👉 Hemophilia A = Factor VIII deficiency.
74. Hemophilia B is due to deficiency of:
A) Factor VIII
B) Factor IX
C) Factor VII
D) Factor XI
Answer: B. Factor IX
👉 Hemophilia B = Christmas disease.
75. Vitamin K is essential for synthesis of which clotting factors?
A) II, VII, IX, X
B) I, II, III, IV
C) V, VII, VIII
D) XI, XII, XIII
Answer: A. II, VII, IX, X
👉 Vitamin K-dependent factors = II, VII, IX, X.
76. Which anemia is caused by vitamin B12 deficiency?
A) Microcytic anemia
B) Macrocytic megaloblastic anemia
C) Hemolytic anemia
D) Aplastic anemia
Answer: B. Macrocytic megaloblastic anemia
👉 B12 deficiency → megaloblastic anemia.
77. Pernicious anemia results from:
A) Lack of iron
B) Lack of intrinsic factor
C) Chronic bleeding
D) Hemolysis
Answer: B. Lack of intrinsic factor
👉 Intrinsic factor deficiency → B12 malabsorption.
78. Which anemia is associated with “spoon-shaped nails”?
A) Iron deficiency anemia
B) Pernicious anemia
C) Aplastic anemia
D) Hemolytic anemia
Answer: A. Iron deficiency anemia
👉 Koilonychia (spoon nails) = iron deficiency.
79. Which anemia shows pancytopenia with hypocellular bone marrow?
A) Aplastic anemia
B) Iron deficiency anemia
C) Megaloblastic anemia
D) Hemolytic anemia
Answer: A. Aplastic anemia
👉 Aplastic anemia = hypocellular marrow.
80. Sickle cell anemia is due to mutation in:
A) Beta-globin chain
B) Alpha-globin chain
C) Hemoglobin structure by iron
D) RBC membrane proteins
Answer: A. Beta-globin chain
👉 Sickle cell = mutation in beta-globin.
81. Which inheritance pattern is seen in sickle cell anemia?
A) Autosomal dominant
B) Autosomal recessive
C) X-linked
D) Mitochondrial
Answer: B. Autosomal recessive
👉 Sickle cell is autosomal recessive.
82. Which hemoglobin variant is seen in sickle cell anemia?
A) HbA
B) HbS
C) HbC
D) HbF
Answer: B. HbS
👉 HbS polymerizes → sickling.
83. Thalassemia is a defect in:
A) DNA replication
B) Globin chain synthesis
C) RBC membrane proteins
D) Iron absorption
Answer: B. Globin chain synthesis
👉 Thalassemia = defective alpha or beta globin synthesis.
84. Which anemia shows “target cells” in blood smear?
A) Iron deficiency anemia
B) Thalassemia
C) Aplastic anemia
D) Pernicious anemia
Answer: B. Thalassemia
👉 Target cells → thalassemia & liver disease.
85. Which disease shows “tear-drop cells” in peripheral smear?
A) Myelofibrosis
B) Iron deficiency anemia
C) Thalassemia
D) Aplastic anemia
Answer: A. Myelofibrosis
👉 Teardrop cells = myelofibrosis.
86. Which anemia shows “Heinz bodies”?
A) G6PD deficiency
B) Iron deficiency anemia
C) Thalassemia
D) Aplastic anemia
Answer: A. G6PD deficiency
👉 Heinz bodies = oxidative damage in G6PD deficiency.
87. Which test is diagnostic for sickle cell anemia?
A) Coombs test
B) Solubility test + electrophoresis
C) Peripheral smear only
D) Bone marrow biopsy
Answer: B. Solubility test + electrophoresis
👉 Hb electrophoresis = confirmatory.
88. Which WBC disorder shows “hypersegmented neutrophils”?
A) Iron deficiency anemia
B) Megaloblastic anemia
C) Aplastic anemia
D) Sickle cell anemia
Answer: B. Megaloblastic anemia
👉 Megaloblastic anemia shows hypersegmented neutrophils.
89. Which malignancy is associated with Bence-Jones proteins?
A) Leukemia
B) Multiple myeloma
C) CLL
D) Hodgkin’s
Answer: B. Multiple myeloma
👉 Light chain proteins in urine = MM.
90. “Punched out lytic bone lesions” are seen in:
A) Multiple myeloma
B) Osteosarcoma
C) Ewing’s sarcoma
D) Leukemia
Answer: A. Multiple myeloma
👉 Classic feature of MM.
91. Which immunoglobulin is most elevated in multiple myeloma?
A) IgA
B) IgE
C) IgG
D) IgM
Answer: C. IgG
👉 Most common = IgG elevation.
92. Which condition shows “Rouleaux formation” in blood smear?
A) Multiple myeloma
B) Leukemia
C) Hodgkin’s lymphoma
D) Thalassemia
Answer: A. Multiple myeloma
👉 RBC stacking (Rouleaux) = MM.
93. Which cancer is linked with asbestos exposure?
A) Lung adenocarcinoma
B) Small cell carcinoma
C) Mesothelioma
D) Melanoma
Answer: C. Mesothelioma
👉 Asbestos → mesothelioma of pleura.
94. Which condition shows “apple-green birefringence” under polarized light?
A) Amyloidosis
B) SLE
C) Thalassemia
D) Hemochromatosis
Answer: A. Amyloidosis
👉 Congo red stain → apple-green birefringence.
95. Which infection is strongly associated with gastric cancer?
A) H. pylori
B) EBV
C) HBV
D) HPV
Answer: A. H. pylori
👉 H. pylori infection predisposes to gastric carcinoma.
96. Which polyp has highest risk of becoming malignant?
A) Hyperplastic polyp
B) Adenomatous polyp
C) Inflammatory polyp
D) Juvenile polyp
Answer: B. Adenomatous polyp
👉 Adenomas are precancerous.
97. Which gene is most associated with colon cancer?
A) BRCA1
B) APC
C) p53
D) RET
Answer: B. APC
👉 APC mutation = colon carcinoma.
98. Which tumor suppressor gene is called “guardian of genome”?
A) BRCA1
B) p53
C) APC
D) RB
Answer: B. p53
👉 p53 prevents mutation accumulation.
99. Retinoblastoma is due to mutation in which gene?
A) p53
B) RB
C) APC
D) BRCA1
Answer: B. RB
👉 RB gene mutation = retinoblastoma.
100. Which hereditary condition increases risk of colon cancer?
A) Peutz-Jeghers syndrome
B) Familial adenomatous polyposis (FAP)
C) Lynch syndrome
D) Both B & C
Answer: D. Both B & C
👉 FAP + Lynch syndrome → high risk colon cancer.
That completes Part 2 (Q.51–100) of NCLEX Pathology MCQs 🎯
We covered necrosis, tumors, leukemia, lymphomas, anemia, myeloma, cancer genetics, and GI pathology.
🔗 Previous: NCLEX Pathology MCQs-Part 1(1-50)