🧪 NCLEX Pathology MCQs (Part 3: Questions 101–150)
Pathology is one of the most tested areas on the NCLEX exam, requiring nurses to understand how diseases develop and affect the human body. In this Part 3 (Q.101–150), we cover a wide range of high-yield pathology topics such as viral infections, autoimmune diseases, genetic disorders, cardiovascular pathology, and neoplasia.
Each multiple-choice question includes the correct answer and a clear explanation, ensuring you build strong conceptual knowledge. Whether you’re preparing for NCLEX in the USA, Canada, UK, or Australia, these questions will help you strengthen your critical thinking and clinical reasoning skills.
Q.101. Which virus is most strongly associated with cervical cancer?
- A. Hepatitis B virus
- B. Epstein-Barr virus
- C. Human papillomavirus (HPV)
- D. Cytomegalovirus
Answer: C. Human papillomavirus (HPV)
Explanation: High-risk HPV strains (especially HPV-16 and HPV-18) are linked to cervical cancer.
Q.102. Systemic lupus erythematosus (SLE) is an example of which hypersensitivity type?
- A. Type I
- B. Type II
- C. Type III
- D. Type IV
Answer: C. Type III
Explanation: SLE is an immune complex-mediated disease, characteristic of Type III hypersensitivity.
Q.103. The genetic defect in cystic fibrosis affects which protein?
- A. Alpha-1 antitrypsin
- B. CFTR chloride channel
- C. Hemoglobin beta chain
- D. Collagen type I
Answer: B. CFTR chloride channel
Explanation: Cystic fibrosis is caused by mutations in the CFTR gene, impairing chloride ion transport.
Q.104. Which of the following is the most common cause of myocardial infarction?
- A. Coronary artery spasm
- B. Atherosclerotic plaque rupture with thrombosis
- C. Viral myocarditis
- D. Hypertension
Answer: B. Atherosclerotic plaque rupture with thrombosis
Explanation: Plaque rupture triggers platelet aggregation and thrombus formation, leading to MI.
Q.105. Reed-Sternberg cells are characteristic of:
- A. Non-Hodgkin lymphoma
- B. Hodgkin lymphoma
- C. Multiple myeloma
- D. Chronic lymphocytic leukemia
Answer: B. Hodgkin lymphoma
Explanation: Reed-Sternberg cells are large, abnormal B-cells seen in Hodgkin lymphoma.
Q.106. Which autoimmune disease primarily affects the neuromuscular junction?
- A. Myasthenia gravis
- B. Multiple sclerosis
- C. Rheumatoid arthritis
- D. Guillain-Barré syndrome
Answer: A. Myasthenia gravis
Explanation: Myasthenia gravis is caused by autoantibodies blocking acetylcholine receptors at the neuromuscular junction.
Q.107. Which genetic condition is associated with a “trisomy 21” karyotype?
- A. Turner syndrome
- B. Down syndrome
- C. Edwards syndrome
- D. Patau syndrome
Answer: B. Down syndrome
Explanation: Trisomy 21 leads to Down syndrome, characterized by intellectual disability and congenital defects.
Q.108. Which of the following is a tumor suppressor gene?
- A. RAS
- B. MYC
- C. p53
- D. HER2
Answer: C. p53
Explanation: The p53 gene prevents damaged cells from dividing, acting as a tumor suppressor.
Q.109. Which heart valve is most commonly affected in rheumatic heart disease?
- A. Aortic valve
- B. Pulmonary valve
- C. Mitral valve
- D. Tricuspid valve
Answer: C. Mitral valve
Explanation: Rheumatic heart disease most frequently damages the mitral valve.
Q.110. A “butterfly rash” on the face is a hallmark of:
- A. Dermatomyositis
- B. Systemic lupus erythematosus
- C. Psoriasis
- D. Scleroderma
Answer: B. Systemic lupus erythematosus
Explanation: The malar (butterfly) rash is a classic feature of SLE due to immune-mediated skin damage.
Q.111. Which cancer is most commonly associated with asbestos exposure?
- A. Lung adenocarcinoma
- B. Mesothelioma
- C. Small cell carcinoma
- D. Squamous cell carcinoma
Answer: B. Mesothelioma
Explanation: Asbestos fibers are strongly linked to malignant mesothelioma, a tumor of pleural mesothelial cells.
Q.112. The Bence Jones protein is typically found in which disease?
- A. Hodgkin lymphoma
- B. Multiple myeloma
- C. Burkitt lymphoma
- D. CLL
Answer: B. Multiple myeloma
Explanation: Bence Jones proteins are free light chains of immunoglobulins excreted in urine, seen in multiple myeloma.
Q.113. Which autoimmune disease is associated with anti-TSH receptor antibodies?
- A. Hashimoto thyroiditis
- B. Graves’ disease
- C. Addison’s disease
- D. Sjögren’s syndrome
Answer: B. Graves’ disease
Explanation: Graves’ disease is caused by stimulatory autoantibodies to TSH receptors, leading to hyperthyroidism.
Q.114. Which genetic disorder is characterized by defective fibrillin-1?
- A. Marfan syndrome
- B. Ehlers-Danlos syndrome
- C. Osteogenesis imperfecta
- D. Huntington’s disease
Answer: A. Marfan syndrome
Explanation: Mutations in fibrillin-1 cause Marfan syndrome, associated with tall stature, lens dislocation, and aortic aneurysm.
Q.115. Which of the following is NOT a tumor marker?
- A. Alpha-fetoprotein (AFP)
- B. CA-125
- C. PSA
- D. Hemoglobin A1c
Answer: D. Hemoglobin A1c
Explanation: HbA1c is used for diabetes monitoring, not cancer diagnosis.
Q.116. Which type of necrosis is seen in tuberculosis?
- A. Coagulative
- B. Liquefactive
- C. Caseous
- D. Fat
Answer: C. Caseous
Explanation: TB produces caseous necrosis due to granulomatous inflammation.
Q.117. Which blood disorder shows “Philadelphia chromosome”?
- A. AML
- B. ALL
- C. CML
- D. CLL
Answer: C. CML
Explanation: Chronic myeloid leukemia is associated with the translocation t(9;22), known as the Philadelphia chromosome.
Q.118. Which bacterium causes peptic ulcers?
- A. Streptococcus pyogenes
- B. Helicobacter pylori
- C. Escherichia coli
- D. Clostridium difficile
Answer: B. Helicobacter pylori
Explanation: H. pylori colonizes gastric mucosa and is linked to ulcers and gastric cancer.
Q.119. Which disease shows “café-au-lait” spots on the skin?
- A. Neurofibromatosis type 1
- B. Albinism
- C. Vitiligo
- D. Psoriasis
Answer: A. Neurofibromatosis type 1
Explanation: NF1 patients have multiple café-au-lait macules and neurofibromas.
Q.120. Which of the following is the most radiosensitive tissue?
- A. Nerve cells
- B. Lymphocytes
- C. Muscle fibers
- D. Cartilage
Answer: B. Lymphocytes
Explanation: Lymphocytes are extremely sensitive to ionizing radiation.
Q.121. The most common type of lung cancer in smokers is:
- A. Adenocarcinoma
- B. Squamous cell carcinoma
- C. Small cell carcinoma
- D. Large cell carcinoma
Answer: B. Squamous cell carcinoma
Explanation: Smoking is strongly linked to squamous cell carcinoma of the lung.
Q.122. Wiskott-Aldrich syndrome is characterized by:
- A. Eczema, thrombocytopenia, recurrent infections
- B. Microcephaly, seizures, hyperactivity
- C. Albinism, bleeding tendency, recurrent infections
- D. Immune deficiency, bone fractures, lens dislocation
Answer: A. Eczema, thrombocytopenia, recurrent infections
Explanation: Wiskott-Aldrich is an X-linked immunodeficiency disorder.
Q.123. Which vitamin deficiency causes megaloblastic anemia?
- A. Vitamin A
- B. Vitamin C
- C. Vitamin B12
- D. Vitamin K
Answer: C. Vitamin B12
Explanation: Vitamin B12 and folate deficiency both cause megaloblastic anemia.
Q.124. Which disease is associated with “amyloid plaques” in the brain?
- A. Parkinson’s disease
- B. Alzheimer’s disease
- C. Multiple sclerosis
- D. Huntington’s disease
Answer: B. Alzheimer’s disease
Explanation: Alzheimer’s disease shows amyloid plaques and neurofibrillary tangles.
Q.125. A young male with gynecomastia and tall stature most likely has:
- A. Turner syndrome
- B. Klinefelter syndrome
- C. Down syndrome
- D. Fragile X syndrome
Answer: B. Klinefelter syndrome
Explanation: XXY karyotype leads to Klinefelter syndrome, with hypogonadism and gynecomastia.
Q.126. Which organ is most commonly affected by amyloidosis?
- A. Heart
- B. Kidney
- C. Liver
- D. Lung
Answer: B. Kidney
Explanation: Amyloidosis commonly causes nephrotic syndrome due to renal involvement.
Q.127. Which type of hypersensitivity is involved in allergic asthma?
- A. Type I
- B. Type II
- C. Type III
- D. Type IV
Answer: A. Type I
Explanation: Allergic asthma results from IgE-mediated Type I hypersensitivity.
Q.128. Which blood cancer is associated with “starry-sky” appearance?
- A. CML
- B. Hodgkin lymphoma
- C. Burkitt lymphoma
- D. Multiple myeloma
Answer: C. Burkitt lymphoma
Explanation: Burkitt lymphoma (EBV-associated) shows “starry-sky” pattern histologically.
Q.129. Which condition is characterized by “moon face” and “buffalo hump”?
- A. Addison’s disease
- B. Cushing’s syndrome
- C. Acromegaly
- D. Hypothyroidism
Answer: B. Cushing’s syndrome
Explanation: Hypercortisolism causes central obesity, moon face, and buffalo hump.
Q.130. The most common primary malignant brain tumor in adults is:
- A. Medulloblastoma
- B. Glioblastoma multiforme
- C. Meningioma
- D. Oligodendroglioma
Answer: B. Glioblastoma multiforme
Explanation: GBM is the most aggressive and common malignant brain tumor in adults.
Q.131. Which organism causes Kaposi sarcoma in HIV patients?
- A. EBV
- B. HPV
- C. HHV-8
- D. CMV
Answer: C. HHV-8
Explanation: Kaposi sarcoma is caused by human herpesvirus-8 infection.
Q.132. Which disease involves demyelination in the central nervous system?
- A. Guillain-Barré syndrome
- B. Multiple sclerosis
- C. Myasthenia gravis
- D. ALS
Answer: B. Multiple sclerosis
Explanation: MS is an autoimmune demyelinating disease of the CNS.
Q.133. Which condition shows a “berry aneurysm” in the brain?
- A. Huntington’s disease
- B. Subarachnoid hemorrhage
- C. Alzheimer’s disease
- D. Parkinson’s disease
Answer: B. Subarachnoid hemorrhage
Explanation: Ruptured berry aneurysms in the Circle of Willis cause subarachnoid hemorrhage.
Q.134. Which of the following is an autosomal recessive disorder?
- A. Marfan syndrome
- B. Cystic fibrosis
- C. Huntington’s disease
- D. Neurofibromatosis
Answer: B. Cystic fibrosis
Explanation: CF is inherited in an autosomal recessive pattern.
Q.135. “Onion-skinning” of renal arterioles is seen in:
- A. Benign hypertension
- B. Malignant hypertension
- C. Diabetes mellitus
- D. Polyarteritis nodosa
Answer: B. Malignant hypertension
Explanation: Severe hypertension produces onion-skinning of vessel walls.
Q.136. Which disease shows “owl’s eye” inclusion bodies?
- A. HSV infection
- B. CMV infection
- C. HPV infection
- D. EBV infection
Answer: B. CMV infection
Explanation: Cytomegalovirus causes characteristic owl’s eye inclusions in infected cells.
Q.137. Which vitamin deficiency causes rickets in children?
- A. Vitamin A
- B. Vitamin C
- C. Vitamin D
- D. Vitamin K
Answer: C. Vitamin D
Explanation: Vitamin D deficiency leads to rickets in children and osteomalacia in adults.
Q.138. Which condition involves defective DNA repair mechanisms?
- A. Xeroderma pigmentosum
- B. Sickle cell anemia
- C. G6PD deficiency
- D. Hemophilia A
Answer: A. Xeroderma pigmentosum
Explanation: Defective nucleotide excision repair leads to extreme UV sensitivity and skin cancers.
Q.139. Which genetic condition causes a trinucleotide repeat expansion?
- A. Down syndrome
- B. Turner syndrome
- C. Fragile X syndrome
- D. Marfan syndrome
Answer: C. Fragile X syndrome
Explanation: Fragile X is caused by CGG trinucleotide repeat expansion in the FMR1 gene.
Q.140. Which cancer spreads most commonly via lymphatics?
- A. Sarcoma
- B. Carcinoma
- C. Melanoma
- D. Leukemia
Answer: B. Carcinoma
Explanation: Carcinomas typically spread through lymphatic channels, unlike sarcomas.
Q.141. Which cell type gives rise to osteosarcoma?
- A. Osteoblast
- B. Osteoclast
- C. Chondrocyte
- D. Fibroblast
Answer: A. Osteoblast
Explanation: Osteosarcoma is a malignant tumor of osteoblasts.
Q.142. Which of the following is a prion disease?
- A. Alzheimer’s disease
- B. Creutzfeldt-Jakob disease
- C. Parkinson’s disease
- D. Huntington’s disease
Answer: B. Creutzfeldt-Jakob disease
Explanation: CJD is caused by infectious prions leading to spongiform encephalopathy.
Q.143. Which disease is associated with “apple-green birefringence” under polarized light?
- A. Amyloidosis
- B. Sarcoidosis
- C. Tuberculosis
- D. Leukemia
Answer: A. Amyloidosis
Explanation: Amyloid deposits stain with Congo red and show apple-green birefringence.
Q.144. Which of the following is the most common childhood malignancy?
- A. Neuroblastoma
- B. Retinoblastoma
- C. Acute lymphoblastic leukemia (ALL)
- D. Wilm’s tumor
Answer: C. Acute lymphoblastic leukemia (ALL)
Explanation: ALL is the most frequent cancer in children.
Q.145. Which type of infarct typically occurs in solid organs like the heart?
- A. Red infarct
- B. White infarct
- C. Hemorrhagic infarct
- D. Septic infarct
Answer: B. White infarct
Explanation: White infarcts occur in solid organs due to arterial occlusion.
Q.146. Which infection is linked to Burkitt lymphoma?
- A. EBV
- B. HPV
- C. CMV
- D. HSV
Answer: A. EBV
Explanation: Epstein-Barr virus infection is strongly associated with Burkitt lymphoma.
Q.147. Which of the following is the hallmark of Parkinson’s disease?
- A. Beta-amyloid plaques
- B. Lewy bodies
- C. Neurofibrillary tangles
- D. Demyelinated plaques
Answer: B. Lewy bodies
Explanation: Parkinson’s disease is characterized by Lewy bodies in substantia nigra neurons.
Q.148. Which liver disease shows “ground-glass hepatocytes”?
- A. Hepatitis A
- B. Hepatitis B
- C. Hepatitis C
- D. Cirrhosis
Answer: B. Hepatitis B
Explanation: Hepatitis B infection produces ground-glass hepatocyte appearance.
Q.149. Which cancer is most associated with smoking?
- A. Pancreatic cancer
- B. Renal cell carcinoma
- C. Lung cancer
- D. Gastric cancer
Answer: C. Lung cancer
Explanation: Cigarette smoking is the leading cause of lung cancer worldwide.
Q.150. Which genetic condition shows a “trinucleotide repeat anticipation” phenomenon?
- A. Marfan syndrome
- B. Cystic fibrosis
- C. Huntington’s disease
- D. Down syndrome
Answer: C. Huntington’s disease
Explanation: Huntington’s is caused by CAG repeat expansion, showing genetic anticipation.
This concludes Part 3 (Q.101–150) of NCLEX Pathology MCQs. In this set, we explored cancer biology, genetic disorders, autoimmune diseases, infectious pathology, and neurological conditions. Each question was paired with an answer and explanation to boost your exam confidence.
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