Free Practice Questions for Anatomic Pathology Board
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Sample Anatomic Pathology Board Practice Questions
Try these sample questions to review concepts for the Anatomic Pathology Board exam. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.
1A 52-year-old woman undergoes a right hemicolectomy for a cecal adenocarcinoma. Immunohistochemistry for DNA mismatch repair (MMR) proteins demonstrates intact nuclear expression of MSH2 and MSH6 in the neoplastic cells, but complete loss of nuclear expression of MLH1 and PMS2. Internal positive controls (stromal cells and infiltrating lymphocytes) show strong nuclear staining for all four proteins. Which of the following is the most appropriate next molecular diagnostic step to distinguish a sporadic neoplasm from Lynch syndrome?
2A 64-year-old man undergoes resection of a 4.5 cm well-circumscribed submucosal gastric mass. Histopathology reveals intersecting fascicles of uniform spindle cells with blunt-ended nuclei and pale eosinophilic cytoplasm. Immunohistochemistry is strongly and diffusely positive for KIT (CD117) and DOG1. Mitotic count demonstrates 2 mitoses per 5 mm². According to the Miettinen and Lasota (AFIP) risk stratification criteria, which of the following risk categories best describes this tumor?
3An endoscopic biopsy of the distal esophagus in a 60-year-old man with chronic gastroesophageal reflux disease shows specialized intestinal metaplasia with goblet cells. Cytologic examination reveals crowded glands with nuclear stratification confined to the basal half of the cells, hyperchromasia, preserved polarity, and mild nuclear enlargement extending to the mucosal surface without loss of nuclear orientation or marked architectural complexity. Which of the following is the most accurate diagnostic interpretation?
4A 28-year-old woman undergoes total proctocolectomy for medically refractory colitis. Gross examination shows diffuse, continuous mucosal erythema, granular ulceration, and inflammatory pseudopolyps extending from the dentate line of the rectum to the mid-transverse colon, with sharp demarcation from normal proximal mucosa. Microscopic examination demonstrates diffuse mucosal architectural distortion, crypt branching, basal lymphoplasmacytosis, and crypt abscesses confined strictly to the mucosa and superficial submucosa, without transmural inflammation or granulomas. Which of the following is the definitive diagnosis?
5A 38-year-old man undergoes total gastrectomy for a diffuse, infiltrative gastric neoplasm causing thickened, rigid gastric walls (linitis plastica). Histopathologic examination demonstrates discohesive neoplastic cells with abundant intracytoplasmic mucin vacuoles displacing eccentric, crescent-shaped hyperchromatic nuclei infiltrating diffusely through the muscularis propria and subserosa. Immunohistochemistry reveals complete absence of membranous staining for E-cadherin in the neoplastic cells. Genetic evaluation is most likely to identify a germline mutation in which of the following genes?
6A 32-year-old woman is found to have a well-circumscribed, 4.0 cm liver mass on abdominal MRI. Surgical resection yields a tan-yellow unencapsulated mass with a prominent central fibrous scar containing thick-walled, dystrophic arteries with eccentric intimal hyperplasia. Surrounding the scar are radiating fibrous septa dividing the lesion into nodules of benign-appearing hepatocytes without portal tracts. Immunohistochemistry for glutamine synthetase demonstrates strong, anastomosing, map-like (geographic) cytoplasmic staining. Which of the following is the most likely diagnosis?
7A 34-year-old man presents with chronic diarrhea, iron-deficiency anemia, and elevated anti-tissue transglutaminase (tTG) IgA titers. Duodenal biopsies show complete blunting and flattening of the intestinal villi, elongated hyperplastic crypts with increased mitotic figures, and a marked increase in intraepithelial lymphocytes (>40 lymphocytes per 100 enterocytes) concentrated in the surface epithelium. According to the modified Marsh-Oberhuber classification, which stage corresponds to these findings?
8An appendectomy specimen from a 55-year-old woman shows a dilated appendix filled with copious extracellular mucin. Microscopic examination reveals a villous and flattened proliferation of mucin-rich columnar epithelium with low-grade cytologic atypia, widespread loss of the lamina propria and muscularis mucosae, and push-type herniation of acellular mucin dissecting into the muscularis propria without desmoplasia or infiltrative destructive invasion. The proximal surgical margin is widely clear. Which of the following is the most accurate diagnosis?
9A core needle biopsy of an ill-defined breast mass in a 58-year-old woman shows a discohesive proliferation of small, uniform, round cells with eccentric nuclei and intracytoplasmic lumina containing mucin droplets. The neoplastic cells infiltrate the dense fibrous stroma in a single-file ('Indian file') pattern and concentrically encircle normal mammary ducts in a targetoid fashion. To confirm the diagnosis, immunohistochemistry is performed. Which of the following staining profiles is characteristic of this lesion?
10A 46-year-old woman undergoes excision of an 8.0 cm rapidly growing, well-circumscribed, fleshy breast mass. Histopathologic examination shows a biphasic fibroepithelial neoplasm with an exaggerated intracanalicular architecture forming leaf-like stromal projections lined by benign luminal epithelial and myoepithelial cells. The stroma shows marked diffuse hypercellularity, severe nuclear pleomorphism, stromal overgrowth (absence of epithelial elements in at least one low-power field), infiltrative margins, and 14 mitoses per 10 high-power fields (HPFs). Which of the following is the definitive diagnosis?
About the Anatomic Pathology Board Exam
Independent English-language MCQ study adaptation by OpenExamPrep. Independent MCQ study aid developed by OpenExamPrep for the Saudi Board Final Written Examination in Anatomic Pathology. Covers surgical pathology, cytopathology, quality and safety, special stains and IHC, general pathology, autopsy and forensic pathology, and molecular pathology. Note: this study aid targets the final written examination and does not simulate the clinical OSCE or structured oral exam.
Exam sponsor: Saudi Commission for Health Specialties (SCFHS). The requirements and fees below concern the certification or admission exam, separate from our free practice resources.
Assessment
Two papers, each with 100–125 single-best-answer MCQs. Up to 10% additional unscored items may be added. Duration is not stated in the written blueprint.
Time Limit
Not published by SCFHS
Passing Score
70% (lowered to minimum 65% if pass rate under 70%)
Reported exam pass rate: Not published by SCFHS. SCFHS publishes no candidate pass rate. The blueprint instead sets the passing score at 70% and, if fewer than 70% of candidates pass before final approval, lowers that score one mark at a time until a 70% pass rate is reached or the score reaches 65%, whichever comes first; it is never lowered below 65%. Exam sponsor website
Fees, eligibility, and exam policies can change. Confirm them with the exam sponsor before applying or paying.
Our practice resources: topics covered
We aim to reflect publicly available exam outlines and topic information in our study resources. Coverage, format, and difficulty may differ from the actual exam, and we cannot guarantee that every detail is accurate or current. Confirm exam requirements, fees, and policies with the official exam sponsor.
Surgical Pathology (including frozen section)
Diagnostic surgical histopathology including frozen section evaluation, neoplastic and non-neoplastic diseases across organ systems.
Cytopathology
Exfoliative and fine needle aspiration (FNA) cytology across gynecologic, thyroid, salivary gland, and body fluid specimens.
Quality and Safety
Pre-analytic, analytic, and post-analytic quality assurance, specimen turnaround, critical value reporting, and laboratory safety regulations.
Special Stains and Immunohistochemistry
Histochemical special stains, antibody panels, diagnostic IHC interpretation, and troubleshooting staining artifacts.
General Pathology
Cell injury, necrosis, apoptosis, acute and chronic inflammation, hemodynamics, and basic neoplasia mechanisms.
Autopsy and Forensic Pathology
Autopsy techniques, postmortem changes, cause and manner of death determination, and forensic trauma investigation principles.
Molecular and Cytogenetics studies and electron microscopy
Molecular diagnostics, next-generation sequencing, FISH, PCR applications, and predictive oncology biomarkers.
Preparing for the Anatomic Pathology Board Exam
What You Need to Know
- Passing score: 70% (lowered to minimum 65% if pass rate under 70%)
- Assessment: Two papers, each with 100–125 single-best-answer MCQs. Up to 10% additional unscored items may be added. Duration is not stated in the written blueprint.
- Time limit: Not published by SCFHS
- Exam / certification fees: Not published by SCFHS Official sources
Using Our Practice Resources
- Work through all 100 available questions
- Review every answer and explanation
- Track weak areas and revisit them
- Use our AI tutor for tough concepts
Anatomic Pathology Board: Suggested Study Strategy
Frequently Asked Questions
What is the format of the Saudi Board Anatomic Pathology final examination?
Two papers, each with 100–125 single-best-answer MCQs. Up to 10% additional unscored items may be added. Duration is not stated in the written blueprint.
What is the passing score for the Saudi Board Anatomic Pathology final written exam?
The passing score is set at 70%. In accordance with SCFHS guidelines, if fewer than 70% of candidates achieve this score, the passing mark is lowered one point at a time toward a 70% pass rate, but never lower than 65%.
Is this practice resource affiliated with or endorsed by the SCFHS?
No. This practice question bank is an independent study aid created by OpenExamPrep to assist candidates preparing for their written board examinations. It is not affiliated with, endorsed by, or officially connected to the Saudi Commission for Health Specialties.
Does this question bank cover the OSCE and structured oral components?
Two papers, each with 100–125 single-best-answer MCQs. Up to 10% additional unscored items may be added. Duration is not stated in the written blueprint.