The Ham test is specifically used for diagnosing paroxysmal nocturnal hemoglobinuria (PNH) and is based upon:
The tissue of origin of the Kaposi's sarcoma is
Which viral proteins are known to act as carcinogens in causing carcinoma cervix?
Alzheimer type II astrocytes are seen in which condition?
Which of the following statements about cross-matching of blood is false?
What is the number of Barr bodies present in Klinefelter's syndrome?
Plaques jaunes are seen in which condition?
Which of the following statements about MALToma is true?
In a patient presenting with gallbladder abnormalities, which condition is characterized by a speckled appearance of the gallbladder mucosa resembling a strawberry?
Which of the following is NOT a recognized cause of Urothelial Carcinomas?
NEET-PG 2015 - Pathology NEET-PG Practice Questions and MCQs
Question 71: The Ham test is specifically used for diagnosing paroxysmal nocturnal hemoglobinuria (PNH) and is based upon:
- A. GPI Anchor Proteins
- B. Complement (Correct Answer)
- C. Spectrin protein
- D. Mannose binding proteins
Explanation: ***Complement*** - The HAM test is based on the activation of the **complement system** which enhances the opsonization and clearance of immune complexes [1]. - It is used in the diagnosis of certain conditions, notably those associated with **hemolytic anemia** due to complement fixation. *GPI Anchor Proteins* - GPI anchor proteins are involved in anchoring proteins to cell membranes but are **not related to the HAM test**. - This oes not explain the **mechanism** or purpose of the HAM test. *Mannose binding proteins* - Mannose binding lectins play a role in **innate immunity** but are not the basis of the HAM test. - They function in the **opsonization of pathogens**, which is unrelated to the complement activation aspect of the HAM test. *Spectrin protein* - Spectrin is a cytoskeletal protein that contributes to the integrity of cell membranes, particularly in red blood cells. - It does not relate to the **mechanism of the HAM test**, which focuses on complement involvement. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Inflammation and Repair, pp. 99-100.
Question 72: The tissue of origin of the Kaposi's sarcoma is
- A. Lymphoid
- B. Vascular (Correct Answer)
- C. Neural
- D. Muscular
Explanation: ***Vascular*** - Kaposi's sarcoma originates from the **vascular tissue**, specifically from endothelial cells lining blood vessels [2]. - The lesions are characterized by **angiogenesis**, leading to the formation of vascular tumors with dilated endothelial cell-lined vascular spaces [1]. *Muscular* - Muscular tissue is involved in **voluntary** and **involuntary movements** but is not related to the etiology of Kaposi's sarcoma. - This condition does not arise from **muscle cells** or any muscular components. *Neural* - Neural tissue consists of **neurons** and **glial cells**, which are not implicated in Kaposi's sarcoma. - Kaposi's sarcoma does not originate from any **neural structures** or pathologies. *Lymphoid* - Lymphoid tissue primarily concerns the immune system, particularly the **lymphatic system**, and does not give rise to Kaposi's sarcoma. - This malignancy does not derive from **lymphoid components** like lymphocytes or lymph nodes. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Diseases of Infancy and Childhood, pp. 526-527. [2] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Cardiovascular Disease, pp. 282-283.
Question 73: Which viral proteins are known to act as carcinogens in causing carcinoma cervix?
- A. P 24 - gene
- B. E - gene (Correct Answer)
- C. L - gene
- D. H - gene
Explanation: ***E - gene*** - The **E - gene** in human papillomavirus (HPV) is known to play a crucial role in the **transformation of cervical cells**, leading to cancer development [1]. - Specifically, the **E6 and E7 proteins** encoded by this gene interfere with tumor suppressor functions, contributing to cervical carcinoma [1,2]. *L - gene* - The **L - gene** is associated with the virus's structural proteins, primarily aiding in the formation of the viral capsid. - It does not have a direct role in the oncogenic process leading to cervical cancer. *H - gene* - The **H - gene** is not specifically linked to the oncogenic effects of HPV; it is not recognized for contributing to cancer development. - It is often confused in discussions but doesn't directly influence the carcinogenic pathway like the E gene does. *P 24 - gene* - The **P 24 - gene** is not related to HPV; instead, it is associated with **HIV** and its structural components. - This gene does not play any role in the development of cervical carcinoma or transformation of cervical cells. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Female Genital Tract, pp. 1006-1007. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Neoplasia, pp. 334-335.
Question 74: Alzheimer type II astrocytes are seen in which condition?
- A. Hepatic encephalopathy (Correct Answer)
- B. Parkinsonism
- C. Alzheimer's
- D. Binswanger disease
Explanation: ***Hepatic encephalopathy*** - **Alzheimer type II astrocytes** are characteristic histological findings in cases of **hepatic encephalopathy**, reflecting the brain's response to elevated ammonia levels. - These astrocytes show enlarged, pale nuclei with prominent nucleoli and marginal chromatin, indicating cellular stress from metabolic dysfunction in the setting of liver failure. *Alzheimer's* - Alzheimer's disease is characterized by the presence of **neurofibrillary tangles** (tau protein) and **amyloid plaques** (beta-amyloid protein), not Alzheimer type II astrocytes. - Astrocytes in Alzheimer's disease may show reactive changes, but they do not typically manifest as the specific "Alzheimer type II" morphology. *Parkinsonism* - Parkinsonism is primarily characterized by the degeneration of **dopaminergic neurons** in the substantia nigra and the presence of **Lewy bodies** (alpha-synuclein aggregates). - While glial cells (astrocytes and microglia) do play a role in neuroinflammation in Parkinson's, they do not exhibit the specific Alzheimer type II astrocytic change. *Binswanger disease* - Binswanger disease is a form of **vascular dementia** characterized by diffuse white matter lesions due to chronic ischemia and damage to small cerebral blood vessels. - The pathology primarily involves demyelination and axonal loss in the white matter, with reactive gliosis, but not the specific changes seen in Alzheimer type II astrocytes.
Question 75: Which of the following statements about cross-matching of blood is false?
- A. Mandatory in all cases except emergency
- B. Involves visible agglutination
- C. Recipient serum is tested against donor packed cells
- D. Donor serum is tested against recipient packed cells (Correct Answer)
Explanation: ***Donor serum is tested against recipient packed cells*** - This statement is **FALSE** and describes a **minor crossmatch**, which is rarely performed in modern transfusion practice. - The minor crossmatch tests donor antibodies against recipient cells, but this is not standard practice because donor plasma is significantly diluted during transfusion, making clinically significant reactions rare. - Modern blood banking focuses on the **major crossmatch** as the critical safety measure. *Recipient serum is tested against donor packed cells* - This statement is **TRUE** and accurately describes the **major crossmatch**, which is the standard and most critical pre-transfusion compatibility test. - The major crossmatch detects antibodies in the recipient's serum that could react with donor red blood cell antigens, preventing potentially fatal hemolytic transfusion reactions. *Mandatory in all cases except emergency* - This statement is **TRUE**. Crossmatching is mandatory for safe transfusion practice. - In life-threatening emergencies where delay could be fatal, uncrossmatched O-negative (universal donor) blood may be given, but this is a rare exception. *Involves visible agglutination* - This statement is **TRUE**. A positive crossmatch indicating incompatibility is identified by **visible agglutination** or **hemolysis**. - These visible reactions occur when recipient antibodies bind to donor red blood cell antigens, signaling that transfusion would cause a severe reaction.
Question 76: What is the number of Barr bodies present in Klinefelter's syndrome?
- A. 0
- B. 1 (Correct Answer)
- C. 2
- D. 3
Explanation: ***1*** - **Klinefelter's syndrome** typically has a 47,XXY karyotype, meaning there are two X chromosomes [1]. - The number of Barr bodies is calculated as **N-1**, where N is the total number of X chromosomes. In this case, 2-1 = **1 Barr body** [1]. - This follows the principle that one X chromosome remains active while additional X chromosomes are inactivated [1]. *0* - **No Barr bodies** are found in individuals with a normal male karyotype (46,XY) or in Turner syndrome (45,XO), neither of which describes Klinefelter's syndrome [1]. - The presence of at least one Barr body indicates the presence of at least two X chromosomes. *2* - **Two Barr bodies** would be indicative of a karyotype with three X chromosomes (e.g., 47,XXX syndrome or Triple X syndrome), which is not Klinefelter's syndrome. - This calculation follows the N-1 rule: 3 X chromosomes - 1 = 2 Barr bodies. *3* - **Three Barr bodies** would correspond to a karyotype with four X chromosomes (e.g., 48,XXXX), which is an even rarer sex chromosome aneuploidy not associated with Klinefelter's syndrome. - The N-1 rule applies: 4 X chromosomes - 1 = 3 Barr bodies. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Genetic Disorders, pp. 173-174.
Question 77: Plaques jaunes are seen in which condition?
- A. Syphilis
- B. Head injury
- C. Endocarditis
- D. Atherosclerosis (Correct Answer)
Explanation: ***Head injury*** - **Plaques jaunes**, or yellow plaques, are primarily associated with brain injuries, particularly in areas of **contusion** or **hemorrhage** [1]. - These plaques may represent **lipid-laden macrophages** and indicate areas of *necrosis* and inflammation in the brain [1]. *Endocarditis* - Endocarditis is characterized by **vegetations** on heart valves rather than plaques in the brain. - Symptoms typically include **fever**, **murmurs**, and **embolization**, which do not involve yellow plaques. *Syphilis* - Syphilis may cause *gummatous lesions* but is not associated with yellow plaques in the brain. - Typical findings include **rash** and **ulcerative lesions**, particularly during the secondary stage. *Atherosclerosis* - Atherosclerosis involves **plaque formation** in blood vessels but these are not the same as **plaques jaunes** in neurological contexts. - It is characterized by **cholesterol** deposits and plaque rupture leading to cardiovascular events, not plaques seen in head injuries. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Central Nervous System, pp. 1262-1264.
Question 78: Which of the following statements about MALToma is true?
- A. They are primary gastric lymphomas
- B. H. Pylori infection is a known risk factor (Correct Answer)
- C. They are a type of T cell lymphoma
- D. Exclusively seen in the gastric antrum
Explanation: ***H. Pylori infection is a risk factor*** - MALToma, or **mucosa-associated lymphoid tissue lymphoma**, is often associated with chronic **H. Pylori infection**, making it a significant risk factor [1]. - **Eradication of H. Pylori** can lead to regression of MALT lymphoma, further supporting the association. *They are a type of T cell lymphoma* - MALToma is classified as a **B-cell lymphoma**, primarily arising from **marginal zone B cells** [1]. - T-cell lymphomas differ significantly in their **pathophysiology** and typical clinical presentations. *They are secondary gastric lymphomas* - MALTomas typically arise **primarily** in the gastric mucosa rather than as secondary lymphomas from another site [1]. - Secondary lymphomas are usually related to more aggressive forms and are often associated with **systemic involvement**. *Commonly seen in gastric cardia* - MALTomas are most frequently found in the **stomach** but are not specifically concentrated in the **gastric cardia** region. - They can also manifest in other areas such as the **antrum**, making this statement misleading. **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Alimentary System Disease, pp. 356-358.
Question 79: In a patient presenting with gallbladder abnormalities, which condition is characterized by a speckled appearance of the gallbladder mucosa resembling a strawberry?
- A. Gangrene of the gallbladder
- B. Porcelain gallbladder
- C. Adenomatosis of the gallbladder
- D. Cholesterolosis of the gallbladder (Correct Answer)
Explanation: ***Cholesterolosis of the gallbladder*** - This condition is characterized by the accumulation of **cholesterol esters** and **triglycerides** within macrophages in the lamina propria of the gallbladder, creating a **speckled appearance** often referred to as a "**strawberry gallbladder**". - It is typically asymptomatic but can be associated with **cholelithiasis** (gallstones) in some cases. *Gangrene of the gallbladder* - This is a severe complication of **acute cholecystitis** where the gallbladder tissue dies due to **ischemia**, often appearing necrotic and dark, not speckled. - It presents with severe abdominal pain, fever, and signs of **sepsis**, which is distinct from a speckled appearance. *Porcelain gallbladder* - This condition involves **extensive calcification of the gallbladder wall**, making it brittle and rigid, and is often associated with an increased risk of gallbladder cancer. - Its appearance is typically hard and white due to calcification, not speckled like a strawberry. *Adenomatosis of the gallbladder* - This term is often used interchangeably with **adenomyomatosis**, which involves **hypertrophy of the muscularis propria** and **outpouchings of the mucosa** (Rokitansky-Aschoff sinuses). - It presents as nodular or diffuse thickening of the gallbladder wall, not a speckled mucosal pattern.
Question 80: Which of the following is NOT a recognized cause of Urothelial Carcinomas?
- A. Industrial solvents
- B. Exposure to thorotrast
- C. Alcohol consumption (Correct Answer)
- D. Smoking
Explanation: ***Alcohol consumption*** - Research does not support a direct association between **alcohol consumption** and an increased risk of urothelial carcinomas. - While excessive alcohol can lead to other forms of cancer, it is not a recognized risk factor for **bladder cancer** specifically. *Smoking* - Smoking is a well-established risk factor for **urothelial carcinomas**, significantly increasing the risk of **bladder cancer** [1]. - It is responsible for up to **50% of bladder cancer cases**, due to carcinogens in tobacco smoke [1]. *Exposure to thorotrast* - **Thorotrast**, a radiopaque contrast medium, is associated with **radiation exposure**, which is a known risk for urothelial carcinomas [3]. - Its use has been linked to increased incidence of bladder cancer due to radioactive properties [3]. *Industrial solvents* - Exposure to various **industrial solvents** such as **aromatic amines** has been linked to a higher risk of developing urothelial carcinomas [1][2]. - These chemicals are commonly found in **dyes**, **rubber**, and other manufacturing processes [2]. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Lower Urinary Tract and Male Genital System, pp. 968-970. [2] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. (Basic Pathology) introduces the student to key general principles of pathology, both as a medical science and as a clinical activity with a vital role in patient care. Part 2 (Disease Mechanisms) provides fundamental knowledge about the cellular and molecular processes involved in diseases, providing the rationale for their treatment. Part 3 (Systematic Pathology) deals in detail with specific diseases, with emphasis on the clinically important aspects., pp. 217-218. [3] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. (Basic Pathology) introduces the student to key general principles of pathology, both as a medical science and as a clinical activity with a vital role in patient care. Part 2 (Disease Mechanisms) provides fundamental knowledge about the cellular and molecular processes involved in diseases, providing the rationale for their treatment. Part 3 (Systematic Pathology) deals in detail with specific diseases, with emphasis on the clinically important aspects., pp. 216-217.