Gastrointestinal Pathology Practice Questions

Q: Which of the following statements is false?

Cronkhite-Canada syndrome is due to SMAD-4 mutation.. **Explanation:** The correct answer is **D** because **Cronkhite-Canada syndrome (CCS)** is a **non-hereditary (sporadic)** polyposis syndrome [1]. Unlike the other options, it is not associated with a specific germline mutation. It is characterized by hamartomatous polyps throughout the GI tract, accompanied by unique ectodermal changes such as alopecia, nail dystrophy, and hyperpigmentation. **Analysis of Options:** * **A. Cowden Syndrome:** This is an autosomal dominant disorder caused by a mutation in the **PTEN** tumor suppressor gene [1]. It presents with multiple hamartomatous polyps and carries a high risk of breast, thyroid, and endometrial cancers. * **B. Gardner Syndrome:** This is a clinical variant of Familial Adenomatous Polyposis (FAP) caused by mutations in the **APC gene**. It is characterized by the triad of colonic polyposis, osteomas (usually of the mandible), and soft tissue tumors (desmoid tumors). * **C. Turcot Syndrome:** This involves colonic polyposis plus central nervous system tumors. It is genetically heterogeneous: Type 1 is associated with DNA mismatch repair genes (HNPCC), while Type 2 is associated with **APC gene** mutations (associated with Medulloblastoma). **NEET-PG High-Yield Pearls:** * **SMAD4/BMPR1A mutations** are actually associated with **Juvenile Polyposis Syndrome (JPS)**, not Cronkhite-Canada [1]. * **Peutz-Jeghers Syndrome** is associated with **STK11 (LKB1)** mutations and presents with perioral pigmentation [1], [2]. * **Remember:** Cronkhite-Canada is **acquired** and typically occurs in older adults (age >50) [1], whereas most other polyposis syndromes are congenital. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Gastrointestinal Tract, p. 813. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Gastrointestinal Tract, pp. 813-814.

Question 1

Histologically, intense lymphocytic infiltration of the gland, replacing acinar structures but preserving the lobular architecture, is seen in which condition?

Accepted Answer

Sjogren syndrome.

Answer

Mucoepidermoid carcinoma.

Answer

Epithelial-myoepithelial carcinoma.

Answer

Myoepithelioma.

Question 2

A 49-year-old woman with a history of peptic ulcer disease treated with proton pump inhibitors presents with nausea and vomiting for the past 2 months. Upper GI endoscopy reveals three circumscribed, round, smooth lesions in the gastric body, each measuring 1 to 2 cm in diameter. Biopsies of these lesions show irregular, cystically dilated glands lined by flattened parietal and chief cells, with no evidence of inflammation, Helicobacter pylori, metaplasia, or dysplasia. What is the most likely diagnosis?

Accepted Answer

Fundic gland polyps

Answer

Hyperplastic polyps

Answer

Gastric adenomas

Answer

Hypertrophic gastropathy

Question 3

Which of the following conditions has a higher risk of malignancy?

Accepted Answer

Erythroplakia

Answer

Leukoplakia

Answer

Dysplasia

Answer

Hyperplasia

Question 4

A 28-year-old male presents with fever, acute abdominal pain, and leukocytosis, suggestive of acute appendicitis. An emergency laparotomy is planned. During surgery, numerous enlarged mesenteric lymph nodes are noted. If the cause is infective, what is the likely diagnosis?

Accepted Answer

Yersinia pseudotuberculosis

Answer

Atypical shigellosis

Answer

Enteric fever

Answer

Gastrointestinal tuberculosis

Question 5

Which of the following is NOT a cause of chronic gastritis?

Accepted Answer

Overuse of salicylates

Answer

Helicobacter pylori

Answer

Pernicious anemia

Answer

Alcohol

Question 6

Which of the following statements about Barrett's Esophagus is false?

Accepted Answer

None of the above statements are false.

Answer

It is a premalignant condition.

Answer

It can be diagnosed by visual inspection during endoscopy.

Answer

Biopsy is necessary to confirm the diagnosis.

Question 7

Which type of colorectal polyp has the highest malignant potential?

Accepted Answer

Sessile polyp

Answer

Pedunculated polyp

Answer

Superficial spreading polyp

Answer

Any of the above

Question 8

Which of the following is not a premalignant lesion or condition?

Accepted Answer

Chronic hypertrophic candidiasis

Answer

Oral submucosal fibrosis

Answer

Lichen planus

Answer

Leukoplakia

Question 9

What is the most common type of gastric carcinoma?

Accepted Answer

Adenocarcinoma

Answer

Squamous cell carcinoma

Answer

Lymphoma

Answer

Leiomyosarcoma

Question 10

Which of the following statements is false?

Accepted Answer

Cronkhite-Canada syndrome is due to SMAD-4 mutation.

Answer

Cowden syndrome is due to PTEN mutation.

Answer

Gardner syndrome is due to APC mutation.

Answer

Turcot syndrome is due to APC mutation.

Gastrointestinal Pathology — MCQs

Gastrointestinal Pathology — MCQs

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