Gastrointestinal Pathology Practice Questions

Q: Which of the following statements is false regarding familial polyposis colon cancer syndrome?

Autosomal recessive transmission. **Explanation:** **1. Why Option A is the correct (false) statement:** Familial Adenomatous Polyposis (FAP) is an **Autosomal Dominant** condition, not recessive. It is caused by a germline mutation in the **APC (Adenomatous Polyposis Coli) gene** located on chromosome **5q21** [1]. According to the "Knudson Two-Hit Hypothesis," an individual inherits one defective copy, and a somatic mutation in the second allele leads to the development of hundreds to thousands of adenomatous polyps [1]. **2. Analysis of other options:** * **Option B (Associated with fibromas and osteomas):** This describes **Gardner Syndrome**, a clinical variant of FAP. It includes intestinal polyps plus extra-colonic manifestations like osteomas (usually of the mandible/skull), epidermal cysts, and desmoid tumors (fibromas). * **Option C (Associated with brain tumors):** This describes **Turcot Syndrome**, another variant of FAP. It is characterized by the association of colonic polyposis with CNS tumors (classically **Medulloblastomas** in FAP-associated Turcot, or Glioblastomas in Lynch syndrome). * **Option D (100% chance of developing colon carcinoma):** This is a hallmark of FAP. If left untreated (without prophylactic colectomy), the progression from adenoma to adenocarcinoma is inevitable, usually by the age of 40-50 [1]. **High-Yield Clinical Pearls for NEET-PG:** * **Minimum Requirement:** Diagnosis requires at least **100 polyps** [1]. * **Screening:** Start colonoscopy/sigmoidoscopy at age **10–12 years**. * **CHRPE:** Congenital Hypertrophy of Retinal Pigment Epithelium is a highly specific early extra-colonic sign of FAP. * **Molecular Pathway:** FAP follows the **APC-Wnt/β-catenin pathway** (the classic Adenoma-Carcinoma sequence). **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Gastrointestinal Tract, pp. 821-822.

Question 1

Which of the following is NOT associated with an increased risk of malignancy in a polyp?

Accepted Answer

Pedunculated polyp

Answer

> 2 cm

Answer

Villous polyp

Answer

Cellular atypia

Question 2

Tuberculosis commonly affects which part of the intestine?

Accepted Answer

Ileum

Answer

Jejunum

Answer

Terminal colon

Answer

Transverse colon

Question 3

Skip lesions of the colon with epithelioid granulomas are usually seen with which of the following conditions?

Accepted Answer

Crohn's disease

Answer

Ulcerative colitis

Answer

Intestinal TB

Answer

Sarcoidosis

Question 4

Which parotid tumor is characterized by the presence of lymphoid tissue?

Accepted Answer

Warthin's tumor

Answer

Pleomorphic adenoma

Answer

Adenoid cystic carcinoma

Answer

Mucoepidermoid carcinoma

Question 5

A 68-year-old male presents with symptoms of anemia. Workup reveals GI tract blood loss secondary to a tumor mass in his colon. A biopsy specimen indicates this mass is an invasive adenocarcinoma. Which of the following best describes the most likely histologic appearance of this tumor?

Accepted Answer

A disorganized mass of cells forming glandular structures

Answer

A uniform proliferation of fibrous tissue

Answer

A disorganized mass of proliferating fibroblasts and blood vessels

Answer

A uniform proliferation of glandular structures

Question 6

Carcinoid tumours commonly arise from which cell type and location?

Accepted Answer

Argentaffin cells of the small intestine

Answer

Gastrin cells in the pancreas

Answer

Pancreatic endocrine tumour

Answer

Colon polyps

Question 7

Which of the following statements is false regarding familial polyposis colon cancer syndrome?

Accepted Answer

Autosomal recessive transmission

Answer

Associated with fibromas and osteomas

Answer

Associated with brain tumors

Answer

100% chance of developing colon carcinoma

Question 8

Which of the following features is NOT characteristic of leukoplakia?

Accepted Answer

Plasma cell infiltration within the dermal papillae

Answer

Hyperkeratosis

Answer

Clinically, a paint-like patch

Answer

A moist shiny lesion

Question 9

Which of the following conditions shows the most specific change in a biopsy?

Accepted Answer

Abetalipoproteinemia

Answer

Tropical sprue

Answer

Giardiasis

Answer

Malnutrition

Question 10

Mixed tumors of the salivary glands are most commonly found in which location?

Accepted Answer

Parotid gland

Answer

Submandibular gland

Answer

Usually malignant

Answer

Associated with calculi

Gastrointestinal Pathology — MCQs

Gastrointestinal Pathology — MCQs

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