General Pathology Practice Questions

Q: Russell bodies are typically seen in which type of cell?

Plasma cells. **Explanation:** **Russell bodies** are eosinophilic, large, homogeneous immunoglobulin inclusions. They represent the accumulation of newly synthesized immunoglobulins within the cisternae of the **Rough Endoplasmic Reticulum (RER)** of a **Plasma cell**. This occurs when the rate of protein synthesis exceeds the cell's capacity to secrete them, leading to "constipation" of the RER. * **Why Plasma Cells (Correct):** Plasma cells are the effector B-lymphocytes specialized for massive antibody production [1]. When these cells become chronically activated or undergo neoplastic transformation (like in Multiple Myeloma), they develop these characteristic globular cytoplasmic inclusions. A plasma cell containing numerous Russell bodies is often referred to as a **Mott cell** (or grape cell). **Analysis of Incorrect Options:** * **Lymphocytes:** While plasma cells are derived from B-lymphocytes, mature lymphocytes themselves do not have the extensive RER machinery required to produce the volume of protein necessary to form Russell bodies [1]. * **Neutrophils:** These cells contain primary (azurophilic) and secondary (specific) granules, but they do not produce immunoglobulins. * **Macrophages:** These are phagocytic cells. While they may contain ingested debris or "tingible bodies" (in germinal centers), they do not synthesize the immunoglobulins that constitute Russell bodies. **High-Yield Clinical Pearls for NEET-PG:** * **Dutcher Bodies:** Similar immunoglobulin inclusions, but located within the **nucleus** (seen in Waldenström macroglobulinemia). * **Mott Cell:** A plasma cell filled with multiple Russell bodies. * **Councilman Bodies:** Eosinophilic globules seen in the liver, representing apoptotic hepatocytes (classic for Yellow Fever and Viral Hepatitis). * **Negri Bodies:** Intracytoplasmic inclusions in pyramidal cells of the hippocampus/Purkinje cells (pathognomonic for Rabies).

Q: What is the characteristic finding of sweat chloride levels in patients with cystic fibrosis?

Increased. **Explanation:** The correct answer is **B (Increased)**. **Pathophysiology:** Cystic Fibrosis (CF) is caused by a mutation in the **CFTR (Cystic Fibrosis Transmembrane Conductance Regulator)** gene. The CFTR protein functions differently depending on the tissue. In the **sweat glands**, its primary role is the **reabsorption** of chloride ions from the primary secretion back into the ductal cells [1]. Sodium follows chloride to maintain electrical neutrality. In CF patients, the defective CFTR channel cannot reabsorb chloride; consequently, chloride remains in the sweat, leading to an abnormally high concentration of salt (NaCl) on the skin surface [1]. **Analysis of Incorrect Options:** * **Option A (Decreased):** This is incorrect because the defect lies in the inability to *reabsorb* chloride from the lumen. Decreased levels are not seen in CF [1]. * **Option C & D (No change / May increase or decrease):** Sweat chloride levels are consistently elevated in classic CF, making these options clinically inaccurately. **High-Yield NEET-PG Pearls:** * **Gold Standard Diagnosis:** The **Pilocarpine Iontophoresis Sweat Test** is the diagnostic test of choice. A chloride concentration **>60 mmol/L** is diagnostic of CF. * **Tissue Paradox:** Remember the "CFTR Paradox"—in the **respiratory and GI tracts**, CFTR failure leads to decreased chloride *secretion* (causing thick, dehydrated mucus), whereas in **sweat glands**, it leads to decreased chloride *reabsorption* [1]. * **Genetics:** Most common mutation is **ΔF508** (Class II defect: protein misfolding and degradation). * **Clinical Sign:** Mothers often report that the infant "tastes salty" when kissed. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Lumen Of Sweat Duct, pp. 475-476.

Question 1

Russell bodies are typically seen in which type of cell?

Accepted Answer

Plasma cells

Answer

Lymphocytes

Answer

Neutrophils

Answer

Macrophages

Question 2

Which of the following is NOT true about apoptosis?

Accepted Answer

Inflammation is present

Answer

Chromosomal breakage

Answer

Clumping of chromatin

Answer

Cell shrinkage

Question 3

What is the mechanism of transmission for Alpha-1 antitrypsin deficiency?

Accepted Answer

Autosomal recessive

Answer

Autosomal dominant

Answer

X-linked recessive

Answer

X-linked dominant

Question 4

A 40-year-old lady presented with sudden onset of breathing difficulty. Clinical examination was essentially normal except for tachycardia and tachypnea. She gives a history of two episodes of lower limb pain and swelling, the first episode was 15 years back during her first pregnancy and the second episode 3 months back. What would be the hematological abnormality responsible for her condition?

Accepted Answer

Resistance to activated protein C

Answer

Protein C excess

Answer

Antithrombin mutation causing accelerated effect

Answer

Polycythemia vera

Question 5

In Lysosomal storage disorders, which of the following statements is true?

Accepted Answer

Lysosomes are deficient in the enzyme hydrolase.

Answer

There is a defect in the fusion of lysosomes and phagosomes.

Answer

There is a defect in the lysosomal membrane.

Answer

There is increased degradation of heteroglycans.

Question 6

Maximum damage to DNA is caused by which type of radiation?

Accepted Answer

alpha rays

Answer

beta rays

Answer

gamma rays

Answer

X-rays and UV rays

Question 7

A phenotypically normal woman with difficulties in conceiving was found to have three Barr bodies on karyotype analysis, with no translocations or large deletions. Her karyotype would be best represented by which one of the following?

Accepted Answer

48 XXXX

Answer

48 XXXXY

Answer

46 XX

Answer

48 XXXY

Question 8

Time taken by tissue to develop frank necrosis is approximately:

Accepted Answer

4 hours

Answer

30 minutes

Answer

1 hour

Answer

2 hours

Question 9

HER-2/NEU receptor gene mutation is seen in which cancer?

Accepted Answer

Breast cancer

Answer

Squamous cell carcinoma

Answer

Glioblastoma

Answer

All of the above

Question 10

What is the characteristic finding of sweat chloride levels in patients with cystic fibrosis?

Accepted Answer

Increased

Answer

Decreased

Answer

No change

Answer

May increase or decrease

General Pathology — MCQs

General Pathology — MCQs

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