General Pathology Practice Questions

Q: Sago spleen is seen in which of the following conditions?

Amyloidosis. **Explanation:** **Amyloidosis (Correct Answer):** Sago spleen is a characteristic macroscopic manifestation of **splenic amyloidosis**. In this condition, amyloid deposits are limited primarily to the **splenic follicles (white pulp)**. On gross examination, these deposits appear as pale, translucent, waxy granules resembling grains of sago (tapioca) [1]. This is distinct from "Lardaceous spleen," where amyloid involves the red pulp (sinusoids), leading to large, map-like deposits. **Analysis of Incorrect Options:** * **Gaucher’s Disease:** Characterized by massive splenomegaly due to the accumulation of glucosylceramide in macrophages (**Gaucher cells**). The spleen appears pale and firm but does not show the "sago" granular pattern. * **Malaria:** Chronic malaria leads to "Congestive Splenomegaly." The spleen becomes slate-grey or blackish due to the deposition of **hemozoin pigment** (malarial pigment), often referred to as "Ague cake." * **Felty’s Disease:** This is a triad of Rheumatoid Arthritis, Splenomegaly, and Neutropenia. While the spleen is enlarged, the pathology involves lymphoid hyperplasia and congestion, not amyloid granules. **High-Yield Clinical Pearls for NEET-PG:** * **Sago Spleen:** Amyloid in **White Pulp** (Follicular) [1]. * **Lardaceous Spleen:** Amyloid in **Red Pulp** (Sinusoidal). * **Staining:** Amyloid shows **Apple-green birefringence** under polarized light with Congo Red stain [1]. * **Most common organ involved in systemic amyloidosis:** Kidney (leading to nephrotic syndrome). * **Most common organ involved in secondary amyloidosis:** Spleen. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Diseases of the Immune System, pp. 264-269.

Q: Which of the following is FALSE regarding cystic fibrosis?

Associated with chromosome 7p. **Explanation:** Cystic Fibrosis (CF) is the most common lethal genetic disease in Caucasian populations. The correct answer is **Option C** because the **CFTR gene** is located on the **long arm of chromosome 7 (7q31.2)**, not the short arm (7p). In genetics, 'p' stands for *petit* (short arm) and 'q' stands for the long arm. **Analysis of Options:** * **Option A (True):** CF is caused by mutations in the **Cystic Fibrosis Transmembrane Conductance Regulator (CFTR)** gene, which encodes a cAMP-regulated chloride channel [1]. * **Option B (True):** It follows an **Autosomal Recessive** inheritance pattern. Parents are typically asymptomatic carriers. * **Option D (True):** Defective chloride transport leads to abnormally thick, viscid mucus [1]. This impairs mucociliary clearance, leading to **recurrent respiratory infections**, bronchiectasis, and colonization by pathogens like *Pseudomonas aeruginosa* [1]. **NEET-PG High-Yield Pearls:** * **Most Common Mutation:** **ΔF508** (a three-base pair deletion of phenylalanine at position 508), which leads to protein misfolding and degradation in the ER (Class II defect) [1]. * **Diagnosis:** Sweat Chloride Test (Gold Standard) showing chloride levels **>60 mEq/L** [1]. * **Clinical Triad:** Chronic sinopulmonary disease, pancreatic insufficiency (steatorrhea), and male infertility (bilateral absence of vas deferens - CBAVD) [1]. * **Meconium Ileus:** A classic neonatal presentation of CF. * **Nasal Polyps:** CF should be suspected in any child presenting with nasal polyposis. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Diseases of Infancy and Childhood, pp. 475-479.

Q: Which of the following caspases is an initiator caspase?

Caspase 9. **Explanation:** Apoptosis (programmed cell death) is mediated by a family of cysteine proteases known as **Caspases**. These are broadly categorized into two functional groups: **Initiator Caspases** and **Executioner (Effector) Caspases**. **1. Why Caspase 9 is Correct:** Caspase 9 is a classic **Initiator Caspase** associated with the **Intrinsic (Mitochondrial) Pathway**. When the mitochondria release Cytochrome c into the cytosol, it binds with Apaf-1 to form the "Apoptosome." This complex recruits and activates pro-caspase 9. Once activated, Caspase 9 triggers a proteolytic cascade that activates the executioner caspases. **2. Why the Other Options are Incorrect:** * **Caspase 3 & 6 (Options A & B):** These are **Executioner (Effector) Caspases**. Once activated by initiators, they cleave structural proteins (like nuclear lamins) and activate nucleases to cause DNA fragmentation, leading to the physical changes of cell death. Caspase 3 is considered the most important executioner caspase. **High-Yield Facts for NEET-PG:** * **Initiator Caspases:** * **Intrinsic Pathway:** Caspase 9. * **Extrinsic (Death Receptor) Pathway:** Caspase 8 and 10. * **Executioner Caspases:** Caspase 3, 6, and 7. * **Inflammatory Caspase:** Caspase 1 (involved in the formation of inflammasomes and processing of IL-1β). * **Mnemonic:** Remember **"8, 9, 10"** as the "starters" (Initiators) and **"3, 6, 7"** as the "finishers" (Executioners). * **Caspase-independent cell death:** This occurs via the release of AIF (Apoptosis Inducing Factor) from mitochondria.

Q: Which stain is used for melanin?

Masson Fontana stain. **Explanation:** The correct answer is **Masson Fontana stain**. **1. Why Masson Fontana is correct:** Melanin is a non-lipid, non-hematogenous pigment produced by melanocytes [1]. It possesses **argentaffin** properties, meaning it has the inherent ability to reduce silver nitrate to metallic silver without the need for an external reducing agent. The Masson Fontana stain utilizes this property; the silver salts are reduced by melanin, resulting in a distinct **black** coloration of the pigment granules. **2. Analysis of Incorrect Options:** * **Alizarin red S:** This is a specialized stain used to identify **calcium** deposits. It reacts with calcium to form an orange-red lake. * **Von Kossa:** This is another method for **calcium** (specifically phosphates and carbonates). It is a metal substitution method where silver replaces calcium, appearing as black deposits. * **PAS (Periodic Acid-Schiff) stain:** This stain is primarily used to demonstrate **glycogen, mucopolysaccharides, and basement membranes**. It stains these structures magenta/bright pink. It is also the stain of choice for identifying fungal cell walls. **3. NEET-PG High-Yield Pearls:** * **Bleaching Test:** To confirm a pigment is melanin, "Melanin Bleaching" is performed using hydrogen peroxide or potassium permanganate. Melanin disappears, whereas other pigments like lipofuscin do not. * **Schmorl’s Reaction:** Another method used for melanin (and lipofuscin), which produces a blue-green color. * **DOPA Reaction:** Used to identify the enzyme tyrosinase in fresh tissue to confirm melanocytic activity. * **Iron Stain:** To differentiate melanin from hemosiderin (which looks similar), use **Prussian Blue (Perl’s stain)**; it stains hemosiderin blue but does not react with melanin. **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Blood And Bone Marrow Disease, pp. 633-634.

Question 1

Sago spleen is seen in which of the following conditions?

Accepted Answer

Amyloidosis

Answer

Gaucher’s disease

Answer

Malaria

Answer

Felty's disease

Question 2

Which of the following is FALSE regarding cystic fibrosis?

Accepted Answer

Associated with chromosome 7p

Answer

Associated with the CFTR gene

Answer

Autosomal recessive inheritance

Answer

Recurrent respiratory tract infection

Question 3

A 28-year-old man begins a program of vigorous body building. After 6 months, his biceps would be expected to exhibit which of the following adaptive cellular changes?

Accepted Answer

Hypertrophy of type II fibers

Answer

Hyperplasia of type I fibers

Answer

Hyperplasia of type II fibers

Answer

Hypertrophy of type I fibers

Question 4

What causes the nuclear and cytoplasmic changes observed in apoptotic cells?

Accepted Answer

Caspases

Answer

Oxygen free radicals

Answer

Complement fixation

Answer

ATPases

Question 5

A 40-year-old male patient complains of muscle and joint pain. The patient has a history of systemic lupus erythematosus. Which type of necrosis is typically associated with the vascular changes seen in this condition?

Accepted Answer

Fibrinoid

Answer

Coagulative

Answer

Liquefactive

Answer

Fat

Question 6

A 20-year-old female presents for an infertility workup. She has never had a menstrual period. She is short with a broad chest, webbed neck, and low-set ears. It is demonstrated that she has an abnormal karyotype. Which one of the following best describes the cause of this genetic abnormality?

Accepted Answer

Monosomy

Answer

Trisomy

Answer

Trinucleotide repeat

Answer

Translocation

Question 7

Which of the following caspases is an initiator caspase?

Accepted Answer

Caspase 9

Answer

Caspase 3

Answer

Caspase 6

Answer

None of the above

Question 8

Amyloid material can be best diagnosed by which method?

Accepted Answer

Polarized microscopy

Answer

Electron microscopy

Answer

X-ray crystallography

Answer

Scanning electron microscopy

Question 9

Yellow or green pigmentation of teeth is seen in which of the following conditions?

Accepted Answer

Erythroblastosis fetalis

Answer

Porphyria

Answer

Internal resorption

Answer

Nasmyth membrane

Question 10

Which stain is used for melanin?

Accepted Answer

Masson Fontana stain

Answer

Alizarin red S

Answer

Von Kossa

Answer

PAS stain

General Pathology — MCQs

General Pathology — MCQs

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