General Pathology Practice Questions

Q: Lardaceous spleen is a feature of:

Amyloidosis. ***Amyloidosis*** - The presence of a **lardaceous spleen** is characteristic of amyloidosis, where **amyloid deposits** infiltrate the spleen leading to enlargement [1][2]. - This condition often results in **firm, waxy appearance** of the spleen on examination [1]. *Thalassemia* - Thalassemia can cause **splenomegaly**, but the spleen typically does not present with a **lardaceous** appearance. - It is associated primarily with **hemolytic anemia** and characteristic changes in blood tests. *Malaria* - In malaria, the spleen can become **enlarged** due to immune response, but not lardaceous. - The splenic enlargement in malaria is usually **soft** and associated with fever and other symptoms of infection. *Sickle cell anemia* - Sickle cell anemia features **splenic atrophy** or dysfunction over time, not a lardaceous spleen. - It causes **recurrent vaso-occlusive crises** and other complications, but does not lead to characteristic amyloid deposition. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Diseases of the Immune System, pp. 268-269. [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. 135-136.

Q: Which of the following is a type of programmed cell death?

All of the above. ***All of the above*** - **Apoptosis**, **pyroptosis**, and **necroptosis** are all recognized forms of **programmed cell death** in current medical literature. - Each represents a distinct, **regulated mechanism** of cell death with specific molecular pathways and physiological functions. *Apoptosis* - This is the classic form of **programmed cell death**, characterized by **cell shrinkage**, chromatin condensation, and formation of apoptotic bodies. - Essential for **tissue homeostasis**, development, and removal of damaged cells without triggering inflammation. *Pyroptosis* - A **regulated form of programmed cell death** mediated by **inflammasome activation** and characterized by cell swelling and membrane rupture. - Functions as an **innate immune response** to eliminate infected cells and release inflammatory signals to recruit immune cells. *Necroptosis* - A **regulated form of programmed cell death** that occurs when apoptosis is inhibited, serving as a backup cell death mechanism. - Characterized by **cell swelling** and membrane permeabilization, triggered by specific signaling pathways involving **RIPK1** and **RIPK3** kinases.

Q: Which of the following is an intermediate filament found in epithelial cells?

Cytokeratin. ***Cytokeratin*** - **Cytokeratins** are the characteristic intermediate filaments of **epithelial cells** [1]. - They provide structural integrity and mechanical support to epithelial tissues and are used as markers in **histopathology** to identify epithelial cell origin [1]. *Neurofilaments* - **Neurofilaments** are specific to **neurons**, providing structural support for axons. - They are primarily found in the cytoplasm of nerve cells, not epithelial tissue. *Desmin (muscle filament)* - **Desmin** is the intermediate filament found predominantly in **muscle cells** (skeletal, cardiac, and smooth muscle). - It links the sarcolemma to the contractile apparatus, not present in epithelial cells. *Vimentin (mesenchymal filament)* - **Vimentin** is typically found in cells of **mesenchymal origin**, such as fibroblasts, endothelial cells, and lymphocytes. - It is used as a marker for cells that have undergone **epithelial-to-mesenchymal transition (EMT)** but is not characteristic of mature epithelial cells. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. With Illustrations By, pp. 22-23.

Q: Among the following anatomical locations, where does fat necrosis most commonly occur?

Pancreatic tissue. ***Omentum*** - Fat necrosis is most commonly associated with the **omentum**, especially following abdominal trauma or pancreatitis. - It is characterized by the release of **lipases**, leading to the breakdown of triglycerides and the production of necrotic fat tissue [1]. *Kidney* - Fat necrosis does not typically occur in the kidney; rather, it is more commonly associated with processes affecting the abdominal cavity. - Kidney pathology more commonly involves conditions like **glomerulonephritis** or **nephrosclerosis**, not fat necrosis. *Heart* - While the heart can undergo necrosis due to ischemia, it does not develop fat necrosis, which is characteristically associated with extra-abdominal fat. - Heart tissue is more prone to **myocardial infarction** resulting from **coronary artery disease**. *Brain* - Brain tissue primarily undergoes *infarction* or **necrosis** due to vascular insults, not fat necrosis. - Pathological changes in the brain include **cerebral edema** and gliosis, rather than fat necrosis. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Cellular Responses to Stress and Toxic Insults: Adaptation, Injury, and Death, p. 55.

Q: Infected gangrene of the skin and subcutaneous tissues is?

Wet gangrene (necrosis with bacterial superinfection). ***Wet gangrene*** - Characterized by **infected gangrene**, where necrosis and infection occur in **skin and subcutaneous tissues**, typically presenting with foul-smelling discharge [1]. - Commonly associated with **venous insufficiency** and **bacterial infection**, leading to rapid progression and systemic symptoms [1]. *None of the above* - This option is incorrect as there are specific types of gangrene that are recognized in medical literature. - Saying "none of the above" does not accurately address the specific condition that is being asked about. *Dry gangrene* - Dry gangrene is typically caused by **ischemia** without significant infection, presenting with **dark, dry tissue**, and does not involve an infected state [1]. - It is mainly seen in conditions like **diabetes mellitus** and does not have the characteristic of **fluid accumulation** or infection that wet gangrene does [1]. *Erysipelas* - Erysipelas is a **superficial skin infection** caused by **Streptococcus**, presenting with redness and swelling, rather than necrosis of tissue. - It does not involve dead tissue as seen in gangrene, making it distinct and not a form of gangrene. **References:** [1] 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. 103-104.

Q: Which stain is used to identify heart failure cells?

Prussian blue. ***Prussian blue*** - **Heart failure cells** are actually **siderophages**, which are macrophages that have phagocytosed red blood cells and subsequently processed the hemoglobin into **hemosiderin**. - **Prussian blue stain** reacts with the iron in hemosiderin, turning it blue, thereby identifying these cells in the sputum or lung tissue of patients with **pulmonary edema secondary to heart failure**. *Alcian blue* - This stain is used to detect **acidic mucopolysaccharides** and **acidic glycoproteins**, typically seen in conditions involving abnormal mucin production or accumulation. - It does not specifically stain or identify **iron deposits** or **siderophages** associated with heart failure. *Silver stains* - **Silver stains** (e.g., Gomori methenamine silver) are primarily used to highlight **fungi**, **basement membranes** in kidney tissue, and **reticulin fibers**. - They are not employed for the identification of **iron-laden macrophages** or **heart failure cells**. *PAS* - The **Periodic Acid-Schiff (PAS) stain** is used to detect **glycogen**, **mucins**, and **glycoproteins**, staining them magenta. - It is often utilized in diagnosing conditions like **Whipple's disease**, **glycogen storage diseases**, or kidney diseases with **thickened basement membranes**, but not for iron detection.

Q: Stem cells are typically harvested from all except which?

Liver. ***Liver*** - **Liver** is not a recognized source of **pluripotent stem cells**, as it primarily contains specialized cells for hepatic functions. - While some **liver stem cells** exist, they are not generally sourced for therapies compared to other tissues like **bone marrow or adipose tissue** [1]. [2] *Adipose tissue* - **Adipose tissue** is a known source of **adipose-derived stem cells (ADSCs)**, which have regenerative potential [1]. - It is frequently used for **cosmetic and reconstructive applications** due to its ease of harvesting [1]. *Blood* - **Blood** contains **hematopoietic stem cells (HSCs)** primarily in the bone marrow, which can be harvested from peripheral blood after mobilization. - These stem cells are essential for **blood cell formation** and are effective in treatments for blood disorders [2]. *Bone marrow* - **Bone marrow** is a primary source of **hematopoietic stem cells**, crucial for **blood and immune system regeneration** [1]. [2] - It is commonly harvested for **transplants in conditions like leukemia** [2].

Question 1

Which of the following is an example of metastatic calcification?

Accepted Answer

Primary hyperparathyroidism

Answer

Rheumatic heart disease

Answer

Monckeberg's medial calcific sclerosis

Answer

Psammoma bodies

Question 2

Lardaceous spleen is a feature of:

Accepted Answer

Amyloidosis

Answer

Thalassemia

Answer

Sickle cell anemia

Answer

Malaria

Question 3

A 25-year-old man complains of myopathy and undergoes a muscle biopsy for diagnosis. Histopathology demonstrates an inflammatory muscle disease characterized by non-caseating granulomas. Which of the following conditions is most likely to have caused his symptoms?

Accepted Answer

Sarcoidosis

Answer

Cysticercosis

Answer

Tuberculosis

Answer

Schistosomiasis

Question 4

Which of the following is a type of programmed cell death?

Accepted Answer

All of the above

Answer

Apoptosis

Answer

Pyroptosis

Answer

Necroptosis

Question 5

Which of the following is an intermediate filament found in epithelial cells?

Accepted Answer

Cytokeratin

Answer

Neurofilaments

Answer

Desmin (muscle filament)

Answer

Vimentin (mesenchymal filament)

Question 6

Among the following anatomical locations, where does fat necrosis most commonly occur?

Accepted Answer

Pancreatic tissue

Answer

Cerebral tissue

Answer

Myocardial tissue

Answer

Renal tissue

Question 7

Infected gangrene of the skin and subcutaneous tissues is?

Accepted Answer

Wet gangrene (necrosis with bacterial superinfection)

Answer

Gas gangrene (clostridial myonecrosis)

Answer

Erysipelas (a superficial bacterial skin infection)

Answer

Dry gangrene (necrosis caused by ischemia without infection)

Question 8

All of the following are associated with increased aging, except which of the following?

Accepted Answer

Increased superoxide dismutase

Answer

Increased levels of oxidative stress due to free radicals

Answer

Accumulation of mutations in somatic cells

Answer

Increased cross linkages in collagen

Question 9

Which stain is used to identify heart failure cells?

Accepted Answer

Prussian blue

Answer

Alcian blue

Answer

Silver stains

Answer

PAS

Question 10

Stem cells are typically harvested from all except which?

Accepted Answer

Liver

Answer

Bone marrow

Answer

Blood

Answer

Adipose tissue

General Pathology — MCQs

General Pathology — MCQs

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