Reproductive Pathology Practice Questions

Q: Which of the following structures is not affected by Gonococcus?

Testis. **Explanation:** The correct answer is **Testis (Option B)**. This is a classic high-yield fact in urogenital pathology. **1. Why the Testis is spared:** *Neisseria gonorrhoeae* primarily infects surfaces lined with **columnar or cuboidal epithelium**. While it frequently involves the entire male reproductive tract via ascending infection, it typically stops at the **epididymis**. The testis possesses a robust blood-testis barrier and a distinct immunological environment that makes it resistant to direct gonococcal invasion. Therefore, while Gonococcus causes **acute epididymitis**, it rarely, if ever, causes orchitis. If a patient presents with "epididymo-orchitis," the orchitis component is usually due to secondary inflammation or other pathogens (like Mumps or *E. coli*), not the Gonococcus itself. **2. Why other options are incorrect:** * **Urethra (Option A):** The most common site of infection. Gonococcus causes "Gonococcal Urethritis," characterized by a profuse, purulent yellow discharge. * **Prostate (Option C):** Ascending infection frequently involves the prostatic ducts, leading to acute or chronic gonococcal prostatitis. * **Seminal Vesicle (Option D):** The infection can easily spread from the ejaculatory ducts to the seminal vesicles, causing seminal vesiculitis. **Clinical Pearls for NEET-PG:** * **Epididymitis vs. Orchitis:** In young, sexually active men ( 35 years), it is usually *E. coli*. * **Prehn’s Sign:** Positive (relief of pain with scrotal elevation) in epididymitis; negative in testicular torsion. * **Treatment:** The current CDC recommendation for uncomplicated gonococcal urethritis is a single IM dose of **Ceftriaxone** (500 mg). Always co-treat for Chlamydia (Doxycycline) unless ruled out.

Q: A cervical lesion is shown, which is similar to that obtained in a cone cervical biopsy from a 28-year-old sexually active woman who had had a "positive" Pap smear. What type of cervical change is often characterized by the lesion shown?

Genomic integration of HPV sequences.. ***Genomic integration of HPV sequences*** - **Genomic integration of HPV DNA** into host cell chromosomes is the key molecular event underlying **cervical intraepithelial neoplasia (CIN)** detected in cone biopsies following positive Pap smears. - This integration disrupts normal cellular growth control mechanisms, leading to the **dysplastic changes** characteristic of precancerous cervical lesions without invasion. *Local invasion* - Local invasion indicates **invasive cervical carcinoma**, which would present with deeper tissue penetration beyond the epithelium. - A cone biopsy showing invasion would require more aggressive treatment than the **precancerous CIN lesions** typically found after positive Pap smears. *Penetration of the basement membrane* - **Basement membrane breach** defines the transition from **carcinoma in situ** to **invasive carcinoma**, representing advanced disease. - CIN lesions detected by cone biopsy characteristically remain **confined above the basement membrane**, maintaining the epithelial boundary. *Lymphatic spread* - **Lymphatic dissemination** occurs only in **invasive cervical carcinoma** when tumor cells have breached tissue barriers. - Cone biopsy findings in a young woman with positive Pap smear typically reveal **localized dysplastic changes** without metastatic potential.

Q: Which of the following is NOT a type of primary uterine carcinoma?

Large cell keratinising type. **Explanation:** The question asks to identify which histological subtype is **not** a primary uterine (endometrial) carcinoma. **Why Option D is the Correct Answer:** **Large cell keratinising type** is a histological subtype of **Squamous Cell Carcinoma (SCC)**, which is classically associated with the **uterine cervix**, not the endometrium. While primary SCC of the endometrium exists, it is extremely rare and must meet strict criteria (e.g., no connection to the cervical epithelium). In standard oncological classification, "Large cell keratinising" is a hallmark descriptor for cervical malignancy. **Analysis of Incorrect Options:** * **A. Adenocarcinoma:** This is the most common primary uterine cancer. The **Endometrioid adenocarcinoma** subtype accounts for approximately 75-80% of all endometrial carcinomas. * **B. Adenosquamous carcinoma:** This is a recognized variant of endometrial carcinoma containing both malignant glandular (adenocarcinoma) and malignant squamous components. To be classified as such, the squamous component must be histologically malignant. * **C. Clear cell type:** This is a **Type II (Non-endometrioid)** endometrial carcinoma. It is highly aggressive, occurs in older postmenopausal women, and is not associated with hyperestrogenism. **High-Yield NEET-PG Pearls:** * **Bokhman’s Classification:** * **Type I (Endometrioid):** Estrogen-dependent, arises from hyperplasia, good prognosis, PTEN mutation. * **Type II (Serous/Clear Cell):** Estrogen-independent, arises from atrophic endometrium, p53 mutation, poor prognosis. * **Most common site of metastasis:** The lungs are the most common site of distant spread for endometrial cancer. * **Precursor lesion:** Endometrial Intraepithelial Neoplasia (EIN).

Question 1

Which of the following structures is not affected by Gonococcus?

Accepted Answer

Testis

Answer

Urethra

Answer

Prostate

Answer

Seminal vesicle

Question 2

Paget's disease of the breast is a manifestation of which of the following?

Accepted Answer

Ductal carcinoma

Answer

Lobular carcinoma

Answer

Ductal carcinoma in situ (DCIS)

Answer

Lobular carcinoma in situ (LCIS)

Question 3

A cervical lesion is shown, which is similar to that obtained in a cone cervical biopsy from a 28-year-old sexually active woman who had had a "positive" Pap smear. What type of cervical change is often characterized by the lesion shown?

Accepted Answer

Genomic integration of HPV sequences.

Answer

Local invasion.

Answer

Penetration of the basement membrane.

Answer

Lymphatic spread.

Question 4

A patient presents with an abdominal mass. Investigations reveal bilateral ovarian masses with smooth surfaces. Microscopy shows cells with signet ring shapes. What is the most likely diagnosis?

Accepted Answer

Krukenberg tumour

Answer

Dysgerminoma

Answer

Primary adenocarcinoma of the ovaries

Answer

Epithelial ovarian tumour

Question 5

Which of the following is NOT a type of primary uterine carcinoma?

Accepted Answer

Large cell keratinising type

Answer

Adenocarcinoma

Answer

Adenosquamous carcinoma

Answer

Clear cell type

Question 6

P57KIP2 immunostaining is helpful in diagnosing which of the following conditions?

Accepted Answer

Complete molar pregnancy

Answer

Ectopic pregnancy

Answer

Normal pregnancy

Answer

Missed abortion

Question 7

Gleason's classification is used for which of the following conditions?

Accepted Answer

Carcinoma of the prostate

Answer

Carcinoma of the breast

Answer

Carcinoma of the pancreas

Answer

Carcinoma of the rectum

Question 8

A 33-year-old woman in her third trimester of pregnancy (gravida I, para 0) is rushed to the emergency room after suffering a seizure. The patient is hypertensive and laboratory studies show that the patient manifests nephritic syndrome. What is the appropriate diagnosis?

Accepted Answer

Eclampsia

Answer

Acute tubular necrosis

Answer

Crescentic glomerulonephritis

Answer

Malignant nephrosclerosis

Question 9

Which of the following is a marker for testicular tumor?

Accepted Answer

Beta hCG

Answer

Acid phosphatase

Answer

Alkaline phosphatase

Answer

Alpha fetoprotein

Question 10

Which gene is involved in endometrial carcinoma?

Accepted Answer

PTEN

Answer

BRAF

Answer

KRAS

Answer

Mismatch repair genes

Reproductive Pathology — MCQs

Reproductive Pathology — MCQs

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