NEET-PG 2015 - Pathology Practice Questions

Q: What is the first cellular response observed after a sharp nerve cut?

Chromatolysis. ***Chromatolysis*** - **Chromatolysis** is the dissolution of the Nissl bodies (rough endoplasmic reticulum) in the neuron cell body following axonal injury, which is the **first observable cellular response** [1]. - This process is a preparatory step for neuronal regeneration, indicating the cell's attempt to repair the damaged axon [1]. *Polymorphic arrangement* - This term is not typically used to describe an immediate cellular response to a nerve cut; it might refer to diverse cell shapes or arrangements in different contexts but is not a recognized initial post-injury event. - The neuron's immediate response involves changes within the cell body, not a re-arrangement of its cellular structure with other cells. *Increased protein synthesis* - While increased protein synthesis does occur during neuronal repair and regeneration, it is a consequence of chromatolysis and part of a later, more sustained response, not the very first visible cellular change [1]. - **Chromatolysis precedes** and facilitates the subsequent increase in protein synthesis necessary for axonal regrowth [1]. *Macrophage activation* - **Macrophage activation** is a crucial part of the inflammatory response and debris clearance following nerve injury, but it is not the *first cellular response* of the neuron itself [2]. - Macrophages migrate to the site of injury hours to days after the initial insult, whereas chromatolysis begins within the neuron's cell body much earlier [2]. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Peripheral Nerves and Skeletal Muscles, pp. 1254-1256. [2] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Manifestations Of Central And Peripheral Nervous System Disease, pp. 697-698.

Q: The tissue of origin of the Kaposi's sarcoma is

Vascular. ***Vascular*** - Kaposi's sarcoma originates from the **vascular tissue**, specifically from endothelial cells lining blood vessels [2]. - The lesions are characterized by **angiogenesis**, leading to the formation of vascular tumors with dilated endothelial cell-lined vascular spaces [1]. *Muscular* - Muscular tissue is involved in **voluntary** and **involuntary movements** but is not related to the etiology of Kaposi's sarcoma. - This condition does not arise from **muscle cells** or any muscular components. *Neural* - Neural tissue consists of **neurons** and **glial cells**, which are not implicated in Kaposi's sarcoma. - Kaposi's sarcoma does not originate from any **neural structures** or pathologies. *Lymphoid* - Lymphoid tissue primarily concerns the immune system, particularly the **lymphatic system**, and does not give rise to Kaposi's sarcoma. - This malignancy does not derive from **lymphoid components** like lymphocytes or lymph nodes. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Diseases of Infancy and Childhood, pp. 526-527. [2] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Cardiovascular Disease, pp. 282-283.

Q: Which tumor is characterized by the presence of cells that resemble tennis rackets?

Langerhans cell histiocytosis. ***Langerhans cell histiocytosis*** - This condition is characterized by **Birbeck granules** within the Langerhans cells, which have a distinctive **tennis racket-like appearance** on electron microscopy. - The cells are also positive for **CD1a** and **S-100** immunohistochemical markers. *Sarcoma botyroides* - This is a subtype of **embryonal rhabdomyosarcoma** typically found in mucosal sites, presenting as a polypoid, grape-like mass. - Its histology shows small, undifferentiated cells with primitive skeletal muscle differentiation, but **not tennis racket-shaped cells**. *Vaginal adenocarcinoma* - This is a rare malignancy of the vagina, often associated with **diethylstilbestrol (DES) exposure** in utero, presenting as glands. - The cells show glandular differentiation and produce mucin, but **lack Birbeck granules**. *Seminoma* - This is a germ cell tumor of the testis characterized by large, uniform cells with clear cytoplasm and prominent nucleoli, divided into lobules by fibrous septa containing lymphocytes. - There are **no tennis racket-shaped cells** or Birbeck granules associated with seminoma.

Q: Primary complex of M bovis involves:

Tonsil and intestine. ***Tonsil and intestine*** - *Mycobacterium bovis* is primarily transmitted through **consumption of contaminated milk and dairy products**, making the **alimentary tract** the main route of infection - The primary complex (Ghon complex) involves the **initial site of infection plus regional lymph nodes** - In alimentary tuberculosis, the organisms enter through the **intestinal mucosa** (Peyer's patches) or **tonsillar tissue**, creating foci with associated mesenteric or cervical lymphadenopathy - Both tonsils and intestines are part of the **alimentary system**, representing the typical primary complex for M. bovis in humans *Tonsil and lung* - This incorrectly combines **two different routes of entry** (alimentary and respiratory) - A primary complex involves a **single portal of entry**, not multiple unrelated organ systems - While M. bovis can rarely cause pulmonary TB through inhalation, this would create a separate lung + hilar node complex, not a combined tonsil-lung complex *Tonsil and skin* - **Skin involvement** requires direct inoculation through cuts or abrasions and does not form a primary complex with tonsillar infection - These represent different portals of entry and would not occur together as a primary complex *Skin and Intestine* - **Skin infection** by M. bovis is rare and requires occupational exposure with direct inoculation (e.g., veterinarians, butchers) - This incorrectly pairs two different routes of infection that would not form a single primary complex

Q: Which viral proteins are known to act as carcinogens in causing carcinoma cervix?

E - gene. ***E - gene*** - The **E - gene** in human papillomavirus (HPV) is known to play a crucial role in the **transformation of cervical cells**, leading to cancer development [1]. - Specifically, the **E6 and E7 proteins** encoded by this gene interfere with tumor suppressor functions, contributing to cervical carcinoma [1,2]. *L - gene* - The **L - gene** is associated with the virus's structural proteins, primarily aiding in the formation of the viral capsid. - It does not have a direct role in the oncogenic process leading to cervical cancer. *H - gene* - The **H - gene** is not specifically linked to the oncogenic effects of HPV; it is not recognized for contributing to cancer development. - It is often confused in discussions but doesn't directly influence the carcinogenic pathway like the E gene does. *P 24 - gene* - The **P 24 - gene** is not related to HPV; instead, it is associated with **HIV** and its structural components. - This gene does not play any role in the development of cervical carcinoma or transformation of cervical cells. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Female Genital Tract, pp. 1006-1007. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Neoplasia, pp. 334-335.

Q: Which condition is not associated with complement deficiency?

Membranous nephritis. Membranous nephritis - Membranous nephritis is associated with immune complex deposition rather than complement deficiencies. [1] - The disease is characterized by thickening of the glomerular basement membrane without significant complement involvement. [1] PNH - Paroxysmal nocturnal hemoglobinuria (PNH) is due to a defect in the GPI-anchor leading to complement-mediated hemolysis. - Complement activation plays a critical role in the destruction of red blood cells in this condition. Hereditary angioedema - Hereditary angioedema is caused by deficiencies in C1 inhibitor, leading to uncontrolled activation of complement. - This results in edema episodes, directly linked to complement pathway dysregulation. SLE - Systemic lupus erythematosus (SLE) involves complement consumption due to autoantibody formation against nuclear antigens. - The disease often presents with hypocomplementemia, indicating complement system involvement.

Q: Indirect Coombs test detects:

Antibodies in the serum. ***Antibodies in the serum*** - The **indirect Coomb's test** is designed to detect the presence of **antibodies** against red blood cells (RBCs in the serum) before transfusion or during pregnancy [1]. - It is crucial in identifying **hemolytic disease of the newborn** (HDN) and ensuring safe blood transfusions [1]. *Antibodies attached to RBC Surface* - This scenario describes the **direct Coomb's test**, which identifies antibodies that are already bound to **RBCs**. - Direct testing assesses conditions like **autoimmune hemolytic anemia**, not the serum. *Antigens attached to RBC Surface* - This option suggests evaluating **antigens** present on the surface of RBCs, which is not the purpose of the indirect Coomb's test. - Antigens are important in blood typing and compatibility assessments, but this test focuses on antibodies. *Antigens in the serum* - Indirect Coomb's does not detect **antigens** but rather the **antibodies** related to those antigens. - Additionally, serum testing for antigens is not a standard procedure for assessing transfusion compatibility. **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Blood And Bone Marrow Disease, pp. 627-628.

Q: ABO non- secretors are more prone to ?

Increased risk of infections. Increased risk of infections - Non-secretors of ABO antigens exhibit an increased susceptibility to a variety of infections, particularly bacterial and viral pathogens. - This is thought to be due to the absence of ABO antigens in secretions, which typically act as decoy receptors to prevent pathogen adhesion to host cells. Autoimmune diseases - While some associations between ABO blood groups and autoimmune diseases exist, non-secretor status is not consistently linked to a higher overall risk of autoimmune conditions. Cardiovascular diseases - ABO blood groups have been associated with cardiovascular risk, with non-O blood types generally having a slightly higher risk of certain cardiovascular events. - However, secretor status (the ability to secrete ABO antigens into bodily fluids) itself is not a prominent independent risk factor for cardiovascular diseases. Cancer - There are some documented associations between specific ABO blood types and certain types of cancer (e.g., non-O blood types with pancreatic cancer), but this is distinct from secretor status. - Being an ABO non-secretor is not a primary, broadly recognized risk factor for developing cancer.

Q: Most common cause of idiopathic interstitial pneumonia is

Idiopathic pulmonary fibrosis. ***Idiopathic pulmonary fibrosis (IPF)*** - This is the **most common** form of idiopathic interstitial pneumonia, accounting for approximately **50-60% of all IIP cases** - Represents the **most severe** IIP subtype with poor prognosis - Characterized by progressive **usual interstitial pneumonia (UIP) pattern** with fibroblastic foci and honeycombing - Presents with progressive dyspnea, dry cough, and restrictive lung disease *Organizing pneumonia* - While **Cryptogenic Organizing Pneumonia (COP)** is a form of idiopathic interstitial pneumonia, it is **much less common than IPF** [1] - Characterized by **intra-alveolar granulation tissue (Masson bodies)** [1] - Better prognosis and steroid-responsive compared to IPF [1] *Sarcoidosis* - This is **NOT classified as an idiopathic interstitial pneumonia** - It is a separate **multisystem granulomatous disease** with **non-caseating granulomas** - Has a distinct etiology related to altered immune response - Does not belong to the IIP classification system *Lipoid pneumonia* - This is **NOT an idiopathic interstitial pneumonia** - Results from **aspiration of lipid substances** causing exogenous lipoid pneumonia - Has a **known extrinsic cause**, therefore not "idiopathic" - Not part of the IIP classification **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Respiratory Tract Disease, pp. 330-331.

Q: Most common malignant tumor of the heart in adults

Cardiac Sarcoma. ***Cardiac Sarcoma*** - **Cardiac sarcomas** are the most common type of **primary malignant tumor** of the heart in adults, accounting for about 95% of primary malignant cardiac tumors. - **Angiosarcoma** is the most common subtype (approximately 33-50% of all cardiac sarcomas), typically originating from the **right atrium**. - These tumors are highly aggressive with rapid growth, early metastasis, and poor prognosis. - They commonly present with right-sided heart failure, pericardial effusion, or constitutional symptoms. *Rhabdomyoma* - **Rhabdomyomas** are the most common **primary cardiac tumors in infants and children** (60-80% of pediatric cardiac tumors), not adults. - These tumors are **benign** and strongly associated with tuberous sclerosis. - They often spontaneously regress after birth. *Lipoma* - **Lipomas** are **benign tumors** composed of mature adipocytes and account for about 10% of benign cardiac tumors. - They are typically asymptomatic and found incidentally. - They are not malignant and therefore not relevant to this question about malignant tumors. *Paraganglioma* - **Paragangliomas** (pheochromocytomas of the heart) are rare neuroendocrine tumors. - They are typically **benign** (though can be locally invasive) and may be hormonally active, causing catecholamine-related symptoms. - They represent less than 1% of cardiac tumors and are not the most common malignant cardiac tumor.

Question 1

What is the first cellular response observed after a sharp nerve cut?

Accepted Answer

Chromatolysis

Answer

Polymorphic arrangement

Answer

Increased protein synthesis

Answer

Macrophage activation

Question 2

The tissue of origin of the Kaposi's sarcoma is

Accepted Answer

Vascular

Answer

Lymphoid

Answer

Neural

Answer

Muscular

Question 3

Which tumor is characterized by the presence of cells that resemble tennis rackets?

Accepted Answer

Langerhans cell histiocytosis

Answer

Seminoma

Answer

Vaginal adenocarcinoma

Answer

Sarcoma botyroides

Question 4

Primary complex of M bovis involves:

Accepted Answer

Tonsil and intestine

Answer

Tonsil and skin

Answer

Tonsil and lung

Answer

Skin and Intestine

Question 5

Which viral proteins are known to act as carcinogens in causing carcinoma cervix?

Accepted Answer

E - gene

Answer

P 24 - gene

Answer

L - gene

Answer

H - gene

Question 6

Which condition is not associated with complement deficiency?

Accepted Answer

Membranous nephritis

Answer

SLE

Answer

PNH

Answer

Hereditary angioedema

Question 7

Indirect Coombs test detects:

Accepted Answer

Antibodies in the serum

Answer

Antibodies bound to RBC Surface

Answer

Antigens bound to RBC Surface

Answer

Antigens in the plasma

Question 8

ABO non- secretors are more prone to ?

Accepted Answer

Increased risk of infections

Answer

Autoimmune diseases

Answer

Cardiovascular diseases

Answer

Cancer

Question 9

Most common cause of idiopathic interstitial pneumonia is

Accepted Answer

Idiopathic pulmonary fibrosis

Answer

Organizing pneumonia

Answer

Sarcoidosis

Answer

Lipoid pneumonia

Question 10

Most common malignant tumor of the heart in adults

Accepted Answer

Cardiac Sarcoma

Answer

Paraganglioma

Answer

Rhabdomyoma

Answer

Lipoma

NEET-PG 2015 — Pathology