UPSC-CMS 2018 - Pathology PYQs Practice Questions

Q: Fine Needle Aspiration Cytology (FNAC) is NOT conclusive in which one of the following thyroid swellings?

Follicular carcinoma thyroid. ***Follicular carcinoma thyroid*** - FNAC cannot definitively distinguish between a **follicular adenoma** and a **follicular carcinoma** [1]. - This is because the diagnosis of follicular carcinoma relies on the presence of **capsular invasion** or **vascular invasion**, which can only be assessed on **histopathological examination** of the resected specimen, not cytology [1]. *Papillary carcinoma thyroid* - FNAC is highly effective in diagnosing papillary carcinoma due to characteristic **nuclear features** such as **Orphan Annie eye nuclei**, nuclear grooves, and intranuclear inclusions [3]. - These distinct cytological findings allow for a confident diagnosis without needing to assess invasion [3]. *Thyroiditis* - FNAC is typically conclusive for diagnosing various forms of thyroiditis (e.g., Hashimoto's thyroiditis, subacute thyroiditis). - It identifies characteristic inflammatory cells, giant cells, and changes in follicular cells consistent with the diagnosis. *Medullary carcinoma thyroid* - Medullary thyroid carcinoma can be reliably diagnosed by FNAC due to its characteristic **polygonal or spindle-shaped cells**, **amyloid deposition**, and presence of **calcitonin** in the aspirate [2]. - Immunocytochemical staining for calcitonin further confirms the diagnosis. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Endocrine System, pp. 1100-1101. [2] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Liver And Biliary System Disease, pp. 429-430. [3] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Endocrine System, p. 1099. [Practice more Pathology PYQs on OnCourse]

Question 1

Fine Needle Aspiration Cytology (FNAC) is NOT conclusive in which one of the following thyroid swellings?

Accepted Answer

Follicular carcinoma thyroid

Answer

Papillary carcinoma thyroid

Answer

Thyroiditis

Answer

Medullary carcinoma thyroid

Question 2

Which one of the following factors is NOT involved in the pathogenesis of Systemic inflammatory response syndrome (SIRS)?

Accepted Answer

Microvascular occlusion

Answer

Free radical production

Answer

Increased cytokine production

Answer

Abnormal nitric oxide synthesis

UPSC-CMS 2018 — Pathology