Question: High mitotic activity with rapid cellular turnover and characteristic "Starry sky" appearance is seen in

Ans. c (Burkitt's lymphoma) (Ref. Robbins 7th/677).The types of NHL involving mature B cells are 4, namely - Burkitt's lymphoma, Diffuse large B-cell lymphoma, Mantle cell lymphoma, and Follicular lymphoma. Burkitt's lymphoma occrs in adolescents or young adults, associated with t(8;14)-- translocation of c-myc (8) and heavy-chain Ig (14), and histologically shows typical "Starry sky" appearance - sheets of lymphocytes with interspersed macrophages. It is known to be associated with EBV.BURKITT LYMPHOMA# <1% of lymphomas# 3 categories:- Endemic in Africa,- Sporadic elsewhere; (Clinically a jaw lesion in endemic form in Africa; pelvis or abdomen in sporadic form)- Increased frequency in immunosuppressed patients;# EBV infection seen in all categories of Burkitt's, which precedes cellular transformation.# Predominantly affects children;# Often presents with visceral involvement;# Highly aggressive.# Diffuse tissue involvement associated with apoptosis produces a "starry-sky" appearance.# Intermediate-sized round lymphoid cells with several nucleoli;# Immunophenotype:-Mature CD10+, CD19+, CD20+ B cells expressing surface IgM, monotypic kappa and lambda light chain and BCL6+.# Common translocations:- t(8,14), -1(2,8), -1(8,22)# C/f:- Endemic and sporadic cases commonly found in children and young adults- Most tumors manifest at extrannodal sites.EndemicSporadicMass involving mandibleAbdominal mass involving ileocecum and peritoneum.May involve abdominal viscera (kidney, ovary, adrenals)Bone marrow and peripheral blood involvement uncommon.# Rx: Treatment of Burkitt's lymphoma in both children and adults should begin within 48 h of diagnosis and involves the use of intensive combination chemotherapy regimens incorporating high doses of cyclophosphamide. Prophylactic therapy to the CNS is mandatory. Burkitt's lymphoma was one of the first cancers shown to be curable by chemotherapy. Today, cure can be expected in 70 to 80% of both children and young adults when effective therapy is administered precisely. EntityFrequencyMorphologyImmunophenotypeCommentsPrecursor B-cell lymphoblastic leukemia/ lymphoma85% of childhood acute leukemiaLymphoblasts with irregular nuclear contours, condensed chromatin,small nucleoli, and scant agranular cytoplasmTdT+immature B cells (CD19+, variable expression of other B-cell markers)Usually presents as acute leukemia; less common in adults; prognosis is predicted by karyotypePrecursor T-cell leukemia/ lymphoma15% of childhood acute leukemia; 40% of childhood lymphomasIdentical to pre-cursor B-cell lymphoblastic leukemia/ lymphomaTdT+immature T cells (CD2+, CD7+, variable expression of other T-cell markers)Most common in ado- lescentmales;presents as a mediasstinal mass due to thymic invo; high asso NOTCH1 mutation.Small lymphocytic lymphoma/ chronic lymphocytic leukemia3% to 4% of adult lymphomas; 30% of all leukemiasSmall resting lymphocytes mixed large activated cells lymph nodes effacedCD5+B-cell expressing surface IgOccurs in older adults; usually involves nodes, marrow, spleen; indolent; most pts have peripheral blood involvement;Follicular lymphoma40% of adult lymphomasFreq small "cleaved" cells mixed with large cells; growth usually nodular (follicular)CD10+BCL2+ mature B cells that express surface IgOccurs in older adults; usually involves nodes, marrow, and spleen; asso with t( 14; 18); indolentMantle cell lymphoma3% to 4% of adult lymphomasSmall to intermediate- sized irregular lymphocytes growing in a diffuse patternCD5+mature B cells that express cyclin D1 and have surface IgOccurs mainly in older males; usually involves nodes, marrow, spleen and GIT; t(11;14) +; moderately aggressiveExtranodal marginal zone lymphoma?5% of adult lymphomasVariable cell size and differentiation;40%show plasmacytic differentia"B cells home to epith creating "lymphoepith lesions"CDS- CD10- mature B cells with surface IgFrequently occurs at extranodal sites involved by chronic inflammation very indolent; may be cured by local excisionDiffuse large B-cell lymphoma40% to 50% of adult lymphomasVariable; most resemble large germinal center B cells; diffuse growth patternMature B cells with variable expression of CD10 and surface IgOccurs in all ages, but most common in olderadults; often arise at extranodal sites; aggressiveBurkitt Lymphoma<1% of lymphomas in the United StatesIntermediate-size round lymphoid cells with nucleoli; diffuse tissue invol asso with apoptosis produces a "starry-sky" app.Mature CD10+B cells expressing surface IgEndemic in Africa, sporadic elsewhere; increased frequency in immunosuppressed; predominantly kids; presents with visceral involvement; highly aggr.Plasmacytoma/ plasma cell myelomaMost common lymphoid neoplasm in older adultsPlasma cells in sheets, some- times with prominent nucleoli or inclusions containing IgTerminally differentiated plasma cells containing cytoplasmic IgMyeloma presents as disseminated bone disease, often with lytic lesions,Hypercalcemia, renal insufficiency, bacterial infections commonMycosis fungoidesMost common cutaneous lymphoid malignancyIn most cases, small lymphoid cells with markedly convoluted nuclei; cells often infiltrate the epidermis (Pautrier microabscesses)CD4+mature T cellsPresents with localized or more generalized skin involvement; generally indolent. Sezary syndrome, a more aggressive variant, is ch by skin erythema and peripheral blood involvementPeripheral T-cell lymphoma, not other wise specified (NOS)Most common adult T-cell lymphomaVariable; usually a spectrum of small to large lymphoid cells with irregular nuclear contoursMature T-cell phenotype (CD3+)Probably spans a diverse collection of rare tumors. Often disseminated, generally aggressive.


Question: Creatinine kinase is elevated in MI after

CK-MB remains a valuable marker of myocardial injury, second only to the cardiac-specific troponins . Total CK activity is not a reliable marker of cardiac injury since various isoforms of CK are also found in brain, myocardium, and skeletal muscle. However, the CK-MB isoform--principally derived from myocardium, but also present at low levels in skeletal muscle--is the more specific indicator of hea damage. CK-MB activity begins to rise within 2 to 4 hours of MI, peaks at 24 to 48 hours, and returns to normal within approximately 72 hours. (Robbins Basic pathology,9th edition.pg no.382)


Question: The tumor suppressor gene P53 induces cell arrest at

(G1 - S phase) (60-195- Basic pathology 8th)* The S phase is the point of no return in the cell cycle and before the cell makes the final commitment to replicate - the G1/S checkpoint checks for damage.* This causes delay at G1/S checkpointThis delay in cell cycle progression provides the time neededfor DNA repair and if the damage is not reparable, apoptoticpathways are activated to kill the cell.G2 M checkpoint* This check point in used for the repair of the DNA which is damaged after its replication* The G2M checkpoint monitors the completion of DNA replication and checks whether the cell can safely initiates mitosis and separate sister chromatids(i) This checkpoint is particularly important in cells exposed to ionizing radiations(ii) Defects in this check points give rise to chromosomal abnormalityAlso known Effector for G1S checkpoint - Mostly mediated through P53 which induces the cell cycle inhibitor P21 Effector for G2M checkpoint - Involves both P53 and independent mechanismCyclinKinaseFunctionsDCD4.CDK6Progression past restriction at G1S boundaryEl-ACDK-2Initiation of DNA synthesis in early S phaseBCDK-1Transition from G2 to M


Question: Brown atrophy is due to accumulation of

Lipofuscin, or "wear-and-tear pigment," is an insoluble brownish-yellow granular intracellular material that accumulates in a variety of tissues (paicularly the hea, liver, and brain) as a function of age or atrophy. Lipofuscin is complexes of lipid and protein that derive from the free radical-catalyzed peroxidation of polyunsaturated lipids of subcellular membranes. It is not injurious to the cell but is a marker of past free radical injury. The brown pigment, when present in large amounts, impas an appearance to the tissue that is called brown atrophy.( Robbins Basic Pathology, 9th edition, page 24 )


Question: Torniquet test is a function of


Question: The following is not a cell cycle inhibitor

Checkpoints Cyclin CDK G1-S Cyclin D CDK 4/6 Cyclin E CDK 2 G2-M Cyclin A CDK 2/1 Cyclin B CDK 1 Family Checkpoints Proteins Functions CIP/KIP (CDKN1) G1-S G2-M p21 p27 p57 p21 induced by p53 p27 responds to TGF-ss INK4/ARF (CDKN2) G1-S p15 p16 p18 p19 p16/INK4a binds to cyclin D/CDK4 & promotes inhibitory effects of RB p14/ARF increased p53 levels by inhibiting MDM2


Question: most impoant cell damage in pathogenesis of ARDS is

RESPIRATORY DISTRESS SYNDROME (ARDS) * Acute respiratory distress syndrome (ARDS) is a life-threatening lung condition that prevents enough oxygen from getting into the blood. * Acute respiratory distress syndrome was first described in 1967 by Ashbaugh and colleagues. * ARDS is also referred with variety of terms like * Stiff Lung * Shock lung * Wet lung * Post traumatic lung * Adult respiratory distress syndrome * Adult hyaline membrane disease * Capillary leak syndrome & * Congestive atelectasis. ARDS - PATHOGENESIS Insult (direct or indirect) =>Activation of inflammatory cells & mediators =>Damage to alveolar capillary membrane =>Increased permeability of alveolar capillary membrane =>Influx of protein rich edema fluid and inflammatory cells into air spaces =>Dysfunction of surfactant ref : robbins 10th ed


Question: Earliest sign of left atrial enlargement

.Left atrial enlargement refers to dilation of the left atrium which occurs from multiple disease states that can chronically increase the left atrial pressure. These include congestive hea failure, cardiomyopathies, congenital hea defects and valvular hea disease In rheumatic mitral valve disease, there may be left atrial enlargement with specific enlargement of the left atrial appendage, first seen as a straightening of the left hea border below the left main bronchus, then as a discrete bulge on the left, immediately below the pulmonary bay and left main bronchus. Ref Robbins 9/e pg 345


Question: Blistering in Bullous pemphigoid is because of antibodies against


Question: Diapedesis is

Diapedesis is immigration of leukocytes through the endothelial gap to the site of inflammation.It occurs mainly in postcapillary venules except in lung where it occurs in capillaries.Robbins 9th edition p 76

Immigration of leukocytes through the basement membrane

Immigration of leukocytes through the endothelial gap to the site of inflammation

Aggregation of platelets at the site of inflammation


Question: Sunflower cataract is seen

Sunflower cataract is seen in Wilson's disease.
It is considered as a second opthalmic sign of Wilson's disease after KF ring.


Question: The bacteria observed as a causative organism in case of Recurrent apthous ulcers isq


Question: Unlike other GI secretions, salivary secretion is controlled almost exclusively by the nervous system and is significantly inhibited by


Question: Lethal midline granuloma arises from

Ans. is 'c' i.e., NK cells Lethal midline granuloma or polymorphic reticulosis is a lymphoma of natural killer (NK) cells infected with EBV.


Question: Silver tatoo is due to


Question: A deep pit Lined by enamel seen in the lingual surface of Maxillary lateral incisor is most Likely to be


Question: Libman sach's endocarditis is found in

(SLE) (598-R) (408-Basic pathology 8th)In SLE, mitral and tricuspid valvulitis with small sterile vegetatons called Libman-Sachs endocarditis is occasionally encounteredDistinguishing features of vegetations in major forms of EndocarditisFeaturesRheumaticLibman-sachsNon - bacterial thrombotic (merantic)Bacterial1. Valves commonly affectedMitral aloneMitral and aortic combinedMitral, tricuspidMainly bacterial less often aortic and tricuspidMitral, aortic combined mitral and aortic2. Location on valve cusps or leaflets* Occurs along the line of closure, atrial surface of AV valves and ventricularOccurs in both surface of valve leaflets or cusps in the valve pocketsOccurs along the line of closureSABE more often on diseased valve ABE on previously normal surface of semilunar valves valves, location same as in RHD3. MicroscopySmall, multiple, warty, grey brown, translucent firmly attached sterile, generally permanent valvular deformityMedium sized, multiple, generally do not produce significant valvular deformitySmaller but longer than those rheumatic single or multiple brownish firm but more friable than those of rheumaticOften large, grey tawny to greenish, irregular, single or multiple typically friable4. Common causeRheumatic feverSLE* Debilated patients cancer or sepsis* Hyper coagulable states* Promyelocytic leukemia* T estrogen state* BumsInfective endocarditis


Question: Thrush refers to


Question: Factor present in final common terminal complement pathway is rpt Q 38

Activation of the classical and alternative pathwaysleads to a common terminal pathway from C5 to C9. These complement components form the finalmembrane attack complex (MAC). ... complementfixation the combining of complement with the antigen-antibody complex, rendering the complement inactive, or fixed. Ref Robbins 9/e p40


Question: Cryoprecipitate is useful in

Cryoprecipitate is a source of fibrinogen, factor VIII, and von Willebrand factor (VWF). It is ideal for supplying fibrinogen to the volume-sensitive patient. Hemophilia A is treated with infusions of recombinant factor VIII. When factor VIII concentrates are not available, cryoprecipitate may be used because each unit contains approximately 80 units of factor VIII.Cryoprecipitate may also supply VWF to patients with dysfunctional (type II) or absent (type III) von Willebrand's disease.Harrison 19e pg: 138e-3


Question: Factor IX deficiency results in increased

Ans. is 'B' i.e., PTT (Paial thromboplastin time) Paial thromboplastin time (PTT) :It tests the intrinsic and common coagulation pathways. So, a prolonged PTT canresults from deficiency of factor V, VIII (factor VIIIc, Von willebrand factor), IX, X, XI, XII, prothrombin or fibrinogen.Prothrombin time (PT) :It tests the extrinsic and common coagulation pathways. So, a prolonged PT can results from deficiency of factor V, VII, X, prothrombin or fibrinogen.Thus in common coagulation pathway defect both PT and PTT are elevated.Activated clotting time (clotting time) :It also tests the intrinsic and common coagulation system. So it is prolonged in deficiency of same factors as for prolonged PTT


Question: Gene for folate carrier protein is located on chromosome

Folate cofactors are one-carbon donors essential for the biosynthesis of purines and thymidylate. Mammalian cells are devoidof folate biosynthesis and are therefore folate auxotrophs that take up folate vitamins primarily via the reduced folate carrier (RFC). The gene for RFC is located on chromosome 21.


Question: Commonest histological finding in benign hypeension is

Hyaline aeriolosclerosis is associated with benign hypeension. It is marked by homogeneous, pink hyaline thickening of the aeriolar walls, with loss of underlying structural detail, and luminal narrowing . The lesions stem from leakage of plasma components across injured endothelial cells, into vessel walls and increased ECM production by smooth muscle cells in response to chronic hemodynamic stress. (Robbins basic pathology,9th edition.pg no.334)


Question: The following drug has anxiolytic action with least sedation

Features of Buspirone Non-benzodiazepine anxiolytic agentDoes not produce significant sedation or cognitive/functional impairmentDoes not interact with BZD receptor or modify GABAergic transmissionDoes not produce tolerance or physical dependence Does not suppress BZD or barbiturate withdrawal syndrome Has no muscle relaxant or anticonvulsant activity (Refer: KD Tripathi's Essentials of Medical Pharmacology, 7th edition, pg no: 466-467)


Question: Delayed prolonged bleeding is caused by

EndotheliumDirect injury to endothelial cells causes delayed prolonged bleeding because, endothelial cells are central regulators of hemostasis, the balance between the anti-and prothrombotic activities of endothelium determines whether thrombus formation, propagation or dissolution occurs.Robbins basic pathology 9th edition page no 79


Question: An example of a tumour suppressor gene is

Robbins basic pathology 9th edition page no 182, Retinoblastoma gene is the first tumour suppressor gene to be discovered.


Question: Bombay blood group contains

Biosynthesis of the H, A and B antigens involves a series of enzymes (glycosyl transferases) that transfer monosaccharides. The resulting antigens are oligosaccharide chains, which are attached to lipidsand proteins that are anchored in the red blood cell membrane. The function of the H antigen, apa from being an intermediate substrate in the synthesis of ABO blood group antigens, is not known, although it may be involved in cell adhesion. People who lack the H antigen do not suffer from deleterious effects, and being H-deficient is only an issue if they need a blood transfusion, because they would need blood without the H antigen present on red blood cells The h/h blood group, also known as Oh or the Bombay blood group, is a rare blood type. Ref sathyanarayana 5th edition ; pg256


Question: Gluten free diet is used in

Coeliac Sprue (Non-tropical Sprue, Gluten-Sensitive Enteropathy, Idiopathic Steatorrhoea) This is the most impoant cause of primary malabsorption occurring in temperate climates. The condition is characterised by significant loss of villi in the small intestine and thence diminished absorptive surface area. The condition occurs in 2 forms: Childhood form, seen in infants and children and is commonly referred to as coeliac disease. Adult form, seen in adolescents and early adult life and used to be called idiopathic steatorrhoea. In either case, there is genetic abnormality resulting in sensitivity to gluten (a protein) and its derivative, gliadin, present in diets such as grains of wheat, barley and rye. Serum antibodies--IgA antigliadin and IgA antiendomysial, have been found but is not known whether these antibodies are primary or appear secondary to tissue damage. TEXTBOOK OF PATHOLOGY 6TH EDITION HARSH MOHAN PAGE NO:575


Question: Inheritance of hereditary multiple exostoses

Answer- A. Autosomal dominant Hereditary multiple exostoses is characterized by multiple osteochonilromas which cause limb deformities, skeletal abnormalities, sho stature, nerve compression and decreased joint range of motion.It is inherited as autosomal dominant disorder due to mutation in EXT 1 or EXT2 gene.


Question: Splenic macrophages in Gaucher's disease differ from those in ceroid histiocytosis by staining

In Gaucher's disease there is an accumulation of Gaucher cells that Contain glucocerebroside which is a lipid (glycolipid)
In ceroid histocytosis, there is an accumulation of lipofuscin (ceroid), a yellow-brown cytoplasmic pigment, in the histiocytes.


Question: Wernick's encephalopathy is caused by deficiency of


Question: Woody feeling of the external nose (Hebra nose) is observed in


Question: Internucleosomal cleavage of DNA is characteristic of

Apoptosis ) is a process of programmed cell death that occurs in multicellular organisms. Biochemical events lead to characteristic cell changes (morphology) and death. These changes include blebbing, cell shrinkage, nuclear fragmentation, chromatin condensation, chromosomal DNA fragmentation, and global mRNA decay. In H&E-stained tissue sections, the nuclei of apoptotic cells show various stages of chromatin condensation and aggregation and, ultimately, karyorrhexis (Fig. 1-21); at the molecular level this is reflected in fragmentation of DNA into nucleosome-sized pieces. Ref Robbins 9/e 18


Question: Developing Ameloblasts are affected by the ingestion of water with high fluoride content resulting in


Question: Most commonly submerged tooth is


Question: Basophilic stippling is

Basophilic Stippling is ribosomal inclusions in RBCs. Seen in Sideroblastic anemia, lead poisoning, megaloblastic anemia, Thalassemia, Arsenic poisoning.


Question: Commonest age group for infant botulism is


Question: Cause of DIC does not include

Causes of disseminated intravascular coagulation include , massive tissue injury as in obstetrical syndrome, trauma, metastatic malignancies in surgery Infections especially endotoxemia ,Gram Negative and meningococcal septicemia ,ceain viral infections ,malaria ,aspergillosis Widespread endothelial damage as in aoic aneurysm ,hemolytic- uremic syndrome, severe burns, acute Glomerulonephritis. Miscellaneous Snake bite shock ,acute intravascular hemolysis ,hea stroke Reference textbook of Pathology 7th edition author Harsha Mohan page number 315 Ref Robbins 9/e pg 450


Question: Virus responsible for infectious mononucleosis is


Question: Inheritance of "Wilsons disease " is


Question: The characteristic feature of benign nephrosclerosis is

Benign nephrosclerosis Malignant nephrosclerosisAge group Elderly Younger individuals Gross Grain leather appearance-Fine granularity over coical surfaceFlea bitten appearance-Pinpoint petechial hemorrhage over coical surfaceMicroscopyHyaline aeriosclerosis, subcapsular scars Fibrinoid necrosis and onion skinning appearance of aeriolesClinical features Mild proteinuria. GFR normal Renal failure, BP >200/120,papilloedema, retinal hemorrhages and encephalopathy (Ref: Robbins 8/e p949)


Question: Antishkow's cells are seen in

Ans. is 'a' i.e.,Rheumatic hea disease Anitschkow (or Anichkov or catterpiller) cells are often cells associated with rheumatic hea disease.Anitschkow cells are enlarged macrophages found within granulomas (called Aschoff bodies) associated with the disease.Aschoff bodies (Aschoff nodules) are characteristic inflammatory lesions of acute rheumatic fever found in any of the three layers of hea, but mostly seen in myocardium (myocarditis).They consist of foci of collagen surrounded by following cells : Lymphocytes (especially T-cells), plasma cells, aschoff giantcells, antischkow cells, histiocytes and fibroblasts. Neutrophils (polymorphonuclear cells) are characteristically absent.


Question: Glossoplagia is

Glossopyrosis- Burning of tongue
Glossodynia- Painful tongue


Question: large friable irregular vegetation on the valves


Question: In Rheumatic fever, fibrinoid necrosis occurs in


Question: Immunoflourescence is seen at basement membrane as patchy distribution in


Question: Risk factor for endometrial carcinoma is

Risk factors for this type of carcinomainclude (1) obesity, (2) diabetes, (3) hypeension (4) infeility, (5) exposure to unopposed estrogen Many of these risk factors result in increased estrogenic stimulation of the endometrium and are associated with endometrial hyperplasia. ref : Robbins Basic Pathology, 9E,page-692


Question: fay Sach's disease is an inborn error of metabolism due to deficiency

(A) Hexosaminidase-A SPHINGOLIPIDOSESDiseaseEnzyme Deficiency* Tay-sachs diseaseHexosaminidase A* Fabry's diseasea-Galactosidase* Metachromatic leukodystrophyArylsulfatase A* Krabbe's diseaseb-Galactosidase* Gaucher's diseaseb-Glucosidase* Niemann-Pick diseaseSphingomyelinase* Farber's diseaseCeramidase


Question: 40 yr old male presented with cirrhosis. Special stain used in the histology slide given below is

Iron in hemosiderin is chemically reactive and turns blue-black when exposed to potassium ferrocyanide, which is the basis for the Prussian blue stain. In iron-overloaded cells, most iron is stored in hemosiderin.Severe hemochromatosis (hereditary or secondary) is characterized principally by (1) deposition of hemosiderin in the following organs (in decreasing order of severity) the liver, pancreas, myocardium, pituitary gland, adrenal gland, thyroid and parathyroid glands, joints, and skin; (2) cirrhosis; and (3) pancreatic fibrosis.Ref: Robbins pathology 9e pg: 650, 848


Question: Liver biopsy in malaria will have

Ans. b. Kupffer cell hyperplasiaCLASSIFICATION OF PARASITIC DISEASE OF THE LIVER AND BILIARY TRACT BY PATHOLOGIC PROCESSPathologic processDiseasesLiver disease Granulomatous hepatitisCapillariasisFascioliasisSchistosomiasisStrongyloidiasisToxocariasisPortal fibrosisSchistosomiasisHepatic abscess or necrosisAmebiasisToxoplasmosisCystic liver diseaseEchinococcosisPeliosis hepatisBacillary angiomatosisReticuloendothelial diseaseKupffer cell infection or hyperplasiaBabesiosisMalariaToxoplasmosisVisceral leishmaniasisBiliary tract diseaseCholangitisClonorchiasis/opisthorchiasisFascioliasisBiliary hyperplasisAscariasisClonorchiasisCryptosporidiosisFascioliasisCholangiocarcinomaClonorchiasis/opisthorchiasis


Question: Amyloidosis deposition most commonly occurs in

Amyloid is an abnormal pathological protein resulting from the improper folding of proteins and deposited extracellularly as fibrils and disrupt their normal function.
The most common site of deposition is (in decreasing order of incidence) Kidney, Liver, Spleen, Lymph nodes, Adrenals, Thyroid, GIT, Heart. In systemic Amyloidosis, any organ can show deposition of Amyloid. Among all organs, kidneys are most commonly and most seriously get affected by Amyloidosis


Question: Dystrophic calcification is seen in

Dystrophic calcification is encountered in areas of necrosis of any type. It is viually inevitable in the atheromas of advanced atherosclerosis, associated with intimal injury in the aoa and large aeries and characterized by the accumulation of lipids.( Robbins Basic Pathology, 9th edition, page 25 )


Question: A  peripheral  smear  with  increased  neutrophils, basophils,  eosinophils,  and  platelets  is  highly suggestive of

The peripheral blood picture of this patient is quite characteristic of chronic myeloid leukemia.
Chronic  myeloid  leukemia  is  a  stem  cell  disease  that  is  characterized  by  leukocytosis  with  granulocytic  immaturities,  basophilia, splenomegaly and distinct chromosomal abnormality Philadelphia chromosome.


Question: Tigered effect of heart is seen in


Question: Carcinoid tumor develops from


Question: In apoptosis, the nucleus is destroyed by

In H&E-stained tissue sections, the nuclei of apoptotic cells show various stages of chromatin condensation and aggregation and, ultimately, karyorrhexis (Fig. 1-21); at the molecular level this is reflected in fragmentation of DNA into nucleosome-sized pieces. Ref Robbins 9/e p 18


Question: White infarcts occurs in one of the following organs


Question: A single nucleotide change in a codon on chromosome 11 that causes valine to replace glutamic acid at the sixth position of the b chain of hemoglobin.peripheral blood film of the patient is given

Hemoglobin S (Hb S) is formed by the replacement of glutamic acid by valine in the sixth position in the b chain of hemoglobin. On deoxygenation, Hb S polymerizes and the red cells sickle. In patients heterozygous for Hb S (sickle cell trait, Hb AS), there is approximately 45% Hb S and 55% Hb A. Because of the content of Hb A, erythrocytes only sickle at low oxygen tension and symptoms are much milder than in sickle cell disease. Hb F does not react with hemoglobin S, so that patients who have Hb S and large amounts of Hb F, as occurs in newborns with sickle cell disease, are asymptomatic. Clinically, sickle cell disease is characterized by the triad of chronic hemolytic anemia, vascular occlusion, and vulnerability to infection. The severe chronic hemolytic anemia leads to chronic hyperbilirubinemia (jaundice), which leads to pigmented gallstones. Vascular occlusion results in leg ulcers, renal papillary necrosis, and multiple infarcts, which may cause severe bone pain. Repeated splenic infarcts cause progressive fibrosis and splenic atrophy (autoinfarction). Rather than hypersplenism, most adults have a small, functionless, fibrotic spleen. The lack of splenic function along with defects in the alternate complement pathway predispose to infections such as Salmonella osteomyelitis and pneumococcal infections. The vasoocclusive disease also leads to painful crises, hand-foot syndrome in children (consisting of the typical triad of fever, pallor, and symmetric swelling of hands and feet), and infarctive crises. In patients not having yet undergone splenic autoinfarction (usually children), massive splenic sequestration (sequestration crisis) may lead to rapid splenic enlargement, hypovolemia, and shock. Patients with sickle cell disease have a normocytic anemia with a corrected reticulocyte count of greater than 3%. The erythrocyte sedimentation rate (ESR) is zero because the sickled red cells cannot aggregate and settle in the test tube. Hydroxyurea has recently been approved for the treatment of sickle cell disease because it increases the synthesis of hemoglobin F, thus reducing the severity of the disease Reference: Robbins & Cotran Pathologic Basis of Disease, 9edition.


Question: The most characteristic and frequent feature of chronic rheumatic hea disease is the development of

Rheumatic fever (RF) produces both acute and chronic manifestations. Acute RF produces a pancarditis of all three layers of the hea. It is manifested by myocarditis, which is characterized histologically by the Aschoff body; pericarditis, which is referred to as "bread-and-butter" pericarditis; and verrucous endocarditis. In contrast to acute RF, chronic RF produces damage to cardiac valves. The mitral valve is most commonly involved, followed by the aoic valve. The stenotic valve has the appearance of a "fish mouth" or "buttonhole." An additional finding in chronic RF is a rough poion of the endocardium of the left atrium, called a MacCallum's patch. Reference: Robbins & Cotran Pathologic Basis of Disease, 9edition.


Question: Vanillyl mandelicacid (VMA) increased in

(Pheochromocytoma) (798- Basic Robbins 8th)PHEOCHROMOCYTOMA - "Rules of 10s"*** Demonstrating characteristic nests of cells ("Zellballen") with abundant cytoplasm* The definite diagnosis of malignancy in pheochromocytoma is based exclusively on the presence of metastasis*** Diagnosis demonstration of increased excretion of free Catecholamines and their metabolites such as vanillylmandelic acid and metanephrines**


Question: The following condition is treated with

The picture and the description are characteristic features of Pyostomatitis vegetans . It is usually treated by corticosteroids


Question: Early tongue changes seen in scarlet fever is


Question: A 2 year old child presents with scattered lesions in the skull. Biopsy revealed Langerhans giant cells. The most commonly associated marker with this condition will be


Question: Reliable screening test for hemophilia is


Question: Early age of sex is risk factor for

Ans. A. Carcinoma cervixEarly Coitarche (early age of first intercourse) is a risk factor for carcinoma cervix.


Question: Smudge cell is seen in

Lymphohistiocytic cells or L-H cells or popcorn cells are seen in lymphocyte predominant Hodgkin's lymphoma.
These cells are CD 45, CD 20 and epithelial membrane antigen positive. Lacunar cells are seen in nodular sclerosis Hodgkin's disease. They are positive for CD15, CD30 and PAX 5.
Smudge cells are seen in CLL.
Sezary cells are seen in Sezary syndrome.

Lymphocyte predominant Hodgkin's lymphoma


Question: Transition from G2 to M phase of the ceil cycle is controlled by


Question:
A flat, circumscribed discolouration of skin or mucosa
that may vary in size and shape is referred to as


Question: Trismus is due to infection by


Question: Lipid in tissue detected by aEUR'

Oil red 0 Congo red is not used in lipid staining. It is used in the staining of amyloid protein. STANING FOR LIPIDS Non polar lipids Example Stain used * Unconjugated lipids Fatty acids III & IV Oil red 0, Sudan black Sudan Cholesterol Filipin * Esters Cholesteryl esters Schultz Monodi and Tri-glycerides Calcium lipase * Polar lipids Phospholipids Glycerol bases Phosphatidylcholine Nile blue sulfate Phosphatidylserine Nile blue sulfate Phosphatidylethanol amine Plasmal reaction Sphingosine-base Sphingomyelins Fenic hematoxylin Glycolipids Cerebrosides PAS Sulfatides Acetone/Toluidine blue Ganglisides PAS


Question: Moell’s Glossitis is due to

Tongue
Strawberry tongue - Early tongue change in scarlet fever
Raspberry - Late tongue change scarlet fever
Stomatitis scalatina - Mucosal change
Geographic tongue - Migratory glossitis
Scrotal tongue - Fissured tongue
Raw beefy tongue - Acrodynia (pink disease or swifts disease)
Black hairy tongue - oral use of antibiotics
Magenta red tongue - Vit. B12 deficiency (Riboflavin)
Moell's/Hunter's Glossitis - Vit. B2 deficiency (Bald tongue)
Bald tongue of sandwith - pellegra


Question: Commonest surgical procedure for soft tissue sarcoma

Soft Tissue SarcomaRare unusual neoplasm of soft tissuesM/C site: Extremity (lower >upper) > Trunk > Retroperitoneum >Head & NeckM/C type: Malignant fibrous histiocytoma>Liposarcoma> Leiomyosarcoma >Synol sarcoma >Malignant peripheral nerve sheath tumorMC pediatric soft tissue sarcoma: RhabdomyosarcomaHistopathological Type of STSExtremityRetroperitoneumVisceraMalignant fibrous histiocytoma > LiposarcomaLiposarcomaGISTPathologyDiagnosis of Soft tissue sarcomaSTS tends to grow along fascial planes, with the surrounding soft tissue compressed to form a pseudocapsule.Clinical behavior of STS is determined by: Anatomic location (depth), grade & sizeM/C route of spread in soft tissue sarcoma: HematogenousM/C site of metastasis: LungCore-cut or true-cut biopsy (CT or USG guided) is diagnosticIncisional biopsy is done if core-cut biopsy is non-diagnosticFNAC: To confirm or rule out presence of metastatic focus or local recurrenceMRI: IOC for assessing extremity STSCECT: IOC for assessing retroperitoneal sarcomaClinical featuresTreatmentM/C symptom of STS: Painless massSize at presentation is dependent on the location of tumor.Smaller tumors - distal extremitiesLarger tumors - proximal extremity & retroperitoneumAdequate excision + adjuvant radiotherapy with or without adjuvant chemotherapy.PrognosisBest prognostic factor of soft tissue sarcoma: GradingBest prognosis is seen in: ExtremitySTSMC cause of death in STS: Metastasis; 5-year survival rate for STS (all stages): 50-60%(Refer: Devita, Hellman, Rosenberg's Cancer Principles and Practice of Oncology, 9th edition, pg no: 1533-1552)


Question: Pathological feature of pyogenic granuloma

Pyogenic granulomas) are pedunculated masses usually found on the gingiva of children, young adults, and pregnant women. These lesions are richly vascular and typically are ulcerated, which gives them a red to purple color. In some cases, growth can be rapid and raise fear of a malignant neoplasm. However, histologic examination demonstrates a dense proliferation of immature vessels similar to that seen in granulation tissue. Pyogenic granulomas can regress, mature into dense fibrous masses, or develop into a peripheral ossifying fibroma. Complete surgical excision is definitive treatment. (Robbins basic pathology,9th edition,pg no.553)


Question: Ig active in type 1 hypersensitivity.

Ans: b (IgE) Ref: Robbins, 7th ed, p. 205Dendritic cells + Antigen ' CD4 Helper T cells '! THL cells produce."Most of the immediate hypersensitivity reactions are mediated by IgE antibodies."Dendritic cells + Antigen - CD4 Helper T cells - THL cells produce.IL5 - stimulate Eosinophils ILA - 'Turning on' of B cellsIgE production.ILB - IgE production, mucus secretion. IgE thus produced will bind to receptors on basophils and mast cells. These cells, aimed with IgE, when re-exposed to specific allergen, leads to a series of reactions responsible for the clinical expression of type 1 hypersensitivity.The primary and secondary mediators released from mast cells are listed belowPrimary mediatorsSecondary mediatorsHistamineLeucotrienes (B4C4D4)ProteasesProstaglandins (PGD2)Chemotactic factors (C39)PAFHeparinCytokines - IL 1, 3, 4, 5, 6, TNF,GM CSF


Question: Horner's syndrome DOES NOT include

Miosis, ptosis, anhydrosis, and flushing are a features of homer's syndrome.


Question: Glomerulonephritis associated with sensory neural deafness are features of

Ans. is 'a' Alport's syndrome Alport's syndrome is characterized byGlomerulonephritis*Deafness*Lenticonus*Some other frequently asked syndromes associated with deafness:1. Waardenburg syndrome*Pigmentary abnormalityHearing loss2. Pendred syndrome*Defect in thyroid hormone synthesis &Hearing loss


Question: Normal amount of pleural fluid is approximately

Normally, no more than 15 ml of serous, relatively acellular, clear fluid lubricates the pleural surface.
Increased accumulation of pleural fluid is called pleural effusion


Question: Folie a deux is seen in


Question: Assessment and aiding for development of funds for the National Blindness Control Programme is done by

Funding for the NPCB- The allocation of funds for the NPCB increased with the sta of the World Bank-financed Project in 1995.


Question: Grinspan syndrome is associated with


Question: Carcinoid tumor secretes

Ans. c (5 HT). (Ref. Baily & Love, Surgery, 22nd/pg.800)CARCINOID TUMOR# Arises from argentaffin/chromafin cells, called as Kulschitsky cells.# These cells stain with ammoniacal silver salt solution to black.# Most common site of occurence is appendix and is benign there.# Next common site is ileum and most of them are malignant.# More than 9 mg/ 24-hour of 5-HIAA in 24 in urine is diagnostic. Carcinoid also secretes 5-HT.# Carcinoid syndrome is characterized by attacks of flushing and diarrhoea, abdominal cramps, bronchospasm, tricuspid and pulmonary regurgitation/stenosis and telangectasia.# Most common cause is small bowel carcinoid metastasizing to liver; and next common is bronchial carcinoid.# Cardiac changes in carcinoid heart disease are largely right sided (tricuspid valve) and are due to inactivation of both serotonin and bradykinin in the blood during passage through lungs by monoamino-oxidase present in pulmonary vascular endothelium.


Question: Annexin Visa marker of

Ans. is 'a' i.e., Apoptosiso Annexin V assays provides simple and effective method to detect apoptosis at a very early stage.o This assay makes advantage of the fact that phosphatidylserine (PS) is translocated from the inner (cytoplasmic)leaflet of the plasma membrane to the outer (cell surface) leaflet soon after the induction of apoptosis and that theannexin V protein has strong specific affinity for phosphatidyl serine.o Phosphatidyl serine on the outer leaflet is available to bind labelled annexin V providing the basis for a simple staining assay.o All of the annexin proteins share the propey of binding calcium and phospholipids.o Annexin V is a cause of syndrome called antiphospholipid antibody syndrome.o Annexin V normally forms a shield around ceain phospholipid molecules that blocks their entry into coagulation (clotting) reactions.o In the antiphospholipid antibody syndrome; the formation of the shield is disrupted by the abnormal antibodies. Without the shield, there is an increased quantity of phospholipid molecules on cell membranes speeding up coagulation reactions and causing the abnormal blood clotting characteristic of antiphospholipid antibody syndrome.


Question: Apoptosis is

Apoptosis is a pathway of cell death in which cells activate enzymes that degrade the cells' own nuclear DNA and nuclear and cytoplasmic proteins. Fragments of the apoptotic cells then break off, giving the appearance that is responsible for the name (apoptosis, "falling off").Apoptosis results from the activation of enzymes called caspases (so named because they are cysteine proteases that cleave proteins after aspaic residues)( Robbins Basic Pathology, 9th edition, page 19 )

Cell death induced by regulated intracellular program

Cell survival by a regulated ultra cellular program

Modification and adaptation by the regulated intracellular program


Question: Perifascicular atropy of muscle fibres is seen in

Inflammatory Myopathies Dermatomyositis is the most common Inflammatory myopathy in children. On microscopic examination it is associated with perivascular mononuclear cell infiltrates, dropouts of capillaries, the presence of so called tubuloreticular inclusions in endothelial cells, and myofiber damage in a paraseptal or perifascicular pattern. Robbins basic pathology 9th edition page no 805,heading=


Question: Best predictor for coronary aery disease aEUR'

LDL ???? Elevated LDL cholesterol and decreased HDL cholesterol are independent predictors of coronary hea disease. - Although there is consensus regarding the benefits of lowering LDL cholesterol the value of elevating HDL cholesterol remains controversial. Low HDL and coronary risk High serum HDL cholesterol is associated with a lower risk of CHD. The incidence of CHD events in a normal population appears to be inversely related to serum HDL cholesterol with low levels being associated with increased coronary risk. - Based upon data .from the Framingham Hea study, the risk for myocardial infarction increases by about 25%.for every 5mg/d1 (.13 nuno1/1) decrement in serum HDL cholesterol. Elevated LDL and coronary risk Elevation in LDL cholesterol is a well known risk factor for the development of coronary aery disease. Association of elevated LDL with coronary aery disease has been established in various trials and studies. There is linear reduction in cardiovascular disease with progressive lowering of the LDL cholesterol. Traditionally LDL levels are considered to be the nzost impoant factor in the prediction of coronary aery disease. The impoance of LDL as a risk factor lies in the fact that effective therapes are avalaible to lower it, while it is not so in the case of HDL. So when treating dyslipidemia for reducing cardiovascular events, the .first target is LDL and not HDL. Doubt and Controversy What is creating doubts in our mind is a table from Braunwald 8th/e p1008 according to which 'Low HDL' appears to be better marker, for prediction of future cardiovascular disease than 'High LDL'. According to this bar diagram in Braunnwald 8"Ye p1008 - the adjusted hazard ratio .for .future cardiovascular events for LDL is 1.62 while that of HDL is 2.32. But the text given in the book does clarify which one is better marker. (we have give this table from Braunwald in our previous discussion on this topic in Nov 2009 Medicine). We have tried to confirm this low HDL' fact from various other books. But none of the texts clearly. ored any one between these 2 to be the better marker. Both LDL and HDL are mentioned to be impoant. We have also consulted several cardiologist on this. All of them say that the answer should be LDL Well, Braunwald is text book of immense reputation. and any information or text given in the book does not need confirmation from any other source. But what has added to the confusion is that the latest edition of Braunwald i.e., 9"/e has eliminated that diagram from the book and in the text have not clarified which one is better marker. Instead, the text states that Apolipo (a) and B 100 are better marker, .for predicting future cardiovascular events than LDL and HDL. We are not absolutely sure of the answer, but we would for the time being go with LDL. Also Know The following lipid and lipoprotein abnormalities are associated with increased coronary risk. - Elevated total cholesterol - Elevated LDL cholesterol Low HDL cholesterol - Increased total to HDL cholesterol ratio - Increased non HDL cholesterol - Hyperiglyceridemia - Increased Lp(a) - Increased apolipoprotein B - Sinai! dense LDL paicles


Question: 'Onion skin' fibrosis of bile duct is seen in

MORPHOLOGY The characteristic features of PSC are different in the extrahepatic and large intrahepatic ducts than in the smaller ducts. The largest ducts have chronic inflammation with superimposed acute inflammation, very similar to the mucosal lesions of ulcerative colitis. These inflamed areas lead to narrowing of the larger ducts either because edema and inflammation narrows the lumen or because of subsequent scarring. The smaller ducts, however, often have little in the way of inflammation and show a striking circumferential fibrosis often referred to as onion skinning around an increasingly atrophic duct lumen Eventually the lumen disappears altogether, leaving just a dense button of scar tissue, the viually diagnostic tombstone scar. Because the likelihood of sampling such smaller duct lesions on a random needle biopsy is minuscule, diagnosis depends not on biopsy but on radiologic imaging of the extrahepatic and largest intrahepatic ducts. TEXT BOOK OF ROBBINS BASIC PATHOLOGY NINTH EDOTION PAGE.628 IMAGE REF: ROBBINS BASIC PATHOLOGY NINTH EDITION FIG 15-24 PAGE 629


Question: Gene involved in rett syndrome

Rett syndrome (T), originally termed cerebroatrophic hyperammonemia, is a rare genetic postnatal neurological disorder of the grey matter of the brain that almost exclusively affects females but has also been found in male patients. The clinical features include small hands and feet and a deceleration of the rate of head growth (including microcephaly in some). Repetitive stereotyped hand movements, such as wringing and/or repeatedly putting hands into the mouth, are also noted. People with Rett syndrome are prone to gastrointestinal disorders and up to 80% have seizures. They typically have no verbal skills, and about 50% of affected individuals do not walk. Scoliosis, growth failure, and constipation are very common and can be problematic. The signs of this disorder are most easily confused with those of Angelman syndrome, cerebral palsy and autism. Rett syndrome occurs in approximately 1:10,000 live female bihs in all geographies, and across all ethnicities. The syndrome was first described by Austrian neurologist Andreas Rett in 1966. While the disorder was identified scientifically, and could be reliably diagnosed, the causes remained unknown for decades. Huda Zoghbi demonstrated in 1999 that mutations in the gene MECP2 cause Rett syndrome


Question: Microalbuminuria is defined as amount of the albumin passing in urine

(30-300): (687 Harsh Mohan 6th edition)MICROALBUMINURIA - refers to the excretion of amounts of albumin too small to detect by urinary dipstick or conventional measures of urine protein. It is a good screening test for early detection of renal disease and may be a marker for the presence of microvascular disease in generalMacroalbuminuria (ie albuminuria > 150 mg/day or random urine albumin / creatinine ratio of > 300 mg/gm creatinine)Microalbuminuria estimated by radio immunoassay ie microalbumin 30-300 mg/day or random urine microalbumin / creatinine ratio of 30-300 mg/gm creatinine.


Question: The most common site for lymphagiosarcoma is

Ans. (c) Post mastectomy arm(Ref: Cancer 1948; 1:64-81)*Lymphangiosarcoma is a misnomer because this malignancy seems to arise from blood vessels instead of lymphatic vessels.*Most commonly, this tumor is a result of lymphedema induced by radical mastectomy*Stewart-Treves syndrome is a rare, cutaneous angiosarcoma that develops in long-standing chronic lymphedema.


Question: Venous malformations involving the leptomeninges of the cerebral cortex is a salient feature of


Question: Characteristics histipathological feature of the kidney in DM

Diabetic lesions of glomerulosclerosis are also called as kimmelstiel-wilson(KW) lesions or intercapillary glomerulosclerosis. These lesions are specific for type 1 diabetics. Refer harshmohan 6/e p678


Question: Principal Actions of prostacyclin in Inflammation is

Principal Actions of Arachidonic Acid Metabolites in InflammationActionEicosanoidVasodilationProstaglandins PGI2 (prostacyclin), PGE1, PGE2, PGD2VasoconstrictionThromboxane A2, leukotrienes C4, D4, E4Increased vascular permeabilityLeukotrienes C4, D4, E4Chemotaxis, leukocyte adhesionLeukotrienes B4, HETERef: Robbins and Cotran Pathologic Basis of Disease; 9th edition; Chapter 3; Inflammation and Repair; Page no: 84; Table 3-5


Question: Cells seen in MI at 48 hours are

The microscopic appearance also undergoes a characteristic sequence of changes . Typical features of coagulative necrosis become detectable within 4 to 12 hours of infarction. "Wavy fibers" also can be present at the edges of an infarct. Light microscopic features in 1-3 days include: Coagulation necrosis with loss of nuclei and striations; interstitial infiltrate of neutrophils. (Robbins basic pathology,9th edition.pg no.380)


Question: Progression of dental caries on pit and fissure occurs from


Question: Paneth cells characterized by

Paneth cells are zinc-containing cells widely distributed in Lieberkuhn's crypts of small intestine in many species, but their function has remained obscure. Our previous study showed that a single intravenous injection of diphenylthiocarbazone (dithizone), a zinc chelator, forms zinc-dithizonate complexes in the cytoplasm of Paneth cells to ensure rapid and selective killing of the cells. REFERENCELE nih.gov


Question: Paneth cells contain

Paneth cells are zinc-containing cells widely distributed in Lieberkuhn's crypts of small intestine in many species, but their function has remained obscure. Our previous study showed that a single intravenous injection of diphenylthiocarbazone (dithizone), a zinc chelator, forms zinc-dithizonate complexes in the cytoplasm of Paneth cells to ensure rapid and selective killing of the cells. REFERANCE. NIH.GOV


Question: Takayasu's arteritis with pulmonary arteries involvement is designated as

(D) Type IV# "Takayasu's arteritis" described as three types on the basis of the location and extent of the arteritis affecting the aorta. In 1977. Lupi- Herrera et al. described an additional variant with pulmonary artery involvement, which they designated type IV.


Question: Tumorogenesis in aging is due to aEUR'

Telomerase reactivation After a fixed number of divisions, normal cells becomes arrested in a terminally nondividing state. How does the normal cells count their divisions i.e. How, do the cells find out that now the), do'nt need to divide fuher. Cells achieve this through telomer shoening Telomers are sho repeated sequences of DNA present at the linear ends of chromosome that are impoant for ensuring complete replication of chromosome ends. It consists of many arrays of TTAGGG repeats at terminal of 3' ending strand. It confers stability to chromosomes. With each successive division there is some shoening of the telomers. Once the telomers are shoened beyond a ceain point the ends of the chromosome are seen as broken DNA, which signals cell cycle arrest. The broken DNA leads to activation of p53 dependent cell cycle check points causing proliferative arrest or apoptosis. Thus telomere shoening functions as a clock that counts cell division. How do the germ cells keep on dividing throughout their life ??? In germ cells telomere shoening is prevented by the sustained function of the enzyme telomerase. Telomerase is a reverse transcriptase and is responsible for telomer synthesis and maintaining the length of telomer. It is RNA dependent DNA polymerase. It has one segment that is complimentary to TTAGGG repeat and is used as template for the replication of telomeric sequence. This enzyme is absent from most somatic cells and hence they suffer progressive loss of telomers and they exit the cell cycle. Telomerase is present in Germ cells thus explaining the ability of these cells to self replicate extensively. If loss of telomere is the basis of finite life span then how do cancer cells continue to divide actively ???? In cancer cells telomerase activity is reactivated. Telomerase activity has been detected in more than 90% of human tumours. Thus telomerase activity and maintenance of telomere length are essential for the replicative potential in cancer cells.


Question: A patient's urine with a particular protein appears normal, but on standing it becomes dark. The dark colour disappears on heating. The patient is suffering from


Question: Koplik spots

Are seen 2-3 days after cutaneous rashes


Question: Intravascular heamolysis occurs in

Paroxysmal noctural hemoglobunuria (PNH) is the only hemolytic anemia caused by an acquired intrinsic defect in the cell membrane. It is associated with intravascular hemolysis. Rest all conditions causes extravascular heamolysis.


Question: Platelets are stored at

Platelets are stored at 20 – 24 degree Celsius with agitation. They can only be stored for 5 days.
Whole blood and packed red cells are stored at 2 – 6 degree Celsius for 35 days.
The anticoagulants which are used for their storage are either CPD (Citrate, Phosphate, Dextrose) or CPDA (Citrate, Phosphate, Dextrose, Adenine).
Fresh frozen plasma is stored at –18 degree Celsius for 1 year.


Question: Atheromatous changes of blood vessels affects early in

repeated question The risk factors are Constitutional- genetic abnormalities,family history , increasing age, male gender, hyperlipidemia,hypeension,cigaratte smoking, diabetes, inflammation Myocardial infarction is the main condition


Question: Sharp instruments like needle, syringes, scalps hospital waste products etc., are thrown in

(Refer: K. Park's Textbook of Preventive and Social medicine, 24th edition, pg no: 830)


Question: The lymphocytic and histiocytic variant of Reed Sternberg cell is seen in

Lymphocyte Predominance Type: This uncommon "nonclassical" variant of HL accounts for about 5% of cases. Involved nodes are effaced by a nodular infiltrate of small lymphocytes admixed with variable numbers of macrophages. "Classical" Reed-Sternberg cells are usually difficult to find. Instead, this tumor contains so-called L&H (lymphocytic and histiocytic) variants, which have a multilobed nucleus resembling a popcorn kernel ("popcorn cell"). Eosinophils and plasma cells are usually scant or absent. L&H variants express B-cell markers typical of germinal-center B cells, such as CD20 and BCL6, and are usually negative for CD15 and CD30. Reference: Robbins and Cotran Pathologic Basis of Disease; 9th edition; Chapter 13; Diseases of White Blood Cells, Lymph Nodes, Spleen, and Thymus

Lymphocyte predominant Hodgkins diseases


Question: Cholangio carcinoma of liver caused by

risk factor of cholangio carcinoma includes Primary sclerosis cholangitis Fibropolypocystic disease of biliary tree Infestation by Clonorchis sinensis or Opisthorchis viverrini. ROBBINS BASIC PATHOLOGY NIanTH EDITION PAGE 643


Question: Normal serum calcium level is


Question: Trigeminal neuralgia (tic doulourex) is characterized by

Trigeminal neuralgia or "Fothergill's disease" is characterized by searing, stabbing or lancinating type of pain that is initiated when the patient touches the "Trigger Zone". The term "tic doulourex" is applied only when the patient suffers from spasmodic contractions of facial muscles.

Sharp, excruciating pain of short duration

Prolonged episodes of pain on one side of the face


Question: Plasmacytoid lymphomas may be associated with

Ans. is `b' i.e., IgM Plasmacytoid lymphoma Plasma cytoid lymphoma, also known as plasmacytoid lymphocyte type malignant lymphoma, is a B cell neoplasm that is associated with plasmacytoid differentiation of lymphocytes. Plasmacytoid lymphocytes are transitional forms between lymphocytes and plasma cells. o These are low grade lymphoid neoplasms that occur in middle aged or older individuals. o In REAL classification, it is classified as lymphoplasmacytic lymphoma. o These may be associated with a monoclonal IgM paraprotein and are thus considered the histological counterpa of Waldenstrom's macroglobulinemia.


Question: Emperipolesis is typical histological finding in

Emperipolesis is the presence of an intact cell within the cytoplasm of another cell. It is a typical histological finding in autoimmune hepatitis.


Question: CD 95 is a marker of


Question: Melanoma is

Benign tumour of skin and mucous membrane

Malignant tumour of skin and mucous membrane


Question: Phleboliths are seen in


Question: Three stages in progression of acute odontogenic infection are

Periapical osteitis, cellulitis, abscess

Abscess, cellulitis, periapical osteitis

Cellulitis, Abscess, periapical osteitis

Periapical osteitis, abscess, cellulitis


Question: Carcinoma lung is associated with exposure to

(Asbestosis): {493- Harsh mohan 6th edition)* Asbestos exposure predisposes to a number of cancers, most importantly bronchogenic carcinoma and malignant mesothelioma. A few others are: carcinoma of oesophagus, stomach, colon, kidney and larynx and various lymphoid malignancies* Asbestos fibres are carcinogenic, the most carcinogenic being crocidolite* Lung carcinoma - occupational exposures to - asbestos, arsenic, bischloromethyl ether, hexavalent chromium, mustard gas, and polycyclic aromatic hydrocarbons, nickel (737-H 18th)* Prolong exposure to low level radon in homes might impart a risk of lung cancer equal or greater than that of environmental tobacco smoke* Prior lung disease such as chronic bronchitis, emphysema and tuberculosis have been linked to increased lung cancer as well.


Question: Ganciclovir is more effective than acyclovir against


Question: Histopathologicali osett een in


Question: Leiomyoma is a tumor of


Question: Drug of choice for trigeminal Neuralgia


Question: Autopsy finding after 12hrs in a case of death due to MI


Question: A 9 year old boy is admitted with acute abdominal pain localized in the right iliac fossa. He is pyrexial with localized peritonism in RIF. The causative cell involved here

Ans. (b) Neutrophil(Ref: Robbins 9th/pg 71; 8th/pg 44)This is a case of acute appendicitisThe principal inflammatory cell in this case of acute appendicitis is the neutrophil.


Question: The characteristic feature of apostosis on light microscopy is

In H&E-stained tissue sections, the nuclei of apoptotic cells show various stages of chromatin condensation and aggregation and, ultimately, karyorrhexis; at the molecular level, this is reflected in fragmentation of DNA into nucleosome-sized pieces. The cells rapidly shrink, form cytoplasmic buds, and fragment into apoptotic bodies composed of membrane-bound vesicles of cytosol and organelles. Because these fragments are quickly extruded and phagocytosed without eliciting an inflammatory response, even substantial apoptosis may be histologically undetectable( Robbins Basic Pathology, 9th edition, page 18 )


Question: Most common of aery involved in MI

Acute occlusion of the proximal left anterior descending (LAD) aery is the cause of 40% to 50% of all MIs and typically results in infarction of the anterior wall of the left ventricle, the anterior two thirds of the ventricular septum, and most of the hea apex; more distal occlusion of the same vessel may affect only the apex. Similarly, acute occlusion of the proximal left circumflex (LCX) aery (seen in 15% to 20% of MIs) will cause necrosis of the lateral left ventricle, and proximal right coronary aery (RCA) occlusion (30% to 40% of MIs) affects much of the right ventricle. (Robbins basic pathology,9th edition,pg no.378)


Question: Type I Rapidly progressive glomerulonephritis is seen in

Rapidly progressive glomerulonephritis (RPGN) is a syndrome of the kidney that is characterized by a rapid loss of kidney function, (usually a 50% decline in the glomerular filtration rate (GFR) within 3 months) with glomerular crescent formation seen in at least 50% or 75% of glomeruli seen on kidney biopsies. Refer robbins 9/e


Question: Endotoxic shock is propagated


Question: "Anaesthesia on the sole of the foot" is caused by injury to


Question: Preformed mediator of inflammation is

Chemical mediators of inflammation Cellular mediatorsPreformed mediators in secretory granulesNewly synthesizedHistamineSerotonin Lysosomal enzymes ProstaglandinsLeukotrienesPlatelet-activating factorActivated oxygen species Nitric oxide Cytokines Plasma mediatorsFactor XII activationComplement activationKinin system Coagulation / fibrinolysis system C3aC5aC3bC5b - 9 (Refer: Robbins & Cotran's - Pathologic Basis of Disease, SAE, 1st edition, Vol I-pg no: 82-85)


Question: An example for tumor suppressor gene is

Selected Tumor Suppressor GenesInhibitors of Mitogenic Signaling Pathways1. APC2. NF13. NF24. PTCH5. PTEN6. SMAD2, SMAD4Inhibitors of Cell Cycle Progression1. RB2. CDKN2AInhibitors of "pro-growth" Programs of Metabolism and Angiogenesis1. VHL2. STK113. SDHB, SDHDInhibitors of Invasion and MetastasisCDH1Enablers of Genomic StabilityTP53DNA Repair Factors1. BRCA1, BRCA22. MSH2, MLH1, MSH6Unknown Mechanisms1. WT12. MEN1Reference: Robbins and Cotran Pathologic Basis of Disease; 9th edition; Chapter 7; Neoplasia


Question: Down's syndrome is most commonly caused by

TRISOMY 21: DOWN SYNDROME Incidence: 1 in 700 bihs Karyotypes: Trisomy 21 type: 47,XX, +21 Translocation type: 46,XX,der(14;21)(q10;q10),+21 Mosaic type: 46,XX/47,XX, +21 The correlation with maternal age suggests that in most cases the meiotic nondisjunction of chromosome 21 occurs in the ovum. Indeed, in 95% of cases the extra chromosome is of maternal origin. In about 4% of all patients with trisomy 21, the extra chromosomal material is present not as an extra chromo- some but as a translocation of the long arm of chromosome 21 to chromosome 22 or 14. Such cases frequently (but not always) are familial, and the translocated chromosome is inherited from one of the parents, who typically is a carrier of a robesonian translocation. (Robbins Basic Pathology, 9 th edition. page : 238)


Question: "Ghon focus" is associated with


Question: Macrophages with abundant cytoplasm containing dusty brown pigment are seen in

Desquamative interstitial pneumonia is characterized by large collections of macrophages in the airspaces in a current or former smoker. The macrophages were originally thought to be desquamated pneumocytes, thus the misnomer "desquamative interstitial pneumonia."The most striking finding is the accumulation of a large number of macrophages with abundant cytoplasm containing dusty brown pigment (smokers' macrophages) in the airspaces.Ref: Robbins and Cotran Pathologic basis of DIsease; 9th edition; Chapter 15; The lung; Change 682


Question: Megaloblastic anemia is caused by

C. i.e. (Folic acid) (377- Harsh Mohan 5th) (437- Basic pathology 8th)MEGALO BLASTIC ANEMIAS - two principal causes1. Folate deficiency (Folic acid metabolism)2. Vitamin B12 deficiency* Earliest change in PBS is appearance of hypersegmented neutrophils*** Bone marrow is markedly hypercellular* Macrocytosis (other causes - Haemolysis, liver disease, alcoholism, hypothyroidism**, aplastic anaemia, myeloproliferative disorders and reticulocytosis)* ** MCV |, MCH|, MCHC Normal or |* **SHILLING TEST for Vitamin Bj2 deficiency* FIGLU TEST for folate deficiency* The gene responsible for folic acid transport is situated on chromosome 21**


Question: Most common cause of Cushing's syndrome is

Causes of Cushing Syndrome: - Exogenous : External supplementation of glucocoicoids - Most common cause - Endogenous : Pituitary adenoma Ectopic ACTH secretion - Small cell lung cancer; Medullary thyroid cancer etc Adrenal causes - Adrenal hyperplasia / adenoma/ cancer


Question: 6 yr old child presented to OPD with eczematous rash On evaluation was found to have fever platelests 80,000 on enquiry multiple hospitalisation for recurrent infections


Question: The given cell is seen in

In tissues, nuclei of damaged cells react with ANAs, lose their chromatin pattern, and become homogeneous, to produce so-called LE bodies or hematoxylin bodies. The LE cell (Lupus Erythematosus cell) is any phagocytic leukocyte (blood neutrophil or macrophage) that consists of degraded nuclear material from an injured cell, along with autoantibodies and a limited amount of cytoplasm


Question: Ectodermal dysplasia is


Question: Sarcoma botyroides is a type of

Rhabdomyosarcoma*Tumours with skeletal muscle differentiation. *Most common soft tissue sarcoma of childhood and adolescence*Three histological types - Embryonal, alveolar and pleomorphic.*"Rhabdomyoblasts" is the characteristic finding in all the three types*Embryonal RMS- Most common type. It has three variants namely sarcoma botryoides, spindle cell and anaplastic variant. Sarcoma botyroides develops in the wall of hollow mucosa lined structures like nasopharynx, common bile duct, bladder and vagina. "Cambium layer" is seen where tumour abuts the mucosa of an organ.*Alveolar RMS - associated with PAX3-FOXO1a fusion gene and PAX7-FOXO1a fusion gene *Of all the types, sarcoma botryoides has the best prognosis while others are often fatal.(Ref: Robbins 8/e p1253)


Question: Most important prognostic factor in Ca. Breast.

Ans. (a) Lymph Node status(Ref: Ref: Robbins 9th/pg 1064 Complete review of pathology 2nd ed/ pg 656)Axillary LN status is the most important prognostic indicator in breast ca


Question: Incubation period of Hepatitis B is


Question: C3 convease acts on

The complement system consists of plasma proteins that play an impoant role in host defence (immunity) and inflammation. the critical step in the generation of biologically active complement products is the activation of C3 C3 cleavage occurs by three pathways: classical pathway, the alternative pathway, lectin pathway, All three pathways lead to the formation of a C3 convease that cleaves C3 to C3a and C3b. Basic Pathology, Robbins 9TH ED Page no.: 50


Question: Argon laser trabeculoplasty is indicated in

Indications for Argon laser trabeculoplasty Uncontrolled open angle glaucoma despite medical therapy Noncompliance of medical therapy and non-availability of ALT Eyes with advanced disease - high IOP, advanced cupping and advanced field lossMechanism of ALT - Increasing outflow facility by producing collagen shrinkage on the inner aspect of trabecular meshwork and opening intratrabecular spaces. Regime consists of 50 spots on the anterior half of the trabecular meshwork over 1800degree Complications - Inflammation, hemorrhage, uveitis,peripheral anterior synechiae and reduced accomodation(Refer: AH Khurana, Comprehensive Textbook of Ophthalmology,5thedition,pg no: 236)


Question: Cystic medial necrosis responsible for aortic dilatation and rupture is seen in

In Marfan syndrome, a connective tissue disorder of autosomal dominant inheritance, the basic biochemical abnormality is a mutation affecting fibrillin.
Most serious, however, is the involvement of the cardiovascular system. Fragmentation of the elastic fibers in the tunica media of the aorta predisposes affected patients to aneurysmal dilation and aortic dissection.
These changes, called cystic medionecrosis, are not specific for the Marfan syndrome.
Similar lesions occur in hypertension and with ageing.
Loss of medial support causes dilation of the aortic valve ring, giving rise to aortic incompetence.


Question: In cell death, myelin bodies are derived from

Myelin bodies are membrane bounded myelin figures. These are derived from the plasma membrane and represent the whorls of phospholipids.


Question: The following substance is most often incriminated in the pathogenesis of Hepatic encephalopathy

It is theorized that neurotoxic substances, including ammonia and manganese, may gain entry into the brain in the setting of liver failure. These neurotoxic substances may then contribute to morphologic changes in astrocytes. In cirrhosis, astrocytes may undergo Alzheimer type II astrocytosis. Here, astrocytes become swollen. They may develop a large pale nucleus, a prominent nucleolus, and margination of chromatin. In ALF, astrocytes may also become swollen. The changes of Alzheimer type II astrocytosis are not seen in ALF. But, in contrast to cirrhosis, astrocyte swelling in ALF may be so marked as to produce brain edema. This may lead to increased intracranial pressure and, potentially, brain herniation. REFERENCES Meds cap.com HARSH MOHAN SIXTH EDITION.PAGE-606 IMAGE REF:


Question: In cystic fibrosis, transmembrane conductance regular gene on chromosome

[Cl (7) (490-Robbins Pathologic Basis of disease 7th) (264-Basic pathology 8th)* The primary defect in cystic fibrosis results from abnormal function of an epithelial chloride channel protein encoded by the cystic fibrosis transmembrane conductance regulator (CFTR) gene on chromosome band 7 q 13.2* CFTR regulates multiple additional ion channels and of cellular processes.* The function CFTR are tissue specific; therefore impact of a mutation in CFTR is also tissue specific. The major function of CFTR in the sweat gland ducts to reabsorb luminal chloride ions and augment sodium reabsorption via the ENaC* Cystic fibrosis modifier locus (CFM1) which influences the incidence and severity of meconium ileus has been recently mapped to chromosome 19 q13


Question: The commonest primary immunodeficiency is

Isolated IgA deficiency Extremely low levels of serum & secretory IgA (may be IgG2 & IgG4 too) Defective differentiation of B cells to IgA producing plasma cells CF Mucosal immunity affected Recurrent sinopulmonary infections & diarrhoea When transfused with blood containing IgA may develop fatal anaphylactic reactions


Question: A decrease in cerebral blood flow to zero causes death of brain tissue within

(A) 4-10 minutes # Decrease in cerebral blood flow to zero causes death of brain tissue within 4-10 minutes;> Values <16-18 mL/100 g tissue per minute cause infarction within an hour; and> Values <20 mL/100 g tissue per minute cause ischemia without infarction unless prolonged for several hours or days.> If blood flow is restored prior to a significant amount of cell death, the patient may experience only transient symptoms, and the clinical syndrome is called a TIA.> Tissue surrounding the core region of infarction is ischemic but reversibly dysfunctional and is referred to as the ischemic penumbra.> The penumbra may be imaged by using perfusion-diffusion imaging with MRI or CT


Question: In a outbreak of cholera in a village of 2,000 population, 20 cases have occurred and 5 died. Case fatality rate is

CFR= (Total number of deaths due to a paicular disease / Total number of cases due to the same disease ) x100CFR=5/20x100CFR= 25 %(Refer: K. Park's Textbook of Preventive and Social medicine, 24th edition, pg no: 63)


Question: Councilman bodies are formed due to process of

The councilman bodies are formed due to process of apoptosis in viral hepatitis.Important pathological process associated with apoptosis:* Tumors exposed to chemotherapeutic agents* Graft versus host disease* Rejection episodes* Depletion of CD4 cells in AIDS* Prostatic atrophy after orchidectomy* Alzheimer's disease* MI (20% necrosis and 80% apoptosis)Important physiological processes with apoptosis* Organised cell destruction during formation of embryo* Endometrial shedding, regression of lactating breast* Involution of thymus* Normal cell destruction followed by replacement proliferation such as intestinal epithelium


Question: A 17 year old female with von Willebrand disease presents for dental extraction the appropriate prior line of management include


Question: Proved association of celiac sprue is with


Question: Pale waxy umbilicated swelling on the lid is

Eyelid disorders Inflammatory disorders of eyelidsClinical pictureTreatmentBlepharitisSubacute or chronic inflammation of lid margins due to Corynebacterium, Staphylococcus aureus, Demodexfolliculorum&PhthiriasisPalpebraCrusts should be removed, Antibiotic ointment at least twice daily ( Erythromycin or tetracycline ), Oral anti-inflammatory drugs, removal of nits with forceps External hordeolum (Stye)Acute suppurative inflammation of the gland of Zeiss or MollStage of cellulitis - Stage of abscessHot compresses 2 - 3 times a day, the Surgical incision for large abscess, Antibiotic drops, anti-inflammatory and analgesics Chalazion Chronic noninfective granulomatous inflammation of meibomian gland - retention secretions which are fatty in nature Intralesional triamcinolone, Incision, and curettage, Diathermy Internal hordeolum ( Infected chalazion )Suppurative inflammation of meibomian gland associated with blockage of the duct Drained by veical incision from the tarsal conjunctiva Molluscum contagiosumMultiple, pale, waxy, umbilicated swellings scattered over the skin near lid margin Incised and interior cautery with tincture of iodine or pure carbolic acid (Refer: AH Khurana, Comprehensive Textbook of Ophthalmology,5thedition,pg no: 366-369)


Question:
Dentinogenesis imperfecta differs from amelogenesis
imperfecta in that, the former is

The result of excessive fluoride ingestion

The result of faulty enamel matrix formation

Characterized by calcification of pulp chambers and the root canals of the teeth


Question: Premalignant lesion of oral cavity includes

Answer- B. ErythroplakiaPremalignant condition: - Leukoplakia, Erythroplakia, Speckled erythroplakia, chronic hyperplastic candidiasis.


Question: Sulfur granules in pus are seen in


Question: Anemia of chronic disease is characterized by

*Anemia of chronic disease- Impaired red cell production associated with any chronic diseases that would be infectious/inflammatory/neoplastic.*Chronic diseases produce a cytokine "IL-6" that increases the production of hepcidin from the liver. Hepcidin inhibits ferropoin function in macrophages and reduces the transfer of iron from the storage pool to developing erythroid precursors in bone marrow. *So the patient develops anemia irrespective of an increased amount of iron in macrophages.*Laboratory findings- Increased ferritin (storage iron), Low serum iron and reduced total iron binding capacity.-progenitors do not proliferate adequately because erythropoietin levels are inappropriately low for the degree of anemia.Whereas in iron deficiency anemia, the patient will have decreased ferritin, low serum iron, and high iron binding capacity. (Ref: Robbins 8/e p662)


Question: Myasthenia gravis is associated with

Some 60%of Myasthenia gravis are associated with a peculiar reactive hyperplasia of intrathymic B cells and another 20%are associated with thymoma, a tumor of thymic epithelial cells. Robbins basic pathology 9th edition page no 800,heading =Myasthenia gravis Option 4 is correct


Question: Cabot's ring is seen in

Ans. is 'a' i.e., Megaloblastic anemia Cabot rings are seen most commonly in megaloblastic anemia, followed by lead poisoning.


Question: Chemical mumps' is synonymous with


Question: Egg shell calcification of Hilar Lymphnode is associated with


Question: nutmeg liver is seen in

Nutmeg liver refers to the mottled appearance of the liver as a result of hepatic venous congestion. Radiologically, it is most appreciable on poovenous phase imaging on cross-sectional imaging. It is named after the cut appearance of thenutmeg seed. Refer robbins 9/e


Question: Neuro fibrillary tangles is seen in

(Alzheimer's disease) (910-HM) (894-Basic pathology 8th)* Deposition of A b amyloid derived from amyloid precursor protein (APP) forming neuritic senile, plaques and neurofibrillary tangles - features of ALZHEIMER'S DISEASE* Lewy bodies - hall marks of Parkinsonism


Question: Cytogenetics for synol cell sarcoma is

Most synol sarcoma show a charecteristic(x:18) translocation that produces a fusion gene encoding a chimeric transcription factor. They usually devolop in deep soft tissues aroundcthe knee,occuring in age groups 20-40s Robbins basic pathology 9th edition page no 795,heading=synol sarcoma


Question: The most common glomerulonephritis is......

Ans: b (IgA nephropathy) Ref: Robbins, 7th ed, p. 986* IgA nephropathy is the most common cause of GN worldwide* Also called Bergers disease* IgA deposits in mesangium along with IgQ IgM, C3. properdin* C/F: Hematuria after a respiratory/urinary/GIT infection* Rx: Steroids (high dose).Remember...* Most common glomerulonephritis is IgA nephropathy* Most common nephrotic syndrome is membranous glomerulonephropathy.


Question: Increase in number of RBC is seen in


Question: NOT a mutation in Down's syndrome

(D) VNTR's# A Variable Number Tandem Repeat (or VNTR) is a location in a genome where a short nucleotide sequence is organized as a tandem repeat is associated with major psychiatric disorders.> Trisomy 21 also known by the karyotype 47, XX+21 for females and 47,XY,+21 for males.> The extra chromosome 21 material may also occur due to a Robertsonian translocation in 2-4% cases. In this situation, the long arm of chromosome 21 is attached to another chromosome, often chromosome 14.


Question: A person suffering from polycythemia vera full** extreme itching after taking hot bath. This may be due to


Question: Bifid ribs, multiple radiolucent lesions of the jaws, multiple basal cell nevi and falx cerebri calcification are found in


Question: Most common in diabetic nephropathy

refer Robbins 1118pgDiabetic Nephropathy The kidneys are prime targets of diabetes. Renal failure is second only to myocardial infarction as a cause of death from this disease. Three lesions are encountered: (1) glo- merular lesions; (2) renal vascular lesions, principally aeriolosclerosis; and (3) pyelonephritis, including nec- rotizing papillitis. The most impoant glomerular lesions are capillary basement membrane thickening, diffuse mesangial sclerosis, and nodular glomerulosclerosis.


Question: Eruption cyst

Is found in the place of the missing tooth


Question: The synthesis of 1 peptide bond involves hydrolysis of

During the translation process, formation of one peptide bond (adding one amino acid) consumes 4 high energy phosphates (2 from ATP & 2 from GTP). Eukaryotes will add 6 amino acids and prokaryotes will add 18 amino acids per second. (Refer: Harper's Illustrated Biochemistry, 26th edition,pg no: 370)


Question: Water brash indicates one of the following


Question: The most common site for myocardial infarction is


Question: Tensile strength of tendon depends on

Collagen - provide tensile strength Elastin - provide recoil to the tension


Question: Binswanger&;s disease is a form of

Binswanger's disease, also known as subcoical leukoencephalopathy and subcoical aeriosclerotic encephalopathy (SAE), is a form of small vessel vascular dementia caused by damage to the white brain matter. White matter atrophy can be caused by many circumstances including chronic hypeension as well as old age.


Question: Sequestrated lobe of the lung is commonly supplied by

BRONCHOPULMONARY SEQUESTRATION
Sequestration is the presence of lobes or segments of lung tissue which are not connected to the airway system. The
blood supply of the sequestered area is not from the pulmonary arteries but from the aorta or its branches.
Sequestration may be intralobar or extralobar.
 Intralobar sequestration is the sequestered bronchopulmonary mass within the pleural covering of the affected lung.
Extralobar sequestration is the sequestered mass of lung tissue lying outside the pleural investing layer such as in the
base of the left lung or below the diaphragm. The extralobar sequestration is predominantly seen in infants and children
and is often associated with other congenital malformations.


Question: 56.	Papillomatous tongue is observed in


Question: The commonest tumour of parotid is

Pleomorphic adenomas are benign tumors that consist of a mixture of ductal (epithelial) and myoepithelial cells, and therefore they show both epithelial and mesenchymal differentiation. Because of their remarkable histologic diversity, these neoplasms have also been called mixed tumors. They represent about 60% of tumors in the parotid. Wahin tumor is the second most common. Both are benign. Robbins 9e pg: 745


Question: Most common cause of dissecting hematoma is

Aoic dissection occurs when blood splays apa the laminar planes of the media to form a blood-filled channel within the aoic wall.Aoic dissection occurs mainly in two age groups: (1)men aged 40 to 60 with antecedent hypeension (more than 90% of cases); and (2) younger patients with connective tissue abnormalities that affect the aoa.Robbins Basic pathology, 9th edition, pg no.346


Question: Somatic mutation of PTEN is seen in


Question: Tumorogenesis in aging is due to

Telomerase, also called terminal transferase, is a ribonucleoprotein that adds a species-dependent telomere repeat sequence to the 3' end of telomeres. A telomere is a region of repetitive sequences at each end of a eukaryotic chromosomes in most eukaryotes. Telomeres protect the end of the chromosome from DNA damage or from fusion with neighbouring chromosomes. The fruit fly Drosophila melanogaster lacks telomerase, but instead uses retrotransposons to maintain telomeres. Telomerase is a reverse transcriptase enzyme that carries its own RNA molecule (e.g., with the sequence "CCCAAUCCC" in veebrates) which is used as a template when it elongates telomeres. Telomerase, active in normal stem cells and most cancer cells, is normally absent from, or at very low levels in, most somatic Cells.


Question: Treacher Collins Syndrome is


Question: Selective granular IgA deposit at dermal papillae tips is seen in


Question: 'Physiologic programmed cell death' is termed as


Question: Best prognostic type of Hodgkins Disease

The treatment of patients with nodular lymphocyte-predominantHodgkin's lymphoma is controversial. Some clinicians or no treatmentand merely close follow-up. In the United States, most physicianswill treat localized disease with radiotherapy and disseminated diseasewith regimens used for patients with classical Hodgkin's lymphoma.Regardless of the therapy used, most series repo a long-term survivalof >80%.Reference: Harrison Principles of Internal Medicine; 19th edition; Chapter 134 Malignancies of Lymphoid Cells


Question: Shelf life of platelets to blood bank is

Platelets are approved by FDA for stored upto 5days at 20-24 (RoomTemperature) because of risk of bacterial contamination. REF: ROBBINS pathology 10th edition


Question: Roth's spots are found in

White-centered retinal hemorrhages (Roth's spots) are considered pathognomonic for subacute bacterial endocarditis, but they also appear in leukemia, diabetes, and many other conditions. Endophthalmitis also occurs as a complication of ocular surgery, occasionally months or even years after the operation. ( Harrison&;s principle of internal medicine,18th edition,pg no. 230)


Question: Target cells are seen in peripheral blood in


Question: A female presents with 3 cm painless ulcer with raised edges on labia majora. Most common cause is

Presence of 3 cm ulcer with raised edges in the labia majora suggests Syphilis. FeaturesSyphilisChancroidLymphogranuloma VenereumDonovanosisAgent Treponema pallidumHemophilus ducreyiChlamydia trachomatis (L1, L2, L3)Calymmatobacterium granulomatisIncubation period 9 - 90 days 1 - 7 days 3 days - 6 weeks 1 - 4 weeks Early lesions Superficial/deep-seated papule Excavated pustule Superficial/deep-seated papule or pustule Elevated papule Edges Sharply, demarcated, elevated, round or oval Undermined, ragged, sloughed or irregular Elevated, round or ovalElevated, irregular serpiginousBaseSmooth, non-purulent, non-vascular Purulent, bleeds easily Variable, Non-vascular Red, velvety bleeds easily with exuberant granulation tissue Induration Firm Soft Firm Firm Pain Uncommon Very tender Variable Uncommon Lymphadenopathy Firm, non tender, shotty, bilateral Tender, loculated, suppurated, unilateral Tender, loculated, suppurated, unilateral PseudobuboesDiagnosis Darkfield microscopy ;SerodiagnosisGram staining Demonstration of LGV as elementary and inclusion bodies; Frie's test Histopathological examination of biopsy ;Staining with Giemsa stain, Wright's stain, Silver stain, Leishman stain TreatmentPenicillin G - Drug of Choice for all stages of syphilisAzithromycin 1 g single oral dose (or) Ceftriaxone 250 mg IM single dose (or) Ciprofloxacin 500 mg bd for 3 daysDoxycycline 100 mg BD for 3 weeksDoxycycline 100 mg BD for 3 weeks(Refer: Essentials in Dermatology, 1st edition)


Question: Secondary amyloidosis is seen most commonly in


Question: Gene for Wilson's disease is located on chromonsome

Harshmohan textbook of pathology 7th edition. *Wilson's disease:the underlying defect in chromosome 13 is a mutation in ATP7B gene ,the normal hepatic copper exceeding gene. </p >


Question: Auer rods represent a

Auer rods, distinctive needle-like azurophilic granules, are present in many cases; they are paicularly numerous in AML with the t(15;17) (acute promyelocytic leukemia) Auer rods are large, crystalline cytoplasmic inclusion bodies sometimes observed in myeloid blast cells during acute myeloid leukemia, acute promyelocytic leukemia, and high-grade myelodysplastic syndromes and myeloproliferative disorders they are peroxidase positive azurophilic intracytoplasmic granules. lysosomal enzymes are sequestered into azurophilic storage granules. used later for digestion of phagocytized microorganism. ref robbins 9th ed page 613


Question: DiGeorge's syndrome is due to


Question: The characteristic feature of apoptosis

The plasma membrane of the apoptotic cell remains intact, but the membrane is altered in such a way that the cell and its fragments become avid targets for phagocytes. The dead cell and its fragments are rapidly cleared before cellular contents have leaked out, so apoptotic cell death does not elicit an inflammatory reaction in the host. Apoptosis differs in this respect from necrosis, which is characterized by loss of membrane integrity, enzymatic digestion of cells, leakage of cellular contents, and frequently a host reaction.( Robbins Basic Pathology, 9th edition, page 18 )


Question: Krukenberg tumour of ovary is due to carcinoma of

Ans. (a) Stomach(Ref: Robbins 9th/pg 771; 8th/pg 785)Metastasis from stomach cancer Occurs to the liver (first organ to be affected) followed by lungs, bone, ovary (where it is known as Krukenberg's rumor), periumbilical lymph nodes (Sister Mary Joseph nodule), peritoneal cul-de-sac (Blumer's shelf palpable on rectal or vaginal examination) and left supraclavicular lymph node (Virchow's lymph node


Question: Most common cause of cellulitis of face is


Question: Type of inheritance in Tuberous sclerosis

Tuberous sclerosis complex (TSC) is a rare multisystem genetic disease that causes benign tumors to grow in the brain and on other vital organs such as the kidneys, hea, liver, eyes, lungs, and skin. A combination of symptoms may include seizures, intellectual disability, developmental delay, behavioral problems, skin abnormalities, and lung and kidney disease. TSC is caused by a mutation of either of two genes, TSC1 and TSC2, which code for the proteins hamain and tuberin, respectively. These proteins act as tumor growth suppressors, agents that regulate cell proliferation and differentiationTSC is a genetic disorder with an autosomal dominant pattern of inheritance, variable expressivity, and complete penetrance. Two-thirds of TSC cases result from sporadic genetic mutations, not inheritance, but their offspring may inherit it from them. Current genetic tests have difficulty locating the mutation in roughly 20% of individuals diagnosed with the disease. So far, it has been mapped to two genetic loci, TSC1 and TSC2.


Question: NESTROFT test is used in the screening of

*NESTROF stands for naked eye single tube red cell osmotic fragility test. *Used in population screening for beta thalassemia trait (BTT).*Method: A stock solution of 10% buffered saline (pH 7.4) is prepared and dissolved in 1 litre of distilled water. 0.36% buffered saline is prepared by diluting 36 mL of 1 % buffered saline with 64 mL distilled water to make 100 mL.2mL of 0.36% buffered saline is taken in one tube (10 cm x 1 cm diameter) and 2 mL distilled water is taken in another. A drop of blood is added to each of the tubes, which are left undisturbed for half an hour at room temperature.After half an hour the contents of both the tubes are shaken and the tubes held against a white paper on which a thin black line is drawn. The line is clearly visible through the contents of the tube containing distilled water due to complete lysis. If the line is visible through the contents of the tube with buffered saline, the test is negative, whereas if the line is not visible, the test is positive.*Interpretation: A positive NESTROFT indicates that all red cells in the tested sample have not undergone lysis in 0.36% buffered saline. These unlysed red cells result in the hazy appearance of the contents of the tube and render the line on the paper indistinct. These red cells also sediment as a button at the bottom of the tube when it is left undisturbed for some time. Thus a positive NESTROFT indicates decreased red cell osmotic fragility and increased resistance to osmotic lysis.*Positive NESTROF test:b- thalassemia traitIron deficiency anemia (IDA)Liver diseasesHemoglobinopathies(Ref: Recent Advances in Hematology -3, 1/e p173)


Question: "Smudge cells" in the peripheral smear are characteristic of

Ans. (b) Chronic lymphocytic leukemia(Ref: Robbins 9th/pg 593; 8th/pg 603)"Smudge cells"Also called 'Basket cells', 'shadow cells of Gumprecht'Caused by decrease in VimentinMay predict good prognosisSeen mainly in CLL; Also have been reported in AML, CML, ALL & in normal peripheral smear, but rare;


Question: 'Presacral fascia' is derivative of


Question: Some micro organisms produce a diffuse spreading inflammatory reaction due to the elaboration of


Question: Most common site of glioblastoma multiforme is

Most common site of glioblastoma multifonne is temporal & frontal lobe and basal ganglia.
It frequently crosses midline.


Question: The immunohistochemical marker used to label basal cells in suspected prostate carcinoma

AFP is an oncofetal antigenAnnexin is an anti-inflammatory moleculeAgNOR is silver-stained nucleolar organizer Region


Question: Ectopic rest of tissue is known as

*Choristoma (Heterotopia) - Microscopically normal cells or tissues that present in abnormal locations.*Hamaoma - Excessive, focal overgrowth of cells or tissues native to the organ in which it occurs.Ref: Robbins 8/e p473


Question: Discoloration of the skin, mucosa and nails is sideeffect of

.When nail discoloration is due to zidovudine, patients are usually able to repo if the discoloration preceded or coincided with the initiation of therapy. Another unusual side effect of zidovudine noted by some is a grayish-black discoloration of the tongue. Azidothymidine-induced nail pigmentation Ref Robbins 9/e pg 789


Question: Kupffer cells are seen in


Question: Most common carcinoma of breast is

Invasive Ductal Carcinoma (IDC) Invasive ductal carcinoma (IDC), sometimes called infiltrating ductal carcinoma, is the most common type of breast cancer. About 80% of all breast cancers are invasive ductal carcinomas. Invasive means that the cancer has "invaded" or spread to the surrounding breast tissues. Refer robbins 9/e 710,713


Question: Oval cells are seen in

Hepatic oval cells (HOC) are a small subpopulation of cells found in the liver when hepatocyte proliferation is inhibited and followed by some type of hepatic injury. ... These cells are believed to be bipotential, i.e., able to differentiate into hepatocytes or bile ductular cells Ref Robbins 9/e p603 from liver and biliary system and internet


Question: Malignant tumour of skeletal muscle is


Question: Citelli's angle is

Sinudural angle, also called Citelli's angle, is situated between the sigmoid sinus and middle cranial fossa dural plate. Solid angle is the area where three bony semicircular canal meet.


Question: A mononuclear poal inflammatory infiltrate that disrupts the limiting plate and surrounds individual hepatocytes (piecemeal necrosis) is characteristic of

) Chronic hepatitis has been defined as an inflammatory process of the liver that lasts longer than 1 year and lacks the nodular regeneration and architectural distoion of cirrhosis. In chronic active hepatitis, an intense inflammatory reaction with numerous plasma cells spreads from poal tracts into peripoal areas. The reaction destroys the limiting plate and results in formation of peripoal hepatocytic islets. Prognosis is poor, and the majority of patients develop cirrhosis. Chronic persistent hepatitis is usually a sequela of acute viral hepatitis and has a benign course without progression to chronic active hepatitis or cirrhosis. The poal inflammation does not extend into the peripoal areas, and this differentiates chronic persistent hepatitis from chronic active hepatitis. Reference: Robbins & Cotran Pathologic Basis of Disease, 9edition


Question: First manifestation in cell injury

Ans. (b) Cell swelling(Ref: Robbins 9th/pg 46; 8th/pg 12)Cloudy swellingQ - earliest morphological change in reversible cell injuryQ due to accumulation of water intracellularly


Question: Transvestism is

Desire for sexual intercourse with dead bodies

Organism from visualiza on pa of the body of a woman


Question: Arrange the cyclins and CDKs in cell cycle from G1 to S checkpoint. a) CDK6/ Cyclin E b) CDK4/ Cyclin D c) CDK 1 / Cyclin B d) CDK2/ Cyclin A

Cyclins D, E, A, and B appear sequentially during the cell cycle and bind to one or more CDKs.


Question: Cytogenetics for synovial cell sarcoma

t (x,18) is seen in synovial cell sarcoma and it produces fusion genes like SS18-SSXl-SSX2-SSX4


Question: Numbness of lip seen with no previous dental treatment


Question: Translocation seen in Synol cell sarcoma


Question: Oral Thrush develops in infants at


Question: Placental ALP is used as tumor marker of

Ans a: (Ref: Robbins 7th edition 1041-42)Testicular tumorsTumor markers1 SeminomaPlacental ALP2 Embryonal carcinomahC'GAFP3 Yolk sac tumor (endodermal sinus tumor)AFP, Alpha 1 AT4 ChoriocarcinomahCGSeminomaMost common type germ cell tumor of testis(50%)Female counterpart is dysgerminoma. Tumor is positive for placental ALP & negative for AFP.Spermocytic seminoma is a morphologic variant that tend to occur in old people.


Question: Sarcoma botryoids is a type of

Sarcoma botryoides or botryoid sarcoma or botryoid rhabdomyosarcoma is a subtype of embryonal rhabdomyosarcoma, that can be observed in the walls of hollow, mucosa-lined structures such as the nasopharynx, common bile duct, urinary bladder of infants and young children or the vagina in females, typically younger than age 8. The name comes from the gross appearance of "grape bunches". Ref:- https://en.wikipedia.org/wiki/Sarcoma_botryoides


Question: During angiogenesis recruitment of pericytes and periendothelial cells is due to

Ans. is 'b' i.e., Angiopoietins, TGF & PDGF Angiogenesis Blood vessels formation in adults is known as angiogenesis or neovascularization. It can occur by two ways:? 1. Angiogenesis from pre-existing blood vessels The major steps in this process are :? Vasodilatation by NO, and VEGF-induced increased permeability of the pre-existing vessel. Preoteolytic degradation of basement membrane by metalloproteinases (MMPs) and disruption of cellto-cell contact between endothelial cells by plasminogen activator. Migration of endothelial cells towards angiogenic stimulus. Proliferation of endothelial cells, just behind the leading front of migrating cells. Maturation of endothelial cells. Recruitment of periendothelial cells (pericytes and vascular smooth muscle cells) to form the mature cells. 2. Angiogenesis from endothelial precursor cells (EPCs) EPCs can be recruited from the bone marrow into tissues to initiate angiogenesis. Growth factors involved in the process of angiogenesis VEGF is the most impoant growth factor in adult tissues undergoing angiogenesis. The most impoant receptor for VEGF is VEGFR-2, a tyrosine kinase receptor. VEGF induces the migration of EPCs in the bone marrow, and enhances the proliferation and differentiation of these cells at sites of angiogenesis. FGF 2 can also stimulate endothelial cell proliferation, differentiation and migration. Newly formed vessels are fragile and need to become stabilized, which requires the recruitment of pericytes and smooth muscle cells (periendothelial cells). Angiopoietin 1 and 2 (Ang 1 & 2), PDGF and TGF-/3 paicipate in stabilization process. Remember VEGF transcription is regulated by the transcription factor HIF, which is induced by hypoxia.


Question: The commonest type of Porphyria is


Question: Radiation exposure during infancy has been linked to

Ans. (c) ThyroidRef: Robbin's pathology 9th ed. /109* The most radio-sensitive organ sites in children in the order of sensitivity are thyroid, breasts, bone marrow and brain.* Exposure to ionizing radiation in first 2 decades predisposes a person for development of papillary CA.


Question: Sulfur granules and multiple draining sinuses is a feature of


Question: Differential expression of same gene depending on parent of origin is referred to as

It has now been established that functional differences exist between the paternal and the maternal copies of some genes. These differences arise from an epigenetic process called genomic imprinting, whereby ceain genes are differentially "inactivated" during paternal and maternal gametogenesis. Maternal imprinting refers to transcriptional silencing of the maternal allele, whereas paternal imprinting implies that the paternal allele is inactivated. At the molecular level, imprinting is associated with methylation of the gene promoter, as well as related events such asmodification of DNA-binding histone proteins, the sum total effect of which is to silence the gene. (Robbins Basic Pathology,9th edition,pg no. 243)


Question: Macular sparing is seen if the lesion is at

Refer AH Khurana, Comprehensive Textbook of Ophthalmology,5thedition, pg no: 310-311)


Question: Multiple pulp stones are seen in

Ehler Danlos syndromes:
Includes more than 10 different disorders involving a genetic defect in collagen and connective tissue synthesis.


Question: Sudden decrease in atmospheric pressure in deep sea divers resulting in "bends" and 'Chokes" are features of


Question: Pain, muscle tenderness, clicking or popping noise in T.M joint and limitation of jaw motion are the four cardinal signs and symptoms of