Question: IFN gamma is secreted by

TH1 cells produce the cytokine IFN-g, which activates macrophages in the classical pathway. TH2 cells secrete IL-4, IL-5, and IL-13, which recruit and activate eosinophils and are responsible for the alternative pathway of macrophage activation IFNg, or type II interferon, is a cytokine that is critical for innate and adaptive immunity against viral, some bacterial and protozoal infections. IFNg is an impoant activator of macrophages and inducer of Class II major histocompatibility complex (MHC) molecule expression. Aberrant IFNg expression is associated with a number of autoinflammatory and autoimmune diseases. The impoance of IFNg in the immune system stems in pa from its ability to inhibit viral replication directly, and most impoantly from its immunostimulatory and immunomodulatory effects. IFNg is produced predominantly by natural killer (NK) and natural killer T (NKT) cells as pa of the innate immune response, and by CD4 Th1 and CD8 cytotoxic T lymphocyte (CTL) effector T cells once antigen-specific immunity develops TH17 cells secrete IL-17 and other cytokines that induce the secretion of chemokines responsible for recruiting neutrophils and monocytes into the reaction ref robbins basic pathology 9th ed page 55


Question: Brown induration term used in

A. i.e. (CVC- Lung) (107-Harsh Mohan 5th)* Chronic Venous Congestion (CVC) of lung - brown induration of the cut surface of the lungs is due to the pigmentation andfibrosis* Breakdown of erythrocytes liberates haemosiderin pigment** which is taken up by alveolar macrophages so called heart failure cells** present in the alveolar lamina* **Nutmeg liver sean in CVC - liver* Gamna -gandy bodies** or siderofibrotic nodules (haemosiderin pigment deposition) - seen in CVC- spleen----Heart Failure----------| |Left- sided Right- sided| |Back- pressure Back pressure| |CVC - lungs Systemic venous congestion |||| CVC- LiverCVC-spleenCVC-KidneyCongested leg veins* Brown tumours found in- Hyperparathyroidism**


Question: Most common site of childhood rhabdomyosarcoma is

Rhabdomyosarcoma usually begins in muscles that are attached to bones and that help the body move. Rhabdomyosarcoma is the most common type of soft tissue sarcoma in children. It can begin in many places in the body. Ref robbins 9/e p510


Question: Frequent bouts of epistaxis are a conspicuous feature of


Question: HLA associated with Rheumatoid ahritis

Association of HLA Alleles and Inflammatory DiseasesDiseaseHLA AlleleRelative Risk Ankylosing SpondylitisB2790-100Postgonococcal ahritisB2714Acute anterior uveitisB2714Rheumatoid ahritisDR44Chronic active hepatitisDR313Primary Sjogren syndromeDR39Type 1 DiabetesDR35DR46DR3/DR420


Question: Type of pericarditis in tuberculosisa) Hemorrhagicb) Constrictivec)  Fibrinousd)  Serofibrinous

Causes of hemorrhagic pericarditis

Tuberculosis
Malignant involvement of pericardial sac
Bleeding diathesis
Cardiac surgery
Post myocardial infarction
Dissecting aneurysm of aorta
Uremic pericarditis


Question: Liquefactive necrosis is seen in

Liquefactive necrosis is seen in focal bacterial or, occasionally, fungal infections because microbes stimulate the accumulation of inflammatory cells and the enzymes of leukocytes digest ("liquefy") the tissue. For obscure reasons, the hypoxic death of cells within the central nervous system often evokes liquefactive necrosis.Tthe dead cells are completely digested, transforming the tissue into a liquid viscous mass.Eventually, the digested tissue is removed by phagocytes.( Robbins Basic Pathology, 9th edition, page 10 )


Question: Epimembranous deposition is seen in

Epimembranous deposits (Immune complex deposits between basement membrane and overlying podocytes) and spike and dome appearance is seen in membranous glomerulonephritis.


Question: The most impoant cells in type I hypersensitivity

Ans. is 'b' i.e., Mast cells Type I hypersensitivity (Immediate hypersensitivity) o It is a rapidly developing immunological reaction occuring within minutes after the combination of an antigen with antibody bound to mast cells in individuals previously sensitized to the antigen. o Immediate hypersensitivity reactions are mediated by Ig E, but T and B cells play impoant role in the development of these antibodies. o Type I reaction requires prior sensitization to a specific antigen (allergen). o Most exposures occur either by inhalation (respiratory route) or ingestion (GIT) of antigen. o Type one hypersensitivity has two phases :- 1.Initial response o After first antigen exposure, this antigen is presented to CD-4 helper T cells (TH2 type) by antigen presenting cells. These primed TH2 cells release IL-4 that acts on B-cells to form Ig E specific for that paicular antigen. The antigen specific lg E antibodies then bind to the surface receptors of mast cells and basophils. The process from first antigen exposure to the coating of mast cells by Ig E acts as sensitization (prior sensitization) and first exposure is also called priming or sensitizing exposure (dose). Subsequent exposure (shocking dose) to same antigen then result in activation of mast cells and basophils with release of mediator from these cells that leads to ? Smooth muscle spasm Increase mucus secretion from the epithelial cells. Vasodilatation Increased vascular permeability Recuritment of inflammatory cells Note - Most of the clinical effects are due to smooth muscle spasm. 2. Late phase response In this phase additional leukocytes are recruited. These cells amplify and sustain the inflammatory response without additional exposure to the triggred antigen. Among the cells that are recruited in the late-phase reaction, eosinophils are paicularly impoant. Eosinophils produce major basic protein and eosinophilic cataionic protein that are toxic to epithelial cells. Platelet activating factor (PAF) recruits and activates inflammatory cells and is most impoant cytokine in the initatiation of late phase response. Type I hypersensitivity occurs in two forms Anaphylaxis --> Acute, potentially fatal, systemic. Atom --> Chronic, Nonfatal, Lacalized. Remember o Mast cells are the most impoant cells in type I hypersensitivity. o Eosinophils are the most impoant cells in the late phase reaction of type I hypersensitivity. o Histamine is the most impoant mediator in type I hypersensitivity. o IL-4 is paicularly impoant, it is essential for turning on IgE secreting B cells. o PAF is the most impoant cytokine in the initiation of late phase reaction. o Most potent eosinophilic activating cytokine is IL-5.


Question: Compared with spectacles, the contact lenses

As contact lenses tend to return the images to near normal size, the images are minifid in hypermetropia and magnified in myopia.

Do not reduce aniseikonia and optical aberra on


Question: Opisthotonus is seen in


Question: MYC gene is

Harshmohan textbook of pathology 7th edition. MYC gene its a proto oncogene code for nuclear transcription factor C- MYC, N- MYC , L- MYC. .


Question: HLA antigen is located at

HLA complex (MHC) gene is located on the short arm of chromosome 6.


Question: Pernicious anemia occur due to

Failure of secretion of intrinsic factor

Failure of absorption of intrinsic factor


Question: The prognosis of rapidly proliferatingglomerulonephritis (Crescentric GN) depends upon


Question: HLA 2 is associated with

Answer- D. Mixed leukocyte reactionMHC-II is resporrsible for graft versus host response and mked leukocyte reaction

Cell mediated cytolysis of viral infected cells


Question: In marfan syndrome the defect is in

In Marfan syndrome, a connective tissue disorder of autosomal dominant inheritance, the basic biochemical abnormality is a mutation affecting fibrillin. This glycoprotein, secreted by fibroblasts, is the major component of microfibrils found in the extracellular matrix. Microfibrils serve as scaffolding for the deposition of tropoelastin, an integral component of elastic fibers. Fibrillin is encoded by the FBN1 gene, which maps to chromosomal locus 15q21. Mutations in the FBN1 gene are found in all patients with Marfan syndrome. Although microfibrils are widely distributed in the body, they are paicularly abundant in the aoa, ligaments, and the ciliary zonules that suppo the ocular lens; these tissues are prominently affected in Marfan syndrome. (Robbins Basic Pathology, 9 th edition. page : 220)


Question: Source of ammonia in urine


Question: Tumour marker for Endodermal Sinus Tumour

Endodermal sinus tumor (yolk sac tumor) is positive for AFP and α1 - antitrypsin.


Question: Polycythemia is associated with

Polycythemia and increased erythropoietin in a patient with chronic kidney disease. ... DIAGNOSIS: Chronic renal insufficiencycaused by obstructive hydronephrosis andaccompanied by increased erythropoietin levels of renal origin and polycythemia.


Question: Most common karyotype abnormality associated with turner syndrome is

Turner syndrome (TS), also known as 45,X or 45,X0, is a condition in which a female is paly or completely missing an X chromosome.] Signs and symptoms vary among those affected. Often, a sho and webbed neck, low-set ears, low hairline at the back of the neck, sho stature, and swollen hands and feet are seen at bih. Typically, they only develop menstrual periods and breasts with hormone treatment, and are unable to have children without reproductive technology. Hea defects, diabetes, and low thyroid hormone occur more frequently.


Question: Histologic sections of lung tissue from an individual with adult respiratory distress syndrome (ARDS) are most likely to reveal

Adult respiratory distress syndrome (ARDS) is a syndrome characterized clinically by the rapid onset of severe, life-threatening respiratory insufficiency. ARDS has also been called adult respiratory failure, shock lung, traumatic wet lung, pump lung, and diffuse alveolar damage (DAD). The initial and basic lesion in ARDS is diffuse damage to the alveolar wall. Protein-rich edema fluid then leaks into the alveolar spaces and combines with fibrin and dead cells to produce hyaline membranes that line the alveoli and are the characteristic histologic feature of ARDS. In the acute edematous stage, the lungs are congested (pulmonary congestion) and show pulmonary edema with interstitial inflammation. Collapsed, airless pulmonary parenchyma is called atelectasis and can also be seen in ARDS. These other changes, although present in ARDS, are not pathognomonic. In contrast, angioinvasive infiltrates of pleomorphic lymphoid cells are seen with lymphomatoid granulomatosis, a disease of middle-aged individuals that is characterized by an angiocentric and angioinvasive infiltrate of atypical lymphoid cells. Deposits of needle-like crystals from the membranes of eosinophils, called Charcot-Leyden crystals, can be seen in patients with asthma, while infiltrating groups of malignant cells having intercellular bridges characterize squamous cell carcinoma. Plexiform lesions within pulmonary aerioles are diagnostic of pulmonary hypeension Reference: Robbins & Cotran Pathologic Basis of Disease, 9edition.

Angioinvasive infiltrates of pleomorphic lymphoid cells

Irregular membranes composed of edema, fibrin, and dead cells lining alveoli

Infiltrating groups of malignant cells having intercellular bridges


Question: pseudolaminar necrosis is a feature of

Coical laminar necrosis, also known as pseudolaminar necrosis, is necrosis of neurons in the coex of the brain in situations when the supply of oxygen and glucose is inadequate to meet regional demands Refer robbins 9/e p814


Question: Tumour marker for a highly vascular tumour

Ans. is 'b' i.e., Keratin o Mesotheloma is highly vascular and keratin is a marker of mesotheloma.


Question: The primary causative factor for myofacial pain dysfunction syndrome of the TMJ is

Muscular overextension and over contraction


Question: Most common testicular tumour of Childhood is

Infantile embryonal carcinoma or endodermal sinus tumor or yolk sac tumor is the most common testicular tumor in infants and children up to 3 years of age.


Question: Broad cast is a feature of

Broad casts in urine appear as a result of chronic damage to tubules and collecting ducts. It is seen in chronic renal failure.


Question: Linitis plastica is a type of

According to Lauren classification, gastric cancers are two types- intestinal and diffuse type. Intestinal type Diffuse type Gross: Tumors are bulky, composed of glandular structures similar to esophageal and colonic adenocarcinoma. Present with heaped up borders and central ulceration. Gross: Infiltrative tumor which evokes a desmoplastic reaction that stiffens the gastric wall and may cause rugal flattening and a rigid, thickened wall that impas " Leather bottle" appearance called lintis plastica. Microscopy: neoplastic cells contain mucin vacuoles, abundant mucin present in the gland lumina. Microcopy: Signet ring cells with large cytoplasmic mucin vacuoles & peripherally displaced crescent shaped nuclei REF: TEXT BOOK OF ROBBINS BASIC PATHOLOGY NINTH EDITION PAGE .570 IMAGE REF: TEXT BOOK OF ROBBINS BASIC PATHOLOGY NINTH EDITION. FIG.14-16, PAGE:571


Question: In pheochromocytoma, not a pa the rule of 10 is

Ans is 'd' i.e. 10% are symptomatic Pheochromocytomas usually subscribe to a convenient "rule of 10" or "10% tumor"; i.e. 10% of pheochromocytomas are :-Bilateral Extra-adrenal FamilialMalignant Multiple Occur in children


Question: The most important source of histamine


Question: Cytosolic cytochrome C plays an impoant function in

Mitochondria contain several proteins that are capable of inducing apoptosis; these proteins include cytochrome c and other proteins that neutralize endogenous inhibitors of apoptosis. Cytochrome c, together with some cofactors, activates caspase-9. Other proteins that leak out of mitochondria block the activities of caspase antagonists that function as physiologic inhibitors of apoptosis.The net result is the activation of the caspase cascade, ultimately leading to nuclear fragmentation.( Robbins Basic Pathology, 9th edition, page 19 )


Question: Angular stomatitis

can be a concomitant of any candidal infection


Question: Acid phosphatase is associated with


Question: Cytokines are secreted in sepsis and Systemic inflammatory Response syndrome (SIRS) by

Ans. is 'a' i.e., Neutrophils Cytokine release in Sepsis o Mechanism by which endotoxin causes activation of inflammatory cells and release of cytoine has already been explained earlier. o It is by TLR-4 and CD-14 mediated. Signals from TLR-4 can directly activate vascular endotheliun and leukocytes to release cytokine mediators. o The major cells that secret cytokines in sepsis area 1. Monocyte/Macrophages 2. Neutrophils 3. Endothelial cells o Cytokine mediators involved are :? 1. TNF - (The most impoant cytokine in sepsis) 2. IL-1 3. IL-6 4. IL-8 5. NO.


Question: Microalbuminuria is defined as protein levels of

• The earliest manifestation of diabetic nephropathy is the appearance of low amounts of albumin in the urine (>30 mg/day, but <300 mg/day), that is, microalbuminuria.
• Microalbuminuria is also a marker for greatly increased cardiovascular morbidity and mortality for persons with either type 1 or type 2 diabetes


Question: Normal serum uric acid levels in males is

serum uric acid male 3.1-7.0 mg/dL female 2.5-5.6 mg/dL Ref: RAM DAS NAYAK EXAM PREPARATORY MANUAL FOR UNDERGRADUATES 2nd ed. pg no: 784


Question: Oval stem cells are located in

Cell Location Function Oval cells Canals of Herring of liver Forms hepatocytes & biliary cells Satellite cells Basal lamina of myotubules Differentiate into myocytes after injury Limbus cells Canals of Schlemm Stem cells for cornea Ito cells Subendothelial space of Disse Store vitamin A Paneth cells Bottom of crypts Host defense against microorganisms


Question: The number of platelets in a single bag of SDP is

*Since each blood bag (usually 250 mL or 500 mL) contains a relativelysmall number of platelets, it can take as many as a dozen blood bags(usually from 5 to 10 bags, depending on the size of the bloodbags and each donor's plateletcount) to accumulate a single unit ofplatelets (enough for one patient). Apheresis platelets are usually called single donor platelets because they are collected from a single donor with an automated cell separator. Donors usually have an IV line in each arm. ... Single donor platelets offer several advantages over random donorconcentrates including: Less inventory and pooling. Refer bailey and love 27th edition ,pg 21


Question: Acute paronychia is treated by

Acute paronychiaM/C hand infection.Due to inappropriate nail trimming or skin picking near nail foldAfter initial inflammation, pus accumulates beside the nailIt's removed by I&D technique with or without the excision of outer quaer of the nail.(Refer: Bailey and Love's Sho Practice of Surgery, 26th edition, pg no: 507)


Question: Mutation seen in malignant melanoma

Germline mutations in CDKN2A gene are found in about 40% of familial malignant melanoma cases.


Question: Neuroendocrine lesions of lung are

Classification of neuroendocrine lesions.

Non-neoplastic

Reactive neuroendocrine cell hyperplasia (associated with inflammation or scarring).
Idiopathic pulmonary neuroendocrine cell hyperplasia.

Benign - Tumorlets
Malignant -

Carcinoid tumor.
Small cell carcinoma of lung.
Large cell neuroendocrine carcinoma of the lung.


Question: CD16 and CD56 are markers of

The function of NK cells is to destroy irreversibly stressed and abnormal cells, such as virus-infected cells and tumor cells. NK cells make up approximately 5% to 10% of peripheral blood lymphocytes. They do not express TCRs or Ig. NK cells are endowed with the ability to kill a variety of virus-infected cells and tumor cells, without prior exposure to or activation by these microbes or tumors. This ability makes NK cells an early line of defense against viral infections and, some tumors. Two cell surface molecules, CD16 and CD56, are commonly used to identify NK cells. CD16 is an Fc receptor for IgG, and it confers on NK cells the ability to lyse IgG-coated target cells. This phenomenon is known as antibody-dependent cell-mediated cytotoxicity (ADCC). The function of CD56 isnot known.Ref: Robbins and Cotran Pathologic Basis of Disease; 9th edition; Chapter 6; Diseases of the Immune System; Page no: 192


Question: Inflammatory cell that will be seen after 2 days of acute appendicitis is


Question: Gene responsible for embryogenesis of eye

Ans. (a) PAX 6(Ref: Emery genetics)The PAX-6 gene locus is a transcription factor for the various genes and growth factors involved in eye formation. Eye formation in the human embryo begins at approximately 3 weeks into embryonic development and continues through the tenth week.


Question: Cooley's anemia is also known as


Question: In a thrombus, the dark lines of zahn are due to


Question: Ahritis occur in


Question: Swiss cheese pattern of the endometrium is seen in

Anovulatory dysfunctional uterine bleeding -Three types*Pubey menorrhagia (threshold bleeding)*Metropathia hemorrhagica (during reproductive period)*Premenopausal menorrhagiaMetropathia hemorrhagica*Age group : 35-40 years *Clinical features : continuous and prolonged menstrual bleeding*Gross: Uterus bulky due to myometrial hyperplasiaHistology : Proliferative endometrial glands with "Swiss cheese pattern". Absence of secretory endometrial glands is characteristic of metropathia hemorrhagica. (Ref: Padubidri's gynecology)


Question: Wear and tear pigment in the body refers to

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 represents 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.( Robbins Basic Pathology, 9th edition, page 24 )


Question: Interleukin secreted by Th17 cells

Ans. (b) IL22(Ref: Immunity 2008 Apr. 28(4): 454-467IL-22 is one of the IL-10 family cytokines, which also include IL-10, IL-19, IL-20, IL-24, and IL-26, as well as more distally related IL-28 and IL-29.It has a role in autoimmune diseases, tissue-repair and wound-healing apart from being proinflammatory


Question: Most sensitive indicator of iron deficiency anemia

Ans. (c) Serum ferritin(Ref: Robbins 9th/pg 649-652)Among the options provided, most sensitive marker in iron deficiency anemia is Serum ferritin.Serum ferritin reflects the storage of Iron which is decreased even in the pre-latent stage of Iron deficiency Anemia and is the most sensitive marker.


Question: Unstable spine injury occurs in

Mode of injuries in Lower Cervical Spine Fractures (C3 - C7)Mode of injuriesPattern of fractureVeical (Axial) compression Burst fracture (Veebral height is decreased in toto)Pure flexion Wedge compression fracture (Decreased anterior height of veebrae)Combined axial compression & flexion Teardrop fracture (Antero inferior fragment of the veebral body is sheared off)Distraction - Flexion /Flexion rotation (MC unstable spine injury)Unilateral or bilateral subluxation & dislocation Flexion sprains Jumped facetsFloating veebra Avulsion injury of spinous process Clay shoveler's fracture Axial compression extension type Second most common type Distraction extension injury Disruption of anterior ligamentous complex followed by posterior soft tissue complex (Refer: Rockwood and Green's Fractures in Adults, 7th edition,pg no: 1498,1413,1435,1485)


Question: Diagnostic accuracy of a test is determined by

(Refer: K. Park's Textbook of Preventive and Social medicine, 24th edition, pg no: 149)


Question: Munro&;s microabscesses are seen in

In psoriasis, the increased rate of proliferation (to replace the damaged, exfoliated keratin) is reflected in epidermal thickening (acanthosis), down the growth of elongated epidermal ridges, and increased mitotic activity. The stratum granulosum is thin or absent, and there is extensive overlying parakeratotic scale. The dermal papillae are elongated and contain dilated capillaries; these extend close to the parakeratotic scale due to thinning of the overlying epidermis.&;When the psoriatic scale is removed, this results in minute points of bleeding (Auspitz's sign). Within the epidermis are focal areas of slight edema (spongiosis); collections of neutrophils in the stratum corneum produce the characteristic Munro&;s microabscesses.


Question: The ‘Iris lesions ’ are pathognomonic of

Erythema Multiforme
The classic skin lesion consists of a central blister or necrosis with concentric rings of variable color around it called typical “target” or “iris” lesion that is pathognomonic of EM;
variants are called “atypical target” lesions (Figure 4-16). The skin may feel itchy and burnt. Postinflammatory hyperpig - mentation is common in dark-skinned individuals and may be worsened by sun exposure.


Question: Macrodontia is associated with


Question: Caseous necrosis is not found in


Question: Inclusions in oligodendrogliocytes is a feature of aEUR'

Progressive multifocal leukoencephalopathy Progressive multifocal leucoencephalopathy :? . Progressive multifocal leucoencephalopathy is a progressive disorder cause by J.C. virusdeg. . The main cells affected in the disease are oligodendrocytesdeg. . Since oligodendrocytes are concerned with myelination, progressive multifocal leucoencephalopathy is characterized by multifocal areas of demyelinationQ of varying size distributed throughout the brain but sparing the spinal cord and optic nerves. Pathology . Besides demyelination there are characteristis cytological alterations in both astrocytes and oligodendrocytes : - AstrocytesQ . Enlarged and contain, hyperchromatic, deformed and bizarre nuclei and frequent mitotic figures. OligodendrocytesQ . These have enlarged densely staining nuclei that contains virus inclusions.formed by crystalline arrays. Symptoms of progressive multifocal leucoencephalopathy :? Visual defects (45%) --> Homonymous hemianopia, Conjugate gaze abnormalities Mental impairment (38%) Dementia, confusion, personality changes Weakness --> Hemi or monoparesis and ataxia Seizures (20%) ---> Speech defect aphasia, hemiparesis, ataxia Focal neurological signs . Progressive multifocal leucoencephalopathy is predominantly seen in patients with immunosuppressive disorders: ? . Most commonly associated conditions are: ? - AIDS (80%)Q - Hematological malignancies (13%) - Transplant recipients (5%) - Chronic inflammatory disease (2%) Prognosis of progressive multifocal leucoencephalopathy . In most cases death occurs in 3-6 months .from onset of neurological symptoms and even more rapidly in patients with AIDS unless aggressive interetrul treatment is undeaken. Diagnosis . MRI is used for the diagnosis of PML. . MRI is better than CT scan in the diagnosis of PML and is frequently used for the diagnosis of PML. . On MRI the lesion appears as multrfocal asymmetric coalescing white matter located periventricularly. . These lesions have increased signals on T2 and FLAIR images and decrease signal on T,-weighted images. . PML lesions are classically nonenhancingQ. . Other impoant diagnostic tool in PML is the PCR amplification of JCV DNA. . The PCR amplification of JCV DNA in association with typical MRI lesion in the appropriate clinical setting is diagnostic of PML. I am not sure of the answer, visual symptoms, aphasia dysahria are commonly seen in PML.


Question: The explosive and widespread form of secondary syphilis in immuno compromised individual is known as


Question: most comon type of carcinoma thyroid is

The most common thyroud carcimoma is papillary carcinoma 75 - 85% of all cases. Option 2 is right. Robbins basic pahology. 7th edition. Chapter Endocrine system. Page no. 1177.


Question: Commonest histological nding in benign hypertension is

Characteristic vascular pathology of benign hypertension is hyaline arteriosclerosis.
Vascular pathology in Hypertension Hypertension is associated with two forms of small blood vessels disease -
1. Hyaline arterioiosclerosis

There is homogenous, pink, hyaline thickening of arteriolar wall.
The lumen becomes narrow, o It is characterisc of benign hypertension,
It may also occur in diabetes and aging.

2. Hyperplastic arteriosclerosis

It is characteristic of malignant hypertension.
There is concentrenc, laminated thickening of arteriolar wall → onion skinning,
There is mucinous intimal thickening and fibrous intimal thickening.
There may be accompanied fibrinoid deposits with necrosis of the vessels w ral! → fibrinoid necrosis.


Question: Prion includes

Ans. is 'c' i.e. Proteins Prions are infectious proteins that cause degeneration of the central nervous system.They are infectious particles that lack nucleic acid.Prions are composed largely, if not entirely of PrP molecules.Four important points about prions are: -Prions are the only known infectious pathogens that are devoid of nucleic acid, all other infectious assents possess genomes composed of either RNA or DNA that direct the synthesis of their progeny.Prions disease may manifest as infectious, genetic and sporadic disorders; no other group of illness with a single etiology presents with such a wide spectrum of clinical manifestations. Prions disease results from the accumulation of PrPSc the conformation of which differs substantially from that of its precursor PrPc.PrPSc can exist in a variety of different conformations each of which seems to specify a particular disease phenotype.Prions reproduce by binding to the normal cellular isoform of prion protein and stimulating conversion of PrP into the disease causing isoform.


Question: NARP is a

Neuropathy, ataxia, and retinitis pigmentosa (NARP) is a condition that causes a variety of signs and symptoms chiefly affecting the nervous system. Beginning in childhood or early adulthood, most people with NARP experience numbness, tingling, or pain in the arms and legs (sensory neuropathy); muscle weakness; and problems with balance and coordination (ataxia). Many affected individuals also have vision loss caused by changes in the light-sensitive tissue that lines the back of the eye (the retina). In some cases, the vision loss results from a condition called retinitis pigmentosa. This eye disease causes the light-sensing cells of the retina gradually to deteriorate. Learning disabilities and developmental delays are often seen in children with NARP, and older individuals with this condition may experience a loss of intellectual function (dementia). Other features of NARP include seizures, hearing loss, and abnormalities of the electrical signals that control the heabeat (cardiac conduction defects). These signs and symptoms vary among affected individuals.


Question: Tumor Suppressor Gene associated with Familial gastric cancer and Lobular breast carcinoma is

GeneProteinFunctionFamilial syndromesSporadic CancersCDH1E-cadherinCell adhesion,inhibition of cell motilityFamilial gastric cancerGastric carcinoma, Lobular breast carcinomaRef: Robbins and Cotran Pathologic Basis of Disease; 9th edition; Chapter 7; Neoplasia; Page no: 291; Table: 7-7


Question: Most severe form of Ehler Danlos syndrome is

Ahrochalasia EDS (aEDS, formerly categorized as types 7A & B) is characterized by severe joint hypermobility and congenital hip dislocation. Other common features include fragile, elastic skin with easy bruising, hypotonia, kyphoscoliosis (kyphosis and scoliosis), and mild osteopenia. Refer robbins 145


Question: On electron microscopy in most of the cases characteic slpiiting of GBM with subepithelial deposits in few cases is seen in

Refer Robbins page no 915By light microscopy the glomeruli either appear normal in the early stages of the disease or exhibit uniform, diffuse thick- ening of the glomerular capillary wall (Fig. 20-12A). By electron microscopy the thickening is seen to be caused by irregular electron dense also deposits containing immune com- plexes between the basement membrane and the overlying epithelial cells, with effacement of podocyte foot processes (Fig. 20-12B and D). Basement membrane material is laid down between these deposits, appearing as irregular spikes protrud- ing from the GBM. These spikes are best seen by silver stains, which color the basement membrane, but not the deposits, black. In time, these spikes thicken to produce domelike protru- sions and eventually close over the immune deposits, burying them within a markedly thickened, irregular membrane. Immunofluorescence microscopy demonstrates that the granu- lar deposits contain both immunoglobulins and complement (Fig. 20-12C). As the disease advances segmental sclerosis may occur; in the course of time glomeruli may become totally sclerosed. The epithelial cells of the proximal tubules contain protein reabsorption droplets, and there may be consider


Question: Aphthous ulcers known as

(Canker sores) (554,114, 211, 564, HM) (580- Basic pathology 8th)* Aphthous ulcers (Canker sores) - Commonest form of painful oral ulcers* In shock due to burns, acute stress ulcers of the stomach or duodenum may occurs and are known as Curling's ulcer* Squamous cell carcinoma developing in an old bum scar (Marjolin's ulcer)* Intra cranial lesion e.g. Head injury (Cushing ulcers developing from hyper acidity following vagal stimulation)


Question: Duodenal villous atrophy is seen in

Ans. (c) Celiac disease(Ref: R9/ 1782)D Xylose absorption test is a medical test to diagnose condition that cause malabsorption of proximal small intestine.


Question: Developmental enamel defects are most commonly seen in


Question: Antisera are prepared from

AntiseraIs a material prepared in animalsPassive immunization was achieved by the administration of antisera or antitoxins prepared from horsesAdministration of antisera give rise to serum sickness and anaphylactic shock(Refer: K. Park's Textbook of Preventive and Social Medicine, 24th edition, pg no:112)


Question: Increased Ig A levels are seen in

Serum IgA increased in - Alcoholic cirrhosis Serum IgM increased in -Primary biliary cirrhosis (Ref: Clin Exp Immunol.2009 Oct; 158(1): 115-124, Liver.1984 Jun;4(3): 214-8)


Question: Tadpole cells comma shaped cells on histopathology are seen in

Rhabdomyosarcoma is the most common soft tissue sarcoma of childhood and adolescence. Rhabdomyosarcoma is histollogically subclassified into embryonal, alveolar, and pleomorphic variants. The rhabdomyoblast is the diagnostic cell in all types. The rhabdomyoblast may be round or elongated, the later are called tadpole or strap cells. Robbins basic pathology 9th edition page no 795,heading=Skeletal muscle tumors. Morphology box Option is 3,Rhabdomyosarcoma ref img


Question: Most common translocation in acute promyelocytic leukemia (APML) is

Answer- C, t (15:17)Acute promyelocytic leukemia (M3 by the FAB classification) is associated with a t(15;17) (q22;q11) translocation.Disseminated intravascular coagulation can occur in this disorder due to the release of procoagulant substances from the leukemic cells, especially during treatment.The t(4;11)(q21;q23) translocation is associated with acute lymphocytic leukemia (ALL) and undifferentiated leukemia.The t(6;9)(p23;q34) translocation is found in subtypes of AML with basophilia (M1, M2, M4).Burkitt's leukemia, which is related to Burkitt's lymphoma, is associated with t(8;14) (q 24;q32).The t(8;21) (q22;q22) translocation (choice D) is seen in M2 leukemia, also known as acute myeloid leukemia (AML) with maturation


Question: The tumor marker for Endodermal sinus tumor is

Endodermal sinus Tumors often have eosinophilic hyaline globules in which a1-antitrypsin and alpha fetoprotein (AFP) can be demonstrated by immunohistochemical techniques. As mentioned later, AFP can also be detected in the serum .Serum AFP is a very good tumor marker in patients with germ cell tumors composed of or containing endodermal sinus (yolk sac) tumor, irrespective of their location. ref : Robbins Basic Pathology, 9E,page-661


Question: Edwards syndrome is

TRISOMY 18: EDWARDS SYNDROME Characterised by Prominent occiput Mental retardation Micrognathia Sho neck Overlapping fingers Congenital hea defects Renal malformations Limited hip abduction Low set ears (Robbins Basic Pathology,9th edition,pg no. 238)


Question: The ocular basement membrane is stained with

Not only ocular almost all basement membranes are stained with PAS (Periodic acid-Schiff) Because they have mucopolysaccharides.Periodic acid-Schiff reactive (PAS) method is principally used to demonstrate structures rich in polysaccharides (glycogen), mucopolysaccharides (e.g., ground substance of connective tissues, basement membrane, and mucus), glycoproteins (thyroglobulin), and glycolipids.


Question: Disease having autosomal recessive inheritance

Autosomal Recessive Inheritance Sickle cell anemia Cystic fibrosis Tay-Sachs disease Phenylketonuria Mucopolysaccharidoses--all types Glycogen storage diseases--all types Galactosemia (Robbins Basic Pathology,9th edition,pg no. 218)


Question: Mediator of acute inflammation not derived from the cell is (D. REPEAT Feb 2014)

Chemical Mediators of Inflammation
Aka permeability factors or endogenous mediators of increased vascular permeability.
They are broadly classified into 2 groups:
i. Mediators released by cells.
ii. Mediators originating from plasma.
Chemical Mediators of Acute Inflammation
A. Cell-Derived Mediators
1. Vasoactive amines

Histamine
5-hydroxytryptamine
Neuropeptides

2. Arachidonic acid metabolites (Eicosanoids)
i. Metabolites via cyclo-oxygenase pathway

Prostaglandins
Thromboxane A2
Prostacyclin
Resolvins

ii. Metabolites via lipo-oxygenase pathway

5-HETE
Leukotrienes
Lipoxins

3. Lysosomal components (from PM Ns, macrophages)
4. Platelet-activating factor (PAF)
5. Cytokines

IL-1
TNF-α
TNF-β
IFN-γ
Chemokines

6. Free radicals

Oxygen metabolites
Nitric oxide

B. Plasma-Derived Mediators (Plasma Proteases) Products of:
1. The Kinin system.
2. The Clotting system.
3. The Fibrinolytic system.
4. The Complement system.


Question: Most demineralised zone in enamel caries


Question: Most common location of SEGA (sub ependymal giant cell strocytoma)

Foramen of monro is the most common site for SEGA.


Question: The most common site of origin for venous thrombi leading to pulmonary embolism is


Question: NA hich of the 10110N% ing is not a cause of point mutation


Question: Hemolytic crisis in hereditary spherocytosis is precipitated by

Ans. (a) Parvovirus B19 infection(Ref: Harrison 18th/pg 1478)Aplastic/hypoplastic crises resulting from parvovirus B19 infection may occur in Hereditary spherocytosis just as is seen in individuals with other chronic hemolytic disorders.Parvovirus B19 selectively infects erythroid precursors and inhibits their growth.Erythropoietic arrest leads to a sudden decrease in hemoglobin concentration and reticulocytopenia.


Question: Receptor on neuronal membrane that induces development of glioma


Question: Necrotising aerioritis with fibrinoid necrosis is characteristic of

Fibrinoid necrosis is a special form of necrosis, visible by light microscopy , usually in immune reaction in which complexes of antigens and antibodies are deposited in the walls of aeries. The deposited immune complexes together with fibrin that has leaked out of vessels produce a bright pink and amorphous appearance on H & E preparation called fibrinoid. Type 3 hypersensitivity disorder Robbins 9th edition page 111,11


Question: Emphysema is due to deficiency of

D. i.e. (Alpha - 1- antitrypsin) (486 - Harsh Mohan 5th) (486- Basic pathology 8th)Emphysema - is characterized by abnormal permanent enlargement of the airspaces distal to the terminal bronchioles accompanied by destruction of their walls without obvious fibrosisal - AT develops in adults and causes pulmonary emphysema in smokers as well as in non smokers* Charcot- Leyden crystal and Curshmann's spirals are seen in B. asthma**** Panacinar (Pan lobular) emphysema is associated with a-1 AT deficiency


Question: Gene for retinoblastoma is located on

harshmohan textbook of pathology 7th edition. *autosomal dominant trait by retinoblastoma susceptibility gene located on chromosome 13. RB Gene: Governor of the Cell Cycle It is useful to begin with the retinoblastoma gene (RB), the first tumor suppressor gene to be discovered and, as it happens, a prototypical representative. As with many advances in medicine, the discovery of tumor suppressor genes was accomplished by the study of a rare disease--in this case, retinoblastoma, an uncommon childhood tumor. Approximately 60% of retinoblastomas are sporadic, and the remaining ones are familial, the predisposition to develop the tumor being transmitted as an autosomal dom- inant trait. To account for the sporadic and familial occur- rence of an identical tumor, Knudson, in 1974, proposed his now famous two-hit hypothesis, which in molecular terms can be stated as follows: * Two mutations (hits) are required to produce retinoblas- toma. These involve the RB gene, which has been mapped to chromosomal locus 13q14. Both of the normal alleles of the RB locus must be inactivated (hence the two hits) for the development of retinoblastoma (Fig. 5-21). * In familial cases, children inherit one defective copy of the RB gene in the germ line; the other copy is normal. Retinoblastoma develops when the normal RB gene is lost in retinoblasts as a result of somatic mutation. Because in retinoblastoma families only a single somatic mutation is required for expression of the disease, the familial transmission follows an autosomal dominant inheritance pattern. * In sporadic cases, both normal RB alleles are lost by somatic mutation in one of the retinoblasts. The end result is the same: a retinal cell that has lost both of the normal copies of the RB gene becomes cancerous. Ref Robbins 9/e pg 183


Question: Semen analysis is to be done

A semen analysis (plural: semen analyses), also called "seminogram" evaluates ceain characteristics of a male's semen and thesperm contained therein. It is done to help evaluate male feility, whether for those seeking pregnancy or verifying the success of vasectomy. Refer robbins 9/e

After 15-30 mins irrespective of liquefaction

After 30-60 mins irrespective of liquefaction


Question: Nuclear and cytoplasmic changes in the apoptotic cells are due to

Activation and Function of Caspases
• The mitochondrial and death receptor pathway leads to the activation of the initiator caspases, caspase 9 and - 8, respectively. Active forms of these enzymes are produced and this cleave and thereby activate another series of caspases that are called the executioner caspases.
These activated caspases cleave numerous targets culminating in activation of nucleases that degrade DNA and nucleoproteins. Caspases also degrade components of nuclear matrix and cytoskeleton, leading to fragmentation of cells.


Question: BRCA 1 & 2 genes are located on chromosomes

BRCA-1 Familial breast & ovarian ca Ca of male breast Prostate Pancreas Fallopian tube


Question: Marker for ovarian carcinoma in serum is

TABLE 8.14: Impoant Tumour Markers. CANCER ASSOCIATED PROTEINS: i. CA-125:-Ovary ii. CA 15-3 :-Breast iii. CA 19-9 :-Colon, pancreas, breast iv. CD30 :-Hodgkin's disease, anaplastic large cell lymphoma (ALCL) v. CD25 :-Hairy cell leukaemia (HCL), adult T cell leukaemia lymphoma (ATLL) vi. Monoclonal immunoglobulins :-Multiple myeloma, other gammopathies vii. Prostate specific antigen (PSA) :-Prostate carcinoma HARSH MOHAN Textbook of pathology 6th edition pg no 234


Question: Maurer's dots are seen in infection with

REMEMBER the following; Plasmodium vivax - Schuffner's dots Plasmodium falciparum - Maurer's dots Plasmodium malariae - Ziemann's dots Plasmodium ovale - James's dots


Question: Fracture of proximal humerus in an elderly patient is best treated by

(Refer: Watson Jones Textbook of Ohopedics & Trauma, 6thedition,pg no: 536-538)


Question: . Antimitochondrial antibodies are seen in

circulating anti-mitochondrial antibody of IgG class detected in more than 90% cases of primary biliary cirrhosis TEXTBOOK OF PATHOLOGY 6TH EDITION HARSH MOHAN PAGE NO:625


Question: Nodular glomerulosclerosis is seen in

Ans. (a) Diabetes mellitus(Ref: Robbins 9th/pg 1118)Most specific histological lesion in diabetic nephropathy (see chapter 18 Endocrine system) is Nodular glomerulosclerosis or Kimmelsteil -Wilson lesions


Question: Response to iron deficiency anemia is denoted by

The indicator for a response to iron therapy is reticulocytosis. The response to iron therapy varies, depending on the erythropoietin stimulus and the rate of absorption. Typically, the reticulocyte count should begin to increase within 4-7 days after initiation of therapy and peak at 1-1 1/2 weeks. Harrison 19e 629; ref Robbins 9/e pg 421


Question: Dystrophic calcification is commonly seen in

(C) Atheromatous plaque # DYSTROPHIC CALCIFICATION:> Calcium and phosphorus metabolism and serum levels are normal and calcification occurs as a result of local abnormality in tissue.> Circumstances is which dystrophic calcification occurs: Necrotic tissue: Fat necrosis; Caseation necrosis in the centre of granuloma; Dead parasites (cysticercosis, hydatid cyst etc.) Abnormal blood vessels & heart: Atheromatous plaque; Organized thrombi in veins; Abnormal cardiac valve> Aging or damaged tissue: Pineal gland; Laryngeal cartilage; Monekeberg's medial sclerosis> Neoplasm: Brain tumor (meningioma,craniopharyngioma, oligodendroglioma); Papillary carcinoma thyroid; Serous tumors of ovary; Breast carcinoma; Chondrosarcoma> Tumor Calcinosis: Formation of nodular non neoplastic calcific masses in subcutaneous tissue


Question: Programmed cell death without caspase activation

Necroptosis is a hybrid of necrosis (consider this more) and apoptosis. It is a programmed cell death without caspase (cysteine- aspaic proteases) activation


Question: The following do not occur with asbestosis

a lung disease resulting from the inhalation of asbestos paicles, marked by severe fibrosis and a high risk of mesothelioma (cancer of the pleura). A history of dyspnea, pleuritic chest pain, fatigue, weight loss and pleural effusion in a former asbestos worker is suggestive of mesothelioma. Cigarette smoking greatly increases the risk of lung cancer in asbestosworkers Refer robbins 9/e


Question: Breslow thickness is used in

In melanoma, the probability of metastasis correlates with the depth of invasion, which by convention is the distance from the superficial epidermal granular cell layer to the deepest intradermal tumour cells; this measurement is known as the Breslow thickness.The probability of metastatic spread and prognosis, to predict an outcome is based on the following variables:(1) tumour depth (the Breslow thickness); (2) number of mitoses; (3) evidence of tumour regression (presumably due to the host immune response); (4) ulceration of overlying skin; (5) the presence and number of tumour infiltrating lymphocytes; (6) gender; and (7) location (central body or extremity)Since most melanomas initially metastasize to regional lymph nodes, additional prognostic information may be obtained by performing a sentinel lymph node biopsyRobbins Pathology 9e pg: 1150


Question: Linear  band of immunofluorescence (due to immunoglobulin deposition) along the dermo epidermal junction (Ribbon candy pattern) is seen in

Bullous pemphigoid shows Linear band of immunofluorescence (due to immunoglobulin deposition) along the dermo epidermal junction (Ribbon candy pattern).


Question: Heparin acts


Question: Best site for taking biopsy for viral oesophagitis is


Question: Necrotising arterioritis with fibrinoid necrosis is characteristic of

Fibrinoid necrosis is a special form of necrosis, visible by light microscopy , usually in immune reaction in which complexes of antigens and antibodies are deposited in the walls of arteries. The deposited immune complexes together with fibrin that has leaked out of vessels produce a bright pink and amorphous appearance on H & E preparation called fibrinoid.


Question: In apoptosis, cytochrome C acts through

Cytochrome c leaks into the cytosol, where it binds to APAF-1 andactivates caspase-9. Like caspase-8 of the extrinsic pathway, caspase-9 can cleave and activate the executioner caspases. The integrity of the mitochondrial outer membrane is regulated by pro-apoptotic and anti-apoptotic members of the BCL2 family of proteins( Robbins Basic Pathology, 9 th edition)


Question: Most common type of class II mutation in cystic fibrosis is

Ans. D. DeletionClass II mutation : 'Deletion' of phenylalanine amino acid so CFTR protein fails to reach cell membrane


Question: Most common cause of DIC

Ans. (a) Obstetric complications(Ref: Harrison 18th ed/pg 1390)The most common causes are bacterial sepsis, malignant disorders such as solid tumors or acute promyelocytic leukemia, and obstetric causes. DIC is diagnosed in almost one-half of pregnant women with abruptio placentae, or with amniotic fluid embolism


Question: Endodermal sinus tumor is characterised by

Refer Robbins page no 977Also known as endodermal sinus tumor, yolk sac tumor is of interest because it is the most common testicular tumor in infants and children up to 3 years of age. In this age group it has a very good prognosis. In adults the pure form of this tumor is rare; instead, yolk sac elements frequently occur in combination with embryonal carcinoma.


Question: Following injury to a blood vessel, immediate haemostasis is achieved by


Question: Papulovesicular oral Lesions are seen in


Question: Peroneus brevis is inseed into

Peroneus brevis is at the lateral side, whereas, peroneus ter us (anterior leg muscle) inses on the dorsum of base of 5th metatarsal


Question: Most common intraoral site of pigmented nevi is


Question: Serous papillary cystadenocarcinomas of the ovaries express


Question: Pseudopolyposis is seen in

Ulcerative colitis: Isolated islands of regenerating mucosa often bulge into the lumen to create small elevations, termed pseudo polyps. TEXT BOOK OF ROBBINS BASIC PATHOLOGY NINTH EDITION PAGE.590 IMAGE REF:


Question: Histopathological feature of HIV encephalitis is/are

Ans. is 'd' i.e., Microglial nodules Microscopic findings of HIV encephalitis are :? i) Diffuse white matter pallor ii) Perivascular infiltrates of lymphocytes and macrophages iii) Foci of necrosis, gliosis and / or demyelination iv) Microglial nodules, macrophages and multinucleated cells


Question: Widely accepted theory of dental caries


Question: A patient of anemia due to chronic inflammation, the positive finding is

Direct quote from Robbins : ‘Hyperacute rejection occurs when preformed antidonor antibodies are present in the circulation of the recipient’. Such antibodies may be present:

In a recipient who has previously rejected a kidney transplant
Multiparous women who develop anti-HLA antibodies against paternal antigens shed from the fetus may have preformed antibodies to grafts taken from their husbands or children
Prior blood transfusions
In recipients not previously sensitized to transplantation antigens, exposure to the class I and class II HLA antigens of the donor graft may evoke antibodies. The initial target of these antibodies in rejection seems to be the graft vasculature.

Thus, antibody-dependent acute humoral rejection is usually manifested by a vasculitis, sometimes referred to as rejection vasculitis


Question: Oral dyskinesia may be caused by


Question: Capgras syndrome is more common in

Capgras is delusion of double which is found in psychotic stage only


Question: Bell's Palsy is characterized by

Bell's palsy is an abrupt, unilateral, peripheral facial nerve paralysis. It is characterized by drooping of the corners of the mouth, watering of the eye, inability to close or wink the eye, absence of forehead wrinkles on the affected side, mask like expression less face, inability to whistle.

Bilateral involvement of the side of the face


Question: Grossly pigmented liver is seen in .... syndrome


Question: Aschoff's nodules are seen in

Acute rheumatic fever is characterised by discrete inflammatory foci within a variety of tissues. The myocardial inflammatory lessons called Aschoff bodies are pathogenic for rheumatic fever. Rheumatic fever occurs due to beta hemolytic streptococcal infections. Robbins 9 th edition page no. 391


Question: Dental anomaly of teeth associated with defective bone formation is seen in


Question: Hemophilia A is caused due to deficiency of


Question: Syndrome associated with increased risk of leukemia is


Question: The translocation seen in follicular lymphoma is

Follicular lymphoma is a non-Hodgkin's lymphoma. When you havefollicular lymphoma, the sick blood cells can travel to many pas of your body, such as your organs, bone marrow, and lymph nodes (pea-sized glands in your neck, groin, and under your arms that are pa of your immune system Follicular lymphoma is a malignant counterpa to normal germinal B cells, and the majority of patients with this disorder show chromosomaltranslocation t(14;18)(q32;q21), which creates a derivative of chromosome 14 on which the BCL-2 gene is juxtaposed to immunoglobulin heavy-chain gene (IgH) sequence. Refer robbins 9/e


Question: HLA marker of bechet's syndrome


Question: Microalbuminuria is defined as protein level of

The earliest manifestation of diabetes nephropathy is the apparence of low amounts of albumin in the urine (>30mg/day,but <300 mg/day) that is, Microalbuminuria Microalbuminuria is also a marker for greatly increased cardiovascular morbidity and moality for person's with either type 1 or type 2 Refer robbins 8/e p1145


Question: The sensitive period for tetracycline induced discolouration in the permanent maxillary mandibular incisors and canines is

4 months in utero to 3 months postpartum

5 months in utero to 9 months postpartum


Question: Mitochondrial DNA linked disease is

(B) Transmitted by females# mtDNA inheritance is that it is transmitted strictly through the maternal line.> Low levels of paternal transmission of mtDNA have been observed in crosses between mouse species, but not within species41, although further studies showed that this paternal mtDNA was not transmitted to the subsequent generation.> Cytochrome c oxidase deficiency (mitochondrial DNA mutations), Kearns-Sayre syndrome (single, large deletion of mitochondrial DNA), Leber hereditary optic neuropathy (Mutations in four mitochondrial genes, MT-ND1, MT-ND4, MT-ND4L, and MT-ND6), Leigh syndrome (most commonly mutated mitochondrial gene in Leigh syndrome, MT-ATP6) are some of the examples for moitochondrial diseases.


Question: Beefy red and painful tongue is characteristic of


Question: Unconjugated hyperbilirubinemia with increased urobilinogen is seen in


Question: DNA repair defect is associated

Robbins basic pathology 9th edition page no 197, The basis of this disorder is DNA repair such dna damage is prevented by nucleotide excision repair system, and an inherited loss of any one of these can give rise to xeroderma pigmentosum


Question: Bence jones proteins are associated with


Question: . Pseudopolyposis is seen in

isolated islands of regenerating mucosa often bulge into the lumen to create small elevations, termed pseudopolyps TEXT BOOK OF ROBBINS BASIC PATHOLOGY NINTH EDITION PAGE.590


Question: Most important bactericidal agent is

H2O2- MPO- halide system is the most efficient bactericidal system of neutrophils


Question: The action of putrefactive bacteria on necrotic tissue results in

Gangrene Gangrene is necrosis of tissue associated with superadded putrefication, most often following coagulative necrosis due to ischemia.


Question: Marfan disease

In Marfan syndrome, a connective tissue disorder of autosomal dominant inheritance, the basic biochemical abnormality is a mutation affecting fibrillin. Mutations in the FBN1 gene are found in all patients with Marfan syndrome. Clinical features may include tall stature, long fingers, bilateral subluxation of lens, mitral valve prolapse, aoic aneurysm, and aoic dissection (Robbins Basic Pathology,9th edition,pg no. 221)


Question: Antoni type A and type B are seen in


Question: Pappenheimer bodies are

Pappenheimer bodies are Iron deposits in siderocytes. (RBCs).
It is seen in sideroblastic anemia, hemolytic anemia, sickle cell disease.


Question: Condyloma are mostly caused by HPV types

Common wa (verruca vulgaris) common type- 1,2 malignant type- 41 Flat wa (verruca plana) common type- 3, 10 malignant type-41 Anogenital was(condyloma acuminatum) common type- 6, 11 malignant type-30, 45 Bowen's disease.. common type- 16 malignant type-31 Bowenoid papulosis common type-16 malignant type-39, 45 Cervical carcinoma common type-16, 18 malignant type-16, 18, 31, 33 Ref: HARSH MOHAN TEXTBOOK OF PATHOLOGY 6th Ed. Pg no: 772


Question: Stellate Granuloma are seen in

Ans. (a) Cat scratch disease(Ref: Robbins 9th/98)Cat-scratch disease causes rounded or stellate granuloma containing central granular debris and recognizable neutrophils; giant cells


Question: Lung abscess is common following ... pneumonia

Ans. is 'd' i.e., Klebsiella o After pneumonia, absess formation is paicularly common with klebsiella and type 3 pneumococci infection.


Question: Edema in nephrotic syndrome is due to aEUR'

Hypoalbuminemia Edema is one of the major clinical manifestations of nephritic syndrome. Two major factors have been thought to be responsible for this problem and it is likely that both contribute to a variable decree in individual patients. i) Low colloid oncotic pressure :? - In nephrotic syndrome the initial event is a derangement in the capillary walls of glomeruli resulting in increased permeability to plasma proteins. - The increased permeability allows protein to escape from plasma to glomerular filtrate. Long standing loss of protein leads to hypoalbuntinemia. - The loss of protein (albumin) leads to reduced colloid oncotic pressure. Fluids are held in the intravascular compament because of the colloid oncotic pressure. When the colloid oncotic pressure is reduced the fluid cannot be retained in the intravascular compament and moves out in the interstitial fluid producing edema. ii)Sodium retention directly induced by renal disease.


Question: Hirschsprung's disease is

Is seen more frequently in children with Down's syndrome than in the general population. polygenic inheritance, male>female. Increase in sympathetic activity is due to absence of parasympathetic ganglions in the plexi of Auerbach and Meissner.

Is inherited in an Autosomal recessive fashion

Is due to unopposed parasympathetic activity in the affected segment of the bowel

Has an equal incidence in girls and boys


Question: Immature bony trabeculae are found in


Question: In renal cell cancer gene involved in mutation

(A) (VHL) (953-Robbins pathologic Basis of disease) (681- Harsh mohan 7th)* VHL, MET geneRenal cell carcinoma* WTI gene (1 lpl3)Wllm's tumour* NFI and NF2 geneNeurofibromatosis* BRC1 and BRCA 2 geneBreast cancers* BRCA 1i. BRCA-1 is located on chromosome 17q21ii. BECA -2 is located on chromosome 13q 12Breast cancer (85%) and ovarion cancer 40%)* P53 gene (TP53)(pretector of the genome)Carcinoma of the lung, head and neck, colon and breastMutated p 53 is also seen in the sequential development stages of cancer from hyperplasia to carcinoma in situ and into invasive carcinomaThe normal p53 gene (wild type) functions as a tumor suppressor gene * and functions as a critical gatekeeper against the development of cancer (Molecular policeman/Guardian of the genome)RB- geneRetinoblastoma, osteosarcoman MYC- HSRNeuroblastomaOver expression of BCL-2 proteinsFollicular LymphomaBCR-ABL hybrid geneCML and some ALL* The most common gene defect in idiopathic steroid resistant nephritic syndrome is NPHS1, NPUS 2* Finish of nephritic syndrome is caused by defect in Nephrin proteinTUMOR MARKERSEpithelial cell carcinomaCytokeratinLymphoid cell carcinomaCD45MelanomaSI00, HMB45Mesenchymal markersVimantineNeuroendocrine markersChromagranin, Neuron specific enolaseGastro intestinal stromal tumors (GIST)CDl 17Granulosa cell tumorInhibinEwing's sarcomaCD. 99* c ANCA is typical of wegner's granulomatosis * *** p ANCA is found in most cases of Microscopic polyangitis and churg- straus syndrome**


Question: Good pasture's syndrome is characterized by

Necrotizing hemorrhagic interstitial pneumonitis


Question: Otospongiosis causes

B/L mixed conductive and sensorineural deafness


Question: Not seen in the inflammatory stage of wound healing

Ans. (a) Angiogenesis(Ref: Robbins 9th/pg 103; 8th/pg 101)Three phases of wound healing:Inflammation (early & late)- option b, c, dGranulation tissue formation & re-epithelialization- option aWound contraction, ECM deposition & remodeling


Question: Best treatment of endometriosis in a young girl is


Question: Down syndrome is

Aneuploidy is the presence of an abnormal number of chromosomes in a cell, for example a human cell having 45 or 47 chromosomes instead of the usual 46


Question: Largest number of bone marrow cells are

Ans. is 'b' i.e., Metamyelocytes o In bone marrow myeloid to erythroid ratio is 3 : 1 or 4 : 1. o Amongst the myeloid series metamyelocytes are maximum.


Question: Reticulocytes are stained with

Reticulocytes are stained in living state in vitro so staining with dyes like brilliant cresyl blue and new methylene blue is referred to as supravital staining.


Question: Most important amino acid for formation Neutrophilic extracellular trap (NET) is

Conversion of arginine residues to Citrulline in the histones is an essential step in the formation of neutrophill extracillular traps.


Question: Process of migration of leukocytes through the endothelium is through

The next step in the process of leukocyte recruitment is migration of the leukocytes through the endothelium, called transmigration or diapedesis. Transmigration of leukocytes occurs mainly in post-capillary venules. Chemokines act on the adherent leukocytes and stimulate the cells to migrate through interendothelial spaces toward the chemical concentration gradient, that is, toward the site of injury or infection where the chemokines are being produced. REF: ROBBINS pathology 10th edition


Question: The given cell is activated by

TH2 cells secrete IL-4, IL-5, and IL-13, which recruit and activate eosinophils and are responsible for the alternative pathway of macrophage activationReference: Robbins and Cotran Pathologic Basis of Disease; 9th edition; Chapter 3; Inflammation and Repair


Question: The following antihelmintic acts by producing flaccid paralysis of the worm

Anti-helminthic drugsAnti-helminthicMechanism of actionParasites susceptibleMebendazole Inhibits polymerization of b-tubulin of susceptible worms - live worms expelled Roundworm, Hookworm, Whipworm, Pinworm, Trichinella spiralis Pyrantel palmate Inhibits cholinesterase in worms - persistent depolarization - spastic paralysis - live worms expelledAscaris , Enterobius , Ancylostoma , Strongyloides Piperazine Hyperpolarization of muscle by GABA agonistic action - flaccid paralysis - live worms expelledAscaris , Enterobius Ivermectin Potentiates glutamate-gated Cl- channel & increases GABA transmission in worms - hyperpolarization and paralysis of worms - dead worms expelledPediculosis , Scabies , Onchocerca , Strongyloides , Ascaris , Cutaneous larva migrans Praziquantel Increased muscular contraction & spastic paralysis of worms - dead worms expelledTrematode , Cestodes Levamisole &Tetramisole Ganglionic stimulation - tonic paralysis - live worms expelledAscaris , Ancylostoma , Strongyloides Diethyl carbamazepine Hyperpolarization of muscles - live worms expelledMicrofilaria of bancrofti , malayi , loa loa , Onchocerca Niclosamide Inhibits oxidative Phosphorylation in mitochondria Cestodes


Question: Pyogenic infection and brain infarction are associated with

Liquefaction necrosis is commonly due to ischemic injury or bacterial and fungal infections but hydrolytic enzymes in the tissues degradation have a dominant role in causing semi-fluid material. Common examples are infracted brain and abscess cavity.Harshmohan textbook of pathology 7th edition.


Question: Spot the diagnosis

Ref: Harsh Mohan, Textbook of Pathology, 7th ed. pg. 236The image shows basophilic stippling of red blood cells. The causes are:Mnemonic: LUNATIC* Lead poisoning* Unstable hemoglobin* Nucleotidase deficiency* Anemia due to B12 deficiency* Thalassemia* Infections* CirrhosisThe closest answer Pappenheimer bodies are basophilic erythrocytic inclusions that are usually located at the I periphery of the cell. They contain iron and stain with Prussian blue. Prussian blue is the stain that is used to identify that these Pappenheimer bodies are pure iron deposits, and not heme as in Heinz bodies.


Question: Lupus erythematosus is


Question: The procedure contraindicated in diabetics

Cone bearing(prosthesis possible)End bearing(where limb fitting facilities are limited)Below knee (stump= 8cm preferably 10-12 cm below knee) Above knee (stump = 20 cm above knee) Gritti stokes (transcondylar at lower femur) Through kneeSyme's (tibia and fibula are sectioned above the ankle joint preserving blood supply to calcaneus) (Refer: Schwaz's Prinicples of Surgery, 9th edition, pg no: 3300-3303)


Question: Initial investigation for obstructive jaundice

Obstructive jaundiceObstructive jaundice is a paicular type of jaundice and occurs when the essential flow of bile to the intestine is blocked and remains in the bloodstream.Causes of Obstructive jaundice Due to blocked bile ducts caused by Swelling of Clinical featuresDiagnosisTreatmentSymptoms of obstructive jaundice include yellowing of the skin and whites of the eyes; paler stools and darker urine; and intense itching. Other symptoms vary, depending on the underlying cause of the obstruction although you may also feel tired.Blood tests to examine the level of Ultrasound the liver and bile ducts to find out the exact cause of the obstruction Surgical resection (Refer: Sabiston's Textbook of Surgery, 19th edition, pg no: 1535-1544)


Question: CD marker specific for myeloid series aEUR'

CD 117 Immunoloyical markers commonly used to detect myeloid lineage: - CD13Q CD33Q CD10Q CDI5Q CD4Q CD117Q cMPO (Lineage specific) "In the myeloid lineage the most useful antigens for recognizing myeloblasts include CD13, CD33, CD117 and cMPO. - Other antigens such as I/b and CD16 are less useful because their expressions vary highly among the AML's and they may appear or disappear at relapse and therefore may not be useful for follow up purpose."- (Flow cytometry in hematopathology by Doyen Nguyen MD Lawrence W. Diamond., MD, Raul C. Bryaland). Immunological markers commonly used in classification of Acute leukemia


Question: Cell surface molecules involved in peripheral tolerance induction are

Immunological tolerance in peripheral lymphoid organs is called as peripheral tolerance. It requires signal to (interaction between CD28 and B7). CD28 molecules (co-stimulatory molecule) bind to their ligands-CD80 (B7-l) and/or CD86 (B7-2) and activates T-cell. If the antigen presented by cell do not bear CD28 ligand, a negative signal is delivered and cell become tolerant and anergic.


Question: Shelf life of blood with CPDA

Ans. is 'c' i.e., 5 weeks Once blood is removed from the donor, it stas a sequences of in vitro changes that change its physiological propeies. Ensuring the blood and its products transfusion safe, their storage is a must. The main aim is to minimize damage to store blood. Addition of some additive solutions increases the bility of blood, paicularly RBCs: Additive Shelf life of RBC Acid-citrate-dextrose (ACD) 21 days Citrate phosphate dextrose (CPD) 21 days Citrate phosphate dextrose-adenine (CPD-A) 35 days Saline-adenine-Glucose-Mannitol (SAG-M) 42 days


Question: Schaumann bodies are seen in


Question: Osteogenesis imperfect defect in

harshmohan textbook of pathology 7th edition. *osteogenesis imperfecta is an autosomal dominant or recessive disorder of synthesizing type1 collagen that constitutes 90 to 95 % bone matrix Osteogenesis Imperfecta Osteogenesis imperfecta (OI), also known as "brittle bone disease," is actually a group of genetic disorders caused by defec- tive synthesis of type I collagen. Because type I collagen is a major component of extracellular matrix in other pas of the body, there are also numerous extraskeletal manifesta- tions (affecting skin, joints, teeth, and eyes, for example). The mutations underlying OI characteristically involve the coding sequences for a1 or a2 chains of type I collagen. Because collagen synthesis and extracellular expo require formation of a complete and intact triple helix, any primary defect in a collagen chain tends to disrupt the entire structure and results in its premature degradation (an example of a dominant negative mutation) (Chapter 6). As a consequence, most defects manifest as autosomal domi- nant disorders and may be associated with severe malformations. There is, however, a broad spectrum of severity, and mutations that result in qualitatively normal collagen but at only reduced levels generally have milder manifestations. The fundamental abnormality in all forms of OI is too little bone, resulting in extreme skeletal fragility. Four major sub- types are recognized. The type II variant is uniformly fatal in utero or immediately postpaum as a consequence of multiple fractures that occur before bih. By contrast, patients with type I OI have a normal lifespan, with only a modestly increased proclivity for fractures during child- hood (decreasing in frequency after pubey). The classic finding of blue sclerae in type I OI is attributable to decreased scleral collagen content; this deficit causes a relative trans- parency that allows the underlying choroid to be seen. Hearing loss can be related to conduction defects in the middle and inner ear bones, and small misshapen teeth are a result of dentin deficiency. Ref Robbins 9/e p767


Question: Medial calcification is seen in

Monckeberg medial sclerosis is characterized by the presence of calcific deposits in muscular aeries, typically in persons older than 50. The lesions do not encroach on the vessel lumen and usually are not clinically significant. ( Robbins Basic Pathology, 9 th edition, page 335)


Question: Amyloidosis mostly affects

Hea. Amyloidosis of the hea may occur either as iso- lated organ involvement or as pa of a systemic distribution. When accompanied by systemic involvement, it is usually of the AL form. The isolated form (senile amyloidosis) usually is confined to older persons. The deposits may not be evident on gross examination, or they may cause minimal to moder- ate cardiac enlargement. The most characteristic gross find- ings are gray-pink, dewdrop-like subendocardial elevations, paicularly evident in the atrial chambers. On histologic examination, deposits typically are found throughout the myocardium, beginning between myocardial fibers and eventually causing their pressure atrophy Ref Robbins 9/e pg 157


Question: Not a family of selectin


Question: Characteristic feature of Goodpasture's syndrome

Ans. (b) Serum antibodies against alpha 3 NC1 domain of collagen - IV(Ref: Robbins 9th/pg 912-913)Goodpasture syndromeIt is type 1 RPGN & a type II hypersensitivity reaction.It is characterized by serum antibodies against alpha 3 NC1 domain of collagen - IV.This shows linear GBM fluorescence, while all other Glomerulonephritis, which are type 3 Hypersensitivity reactions show granular immune deposits.

Lumpy-bumpy deposits on immunofluorescence

Serum antibodies against alpha 1 NCI domain of collagen III


Question: Lipid in tissue is detected by


Question: Primary pleural tumor is

Ref:Textbook of pathology (Harsh mohan) 6th edition,page no.505 TUMOURS OF PLEURA Pleural tumours may be primary or secondary. In line with pulmonary tumours, the secondary tumours in the pleura are more common. The only impoant primary tumour of pleura is mesothelioma. MESOTHELIOMA Mesothelioma is an uncommon tumour arising from mesothelial lining of serous cavities, most often in pleural cavity, and rarely in peritoneal cavity and pericardial sac. Mesotheliomas are of 2 types--benign (solitary) and malignant (diffuse). The biologic behaviour of pleural mesotheliomas is usually predicted by their gross appearance--those forming solitary, discrete masses are generally benign, whereas those which grow diffusely are usually malignant.


Question: Basophilic stippling is seen with

i.e. (Thalassaemia) : (292-Harsh mohan 6th) (658-H17th/6th)Punctate basophilia or basophilic stippling is diffuse and uniform basophilic granularity in the cell which does not stain positively with Perl's reaction (in contrast to pappenhamer bodies which stain positively)Examples -* Aplastic anaemia* Thalassaemia* Myelodysplasia* Infections* Lead poisoning* Howell -Jolly bodies - present in Megaloblastic anemia and after splenectomy* Basophilic leucocytosis indicative of CML**PYRIMIDINE 5' - NUCLEOTIDASE (PSN) DEFICIENCY - Highly distinctive feature of this condition is a morphological abnormality of the red cells known as basophilic stippling. This condition is rare but it probably ranks third in frequency among red cell enzyme defects (after G6PD deficiency and pyruvate Kinase deficiency) (658-H17th)


Question: Failure of clot retraction indicates

Ans. (a) Low platelet count(Ref: Robbins 9th/pg 657)This test measures the amount of time it takes for a blood clot to pull away from the walls of a test tube (Shrinking).The edges of the blood vessel wall at the point of injury are slowly brought together again to repair the damage.It is used to evaluate and manage blood platelet disorders, including Glanzmann's thrombastheniaSo Clot retraction depends primarily on the number and activity of the blood platelets


Question: HLA B 27 is not seen in

Major histocompatibility complex:*Required for recognition of antigens by T cells*Encoded by genes located on chromosome 6. The genes encoding MHC is categorized into 3 classes.*Class I contains three loci namely A, B and C. Class II contains 3 loci namely DP, DQ and DR. Class III contains genes that produce complement proteins and TNF. *Class I MHC: Expressed on all nucleated cells and platelets. The receptor comprised of 4 molecules - 3 alpha and 1 beta2 microglobulin. Peptide binding cleft is formed by alpha1 and alpha 2 which display viral (exogenous) antigens. Present in CD 4 positive T lymphocytes.*Class II MHC: Expressed on antigen presenting cells( macrophages, B lymphocytes, and dendritic cells) and on CD8 positive T lymphocytes. The receptor comprised of two alpha and 2 beta domains. Peptide binding cleft is formed by alpha 1 and beta 1 domains which display endogenous antigens. Present in CD8 positive T cells.*HLA -B27 is a class I MHC molecule which is present in all nucleated cells, hence B cells and T cells are excluded.Inflammatory diseases associated with HLA B27 are ankylosing spondylitis, Reactive ahritis, Juvenile rheumatoid ahritis and acute anterior uveitis. (Ref: Robbins 8/e p190-193)


Question: Earliest manifestation of megaloblastic anaemia is

What Are the Symptoms of Megaloblastic Anemia? shoness of breath. muscle weakness. abnormal paleness of the skin. glossitis (swollen tongue) loss of appetite/weight loss. diarrhea. nausea. fast heabeat MORPHOLOGY Ceain morphologic features are common to all forms of megaloblastic anemia. The bone marrow is markedly hyper- cellular and contains numerous megaloblastic erythroid pro- genitors. Megaloblasts are larger than normal erythroid progenitors (normoblasts) and have delicate, finely reticu- lated nuclear chromatin (indicative of nuclear immaturity) (Fig. 11-11). As megaloblasts differentiate and acquire hemo- globin, the nucleus retains its finely distributed chromatin and fails to undergo the chromatin clumping typical of normo- blasts. The granulocytic precursors also demonstrate nuclear- cytoplasmic asynchrony, yielding giant metamyelocytes. Megakaryocytes may also be abnormally large and have bizarre multilobed nuclei. In the peripheral blood the earliest change is the appear- ance of hypersegmented neutrophils, which appear before the onset of anemia. Normal neutrophils have three or four nuclear lobes, but in megaloblastic anemias they often have five or more. The red cells typically include large, egg- shaped macro-ovalocytes; the mean cell volume often is greater than 110 fL (normal, 82 to 92 fL). Although macro- cytes appear hyperchromic, in reality the mean cell hemoglo- bin concentration is normal. Large, misshapen platelets also may be seen. Morphologic changes in other systems, espe- cially the gastrointestinal tract, also occur, giving rise to some of the clinical manifestations. Refer robbins 9/e pg 422


Question: Normal transferrin is saturated with iron

In normal individuals transferrin is about 1/3 rd saturated with iron , which is roughly near 35%. Ref :Robbins Pathologic basis of disease, pg :649


Question: Major Apthous ulcers are seen in

SYSTEMIC DISEASES IN WHICH APHTHOUS ULCERS ARE SEEN


Question: The developmental Odontogenic cyst is

Histologic Classification of Odontogenic CystsInflammatoryDevelopmentalPeriapical cystResidual cystParadental cystDentigerous cystOdontogenic keratocystGingival cyst of newbornGingival cyst of adultEruption cystLateral periodontal cystGlandular odontogenic cystCalcifying epithelial odontogenic cyst (Gorlin cyst)Ref: Robbins and Cotran Pathologic Basis of Disease; 9th edition; Chapter 16; Head and Neck; Change 734


Question: Cellular content of DNA is doubled in


Question: Immunohistochemistry marker of histiocytosis X


Question: Bleeding manifestation of Hemophilia is

(B) Hemarthrosis[?]Hemophilia is an X linked disorder of coagulation caused by the deficiency in a circulating plasma protein.oHemophilia A is caused by the deficiency of factor VIII, and hemophilia B is caused by the deficiency of factor IX.oIt is PTT which is affected (increased) and not PT (unaffected).oFactor VIII is involved in the intrinsic pathway which is measured by PTT and not in extrinsic pathway which is measured as PT.oBleeding is the common manifestation of hemophilia and the common bleeding manifestations are Hemarthoses, Hematomas, Mucocutaneous bleeding, Intracranial bleeding, Hematuria and Pseudotumor.i|SITES OF BLEEDINGSeriousLife-threatening* Joints (Hemarthrosis)* Central Nervous System (CNS)* Muscle/soft tissue* Gastrointestinal (GI)* Mouth/gums/nose* Neck/throat* Hematuria* Severe trauma [?]Clinical Manifestations: HemarthrosisoPathophysiology:-Bleeding probably starts from synovial vessels into the synovial space.-Re-absorption of this blood is often incomplete leading to chronic proliferative synovitis, where the synovium is more thickened & vascular, creating a 'target joint' with recurrence of bleeding.-There is destruction of surrounding structures as well-bone necrosis & cyst formations, osteophytes.-Terminal stage: Chronic Hemophiliac arthropathy: Fibrous or bony ankylosing of the joint.oDefects of secondary hemostasis (coagulation factor defects) often present with bleeds into soft tissues (e.g., muscle) or joints. Bleeding into joints (hemarthrosis) following minor trauma is particularly characteristic of hemophilia.oIt is unknown why severe defects in secondary hemostasis present with this peculiar pattern of bleeding; as with severe platelet defects, intracranial hemorrhage, sometimes fatal, may also occur.Other Options[?]Hemoptysis:-Diseases causing repeated haemoptysis include carcinoma, bronchiectasis, carcinoid tumours and some infections.-Severe mitral stenosis is now a rare cause. Patients with repeated haemoptysis should be investigated, at the very least by chest radiography and bronchoscopy.-Haemoptysis following trauma may be from a lung contusion or injury to a major airway. Treatment depends on the underlying cause.[?]Hematomas:-If large, painful or causing neural deficit, a haematoma may require release by incision or aspiration.-In the gluteal or thigh region, there may be an associated disruption of fat in the form of a fat fracture, which results in an unsightly groove but intact skin.-An untreated haematoma may also calcify and therefore require surgical exploration if symptomatic.[?]Hematuria:-Blood in the urine (haematuria) may be the only indication of cancer and other pathology in the urinary tract.-Microscopic haematuria may be detected by dipstick testing in a routine health check. A substantial haemorrhage imparts a red or brownish tinge to the urine (macroscopic haematuria) and the patient may pass clots.


Question: The earliest feature of tuberculosis is

• Macrophages are the primary cells infected by M. tuberculosis. Early in infection, tuberculosis bacilli replicate essentially unchecked, while later in infection, the cell response stimulates macrophages to contain the proliferation of the bacteria.
• About 3 weeks after infection, a T-helper 1 (TH1) response is mounted that activates macrophages to become bactericidal.
• The TH1 response orchestrates the formation of granulomas and caseous necrosis. Macrophages activated by IFN-γ
differentiate into the “epithelioid histiocytes” that characterize the granulomatous response, and may fuse to form giant cells.


Question: Thromboangitis obliterans is associated with

HLA A9 and HLA B5 is associated with increased risk of Thromboangitis obliterans (TAO) HLA-B12 is protective against TAO.


Question: The Finnish type of congenital nephrotic syndrome occurs due to gene mutations affecting the following protein

The first relevant gene to be identified, NPHS1, maps to chromosome 19q13 and encodes the protein nephrin. 'Nephrin' is a key component of the slit diaphragm, the zipper like structure between podocyte foot process that might control glomerular permeability. several mutations of NHPS1 gene have been identified that give rise to congenital nephrotic syndrome of FINNISH TYPE, producing a minimal change disease-like glomerulonephropathy with extensive foot process effacement. Ref: Pathologic basis of disease Robbins 8th edition, pg no:927


Question: Commonest salivary gland tumour in children


Question: In cleft lip surgery rule of 10 says

10 weeks of age, having 10 dL/mg Hb and weight 10 pounds

10 weeks of age, having 10 dL/mg Hb and weight 10 kgs

10 months of age, having 10 dL/mg Hb and weight 10 pounds

10 months of age, having 10 dL/mg Hb and weight 10 kgs


Question: The earliest manifestation of megaloblastic anemia is

Peripheral blood pictureBone marrow picture1.Macrocytosis (| MCV, MCH. Normal MCHC)2.Peripheral smearMacroovalocytes Few nucleated RBCsEvidence of dyserythropoiesis like--Basophilic stippling-Cabot ring-Howell- Jolly bodies3.| Hb4.| Hematocrit 5.Reticulocyte count - Normal or mild decrease6.White cells- Leucopenia7.Hypersegmented neutrophils/ Macropolycytes- First manifestation 8.| Platelets9.Pancytopenia (10-20%)Lab investigations:10.Serum iron, ferritin - | in pure VitB12/ Folate defect11.Serum bilirubin & LDH |- due to hemolytic component12.Schillings test: Used to assess status of intrinsic factor (IF) & Vit B12 to distinguish pernicious anemia from other causes of Vit.B12 deficiency.1.Moderate- marked hypercellularity2.Erythroid hyperplasia3.M:E ratio reversal4.Ehropoiesis- Megaloblastic5.Giant metamyelocytes6.Mildly reduced megakaryocytes7.BM iron moderately increased in pure Vit B12/ Folate defects.(Ref: Harrison 18/e p866, 17/e p645-646, Tejinder Singh 2/e p54-61)


Question: Alma Ata conference was held in

The Declaration of Alma Act, 1978 stated that primary health care includes at leastEducation about health problems and methods of preventing and controlling themPromotion of food supply and nutritionAdequate supply of safe water and sanitationImmunizationPrevention and control of endemic diseasesAppropriate treatment of common diseases and injuriesProvision of essential drugs(Refer: K. Park's Textbook of Preventive and Social Medicine, 24th edition, pg no:928)


Question: Nuclear bag fiber detects


Question: Increase in MCHC is associated with

Ans is 'd' i.e. Hereditary spherocystosis Mean cell hemoglobin concentration (MCHC) is the average concentration of hemoglobin in a given volume of packed red blood cells, expressed in grams per deciliter. Normal value is 33-37 gm/dlMCHC is increased in hereditary spherocytosis, not because of increased hemoglobin, but due to decerase volume of spherocytes.MCHC is decreased in microcytic hypochromic anemia(iron deficiency anemia & anemia of chronic disease).MCHC remains normal in megaloblastic anemia.


Question: Fibrin is degraded by

Clotting also sets into motion a fibrinolytic cascade that moderates the ultimate size of the clot. Fibrinolysis is largely carried out by plasmin, which breaks down fibrin and interferes with its polymerization. The resulting fibrin split products (FSPs or fibrin degradation products) also can act as weak anticoagulants.
Elevated levels of FSPs (most notably fibrin-derived D-dimers) can be used for diagnosing abnormal thrombotic states including disseminated intravascular coagulation (DIC), deep venous thrombosis, or pulmonary thromboembolism.
Plasmin is generated by proteolysis of plasminogen, an inactive plasma precursor, either by factor XII or by plasminogen activators. The most important of the plasminogen activators is tissue-type plasminogen activator (t-PA); t-PA is synthesized principally by endothelial cells and is most active when attached to fibrin.


Question: A characteristic histologic feature of class IV lupus nephritis is

The glomerular diseases of patients with systemic lupus erythematosus (SLE) are many and include mesangial lupus glomerulonephritis (GN), focal or diffuse proliferative GN, and membranous GN. The World Health Organization (WHO) classifies SLE renal disease into five classes as follows: class I = no changes; class II = mesangial GN; class III = focal proliferative GN; class IV = diffuse proliferative GN (the most common class); class V = diffuse membranous GN. All of these glomerular diseases are the result of the deposition of immune complexes (DNA-anti-DNA complexes) that may be in a mesangial, intramembranous, subepithelial, or subendothelial location. In membranous lupus GN, the deposits are in a subepithelial location, while in diffuse proliferative lupus GN (WHO class IV) the deposits are mainly in a subendothelial location and produce a characteristic "wire-loop" appearance due to thickening of the capillary wall. None of these changes are specific for lupus In contrast to the "wire-loop" appearance of the glomerular capillaries with lupus nephritis, "holly leaf" mesangial deposits are seen with focal segmental GN (IgA deposits suggests Berger disease), "spike and dome" appearance of the basement membrane is seen with membranous glomerulonephropathy, a "string of popcorn" immunofluorescence pattern is also seen with membranous glomerulonephropathy, and "tram-track" splitting of the basement membrane is seen with both types of membranoproliferative GN. Reference: Robbins & Cotran Pathologic Basis of Disease, 9edition

"Spike and dome" appearance of the basement membrane

"Wire-loop" appearance of the glomerular capillaries

"Tram-track" splitting of the basement membrane


Question: Highest refractory of index is at


Question: Conjugated hyperbilirubinemia is seen in


Question: 'Row of tombstones ' appearance is seen in

Ans. is 'b' i.e., Pemphigus o The Suprabasal acantholytic blister is characteristic of pemphigus vulgaris. The single layer of intact basal cells that forms the blister base has been likened to a row of tombstones.


Question: Brown tumor is seen in

Primary hyperparathyroidism is a disease characterized by excessive secretion of parathormone which results in increased osteoclastic activity therby causing bone loss . The bone loss predisoses to microfractures and secondary hemorrhages that elicit an influx of macrophages and an ingrowth of reparative fibrous tissue, creating a mass of reactive tissue known as brown tumor . Ref: Robbins and cotrans 9e Pg 1102


Question: Causative agent of Infectious mononucleosis

Solution

Epstein - Barr virus (EBV) causes infectious mononucleosis
EBV nfect B lymphocytes by binding to CD21 (CR2) receptor


Question: Neuroleptic malignant syndrome is characterized by

Features of Neuroleptic malignant syndrome Increased body temperature >38degC (>100.4degF), orConfused or altered consciousnessDiaphoresis "sweat shock"Rigid musclesAutonomic imbalanceLabile hypeension Metabolic acidosis (Refer: Kaplan and Saddock's Synopsis of Psychiatry, 10th edition, pg no: 995)


Question: The cytogenetics of chromophilic renal cell carcinoma is characterized by

Chromophilic renal cell carcinoma is a distinct type of human renal cancer, only recently recognized and defined by its characteristic histomorphological aspect and cytogenetic aberrations. Immunohistochemistry revealed coexpression of vimentin and cytokeratins in all cell lines the cytokeratin polypeptide patterns, however, varying between the different cell lines. Chromphi-1 tumour cells produced slowly growing tumors in nude mice using the subrenal capsule assay. In all cell lines, the cytogenetic analysis revealed numerical chromosomal aberrations known to be characteristic for chromophilic RCCs, i.e. loss of the Y chromosome, tri- or tetrasomy of chromosomes 7 and 17 as well as various combinations of additional structural and numerical chromosomal aberrations. Ref: Wikipedia


Question: Misfolded amyloid deposition in brain is seen in

Answer- B. Alzheimer's diseaseA Beta protein precursor (A Beta PP)-Alzheimer's disease


Question: The most common prescription medication for sialorrhea

Traditional medications for the treatment of drooling target the reduction of saliva production using anticholin- ergic mechanisms. While they will reduce salivary output, they do not treat the underlying neuromuscular problems, so some patients may find the anticholinergic side effects out - weigh the benefit of the drug. Additionally, the drying effect these medications have can lead to xerostomia, especially if the patient has a constant open mouth. Glycopyrrolate is the most common prescription medication for sialorrhea and drooling , with atropine sulfate, scopolamine, amitriptyline, and benztropine also being reported in the literature. OnabotulinumtoxinA (Botox ) injections into salivary glands with ultrasonic guidance have shown to be of some benefit in patients who have failed or are intolerant to anticholinergics


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

Kaposi sarcoma (KS) is a vascular neoplasm caused by Kaposi sarcoma herpesvirus (KSHV, also known as human herpesvirus- 8, or HHV-8). Although it occurs in a number of contexts, it is by far most common in patients with AIDS; indeed, its presence is used as a criterion for the diagnosis. (Robbins basic pathology,9th edition,pg no.360)


Question: Arbiskov cells are seen in

An Arbiskov cell is a modified monocytemostly found in myeloblastomas.


Question: Earliest response to iron in iron deficiency anemia is denoted by

Response to iron therapy:

Rapid subjective improvement, with disappearance (or) marked dimination of fatigue, lassitude, and other nonspecific symptoms before any improvement in anemia is observed.
Earliest heamotologic evidence of response to treatement is an increase in reticulocytes % G and Hb content.
Maximal reticulocytes % is on 5th to 10th day after institution of therapy and thereafter returns to normal.
Maximum value usually ranges from 5 to 10 % and is inversly related to the level of heamoglobin.
Heamoglobin level is the most accurate measure of the degree of anemia in iron deficiency.


Question: The inheritance pattern of familial retinoblastoma

In hereditary retinoblastoma, mutations in the RB1 gene appear to be inherited in an autosomal dominant pattern. Autosomal dominant inheritance means that one copy of the altered gene in each cell is sufficient to increase the risk of cancer. Refer robbins 1339


Question: Mucooceles are rarely seen in the


Question: Clinical evidence of dentinogenesis imperfecta is

Defective dentine and obliterated pulp chamber


Question: chemotaxis in response to activation of cells results in

Chemotaxis :-After extravasating from the blood, leukocytes move toward sites of infection or injury along a chemical gradient. It is unidirectional or targeted movement of the leukocytes towards antigens/ bacteria. Both exogenous and endogenous substances can be chemotactic for leukocytes, including the following: Exogenous Bacterial products, paicularly peptides with N-formylmethionine termini Endogenous Cytokines, especially those of the chemokine family Components of the complement system, paicularly C5 Products of the lipoxygenase pathway of arachidonic acid (AA) metabolism, paicularly leukotriene B4 (LTB4) ref:- basic pathology, Robbins 9th ed, page 36

Augmeted oxygen dependent bactericidal effect


Question: Alcoholic hyaline, in alcoholic liver disease is composed of

mallory body or hyaline degeneration consist of dense eosinophilic ropey cytoplasmic inclusion body GENERAL AND SYSTEMIC PATHOLOGY RAMDAS NAYAK PGNO.449 IMAGE REF:


Question: Acantholysis means

Answer is option 2, loss of intercellular connections We performed scanning electron microscopy of an inveed blister roof in a case of pemphigus foliaceus. The loss of intercellular adherence could be easily seen with low magnification. The acantholytic keratinocytes displayed an irregular and sometimes polygonal contour. Round cells, typically seen in light microscopy, were also observed. The examination of a blister roof allows ultrastructural documentation of the acantholytic changes.


Question: Arecanut chewing is aetiological factor in


Question: Dyskeratosis means

Abnormal,premature keratinization within cells  below the stratum granulosum-Dyskeratosis.
Discontinuity of the  skin showing incomplete loss of epidermis-Erosion.
Thickening of stratum corneum, often associated with a qualitative abnormality of keratin-Hyperkeratosis.
Keratinization with retained nuclei in the stratum corneum.-Parakeratosis.


Question: Exfoliative cytology is indicated in

Heavily keratinized lesions of oral cavity


Question: The most likely cause of bihilar lymphadenopathy is

Sarcoidosis Chronic multisystem disorder of unknown cause characterized by accumulation of TH 1 lymphocytes and mononuclear phagocyte in various tissuesof body.Non-caseating sarcoid Granuloma in affected organsLungs (90%)Lymph nodesSkinOthersInterstitial lung disease (fibrosis of lung parenchyma)Pleura is involved, in 1-5% cases unilateral pleural effusion Cavitation is rare B/L hilar lymphadenopathy is the hallmark of Sarcoidosis B/L parotid enlargement Erythema nodosum Lupus pernio (purple blue shiny swollen lesion on nose, cheeks, lips, ears)UveitisRenal hypercalcemia with or without hypercalciuriaAhritisPeripheral neuropathyCor-pulmonale(Refer: Harrison's Principles of Internal Medicine, 18th edition, pg no: 2805-2813)


Question:
Ability of stem cells to cross barrier of differentiation to transform into a cell of another lineage expressing the molecular characteristics of different cell type with the ability to perform the function of the new cell type is
referred as

Stem cell is defined as a cell with a unique capacity to produce unaltered daughter cells (self-renewal) and to generate specialized cell types (potency).
The prevailing paradigm in developmental biology is that once cells are differentiated, their phenotypes are stable. However, tissue stem cells, which are thought to be lineage-committed multipotent cells, possess the capacity to differentiate into cell types outside their lineage restrictions (called trans-differentiation or stem cell plasticity). For example, hematopoietic stem cells may be converted into neurons as well as germ cells.


Question: Lipid peroxidation in cells exposed to ionizing radiation is initiated by

Radiolysis of water leads to formation of hydroxyl radicals that initiate lipid peroxidation of membrane phospholipids.


Question: Giant cell tumor is seen at

Giant cell tumour also known as osteoclastoma usually orginate from epiphysis of long bones close to aicular cailage. Most common site of involvement are lower end of femur and upper end of tibia. Clinical features include noticeable swelling and pathological fracture. Soap bubble appearance is seen in it. Reference..Harsh mohan textbook of pathology The muskuloskeletal system ref img


Question: Antinuclear antibody specific for SLE is

Systemic lupus erythematosus (SLE) is a multisystem autoimmunedisease of protean manifestations and variableclinical behavior. Clinically, it is an unpredictable, remittingand relapsing disease of acute or insidious onset thatmay involve viually any organ in the body; however, itaffects principally the skin, kidneys, serosal membranes,joints, and hea.Antibodies to doublestranded DNA (dsDNA) and the so-called Smith (Sm) antigen can be detected by ELISA or multiplex flow methods and are specific for SLE.Robbins Basic pathology,9th edition,pg no.127


Question: Raw beefy tongue is seen in deficiency of


Question: Last organ to putrefy after death is


Question: Verrucuous carcinoma is

Verrucous carcinoma (also known as Ackerman tumor) is an uncommon exophytic low-grade well-differentiated variant of squamous cell carcinoma. This neoplasm typically involves the oral cavity, larynx, genitalia, skin, and esophagus Refer robbins 9/e

Extremely well differentiated squamous cell carcinoma

Poorly differentiated squamous cell carcinoma


Question: The following feature is not common in 22q 11.2 deletion syndrome

Ans. (a) Mental retardation(Ref: Robbins 9th/pg 163)Individuals with the 22qll.2 deletion syndrome have high risk for psychotic illnesses, such as schizophrenia (25% cases) and bipolar disorders.In addition, attention deficit hyperactivity disorder is seen in 30-35% of affected children.


Question: The removal of malarial parasites from the red blood

It is currently accepted that malaria-parasitized red blood cells (pRBC) are eliminated, like senescent erythrocytes, phagocytically by macrophages in the red pulp of the spleen. REFERENCE.nih.gov


Question:
Ram Devi presented with generalized edema sweating and ushing
tachycardia and fever after bee sting. This is

The symptoms of the patient are d/t hypersensitivity type I reaction Type I is mediated by IgE and it airs up within minutes.
The symptoms range from rashes to anaphylactic shock with vasodilatory hypotension and bronchiolar spasm.
Examples of type I
Eczema* Hay fever* Asthma* Anaphylactic shock* Urticaria* A cute dermatitis
* Theobald Smith reaction *
Other hypersensitivity reactions Type II is characterized by an antigen antibody reaction on the surface of a host cell*.
Mediated by IgG or IgM. Examples

Blood transfusion reactions *
Transplant rejection *
Auto immune hemolytic anaemia*
Auto immune thrombocytopenic purpura *
Diabetes disease*
Good pasture’s syndrome *
Grave's disease*
Myasthenia gravis*
Pemphigus
Pernicious anaemia

1. Rheumatic fever* Type HI reactions Mediated by antigen / antibody complex*.
Examples

PAN*
Post streptococcal glomerulonephritis*
Rheumatoid arthritis*
Systemic lupus erythematosis*
Acute viral hepatitis*
Penicillamine toxicity*
Serum sickness*
Arthus reaction*


Question: Good prognosis in schizophrenia is indicated by


Question: Capacity of a cell to differentiate into diverse lineages

Transdifferentiation - irreversible conversion of cells from one differentiated cell type to another Dedifferentiation - reverse developmental process in which differentiated cells with specialized functions become undifferentiated progenitor cells Metaplasia - reversible transformation of one differentiated cell type to another differentiated cell type.


Question: Most common variant of RCC is

Clear cell type RCC (70%): This is the most common pattern. The clear cytoplasm of tumour cells is due to the removal of glycogen and lipid from the cytoplasm during the processing of tissues. The tumour cells have a variety of patterns: solid, trabecular and tubular, separated by delicate vasculature. Majority of clear cell tumours are well differentiated. Ref: HARSH MOHAN TEXTBOOK OF PATHOLOGY 6th ed. pg no: 695