Question: Mechanism of action of NO occurs by

NO is a sho-lived, soluble, free radical gas NO is synthesized de novo from L-arginine, molecular oxygen, and NADPH by the enzyme nitric oxide synthase three isoforms of NOS are present Type I, neuronal NOS (nNOS)- present in Neurons, does not play a significant role in inflammation. Type II, inducible NOS (iNOS)- inducible form, responsible for the production of NO in inflammatory reactions. Type III, endothelial NOS, (eNOS)- synthesized primarily (but not exclusively) in the endothelium impoant actions regulation of neurotransmitter release potent vasodilator killing microbes and tumour cells. Endogenous regulator of leucocyte recruitment antagonism of all stages of platelet activation Mechanism of action NO induces vasodilation by acting on guanylate cyclase Cyclic-GMP activates protein kinase causes reuptake of ca2+ which activates potassium channel fall in ca 2+, myosin light chain kinase cannot phosphorylate myosin no cross bridging relaxation Robbins pathology 9th ed page 49


Question: Inclusion bodies are not seen in

Inclusion bodies seen in - CMV, HSV, Rabies, small pox, trachoma, Molluscum Contagiosum, yello fever, adenovirus, poliovirus, measles virus


Question: The shape of RBC is biconcave due to

The remarkable deformability and durability of the normal red cell are attributable to the physicochemical propeies of its specialized membrane skeleton, which lies closely apposed to the internal surface of the plasma membrane. Its chief protein component is spectrin.Hereditary spherocytosis is caused by diverse mutations that lead to an insufficiency of membrane skeletal componentsRobbins 9e pg: 632


Question: Most common site of tuberculous lesion in the oral cavity is


Question: Hyperophy is a type of

Physiological adaptive responses include: * Hyperophy - increase in cell size * Hyperplasia - increase in number of cells * Atrophy - decrease in cell size and number * Metaplasia - reversible replacement of one cell type by another differentiated cell type Refer robbins 9/e p3


Question: Fordyce&;s spots in oral cavity arise from

Fordyce's granules these are heterotropic sebaceous glands occurring in the oral mucosa. They present either as yellow-white point points, usually in the buccal mucosa or as plaque-like configurations They have no significance and no treatment is required.


Question: Most common malignant tumor of salivary glands

BENIGN MALIGNANT Pleomorphic adenoma(50%) Mucoepidermoid carcinoma(15%) Wahin tumor(5%) Acinic cell carcinoma (6%) Oncocytoma(2%) Adenocarcinoma NOS(6%) Cystadenoma(2%) Adenoid cystic carcinoma(4%) Basal cell adenoma(2%) Malignant mixed tumor(3%) TEXT BOOK OF ROBINS BASIC PATHOLOGY NINTH EDITION PAGE.556


Question: Most common cause of Down syndrome is

Genetics of Down syndrome 95% cases - Meiotic nondisjunction of chromosome 21 occurring in the ovum 4% cases - Robesonian translocation 1% cases - Mosaicism resulting from mitotic nondisjunction of chr 21


Question: Salt loosing nephritis is due to

Salt-losing nephritis is one of many clinical situations involving electrolyte disturbance in renal disease. This type of nephropathy is characterized by hyponatremia and hypochloremia, lassitude, thirst, polyuria, azotemia, and circulatory collapse. Interstitial nephritis is a kidney disorder in which the spaces between the kidney tubules become swollen (inflamed). This can cause problems with the way your kidneys work. Refer robbins 9/e p930


Question: Cytokine causing fever


Question: A characteristic feature of acute inflammation

Acute inflammation has three major steps: -
Among these three major steps “The hallmark of acute inflammation is increased vascular permeability leading to
escape of protein-rich fluid (exudates) into the extravascular tissue”.
Mechanism of increased vascular permeability
i. Formation of endothelial gaps in venules
ii. Direct endothelial injury resulting in endothelial cell necrosis and detachment.
iii. Delayed prolonged leakage
iv. Leucocyte mediated endothelial injury.

Vasodilatation and increased vascular permeability


Question: Fatal arrythmias are seen if myocardial infarction is

The most common arrhythmias associated with inferior-wall and anterior-wall myocardial infarction are bradycardia and supraventricular and ventricular tachycardia. Optimal treatment approaches are based on the pathophysiology of the infarct and the presence of contributing medical factors (eg, congestive hea failure, metabolic disorders). Robbins 9 th edition page no. 377


Question: In Cleidocranial dysostosis, sometimes the roots of the permanent teeth are


Question: With reference to neoplasia, the term 'tumor progression means

Multi step.theory of carcinogenesis Phy.attributes are .self sufficient in growth signal .local invasion ,metastasis .karyotic pattern .hormonal response .response to Anti malignant drugs Evading apoptosis All these acquired in a step wise fashion This phenomenon is tumour progression

Abi1ity of cancer cells to resemble their normal counterpa

Sequential appearnace of features of increasing malignancy


Question: Decrease in osmotic fragility cause hemolysis in


Question: Among the following conditions of hypercalcemia, PTH is not elevated in

In individuals with primary hyperparathyroidism, serum PTH levels are inappropriately elevated for the level of serum calcium, whereas PTH levels are low to undetectable in hypercalcemia caused by of non-parathyroid diseasesSarcoidosis is a non-parathyroid cause of hypercalcemiaFamilial hypocalciuric hypercalcemia, a rare autosomal dominant disorder caused by loss-of-function mutations in the parathyroid calcium-sensing receptor gene (CASR), which results in decreased sensitivity to extracellular calcium. PTH is elevated.Robbins pathology 9e pg: 1103


Question: ANCA negative vasculitis amongst the following is

ANCA p-ANCA | MPO ANCA Churg strauss syndrome Microscopic polyangiitis c-ANCA | PR3 ANCA Wegener granulomatosis Polyaeritis nodosa: ANCA negative medium vessel vasculitis Deposition of Immune complex: Fibrinoid necrosis (Type 3 HSR) 30% of patient have history of Hep B infection HBsAg + anti-HBs ab. (complex). | Deposition in many organ Sparing of small vessel (LUNGS)


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

The history is suggestive of langerhans cell histiocytosis( eosinophilic granuloma ).The tumour cells in addition to birbeck granules express HLA -DR, S- 100 and CD1a Reference : Robbins and Cotran Pathologic basis of disease.South Asia Edition volume 1.page no. 622


Question: The most common antecedent of erythroplakia and leukoplakia is

Ans. is 'b' i.e., Tobacco use Leukoplakia (from the Greek, ieukos, "white" andplax, "plaque")o Is an asymptomatic white lesion on the surface of a mucous membrane that affects both sexes equally, mostly after the third decade of life.o A variety of diseases are characterized by white plaques on the oral mucosa (e.g., candidiasis, lichen planus, psoriasis, syphilis).o Erythroplakia is the red equivalent of leukoplakia but is less common.o Red areas associated with leukoplakic lesions are referred to as speckled leukoplakia (erythroleukoplakia, speckled mucosa). In contrast to leukoplakia, erythroplakia may represent moderate to severe dysplasia or carcinoma. Not all of these lesions herald malignancy, as many may be inflammatory' in natureo Oral Leukoplakia is the most common potentially malignant Lesion of the oral mucosa. It is seen most frequently in middle-aged and older men, with an increasing prevalence with age. Less than one percent of men below the age of 30 years have oral leukoplakia. The etiology is multifactorial but the most common cause associated with oral leukoplakia is tobacco consumption.Thus, we derive that the most common antecedent of either ery throplakia or leukoplakia in India is tobacco use.


Question: The main driving force for water reabsorp on by the proximal tubule epithelium is

Active reabsorp on of amino acids and glucose


Question: RS cells are seen in

• Hodgkin’s disease is characterized by presence of Reed-sternberg cells (Classical Reed-sternberg cells) and its variants.
RS cells are derived from B-cells of germinal center and induce accumulation of reactive, lymphocytes, histiocytes (macrophages) and granulocytes.


Question: 7 day old MI the most sensitive biochemical marker

TnI and TnT normally are not found in the circulation; however, after acute MI, both are detectable within 2 to 4 hours, with levels peaking at 48 hours and remaining elevated for 7 to 10 days. Although cardiac troponin and CK-MB are equally sensitive markers of the early stages of an MI, persistence of elevated troponin levels for approximately 10 days allows the diagnosis of an acute MI long after CK-MB levels have returned to normal. With reperfusion, both troponin and CK-MB levels may peak earlier owing to more rapid washout of the enzyme from the necrotic tissue. (Robbins basic pathology,9th edition,pg no.383)


Question: Lineage specific T Cell marker is

CD 3 is considered as lineage specific for Tcells.


Question: Uveoparotitis is seen in


Question: The most common etiology of native valve endocarditis is

The causative organanism differ depending on the underlying risk factors. 50-60% of cases of endocarditis occurring on damaged or deformed valves are caused by Streptococcus viridans, a relative banal group of normal oral flora By contrast more virulent S. aureus can attack deformed as well as healthy valves and is responsible for 10%-20% of cases overall Robbins 9 th edition page no. 393


Question: Shelf life is maximum for

Frozen Plasma - The shelf life is 1 year from the date of collection. Thawed Plasma - The shelf life of thawed plasma is either 24 hours or 5 days, depending on the plasma product.


Question: Achalasia cardia

Achalasia of the oesophagus is a neuromuscular dysfunction due to which the cardiac sphincter fails to relax during swallowing and results in progressive dysphagia and dilatation of the oesophagus (mega-oesophagus). etiology. There is loss of intramural neurons in the wall of the oesophagus. Most cases are of primary idiopathic achalasia which may be congenital. Secondary achalasia may occur from some other causes which include: Chagas' disease (an epidemic parasitosis with Trypanosoma cruzi), infiltration into the oesophagus by gastric carcinoma or lymphoma, ceain viral infections, and neurodegenerative diseases. TEXTBOOK OF PATHOLOGY HARSH MOHAN 6TH EDITION PAGE NO:538


Question: Pseudotumor syndrome is seen in


Question: Normal adult haemoglobin contains


Question: TSG mutated in familial gastric ca


Question: Female treated for Urinary tract infection now has vaginal discharge. Most likely organism is

Vaginal yeast infections occur when new yeast is introduced into the vaginal area, or when there is an increase in the quantity of yeast already present in the vagina relative to the quantity of normal bacteria. For example, when the normal, protective bacteria are eradicated by antibiotics (taken to treat a urinary tract, respiratory, or other types of infection) or by immunosuppressive drugs, the yeast can multiply, invade tissues, and cause irritation of the lining of the vagina(Refer: Shaw&;s Textbook of Gynaecology, 15th edition, pg no: 146)


Question: The polypeptide chains of hemoglobin A are composed of

Hemoglobin A has 2 alpha and 2 beta chains.
HbA2 has two alpha and two delta chains.


Question: The term dilaceration refers to

A deformity of a tooth consisting of a sharp bend in the root

Abrasions on two surfaces of a single tooth

A tooth that is fractured at two or more places


Question: Schilling test is performed to find out


Question: Stain for detecting early cancer in the oral and pharyngeal cavity is


Question: Post streptococcal glomerulonephritis in children is diagnosed by

In post streptococcal glomerulonephritis there elevated levels of antistreptolysin O or ASO and anti DNA awe antibodies and reduced levels of serumC3

Heavy proteinuria, high cholesterol, highASO titre

Heavy proteinuria, hematuria, low aso titre

Mild proteinuria, hematuria, low ASO tire

Mild proteinuria, high cholesterol, normal ASO titre


Question: Infertility is a common feature in "Sertoli cell only" syndrome because

Ans. is 'c' i.e. There is no germ cells in this condition 'Sertoli cell only syndrome is another name for Germ cell aplasia.In this condition seminiferous tubules are smaller than normal and are lined by a single layer of Sertoli cells. There are no germ cells lining the seminiferous tubules.Absence of germ cells leads to absence of spermatogenesis because spermatogenesis begins from primitive germ cells, leading to infertility.

Too many Sertoli cells inhibit spermatogenesis via inhibin

Proper blood-testis barrier is not established

Sufficient numbers of spermatozoa are not produced


Question: Heart failure cells are seen in

Ans. (c) Lungs(Ref: Robbins 9th/pg 529; 8th/pg 535)Morphology in Lungs in LVFLungs: Most commonly affected organHeart failure cells Q-hemosiderin containing macrophages.Edematous widening of alveolar septa and -Edema fluid in the alveolar spaces.


Question: Apoptosis is initiated by


Question: Medullary ca of thyroid is associated with increase in

Ans. (a) Calcitonin(Ref: Robbins 9th/pg 1099-1100)*In Medullary Carcinoma Thyroid, serum Calcitonin is elevated.*Elevated serum calcitonin also provides a marker of residual or recurrent disease.*All patients with Medullary Carcinoma Thyroid*should also be tested for RET mutations, so that genetic counseling and testing of family members can be offered;


Question: Etiological agent of Roseola infantum includes

Roseola infantumA history of 3 days of high-grade fever in an otherwise nontoxic 10-month-old child with a blanchable maculopapular rash on trunk -Roseola.Mean duration- 6days - so sixth disease/Exanthem subitum.Nagayama spots-ulcers at uvulopalatoglossal junction.DD - Measles, Rubella, Drug allergy.M/C complication-convulsions / recurrent seizures/temporal lobe epilepsy.Rx suppoiveSevere cases-Ganciclovir/ Foscarnet.(Refer: Nelson's Textbook of Paediatrics, 19thedition, pg no:1117)


Question: In the clinical evaluation, the most significant, finding of the parotid mass may be accompanying

Supramental and preauricular lymphadenopathy


Question: The following cell types does not paicipate in repair after brain infarction

The greatest factor in functional recovery after brain injury comes from the brain's ability to learn, called neuroplasticity. ... Recent studies have found collagen is extensively distributed throughout the brain and may be essential in protecting the brain against degeneration such as that in Alzheimers. Fibroblast do not play a role Refer robbins 9/e p774


Question: Steroids hormones exe their effects by binding to

Steroid hormones cross the cell membrane and bind to specific receptors within the cell. These receptors are transcription factors that are active only in the presence of paicular hormones. The hormone-transcription factor complex binds to steroid hormone responsive elements in DNA to influence transcription from steroid-sensitive genes. Thyroid hormone, retinoic acid, and 1,25-dihydroxycholecalciferol exe their effects in a similar way.


Question: Brain natriuretic peptide is degraded by

Brain natriuretic peptide or B type natriuretic peptide: It is a hormone produced by the ventricles of the heart.
It has been shown to increase in response to ventricular volume expansion and pressure overload. B.N.P. is a marker of ventricular systolic and diastolic function.
Like Atrial natriuretic peptide, it is degraded by neutral endopeptidase. Atrial natriuretic peptide:
Atrial natriuretic factor (ANP) is a hormone released by atrial walls of the heart when they become stretched.
Because in heart failure,
there is an almost always excessive increase in both the right and left atrial pressures that stretch the atrial walls the circulating levels of ANP in the blood increase
fivefold to tenfold in severe heart failure. The ANF, in turn, has a direct effect on the kidneys to increase greatly their excretion of salt and water.
Therefore ANP plays a natural role to prevent the extreme congestive symptoms of cardiac failure.
But the other factors promoting cardiac decompensation quickly overrides this ANP effect.
More on the physiological properties of ANP: Circulating ANP has a short half-life.
Their steady level in blood is maintained by clearance receptors. It is metabolized by neutral endopeptidase (NEP) which is inhibited by Thiorphan.


Question: In Marfan&;s syndrome defect is in

Marfan syndrome is caused by a mutation in FBNI gene encoding fibrillin. The major tissue effected are skeleton, eyes and cardiovascular system Refer robbins 146


Question: Noma is


Question: Epithelial Tumour of Stomach is

(B) Carcinoid tumouroEpithelial tumour of stomach is carcinoid tumour.[?]Carcinoid TumoroCarcinoid tumors arise from the diffuse components of the endocrine system and are now properly referred to as well-differentiated neuroendocrine tumors.oThe term carcinoid, or "carcinoma-like," was applied because these tumors tend to have a more indolent clinical course than GI carcinomas. Most are found in the GI tract, and more than 40% occur in the small intestine.FEATURES OF GASTROINTESTINAL CARCINOID TUMORSFeatureEsophagusStomachProximalDuodenumJejunum and IleumAppendixColo rectum*. Fraction of GI carcinoids<1%<10%<10%>40%<25%<25%*. Mean patient age (yr)Rare555065All ages60*. LocationDistalBody and fundusProximal third, peri-ampullaryThroughoutTipRectum > cecum*. SizeLimited data1-2 cm, multiple; >2 cm, solitary0.5-2 cm3.5 cm0.2-1 cm>5 cm (cecum); <1 cm (rectum)*. Secretory product(s)Limited dataHistamine, somatostatin, serotoninGastrin, somatostatin, cholecystokininSerotonin, substance P, polypeptide YYSerotonin, polypeptide YYSerotonin, polypeptide YY*. SymptomsDysphagia, weight loss, refluxGastritis, ulcer, incidentalPeptic ulcer, biliary obstruction, abdominal painAsymptomatic, obstruction, metastatic diseaseAsymptomatic,incidentalAbdominal pain, weight loss, incidental*. BehaviorLimited dataVariableVariableAggressiveBenignVariable*. Disease associationsNoneAtrophic gastritis, MEN-IZollinger-Eilison syndrome, NF-1, sporadicNoneNoneNoneMEN-I, Multiple endocrine neoplasia type I; NF-1, neurofibromatosis type I.oThe peak incidence of carcinoid tumors is in the sixth decade, but they may appear at any age.oSymptoms are determined by the hormones produced.oFor example, tumors that produce gastrin may cause Zollinger-Eilison syndrome, while ileal tumors may cause carcinoid syndrome, which is characterized by cutaneous flushing, sweating, bronchospasm, colicky abdominal pain, diarrhea, and right-sided cardiac valvular fibrosis.oMost common benign tumor of esophagus - LeiomyomaoMost common malignancy esophagus - Squamous Cell CarcinomaoMost common benign tumor of stomach - Adenoma (Epithelial Polyps)oMost common site of Leiomyoma in GIT - StomachoMost common malignancy of small intestine - CarcinoidoMost common benign tumor of small intestine - AdenomaoMost common symptomatic benign tumor of small intestine - LeiomyomaoCarcinoma is the most important & the most common (90-95%) of malignant tumors of the stomach.oNext, in order of frequency are lymphoma (4%), carcinoids (3%) and mesenchymal tumors (2%).oEpidemiology:-Gastric carcinoma is the second most common tumor in the world.-It's incidence, however, varies widely, being particularly high in countries such as Japan.-Male - to - Female ratio of about 2:1.


Question: Best marker for GIST is

Diagnostic markers GISTs and cajal cells express c-KIT (also known as CD117) and CD34. Most useful diagnostic marker is c-KIT and immunohistochemically detected in 95% of gastric GISTs GENERAL AND SYSTEMIC PATHOLOGY RAMDAS NAYAK FIRST EDITION PAGE 390


Question: Prostate specific antigen is used as


Question: A baby's blood group was determined as O Rh negative.Select the blood group the baby's mother or fatherwill not have.


Question: Wound strength of healing is provided by

Type 1 collagen fibres have high tensile strength.


Question: "Mikulicz cells" are seen in

"Mikulicz cells" & "Russell bodies" are seen in Rhinoscleroma.


Question: A person taking an oral sulfonamide is found to have a markedly decreased peripheral blood neutrophil count, but the numbers of platelets and erythrocytes are normal. If the peripheral neutropenia is the result of antineutrophil antibodies being produced in response to taking the sulfonamide, then this patient would be expected to have

Decreased numbers of neutrophils in the peripheral blood (neutropenia) may be due to decreased production of neutrophils in the bone marrow or to increased peripheral destruction of neutrophils. Decreased production may be caused by megaloblastic anemia, ceain drugs, or stem cell defects such as aplastic anemia, leukemias, or lymphomas. Drug-induced destruction of neutrophil precursors is the most common cause of peripheral neutropenia. With all of these different causes of decreased neutrophil production, the bone marrow is hypoplastic and there is a decrease in the number of granulocytic precursors. Some causes of neutropenia also cause a decrease in the numbers of platelets and erythrocytes (pancytopenia). In contrast to decreased production, neutropenia secondary to peripheral destruction causes a hyperplasia of the bone marrow, with an increase in the number of granulocytic precursors. Causes of increased destruction of neutrophils include sequestration in the spleen due to hypersplenism (not splenic atrophy), increased utilization, such as with overwhelming infections, and immunologically mediated destruction (immune destruction). Causes of immune destruction include Felty's syndrome and ceain drug reactions, such as to aminopyrine and some sulfonamides. Drugs may cause decreased production or increased destruction of neutrophils. In the latter, antibodies are formed against neutrophils, and then these cells are destroyed peripherally. Felty's syndrome refers to the combination of rheumatoid ahritis, splenomegaly, and neutropenia. A significant number of patients with Felty's syndrome have a monoclonal proliferation of CD8 large granular lymphocytes, unrelated to drug use. Reference: Robbins & Cotran Pathologic Basis of Disease, 9edition.

Hypoplasia of the bone marrow myeloid series

Hyperplasia of the bone marrow myeloid series


Question: Sentinel node biopsy for Ca breast is for

*Sentinel lymph nodes: Lymph nodes where the lymphatics drain first from a primary tumorSentinel lymph node biopsy can be identified by radiotracer or colored dyes. If the sentinel node is negative for metastasis, it is unlikely that other more distant nodes will be involved and the patient can be spared the morbidity (like lymphedema) of complete axillary dissection.Ref: Robbins 8/e p1089


Question: Tumor that follows rule of 10 is

Pheochromocytomas are neoplasms composed of chromaffin cells. They follow rule of 10: - 10% of pheochromocytomas are extra adrenal - 10% of sporadic adrenal pheochromocytomas are bilateral - 10% of adrenal pheochromocytomas are biologically malignant. -10% of adrenal pheochromocytomas are not associated with hypeension. Ref: Robbins and cotrans 9e


Question: Miller put forth the acidogenic theory of dental caries in the year


Question: The first consideration in the differential diagnosis of a painless palatal perforation would be


Question: Raynaud's phenomenon is seen in

Raynaud phenomenon results from exaggerated vasoconstrictionof aeries and aerioles in the extremities, paicularlythe fingers and toes, but also sometimes the nose,earlobes, or lips. The restricted blood flow induces paroxysmalpallor or cyanosis; involved digits characteristicallyshow "red-white-and-blue" color changes from most proximalto most distal, reflecting proximal vasodilation, centralvasoconstriction, and more distal cyanosis, respectively.Raynaud phenomenon can be a primary entity or may besecondary to other disorders.Secondary Raynaud phenomenon refers to vascular insufficiencydue to aerial disease caused by other entitiesincluding systemic lupus erythematosus, scleroderma, Buerger disease, or even atherosclerosis.(Robbins Basic Pathology,9th edition,pg no.355)


Question: The given site encodes

MHC class III genes encode*Complement components C2 and C4*Properdin factor B of alternate pathway*TNF - alpha and betaHeat shock proteinsReference: Harrison&;s Principles of Internal Medicine; 19th edition


Question: BRCA2 not associated with


Question: Toll like receptors are present in

Toll-like receptors (TLRs)
Microbial sensors that recognize products of bacteria (such as endotoxin and bacterial DNA), viruses (like DS-RNA), and other pathogens.
TLRs are located in plasma membranes and endosomes of leukocytes, so they are able to detect extracellular and ingested microbes.


Question: Low grade Central Nervous System tumour among the following is

(D) Meningioma # SPECTRUM OF CNS TUMORS range from Diffuse astrocytoma (grade ll/IV) Anaplastic astrocytoma (grade lll/IV) Glioblastoma (grade IV/IV)> Most meningiomas have a relatively low risk of recurrence or aggressive growth, and so are considered WHO grade l/IV.


Question: Sensory supply of middle ear cavity is by

.Sensory Innervation. The middle ear is supplied by the auriculotemporal (fifth cranial) and tympanic (ninth cranial) nerves and by the auricular branch of the vagus ref Robbins 9/e pg 567


Question: Peutz  Jeghers Syndrome has

Peutz  Jegher Syndrome is Autosomal dominant disorder charcterised  by multiple hamartomatous polyps in the gastrointestinal tract.


Question: Angelman syndrome is due to

Most cases of Angelman syndrome are notinherited, paicularly those caused by a deletion in the maternal chromosome 15 or by paternal uniparental disomy. Thesegenetic changes occur as random events during the formation of reproductive cells (eggs and sperm) or in early embryonic development. Angelman syndrome was once known as'happy puppet syndrome' because of the child's sunny outlook and jerky movements. It is now called Angelman syndrome after Harry Angelman, the doctor who first investigated the symptoms in 1965. Refer robbins 172


Question: Most common intracranial tumour is

More than one-quaer of the CNS tumors are secondary metastases arising in patients undergoing treatment for systemic cancer. Both benign and malignant CNS tumors are capable of producing neurologic impairment depending upon their site. Primary CNS tumors or intracranial tumors include :- tumors arising from constituent cells of the brain (with the sole exception of microglial cells) and from the suppoing tissues. The anatomic distribution of common intracranial tumors is illustrated Among the primary brain tumors, gliomas constitute 50-60%, meningiomas 25%, schwannomas 10% and other primary tumors comprise the remainder. Ref: TEXTBOOK OF PATHOLOGY 6th EDITION - HARSH MOHAN PAGE NO:886


Question: A 56 year old Chronic smoker, mass in bronchusresected. Most useful immunohistochemical marker to make a proper diagnosis would be aEUR'

Cytokeratin Immunohistochemistry Immunohistochennstry is an impoant tool for determination of type of tissue by the presence (or absence) of tissue specific lineage markers. Basic principle of immunohistochemistty is to label an antibody with a probe (coloured marker) which is specific to an antigen of a paicular tissue. - This antibody is run on the tissue of unknown origin. If the tissue has that paicular antigen site (epitope), then the antibody will get attached to the tissue. Because this antibody is labeled, it can be seen under a microscope and the origin of the tissue can be diagnosed. Let's begin the discussion with intermediate filaments: Intermediate filaments are cytoskeleton components of both normal and neoplastic tissue. There are the major antigens used in immunohistochemistry. Five broad classes of intermediate filaments exist. Most neoplasms show a predominant expression of one of these: a) Keratins Carcinomas, mesothelioma and non? seminomous GCT b) Vimentin Sarcoma, melanomas, seminomas, lymphomas c) Neurofilament Neural and neuroendocrine tumours d) Glial fibrillary acidic protein (GFAP) Neoplasms of astroglial origin e) Desmin Tumours of muscular origin (leiomyoma and rhabdomyomas) Neoplastic cells can co-express more than one of these intennediate filaments i.e. they may be +ve for 2 markers of different origin. These .findings can also be helpful to diagnose a tumour. After this brief outline let us examine various markers in each neoplasia. Carcinomas Cytokeratins are the most sensitive markers for carcinoma. - These are. fuher subdivided into 20 subtypes based on molecular weight and isoelectric pH. - These individual keratins provide impoant information about site of origin of given carcinoma. CK7+/CK20+ Urothelial transitional cell ca ; Ca pancreas, Ovarian macinous carcinoma CK7+/CK20- Breast, lung, endometrium, thyroid, ovary (serous), thymoma CK7-/CK20+ Colorectal, stomach, Merkel cell CK7-/CK20- Liver, kidney (clear cell), prostate Epithelial markers for determination of site of origin of carcinoma Breast * Estrogen and progesterone receptor (ifpositive, denotes good prognosis) * GCDP (gross cystic disease protein) specific breast marker * (HE2/neu-poor prognosis) * Cadherin is -ye in lobular carcinoma but +ve in ductal carcinoma Liver CAM, AFP Thyroid Thyroglobul in (papillary & follicular) calcitonin (medullary) Prostate PAP, prostate specific antigen Colorectal CEA, CK20, pancreas CA19-9, ovary CA-125 Other epithelial markers Epithelial membrane antigen (EMA) -4 Breast, lung and kidneys, adenocarcinoma are typically +ve. Carcinoma embryonic antigen +ve in carcinomas of GIT, pancreas, lung, breast, uterus and ovary Keratin positive tumours besides carcinomas Mesotheliomas - Usually +ve HMW keratin, CK5/6 should be distinguished from adenocarcinomas which are protective for low molecular weight cytokeratin and carcinoma embryonic origin. Non-seminomatous GCT - These can be distinguished from carcinoma as they are positive for - HCG (choriocarcinoma) - AFP (endothelial sinus tumour), - Placental alkaline phosphatase (PCAP), - Embryonal Ca (choriocarcinoma and endodennal sinus tumour). Sarcomas Vimentin: -Characteristically expressed in normal mesenchymal cells - Such tumours would include tumors derived from - blood vessels, - muscle, - fat, - cailage, - hemopoietic elements, - neural tube & neural crest, and - Seoli & Granulosa cells of testis and ovary. Other markers used in mesenchymal cell tumours. Tumour of myogenous origin, i.e. leio and rhabdomyosarcoma - Muscle specific Actin & Desmin - Myoglobin, myogenin and myo-D1 Tumour of vascular origin, i.e. hemangioma and angiosarcoma - Factor VIII - CD31 Fibrohistiocytic tumors, e.g. malignant fibrous histiocytoma - CD68 - HAM56 Osteosarcoma: - Osteopontin - Osteocalcin - Osteonectin - Bone GIA protein Ewing Sarcoma and PNET (Ewing in soft tissue): - CD99 (antibodies against MIC-2 gene) - besides Ewings this is also positive in few other tumours including ovarian granulosa cell tumour. GIST (gastrointestinal stromal tumours): - CD117 identifies C-KIT gene for tyrosine kinase. - These are normally present on Cajal's interstitial cells. - These tumours respond to drug Glevac/Imatinib, which is also given to patients of CML having (9:22) translocation. Other impoant tumours where immunohistochemistry has a role: Melanomas -S-100 (sensitive but not specific marker) - HMB-45 (melanosome, highly sensitive and specific) Lymphomas -CD-45 - used in screening of lymphomas. - Fuher typing is done by: - B cell markers CD19, CD20, CD23 - T-cell markers CD-2, CD-3, CD-7 - Reedsternberg cells - CD15 & CD30 .for Hodgkin's lymphoma Seminoma -Vimentin & PLAP +ve - AFP and HCG (-ye) Neuroendocrine tumour, e.g. carcinoid tumors -NSE (neuron specific enolase) - Chromogranin - Synaptophysin - Leu-7 Neural tumours of glial origin, e.g. Astrocvtomas -GFAP (Glial fibrillary acid protein)


Question: The chronic granulomatous disease is

defects in the phagocyte oxidase (NADPH oxidase) enzyme, the cause of chronic granulomatous disease In these patients, engulfment of bacteria does not result in activation of oxygen-dependent killing mechanisms. In an attempt to control these infections, the microbes are surrounded by activated macrophages, forming the "granulomas Tuberculosis is the prototype of the granulomatous diseases but sarcoidosis, Crohn's disease, cat-scratch disease, leprosy, brucellosis, syphilis, some mycotic infections, berylliosis, and reactions of irritant lipids are also included. it is a congenital and not acquired leukocyte function defect ref:-robbins 9th ed, page 79

Associated with formation of multiple granulomas


Question: ANCA positive vasculitis is

Wegener granulomatosis is likely to be initiated as a cell mediated hypersensitivity response directed aganist inhaled infectious or environmental antigens. PR3-ANCA are present in almost 95 c/o of cases Chrug - stauss syndrome is a small vessel necrotising vasculitis classically associated with asthma, allergic rhinitis, lung infiltrate, etc. This syndrome may stem from hyperresponsiveness to normally innocuous allergic stimuli. MPO-ANCA s are present in a minority of cases Robbins 9 th edition page no. 354


Question: Paradoxical embolism is seen in

PARADOXICAL EMBOLISM - right heart into the left heart (right to left shunt) permit venous emboli to
bypass the lungs and directly enter the systemic circulation


Question: Pseudopolyps are features of

Answer is B (Ulcerative colitis) Colonic involvement with ulcerative colitis is characterised by extensive, broad based ulceration of the mucosa in the distal colon or throughout its length. Pseudopolyps are created by bulging upwards of isolated islands of regenerating mucosa.


Question: Sickle cell disease is due to

(Point mutation) (628-R) (227-426-Basicpathology> 8th)Sickle cell disease is an important hereditary hemoglobinopathy, a type of disease characterized by production of defective hemoglobins.Sickle cell disease is caused by a point mutation at the sixth position of the b-globin chain leading to the substitution of a valine residue for a glutamic acid residue.Sickle syndromes occurs in 3 different forms (394-HM 5th)1. As heterozygous state for HbS: Sickle cell trait (AS)2. As homozygous state for HbS: Sickle cell anaemia (SS)3. As double heterozygous states eg. Sickle p-thalassaemia Sickle-C-disease, sickle-D disease (SD)Frame-shift mutation - occurs when there is insertion or deletion of one or two base pairs in the DNA sequence eg. Cystic fibrosis


Question: Shell teeth are more common in this variant of dentinogenesis imperfecta


Question: The most important factor associated with causation of head and neck carcinoma is


Question: Curvilinear trabeculae mimicking Chinese character pattern are seen in

Lesions of fibrous dysplasia are well circumscribed, intramedullary and greatly vary in size. The lesional tissue is tan-white and gritty and is composed of curvilinear trabeculae of woven bone surrounded by a moderately cellular fibroblastic proliferation. The Curvilinear shapes of trabeculae mimic Chinese characters, and the bone lacks prominent osteoblastic rimming.Reference: Robbins and Cotran Pathologic Basis of Disease; 9th edition; Volume II; Bones, Joints and Soft Tissue Tumors; Page no: 1206


Question: Multiple schwannomas are seen with

Multiple schwannomas occur in association with neurofibromatosis type 2 (NF2) and schwannomatosis. ... Schwannomatosis is the third major form of neurofibromatosis and involves the development of multiple schwannomas in the absence of vestibularschwannomas.


Question: In herpes primary lesion is


Question: Ocular basement membrane is stained by

Not only ocular almost all basement membranes are stained with PAS (Periodic acid-Schiff) Because it has 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: Ulceration of Peyer's patches occur in ... infection

Ans. is 'c' i.e., Salmonellao The Peyer's patches show oval ulcers with their long axis along the length of the bowel in typhoid ulcer (salmonella infection).


Question: The system responsible for transporting blood around the body is

The circulatory system consists of the heart, the blood vessels and the blood,
and its function is to transport the blood around the body


Question: Smoking is not a risk factor for

Answer- D. Alzhiemers disease"Recent research has shown that smoking is a signifcant risk factor for vascular dementia and Alzheimer's disease, with smokers twice as likely to develop the disease as non-smokers".


Question: ck 7 negative and ck 20 negative tumor is

Answer- A. Prostate carcinomaCK7- 1 CK20 - carcinoma of adrenal coex, prostate


Question: The commonest tumor of the myocardium is

Primary benign cardiac tumors are seen mostly in children and young adults and include atrial myxoma, rhabdomyoma, fibroma, and endocardial fibroelastoma.Atrial myxomas are often seen as a round or multilobar mass in the left atrium (75%), right atrium (20%), or ventricles or mixed chambers (5%). They typically have inhomogeneous brightness in the center of cine steady-state free precession imaging due to their gelatinous contents and may havea pedunculated attachment to the fossa ovalis.Primary malignant cardiac tumors are extremely rare and include angiosarcoma, fibrosarcoma, rhabdomyosarcoma, and liposarcoma.Reference: Harrison&;s Principles of Internal Medicine; 19th edition; Chapter 270e Noninvasive Cardiac Imaging: Echocardiography, Nuclear Cardiology, and Magnetic Resonance/Computed Tomography Imaging


Question: Sarcoma of the soft tissues spread by


Question: Cell to cell permeability occurs through

Ans. (c) Connexins(Ref: Robbins 9th/ pg 11)*Communicating junctions (Gap junctions): mediate the passage of chemical or electrical signals from one cell to another.*Consists of pores called connexions and formed by hexamers of transmembrane proteins called connexins


Question: Multiple ileal strictures and internal fistulas are features of

Answer-B. Crohn's, diseaseCrohn's disease complicated by multiple strictures and internal fistulas.


Question: Barrette's oesophagus is diagnosed by

(B) Intestinal metaplasia # Barrett's esophagus is a serious complication of GERD.> In Barrett's esophagus, normal tissue lining the esophagus changes to tissue that resembles the lining of the intestine(columnar epithelium).> Barrett's esophagus is marked by the presence of columnar epithelia in the lower esophagus, replacing the normal squamous cell epithelium--an example of metaplasia.


Question: Raspberry tongue is seen in


Question: The most severe form of Ehler Danlos syndrome is

Ehlers danlos syndrome *A genetic defect in the synthesis of fibrillar collagen*Of all the types, type IV (vascular type) is the most severe form as it involves internal organs*Common type - Type VI (kyphoscoliosis type) caused due to a defect in lysyl hydroxylase*Type VII - defect in type 1 collagen*Type IV - Defect in type 3 collagen*Type I and II - Defect in type 5 collagen ( Ref: Robbins 8/e p146)


Question: Akathisia is treated by

(Refer: Harrison&;s Principles of Internal medicine, 18th edition, pg no - 3544)


Question: Epithelioid hemangioendothelioma of nose is

Ans. is 'B' i.e., SarcomaSoft tissue sarcoma arise from mesenchyme, like muscles (myoma), endothalial cells (endothelioma) and cailage (chondroma)Epithelioid hemangioendothelioma (EHE) is a soft tissue sarcoma.It arises from distinct type of endothelial cells which exhibit epitheloid morphology.


Question: Features of trigeminal neuralgia do not include

Trigeminal neuralgia is an archetype of orofacial neuralgias that follows the anatomic distribution of fifth nerve that exhibits a trigger zone, stimulation of which initiates a paroxysm of pain. It is characterised by paroxysmal, excruciating pain in trigeminal dermatornes. Latency (refers to the short time period between stimulation of a trigger area and pain onset) and refractory period (occurs following an attack and during this time pain may not be initiated) are other 2 attack related phenomena related to TN.


Question: Dose of acute radiation causing permanent sterility in males is

Estimated Threshold Doses for Acute Radiation Effects on Specific OrgansHealth EffectOrganDose Temporary sterilityTestes0.15Depression of hematopoiesisBone marrow0.5Reversible skin effects (e.g., erythema)Skin1-2Permanent sterilityOvaries2.5-6Temporary hair lossSkin3-5Permanent sterilityTestes3.5CataractLens of eye5Ref: Robbins and Cotran Pathologic Basis of Disease; 9th edition; Chapter 9; Environmental and Nutritional Diseases; Page no: 442; Table 9-7


Question: Theirsch graft is also known as

Types of skin graftFeaturesPaial thickness ( Thiersch)Full thickness ( Wolfe)Graft uptake Easy uptake and survivalUptake is difficult Graft derivation Large grafts can be derivedOnly small grafts can be takenMC site Thigh Behind ear Cosmetic appearance Unacceptable Good Donorsite healing Donor site heals without contractionDonor site has to be closed or else it will heal with contracture(Refer: Sabiston's Textbook of Surgery, 19th edition, pg no: 1916-1917)


Question: A 45 year old lady is having persistent reflux symptoms. Most accurate investigations in establishing diagnosis before surgical treatment is

GERD is often associated with hiatus hernia type IClinical featuresInvestigationsClassical traid: reterosternal burning pain, epigastric pain and regurgitation.HeaburnsRegurgitationAbdominal painCoughDysphagia for solidsBelchingBloatingManometry for measuring LES tone24 hrs PH monitoringEsophagogram TreatmentLifestyle modifications: cessation of smoking, decreased caffeine intake and avoidance of large meal at nightMedical management: double dose of PPI'SSurgical therapy: laparoscopic Nissen's fundoplication, modern fundoplication, 3600 floppy fundoplication (Refer: Sabiston's Textbook of Surgery, 19th edition, pg no: 1081)


Question: Bowen's disease is


Question: Reactivation tuberculosis is almost excusively a disease of the

Persons who are previously exposed to tuberculous infection shows incidence of reactivation of primary tuberculosis and the pattern of lesions in such cases is similar to that of primary tuberculosis i.e. with involvement of hilar lymph nodes rather than cavitary and apical lesions in the lung. In addition, infection with M. avium-intracellulare occurs more frequently in cases of AIDS Ref: Textbook of pathology (harsh mohan)6th edition, page no.153


Question: A young patient complains of shooting pain , paraesthesia and tenderness on one side of the palate. Unilateral vesicles appear in clusters. The patient gives previous history of chickenpox.


Question: Spleniculi means

Ans. (d) Accessory spleen(Ref: Robbins 9th/pg)Accessory spleens or spleniculi are seen inGastrosplenic LigamentLienorenal ligamentGastrophrenic ligamentGreater omentumBroad ligament of uterusSpermatic cord.


Question: Pyknosis is characterized by


Question: Most specific marker for myeloid series is

The markers for myeloid series are CD13, CD33, CD 11b, CD15, CD117 and cMPO. c MPO is the most lineage specific marker amongst these. Regarding other options, CD 34 - Myeloid and lymphoid blasts, stem cells, CD 45 - Leukocyte common antigen (nonerythroid hematopoietic cells), CD 99 - Ewing's sarcoma/primitive neuroectodermal cells.


Question: Schizophrenia occurring in persons with IQ less than 70 is

Schizophrenia in mental retardation is known as Proff schizophrenia Other named Schizophrenia is 1. Van-Gogh schizophrenia - schizophrenia with self-mutilating behaviours. 2. Nuclear schizophrenia: It is when both hebephrenic and catatonic schizophrenia occur.


Question: Riga fede disease is the ulceration seen on


Question: Characteristic histopathological finding in Shock lung


Question: Anthracosis is due to inhalation of


Question: Flow cytometry is used to

Flow cytometry:These include B- and T-cell lymphomas and leukemias, as well as myeloid neoplasms. An advantage of flow cytometry over immunohistochemistry is that multiple antigens (CD molecule) can be assessed. Also PNH is diagnosed by flow cytometry, which provides a sensitive means for detecting red cells that are deficient in GPI-linked proteins such as CD59.


Question: Most common benign lesion of vocal cord in pediatric age group is


Question: Carcinoid of lung (bronchial adenoma) arise from

Ans. (b) Kulchitsky cell(Ref: Robbins 9th/pg 719)Enterochromaffin (EC) cells, or "Kulchitsky cells"; are a type of enteroendocrine and neuroendocrine cell occurring in the epithelia lining the lumen of the digestive tract and the respiratory tract that release serotonin.Tumors from these cells results in carcinoid.


Question: Type of immunologic injury in AIHA (Auto immune hemolytic anemia)

Ans. b (Type II) (Ref. Robbin's pathology 8th ed., Table no. 5-1; p. 121)Hypersensitivity Type IAnaphylactic and atopic - antigen cross-links IgE on presensitized mast cells and basophils, triggering release of vasoactive amines (i.e., histamine). Reaction develops rapidly after antigen exposure due to preformed antibody. E.g. include anaphylaxis, asthma, hives, local wheal and flare.First and Fast (anaphylaxis)Type I, II and Ml are all antibody mediated.Type IIAntibody mediated - IgM, IgG bind to antigen on "enemy" cell, leading to lysis (by complement) or phagocytosis.E.g. include autoimmune hemolytic anemia, Rh disease (erythroblastosis fetalis), Goodpasture's syndrome, rheumatic fever,Graves' disease, bullous pemphigoid, myasthenia gravis, ITP.Cy-2-toxicAntibody and complement lead to membrane attack complex (MAC).Type IIIImmune complex - antigen-antibody complexes activate complement, which attracts neurophils; neurophils release lysosomal enzymes.Examples include PAN, immune complex GN/PSGN, SLE, rheumatoid arthritis. Serum sickness - an immune complex disease (type III) in which antibodies to the foreign proteins are produced (takes 5 days).Immune complex form and are deposited in membranes where they fix complement (leads to tissue damage). More common than Arthus reaction. Arthus reaction - a local subacute antibody-mediated hypersensitivity (type Ml) reaction. Intradermal injection of antigen induces antibodies, which form antigen-antibody complexes in the skin. Characterised by edema, necrosis, and activation of complement. E.g. hypersensitivity pneumonitis (farmer's lung), thermophilic actinomycetes.Imagine an immune complex as 3 things stuck together; antigen-antibody- complement.Most serum sickness is now caused by drugs (not serum)Fever, urticaria, proteinuria, arthralgias, lymphadenopathy 5-10 days after antigen exposure. Antigen-antibody complexes cause the Arthus reaction.Type IVDelayed (T-cell mediated) type - sensitized T lymphocytes encounter antigen and then release lymphokines (leads to macrophage activation).4th and last - delayed. Cell mediated; therefore, it is not transferable by serum, e.g. 4 T's = T lymphocytes, Transplant rejection (GVHD),TB skin tests (PPD), Touching (contact dermatitis).Anaphylactic and AtopicType 1 Diabetes mellitusMultiple sclerosisGuillain-Barre syndromeHashimoto's thyroiditis


Question: Aschoff bodies are seen in

Aschoff bodies are pathognomonic of Rheumatic heart disease.

Arrhythmogenic right ventricular cardiomyopathy


Question: Mesangial deposits of Lambda chain is seen in

The nature of the light chains in mesangial IgA deposits and serum IgA was studied in patients with IgA nephropathy. Immunofluorescence (IF) studies using murine monoclonal antibodies, rabbit and goat anti-human monospecific antisera were performed in kidney sections from 15 IgA nephritic patients with only IgA isotype detected in the renal biopsy. Lambda light chain IF was demonstrated in all biopsy specimens and kappa light chain IF in 11 renal biopsy specimens. The majority of renal biopsies showed a predominance of lambda light chain IF staining in the mesangial deposits. The concentration of individual immunoglobulins and their light chain fractions, and the kappa/lambda ratio were determined in the serum and the supernate from peripheral blood mononuclear cells culture of 30 IgA nephritic patients and 30 age-matched healthy controls. The IgA nephritic patients had a higher serum concentration of total IgA (P less than 0.001) and a significantly lower IgA kappa/lambda ratio (P less than 0.001) compared with the controls. The kappa/lambda ratio of supernatant IgA from IgA nephritic patients (N = 20) was also significantly lower than that of the normal subjects (N = 14), both in the unstimulated (P less than 0.01) and pokeweed mitogen stimulated, peripheral blood mononuclear-cell culture (P less than 0.05). Our results showed that patients with primary IgA nephropathy displayed a unique immunologic response characterized by a predominance of IgA with lambda light chain in circulation


Question: Induration of seminal vesicle is seen most often in

Tuberculosis of genital tract should be considered in the presence of following situationsChronic cystitis that refuses to respond to adequate treatmentSterile pyuria, gross or microscopic hematuriaNon-tender enlarged epididymis with beaded or thickened vasChronic draining scrotal sinusInduration or nodulation of prostate and thickening of one or both seminal vesicle(Refer: Smith's Urology, 17th edition, pg no: 219-225)


Question: JC virus causes

(A) Progressive Multifocal Leukoencephalopathy (PML) # JC virus (JCV): JCV is a type of human polyomavirus (formerly known as papovavirus) and is genetically similar to BK virus and SV40. It was discovered in 1971 and named after the two initials of a patient with progressive multifocal leukoencephalopa:hy (PML). The virus causes PML and other diseases only in cases of immunodeficiency, as in AIDS or during treatment with drugs intended to induce a state of immunosuppression (e.g. organ transplant patients).> Subacute Sclerosing Panencephalitis (SSPE) is a rare progressive clinical syndrome characterized by cognitive decline, spasticity of limbs, and seizures and caused by early-age acute infection with measles.> Subacute Encephalitis or HIV Meningoencephalitis or AIDS dementia complex (ADC) characterized by insidiously beginning dementia, with mental slowing, memory loss, and mood disturbances, such as apathy & depression; with motor abnormalities, ataxia, bladder & bowel incontinence, and seizure.> Tropical spastic paraparesis or HTLV -1 associated myelopathy (HAM) or Vascular Myelopathy is a disorder of spinal cord is found in 20%-30% of patients with AIDS & histopathological findings resemble subacute combined degeneration, though serum levels of vitamin B12 are normal.


Question: Hemosiderosis of liver, pigment deposited is

it is a homozygous recessive inherited disorder due to excessive absorption of iron GENERAL AND SYSTEMIC PATHOLOGY RAMDAS NAYAK PG NO.458


Question: Globulomaxillary cyst is

Soft tissue cyst present often between maxillary lateral incisor and cuspid teeth

Often present between incisor and cuspid teeth but is a bone cyst

A cyst present between the midline of the palate


Question: Irreversible injury to myocardium in MI occurs earliest by

Answer- C. 20 minuteshlyocardial function is more seflsith'e to kchemia (loss of contractility occurs within 60 seconds) than myocardial structure(irreversible injury occurs in 2O-40 minutes), thus myocardial necrosis begins at approximately 30 minutes after coronary occlusion


Question: The reagent used in Apt test is

Alkali denaturation test (Apt-Downey test / apt test)Used to detect differentiate Fetal or neonatal blood from maternal blood (Qualitative).PrincipleMethodFetal hemoglobin (alpha 2 gamma 2 subunits) is resistant to alkali (basic) denaturation, whereas adult hemoglobin (alpha2 beta 2 subunits) is susceptible to such denaturation.Exposing the blood specimen to sodium hydroxide (NaOH) will denature the adult but NOT the fetal hemoglobin.The fetal hemoglobin will appear as a pinkish color under the microscope while the adult hemoglobin will appear as a yellow-brownish colorThe blood is mixed with sterile water to cause hemolysis of the RBCs, yielding free hemoglobin,The 5 ml pink hemoglobin-containing supernatant is then mixed with 1 mL of 1% NaOH.Fetal hemoglobin will stay pink and adult hemoglobin will turn yellow-brown.Adult hemoglobin changes color because it is less stable and will conve to hematin.Clinical UsesVaginal bleeding in late pregnancy is tested to rule vasa pre.Neonatal bloody vomitus or bloody stool to rule out swallowed maternal blood.To detect the presence of fetal blood in the maternal circulation in cases of suspected fetal-maternal hemorrhage.Positive test indicates that blood is of fetal origin.Negative test indicates that the blood is of maternal origin.


Question: Mutation of STK II / LKB I gene results in


Question: In sickle cell trait, number of bands found in

Ans. is 'a' i.e., 2 o In hemolobin electrophoresis, various types of hemoglobin move at varying speed. o In Sickle cell trait (heterozygous state), there are two types of hemoglobin : - HbS (40%) and HbA (60%). So, on elecrophoresis two different bands are produced. o In homozygous state, almost all hemoglobin is HbS. So, single band is produced.


Question: Area of skin supplied by single nerve supply

A dermatome is an area of skin that is mainly supplied by a single spinal nerve. There are eight cervical nerves (C1 being an exception with no dermatome), twelve thoracic nerves, five lumbar nerves and five sacral nerves. Each of these nerves relays sensation (including pain) from a particular region of skin to the brain. Spinal nerves not only play an important role in differentiation and motor innervation of the limb musculature, but also provide sensory innervations for the dermatomes.


Question: In AML, diagnosis of blasts cells is

C. i.e. (20% of myloid blasts) (462 - Basic pathology) (418 Harsh Mohan 5th)ACUTE MYELOGENOUS LEUKEMIA* As per WHO classification of leukemias, these criteria have been revised upwards to 20% blasts in the marrow for labeling and treating a case as AML (418 - Harsh Mohan 5th)* By definition, in AML myeloid blasts or promyelocytes make up more than 20% of bone marrow cellularity (462- Basic pathology 8th)* **DIC is seen in M3 type of AML* ** Auer rods, red -staining rod like structures present in the myeloblasts or more differentiated cells (Diagnostic clue)* Abnormal PML/RARA fusion proteins* Autoimmune haemolytic anemia is seen in CLL*** Chloroma is greenish in appearance due to the presence of myeloperoxidase seen in AML**** In AML, Chromosomal anomaly is - 8: 21 *** All - trans- retinoic acid is used in treatment for Acute- Promyelocytic Leukemia (PML)**

10% of myeloid blasts and 15% promyelocytes


Question: Enlargement of lip occured with in seconds to 24 hours is


Question: Procoagulant factors produced by endothelial cells include

The three main components of hemostasis include endothelial cells, platelets, and the coagulation system. Endothelial cells exhibit both procoagulant and anticoagulant properties. Their procoagulant activities involve activation of the extrinsic coagulation cascade by their production of tissue factor (thromboplastin) and stimulation of platelet aggregation by their production of von Willebrand factor and platelet-activating factor.


Question: Iron dispersed in the cytoplasm seen in electron microscope as

(Ferritin):FERRITIN - is the storage protein of iron and found in blood liver, spleen, bone marrow and intestine (mucosal cells) The maximum iron content of ferritin on weight basis is around 25%.HEMOSIDERIN - is another iron storage protein which can hold about 35% of iron by weight. Hemosiderin accumulates in the body (Spleen, liver) when the supply of iron is in excess of body demands.Major function of Transferrin is transport of iron to RE cells, bone marrow to reach the immature red blood cells. Transferrin is internalized by receptor mediated endocytosis within the target cells, iron is released and apotransferrin is recycled to form new transferring molecules.


Question: A patient with fibrous dysplasia can be treated by


Question: Mucocutaneous lesion associated with neoplasia

Paraneoplastic pemphigus is a severe variant of pemphigus, associated with an underlying neoplasm — most frequently non Hodgkin's lymphoma, chronic lymphocytic Leukemia, thymoma, and castleman disease. Tumor antigens are hypothesized to evoke an immune response that leads to the development of an autoimmune response to intercellular adhesins (plakins). This autoantibody response leads to blistering in mucosa and other epithelia.


Question: Vitamin deficiency associated with increase xanthurenic acid excretion in urine


Question: Mebendazole is more effective than albendazole in Rx of


Question: Chemotaxis is


Question: Carcinoid tumors of lung arises from


Question: Chronic kidney disease is defined as the presence of a diminished GFR for at least

Chronic kidney disease (previously called chronic renal failure) is defined as the presence of a diminished GFR that is persistently less than 60 mL/minute/1.73 m2 for at least 3 months, from any cause, and/or persistent albuminuria.It may present with clinically silent decline in renal excretory function in milder forms, and in more severe cases, by prolonged symptoms and signs ofuremia. It is the end result of all chronic renal parenchymal diseases.Ref: Robbins and Cotran Pathologic Basis of Disease; 9th edition; Chapter 20; The Kidney; Page no: 898


Question: The professional antigen presenting cells are

Professional APC Express MHC class II molecules Dendritic cells Immature dendritic cells (Langerhans cells) Macrophages B cells Non - professional APC Do not express MHC class II molecules Stimulated by cytokines like IFN Fibroblasts Thymic epithelial cells Thyroid epithelial cells Glial cells Pancreatic beta cells Endothelial cells


Question: The commonest site of liquefactive necrosis is

NECROSIS
■ Enzymatic degradation of a cell resulting from exogenous injury.
■ Characterized by enzymatic digestion and protein denaturation, with the release of intracellular components.
■ Morphologically occurs as coagulative (heart, liver, kidney), liquefactive (brain), caseous (tuberculosis), fat (pancreas), fibrinoid (blood vessels), or gangrenous (limbs, GI tract).
■ Kidney infarct exhibiting coagulative necrosis will be seen with loss of nuclei and clumping of cytoplasm but with preservation of basic outlines of glomerular and tubular architecture.
■ Liquefactive necrosis in the kidney can be caused by fungal infection, which will be seen filled with white cells and cellular debris, creating a renal abscess that obliterates the normal architecture.


Question: Kernicterus is invariably associated with

Inherited Unconjugated HyperbilirubinemiaCrigler Najjar Type - 1 Crigler Najjar Type - 2Persistence of unconjugated bilirubin > 20mg/dl after 1st week in the absence of hemolysis suggests CN-1.KERNICTERUS -usual UDPGT activity reduced.Autosomal recessive.Rx - Phototherapy.Heme oxygenase inhibition by metalloporphyrin therapy.Cure - ohotropic liver transplantation.Can be differentiated from CN1 by marked decrease in serum bilirubin with phenobarbitone.KERNICTERUS -unusual.Inducible phenobarbitone response on UGTA1 promoter.Orlistat intestinal lipase inhibitor reduces bilirubin in both CN-1 & CN -2Inherited Conjugated HyperbilirubinemiaDubin Johnson syndrome Rotor syndrome Absent MRP2 protein - multiple drug resistant protein is responsible defectCholangiography fails to visualize gall bladderTotal urinary coproporphyrin is normal||| coproporphyrin 1 excretion||| coproporphyrin 3 excretionX ray -Gall bladder abnormalLiver histology-Black pigment.Additional deficiency of organic anion uptakeTotal urinary coproporphyrin is increasedX ray gall bladder - normalNo black pigment(Refer: Nelson's Textbook of Paediatrics, 19thedition, pg no:604)


Question: In fanconi anemia, there is a

No increased risk of squamous cell carcinoma


Question: Common antibody in Polymyositis and Dermatomyositis includes

(C) Anti-aminoacyl-tRNA synthetase# About 50% of patients with polymyositis or dermatomyositis have myositis-specific antibodies, so when the clinical exam and testing suggest the possibility of these diseases, the presence of these antibodies can be strong supporting evidence for the diagnosis.> There are literally dozens of myositis-specific and myositis-associated antibodies identified, and researchers are learning more about them.> Some of the best-known are anti-aminoacyl-tRNA synthetases, anti-Signal Recognition Particle (SRP), and anti-Mi-2: chromodomain helicase DNA binding protein 4.> Several studies have noted that these serological types are identified with differences in presentation and prognosis. Patients with anti-aminoacyl-tRNA synthetases may have arthritis in addition to myositis, fevers, interstitial lung disease and the "mechanic's hands" so named because of the thickening of the palms of the hands. Patients with anti-Signal Recognition Particle may have severe muscle weakness that comes on very rapidly, muscle aches, and cardiac involvement. Those with anti-Mi-2: chromodomain helicase DNA binding protein 4 may have the classic dermatomyositis skin signs, like the shawl rashes and cuticle overgrowth.


Question: Ganglion of tendons is an example of

ganglions arises due to cystic or myxoid degeneration of connective tissue. The cyst wall lacks a true cell lining. The fluid that collects is similar to synol fluid.A ganglion is a term applied to a cyst filled with colloid material which is met within the vicinity of a joint or tendon sheath. ... A hernial protrusion of a synol membrane of a joint or tendon sheath often occurs with the resultant formation of a ganglion. option 4 is right robbins basic pathology. chapter bones,joints and soft tissue tumours. page no. 1315.


Question: After cataract is best treated with


Question: Multiple bilatertal dentigerous cysts are seen in


Question: Central organ in apoptosis is


Question: The liver removes LDLs in the blood by the LDLs binding to

LDL receptors and then internalizing them

HDL receptors and then internalizing them

The albumin present on LDLs and then internalizing them

The transferrin present on LDL and then internalizing them


Question: Cyst without lining is


Question: The most common odontogenic cyst is


Question: In children commonest organ involved in nocardiosis is


Question: Unconjugated hyperbilirubinemia is seen in

Classification of jaundice A. Predominantly unconjugated hyperbilirubinemia 1. increased production of bilirubin Hemolytic anemias Resorption of blood from intestinal hemorrhages(eg: gi bleeding, hematomas) Ineffective erythropoiesis 2. Reduced hepatic intake Drug that interfere with the membrane carrier systems Diffuse liver disease ( hepatitis, cirrhosis) Some cases of Gilbe syndrome 3. Impaired bilirubin conjugation Physiological jaundice of the new born Crigler-Najjar syndrome types I and II Gilbe syndrome Diffuse liver disease ( hepatitis, cirrhosis) B. Predominantly conjugated hyperbilirubinemia 1. Decreased hepatocellular excretion Deficiency of canalicular membrane transpoers - Dubin- Johnson syndrome - Rotor syndrome Liver damage or toxicity 2. Impaired intra/extra hepatic bile flow Inflammatory destruction of bile ducts( eg: primary biliary cirrhosis) Gallstones Carcinoma of pancreas GENERAL AND SYSTEMIC PATHOLOGY RAMDAS NAYAK PGNO.429


Question: A ring chromosome is a special form of

A ring chromosome is a special form of deletion. It is produced when a break occurs at both ends of a chromosome with the fusion of the damaged ends. If significant genetic material is lost, phenotypic abnormalities result. This might be expressed as 46, XY,r(14). Ring chromosomes do not behave normally in meiosis or mitosis and usually result in serious consequences.Ref: Robbins and Cotran Pathologic Basis of Disease; 9th edition; Chapter 5; Genetic Disorders; Page no: 160


Question: Glanzmann thrombasthenia is due to defect in

Platelet Function Defects:- * Defect in platelet adhesion:- Bernard Soulier syndrome,Von Willebrand's disease * Defect in platelet aggregation:- Glanzmann thrombasthenia, Afbrinogenemia * Defect in platelet secretion:- Storage pool disorders,drugs (NSAID) induced Glanzmann thrombasthenia is due to defective platelet aggregation, due to defect in receptor Gp IIb-IIIa Bernard Soulier syndrome is due to defective platelet adhesion due to defect in Gp Ib-IX * In the image shown above, agglutination is seen with theristocetin. There is no aggregation with ADP, adrenaline or collagen. * Possible diagnosis:- Glanzmann's thrombasthenia or afibrinogenaemia * In the image above, there is lack of agglutination with ristocetin, but agglutination occurs with other agonists. * Possible diagnosis:- Von Willebrand Disease (vWD) or Bernard Soulier Syndrome (BSS). * vWD is differentiated from BSS by repeating the platelet aggregometry after adding cryoprecipitate. * After adding cryoprecipitate (which contains von Willebrand factor), agglutination occurs with ristocetin.Then a diagnosis of vWD can be made. * BSS - Disorder of platelet adhesion, due to defect in Ib-IX receptor * Glanzmann thrombasthenia - Disorder of platelet aggregatation, due to defect in IIb-IIIa receptor. * Glanzmann's thrombasthenia (GT) is an autosomal recessive inherited platelet function defect characterized by normal platelet count, prolonged bleeding time and abnormal clot retraction. * Clot retraction test is a measurement of platelet function. Clot retraction test is abnormal in thrombocytopenia, thrombasthenia and polycythemia Ref:- Robbins Basic Pathology 9th Edition; Pg num:- 660


Question: Most specific immunohistochemical marker for melanoma cells is

HMB-45 is the most specific for melanoma cells.
S-100 is the most sensitive marker.


Question: In Bare Lymphocyte Syndrome, failure of antigen presentation is due to defective expression of

Ans. a (MHC class I genes) (Ref. Nelson Textbook of Pediatrics 17th / 699; Robbin's pathology 7th/pg. 244)BARE LYMPHOCYTE SYNDROME# It is a condition caused by deficiencies in major histocompatibility complex:- Type 1: MHC class I (HLA-A, -B, and -C) antigens- Type 2: MHC class II (HLA-DR, -DQ, and -DP) antigens# Isolated deficiency of MHC class I antigens, the bare lymphocyte syndrome, is rare.- The resulting immunodeficiency is much milder than in SCID, contributing to a later age of presentation. - Sera from affected children contain normal quantities of MHC class I antigens and ss2 -microglobulin.- But MHC class I antigens are not detected on any cells in the body.- There is a deficiency of CD8 but not CD4 T cells.# The bare lymphocyte syndrome, type II (MHC class II is not expressed).- The result is that the immune system is severely compromised.- Clinically, this is known as a severe combined immunodeficiency (SCID).- MHC class II-deficient patients have a very low number of CD4 T cells but normal or elevated numbers of CD8 T cells. Lymphopenia is only moderate. The MHC class II antigens HLA-DP, DQ, and DR are undetectable on blood B cells and monocytes, even though B cells are present in normal number.# Rx: Bone marrow transplant is currently the only treatment.IMMUNODEFICIENCY DISEASESPhagocytic DeficienciesHumoral DeficienciesCell-mediated Combined immunodeficiences# Reduced neutrophils# Defective phagocytes# Adherence defects# Chemotactic defects# Killing defects# X-linked agammaglobu- linemia# X-linked hyper-IgM syndrome# Common variable hypo- gammaglobulinemia# Selective immunoglobulin deficiencies# DiGeorge syndrome# Reticular dysgenesis# Bare lymphocyte syndrome# SCID# Wiskott-Aldrich syndrome# Complement deficiencies


Question: Curschmann spirals are found in

(Asthma) (726- Robbins 7th) (485- 492- HM 5,h) (492- Basic pathology 8th)* Bronchial Asthma - Histologically the mucous plugs contain whorls of shed epithelium. Which give rise to the well known Curschmann spirals*, Numerous eosinophils and charcot Leyden crystals* are present* The other characteristic histologic findings of asthma collectively called "airway remodeling"* REID INDEX is the ratio between thickness of the submucosal mucous glands (i.e, hypertrophy and hyper plasia) in the cartilage containg large airway to that of the total bronchial wall seen in chronic bronchitis**


Question: Target lesions are observed in case of

"Target" or "Iris" or "Bull's eye" lesions on hands, wrists and ankles are characteristic of erythema multiformae.


Question: Inheritance pattern of ABO blood group system is

harshmohan textbook of pathology 7th edition ABO blood grouping shows codominance as both alleles of a gene pair are expressed in heterozygous state


Question: Hemophilia is associated with

Mutations involving single genes follow one of three patterns of inheritance: autosomal dominant, autosomal recessive, or X-linked. Autosomal Dominant Inheritance Familial hypercholesterolemia Huntington disease Marfan syndrome Ehlers-Danlos syndrome Hereditary spherocytosis Neurofibromatosis, type 1 Adult polycystic kidney disease Autosomal Recessive Inheritance Cystic fibrosis Phenylketonuria Tay-Sachs disease Severe combined immunodeficiency a- and b-Thalassemias Sickle cell anemia Mucopolysaccharidoses--all types Glycogen storage diseases--all types Galactosemia X-linked Recessive Inheritance Hemophilia A Duchenne/Becker muscular dystrophy Fragile X syndrome (Robbins Basic Pathology,9th edition,pg no. 219)


Question: Follicular thyroid carcinoma is differenciated with follicular adenoma with

B. i.e. (Capsular invasion) (768 - 69- Basic pathology 8th)* The follicular thyroid carcinoma is impossible to distinguish from follicular adenomas on gross examination. This distinction requires extensive histologic sampling of the tumor-capsule- thyroid interface, to exclude capsule and or vascular invasion (768 - Basic pathology 8th)* Extensive invasion of adjacent thyroid parenchyma makes the diagnosis of carcinoma obvious in some cases. Follicular lesions in which the nuclear features are typical of papillary carcinomas should be regarded as papillary cancers* Follicular thyroid carcinoma differs from papillary carcinoma in lacking. Papillae, ground- glass nuclei of tumour cells and psammoma bodies *** Term fetal adenoma is used for follicular adenoma thyroid*** Psammoma bodies are seen in - Papillary carcinoma of thyroid, Meningioma, serous cyst adenoma o fovary**** Mesothelioma is differentiated from adenocarcinoma by presence of long slender microvilli** (Kerala - 08)


Question: Green discoloration on the surface of teeth is due to


Question: A 40yr old male presenting with URTI, hemoptysis and has elevated cANCA value is most likely having

Ans: b) Wegner's granulomatosis Wegner's granulomatosis is a necrotizing vasculitis characterized by:i) Acute necrotizing granuloma of URT/LRTii) Necrotizing vasculitis involving small to medium vesselsiii) Renal disease - focal necrotizing crescentic glomerulitiscANCA is positive in 95% of all patients with acute generalized disease. Arise in titre suggest relapse.cANCA typically found in Wegner's granulomatosispANCAMicroscopic polyangitisChurg strauss syndromeGood pasteur's syndromeIdiopathic crescentic glomerulonephritis


Question: Curschmann spirals are a characteristic finding in

In patients dying of acute severe asthma (status asthmaticus) the lungs are distended by overinflation and contain small areas of atelectasis. The most striking gross finding is occlusion of bronchi and bronchioles by thick, tenacious mucus plugs, which often contain shed epithelium. A characteristic finding in sputum or bronchoalveolar lavage specimens is Curschmann spirals, which may result from extrusion of mucus plugs fromsubepithelial mucous gland ducts or bronchioles. Also present are numerous eosinophils and Charcot-Leyden crystals; the latter are composed of an eosinophil protein called galectin-10.Ref: Robbins and Cotran Pathologic basis of DIsease; 9th edition; Chapter 15; The lung; Change 682


Question: The amount of blood lost in GIT to produce a single black stool is approximately

approximately 60 ml of blood is required to produce a single black stool


Question: Erythematous lesions with Collarets of scales on trunk


Question: Shingles occurs


Question: Most common causative agent for meningitis after spinal subarachnoid block is

Infective meningitis is mainly due to Staphylococcus epidermidis carried along with needle from skin. Spinal epidural abscess (SEA) in children is a rare infectious emergency warranting prompt intervention. Predisposing factors include immunosuppression, spinal procedures, and local site infections such as veebral osteomyelitis and paraspinal abscess. Staphylococcus aureus is the most common isolate. Iatrogenic meningitis is a rare, but potentially fatal condition. We repo four cases of meningitis after spinal anesthesia and review the possible etiological factors of post spinal meningitis Ref Robbins 9/e pg 345


Question: Follicular carcinoma of thyroid

Follicular cancer of thyroid 20% of thyroid malignancies More common in iodine-deficient areas Clinical featuresTreatmentPredisposed by long-standing multinodular goiterHematogenous metastasis is more common than lymph nodal metastasis. Pulsatile secondaries may be seen in skull, ribs, pelvis. Malignancy is defined by the presence of capsular and vascular invasion. Hence FNAC cannot differentiate between follicular adenoma and carcinoma Follicular tumors>4 cm size are more likely to be malignant. Follow up can be done using I123 scan or by thyroglobulin estimation. Thyroglobulin levels in patients who have undergone total thyroidectomy should be below 2 ng/ml. Total thyroidectomyProphylactic nodal dissection is not needed because nodal involvement is infrequentIf nodal involvement is seen functional block dissection must be done. If FNAC shows follicular adenoma; lobectomy is enough because 80% of cases are benign. If the biopsy repo becomes positive for malignancy based on angio or capsular invasion Completion Total thyroidectomy must be done I131 therapyExternal beam RadiotherapyChemotherapy: Adriamycin and taxanes (Refer: Schwaz's Principles of Surgery, 9th edition, pg no: 1363-1365)


Question: Clear cells are seen in

Clear cells are seen in

Chondrosarcoma
Clear cell carcinoma
Clear cell acanthoma


Question: Dystrophic calcification are calcifications seen in


Question: The main clinicalfeature of primary antiphospholipid syndrome is


Question: Shock is a circulatory disturbance characterized by


Question: Ammonia causes

Causes precipitation of salivary proteins


Question: C3 compliment is cleared by

Answer- B. CD 55Decay accelerating factor (DAF; CD55) increases the dissolution of C3 convease.


Question: Dental cyst

Occurs from the reduced enamel epithelium

Replaces the tooth to which it it attached

Is frequently seen with a missing tooth on the X-ray.

Cystic lining of stratified squamous epithelium


Question: McEwen's triangle is a landmark for

Mac Ewen's (Suprameatal) Triangle: Boundaries of the triangle are: a. Anteriorly: posterosuperior border of the bony external auditory canal along with the spine of Henle. b. Posteriorly: a veical line drawn tangential to the posterior margin of the external, canal. c. Superiorly: the supramastoid crest. It is land mark for exposure of lateral surface of mastoid.


Question: Hereditary retinoblastomas


Question: In an infant, bone marrow biopsy is done from

. The tibia is the site for bone marrow biopsy in the newborn infant and in children under 2 years of age. Ref Robbins 9/e pg 261-262


Question: Sweat glands in cystic fibrosis


Question: Pseudopelade is

Pseudopelade of Brocq is an idiopathic, chronic, slowly progressive, patchy cicatricial alopecia that occurs without any evidence of inflammation. It is primarily atrophy rather than an inflammatory folliculitis. The term pseudopelade was first used by Brocq to distinguish this condition from the 'pelade' of alopecia areata. In recent times, the term pseudopelade has been used to describe a generic scarring alopecia, the end result of any number of different pathological processes, and the interchangeable use by some of 'pseudopelade' and 'pseudopelade of Brocq' has led to confusion in the literature. Pseudopelade of Brocq is an unusual form of permanent hair loss from the scalp, the cause of which is unknown. This is a specific diagnosis reached after excluding known causes of patchy scarring alopecia (pseudopelade) such as lichen planopilaris and discoid lupus erythematosus. ref Robbins 9/e pg 677


Question: Patients with Hashimoto's thyroiditis are at increase risk of developing

Individuals with hashimotos thyroiditis are at an increased risk of development of extra nodal marginal zone B - cell lymphoma. Hashimotos thyroiditis is an auto immune disease. It causes destruction of thyroid gland and progressive thyroid failure. It also increases the risk of development of other autoimmune diseases, both endocrine and neuroendocrine.(Ref:ROBBINS Text book of pathology)


Question: MMR is expressed in

Maternal moality ratio(Total no of female deaths due to complications of pregnancy, childbih or within 42 days of delivery from puerperal causes in an area during a given year / Total no of live bihs in the same area and year) x 1000Maternal moality ratio: Number of maternal deaths during a given time period per 100,000 live bihs during the same time period (Refer: K. Park's Textbook of Preventive and Social Medicine, 24th edition, pg no: 593 )


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

Ans. is 'a' No. of crescents (Ref: Robbins (Basic) 6/e, p453]Following lines from Robbins (Basics) gives us fair idea of the answer.Robbins says about rapidly progressive glomerulo nephritis that.- " prognosis can be roughly related to the number of crescents; patients with crescents in less than 80% ~ of the glomeruli have a slightly better prognosis than those with higher percentage of crescents"


Question: Acute graft rejection occurs within

Answer- C. 3 monthsAcute rejection - It occurs 5 days to 3 months after transplantation.Both cell-mediated (cellular) rejection and humoral (antibody mediated) rejection are involved.


Question: The worst prognosis for renal cell carcinoma is


Question: Plasrnacytoid lymphomas may be associated with

Plasmacytoid lymphoma is lymphoplasmacytic lymphoma.Its a B cell neoplasm in adults.Most commonly the plasma cell component secretes monoclonal IgM,often in amount sufficient to cause a hyperviscosity syndrome, Waldenstrom macroglobulinemia


Question: Triple helix is found in

Robbins basic pathology 9th edition page no 63 The collagens are composed of three seperate polypeptide chains braided into a ropelike triple helix.


Question: Spindle Cell Carinoma is a variant of


Question: The immune complex Hypersensitivity reaction is

In immediate hypersensitivity (type I hypersensitivity), the injury is caused by TH2 cells, IgE antibodies, and mast cells and other leukocytes Mast cells release mediators that act on vessels and smooth muscle and proinflammatory cytokines that recruit inflammatory cells. In antibody-mediated disorders (type II hypersensitivity), secreted IgG and IgM antibodies injure cells by promoting their phagocytosis or lysis and injure tissues by inducing inflammation In immune complex-mediated disorders (type III hypersensitivity), IgG and IgM antibodies bind antigens usually in the circulation, and the antigen-antibody complexes deposit in tissues and induce inflammation In cell-mediated immune disorders (type IV hypersensitivity), sensitized T lymphocytes (TH1 and TH17 cells and CTLs) are the cause of the tissue injury ref robbins pathology 9th ed page 201


Question: Burning Mouth Syndrome describes pain associated with

Burning Mouth Syndrome (BMS) is burning or stinging of the mucosa, tips, and/or tongue in the absence of visible mucosal lesions. Van der Waal defined the term Burning mouth syndrome to refer only to idiopathic cases. There is strong predilection with most female patients being menopausal and the age of onset being approximately 50 years.


Question: Autoimmunity is caused

Autoimmunity is the system of immune responses of an organism against its own healthy cells and tissues. Any disease that results from such an aberrant immune response is termed an autoimmune disease. Prominent examples include celiac disease, diabetes mellitus type 1, sarcoidosis, systemic lupus erythematosus (SLE), Sjogren's syndrome, eosinophilic granulomatosis with polyangiitis, Hashimoto's thyroiditis, Graves' disease, idiopathic thrombocytopenic purpura, Addison's disease, rheumatoid ahritis (RA), ankylosing spondylitis, polymyositis (PM), and dermatomyositis (DM). Autoimmune diseases are very often treated with steroids.

Negative selection of T-cells in the thymus

Inappropriate expression of the MHC proteins


Question: Sago spleen is seen in

i.e. (Amyloidosis): (90-Harshmohan 6th) (254-Robbin & Cotran 8th)Sagospleen & Lardaceous spleen - common pattern of amyloid deposition in the spleenSAGO-SPLEEN : characteristic translucent pale and waxy nodules resembling sago grains (tapoica like granules)LARDACEOUS - SPLEEN - shows map-like areas of amyloid lardaceous lard-like; lard means fat of pigsGamma-Gandy bodies or sidero fibrotic nodules which are deposits of haemosiderin pigment and calcium salts on fibrous connective tissue and elastic fibre are features of CVC of spleenNut-meg liver gross appearance of liver seen in chronic passive congestion of liver**


Question: Commonest site of intestinal T.B.

Ans, is 'C' i.e., ileum o Most common site of intestinal T.B. is ileum.o Tuberculosis of the small intestine occurs in two forms,o Primary infection is usually due to bovine strain of mycobacterium tuberculosis and results from ingesting infected milk. In India the human strain may also cause such primary tuberculosis. This produces hyperplastic tuberculosis.o Secondary infection occurs due to swallowing of tubercle bacilli in a patient with pulmonar\! tuberculosis. This leads to ulcerative tuberculosis, the more common form of intestinal tuberculosis,o Hyperplastic tuberculosiso Caused by ingestion of mycobacterium tuberculosis by pts with a high resistance to the organism. The infection established itself in lymphoid follicles and the resulting chronic inflammation causes thickening of the intestinal wall and narrowing of the lumen. There is early involvement of the regional lymph nodes which may caseate.o Untreated sooner or later subacute intestinal obstruction will supervene often together with the impaction of an enterolith in the narrowed lumen,o It usually occurs in the ileocecal region,o Clinical featuresAttacks of acute abdominal pain with intermittent diarrhoea.Sometimes the presenting picture is of a mas in the rt iliac fossa in a pt with vague ill health.Features of blind loop syndrome may develop due to stasis, distention and chronic infection in the segment of ileum proximal to obstruction.o Barium meal radiography will revealPersistent narrowing of the affected segment ie the terminal ileum and the caecum.The caecum is pulled up and may become subhepatic.As the caecum is pulled up the ileo-caeca! angle is widened. Normal ileo-caecat angle is 90o. In ileocaecal tuberculosis this angle may increase upto 150o.o Treatment: This depends on the presence or absence of obstructive symptoms.A TT is given both cases.If obstruction is present ileocaecal resection is best method of t/t (along with ATT)o Thus, all the options are correct in this question but (d) option is partly correct as conservative nv'n is not the t/t of choice. The t/t of choice depends on the presence or absense of obstructive sympt. In case of obstruction, surgery is the t/t of choice,o Ulcerative tuberculosiso It is usually secondary to pulmonary tuberculosis and results from swallowing tubercle bacilli in the sputum (cf. Hyperplastic tuberculosis is usually primary there is no pulmonary tuberculosis),o Usually longer parts of the terminal ileum is involved.o There are multiple ulcers in the terminal ileum lying transversely o Pt presents with diarrhoea and wt loss.o Barium meal shows - absence of filling of the lower ileum, caecum and most of the ascending colon as a result of narrowing and hypermotility of the ulcerated segment,o TreatmentA course of A TT is adequateOperation is rarely required, in rare events of perforation or intestinal obstruction.


Question: The fixative used in histopathology

Tissue cassettes along with the unique number given in the gross room to the tissue sample are carried throughout laboratory procedures. Majority of histopathology depaments use automated tissue processors (Fig. 2.1) having 12 separate stages completing the cycle in about 18 hours by overnight schedule as under:10% formalin for fixation;ascending grades of alcohol (70%, 95% through 100%) for dehydration for about 5 hours in 6-7 jars, xylene/toluene/chloroform for clearing for 3 hours in two jars; and paraffin impregnation for 6 hours in two thermostat-fitted wax baths. Commonest fixative for light microscopic examination: 10% buffered neutral formalin. Commonest fixative for electron microscopic examination: Glutaradehyde. HARSH MOHAN Textbook of pathology 6th edition pg no 10


Question: Gluten sensitive enteropathy is most strongly associated with

Almost all people with celiac disease carry the class II HLA-DQ2 or HLA-DQ8 allelles. ROBBINS BASIC PATHOLOGY NINTH EDITION PAGE 578


Question: The fascial spaces involved in Ludwig's angina are

Unilateral -submandibular & sublingual spaces

Bilateral - submandibular & sublingual spaces

Unilateral - submandibular, sublingual & submental spaces

Bilateral -submandibular, sublingual & submental spaces


Question: For determination of sex, smear is taken from


Question: Heat rupture is characterised by

Clotted blood vessels > 'a' Irregular margins. Heat rupture is cracks or.fissures of skin & soft tissue occuring in cases of severe burning or charring These cracks or fissures are several inches long and are usually seen over the extensor surfaces and joints Heat rupture can be distinguished from lacerations & incised wounds by? Absence of blood clots in the wound & absence of extravasation of blood in the surroundings tissues since heat coagulates blood in the vessels. Intact blood vessels & nerves running across the fissures as they are not usually burnt Absence of bruising or other signs of vital reaction in the margins. Irregular margin is seen in heat rupture but this is also a feature of lacerated wounds.


Question: Tense and painful thyroiditis is

Answer- A. Dequern's thyroiditisDequervain thyroidits (granulomatous thyoiditis) - Most common cause of thyroid pain.


Question: Histologic sections of a parotid gland tumor that is found to be infiltrating along the facial nerve are most likely to reveal

The salivary glands give rise to a wide variety of tumors, the majority of which are of epithelial origin and benign. Most tumors occur in adults and have a slight female predominance. Approximately 75 to 85% occur in the parotids, 10 to 20% in the submandibular glands, and the remainder in the minor glands. In the parotid the vast majority are benign, whereas in the minor glands 35 to 50% are malignant. Clinically, most tumors of the salivary glands present as palpable masses, regardless of histologic type. The most common neoplasm of the parotid gland is the pleomorphic adenoma (mixed tumor), which histologically reveals epithelial structures embedded within a mesenchyme-like stroma consisting of mucoid, myxoid, or chondroid tissue. A malignant tumor may develop from a pleomorphic adenoma, in which case it is called a carcinoma ex pleomorphic adenoma. The second most common tumor is Wahin's tumor (papillary cystadenoma lymphomatosum), which histologically reveals cleftlike spaces lined by oncocytic epithelial cells overlying a stroma with a dense lymphocytic infiltrate. The epithelial cells are oncocytic because their pink cytoplasm is packed with mitochondria Three malignant tumors of the salivary glands are mucoepidermoid carcinoma, adenoid cystic carcinoma, and acinic cell carcinoma. Mucoepidermoid carcinomas consist of a mixture of squamous epithelial cells and mucus-secreting cells. The mucus-secreting cells of a mucoepidermoid carcinoma can demonstrate intracellular mucin with a special mucicarmine stain. Adenoid cystic carcinomas form tubular or cribriform patterns histologically and have a tendency to invade along perineural spaces, especially the facial nerve. Acinic cell carcinomas contain glands with cleared or vacuolated epithelial cells. Reference: Robbins & Cotran Pathologic Basis of Disease, 9edition

Atypical cells forming tubular and cribriform patterns

Infiltrating groups of vacuolated epithelial cells

A mixture of epithelial structures and mesenchyme-like stroma

A mixture of squamous epithelial cells and mucus-secreting cells


Question: Tumarkin's crisis is said to be a variant of


Question: The granuloma is characterized by

Granulomatous inflammation is a distinctive pattern of chronic inflammation characterized by aggregates of activated macrophages with scattered lymphocytes granuloma:-is an aggregation of macrophages surrounded by a collar of mononuclear cells principally lymphocytes Macrophages may get activated to form epithelioid cells Some of the cells may fuse together to form a bigger cell called a giant cell Older granulomas may have a rim of fibroblasts and connective tissue Common conditions resulting in granuloma formation with impoant features Tuberculosis Sarcoidosis (Non-caseating granuloma) Brucellosis Cat scratch disease (Stellate shaped or round granuloma) Syphilis (Gumma) Leprosy Inflammatory bowel disease ref pathology robbins 9th ed page 56

Focal accumulation of activated macrophages


Question: Facial nerve paralysis is common with


Question: Angiomatosis is


Question: Headache or pain in distribution of Trigeminal nerve with ocular sympathetic paralysis is seen in


Question: “Acrodermatitis enteropathica” is seen in a deficiency of

Essential features of zinc deficiency are:

Distinctive rash, often around the eyes, nose, mouth, anus and distal parts.
Anorexia, often accompanied by diarrhoea
Growth retardation in children
Impaired wound healing
Hypogonadism with I reproductive capacity.
Altered immune function
Impaired night vision related to altered vitamin A metabolism
Depressed mental function
Increased incidence of congenital malformation in infants of Zn-deficient mothers. Micro and macroelements


Question: C3 convertase acts on

All 3 pathways of complement system lead to the formation of C3 convertase, which cleaves C3 into C3a and C3b.


Question: Salivary gland stone most commonly involves


Question: Intermaxillary suture are sometimes raised forming a longitudinal midline ridge known as

Intermaxillary suture are sometimes raised forming a longitudinal midline ridge called torus palatine


Question: Paget's disease of breast indicative of

A. i.e. (Ductal carcinoma) (790 - Harsh mohan 5th) (745 Basic pathology 8th)* ** Invasive ductal carcinoma is the most common carcinoma of the breast* **Upper outer quadrant is most common site (left side is more common)PAGET'S DISEASE OF THE NIPPLE - is an eczematous lesion of the nipple associated with invasive or non invasive ductal carcinoma of the under lying breast* Prognosis is based on the underlying carcinoma and is not worsened by the presence of pagets disease **** Atypical epithelial hyperplasia is associated with malignancy of breast** Fibroadenoma is most common benign neoplasm of the female breast* Marker of Paget's disease of the mammary gland is CA - 15 - 3, CEA**


Question: The number of Fe++ atoms in one Hb molecule

Hemoglobin is a globular molecule made up of four subunits. Each subunit contains a heme moiety conjugated to a polypeptide. Heme is an iron-containing porphyrin derivative.
So, hemoglobin = 4 globins + 4 heme groups Since each heme molecule contains an iron, so total iron atoms present in hemoglobin are 4 in number.
70% of the iron in the body is in hemoglobin, 3% in myoglobin, and the rest in ferritin, which is present not only in enterocytes, but also in many other cells.


Question: "Crescents" on histopathologic examination of glomerulus are seen in

Ans. b (RPGN). (Ref. Robbin, Pathology 8th ed., 545)Rapidly Progressive (Crescentic) Glomerulonephritis# RPGN is a clinical syndrome and not a specific etiologic form of GN.# Clinically, it is characterized by rapid and progressive loss of renal function with features of the nephritic syndrome, often with severe oliguria and (if untreated) death from renal failure within weeks to months.# Regardless of the cause, the histologic picture is characterized by the presence of crescents (crescentic GN).# These are produced in part by proliferation of the parietal epithelial cells of Bowman's capsule in response to injury and in part by infiltration of monocytes and macrophages.Type I (Anti-GBM Antibody)IdiopathicGoodpasture syndromeType II (Immune Complex)IdiopathicPostinfectious/infection relatedSystemic lupus erythematosusHenoch-Schonlein purpura/IgA nephropathyType III (Pauci-Immune) ANC A AssociatedIdiopathicWegener granulomatosisMicroscopic angiitis


Question: Most common tumour due to radiation arises from

Ans. is 'c' i.e., Bone marrow o Hematological malignancies e.g., leukemias are the most common radiation induced cancers.


Question: Drug used to treat oral thrush


Question: Xeroderma pigmentosum is characterized by

Xeroderma pigmentosum is a genetically determined disorder, in which defective DNA repair mechanisms lead to chronic UV damage and subsequent development of different sun related skin tumors, including melanoma, in sun exposed areas.

Inability to repair sunlight induced damage to DNA

Irregular accumulation of melanin in the basal cell layer

Acanthosis of epithelium with elongation of rete ridges


Question: Most common glial tumor

Astrocytomas are the most common tumours among all other gliomas .....and in astrocytoma infiltrating type has an occurrence of 80 percent of all cases. REF : Robbins and cotrans , 9e , pg : 1306


Question: Kissing disease is representative of


Question: Tuohy's needle is used for

Tuohy's needle used for epidural anaesthesia has blunt bevel with 15 to 30 curve at tip.


Question: Autoimmune Disease mediated by T cells is

Autoimmune DiseasesDiseases Mediated by AntibodiesDiseases Mediated by T CellsDiseases Postulated to Be AutoimmuneAutoimmune hemolytic anemiaSystemic lupus erythematosusAutoimmune thrombocytopeniaAutoimmune atrophic gastritis of pernicious anemiaMyasthenia gravisGraves diseaseGoodpasture syndromeType 1 diabetes mellitusRheumatoid ahritisMultiple sclerosisSystemic sclerosisInflammatory bowel diseasesPrimary biliary cirrhosisPolyaeritis nodosaAutoimmune (chronic active) hepatitisInflammatory myopathiesRef: Robbins and Cotran Pathologic Basis of Disease; 9th edition; Chapter 6; Diseases of the Immune System; Page no: 211; Table: 6-6


Question: Cribriform, Honey comb (or) swiss cheese histology pattern is seen in