FMGE 2023 - Pathology PYQs Practice Questions

Q: A 65-year-old man dies due to myocardial infarction. Which stains can be used to see the infarct in the heart while conducting an autopsy?

Triphenyl tetrazolium chloride. ***Triphenyl tetrazolium chloride***- This stain is used to macroscopically identify **acute myocardial infarction** during autopsy, typically within the first few hours up to 2 weeks post-infarct [1].- It detects the activity of **dehydrogenase enzymes** (like LDH); viable myocardium reacts with TTC to form a **brick red** color, while the necrotic (infarcted) tissue lacks these enzymes and remains **pale** or *gray-yellow* [1].*Oil red O*- **Oil red O** is a lipid stain primarily used to demonstrate neutral lipids and **triglycerides**, often used for conditions like steatosis or fat emboli.- It is not specific for the cellular necrosis defining an acute infarct and is generally used on frozen sections.*Sudan black B*- **Sudan black B** is a lipid stain used to visualize phospholipids, neutral lipids, and lipoproteins.- It is more commonly employed in hematopathology (e.g., staining **myeloblasts**) or for demonstrating specific lipid storage, not for defining the boundaries of an acute myocardial infarct in gross pathology examination.*Masson trichrome*- This is a differential stain used to distinguish between muscle (red) and **collagen** (blue or green), used to highlight **fibrosis**.- While crucial for identifying **old, healed myocardial infarcts** (scar tissue), it is ineffective for rapid visualization of a fresh, acute infarct where significant collagen deposition has not yet taken place [1]. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Heart, pp. 552-554. [Practice more Pathology PYQs on OnCourse]

Q: Which of the following is a feature of hemolytic anemia?

Decreased haptoglobin. ***Decreased haptoglobin***- Hemolytic anemia involves the rapid breakdown of red blood cells, which releases **free hemoglobin** into the blood plasma. [1]- **Haptoglobin** rapidly binds to this free hemoglobin and is subsequently cleared by the **reticuloendothelial system**, leading to significantly reduced or absent plasma haptoglobin levels. [1]*All of the options given below*- This option is incorrect because both **neutropenia** and **reticulocytopenia** are generally *not* features of uncomplicated hemolytic anemia.*Neutropenia*- **Neutropenia** (low neutrophil count) is not typically associated with hemolytic anemia, which primarily affects the **red cell line**.- It is usually seen in conditions involving bone marrow failure (e.g., **aplastic anemia**) or destruction of white cells, not premature RBC destruction.*Reticulocytopenia*- Uncomplicated hemolytic anemia stimulates the bone marrow to produce new RBCs, resulting in **reticulocytosis** (increased reticulocytes) as a compensatory mechanism. [1]- **Reticulocytopenia** (low reticulocytes) is seen when the bone marrow cannot respond, such as during an **aplastic crisis** (often due to **Parvovirus B19** infection) or when the anemia is caused by true bone marrow failure. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Red Blood Cell and Bleeding Disorders, pp. 638-640. [Practice more Pathology PYQs on OnCourse]

Question 1

A 65-year-old man dies due to myocardial infarction. Which stains can be used to see the infarct in the heart while conducting an autopsy?

Accepted Answer

Triphenyl tetrazolium chloride

Answer

Oil red O

Answer

Sudan black B

Answer

Masson trichrome

Question 2

Which of the following is implicated in the pathogenesis of rheumatoid arthritis?

Accepted Answer

Autoimmunity

Answer

Defective cellular and humoral immunity

Answer

Chronic microbial infections

Answer

IgE mediated

Question 3

Asbestos exposure may be associated with which of the following malignancies?

Accepted Answer

Mesothelioma

Answer

Hepatic angiosarcoma

Answer

Skin carcinoma

Answer

Acute myeloid leukemia

Question 4

An 8-year-old boy presents with progressive muscle weakness and walking difficulties. On examination, pseudohypertrophy of calf muscles was noted. Which of the following is true regarding this condition?

Accepted Answer

Absent dystrophin

Answer

Defective fibrillin

Answer

Abnormal collagen

Answer

Expansions of CTG triplet repeats

Question 5

Which of the following is a feature of hemolytic anemia?

Accepted Answer

Decreased haptoglobin

Answer

Neutropenia

Answer

Reticulocytopenia

Answer

All of the above

Question 6

Tamm-Horsfall mucoprotein is a major component of which of the following?

Accepted Answer

Renal casts

Answer

Bence-Jones proteins

Answer

Mural thrombi

Answer

Curschmann spirals

Question 7

A three-year-old boy has been observed by his parents to be increasingly clumsy for the past 6 months. On a physical examination, there is a cauliflower-like growth in the left eye, leukocoria, and an absent red reflex. The microscopic appearance of the specimen shows Flexner-Wintersteiner rosettes. Which gene is involved in the given condition?

Accepted Answer

Rb gene

Answer

Rhodopsin gene

Answer

FBN 1 gene

Answer

ATP 7B gene

Question 8

The given inclusion bodies are characteristic of which of the following organisms? ![img-30.jpeg](img-30.jpeg)

Accepted Answer

Cytomegalovirus

Answer

Epstein-Barr virus

Answer

Herpes simplex virus

Answer

Human papillomavirus

Question 9

A 70-year-old male comes with complaints of hip pain. An X-ray of the hip shows lytic lesions and elevated serum calcium levels. Bone marrow plasma cells are 42%, and the cells seen are given in the image below. What is the most likely diagnosis? ![img-31.jpeg](img-31.jpeg)

Accepted Answer

Multiple myeloma

Answer

ALL

Answer

CML

Answer

CLL

Question 10

The following picture shows a lymph node biopsy of a 30-year-old male with cervical lymphadenopathy. The diagnosis is

Accepted Answer

Hodgkin disease

Answer

Chronic lymphocytic leukemia (CLL)

Answer

Human papillomavirus (HPV)

Answer

Acute myeloid leukemia (AML)

FMGE 2023 — Pathology