Which antigen is tested in routine Rh typing?
Shelf life of platelets in a blood bank is
What is a distinguishing feature of reticulocytes?
What is the characteristic feature of neuropraxia?
Which of the following statements about peripheral nerve injury is false?
What is the first cellular response observed after a sharp nerve cut?
Which of the following statements is true regarding the Duffy Fy(a-b-) blood group?
What is the primary process involved in Wallerian degeneration?
Hyaline degeneration is found in -
Which molecule is primarily responsible for nuclear fragmentation during apoptosis?
NEET-PG 2015 - Pathology NEET-PG Practice Questions and MCQs
Question 21: Which antigen is tested in routine Rh typing?
- A. C antigen
- B. D antigen (Correct Answer)
- C. A antigen
- D. B antigen
Explanation: ***D antigen*** - Routine Rh typing specifically tests for the **D antigen**, which determines the Rh status of an individual as Rh-positive or Rh-negative [1]. - The presence of the **D antigen** is crucial for blood transfusions and pregnancy management [1]. *A antigen* - The **A antigen** is tested in the context of the ABO blood group system, not specifically for Rh typing. - It does not provide information regarding the Rh factor which is critical in blood compatibility. *C antigen* - Similar to the **A antigen**, the **C antigen** is part of the broader Rh system but is not routinely assessed in standard Rh typing. - Its testing is typically reserved for specific clinical scenarios involving Rh incompatibility. *B antigen* - The **B antigen** pertains to the ABO blood group and does not relate to the Rh factor or routine Rh typing. - Rh typing is solely focused on the **presence of the D antigen** to determine the Rh status. **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Blood And Bone Marrow Disease, pp. 627-628.
Question 22: Shelf life of platelets in a blood bank is
- A. 5 days (Correct Answer)
- B. 7 days
- C. 10 days
- D. 21 days
Explanation: **5 days** - Platelets stored at **room temperature (20-24°C)** have a limited shelf life due to the risk of bacterial contamination and metabolic changes. - This short storage period ensures the **viability and function** of platelets for transfusion. *7 days* - A 7-day shelf life was initially proposed but was not widely adopted due to concerns about increased **bacterial growth** and the practical challenges of extended storage at room temperature. - The risk of **bacterial sepsis** significantly increases with longer room temperature storage. *10 days* - This duration is beyond the currently accepted shelf life for platelets, leading to an unacceptably high risk of **bacterial contamination** and reduced therapeutic efficacy. - Storing platelets for 10 days would likely result in an increased incidence of **transfusion-associated sepsis**. *21 days* - A shelf life of 21 days is typical for **red blood cells** when stored at 1-6°C with specific anticoagulants, but it is far too long for platelets. - Platelets stored for this duration at room temperature would be significantly **non-viable** and pose a severe risk of bacterial infection.
Question 23: What is a distinguishing feature of reticulocytes?
- A. Slightly larger in size than RBCs
- B. Presence of residual RNA and ribosomes (Correct Answer)
- C. Mature in bone marrow
- D. Constitute approximately 1% of the red cells
Explanation: ***Presence of residual RNA and ribosomes*** - This is the **defining and most distinguishing feature** of reticulocytes that differentiates them from mature red blood cells. - Reticulocytes contain residual **ribosomal RNA** and other organelles that are lost when they mature into erythrocytes. - This residual RNA forms a **reticular (network-like) pattern** when stained with supravital stains like **new methylene blue** or **brilliant cresyl blue**, which is the basis for their name and identification. - The presence of RNA allows for **reticulocyte counting**, an important marker of bone marrow erythropoietic activity. *Slightly larger in size than RBCs* - While reticulocytes may be slightly larger (polychromatophilic appearance), size variation is **not specific** and overlaps significantly with mature RBCs. - Size is not a reliable distinguishing feature and is not used for identification or counting. *Mature in bone marrow* - Reticulocytes are **released from the bone marrow** as immature red cells and complete their maturation in the **peripheral circulation** over 24-48 hours. - They do not fully mature in the bone marrow; their presence in peripheral blood is normal. *Constitute approximately 1% of the red cells* - Normal reticulocyte count is **0.5-2%** (or approximately 1%) of total red blood cells in healthy adults. - This is a **population characteristic** indicating normal erythropoietic activity, not a distinguishing cellular feature.
Question 24: What is the characteristic feature of neuropraxia?
- A. Damage to the endoneurium
- B. Damage to the epineurium
- C. No structural damage to the nerve (Correct Answer)
- D. Damage to the axon
Explanation: ***No structural damage to the nerve*** - **Neuropraxia** is the mildest form of nerve injury, characterized by a **temporary block in nerve conduction** without structural damage to the axon or surrounding connective tissues. - This typically results in **temporary sensory and/or motor deficits** that fully resolve within weeks to months. *Damage to the endoneurium* - Damage to the **endoneurium** would indicate a more severe injury, such as **axonotmesis**, where the axon is damaged but the connective tissue sheaths are preserved. - This level of injury suggests that wallerian degeneration would occur distal to the lesion, leading to **slower and incomplete recovery**. *Damage to the epineurium* - Damage to the **epineurium**, along with the endoneurium and perineurium, signifies **neurotmesis**, the most severe nerve injury. - This involves a **complete transection of the nerve**, requiring surgical intervention for any chance of functional recovery. *Damage to the axon* - Damage to the **axon** itself, often alongside preserved connective tissues, is characteristic of **axonotmesis**. - While recovery is possible through axonal regeneration, it is **slower and less complete** than in neuropraxia.
Question 25: Which of the following statements about peripheral nerve injury is false?
- A. Wallerian degeneration starts in axonotmesis
- B. Neuropraxia is irreversible (Correct Answer)
- C. Neurotmesis is the most severe form of injury
- D. Epineurium is intact in axonotmesis
Explanation: This question asks which statement is **FALSE** about peripheral nerve injury. ***Neuropraxia is irreversible*** - This statement is **FALSE** (making it the correct answer to this question). - Neuropraxia represents the **mildest form** of peripheral nerve injury, characterized by local **demyelination** or temporary conduction block without axonal damage [2]. - Recovery from neuropraxia is typically **complete and rapid**, usually within **weeks to months**, as axonal continuity is preserved. - **No Wallerian degeneration** occurs because the axon remains intact. *Epineurium is intact in axonotmesis* - This statement is **TRUE**. In **axonotmesis**, there is disruption of the axon and myelin sheath, but the **connective tissue sheaths** (epineurium, perineurium, and endoneurium) remain intact. - The intact connective tissue provides a guide for **axonal regeneration**, which makes recovery possible, although often incomplete [1]. - Recovery occurs at approximately **1 mm/day** or **1 inch/month**. *Neurotmesis is the most severe form of injury* - This statement is **TRUE**. **Neurotmesis** involves complete severance of the nerve fiber, including the axon, myelin, and **all supporting connective tissue structures** (epineurium, perineurium, and endoneurium). - This type of injury has the **poorest prognosis** for recovery and usually requires **surgical intervention** to attempt repair [1]. *Wallerian degeneration starts in axonotmesis* - This statement is **TRUE**. **Wallerian degeneration** is a process that occurs when a nerve fiber is severed or severely injured, affecting the segment **distal to the injury** [1]. - In **axonotmesis**, the axon is disrupted, leading to degeneration of the distal axonal segment and its myelin sheath, which is characteristic of Wallerian degeneration. - Wallerian degeneration also occurs in **neurotmesis** but NOT in **neuropraxia**. **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. (Basic Pathology) introduces the student to key general principles of pathology, both as a medical science and as a clinical activity with a vital role in patient care. Part 2 (Disease Mechanisms) provides fundamental knowledge about the cellular and molecular processes involved in diseases, providing the rationale for their treatment. Part 3 (Systematic Pathology) deals in detail with specific diseases, with emphasis on the clinically important aspects., pp. 109-110. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Peripheral Nerves and Skeletal Muscles, p. 1232.
Question 26: What is the first cellular response observed after a sharp nerve cut?
- A. Chromatolysis (Correct Answer)
- B. Polymorphic arrangement
- C. Increased protein synthesis
- D. Macrophage activation
Explanation: ***Chromatolysis*** - **Chromatolysis** is the dissolution of the Nissl bodies (rough endoplasmic reticulum) in the neuron cell body following axonal injury, which is the **first observable cellular response** [1]. - This process is a preparatory step for neuronal regeneration, indicating the cell's attempt to repair the damaged axon [1]. *Polymorphic arrangement* - This term is not typically used to describe an immediate cellular response to a nerve cut; it might refer to diverse cell shapes or arrangements in different contexts but is not a recognized initial post-injury event. - The neuron's immediate response involves changes within the cell body, not a re-arrangement of its cellular structure with other cells. *Increased protein synthesis* - While increased protein synthesis does occur during neuronal repair and regeneration, it is a consequence of chromatolysis and part of a later, more sustained response, not the very first visible cellular change [1]. - **Chromatolysis precedes** and facilitates the subsequent increase in protein synthesis necessary for axonal regrowth [1]. *Macrophage activation* - **Macrophage activation** is a crucial part of the inflammatory response and debris clearance following nerve injury, but it is not the *first cellular response* of the neuron itself [2]. - Macrophages migrate to the site of injury hours to days after the initial insult, whereas chromatolysis begins within the neuron's cell body much earlier [2]. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Peripheral Nerves and Skeletal Muscles, pp. 1254-1256. [2] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Manifestations Of Central And Peripheral Nervous System Disease, pp. 697-698.
Question 27: Which of the following statements is true regarding the Duffy Fy(a-b-) blood group?
- A. lacks H- antigen
- B. lacks A-antigen
- C. All of the options
- D. lacks Fy(b) antigen (Correct Answer)
Explanation: ***lacks Fy(b) antigen*** - The **Duffy Fy(a-b-)** phenotype indicates absence of both Fy<sup>a</sup> and Fy<sup>b</sup> antigens on red blood cells. - Since the phenotype is **Fy(a-b-)**, it definitively lacks the **Fy<sup>b</sup> antigen** (indicated by the "b-" notation). - This phenotype is common in people of **African descent** and confers natural **resistance to Plasmodium vivax malaria**, as these antigens serve as receptors for the parasite to enter RBCs. *lacks H- antigen* - The **H antigen** belongs to the **H/h blood group system** and is a precursor to A and B antigens in the ABO system. - The absence of H antigen (Bombay phenotype - Oh) is completely **unrelated to the Duffy blood group system**. - Duffy antigens are on the **DARC (Duffy Antigen Receptor for Chemokines)** protein, distinct from the H antigen. *lacks A-antigen* - The **A antigen** is part of the **ABO blood group system** and defines blood types A and AB. - The Duffy blood group system is **genetically and structurally independent** from the ABO system. - Having Fy(a-b-) phenotype does not affect A antigen expression. *All of the options* - This is incorrect because the Duffy Fy(a-b-) phenotype **specifically refers only to the absence of Duffy antigens** (Fy<sup>a</sup> and Fy<sup>b</sup>). - It has **no relationship** with A, B, or H antigens, which belong to different blood group systems controlled by different genes on different chromosomes.
Question 28: What is the primary process involved in Wallerian degeneration?
- A. Nerve degeneration (Correct Answer)
- B. Muscle degeneration
- C. Nerve regeneration
- D. Muscle regeneration
Explanation: ***Nerve degeneration*** - **Wallerian degeneration** specifically refers to the process of **axon degeneration** that occurs distal to the site of injury when a nerve fiber is severed [2]. - This process involves the breakdown of the **axon** and its myelin sheath, leading to loss of function [1]. *Muscle degeneration* - While prolonged nerve degeneration can lead to muscle **atrophy** due to denervation, **muscle degeneration itself** is not the primary process of Wallerian degeneration. - Wallerian degeneration focuses on the **nerve itself**, not the target tissue. *Nerve regeneration* - **Nerve regeneration** is the process where damaged nerves attempt to regrow and re-establish connections [2]. - This is a subsequent, and not always successful, event that can occur *after* Wallerian degeneration has cleared the debris [1]. *Muscle regeneration* - **Muscle regeneration** refers to the repair and regrowth of damaged muscle tissue, typically involving satellite cells. - It is unrelated to Wallerian degeneration, which is a process affecting the **nerve**. **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Manifestations Of Central And Peripheral Nervous System Disease, pp. 697-698. [2] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. (Basic Pathology) introduces the student to key general principles of pathology, both as a medical science and as a clinical activity with a vital role in patient care. Part 2 (Disease Mechanisms) provides fundamental knowledge about the cellular and molecular processes involved in diseases, providing the rationale for their treatment. Part 3 (Systematic Pathology) deals in detail with specific diseases, with emphasis on the clinically important aspects., pp. 109-110.
Question 29: Hyaline degeneration is found in -
- A. Alzheimer's disease
- B. Alcoholic liver disease (Correct Answer)
- C. Acute myocardial infarction
- D. Acute appendicitis
Explanation: ***Alcoholic liver disease*** - **Mallory bodies**, a form of hyaline degeneration, are characteristic histologic findings in hepatocytes in alcoholic liver disease. - They represent aggregates of **intermediate filaments** and other proteins, indicating severe hepatocellular damage. *Acute myocardial infarction* - Characterized by **coagulative necrosis** of cardiac myocytes due to ischemia, not hyaline degeneration. - Inflammation and subsequent repair with **fibrosis** are key features. *Alzheimer's disease* - Defined by the presence of **senile plaques** (amyloid-beta deposits) and **neurofibrillary tangles** (hyperphosphorylated tau protein). - These are specific protein aggregates, distinct from hyaline degeneration of cellular components. *Acute appendicitis* - Involves acute inflammation of the appendix, leading to **neutrophilic infiltration** and often **fibrinopurulent exudate**. - There is no characteristic hyaline degeneration associated with this inflammatory process.
Question 30: Which molecule is primarily responsible for nuclear fragmentation during apoptosis?
- A. Caspases (Correct Answer)
- B. Apaf - 1
- C. Oxygen free radicals
- D. Endonuclease G
Explanation: ***Caspases*** - **Caspases** are a family of proteases that play a central role in the execution phase of apoptosis, including the **cleavage of nuclear proteins** and DNA fragmentation [1]. - Specifically, **executioner caspases** (e.g., caspase-3, -6, -7) activate **CAD (caspase-activated DNase)** by cleaving its inhibitor ICAD, leading to **nuclear fragmentation** and DNA laddering [1]. - This is the **primary mechanism** of nuclear breakdown in apoptosis. *Apaf-1* - **Apaf-1 (apoptotic protease activating factor 1)** is an adaptor protein that, upon activation by cytochrome c, forms the **apoptosome** [1]. - While essential for **caspase activation** (specifically caspase-9), Apaf-1 does not directly cleave nuclear components or cause fragmentation itself [1]. *Oxygen free radicals* - **Oxygen free radicals** (reactive oxygen species) can induce cellular damage and stress, and in high concentrations, can trigger apoptosis [2]. - However, they are generally upstream initiators of apoptosis pathways and do not directly mediate nuclear fragmentation; this process is carried out by **caspases**. *Endonuclease G* - **Endonuclease G** is a mitochondrial nuclease released during apoptosis that can contribute to DNA degradation. - However, it plays a **secondary role** and acts in a caspase-independent manner, whereas **caspases** remain the primary executors of nuclear fragmentation in apoptosis. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Cellular Responses to Stress and Toxic Insults: Adaptation, Injury, and Death, pp. 64-67. [2] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. (Basic Pathology) introduces the student to key general principles of pathology, both as a medical science and as a clinical activity with a vital role in patient care. Part 2 (Disease Mechanisms) provides fundamental knowledge about the cellular and molecular processes involved in diseases, providing the rationale for their treatment. Part 3 (Systematic Pathology) deals in detail with specific diseases, with emphasis on the clinically important aspects., pp. 100-101.