NEET-PG 2018 - Pathology PYQs Practice Questions

Q: Stellate granulomas are seen in

Cat scratch disease. ***Cat scratch disease*** - **Stellate granulomas** are a characteristic histological feature of **Cat scratch disease**, caused by **Bartonella henselae**. - These granulomas are composed of macrophages, lymphocytes, and neutrophils arranged in a **star-shaped or stellate pattern**, often with central necrosis. *Sarcoidosis* - Sarcoidosis is characterized by **non-caseating granulomas**, which are typically well-formed and discrete [2], [3]. - However, they do not usually have the distinct **stellate (star-shaped) morphology** seen in cat scratch disease [3]. *Cryptococcosis* - Cryptococcosis is a fungal infection that typically presents with **granulomas containing yeasts** within macrophages. - The granulomas formed in cryptococcosis are not classically described as **stellate granulomas**. *Histoplasmosis* - Histoplasmosis is another fungal infection that can cause granuloma formation, usually with **caseous necrosis** similar to tuberculosis [1]. - The granulomas in histoplasmosis do not exhibit the **stellate architectural pattern** [1]. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Lung, p. 717. [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. 198-200. [3] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Lung, pp. 700-701. [Practice more Pathology PYQs on OnCourse]

Q: RET proto-oncogene is associated with the development of

Medullary carcinoma thyroid. ***Medullary carcinoma thyroid*** - The **RET proto-oncogene** mutation is strongly linked to medullary thyroid carcinoma, particularly in Multiple Endocrine Neoplasia (MEN) type 2 syndrome [1]. - This carcinoma originates from **C-cells** of the thyroid, which produce calcitonin, and its presence is typically assessed via genetic testing. *Hurthle cell tumor thyroid* - Hurthle cell tumors, while associated with the thyroid, are not typically linked to **RET proto-oncogene** mutations but rather are considered a variant of follicular thyroid carcinoma. - They primarily appear as **eosinophilic cells** and are related to **radioactive iodine resistance**, which differs from medullary carcinoma. *Paraganglioma* - Paragangliomas arise from **neuroendocrine cells** and are associated with mutations in genes such as **SDHB** or **SDHD**, not RET. - They commonly present as **extra-adrenal pheochromocytomas** and are not related to thyroid pathology. *Astrocytoma* - Astrocytomas are primary **central nervous system tumors** that originate from astrocytic cells and have no known association with RET proto-oncogene mutations. - The mutations in this type of tumor are different, often involving genes like **TP53** and **IDH1**. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Endocrine System, pp. 1102-1103. [Practice more Pathology PYQs on OnCourse]

Q: TRALI occurs within how many hours of transfusion?

6 hours. ***6 hours*** - **Transfusion-related acute lung injury (TRALI)** is defined as new acute lung injury occurring during or within **6 hours** after the completion of a blood transfusion [1]. - It is a severe and potentially life-threatening transfusion reaction characterized by **acute respiratory distress**, **hypoxemia**, and **bilateral pulmonary infiltrates** on chest imaging [1]. *48 hours* - While other transfusion reactions or complications may manifest within 48 hours, TRALI has a more **acute onset**, typically within the first 6 hours. - A pulmonary event occurring between 6 and 48 hours post-transfusion might be considered **delayed TRALI** or another diagnosis like **transfusion-associated circulatory overload (TACO)**, but the classic definition refers to the 6-hour window. *72 hours* - Reactions occurring 72 hours after transfusion are generally considered **delayed transfusion reactions**, which include conditions like **delayed hemolytic transfusion reactions** or **post-transfusion purpura**. - This timeframe is too long for the typical presentation of TRALI, which is characterized by rapid onset. *12 hours* - Although 12 hours falls within an acute window, the most commonly accepted and diagnostically crucial timeframe for TRALI is **within 6 hours** of transfusion. - A reaction occurring between 6 and 12 hours would still be considered suspiciously TRALI, but the strict definition emphasizes the earlier onset. [Practice more Pathology PYQs on OnCourse]

Q: Anaplasia is

Lack of differentiation. ***Lack of differentiation*** - Anaplasia refers to a **loss of differentiation** in cells, making them more primitive and less specialized [1]. - It is often seen in **malignant tumors**, indicating a poor prognosis and aggressive behavior [1]. *Morphological changes* - While anaplasia involves **morphological changes**, this term is too broad and can relate to various cellular alterations, not exclusively anaplasia [1]. - Anaplasia specifically emphasizes **lack of differentiation**, distinct from general changes in cell appearance [1]. *Changing one type of epithelium to another* - This describes a process known as **metaplasia**, where one adult cell type transforms into another, not anaplasia. - Anaplasia signifies a **de-differentiation** rather than a change to a different epithelial type [1]. *Nuclear chromatin* - While changes in **nuclear chromatin** can occur in anaplastic cells, this does not define anaplasia itself [1]. - Anaplasia primarily refers to **loss of cell differentiation**, making this option insufficient to describe the concept [1]. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Neoplasia, pp. 276-280. [Practice more Pathology PYQs on OnCourse]

Q: Which gene is primarily associated with Cowden syndrome?

PTEN. ***PTEN*** - Cowden syndrome is an **autosomal dominant** inherited disorder caused by germline mutations in the **PTEN (phosphatase and tensin homolog) tumor suppressor gene**. - The PTEN gene plays a crucial role in cell growth, proliferation, and apoptosis, and its dysfunction leads to uncontrolled cell growth and the development of multiple **hamartomas** and increased cancer risk. *TP53* - Mutations in the **TP53 gene** are primarily associated with Li-Fraumeni syndrome, a different inherited cancer predisposition syndrome characterized by a high risk of various cancers including sarcomas, breast cancer, and adrenocortical carcinoma. - While both inherited cancer syndromes involve tumor suppressor gene mutations, the specific gene affected and the clinical presentation differ significantly. *RB1* - The **RB1 gene** is a tumor suppressor gene primarily associated with **retinoblastoma**, a rare childhood eye cancer, and an increased risk of other cancers like osteosarcoma. - It plays a critical role in cell cycle regulation, and its mutation leads to uncontrolled cell division in the retina and other tissues. *KRAS* - The **KRAS gene** is an oncogene, not a tumor suppressor gene, and its mutations are frequently found in various sporadic cancers, particularly **colorectal cancer**, pancreatic cancer, and lung cancer. - KRAS mutations lead to constitutive activation of signaling pathways that promote cell growth and survival, but they are not the primary genetic cause of inherited Cowden syndrome. [Practice more Pathology PYQs on OnCourse]

Question 1

Stellate granulomas are seen in

Accepted Answer

Cat scratch disease

Answer

Sarcoidosis

Answer

Cryptococcosis

Answer

Histoplasmosis

Question 2

RET proto-oncogene is associated with the development of

Accepted Answer

Medullary carcinoma thyroid

Answer

Astrocytoma

Answer

Paraganglioma

Answer

Hurthle cell tumor thyroid

Question 3

TRALI occurs within how many hours of transfusion?

Accepted Answer

6 hours

Answer

48 hours

Answer

72 hours

Answer

12 hours

Question 4

Anaplasia is

Accepted Answer

Lack of differentiation

Answer

Changing one type of epithelium to another

Answer

Nuclear chromatin

Answer

Morphological changes

Question 5

Which gene is primarily associated with Cowden syndrome?

Accepted Answer

PTEN

Answer

RB1

Answer

KRAS

Answer

TP53

Question 6

Bernard–Soulier syndrome is caused by a deficiency of which glycoprotein complex?

Accepted Answer

Gp Ib-IX-V complex

Answer

TNF

Answer

von Willebrand factor (vWf)

Answer

Gp IIb/IIIa

Question 7

Warthin-Finkeldey cells are seen in

Accepted Answer

Measles infection

Answer

Rubella infection

Answer

Rabies infection

Answer

Typhoid infection

Question 8

Which disease is associated with the CD59 marker?

Accepted Answer

PNH

Answer

Cowden syndrome

Answer

Bannayan-Riley-Ruvalcaba syndrome

Answer

PTEN hamartoma tumor syndrome

Question 9

In which type of Hodgkin's lymphoma are classical Reed-Sternberg cells most characteristically observed?

Accepted Answer

Mixed cellularity Hodgkin

Answer

Lymphocyte depleted

Answer

Nodular sclerosis

Answer

Lymphocyte predominance

Question 10

Chordoma arises from:

Accepted Answer

Notochord

Answer

Pharyngeal bursa

Answer

Rathke’s pouch

Answer

Luschka's bursa

NEET-PG 2018 — Pathology