NEET-PG 2019 - Pathology PYQs Practice Questions

Q: Fish mouth appearance of valve in RHD is due to-

Calcification & fibrosis. ***Calcification & fibrosis*** - The **fish mouth appearance** of the valve in rheumatic heart disease (RHD) is primarily due to **calcification and fibrosis** of the mitral valve [1]. - This results in **narrowing of the valve orifice**, which mimics the shape of a fish mouth during diastole [1]. *Rupture of valve* - Rupture of the valve typically leads to **acute severe valvular insufficiency** and does not explain the **gradual narrowing** characteristic of the fish mouth appearance. - It would generally be associated with **acute symptoms** rather than the chronic changes seen in RHD. *None of the above* - This option is incorrect as the fish mouth appearance is well-defined by **calcification and fibrosis**, making it a specific feature of RHD. - It also disregards the specific etiology associated with the valvular deformity in RHD. *Hypertrophy of ventricular wall* - While hypertrophy of the ventricular wall can occur in RHD due to increased workload, it does not directly lead to the **valvular deformity** known as fish mouth appearance. - This hypertrophy affects the **myocardium**, not the structure of the valves themselves which are primarily affected by fibrosis and calcification. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Heart, pp. 566-567. [Practice more Pathology PYQs on OnCourse]

Q: Which marker is commonly associated with positivity in follicular lymphoma?

Bcl-2. ***Bcl-2*** - **Follicular lymphoma** is characterized by the overexpression of the **Bcl-2 protein**, which inhibits apoptosis, leading to the survival of malignant B cells [1][3]. - The **Bcl-2 gene** is often involved in the **t(14;18)** chromosomal translocation, which is a hallmark of this lymphoma [1][3][4]. *Bcl-6* - Although **Bcl-6** can be expressed in some lymphomas, it is primarily associated with **diffuse large B-cell lymphoma**, not follicular lymphoma. - **Bcl-6** is involved in **germinal center formation** and its positivity does not indicate follicular lymphoma specifically. *Bcl-1* - **Bcl-1** (also known as **CCND1**) is primarily associated with **mantle cell lymphoma** and is not a characteristic marker for follicular lymphoma. - It is linked to the **t(11;14)** translocation, which is distinct from the genetic alterations seen in follicular lymphoma. *None of the above* - This option is incorrect as **Bcl-2 positivity** is definitive for follicular lymphoma [2]. - The presence of other markers like **Bcl-6** or **Bcl-1** does not negate the expression of Bcl-2 in this lymphoma type. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Diseases of White Blood Cells, Lymph Nodes, Spleen, and Thymus, pp. 602-604. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Diseases of White Blood Cells, Lymph Nodes, Spleen, and Thymus, p. 604. [3] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Diseases Of The Urinary And Male Genital Tracts, pp. 561-562. [4] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Neoplasia, pp. 310-311. [Practice more Pathology PYQs on OnCourse]

Q: What are Gitter cells?

Modified macrophages in the CNS. ***Modified macrophages in CNS*** - Gitter cells are **modified macrophages** that have phagocytized lipid and other debris in the central nervous system (CNS), particularly in response to injury or disease [1][2]. - They play a crucial role in **cleaning up cellular debris** and are involved in the inflammatory response within the CNS [2]. *Macroglia* - Macroglia refers to **supportive cells** in the CNS, including astrocytes and oligodendrocytes, rather than being specifically modified macrophages. - It does not specifically describe the **phagocytic role** characteristic of Gitter cells. *Oligodendrocytes* - Oligodendrocytes primarily function to **myelinate axons** in the CNS and do not possess the same phagocytic capabilities as Gitter cells. - They are involved in **insulation** of neuronal axons rather than debris clearance. *Astrocytes* - Astrocytes are the principal **supportive glial cells** in the CNS and do not exhibit the characteristics of Gitter cells. - Their functions include **maintaining blood-brain barrier**, regulating blood flow, and supporting neuronal metabolism, not phagocytosis. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Peripheral Nerves and Skeletal Muscles, pp. 1255-1256. [2] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Manifestations Of Central And Peripheral Nervous System Disease, pp. 697-698. [Practice more Pathology PYQs on OnCourse]

Q: Which of the following genes primarily promotes apoptosis (programmed cell death)?

Bax. ***Bax*** - **Bax** is a **pro-apoptotic gene** that actively promotes programmed cell death by forming channels in the mitochondrial outer membrane, leading to cytochrome c release and activation of caspases [1]. - It is a key member of the Bcl-2 family and plays a critical role in the **intrinsic apoptotic pathway** [2]. - Unlike the other options, Bax **promotes** rather than inhibits apoptosis [1]. *Bclx* - **Bcl-xL** is an **anti-apoptotic** gene that **inhibits** cell death by preventing the activation of pro-apoptotic proteins like Bax [1]. - It maintains mitochondrial membrane integrity, thereby **blocking** apoptosis [1]. *Mcl* - **Mcl-1** (Myeloid cell leukemia sequence 1) is an **anti-apoptotic** gene belonging to the Bcl-2 family [1]. - Its primary role is to **inhibit** apoptosis and promote cell survival by sequestering pro-apoptotic proteins [1]. *Bcl2* - **Bcl-2** (B-cell lymphoma 2) is the prototype **anti-apoptotic** gene that **prevents** programmed cell death [3]. - It functions by binding to and inhibiting pro-apoptotic members of the Bcl-2 family, thus maintaining cell viability and **opposing** apoptosis [3]. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Neoplasia, p. 310. [2] 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. [3] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Neoplasia, pp. 310-311. [Practice more Pathology PYQs on OnCourse]

Question 1

Fish mouth stenosis in rheumatic heart disease is due to which of the following mechanisms?

Accepted Answer

Calcification and fibrosis bridging across valvular commissures

Answer

Fibrinoid necrosis

Answer

Acute inflammation leading to valvular damage

Answer

Myxomatous degeneration of the valve, which can occur in rheumatic heart disease

Question 2

Fish mouth appearance of valve in RHD is due to-

Accepted Answer

Calcification & fibrosis

Answer

Rupture of valve

Answer

Hypertrophy of ventricular wall

Answer

None of the options

Question 3

Which marker is commonly associated with positivity in follicular lymphoma?

Accepted Answer

Bcl-2

Answer

Bcl-1

Answer

Bcl-6

Answer

None of the options

Question 4

What are Gitter cells?

Accepted Answer

Modified macrophages in the CNS

Answer

Microglia

Answer

Astrocytic cells

Answer

Oligodendrocytic cells

Question 5

Which of the following genes primarily promotes apoptosis (programmed cell death)?

Accepted Answer

Bax

Answer

Bclx

Answer

Mcl

Answer

Bcl2

Question 6

Which statement is incorrect about the pathology of the bone tumor?

Accepted Answer

Chemotherapy is the treatment of choice for all bone tumors.

Answer

Tumor has distinct margin

Answer

Tumor arises from epiphyseal to metaphyseal region

Answer

Eccentric lesion

Question 7

Which one of the following is an autosomal recessive disorder?

Accepted Answer

Albinism

Answer

Marfan’s syndrome

Answer

Neurofibromatosis-1

Answer

Huntington's disease

Question 8

A blood grouping test shows clumping with Anti-A serum, clumping with Anti-B serum, and no clumping in the control. What blood group does this indicate?

Accepted Answer

AB

Answer

A

Answer

B

Answer

O

Question 9

Characteristic feature of hypertrophic obstructive cardiomyopathy is:

Accepted Answer

Asymmetric septal hypertrophy

Answer

Increased size of ventricle

Answer

Normal myofiber arrangement

Answer

Increased size of atria

Question 10

Which chamber of the heart is enlarged first in a patient with McCallum patch?

Accepted Answer

Left atrium

Answer

Left ventricle

Answer

Right atrium

Answer

Right ventricle

NEET-PG 2019 — Pathology