Gastrointestinal Pathology Practice Questions

Q: Which of the following statements is false?

Cronkhite-Canada syndrome is due to SMAD-4 mutation.. **Explanation:** The correct answer is **D** because **Cronkhite-Canada syndrome (CCS)** is a **non-hereditary (sporadic)** polyposis syndrome [1]. Unlike the other options, it is not associated with a specific germline mutation. It is characterized by hamartomatous polyps throughout the GI tract, accompanied by unique ectodermal changes such as alopecia, nail dystrophy, and hyperpigmentation. **Analysis of Options:** * **A. Cowden Syndrome:** This is an autosomal dominant disorder caused by a mutation in the **PTEN** tumor suppressor gene [1]. It presents with multiple hamartomatous polyps and carries a high risk of breast, thyroid, and endometrial cancers. * **B. Gardner Syndrome:** This is a clinical variant of Familial Adenomatous Polyposis (FAP) caused by mutations in the **APC gene**. It is characterized by the triad of colonic polyposis, osteomas (usually of the mandible), and soft tissue tumors (desmoid tumors). * **C. Turcot Syndrome:** This involves colonic polyposis plus central nervous system tumors. It is genetically heterogeneous: Type 1 is associated with DNA mismatch repair genes (HNPCC), while Type 2 is associated with **APC gene** mutations (associated with Medulloblastoma). **NEET-PG High-Yield Pearls:** * **SMAD4/BMPR1A mutations** are actually associated with **Juvenile Polyposis Syndrome (JPS)**, not Cronkhite-Canada [1]. * **Peutz-Jeghers Syndrome** is associated with **STK11 (LKB1)** mutations and presents with perioral pigmentation [1], [2]. * **Remember:** Cronkhite-Canada is **acquired** and typically occurs in older adults (age >50) [1], whereas most other polyposis syndromes are congenital. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Gastrointestinal Tract, p. 813. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Gastrointestinal Tract, pp. 813-814.

Question 1

Which of the following statements about Barrett's Esophagus is false?

Accepted Answer

None of the above statements are false.

Answer

It is a premalignant condition.

Answer

It can be diagnosed by visual inspection during endoscopy.

Answer

Biopsy is necessary to confirm the diagnosis.

Question 2

What is the most common type of gastric carcinoma?

Accepted Answer

Adenocarcinoma

Answer

Squamous cell carcinoma

Answer

Lymphoma

Answer

Leiomyosarcoma

Question 3

The adenomatous polyps of the large bowel are most often situated in which location?

Accepted Answer

Sigmoid colon

Answer

Ascending colon

Answer

Transverse colon

Answer

Descending colon

Question 4

Which of the following statements is false?

Accepted Answer

Cronkhite-Canada syndrome is due to SMAD-4 mutation.

Answer

Cowden syndrome is due to PTEN mutation.

Answer

Gardner syndrome is due to APC mutation.

Answer

Turcot syndrome is due to APC mutation.

Question 5

The chances of a gastric carcinoma are not increased in which of the following conditions?

Accepted Answer

Duodenal ulcer

Answer

Pernicious anemia

Answer

Atrophic gastritis

Answer

Achlorhydria

Question 6

In which of the following conditions of malabsorption is an intestinal biopsy diagnostic?

Accepted Answer

Whipple's disease

Answer

Celiac disease

Answer

Tropical sprue

Answer

Lactose intolerance

Question 7

Multiple transverse small intestinal ulcers with undermined edges are commonly found in patients of which condition?

Accepted Answer

Tuberculosis

Answer

Typhoid

Answer

Amoebiasis

Answer

Regional ileitis (Crohn's disease)

Question 8

What is a highly sensitive and specific marker for detecting intestinal inflammation, as seen in ulcerative colitis?

Accepted Answer

Fecal lactoferrin

Answer

C-reactive protein (CRP)

Answer

Fecal calprotectin

Answer

Erythrocyte sedimentation rate (ESR)

Question 9

Which of the following is a risk factor for the development of gastric carcinoma?

Accepted Answer

Intestinal metaplasia type III

Answer

Blood group O

Answer

Duodenal ulcer

Answer

Intestinal hyperplasia

Question 10

A 55-year-old woman presents with fatigue and malaise which has been worsening over the last 2 months. She also noticed loss of appetite and early satiety. Evaluation finds an ulcerative mass located along the lesser curvature of the stomach along with bilateral ovarian masses. Which of the following is this patient most likely to have?

Accepted Answer

Krukenberg tumor

Answer

Gastric leiomyosarcoma

Answer

Meig syndrome

Answer

Ovarian dysgerminoma

Gastrointestinal Pathology — MCQs

Gastrointestinal Pathology — MCQs

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