Gastrointestinal Pathology Practice Questions

Q: Long arm chromosome 5 deletion is seen in which of the following conditions?

Polyposis coli. **Explanation:** **Correct Answer: C. Polyposis coli** Familial Adenomatous Polyposis (FAP), or Polyposis coli, is an autosomal dominant condition characterized by the development of hundreds to thousands of adenomatous colonic polyps [1]. The underlying genetic defect is a mutation or deletion in the **APC (Adenomatous Polyposis Coli) gene**, which is located on the **long arm of chromosome 5 (5q21)**. The APC gene is a tumor suppressor gene that regulates the Wnt signaling pathway; its loss leads to the accumulation of β-catenin, promoting cellular proliferation and the "adenoma-carcinoma sequence." **Analysis of Incorrect Options:** * **A & B. Crohn's disease and Ulcerative Colitis:** These are Inflammatory Bowel Diseases (IBD). While they have a genetic predisposition (e.g., *NOD2/CARD15* mutations on chromosome 16 for Crohn’s), they are not primarily associated with 5q deletions. * **D. Pheochromocytoma:** This neuroendocrine tumor is associated with mutations in genes like *RET* (Chr 10), *VHL* (Chr 3), *NF1* (Chr 17), and *SDHB/D* (Chr 1/11). It is not linked to chromosome 5q. **High-Yield Clinical Pearls for NEET-PG:** * **Gardner Syndrome:** FAP + Osteomas (mandible) + Soft tissue tumors (desmoid tumors) + Dental abnormalities. * **Turcot Syndrome:** FAP + Central Nervous System tumors (Medulloblastoma). * **Rule of 100s:** In FAP, >100 polyps are required for diagnosis, and the risk of progression to colorectal carcinoma is nearly **100%** by age 40 if a prophylactic colectomy is not performed [1]. * **Screening:** Annual sigmoidoscopy starting at age 10-12 for at-risk family members. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Gastrointestinal Tract, pp. 821-822.

Q: Gamma Gandy bodies contain hemosiderin and which other substance?

Ca++. **Explanation:** **Gamma-Gandy bodies** (also known as siderofibrotic nodules) are small, firm, brownish-yellow nodules found in the spleen. They represent organized areas of focal hemorrhage within the splenic parenchyma. 1. **Why Ca++ is correct:** When focal hemorrhage occurs in the spleen (most commonly due to **portal hypertension**), the extravasated red blood cells break down. This leads to the deposition of **hemosiderin** (iron) [1]. Over time, these areas undergo fibrous scarring and secondary **dystrophic calcification**. Therefore, Gamma-Gandy bodies are histologically composed of fibrous tissue containing deposits of both iron (hemosiderin) and **calcium salts (Ca++)**. 2. **Why other options are incorrect:** * **Na+, Mg++, and Cl-:** These are common physiological electrolytes but do not typically form insoluble precipitates or "bodies" within necrotic or fibrotic tissue. Dystrophic calcification specifically involves calcium deposition in damaged tissues, regardless of systemic serum calcium levels. **NEET-PG High-Yield Pearls:** * **Most Common Cause:** Portal hypertension (leading to congestive splenomegaly). Other causes include Sickle Cell Anemia, Hemochromatosis, and Lymphoma. * **Imaging Appearance:** On **MRI (T2-weighted sequences)**, they appear as "signal voids" (dark spots) due to the paramagnetic effect of iron. * **Staining:** Hemosiderin is highlighted by **Prussian Blue** stain [1], while calcium can be highlighted by **Von Kossa** or **Alizarin Red** stains. * **Gross Appearance:** They are often described as "tobacco-fleck" or "siderofibrotic" nodules. **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. 75-76.

Question 1

What is the most common extra-intestinal malignancy associated with Hereditary Non-Polyposis Colorectal Cancer (HNPCC)?

Accepted Answer

Gastric carcinoma

Answer

Pancreatic carcinoma

Answer

Small bowel carcinoma

Answer

Transitional cell carcinoma

Question 2

What is the characteristic feature of Crohn's disease?

Accepted Answer

Skip lesions

Answer

Toxic megacolon

Answer

Fibrosis is rare

Answer

Involvement is superficial

Question 3

Long arm chromosome 5 deletion is seen in which of the following conditions?

Accepted Answer

Polyposis coli

Answer

Crohn's disease

Answer

Ulcerative colitis

Answer

Pheochromocytoma

Question 4

Which of the following statements is NOT true regarding pseudomembranous colitis?

Accepted Answer

Clostridium difficile is the only causative agent.

Answer

It can be associated with antibiotic use, for example, with third-generation cephalosporins.

Answer

It is characterized by the presence of pseudomembranes at the site of mucosal injury.

Answer

It typically presents with watery diarrhea, abdominal pain, and fever.

Question 5

Tooth discoloration due to an increased amount of bilirubin is called what?

Accepted Answer

Chlorodontia

Answer

Acrodontia

Answer

Trochodontia

Answer

None of the above

Question 6

Hypergastrinemia with hypochlorhydria is seen in which condition?

Accepted Answer

Pernicious anemia

Answer

Zollinger Ellison Syndrome

Answer

VIPoma

Answer

Glucagonoma

Question 7

Point mutation in which proto-oncogene is responsible for the development of gastrointestinal stromal tumor?

Accepted Answer

KIT

Answer

ALK

Answer

RET

Answer

FLT3

Question 8

What is the genetic abnormality associated with the progression from late adenoma to carcinoma in colorectal cancer?

Accepted Answer

p53

Answer

APC

Answer

K-ras

Answer

DCC

Question 9

Features of typhoid ulcers include all of the following EXCEPT?

Accepted Answer

Stricture and obstruction

Answer

Bleeding

Answer

Perforation

Answer

Longitudinal orientation

Question 10

Gamma Gandy bodies contain hemosiderin and which other substance?

Accepted Answer

Ca++

Answer

Na+

Answer

Mg ++

Answer

Cl-

Gastrointestinal Pathology — MCQs

Gastrointestinal Pathology — MCQs

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