Gastrointestinal Pathology Practice Questions

Q: What is the most common site of GIST?

Stomach. **Explanation:** **Gastrointestinal Stromal Tumor (GIST)** is the most common mesenchymal tumor of the gastrointestinal tract. It originates from the **Interstitial Cells of Cajal (ICC)**, which are the pacemaker cells located in the muscularis propria. **Why Stomach is Correct:** The stomach is the most frequent site of occurrence, accounting for approximately **60%** of all GIST cases. These tumors are typically driven by gain-of-function mutations in the **c-KIT (CD117)** tyrosine kinase gene (80%) or the **PDGFRA** gene [1]. **Analysis of Incorrect Options:** * **Ileum (Small Intestine):** This is the second most common site, accounting for about **25-30%** of cases. While common, it is significantly less frequent than the stomach [1]. * **Esophagus & Colon:** These are rare sites for GIST, each accounting for less than **5%** of cases. GISTs in the rectum are slightly more common than in the colon but still far less frequent than gastric GISTs. **High-Yield Clinical Pearls for NEET-PG:** * **Immunohistochemistry (IHC) Marker:** **CD117 (c-KIT)** is the most sensitive and specific marker. **DOG1** (Discovered On GIST 1) is another highly specific marker used in KIT-negative cases. * **Histology:** Most GISTs show a **spindle cell** pattern (70%), followed by an epithelioid pattern. * **Treatment:** The targeted therapy of choice is **Imatinib mesylate**, a tyrosine kinase inhibitor [1]. * **Prognostic Factors:** The risk of malignancy is determined by **tumor size** and **mitotic count** (Mitotic index) [1]. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Gastrointestinal Tract, pp. 782-784.

Question 1

What is the most common site of GIST?

Accepted Answer

Stomach

Answer

Ileum

Answer

Esophagus

Answer

Colon

Question 2

On rectal examination, a patient is found to have a large, fungating mass protruding into the rectal lumen. Biopsy of this mass demonstrates an invasive malignant tumor composed of glandular structures. The development of this condition is most strongly associated with which of the following?

Accepted Answer

Ulcerative colitis

Answer

Diverticulitis

Answer

Diverticulosis

Answer

Juvenile polyposis syndrome

Question 3

Stress-induced ulcers are most commonly found in which location?

Accepted Answer

Fundus of the stomach

Answer

Antrum of the stomach

Answer

Pyloric channel

Answer

First part of the duodenum

Question 4

Which statement best describes the tears seen in Mallory-Weiss syndrome?

Accepted Answer

Longitudinal tears in the lower one-third of the esophagus

Answer

Circumferential tears in the lower one-third of the esophagus

Answer

Longitudinal tears in the middle one-third of the esophagus

Answer

Circumferential tears in the middle one-third of the esophagus

Question 5

Which of the following is associated with Periodic Acid-Schiff (PAS) positive macrophages?

Accepted Answer

Whipple disease

Answer

Abetalipoproteinemia

Answer

Crohn's disease

Answer

Ulcerative colitis

Question 6

Tuberculosis commonly affects which part of the intestine?

Accepted Answer

Ileum

Answer

Jejunum

Answer

Terminal colon

Answer

Transverse colon

Question 7

Skip lesions of the colon with epithelioid granulomas are usually seen with which of the following conditions?

Accepted Answer

Crohn's disease

Answer

Ulcerative colitis

Answer

Intestinal TB

Answer

Sarcoidosis

Question 8

What is the hallmark of Barrett's epithelium?

Accepted Answer

Mucus secreting goblet cells

Answer

Transitional columnar epithelium

Answer

Stratified squamous epithelium

Answer

Acid producing parietal cells

Question 9

Skip granulomatous lesions are seen in:

Accepted Answer

Crohn's disease

Answer

Ulcerative colitis

Answer

Whipple's disease

Answer

Reiter's disease

Question 10

What is true about ulcerative colitis?

Accepted Answer

Primarily involves the colon

Answer

Involves rectum and then extends proximally throughout the colon

Answer

Characterized by skip lesions

Answer

Does not involve the ileum

Gastrointestinal Pathology — MCQs

Gastrointestinal Pathology — MCQs

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