General Pathology Practice Questions

Q: Diffuse proliferative glomerulonephritis in Lupus nephritis falls under which class?

Class IV. **Explanation:** The classification of Lupus Nephritis is based on the **ISN/RPS (International Society of Nephrology/Renal Pathology Society)** criteria, which is a high-yield topic for NEET-PG. **Correct Option: C (Class IV)** **Class IV (Diffuse Proliferative Glomerulonephritis)** is the most common and most severe form of lupus nephritis [1]. It is characterized by involvement of **≥ 50% of glomeruli** [1]. Pathologically, it shows global or segmental endocapillary proliferation, "wire-loop" lesions (due to subendothelial immune complex deposits), and often presents with nephritic syndrome or rapidly progressive renal failure [1]. **Analysis of Incorrect Options:** * **Class II (Mesangial Proliferative LN):** Characterized by purely mesangial hypercellularity and matrix expansion with mesangial immune deposits. * **Class III (Focal Proliferative LN):** Similar to Class IV but involves **< 50% of glomeruli** [1]. It is the focal counterpart of the diffuse form. * **Class V (Membranous LN):** Characterized by diffuse thickening of the glomerular basement membrane due to **subepithelial** deposits. It typically presents with nephrotic-range proteinuria. **NEET-PG High-Yield Pearls:** * **Most common class:** Class IV [1]. * **Most severe/worst prognosis:** Class IV [1]. * **Wire-loop lesions:** Characteristic of Class IV (subendothelial deposits) [1]. * **Spikes and Domes:** Characteristic of Class V (subepithelial deposits). * **Full House Pattern:** Immunofluorescence showing IgG, IgA, IgM, C3, and C1q positivity is classic for Lupus Nephritis. * **Class VI:** Advanced Sclerotic LN (>90% sclerosed glomeruli). **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Diseases of the Immune System, pp. 230-232.

Q: All the following organs likely undergo coagulative necrosis except?

Brain. **Explanation:** The core concept tested here is the pattern of tissue death following ischemia. **Coagulative necrosis** is the most common pattern of necrosis, typically seen in all solid visceral organs following hypoxic/ischemic injury (infarction). **Why Brain is the Correct Answer:** The **Brain** is the notable exception to the rule of coagulative necrosis. Ischemic injury to the central nervous system (CNS) results in **Liquefactive necrosis** [1]. This occurs because the brain has a high lipid content and a high concentration of lysosomal enzymes (hydrolases) within microglial cells. These enzymes rapidly digest the dead tissue, turning it into a liquid, viscous mass, eventually forming a cystic space [1]. **Analysis of Incorrect Options:** * **Heart (Myocardium):** Ischemic injury (Myocardial Infarction) is the classic example of coagulative necrosis. The cell proteins and enzymes are denatured, preserving the basic structural outline of the "tombstone" cells for several days. * **Kidney:** Renal infarcts (often wedge-shaped) undergo coagulative necrosis due to the denaturation of structural proteins. * **Spleen:** Splenic infarcts also follow the coagulative pattern, maintaining the tissue architecture while losing cellular detail. **NEET-PG High-Yield Pearls:** * **Coagulative Necrosis:** Characteristic of all solid organ infarcts **except the brain**. * **Liquefactive Necrosis:** Seen in **Brain infarcts** and **Abscesses** (due to bacterial/fungal infections) [1]. * **Caseous Necrosis:** "Cheese-like" appearance, characteristic of **Tuberculosis**. * **Fat Necrosis:** Seen in **Acute Pancreatitis** (enzymatic) and breast trauma (non-enzymatic). * **Fibridoid Necrosis:** Seen in immune-mediated vascular damage (e.g., Polyarteritis Nodosa, Malignant Hypertension). **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Central Nervous System, pp. 1268-1269.

Question 1

Which stain is used to detect lipids in tissue?

Accepted Answer

Oil Red O

Answer

Mucicarmine

Answer

PAS

Answer

Myeloperoxidase

Question 2

A patient, two months post-renal transplant, presents with difficulty in breathing. Chest X-ray reveals bilateral diffuse interstitial infiltrates, predominantly in the perihilar region. What is the most probable etiologic agent?

Accepted Answer

Pneumocystis jirovecii

Answer

Cytomegalovirus (CMV)

Answer

Mycobacterium tuberculosis

Answer

Staphylococcus aureus

Question 3

Which anticoagulant is best suited for the osmotic fragility test?

Accepted Answer

Heparin

Answer

EDTA

Answer

Trisodium citrate

Answer

Potassium oxalate

Question 4

Intracellular calcification begins in which organelle?

Accepted Answer

Mitochondria

Answer

Golgi body

Answer

Nucleus

Answer

Endoplasmic reticulum

Question 5

Diffuse proliferative glomerulonephritis in Lupus nephritis falls under which class?

Accepted Answer

Class IV

Answer

Class II

Answer

Class III

Answer

Class V

Question 6

Which of the following is an example of immune complex-mediated (Type III) hypersensitivity?

Accepted Answer

Systemic lupus erythematosus

Answer

Anaphylaxis

Answer

Autoimmune hemolytic anemia

Answer

Type 1 diabetes

Question 7

Tigered effect in tissues is due to accumulation of:

Accepted Answer

Fat

Answer

Calcium

Answer

Fibrin

Answer

Copper

Question 8

What is true about metastatic calcification?

Accepted Answer

Principally affects the kidneys, lungs, and gastric mucosa

Answer

Serum calcium level is normal

Answer

Occurs in dead or dying tissue

Answer

Occurs in damaged heart valves

Question 9

All the following organs likely undergo coagulative necrosis except?

Accepted Answer

Brain

Answer

Spleen

Answer

Heart

Answer

Kidney

Question 10

Chediak-Higashi syndrome is characterized by the following findings, except?

Accepted Answer

It results in effective phagolysosome formation.

Answer

It is an autosomal recessive disorder.

Answer

It involves mutation in the LYST gene.

Answer

It is associated with oculocutaneous albinism.

General Pathology — MCQs

General Pathology — MCQs

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