General Pathology Practice Questions

Q: Which of the following is a developmental odontogenic cyst?

Dentigerous cyst. **Explanation:** Odontogenic cysts are classified into two main categories based on their pathogenesis: **Developmental** (arising from remnants of the dental lamina or enamel organ) and **Inflammatory** (arising as a result of inflammation) [1]. **1. Why Dentigerous Cyst is Correct:** A **Dentigerous cyst** (also known as a follicular cyst) is the most common **developmental** odontogenic cyst. It originates from the separation of the follicle from around the crown of an **unerupted tooth**. It is attached to the cemento-enamel junction (CEJ) and is caused by fluid accumulation between the reduced enamel epithelium and the tooth crown. **2. Why the other options are incorrect:** * **Periapical Cyst (Radicular Cyst):** This is the most common **inflammatory** odontogenic cyst [1]. It arises from Malassez epithelial rests in the periodontal ligament following pulp necrosis due to dental caries or trauma [1]. * **Residual Cyst:** This is an **inflammatory** cyst. It is essentially a periapical cyst that remains in the jaw after the offending tooth has been extracted. * **Paradental Cyst:** This is an **inflammatory** cyst typically located on the buccal or distal aspect of a partially erupted mandibular third molar, usually associated with a history of pericoronitis. **High-Yield Clinical Pearls for NEET-PG:** * **Most common odontogenic cyst:** Radicular (Periapical) cyst. * **Most common developmental odontogenic cyst:** Dentigerous cyst. * **Radiological Hallmark:** Dentigerous cysts appear as a well-defined unilocular radiolucency associated with the crown of an impacted tooth (most commonly the mandibular 3rd molar). * **Potential Complications:** If left untreated, a dentigerous cyst can transform into an Ameloblastoma or Mucoepidermoid carcinoma. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Head and Neck, pp. 741-742.

Q: Which of the following is NOT a marker for muscle tumors?

Neurofilament. **Explanation:** The diagnosis of muscle tumors in histopathology relies heavily on **Immunohistochemistry (IHC)** markers, specifically those targeting the cytoskeleton. **Why Neurofilament is the correct answer:** **Neurofilaments (NF)** are intermediate filaments specific to **neurons**. They are used as markers for tumors of neural origin, such as neuroblastomas, ganglioneuromas, and pheochromocytomas. They are **not** expressed in muscle tissue; therefore, they cannot serve as a marker for myogenic tumors. **Analysis of other options:** * **Desmin (Option A):** This is the most specific and widely used marker for both skeletal and smooth muscle cells. It is an intermediate filament that integrates the sarcolemma with the Z-discs. It is positive in Rhabdomyosarcomas and Leiomyosarcomas. * **Actin (Option B):** Specifically **Muscle-Specific Actin (MSA)** and **Smooth Muscle Actin (SMA)** are primary markers for myogenic differentiation. SMA is particularly useful for identifying smooth muscle tumors and myofibroblastic proliferation. * **Intermediate Filament (Option D):** This is a broad category of cytoskeletal proteins. Both **Desmin** (muscle) and **Vimentin** (mesenchymal cells) are types of intermediate filaments found in muscle tumors. Since muscle tumors are mesenchymal in origin, they express these filaments. **High-Yield Clinical Pearls for NEET-PG:** * **Myogenin & MyoD1:** These are the most specific nuclear markers for **Rhabdomyosarcoma** (skeletal muscle) [1]. * **Vimentin:** A general marker for all mesenchymal tumors (sarcomas). * **Caldesmon:** A highly specific marker for **smooth muscle** differentiation, helping to distinguish leiomyosarcomas from myofibroblastic tumors. * **Cytokeratin:** The hallmark marker for epithelial tumors (carcinomas). **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Bones, Joints, and Soft Tissue Tumors, pp. 1224-1225.

Q: Acid mucin is best demonstrated by which stain?

Alcian blue. **Explanation:** The correct answer is **Alcian Blue**. **1. Why Alcian Blue is correct:** Mucins are high-molecular-weight glycoproteins. They are broadly classified into **Acid mucins** (found in the intestinal tract and connective tissue) and **Neutral mucins** (found in the stomach and Brunner’s glands). Alcian blue is a basic dye that contains copper; it binds to the negatively charged carboxylated and sulfated groups of **acid mucins**, staining them a striking **blue**. By adjusting the pH (e.g., pH 2.5 vs. pH 1.0), pathologists can further differentiate between various types of acid mucins. **2. Why other options are incorrect:** * **Periodic Acid Schiff (PAS):** PAS primarily demonstrates **neutral mucins**, glycogen, and basement membranes. While some acid mucins may show weak positivity, PAS is the gold standard for neutral mucins and fungi. * **Van Gieson:** This is a connective tissue stain used to differentiate **collagen** (red) from muscle and cytoplasm (yellow). * **Reticulin:** This silver-based stain is used to visualize **Type III collagen (reticulin fibers)**, which form the structural framework of organs like the liver, bone marrow, and lymph nodes. **High-Yield Clinical Pearls for NEET-PG:** * **Combined PAS-Alcian Blue:** This stain is used to distinguish between neutral and acid mucins in the same section (e.g., detecting **Intestinal Metaplasia** in Barrett’s esophagus). * **Mucicarmine:** Another specific stain for acid mucins, often used to identify *Cryptococcus neoformans* (capsule) and adenocarcinoma. * **Colloidal Iron:** Also used for acid mucins; it is particularly useful in diagnosing **Chromophobe Renal Cell Carcinoma**. [1] **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Gastrointestinal Tract, p. 779.

Question 1

A 75-year-old lady is diagnosed with thyroid malignancy and presents with low serum calcium. What is the most likely explanation?

Accepted Answer

Medullary carcinoma of the thyroid

Answer

Metastasis to the parathyroid glands

Answer

Follicular carcinoma of the thyroid

Answer

Papillary carcinoma of the thyroid

Question 2

Which of the following is a developmental odontogenic cyst?

Accepted Answer

Dentigerous cyst

Answer

Periapical cyst

Answer

Paradental cyst

Answer

Residual cyst

Question 3

Which of the following is NOT a marker for muscle tumors?

Accepted Answer

Neurofilament

Answer

Desmin

Answer

Actin

Answer

Intermediate filament

Question 4

Metastatic calcification is characterized by which of the following?

Accepted Answer

Hypercalcemia

Answer

Hypocalcemia

Answer

Eucalcemia

Answer

None of the above

Question 5

Which statement is true regarding Interleukin-1 (IL-1)?

Accepted Answer

Upregulates adhesion molecules

Answer

Mainly derived from neutrophils

Answer

Produces necrosis of tumor cells

Answer

Increases expression of MHC coded proteins

Question 6

What is the normal range for Prostate-Specific Antigen (PSA)?

Accepted Answer

< 4 ng/mL

Answer

4-10 ng/mL

Answer

10-20 ng/mL

Answer

> 20 ng/mL

Question 7

Virchow's triad includes all of the following, EXCEPT?

Accepted Answer

Venous thrombosis

Answer

Venous stasis

Answer

Injury to veins

Answer

Blood hypercoagulability

Question 8

Splenosis means:

Accepted Answer

Rupture of spleen and distribution of its tissue on peritoneum

Answer

Infection of spleen

Answer

Presence of accessory spleen

Answer

Non-functioning spleen

Question 9

Acid mucin is best demonstrated by which stain?

Accepted Answer

Alcian blue

Answer

Periodic Acid Schiff (PAS)

Answer

Van Gieson

Answer

Reticulin

Question 10

All the statements related to neutrophil extracellular traps (NETs) are true except:

Accepted Answer

NETs provide a low concentration of antimicrobials at the site of infection.

Answer

NETs are an example of beneficial suicide for the neutrophil.

Answer

It is an extracellular fibrillary network.

Answer

NETs can be associated with an increased risk of autoimmune disease.

General Pathology — MCQs

General Pathology — MCQs

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