General Pathology Practice Questions

Q: Which of the following is a known effect of bradykinin?

Pain at the site of inflammation. **Explanation:** Bradykinin is a potent inflammatory mediator belonging to the **Kinin system**. It is derived from high-molecular-weight kininogen (HMWK) through the action of the enzyme kallikrein [1]. **Why the correct answer is right:** Bradykinin is one of the primary chemical mediators responsible for the sensation of **pain** during acute inflammation (along with prostaglandins) [1]. It acts by sensitizing and stimulating nociceptors (sensory nerve endings) at the site of injury. **Analysis of incorrect options:** * **A. Vasoconstriction:** Bradykinin is a powerful **vasodilator**, not a vasoconstrictor [1]. It acts on endothelial cells to release nitric oxide and PGI2, leading to smooth muscle relaxation. * **C. Bronchodilatation:** Bradykinin causes **bronchoconstriction** (contraction of bronchial smooth muscle) [1]. This is particularly relevant in allergic reactions and asthma. * **D. Decreased vascular permeability:** Bradykinin significantly **increases vascular permeability** by causing endothelial cell contraction, leading to the formation of intercellular gaps (exudation/edema) [1]. **High-Yield NEET-PG Pearls:** * **The "Triple Response" of Bradykinin:** Vasodilation, increased vascular permeability, and pain. * **ACE Inhibitor Link:** Angiotensin-Converting Enzyme (ACE) normally degrades bradykinin [1]. Therefore, ACE inhibitors lead to increased bradykinin levels, which can cause the classic side effects of **dry cough** and **angioedema**. * **C1 Esterase Inhibitor Deficiency:** This leads to Hereditary Angioedema due to the overproduction of bradykinin. * **Short Half-life:** Bradykinin is rapidly inactivated by kinases (like kininase II/ACE) [1]. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Inflammation and Repair, pp. 100-101.

Q: Which of the following inflammatory mediators does not cause fever?

Nitric oxide. ### Explanation The correct answer is **Nitric oxide (A)**. **1. Why Nitric Oxide is the correct answer:** Fever (pyrexia) is primarily mediated by **pyrogens**. Nitric oxide (NO) is a potent vasodilator and a free radical involved in microbial killing and vascular permeability, but it does not act on the thermoregulatory center of the hypothalamus to raise body temperature [1]. In fact, in the context of septic shock, excessive NO production leads to severe hypotension rather than being a direct mediator of the febrile response. **2. Why the other options are incorrect:** * **Prostaglandins (PGE2):** This is the ultimate mediator of fever [1]. Cytokines stimulate the perivascular cells of the hypothalamus to produce PGE2, which resets the hypothalamic thermostat to a higher level. Aspirin and NSAIDs reduce fever by inhibiting the cyclooxygenase (COX) enzyme responsible for PGE2 synthesis. * **IL-1 and TNF-alpha:** These are **endogenous pyrogens** [1]. They are released by macrophages in response to bacterial products (like LPS/endotoxins). They travel through the bloodstream to the hypothalamus, where they induce the production of PGE2. **3. NEET-PG High-Yield Pearls:** * **Exogenous Pyrogen:** Bacterial Lipopolysaccharide (LPS) is the most common example. * **Endogenous Pyrogens:** IL-1, TNF-α, and IL-6 [1]. * **The "Master Mediator" of Fever:** Prostaglandin E2 (PGE2) [1]. * **Nitric Oxide Functions:** Vasodilation (via cGMP), inhibition of platelet aggregation, and microbicidal activity (via reactive nitrogen species) [1]. It is produced by the enzyme Nitric Oxide Synthase (NOS). **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Inflammation and Repair, pp. 91, 95-96, 101.

Q: Which autoantibody is associated with Sjögren's syndrome?

Anti Ro and Anti La antibodies. **Explanation:** Sjögren's syndrome is a chronic autoimmune disorder characterized by lymphocytic infiltration of exocrine glands, primarily leading to keratoconjunctivitis sicca (dry eyes) and xerostomia (dry mouth) [1]. **Why Option B is Correct:** The hallmark autoantibodies for Sjögren's syndrome are **Anti-Ro (SS-A)** and **Anti-La (SS-B)** [1]. These are directed against ribonucleoprotein antigens. Anti-Ro is found in about 60-90% of patients, while Anti-La is found in approximately 30-60%. Their presence is a key diagnostic criterion and is often associated with earlier disease onset, longer duration, and extraglandular manifestations (like vasculitis). **Analysis of Incorrect Options:** * **A. Anti-centromere antibody:** Highly specific for **Limited Cutaneous Systemic Sclerosis** (formerly CREST syndrome). * **C. Anti-dsDNA antibody:** Highly specific for **Systemic Lupus Erythematosus (SLE)** and correlates with disease activity and lupus nephritis. * **D. Anti-RNP antibody:** The defining serological marker for **Mixed Connective Tissue Disease (MCTD)**. **High-Yield Clinical Pearls for NEET-PG:** * **Schirmer’s Test:** Used to quantify decreased tear production. * **Lip Biopsy:** The gold standard for diagnosis, showing focal lymphocytic sialadenitis in minor salivary glands [1]. * **Malignancy Risk:** Patients with Sjögren's syndrome have a 40-fold increased risk of developing **B-cell Non-Hodgkin Lymphoma** (specifically MALT lymphoma) [1]. * **Neonatal Lupus:** Pregnant women with Anti-Ro/SSA antibodies are at risk of having infants with neonatal lupus and **congenital heart block**. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Diseases of the Immune System, pp. 234-236.

Question 1

Which of the following is a known effect of bradykinin?

Accepted Answer

Pain at the site of inflammation

Answer

Vasoconstriction

Answer

Bronchodilatation

Answer

Decreased vascular permeability

Question 2

Coagulative necrosis is commonly seen in all except:

Accepted Answer

Encephalitis

Answer

Tuberculosis

Answer

Sarcoidosis

Answer

Wet gangrene

Question 3

Which of the following inflammatory mediators does not cause fever?

Accepted Answer

Nitric oxide

Answer

Prostaglandin

Answer

IL-1

Answer

TNF-alpha

Question 4

What is a characteristic of exudative fluid?

Accepted Answer

Cellular debris

Answer

Low protein content

Answer

Specific gravity < 1.012

Answer

Normal vascular permeability

Question 5

Which autoantibody is associated with Sjögren's syndrome?

Accepted Answer

Anti Ro and Anti La antibodies

Answer

Anti centromere antibody

Answer

Anti ds DNA antibody

Answer

Anti RNP antibody

Question 6

Fatty change is typically seen in which of the following organs?

Accepted Answer

Kidney

Answer

Brain

Answer

Adrenal

Answer

Bladder

Question 7

Protein level more than 4-5 g/100ml is seen in all of the following except:

Accepted Answer

Odontogenic keratocyst (OKC).

Answer

Dentigerous cyst.

Answer

Radicular cyst.

Answer

None of the above.

Question 8

A patient is a known case of polyarteritis nodosa. On examination of a biopsy, accumulation of amorphous, eosinophilic, proteinaceous material in the vessel wall was seen. This finding is suggestive of:

Accepted Answer

Fibrinoid necrosis

Answer

Leukocytoclastic vasculitis

Answer

Hyaline arteriosclerosis

Answer

Caseous necrosis

Question 9

Pathologic calcification is seen in which of the following conditions?

Accepted Answer

Scleroderma

Answer

Lichen planus

Answer

Dystrophic epidermolysis bullosa

Answer

Lupus erythematosus

Question 10

What is the most common trisomy?

Accepted Answer

Trisomy 16

Answer

Trisomy 21

Answer

Trisomy 18

Answer

Trisomy 13

General Pathology — MCQs

General Pathology — MCQs

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