General Pathology Practice Questions

Q: Thymus gland abscess seen in congenital syphilis is called:

Dubois' abscess. ***Dubois' abscess*** - **Dubois' abscesses** are characteristic microscopic foci of necrosis and granulomatous inflammation that occur in the **thymus gland** in cases of **congenital syphilis**. - They are a specific pathological finding associated with **early congenital syphilis**, reflecting the systemic dissemination of *Treponema pallidum*. *Politzer's abscess* - **Politzer's abscess** is a term mainly associated with an abscess in the external or middle ear, often following **otitis media**. - It has no known association with **congenital syphilis** or the **thymus gland**. *Douglas abscess* - A **Douglas abscess** refers to a collection of pus in the **rectouterine pouch** (pouch of Douglas) in females, or the rectovesical pouch in males. - This is typically a complication of **pelvic inflammatory disease** or appendicitis and is unrelated to the thymus or syphilis. *Fouchier's abscess* - **Fouchier's abscess** is an older term sometimes used to describe an **epidural abscess**, particularly in the spine. - This condition involves an infection within the spinal canal and is not linked to the thymus or congenital syphilis.

Q: Which of the following is most susceptible to ionizing radiation?

Small lymphocytes. ***Small lymphocytes*** - **Lymphocytes** are highly sensitive to **ionizing radiation** due to their rapid proliferation and vulnerability during DNA synthesis [1]. - Exposure to radiation can lead to rapid **apoptosis** (programmed cell death) of lymphocytes, causing **lymphocytopenia** [1]. *Nerve cells* - **Nerve cells** are generally considered **radioresistant** because they are terminally differentiated and do not undergo cell division. - Their primary function is transmission of electrical impulses, which is not immediately disrupted by typical radiation doses. *Epithelial cells* - **Epithelial cells** (e.g., skin, gut lining) are moderately sensitive to radiation, primarily due to their **high turnover rate** [1]. - However, they are generally less sensitive than lymphocytes, and their damage often requires higher doses or prolonged exposure [1]. *Mature bone* - **Mature bone** is highly resistant to radiation because its cells (osteocytes) are largely quiescent and the extracellular matrix is inert [1]. - Significant damage to bone typically occurs at very high doses, affecting the more sensitive **bone marrow** stem cells within it rather than the mature bone itself [1]. **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. (Basic Pathology) introduces the student to key general principles of pathology, both as a medical science and as a clinical activity with a vital role in patient care. Part 2 (Disease Mechanisms) provides fundamental knowledge about the cellular and molecular processes involved in diseases, providing the rationale for their treatment. Part 3 (Systematic Pathology) deals in detail with specific diseases, with emphasis on the clinically important aspects., pp. 111-114.

Q: Type of necrosis seen in case of burn:

Coagulative necrosis.. ***Coagulative necrosis.*** [1] - Burn injuries cause **protein denaturation** due to heat, leading to **cell death** where the cellular architecture is preserved for some time [1]. - This is the **primary and characteristic** type of necrosis directly resulting from thermal injury [1]. - The coagulation of intracellular proteins results in an **infarcted area** that appears firm and opaque [1]. *Both coagulative and liquefactive.* - While coagulative necrosis is the primary type, liquefactive necrosis may occur **secondarily** if there is superimposed infection or tissue breakdown. - However, the question asks for the type of necrosis **seen in case of burn**, which refers to the **primary pathological process** caused by thermal injury itself. - The characteristic and predominant pattern is **coagulative**, not both simultaneously. *Liquefactive necrosis.* - **Liquefactive necrosis** is characterized by the dissolution of dead cells into a viscous liquid mass due to enzymatic digestion. - Typically seen in **bacterial abscesses**, **brain infarcts**, and **hypoxic death of CNS tissue**. - This is not the primary type of necrosis directly caused by thermal injury of a burn. *Caseous necrosis.* - **Caseous necrosis** is a distinct form of cell death associated with specific granulomatous diseases, most notably **tuberculosis**. - Results in cheese-like, friable dead tissue with loss of cellular architecture. - Not characteristic of burn injuries. **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. 51-55.

Q: Ischemic necrosis in alkali burn corresponds to which stage?

Stage II. ***Stage II*** - **Ischemic necrosis** in an alkali burn corresponds to Stage II, indicating a more severe and damaging effect on the tissue. - This stage involves significant cell death due to **loss of blood supply**, often seen in deeper tissue penetration by the corrosive agent [1]. *Stage I* - Stage I describes **edema** and **epithelial erosion** without significant tissue necrosis or ischemia [1]. - This stage is typically characterized by superficial damage, good perfusion, and a relatively rapid recovery without permanent scarring. *Stage III* - Stage III represents a severely advanced burn that progresses beyond necrosis to **perforation** of the esophagus or other affected organs. - At this stage, the tissue damage is extensive, leading to a high risk of complications like **mediastinitis** or **peritonitis**. *Stage IV* - While not a universally recognized stage for alkali burns, if used, Stage IV would imply **incurable damage** or **systemic complications** that threaten the patient's life, possibly involving multiple organ failure due to sepsis or other severe sequelae. - This stage would signify irreversible harm beyond localized tissue destruction, often leading to a fatal outcome. **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. 53-56, 61-62.

Q: Crumpled paper appearance of cells is a feature of-

Gaucher disease. ***Gaucher disease*** - The **crumpled paper** or **wrinkled tissue paper** appearance is characteristic of **Gaucher cells**, which are macrophages engorged with **glucocerebroside** [1]. - This accumulation results from a deficiency in the enzyme **glucocerebrosidase**, a hallmark of Gaucher disease [1]. *Asbestosis* - Characterized by the presence of **asbestos bodies** (ferruginous bodies), which are asbestos fibers coated with an iron-protein complex, not cells with crumpled appearance [2]. - This condition involves **pulmonary fibrosis** due to asbestos exposure [2]. *GVHD (Graft-versus-host disease)* - Histologically, GVHD is characterized by **lymphocytic infiltration** and damage to target organs like skin, liver, and GI tract, not by storage cells with a crumpled appearance. - It is an immunological reaction occurring after **allogeneic hematopoietic stem cell transplantation**. *Wilson's disease* - Involves excessive accumulation of **copper** in various tissues, particularly the liver, brain, and cornea. - Diagnosed by markers like low **ceruloplasmin** and high urinary copper, and does not involve cells with a storage-related crumpled appearance. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Genetic Disorders, pp. 162-163. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Lung, pp. 698-699.

Question 1

White infarcts are seen in which of the following?

Accepted Answer

Spleen

Answer

Heart

Answer

Kidney

Answer

All of the options

Question 2

Thymus gland abscess seen in congenital syphilis is called:

Accepted Answer

Dubois' abscess

Answer

Politzer's abscess

Answer

Douglas abscess

Answer

Fouchier's abscess

Question 3

Fibroblasts in healing wound are derived from -

Accepted Answer

Local mesenchyme

Answer

Epithelium

Answer

Endothelium

Answer

Bone marrow

Question 4

Which of these cells is most radio-resistant?

Accepted Answer

Muscle cells

Answer

Fibroblasts

Answer

Vascular endothelial cells

Answer

Early precursor cells of erythroblastic series

Question 5

Which of the following is most susceptible to ionizing radiation?

Accepted Answer

Small lymphocytes

Answer

Nerve cells

Answer

Epithelial cells

Answer

Mature bone

Question 6

Liver after transplant enlarges by -

Accepted Answer

Both

Answer

Increase in number of cells

Answer

Increase in size of cell

Answer

None of the options

Question 7

Type of necrosis seen in case of burn:

Accepted Answer

Coagulative necrosis.

Answer

Liquefactive necrosis.

Answer

Caseous necrosis.

Answer

Both coagulative and liquefactive.

Question 8

Necrotizing granulomatous lymphadenopathy is caused by -

Accepted Answer

Atypical mycobacterial infection

Answer

Cat Scratch Disease (Bartonella henselae)

Answer

Sarcoidosis

Answer

Kikuchi disease

Question 9

Ischemic necrosis in alkali burn corresponds to which stage?

Accepted Answer

Stage II

Answer

Stage I

Answer

Stage III

Answer

Stage IV

Question 10

Crumpled paper appearance of cells is a feature of-

Accepted Answer

Gaucher disease

Answer

Asbestosis

Answer

GVHD

Answer

Wilson's disease

General Pathology — MCQs

General Pathology — MCQs

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