General Pathology Practice Questions

Q: What is the cause of infertility in KÃ¤gener syndrome?

Asthenospermia. **Explanation:** **Kartagener Syndrome** is a subset of **Primary Ciliary Dyskinesia (PCD)**, characterized by the clinical triad of situs inversus, chronic sinusitis, and bronchiectasis. The underlying pathology is a structural defect in the **dynein arms** of cilia and flagella. 1. **Why Asthenospermia is correct:** The tail of a spermatozoon is a modified flagellum with a "9+2" microtubule arrangement, identical to respiratory cilia. In Kartagener syndrome, the deficiency of dynein arms results in **impaired motility**. While the sperm count (oligospermia) and morphology are typically normal, the sperm are unable to swim effectively to reach the oocyte. This state of reduced or absent motility is termed **Asthenospermia**. 2. **Why other options are incorrect:** * **Oligospermia:** Sperm production in the testes is generally normal because spermatogenesis is not dependent on ciliary function. * **Undescended testis:** This is an anatomical developmental defect (cryptorchidism) not associated with microtubule or dynein arm dysfunction. * **Epididymis obstruction:** While PCD can occasionally affect the efferent ductules, the primary and classic cause of infertility in these patients is the functional defect in sperm motility, not a physical blockage. **High-Yield Clinical Pearls for NEET-PG:** * **Inheritance:** Autosomal Recessive. * **Diagnosis:** Screening via nasal nitric oxide levels; definitive diagnosis via electron microscopy (showing absent dynein arms). * **Female Infertility:** Women with Kartagener syndrome may also face subfertility due to impaired ciliary action in the **fallopian tubes**, which hinders ovum transport. * **Management:** Infertility in males is best treated with **ICSI (Intracytoplasmic Sperm Injection)**, as motility is not required for successful fertilization in vitro.

Q: A 22-year-old woman with an uncomplicated pregnancy develops sudden dyspnea with cyanosis and hypotension intrapartum during routine vaginal delivery of a term infant. She has a generalized seizure and becomes comatose. Her condition does not improve over the next 2 days. Which of the following findings is most likely to be present in her peripheral pulmonary arteries?

Amniotic fluid. ### Explanation The clinical presentation described—**sudden onset dyspnea, cyanosis, hypotension, seizures, and coma** during labor—is the classic triad of **Amniotic Fluid Embolism (AFE)**. #### Why Amniotic Fluid is Correct AFE occurs when amniotic fluid (containing fetal debris like squamous cells, lanugo hair, and mucin) enters the maternal circulation through a breach in the placental membranes or uterine veins. This triggers a catastrophic biphasic response: 1. **Phase 1:** Pulmonary vasospasm leading to acute right heart failure and respiratory distress. 2. **Phase 2:** Left heart failure and a massive inflammatory response resembling systemic inflammatory response syndrome (SIRS), often leading to **Disseminated Intravascular Coagulation (DIC)**. Histologically, the presence of **fetal squamous cells** or mucin within the maternal peripheral pulmonary arteries confirms the diagnosis. #### Why Other Options are Incorrect * **A. Aggregates of platelets:** Suggests a thromboembolism. While DIC occurs in AFE, the primary inciting event is the entry of amniotic fluid, not a simple blood clot. * **C. Fat globules:** Characteristic of **Fat Embolism Syndrome**, typically seen after long-bone fractures or orthopedic surgery, not routine vaginal delivery. * **D. Gas bubbles:** Indicates **Air Embolism**, which can occur during procedures like manual removal of the placenta or deep-sea diving (decompression sickness), but is less likely than AFE in this specific clinical context. #### NEET-PG High-Yield Pearls * **Risk Factors:** Advanced maternal age, multiparity, hypertonic uterine contractions, and instrumental delivery. * **Classic Triad:** Hypoxia, Hypotension, and Coagulopathy (DIC). * **Diagnosis:** Primarily clinical; definitive diagnosis is often made post-mortem by finding fetal elements in the pulmonary vasculature. * **Management:** Supportive (A-B-C: Airway, Breathing, Circulation). There is no specific antidote.

Question 1

Which of the following is NOT an example of coagulative necrosis?

Accepted Answer

Brain infarct

Answer

Myocardial infarct

Answer

Kidney infarct

Answer

Adrenal infarct

Question 2

What fixative is used for bone histopathology?

Accepted Answer

10% formalin

Answer

Normal saline

Answer

Rectified spirit

Answer

Nothing

Question 3

What is the cause of infertility in KÃ¤gener syndrome?

Accepted Answer

Asthenospermia

Answer

Oligospermia

Answer

Undescended testis

Answer

Epididymis obstruction

Question 4

Cloudy swelling occurs in which of the following organs, EXCEPT?

Accepted Answer

Lungs

Answer

Kidney

Answer

Liver

Answer

Adrenals

Question 5

Amyloidosis of the kidney may be seen in which of the following conditions, except?

Accepted Answer

Enteric fever

Answer

Ulcerative colitis

Answer

Suppurative lung disease

Answer

Hansen's disease

Question 6

Which apoptotic gene is also associated with autophagy?

Accepted Answer

BCL-2

Answer

p53

Answer

BAX

Answer

BID

Question 7

A 40-year-old man is pulled from the ocean after a boating accident and resuscitated. Six hours later, the patient develops acute renal failure. Kidney biopsy reveals evidence of karyorrhexis and karyolysis in renal tubular epithelial cells. Which of the following biochemical events preceded these pathologic changes?

Accepted Answer

Decrease in intracellular pH

Answer

Activation of Na+/K+ ATPase

Answer

Decrease in intracellular calcium

Answer

Increase in ATP production

Question 8

Metastatic calcification does not occur in which of the following locations?

Accepted Answer

Fundal glands of intestine

Answer

Renal tubules

Answer

Lungs alveoli

Answer

Blood vessels

Question 9

All of the following are hypercoagulable conditions EXCEPT?

Accepted Answer

Antiphospholipid antibody syndrome (associated with lupus anticoagulant)

Answer

Antithrombin III deficiency

Answer

Protein C deficiency

Answer

Protein S deficiency

Question 10

A 22-year-old woman with an uncomplicated pregnancy develops sudden dyspnea with cyanosis and hypotension intrapartum during routine vaginal delivery of a term infant. She has a generalized seizure and becomes comatose. Her condition does not improve over the next 2 days. Which of the following findings is most likely to be present in her peripheral pulmonary arteries?

Accepted Answer

Amniotic fluid

Answer

Aggregates of platelets

Answer

Fat globules

Answer

Gas bubbles

General Pathology — MCQs

General Pathology — MCQs

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