General Pathology Practice Questions

Q: A patient diagnosed with bronchiectasis develops features of nephrotic syndrome. What is the most probable diagnosis?

Amyloidosis. **Explanation:** The correct answer is **Amyloidosis**, specifically **Secondary (AA) Amyloidosis**. **1. Why Amyloidosis is correct:** Chronic inflammatory conditions, such as **bronchiectasis**, tuberculosis, osteomyelitis, or rheumatoid arthritis, lead to the chronic overproduction of **Serum Amyloid A (SAA)**, an acute-phase reactant. This protein undergoes proteolytic cleavage and deposits in tissues as insoluble **AA amyloid fibrils**. The kidney is the most common organ involved in AA amyloidosis, typically presenting as asymptomatic proteinuria that rapidly progresses to **Nephrotic Syndrome** [1]. **2. Why the other options are incorrect:** * **SLE:** While SLE causes lupus nephritis (nephrotic syndrome), it is an autoimmune connective tissue disorder not directly triggered by chronic suppurative lung diseases like bronchiectasis. * **Cystic Fibrosis:** Although CF is a common cause of bronchiectasis, the CF itself does not cause nephrotic syndrome. However, a CF patient could *develop* amyloidosis due to chronic infection, making Amyloidosis the more specific pathological diagnosis for the renal finding [1]. * **HIV:** HIV is associated with HIV-Associated Nephropathy (HIVAN), which presents as nephrotic syndrome (typically collapsing FSGS), but it is not etiologically linked to bronchiectasis. **3. High-Yield Clinical Pearls for NEET-PG:** * **Staining:** Amyloid shows **Apple-green birefringence** under polarized light when stained with **Congo Red**. * **Kidney Size:** Unlike most causes of chronic kidney disease, amyloidosis often presents with **enlarged or normal-sized kidneys** on ultrasound. * **Most common cause of AA Amyloidosis (Global):** Rheumatoid Arthritis. * **Most common cause of AA Amyloidosis (India):** Tuberculosis/Chronic infections. * **Biopsy site:** While renal biopsy is definitive, a **rectal biopsy** or **abdominal fat pad aspiration** are less invasive screening methods.

Question 1

Fibrinoid necrosis can be seen in:

Accepted Answer

Peptic ulcer.

Answer

Abscess cavity.

Answer

Pancreas.

Answer

Heart.

Question 2

A one-year-old boy presented with hepatosplenomegaly and delayed milestones. Liver biopsy and bone marrow biopsy revealed histiocytes with PAS-positive, diastase-resistant material in the cytoplasm. Electron-microscopic examination of these histiocytes is most likely to reveal the presence of?

Accepted Answer

Parallel arrays of tubular structures in lysosomes

Answer

Birbeck's granules in the cytoplasm

Answer

Myelin figures in the cytoplasm

Answer

Electron-dense deposits in the mitochondria

Question 3

Amplification of N-myc is associated with which tumour?

Accepted Answer

Neuroblastoma

Answer

Retinoblastoma

Answer

Osteosarcoma

Answer

Neuroma

Question 4

Dystrophic calcification is seen in which of the following conditions?

Accepted Answer

Atheroma

Answer

Paget disease

Answer

Renal osteodystrophy

Answer

Milk alkali syndrome

Question 5

A phenotypically normal woman, whose father was color blind, marries a phenotypically normal man. What is the probability of their son being color blind?

Accepted Answer

50%

Answer

25%

Answer

75%

Answer

0%

Question 6

PAS stains the following, except:

Accepted Answer

Basement membrane of bacteria

Answer

Glycogen

Answer

Lipids

Answer

Fungal cell wall

Question 7

What is the conventional site for taking a biopsy in secondary amyloidosis?

Accepted Answer

Abdominal fat aspirate

Answer

Liver

Answer

Kidney

Answer

Rectum

Question 8

Fibrinoid necrosis is seen in which of the following conditions, except?

Accepted Answer

Diabetes mellitus

Answer

Serum sickness

Answer

Arthus reaction

Answer

Systemic lupus erythematosus

Question 9

A patient diagnosed with bronchiectasis develops features of nephrotic syndrome. What is the most probable diagnosis?

Accepted Answer

Amyloidosis

Answer

Systemic lupus erythematosus (SLE)

Answer

Cystic fibrosis

Answer

Human immunodeficiency virus (HIV)

Question 10

Which of the following is a characteristic morphological feature of apoptosis?

Accepted Answer

Councilman bodies

Answer

Chromatid bodies

Answer

Citron bodies

Answer

Call-Exner bodies

General Pathology — MCQs

General Pathology — MCQs

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