General Pathology Practice Questions

Q: What is the shelf life of blood preserved with CPDA?

5 weeks. **Explanation:** The shelf life of stored blood is determined by the anticoagulant-preservative solution used, which maintains red cell viability and prevents clotting. **CPDA-1 (Citrate Phosphate Dextrose Adenine)** is the most commonly used conventional preservative. * **Why 5 weeks is correct:** CPDA-1 extends the storage life of whole blood or packed red blood cells (PRBCs) to **35 days (5 weeks)**. The addition of **Adenine** is the key factor here; it provides a substrate for red cells to synthesize ATP, which maintains membrane integrity and improves post-transfusion survival compared to older solutions. **Analysis of Incorrect Options:** * **A & B (2-3 weeks):** These durations are associated with older preservatives like **ACD (Acid Citrate Dextrose)** or **CPD (Citrate Phosphate Dextrose)**, which lack adenine and only preserve blood for 21 days. * **D (8 weeks):** This exceeds the capability of CPDA-1. However, storage can be extended to **42 days (6 weeks)** if **Additive Solutions** (like SAGM: Saline, Adenine, Glucose, and Mannitol) are used. **High-Yield Clinical Pearls for NEET-PG:** * **Storage Temperature:** Blood must be stored at **2°C to 6°C**. * **The "Storage Lesion":** During storage, certain changes occur (decreased pH, decreased 2,3-DPG, decreased Sodium, and **increased Potassium**). * **Fresh Blood:** Defined as blood stored for <7 days; preferred in exchange transfusions to avoid hyperkalemia and ensure high 2,3-DPG levels for oxygen delivery. * **Frozen RBCs:** Can be stored for up to **10 years** using glycerol as a cryoprotectant.

Q: Liquefactive necrosis is typically seen in which organ?

Brain. **Explanation:** **Liquefactive necrosis** is characterized by the transformation of the tissue into a liquid, viscous mass. This occurs when the rate of enzymatic digestion of cells exceeds the rate of protein denaturation. **Why the Brain is Correct:** In the Central Nervous System (CNS), ischemic injury (infarct) leads to liquefactive necrosis rather than coagulative necrosis [1]. This is due to two primary reasons: 1. **High Lipid Content:** Brain tissue is rich in lipids and low in supportive connective tissue (collagen). 2. **Hydrolytic Enzymes:** Ischemia triggers the release of potent hydrolytic enzymes from lysosomes (autolysis) and microglial cells, which rapidly dissolve the dead tissue into a fluid-filled cavity [1]. **Analysis of Incorrect Options:** * **A. Heart:** Ischemia of the myocardium leads to **Coagulative Necrosis**. The basic cell outline is preserved for several days as proteins and enzymes are denatured. * **C. Lungs:** While lung infections (like abscesses) can show liquefactive necrosis, an infarct in the lung typically results in **Coagulative Necrosis** (Hemorrhagic/Red Infarct). * **D. Spleen:** Ischemia in solid organs like the spleen results in **Coagulative Necrosis** (Pale/White Infarct). **High-Yield Clinical Pearls for NEET-PG:** * **Two main settings for Liquefactive Necrosis:** 1. Brain Infarcts. 2. Abscesses (due to bacterial or fungal infections where neutrophils release proteolytic enzymes). * **Coagulative Necrosis** is the most common pattern of necrosis and is seen in all solid organ infarcts **except** the brain. * **Wet Gangrene** is a clinical variation of liquefactive necrosis superimposed on coagulative necrosis. * **Morphology:** The necrotic area is eventually removed by phagocytes, leaving a cystic space [1]. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Central Nervous System, pp. 1268-1269.

Q: Papillary cystadenoma lymphomatosum is otherwise called:

Warthin's tumour. **Explanation:** **Papillary cystadenoma lymphomatosum**, commonly known as **Warthin’s tumour**, is the second most common benign salivary gland neoplasm. The name is derived from its unique histological appearance: it consists of **papillary** projections lined by a double layer of oncocytic cells (columnar and cuboidal) forming **cysts**, all set within a dense **lymphoid** stroma (often containing germinal centers) [1]. **Analysis of Options:** * **Warthin’s tumour (Correct):** It occurs almost exclusively in the **parotid gland** (often in the tail). It is unique because it is the most common salivary gland tumor to present **bilaterally** (10%) or multicentrically [1]. * **Pleomorphic adenoma:** This is the most common salivary gland tumor overall. It is a "mixed tumor" containing both epithelial and mesenchymal elements (chondroid or myxoid stroma), but it lacks the lymphoid-cystic architecture of Warthin’s. * **Mucoepidermoid carcinoma:** This is the most common **malignant** salivary gland tumor. It is composed of a mixture of squamous (epidermoid), mucus-secreting, and intermediate cells. * **Medullary carcinoma:** This is a thyroid malignancy derived from parafollicular C-cells (secreting calcitonin). It is unrelated to salivary gland pathology. **High-Yield Clinical Pearls for NEET-PG:** * **Smoking Link:** Warthin’s tumour has the strongest association with **cigarette smoking** among all salivary tumors (8x higher risk). * **Demographics:** Classically seen in **older males** (though the gender gap is narrowing). * **Imaging:** On Technetium-99m pertechnetate scan, it appears as a **"Hot Nodule"** because the oncocytic cells concentrate the isotope. * **Origin:** It is thought to arise from salivary gland epithelium entrapped within intra-parotid lymph nodes during embryogenesis. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Head and Neck, p. 753.

Q: What is the term for a dilated endoplasmic reticulum?

Dohle bodies. **Explanation:** **Dohle bodies** are the correct answer. They are light blue-gray, oval, or teardrop-shaped inclusions found in the cytoplasm of neutrophils. Ultrastructurally, they represent **dilated strands of rough endoplasmic reticulum (RER)**. They are typically seen in "toxic" states such as severe bacterial infections, burns, trauma, or pregnancy, often alongside toxic granulation and cytoplasmic vacuolation. **Analysis of Incorrect Options:** * **Asteroid bodies:** These are star-shaped eosinophilic inclusions found within giant cells in granulomatous diseases, most classically **Sarcoidosis** and Sporotrichosis. * **Bamboo bodies:** These are ferruginous bodies (asbestos bodies) that appear segmented or beaded, resembling bamboo. They are found in the lungs of patients with **Asbestosis**. * **Hirano bodies:** These are eosinophilic, rod-like inclusions made of actin-binding proteins found in the neurons (specifically the hippocampus) of patients with **Alzheimer’s disease**. **High-Yield Clinical Pearls for NEET-PG:** * **May-Hegglin Anomaly:** This is a rare autosomal dominant disorder characterized by large, "Dohle-like" bodies in leukocytes, associated with giant platelets and thrombocytopenia. * **Toxic Granulation:** Often seen with Dohle bodies, these represent prominent primary granules (lysosomes) in neutrophils during inflammation. * **Chediak-Higashi Syndrome:** Characterized by giant lysosomal granules in neutrophils (due to a defect in vesicle trafficking), which should not be confused with Dohle bodies.

Q: The execution phase of apoptosis, which mediates the final phase of programmed cell death, is associated with which of the following caspases?

Caspase 3. **Explanation:** Apoptosis occurs in two distinct phases: the **Initiation phase**, where caspases become catalytically active, and the **Execution phase**, where these enzymes actually cause cell death [1]. **Why Caspase 3 is correct:** Caspase 3 is the primary **executioner caspase** (along with Caspases 6 and 7). Once activated by either the intrinsic or extrinsic pathway, Caspase 3 cleaves structural proteins (like nuclear lamins) and activates **Cytoplasmic DNase**, leading to the characteristic DNA fragmentation and cytoskeletal breakdown seen in apoptosis. **Analysis of Incorrect Options:** * **Caspase 9 (Option A):** This is the **initiator caspase** for the **Intrinsic (Mitochondrial) pathway** [1]. It is activated after the release of Cytochrome C and the formation of the apoptosome. * **Caspase 8 (Option B):** This is the **initiator caspase** for the **Extrinsic (Death Receptor) pathway** [1]. It is activated by the binding of ligands like FasL to the Fas receptor. * **Caspase 1 (Option C):** This is not involved in classical apoptosis. It is an "inflammatory caspase" involved in **Pyroptosis** and the activation of IL-1̢. **High-Yield Clinical Pearls for NEET-PG:** * **Initiator Caspases:** 8, 9, 10. * **Executioner Caspases:** 3, 6, 7. * **Caspase-Independent Death:** Mediated by AIF (Apoptosis Inducing Factor). * **Marker of Apoptosis:** Annexin V (binds to Phosphatidylserine flipped to the outer membrane). * **DNA Laddering:** A hallmark of apoptosis (180-200 base pair fragments), visualized on gel electrophoresis. **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. 64-65.

Question 1

Which of the following is NOT a cardinal sign of inflammation?

Accepted Answer

Cyanosis

Answer

Pain

Answer

Swelling

Answer

Redness

Question 2

What is the shelf life of blood preserved with CPDA?

Accepted Answer

5 weeks

Answer

2 weeks

Answer

3 weeks

Answer

8 weeks

Question 3

An oval lesion is found in the right lobe of the liver in an otherwise asymptomatic 24-year-old female. Surgical resection finds a single well-demarcated lesion that has a prominent, central, stellate white scar. What is the most consistent diagnosis based on this gross appearance?

Accepted Answer

Focal nodular hyperplasia

Answer

Metastatic adenocarcinoma

Answer

Hemangioma

Answer

Hepatocellular carcinoma

Question 4

Liquefactive necrosis is typically seen in which organ?

Accepted Answer

Brain

Answer

Heart

Answer

Lungs

Answer

Spleen

Question 5

Papillary cystadenoma lymphomatosum is otherwise called:

Accepted Answer

Warthin's tumour

Answer

Pleomorphic adenoma

Answer

Mucoepidermoid carcinoma

Answer

Medullary carcinoma

Question 6

What is the term for a dilated endoplasmic reticulum?

Accepted Answer

Dohle bodies

Answer

Asteroid bodies

Answer

Bamboo bodies

Answer

Hirano bodies

Question 7

A cyst showing cholesterol crystals is/are:

Accepted Answer

All of the above.

Answer

Branchial cyst.

Answer

Dentigerous cyst.

Answer

Old hydrocele.

Question 8

Dystrophic calcification is seen in which of the following conditions?

Accepted Answer

Atheromatous plaque

Answer

Rickets

Answer

Hyperparathyroidism

Answer

Vitamin A intoxication

Question 9

CD-95 has a major role in:

Accepted Answer

Apoptosis

Answer

Cell necrosis

Answer

Interferon activation

Answer

Proteolysis

Question 10

The execution phase of apoptosis, which mediates the final phase of programmed cell death, is associated with which of the following caspases?

Accepted Answer

Caspase 3

Answer

Caspase 9

Answer

Caspase 8

Answer

Caspase 1

General Pathology — MCQs

General Pathology — MCQs

On this page

Practice by Chapter

Want unlimited practice?