General Pathology Practice Questions

Q: Which tumour has the tendency to invade perineural spaces?

Adenoid cystic carcinoma. **Explanation:** **Adenoid Cystic Carcinoma (ACC)** is the correct answer because it is classically characterized by its high propensity for **perineural invasion (PNI)**. [1] This occurs when tumor cells infiltrate the space surrounding a nerve. In the head and neck region, this often leads to clinical symptoms such as pain, numbness, or facial nerve palsy, and it is a major factor contributing to the tumor's high rate of local recurrence and late distant metastasis. [1] **Analysis of Options:** * **Adenoid Cystic Carcinoma (A):** Histologically, it shows "Swiss-cheese" (cribriform) patterns. Its neurotropic nature is its most defining surgical and pathological feature. [1] * **Mucoepidermoid Carcinoma (B):** This is the most common malignant salivary gland tumor. While it can be aggressive, it is characterized by a mixture of mucus-secreting, squamous, and intermediate cells rather than a specific tendency for perineural spread. [1] * **Acinic Cell Carcinoma (C):** This is generally a low-grade malignancy with a relatively good prognosis; perineural invasion is rare. [1] * **Adenocarcinoma (D):** While some subtypes (like Polymorphous Adenocarcinoma) show perineural invasion, ACC is the "classic" and most frequent association tested in exams regarding this feature. **High-Yield Pearls for NEET-PG:** * **Classic Triad of ACC:** Cribriform pattern (Swiss-cheese appearance), Perineural invasion, and Slow-growing but relentless clinical course. * **Staining:** The "pseudocysts" in the cribriform pattern stain positive with **PAS** and **Alcian Blue** (containing glycosaminoglycans). * **Other tumors with PNI:** Squamous cell carcinoma of the skin, Pancreatic adenocarcinoma, and Prostate cancer. * **Common Site:** Most commonly involves the minor salivary glands (palate). [1] **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Head and Neck, pp. 753-755.

Q: What is true about integrins?

They are used in binding.. **Explanation:** **Integrins** are transmembrane heterodimeric glycoproteins (composed of $\alpha$ and $\beta$ subunits) that function as primary **adhesion molecules** [1]. They play a critical role in cell-matrix and cell-cell interactions [1]. 1. **Why Option A is correct:** Integrins are essential for **binding**. They link the intracellular cytoskeleton (actin filaments) to the extracellular matrix (ECM) components like fibronectin and laminin [1]. In the context of inflammation, integrins on leukocytes (e.g., LFA-1, VLA-4) bind to ligands on endothelial cells (e.g., ICAM-1, VCAM-1), facilitating the **firm adhesion** phase of leukocyte extravasation [1]. 2. **Why Options B and C are incorrect:** Integrins are structural and signaling receptors, not genes [2]. While altered integrin expression is seen in cancer metastasis (helping cells detach and reattach), they are not classified as **oncogenes** (genes that promote cell growth) or **anti-oncogenes** (tumor suppressor genes). **Clinical Pearls for NEET-PG:** * **Leukocyte Adhesion Deficiency (LAD) Type 1:** Caused by a defect in the **$\beta$2-integrin (CD18)**. It presents with delayed umbilical cord separation, recurrent bacterial infections without pus formation, and persistent leukocytosis. * **Glanzmann Thrombasthenia:** Caused by a deficiency of **GpIIb/IIIa** (an integrin) on platelets, leading to defective platelet aggregation and bleeding [1]. * **Inside-out signaling:** A unique feature where intracellular signals trigger a conformational change in the extracellular domain of the integrin to increase its binding affinity. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. With Illustrations By, pp. 36-37. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. With Illustrations By, pp. 29-30.

Question 1

Which tumour has the tendency to invade perineural spaces?

Accepted Answer

Adenoid cystic carcinoma

Answer

Mucoepidermoid Carcinoma

Answer

Acinic cell carcinoma

Answer

Adenocarcinoma

Question 2

What is the first event to appear in acute inflammation?

Accepted Answer

Vasodilation

Answer

Increased vascular permeability

Answer

Vasoconstriction

Answer

Decreased vascular permeability

Question 3

Which of the following statements regarding apoptosis is incorrect?

Accepted Answer

Caspases are endonucleases.

Answer

It exhibits a step ladder pattern on agarose gel electrophoresis.

Answer

Apoptosis is an energy-independent process.

Answer

Annexin V is a marker of apoptosis.

Question 4

Which vasoactive amine is involved in inflammation?

Accepted Answer

Histamine

Answer

Dopamine

Answer

Adrenaline

Answer

Angiotensin

Question 5

What is true about integrins?

Accepted Answer

They are used in binding.

Answer

They are oncogenes.

Answer

They are anti-oncogenes.

Answer

All of the above.

Question 6

Anticipation is seen in which of the following genetic mechanisms?

Accepted Answer

Trinucleotide-repeat expansion

Answer

Translocation

Answer

Chromosome breaking

Answer

Mitochondrial mutation

Question 7

A 65-year-old woman has noticed a slowly enlarging nodule on her face for the past 3 years. On physical examination, a 3-cm, nontender, mobile, discrete mass is palpable on the left side of the face, anterior to the ear and just superior to the mandible. The mass is completely excised, and histologic examination shows ductal epithelial cells in a myxoid stroma containing islands of chondroid like tissue and bone. This patient is most likely to have which of the following neoplasms?

Accepted Answer

Pleomorphic adenoma

Answer

Acinic cell tumor

Answer

Mucoepidermoid carcinoma

Answer

Primitive neuroectodermal tumor

Question 8

All of the following are signs of necrosis except?

Accepted Answer

Lipofuscin

Answer

Cell membrane rupture

Answer

Karyolysis

Answer

Karyorrhexis

Question 9

Which of the following conditions is NOT associated with HLA-B27?

Accepted Answer

Systemic lupus erythematosus (SLE)

Answer

Ankylosing spondylitis

Answer

Juvenile rheumatoid arthritis

Answer

Reactive arthritis

Question 10

What is the most characteristic feature of acute inflammation?

Accepted Answer

Vasodilation and increased vascular permeability

Answer

Vasoconstriction

Answer

Vascular stasis

Answer

Margination of leucocytes

General Pathology — MCQs

General Pathology — MCQs

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