General Pathology Practice Questions

Q: Which cells are most susceptible to hypoxia?

Neuron. **Explanation:** The correct answer is **A. Neuron**. **Why Neurons are Most Susceptible:** Neurons have the highest metabolic rate of any cell in the body and possess virtually no capacity for anaerobic metabolism. They rely almost exclusively on a continuous supply of oxygen and glucose to maintain the ATP-dependent sodium-potassium pumps ($Na^+/K^+$ ATPase). When hypoxia occurs, ATP levels plummet rapidly, leading to pump failure, cellular swelling (cytotoxic edema), and irreversible damage. Irreversible brain damage typically begins after only **3–5 minutes** of total anoxia. Within the brain, the most sensitive areas are the **Pyramidal cells of the Hippocampus (CA1)** and the **Purkinje cells of the Cerebellum**. **Why Other Options are Incorrect:** * **B. Myocytes:** While cardiac muscle is sensitive to hypoxia, it can survive for approximately 20–30 minutes before irreversible necrosis occurs. Skeletal muscle is even more resistant, capable of surviving several hours of ischemia. * **C. Hepatocytes:** The liver has a dual blood supply (portal vein and hepatic artery) and cells contain significant glycogen stores, making them more resilient to hypoxic insult than neurons. * **D. Epithelium:** Epithelial cells (like those in the skin or GI tract) have lower metabolic demands and can tolerate hypoxia for significantly longer periods compared to neural tissue. **NEET-PG High-Yield Pearls:** * **Order of Susceptibility:** Neurons > Cardiac Myocytes > Hepatocytes > Skeletal Muscle > Connective Tissue. * **Vulnerable Brain Regions:** Hippocampus (Sommer’s sector) > Purkinje cells > Neocortex (Layers III, V, VI) > Striatum. * **Haldane Effect vs. Bohr Effect:** Often tested alongside neuro-respiratory physiology; remember that the Bohr effect describes how $CO_2/H^+$ affects $O_2$ affinity, whereas the Haldane effect describes how $O_2$ affects $CO_2$ affinity.

Q: Werner syndrome is characterized by which of the following?

Premature ageing. **Explanation:** **Werner Syndrome** is a rare autosomal recessive disorder characterized by **premature ageing** (progeria) [1]. It is caused by a mutation in the **WRN gene**, which encodes a member of the **RecQ helicase** family [1]. This enzyme is essential for DNA repair, replication, and maintaining telomere integrity. In its absence, cells accumulate genomic instability and enter replicative senescence prematurely, leading to the clinical manifestation of "adult progeria" [1]. **Analysis of Options:** * **A & B (MEN-I and MEN-II):** These are autosomal dominant syndromes involving endocrine tumors. While **Wermer Syndrome** (with an 'm') is another name for **MEN-I**, it is distinct from **Werner Syndrome** (with an 'n'). This is a common phonetic trap in exams. * **D (Defective sirtuins):** Sirtuins are NAD+-dependent deacetylases that promote longevity by inhibiting metabolic activity and increasing DNA repair. While decreased sirtuin activity is linked to the general aging process, it is not the primary molecular defect in Werner syndrome. **Clinical Pearls for NEET-PG:** * **Clinical Features:** Patients appear normal until puberty, followed by rapid aging: graying/loss of hair, bilateral cataracts, scleroderma-like skin changes, osteoporosis, and atherosclerosis. * **Malignancy Risk:** There is a significantly increased risk of rare cancers, particularly **soft tissue sarcomas** and osteosarcomas. * **Hutchinson-Gilford Progeria:** Unlike Werner (adult-onset), this is a childhood-onset progeria caused by mutations in the **LMNA gene** (Lamin A). * **Key Distinction:** Remember **Wermer** = MEN-1 (3 Ps: Pituitary, Parathyroid, Pancreas); **Werner** = WRN gene (Premature Ageing). **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. 77-78.

Question 1

Which cells are most susceptible to hypoxia?

Accepted Answer

Neuron

Answer

Myocytes

Answer

Hepatocytes

Answer

Epithelium

Question 2

What is the most reliable investigation for amyloidosis?

Accepted Answer

Kidney biopsy

Answer

Abdominal fat pad aspirate

Answer

Ultrasound (USG)

Answer

Urine examination

Question 3

Which of the following is NOT a pathologic effect of free radicals?

Accepted Answer

Synthesis of new proteins.

Answer

Lipid peroxidation in membranes.

Answer

Oxidative modification of proteins.

Answer

Single- and double-strand breaks in DNA.

Question 4

Werner syndrome is characterized by which of the following?

Accepted Answer

Premature ageing

Answer

Multiple Endocrine Neoplasia type I (MEN-I)

Answer

Multiple Endocrine Neoplasia type II (MEN-II)

Answer

Defective sirtuins

Question 5

Which of the following is NOT a clinical manifestation of Disseminated Intravascular Coagulation?

Accepted Answer

Brain edema

Answer

Microthrombi

Answer

Sheehan postpartum pituitary necrosis

Answer

Waterhouse-Friderichsen syndrome

Question 6

Down's syndrome is associated with which of the following?

Accepted Answer

Congenital heart disease, Acute lymphoblastic leukemia, Early onset Alzheimer's disease

Answer

Acute lymphoblastic leukemia, Early onset Alzheimer's disease, CNS tumors, Infection

Answer

Early onset Alzheimer's disease, CNS tumors, Infection

Answer

Congenital heart disease, CNS tumors, Infection

Question 7

Which organ is most vulnerable to ischemic injury due to shock?

Accepted Answer

Heart

Answer

Lungs

Answer

Adrenals

Answer

Kidney

Question 8

Which of the following statements is NOT true for a white infarct?

Accepted Answer

Seen in loose tissues.

Answer

Wedge-shaped area with the apex pointing towards the arterial obstruction.

Answer

Can be transiently red.

Answer

Caused by arterial obstruction.

Question 9

A 28-year-old female patient presents with patches of burns and swelling of the arm. Histopathological findings reveal swelling of the endoplasmic reticulum, blebs from the cell membrane, loss of microvilli, presence of myeloid bodies, and no changes in the nucleus. Which type of cell injury is seen in this patient?

Accepted Answer

Reversible cell injury

Answer

Irreversible cell injury

Answer

Autolysis

Answer

Pyroptosis

Question 10

Which of the following conditions does NOT show the presence of fibrinoid necrosis?

Accepted Answer

Diabetic Glomerulosclerosis

Answer

Systemic Lupus Erythematosus (SLE)

Answer

Polyarteritis Nodosa (PAN)

Answer

Subacute Bacterial Endocarditis (SABE)

General Pathology — MCQs

General Pathology — MCQs

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