General Pathology Practice Questions

Q: Which X-linked recessive disease in males presents with a clotting defect?

Hemophilia A. **Explanation:** **Hemophilia A** is the correct answer because it is a classic **X-linked recessive** bleeding disorder caused by a deficiency of **Coagulation Factor VIII** [1]. Since males have only one X chromosome, they manifest the disease if they inherit the defective gene, leading to a significant **clotting defect**. This typically presents as deep tissue bleeding, hemarthrosis (bleeding into joints), and prolonged Activated Partial Thromboplastin Time (aPTT). **Analysis of Incorrect Options:** * **Idiopathic Thrombocytopenic Purpura (ITP):** This is an **acquired autoimmune disorder** where antibodies are directed against platelets. It is not a genetic clotting factor deficiency and typically presents with superficial bleeding (petechiae, ecchymosis) rather than deep-seated clotting defects. * **Von-Willebrand Disease (vWD):** While it is the most common inherited bleeding disorder, it is primarily inherited in an **Autosomal Dominant** fashion (except for Type 3, which is recessive). It involves a deficiency or dysfunction of Von-Willebrand Factor, affecting both platelet adhesion and Factor VIII stability. * **None of the above:** Incorrect, as Hemophilia A fits all the criteria mentioned in the stem. **High-Yield Clinical Pearls for NEET-PG:** * **Inheritance:** Hemophilia A and B (Christmas Disease/Factor IX deficiency) are both **X-linked recessive** [1]. * **Mixing Studies:** In Hemophilia, the prolonged aPTT **corrects** upon mixing with normal plasma (distinguishing it from factor inhibitors). * **vWD vs. Hemophilia:** vWD presents with a prolonged **Bleeding Time (BT)** and aPTT, whereas Hemophilia presents with a normal BT and prolonged aPTT. * **Most common cause of inherited serious bleeding:** Hemophilia A. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Red Blood Cell and Bleeding Disorders, pp. 670-671.

Q: Sago spleen is seen in which of the following conditions?

Amyloidosis. **Explanation:** **Amyloidosis (Correct Answer):** Sago spleen is a characteristic macroscopic manifestation of **splenic amyloidosis**. In this condition, amyloid deposits are limited primarily to the **splenic follicles (white pulp)**. On gross examination, these deposits appear as pale, translucent, waxy granules resembling grains of sago (tapioca) [1]. This is distinct from "Lardaceous spleen," where amyloid involves the red pulp (sinusoids), leading to large, map-like deposits. **Analysis of Incorrect Options:** * **Gaucher’s Disease:** Characterized by massive splenomegaly due to the accumulation of glucosylceramide in macrophages (**Gaucher cells**). The spleen appears pale and firm but does not show the "sago" granular pattern. * **Malaria:** Chronic malaria leads to "Congestive Splenomegaly." The spleen becomes slate-grey or blackish due to the deposition of **hemozoin pigment** (malarial pigment), often referred to as "Ague cake." * **Felty’s Disease:** This is a triad of Rheumatoid Arthritis, Splenomegaly, and Neutropenia. While the spleen is enlarged, the pathology involves lymphoid hyperplasia and congestion, not amyloid granules. **High-Yield Clinical Pearls for NEET-PG:** * **Sago Spleen:** Amyloid in **White Pulp** (Follicular) [1]. * **Lardaceous Spleen:** Amyloid in **Red Pulp** (Sinusoidal). * **Staining:** Amyloid shows **Apple-green birefringence** under polarized light with Congo Red stain [1]. * **Most common organ involved in systemic amyloidosis:** Kidney (leading to nephrotic syndrome). * **Most common organ involved in secondary amyloidosis:** Spleen. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Diseases of the Immune System, pp. 264-269.

Q: What erupts from an unerupted tooth?

Dentigerous cyst. **Explanation:** The correct answer is **Dentigerous cyst** (also known as a follicular cyst). **1. Why Dentigerous Cyst is Correct:** A dentigerous cyst is an odontogenic cyst that originates from the **reduced enamel epithelium** of the dental follicle [1]. It characteristically forms around the crown of an **unerupted or impacted tooth**. The cyst attaches at the cemento-enamel junction (CEJ), and as fluid accumulates between the reduced enamel epithelium and the tooth crown, the cyst expands. The most common site is the mandibular third molar, followed by the maxillary canine. **2. Why Other Options are Incorrect:** * **Dental Cyst (Radicular Cyst):** This is the most common inflammatory odontogenic cyst. It arises from the **rests of Malassez** in the periodontal ligament and is typically found at the apex (root tip) of a **non-vital (carious/erupted) tooth**, not an unerupted one. * **Both of the above:** Incorrect because the mechanisms of origin (developmental vs. inflammatory) and the status of the associated tooth (unerupted vs. erupted/non-vital) are distinct for each [1]. **3. NEET-PG High-Yield Clinical Pearls:** * **Radiological Appearance:** Presents as a well-defined, unilocular radiolucency surrounding the crown of an unerupted tooth. * **Histopathology:** Lined by thin, non-keratinized stratified squamous epithelium (usually 2–4 layers thick). * **Potential Complications:** If left untreated, a dentigerous cyst can transform into an **Ameloblastoma**, Squamous Cell Carcinoma, or Mucoepidermoid Carcinoma. * **Differential Diagnosis:** Odontogenic Keratocyst (OKC) and Unicystic Ameloblastoma. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Head and Neck, pp. 741-742.

Question 1

Pain in inflammation is mediated by?

Accepted Answer

Prostaglandins and bradykinins

Answer

Histamine and nitric oxide

Answer

Prostaglandins and interleukins

Answer

Interferons and free radicals

Question 2

Males who are sexually underdeveloped with rudimentary testes and prostate glands, sparse pubic and facial hair, long arms and legs and large hands & feet are likely to have which chromosomal abnormality?

Accepted Answer

46, XXY

Answer

45, XYY

Answer

46, XY

Answer

46, X

Question 3

Which X-linked recessive disease in males presents with a clotting defect?

Accepted Answer

Hemophilia A

Answer

Idiopathic Thrombocytopenic Purpura (ITP)

Answer

Von-Willebrand disease

Answer

None of the above

Question 4

Sago spleen is seen in which of the following conditions?

Accepted Answer

Amyloidosis

Answer

Gaucher’s disease

Answer

Malaria

Answer

Felty's disease

Question 5

Chemotaxis in response to activation of cells results in which type of movement?

Accepted Answer

Unidirectional motion

Answer

Random multidirectional movement

Answer

Adhesion to endothelium

Answer

Augmented oxygen-dependent bactericidal effect

Question 6

What erupts from an unerupted tooth?

Accepted Answer

Dentigerous cyst

Answer

Dental cyst

Answer

Both of the above

Answer

None of the above

Question 7

Amyloidosis most commonly affects which organ?

Accepted Answer

Heart

Answer

Liver

Answer

Tongue

Answer

Colon

Question 8

A 28-year-old man begins a program of vigorous body building. After 6 months, his biceps would be expected to exhibit which of the following adaptive cellular changes?

Accepted Answer

Hypertrophy of type II fibers

Answer

Hyperplasia of type I fibers

Answer

Hyperplasia of type II fibers

Answer

Hypertrophy of type I fibers

Question 9

Deficiency of Vitamin D increases the risk of which of the following conditions?

Accepted Answer

All of the above

Answer

Colon cancer

Answer

Prostate cancer

Answer

Breast cancer

Question 10

What causes the nuclear and cytoplasmic changes observed in apoptotic cells?

Accepted Answer

Caspases

Answer

Oxygen free radicals

Answer

Complement fixation

Answer

ATPases

General Pathology — MCQs

General Pathology — MCQs

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