General Pathology Practice Questions

Q: Amyloid deposits stain positively with all of the following agents except?

Methenamine silver. ### Explanation **Amyloidosis** is characterized by the extracellular deposition of misfolded proteins in a cross-beta pleated sheet conformation. Identifying these deposits requires specific histochemical stains. **Why Methenamine Silver is the Correct Answer:** **Methenamine silver (Gomori's or Grocott's)** is primarily used to visualize **fungal elements** (like *Candida* or *Pneumocystis*) and basement membranes. It is not a standard stain for amyloid. While silver stains like Bielschowsky or Thioflavin-S are used to identify amyloid plaques in Alzheimer’s disease [1], Methenamine silver specifically does not target amyloid deposits. **Analysis of Incorrect Options:** * **Congo Red:** The gold standard for amyloid. Under ordinary light, it stains amyloid pink-red. Under polarized light, it exhibits the pathognomonic **apple-green birefringence** due to the beta-pleated sheet structure. * **Crystal Violet (and Methyl Violet):** These are metachromatic stains. Amyloid reacts with these dyes to produce a **rose-pink or violet** color against a blue background. * **Thioflavin T:** A fluorescent dye that binds to the beta-sheet structure of amyloid. When viewed under a fluorescence microscope, it emits a **bright yellow-green fluorescence**. It is highly sensitive but less specific than Congo red. **NEET-PG High-Yield Pearls:** * **Most sensitive stain:** Thioflavin T (used for screening). * **Most specific/Gold standard:** Congo Red (with polarization). * **Electron Microscopy:** Shows non-branching, linear fibrils (7.5–10 nm diameter). * **H&E Stain:** Amyloid appears as an amorphous, eosinophilic, extracellular hyaline substance. * **Common Amyloid Types:** **AL** (Light chain - Plasma cell dyscrasias), **AA** (Serum Amyloid Associated - Chronic inflammation), **Aβ** (Alzheimer’s disease) [2].

Q: What is the most important cause of death in septic shock?

Cardiac failure. In septic shock, the most critical factor leading to mortality is **Cardiac Failure** (specifically, septic cardiomyopathy) [3]. While sepsis is initially characterized by high cardiac output and low systemic vascular resistance (distributive shock), the release of pro-inflammatory cytokines (like TNF-α and IL-1β) and nitric oxide leads to direct myocardial depression [2]. This results in biventricular dilatation, decreased ejection fraction, and impaired contractility. Despite adequate fluid resuscitation, the heart's inability to maintain perfusion to vital organs is the primary driver of death. **Analysis of Incorrect Options:** * **Renal Failure (A):** Acute Kidney Injury (AKI) is a very common complication of sepsis due to hypoperfusion and inflammation, but it is rarely the immediate cause of death due to the availability of Renal Replacement Therapy (dialysis). * **Respiratory Failure (C):** While many patients develop ARDS (Acute Respiratory Distress Syndrome), modern mechanical ventilation strategies have significantly reduced it as the primary cause of mortality compared to circulatory collapse. * **DIC (D):** Disseminated Intravascular Coagulation is a severe hematological complication that leads to microvascular thrombosis and bleeding, but it is usually a secondary manifestation of the systemic inflammatory response rather than the terminal event [1]. **NEET-PG High-Yield Pearls:** * **Septic Cardiomyopathy:** Characterized by reversible systolic and diastolic dysfunction. * **Hemodynamic Hallmark:** Decreased Systemic Vascular Resistance (SVR) and increased Cardiac Output (initially). * **Early Goal-Directed Therapy (EGDT):** Focuses on maintaining Mean Arterial Pressure (MAP) >70 mmHg to prevent multi-organ failure [4]. * **Drug of Choice:** Norepinephrine is the first-line vasopressor for septic shock.

Question 1

A 60-year-old farmer presents with multiple patches of discoloration on his face. Biopsy of lesional skin reveals actinic keratosis. Which of the following terms best describes this response of the skin to chronic sunlight exposure?

Accepted Answer

Dysplasia

Answer

Atrophy

Answer

Hyperplasia

Answer

Hypertrophy

Question 2

Which of the following is not a sign of reversible cell injury?

Accepted Answer

Cell shrinkage

Answer

ATP depletion

Answer

Fatty acid deposition

Answer

Reduction of phosphorylation

Question 3

Which of the following is NOT true about apoptosis?

Accepted Answer

Inflammation is typically present.

Answer

Annexin V can be used as a marker.

Answer

Cell shrinkage is a characteristic feature.

Answer

Clumping of chromatin is observed.

Question 4

Which of the following is NOT a component of Virchow's triad?

Accepted Answer

Abnormalities of venous channels

Answer

Stasis of blood

Answer

Hypercoagulability

Answer

Endothelial damage

Question 5

Dystrophic calcification occurs in all of the following conditions except?

Accepted Answer

Normal kidney

Answer

Rheumatic heart disease

Answer

Lymph node

Answer

Aneurysm

Question 6

What ultrastructural finding is characteristic of irreversible cellular injury?

Accepted Answer

Amorphous densities in mitochondria

Answer

Ribosomal detachment from the endoplasmic reticulum

Answer

Formation of phagolysosomes

Answer

Cell swelling

Question 7

In an experiment, metabolically active cells are subjected to radiant energy in the form of x-rays. This results in cell injury caused by hydrolysis of water. Which of the following intracellular enzymes helps to protect the cells from this type of injury?

Accepted Answer

Glutathione peroxidase

Answer

Endonuclease

Answer

Lactate dehydrogenase

Answer

Phospholipase

Question 8

Amyloid deposits stain positively with all of the following agents except?

Accepted Answer

Methenamine silver

Answer

Congo red

Answer

Crystal violet

Answer

Thioflavin T

Question 9

Which of the following is NOT a mutation associated with Down syndrome?

Accepted Answer

VNTRs

Answer

Mosaicism

Answer

Robertsonian translocation

Answer

Maternal nondisjunction

Question 10

What is the most important cause of death in septic shock?

Accepted Answer

Cardiac failure

Answer

Renal failure

Answer

Respiratory failure

Answer

Disseminated Intravascular Coagulation (DIC)

General Pathology — MCQs

General Pathology — MCQs

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