General Pathology Practice Questions

Q: Necrosis with cell bodies retained as ghost cells is characteristic of which type?

Coagulative necrosis. **Explanation:** **Coagulative necrosis** is the correct answer because it is characterized by the preservation of the basic structural outline of the cell and tissue for several days [1]. This occurs because the injury denatures not only structural proteins but also **enzymatic proteins**, thereby blocking the proteolysis (self-digestion) of the dead cells. As a result, eosinophilic, anucleated cells persist as **"ghost cells"**—cells that retain their cellular shape and tissue architecture but lack internal molecular detail [1]. **Why other options are incorrect:** * **Liquefactive necrosis:** Characterized by complete digestion of dead cells, resulting in a liquid viscous mass (pus). The tissue architecture is totally lost, making "ghost cells" impossible. It is typical of CNS infarcts and bacterial infections [1]. * **Caseous necrosis:** A form of friable, white, "cheese-like" necrosis (common in Tuberculosis). Microscopically, it appears as a structureless, granular debris enclosed within a granulomatous inflammatory border [1]. The tissue architecture is completely obliterated. **High-Yield Clinical Pearls for NEET-PG:** * **Most Common Site:** Coagulative necrosis is the most common pattern of necrosis and is seen in all solid organ infarcts (Heart, Kidney, Spleen) **EXCEPT the Brain** (which undergoes liquefactive necrosis) [1]. * **Mechanism:** Denaturation of proteins is the dominant process [1]. * **Microscopic Hallmark:** Loss of nucleus (Karyolysis/Pyknosis/Karyorrhexis) with preservation of the cell boundary [1]. * **Fate:** The dead cells are eventually removed by phagocytosis by infiltrating leukocytes [1]. **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. 53-55.

Q: Lipofuschin is an insoluble endogenous pigment, also known as?

All of the above. **Explanation:** **Lipofuscin** is an insoluble, brownish-yellow granular intracellular pigment. It is considered the hallmark of **free radical injury and lipid peroxidation**. [1] 1. **Why "All of the above" is correct:** * **Lipochrome (Option A):** Lipofuscin is derived from the breakdown of polyunsaturated lipids of subcellular membranes. Due to its lipid origin and yellowish appearance, it is historically termed "lipochrome." * **Wear and tear pigment (Option B):** It represents the indigestible residue of autophagic vacuoles. It accumulates over time as a byproduct of metabolic activity, signifying cellular "wear and tear." * **Aging pigment (Option C):** Its accumulation is progressive with age. It is most prominently seen in permanent cells that do not divide, such as **neurons and cardiac myocytes**, making it a reliable marker of cellular aging. [1] 2. **Why other options are considered together:** Since Lipofuscin is synonymous with all three terms (Lipochrome, Wear and Tear, and Aging pigment), Option D is the most accurate choice. **High-Yield Clinical Pearls for NEET-PG:** * **Appearance:** On H&E stain, it appears as fine, golden-brown perinuclear granules. [1] * **Brown Atrophy:** When massive amounts of lipofuscin accumulate in an organ (commonly the heart or liver), the organ shrinks and turns brown, a condition known as "Brown Atrophy." * **Electron Microscopy:** It appears as electron-dense bodies (residual bodies). [1] * **Distinction:** Unlike **Hemosiderin** (which is also brown), Lipofuscin is **negative for Prussian Blue stain** and does not contain iron. It is, however, positive with **Sudan Black B** (lipid stain) and **PAS stain**. **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, p. 75.

Q: Osteogenesis imperfecta is a defect in which of the following?

Collagen type I. **Explanation:** **Osteogenesis Imperfecta (OI)**, also known as "Brittle Bone Disease," is a genetic disorder characterized by extreme bone fragility. **1. Why Option A is Correct:** The fundamental defect in OI lies in the synthesis of **Type I Collagen**. It is most commonly caused by autosomal dominant mutations in the **COL1A1** and **COL1A2** genes. Type I collagen is the primary structural protein in bone (osteoid), skin, tendons, and the sclera [1]. Mutations lead to either a quantitative deficiency (Type I OI) or a qualitative defect (Type II OI) in the triple helix structure of collagen, resulting in weak bones prone to multiple fractures [1]. **2. Why Other Options are Incorrect:** * **Option B (Elastin):** Defects in elastin or its scaffold protein, fibrillin-1, are associated with **Marfan Syndrome**, not OI. * **Option C & D (Collagen Type IV / Basement Membrane):** Type IV collagen is a major component of the basement membrane. Defects here are characteristic of **Alport Syndrome** (presents with nephritis and sensorineural deafness) and **Goodpasture Syndrome** (autoantibodies against Type IV collagen). **Clinical Pearls for NEET-PG:** * **Blue Sclera:** A classic sign caused by the thinning of collagen, allowing the underlying choroidal veins to show through. * **Dentinogenesis Imperfecta:** "Opalescent teeth" due to deficiency of Type I collagen in dentin. * **Hearing Loss:** Occurs due to fractures or fusion of the auditory ossicles. * **Classification:** **Type I** is the most common and mildest form; **Type II** is the most severe and typically lethal in the perinatal period [1]. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Bones, Joints, and Soft Tissue Tumors, p. 1188.

Question 1

Which of the following statements regarding hyperplasia is false?

Accepted Answer

Increase in cell size is hyperplasia.

Answer

Increase in cell number is hyperplasia.

Answer

Hyperplasia is not cancer.

Answer

Hyperplasia may predispose to cancer.

Question 2

Which is the largest gene expressed in cardiac and smooth muscle?

Accepted Answer

Dystrophin gene

Answer

Semiphorin gene

Answer

Tumor suppressor gene

Answer

Huntington gene

Question 3

Fibrinoid necrosis is seen in all of the following except:

Accepted Answer

Diabetes mellitus

Answer

Polyarteritis nodosa (PAN)

Answer

Malignant hypertension

Answer

Systemic lupus erythematosus (SLE)

Question 4

Necrosis with cell bodies retained as ghost cells is characteristic of which type?

Accepted Answer

Coagulative necrosis

Answer

Liquefactive necrosis

Answer

Caseous necrosis

Answer

None of the above

Question 5

Lipofuschin is an insoluble endogenous pigment, also known as?

Accepted Answer

All of the above

Answer

Lipochrome

Answer

Wear and tear pigment

Answer

Aging pigment

Question 6

Which of the following conditions has an increased risk of malignancy?

Accepted Answer

Metaplasia

Answer

Dysplasia

Answer

Hyperplasia

Answer

Inflammation

Question 7

Which of the following statements about carcinogenesis is false?

Accepted Answer

Papilloma viruses produce tumors in animals but not in humans.

Answer

Asbestos exposure increases the incidence of lung cancer.

Answer

Exposure to aniline dyes predisposes to cancer of the urinary bladder.

Answer

Hepatitis B virus has been implicated in hepatocellular carcinoma.

Question 8

If calcium levels are normal, which type of calcification is seen?

Accepted Answer

Dystrophic

Answer

Metastatic

Answer

Dysplastic

Answer

Metaplastic

Question 9

A 55-year-old male presents with severe chest pain radiating to the left arm. ECG shows ST segment elevation in the V4, V5, and V6 leads. CK-MB and troponin levels are found to be increased. What is the most likely cause for the increase in serum enzymes?

Accepted Answer

Cell membrane defects

Answer

Clumping of nuclear chromatin

Answer

Lysosomal Autophagy

Answer

Mitochondrial swelling

Question 10

Osteogenesis imperfecta is a defect in which of the following?

Accepted Answer

Collagen type I

Answer

Elastin

Answer

Collagen type IV

Answer

Basement membrane

General Pathology — MCQs

General Pathology — MCQs

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