General Pathology Practice Questions

Q: Which type of necrosis is typically seen in acute pancreatitis?

Fat necrosis. **Explanation:** **Fat necrosis** is the hallmark of acute pancreatitis [1]. This process occurs due to the premature activation of pancreatic enzymes, specifically **lipases**, which are released into the peripancreatic tissue and the peritoneal cavity. These enzymes break down triglycerides into free fatty acids. These fatty acids then combine with calcium ions in a process called **saponification**, forming chalky white, soap-like deposits that are macroscopically visible [1]. **Analysis of Incorrect Options:** * **Coagulative necrosis:** This is the most common type of necrosis, typically seen in hypoxic/ischemic injury in solid organs (e.g., myocardial infarction), except the brain. It preserves the basic structural outline of the tissue for a few days. * **Liquefactive necrosis:** Characterized by the digestion of dead cells into a liquid viscous mass. It is typically seen in bacterial/fungal infections and **ischaemic injury to the brain**. (Note: While the pancreatic parenchyma itself may undergo liquefaction, "Fat Necrosis" is the classic descriptor for the condition). * **Fibrinoid necrosis:** Usually seen in immune-mediated vascular damage (e.g., Polyarteritis Nodosa or malignant hypertension) where complexes of antigens and antibodies are deposited in arterial walls. **High-Yield Clinical Pearls for NEET-PG:** * **Microscopic appearance:** Fat necrosis shows shadowy outlines of necrotic adipocytes with basophilic (bluish) calcium deposits [1]. * **Saponification:** The "chalky white" appearance is a classic gross pathology description [1]. * **Clinical Correlation:** In acute pancreatitis, the degree of **hypocalcemia** (due to calcium being "consumed" during saponification) is a key prognostic indicator used in Ranson’s Criteria. **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. 55.

Q: Which of the following types of hypersensitivity reactions is associated with the given condition?

Cytotoxic type. ***Cytotoxic type*** - **Type II hypersensitivity** involves **IgG/IgM antibodies** binding to cell-surface or extracellular matrix antigens, leading to **complement activation** and **cell destruction**. - Classic example is **pemphigus vulgaris** where antibodies target **desmoglein proteins** in desmosomes, causing **acantholysis** and blister formation. *Anaphylactic type* - **Type I hypersensitivity** is mediated by **IgE antibodies** and **mast cell degranulation**, causing immediate reactions like **anaphylaxis**. - Involves **histamine release** and **vasodilation**, not direct cellular destruction by antibodies against structural proteins. *Type III hypersensitivity* - **Immune complex-mediated** reaction involving **antigen-antibody complexes** depositing in tissues, causing **inflammation**. - Examples include **serum sickness** and **lupus nephritis**, not autoantibodies targeting specific cell adhesion molecules. *Cell-mediated hypersensitivity* - **Type IV hypersensitivity** involves **T-cells** and **delayed-type reactions**, typically occurring **48-72 hours** after exposure. - Examples include **contact dermatitis** and **tuberculin skin test**, not antibody-mediated cellular damage.

Q: A couple is referred to the physician because their first three pregnancies have ended in spontaneous abortion. Chromosomal analysis reveals that the wife has two cell lines in her blood, one with a missing X chromosome (45,X) and the other normal (46,XX). Her chromosomal constitution can be described as?

Mosaic. ### Explanation **Correct Option: D. Mosaic** **Mosaicism** is defined as the presence of two or more populations of cells with different genotypes in one individual who has developed from a **single fertilized egg (zygote)** [1]. In this case, the wife has two cell lines (45,X and 46,XX) originating from the same zygote. This typically occurs due to **post-zygotic mitotic non-disjunction** or anaphase lag during early embryonic development [1]. Mosaic Turner syndrome (45,X/46,XX) often presents with a milder phenotype than classic Turner syndrome (45,X), allowing for secondary sexual characteristics and, occasionally, the ability to conceive, though it is a known cause of recurrent spontaneous abortions. **Why Incorrect Options are Wrong:** * **A. Chimeric:** Chimerism involves two or more cell lines derived from **different zygotes** (e.g., the fusion of two embryos or exchange of cells between twins in utero). * **B. Monoploid:** This refers to a cell or organism having a single set of chromosomes (n). In humans, only gametes are monoploid. * **C. Trisomic:** This refers to the presence of an extra chromosome (e.g., Trisomy 21). The patient in the question has a cell line with a missing chromosome (monosomy), not an extra one. **High-Yield Clinical Pearls for NEET-PG:** * **Mechanism:** Mosaicism results from **post-zygotic** errors; Chimerism results from **fusion** of different zygotes. * **Germline Mosaicism:** If a mutation occurs in a germ cell precursor, the individual is phenotypically normal but can pass the mutation to multiple offspring (e.g., Osteogenesis Imperfecta, Duchenne Muscular Dystrophy). * **Turner Syndrome:** 45,X/46,XX is the most common mosaic pattern in Turner syndrome [1]. These patients have a higher risk of premature ovarian failure and recurrent pregnancy loss. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Genetic Disorders, pp. 168-169.

Question 1

Which type of necrosis is typically seen in acute pancreatitis?

Accepted Answer

Fat necrosis

Answer

Coagulative necrosis

Answer

Liquefactive necrosis

Answer

Fibrinoid necrosis

Question 2

What is a reason for tissue analysis in surgery?

Accepted Answer

To confirm a suspected or established clinical diagnosis for prognosis and treatment planning

Answer

Repeated Fine Needle Aspiration Cytology (FNAC)

Answer

To confirm radiological findings

Answer

For data recording purposes

Question 3

All of the following mediators of acute inflammation are derived from cells except?

Accepted Answer

Kinins

Answer

Cytokines

Answer

Histamine

Answer

Leukotrienes

Question 4

Tooth discolouration due to high bilirubin secretion is seen in which condition?

Accepted Answer

Chlorodontia

Answer

Pink tooth of Mummery

Answer

Ochronosis

Answer

Leong teeth

Question 5

Which of the following is seen in both apoptosis and necrosis?

Accepted Answer

Both may be pathological

Answer

Both may be physiological

Answer

Inflammation

Answer

Intact cell membrane

Question 6

Histologic sections of the thymus that reveal reactive follicles with germinal centers are diagnostic of what condition?

Accepted Answer

Thymic hyperplasia

Answer

Acute inflammation

Answer

Chronic inflammation

Answer

Thymic hypoplasia

Question 7

Which of the following types of hypersensitivity reactions is associated with the given condition?

Accepted Answer

Cytotoxic type

Answer

Anaphylactic type

Answer

Type III hypersensitivity

Answer

Cell-mediated hypersensitivity

Question 8

A couple is referred to the physician because their first three pregnancies have ended in spontaneous abortion. Chromosomal analysis reveals that the wife has two cell lines in her blood, one with a missing X chromosome (45,X) and the other normal (46,XX). Her chromosomal constitution can be described as?

Accepted Answer

Mosaic

Answer

Chimeric

Answer

Monoploid

Answer

Trisomic

Question 9

Secondary amyloidosis complicates which of the following?

Accepted Answer

Chronic osteomyelitis

Answer

Pneumonia

Answer

Chronic glomerulonephritis

Answer

Osteosarcoma

Question 10

Amyloid protein in human beings is:

Accepted Answer

A material that gets deposited in extracellular spaces

Answer

A naturally present protein in normal individuals

Answer

Selectively involves blood vessels

Answer

Visible to the naked eye as whitish cheesy material

General Pathology — MCQs

General Pathology — MCQs

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