General Pathology Practice Questions

Q: Fat necrosis is common in:

Breast. ***Breast*** - **Fat necrosis** in the breast is a relatively common benign condition, often resulting from trauma, surgery, or radiation. - It presents as a palpable lump that can mimic malignancy, making its differentiation crucial. *Retroperitoneal fat* - While fat necrosis can occur in the retroperitoneum, particularly in cases of **acute pancreatitis**, it is not considered "common" in this location independently [1]. - The primary tissue affected in pancreatitis is the pancreas itself, with necrosis extending to surrounding fat [1]. *Omentum* - **Omental fat necrosis** can occur but is rare and usually associated with torsion of the omentum or, less commonly, blunt abdominal trauma. - It is not a common site for isolated fat necrosis compared to the breast. *All of the options* - Although fat necrosis can occur in all these locations under specific circumstances, it is not "common" in all of them when considering the typical incidence of the condition. - **Breast fat necrosis** is more frequently encountered in clinical practice than in the omentum or retroperitoneal region. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Pancreas, p. 895.

Q: Which of the following is an anti-apoptotic gene?

Bcl-2. ***Bcl-2*** - **Bcl-2** (B-cell lymphoma 2) is a proto-oncogene that plays a critical role in regulating **apoptosis** by inhibiting programmed cell death. - It prevents the release of pro-apoptotic factors from the mitochondria, thereby promoting **cell survival**. *c-myc* - **c-myc** is a proto-oncogene involved in cell proliferation, growth, and **apoptosis**; it is not primarily an anti-apoptotic gene. - Upregulation of c-myc can, in fact, sensitize cells to **apoptosis** if survival signals are absent. *p53* - **p53** is a tumor suppressor gene that induces cell cycle arrest or **apoptosis** in response to DNA damage or other cellular stresses. - It is a **pro-apoptotic** gene that actively promotes programmed cell death, rather than preventing it. *Bax* - **Bax** (Bcl-2-associated X protein) is a prominent **pro-apoptotic** protein. - It promotes **apoptosis** by forming pores in the mitochondrial outer membrane, leading to the release of cytochrome c and activation of caspases.

Q: Which of the following is most susceptible to ionizing radiation?

Small lymphocytes. ***Small lymphocytes*** - **Lymphocytes** are highly sensitive to **ionizing radiation** due to their rapid proliferation and vulnerability during DNA synthesis [1]. - Exposure to radiation can lead to rapid **apoptosis** (programmed cell death) of lymphocytes, causing **lymphocytopenia** [1]. *Nerve cells* - **Nerve cells** are generally considered **radioresistant** because they are terminally differentiated and do not undergo cell division. - Their primary function is transmission of electrical impulses, which is not immediately disrupted by typical radiation doses. *Epithelial cells* - **Epithelial cells** (e.g., skin, gut lining) are moderately sensitive to radiation, primarily due to their **high turnover rate** [1]. - However, they are generally less sensitive than lymphocytes, and their damage often requires higher doses or prolonged exposure [1]. *Mature bone* - **Mature bone** is highly resistant to radiation because its cells (osteocytes) are largely quiescent and the extracellular matrix is inert [1]. - Significant damage to bone typically occurs at very high doses, affecting the more sensitive **bone marrow** stem cells within it rather than the mature bone itself [1]. **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. (Basic Pathology) introduces the student to key general principles of pathology, both as a medical science and as a clinical activity with a vital role in patient care. Part 2 (Disease Mechanisms) provides fundamental knowledge about the cellular and molecular processes involved in diseases, providing the rationale for their treatment. Part 3 (Systematic Pathology) deals in detail with specific diseases, with emphasis on the clinically important aspects., pp. 111-114.

Q: Type of necrosis seen in case of burn:

Coagulative necrosis.. ***Coagulative necrosis.*** [1] - Burn injuries cause **protein denaturation** due to heat, leading to **cell death** where the cellular architecture is preserved for some time [1]. - This is the **primary and characteristic** type of necrosis directly resulting from thermal injury [1]. - The coagulation of intracellular proteins results in an **infarcted area** that appears firm and opaque [1]. *Both coagulative and liquefactive.* - While coagulative necrosis is the primary type, liquefactive necrosis may occur **secondarily** if there is superimposed infection or tissue breakdown. - However, the question asks for the type of necrosis **seen in case of burn**, which refers to the **primary pathological process** caused by thermal injury itself. - The characteristic and predominant pattern is **coagulative**, not both simultaneously. *Liquefactive necrosis.* - **Liquefactive necrosis** is characterized by the dissolution of dead cells into a viscous liquid mass due to enzymatic digestion. - Typically seen in **bacterial abscesses**, **brain infarcts**, and **hypoxic death of CNS tissue**. - This is not the primary type of necrosis directly caused by thermal injury of a burn. *Caseous necrosis.* - **Caseous necrosis** is a distinct form of cell death associated with specific granulomatous diseases, most notably **tuberculosis**. - Results in cheese-like, friable dead tissue with loss of cellular architecture. - Not characteristic of burn injuries. **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. 51-55.

Q: Crumpled paper appearance of cells is a feature of-

Gaucher disease. ***Gaucher disease*** - The **crumpled paper** or **wrinkled tissue paper** appearance is characteristic of **Gaucher cells**, which are macrophages engorged with **glucocerebroside** [1]. - This accumulation results from a deficiency in the enzyme **glucocerebrosidase**, a hallmark of Gaucher disease [1]. *Asbestosis* - Characterized by the presence of **asbestos bodies** (ferruginous bodies), which are asbestos fibers coated with an iron-protein complex, not cells with crumpled appearance [2]. - This condition involves **pulmonary fibrosis** due to asbestos exposure [2]. *GVHD (Graft-versus-host disease)* - Histologically, GVHD is characterized by **lymphocytic infiltration** and damage to target organs like skin, liver, and GI tract, not by storage cells with a crumpled appearance. - It is an immunological reaction occurring after **allogeneic hematopoietic stem cell transplantation**. *Wilson's disease* - Involves excessive accumulation of **copper** in various tissues, particularly the liver, brain, and cornea. - Diagnosed by markers like low **ceruloplasmin** and high urinary copper, and does not involve cells with a storage-related crumpled appearance. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Genetic Disorders, pp. 162-163. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Lung, pp. 698-699.

Question 1

Fat necrosis is common in:

Accepted Answer

Breast

Answer

Retroperitoneal fat

Answer

Omentum

Answer

All of the options

Question 2

White infarcts are seen in which of the following?

Accepted Answer

Spleen

Answer

Heart

Answer

Kidney

Answer

All of the options

Question 3

Which of these cells is most radio-resistant?

Accepted Answer

Muscle cells

Answer

Fibroblasts

Answer

Vascular endothelial cells

Answer

Early precursor cells of erythroblastic series

Question 4

Which of the following is an anti-apoptotic gene?

Accepted Answer

Bcl-2

Answer

c-myc

Answer

p53

Answer

Bax

Question 5

Which of the following is most susceptible to ionizing radiation?

Accepted Answer

Small lymphocytes

Answer

Nerve cells

Answer

Epithelial cells

Answer

Mature bone

Question 6

The following pattern of aberration occurs, when irradiation is done at which of the following phase of cell cycle?​

Accepted Answer

Both 1 and 2

Answer

Early S phase

Answer

G1 Phase

Answer

G2 phase

Question 7

Type of necrosis seen in case of burn:

Accepted Answer

Coagulative necrosis.

Answer

Liquefactive necrosis.

Answer

Caseous necrosis.

Answer

Both coagulative and liquefactive.

Question 8

Crumpled paper appearance of cells is a feature of-

Accepted Answer

Gaucher disease

Answer

Asbestosis

Answer

GVHD

Answer

Wilson's disease

Question 9

Stain used in electron microscopy

Accepted Answer

Phosphotungstic acid

Answer

Coomassie blue

Answer

2.5% FAM

Answer

Saffranin

Question 10

Endotoxin shock is initiated by:

Accepted Answer

Cytokine action

Answer

Endothelial injury

Answer

Peripheral vasodilation

Answer

Increased vascular permeability

General Pathology — MCQs

General Pathology — MCQs

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