General Pathology Practice Questions

Q: Which of the following conditions does not typically cause an increase in alpha-fetoprotein (AFP)?

Bronchial aplasia. ***Bronchial aplasia*** - **Bronchial aplasia** is a rare congenital malformation of the respiratory system and does not typically involve the production or release of AFP. - This condition is characterized by the **absence or hypoplasia of a bronchus** and is not associated with the embryonic tissues responsible for AFP synthesis. *Open spina bifida* - **Open neural tube defects** like spina bifida lead to leakage of AFP from the fetal cerebrospinal fluid into the amniotic fluid and maternal circulation. - This leakage results in significantly **elevated levels of AFP**, making it a key diagnostic marker. *Endodermal sinus tumor* - **Endodermal sinus tumors**, also known as yolk sac tumors, are malignant germ cell tumors that produce copious amounts of **alpha-fetoprotein (AFP)**. - These tumors mimic the embryonic yolk sac, which is a primary site of AFP synthesis during fetal development. *Dysgerminoma* - **Dysgerminoma** is a germ cell tumor that typically does *not* produce AFP; instead, it is often associated with elevated levels of **lactate dehydrogenase (LDH)** and **human chorionic gonadotropin (hCG)** in some cases. - While AFP can be mildly elevated in mixed germ cell tumors containing dysgerminoma components, pure dysgerminoma is not a primary source of AFP production.

Q: Which organ is least commonly affected by arterial thromboembolism?

Liver. ***Liver*** - The liver has a **dual blood supply** from both the **hepatic artery** and the **portal vein**, providing a significant compensatory mechanism against arterial occlusion. - This dual supply makes the liver highly **resistant to ischemia** from arterial thromboembolism, meaning it is less commonly affected compared to other organs. *Kidney* - The kidney is commonly affected by arterial thromboembolism due to its **end-arterial circulation** and a high proportion of **blood flow** from the aorta. - Renal arterial occlusion can rapidly lead to **renal infarcts** and acute kidney injury. *Heart* - The heart is frequently affected by arterial thromboembolism, particularly within the **coronary arteries**, leading to **myocardial infarction**. - This is a primary cause of cardiovascular morbidity and mortality. *Brain* - The brain is highly susceptible to arterial thromboembolism, leading to **ischemic stroke**, a common and devastating condition. - Emboli originating from the heart or carotid arteries frequently travel to the **cerebral circulation**, causing neurological deficits.

Q: Which adhesion molecule is involved in morphogenesis?

Tenascin. ***Tenascin*** - **Tenascin** is an extracellular matrix glycoprotein that plays a crucial role in various developmental processes, including **morphogenesis**. - It influences cell adhesion, migration, and differentiation, which are all fundamental to the proper formation of tissues and organs during development. *Osteopontin* - **Osteopontin** is primarily involved in bone mineralization, cell adhesion, and immune responses. - While it has adhesive properties, its main role is not central to the broad process of **morphogenesis**. *Osteonectin SPARC* - **Osteonectin (SPARC)** is a matricellular protein involved in tissue remodeling, cell proliferation, and angiogenesis. - While important in various biological processes, it is not primarily recognized as a key player in the direct adhesive mechanisms driving **morphogenesis**. *Thrombospondin* - **Thrombospondin** is a family of matricellular proteins involved in angiogenesis, inflammation, and wound healing. - Its adhesive properties are more focused on platelet aggregation and cell-matrix interactions in tissue repair rather than the orchestrating events of **morphogenesis**.

Q: Lardaceous spleen is a feature of:

Amyloidosis. ***Amyloidosis*** - The presence of a **lardaceous spleen** is characteristic of amyloidosis, where **amyloid deposits** infiltrate the spleen leading to enlargement [1][2]. - This condition often results in **firm, waxy appearance** of the spleen on examination [1]. *Thalassemia* - Thalassemia can cause **splenomegaly**, but the spleen typically does not present with a **lardaceous** appearance. - It is associated primarily with **hemolytic anemia** and characteristic changes in blood tests. *Malaria* - In malaria, the spleen can become **enlarged** due to immune response, but not lardaceous. - The splenic enlargement in malaria is usually **soft** and associated with fever and other symptoms of infection. *Sickle cell anemia* - Sickle cell anemia features **splenic atrophy** or dysfunction over time, not a lardaceous spleen. - It causes **recurrent vaso-occlusive crises** and other complications, but does not lead to characteristic amyloid deposition. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Diseases of the Immune System, pp. 268-269. [2] 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. 135-136.

Q: Which of the following is a type of programmed cell death?

All of the above. ***All of the above*** - **Apoptosis**, **pyroptosis**, and **necroptosis** are all recognized forms of **programmed cell death** in current medical literature. - Each represents a distinct, **regulated mechanism** of cell death with specific molecular pathways and physiological functions. *Apoptosis* - This is the classic form of **programmed cell death**, characterized by **cell shrinkage**, chromatin condensation, and formation of apoptotic bodies. - Essential for **tissue homeostasis**, development, and removal of damaged cells without triggering inflammation. *Pyroptosis* - A **regulated form of programmed cell death** mediated by **inflammasome activation** and characterized by cell swelling and membrane rupture. - Functions as an **innate immune response** to eliminate infected cells and release inflammatory signals to recruit immune cells. *Necroptosis* - A **regulated form of programmed cell death** that occurs when apoptosis is inhibited, serving as a backup cell death mechanism. - Characterized by **cell swelling** and membrane permeabilization, triggered by specific signaling pathways involving **RIPK1** and **RIPK3** kinases.

Q: Which of the following is an intermediate filament found in epithelial cells?

Cytokeratin. ***Cytokeratin*** - **Cytokeratins** are the characteristic intermediate filaments of **epithelial cells** [1]. - They provide structural integrity and mechanical support to epithelial tissues and are used as markers in **histopathology** to identify epithelial cell origin [1]. *Neurofilaments* - **Neurofilaments** are specific to **neurons**, providing structural support for axons. - They are primarily found in the cytoplasm of nerve cells, not epithelial tissue. *Desmin (muscle filament)* - **Desmin** is the intermediate filament found predominantly in **muscle cells** (skeletal, cardiac, and smooth muscle). - It links the sarcolemma to the contractile apparatus, not present in epithelial cells. *Vimentin (mesenchymal filament)* - **Vimentin** is typically found in cells of **mesenchymal origin**, such as fibroblasts, endothelial cells, and lymphocytes. - It is used as a marker for cells that have undergone **epithelial-to-mesenchymal transition (EMT)** but is not characteristic of mature epithelial cells. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. With Illustrations By, pp. 22-23.

Q: Among the following anatomical locations, where does fat necrosis most commonly occur?

Pancreatic tissue. ***Omentum*** - Fat necrosis is most commonly associated with the **omentum**, especially following abdominal trauma or pancreatitis. - It is characterized by the release of **lipases**, leading to the breakdown of triglycerides and the production of necrotic fat tissue [1]. *Kidney* - Fat necrosis does not typically occur in the kidney; rather, it is more commonly associated with processes affecting the abdominal cavity. - Kidney pathology more commonly involves conditions like **glomerulonephritis** or **nephrosclerosis**, not fat necrosis. *Heart* - While the heart can undergo necrosis due to ischemia, it does not develop fat necrosis, which is characteristically associated with extra-abdominal fat. - Heart tissue is more prone to **myocardial infarction** resulting from **coronary artery disease**. *Brain* - Brain tissue primarily undergoes *infarction* or **necrosis** due to vascular insults, not fat necrosis. - Pathological changes in the brain include **cerebral edema** and gliosis, rather than fat necrosis. **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: Infected gangrene of the skin and subcutaneous tissues is?

Wet gangrene (necrosis with bacterial superinfection). ***Wet gangrene*** - Characterized by **infected gangrene**, where necrosis and infection occur in **skin and subcutaneous tissues**, typically presenting with foul-smelling discharge [1]. - Commonly associated with **venous insufficiency** and **bacterial infection**, leading to rapid progression and systemic symptoms [1]. *None of the above* - This option is incorrect as there are specific types of gangrene that are recognized in medical literature. - Saying "none of the above" does not accurately address the specific condition that is being asked about. *Dry gangrene* - Dry gangrene is typically caused by **ischemia** without significant infection, presenting with **dark, dry tissue**, and does not involve an infected state [1]. - It is mainly seen in conditions like **diabetes mellitus** and does not have the characteristic of **fluid accumulation** or infection that wet gangrene does [1]. *Erysipelas* - Erysipelas is a **superficial skin infection** caused by **Streptococcus**, presenting with redness and swelling, rather than necrosis of tissue. - It does not involve dead tissue as seen in gangrene, making it distinct and not a form of gangrene. **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. 103-104.

Question 1

Which of the following conditions does not typically cause an increase in alpha-fetoprotein (AFP)?

Accepted Answer

Bronchial aplasia

Answer

Endodermal sinus tumor

Answer

Open spina bifida

Answer

Dysgerminoma

Question 2

Which organ is least commonly affected by arterial thromboembolism?

Accepted Answer

Liver

Answer

Kidney

Answer

Brain

Answer

Heart

Question 3

Which adhesion molecule is involved in morphogenesis?

Accepted Answer

Tenascin

Answer

Osteopontin

Answer

Osteonectin SPARC

Answer

Thrombospondin

Question 4

Which of the following is an example of metastatic calcification?

Accepted Answer

Primary hyperparathyroidism

Answer

Rheumatic heart disease

Answer

Monckeberg's medial calcific sclerosis

Answer

Psammoma bodies

Question 5

Lardaceous spleen is a feature of:

Accepted Answer

Amyloidosis

Answer

Thalassemia

Answer

Sickle cell anemia

Answer

Malaria

Question 6

A 25-year-old man complains of myopathy and undergoes a muscle biopsy for diagnosis. Histopathology demonstrates an inflammatory muscle disease characterized by non-caseating granulomas. Which of the following conditions is most likely to have caused his symptoms?

Accepted Answer

Sarcoidosis

Answer

Cysticercosis

Answer

Tuberculosis

Answer

Schistosomiasis

Question 7

Which of the following is a type of programmed cell death?

Accepted Answer

All of the above

Answer

Apoptosis

Answer

Pyroptosis

Answer

Necroptosis

Question 8

Which of the following is an intermediate filament found in epithelial cells?

Accepted Answer

Cytokeratin

Answer

Neurofilaments

Answer

Desmin (muscle filament)

Answer

Vimentin (mesenchymal filament)

Question 9

Among the following anatomical locations, where does fat necrosis most commonly occur?

Accepted Answer

Pancreatic tissue

Answer

Cerebral tissue

Answer

Myocardial tissue

Answer

Renal tissue

Question 10

Infected gangrene of the skin and subcutaneous tissues is?

Accepted Answer

Wet gangrene (necrosis with bacterial superinfection)

Answer

Gas gangrene (clostridial myonecrosis)

Answer

Erysipelas (a superficial bacterial skin infection)

Answer

Dry gangrene (necrosis caused by ischemia without infection)

General Pathology — MCQs

General Pathology — MCQs

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