General Pathology Practice Questions

Q: Which stain is used to identify heart failure cells?

Prussian blue. ***Prussian blue*** - **Heart failure cells** are actually **siderophages**, which are macrophages that have phagocytosed red blood cells and subsequently processed the hemoglobin into **hemosiderin**. - **Prussian blue stain** reacts with the iron in hemosiderin, turning it blue, thereby identifying these cells in the sputum or lung tissue of patients with **pulmonary edema secondary to heart failure**. *Alcian blue* - This stain is used to detect **acidic mucopolysaccharides** and **acidic glycoproteins**, typically seen in conditions involving abnormal mucin production or accumulation. - It does not specifically stain or identify **iron deposits** or **siderophages** associated with heart failure. *Silver stains* - **Silver stains** (e.g., Gomori methenamine silver) are primarily used to highlight **fungi**, **basement membranes** in kidney tissue, and **reticulin fibers**. - They are not employed for the identification of **iron-laden macrophages** or **heart failure cells**. *PAS* - The **Periodic Acid-Schiff (PAS) stain** is used to detect **glycogen**, **mucins**, and **glycoproteins**, staining them magenta. - It is often utilized in diagnosing conditions like **Whipple's disease**, **glycogen storage diseases**, or kidney diseases with **thickened basement membranes**, but not for iron detection.

Q: Stem cells are typically harvested from all except which?

Liver. ***Liver*** - **Liver** is not a recognized source of **pluripotent stem cells**, as it primarily contains specialized cells for hepatic functions. - While some **liver stem cells** exist, they are not generally sourced for therapies compared to other tissues like **bone marrow or adipose tissue** [1]. [2] *Adipose tissue* - **Adipose tissue** is a known source of **adipose-derived stem cells (ADSCs)**, which have regenerative potential [1]. - It is frequently used for **cosmetic and reconstructive applications** due to its ease of harvesting [1]. *Blood* - **Blood** contains **hematopoietic stem cells (HSCs)** primarily in the bone marrow, which can be harvested from peripheral blood after mobilization. - These stem cells are essential for **blood cell formation** and are effective in treatments for blood disorders [2]. *Bone marrow* - **Bone marrow** is a primary source of **hematopoietic stem cells**, crucial for **blood and immune system regeneration** [1]. [2] - It is commonly harvested for **transplants in conditions like leukemia** [2].

Q: Which of the following is known as wear and tear pigment?

Lipochrome. ***Lipochrome*** - Known as **wear and tear pigment**, lipochrome accumulates in tissues with age and is linked to oxidative stress [1]. - It is associated with aging and is found in various organs, indicating **cellular damage over time** [1]. *Cytochrome* - Cytochromes are **heme-containing proteins** involved in electron transport and metabolism, not specifically associated with aging pigment. - They play a crucial role in **cellular respiration** but do not accumulate as a result of "wear and tear." *Lipoprotein* - Lipoproteins are complexes of **lipids and proteins** that transport lipids in the blood, not related to the concept of wear and tear pigment. - Their primary function is in **lipid metabolism and transport**, rather than indicating aging or cellular damage. *Lipoxin* - Lipoxins are signaling molecules involved in the resolution of inflammation, not associated with aging or wear and tear. - They play a role in **immune response** rather than serving as a pigment of age-related cellular degradation. **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: Which of the following is an example of programmed cell death?

Apoptosis. ***Apoptosis*** - Apoptosis is a form of **programmed cell death** [1], essential for normal cellular turnover and development. - It is characterized by cellular shrinkage, chromatin condensation, and membrane blebbing, without provoking an inflammatory response [4]. *Cytolysis* - Cytolysis refers to the **destruction of cells by external agents**, such as toxins or pathogens, leading to membrane rupture. - It typically results in **inflammation** and is not a programmed or controlled process like apoptosis. *Necrosis* - Necrosis is an **uncontrolled form of cell death** resulting from acute cellular injury, leading to inflammation and damage to surrounding tissues. - Unlike apoptosis, necrosis involves rapid cell swelling and bursting of cell membranes, causing inflammation. However, some forms of necrosis can be programmed, such as necroptosis [2][3]. *Proptosis* - Proptosis refers to **eye bulging** (exophthalmos), often due to thyroid disease or certain tumors, and is not related to cell death. - It does not involve a process of cell death but rather anatomical displacement of the eyeball. **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. 63-64. [2] 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. 71. [3] 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. 69-71. [4] 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. 67-69.

Q: Which of the following is known as the old age pigment?

Lipofuscin. ***Lipofuscin*** - Known as **"old age pigment,"** lipofuscin accumulates in cells as a byproduct of lipid peroxidation, particularly in aged tissues [1]. - It is a marker of **cellular aging** and is particularly prominent in long-lived cells like neurons and cardiac myocytes [1]. *Hemosiderin* - A pigment associated with **iron storage**, hemosiderin accumulates in conditions like hemochromatosis or hemosiderosis. - It does not specifically indicate **aging** or the typical accumulation seen with lipofuscin. *Bilirubin* - Bilirubin is the product of **hemoglobin breakdown** and is primarily associated with jaundice and liver function. - It does not represent an age-related pigment and typically indicates **liver dysfunction** or hemolysis. *Melanin* - Melanin is the pigment responsible for **skin color** and protection against UV radiation but is not related to aging. - Its accumulation can occur with sun exposure but does not represent the physiological changes associated with **cellular aging** like lipofuscin. **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. 75-77.

Q: Acidophilia in necrotic tissue is due to?

Denaturation of proteins. ***Denaturation of proteins*** - **Denaturation of proteins** in necrotic tissue leads to increased binding of **acidic dyes** (eosin), resulting in an **acidophilic appearance**. - This process is a hallmark of irreversible cell injury, where the normal protein structure is altered, exposing more basic groups. *Coagulation of proteins* - While **protein coagulation** does occur in some forms of necrosis, it's the **denaturation** that specifically alters the protein's charge, increasing its affinity for acidic stains. - Coagulation refers broadly to the 'clumped' appearance of proteins, but not directly to the staining property. *Denaturation of enzymes* - **Enzyme denaturation** is a component of overall protein denaturation in necrosis and contributes to cellular dysfunction and eventual death. - However, the direct cause of acidophilia is the denaturation of **structural and enzymatic proteins** collectively, altering their staining characteristics. *Mitochondrial damage* - **Mitochondrial damage** is an early and crucial event in irreversible cell injury, leading to ATP depletion and accumulation of reactive oxygen species. - While it initiates the cascade towards necrosis, it does not directly explain the **acidophilic staining property** of the dead tissue itself.

Q: Which type of necrosis is seen in the brain?

Liquefactive. ***Liquefactive*** - Liquefactive necrosis is characterized by the transformation of tissue into a **liquid viscous mass**, commonly seen in the brain after **ischemic injury**. - Often associated with brain **infarcts** or **abscess formation**, where cell death results in the accumulation of **neutrophils and pus**. [1] *Fibrinoid* - Fibrinoid necrosis is typically associated with **immune-mediated vascular damage**, not commonly seen in the brain. - This type of necrosis occurs in conditions like **polyarteritis nodosa** or **lupus**, where **fibrin-like protein** deposits are found in vessel walls. *Coagulative* - Coagulative necrosis usually occurs in **myocardial infarction** and is characterized by the preservation of cell outlines due to **denaturation of proteins**. - It is not typical in brain tissue, which undergoes liquefactive necrosis in cases of cell death. *Fat* - Fat necrosis is primarily associated with **enzymatic destruction of adipose tissue**, often related to pancreatic damage or trauma. - It is not relevant to brain necrosis, which does not characteristically present with fat necrosis. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Central Nervous System, pp. 1268-1269.

Q: Size of fibrillary proteins in amyloidosis is:

7.5-10 nm. ***7.5-10 nm*** - Amyloid fibrils are characteristically **non-branching**, **insoluble protein fibrils** that range in diameter from **7.5 to 10 nm**. - This specific size and morphology are crucial for their identification via **electron microscopy**, which is a key diagnostic tool for amyloidosis. *0-5 nm* - This range is generally too small for the characteristic amyloid fibrils and would likely represent **monomeric proteins** or very small aggregates. - Fibrillary structures typically need to be larger to achieve the stable, ordered beta-pleated sheet conformation seen in amyloid. *12-17 nm* - This diameter is typically **too large** for classic amyloid fibrils, which are known for their consistent size. - Fibrils in this range might suggest different types of protein aggregates or other pathological structures not characteristic of amyloid. *18-20 nm* - Fibrils of this diameter are significantly **larger than the typical amyloid fibrils** and would not be consistent with the ultrastructural definition of amyloid. - This size might be indicative of bundled fibrils or other forms of protein deposits.

Question 1

All of the following are associated with increased aging, except which of the following?

Accepted Answer

Increased superoxide dismutase

Answer

Increased levels of oxidative stress due to free radicals

Answer

Accumulation of mutations in somatic cells

Answer

Increased cross linkages in collagen

Question 2

Which stain is used to identify heart failure cells?

Accepted Answer

Prussian blue

Answer

Alcian blue

Answer

Silver stains

Answer

PAS

Question 3

Stem cells are typically harvested from all except which?

Accepted Answer

Liver

Answer

Bone marrow

Answer

Blood

Answer

Adipose tissue

Question 4

Which of the following is known as wear and tear pigment?

Accepted Answer

Lipochrome

Answer

Cytochrome

Answer

Lipoxin

Answer

Lipoprotein

Question 5

Which of the following is an example of programmed cell death?

Accepted Answer

Apoptosis

Answer

Cytolysis

Answer

Necrosis

Answer

Autophagy

Question 6

Which of the following is known as the old age pigment?

Accepted Answer

Lipofuscin

Answer

Melanin

Answer

Bilirubin

Answer

Hemosiderin

Question 7

Which type of amyloid is associated with long-term hemodialysis?

Accepted Answer

Beta 2 microglobulin

Answer

AA

Answer

AL

Answer

ATTR

Question 8

Acidophilia in necrotic tissue is due to?

Accepted Answer

Denaturation of proteins

Answer

Coagulation of proteins

Answer

Denaturation of enzymes

Answer

Mitochondrial damage

Question 9

Which type of necrosis is seen in the brain?

Accepted Answer

Liquefactive

Answer

Coagulative

Answer

Fat

Answer

Fibrinoid

Question 10

Size of fibrillary proteins in amyloidosis is:

Accepted Answer

7.5-10 nm

Answer

0-5 nm

Answer

12-17 nm

Answer

18-20 nm

General Pathology — MCQs

General Pathology — MCQs

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