General Pathology Practice Questions

Q: Alkaline phosphatase is a tumor marker of which tumor?

Seminoma. **Explanation:** **Alkaline Phosphatase (specifically the Placental-like isoform, PLAP)** is a highly characteristic serum and immunohistochemical marker for **Seminoma**. In the context of germ cell tumors (GCTs), PLAP is elevated in approximately 50-95% of patients with seminoma [1]. While it is not entirely specific (as it can be elevated in smokers), it remains the classic diagnostic marker for this tumor type in medical examinations. **Analysis of Incorrect Options:** * **Embryonal Carcinoma:** This tumor typically shows elevation of **hCG** and occasionally **AFP** (if mixed components are present). Its characteristic IHC marker is **CD30**. * **Yolk Sac Tumor:** The hallmark marker is **Alpha-Fetoprotein (AFP)**. It is the most common testicular tumor in infants and children and is histologically characterized by Schiller-Duval bodies. * **Endodermal Sinus Tumor:** This is simply another name for **Yolk Sac Tumor**; therefore, the primary marker remains **AFP**. **High-Yield Clinical Pearls for NEET-PG:** * **Seminoma:** Most common GCT; highly radiosensitive; markers include **PLAP**, **hCG** (in 10-15% of cases due to syncytiotrophoblasts), and **LDH** (used to monitor tumor burden) [1]. * **AFP Rule:** AFP is **never** elevated in a pure seminoma. If AFP is high, it indicates a non-seminomatous component (usually Yolk Sac). * **LDH:** A non-specific marker for all GCTs, used primarily for prognostic staging and monitoring treatment response. * **Choriocarcinoma:** Characterized by very high levels of **hCG**. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Lower Urinary Tract and Male Genital System, pp. 980-982.

Q: CD34 is a tumor marker used for which of the following conditions?

Alveolar soft part sarcoma. **Explanation:** **CD34** is a transmembrane glycoprotein primarily expressed on hematopoietic stem cells and vascular endothelium [1]. In surgical pathology, it serves as a marker for vascular tumors and specific mesenchymal neoplasms [1]. **Why Alveolar Soft Part Sarcoma (ASPS) is the correct answer:** While ASPS is classically defined by the **t(X;17)(p11;q25)** translocation resulting in the *ASPSCR1-TFE3* fusion, it characteristically demonstrates a rich, sinusoidal capillary network surrounding nests of tumor cells (organoid/pseudoalveolar pattern). **CD34** is used to highlight this characteristic **intricate vascular network**, which is a diagnostic hallmark of ASPS, aiding in its differentiation from other clear cell tumors. **Analysis of Incorrect Options:** * **Ewing’s Sarcoma:** The definitive marker is **CD99 (MIC2)**, showing a strong membranous staining pattern. It is also associated with the t(11;22) translocation. * **Myofibrosarcoma:** These tumors typically express myogenic markers like **SMA (Smooth Muscle Actin)** and Desmin. They are generally CD34 negative. * **Inflammatory Myofibroblastic Tumor (IMT):** The most specific marker is **ALK (Anaplastic Lymphoma Kinase)**, positive in approximately 50-60% of cases due to 2p23 rearrangements. **High-Yield Clinical Pearls for NEET-PG:** * **Other CD34+ Tumors:** Solitary Fibrous Tumor (SFT) - *strong/diffuse*, Dermatofibrosarcoma Protuberans (DFSP), Kaposi Sarcoma, and Angiosarcoma [1]. * **ASPS Key Fact:** It commonly affects young adults, involves the lower extremities, and has a high propensity for **brain metastasis**. * **PAS Stain:** ASPS shows PAS-positive, diastase-resistant rhomboid crystals. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Diseases of Infancy and Childhood, pp. 523-528.

Q: CD-99 is a marker for which of the following tumors?

Ewing's sarcoma. **Explanation:** **CD-99 (MIC2 gene product)** is a highly sensitive cell surface glycoprotein marker used in the diagnosis of **Ewing’s Sarcoma** and Peripheral Primitive Neuroectodermal Tumors (PNET). In Ewing’s sarcoma, CD-99 typically shows a characteristic **strong, diffuse membranous staining** pattern. While not 100% specific, it is the primary diagnostic marker used to differentiate Ewing’s from other "small round blue cell tumors." **Analysis of Incorrect Options:** * **Small Lymphocytic Lymphoma (SLL):** This is a B-cell neoplasm characterized by markers like **CD5, CD19, CD20, and CD23**. CD-99 is not used for its diagnosis. * **Dermatofibroma:** This is a common benign fibrous histiocytoma of the skin. The characteristic immunohistochemical marker is **Factor XIIIa**, and it is typically negative for CD34 (unlike Dermatofibrosarcoma Protuberans). * **Malignant Fibrous Histiocytoma (MFH):** Now largely reclassified as Pleomorphic Undifferentiated Sarcoma, it lacks a specific single marker like CD-99 and is often a diagnosis of exclusion. **High-Yield NEET-PG Pearls:** * **Genetics:** Ewing’s sarcoma is associated with the **t(11;22)(q24;q12)** translocation, resulting in the **EWS-FLI1** fusion gene. * **Morphology:** On H&E stain, it appears as a **"Small Round Blue Cell Tumor"** with Homer-Wright rosettes (in PNET variants) and PAS-positive glycogen in the cytoplasm. * **Radiology:** Classically presents with an **"Onion-skin"** periosteal reaction. * **Other CD-99 positive tumors:** Though less common, CD-99 can also be positive in Lymphoblastic Lymphoma, Synovial Sarcoma, and Solitary Fibrous Tumor [1]. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Bones, Joints, and Soft Tissue Tumors, pp. 1225-1226.

Question 1

Which of the following is NOT a clinical feature of gangrene?

Accepted Answer

Gas produced by the organism in the kidney leading to foaming kidney

Answer

Foul smelling necrosis of the muscle bundle

Answer

Loss of contractility of the muscle

Answer

The skin becomes dull red, green, or black

Question 2

Alkaline phosphatase is a tumor marker of which tumor?

Accepted Answer

Seminoma

Answer

Embryonal carcinoma

Answer

Yolk sac tumor

Answer

Embryonal sinus tumor

Question 3

Which of the following parasitic infections predisposes to malignancies?

Accepted Answer

Schistosomiasis

Answer

Pargibunuasus

Answer

Guinea worm infection

Answer

Clonorchiasis

Question 4

All of the following are true regarding deep partial thickness burns except?

Accepted Answer

Capillary staining noted after 48 hours

Answer

Deeper parts of dermis involved

Answer

Skin is completely anaesthetized

Answer

Heals with scarring

Question 5

Which of the following is NOT true of dystrophic calcification?

Accepted Answer

Serum calcium levels are high

Answer

Occurs in damaged tissue

Answer

Tuberculous lesions

Answer

Atherosclerotic lesions

Question 6

Dermatomyositis associated with Anti-Mi2 antibodies shows strong association with which of the following clinical features?

Accepted Answer

Heliotrope rash

Answer

Mechanic hands

Answer

Butterfly rash

Answer

Discoid rash

Question 7

Apoptosis means:

Accepted Answer

Programmed internal cell death

Answer

Regeneration of cells after injury

Answer

Reperfusion injury of the cells

Answer

Uncontrolled multiplication of cells

Question 8

CD34 is a tumor marker used for which of the following conditions?

Accepted Answer

Alveolar soft part sarcoma

Answer

Ewing's sarcoma

Answer

Myofibrosarcoma

Answer

Inflammatory myofibroblastic tumor

Question 9

CD-99 is a marker for which of the following tumors?

Accepted Answer

Ewing's sarcoma

Answer

Small lymphocytic lymphoma (SLL)

Answer

Dermatofibroma

Answer

Malignant fibrous histiocytoma

Question 10

Hydropic swelling of the cell is characterized by all the following EXCEPT?

Accepted Answer

Increased number of cytoplasmic organelles

Answer

Dilatation of cisternae of endoplasmic reticulum

Answer

Impairment of cellular volume regulation

Answer

Influx of sodium into the cell

General Pathology — MCQs

General Pathology — MCQs

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