General Pathology Practice Questions

Q: Which of the following conditions classically shows a rosette-shaped arrangement of cells?

Ependymoma. **Explanation:** The correct answer is **Ependymoma**. In pathology, a "rosette" refers to a circular or flower-like arrangement of cells. Ependymomas are neuroepithelial tumors that classically exhibit two types of rosette formations [1]: 1. **Perivascular Pseudorosettes:** Tumor cells are arranged around a central blood vessel, separated by a fibrillary zone (cytoplasmic processes) [1]. This is a hallmark feature found in almost all ependymomas. 2. **True Ependymal Rosettes (True Rosettes):** Tumor cells surround a central lumen (resembling a small duct), mimicking the structure of the central canal of the spinal cord [1]. **Analysis of Incorrect Options:** * **A. Thecoma of ovary:** These are sex cord-stromal tumors composed of spindle-shaped cells with lipid-laden cytoplasm. They typically show a diffuse or fascicular growth pattern, not rosettes. * **C. Neurofibroma:** These are peripheral nerve sheath tumors characterized by a "shredded carrot" appearance due to wavy collagen bundles and spindle cells in a myxoid background. * **D. Lymphoma:** Malignant lymphomas generally present as a diffuse sheet of discohesive, monomorphic round cells. They do not form organized architectural patterns like rosettes. **High-Yield Clinical Pearls for NEET-PG:** * **Homer Wright Rosettes:** Cells surround a central fibrillary core (no lumen/vessel). Seen in **Neuroblastoma**, Medulloblastoma, and Retinoblastoma. * **Flexner-Wintersteiner Rosettes:** Cells surround a central lumen. Highly specific for **Retinoblastoma**. * **Call-Exner Bodies:** Small follicles filled with eosinophilic material, seen in **Granulosa Cell Tumors** (often confused with rosettes). * **Ependymoma Location:** Most common in the fourth ventricle in children and the spinal cord in adults [1]. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Central Nervous System, pp. 1312-1313.

Q: Red infarction is typically seen in which organ?

Small intestine. **Explanation:** Infarction is classified into two types based on the amount of hemorrhage: **Red (Hemorrhagic)** and **White (Anemic)** [2]. **Why Small Intestine is Correct:** Red infarcts occur in tissues with a **dual blood supply**, loose textures, or where blood can collect in the infarcted zone [2]. The small intestine is a classic example because it has extensive collateral circulation (mesenteric arcades) [1]. When an arterial occlusion occurs, blood from collateral vessels seeps into the necrotic area. Additionally, red infarcts are characteristic of **venous occlusions** (e.g., mesenteric venous thrombosis) and **reperfusion injury**, both of which are common in the bowel [2]. **Analysis of Incorrect Options:** * **Kidney (A) & Heart (D):** These are solid organs with **end-arterial circulation**. When an artery is blocked, there is no secondary supply to bleed into the necrotic zone, resulting in a **White (Anemic) Infarct** [2]. * **Brain (B):** While the brain can undergo "hemorrhagic transformation," it typically undergoes **Liquefactive Necrosis**. In the context of primary arterial occlusion, it is generally considered a pale infarct unless reperfused. **High-Yield NEET-PG Pearls:** * **Mnemonic for Red Infarcts (S-L-O-B):** **S**pongiose tissue (Lung), **L**oose tissue (Testis/Ovary), **O**cclusion (Venous), **B**lood (Dual supply/Small Intestine/Liver). * **White Infarcts** occur in solid organs with a single blood supply: **Heart, Spleen, and Kidney** [2]. * **Morphology:** Red infarcts remain red/firm, while white infarcts are wedge-shaped with the apex pointing toward the occlusion [2]. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Gastrointestinal Tract, pp. 785-786. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Hemodynamic Disorders, Thromboembolic Disease, and Shock, p. 140.

Q: Sago spleen is a feature of which of the following conditions?

Amyloidosis. **Explanation:** **Amyloidosis (Correct Answer):** Sago spleen is a classic gross pathological manifestation of **systemic amyloidosis** [1]. In this condition, amyloid fibrils are deposited primarily in the **white pulp** (splenic follicles). On gross examination, these deposits appear as pale, translucent, waxy granules resembling grains of **sago** (a starch derived from palm stems). This pattern is distinct from "Lardaceous spleen," where amyloid is deposited in the **red pulp**, leading to large, map-like waxy areas. **Why other options are incorrect:** * **Chronic Congestion:** Typically seen in portal hypertension (e.g., Cirrhosis), this leads to **congestive splenomegaly**. Microscopically, it is characterized by **Gamna-Gandy bodies** (siderofibrotic nodules containing calcium and hemosiderin), not sago-like granules. * **Malaria:** Chronic malaria results in massive splenomegaly (Ague cake spleen). The spleen appears slate-grey or black due to the accumulation of **hemozoin pigment** (malarial pigment) within the reticuloendothelial cells. * **Pneumocystis carinii:** While it can cause extrapulmonary lesions in immunocompromised patients, it typically presents as foamy, eosinophilic exudates in tissues, not the organized follicular deposition seen in sago spleen. **High-Yield Clinical Pearls for NEET-PG:** * **Sago Spleen:** Amyloid in **White Pulp** (Follicular) [1]. * **Lardaceous Spleen:** Amyloid in **Red Pulp** (Sinusoidal) [1]. * **Stain of Choice:** **Congo Red** (shows Apple-green birefringence under polarized light) [1]. * **Most common protein in Secondary Amyloidosis:** AA (Amyloid Associated) protein, often secondary to chronic infections like TB or Bronchiectasis [1]. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Diseases of the Immune System, pp. 264-269.

Question 1

Which of the following conditions classically shows a rosette-shaped arrangement of cells?

Accepted Answer

Ependymoma

Answer

Thecoma of ovary

Answer

Neurofibroma

Answer

Lymphoma

Question 2

Which of the following is a proapoptotic marker?

Accepted Answer

BAX

Answer

BCL-X

Answer

BCL-2

Answer

Mcl-1

Question 3

A 45-year-old male presents with weight loss, steatorrhea, and malabsorption. A CT scan of the abdomen reveals a questionable mass in the head of the pancreas. A biopsy specimen microscopically reveals chronic inflammation and atrophy of the pancreatic acini with marked fibrosis. No malignancy is identified. What is the most common cause of this patient's condition in adults?

Accepted Answer

Chronic alcoholism

Answer

Abdominal trauma

Answer

Gallstones

Answer

Hyperlipidemia

Question 4

What is the most reliable investigation for amyloid disease?

Accepted Answer

Rectal biopsy

Answer

Immunoglobulin assay

Answer

Ultrasound

Answer

Urine examination

Question 5

Down syndrome is due to which chromosomal abnormality?

Accepted Answer

All of the above

Answer

Trisomy 21

Answer

Translocation involving chromosome 21

Answer

Translocation involving chromosome 22

Question 6

Fat necrosis is classically seen in which organ?

Accepted Answer

Breast

Answer

Heart

Answer

Brain

Answer

Lungs

Question 7

Red infarction is typically seen in which organ?

Accepted Answer

Small intestine

Answer

Kidney

Answer

Brain

Answer

Heart

Question 8

Zellballen pattern on histopathology is observed in which of the following tumors?

Accepted Answer

Carotid body tumor

Answer

Gastrointestinal stromal tumor (GIST)

Answer

Astrocytoma

Answer

Retinoblastoma

Question 9

Ruffled membrane is characteristically seen in which of the following cells?

Accepted Answer

Osteoclast

Answer

White fibrous cartilage

Answer

Osteoblast

Answer

Elastic cartilage

Question 10

Sago spleen is a feature of which of the following conditions?

Accepted Answer

Amyloidosis

Answer

Chronic congestion of the spleen

Answer

Malaria

Answer

Pneumocystis carinii infection

General Pathology — MCQs

General Pathology — MCQs

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