General Pathology Practice Questions

Q: What is considered the most severe form of Ehlers-Danlos syndrome?

Type 4. **Explanation:** **Ehlers-Danlos Syndrome (EDS)** is a heterogeneous group of inherited connective tissue disorders characterized by defects in collagen synthesis [1]. **Why Type 4 is Correct:** **Type 4 (Vascular Type)** is considered the most severe and life-threatening form of EDS. It results from a mutation in the **COL3A1 gene**, leading to deficient synthesis of **Type III collagen**. Since Type III collagen is a major structural component of blood vessels and hollow organs, patients are predisposed to spontaneous **rupture of large arteries** (e.g., aorta), **bowel perforation**, and **uterine rupture** during pregnancy [1]. These catastrophic events often lead to sudden death at a young age. **Analysis of Incorrect Options:** * **Type 1 & 2 (Classical Type):** These are caused by mutations in **Type V collagen** (COL5A1, COL5A2). While they present with significant skin hyperextensibility, "cigarette paper" scarring, and joint hypermobility, they are generally not life-threatening [1]. * **Type 8 (Periodontal Type):** This is a rare variant characterized primarily by severe early-onset periodontitis leading to premature loss of teeth and skin fragility, but it lacks the fatal systemic complications of the vascular type. **High-Yield Clinical Pearls for NEET-PG:** * **Inheritance:** Most EDS types are Autosomal Dominant (including Types 1, 2, and 4). * **Kyphoscoliotic Type (Type 6):** Notable for lysyl hydroxylase deficiency; presents with ocular fragility (corneal rupture) [1]. * **Key Clinical Triad:** Hyperextensible skin, hypermobile joints, and fragile tissues (poor wound healing) [1]. * **Vascular EDS Sign:** Translucent skin with visible underlying veins and characteristic "aged" facial features (acrogeria). **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Genetic Disorders, pp. 154-156.

Q: Pulp chamber is absent in which of the following conditions?

Dentinogenesis imperfecta. **Explanation:** The correct answer is **Dentinogenesis Imperfecta (DI)**. **1. Why Dentinogenesis Imperfecta is correct:** Dentinogenesis imperfecta is a hereditary defect of dentin formation (specifically involving the DSPP gene). The hallmark of this condition is the **obliteration of the pulp chamber and root canals**. This occurs because the odontoblasts are functionally abnormal, leading to the continuous, rapid, and irregular deposition of dentin (circumpulpal dentin) until the entire pulp space is filled. Radiographically, this presents as "opalescent teeth" with bulbous crowns, cervical constriction (bell-shaped), and absent pulp chambers. **2. Why other options are incorrect:** * **Amelogenesis Imperfecta:** This is a defect of **enamel** formation, not dentin. While the enamel may be thin, pitted, or hypoplastic, the underlying dentin and the pulp chamber remain structurally normal. * **Craniofacial Dysostosis (Crouzon Syndrome):** This is a genetic disorder characterized by premature fusion of skull bones (craniosynostosis). While it causes midface hypoplasia and dental crowding, it does not inherently cause the obliteration of the pulp chambers. **3. Clinical Pearls for NEET-PG:** * **Shields Classification:** DI is divided into Type I (associated with Osteogenesis Imperfecta), Type II (isolated DI - most common), and Type III (Brandywine type - features "shell teeth" with enlarged pulps, the exception to the rule). * **Radiographic Triad for DI:** Bulbous crowns, constricted necks (cervical constriction), and **obliterated pulp chambers**. * **Differential Diagnosis:** Dentin Dysplasia Type I also shows pulp obliteration, but the teeth typically have "half-moon" shaped pulp remains and short, blunted roots.

Q: Which of the following is characteristic of a dental cyst?

Has a cystic lining of stratified squamous epithelium. **Explanation:** A **Dental Cyst** (also known as a **Radicular Cyst** or Periapical Cyst) is the most common inflammatory odontogenic cyst. It typically forms at the apex of a non-vital (necrotic) tooth due to inflammation following dental caries or pulpitis [1]. **1. Why Option D is correct:** The hallmark histological feature of a dental cyst is a lumen lined by **non-keratinized stratified squamous epithelium**. This lining is derived from the **Rest Cells of Malassez** (remnants of Hertwig’s epithelial root sheath) found in the periodontal ligament, which proliferate in response to inflammatory cytokines. **2. Why other options are incorrect:** * **Option A:** This describes a **Dentigerous Cyst** (Follicular Cyst). Dentigerous cysts originate from the reduced enamel epithelium and surround the crown of an unerupted tooth. * **Option B:** This describes an **Odontogenic Keratocyst (OKC)** or a Primordial Cyst. A dental cyst is attached to the root of an existing tooth rather than replacing it. * **Option C:** A "missing tooth" on an X-ray associated with a radiolucency is characteristic of a **Dentigerous Cyst** (where the tooth is impacted/unerupted). In a dental cyst, the involved tooth is present in the oral cavity but is non-vital. **NEET-PG High-Yield Pearls:** * **Rushton Bodies:** Eosinophilic, linear, or arch-shaped calcifications often found within the epithelial lining of radicular cysts. * **Radiology:** Appears as a well-defined unilocular radiolucency at the periapical region. * **Cholesterol Clefts:** Frequently seen in the cyst wall with associated multinucleated giant cells. * **Key Distinction:** Radicular cyst = Non-vital tooth; Dentigerous cyst = Unerupted tooth. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Head and Neck, pp. 741-742.

Question 1

Pseudoepitheliomatous hyperplasia is a feature of:

Accepted Answer

All of the above

Answer

Myoblastoma

Answer

Blastomycosis

Answer

Papillary hyperplasia

Question 2

Which of the following is associated with cystic hygroma?

Accepted Answer

Turner syndrome

Answer

Marfan syndrome

Answer

Down syndrome

Answer

Noonan syndrome

Question 3

Which of the following structures is seen in all except?

Accepted Answer

Follicular carcinoma of thyroid

Answer

Papillary carcinoma of thyroid

Answer

Serous cystadenoma of ovary

Answer

Meningioma

Question 4

What is considered the most severe form of Ehlers-Danlos syndrome?

Accepted Answer

Type 4

Answer

Type 1

Answer

Type 2

Answer

Type 8

Question 5

Granulomatous inflammatory reaction is caused by all of the following organisms, EXCEPT:

Accepted Answer

Mycoplasma

Answer

M. Tuberculosis

Answer

M. Leprae

Answer

Yersinia pestis

Question 6

Pulp chamber is absent in which of the following conditions?

Accepted Answer

Dentinogenesis imperfecta

Answer

Amelogenesis imperfecta

Answer

Craniofacial dysostosis

Answer

None of the above

Question 7

Which statement is true about fragile-X syndrome?

Accepted Answer

It is caused by a trinucleotide repeat sequence.

Answer

It is associated with chromosome breaks.

Answer

It involves a mitochondrial mutation.

Answer

It is characterized by the absence of the centromere.

Question 8

A 49-year-old female presents with shortness of breath and hilar lymphadenopathy on chest x-ray. Biopsy of a lymph node reveals granulomas, highly suggestive of sarcoidosis. Which of the following histological findings must be present in the biopsy material to support the diagnosis of granulomatous inflammation?

Accepted Answer

Epithelioid histiocytes

Answer

Asteroid bodies

Answer

Caseous necrosis

Answer

Fibroblast proliferation

Question 9

Which of the following is characteristic of a dental cyst?

Accepted Answer

Has a cystic lining of stratified squamous epithelium

Answer

Occurs from the reduced enamel epithelium

Answer

Replaces the tooth to which it is attached

Answer

Is frequently seen with a missing tooth on the X-ray

Question 10

What is most important for diapedesis?

Accepted Answer

PECAM

Answer

Selectins

Answer

Integrins

Answer

Mucin-like glycoprotein

General Pathology — MCQs

General Pathology — MCQs

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