Reproductive Pathology Practice Questions

Q: What is the most common cause of a Krukenberg tumor?

Stomach cancer. **Explanation:** A **Krukenberg tumor** refers to a metastatic signet-ring cell carcinoma of the ovary, where the primary malignancy arises from a gastrointestinal site. **Why Stomach Cancer is Correct:** The most common primary site for a Krukenberg tumor is the **stomach** (specifically the gastric antrum), accounting for approximately 70% of cases. The characteristic histological feature is the **signet-ring cell**, where intracellular mucin displaces the nucleus to the periphery. The spread typically occurs via retrograde lymphatic dissemination rather than direct peritoneal seeding. **Why Other Options are Incorrect:** * **Ovarian Cancer:** Krukenberg tumors are by definition metastatic. Primary ovarian cancers (like serous or mucinous cystadenocarcinomas) arise within the ovary itself and do not show the classic signet-ring morphology associated with Krukenberg tumors. * **Liver Cancer:** Primary hepatocellular carcinoma rarely metastasizes to the ovaries. * **Small Bowel Cancer:** While any GI malignancy can theoretically spread to the ovary, the small bowel is a much rarer primary site compared to the stomach or the large bowel (colon). **High-Yield Clinical Pearls for NEET-PG:** * **Bilateralism:** Krukenberg tumors are characteristically **bilateral** (80% of cases), whereas primary ovarian tumors are more likely to be unilateral. * **Histology:** Look for "Signet-ring cells" and a dense "sarcomatoid-like" reactive stroma. * **Stain:** They stain positive for **PAS** and **Mucicarmine** (due to mucin content). * **Differential:** If the primary is not in the stomach, the second most common site is the **colon**.

Q: Funisitis describes infection of which of the following?

Umbilical cord. **Explanation:** **Funisitis** refers specifically to the inflammation of the **umbilical cord** connective tissue (Wharton’s jelly). It is a histological hallmark of the **Fetal Inflammatory Response Syndrome (FIRS)**. The infection typically ascends from the maternal birth canal, leading to the migration of fetal neutrophils from the umbilical vessels into the surrounding cord matrix. [1] **Analysis of Options:** * **Option C (Correct):** Funisitis is the involvement of the umbilical cord. It is often preceded by vasculitis (inflammation of the umbilical vein, followed by the umbilical arteries). [1] * **Option A (Incorrect):** Infection or inflammation of the decidua (maternal uterine lining during pregnancy) is termed **deciduitis**. * **Option B (Incorrect):** Infection of the chorionic villi is termed **villitis**. This is more commonly associated with hematogenous (transplacental) infections, such as the TORCH group, rather than ascending bacterial infections. [1] * **Option D (Incorrect):** The placental septa are projections of the decidua; their inflammation does not have a specific clinical name like funisitis. **High-Yield NEET-PG Pearls:** 1. **Chorioamnionitis:** Inflammation of the fetal membranes (chorion and amnion), usually due to ascending bacterial infection (e.g., *E. coli*, Group B *Streptococcus*). [1] 2. **Sequence of Infection:** Ascending infections typically follow a pattern: **Chorioamnionitis** (maternal response) → **Umbilical Vasculitis** → **Funisitis** (fetal response). 3. **Gross Appearance:** In severe cases, the umbilical cord may show "barer pole" spiraling or yellowish-white plaques. 4. **Clinical Significance:** Funisitis is strongly associated with increased neonatal morbidity, including sepsis and cerebral palsy. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Female Genital Tract, pp. 1041-1042.

Question 1

Which of the following are predisposing factors for Testicular germ cell tumor?

Accepted Answer

Klinefelter's syndrome

Answer

Cryptorchidism

Answer

Testicular feminization syndrome

Answer

Radiation

Question 2

A 4-year-old girl is brought to the physician by her parents who report seeing blood in the child's urine. A CT scan reveals a neoplasm of the urinary bladder. Which of the following is the most likely diagnosis?

Accepted Answer

Embryonal rhabdomyosarcoma

Answer

Angiosarcoma

Answer

Leiomyosarcoma

Answer

Liposarcoma

Question 3

Which of the following is NOT a testicular tumor marker?

Accepted Answer

CA-125

Answer

Alpha-1 antitrypsin

Answer

Human chorionic gonadotropin (HCG)

Answer

Alpha-fetoprotein (AFP)

Question 4

Which of the following cell type(s) secrete prostate-specific antigen (PSA)?

Accepted Answer

Benign and malignant prostate epithelial cells

Answer

Benign prostate epithelial cells only

Answer

Malignant prostate epithelial cells only

Answer

Prostate stromal cells

Question 5

A 22-year-old woman has an abnormal cervical Pap smear. A biopsy is obtained from a suspicious area on the cervix. The pathology report describes changes including loss of normal squamous cell orientation, atypical cells with wrinkled nuclei and perinuclear halos involving the full thickness of the squamous epithelium, and an intact basement membrane. What is the most likely diagnosis?

Accepted Answer

CIN III with koilocytic atypia

Answer

Cervical intraepithelial neoplasia (CIN) I with koilocytic atypia

Answer

CIN II with koilocytic atypia

Answer

Inflammatory atypia secondary to colposcopy artifact

Question 6

A 46-year-old chronic alcoholic complains of infertility. What is the cause of testicular atrophy?

Accepted Answer

Liver dysfunction

Answer

Thrombosis of testicular vessels

Answer

Vitamin B12 deficiency

Answer

Peripheral neuropathy

Question 7

What is the most common cause of a Krukenberg tumor?

Accepted Answer

Stomach cancer

Answer

Ovarian cancer

Answer

Liver cancer

Answer

Small bowel cancer

Question 8

Funisitis describes infection of which of the following?

Accepted Answer

Umbilical cord

Answer

Decidua

Answer

Chorionic villi

Answer

Placental septum

Question 9

A middle-aged man operated for testicular cancer presents with histological examination showing primitive looking 'ugly' cells with abundant mitotic cells. The tumor cells are positive for cytokeratin and CD30. What is the likely type of tumor?

Accepted Answer

Embryonal carcinoma

Answer

Choriocarcinoma

Answer

Yolk sac tumors

Answer

Teratoma

Question 10

Which of the following are predisposing features for germ cell tumor?

Accepted Answer

Cryptorchidism, Testicular feminizing syndrome, Klinefelter's syndrome, Right side more common than Left side

Answer

Testicular feminizing syndrome, Klinefelter's syndrome, Smoking, Right side more common than Left side

Answer

Cryptorchidism, Testicular feminizing syndrome, Klinefelter's syndrome, Smoking

Answer

Cryptorchidism, Testicular feminizing syndrome, Smoking, Right side more common than Left side

Reproductive Pathology — MCQs

Reproductive Pathology — MCQs

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