INI-CET 2023 - Pathology PYQs Practice Questions

Q: Which of the following is an Anti-apoptotic gene?

MCL-1. ***MCL-1*** - **MCL-1 (myeloid cell leukemia sequence 1)** is a pro-survival protein belonging to the **Bcl-2 family**, which inhibits apoptosis by binding to and sequestering pro-apoptotic proteins [1]. - Its overexpression is frequently observed in various cancers, contributing to **chemoresistance** and tumor survival [2]. *BAK* - **BAK (Bcl-2 antagonist killer 1)** is a **pro-apoptotic protein** that belongs to the Bcl-2 family. - Upon activation, BAK undergoes **oligomerization** on the mitochondrial outer membrane, leading to its permeabilization and the release of pro-apoptotic factors into the cytoplasm. *BIN* - **BIN1 (Bridging Integrator 1)** is a **tumor suppressor gene** that can promote apoptosis in certain contexts, particularly when associated with DNA damage or cellular stress. - It is not primarily known as an anti-apoptotic gene but rather as a protein involved in **membrane dynamics** and cellular signaling, with roles in endocytosis and cytoskeletal regulation. *NOX-Q* - **NOX-Q** is not a commonly recognized or established gene in the context of apoptosis regulation. - The **NOX (NADPH oxidase) family** of enzymes is primarily involved in the production of **reactive oxygen species (ROS)**, which can either induce or inhibit apoptosis depending on the cellular context and concentration. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Neoplasia, p. 310. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Neoplasia, pp. 310-311. [Practice more Pathology PYQs on OnCourse]

Q: Which of the following are characteristic laboratory findings in Iron Deficiency Anemia (IDA)? 1. Low serum ferritin 2. Low transferrin saturation 3. Low serum iron 4. Increased TIBC

All of the above. ***All of the above (1, 2, 3, and 4)*** - **All listed parameters are characteristic findings in Iron Deficiency Anemia (IDA):** - **Low serum ferritin** - Indicates depleted iron stores; most specific early marker [1] - **Low serum iron** - Reflects reduced circulating iron availability [1] - **Low transferrin saturation** - Shows decreased percentage of iron-bound transferrin molecules (typically <15%) [1] - **Increased TIBC** - Compensatory increase in total iron-binding capacity as the liver produces more transferrin to capture available iron [1] *Why not just 1, 2, and 3?* - Increased TIBC is also a hallmark finding in IDA, distinguishing it from anemia of chronic disease (where TIBC is typically low) [1] *Why not just 3 and 4?* - Serum ferritin and transferrin saturation are equally important diagnostic parameters [1] *Why not just 1, 3, and 4?* - Low transferrin saturation is a key diagnostic criterion for IDA [1] **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Red Blood Cell and Bleeding Disorders, pp. 657-660. [Practice more Pathology PYQs on OnCourse]

Q: Order of drawing blood in vacutainers should be in the following sequence to prevent contamination:

Blood culture → Citrate → Plain → EDTA → Fluoride. ***Blood culture → Citrate → Plain → EDTA → Fluoride*** - This sequence is the recommended order of draw to prevent **cross-contamination** between different additives, which could interfere with laboratory test results. - Starting with **blood cultures** minimizes contamination risk for microbiological analysis [1], followed by tubes containing anticoagulants like **citrate** (for coagulation studies), then **plain** tubes (for serum), followed by **EDTA** (for hematology), and finally **fluoride** (for glucose). - This order prevents carryover of additives that could affect subsequent test results. *Plain → Blood culture → Citrate → EDTA → Fluoride* - Drawing a **plain tube** first is incorrect as it might introduce skin flora into the blood culture bottle if performed later. - **Blood culture** should always be drawn first to ensure sterility and prevent contamination from other tube additives [1]. *Citrate → Blood culture → Plain → EDTA → Fluoride* - Drawing the **citrate tube** before blood culture is incorrect due to the risk of introducing citrate anticoagulant into the blood culture, which could inhibit bacterial growth. - The **blood culture** bottle requires the highest priority for sterility [1]. *Blood culture → Plain → EDTA → Citrate → Fluoride* - Placing the **plain tube** before **citrate tube** is incorrect according to CLSI guidelines. - Drawing the **EDTA tube** before the **citrate tube** can lead to contamination of the citrate sample with EDTA, potentially affecting coagulation tests by chelating calcium. **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Cardiovascular Disease, pp. 296-297. [Practice more Pathology PYQs on OnCourse]

Q: Which of the following cells is shown in the given image?

Hairy cell. ***Hairy cell*** - The image displays prominent **cytoplasmic projections** or "hairs" on the cell surface, which are characteristic features of **hairy cells** (lymphocytes seen in hairy cell leukemia) [1]. - These cells typically have an irregularly shaped nucleus and cytoplasm rich in ribosomes, as suggested by the granular appearance [1]. *Sickle cell* - **Sickle cells** are **red blood cells** that have a characteristic crescent or sickle shape due to abnormal hemoglobin polymerization. - The cell in the image is a **white blood cell** with a large nucleus and cytoplasmic extensions, clearly not a red blood cell. *Gaucher cell* - **Gaucher cells** are **macrophages** that accumulate glucocerebroside, giving them a characteristic **"crinkled paper"** or **"chicken scratch"** cytoplasm. - While they are large cells, they lack the distinct, fine, hair-like projections seen in the provided image. *Target cell* - **Target cells** are **red blood cells** with a central bullseye appearance due to an abnormal distribution of hemoglobin, often seen in thalassemia or liver disease. - The presented image is not a red blood cell and does not demonstrate the morphology of a target cell. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Diseases of White Blood Cells, Lymph Nodes, Spleen, and Thymus, p. 612. [Practice more Pathology PYQs on OnCourse]

Question 1

Which of the following is an Anti-apoptotic gene?

Accepted Answer

MCL-1

Answer

BAK

Answer

BIN

Answer

NOX-Q

Question 2

Which of the following are characteristic laboratory findings in Iron Deficiency Anemia (IDA)?

1. Low serum ferritin
2. Low transferrin saturation
3. Low serum iron
4. Increased TIBC

Accepted Answer

All of the above

Answer

3 and 4 only

Answer

1, 3, and 4 only

Answer

1 and 2 only

Question 3

Order of drawing blood in vacutainers should be in the following sequence to prevent contamination:

Accepted Answer

Blood culture → Citrate → Plain → EDTA → Fluoride

Answer

Plain → Blood culture → Citrate → EDTA → Fluoride

Answer

Citrate → Blood culture → Plain → EDTA → Fluoride

Answer

Blood culture → Plain → EDTA → Citrate → Fluoride

Question 4

Which of the following cells is shown in the given image?

Accepted Answer

Hairy cell

Answer

Sickle cell

Answer

Gaucher cell

Answer

Target cell

Question 5

Match the following?
a. Trisomy 13 1. Huntington disease
b. Trisomy 18 2. Patau syndrome
c. Trinucleotide repeat sequence 3. Sickle cell disease
d. Hb point mutation of glutamate to valine 4. Edward syndrome

Accepted Answer

a2-b4-c1-d3

Answer

b1-a3-d2-c4

Answer

a2-b1-c4-d3

Answer

a4-b1-c3-d2

Question 6

What is the correct statement about thymoma?

Accepted Answer

Thymoma is the most common neoplasia of the thymus.

Answer

Chest X-ray is the investigation of choice for the diagnosis of thymoma.

Answer

Thymoma is primarily located in the posterior mediastinum.

Answer

Thymoma is usually asymptomatic and only occasionally causes symptoms.

Question 7

Which of the following conditions is associated with perineural invasion?

Accepted Answer

Adenoid cystic carcinoma

Answer

Mucoepidermoid tumor

Answer

Pancreatic cancer

Answer

Pleomorphic adenoma

Question 8

What is the interpretation of the given pedigree chart?

Accepted Answer

Autosomal dominant

Answer

Incomplete penetrance

Answer

Autosomal recessive

Answer

X-linked dominant

Question 9

Identify the correct statement regarding Amyloidosis?

Accepted Answer

Amyloid deposits have beta pleated sheet conformation

Answer

Secondary amyloidosis is AL

Answer

Amyloidosis is called so because of deposition of complex carbohydrates

Answer

All of the options

Question 10

Match the following columns
A. Caplan syndrome
B. Mesothelioma
C. Silicosis
D. Asbestosis

1. Pleural effusion without shift
2. Crazy Paving
3. Lower lobe involved
4. Described in coal workers

Accepted Answer

A4-B1-C3-D2

Answer

A4-B1-C3-D3

Answer

A2-B1-C4-D3

Answer

A4-B3-C1-D2

INI-CET 2023 — Pathology