NEET-PG 2012 - Pathology Practice Questions

Q: What do Döhle bodies represent in neutrophils?

Presence of dilated endoplasmic reticulum in neutrophils. ***Presence of dilated endoplasmic reticulum in neutrophils*** - **Döhle bodies** are inclusions found in the cytoplasm of neutrophils, classic hallmarks of **severe infection** or inflammatory conditions. - They represent remnants of dilated **rough endoplasmic reticulum**, which appears as pale-blue, irregular aggregates on stained blood smears. *Increased mitochondria in neutrophils* - An increase in mitochondria is not a characteristic feature associated with Döhle bodies. - While mitochondria are essential for cellular energy production, their proliferation does not form visible inclusions known as Döhle bodies. *Golgi apparatus proliferation in neutrophils* - Proliferation of the Golgi apparatus is not typically observed as a Döhle body. - The Golgi apparatus is involved in protein modification and packaging, but its changes do not manifest as these specific inclusions. *Lysosomal activity in neutrophils* - Lysosomal activity involves the breakdown of cellular debris and pathogens and is not directly related to the formation of Döhle bodies. - Although lysosomes are abundant in neutrophils, their activity does not result in the presence of Döhle bodies.

Q: In which organ are corpora amylacea typically observed in a pathological context?

Prostate. ***Prostate*** - **Corpora amylacea**, also known as prostatic concretions, are common, benign findings in the prostate gland, especially with increasing age. - They are composed of glycoproteins and often found within the **acini and ducts of the prostate**. *Thymus* - The thymus is known for **Hassall's corpuscles**, which are epithelial reticular cells arranged concentrically, playing a role in T-cell selection. - **Corpora amylacea** are not typically found in the normal thymus. *Lymph node* - Lymph nodes are characterized by their lymphoid follicles, germinal centers, and medullary cords. - While they can have various inclusions or changes in disease states, **corpora amylacea** are not a typical pathological finding in lymph nodes. *Spleen* - The spleen is primarily involved in filtering blood and immune responses, with distinct red and white pulp regions. - **Corpora amylacea** are not associated with the normal or pathological histology of the spleen.

Q: What color is emitted by FITC after absorbing blue light?

Yellow-green. ***Yellow-green*** - Fluorescein isothiocyanate (FITC) is a common fluorochrome used in **fluorescence microscopy** and flow cytometry. - Upon excitation by blue light (typically around 495 nm), FITC emits light in the **yellow-green spectrum**, specifically around 521 nm. - This is the **spectroscopically accurate** description of FITC's emission peak. *Orange-red* - **Orange-red emission** is characteristic of fluorochromes like **phycoerythrin (PE)** or **Texas Red**, not FITC. - These fluorochromes have different **excitation and emission maxima** compared to FITC. *Apple-green* - While FITC fluorescence is sometimes clinically described as **"apple-green"** (especially in immunofluorescence), this is a **subjective visual description** rather than a precise spectral term. - The more **spectroscopically accurate** description is **yellow-green**, which reflects FITC's specific emission peak at 521 nm. - "Apple-green" typically suggests a purer green without the yellow component. *Golden-brown* - **Golden-brown** is not a typical emission color for fluorochromes like FITC. - This color is generally associated with **pigments** or stained tissues (e.g., lipofuscin, hemosiderin), not fluorescent probes.

Q: Which of the following does not belong to the family of selectins?

A selectin. ***A selectin*** - ***A selectin*** is not a recognized member of the selectin family, which includes other specific types. - The known selectins are **E-selectin**, **L-selectin**, and **P-selectin**, demonstrating a distinct classification [1]. *E selectin* - E selectin is a specific type of selectin expressed on **endothelial cells** activated by cytokines [1]. - It plays a crucial role in **leukocyte adhesion** during inflammation, distinguishing it as part of the selectin family [1]. *L selectin* - L selectin is involved in the **homing** of leukocytes to lymph nodes and forms part of the selectin family [1]. - Responsible for the initial tethering and rolling of leukocytes on **venular endothelium** [1]. *P selectin* - P selectin is found on platelets and endothelial cells and is critical in the **aggregation** of platelets and leukocytes. - It is also an established member of the selectin family, involved in **inflammatory responses** [1]. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Inflammation and Repair, p. 87.

Q: What occurs during the stage of Grey hepatization?

Accumulation of fibrin. ***Accumulation of fibrin*** - Grey hepatization is characterized by the **presence of fibrinous exudate** in the alveoli, indicating significant lung pathology, usually in cases of pneumonia [1,2]. - This stage follows red hepatization and reflects the **progression of inflammation** within the lung tissue [1,2]. *RBC's fill the alveoli* - This occurs during the **red hepatization** stage, where RBCs invade alveoli, not grey hepatization [1,2]. - **Grey hepatization** is marked by **fibrinous deposits** instead of erythrocytes [1,2]. *Organisms fill the alveoli* - While organisms, such as bacteria, can be present, they are more characteristic of the **initial infection phase** rather than grey hepatization [1]. - This stage reflects more on the **inflammatory response** than the presence of pathogens. *WBC's fill the alveoli* - The infiltration of **WBCs (like neutrophils)** represents an earlier inflammatory process, usually preceding grey hepatization [1,2]. - In grey hepatization, the focus is on the **accumulation of fibrin**, not directly on WBC infiltration [1,2]. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Lung, pp. 711-712. [2] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Respiratory Tract Disease, pp. 317-318.

Q: Maximum collagen deposition in wound healing is seen at -

End of third week. ***End of third week*** - By the end of the **third week**, the proliferative phase of wound healing is well underway, characterized by significant **collagen deposition**. [1] - At this stage, **Type III collagen** is initially laid down, which is later replaced by stronger **Type I collagen**, contributing to increasing wound strength. *End of first week* - The first week primarily involves the **inflammatory phase** and the initial stages of **proliferation**, with minimal new collagen deposition. [2] - While some **fibroblasts** are present, the amount of collagen synthesized is still relatively low. *End of second week* - Collagen synthesis is ongoing during the second week, but the **peak deposition rate** and overall amount of collagen accumulated are typically not as high as at the end of the third week. - The wound is gaining strength, but further increase in collagen content and remodeling is yet to occur. *End of 2 months* - By 2 months, the wound is in the **remodeling phase**, where the total collagen content might be substantial but the *rate of new collagen synthesis* has slowed down. - At this stage, there is a balance between **collagen synthesis** and **degradation**, and the collagen fibers are being reorganized and cross-linked to further improve tensile strength. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Inflammation and Repair, pp. 117-119. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Inflammation and Repair, p. 115.

Q: Which of the following is not typically seen in Disseminated Intravascular Coagulation (DIC)?

Normal aPTT. ***Normal APTT*** - In Disseminated Intravascular Coagulation (**DIC**), **APTT** is typically **prolonged** due to consumption of clotting factors [1]. - The presence of normal APTT indicates that coagulation pathways are not significantly affected, which is contrary to what is seen in DIC. *Fibrinogen decreased* - **Decreased fibrinogen levels** are common in DIC, reflecting its consumption during the coagulation process [1]. - This depletion is linked to the increased clotting and is a hallmark of DIC, making this statement false in the context of the question. *Thrombocytopenia* - **Thrombocytopenia** occurs in DIC as platelets are consumed during the formation of microclots [1]. - A significant drop in platelet count is a key feature of DIC, therefore this statement does not align with the "except" clause. *PT elevation* - Prothrombin Time (**PT**) is usually **elevated** in DIC due to the consumption of clotting factors [1]. - This reflects the ongoing activation of the coagulation cascade, supporting the exclusion in the question context. **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Blood And Bone Marrow Disease, pp. 625-626.

Q: Li–Fraumeni syndrome is associated with mutations in which of the following genes?

Gene TP53. ***Gene TP53*** - Li-Fraumeni syndrome is a rare, inherited cancer susceptibility syndrome associated with germline mutations in the **TP53 tumor suppressor gene**. - The **TP53 gene** encodes the p53 protein, which plays a critical role in cell cycle arrest, DNA repair, and initiation of apoptosis in response to cellular stress, thus preventing tumor formation. *Gene P21* - The **p21 gene** (CDKN1A) is a cyclin-dependent kinase inhibitor that acts downstream of p53, mediating p53-induced cell cycle arrest. - While p21 is involved in the p53 pathway, mutations in p21 itself are not the primary cause of Li-Fraumeni syndrome. *Gene RB1* - The **RB1 gene** encodes the retinoblastoma protein, a tumor suppressor involved in cell cycle regulation, particularly in controlling passage from G1 to S phase. - Mutations in **RB1** are primarily associated with hereditary retinoblastoma and osteosarcoma, not Li-Fraumeni syndrome. *Gene BRCA1* - The **BRCA1 gene** is a tumor suppressor gene involved in DNA repair, especially homologous recombination. - Germline mutations in **BRCA1** are strongly associated with hereditary breast and ovarian cancer syndrome, not Li-Fraumeni syndrome.

Q: What laboratory findings are associated with common variable hypogammaglobulinemia?

Low serum immunoglobulin levels. ***Low serum immunoglobulin levels*** - **Common variable hypogammaglobulinemia (CVID)** is characterized by significantly **low levels of IgG, IgA, and/or IgM** due to impaired B cell differentiation into plasma cells. - This deficiency in antibodies is the hallmark of the disorder, explaining the increased susceptibility to infections. *Decreased B cell count* - While CVID involves impaired B cell function, the **B cell counts** in the peripheral blood are typically **normal** or sometimes even elevated [1]. - The problem lies in their inability to differentiate and produce adequate antibodies, not in their numerical presence [1]. *Increased B cell count* - An increased B cell count is not a characteristic finding in CVID; peripheral B cell numbers are usually normal [1]. - If B cell counts are significantly increased, other conditions such as certain **lymphoproliferative disorders** should be considered. *Neutropenia* - **Neutropenia** (low neutrophil count) is not a primary diagnostic feature of CVID, although it can occur in some patients with autoimmune complications. - The defining laboratory finding is the **deficiency of immunoglobulins**, leading to recurrent infections. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Diseases of the Immune System, pp. 249-250.

Q: What type of anaemia is primarily associated with leukaemia?

Myelophthisic anaemia. ***Myelophthisic anaemia*** - This condition arises from the **displacement of normal hematopoietic tissue** in the bone marrow by abnormal cells, like those seen in leukaemia, leading to **extramedullary hematopoiesis**. - Marrow infiltration causes **pancytopenia** and often results in the presence of **immature granulocytes** and **nucleated red blood cells** in the peripheral blood (leukoerythroblastosis). *Iron deficiency anaemia* - This type of anaemia is caused by insufficient iron for **hemoglobin synthesis**, often due to chronic blood loss or inadequate dietary intake. - While leukaemia patients can develop iron deficiency due to bleeding, it is not the **primary type of anaemia** directly resulting from the marrow infiltration by leukaemic cells. *Megaloblastic anaemia* - Characterized by the production of abnormally large, immature red blood cells, primarily due to **vitamin B12** or **folate deficiency**. - There is no direct causal link between leukaemia and the development of megaloblastic anaemia as a **primary haemato-pathological mechanism**. *Aplastic anaemia* - Characterized by **pancytopenia** due to bone marrow failure with hypocellular marrow, not marrow infiltration. - While both leukaemia and aplastic anaemia can present with cytopenias, aplastic anaemia shows a **hypocellular marrow** whereas leukaemia shows a **hypercellular marrow** with infiltration by malignant cells.

Question 1

What do Döhle bodies represent in neutrophils?

Accepted Answer

Presence of dilated endoplasmic reticulum in neutrophils

Answer

Increased mitochondria in neutrophils

Answer

Golgi apparatus proliferation in neutrophils

Answer

Lysosomal activity in neutrophils

Question 2

In which organ are corpora amylacea typically observed in a pathological context?

Accepted Answer

Prostate

Answer

Thymus

Answer

Lymph node

Answer

Spleen

Question 3

What color is emitted by FITC after absorbing blue light?

Accepted Answer

Yellow-green

Answer

Orange-red

Answer

Apple-green

Answer

Golden-brown

Question 4

Which of the following does not belong to the family of selectins?

Accepted Answer

A selectin

Answer

P selectin

Answer

L selectin

Answer

E selectin

Question 5

What occurs during the stage of Grey hepatization?

Accepted Answer

Accumulation of fibrin

Answer

Red blood cells fill the alveoli

Answer

White blood cells fill the alveoli

Answer

Bacteria fill the alveoli

Question 6

Maximum collagen deposition in wound healing is seen at -

Accepted Answer

End of third week

Answer

End of first week

Answer

End of 2 months

Answer

End of second week

Question 7

Which of the following is not typically seen in Disseminated Intravascular Coagulation (DIC)?

Accepted Answer

Normal aPTT

Answer

Thrombocytopenia

Answer

PT elevation

Answer

Fibrinogen decreased

Question 8

Li–Fraumeni syndrome is associated with mutations in which of the following genes?

Accepted Answer

Gene TP53

Answer

Gene RB1

Answer

Gene BRCA1

Answer

Gene P21

Question 9

What laboratory findings are associated with common variable hypogammaglobulinemia?

Accepted Answer

Low serum immunoglobulin levels

Answer

Decreased B cell count

Answer

Increased B cell count

Answer

Neutropenia

Question 10

What type of anaemia is primarily associated with leukaemia?

Accepted Answer

Myelophthisic anaemia

Answer

Aplastic anaemia

Answer

Iron deficiency anaemia

Answer

Megaloblastic anaemia

NEET-PG 2012 — Pathology