NEET-PG 2012 - Pathology Practice Questions

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: What is the most common cause of nephritic syndrome in adults, excluding IgA nephropathy?

Membranoproliferative glomerulonephritis. ***None*** - Nephritic syndrome in adults is often caused by various conditions, but there is **no single most common cause** that universally applies. - The true prevalence can vary by population, but conditions like **IgA nephropathy** or **post-infectious glomerulonephritis** [1] are frequently encountered rather than one specific disease. *Membranoproliferative glomerulonephritis* - This condition can cause a **nephritic syndrome** [1], but it is not the most common cause in adults, often seen in association with **hepatitis C** or other infections. - In practice, **IgA nephropathy** or **post-streptococcal glomerulonephritis** [1] are more frequently recognized causes of nephritic syndrome in adults. *Membranous glomerulonephritis* - Primarily presents with **nephrotic syndrome** rather than nephritic features [1], making it less likely to be cited as a common cause of nephritic syndrome. - It is associated with **anti-phospholipase A2 receptor antibodies** but lacks the inflammatory features of nephritis [1]. *FSGN* - **Focal Segmental Glomerulosclerosis** is associated with nephrotic syndrome and doesn't typically lead to classic nephritic features, such as hematuria and hypertension [1]. - Its primary presentation is with **proteinuria** and possible renal failure but not with the typical characteristics of nephritic syndrome [1]. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Kidney, pp. 915-919.

Q: Which acquired condition is most commonly associated with spherocytes?

Autoimmune hemolytic anemia (AIHA). ***Autoimmune haemolytic anemia*** - This condition is characterized by the **production of antibodies** against the patient's own red blood cells, leading to **destruction** and the formation of spherocytes [1]. - The presence of ***maximum spherocytes*** in blood smears is a hallmark of this disorder due to **extravascular hemolysis** [1]. *Aplastic anemia* - Aplastic anemia is mainly due to **failure of hematopoiesis**, resulting in pancytopenia rather than spherocyte formation. - It typically presents with **normocytic** or **macrocytic anemia**, not spherocytes, as the bone marrow is not producing enough red blood cells [2]. *Vit B12 deficiency* - Vit B12 deficiency usually causes **macrocytic anemia** characterized by **megaloblastic changes** in the bone marrow and peripheral blood, not the formation of spherocytes. - The primary indicators would be **hypersegmented neutrophils** and large, ovalocytes rather than spherocytes. *None* - This option incorrectly implies that no condition causes maximum spherocytes, while autoimmune hemolytic anemia is the known condition for this finding. - Spherocytes are a specific sign in hemolytic processes and are definitely seen in conditions like **autoimmune hemolytic anemia**. **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Blood And Bone Marrow Disease, pp. 602-603. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Red Blood Cell and Bleeding Disorders, pp. 662-663.

Q: Which condition is most commonly associated with systemic amyloidosis?

Chronic Kidney Disease. Type II DM - Amyloidosis is commonly associated with **chronic diseases** like type II diabetes mellitus due to insulin resistance leading to amyloid deposition [4]. - The presence of **amiloid in the pancreas** often correlates with the complications of this type of diabetes [3]. *Maturity onset DM* - While maturity-onset diabetes can lead to complications, it is often synonymous with **type II DM**, making this distinction inaccurate regarding amyloidosis. - This term is less commonly used and does not emphasize the direct link to amyloidosis seen in type II diabetes. *HTN* - Hypertension itself is not a direct cause of amyloidosis; it typically results from other underlying conditions. - The association of amyloidosis with hypertension is usually **secondary**, not a primary condition leading to amyloid deposits [2]. *Type I DM* - Type I diabetes is primarily **autoimmune**, resulting in insulin-deficient states and does not strongly associate with amyloidosis like type II [1]. - The amyloid deposits seen in type I are much less common compared to type II or associated chronic conditions.

Q: Which of the following tumors is not derived from the meninges?

Hemangioblastoma. ***Hemangioblastoma*** - This tumor is derived from **vascular endothelial cells and stromal cells**, not meningeal cells [1] - Typically found in the **cerebellum** and strongly associated with **von Hippel-Lindau disease** [1] - Has **no meningeal origin** and represents a distinct vascular neoplasm *Meningioma* - Derived from **arachnoidal cap cells** of the meninges [2] - Most common **benign primary intracranial tumor** arising from meningeal coverings [2] - Clearly of **meningeal origin** [3] *Schwannoma* - Originates from **Schwann cells** of peripheral nerve sheaths (neural crest origin) [4] - While not meningeal in origin, it commonly occurs **intracranially** affecting cranial nerves (especially CN VIII) [2] - Though also not meningeal, **hemangioblastoma is the better answer** as it's purely parenchymal/vascular, whereas schwannomas can have anatomic association with meninges [4] *Hemangiopericytoma* - Now classified as **solitary fibrous tumor/hemangiopericytoma** (WHO classification) - Arises from **meningeal pericytes** around blood vessels in the meninges - Despite mesenchymal origin, it is considered part of the **meningeal tumor spectrum** and has meningeal associations **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Manifestations Of Central And Peripheral Nervous System Disease, pp. 726-727. [2] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Manifestations Of Central And Peripheral Nervous System Disease, pp. 727-728. [3] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Central Nervous System, pp. 1316-1317. [4] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Peripheral Nerves and Skeletal Muscles, pp. 1248-1249.

Q: Which of the following is NOT a pathological manifestation of chronic alcoholism?

Piecemeal necrosis. ***Piecemeal necrosis*** - Piecemeal necrosis is not a common manifestation of chronic alcoholism but is instead more typical of **autoimmune hepatitis** or **chronic viral hepatitis**. - Chronic alcoholism primarily leads to different types of liver damage, such as **steatosis** or **apoptosis**, rather than piecemeal necrosis. *Balloning degeneration* - Balloning degeneration reflects **swelling** of hepatocytes, often associated with **alcoholic liver disease** and represents liver cell injury [1]. - It is a recognized feature seen in chronic alcohol exposure indicating the effect of toxicity on liver cells [1]. *Microvesicular fatty changes* - Microvesicular fatty changes, characterized by small fat vacuoles in liver cells, can be induced by chronic alcohol use and is commonly noted in **steatosis** [2]. - This finding is also seen in conditions like **reye syndrome** and is closely related to alcohol-induced liver injury. *Central hyaline sclerosis* - Central hyaline sclerosis refers to fibrosis and is often related to chronic liver disease but is not a direct pathological manifestation seen in chronic alcoholism. - However, chronic alcohol abuse contributes to **cirrhosis**, which can lead to various forms of liver scarring, but this is not specific to alcohol alone [3]. **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Liver And Biliary System Disease, pp. 389-390. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Liver and Gallbladder, pp. 848-850. [3] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Liver and Gallbladder, p. 848.

Q: Medial calcification is seen in -

Monckeberg's sclerosis. ***Monckeberg's sclerosis*** - This condition is characterized by **calcific deposits** within the **tunica media** of muscular arteries. - It typically does not occlude the vessel lumen and is often asymptomatic, though severe calcification can lead to vessel rigidity. *Atherosclerosis* - Involves the formation of **atheromatous plaques** in the **tunica intima** of large and medium-sized arteries. - These plaques consist of lipids, inflammatory cells, smooth muscle cells, and fibrous connective tissue, leading to luminal narrowing and hardening of arteries. *Arteriolosclerosis* - Refers to the thickening and hardening of the walls of **arterioles** (small arteries). - It is often associated with hypertension and diabetes, affecting resistance vessels but typically not involving extensive medial calcification. *Dissecting aneurysm* - This condition involves a **tear in the tunica intima** of an artery, allowing blood to enter and dissect between the layers of the arterial wall. - It is a life-threatening condition primarily affecting the aorta and is characterized by a false lumen, not medial calcification.

Q: Creola bodies are seen in:

Bronchial asthma. ***Bronchial asthma*** - **Creola bodies** are clusters of **desquamated columnar epithelial cells** found in the sputum of patients with asthma. [1] - Their presence indicates ongoing **bronchial inflammation** and epithelial damage, characteristic of asthma exacerbations. *Chronic bronchitis* - Characterized by **mucus hypersecretion** and **chronic productive cough**, without the specific finding of Creola bodies. - Histologically, it involves **goblet cell hyperplasia** and **mucous gland enlargement**. *Emphysema* - Defined by irreversible enlargement of airspaces distal to the terminal bronchioles with **destruction of alveolar walls**, not specific cell aggregates. [1] - The primary defect is loss of **elastic recoil** and **airflow limitation**. *Bronchiectasis* - Involves **permanent abnormal dilation** of the bronchi due to destruction of the muscular and elastic components of the bronchial wall. [1] - Sputum typically contains inflammatory cells and bacteria, but Creola bodies are not a defining feature.

Q: Cells most sensitive to hypoxia are?

Neurons. ***Neurons*** - Neurons have a very high metabolic rate and an **absolute requirement for oxygen** and glucose to maintain their complex electrochemical functions and ionic gradients. - Due to their lack of significant energy reserves and high metabolic demand, they can sustain **irreversible damage within minutes** (typically 3-5 minutes) of complete oxygen deprivation. *Myocardial cells* - While myocardial cells are highly susceptible to hypoxia and can undergo **ischemic necrosis** (e.g., in a myocardial infarction), they can often tolerate oxygen deprivation for somewhat longer periods than neurons due to some anaerobic metabolic capacity. - Significant damage to myocardial cells usually occurs after **20-30 minutes of severe ischemia**. *Hepatocytes* - Hepatocytes (liver cells) are relatively **resilient to hypoxia** compared to neurons, possessing significant metabolic flexibility and capacity for regeneration. - They can endure **longer periods of oxygen deprivation** before irreversible damage occurs, often hours. *Renal tubular epithelial cells* - Renal tubular epithelial cells are generally **sensitive to hypoxia**, especially those in the medulla, due to their high metabolic activity for reabsorption and secretion. - They are a common target for **acute tubular necrosis** in ischemic injury but generally have a **higher tolerance than neurons**, with damage becoming widespread after tens of minutes to an hour of severe ischemia.

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.

Question 1

What color is emitted by FITC after absorbing blue light?

Accepted Answer

Yellow-green

Answer

Orange-red

Answer

Apple-green

Answer

Golden-brown

Question 2

What is the most common cause of nephritic syndrome in adults, excluding IgA nephropathy?

Accepted Answer

Membranoproliferative glomerulonephritis

Answer

FSGS

Answer

Membranous glomerulonephritis

Answer

Post-infectious glomerulonephritis

Question 3

Which acquired condition is most commonly associated with spherocytes?

Accepted Answer

Autoimmune hemolytic anemia (AIHA)

Answer

Vitamin B12 deficiency anemia

Answer

Aplastic anemia

Answer

None of the options

Question 4

Which condition is most commonly associated with systemic amyloidosis?

Accepted Answer

Chronic Kidney Disease

Answer

Multiple Myeloma

Answer

Rheumatoid Arthritis

Answer

Familial Mediterranean Fever

Question 5

Which of the following tumors is not derived from the meninges?

Accepted Answer

Hemangioblastoma

Answer

Meningioma

Answer

Hemangiopericytoma

Answer

Schwannoma

Question 6

Which of the following is NOT a pathological manifestation of chronic alcoholism?

Accepted Answer

Piecemeal necrosis

Answer

Microvesicular fatty changes

Answer

Central hyaline sclerosis

Answer

Ballooning degeneration

Question 7

Medial calcification is seen in -

Accepted Answer

Monckeberg's sclerosis

Answer

Atherosclerosis

Answer

Arteriolosclerosis

Answer

Dissecting aneurysm

Question 8

Creola bodies are seen in:

Accepted Answer

Bronchial asthma

Answer

Emphysema

Answer

Chronic bronchitis

Answer

Bronchiectasis

Question 9

Cells most sensitive to hypoxia are?

Accepted Answer

Neurons

Answer

Myocardial cells

Answer

Hepatocytes

Answer

Renal tubular epithelial cells

Question 10

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

NEET-PG 2012 — Pathology