Parasitosis of extraocular eye muscles is seen in?
Most common cause of idiopathic interstitial pneumonia is
Most common malignant tumor of the heart in adults
Aetiology of Dressler Syndrome is
Basket weave appearance of glomerular basement membrane on electron microscopy is seen in
Which is a hormone dependent liver tumor?
Which type of anemia is most commonly characterized by marked poikilocytosis and anisocytosis on peripheral blood smear?
The tissue of origin of the Kaposi's sarcoma is
The Ham test is specifically used for diagnosing paroxysmal nocturnal hemoglobinuria (PNH) and is based upon:
Which tumor is characterized by the presence of cells that resemble tennis rackets?
NEET-PG 2015 - Pathology NEET-PG Practice Questions and MCQs
Question 61: Parasitosis of extraocular eye muscles is seen in?
- A. Trichinella infection (Correct Answer)
- B. Cysticercus infection
- C. Amoebic infection
- D. Ascariasis infection
Explanation: ***Trichinella infection*** - **Trichinellosis** (caused by *Trichinella spiralis*) commonly involves the **extraocular muscles** during the muscle encystment phase [1]. - Ocular symptoms like **periorbital edema**, eosinophilic myositis of extraocular muscles, and subconjunctival hemorrhage are characteristic [1]. *Cysticercus infection* - **Cysticercosis**, caused by *Taenia solium* larvae, can affect the eye, predominantly forming **subretinal** or **vitreous cysts** [2]. - While it can involve orbital muscles, involvement of extraocular muscles is less typical and less specific than in trichinellosis [2]. *Amoebic infection* - **Amoebic infections** primarily cause **keratitis** (e.g., *Acanthamoeba*) [3] or can lead to granulomatous encephalitis in immunocompromised individuals. - They do not typically cause direct parasitosis of the extraocular muscles. *Ascariasis infection* - **Ascariasis**, caused by *Ascaris lumbricoides*, is an intestinal nematode and is not known to infect the extraocular muscles. - Ocular manifestations are rare and usually involve migration of adult worms to the orbit or eyelid, not muscle encystment. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Infectious Diseases, pp. 404-405. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Infectious Diseases, pp. 403-404. [3] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Manifestations Of Central And Peripheral Nervous System Disease, pp. 735-736.
Question 62: Most common cause of idiopathic interstitial pneumonia is
- A. Idiopathic pulmonary fibrosis (Correct Answer)
- B. Organizing pneumonia
- C. Sarcoidosis
- D. Lipoid pneumonia
Explanation: ***Idiopathic pulmonary fibrosis (IPF)*** - This is the **most common** form of idiopathic interstitial pneumonia, accounting for approximately **50-60% of all IIP cases** - Represents the **most severe** IIP subtype with poor prognosis - Characterized by progressive **usual interstitial pneumonia (UIP) pattern** with fibroblastic foci and honeycombing - Presents with progressive dyspnea, dry cough, and restrictive lung disease *Organizing pneumonia* - While **Cryptogenic Organizing Pneumonia (COP)** is a form of idiopathic interstitial pneumonia, it is **much less common than IPF** [1] - Characterized by **intra-alveolar granulation tissue (Masson bodies)** [1] - Better prognosis and steroid-responsive compared to IPF [1] *Sarcoidosis* - This is **NOT classified as an idiopathic interstitial pneumonia** - It is a separate **multisystem granulomatous disease** with **non-caseating granulomas** - Has a distinct etiology related to altered immune response - Does not belong to the IIP classification system *Lipoid pneumonia* - This is **NOT an idiopathic interstitial pneumonia** - Results from **aspiration of lipid substances** causing exogenous lipoid pneumonia - Has a **known extrinsic cause**, therefore not "idiopathic" - Not part of the IIP classification **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Respiratory Tract Disease, pp. 330-331.
Question 63: Most common malignant tumor of the heart in adults
- A. Cardiac Sarcoma (Correct Answer)
- B. Paraganglioma
- C. Rhabdomyoma
- D. Lipoma
Explanation: ***Cardiac Sarcoma*** - **Cardiac sarcomas** are the most common type of **primary malignant tumor** of the heart in adults, accounting for about 95% of primary malignant cardiac tumors. - **Angiosarcoma** is the most common subtype (approximately 33-50% of all cardiac sarcomas), typically originating from the **right atrium**. - These tumors are highly aggressive with rapid growth, early metastasis, and poor prognosis. - They commonly present with right-sided heart failure, pericardial effusion, or constitutional symptoms. *Rhabdomyoma* - **Rhabdomyomas** are the most common **primary cardiac tumors in infants and children** (60-80% of pediatric cardiac tumors), not adults. - These tumors are **benign** and strongly associated with tuberous sclerosis. - They often spontaneously regress after birth. *Lipoma* - **Lipomas** are **benign tumors** composed of mature adipocytes and account for about 10% of benign cardiac tumors. - They are typically asymptomatic and found incidentally. - They are not malignant and therefore not relevant to this question about malignant tumors. *Paraganglioma* - **Paragangliomas** (pheochromocytomas of the heart) are rare neuroendocrine tumors. - They are typically **benign** (though can be locally invasive) and may be hormonally active, causing catecholamine-related symptoms. - They represent less than 1% of cardiac tumors and are not the most common malignant cardiac tumor.
Question 64: Aetiology of Dressler Syndrome is
- A. Autoimmune (Correct Answer)
- B. Toxin mediated
- C. Viral infection
- D. Idiopathic cause
Explanation: ***Autoimmune*** - Dressler syndrome is a form of **pericarditis** that occurs several days to weeks after myocardial injury (e.g., myocardial infarction, cardiac surgery, trauma). [3] - It is considered an **autoimmune phenomenon** where the body's immune system attacks damaged cardiac tissue. [1] *Viral infection* - While viral infections can cause general pericarditis, Dressler syndrome specifically refers to **post-cardiac injury** inflammation, not direct viral involvement. [2], [3] - Viral pericarditis typically has a more acute presentation without a preceding cardiac event. [2] *Toxin mediated* - There is no evidence to suggest that Dressler syndrome is caused by **toxins** or toxic substances. - The pathogenesis is linked to an immune response to damaged myocardial cells. *Idiopathic cause* - While some forms of pericarditis are idiopathic, Dressler syndrome has a clear **triggering event** (cardiac injury) and a well-understood autoimmune mechanism. [3] - Therefore, it is not classified as idiopathic. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Diseases of the Immune System, pp. 214-215. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Heart, pp. 581-582. [3] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Cardiovascular Disease, pp. 297-298.
Question 65: Basket weave appearance of glomerular basement membrane on electron microscopy is seen in
- A. Alport syndrome (Correct Answer)
- B. Polyarteritis nodosa
- C. Giant cell arteritis
- D. Acute post-streptococcal glomerulonephritis
Explanation: ***Alport syndrome*** - **Alport syndrome** is characterized by a "basket weave" appearance of the **glomerular basement membrane (GBM)** on electron microscopy due to irregular thickening, thinning, and splitting of the lamina densa. - This structural abnormality results from mutations in genes encoding **Type IV collagen**, particularly **COL4A5**, leading to progressive kidney disease, hearing loss, and ocular abnormalities. *Polyarteritis nodosa* - This is a **necrotizing vasculitis** primarily affecting medium-sized arteries, and its renal involvement typically manifests as a focal or diffuse necrotizing glomerulonephritis, often without specific GBM changes. - The electron microscopic findings would generally show inflammatory cell infiltration and fibrinoid necrosis of vessel walls, not a characteristic GBM pattern. *Giant cell arteritis* - **Giant cell arteritis** is a vasculitis affecting large- and medium-sized arteries, typically in the elderly, and often involves the temporal arteries. - Renal involvement is rare, and the characteristic pathological finding is **granulomatous inflammation** within the arterial wall with giant cells, not GBM changes. *Acute post-streptococcal glomerulonephritis* - This condition is characterized by **subepithelial immune deposits ("humps")** on electron microscopy, not a "basket weave" pattern of the GBM. - The GBM itself may show minor changes but does not exhibit the lamellated and split appearance seen in Alport syndrome.
Question 66: Which is a hormone dependent liver tumor?
- A. Adenoma (Correct Answer)
- B. Hemangioma
- C. Hepatocellular carcinoma
- D. Hemangiopericytoma
Explanation: ***Adenoma*** - Hepatic adenomas are **hormone-dependent tumors** commonly associated with conditions like **oral contraceptive use** and are influenced by estrogen [1]. - These tumors can present as **benign liver masses**, but they have a risk of hemorrhage and malignant transformation [1]. *Hepatocellular carcinoma* - This is a **malignant tumor** of the liver primarily associated with cirrhosis and chronic liver disease, not directly hormone-dependent. - Risk factors include **viral hepatitis** and **alcohol exposure**, rather than hormonal influences. *Hemangioma* - Liver hemangiomas are **vascular lesions** that are usually asymptomatic and are **not hormone-dependent**. - They are the most common benign liver tumors, often discovered incidentally during imaging. *Hemangiopericytoma* - A rare tumor, hemangiopericytoma originates from **pericytes** around blood vessels and is not specifically associated with liver tissue or hormones. - It can arise in various organs but lacks the dependency on hormones seen in hepatic adenomas. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Liver and Gallbladder, p. 874.
Question 67: Which type of anemia is most commonly characterized by marked poikilocytosis and anisocytosis on peripheral blood smear?
- A. Megaloblastic anemia
- B. Iron deficiency anemia (Correct Answer)
- C. Nutritional anemia
- D. Thalassemia
Explanation: ***Iron deficiency anaemia*** - Characterized by **poikilocytosis** (abnormal shapes) and **anisocytosis** (variation in red blood cell sizes), which are common findings in iron deficiency [1]. - Typically results in **microcytic hypochromic anemia** [1], distinguishing it from other types of anemia. *Nutritional deficiency anaemia* - May present with various blood cell morphology but does not specifically exhibit **poikilocytosis** and **anisocytosis** characteristic of iron deficiency anemia. - Usually includes deficiencies like **vitamin B12** or **folate**, which result in **macrocytic anemia** instead. *Megaloblastic anaemia* - Primarily caused by deficiency of **vitamin B12** or **folate**, leading to large, immature red blood cells (megaloblasts) rather than varied shapes and sizes. - Associated with **hypersegmented neutrophils** in the blood smear, which differentiates it from iron deficiency anemia. *Thalassemia* - Characterized by **microcytic hypochromic red blood cells** and often involves **target cells** rather than generalized poikilocytosis and anisocytosis. - Typically presents with **hemolytic anemia** but does not show the same variability in cell shapes and sizes as seen in iron deficiency anemia. **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Blood And Bone Marrow Disease, pp. 590-591.
Question 68: The tissue of origin of the Kaposi's sarcoma is
- A. Lymphoid
- B. Vascular (Correct Answer)
- C. Neural
- D. Muscular
Explanation: ***Vascular*** - Kaposi's sarcoma originates from the **vascular tissue**, specifically from endothelial cells lining blood vessels [2]. - The lesions are characterized by **angiogenesis**, leading to the formation of vascular tumors with dilated endothelial cell-lined vascular spaces [1]. *Muscular* - Muscular tissue is involved in **voluntary** and **involuntary movements** but is not related to the etiology of Kaposi's sarcoma. - This condition does not arise from **muscle cells** or any muscular components. *Neural* - Neural tissue consists of **neurons** and **glial cells**, which are not implicated in Kaposi's sarcoma. - Kaposi's sarcoma does not originate from any **neural structures** or pathologies. *Lymphoid* - Lymphoid tissue primarily concerns the immune system, particularly the **lymphatic system**, and does not give rise to Kaposi's sarcoma. - This malignancy does not derive from **lymphoid components** like lymphocytes or lymph nodes. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Diseases of Infancy and Childhood, pp. 526-527. [2] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Cardiovascular Disease, pp. 282-283.
Question 69: The Ham test is specifically used for diagnosing paroxysmal nocturnal hemoglobinuria (PNH) and is based upon:
- A. GPI Anchor Proteins
- B. Complement (Correct Answer)
- C. Spectrin protein
- D. Mannose binding proteins
Explanation: ***Complement*** - The HAM test is based on the activation of the **complement system** which enhances the opsonization and clearance of immune complexes [1]. - It is used in the diagnosis of certain conditions, notably those associated with **hemolytic anemia** due to complement fixation. *GPI Anchor Proteins* - GPI anchor proteins are involved in anchoring proteins to cell membranes but are **not related to the HAM test**. - This oes not explain the **mechanism** or purpose of the HAM test. *Mannose binding proteins* - Mannose binding lectins play a role in **innate immunity** but are not the basis of the HAM test. - They function in the **opsonization of pathogens**, which is unrelated to the complement activation aspect of the HAM test. *Spectrin protein* - Spectrin is a cytoskeletal protein that contributes to the integrity of cell membranes, particularly in red blood cells. - It does not relate to the **mechanism of the HAM test**, which focuses on complement involvement. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Inflammation and Repair, pp. 99-100.
Question 70: Which tumor is characterized by the presence of cells that resemble tennis rackets?
- A. Seminoma
- B. Vaginal adenocarcinoma
- C. Langerhans cell histiocytosis (Correct Answer)
- D. Sarcoma botyroides
Explanation: ***Langerhans cell histiocytosis*** - This condition is characterized by **Birbeck granules** within the Langerhans cells, which have a distinctive **tennis racket-like appearance** on electron microscopy. - The cells are also positive for **CD1a** and **S-100** immunohistochemical markers. *Sarcoma botyroides* - This is a subtype of **embryonal rhabdomyosarcoma** typically found in mucosal sites, presenting as a polypoid, grape-like mass. - Its histology shows small, undifferentiated cells with primitive skeletal muscle differentiation, but **not tennis racket-shaped cells**. *Vaginal adenocarcinoma* - This is a rare malignancy of the vagina, often associated with **diethylstilbestrol (DES) exposure** in utero, presenting as glands. - The cells show glandular differentiation and produce mucin, but **lack Birbeck granules**. *Seminoma* - This is a germ cell tumor of the testis characterized by large, uniform cells with clear cytoplasm and prominent nucleoli, divided into lobules by fibrous septa containing lymphocytes. - There are **no tennis racket-shaped cells** or Birbeck granules associated with seminoma.