NEET-PG 2017 - Pathology PYQs Practice Questions

Q: The pattern of inheritance of the hematological disorder shown is:

X-linked recessive. ***X-linked recessive*** - This pattern is characterized by affected males, unaffected females who can be carriers, and the absence of male-to-male transmission [1]. - The disorder is passed from an affected father to all his daughters (who become carriers) and from a carrier mother to 50% of her sons (who are affected) and 50% of her daughters (who are carriers) [1]. *Autosomal recessive* - In this pattern, affected individuals typically have unaffected parents, and both males and females are affected equally. - The disorder often skips generations, and consanguinity increases the risk. *Autosomal dominant* - This pattern shows affected individuals in every generation, with affected individuals having at least one affected parent. - Both males and females are affected equally, and male-to-male transmission can occur. *X-linked dominant* - This pattern is characterized by affected fathers passing the trait to all their daughters but none of their sons. - Affected mothers have a 50% chance of passing the trait to each child, regardless of sex. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Genetic Disorders, p. 151. [Practice more Pathology PYQs on OnCourse]

Q: A 70-year-old man presents with painless cervical lymphadenopathy with progressive pallor and petechiae on ankles. Peripheral smear shows presence of:

CLL. ***CLL*** - The presentation of **painless cervical lymphadenopathy**, progressive **pallor** (due to anemia), and **petechiae** (due to thrombocytopenia) in an elderly patient is highly suggestive of **Chronic Lymphocytic Leukemia (CLL)** [2]. - Peripheral smear in CLL typically shows a proliferation of mature-appearing **small lymphocytes** and characteristic **smudge cells** [1]. *Acute ITP* - Acute ITP is characterized by sudden onset of **thrombocytopenia** and bleeding, often following a viral infection, and is more common in children. - It does not typically present with **lymphadenopathy** or progressive pallor as a primary feature. *Chronic ITP* - Chronic ITP is characterized by isolated **thrombocytopenia** and bleeding symptoms, usually without lymphadenopathy or significant anemia unless bleeding is severe. - The presence of **lymphadenopathy** points away from isolated ITP and towards a systemic hematological malignancy. *Richter syndrome* - Richter syndrome is the transformation of CLL into a more aggressive lymphoma, most commonly **diffuse large B-cell lymphoma (DLBCL)**. - While it can present with rapidly enlarging lymph nodes and systemic symptoms, the initial presentation described (painless lymphadenopathy, progressive pallor, petechiae) is more typical of **untreated CLL** before transformation [2]. **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. 602. [2] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Blood And Bone Marrow Disease, pp. 612-613. [Practice more Pathology PYQs on OnCourse]

Q: Identify the cell.

Monocyte. ***Monocyte*** - Monocytes are characterized by their **large size** (12-20 µm), **kidney-shaped or horseshoe-shaped nucleus**, and **abundant, often grayish-blue cytoplasm** with fine azurophilic granules [1]. - They are precursors to **macrophages** and play a crucial role in phagocytosis and antigen presentation [1]. *Eosinophil* - Eosinophils have a **bilobed nucleus** and prominent **red-orange granules** in their cytoplasm, which stain with eosin [1]. - They are primarily involved in allergic reactions and defense against **parasitic infections** [1]. *Basophil* - Basophils are characterized by a **lobed nucleus** often obscured by large, coarse, **dark purple-blue granules** that contain histamine and heparin [1]. - They are the least common granulocyte and are involved in **allergic and inflammatory responses** [1]. *Lymphocyte* - Lymphocytes are typically **smaller** than monocytes, with a **large, round, or slightly indented nucleus** that occupies most of the cell [1]. - Their cytoplasm is usually **scanty and pale blue**, often appearing as a thin rim around the nucleus [1]. **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Blood And Bone Marrow Disease, pp. 578-580. [Practice more Pathology PYQs on OnCourse]

Q: Identify the cell.

Basophil. ***Basophil*** - The cell has **large, coarse, and dense basophilic (dark purple-blue) granules** in its cytoplasm, which often obscure the multi-lobed nucleus. - This characteristic appearance, with the **prominent dark granules that obscure the nucleus**, is distinctive of a **basophil** on a peripheral blood smear. - Basophils contain histamine and heparin, and their granules stain intensely with basic dyes. *Eosinophil* - Would have **bright red-orange granules** that are uniform in size and do NOT obscure the nucleus. - The nucleus is typically bilobed and clearly visible. *Neutrophil* - Would have a **multilobed nucleus** (2-5 lobes) that is clearly visible. - Contains fine, light pink or neutral-staining granules in the cytoplasm. - Most common white blood cell (50-70% of WBCs). *Monocyte* - Largest white blood cell with abundant **grayish-blue cytoplasm**. - Has a **kidney-shaped or horseshoe-shaped nucleus** that is clearly visible. - Lacks prominent granules. *Lymphocyte* - Small cell with a **large, round, dark-staining nucleus** that occupies most of the cell. - Scant cytoplasm, typically appearing as a thin rim around the nucleus. - No cytoplasmic granules. [Practice more Pathology PYQs on OnCourse]

Question 1

The pattern of inheritance of the hematological disorder shown is:

Accepted Answer

X-linked recessive

Answer

Autosomal dominant

Answer

Mitochondrial inheritance

Answer

Autosomal recessive

Answer

X-linked dominant

Question 2

A 70-year-old man presents with painless cervical lymphadenopathy with progressive pallor and petechiae on ankles. Peripheral smear shows presence of:

Accepted Answer

CLL

Answer

Acute ITP

Answer

Chronic ITP

Answer

Richter syndrome

Answer

Hairy cell leukemia

Question 3

The following bone marrow specimen is suggestive of diagnosis of:

Accepted Answer

Aplastic anemia

Answer

Pure red cell aplasia

Answer

Myelodysplasia

Answer

Normal marrow

Answer

Hairy cell leukemia

Question 4

Identify the cell.

Accepted Answer

Monocyte

Answer

Eosinophil

Answer

Basophil

Answer

Lymphocyte

Answer

Neutrophil

Question 5

Identify the cell.

Accepted Answer

Basophil

Answer

Eosinophil

Answer

Neutrophil

Answer

Monocyte

Answer

Lymphocyte

Question 6

Name the test given.

Accepted Answer

ESR measurement

Answer

Osmotic fragility

Answer

NESTROFT

Answer

Sickling test

Answer

Packed cell volume (PCV)

Question 7

Name the anticoagulant used in the following method.

Accepted Answer

Trisodium citrate

Answer

EDTA

Answer

Heparin

Answer

Dalteparin

Answer

Sodium fluoride

Question 8

The resected specimen of a kidney is seen below. What is the diagnosis?

Accepted Answer

Flea bitten kidney of malignant hypertension

Answer

Amyloidosis

Answer

Acute poststreptococcal glomerulonephritis

Answer

Chronic glomerulonephritis

Answer

Acute tubular necrosis

Question 9

Identify the lesion shown in kidney biopsy of 6-year-old child with recurrent U.T.I and vesico-ureteric reflux.

Accepted Answer

Focal segmental glomerulosclerosis

Answer

Diffuse glomerulosclerosis

Answer

Kimmelstiel Wilson change

Answer

Wire loop lesions

Answer

Membranous glomerulonephritis

Question 10

Comment on type of glomerulonephritis present in the kidney biopsy slide. (Recent NEET Pattern 2016-17)

Accepted Answer

Crescentic glomerulonephritis

Answer

Acute glomerulonephritis

Answer

Focal segmental glomerulosclerosis

Answer

Diffuse glomerulosclerosis

Answer

Membranous glomerulonephritis

NEET-PG 2017 — Pathology