UPSC-CMS 2010 - Pathology PYQs Practice Questions

Q: Hypertrophic scar is characterized by the following, except

it outgrows the wound area. ***it outgrows the wound area*** - This statement is characteristic of a **keloid scar**, not a hypertrophic scar. Keloids are distinguished by their growth beyond the original wound margins [1]. - **Hypertrophic scars**, on the other hand, remain confined within the boundaries of the original injury, though they may be raised and erythematous [1]. *it involves the flexor surface* - While hypertrophic scars can occur on any body surface, they are commonly found on areas of **high tension**, such as the **flexor surfaces** of joints (e.g., knee, elbow) or the chest and shoulders. - This involvement is due to constant movement stretching the healing skin, which can stimulate excessive collagen production. *it is non-familial* - Hypertrophic scars are generally **not associated with a strong genetic predisposition** or familial inheritance patterns. - Their development is primarily linked to factors like wound tension, infection, and individual healing responses rather than inherited tendencies. *it is not related to the race* - The incidence of hypertrophic scars does **not show a significant racial predilection**, unlike keloid scars, which are more common in individuals with darker skin types. - Hypertrophic scars can affect individuals from all racial backgrounds. **References:** [1] Kumar v, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Inflammation and Repair, pp. 119-121. [Practice more Pathology PYQs on OnCourse]

Q: Langhans' giant cells are characteristically seen in

peritoneal tuberculosis. ***Peritoneal tuberculosis*** - **Langhans' giant cells** are a characteristic histological feature of **granulomatous inflammation**, particularly seen in **tuberculosis** [1], [2]. - They are formed by the fusion of epithelioid histiocytes and are a hallmark of **mycobacterial infections**, including peritoneal tuberculosis [2]. - While not pathognomonic, their presence in the appropriate clinical context strongly suggests tuberculosis [1]. *Typhoid Peyer's patch* - **Typhoid fever** causes **macrophage infiltration** with **necrosis** and **ulceration** in Peyer's patches. - The inflammatory response is mononuclear but does **not** form **epithelioid granulomas** or Langhans' giant cells. - Histology shows mononuclear cell infiltration and typhoid nodules, not granulomatous inflammation. *Tuberculoma* - A **tuberculoma** is a localized form of tuberculosis and **also contains Langhans' giant cells** within its granulomatous structure [1]. - However, peritoneal tuberculosis represents a broader clinical entity where identification of these cells in peritoneal tissue/fluid is diagnostically significant. - Both are forms of TB, but the question context favors the systemic/cavity involvement over a localized mass lesion. *Lymphoma* - **Lymphoma** shows malignant proliferation of lymphoid cells with effacement of normal architecture. - It does **not** show **granulomatous inflammation** or Langhans' giant cells. - Histology reveals sheets of atypical lymphoid cells, not epithelioid granulomas. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Infectious Diseases, pp. 383-384. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Inflammation and Repair, p. 109. [Practice more Pathology PYQs on OnCourse]

Q: Acinic cell carcinoma is found in

salivary glands. ***salivary glands*** - **Acinic cell carcinoma** is a rare malignant tumor that primarily arises in the **major salivary glands**, most commonly the **parotid gland** [1]. - Its name derives from its histologic resemblance to **serous acinar cells**, which are characteristic of salivary gland tissue. *breast* - While various carcinomas occur in the breast, **acinic cell carcinoma** is not a primary breast cancer type [2]. - Breast cancers originate from **ductal** or **lobular epithelial cells** [2]. *thyroid* - Thyroid cancers include **papillary**, **follicular**, **medullary**, and **anaplastic carcinomas**, which originate from thyroid follicular or parafollicular cells. - **Acinic cell carcinoma** is not a recognized type of thyroid malignancy. *stomach* - The stomach is susceptible to **adenocarcinomas**, particularly **intestinal** and **diffuse types**, as well as other less common tumors. - **Acinic cell carcinoma** is not found as a primary tumor in the stomach. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Head and Neck, pp. 753-755. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Breast, pp. 1059-1060. [Practice more Pathology PYQs on OnCourse]

Q: Osteitis fibrosa cystica is a feature of

hyperparathyroidism. ***Correct: Hyperparathyroidism*** - **Osteitis fibrosa cystica** is a classic bone manifestation of **severe primary hyperparathyroidism**, resulting from excessive **parathyroid hormone (PTH)** [1]. - **PTH** causes increased bone resorption, leading to fibrous tissue replacement, cystic changes, and **brown tumors** (osteoclast-rich lesions with hemosiderin deposition) [1], [2]. - This represents advanced skeletal disease in hyperparathyroidism, though now rare due to early detection [1]. *Incorrect: Milk-alkali syndrome* - This syndrome is characterized by **hypercalcemia**, **metabolic alkalosis**, and **renal insufficiency** due to excessive intake of calcium and absorbable alkali. - It does not cause osteitis fibrosa cystica, which is a specific bone lesion requiring prolonged elevated **PTH**. *Incorrect: Rickets* - **Rickets** is a disorder primarily affecting children, characterized by defective bone mineralization leading to soft and weakened bones. - It is caused by **vitamin D deficiency** or resistance and manifests as bone deformities (bowing, rachitic rosary), not cystic bone lesions. *Incorrect: Hyperthyroidism* - **Hyperthyroidism** can lead to generalized **osteopenia** or **osteoporosis** due to increased bone turnover, but it does not cause osteitis fibrosa cystica. - The bone changes in hyperthyroidism are diffuse and distinct from the focal cystic lesions seen in excessive **PTH** activity. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Endocrine System, pp. 1105-1106. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Bones, Joints, and Soft Tissue Tumors, p. 1194. [Practice more Pathology PYQs on OnCourse]

Question 1

Hypertrophic scar is characterized by the following, except

Accepted Answer

it outgrows the wound area

Answer

it involves the flexor surface

Answer

it is non-familial

Answer

it is not related to the race

Question 2

Langhans' giant cells are characteristically seen in

Accepted Answer

peritoneal tuberculosis

Answer

typhoid Peyer's patch

Answer

tuberculoma

Answer

lymphoma

Question 3

Acinic cell carcinoma is found in

Accepted Answer

salivary glands

Answer

breast

Answer

thyroid

Answer

stomach

Question 4

Which one of the following is not a premalignant condition for colon cancer?

Accepted Answer

Sporadic hamartomatous polyps

Answer

Ulcerative colitis

Answer

Villous adenoma

Answer

Familial adenomatous polyposis coli

Question 5

Osteitis fibrosa cystica is a feature of

Accepted Answer

hyperparathyroidism

Answer

milk-alkali syndrome

Answer

rickets

Answer

hyperthyroidism

Question 6

Match List-I with List-II and select the correct answer using the code given below the Lists:

Accepted Answer

A→4  B→3  C→2  D→1

Answer

A→3  B→4  C→1  D→2

Answer

A→3  B→1  C→4  D→2

Answer

A→2  B→4  C→1  D→3

Question 7

Which one of the following is due to the monosomy of X-chromosome?

Accepted Answer

Turner's syndrome

Answer

Klinefelter's syndrome

Answer

Testicular feminization

Answer

Adrenogenital syndrome

Question 8

Which tumour marker is most often elevated in ovarian granulosa cell tumour?

Accepted Answer

Inhibin

Answer

Alpha fetoprotein

Answer

CA 125

Answer

Beta-HCG

Question 9

Which one of the following is an autosomal recessive disease?

Accepted Answer

Cystic fibrosis

Answer

Retinitis pigmentosa

Answer

Vitamin D resistant rickets

Answer

Neurofibromatosis

UPSC-CMS 2010 — Pathology