Question: The inheritance pattern of Familial hypercholesterolemia is

Mutations involving single genes follow one of three patterns of inheritance: autosomal dominant, autosomal recessive, or X-linked. Autosomal Dominant Inheritance Familial hypercholesterolemia Huntington disease Marfan syndrome Ehlers-Danlos syndrome Hereditary spherocytosis Neurofibromatosis, type 1 Adult polycystic kidney disease Familial Hypercholesterolemia Familial hypercholesterolemia is among the most common mendelian disorders; the frequency of the heterozygous condition is 1 in 500 in the general population. It is caused by a mutation in the LDLR gene that encodes the receptor for low-density lipoprotein (LDL), the form in which 70% of total plasma cholesterol is transpoed. A brief review of the synthesis and transpo of cholesterol follows. Normal Cholesterol Metabolism. Cholesterol may be derived from the diet or from endogenous synthesis. Dietary triglycerides and cholesterol are incorporated into chylomicrons in the intestinal mucosa, which drain by way of the gut lymphatics into the blood. These chylomicrons are hydrolyzed by an endothelial lipoprotein lipase in the capillaries of muscle and fat. The chylomicron remnants, rich in cholesterol, are then delivered to the liver. Some of the cholesterol enters the metabolic pool (to be described), and some is excreted as free cholesterol or bile acids into the biliary tract. The endogenous synthesis of cholesterol and LDL begins in the liver (Fig. 6-2). The first step in the synthesis of LDL is the secretion of triglyceride-rich very- low-density lipoprotein (VLDL) by the liver into the blood. In the capillaries of adipose tissue and muscle, the VLDL paicle undergoes lipolysis and is conveed to intermediate- density lipoprotein (IDL). In comparison with VLDL, the content of triglyceride is reduced and that of cholesteryl esters enriched in intermediate-density lipoprotein (IDL), but IDL retains on its surface two of the three VLDL- associated apolipoproteins B-100 and E. Fuher metabo- lism of IDL occurs along two pathways: Most of the IDL paicles are directly taken up by the liver through the LDL receptor described later; others are conveed to cholesterol- rich LDL by a fuher loss of triglycerides and apolipopro- tein E. In the liver cells, IDL is recycled to generate VLDL. Two thirds of the resultant LDL paicles are metabo- lized by the LDL receptor pathway, and the rest is metabo- lized by a receptor for oxidized LDL (scavenger receptor), to be described later. The LDL receptor binds to apolipo- proteins B-100 and E and thus is involved in the transpo of both LDL and IDL. Although the LDL receptors are widely distributed, approximately 75% are located on hepatocytes, so the liver plays an extremely impoant role in LDL metabolism. The first step in the receptor-mediated transpo of LDL involves binding to the cell surface receptor, followed by endocy- totic internalization inside so-called "clathrin-coated pits" (Fig. 6-3). Within the cell, the endocytic vesicles fuse with the lysosomes, and the LDL molecule is enzymatically degraded, resulting ultimately in the release of free cholesterol into the cytoplasm. The cholesterol not only is used by the cell for membrane synthesis but also takes pa in intracel- lular cholesterol homeostasis by a sophisticated system of feed- back control: * It suppresses cholesterol synthesis by inhibiting the activity of the enzyme 3-hydroxy-3-methylglutaryl- coenzyme A reductase (HMG-CoA reductase), which is the rate-limiting enzyme in the synthetic pathway. * It stimulates the formation of cholesterol esters for storage of excess cholesterol. * It downregulates the synthesis of cell surface LDL recep- tors, thus protecting cells from excessive accumulation of cholesterol. The transpo of LDL by the scavenger receptors, alluded to earlier, seems to take place in cells of the mononuclear- phagocyte system and possibly in other cells as well. Monocytes and macrophages have receptors for chemically modified (e.g., acetylated or oxidized) LDLs. The amount catabolized by this "scavenger receptor" pathway is directly related to the plasma cholesterol level. (Robbins Basic Pathology,9th edition,pg no. 219)


Question: ARDS is due to a defect

Ans. d. Endothelial cells The alveolar capillary membrane is formed by two separate barriers: Microvascular endothelium and Alveolar epithelium. In ARDS the integrity of this barrier is compromised by either endothelial or epithelial injury or, more commonly, both." ARDS is a clinical syndrome associated with pathological findings including pneumonia, eosinophilic pneumonia, cryptogenic organizing pneumonia, acute fibrinous organizing pneumonia, and diffuse alveolar damage (DAD). Of these, the pathology most commonly associated with ARDS is DAD, which is characterized by a diffuse inflammation of lung parenchyma. The triggering insult to the parenchyma usually results in an initial release of cytokines and other inflammatory mediators secreted by local epithelial and endothelial cells."-http://en.wikipedia.otg/wiki/Acute_respiratory_ distress syndrome "The intimal lining of all blood vessels is a single layer of functionally and structurally heterogeneous endothelial cells depending on organ and vascular bed location. Pulmonary microvascular endothelium is a metabolically active organ essential for maintaining adequate pulmonary and systemic cardiovascular homeostasis. Noxious stimuli compromise pulmonary endothelial functional and structural integrity leading to noncardiogenic pulmonary edema and parenchymal inflammation. Thus, pulmonary endothelium has a key role in the development of acute lung injury (ALI) and its most severe form, the acute respiratory distress syndrome (ARDS). "- Curr Opin Crit Care 14:22-30 Acute Respiratory Distress Syndrome Pathogenesis: The alveolar capillary membrane is formed by two separate barriers: Microvascular endothelium Alveolar epithelium. In ARDS the integrity of this barrier is compromised by either endothelial or epithelial injury or, more commonly, both. Markers of endothelial injury and activation such as endothelin and von Willebrand factor can be detected at high levels in the serum of patients with ARDS. The acute consequences of damage to the alveolar capillary membrane include increased vascular permeability and alveolar flooding, loss of diffusion capacity, and widespread surfactant abnormalities caused by damage to type II pneumocytesQ Endothelial injury also triggers the formation of microthrombi that add the insult of ischemic injury. Hyaline membranes so characteristic of ALI/ARDS result from inspissation of protein rich edema fluid that entraps debris of dead alveolar epithelial cellsQ.


Question: Free radical scavanging system enzyme is

Answer-B. Glutathione peroxidaseAntioxidant mechanisms1. Non-enzymatic systemAntioxidants (Vit E , Vit A, Vit C, glutathione and Cysteine)Tissue proteins (transferrin, ferritin, laetofeftifl, and ceruloplasmin).2. Enzymatic systemCatalaseSupuoxide damutase (SOD)3. Glutathione peroxidasePresent in mitochondria & cytosol.It catalyzes free radical breakdown.H2O2 + 2 G S H - G S S G + 2 H2O2OH + 2 G S H - G S S G + 2H2O


Question: Salivary gland tumor exclusively seen in parotid gland

Answer-A. Wahin's tumor"Wahin's tumor arises only in the parotid gland" - Textbook of surgery"Wahin's tumor arises almost exclusively in the parotid gland (the only tumor viually restricted to the parotid)"Salivary gland tumor seen only it parotid gland- Wahins'tumor.


Question: Herpetic Whitlow is seen in


Question: MC site of composite complex odontoma


Question: Burkitt's lymphoma is associated with the proliferation of


Question: Long thyroid stimulating agent is

Answer is option 2, antibody to thyroid receptors. Thyrotropin receptor (TSHR) antibodies that stimulate the thyroid (TSAb) cause Graves' hypehyroidism and TSHR antibodies which block thyrotropin action (TBAb) are occasionally responsible for hypothyroidism. Unusual patients switch from TSAb to TBAb (or vice versa) with concomitant thyroid function changes. We have examined case repos to obtain insight into the basis for "switching."


Question: Most common gene associated with renal cell carcinoma

Both sporadic and familial RCC is associated with: Loss of sequence on chromosome 3 either by translocation (3:6, 3:8, 3:11) or deletion. This region harbours the VHL gene. Familial RCC is associated with:- Von Hippel-Lindau syndrome Ref: RAM DAS NAYAK EXAM PREPARATORY MANUAL FOR UNDERGRADUATES 2nd ed. pg no: 633


Question: Struma ovarii is

Struma ovarii is the most common type of specialised teratoma.
It is composed of mature thyroid tissue and may present as hyperthyroidism.


Question: The division of a single tooth resulting in one normal and one supernumerary tooth is known as


Question: Yellowish discolouration of oral mucous membrane, skin and sclera of eye is


Question: Abtropfing affect is seen in


Question: Fibrin degradation product help in detection of


Question: The type of mammary ductal carcinoma in situ most likely to result in a palpable abnormality in the breast is

Refer Robbins page no necrosis DCIS can be divided into two major architectural subtypes, comedo and noncomedo (Fig. 23-17). Some cases of DCIS have a single growth pattern, but most are comprised of a mixture of patterns. Nuclear grade and necrosis are better predictors of local recurrence and progression to invasion than architectural type. Comedo DCIS may occasionally produce vague nodularity, but more often it is detected on mammography as clustered or linear and branching areas of calcification (Fig. 23-17A). It is defined by two features: (1) tumor cells with pleomorphic, high-grade nuclei and (2) areas of central


Question: Squamous cell carcinoma spreads commonly

In SCC, when deep invasion leads to eventual metastasis.Local and regional lymph nodes are the most common sites of metastasis.AJCC 8E pg: 171


Question: Complement complex that attacks cell membrane is

The complement complex attacking the cell membrane is membrane attack complex having a composition of C56789
Action of this complex leads to entry of fluid and ions inside the cells leading to cell lysis.
	Complement system has three main function
	1. Inflammation
	2. Opsonization
	3. Cell lysis


Question: Feulgen reaction is used to test

DNA should be stained red. The background, if counterstained, is green. The Feulgen reaction is a semi-quantitative technique. If the only aldehydes remaining in the cell are those produced from the hydrolysis of DNA, then the technique is quantitative for DNA.


Question:
60 year old diabetic female presented with burning sensation to spicy food. Intraoral examination revealed multiple periodontal abscess and keratotic area in a lace pattern with occasional erosive areas inside the lace pattern.

Provisional diagnosis for this lady will be

Oral lichen planus is a common mucocutaneous disease, characterised by bilateral white striations, papules, plaques on the buccal mucosa, tongue and gingiva. Erosive form may present as erosions or frankly ulcerated lesions, with characteristic radiating striae on the periphery of the individual lesions. Grinspan's syndrome is an interesting association of lichen planus, diabetes mellitus and vascular hypertension.


Question: Liquefaction necrosis is commonly seen in


Question: Ca 125 is used for

Harshmohan textbook of pathology 7th edition. ☆ CA 125 is a tumor marker of ovarian cancer. Most commonly used for follow up of ovarian cancer. ☆ pancreas tumor marker CA 19-9.


Question: Person having heterozygous sickle cell trait is protected from infection of


Question: An enzyme that protects the brain from free radical injury is

Reactive oxygen species(ROS) produced in small amounts in all cells during redox reactions that occur during mitochondrial respiration and energy generation. In this reaction, molecular oxygen is reduced by addition of four electrons to generate water. As this reaction is incomplete, toxic intermediates are produced.These intermediates include superoxide, which is conveed to H2O2 spontaneously by the action of enzyme superoxide dismutase. MPO: myeloperoxidase Conves H2O2 to highly reactive compound hypochlorite. Present in leucocytes. Refer robbins 9/e p39


Question: Food interferes with absorption of


Question: "Proofreading" is the role of

"Polymerase II (pol II) is mostly involved in proofreading and DNA repair. Polymerase I (pol I) completes chain synthesis between Okazaki fragments on the lagging strand.


Question: On rectal examination, a patient is found to have a large, fungating mass protruding into the rectal lumen. Biopsy of this mass demonstrates an invasive malignant tumor composed of glandular structures. The development of this condition is most strongly associated with

The disease is adenocarcinoma of the colon. Predisposing conditions include inflammatory bowel disease (ulcerative colitis more than Crohn's disease) and adenomatous polyps occurring either as an isolated finding or as pa of familial syndromes including familial polyposis coli, Gardner syndrome, and Turcot syndrome. Western diets high in fat and protein and low in fiber are also thought to predispose for colon cancer. Diveiculitis (inflamed diveicula) and diveiculosis (presence of diveicula in colon) do not appear to predispose for colon cancer. Neither juvenile polyposis syndrome , in which the polyps consist of mucus-filled tubules, nor Peutz-Jeghers syndrome , in which polyps form around an arborizing tree of connective tissue and smooth muscle, predisposes for colon cancer. Ref: Wyatt C., Butterwoh IV J.F., Moos P.J., Mackey D.C., Brown T.G. (2008). Chapter 14. Gastrointestinal Pathology. In C. Wyatt, J.F. Butterwoh IV, P.J. Moos, D.C. Mackey, T.G. Brown (Eds), Pathology: The Big Picture.


Question: Werner syndrome is

Patients with Werner syndrome show premature ageing due to the defect in DNA helicase enzyme, a protein involved in DNA replication and repair and other functions requiring DNA unwinding.Wermer syndrome is MEN-1 (note the spelling)Robbins 9th edition 66


Question: Hepatolenticular degeneration is seen with deposition of


Question: 42 years old female presents diagnosed as iron deficiency anemia was staed on oral iron therapy and her Hb condition during review was 8 g%. The cause for failure of treatment is


Question: Intestional absorption of Calcium is decreased by


Question: Feature of acanthosis nigricans is

Insulinoma, obesity & cutaneous hypopigmentation

Insulin resistance, obesity, cutaneous hyperpigmentation

Thickening of spinous Layer, insulin resistance, obesity

Thickening of spinous layer, insulin resistance, lean


Question: Agent responsible for increasing factor VIII activity in haemophilia is


Question: Juvenile polyp is a

Ans: b) Hamartomatous polyp ( Ref: Robbins 7th ed / Pg 857 )All four options are non neoplastic (benign) lesions of intestine.Juvenile polyps:Focal hamartomatous malformations involving mucosal epithelium and lamina propriaUsually large rounded glistening lesions with stalks upto 2 cm in length.Usually in children < 5 years of age. Around 80% occurs in rectum.Peutz Jeghers polypsHamartomatous polyps involving mucosal epithelium, lamina propria and muscularis mucosa.Peutz Jeghers syndrome - AD disorder. Multiple polyps throughout GIT, mucocutaneous pigmentation.M/E: Arborizing network of connective tissue and well developed smooth muscle extends into the polyp and surrounds normal abundant glands lined by normal intestinal epithelium rich in goblet cells.- Increased chance of intussusception- No malignant potential of its own, but increased risk of Ca ovary, lung, pancreas, breast, uterus (adenoma malignum), sertoli cell tumors of testes.Bridge:Juvenile polyposis syndrome.AD disorder with risk of adenocarcinoma along with mutations in SMAD4 /DPC4 gene (encoding TGF beta)Mutations of STKII (LKbl ) on chromosome 19.Other hamartomatous polyposis1) Cowden syndromeAD, involving all 3 germ layers.Intestinal hamartomatous, facial trichilemmomas, acral keratosis, oral papillomasIncreased chance of thyroid and breast cancerMutation - PTEN gene on chromosome 10.2) Cronkhite Canada syndromeNm hereditary disorder; idiopathicGI hamartomatous polyps + ectodermal abnormalities (nail atrophy, alopecia)


Question: EBV infects B cells binding to

CD21- EBV uses this receptor to bind and infect B cellsReference: Robbins; 9th edition; Volume I; Page no: 327


Question: Most common site of osteoma

Bone forming tumor Osteomas are benign lesions most commonly encountered in the head and neck, including the paranasal sinuses, but which can occur in elsewhere also. Hence the most apt answer is skull. Robbins basic pathology 9th edition page no 775,heading


Question: The teeth that erupt prematurely after 30 days of birth are known as


Question: Blashco's lines are present along the

Blaschko's Lines: a. The lines of Blaschko were delineated over 100 years ago. b. First described by Blaschko in 1901. The pattern is attributed to the lines of migration and proliferation of epidermal cells during embryogenesis (i.e., the bands of abnormal skin represent clones of cells carrying a mutation in a gene expressed in the skin).


Question: Patient with blood group O receive plasma from

Persons with a given antigen do not make antibodies against their own antigen, but will against the other antigens in that group. For example, if a person has type A blood, he (or she) will make antibodies against the B antigen, but not against the A antigen. That means that if this person is given either type B red blood cells or type AB red blood cells, his or her antibodies will attack and destroy the foreign red cells possessing the B antigen, causing a transfusion reaction. Similarly, a person having the RhD antigen will not make antibodies against RhD antigen, but the RhD negative person will make antibodies against blood with RhD positive red cells. Recipient Blood Type Matching Donor Blood Type A+ A+, A-, O+, O- A- A-, O- B+ B+, B-, O+, O- B- B-, O- AB+ Compatible with all blood types AB- AB-, A-, B-, O- O+ O+, O- O- O- Antibodies in the plasma of donors with different blood types cause a reverse situation. For example, since a person with Type AB blood makes no antibodies against Type A or Type B cells, his or her plasma can be given to a person with Type A, Type B, Type AB, or Type O blood


Question: Osteomalacia is

defective osteoid + normal mineralization

normal osteoid + defective mineralization

abnormal osteoid + abnormal mineralization


Question: Venous air embolism during surgery is seen with

Venous air embolismEntrapment of air or medical gases into the venous system causing symptoms and signs of pulmonary vessel obstruction. Medical gases such as carbon dioxide, nitrous dioxide, nitrogen, and helium can also cause or aggravate this condition.Numerous studies on VAE have been repoed in medical or surgical procedures and trauma. Neurosurgery performed in a sitting position has a high risk of VAE, with an incidence of 76% in posterior fossa surgery but 25% or 7% in cervical laminectomy whereas, neurosurgical procedures in lateral, supine or prone position showed an incidence of 15% to 25%VAE is also repoed in total hip replacement surgery, laparoscopic cholecystectomy, endoscopic procedures, lung & abdominal trauma.(Refer: Morgan's, Clinical Anaesthesia, 4thedition, pg no:638-639)


Question: Gain of function mutation in RAS gene is equal to loss of function mutation in


Question: A critical factor in the regulation of craniofacial development

Wingless Drosophila melanogaster segment — Polarity gene (Wnt)


Question: RBC casts seen in

RBC casts are a feature of glomerular damage .Normally <3 RBC/HPF are going to leak. But in the case of glomerular damage the number of RBC in the urine will exceed the limit mentioned above and these RBC get impinged on Tamm horsefall protein. The resultant RBC casts can be seen under microscopic examination of urine. Refer robbins 9/e p912


Question: Radiation caries develops in


Question: Principle mediator of vasodilation in acute inflammation is

Vasodilation is induced by chemical mediators such as histamine and is the cause of erythema and stasis of blood flow in acute inflammation.Histamine causes dilation of aerioles and increases the permeability of venules. Histamine is considered to be the principal mediator of the immediate transient phase of increased vascular permeability, producing interendothelial gaps in venules. Its vasoactive effects are mediated mainly binding to receptors, called H1 receptors, on microvascular endothelial cells. The antihistamine drugs that are commonly used to treat some inflammatory reactions, such as allergies, are H1 receptor antagonists that bind to and block the receptor.Ref: Robbins and Cotran Pathologic Basis of Disease; 9th edition; Chapter 3; Acute inflammation; Page no: 75


Question: Hemophilia A due to deficiency of

Hemophila A:-

Hemophilia A is due to deficiency of factor VIII
Hemophilia A is inherited as an X-linked recessive trait.
Factor VIII is an intrinsic pathway component required for activation of factor X.
Clinical manifestations are due to defect in coagulation system : -

Large post traumatic ecchymoses or hematoma. Prolonged bleeding after a laceration or any form of surgical procedure.
Bleeding into weight bearing joints.

Petechiae are characteristically absent (in contrast to platelet dysfunction where bleeding occur from small vessels of skin and mucous membrane, e,g.: petechiae).
Laboratory findings :-

□ ↑ PTT □ Normal BT □ Normal PT
Normal platelet counts Remember
Hemophilia B (christmas disease) is due to deficiency of factor IX.
Hemophilia B has clinical features and laboratory findings similar to hemophilia A


Question: The most reliable test in the diagnosis of pheochromocytoma is

Pheochromocytomas are neoplasms of chromaffin cells,which synthesize and release catecholamines. The lab diagnosis of this condition is based on demonstration of increased urinary excretion of free catecholamines and their metabolites; vanilylmandelic acid and metanephrines. (ref:ROBBINS Text book of pathology


Question: Leucocyte common antigen

Antigen DesignationNormal Cellular DistributionCD14MonocytesCD15Granulocytes; Reed-Sternberg cells and variantsCD23Activated mature B cellsCD45All leukocytes; also known as leukocyte common antigen(LCA)Ref: Robbins and Cotran Pathologic Basis of Disease; 9th edition; Chapter 13; Diseases of White Blood Cells, Lymph Nodes, Spleen, and Thymus; Page no: 590


Question: Poststreptococcal glomerulonephritis presents with

Clinical Features The most common clinical presentation is acute nephritic syndrome. Edema and hypeension are common, with mild to moderate azotemia. Characteristically, there is gross hematuria, the urine appearing smoky brown rather than bright red due to oxidation of hemoglobin to methemoglobin. Some degree of proteinuria is a constant feature, and, as mentioned earlier, it occasionally may be severe enough to produce the nephrotic syndrome. Serum complement levels are low during the active phase of the disease, and serum antistreptolysin O antibody titers are elevated in poststreptococcal cases. Ref: ROBBINS BASIC PATHOLOGY 10th ed Pg no: 561


Question: Ground glass hepatocytes are seen in

Ground glass hepatocytes are liver cells which have eosinophilic, granular, glassy cytoplasm on light microscopy. It is due to HBs Ag accumulation inside the cells, seen in Hepatitis B virus infection.


Question: Ultrastructural finding of irreversible injury

Ans. is 'b' i.e. Amorphous densities in mitochondria Reversible injuryIrreversible injuryGeneralized swelling of the cell and its organelleBlebbing of the plasma membraneDetachment of ribosome from the endoplasmic reticulumClumping of nuclear chromatingIncreased swelling of the cellSwelling and disruption of lysosomesPresence of large amorphous densities in the swollen mitochondriaProfound nuclear changes which include:Pyknosis (nuclear condensation)Karyorrhexis (nuclear fragmentation)Karyolysis (dissolution of nucleus)The earliest changes associated with various forms of cell injury are:decreased generation of A.T.P.loss of cell membrane permeabilitydefect in protein synthesiscytoskeletal damageDNA damageWithin limits the cell can compensate for these derangements and if injurious stimulus is removed, it will return to normality.Persistent or excessive injury, however causes cells to pass the threshold and cause irreversible injury.But the "point of no return" at which irreversible damage has occurred is still largely undetermined thus we have no precise cut off points to establish irreversibility.Actually, there is probably no single final common pathway by which cells die. It is therefore difficult to define the stage beyond which the cell is doomed for destruction.However, two phenomenon consistently characterize irreversibilityFirst is the inability to reverse mitochondrial dysfunction.The second is the development of profound disturbances in membrane function.Membrane damage leads to massive leak of intracellular enzymes and massive influx of calcium.Injury to lysosomal membranes results in leakage of hydrolysis in the cytoplasm, which degrade cytoplasmic and nuclear components.Massive influx of calcium and release of calcium from intracellular stores result in activation of enzymes that can catabolize membranes, proteins, ATP and nucleic acid and cause irreversible damage to the cells.

Ribosomal detachment from endoplasmic reticulum


Question: Familial amyloidosis is seen in

Answer- B. Senile cardiac amyloidosisSystemic senile amyloidosis (Senile cardiac amyloidosis). Wild or non-mutant transthyretin amyloid.


Question: Venous emboli are most often lodged in


Question: Retinoblastoma gene regulates

Tumor suppressor gene types (Based on the location in the cell):*Cell surface: TGF-beta, E-cadherin*Inner plasma membrane: NF-1*Cytoplasm: NF-2, APC/beta-catenin, PTEN, SMAD 2 and SMAD 4*Nucleus: RB1, P53, WT-1, BRCA1, and BRCA2Cell cycle :*Four phases of cell cycle in the following order: G1, S, G2, and M*There are classes of proteins that stimulates or suppresses cell cycle progression from one phase to another which are CDK (Cyclin dependent kinases), Cyclins and CDK inhibitors*There are 4 CDKs (CDK1, CDK2, CDK4, CDK6) and 4 cyclins (Cyclin D, Cyclin E, Cyclin A and Cyclin B) involved in regulation of cell cycle.*2 Checkpoints in the cell cycle: G1-S checkpoint and G2-M checkpoint*Proteins that enhance cell cycle progression are CDKs which are helped by Cyclins*Proteins that cause cell cycle arrest are CDK inhibitorsFactors causing cell cycle progression at the G1-S checkpoint:uCyclinD-CDK4, CyclinD-CDK6, Cyclin E-CDK2. (Sholy D4, D6, E2)uGrowth factors (EGF, PDGF)uHyperphophorylated RB gene (E2F released from RB )Factors causing cell cycle arrest at G1-S check point:uHypophosphorylated RB (E2F binds to RB)uP53uCDK inhibitors- p15,p16,p18,p19 ( inhibits CyclinD-CDK4)uCDK inhibitors - p21,p27,p57 (inhibits both CyclinD-CDK6, CyclinE-CDK2)Factors causing cell cycle progression at the G2-M checkpoint:uCyclin B-CDK1 (B1)Factors causing cell cycle arrest at the G2-M checkpoint uCDK inhibitors - p21,p27,p57 (inhibits CyclinB-CDK1)uIonising radiationFactors causing cell cycle progression at S phase uCyclinA-CDK2 (A2)Factors causing cell cycle arrest at S phase uCDK inhibitors - p21,p27,p57 (inhibits CyclinA-CDK2) Note: D4 inhibited by p15, 16, 18 and 19 D6, E2, A2 and B1 inhibited by p21, 27 and 57.Key regulators of the cell cycle: Cyclin D, CDK4, RB, and p16.(Ref: Robbins 8/e p284-290)


Question: Munro microabscesse are seen in

PSORIASIS. It usually appears first between the age of 15 and 30 years. The lesions are characterised by brownish-red papules and plaqueswhich are sharply demarcated and are covered with fine, silvery white scales. As the scales are removed by gentle scraping, fine bleeding points appear termed Auspitz sign. In about 25% of cases, peculiar pitting of nails is seen. Psoriatic ahritis resembling rheumatoid ahritis is produced in about 5% of cases but the rheumatoid factor is absent.Histologically, the following features are observed in fully-developed lesions.i) Acanthosis with regular down growth of rete ridges to almost the same dermal level with thickening of their lower poion.ii) Elongation and oedema of the dermal papillae with broadening of their tips. iii) Suprapapillary thinning of stratum Malpighi.iv) Absence of granular cell layer.v) Prominent parakeratosis.vi) Presence of Munro microabscesses in the parakeratotic horny layer is diagnostic of psoriasis. Ref: Harsh Mohan - Textbook of Pathology, 6th Edition.page no.778


Question: Chronic periostitis in children is known as


Question: Botryomycosis is a ..................... disease


Question: Substance playing a role in tumor metastasis cascade is

Ans is 'a' i.e. Collagenase IVVarious steps of metastasis and molecules involvedDetachment of tumor cells - Down regulation of expression of either E-cadherins or cateninsAttachement to ECM (including basement membrane) - Tumor cells express integrins that helps in the attachement.Degradation of ECM - proteolytic enzymes (most impoant proteases are metalloproteinases (MMPs) including collegenase IV).Vascular dissemination and homing of tumor cells - Among adhesion molecule CD44 is of paicular interest.


Question: Indication for cryoprecipitate is

Medical uses for giving cryoprecipitate include: Haemophilia - Used for emergency back up when factor concentrates are not available. von Willebrand disease - Not currently recommended unless the last reserve. ddAVP is the first line, followed by factor concentrates. Hypofibrinogenaemia (low fibrinogen levels), as can occur with massive transfusions Afibrinogenemia Bleeding from excessive anticoagulation - Fresh frozen plasma contains most of the coagulation factors and is an alternative choice when anticoagulation has to be reversed quickly. Massive hemorrhage - RBCs and volume expanders are preferred therapies. Disseminated intravascular coagulation Uremic bleeding tendency


Question: Following is used to stain fungi


Question: The most common congenital defect of the face and jaws is


Question: Ring sideroblasts, with iron laden occurs in

i.e. (Mitochondria) : (301-Harsh Mohan 6th ) (625-Robbins & Cotran-Pathologic basis of disease 8th)Ringed sideroblasts is characteristic of sideroblastic anemia /Myelodysplastic SyndromeRinged sideroblast in which haem synthesis is disturbed as occurs in sideroblastic anaemiasRinged sideroblasts containing numerous large granules, often forming a complete or partial ring around the nucleus. These ringed arrangement of these granules is due to presence of iron laden mitochondria around the nucleus


Question: Coagulative necrosis is seen in


Question: Hypertrophy is a type of

Physiological adaptive responses include:

Hypertrophy - increase in cell size
Hyperplasia - increase in the number of cells
Atrophy - decrease in cell size and number
Metaplasia - reversible replacement of one cell type by another differentiated cell type


Question: Osteogenesis imperfecta

Is a sex-linked disorder of bones that develop in cartilage

manifests with blue sclera which are pathognomonic of this disease

Has associations with amelogenesis imperfecta


Question: Cell injury occurs due to

Cell injury occurs due to decreased generation of cellular ATP ATP is necessary for Na+--K+ ATPase pump and Ca pump action and many other cellular functions for the existence of the cell THE MORPHOLOGY OF CELL AND TISSUE INJURY It is useful to describe the structural alterations that occur in damaged cells before we discuss the biochemical mecha- nisms that bring about these changes. All stresses and noxious influences exe their effects first at the molecular or biochemical level. Cellular function may be lost long before cell death occurs, and the morphologic changes of cell injury (or death) lag far behind both (Fig. 1-7). For example, myocardial cells become noncontractile after 1 to 2 minutes of isch- emia, although they do not die until 20 to 30 minutes of ischemia have elapsed. These myocytes may not appear dead by electron microscopy for 2 to 3 hours, or by light microscopy for 6 to 12 hours. The cellular derangements of reversible injury can be corrected, and if the injurious stimulus abates, the cell can return to normalcy. Persistent or excessive injury, however, causes cells to pass the nebulous "point of no return" into irreversible injury and cell death. The events that determine when reversible injury becomes irreversible and progresses to cell death remain poorly understood. The clinical rele- vance of this question is obvious; if the biochemical and molecular changes that predict cell death can be identified with precision, it may be possible to devise strategies for preventing the transition from reversible to irreversible cell injury. Although there are no definitive morphologic or biochemical correlates of irreversibility, two phenomena con- sistently characterize irreversibility: the inability to correct mito- chondrial dysfunction (lack of oxidative phosphorylation and ATP generation) even after resolution of the original injury, and profound disturbances in membrane function. As mentioned earlier, injury to lysosomal membranes results in the enzymatic dissolution of the injured cell, which is the culmination of injury progressing to necrosis. As mentioned earlier, different injurious stimuli may induce death by necrosis or apoptosis (Fig. 1-6 and Table Refer robbins 9/e p6


Question: Incidence of most common malignant tumours in women is


Question: Platelet function can be assessed by

Bleeding time is the time taken for bleeding to stop (time for platelet plug to form)
Bleeding time is a test of platelet function.


Question: Paradoxical respiration is seen in

Diaphragmatic palsy Bilateral diaphragmatic paralysisUnilateral diaphragmatic paralysisMost common cause of bilateral diaphragmatic paralysis are:High spinal cord injuryThoracic trauma (cardiac surgery)Multiple sclerosisAnterior horn disease Muscular dystrophyMost patients present with hypercapnic respiratory failure, frequently complicated by cor pulmonale and right ventricular failure, Atelectasis and pneumonia.The degree of diaphragmatic weakness is best quantitated by measuring trans diaphragmatic pressures.Treatment of choice is assisted ventilation for all or pa of each day.If the nerve to the diaphragm is intact, diaphragmatic pacing may be a ble alternativeUnilateral palsy is MC than bilateral, MC cause is nerve invasion from malignancy, usually a bronchogenic carcinoma.Diagnosis is suggested by an elevated hemidiaphragm on the CXR.Confirmation is best established with the "sniff test"(when the patient is observed with fluoroscopy while sniffing, then paralyzed diaphragm will move paradoxically upward due to the negative intrathoracic pressure).Patients with unilateral paralyzed diaphragm are usually asymptomatic, vital capacity and total lung capacity is reduced about 25%.No treatment if CXR is normal and patient is asymptomatic(Refer: Harrison's Principles of Internal Medicine, 18th edition, pg no: 2221)


Question: Staining done for sebaceous cell carcinoma

Ans. a. Oil Red 0 Histopathology of Sebaceous cell carcinoma Tumor is composed of lobules or sheets of cells separated by a fibrovascular stroma. The cell extend deeply and often involve the subcutaneous tissue and even the underlying muscle. The cells show various sebaceous differentiation, manifest as finely vacuolated or foamydeg rather than clear cytoplasm. There is more differentiation at the centre of the nest. Sometimes pseudoglandular formationdeg occurs. The vacuolated cells show abundant lipid, if a frozen section is stained with Oil Red '0' or Sudan Blackdeg. Sebaceous cell carcinoma Chlazion is tarsal or meibomian cyst and sebaceous cell carcinoma arises from the meibomian glands, so a recurrent chlazion should be subjected to histo-pathologic evaluation to exclude possibility of Sebaceous cell carcinomadeg. Usually presents as a nodule (which maybe mistaken for chlazion)deg, which then grows to form a big growth Surgical excision with reconstruction of the lids is the treatment of choicedeg


Question:
Autoantibodies Ani Ro and Anti La are completely absent
in

Decreasing order of frequency of finding Anti - Ra (or SSa) & Anti- La (or SSb) antibodies is Sjogren's syndrome, SLE, Systemic sclerosis. SSa antibodies may be occasionally found but SSb antibodies may be totally absent in rheumatoid arthritis.


Question: Hemophilia B is due to deficiency of

Hemophilia B is also known as Christmas disease
Deficiency of factor 9 X linked recessive

Disorder
Deficiency

Hemophilia A
			Hemophilia B
			Hemophilia C
Factor 8
			Factor 9
			Factor 11


Question: Alosetron is


Question: Shelf life of gamma irradiated pRBC is

Irradiation reduces RBC storage shelf life to not >28 days postirradiation depending on the time of irradiation relative to collection. Irradiation followed by refrigerator storage causes a higher concentration of in the product. To avoid wastage of RBC units, irradiation prior to issue is optimal. Ref baley and love 27 pg 17-18


Question: Linear pattern of Ig deposition in glomerular basement membrane is seen in

Ans: d (Good pasture s disease)Reference: Robbins, 8th ed pg. 912Renal InvolvementCharacteristic1. Post Streptococcal glomerulonephritis (PSGN)2. Membranous glomerulopathy3. IgA nephropathy4. Membrano proliferative glomerulo nephritis (MPGN)Enlarged hypercellular glomeruli Severe form - Crescent formation IF: Granular deposits of IgG, IgM, C3 along GBM E/M: "Subepithelial humps"Diffuse thickening of glomerular capillary wallE/M: electro denseSubepithelial deposit of IgSilver- "Spike like projection"Focal segmental or diffuseProliferation of mesangiumIF: IgA deposits in mesangiumE/M: Electron dense mesangial deposits Thickening of GBM with proliferation of glomerular cells & leukocytic infiltrationLight microscopy - Double contour or tram-track appearance - split basement membraneType 1 - Subendothelial depositsType 2 - Intramembranous deposits5. Lupus nephritis IF: Irregular mesangial & capillary loop deposits Subendothelial location6. Good Pasture Dense linear IgG staining of syndrome the GBM7. Diabetic Nephropathy Nodular Mesangial expansion "Kimmelstal Wilson Nodule" with increased mesangial matrix and cellularity & micro aneurysm formation.


Question: Plasmacytoid lymphomas may be associated with increase in

Lymphoplasmacytic lymphoma is a B-cell neoplasm composed of small lymphocytes, plasmacytoidlymphocytes, and plasma cells, which typically affects older adults. There is maturation to plasmacytoid cells, but lacking the features of other lymphomas (pseudofollicles, neoplastic follicles, monocytoid B cells). lymph nodes; the pattern is diffuse or interfollicular, sparing the sinuses. The infiltrate consists of small lymphocytes,plasmacytoid cells and plasma cells Immunoblasts, epithelioid histiocytes and mast cells may be present. bone marrow; diffuse, nodular or interstitial infiltration. The consensus panel requires bone marrow involvement for the diagnosis of WM4. There may be circulating neoplastic cells, but the count is lower than for CLL


Question: Red infarct is seen in

Ans. a (Lung). (Ref. Robbin, Pathology 6th ed., 1308) Hemorrhagic/ Red infarctNonhemorrhagic/pale/ bland/anaemic infarct1Ovarian torsionHeart2LungSpleen3Small intestineKidney


Question: In internal auditory meatus

The facial nerve lies lateral to superior vestibular nerve. The IAM on either side face each other across the posterior fossa

The cochlear nerve is medial to inferior vestibular nerve

The facial nerve is lateral to superior vestibular nerve

The inferior vestibular nerve is inferior to the cochlear nerve

The superior vestibular nerve is medial to the inferior vestibular nerve


Question: Mulberry molars are characteristic features of

Due to chronic suppurative abscess in over lying gingival tissue


Question: Microarray is best characterised by

Microarrays are gene chips used to sequence genes or portions of genes.In this technique, short sequences of DNA(oligonucleotides) that are complementary to the wild-type sequence and to known mutations are “tiled” adjacent to each other on the gene chip, and the DNA sample to be tested is hybridized to the array. Before hybridization the sample is labeled with fluorescent dyes. The hybridization (and consequently, the fluorescent signal emitted) will be strongest at the oligonucleotide that is complementary to wild-type sequence if no mutations are present, while the presence of a mutation will cause hybridization to occur at the complementary mutant oligonucleotide.


Question: Stony dull note on percussion is characteristic of

Pleural Effusion - Percussion findings Stony dullness with increased resistance and no shifting dullness below the level of fluid.Skodaic resonance (boxy note) just above the effusionObliteration of Traube&;s space in left side effusionGrocco&;s triangle: Triangular area of dullness against veebral column, at the base of opposite lung, due to collapse&; of lungEllis&;S&; shaped curve(Refer: Harrison's Principles of Internal Medicine, 18th edition, pg no: 2178-2180)


Question: Generalised thickening of cortical and cancellous bones is seen in


Question: The most common precancerous lesion for oral  malignancy is


Question: Most common nephropathy in the world is

IgA nephropathy (nuh-FROP-uh-thee), also known as Berger's disease, is akidney disease that occurs when an antibody called immunoglobulin A(IgA) builds up in your kidneys. This results in local inflammation that, over time, can hamper your kidneys' ability to filter waste from your blood. Refer robbins 9/e


Question: Delayed dentition with multiple supernumerary teeth is seen in


Question: Amyloidosis most commonly affects

Amyloidosis*A disease due to an accumulation of abnormal proteins which are formed due to abnormal protein misfolding. *Light microscopy: Amorphous, eosinophilic, hyaline, extracellular substance that causes atrophy of adjacent cells*Congored stain: Pink or red color to amyloid deposits*Congored under polarized microscopy: Apple green birefringence*To differentiate primary amyloidosis from secondary amyloidosis: Treat with potassium permanganate and then perform congo red stain. Congo red stain show positive in primary amyloidosis but negative in secondary amyloidosis due to potassium permanganate treatment. (Primary-persists) *Electron microscopy: Continous non-branching fibril with a diameter of 7.5 to 10nm*X-ray crystallography and Infrared spectroscopy- cross beta-pleated sheet conformation*Most common organs involved: Kidney and Hea *Most common test performed to diagnose amyloidosis: Abdominal fat pad aspiration*Most reliable test performed to diagnose amyloidosis: Tissue biopsy*Most rapid test to diagnose amyloidosis: Scintigraphy with radiolabelled serum amyloid O component*Test used in treatment follow up: Scintigraphy with radiolabelled serum amyloid O componentRef: Robbins 8/e p249


Question: Diffuse epidermal hyperplasia is


Question: The commonest site of endometriosis

Endometriosis

Endometriosis (ectopic endometrium) is the term used to describe the presence of endometrium (endometrial glands or stroma) in abnormal locations outside the uterus.
It occurs in following sites, in decreasing order of frequency -

1. Ovary                       2. Uterine ligaments           3. Rectovaginal septum                     4. Pelvic peritoneum
5. Laprotomy scar       6. Umbilicus, vagina, vulva or appendix.

Adenomyosis is the presence of endometrial tissue in the uterine wall, i.e., in the myometrium.


Question: OsteoscLerosis of bone occurs due to

Increase in the virulence of organisms causes infection


Question: The most common cause of Addison's disease is

Ans. is 'a' i.e., Autoimmune adrenalitis o Most common cause (60%-70%) of primary adrenocoicol insufficiency (Addison'discases) is autoimmune adrenelitis. o Other common cause are. Tuberculosis -*Most common cause of Addison's disease in India . AIDS Metastatic cancers


Question: Lacunar cells are seen in

Hodgkins Lymphoma*Hodgkin lymphoma encompasses a group of lymphoid neoplasms*Arise almost invariably in a single lymph node or chain of lymph nodes and spread characteristically in a stepwise fashion to the anatomically contiguous nodes. Hence staging is impoant.*Its characterized by presence of noeplastic giant cells called as Reed-Sternbergs cell with two nuclear lobes, large inclusion-like nucleoli and abundant cytoplasm.Classification1.Nodular sclerosis2.Mixed cellularity3.Lymphocyte rich4.Lymphocyte depleted5.Lymphocyte predominanceCharacteristics of different subtypes of Hodgkin lymphomaSubtypeMorphology Background infiltrateImmunophenotypeNodular sclerosisLacunar cellsOccasional RS cellsT cells, esinophils, macrophages, plasma cellsCD15+ CD30+ EBV-Mixed cellularityMononuclear cells ( Hodgkin cell) & RS cellT cells, esinophils, macrophages, plasma cellsCD15+ CD30+ EBV+ (70%)Lymphocyte richMononuclear cells ( Hodgkin cell) & RS cellT cells richCD15+ CD30+ EBV+ (40%)Lymphocyte depletedFrequent RS cellsPaucity of background reactive cellsCD15+ CD30+ EBV+ (90%)Lymphocyte predominanceFrequent L&H (popcorn cells)Follicular dentritic cells and reactive B cellsCD15- CD30- EBV- CD20+Note: 1) L&H - lymphocytic and histiocytic variant of Hodgkin lymphoma seen in Lymphocyte predominant subtype. 2) CD 15 and 30 are the classical markers of Hodgkin lymphoma 3) Lymphocyte predominant is different from the other 4 subtypes of Hodgkin lymphoma. Hence called as a NONCLASSICAL variant.4) Prognosis Excellent - Nodular sclerosis, Mixed cellularity, Lymphocyte-rich, Lymphocyte predominant Less orable- Lymphocyte depleted(Ref: Robbins 8/e p618, 7/e p422-423)


Question: Type of necrosis seen in Neervous tissue


Question: Popkorn cells are found in


Question: Break up time (BUT) test is done in


Question: Anti trans glutaminase antibodies are seen in

- Celiac sprue is associated with Anti-tissue transglutaminase Ab Anti-endomysial Ab Anti-gliadin Ab OTHER OPTIONS: - Tropical sprue is infectious disease most commonly caused by E.coli involving complete small intestine resulting in iron, folic acid & vit B12 deficiencies - Crohn's disease is inflammatory bowel disease associated with Anti-Saccharomyces cerevisiae Antibody - Familial adenomatous polyposis is autosomal dominant disorder caused by germline mutation in APC gene resulting in multiple polyps in GI tract.


Question: ANCA is associated with

• ANCA or antineutrophilic cytoplasmic antibodies are formed against certain proteins in the cytoplasm of neutrophils. Out of the given options, Wegener’s granulomatosis is most strongly associated with ANCA.


Question: Scar in lung tissue may get transformed into

“Peripheral adenocarcinomas with a small central invasive component associated with scarring and a predominantly peripheral bronchioloalveolar growth pattern may have a better outcome than invasive carcinomas of the same size.”.. Robbins


Question: As a general rule, veins carry

All veins carry deoxygenated blood from the body to the heart with the exception of the pulmonary vein
which carries oxygenated blood from the lungs to the heart.


Question: Hea failure cells are found in

It is seen characteristically found in lungs during left hea failure.The morphology of lung in LVH described by: Lungs. Rising pressure in the pulmonary veins is ultimately transmitted back to the capillaries and aeries of the lungs, resulting in congestion and edema as well as pleural effusion due to an increase in hydrostatic pressure in the venules of the visceral pleura. The lungs are heavy and boggy, and microscopically show perivascular and interstitial transudates, alveolar septal edema, and accumulation of edema fluid in the alveolar spaces. In addition, variable numbers of red cells extravasate from the leaky capillaries into alveolar spaces, where they are phagocytosed by macrophages The subsequent breakdown of red cells and hemoglobin leads to the appearance of hemosiderin-laden alveolar macrophages-- so-called hea failure cells--that reflect previous epi sodes of pulmonary edema. (Robbins Basic Pathology,9th edition,pg no.367)


Question: Phagocytosis in brain is caused by

Microglia is the nervous system counter- pa of the monocyte-macrophage system. Although the term 'microglia' is commonly used but it is inappropriate since these cells, unlike neuroglia, are not of neuroectodermal origin. Microglial cells (or Hoega cells) are not fixed but are mobile cells. These cells are found throughout the brain and are often present close to the blood vessels. Normally, microglial cells appear as small inconspicuous cells with bean-shaped vesicular nuclei, scanty cytoplasm and long cytoplasmic processes (Fig. 30.1,C). In response to injury or damage, however, these cells have capability to enlarge in size, proliferate and develop elongated nuclei, so called rod cells. Microglial cells may actually assume the shape and phagocytic function of macrophages and form gitter cells. The foci of necrosis and areas of selective hypoxic damage to the neurons are surrounded by microglial cells which perform phagocytosis of damaged and necrosed cells; this is known as neuronophagia. NEUROGLIA. The neuroglia provides suppoive matrix and maintenance to the neurons. It includes 3 types of cells: astrocytes, oligodendrocytes and ependymal cells Neuroglia is generally referred to as glia; thetumours originating from it are termed gliomas, and reactive proliferation of the astrocytes being called gliosis. i) Astrocytes. The astrocytes are stellate cells with numerous fine branching processes. In routine haematoxylin and eosin stains, an astrocyte has round or oval vesicular nucleus, but unlike neuron, lacks a prominent nucleolus. The cytoplasm is generally scanty. The processes radiate from the cell body. Depending upon the type of processes, two types of astrocytes are distinguished: Protoplasmic astrocytes have branched processes and are found mostly in the grey matter. Fibrous astrocytes have long, thin processes and are present mainly in the white matter. Some astrocytic processes are directed towards neurons and their processes, which others surround capillaries by terminal expansions called foot processes. The astrocytic processes may not be visible by routine stains but can be demonstrated by phosphotungstic acid haematoxylin (PTAH) stain. Ultrastructurally, these processes are composed of abundant intermediate filaments, mostly vimentin. The main functions of astrocytes in health are physio- logical and biochemical suppo to the neurons and interactions with capillary endothelial cells to establish blood brain barrier. In case of damage to the brain, astrocytes act like fibroblasts of other tissues. The astrocytes in respond to injury undergo hyperplasia and hyperophy termed 'gliosis' which is an equivalent of scar elsewhere in the body. Gemistocytic astrocytes are early reactive astrocytes having prominent pink cytoplasm. Long-standing progressive gliosis results in the development of Rosenthal fibres which are eosinophilic, elongated or globular bodies present on the astrocytic processes. Corpora amylacea are basophilic, rounded, sometimes laminated bodies, present in elderly people in the white matter and result from accumulation of starch-like material in the degenerating astrocytes. ii) Oligodendrocytes. Oligodendrocytes are so named because of their sho and fewer processes when examined by light microscopy with special stains (oligo=sho). In haematoxylin-eosin stained sections, these cells appear as small cells with a darkly-staining nucleus resembling that of small lymphocyte. The cytoplasm appears as a clear halo around the nucleus. Oligodendrocytes are present throughout the brain in grey as well as white matter and are most numerous of all other cells in the CNS. In grey matter, they are clustered around the neurons and are called satellite cells. In white matter, they are present along the myelinated nerve fibres and are termed interfascicular oligodendroglia. The major function of oligodendrocytes is formation and maintenance of myelin. Thus, in this respect they are counterpas of Schwann cells of the peripheral nervous system. Diseases of oligodendrocytes are, therefore, disorders of myelin and myelinisation such as inherited leucodys- trophies and acquired demyelinating diseases. iii) Ependymal cells. The ependymal cells are epithelium- like and form a single layer of cells lining the ventricular system, aqueduct, central canal of the spinal cord and cover the choroid plexus. They are cuboidal to columnar cells and have ciliated luminal surface, just beneath which are present small bodies termed blepharoplasts. The ependymal cells influence the formation and composition of the cerebrospinal fluid (CSF) by processes of active secretion, diffusion, absorption and exchange. The function of cilia is not very clear but probably they play a role in the circulation of CSF. The ependymal cells respond to injury by cell loss and the space left is filled by proliferation of underlying glial fibres. Ref:TEXTBOOK OF PATHOLOGY 6th EDITION - HARSH MOHAN PAGE NO:871-872 MICROGLIA.


Question: Protein affected in spinocerebellar ataxia type 6

Ans. (b) a1A-Voltage-dependent calcium channel subunit(Ref: 19tha/pg 451)Spinocerebellar ataxia type 6 is due to CACNA2A gene on chromosome 19pl3.3, which codes for a1A-Voltage- dependent calcium channel subunit protein.


Question: Adenosine deaminase deficiency is seen in the following disease


Question: Low serum haptoglobin in hemolysis is masked by

Bile duct obstruction llapatoglobin is a transpo glycoprotein synthesized by the liver. - It is a carrier, for.free Hb in plasma. - Its primary physiological. function is the preservation of iron. - Haptoglobin binds hemoglobin and carries it to the reticuloendothelial system. A decrease in haptoglobin (with normal liver function) is most likely to occur with increased consumption of haptoglobin due to increased intravascular activity. The concentration of haptoglobin is inversely related to the degree of hemolysis and to the duration of hemolytic episode. aiims pginee answers & explanations - Nov 2009 - Normal blood has sufficient haptoglobin to bind to about 100-200 mg of hemoglobin. As a result the hemoglobin released due to intravascular hemolysis binds to haptoglobin. The resulting hemoglobin complex is removed by hepatocytes. "This result in decreased serum haptoglobin in individuals with hemolytic disease". "In biliary obstruction the serum haptoglobin level is increased this may mask the decrease in serum haptoglobin due to hemolysis".


Question: Chromosome on ABO blood group is

Histo-blood group ABO system transferaseis an enzyme with glycosyltransferaseactivity, which is encoded by the ABO genein humans. It is ubiquitously expressed in many tissues and cell types. ABO determines the ABO blood group of an individual by modifying the oligosaccharides on cell surface glycoproteins. The ABO gene resides on chromosome 9 at the band 9q34.2 and contains 7 exons. The ABO locus encodes three alleles. The A allele produces a-1,3-N-acetylgalactosamine transferase (A-transferase), which catalyzes the transfer of GalNAc residuesfrom the UDP-GalNAc donor nucleotide to the Gal residues of the acceptor H antigen, conveing the H antigen into A antigen in A and AB individuals. The B allele encodes a-1,3-galactosyl transferase (B-transferase), which catalyzes the transfer of Gal residues from the UDP-Gal donor nucleotide to the Gal residues of the acceptor H antigen, conveing the H antigen into B antigen in B and AB individuals.


Question: In Hodgkin's disease, the lymphoma cells seen are


Question: Hemolytic uremic syndrome

Hemolytic uremic syndrome: Caused by deficiencies of complement regulatory proteins or agents that damage endothelial cells, such as a Shiga-like toxin elaborated by E. coli strain O157:H7. The endothelial injury initiates platelet activation, platelet aggregation, and microvascular thrombosis. Ref: ROBBINS BASIC PATHOLOGY 10th ed Pg no: 491

Most commonly caused by verocytogenic E.Coli

Causes mild to severe coombs positive hemolytic anemia


Question: The subtype of hodgkin lymphoma characterized by L and H cells

L and H cells are seen in lymphocyte predominane type of Hodgkin&;s disease. It is also known as polyploid type or popcorn type RS (reed -sternberg) cells This type of RS cells is larger with lobulated nucleus in the shape of popcorn Reference: textbook of Pathology 6th edition Author Harsha Mohan page number 369


Question: Lymphocytosis is seen in


Question: In comparison to hyperplasia, hyperophy is

* Hyperophy: increase in size of cells. There are no new cells just bigger cells containing increased amount of structural proteins and organelles * Hyperplasia: increase in cell number Both results in enlarged organ * Hyperplasia occurs in cells capable of replication * Hyperophy occurs in cells which have limited capacity to divide Refer robbins 9/e p3.

Increase in cell size without increase in number

Increase in cell number without increase in size

Increase in cell size and decrease in number


Question: During a routine checkup a 70 year old mate is found to have Serum Alkaline Phosphatase three times the upper limit of norrnal. Serum Calcium, Serum Phosphorous and liver function tests are normal. The most likely diagonsis is


Question: Effective red cell diameter

Answer: (C) Thalassemia minor anemia may present with normal RBC diameter (265-68-Hrshmohon 7th) (630= Rabbins- basis disease)Red blood cell distribution width (RDW or RCDW) is a measure of the variation of red blood cell (RBC) volume that is reported as part of a standard complete blood count. Usually red blood cells are a standard size of about 6-8 pm in diameter. Certain disorders, however, cause a significant variation in cell size. Higher RDW values indicate greater variation in size. Normal reference range in human red blood cells is 11.5-14.5%. If anemia is observed, RDW test results are often used together with mean corpuscular volume (MCV) results to determine the possible causes of the anemia. It is mainly used to differentiate an anemia of mixed causes from an anemia of a single cause. Deficiencies of Vitamin Bl2 orfolate produce a macrocytic anemia (large cell anemia) in which the RDW is elevated in roughly two- thirds of all cases; however, a varied size distribution of red blood cells is a hallmark of iron deficiency anemia, and as such shows an increased RDW in virtually all cases. In the case of a mixed iron and B!2 deficiency, there will normally be a mix of both large cells and small cells, causing the RDW to be elevated. An elevated RDW (red blood cells of unequal sizes) is known as anisocytosis. An elevation in the RDW is not characteristic of all anemias; anemia of chronic disease,hereditary spherocytosis, acute blood loss, aplastic anemia (anemia resulting from an inability of the bone marrow to produce red blood cells), and certain hereditary hemoglobinopathies (including some cases of thalassemia minor) all may present with a normal RDW* The human erythrocyte is a biconcave disc, 7-2 pm in diameter, and has a thickness of 2-4 pm at the periphery and 1 mm in the centre* More than 90% of the weight of erythrocytes consists of haemoglobin. The life span of red cell is 120 +- 30 day.* Range of normal red cell count in health in 5.5 +- 1.0 x1012/L in men and 4.8 +- l.0x 1012/l in women* Packed cell volume (PCV) or haematocrit- 0.47 + 0.07L/L (40-54%) in men- 0.42 +- 0.05 L/L (37-47%) in women* Reticulocyte count (%)0.5-l .5* Red cell distribution width-11.5-14.51. Mean corpuscular volume (MCV) =PCV in L/LRBC Count/L Normal value is 85 +- 8fl (77-93 fl)2. Mean corpuscular haemoglobin (MCH) =Hb/LRBC Count/L Normal range is 29.5 +2.5pg (27-32 Pg)3. Mean corpuscular haemoglobin concentration (MCHC) =Hb /dlPCV in L/LNormal value is 32.5 +2.5 g/dl (30-35 g/dl)* The size of the RBC is measured by MCV. MCHC is independent of red cell count and size *** Monocyte is the largest mature leucocyte in peripheral blood* Flow cytometry is done on - Lymphocytes* The anticoagulant used in Wintrobe ESR- Double oxalate1. Alkaline phosphatase is specific to Neutrophils cells2. Acid phasphatase is found in all hematopoitic cells but the highest levels are found in macrophages and osteoclasts (Monocytes)* Anticoagalant of choice for coagulation test is 3.2% sodium citrate *** Potassium oxalate + sodium fluoride is anticoagulant used in collection of blood sugar.Increases Leucocyte Alkaline phosphateDecreased Leucocyte Alkaline phosphate* Infections* Leukamoid reactions* Polycythemia- vera* Paroxysmal nocturnal hemoglobinuria (PNH)* CMLBlood group A is associated with1. Carcinoma stomach, cervix salivary gland pancreas2. Pernicious anemia3. Thrombosis in OCP users

Mixed iron and folic deficiency anemia produce microcytic


Question: An acute inflammation would attract


Question: Whipple's disease is caused by.

Whipple disease is cause by bacteria called tropheryma whippli. It is responsible fot causing influx of lot of macrophages leading to compression of lacteals and impairment in absorption of nutrients. Rod shaped bacillis in macrophage is seen. Patient complains of malabsorption. Pas +ve diastase resistant is seen in macrophage. Treatment with antibiotic will show dramatic improvement.


Question: Berger disease does not involve

Ans. (d) Lymphatics(Ref: Robbins 9th/pg 512; 8th/pg 517)Buerger's disease: Segmental, thrombosing, acute and chronic inflammation of medium-sized and small arteries, principally the tibial and radial arteries, with occasional secondary extension into the veins and nerves of the extremities


Question: Anemia of chronic disorder is characterized by


Question: Glanzmann thrombasthenia is due to

Glanzmann thrombasthenia is an autosomal recessive disorder. There is a failure of primary platelet aggregation with ADP or collagen due to inherited deficiency of two platelets membrane glycoproteins. It is caused due to deficiency of glycoprotein IIb- IIa.


Question: The risk factor in cholangiocarcinoma

Cholangiocarcinoma is a malignancy of the biliary tree, arising from bile ducts within or outside the liver,
o Risk factors All risk factors for cholangiocarcinomas cause chronic inammation and cholestasis,
which presumably promote the occurrence of somatic mutations or epigenetic alterations in cholangiocytes. Primary sclerosing cholangitis.
Hepatolithiasis. Congenital bro-polycystic disease of the biliary system (Caroli disease, choledochal cyst). Hepatitis B and C. Exposure to thorotrast.
Opisthorchissinensis and clonorchiasis infection


Question: Pauci immune glomerulonephritis is seen in aEUR'

Microscopic polyangitis fRef Bobbin's Th/e p. 976] Rapidly progressive glomerulonephritis may be caused by number of different diseases, some restricted to the kidneys and others systemic. Although no single mechanism can explain all cases, there is little doubt that in most cases, the glomerular injury is immunologically mediated. Thus a practical classification divides rapidly progressive glomerulonephritis into three groups on the basis of immunological findings. RAPIDLY PROGRESSIVE GLOMERULONEPHRITIS II Type RPGN Type I RPGN (anti GBM antibody) m (Immune (I complex) Type III RPGN (Pauci immune) * Idiopathic * Idiopathic * ANCA associated * Goodpasture * Post infectious * Idiopathic syndrome * Systemic lupus * Wegener erythematous granulomatosis * Henoch schnolein * Microscopic PAN purpura * Microscopic polyangitis


Question: Pheochromocytoma is a neoplasm derived from

Pheochromocytomas are neoplasms composed of chromaffin cells, which synthesize and release catecholamines and in some instances peptide hormones. Pheochromocytomas that develop in extra-adrenal paraganglia are designated paragangliomas Robbins 9e pg: 1134 Ref img

An adrenal gland tumor due to nephrogenic rest


Question: Constant feature associated with a radicular cyst


Question: Collagen most abundant in Hyaline cailage

Hyaline cailage is a unique connective tissue ideally suited to serve as an elastic shock absorber and wear-resistant surface It lacks a blood supply and does not have lymphatic drainage or innervation it is composed of water (70%), type II collagen (10%), proteoglycans (8%), and chondrocytes ref robbins 9th ed page 1208


Question: Most common cancer in liver is

Answer- C. MetastasisMost commonhqtatic neoplasm is metastasis.Most common primary benig nlesion of liver is cavernous hemangioma.Most common primary malignant lesion of liver is hepatocellular carcinoma.Most common primary hepatic tumor of children is hepatoblastoma.


Question: The gene involved in GIST

Pathogenesis of GISTs

Approximately 75% to 80% of all GISTs have oncogenic, gain-of-function mutations of the gene encoding the tyrosine kinase c-KIT.
Approximately 8% of GISTs have mutations that activate a related tyrosine kinase, platelet-derived growth factor receptor a (PDGFRA).
Constitutively active c-KIT or PDGFRA receptor tyrosine kinases activate RAS and P13K/AKT pathways and thereby promote tumor cell proliferation.


Question: Shoest acting synthetic opioid is

.Remifentanil is a potent, sho-acting synthetic opioid analgesic drug. It is given to patients during surgery to relieve pain and as an adjunct to an anaesthetic. Remifentanil is used for sedation as well as combined with other medications for use in general anesthesia Ref Robbins 9/e pg 345


Question: Ratio of fat cells and RBC in bone marrow

Bone marrow contains two types of stemcells: hemopoietic (which can produce blood cells) and stromal (which can produce fat, cailage and bone). ... Red blood cells, platelets and most white blood cells arise in red marrow; some white blood cells develop in yellow marrow


Question: KleihauerBetke test is used to detect

Ans. (c) Fetomaternal blood leak(Ref: Oski's Pediatrics: Principles & Practice, chapter 66; Dacie 11th/pg 307)Ring sideroblasts are not seen in sickle cell anemia, but in Sideroblastic AnemiaPeripheral smear finding in sickle cell anemia:Ansiopoikilocytosis, polychromasia, Increased Retie %Irreversibly sickle RBCs and target cells (increased after autosplenectomy).Howell-Jolly bodies due to asplenia. Q


Question: The most common site of metastasis from the mandibular sarcoma is


Question: The following is not a pyrogenic cytokine

Ans. (c) Substance P(Ref: J Infect Dis. (1999) 179 (Supplement 2): S294-S304. doi: 10.1086/513856, Harrison 18th ed:2666.)IL1 AND TNF are well known pyrogenic cytokines In the hypothalamus, the prostaglandins, especially PGE2, stimulate the production of neurotransmitters that reset the temperature set point at a higher level, hence pyrogenic


Question: The incidence of bilaterality in a dermoid cyst is approximately

Dermoid cyst is a benign germ cell tumour (very rarely malignant 1.7% typically in women older than 40 years). They are bilateral in 10% cases, usually unilocular with smooth surface, contains hair and sebaceousmaterial, lined in pa by squamous epithelium.


Question: Two siblings with ostegenesis imperfect, but their parents are normal. Mechanism of inheritance Is

Germline mosaicism, also called gonadal mosaicism, is a type of genetic mosaicism where more than one set of genetic information is found specifically within the gamete cells. Somatic mosaicism, a type of genetic mosaicism found in somatic cells, and germline mosaicism can be present at the same time or individually depending on when the conditions occur. When the mosaicism is only found in the gametes and not in any somatic cells, it is referred to as pure germline mosaicism. Germline mosaicism can be caused either by a mutation that occurs after conception, or by epigenetic regulation, alterations to DNA such as methylation that do not involve changes in the DNA coding sequence. A mutation in an allele acquired by a somatic cell early in its development can be passed on to its daughter cells, including those that later specialize to gametes. It can also be caused by a sporadic mutation in a gamete cell. If the germline mosaicism causing mutation occurs in the somatic cell, it never results in pure germline mosaicism because it will be present in somatic cells as well.


Question: Defect in xeroderma pigmentosum (Repeat)

Ans: C (Nucleotide excision repair) Ref: Robbins Pathologic Basis of Disease, 8th edition, Pg: 275 & Frosiius G Commentary: DNA base excision repair defects in human pathologies Free Radic Res. 2004 Oct:38(10): 1037-54.Explanation:Types of defects in DNA-repair systems and conditions associatedDNA Repair MechanismsDiseases associatedMismatch repair* Hereditary Nonpolyposis Colon Cancer Syndrome* Muir-Torre SyndromeNucleotide excision repair* Xeroderma pigmentosum* Cockayne's syndrome* T richothiodystrophyBase excision repair* Gross defects - Not compatible with life* Partial defects -Colorectal cancer & LungRecombinational repairCancers* Ataxia Telangiectasia (ATM gene, genome instability syndrome)* Bloom syndrome (RecQ DNA helicase; BLM gene)* Fancont anemia (BRCA-2)* Werner syndrome (WRNp protein- RecQ DNA helicase)Direct Repair-- DNA damaging agent X-raysoxygen radicals (internal/external) alkylating agents spontaneousUV-light oxygen radicals (internal/external)X-raysoxygen radicals (internal/external) UV-lightanti-tumor agentsreplicationerrorsnon-enzymatic methylation of DNA by cellular S-adenosyl- methionine||Lesions|||Uracilabasic site 8-oxoguanme single-strand break6-4 photoproduct bulky adducts cyclobutane pyrimidine dimerdouble-strandbreakinterstrand-crosslinkA-G mismatchT-C mismatch insertiondeletionO-6-methyl-guanine||Repairprocess|||Base excision repair (BER)Nucleotide excision repair (NER)Recombinational repair (HR/NHEJ)Mismatch repair (MMR)Direct reversal (DR)


Question: &;Lacunar cells&; seen in the following histological type of Hodgkin&;s lymphoma

WHO classification of Hodgkin's lymphoma Nodular sclerosisMixed cellularityLymphocyte richLymphocyte depletedLymphocyte predominantMost common type of HL Most common type of HL in India Associated with HIV M = FM > FM > FM > FM > FReed Sternberg cell variant in lacunar cell ( clear space surrounding cell)Has eosinophils & plasma cells and Reed Sternberg cell in maximum numbersMononuclear and Reed Sternberg cell in low numbers Reed Sternberg cell - pleomorphic , mummified & necrobiotic LH cells ( pop corn cells ) with absence of B cellCells are CD 15+ and CD 30+Cells are CD 15+ and CD 30+Cells are CD 15+ CD 30+and CD 20 -Cells are CD 15+ and CD 30+Cells are CD 15- , CD 30- , CD 20 +, BCL6+ and EMA+No association with EBV Associated with EBV Associated with EBV Associated with EBV No association with EBV Excellent prognosis Very good prognosis Good to excellent prognosis Poor prognosis Excellent prognosis Adolescent and young adult Biphasic incidence Old age group Old age group Young males (Refer: Robbins & Cotran's - Pathologic Basis of Disease, SAE, 1st edition, Vol I-pg no: 607-609)


Question: Increased osmotic fragility seen in

Ans. is 'd' i.e., Hereditary spherocytosisOsmotic fragility of Red blood cells.Red blood cell osmotic fragility is the resistance of RBC hemolysis to osmotic changes.Normally RBC maintains osmotic equilibrium with the surrounding medium i.e., with serum that has 0.9% NaCI.As the surrounding medium becomes hypotonic fluid will enter into the cell along osmotic gradiant, eventuallyunder very hypotonic conditions the cell will enlarge to capacity and rupture Osmotic lysis.Osmotic fragility is determined by measuring the degree of hemolysis in hypotonic saline. Normal red cell begins to lyse at 0.5% NaC1 and the hemolysis is complete at 0.3 NaCl.Red blood cells osmotic fragility is considered to be increased if hemolysis occur in a NaCI concentration > 0-5%.Osmotic fragility is considered to be decreased if the hemolysis is not complete in a 0-3% of NaCI.


Question: Kilnefelter no of chromosomes

Klinefelter syndrome is best defined as male hypogonadism that develops when there are at least two X chromosomes and one or more Y chromosomes. Most affected patients have a 47,XXY karyotype. This karyotype results from nondisjunction of sex chromosomes during meiosis. The extra X chromosome may be of either maternal or paternal origin. (Robbins Basic Pathology, 9 th edition. page : 239)


Question: Mitochondrial chromosomal abnormaity leads to

Diseases caused by mutations in mitochondrial genes are rare. Because mitochondrial DNA encodes enzymes involved in oxidative phosphorylation, diseases caused by mutations in such genes affect organs most dependent on oxidative phosphorylation (skeletal muscle, hea, brain). Leber hereditary optic neuropathy is the prototypical disorder in this group. This neurodegenerative disease manifests itself as progressive bilateral loss of central vision that leads in due course to blindness. Prader-Willi and Angelman Syndromes- Diseases Caused by Alterations of Imprinted Regions (Robbins Basic Pathology, 9 th edition. page : 243)


Question: Increased levels of haemoglobin A2 is characteristic of


Question: Salivary duct calculi

Are associated with hypercaleaemic states


Question: Reactive oxygen free radical in lysosome is released by


Question: Bronchopneumonia means

Ans. b (Inflammatory involvement of the airways; the bronchus & the lung parenchyma).BRONCHOPNEUMONIA# It is multi focal, heterogenous inflammatory involvement of distal airways, thus distributed along the course of airways & patchy affection of lung parenchyma.# An Airbronchogram is usually absent & volume loss is common with occasional pneumatoceles.# Staphylococcus is a common bacteria causing bronchopneumonia.QLOBAR PNEUMONIA# It is usually unifocal & central in distal airspaces adjacent to the visceral pleura.# It spreads rapidly via the pores of Kohn across segmental boundaries producing a uniform consolidation in lung parenchyma.# It spares distal airways.# Streptococcus pneumoniae is the most common organism causing lobar pneumonia.# Klebsiella pneumoniae:- Friedlander's pneumonia- Causes a only small proportion of cases of Community acquired pneumonia- Lobar pneumonia ("bulging fissure" sign)--- Predisposing factors:* Alcoholism,* Diabetes &* COPD.# Rx:- Given both the undesirability of treating the latter strains with penicillins or cephalosporins and the quinolone resistance, empirical treatment of serious or health care-associated Klebsiella infections with amikacin, carbapenems, or tigecycline is prudent.- Polymyxin B can be considered for use against highly resistant strains but is an agent of last resort because of its potential toxicities.

Inflammatory involvement of a lobe of a lung

Inflammatory involvement of the lymphatics


Question: Fibrinoid necrosis is seen in

Ans. (d) Sarcoidosis(Ref: R 9th/pg 507-8,510; 8th/pg 512-13)Fibrinoid necrosis is seen in PanAschoff Nodule, SLE, HIV and Malignant Hypertension


Question: The two pathogenic Neisseria species, N. meningitidis and N. gonorrhoeae, differ from the nonpathogenic Neisseria species in that

Neisseria gonorrhoeae and N. meningitidis are true human pathogens, surviving best in the human host. They are more fastidious in their nutritional requirement, requiring an enriched selective medium and temperature for growth. All Neisseria are oxidase positive. Normal flora (nonpathogenic) Neisseria will grow at room temperature on simple medium. Because of beta-lactamase production, sensitivities should be done to ensure proper antimicrobial selection for treatment. Ref Robbins 9/e pg 400

The former are less resistant to ceain antibiotics than the nonpathogenic species

The pathogenic species are oxidase positive

The pathogenic species grow well in enriched chocolate agar

The pathogenic species do not grow well at room temperature


Question: A person experiences throbbing pain at night. It is due to


Question: Lactobacilli are numerous in carious lesions because they

Can produce insoluble extracellular polysaccharides


Question: Paget's disease of bone is a chronic disease of the


Question: Chromosomal translocation characteristic in acute promyclocytic leulamia

In Aml with +(15;17), acute promyelocytic leulamia (M3 stage), auer rode present (most common stage associated with DIC).


Question: Coombs positive hemolytic anemia is associated with

Amongst the collagen vascular diseases, SLE is most frequently associated with Coomb's positive hemolytic anemia.
PAN can also cause Coomb's positive hemolytic anemia, but it is very rare.


Question: Prolonged use of antibiotics in children can result in


Question: Annexin V is a marker of

Ans. (d) Apoptosis(Ref: Robbins 9th/pg 53; Robbins 9th/pg 29-30)Apoptotic cells express phosphatidylserine/thrombos - pondinQ on the outer layer of plasma membrane because of which these cells are recognized by the dye Annexin V


Question: Feature common to carcinoma pancreas, lungs,stomach is,a) Retinoblastomab) Migratory thrombophlebitisc) Ascitesd) DIC

Migratory or  recurrent thrombophlebitis and DIC may be seen in following Cancers-

Pancrease
Breast
Lymbphomas
Lung
Stomach
Prostate
Brain


Question: Peptic ulcer is caused by

A. i.e. (H. pylori) (594 - Basic pathology 8th)PEPTIC ULCER - two conditions are key for the development of peptic ulcers1. H. pylori infection(i) 70 - 90% persons with duodenal ulcer(ii) 70% persons with gastric ulcers2. Mucosal exposure to gastric acid and pepsin* NSAIDs are the major cause of peptic ulcer disease in persons who do not have H. pylori infection


Question: Ladder pattern of DNA electrophoresis is seen in

Ans. (b) Apoptosis(Ref: Robbins 9th/pg 53; R 9th/pg 29-30)DNA breakdown (Internucleosome cleavage by endonuclease into 200 bp oligonucleosomes is a characteristic)Q at specific sites can be detected by 'step ladder pattern' on gel electrophoresis or TUNEL (TdT mediated d-UTP Nick End Labelling) technique


Question: Example of Type IV Hypersensitivity is/are

Clinical examples of Type IV HS TB Sarcoidosis Temporal aeritis Contact dermatitis Lepromin test and PPD Patch test/contact HS Type I DM


Question: Vertical measure in mm from granular cell layer to the deepest part of tumour used in Melanoma for prognosis is

Breslow s thickness less than 1.7mm carries favorable prognosis.


Question: The diagnostic procedure of applying pressure to a suspected lesion to visualize the evacuation of coloration of the lesion is


Question: Progressive multifocal leukoencephalopathy spares

Progressive multifocal leukoencephalopathy (PML) is a demyelinating disease which results from the reactivation of John Cunningham virus (JC virus) infecting oligodendrocytes(which provide suppo and insulation to axons in CNS) The term Leukoencephalopathy refers to all of the brain white matter diseases Toxic leukoencephalopathy or toxicspongiform leukoencephalopathy is a rare condition that is characterized by progressive damage (-pathy) to white matter (-leuko-) in the brain (-encephalo-), paicularly myelin, due to causes such as exposure to drug abuse, environmental toxins, or chemotherapeutic drugs


Question: The protein in the GBM responsible for charge dependent filtration is

Glomerular basement membrane contains: a. Collagen type IV b. Laminin c. Polyanionic proteoglycans (responsible of charge-dependent filtration) d. Entactin e. Fibronectin f. Sialoglycoprotein coating on endothelial and visceral epithelial cells. Ref: ROBBINS BASIC PATHOLOGY 10th ed Pg no: 551


Question: Paroxysmal lacrimation during mastication occurs due to damage to

Paroxysmal lacrimation (crocodile tears) is seen in patients exhibiting profuse lacrimation when food is eaten, particularly hot and spicy foods. It generally follows facial paralysis, either Bell's palsy type or the result of herpes zoster, head injury or intracraniaL operative trauma. This is thought to be due to the degeneration of autonomic nerve, when adjacent normal autonomic fibers will give sprouts that connect up with appropriate cholinergic or adrenergic endings, resulting in crocodile tears.


Question: Gluten free diet is use in


Question: Another name for encephalotrigeminal angiomatosis is


Question: Nasal mucosa is supplied by

Branch of external carotid aery supplying nasal mucosa are Sphenopalatine aery, Greater palatine aery, Superior labial aery (Branch of facial aery), while, the only branch of Branch of internal Carotid aery supplying nose is Anterior ethmoidal aery.


Question: The activation of caspases is likely to lead to


Question: White piedra is caused by


Question: HPV oncogene expression is

The oncogenic potential of HPV can be related to production of two early viral genes E6&E7 Together they interact with variety of growth regulating proteins encoded by protooncogene and tumour suppressor genes E6- binds to and mediate the degradation of p53 E7-binds to Rb protein and release E2F transcription factor,also inactivates the CDKIs Robbins basic pathology 9th edition chapter 5 pageno. 202


Question: Decrease in cell size refers to

* Shrinkage in the size of the cell by the loss of cell substance is known as atrophy * Although atrophied cells have diminished its function, they are not dead Shrinkage in the size of the cell by the loss of cell substance is known as atrophy. When a sufficient number of cells are involved, the entire tissue or organ diminishes in size, becoming atrophic (Fig. 1-4). Although atrophic cells may have diminished function, they are not dead. Causes of atrophy include a decreased workload (e.g., immobilization of a limb to permit healing of a fracture), loss of innervation, diminished blood supply, inadequate nutrition, loss of endocrine stimulation, and aging (senile atrophy). Although some of these stimuli are physiologic (e.g., the loss of hormone stimulation in menopause) and others pathologic (e.g., denervation), the fundamental cel- lular changes are identical. They represent a retreat by the cell to a smaller size at which survival is still possible; a new equilibrium is achieved between cell size and dimin- ished blood supply, nutrition, or trophic stimulation. The mechanisms of atrophy consist of a combination of decreased protein synthesis and increased protein degradation in cells. * Protein synthesis decreases because of reduced meta- bolic activity. * The degradation of cellular proteins occurs mainly by the ubiquitin-proteasome pathway. Nutrient deficiency and disuse may activate ubiquitin ligases, which attach mul- tiple copies of the small peptide ubiquitin to cellular proteins and target them for degradation in protea- somes. This pathway is also thought to be responsible for the accelerated proteolysis seen in a variety of cata- bolic conditions, including the cachexia associated with cancer. * In many situations, atrophy is also accompanied by increased autophagy, with resulting increases in the number of autophagic vacuoles. Autophagy ("self-eating") is the process in which the starved cell eats its own components in an attempt to survive. We describe this process later in the chapter. Refer robbins 9/e p4-5


Question: In hypodontia, the most commonly affected tooth is


Question: Koenen&;s tumour is seen in

Tuberous sclerosis is a rare disease that causes tumors, or growths, in the brain and other organs. These growths can occur in the skin, kidneys, eyes, hea, or lungs. They are usually benign (non-cancerous). The first signs of tuberous sclerosismay occur at bih.


Question: Stary sky" appearance is seen in

(A) (Burkitt's lymphoma) (456 - HM) (453- Basic pathology 8th)Burkitt's lymphoma - The tumour cells have a very high mitotic rate, and therefore high cell death. This features accounts for presence of numerous macrophages in the background of this tumour containing phagocytosed tumour debris giving it a "starry sky appearance"

Extra nodal marginal zone B-cell lymphoma of MALT type


Question: Thorium dioxide causes

Angiosarcoma of liver is a aggresive neoplasm associated with exposure to vinyl chloride ,arsenic or thorotrast GENERAL AND SYSTEMIC PATHOLOGY RAMDAS NAYAK PGNO.464 IMAGE REF:


Question: Most common gene associated with pancreatic cancer

Ans. (a) KRAS(Ref Robbins 9th/pg 892-894)GeneChrPercentage KRAS12p90Most commonly involved Oncogene Qp16/CDKN2A9p95Most commonly involved Tumor suppressor gene QTP5317p50-70Involved in Response to DNA damageSMAD418q55TGF b pathwayBRCA213q10Germ-line mutation Q


Question: Lacunar variant Reed Sternberg cells are Characteristic of

SubtypeReed Sternberg cellsNodular SclerosisLacunar variantLymphocyte-richMononuclear variantsLymphocyte depletionReticular variantLymphocyte predominanceL&H (lymphocytic and histiocytic)Ref: Robbins and Cotran Pathologic Basis of Disease; 9th edition; Chapter 11; Diseases of White Blood Cells, Lymph Nodes, Spleen, and Thymus; Page no: 609


Question: Protector or inhibitor of Apoptosis


Question: Owl eye inclusion is seen in

Owl's eye appearance is a pattern in medical radiology and histopathology, and may refer to: Owl's eye appearance of inclusion bodies, which is highly specific for cytomegalovirus infection. Owl's eye appearance of the entire nucleus - a finding in Reed-Sternberg cells in individuals with Hodgkin's lymphoma. Owl's eye appearance of the Lentiform nucleus of the basal ganglia on head CT scan images in individuals with cerebral hypoxia Ref: WIKIPEDIA


Question: Serum amyloid associated protein is form in

The AA  (amyloid associated) type of amyloid fibriprotein is derived from a unique non- Ieg protein madeby the liver.
A fibrils are derived by proteolysis from a larger (12,000 daltons) percursorian the serum called SAA (serum amyloid - associated) protein that is synthesized in the liver and circustesbound to high density lipoproteins.
The production of SAA protein is increased in inflammatory states as part of the acute phase response, therefore, this form of amyloidosis associated with chronic inflammation, and isotten called secondary amyloidosis.


Question: Denominator in crude death rate is

Crude death rate is defined as the number of deaths per 1000 estimated mid year population in one year, in a given place. Crude death rate = ( Number of deaths during the year / Mid year population ) x 1000CDR summaries the effects of two factors:population composition age specific death rates (reflects the probability of dying)(Refer: K. Park's Textbook of Preventive and Social medicine, 24th edition, pg no: 62)


Question: Elephantiasis neuromatosa is a feature of


Question: Wickham's striae are seen in


Question: Low serum hepatoglobin in hemolysis is masked by

In case of Bile duct obstruction, serum haptoglobin not excreted properly, so their levels falsely normal even in Intravascular hemolysis.


Question: Eosinophilia in necrosed tissue is due to

Ans. is 'c' i.e., Denaturation of protein Necrotic cells show increased eosinophilia in hematoxylin and eosin (H & E) stains. It is due to - Loss of cytoplasmic RNA (or ribonucleoprotein/RNP) which binds the blue dye, hematoxylin. Denatured cytoplasmic proteins which bind the red dye, eosin.


Question: Florid duct lesions are diagnostic of

Ans. (c) Primary biliary cirrhosis(Ref: Robbins 9th/pg 858; 8th/pg 867)In Primary biliary cirrhosis: Interlobular bile ducts are actively destroyed by lymphoplasmacytic inflammation with or without granulomas (the florid duct lesion)


Question: Increased amounts of calcium in the cytosol of an injured cell reflect a release of calcium from stores in the

Increased amounts of calcium in the cytosol of an injured cell result from an influx from extracellular space, mitochondria, and rough endoplasmic reticulum.


Question: In an acute attack of migraine, the drug of choice

Headaches are believed to be either vascular or muscular in origin. Migraine is most common of the vascular headaches, and it occasionally causes pain of the face and jaws. Migraine is due to vasoconstriction of intracranial vessels (that causes neurologic symptoms) followed by vasodilation that results in pounding headache. Basilar migraine is most common in young women.
Drugs that are useful. in aborting migraine include ergotamine and sumatriptan. These drugs must be used cautiously since they may cause hypertension and other CNS problems. Methysergide or monoamine oxidase inhibitors such as phenelzine can be used to manage difficult cases.


Question: Curshmann&;s crystals are seen in

Ref: Textbook of pathology (Harsh Mohan) 6th edition, page No.484 MORPHOLOGIC FEATURES. The pathologic changes are similar in both major types of asthma. The pathologic material examined is generally autopsy of lungs in patients dying of status asthmaticus but the changes are expected to be similar in non-fatal cases. Grossly, the lungs are overdistended due to over-inflation. The cut surface shows characteristic occlusion of the bronchi and bronchioles by viscid mucus plugs. Microscopically, the following changes are observed: 1. The mucus plugs contain normal or degenerated respiratory epithelium forming twisted strips called Curschmann's spirals. 2. The sputum usually contains numerous eosinophils and diamond-shaped crystals derived from eosinophils called Charcot-Leyden crystals. 3. The bronchial wall shows thickened basement membrane of the bronchial epithelium, submucosal oedema and inflammatory infiltrate consisting of lymphocytes and plasma cells with prominence of eosinophils. There is hyperophy of submucosal glands as well as of the bronchial smooth muscle. 4. Changes of bronchitis and emphysema may supervene, especially in intrinsic asthma.


Question: Most accurate method to detect pregnancy at 6 weeks gestation is

"Most accurate and safest method to diagnose ble pregnancy at 6 weeks is USG for fetal cardiac activity." Ref: DaftaryFetal cardiac activity by Transvaginal USG can be picked as early as 6 weeks.Fetal cardiac activity by Transabdominal USG can be picked as early as 7 weeks.Doppler is most sensitive but not safe in early pregnancy.Doppler examination of fetal vessels in early pregnancy shouldn&;t be performed without a clinical indication. TAS can detect the fetal parameters in the following sequences:Gestational sac - 4-5 weeks of menstrual age.Fetal pole - 6th week.Fetal cardiac activity 7th week.CRL - 7th week.TVS detects the parameters 1 week earlier.(Refer: William's Obstetrics, 23rd edition)(Refer: Ultrasound Obstetric Gynaecology 2011; 37: 625-8)


Question: Loss of tooth surface because of chemomechanical action is known as


Question: Uterine leiomyoma is least likely to undergoe

Refer 9/e 1020 Leiomyomas are sharply circumscribed, discrete, round, firm, gray-white tumors varying in size from small, barely visible nodules to massive tumors that fill the pelvis. Except in rare instances, they are found within the myometrium of the corpus. Only infrequently do they involve the uterine ligaments, lower uterine segment, or cervix. They can occur within the myome- trium (intramural), just beneath the endometrium (submucosal) or beneath the serosa (subserosal) (Fig. 22-28A). Whatever their size, the characteristic whorled pattern of smooth muscle bundles on cut section usually makes these lesions readily identifiable. Large tumors may develop areas of yellow-brown to red softening. Leiomyomas are typically composed of bundles of smooth muscle cells that resemble the uninvolved myometrium


Question: Dilation of the salivary duct secondary to epithelial atrophy as a result of repeated inflammatory or infectious process is


Question: Crescents are derived from

Crescents are feature of RPGN.
They are made up of parietal epithelial cells,
fibrin and monocytcs / Macrophages.

Visceral epithelial cells + fibrin + macrophage

Parietal epithelial cells + fibrin + macrophages

Tubular epithelium + fibrin + macrophages


Question: The least extrapyramidal side effects are seen with the following phenothiazine

Side effects of impoant CNS drugs Midazolam Ataxia , Blackouts in elderlyTolcapone Hepatotoxic Phenytoin Hirsuitism , Gingival hyperplasia , Osteomalacia , Teratogen , Megaloblastic anemia , Ataxia , Lymphadenopathy , Hyperglycemia , Arrhythmias , Vitamin K deficiency Valproate Irreversible hepatic necrosis in older children , Acute pancreatitis Zonisamide , Topiramate Renal stones VigabatrineIrreversible visual field defectsFelbamate Aplastic anemia Thioridazine Male sexual dysfunction , Retinal damage , Least extra pyramidal symptomsClozapine Agranulocytosis , Myocarditis Risperidone Extra pyramidal symptoms HaloperidolExtra pyramidal symptoms , Akathisia Olanzapine Risk of stroke and death Ziprasidone , Pimozide QT prolongation Quetiapine Cataract Iloperidone Ohostatic hypotension Lithium in expectant mothers Ebstein's anomalyFormic acid Retinal damage Opioids Tolerance & addiction


Question: BRCA 1 gene is located on chromosome

A BRCA mutation is a mutation in either of the BRCA1 and BRCA2 genes, which are tumour suppressor genes. ... Women with harmful mutations in either BRCA1 or BRCA2 have a risk of breast cancer that is about five times the normal risk, and a risk of ovarian cancer that is about ten to thiy times normal.


Question: Benign tumour of voluntary muscle


Question: The most common metabolic abnormality predisposing patients to the renal stone formation is

The most common metabolic abnormality predisposing patients to renal stone formation is hypercalciuria. Calcium oxalate and calcium phosphate stones are the two most common stones. Hypercalciuria combined with decreased fluid intake is frequently associated with stone formation; thus, adequate hydration is impoant in the treatment of stones.Hyperuricemia can contribute to stone formation, but uric acid stones are not as common as calcium stones and most people with hyperuricemia do not have stones. Distal renal tubular acidosis can lead to calcium phosphate stones, but this disorder is not as common as stone formation in hypercalciuria. Increased urine volume and increased urine citrate concentration would both decrease the incidence of stones. In adequate concentrations, citrate binds to calcium and renders it unavailable for stone formation.


Question: Not an inherited disorder

Antiphospholipid syndrome or antiphospholipid antibody syndrome (APS or APLS), or often known also as Hughes syndrome in the UK, is an autoimmune, hypercoagulable state caused by antiphospholipid antibodies. APS provokes blood clots (thrombosis) in both aeries and veins as well as pregnancy-related complications such as miscarriage, stillbih, preterm delivery, and severe preeclampsia. The diagnostic criteria require one clinical event, i.e. thrombosis or pregnancy complication, and two antibody blood tests spaced at least three months apa that confirm the presence of either lupus anticoagulant, or anti-b2-glycoprotein-I (since b2-glycoprotein-I antibodies are a subset of anti-cardiolipin antibodies, an anti-cardiolipin assay can be performed as a less specific proxy). Antiphospholipid syndrome can be primary or secondary. Primary antiphospholipid syndrome occurs in the absence of any other related disease. Secondary antiphospholipid syndrome occurs with other autoimmune diseases, such as systemic lupus erythematosus (SLE). In rare cases, APS leads to rapid organ failure due to generalised thrombosis; this is termed "catastrophic antiphospholipid syndrome" (CAPS or Asherson syndrome) and is associated with a high risk of death.


Question: The cause of oedema in nephritic syndrome

Robbins page no p922 Glomerular diseases presenting with a nephritic syn- drome are often characterized by inflammation in the glomeruli. The nephritic patient usually presents with hematuria, red cell casts in the urine, azotemia, oliguria, and mild to moderate hypeension. Proteinuria and edema are common, but these are not as severe as those encountered in the nephrotic syndrome, discussed later. The acute nephritic syndrome may occur in such multi- system diseases as SLE and microscopic polyangiitis.


Question: Post spinal headache can be prevented by

The most impoant causative factor for spinal headache is needle size, so use of small gauge needle is the best method to prevent post spinal headache. There is no evidence that any duration of bed rest after lumbar puncture has a role in preventing headache. Improving hydration by increased fluids (either oral or intravenous) has not been shown to prevent headache after lumbar puncture Ref Robbins 9/e pg 234


Question: Diagnosis is

This is a specimen of linitis plastica, a diffuse type of gastric carcinoma.These infiltrative tumors often evoke a desmoplastic reaction that stiffens the gastric wall. When there are large areas of infiltration, diffuse rugal flattening and a rigid, thickened wall may impa a leather bottle appearance termed linitis plastica.Meitner&;s disease has hyperophic gastric folds.Ref: Robbins Pathology; 9th edition; Page no: 772


Question: Gamma gandy bodies are seen in


Question: Oncogene was first identified in

(D) Retrovirus > Cellular Protooncogenes were first discovered in their mutated or "oncogenic" forms as "passengers" within the genome of acute transforming retroviruses by the 1989 Nobel laureates Harold Varmus and Michael Bishop.


Question: Histologic sections of the thymus that reveal reactive follicles with germinal centers are diagnostic of

The thymus, derived from the third pair of pharyngeal pouches and inconsistently from the fouh pair, is divided into an outer coex and an inner medulla and is composed of lymphocytes and epithelial cells. The lymphocytes are mainly T cells, which are immature (thymocytes) in the coex and are mature in the medulla, where they have phenotypic characteristics of peripheral blood T lymphocytes. The epithelial cells are mainly located in the medulla, forming Hassall's corpuscles. The thymus normally has a few neuroendocrine cells, which may give rise to carcinoid tumors or small cell carcinoma, and a few myoid cells, which are similar to striated muscle cells and may play a role in the autoimmune pathogenesis of myasthenia gravis. The appearance of lymphoid follicles with germinal centers is diagnostic of thymic hyperplasia Reference: Robbins & Cotran Pathologic Basis of Disease, 9edition