Question: Splitted papule at corner of mouth


Question: Amino acids that promote healing includes

(B) Arginine > Adequate dietary protein is absolutely essential for proper wound healing, and tissue levels of the amino acids Arginine and Glutamine may influence wound repair & immune function.> Healing of wounds, whether from accidental injury or surgical intervention, involves the activity of an intricate network of blood cells, tissue types, cytokines, and growth factors.> This results in increased cellular activity, which causes an intensified metabolic demand for nutrients.> Nutritional deficiencies can impede wound healing, and several nutritional factors required for wound repair may improve healing time and wound outcome.> Vitamin A is required for epithelial and bone formation, cellular differentiation, and immune function. Vitamin C is necessary for collagen formation, proper immune function, and as a tissue antioxidant.> Vitamin E is the major lipid-soluble antioxidant in the skin; however, the effect of vitamin E on surgical wounds is inconclusive.> Bromelain reduces edema, bruising, pain, and healing time following trauma and surgical procedures. Glucosamine appears to be the rate-limiting substrate for hyaluronic acid production in the wound


Question: Best indicator for coronary aery disease

Hyperlipidemia is a major risk factor for development of atheroscerosis The main cholesterol component associated with increased risk is LDL (bad cholesterol) Robbins 9th edition page no. 336


Question: Activities of daily living to MR child can be taught by

Self -Instruction is used in substance abuse where the person keeps on instructing oneself for not taking the substance,Cognitive Behaviour therapy is based on correcting the faulty cognitive distoions and faulty ideas and belief ,,All needing normal IQ. Token economy is a component of Contingency management, wherein the Consequence is contingent upon the action done in aicular manner.


Question: Platelet adhesion to collagen occurs


Question: The most important cytokine for the synthesis and deposition of connective tissue proteins is

The laying down of connective tissue occurs in two steps:

Migration and proliferation of fibroblasts into the site of injury.
Deposition of ECM proteins produced by these cells.

These processes are orchestrated by locally produced cytokines and growth factors, including PDGF, FGF-2 and TGF-β.
TGF-β is the most important cytokine for the synthesis and deposition of connective tissue proteins.


Question: A most characteristic feature of acute in

Acute inflammation has three major steps: -
Among these three major steps “The hallmark of acute inflammation is increased vascular permeability leading to escape of protein-rich fluid (exudates) into the extravascular tissue”.
Mechanism of increased vascular permeability
i. Formation of endothelial gaps in venules
ii. Direct endothelial injury resulting in endothelial cell necrosis and detachment.
iii. Delayed prolonged leakage
iv. Leucocyte mediated endothelial injury.

Vasodilatation and increased vascular permeability


Question: Most common antibody in sjogren syndrome

Ans. (d) Anti-Ribonucleoprotein(Ref: Robbins 9th/pg218; 8th/pg213)Autoantibodies in Sjogren's syndrome:Anti SS-A (Ro) and SS-B (La) Q: Most important, present in 90% patients;High titers of Anti SS-A - more likely to have early disease onset, longer disease duration, and extra- glandular manifestations (eg cutaneous vasculitis and nephritis)Rheumatoid factor (an antibody reactive with self IgG): in 75% Q, ANA: in 50% to 80%


Question: Most impoant adhesion molecule for diapedesis

CD31 or PECAM-1 (platelet endothelial cell adhesion molecule). is the most impoant molecule for diapedesisRobbins 9the p.76 -77


Question: Chromophilic Renal Cell Carcinoma is associated with


Question: Inheritance pattern of ABO blood group system and HLA system

"The genes that determine the A and B phenotypes are found on chromosome 9p and are expressed in a Mendelian codominant manner."


Question: Excessive sunlight exposure can cause


Question: Triad of biotin deficiency is

(Dermatitis, glossitis, Alopecia) (407-H) (314-Basic pathology 8th)(Biotin deficiency) - clinical features -Adult = Mental changes (depression, hallucination), paresthesia, anorexia, nausea, A scaling, seborrheic and erythematous rash may occur around the eye, nose, mouth, as well as extremities (407-H)Infant = hypotonia, lethargy, apathy, alopecia and a characteristic rash that includes the ears.Symptoms of biotin deficiency includes - Anaemia, loss of apepite dermatitis, glossitis (150- U. Satyanarayan) Symptoms of biotin deficiency - Dermatitis "spectacle eyed" appearance due to circumocular alopecia, pallor of skin & membrane, depression, Lassitude, somnolence, anemia and hypercholesterolaemia - (173-Rana Shinde 6th)

Dermatitis, glossitis, Alopecia (314-Basic 8th)


Question: HER2/neu receptor plays a role in

Friends, direct quote from Robbins….’HER2/neu overexpression is associated with poorer survival but its main importance is as a predictor of response to agents that target this transmembrane protein (examples trastuzumab or lapatinib).’
• The overexpression is due to amplification of the gene HER2/neu located on 17q21. Ackerman writes…. HER2/new encodes a transmembrane glycoprotein with tyrosine kinase activity and its overexpression is a good predictor of response to herceptin (trastuzumab) but not a good predictor of response to chemotherapy or overall survival.


Question: Metastatic calcification is most often seen in

Metastatic calcification can occur in normal tissues whenever there is hypercalcemia.Metastatic calcification can occur widely throughout the body but principally affects the interstitial tissues of the vasculature, kidneys, lungs, and gastric mucosa.( Robbins Basic Pathology, 9th edition, page 26 )


Question: Anti thyroglobulin antibodies seen in


Question: Proliferating breast mass is

the proliferating epithelium projects as multiple small papillary excrescences into the ductal lumen (ductal papillomatosis). The degree of hyperplasia, judged in pa by the number of layers of intraductal epithelium, can be mild, moderate, or marked. Occasionally, hyperplasia produces microcalcifications on mammography, raising concern for cancer. ref : Robbins Basic Pathology, 9E,page-706


Question: Calcium dependant cell adhesion molecule is

Answer- A. CadherinThe cadherins are calcium-ilependent adhesion molecules. The three most common cadherins are neural (N)-cadherin, placental (P) cadherin, and epithelial (E)-cadherin. All three belong to the classical cadherin subfamily. There are also desmosomal cadherins and proto-cadherins. Cadherins are intimately involved in embryonic development and tissue organization. They exhibit homophilic adhesion. The extracellular domain consists of several cadherin repeats, each is capable of binding a calcium ion. When calcium is bound, the extracellular domain has a rigid, rod-like structure.Following the transmembrane domain, the intracellular domain is highly conserved. The intracellular domain is capable of binding the alpha, beta, gamma catenins.


Question: Commonest site of lytic lesion in multiple myeloma is

The bones most commonly affected in multiple myeloma in descending order of frequency are veebral coloumn,ribs, skull, pelvis, femur, clavicle and scapula Ref:Robbins and Cotran Pathologic basis of disease.South Asia Edition volume 1.Page no.599


Question: Treatment for recurrent ranula is


Question: Histological finding in Reye&;s syndrome is

Reyes syndrome characterised by mitochondrial injury and decreased synthesis of mitochondrial enzymes in liver. Which leads to rise in blood ammonia and accumulation of triglycerides within hepatocytes. TEXTBOOK OF PATHOLOGY HARSH MOHAN 6TH EDITION PAGE 602


Question: Starry sky appearance is seen in


Question: Fibrinogen degradation products help in detection of

DIC - Disseminated intravascular coagulation
	Multiple coagulation factors are consumed and are therefore deficient
Plasminogen bound to platelet-fibrin thrombi is converted to plasmin by plasminogen activators
Plasmin cleaves fibrinogen as well as fibrin to generate fibrin degradation products.


Question: A patient with nephritic syndrome will not have September 2009


Question: HLA associated with rhaumatoid ahritis

HLA-DR4 (DR4) is an HLA-DR serotype that recognizes the DRB1*04 gene products. The DR4 serogroup is large and has a number of moderate frequency alleles spread over large regions of the worldDR4 is associated with extraaicularrheumatoid ahritis, hydralazine-induced female systemic lupus erythematosus, pemphigoid gestationis, pemphigus foliaceus, obstructive hyperophic cardiomyopathy, IgA nephropathy, 'shared syndrome'-systemic sclerosis/rheumatoid ahritis and polymyalgia rheumatica


Question: First to be blocked by muscle relaxants

First muscles to be blocked by muscle relaxants (both depolarizing and non-depolarizing type) are central muscles i.e., muscles of head and neck (face, jaw, pharynx, larynx), respiratory, abdominal muscles and muscles of trunk. After the central muscles, muscles of limbs (peripheral muscles) are blocked.muscle relaxant is a drug that affects skeletal muscle function and decreases the muscle tone. It may be used to allete symptoms such as muscle spasms, Ref Robbins 9/e 456


Question: Red fluorescent fluid is seen in


Question: Caspases are involved in

Apoptosis results from the activation of enzymes called caspases (so named because they are cysteine proteases that cleave proteins after aspaic residues). The activation of caspases depends on a finely tuned balance between production of pro- and anti-apoptotic proteins. Two distinct pathways converge on caspase activation: the mitochondrial pathway and the death receptor pathway.( Robbins Basic Pathology, 9th edition, page 19 )


Question: Mutation seen in malignant melanoma is

CDKN2A is a complex locus that encodes three different tumor sup- pressors, p15/INK4b, p16/INK4a, and p14/ARF. Of these, loss of p16/INK4a is clearly implicated in human melanoma, and experimental evidence also suppos a role for loss of p14/ARF. As already mentioned, p16/ INK4a inhibits cyclin-dependent kinase 4 (CDK4) and cyclin-dependent kinase 6 (CDK6), thus reinforcing the ability of the RB tumor suppressor to block cells in the G1 phase of the cell cycle. By contrast, p14/ARF enhances the activity of the p53 tumor suppressor by inhibiting MDM2, an oncoprotein that stimulates p53 degradation. CDKN2A is mutated in approximately 10% of sporadic melanomas, and these mutations uniformly abolish the production of p16/INK4a and more variably affect p14/ ARF. However, it is suspected that these mutations are the tip of the "oncogenic iceberg" with respect to molec- ular lesions affecting the G1 checkpoint. For example, 30% to 70% of melanomas show loss of p16/INK4a expression though varied mechanisms, and other famil- ial and sporadic melanomas have mutations in CDK4


Question: Eosinophilic granuloma results from the proliferation of


Question: DIC in association with giant hemangiomas is seen in

An unusual form of DIC occurs in association with giant hemangiomas (Kasabach-Merritt syndrome), in which thrombi form within the neoplasm because of stasis and recurrent trauma to fragile blood vessels.Ref: Robbins and Cotran Pathologic Basis of Disease; 9th edition; Chapter 14; Red Blood Cell and Bleeding Disorders; Page no: 664


Question: Mutation in GNAS 1 gene is associated with


Question: Borrelia recurrentis in transmitted by

Louse-borne infections include: 1.Pediculosis 2.Epidemic typhus (Rickettsia prowazekii) 3.Relapsing fever (Borrelia recurrentis) 4.Trench fever (Rochlamia Quintana)


Question: Magenta tongue is found in


Question: In apoptosis, permeabilization of the membrane occurs in

Mitochondria contain several proteins that are capable of inducing apoptosis; these proteins include cytochrome c and other proteins that neutralize endogenous inhibitors ofapoptosis. When cells are deprived of growth factors and other survival signals, or are exposed to agents that damage DNA, or accumulate unacceptable amounts of misfolded proteins, a number of sensors are activated. These sensors are members of the Bcl-2 family called "BH3 proteins" (because they contain only the third of multiple conserved domains of the Bcl-2 family). They, in turn, activate two pro-apoptotic members of the family called Bax and Bak, which dimerize, inse into the mitochondrial membrane, and form channels through which cytochrome c and other mitochondrial proteins escape into the cytosol.( Robbins Basic Pathology, 9th edition, page 18 )


Question: Diagnosis of falciparum


Question: Mechanism of secretion of macro molecules by cell in the manner of fusion with vesicle is

(A) Phagocytosis # Phagocytosis:> Phagocytosis is the cellular process of phagocytes and protists of engulfing solid particles by the cell membrane to form an internal phagosome. Phagocytosis is a specific form of endocytosis involving the vesicular internalization of solid particles, such as bacteria, and is therefore distinct from other forms of endocytosis such as the vesicular internalization of various liquids.# Pinocytosis> In cellular biology, pinocytosis ("cell-drinking", "bulk-phase pinocytosis", "nonspecific, non-adsorptive pinocytosis", "fluid endocytosis") is a form of endocytosis in which small particles are brought into the cell suspended within small vesicles which subsequently fuse with lysosomes to hydrolyze, or to break down, the particles.# Exocytosis> Exocytosis is the durable process by which a cell directs the contents of secretory vesicles out of the cell membrane.# Endocytosis> Endocytosis is the process by which cells absorb molecules (such as proteins) from outside the cell by engulfing it with their cell membrane. It is used by all cells of the body because most substances important to them are large polar molecules that cannot pass through the hydrophobic plasma membrane or cell membrane. The process opposite to endocytosis is exocytosis.


Question: Delayed eruption of teeth occurs in


Question: Tumors metastatic to the jaw bones are most likely to be found in the


Question: Pseudobronchiectasis is seen in

PseudobronchiectasisCondition in which a bronchiectasis like pattern appears in the bronchogram of the paially atelectatic pulmonary segments when the larger bronchi have become shoened and broadened in outline. These reversible changes do not indicate destruction of the bronchial walls.(Refer: Harrison's Principles of Internal Medicine, 18th edition, pg no: 2200)


Question: After entering a radiolucent lesion in a 30 year old man, hollow cavity without epithelial lining is seen, the most probable diagnosis is


Question: The interaction of histamine with its H2 receptor in the parietal cell results in

An increase in intracellular sodium concentration

An increase in intracellular cAMP production

An increase in intracellular cGMP production

A decrease in intracellular calcium concentration


Question: The most common histologic type of carcinoma of the oral cavity is

Carcinoma of the oral cavity accounts for approximately 5% of all human malignancies. More than 90% of oral carcinomas are of the squamous cell type. Precursor lesions include leukoplakia (dysplastic leukoplakia) and erythroplasia, with transformation rates of approximately 15 and 50%, respectively. Oral carcinoma is more common in males. Smoking, tobacco chewing, chronic irritation, heat exposure, and irradiation are all thought to contribute to carcinogenesis. The lower lip is the most common site, followed by the floor of the mouth, the anterior tongue, the palate, and the posterior tongue. Prognosis varies according to site but is best for lesions of the lip and worst for lesions in the floor of the mouth.


Question: Mesothelioma marker is


Question: Commonest mutations that are associated with GIST are in

Approximately 75% to 80% of all GISTs have oncogenic, gain-of-function mutations in the receptor tyrosine kinase KIT. (C-KIT or CD 117)Approximately 8% of GISTs have mutations that activate a closely related receptor tyrosine kinase, platelet-derived growth factor receptor a (PDGFRA).Some GISTs without mutated KIT or PDGFRA have mutations in other genes that function in these pathways (NF1, BRAF, HRAS, or NRAS).Ref: Robbins Pathology; 9th edition; Page no: 775

Platelet-derived growth factor receptor a


Question: Subclan steal syndrome is due to

Subclan steal syndrome refers to steno-occlusive disease of the proximal subclan aery with retrograde flow in the ipsilateral veebral aery and associated cerebral ischaemic symptoms.CausesClinical presentationIpsilateral upper limbNeurological, radiationCongenital Weak or absent pulseDecreased blood pressure (>20 mmHg)Arm claudication (rare due to collateral perfusion)DizzinessVeigoSyncopeAtaxiaVisual changesDysahriaWeaknessSensory disturbancesRadiographic featuresUltrasoundCT angiographyMR angiographyRetrograde flow in ipsilateral veebral aeryEarly changes prior to reversal of flow: decreased velocity, biphasic flow (in veebral aery)Changes can be augmented with arm exercise or inflation of BP cuff above systolic pressureProximal subclan aery usually can't be seen well enough to assessDistal subclan aery shows parvus-tardus waveform and monophasic waveformSubclan aery stenosis or occlusion easily identifiedDelayed enhancement of ipsilateral veebral aeryDirection of flow in veebral aery cannot be determinedOther intracranial or extracranial cerebral vascular lesions can be identifiedSubclan aery stenosis or occlusion easily identifiedDelayed enhancement of ipsilateral veebral aeryRetrograde direction of flow in ipsilateral veebral aeryOther intracranial or extracranial cerebral vascular lesions can also be identifiedTreatmentEndovascular: angioplasty & stent inseionSurgical: bypass surgery


Question: 10 Weeks pregnant lady, best method of aboion is

Vacuum evacuation is the most efficient method of termination upto 12 wks of pregnancy.Vacuum AspirationDone under paracervical block, cervical os is dilated through hegar's dilators. Instrument used is Karman suction cannula. Suction pressure is 60-70cms of Hg. End point of suction is when:No more material is sucked outGripping of cannula by contracting smaller uterus Grating sensationAppearance of bubbles in cannulaMerits: OP procedureLow failure rate-<1%Complications like bleeding, perforation, infection are <2%Moality <2%(Refer: Mudaliar and Menon&;s Clinical Obstetrics, 11th edition, pg no: 494)(Refer: Shaw&;s Textbook of Gynaecology, 15th edition, pg no: 245)


Question: Parents are carrier of an autosomal recessive disorder. Chances of offspring to get affected

To have an autosomal recessive disorder, you inherit two mutated genes, one from each parent. These disorders are usually passed on by two carriers. Their health is rarely affected, but they have one mutated gene (recessive gene) and one normal gene (dominant gene) for the condition. Two carriers have a 25 percent chance of having an unaffected child with two normal genes (left), a 50 percent chance of having an unaffected child who also is a carrier (middle), and a 25 percent chance of having an affected child with two recessive genes


Question: Atheromatous plaque does not contain

The main components of atherosclerotic plaques are 1.Cells: Smooth muscle cells, monocytes/macrophages, T cells2.Extracellular matrix: Collagen, elastic fibers, proteoglycans3.Intra and extracellular lipids(Ref: Robbins 8/e p502)


Question:
A child is diagnosed with osteosarcoma based on Sunray appearance seen on X ray.
This is because of


Question: Aplastic crisis in sickle cell anemia as compared to haemolytic crisis leads to

Aplastic crisis is an acute event caused by sudden decrease in red cell production. This is usually triggered by infection of erythroblasts by parvovirus B-19.
Hemolytic crisis is associated with hyperbilirubinemia and compensatory reticulocytosis.


Question: Selenium is a cofactor in following enzyme

Selenium21st amino acid = Selenocysteine RDA = 50 - 100 mcg/daySelenium as a co-factorSelenium deficiencySelenium toxicityGlutathione peroxidaseDeiodinase Thioredoxin reductase Keshan's cardiomegaly Kashin-beck disease Peripheral neuropathy Garlic odor to breathDermatitis (Refer: DM Vasudevan, Textbook of Biochemistry, 7th edition, pg no: 523)


Question: Cell matrix adhesions are mediated by

Integrins
Have alpha (CD11) and beta (CD18) subunits and play a role in cell-ECM interactions as well as in leucocyte-endothelial cell interaction.


Question: BRAF mutation is seen in 60% of cancers of

Point mutation of BRAF seen in 60% of malignant melanoma and 80% of benign nevi.Category of oncogenes:1)Growth factors *Overexpression of HGF - Thyroid cancer2)Growth factor receptors *EGFR -Squamous cell carcinoma of lung and glioblastoma*Her2/neu- Breast cancer *FLT3 - Breast cancer, ovarian cancers, and myeloid leukemia*KIT- GIST3)Proteins involved in signal transduction*KRAS-Colon, lung and pancreatic cancers*HRAS- Bladder cancers, kidney tumors*NRAS - Melanoma*ABL -Chronic myelogenous leukemia*BRAF- Melanoma*Beta-catenin- Hepatoblastoma and Hepatocellular carcinoma4)Nuclear regulatory proteins *C-MYC- Burkitt lymphoma*N-MYC- Neuroblastoma, Small cell carcinoma of the lung*L-MYC - Small cell carcinoma of the lung5)Cell cycle regulators*Cyclin D - Mantle cell lymphoma(Ref: Robbins 8/e p281, 283)


Question: Thrombocytopenia due to increased platelet destruction is seen in


Question: Copper penny bodies are seen in

Ans: a (Chromoblastomycosis)Ref: Henry's Clinical Diagnosis and Management by Laboratory Methods, 21st ed.Chromoblastomycosis is a chronic infection of the skin and soft tissue.Characterized by the presence of muriform fungal structures called sclerotic bodies (copper penny bodies) within the infected tissues.


Question: Not a feature of Venal keratoconjunctivitis is

Fascicular ulcer is seen in Phlyctenular keratoconjunc vi s.


Question: Adenomatoid odontogenic tumour is most commonly found in


Question: Caissons disease is caused by


Question: a1 antitrypsin deficiency is seen in

i.e. (Emphysema): (486-Basicpathology 8th) (1638-H17th)Panacinar (Pan lobular) emphysema is associated with a-lAT deficiency which has a predilection for the lower lobesPatients with severe a 1-antiprotease (a 1-antitrypsin) deficiency are recognized by family history and the appearance of panacinar bibasilar emphysema early in life usually in the third or fourth decade; hepatic cirrhosis and hepatocellular carcinoma may occur (258-CMDT 11th)Panacinar emphysemaCentriacinar emphysema* Acini are uniformly involved from level of respiratory bronchiole to terminal blind alveoli* Central or proximal parts of acini formed by respiratory bronchioles are affected whereas distal alveoli are spared* Lesions are more common in lower zone and bases* Lesions are more severe and common in upper lobes* Occurs in association with a1 antitrypsin deficiency* Occurs predominantly in smokers*** Is the commonest pattern


Question: Nuclear cytoplasmic ratio in malignant cells is


Question: Tram track appearance on histopathology of kidney is seen in

Refer Robbins page no 920PHOLOGY The glomeruli are large and hypercellular. The hypercellu- larity is produced both by proliferation of cells in the mesangium and so-called endocapillary proliferation involving capillary endothelium and infiltrating leukocytes. The glomeruli have an accentuated "lobular" appearance due to the proliferating mesangial cells and increased mesangial matrix (Fig. 20-16). The GBM is thickened, and often shows a "double- contour" or "tram-track" appearance, especially evident in silver or PAS stains. This is caused by "duplication" of the basement membrane (also commonly referred to as splitting), usually as the result of new basement membrane synthesis in response to subendothelial deposits of immune complexes. Between the duplicated basement membranes there is inclu- sion or interposition of cellular elements, which can be of mesangial, endothelial, or leukocytic origin. Such interposition also gives rise to the appearance of "split" basement mem- branes


Question: Pedigree chart description of

(A) Autosomal recessive# AUTOSOMAL RECESSIVE> Appears with equal frequency in both sexes> Trait tend to skip generations> Affected offspring are usually born to unaffected parents> If both parents are heterozygous, approximately % of the progeny will be affected> Appears more frequently among the children of consanguine marriages.


Question: Most common translocation in follicular lymphomas.

Ans. is 'a' i.e., 14 : 18 o The hallmark of typical follicular lymphoma is a 14 : 18 translocation that juxtaposes the IgH locus on chromosome 14 and the BCL2 locus on chromosome 18.


Question: In Nulliparous, cervical opening is


Question: Hereditary nephritis is seen in

Hereditary nephritis refers to a group of heterogeneous Heriditary familial diseases associated primarily with glomerular injury. These are Alpos syndrome Thin membrane disease Refer Harrison 17/1794 Robbins 7/988


Question:
An Inflammed capillary hemangioma of the oral cavity
looks similar to a


Question: Schwannoma, the marked area represents

Schwannoma Well circumscribed, encapsulated masses that are attached to a nerve but can be separated from it (Whereas neurofibromas are unencapsulated, an ill circumscribed mass that presents within the nerve and expanding them, hence the tumor cannot be separated from the nerve)Microscopic findings :Two patterns - Antoni A and Antoni B patterns Antoni A - Cellular with spindle cells showing nuclear palisades. There is an alternate array of nuclear palisades and nuclear-free zones were together called "Verocay bodies"Antoni B - Less densely cellular and consists of a loose meshwork of cells, microcysts, and myxoid stroma.Ref: Robbins 8/e p1340


Question: A 24 year old male complained of recurrent attacks of sore throat since 2 years. The total leucocyte count was 3000/ μl. A differential count revealed severe neutropenia. The diagnosis is


Question: Endotoxin shock is initiated by aEUR'

Cytokines action Septic shock is caused by vasodilation and peripheral pooling of blood as a pa of systemic immune reaction to bacterial or fungal infection. Septic shock was earlier also known as endotoxic shock because it was believed to be most commonly associated with endotoxin secreted due to gram negative bacteria. Currently, septic shock is most .frequently triggered by grain positive bacterial infections followed by gram negative bacteria and fungi. Hence the older synonym of "endotoxic shock" is not appropriate. Septic shock may be caused by either gram positive or gram negative bacteria. The microbial triggers for septic shock are different in different bacterias :- - Grain negative bacteria --> * Lipopolysaccharide entotoxin - Gram positive bacteria * Lipoteichoic acid Cell wall murantyl peotide 'Superantigens Streptococcal pyrogenic exotoxin The primary initial event in endotoxic shock is release of cytokines irrespective of whether it is caused by gram positive or gram negative organism -The sequence of events leading to the production of primary cytokines is different in gram negative and grain positive bacterias but the result is the same i.e. both the gram (-ye) and gram (+ve) bacterias leads to production of same mediators of inflammation i.e. TNFa and IL-1. The sequence of events after the release of primary mediators of inflammation is same in both the types of bacteria. - Once the primary cytokines i.e. TNFa and IL-1 are released they activate endothelium and leucocytes to release secondary mediators. - The secondary mediators cause vasodilatation, vascular leak and endothelial damage. So two mechanisms are impoant in septic shock :- i) Release of primary mediators of inflammation TNFa and IL-1. ii) Activation and damage to endothelium Damage to endothelium leads to systemic inflammatory response which causes vasodilation and permeability leading to septic shock. But the initial primary event is the release of primary mediators of inflammation cytokines as a result of interaction between bacterial cell wall components and host cell. The endothelium is subsequently activated and damaged by these mediators (cytokines). Therefore cytokine release is the primary initiating factor in endotoxic shock.


Question: Not Mesodermal in origin is

Respiratory system* develops from foregut and is endodermal


Question: Breast CA with best prognosis

Ans. (a) Mucinous(Ref: Robbins 9th/pg 1064-65)*Histological type: Invasive ductal carcinoma (no special type; NST) carries poor prognosis.*Tubular, mucinous, lobular, papillary, adenoid cystic has better prognosis#Metaplastic carcinoma or micro-papillary carcinoma have a poorer prognosis QRemember mucinous > lobular


Question: Oral hairy leukoplakia occurs in

Hairy leukoplakia is a distinctive oral lesion that is usually seen in immunocompromised patients. Approx 80% of patients with hairy leukoplakia are infected with HIV; the presence of this lesion sometimes calls attention to the existence of HIV infection. However rest 20% are seen in Immunocompromised due to cancer therapyor transplant immunosuppression. ref:Robbins pathologic basis of disease; Edition 8 ;pg;743.


Question: Poly arteritis nodosa does not involve

Polyarteritis nodosa (PAN) is a systemic vasculitis of small or medium sized muscular arteries, typically involving renal and visceral vessels but sparing the pulmonary circulation.
P  A  N -----
* Pulmonary  artery not involved.
*P ANCA -negative


Question: Paternal 15 chromosome deletion is seen in


Question: Hepatitis B infectivity is indicated by


Question: The tooth most commonly involved in chronic focal sclerosing osteomyelitis is


Question: Baclofen is used for

Baclofen is a centrally acting skeletal muscle relaxant. Baclofen is a muscle relaxer and an antispastic agent. Baclofen is used to treat muscle symptoms caused by multiple sclerosis, including spasm, pain, and stiffness. Baclofen is sometimes used to treat muscle spasms and other symptoms in people with injury or disease of the spinal cord. Baclofen is used to treat muscle spasms caused by ceain conditions (such as multiple sclerosis, spinal cord injury/disease).


Question: Periportal necrosis of liver is seen in

Periportal necrosis is seen in eclampsia, phosphorus poisoning.


Question: In postmenopausal women, estrogen is metabolized mostly into


Question: Toll like receptors, recognize bacterial products and stimulates immune response by,

The Toll-like receptors are membrane proteins that recognize a variety of microbe-derived molecules and stimulate innate immune responses against the microbes.
The Toll-like receptors are expressed on many different cell types that participate in innate immune responses including macrophages, dendritic cells, neutrophils, NK cells, mucosal epithelial cells and endothelial cells.
Signalling by Toll like receptors results in the activation of transcription factors. notably NF-K0 and AP-L
The genes that are expressed in response to TLR signalling encode proteins important in many different components of innate immune response.
These include
Inflammatory cytokines (TNF, IL-1, IL-2)
Endothelial adhesion molecules (E-selection) and
Proteins involved in microbial killing mechanisms.

Perforin and granzyme mediated apoptosis

Transcriptions of nuclear factor mediated by NFKP which recruits cytokines


Question: The transition from G2 to M phase is controlled by

The cell cycle is regulated by activators and inhibitors. Cell cycle progression is driven by proteins called cyclins. cyclin D-CDK4, cyclin D-CDK6, and cyclin E-CDK2 regulate the G1-to-S transition by phosphorylating the Rb protein (pRb). Cyclin A-CDK2 and cyclin A-CDK1 are active in the S phase. Cyclin B-CDK1 is essential for the G2-to-M transition.Reference: Robbins and Cotran Pathologic Basis of Disease; 9th edition; Chapter 1; The Cell as a Unit of Health and Disease


Question: macrophage in the brain is

Answer is option 4 Microglia are considered the resident macrophages of the brain given that they are the only myeloid cells present in the CNS parenchyma. Microglia perform both homeostatic and immune-related functions and constitute about 5-20% of all cells in the CNS. Ref of img :


Question: Most common malignancy in HIV is

Most common malignancy/tumor in I IIV is - Kaposi sarcoma
Second most common malignancy in HIV is - Hodgkin's and non-Hodgkin's lymphomas
Most common oral manifestation of HIV — Oral candidiasis Second most common oral manifestation of HIV — Oral hairy leukoplakia


Question: The most reliable criteria in Gustafson's method of identification is


Question: Myocaditis can be caused by

In the United States, viral infections are the most common cause of myocarditis, with coxsackieviruses A and B and other enteroviruses accounting for a majority of the cases. Cytomegalovirus (CMV), human immunodeficiency virus (HIV), influenza virus, and others are less common pathogens. Toxoplasma gondii (household cats are the most common vector) also can cause myocarditis, paicularly in immunocompromised persons. Trichinosis is the most common helminthic disease with associated cardiac involvement. (Robbins Basic Pathology,9th edition,pg no.401,402)


Question: Multifactorial inheritance is seen in

*The multifactorial disorders result from the combined actions of environmental influences and two or more mutant genes.*Some disorders of multifactorial inheritance are cleft lip/palate, congenital hea disease, coronary hea disease, hypeension, gout, diabetes, pyloric stenosis etc.*Note: Most of the congenital diseases are multifactorial. In our question "cardiac septal defect" is the only congenital disease.(Ref: Robbins 7/e p170)


Question: The following lesion is a doubtful premalignant lesion for oral malignancy


Question: "Warty" or "Cauliflower" like growth is


Question: Stain used for melanin is


Question: The cytoprotective agent used for the prevention of xerostomia in patients undergoing head and neck radiotherapy is


Question: Thrombosis is initiated by


Question: Indirectly cytopathic viruses kill cells by provoking an

In contrast to directly cytopathic viruses, which cause cell death by damaging the cell membrane indirectly, cytopathic viruses produce antigenic proteins that are inseed into the cell membrane and are capable of evoking an immune response. Attack by immune lymphocytes, which recognize the viral protein as foreign, destroys the cell membrane.


Question: In marfan syndrome, the defect is in

Marfan syndrome
o Marfan syndrome results from an inherited defect in an extracellular glycoprotein fibrillin - 1 on a chromosome -15.
o It has autosomal dominant inheritance,
o Pathogenesis
o A defect in fibrillin affects the elastic recoil of extracellular connective tissue.

Elastic fibers consist of a central core made up of elastin, surrounded by a peripheral network of microfibrils that consists largely fibrillin.
The defect in fibrillin causes the defective function of elastic fibers.
Microfibrils (containing fibrillin) are mainly distributed to Aorta, ligaments of joint and ciliary zonules of lens → So, in Marfan syndrome these tissues are primarily of elected


Question: Laminated concretions of calcium and proteins are

*Schaumann bodies : Laminated concretions of calcium and proteins in giant cells. Seen in *sarcoidosis*Asteroid bodies : Stellate inclusions seen in giant cells which is composed of microfilaments, *microtubules and centrioles. Seen in sarcoidosis.*Asbestos bodies : Shish cabab appearance of asbestos fibre with ferritin in macrophages. Seen in *asbestosis.*Ferruginous bodies - Linear arrays of ferritin without asbestos fibres in macrophages. Seen in asbestosis.*Gamna gandy bodies - Siderosclerotic bodies seen in chronic venous congestion of spleen( Ref: Robbins 8/e p700-703)


Question: Russel bodies seen in


Question: Hereditary hemorrhagic telangiectasia is seen commonly on


Question: Best prognosis in Carcinoma stomach is seen in

Ans. (a) Superficial spreading type(Ref: R 9th/pg 771)The depth of invasion and the extent of nodal and distant metastases at the time of diagnosis remain the most powerful prognostic indicators in gastric cancer.


Question: Hematuria with dysmorphic RBC are seen in

Acute pyelonephritis, a common suppurative inflammation of the kidney and the renal pelvis, is caused by bacterial infection. It is an impoant manifestation of urinary tract infection (UTI), which can involve the lower (cystitis, prostatitis, urethritis) or upper (pyelonephritis) urinary tract, or both. As we shall see, the great majority of cases of pyelonephritis are associated with infection of the lower urinary tract. Such infection, however, may remain localized without extending to involve the kidney. UTIs constitute an extremely common clinical problem. Refer robbins 9/e p911


Question: Negri bodies are seen in

Ans. b (Rabies). (Ref Robbin, Pathology, 7th ed., 137)PATHOGENESIS OF RABIES# The first event in rabies is the inoculation of virus through the skin, usually through a bite that delivers virus-laden saliva.# Initial viral replication appears to occur within striated muscle cells at the site of inoculation.# The peripheral nervous system is exposed at the neuromuscular and/or neurotendinous spindles of unmyelinated sensory nerve cell endings, with neurotransmitter receptors such as acetylcholine implicated in viral attachment and internalization.# The virus then spreads centripetally up the nerve to the CNS, probably via peripheral nerve axoplasm, at a rate of 3 mm/ h.# Once the virus reaches the CNS, it replicates almost exclusively within the gray matter and then passes centrifugally alone autonomic nerves to other tissues--- The salivary glands,Adrenal medulla,Kidneys,Lungs,- Liver,Skeletal muscles,Skin, andHeart.# The incubation period of rabies is exceedingly variable, from 7 days to 1 year (mean, 1 to 2 months)/# Rates of infection and mortality are highest from bites on the face, intermediate from bites on the hands and arms, and lowest from bites on the legs.# The neuropathology of rabies resembles that of other viral diseases of the CNS:- Hyperemia,- Varying degrees of chromatolysis,- Nuclear pyknosis, and- Neuronophagia of the nerve cells;- Infiltration by lymphocytes and plasma cells of the Virchow-Robin space;- Microglial infiltration; and- Parenchymal areas of nerve cell destruction.# The most characteristic pathologic finding of rabies is the eosinophilic cytoplasmic inclusions called Negri bodies within neurons. Each measures 10 nm and is made up of fibrillar matrix and virus particles.# Negri bodies are distributed throughout the brain, particularly in:- Ammon's horn,- Brainstem,- Hypothalamus, and- Purkinje cells of the cerebellumCerebellar,cerebral cortex,Dorsal spinal ganglia.# Negri bodies are not demonstrated in at least 20% of cases of rabies, and their absence from brain material does not rule out the diagnosis.RFFIT is valuable test to diagnose rabies.


Question: Feature of Apoptosis

Features of Necrosis and ApoptosisFeatureNecrosisApoptosisCell sizeEnlarged (swelling)Reduced (shrinkage)NucleusPyknosis - karyorrhexis - karyolysisFragmentation into nucleosome-sizefragmentsPlasmamembraneDisruptedIntact; altered structure,especially orientation of lipidsCellularcontentsEnzymatic digestion;may leak out of the cellIntact; may be released inapoptotic bodiesAdjacentinflammationFrequentNoPhysiologic orpathologicroleInvariably pathologic(culmination ofirreversible cellinjury)Often physiologic, means ofeliminating unwanted cells;may be pathologic after someforms of cell injury, especiallyDNA damageRef: Robbins and Cotran Pathologic Basis of Disease; 9th edition; Chapter 2; Cellular Responses to Stress and Toxic Insults: Adaptation, Injury, and Death


Question: Cellular swelling with blebs and myelin Figures are the changes seen in


Question: Lisch nodules (Pigmented Iris hamartomas) are seen in

Ans. b (Neurofibromatosis) (Ref. Harrison's Internal Medicine 17th ed., Chapter 374; RRM 7th ed., p.316)# Lisch nodules (iris hamartoma) and Optic gliomas = NF-1.# Glaucoma = Sturge Weber syndome.# Retinal angiomas = VHL# GlaucomaNEUROFIBROMATOSIS# Autosomal dominant inherited disorder- pure neurofibromas (= tumor of nerve sheath with involvement of nerve, nerve fibers run through mass)- neurilemmomas (= nerve fibers diverge and course over the surface of the tumor mass)(a) localized neurofibroma (most common, 90%)(b) diffuse neurofibroma (mostly solitary + not associated with NF1)(c) plexiform neurofibroma (PATHOGNOMONIC of NF1)Peripheral Neurofibromatosis (90%) = NEUROFIBROMATOSIS TYPE 1 = von Recklinghausen disease# autosomal dominant with abnormalities localized to the pericentromeric region of chromosome 17.- CLASSIC TRIAD:- Cutaneous lesions- Skeletal deformity- CNS manifestations# CNS and ocular MANIFESTATIONS- Lisch nodules= melanocytic iris hamartomas <2 mm in size- Optic pathway glioma- Hydrocephalus (Aqueductal stenosis)- Vascular dysplasia= occlusion / stenosis of distal ICA, proximal MCA/ACA- Plexiform neurofibromas are PATHOGNOMONIC for NF1- Erosion of bony elements with marked posterior scalloping# SKELETAL MANIFESTATIONS (in 25-40%)- Harlequin appearance to orbit (empty orbit) = partial absence of greater and lesser wing of sphenoid + orbital plate of frontal bone- Sharply angled focal kyphoscoliosis (50%) in lower thoracic + lumbar spine- Pseudarthrosis after bowing fracture (particularly in tibia) in 1st year of life# Others:- Cafe-au-lait spots= pigmented cutaneous macules >6 in number, >5 mm in greatest diameter; Coast of California.; Freckling.- Progressive pulmonary interstitial fibrosis with lower lung field predominance (up to 20%)- Pheochromocytoma- Renal artery stenosis: very proximal- Malignant peripheral nerve sheath tumor - most common malignant abdominal tumor in NF1


Question: Chance of having cystic fibrosis if only one parent is affected and other is normal


Question: The following condition is associated with brown skin pigmentation, hypoplasia of kidney and spleen, absent or hypoplastic thumb or radius, microcephaly and mental and sexual retardation


Question: Most common type of bladder cancer is

Types of bladder cancers*Epithelial tumours: (95%)*Urothelial ( Transitional ) carcinomas- Most common*Squamous cell carcinoma*Adenocarcinoma Rare types*Small cell carcinoma*Mesenchymal tumours: (5%)*Sarcomas


Question: The size of the red blood cells is measured by

(MCV) (361 - HM) (422- Basic pathology 8th)* Mean corpuscular volume (MCV) =PCV in L/L---------RBC count / L= Normal value is 85 +-8 pg (77 - 93 p1)* Mean corpuscular haemoglobin (MCH) =Hb/L---------RBC count / L= normal range is 29.5 +- 2.5 pg (27 - 32 pg)* Mean corpuscular haemoglobin concentration (MCHC) =Hb/dl-------DCV in L/ L * Normal value is 32.5 +- 2.5 g / dL (30 - 35 g/dL)* Since MCHC is independent of red cell count and size


Question: Linear deposition of the immunoglobulins

(Good-Pasteur syndrome): (485- Robbins-basic 7th edition)Linear pattern of immunoglobulin deposition (usually IgG, sometimes IgA or IgM) that is the hallmark diagnostic finding in renal biopsy in Good pasture syndromeLUPUS NEPHRITISClass I: Minimal lesionsDeposits within the mesangium which consist of IgG and C3Class II: Mesangial lupus nephritis* Increase in the number of mesangial cells and of the mesangial matrix* Granular mesangial deposits of IgG and C3 sometimes IgA and IgMClass III: Focal segmental LN* Haematoxylin bodies of gross may be present* Subendothelial and subepithelial deposits of IgG often with IgM or IgA and C3 are seenClass IV: Diffuse proliferative LN* Most severe and most common form of LN*** Diffuse proliferation of endothelial, masangial and sometimes epithelial cells involving most or all glomeruliClass V: Membranous LN* Resemble those of idiopathic membranous GN* Diffuse thickening of glomerular capillary wall on light microscopy and show sub endothelial deposits of immune complexes* Mesangial hypercellarity**Class VI: Sclerosing LN* End stage kidney of SLE akin to chronic GN* Most glomeruli are sclerosed and hyalinised


Question: Patau syndrome due to

PATAU SYNDROME:- Trisomy 13 47 XX Characteristic features:- 1. Microcephaly and mental retardation. 2. Microphthalmia 3. Cleft lip and palate. 4. Cardiac and renal defects 5. Umbilical hernia 6. Rocker bottom feet {Reference:Robbins basic pathology 9E pg no.248}


Question: A defect in xeroderma pigmentosum

Explanation:
Types of defects in DNA-repair systems and conditions associated


Question: Medulloblastoma most commonly metastasize to

Spread through the CSF is common, may present as nodular masses anywhere in the CNS. Metastases to the cauda equina are sometimes termed drop metastases. Refer robbins 9/e 844


Question: F body is

Ans. (a) Y chromatin(Ref: Emery Genetics)Quinacrine, a fluorescence dye, binds strongly to the Y chromosome forming a bright fluorescent spot (F body). This is clearly visible in stained interphase cells from various tissues from the human male and in mature spermatozoa


Question: Pagets disease of the nipple is

Refer Robbins page no 1057 Paget disease of the nipple is a rare manifestation of Breast cancer that presents as a lateral erythematous eruption with a scale crust.


Question: Most common primary in brain metastasis is from

Brain metastases occur when cancer cells spread from their original site to the brain. Any cancer can spread to the brain, but the types most likely to cause brain metastases are lung, breast, colon, kidney and melanoma. Brain metastases, or secondary brain tumors, occur in 10 to 30 percent of adults with cancer.


Question: Deficiency of enzyme hexosaminidase, n subunit causes

Tay-Sachs disease, by far the most common of all gangliosidoses, is characterized by a mutation in and consequent deficiency of the b subunit of theenzyme hexosaminidase A, which is necessary for the degradation of GM2. More than 100 mutations have been described; most affect protein folding or intracellular transpo. The brain is principally affected Type II glycogenosis (Pompe disease) is caused by a deficiency of lysosomal acid maltase and so is associated with deposition of glycogen in viually every organ, but cardiomegaly is most prominent. MPS type I, also known as Hurler syndrome, is caused by a deficiency of a-L-iduronidase. (Robbins Basic Pathology,9th edition,pg no. 229)


Question: Mucinous cystadenoma of the ovary arises

Ans. is 'b' i.e., From surface coelomic epithelium


Question: The causative agent for "Oculoglandular syndrome of Parinoud" is


Question: List the odd one out among the following

Trisomy 18 is Edward syndrome & not Noonan syndrome. Noonan syndrome occurs in both males and females with a normal karyotype(46,XX and 46,XY). Refer to the image below.


Question: Premalignant lesion of the vulva is

Leukoplakia of vulva means white plaque which may indicate : -

Benign Lesions
Premalignant Lesions
Malignant Lesions


Question: Bohn's nodules are


Question: Best test to detect benign form malignant thyroid is

Robbins basic pathology 9th edition page no, 729, Answer is option 3,excision Ultimately it is the morphological evaluation of a given thyroid nodule by fine needle aspiration, combined with histological study of surgically resected thyroid parenchyma, that provides the most defenitive information about its nature.


Question: Commonest thyroid tumor in MEN (multiple endocrine neoplasia)

Medullary Thyroid Carcinoma Medullary carcinoma is a less frequent type derived from parafollicular or C-cells present in the thyroid and comprises about 5% of thyroid carcinomas. It is equally common in men and women. There are 3 distinctive features which distinguish medullary carcinoma from the other thyroid carcinomas. They are : its familial occurrence, secretion of calcitonin and other peptides, and amyloid stroma. 1. Familial occurrence. Most cases of medullary carcinoma occur sporadically, but about 10% have a genetic background with point mutation in RET-protooncogene located on chromosome 10q. The familial form of medullary carcinoma in association with pheochromocytoma and parathyroid adenoma (multiple endocrine neoplasias, MEN II A), or with pheochromocytoma and multiple mucosal neuromas (MEN II B). 2. Secretion of calcitonin and other peptides. Like normal C-cells, tumour cells of medullary carcinoma secrete calcitonin, the hypocalcaemic hormone. In addition, the tumour may also elaborate prostaglandins, histaminase, somatostatin, vasoactive intestinal peptide (VIP) and ACTH. These hormone elaborations are responsible for a number of clinical syndromes such as carcinoid syndrome, Cushing's syndrome and diarrhoea. 3. Amyloid stroma. Most medullary carcinomas have amyloid deposits in the stroma which stains positively with usual amyloid stains such as Congo red. The amyloid deposits are believed to represent stored calcitonin derived from neoplastic C-cells in the form of prohormone. Most cases of medullary carcinoma present as solitary thyroid nodule but sometimes an enlarged cervical lymph node may be the first manifestation. Most medullary carcinomas are slow-growing. Regional lymph node metastases may occur but distant organ metastases are infrequent. The prognosis is better in familial form than in the sporadic form: overall 10-year survival rate is 60-70%. Ref: TEXTBOOK OF PATHOLOGY 6th EDITION - HARSH MOHAN PAGE NO:813-814


Question: Deficiency of folic acid leads to


Question: The most ideal explanation for recurrence of odontogenic keratocyst is

Increased mitotic activity of the epithelial lining

Presence of satellite cysts or daughter cysts

Continued proliferation of rests of dental lamina


Question: Phlegmon is


Question: Anti GBM antibodies are seen in

Goodpasture syndrome (GPS), also known as anti-glomerular basement membrane disease, is a rare autoimmune disease in which antibodies attack the basement membrane in lungs and kidneys, leading to bleeding from the lungs and kidney failure. It is thought to attack the alpha-3 subunit of type IV collagen, which has therefore been referred to as Goodpasture's antigen.Goodpasture syndrome may quickly result in permanent lung and kidney damage, often leading to death. It is treated with medications that suppress the immune system such as coicosteroids and cyclophosphamide, and with plasmapheresis, in which the antibodies are removed from the blood


Question: The cells most frequently found in a granuloma are


Question: In Serotonin syndrome the most characteristic feature is


Question: An ovarian neoplasm in a 15l4 year old girl is most likely to be

Refer Robbins page no 1029 Benign teratomas are bilateral in 10% to 15% of cases. Characteristically they are unilocular cysts containing hair and sebaceous material (Fig. 22-38). Sectioning reveals a thin wall lined by an opaque, gray-white, wrinkled epidermis, frequently with protruding hair shafts. Within the wall, it is common to find grossly evident tooth structures and areas of calcification. Microscopically, the cyst wall is composed of stratified squa- mous epithelium with underlying sebaceous glands, hair shafts, and other skin adnexal structures (Fig. 22-39). In most cases tissues from other germ layers can be identified, such as cailage, bone, thyroid, and neural tissue. Dermoid cysts are sometimes incorporated within the wall of a mucinous cystad- enoma. About 1% of the dermoids undergo malignant transformation, most commonly to squamous cell carci- noma, but also to other cancers as well (e.g., thyroid carcinoma, melanoma)


Question: The condition commonly involving V1 is


Question: Crescentic glomerulonephritis seen in

RPGN presents with an acute reduction in renal function resulting in acute renal failure in a few weeks or months. It is characterized by the formation of 'crescents'(crescentic GN)outside the glomerular capillaries (extracapillary GN).' crescents' are formed from the proliferation of parietal epithelial cells lining Bowman's capsule with contribution from visceral epithelial cells and the invading mononuclear cells. The stimulus for crescent formation appears to be the presence of fibrin in the capsular space. From HARSH MOHAN 7th edition, pg no:654


Question: The most efficient bactericidal system of neutrophils is

H2O2-MPO-halide system is the most efficient bactericidal system of neutrophils H2O2 is not able to efficiently kill microbes by itself. the azurophilic granules of neutrophils contain the enzyme myeloperoxidase (MPO), in the presence of a halide such as Cl-, conves H2O2 to hypochlorite(OCl2-) which is a potent antimicrobial agent that destroys microbes by halogenation (in which the halide is bound covalently to cellular constituents) or by oxidation of proteins and lipids (lipid peroxidation). Robbins 9th ed page 79


Question: Increased IgA levels are seen in

Alcoholic liver cirrhosis is characterised by increasing levels of immunoglobulins. Increased levels of IgA was observed in alcoholic cirrhosis. REFERENCE: NCBI.


Question: ITGCN is seen in

ITGCN is seen adjacent to all germ cell tumors in adults except for spermatocytic seminoma and epidermoid and dermoid cysts. With rare exceptions, it is also not seen in pediatric tumors (teratomas, yolk sac tumors... Robbins 7th edition page 1096) ITGCN is seen with a high frequency in the following conditions: a. Cryptorchidism b. Prior germ cell tumors c. Strong family history of germ cell tumor d. Androgen insensitivity syndrome e. Gonadal dysgenesis syndrome. Ref: gradestack.com


Question: "Jack in the box" phenomenon is because of


Question: Michalis Gutmann bodies are seen in

Malakoplakia *Etiology : Inflammation due to chronic bacterial infection, mostly by E.coli and proteus.*Common in immunosuppressed individuals*Pathogenesis : Disturbed phagocytic activity due to overloaded bacteria within macrophages*Sites : Urinary bladder, Colon, Lungs,Bones, Kidneys, prostate and epididymis *Microscopic findings : Sheets of macrophages, giant cells and michaelis-gutmann bodies *Michaelis gutmann bodies - Laminated mineralized concretions resulting from deposition of calcium In enlarged lysosomes of macrophages (Ref: Robbins 8/e p975)


Question: Most common neuroendocrine tumour in MEN 1 is

Most common neuroendocrine tumor of MEN1 is Gastrinoma where there is over production of Gastrin. MEN1 associated gastrinomas are frequently multifocal whereas sporadic ones are single. Ref: Robbins and cotrans 9e Pg 1122 A gastrinoma is a tumor in the pancreas or duodenum that secretes excess of gastrin leading to ulceration in the duodenum, stomach and the small intestine. There is hypersecretion of HCl acid into the duodenum, which causes the ulcers


Question: Reagent used in Apt test

Alkali denaturation test (Apt-Downey test / apt test)Used to detect differentiate Fetal or neonatal blood from maternal blood (Qualitative).PrincipleMethodFetal hemoglobin (alpha 2 gamma 2 subunits) is resistant to alkali (basic) denaturation, whereas adult hemoglobin (alpha2 beta 2 subunits) is susceptible to such denaturation.Exposing the blood specimen to sodium hydroxide (NaOH) will denature the adult but NOT the fetal hemoglobin.The fetal hemoglobin will appear as a pinkish color under the microscope while the adult hemoglobin will appear as a yellow-brownish colorThe blood is mixed with sterile water to cause hemolysis of the RBCs, yielding free hemoglobin,The 5 ml pink hemoglobin-containing supernatant is then mixed with 1 mL of 1% NaOH.Fetal hemoglobin will stay pink and adult hemoglobin will turn yellow-brown.Adult hemoglobin changes color because it is less stable and will conve to hematin.


Question: Comment on the histopathological specimen

Ref: Robbins and Cotran Atlas of Pathology, 3rd ed. pg. 356* Teratomas are made up of a variety of parenchymal cell types representing more than 1 germ layer and often all 3 germ layer.* Cells differentiate along various germ lines, essentially recapitulating any tissue of the body. Examples include hair, teeth, fat, skin, muscle, and endocrine tissue.* Arising from totipotential cells, these tumors typically are midline or paraxial.* The most common location is sacrococcygeal (57%).* Because they arise from totipotential cells, they are encountered commonly in the gonads (29%).* The most common gonadal location is the ovary, although they also occur somewhat less frequently in the testes.


Question: Receptor of joint capsule and ligaments is

Receptors can be classified into rapidly adapting (phasic) receptors and slowly adapting (tonic) receptors.Rapidly adapting receptorsSlowly adapting receptorsCutaneous mechanoreceptors such as:Meissner corpuscles (respond to changes in texture and slow vibrations)Pacinian corpuscles (respond to deep pressure and fast vibration)Cutaneous mechanoreceptors such as:Merkel cells (respond to sustained pressure and touch)Ruffini endings (respond to sustained pressure)ProprioceptorsNociceptors (free nerve endings - respond to thermal, chemical and thermal noxious stimuli)(Refer: Ganong&;s Review of Medical physiology 24th edition,pg no: 158)


Question: Myotonic dystrophy is inherited in chromosomes

Ans. is 'c' i.e., 19 o Myotonic dystrophy is associated with a trinucleotide CTG repeat expansion on chromosome 9. o This expansion affects the mRNA for the dystrophila myotonia protein kinase (DMPK). Myotonic dystrophy' o The characteristic feature of myotonic dystrophy is myotonia, i.e., the sustained involuntary contraction of group of muscles. o Of all the dysdrophies, only myotonic dystrophy shows pathological changes in the intrafusal fibres of the muscle spindles. o Extra-muscular abnormalities are : - Cataract Frontal baldness Gonadal atrophy o DM Dementia Decreased IgG


Question: Spindle cell tumor is

Alveolar soft pa sarcoma (ASPS) is a rare, poor prognosis neoplasm of unknown histogenesis with a distinctive histology, specific molecular characteristics, and unique clinical behaviors. ASPS generally develop in younger patients. Unlike other soft tissue sarcomas, ASPS also metastasizes to the brain. Ramdas Nayak 2nd edition page no. 371


Question: Most consistent and persistent feature of Ca Bladder

Hematuria is the most consistent and Persistent feature of Ca Bladder.


Question: The most common reported oral malignancy in HIV infection is


Question: At a constant blood flow, an increase in the number of perfused capillaries improves the exchange between blood and tissue because of

Greater surface area for the diffusion of molecules

Faster flow velocity of plasma and red blood cells in capillaries

Increased permeability of the microvasculature

Decreased concentration of chemicals in the capillary blood


Question: Invasion of perineural space is a feature of

Adenoid cystic carcinoma Most common location -Parotid & submandibular glands are M/E - Small cells having dark, compact nuclei & scant cytoplasm. Pattern : Tubular, solid, or cribriform patterns reminiscent of cylindromas arising in adnexa of skin Slow growing, adenoid cystic carcinomas are unpredictable tumors with tendency to invade perineural spaces & are stubbornly recurrent.


Question: MCV is

(82-92 FL) (283-Harsh mohan 6th/(439-CMDT-10)Mean corpuscular volume (MCV) =PCV in L/L--------RBC count / L* The normal values is 85 + 8fL (77-93-fL)* MCH normal values - 26-34 pg* MCHC normal values - 31 - 36g/dL* A severely microcytic anemia (MCV < 70 fL) is due to iron deficiency or thalassemia* MCV in infants of 1 month of age is = 90- 110fl**** A severely macrocytic anemia (MCV > 125 fL) is almost always due to either megaloblastic anemia or myelo dysplasia* Aplastic Anemia - Hallmark of aplastic anemia is pancytopenia**, Decreased reticulocytosis, macrocytosis,Neutrophils and platelets are reduced in number, no abnormal cells seen, Hypocellular bone marrow**B12 deficiency MCV is usually strikingly elevated between 110 and 140 fL Vitamin B12 deficiency | ||HaematologicalNeurological manifestations* Megaloblastic anemia(due to demyelination)* Macrocytic anemia||| ||||CerebrumSpinal cordCranial nervePeripheral nerve|||DementiaMyelopathyOptic neuritis| (SACD)/optic atrophyPeripheral neuropathy* Megaloblastic anemia should be treated with both folic acid and vitamin B12 because - folic acid alone causes improvement of hematologic symptoms but worsening of neurological symptoms*** Megaloblastic anemia due to folic acid deficiency is commonly due to- Inadequate dietary intake or increased metabolic demand**. The deficiency of cobalamine is almost always due to malabsorption*** Megaloblastic, anemia in blind loop syndrome is due to Bacterial over growth*** Intrinsic factor of castle is secreted by parietal cells in gastric glandsSCHILLING-TEST - measures cobalamine absorption by measuring urine radioactivity after an oral dose of radioactive cobalamine.The test is useful in demonstrating that the anemia is caused by an absence of intrinsic factor schilling test may be abnormal (usually defined as <10% excretion in 24 hr) in pernicious anemia, chronic pancreatitis, blind loop syndrome, and ileal diseaseFalse positive Schilling test - results are observed in patients with incomplete 24 hour urine collections or renal insufficiency**** Cells are macrocytic, hyperchromic, anisocytosis, hypersegmented neutrophils* ** Bone marrow have decreased myeloid: erythroid ratio (Normal 3:1)* In megaloblastic anemia - nuclear maturation lags behind cytoplasmic maturation* BM shows hypercellularity, erythrocyte precursors at different stages of development is found. Increased megaloblast causes ineffective erythropoisis*** Elevated levels of homocysteine and methylmalonic acid in the serum (This is more sensitive than serum levels of vitamin BI2)*** FIGLU test for Folate deficiency (F for F)* The gene responsible for folic acid transport is situated on chromosome 21***


Question: Oval cells are seen in the stem cells of


Question: Most common vascular tumour in AIDS

(Kaposi - sarcoma) (256 - R) (164- Basic pathology 8th)* Patients with AIDS have a high incidence of certain tumours especially Kaposi-sarcoma, non hodgkins B-cell lymphoma, cervical cancer in women and anal cancer in men* Kaposi - sarcoma is a vascular tumour that is otherwise rare in US is the most common neoplasm in patients with AIDS* The lesion of kaposi sarcoma are characterised by the proliferation of spindle cells that express markers of both endothelial (vascular or lymphatic) and smooth muscle lineages. There is also a profusion of slit -like vascular spaces, suggests that the lesions may arise from primitive mesenchymal precursors of vascular channels


Question: Lack of differentiation of cell is known as

Anaplasia: Lack of differentiation is called anaplasia.


Question: To prevent exercise induced bronchial asthma drug used is

Sodium cromoglycate (Mast cell stabilizing agent)Inhibit degranulation of mast cells, thereby preventing the release of the chemical mediators of anaphylaxis.Improves lung function, reduce symptoms, and lower airway activity in persons with asthma.Most effective in patients who have either seasonal disease or perennial airway stimulation.Steroids have no role in exercise-induced asthma.(Refer: Harrison's Principles of Internal Medicine, 18th edition, pg no: 2106-2115)


Question: Bilateral Renal cell carcimoma is seen in

VHL syndrome: Autosomal dominant cancer syndrome, characterized by: Cerebellar hemangioblastomas Retinal angiomas Clear cell RCC Pheochromocytoma Cysts in various organs. Patients of VHL disease have germline mutations of tumor suppressor VHL gene located on chromosome 3p, commonly as homozygous loss of the VHL gene. About 35% of cases of VHL develop RCC. Ref: Ram Das Nayak 2nd edition page no: 633


Question: Oncocytes are modified form of


Question: Atheromatous plaque do not contain

Atherosclerotic plaque have 3 principal components: 1. Cells including smooth muscle cells,macrophages and T cells 2. Extra cellular matrix including collagen,elasticfibers,proteoglycans 3. Intracellular and extracellular lipid Robbins 9th edition page no. 341


Question: The following condition is not a single gene disorder

Arrhythmogenic right ventricular cardiomyopathy


Question: The cause of oedema in Nephritic syndrome is

(Sodium and water retension) (80, 522 - R) (100, 683 - HM) (554- Basic pathology 8th)Patho Physiologic categories of EDEMAIncreased Hydrostatic pressureReduced plasma Osmotic pressure(Hypo proteinemia)Increased venous return* CHF* Constrictive pericarditis* Ascites (liver cirrhosis)* Venous obstruction or compression* Thrombosis* External pressure (e.g. mass)* Lower extremity inactivity with prolong dependancy* Arterioler dilation- Heat- Neuro humoral dysregulation- Protein losing glomerulopathies (Nephroticsyndrome)- Liver cirrhoses (ascitis)- Malnutrition- Protein losing gastro enteropathySODIUM RETENSION* Excessive salt intake with renal insufficiency* Increased tubular reabsorption of sodium- Renal hypoperfusion- Increased renin - angio tension aldosterone secretion* Reduced plasma osmotic pressure can result from excessive loss or reduced synthesis of albumin, the serum protein most responsible for maintaining colloid osmotic pressure. An important cause of albumin loss is the NEPHROTIC SYNDROME characterized by a leak glomerular capillary wall and generalized edema* Nephritic syndrome - oedema is due to excessive reabsorption of sodium and water in the renal tubules via renin angiotensin - aldosterone mechanism

Decreased in plasma protein concentration

Increased in plasma protein concentration


Question: Most common cause of leukocoria in newborn is


Question: Giant cells seen

Giant cell tumors of bone also known as osteoclastomas are relatively common bone tumors, usually benign which are arising from metaphsis and typically extending into epiphysis of the long bones. Young adults of ages 20-40 are more prone to these conditions. In a x ray we can find soap bubble appearance . >aicles > REF OF IMG:


Question: Lowest in the hierarchy of specialisation

Ans b: (Ref:Ganong)The bone marrow contains multipotent uncommitted stem cells otherwise called pluripotent stem cells Pluripotent stem cells differentiate into one or other type of committed stem cells otherwise called Progenitor cellsBut pluripotent stem cells are derived from uncommitted totipotent stem cells that can be stimulated to form any cell in the body.


Question: Cachexin is

In patients with advanced cancers, this inflammatory reaction can be so extensive as to cause systemic signs and symptoms such as Cachexia, or wasting due to cancer, manifests with weakness, weight loss, anorexia, anaemia, and infection. The principal cytokine responsible for such manifestations is tumour necrosis-a (TNF-a) IL-12 Increased production of IFN-g IFN-g Activation of macrophages (increased ability to kill microbes and tumour cells) IL-2 growth factor for T cell ref robbins 9th ed page 315, 101


Question: Preformed antibodies cause

Rejection- Antibody mediated Humoral or hyperacute rejection When preformed antidonor antibodies are present in circulation of recipient Previous rejection of a transplant Multiparous women Prior blood transfusions Mechanisms of injury - complement dependent cytotoxicity, inflammation, ADCC. Target is graft vasculature - rejection vasculitis


Question: Mycosis fungoides is a


Question: Chronic granulomatous disease is due to deficiency of

(Oxydase): (153- Baveja 4th Microbiology)Chronic Granulomatous disease (CGD) is fatal genetic disorder, deficiency of NADPH oxidase. In these patients polymorphonuclear leucocytes phagocytose invading bacteria normally but are unable to kill ingested micro organism because engulfment of bacteria is not followed by activation of oxygen-dependent killing mechanism. The bacteria involved in the recurrent infections are catalase positive organisms such as staphylococci and coliforms Leucocytes from these patients fail to reduce nitroblue tetrazolium (NBT) during phagocytosis. This property has been used (NBT test) for diagnosis of CGD


Question: Giant cell tumor of tendon sheath Is

Giant cell tumours of tendon sheath are benign tumours, occurs as discrete nodules on a tendon sheath along wrist and fingers. Giant cell tumor of the tendon sheath (GCTTS) is the second most common tumor of the hand after ganglion cysts (1,2). It is a slowly growing, usually painless benign lesion of soft tissues. Robbins basic pathology. 7tyh edition. chapter - joints and soft tissue tumours. Page no 1315. REF IMG answer is option 4.


Question: Severe hereditary spherocytosis is seen due to the defect of the following protein


Question: Caseous necrosis is seen in

Caseous necrosis is encountered most often in foci of tuberculous infection. Caseous means "cheese-like," referring to the friable yellow-white appearance of the area of necrosis.Unlike with coagulative necrosis, the tissue architecture is completely obliterated and cellular outlines cannot be discerned. The area of caseous necrosis is often enclosed within a distinctive inflammatory border; this appearance is characteristic of a focus of inflammation known as a granuloma.( Robbins Basic Pathology, 9th edition, page 10)


Question: Proopiomelanocoin is released from

Proopiomelanocoin (POMC) is the pituitary precursor of circulating melanocyte stimulating hormone (a-MSH), adrenocoicotropin hormone (ACTH), and b-endorphin released from hypothalamus.


Question: The combination of rest pain, colour changes, oedema and hyperaesthesia


Question: Highest molecular weight immunoglobulins are

Ref: Ananthanarayan and Paniker's, 8th ed. pg. 100Immunoglobulins and their salient featuresImmuno-globulinsSalient featuresIgG* Most abundant Ig, makes as about 80%* Marker of chronic infection* Only Ig that can cross placentaIgA* 2nd most abundant, 10-13%* Found in glandular secretion like saliva, tear, ileum, and mucosal secretion like bronchial secretionIgM* 5-8% of total Ig; aka pentameric Ig - has highest molecular weight* First Ig to be synthesized by fetus (20 weeks AOG)* Marker of acute infectionIgD* Present mostly intravascular* Serve as recognition receptor for antigensIgE* Mostly extravascular in distribution* Highly elevated levels in case of type-I HPS reaction* Produced chiefly in the linings of respiratory and intestinal tractsImmunoglobulin and their effective valencyAntibodyEffective valency* IgM5* IgG2* IgD2* IgE2* IgA2,4* Ig having maximum molecular weight: IgM* First antibody produced by newborn: IgM* All immunoglobulins are heat stable except: IgE* Ig present in breast milk: IgA* Ig with maximum half-life: IgG* Ig with minimum half-life: IgE* Ig having maximum serum concentration: IgG* Ig having least serum concentration: IgE


Question: GNAS mutation is associated with malignancy of

GNAS encodes for alpha subunit of stimulatory G-protein , Gsalpha . Oncogenic activation of GNAS constitutively activates Gsalpha leading to Growth hormone(GH) adenomas. Ref: Robbins and cotrans 9e Pg 1076


Question: Sweat chloride in cystic fibrosis

Robbins basic pathology 9th edition page no 226, An increase in sweat chloride concentration is a major criteria for the diagnosis of cystic fibrosis. Page no 223: the primary defect in cystic fibrosis is abnormal function of an epithelium chloride channel protien encoded by the cystic fibrosis transmembrane conductance regulator gene at chromosome locus. Thus the epithelium membrane become impermeable to chloride channels


Question: Microarray is used to

A DNA microarray (also commonly known as DNA chip or biochip) is a collection of microscopic DNA spots attached to a solid surface Summery of Microarry; Within the organisms, genes are transcribed and spliced to produce mature mRNA transcripts (red). The mRNA is extracted from the organism and reverse transcriptase is used to copy the mRNA into stable ds-cDNA (blue). In microarrays, the ds-cDNA is fragmented and fluorescently labelled (orange). The labelled fragments bind to an ordered array of complementary oligonucleotides, and measurement of fluorescent intensity across the array indicates the abundance of a predetermined set of sequences. These sequences are typically specifically chosen to repo on genes of interest within the organism's genome.


Question: MYD88 L265P mutation is seen in

Ans. A. Waldenstrom macroglobulinemiaExplanationMYD88L 265P is expressed in 90 to 95% of WM cases when more sensitive allele-specific PCR has been employed.Waldenstrom's macroglobulinemia (WM):It is a IgM-secreting lymphoplasmacytic lymphoma (LPL).Clinical manifestations:Cytopenia resulting from bone marrow infiltration by lymphoplasmacytic cells,Paraprotein-related cryoglobulinemia,The cold agglutinin syndrome,Demyelinating neuropathySymptomatic hyperviscosity.Oncogenic basis: not been defined.Familial clustering of Waldenstrom's macroglobulinemia and other B-cell disorders suggests that genetic factors play a role in certain patients.IgM monoclonal gammopathy of unknown significance (MGUS) is characterized by the presence of a monoclonal IgM protein and the absence of bone marrow disease involvement on histologic examination. IgM MGUS can progress to Waldenstrom's macroglobulinemia or other B-cell lymphoproliferative disordersMYD88 L265P is a commonly recurring mutation in patients with Waldenstrom's macroglobulinemia that can be useful in differentiating Waldenstrom's macroglobulinemia and non-IgM LPL from B-cell disorders that have some of the same features.


Question: Antibiotic stomatitis is the other name for


Question: In Wegener's granulomatosis cytoplasmic anti neutrophilic antibodies are directed against

Wegener granulomatosis is a necrotizing vasculitis characterized by a specific triad of findings: * Granulomas of the lung and/or the upper respiratory tract (ear, nose, sinuses, throat) * Vasculitis of small to medium-sized vessels (capillaries, venules, aerioles, and aeries), most prominently in the lungs and upper respiratory tract * Glomerulonephritis PR3-ANCAs are present in almost 95% of cases and probably drive the subsequent tissue injury; they also are useful markers of disease activity. (Robbins basic pathology,9th edition.pg no.353)


Question: Internal resorption is characterised by


Question: First enzyme to be raised in MI is

The laboratory evaluation of MI is based on measuring blood levels of macromolecules that leak out of injured myocardial cells through damaged cell membranes these molecules include myoglobin, cardiac troponins T and I (TnT, TnI), creatine kinase (CK) (specifically the myocardial isoform, CK-MB), and lactate dehydrogenase. Troponins and CK-MB have high specificity and sensitivity for myocardial damage. (Robbins Basic pathology,9th edition.pg no.382)


Question: The following is not a feature of malignant transformation by cultured cells

Malignant cells do not require stimulation by growth signals. they have capacity to proliferate without it.

Increased requirement for growth factors


Question: Sideroblastic anemia is seen in chronic poisoning of

Ans. (a) Lead(Ref: Wintrobe's 12th/pg837)Sideroblastic anemia is seen in:*. Alcoholism*. Lead poisoning*. Drugs (isoniazid, pyrazinamide, chloramphenicol)*. Copper deficiency (zinc ingestion, copper chelation, nutritional, malabsorption)*. Hypothermia


Question: The layer responsible for the strength of an intestinal anastomosis is

Mechanical propeiesThe mechanical propeies of intact intestine in axial and transversal directions were different. The mechanical strength of the intact intestinal wall was conditioned by the submucosa and muscularis, while the serosa and mucosa showed no significant strength. Comparison of axial specimens&; mechanical propeies of the intact intestinal wall and intestinal wall with all layers sutured through determined that only the submucosa supplies mechanical strength to anastomosis.Other layers contribute no significant force to anastomotic strength. The strength applied to the thread during knot tying does not change the paicipation of the intestinal layers in supplying suture-holding capacity for 8 and 12 mm stitch depth. (Refer:


Question: Dilated cardiomyopathy is due to

Option a: Arrhythmogenic right ventricular hypertrophy
Option b: Hypertrophic cardiomyopathy
Option d: Left ventricular hypertrophy.


Question: The single most important predictor of survival in multiple myeloma

Ans. (d) Serum b2 -microglobulin(Ref: Robbins 9th/pg 598-602/8th 608-612)b2-M concentration is the strongest and most reliable prognostic factor for multiple myeloma. It depends not only on tumor burden but also on renal function. Elevated b2-M values predict early death


Question: Sentinel node biopsy for Carcinoma breast is for

Sentinel node biopsy is a surgical procedure used to determine whether cancer has spread beyond a primary tumor into your lymphatic system. It's used most commonly in evaluating breast cancer and melanoma. The sentinel nodes are the first few lymph nodes into which a tumor drains.


Question: The primary cause of acantholysis in pemphigusvulgaris is


Question: The probable interval between throat infection and onset of rheumatic fever is

Rheumatic fever is an acute, immunologically mediated, multisystem inflammatory disease that occurs after group A b-hemolytic streptococcal infections (usually pharyngitis, but also rarely with infections at other sites such as skin). Acute rheumatic fever occurs most often in children; the principal clinical manifestation is carditis. Neveheless, about 20% of first attacks occur in adults, with ahritis being the predominant feature. Symptoms in all age groups typically begin 2 to 3 weeks after streptococcal infection, and are heralded by fever and migratory polyahritis. (Robbins basic pathology,9th edition.pg no.391)


Question: Crescents are characteristic of

Crescents are histological characteristic of RPGN.


Question: RB gene is located on

Ans. is 'a' 13q14Retinoblastoma is a prime example of a tumour which is associated with loss of heterozygosity.The mutations required to produce retinoblastomas involve the RB genelocated on chromosome 13 q14.


Question: Toxic megacolon is most commonly associated with

inflammation and inflammatory mediators can damage the muscularis propria and disturb neuromuscular function leading to colonic dilation and toxic megacolon TEXT BOOK OF ROBBINS BASIC PATHOLOGY NINTH EDITION PAGE.590-591


Question: Autophagy is the function of

Autophagy refers self eating (lysosomal digestion) of cell's own components during nutrient deprivation.


Question: The principle cell in granuloma

Ans. (b) Epithelioid cell(Ref: Anderson 10th ed pg 583)Macrophages (also known as histiocytes) are the cells that define a granulomaThe macrophages in granulomas are often referred to as "epithelioid"Epithelioid macrophages differ from ordinary macrophages in that they have elongated nuclei that often resemble the sole of a slipper or shoe.These changes are thought to be a consequence of "activation" of the macrophage by the offending antigen.


Question: Turner no of chromosomes

Turner syndrome, characterized by primary hypogonadism in phenotypic females, results from paial or complete monosomy of the sho arm of the X chromosome. With routine cytogenetic methods, the entire X chromosome is found to be missing in 57% of patients, resulting in a 45,X karyotype Clinical features Low posterior hairline Sho stature Coarctation of aoa Cubitus valgus Streak ovaries, infeility, amenorrhea Peripheral lymphedema at bih Webbing of neck Broad chest and widely spaced nipples Pigmented nevi (Robbins Basic Pathology, 9 th edition. page : 240)


Question: Most important for diapedesis

Diapedesis or Transmigration-process of leukocyte recruitment is migration of the leukocytes through the endothelium.

Most important for diapedesis is PECAM- 1 and CD31 molecules


Question: Most common nerve injury associated with thyroid surgery

.The external branch of the superior laryngeal nerve (EBSLN) is at risk of injury during thyroid operations when dissection of the superior pole and ligation of the superior thyroid vessels (STV) are carried out. From that perspective, EBSLN injury poses a threat to handicap all patients undergoing thyroid operations. ref Robbins 9/e pg 345

External branch of superior laryngeal nerve


Question: Not a feature of multiple myeloma

Answwe is option 4, elevated alkaline phosphatase. Alkaline phosphatase only increase if there is a bone fracture along with multiple myeloma Bone-specific ALP may increase in Paget's disease, osteosarcoma, bone metastases of prostatic cancer (high/very high ALP values), other bone metastases, fractured bones, multiple myeloma (only when associated with fractures), osteomalacia, rickets, vitamin D deficiency (moderate rise), malignant tumors (ALP originating from tumors), renal disease (secondary hyperparathyroidism), and primary hypothyroidism


Question: The risk of sarcoma developing in a fibroid uterus is approximately

Though uterine sarcoma is rare--with the annual incidence of leiomyosarcomas at approximately 0.4 to 0.64 per 100,000 women--it has been estimated that approximately 1:8300 to 1:352 women undergoinguterine surgery for presumedfibroids have unsuspected sarcoma.


Question: MI is a type of

Coagulative necrosis is a form of necrosis in which the underlying tissue architecture is preserved for at least several days. The affected tissues take on a firm texture. Presumably, the injury denatures not only structural proteins but also enzymes, thereby blocking the proteolysis of the dead cells; Coagulative necrosis is characteristic of infarcts (areas of ischemic necrosis) in all of the solid organs except the brain.( Robbins Basic Pathology, 9th edition, page 10 )


Question: Iron is absorbed from


Question: In amyloidosis of tongue, the amyloid is deposited primarily in the


Question: Not a sequelae of cellular events in atherosclerotic infarction


Question: Migratory thrombophlebitis is caused by

Carcinomas of the pancreas typically remain silent until theirextension impinges on some other structure. Pain usually is thefirst symptom, but by that point these cancers are oftenbeyond cure. Obstructive jaundice can be associated withcarcinoma in the head of the pancreas, but it rarely drawsattention to the cancer soon enough for timely intervention.Weight loss, anorexia, and generalized malaise and weaknessare manifestations of advanced disease. Migratory thrombophlebitis (Trousseau syndrome) occurs in about 10% of patients and is attributable to the elaboration of platelet aggregating factors and pro-coagulants from the tumor or its necrotic products.Robbins Basic pathology, 9th edition, pg no.654


Question: Swiss cheese pattern endometrium is seen in

Ans. (b) Metropathia hemorrhagica(Ref: Textbook of gynecology by Rao:65)Metropathia hemorrhagicaAnovulatory DUB associated with endometrial hyperplasia with acyclical bleedingOvergrowth of endometrial stroma and glands producing swiss cheee appearance


Question: Acanthosis means

HISTOPATHOLOGIC TERMS Before describing the pathology of common skin diseases, the following pathologic terms in common use need to be defined for the understanding of Dermatopathology: Acanthosis: Thickening of the epidermis due to hyperplasia of stratum Malpighi. Acantholysis: Loss of cohesion between epidermal cells with formation of intraepidermal space containing edema fluid and detached epithelial cells. Dyskeratosis: Abnormal development of epidermal cells resulting in rounded cells devoid of their prickles and having pyknotic nuclei. Dyskeratosis is a feature of premalignant and malignant lesions and is rarely seen in benign conditions. Hyperkeratosis: Thickening of the horny layer. Parakeratosis: Abnormal keratinization of the cells so that the horny layer contains nucleated keratinocytes rather than the normal non-nucleate keratin layer. Spongiosis: Intercellular edema of the epidermis which may progress to vesicle formation in the epidermis. Pigment incontinence: Loss of melanin pigment from damaged basal cell layer so that the pigment accumulates in the melanophages in the dermis. Ref: Textbook of pathology (Harsh Mohan)6th edition, page no.769


Question: Most common mutation in hereditary spherocytosis

Ans. (b) Ankyrin(Ref: Robbins 9th/pg 632; 8th/pg 642)Most common mutation:Hereditary spherocytosis is Ankyrin>Band-3>spectrinHereditary elliptocytosis is Spectrin


Question: Inhalational agent of choice for Pediatric Anaesthesia ina child with congenital hea disease

Anaesthetic agent of choice in Pediatric age group Inhalational agentIV anaestheticsNM blockersIM anaestheticsSevoflurane, Nitrous oxide Thiopentone, Propofol Rocuronium, Atracurium, Mivacurium, Succinylcholine Ketamine ( Reserved drug )(Refer: Morgan's Clinical Anaesthesiology, 4th edition, pg no: 922-938)


Question: MHC class III genes encode

*HLA class III contains genes for
• Complement components C2 and C4 of classical pathway (Not C3)
• Properdin factor B of alternate pathway
• Tumor necrosis factor: Alpha and Beta
• Heat shock protein 70
• Enzyme tyrosine hydroxylase
• Genes for MHC (also known as HLA) are located on short arm of chromosome 6.


Question: Telomerase activity is expressed in

Telomeres are sho repeated sequences of DNA present at the ends of linear chromosomes that are impoant for ensuring the complete replication of chromosome ends and for protecting the ends from fusion and degradation. When somatic cells replicate, a small section of the telomere is not duplicated and telomeres become progressively shoened. As the telomeres become shoer, the ends of chromosomes cannot be protected and areseen as broken DNA, which signals cell cycle arrest. Telomere length is maintained by nucleotide addition mediated by an enzyme called telomerase. Telomerase is a specialized RNA-protein complex that uses its own RNA as a template for adding nucleotides to the ends of chromosomes. Telomerase activity is expressed in germ cells and is present at low levels in stem cells, but it is absent in most somatic tissues.Ref: Robbins and Cotran Pathologic Basis of Disease; 9th edition; Chapter 2; Cellular aging; Page no: 67


Question: The most common condition of inherited blindness to mitochondrial chromosomal anomaly is

(Lebers hereditary optic neuropathy) Leber's hereditary optic neuropathy (LHON) * Which is result of maternal mitochondria] DNA mutations 34660, 14484, 1778 and 15257) * The majority of patients are males in their twenties with the 11778 mutation, which carries worst prognosis * Diagnosis of any patients with bilateral] optic neuritis, painless visual loss * Telangiectatic female relatives


Question: Gene for Wilm’s tumor is located on

Easiest way to remember that info….. count the number of letters in Wilms tumour..yea it is exactly 11…the location ofboth genes associated with Wilms tumour
So, the two genes associated with Wilms tumour WT1 gene (located on chr 11p13)and WT2 gene (located on chr 11p15).


Question: Pioneer bacteria in dental caries are in


Question: You expect a patient in the oliguric phase of renal failure to have a 24 hour urine output less than

Oliguria is defined as urine output of less than 400ml/24hours


Question: Herpes simplex is seen in


Question: Pyogenic infection and brain infarction associated with

(Liquefactive necrosis) (10- Basic- Robbins 8th) (52-(i) Coagulative necrosis - Infarcts in all solid organs (heart, kidney , splen) Except brain(ii) Liquefactive necrosis - Bacterial or fungal infection and brain infarctions(iii) Caseous necrosis - Tuberculosis(iv) Fat necrosis - Acute pancreatic necrosis and traumatic necrosis commonly in breasts(v) Fibrinoid necrosis - Immune complex vasculitis


Question: Forcheimer sign is seen in


Question: Trinucleotide repeat seen in Fragile X syndrome is

Examples of Trinucleotide-Repeat DisordersDiseaseRepeatFragile X syndromeCGGFriedreich ataxiaGAAMyotonic dystrophyCTGSpinobulbar muscular atrophy(Kennedy disease)Huntington diseaseSpinocerebellar ataxiaCAGRef: Robbins and Cotran Pathologic Basis of Disease; 9th edition; Chapter 5; Genetic Disorders; Page no: 168


Question: Not seen in children is

Seminoma, the most common GCT in adults, does not occur before 5 years of age. seminoma is considered a postpubeal tumor.


Question: In a specimen of kidney, fibrinoid necrosis is seen and onion peel appearance is also present. Most probable pathology is

Ans. b. Hyperplastic aeriosclerosis Aeriolosclerosis Hyaline Aeriolosclerosis with associated luminal narrowingdeg. These changes stem from plasma protein leakage across injured endosthelial cells, and increased smooth muscle cell matrix synthesis in response to chronic hemodynamic stressdeg. Although the vessels of elderly persons (either normo- or hypeensive) also frequently show hyaline aeriosclerosis, it is more generalized and severe in individuals with hypeensiondeg. Major morphologic characteristic of benign hypertensiondeg Also a common feature of diabetic microangiographydeg; in that case the underlying etiology is hyperglycemia-induced endothelial cell dysfunctiondeg. In nephrosclerosis due to chronic hypeension, the aeriolar narrowing of hyaline aeriosclerosis causes diffuse impairment of renal blood supply and causes glomerular scarringdeg Hyperplastic Aeriolosclerosis Occurs in severe (malignant) hypeensiondeg Vessels exhibit "onion-skin lesions," deg characterized by concentric, laminated thickening of the walls and luminal narrowing. The laminations consist of smooth muscle cells with thickened, reduplicated basement membranesdeg In malignant hypeension they are accompanied by fibrinoid deposits and vessel wall necrosisdeg (necrotizing aeriolitis)deg, paicularly in the kidney. Characteristic of malignant hypeension


Question: Anti GDla

Immunopathological studies suggest that the target of immune attack is different in the subtypes of Guillain-Barre syndrome (GBS). In acute motor axonal neuropathy (AMAN), the attack appears directed against the axolemma and nodes of Ranvier. In acute inflammatory demyelinating polyneuropathy (AIDP), the attack appears directed against a component of the Schwann cell. However, the nature of the antigenic targets is still not clear. We prospectively studied 138 Chinese GBS patients and found that IgG anti-GD1a antibodies were closely associated with AMAN but not AIDP. With a cutoff titer of greater than 1:100, 60% of AMAN versus 4% of AIDP patients had IgG anti-GD1a antibodies; with a cutoff titer of greater than 1:1,000, 24% of AMAN patients and none of the AIDP patients had IgG anti-GD1a antibodies. In contrast, low levels of IgG anti-GM1 antibodies (> 1:100) were detected in both the AMAN and the AIDP forms (57% vs 35%, NS). High titers of IgG anti-GM1 (>1:1,000) were more common in the AMAN form (24% vs 8%, NS). Serological evidence of recent Campylobacter infection was detected in 81% of AMAN and 50% of AIDP patients, and anti-ganglioside antibodies were common in both Campylobacter-infected and noninfected patients. Our results suggest that IgG anti-GD1a antibodies may be involved in the pathogenesis of AMAN.


Question: Myelofibrosis leading to a dry tap on bone marrow aspiration is seen with ach of the following condition

Ans. c. Acute megakaryocytic leukemia Bone marrow maybe difficult to aspirate in Acute megakaryocytic leukemia and more than 2/3rd of patients have significant fibrosis caused by release of fibrogenic cytokine Erythroleukemia (M6) FAB Bone marrow findings: Usually hypercellular with megaloblastic changesdeg - Erythroid precursors commonly have multicentricity (65%), karyorrhexis (53%), morulae (25%) and cytoplasmic inclusionsdeg. MC immunophenotypic marker for erythroleukemia: Glycoprotein 7 and transferring receptor (CD-71 Acute Megakaryocytic Leukemia (M7) FAB Bone marrow findings: Bone marrow maybe difficult to aspirate and more than 2/3' of patients have significant fibrosisdeg caused by release of fibrogenic cytokine Burkitt's Lymphoma Bone marrow findings: When the bone marrow is involved, aspirates reveal tumor cells with slightly clumped nuclear chromatindeg, 2-5distinct nucleoli and royal blue cytoplasm containing clear cytoplasmic vacuole Acute Myelomonocytic Leukemia (M4) FAB Bone marrow findings: Ultra-structures are present in association with monocytosis and myeloblastic/monoblastic infiltration of bone


Question: In patients with Chronic Myeloid Leukemia

Ans. (b) The fusion gene bcr-abl forms a protein with tyrosine kinase activity(Ref: Robbins 9th/pg 616-618)a. FALSE, as ABL gene is on chr9q while BCR is on chr22qb. The fusion gene bcr-abl forms a protein with tyrosine kinase activity: TRUEc. FALSE; Massive splenomegaly is a feature of CMLd. FALSE; as response to Imatinib is good in patients with Philadelphia chromosome +ve

ABL gene on Chr. 22 is trans-located to BCR gene on Chr.9

Philadelphia chromosome positive patients respond poorly to Imatinib


Question: Eruption fails in this bone disease, as there is no bone resorption


Question: Most friable vegetation is seen in

Vegetations on hea valves are the classic hallmark of IE; these are friable, bulky, potentially destructive lesions containing fibrin, inflammatory cells, and bacteria or other organisms (Figs. 12-24 and 12-25). The aoic and mitral valves are the mostsites of infection, although the valves of the right hea may also be involved, paicularly in intravenous drug abusers. Vegetations can be single or multiple and may involve more than one valve; they can occasionally erode into the underlying myocardium and produce an abscess (ring abscess; Fig. 12-25B). Vegetations are prone to embolization; because the embolic fragments often contain virulent organisms, abscesses frequently develop where they lodge, leading to sequelae such as septic infarcts or mycotic aneurysms. The vegetations of subacute endocarditis are associated with less valvular destruction than those of acute endocarditis, although the distinction can be subtle. Microscopically, the vegetations of subacute IE typically exhibit granulation tissue at their bases indicative of healing. With time, fibrosis, calcification, and a chronic inflammatory infiltrate can develop.


Question: 'Wireloop' lesions in kidney are seen in

Ans. b (SLE) .(Ref. Robbins, Pathology, 6th/pg.221)SYSTEMIC LUPUS ERYTHEMATOSUS (SLE)# Connective tissue disorder associated with HLA B8 and DR3.# 'Onion skin' lesions in spleen occur.# 'Wire-loop' lesions in kidneys are seen.- Photosensitive erythematous butterfly rash on the face/discoid rash, lupus profundus, livido reticularis.- Transient, migratory or seronegative chronic arthritis.; Bony erosions- Lymphadenopathy, Splenomegaly, Alopecia- Pericarditis/myocarditis/Libmann Sack's verrrucous endocarditi- Pleurisy, ILD, fibrosing alveolitis, shrinking lung syndrome- Kerato-conjunctivitis sicca, episcleritis, retinal vasculitis, soft exudates- CNS features# Treatment; antimalarials, immunosupressants and steroids.# Congenital lupus erythematosus is characterized by- Complete heart block- Lupus erythematosus rash# Drug induced lupus- Procainamide, hydralazine, phenothiazines, OC pills, anticonvulsants implicated.- Anti-histones abs +- Absent anti dd DNA abs- Renal and CNS lesions.


Question: Berry aneurysm most commonly occurs due to

Ref: Harrison 20th, P 2084As an aneurysm develops, it typically forms a neck with a dome. The length of the neck and the size of the dome vary greatly and are important factors in planning neurosurgical obliteration or endovascular embolization. The arterial internal elastic lamina disappears at the base of the neck. The media thins, and connective tissue replaces smooth- muscle cells. At the site of rupture (most often the dome), the wall thins, and the tear that allows bleeding is often <=0.5mm long. Aneurysm size and site are important in predicting risk of rupture. Those>7mm in diameter and those at the top of the basilar artery and at the origin of the posterior communicating artery are at greater risk

Muscle intimal elastic lamina layer defect


Question: Nut meg liver occurs in


Question: The diagnostic procedure not done in case of ph eochromoc ytoma.

FNAC "Percutaneous fine-needle aspiration of chromallin tumors is contraindicated; indeed, pheochronwcytoma should be considered before adrenal lesions are aspirated." -Harrison "Catastrophic hypeensive crisis and fatal cardiac arrhythmias can occur spontaneously or may be triggered by intravenous contrast dye or glucagon injection, needle biopsy of the mass, anesthesia, and surgical procedures." -


Question: The only Species of Shigella that produces exotoxin


Question: Pleomorphic adenoma arises from


Question: The following chemical mediator is a product of arachidonic add metabolite by cyclo oxygenase pathway


Question: Maximum IMR is seen in

State (2014)IMR / 1000Tamil Nadu20Orissa/Odisha49Maharashtra22Kerala12Madhya Pradesh52(Refer: K. Park's Textbook of Preventive and Social medicine, 24th edition, pg no:604)


Question: Lymphocytic colitis

The characteristic feature of LC is an infiltration by lymphocytes into the colonic epithelium. Collagenous colitis (CC) shares this feature but additionally shows a distinctive thickening of the subepithelial collagen table. LC and CC have been suggested to represent different phases of a single pathophysiologic process, with LC possibly being a precursor or earlier phase of CC; however, this has not been proven. REFERANCE. MEDSCAP.COM IMAGE REF:

Through Ileoscopy look for payer's patches


Question: In Bing test, on alternately compressing and releasing the external acoustic meatus, the sound increases and decreases. This indicates

Tests for bone conduction TestPrincipleMethodImpressionBing test Examines the effect of occlusion of ear canal on hearing Tuning fork placed on mastoid while examiner alternatively closes & opens the ear canal by pressing on the tragus inwards Patient hears louder when the ear canal is occluded & softer when the ear canal is open - Normal persons or sensorineural deafness ( Bing + ve )No change in ear canal opening or occlusion - conductive deafness ( Bing - ve )Gelle's test Examines the effect of increased air pressure in ear canal on hearing Placing a vibrating fork on mastoid while changes in air pressure in the ear canal are brought about by Siegel&;s speculum Positive - normal persons or sensorineural deafnessNegative - ossicular chain fixed or disconnected(Refer: PL Dhingra, Textbook of Ear, Nose, Throat, 6thedition, pg no: 21,22,23)


Question: Amino acid that is high in root dentin used for age estimation is