Question: A 56 year old Chronic smoker, mass in bronchus resected. Most useful immunohistochemical marker to make a proper diagnosis would be

Cytokeratins are proteins of keratin-containing intermediate filaments found in the intracytoplasmic cytoskeleton of epithelial tissue. The term "cytokeratin" began to be used in the late 1970s (for example, see "Intermediate-sized filaments of human endothelial cells" by Franke, Schmid, Osborn and Weber when the protein subunits of keratin intermediate filaments inside cells were first being identified and characterized. In 2006 a new systematic nomenclature for keratins was created and now the proteins previously called "cytokeratins" are simply called keratins. Cytokeratin Sites Cytokeratin 4 Non-keratinized squamous epithelium, including cornea and transitional epithelium Cytokeratin 7 A subgroup of glandular epithelia and their tumors Transitional epithelium and transitional carcinoma Cytokeratin 8 Glandular epithelia of the digestive, respiratory and urogenital tracts, both endocrine and exocrine cells, as well as mesothelial cells Adenocarcinomas originating from those above Cytokeratin 10 Keratinized stratified epithelium Differentiated areas of highly differentiated squamous cell carcinomas Cytokeratin 13 Non-keratinized squamous epithelia, except cornea Cytokeratin 14 Basal layer of stratified and combined epithelia Cytokeratin 18 Glandular epithelia of the digestive, respiratory, and urogenital tracts, both endocrine and exocrine cells, as well as mesothelial cells Adenocarcinomas originating from those above Cytokeratin 19 Glandular-type epithelia Does not react with hepatocytes and hepatocellular carcinoma[ Cytokeratin 20 Glandular-type epithelia. Signet ring/round clear cells [ GI stromal tumor (Krukenberg)[


Question: This technique of staining is used to detect

A routine Wright-Giemsa stain of peripheral blood detects coarse basophilic stippling, which is pathognomonic for lead poisoning. In general, basophilic stippling refers to clumps of blue-staining ribosomes, most often seen in anemias with defects in hemoglobin synthesis (e.g., iron deficiency, the thalassemias, lead poisoning). The ribosomal clumps in lead poisoning are large because of the inactivation by lead of ribonuclease, which normally breaks down the ribosomes. In addition, a routine Wright-Giemsa stain specifically identifies Howell-Jolly bodies (nuclear remnants), malarial pigments, marrow reticulocytes (polychromatic cells or shift cells with a bluish-gray discoloration), and intraerythrocytic parasites (malaria, babesiosis). Special stains are necessary to identify Pappenheimer bodies (hemosiderin requires a Prussian blue stain), reticulocytes (supravital stain detects residual RNA), Heinz bodies (clumps of denatured hemoglobin in glucose-6-phosphate dehydrogenase deficiency), and globin chain inclusions (excess a-chains) in severe thalassemia..

Globin chain inclusions in sever - thalassemia


Question: Perimolysis is


Question: Not associated with coal tar

(D) Leukaemia# Occupational exposure to coal tar or coal-tar pitch is associated with an increased risk of skin cancer.> Other types of cancer, including lung, bladder, kidney, and digestive tract cancer, have also been linked to occupational exposure to coal tar and coal-tar pitch.


Question: NGS stands for

Newer DNA sequencing technology Capable of producing large amounts of sequence data in a parallel manner


Question: Darlings disease is


Question: Alzheimer's disease associated chromosome is

In familial Alzheimer disease and down syndrome. The gene encoding APP on chromosome 21 is involved.
The genitic locus on chromosome 19 that encodes apolipoprotein E (ADOE) has a strong inthences on the risk of developing AD.


Question: Dohle bodies are seen in

Dohle bodies are patches of dilated endoplasmic reticulum that appear as sky-blue cytoplasmic "puddles.*. Seen in burns, infections, physical trauma, neoplastic diseases, May-Hegglin anomaly etc.*Multiple myeloma and Waldenstrom&;s macroglobulinemia- Both are plasma cells dyscrasias. These plasma cells may have intracytoplasmic inclusion called as Russel bodies and intranuclear inclusions called Dutcher bodies.


Question: Dissecting haematoma is a clinical complication occurring in

Ans. (d) Marfan syndrome(Ref: Robbins 9th/pg 491-492; 8th/pg 496-497, Harrison 18th ed 2063)Dissecting aneurysmWall of an artery rips (dissects) longitudinallyThis occurs because bleeding into the weakened wall splits the wall.Common in Marfan syndrome QThoracic aorta more affected Q


Question: Intracellular calcification begins in


Question: Commonest type of emphysema is

Centriacinar emphysema

Destruction and enlargement of the central or proximal parts of acinus with sparing of distal alveoli.
Most common type emphysema.
Upper lobe and apices are predominant involvement.
Commonly seen in heavy smokers and chronic bronchitis.


Question: Mikulicz cell & Russell bodies are seen in

(Refer: PL Dhingra, Textbook of Ear, Nose, Throat, 6thedition,pg no: 156)Granulomatous disease of the nose BacterialFungalUnspecified causeRhinoscleroma Syphilis TuberculosisLupusLeprosy RhinosporidiosisAspergillosis Mucormycosis CandidiasisHistoplasmosis Blastomycosis Wegner's granulomatosisNon-healing midline granuloma Sarcoidosis Churg Strauss syndrome Rhinoscleroma Agent - Klebsiella rhinoscleromatisSite - nose , nasopharynx, oropharynx, larynx, trachea, bronchi Atrophic stageFoul smelling purulent nasal dischargeGranulomatous stage Subdermal infiltration of lower pa of external nose & upper lip - woody feelRubbery nodules - Tapir nose Cicatricial stage Stenosis of nares Distoion of upper lip Adhesions of nose, nasopharynx , oropharynx Subglottic stenosisNose deformity - Hebra nose Soft palate deformity - Gothic arch deformity Diagnosis Biopsy - infiltration of submucosa with plasma cells, lymphocytes, eosinophils, Mikulicz cells ( large foam cells with central nucleus & vacuolated cytoplasm containing causative bacilli ) &Russellbodies(homogenous eosinophilic inclusion bodies found in plasma cells)The culture of the organism Treatment - Streptomycin (1g/day) & tetracycline (2g/day) for 4 - 6 weeks


Question: Sudden onset of cough followed by increasing dyspnea is characteristic of

PatientsMC presents with chest pain, often sharp and pleuritic and may lead to severe respiratory embarrassment or becomes dull and persistent.Dyspnea is the 2nd MC symptom.Less common symptoms include a nonproductive cough and ohopnea.Physical findings may be normal if the Pneumothorax is less than 25%.Characteristic physical finding includes diminished chest excursion and (Refer: Harrison's Principles of Internal Medicine, 18th edition, pg no: 2181, 2221, 3212)


Question: Cold abscess formation is due to

Formation of caseous pus with signs of acute inflammation

Formation of caseous pus without signs of acute inflammation


Question: The microarray is used to

Microarray - A type of hybridization technique which utilizes multiple oligonucleotide probes to study multiple genes within a sho period of time.(Ref: Robbins 8/e p174)


Question: Contraction of endothelial cytoskeleton in acute inflammation leads to

Increased vascular permeability is the hallmark of acute inflammation.

Remember

Early transient increase is due to = Endothelial cell contraction
Delayed transient increase in permeability is due to = Direct endothelial injury
Delayed permanent increase Endothelial cell retraction is due to = endothelial cell damage

Early transient increase in permeability

Delayed permanent increase in permeability

Early permanent increase in permeability


Question: Osteomyelitis begins as an inflammation of


Question: Osteoporosis circumscripta is a finding seen in


Question: Primary hemostasis is disturbed in


Question: Commonest type of necrosis is

Ans. c (Coagulative). (Ref. Robbins, Pathologic Basis of Disease, 8th/pg.7-13)Caseation necrosis - Tubercular lymph nodesCoagulative necrosis - Myocardial infarction, sarcoidosisLiquefactive necrosis - Brain infarcts and infections (abscess).TYPE OF NECROSISCOMMMENTSCoagulative necrosis- is a form of tissue necrosis in which the component cells are dead but the basic tissue architecture is preserved.- The affected tissues take on a firm texture.- Presumably the injury denatures not only structural proteins but also enzymes and so blocks the proteolysis of the dead cells; as a result, eosinophilic, anucleate cells may persist for days or weeks.- Coagulative necrosis is characteristic of infarcts (areas of ischemic necrosis) in all solid organs except the brain.Liquefactive necrosis- is seen in focal bacterial or, occasionally, fungal infections, because microbes stimulate the accumulation of inflammatory cells and the enzymes of leukocytes digest ("liquefy") the tissue.- For obscure reasons, hypoxic death of cells within central nervous system often evokes liquefactive necrosis.- If the process was initiated by acute inflammation, the material is frequently creamy yellow and is called pus.Gangrenous necrosis- It is usually applied to a limb, generally the lower leg, that has lost its blood supply and has undergone coagulative necrosis involving multiple tissue layers.- When bacterial infection is superimposed, coagulative necrosis is modified by the liquefactive action of the bacteria and the attracted leukocytes (so-called wet gangrene).Caseous necrosis(term "caseous" = cheese-iike)- is encountered most often in foci of tuberculous infection.- On microscopic examination, the necrotic focus appears as a collection of fragmented or lysed cells with an amorphous granular appearance. Unlike coagulative necrosis, the tissue architecture is completely obliterated and cellular outlines cannot be discerned. Caseous necrosis is often enclosed within a distinctive inflammatory border; this appearance is characteristic of a focus of inflammation known as a granuloma.Fat necrosis- Refers to focal areas of fat destruction, typically resulting from release of activated pancreatic lipases into the substance of the pancreas and the peritonea! cavity e.g. acute pancreatitis (fat saponification).- On histologic examination, the foci of necrosis contain shadowy outlines of necrotic fat cells with basophilic calcium deposits, surrounded by an inflammatory reaction.


Question: Trigeminal neuralgia

Carbamazepine is the drug of choice in trigeminal neuralgia.

Does not disturb the patient during sleep


Question: AKT1 E17K somatic mutation is associated with

AKT1 is a member of the serine-threonine kinase class that plays a key role in cellular processes, including growth, proliferation, survival, and angiogenesis. It is a downstream mediator of phosphatidylinositol 3-kinase which, along with AKT1, is a key mediator of proliferation and survival pathways frequently activated in cancer .The single hotspot mutation AKT1 has been described in several cancers, with the highest incidence observed in breast cancer.


Question: Pink disease is seen due to

Pink disease (infantile acrodynia) was especially prevalent in the first half of the 20th century. Primarily attributed to exposure to mercury (Hg) commonly found in teething powders.


Question: . Primary biliary cirrhosis is positive for

Primary Biliary Cirrhosis(PBC) - A progressive autoimmune liver disease characterised by non suppurative, inflammatory destruction of intra hepatic bile ducts. Characteristic autoantibody detected in primary biliary cirrhosis is antimitochondrial antibody Consequences: bile duct destruction-impaired secretion of bile, cholestasis, and inflammatory reaction in the poal tract-hepatic damage, fibrosis- cirrhosis and liver failure. SYSTEMIC AND GENERAL PATHOLOGY RAMDAS NAYAK PG NO 461 IMAGE REF:


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

The histological features include hyperparakeratosis or hyperorthokeratosis,with thickening of granular layer, acanthosis with intracellular edema, saw tooth appearance of rete ridges, band like subepithelial mononuclear infiltrate, degenerating basal keratinocytes that form colloid known as Civatte, hyaline, cytoid bodies.


Question: NPHS 1 gene codes for

NPHS - 1 codes for Nephrin
NPHS - 2 codes for Podocin.


Question: The chromosomal karyotype in patau syndrome is

TRISOMY 13: PATAU SYNDROME Incidence: 1 in 15,000 bihs Karyotypes: Trisomy 13 type: 47,XX, +13 Translocation type: 46,XX,+13,der(13;14)(q10;q10) Mosaic type: 46,XX/47,XX, +13 (Robbins Basic Pathology, 9 th edition. page : 238)


Question: Whiff test is useful in thediagnosis

Bacterial vaginosis AMSEL criteriaNugnets criteriaThin, white, yellow, homogeneous discharge.Clue cells on microscopy.pH of vaginal fluid >4.5.Release of a fishy odor on adding alkali--10% potassium hydroxide (KOH) solution(Whiff test)At least three of the four criteria should be present for a confirmed diagnosis.Grade 1 (Normal): Lactobacillus morphotypes predominate.Grade 2 (Intermediate): Mixed flora with some Lactobacilli present, but Gardnerella or Mobiluncus morphotypes also present.Grade 3 (Bacterial Vaginosis): Predominantly Gardnerella and/or Mobiluncus morphotypes. Few or absent Lactobacilli.


Question: Phantogeusia is

Taste Dysfunctions
1. Ageusia: Complete loss of all taste stimuli
2. Hypogeusia: Impairment of the sense of taste or decreased sensitivity for all taste stimuli
3. Dysgeusia or parageusia: A distortion or perversion in the perception of a taste
4. Phantogeusia or gustatory hallucination: Perception of a taste in the absence of any recognized taste stimulus
Cacogeusia: Bad taste
Torquegeusia: Twisted taste
5. Hypergeusia: Increased sensitivity for all taste stimuli, some or a single stimulus
6. Gustatory agnosia: Loss of the ability to classify, contrast or identify a given taste stimulus verbally
7. Glossodynia: Painful tongue
8. Glossopyroses: Painful pyrosis

Perception of pain in absence of any recognized stimuli

Painful pyrosis in absence of any recognized stimuli


Question: Most common site for intraoral acanthosis nigricans is


Question: An obese woman with type 2 diabetes and hypeension is diagnosed with endometrioid type of endometrial carcinoma. The most likely gene defect in this patient is

Type 1 endometrial cancer is associated with PTEN gene. Type 2 endometrial cancer is associated with p53 gene mutation. Type 1 Endometrial cancer Type 2 Endometrial cancer 55-65 years 65-75 years Unopposed estrogen Obesity Hypeension Diabetes Atrophy Thin physique Endometroid Serous clear cell Hyperplasia Serous endometrial intraepithelial carcinomas Indolent Aggressive


Question: Gene involved in medullary carcinoma thyroid is

The RET proto-oncogene encodes a receptor tyrosine kinase for members of the glial cell line-derived neurotrophic factor (GDNF) family of extracellular signalling molecules.RET loss of function mutations are associated with the development of Hirschsprung's disease, while gain of function mutations are associated with the development of various types of human cancer, including medullary thyroid carcinoma, multiple endocrine neoplasiastype 2A and 2B, pheochromocytoma and parathyroid hyperplasia


Question: Neoplastic transformation in leucopLakia is seen most commonly in


Question: Translocation seen in Follicular lymphoma

MalignancyTranslocationAcute myeloid leukemia (AML)(8;21)(q22;q22)(15;17)(q22;q21)Chronic myelogenous leukemia (CML)(9;22)(q34;q11)Burkitt lymphoma(8;14)(q24;q32)Mantle cell lymphoma(11;14)(q13;q32)Follicular lymphoma(14;18)(q32;q21)Ewing sarcoma(11;22)(q24;q12)Prostatic adenocarcinoma(7:21)(p22;q22)(17:21)(p21;q22)Ref: Robbins and Cotran Pathologic Basis of Disease; 9th edition; Chapter 7; Neoplasia; Page no:317; Table: 7-8


Question: Chromosome associated with ADPKD

ADPKD Cytogenetic defect Chromosome 16 (85%): ADPKD-1 & Chromosome 4 (15%): ADPKD-2 ARPKD Cytogenetic defect Chromosome 6 Ref: HARSH MOHAN TEXTBOOK OF PATHOLOGY 6th ed. pg no: 659


Question: Hypersensitivity reaction seen in immune thrombocytopenic purpura is

Hypersensitivity Reactions Type 2 HSR Associated with Production of IgG, IgMwhich binds to antigen on target cell or tissue. Causing phagocytosis or lysis of target cell by activated complement or Fc receptors; recruitment of leukocytes. ITP is a type 2 HSR. Type 1 HSR Associated with Production of IgE antibodyleading to immediate release of vasoactive amines and other mediators from mast cells; later recruitment of inflammatory cells. Ex: Anaphylaxis; allergies; bronchial asthma Type 3 HSR Deposition of antigen-antibody complexes-complement activation - recruitment of leukocytesby complement products and Fc receptors -release of enzymes and other toxic molecules Ex: SLE, serum sickness, ahus reaction Type 4 HSR Associated with Activated T lymphocytes - (1) release of cytokines, Inflammation and macrophage activation; (2) Tcell-mediated cytotoxicity Ex: Type 1 DM, Contact dermatitis


Question: Chromosomal translocation in CML is

Cytogenetic and molecular abnormalitiesType of malignancyCytogenetic and molecular abnormalities1.Acute promyelocytic leukemia (APML)2.B-cell ALL3.CML4.Follicular lymphoma5.Mantle cell lymphoma6.Burkitt lymphoma7.Myelodysplastic syndromet (15:17)t (2:8)t(9:22)t (14:18)t (11:14)t (2:8), t( 8:14), t (8:22)Monosomy 5& 7; del 5q , 7q &20q; Trisomy 8 (m/c is 5q-)(Ref: Robbins 8/e p608)


Question: Pipe stem appearance in barium enema is seen

In UC, Transverse colon and left colon may show pipestem appearance on barium enema.


Question: Melanin pigmentation in pregnancy is known as


Question: Perivascular lymphocytic and microglial nodules are seen in

HIV encephalitis Chronic inflammatory reaction characterized by widely distributed microglial nodules, often containing macrophage-derived multinucleated giant cells; foci of tissue necrosis . Reactive gliosis are sometimes seen together with these lesions. Microglial nodules found near small blood vessels, show abnormally prominent endothelial cells and perivascular foamy or pigment-laden macrophages.


Question: Colonic polyp that has maximum chance of malignant


Question: Following is transmitted as autosomal dominant disorder

Hereditary spherocytosis (also known as Minkowski-Chauffard syndrome) is an autosomal dominant abnormality of erythrocytes. The disorder is caused by mutations in genes relating to membrane proteins that allow for the erythrocytes to change shape. The abnormal erythrocytes are sphere-shaped (spherocytosis) rather than the normal biconcave disk shaped. Dysfunctional membrane proteins interfere with the cell's ability to be flexible to travel from the aeries to the smaller capillaries. This difference in shape also makes the red blood cells more prone to rupture. Cells with these dysfunctional proteins are taken for degradation at the spleen. This shoage of erythrocytes results in hemolytic anemia.Hereditary spherocytosis is caused by a variety of molecular defects in the genes that code for the red blood cell proteins spectrin (alpha and beta), ankyrin, band 3 protein, protein 4.2, and other red blood cell membrane proteins


Question: Periapical granuloma is

A direct lift from Cohen.
Bacteriological features of periapical granuloma:

Majority of the studies have been based upon bacteriological cultures taken after the extraction of tooth
Pre extraction cultures have been made in a few instances through the root canal or the alveolar plate and these have been relatively free of actual contamination.
The microorganisms that have been isolated by such techniques were, generally found in oral cavity such as  s.viridans, s.albus, e.coli and pneumococci.
Seldom can microorganisms actually be demonstrated histologically in the periapical granuloma.
 Some investigators have suggested that dental granuloma is usually a sterile lesion.


Question: Glucose — 6 phosphate dehydrogenase deficiency causes


Question: Most common site of Atherosclerotic aneurysm is

i.e. (Abdominal aorta): (406-Harsh Mohan 6th) (507-509-Robbins & Cotran 8th)* Most common site of Atherosclerotic aneurysm is-Abdominal aorta*** Most common site of Syphilic (Luetic) aneurysm is - Thorasic aorta (especially ascending part)**Thoracic aortic aneurysms are most commonly associated with Hypertension other causes Marfan and Leoys Dietz syndromes* Most common site of Dissecting aneurysm and Cystic Medial Necrosis is - AortaMost common cause of aneurysm of aortic arch = Atherosclerosis* Aneurysm of Takayasu arteritis affect == Aortic arch* MYCOTIC ANEURYSM - resulting from direct trauma to a vessel with secondary infections Most commonly occur in femoral arteries and less commonly in arteries of of the neck (1237-CMDT-2011)* Saccular (Berry) aneurysm - is the most common type of intracranial aneurysm. About 90% of saccular aneurysm are found near major arterial branch points in the anterior circulation*** Most common site of rupture of Abdominal aortic aneurysm is - Laterally in the left retroperitoneum (Postero-lateral wall Cleft)**


Question: ASO Titres are used in the diagnosis of

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). Rheumatic hea disease is the cardiac manifestation of rheumatic fever. It is associated with inflammation of all pas of the hea. Although cultures are negative for streptococci at the time of symptom onset, serum titers to one or more streptococcal antigens (e.g., streptolysin O or DNAase) usually are elevated. (Robbins Basic Pathology,9th edition,pg no. 392)


Question: The characteristic alarm clock headache is a feature of


Question: Megaloblastic anaemia occurs due to deficiency of


Question: A patient with ameloblastoma of the jaw can best be treated by

Surgical removal followed by cauterization


Question: Red or brown discoloration of teeth is seen in


Question: The Common site of hematopoiesis in the fetus is

*Hematopoiesis from 3rd month of gestation till bih: Liver*Hematopoiesis from bih up to pubey: Whole skeleton*Hematopoiesis after pubey: Axial skeleton(Ref: Robbins 8/e p590)


Question: Oral ulceration resembling apthae are encountered in


Question: Marker of T lymphocyte

In addition to CD3 and z proteins, T cells express several other proteins that assist the TCR complex in functional responses. These include CD4, CD8, CD28, and integrins. CD4 and CD8 are expressed on two mutually exclusive subsets of ab T cells. Approximately 60% of mature T cells are CD4+ and about 30% are CD8+. Most CD4+ T cells function as cytokine-secreting helper cells that assist macrophages and B lymphocytes to combat infections. Most CD8+ cells function as cytotoxic (killer) T lymphocytes (CTLs) to destroy host cells harboring microbes. During antigen recognition, CD4 molecules bind to class II MHC molecules that are displaying antigen and CD8 molecules bind to class I MHC molecules, and the CD4 or CD8 coreceptor initiates signals that are necessary for activation of the T cells.Reference: Robbins and Cotran Pathologic Basis of Disease; 9th edition; Chapter 6; 191The normal immune response


Question: A patient presented with trismus and opisthotonus. The probable causative organism is

Clostridiumtetani:General characteristicsCultural characteristicsStrict anaerobe gram positive bacilliStately motilitySpherical terminal sporesDrum stick appearanceSwarming growth Blood agar - a hemolysis - b hemolysis Virulence factors Clinical featuresTetanospasmin , Tetanolysin Generalized tetanus Risus sardonicus, Opisthotonus, Respiratory muscle spasmTrismus - first signNeonatal tetanus - 8th-day diseaseDiagnosisTreatmentDirect culture of unheated material on blood agar incubated anaerobically DOC - Penicillin or MetronidazoleAlternative - Clindamycin or Erythromycin Mainstay of treatment - AntitoxinProphylaxisPreventionActive immunization - Antitoxin>0.01 IU/ml serumPassive immunization - Human tetanus Immunoglobulin7 cleans - Clean hand, Clean surface, Clean cord blade, Clean cord tie, Clean cord stump, Clean towel, Clean water(Ref: Ananthanarayan 9th edition, p260-262)


Question: The most common indication for liver transplantation in end stage liver disease is


Question: Increased number of autophagic vacuoles is seen in


Question: Lateral skull view of palatal tori is used to know


Question: The characteristic finding in chronic myeloid leukemia is

Reduced score of alkaline phosphatase in granulocytes

Reduced score of acid phosphatase in granulocytes


Question: The parvocellular pathway from lateral geniculate nucleus to visual coex is most sensi ve for the stimulus of

Color contrast Parvocellular pathway - Color vision, texture, shape, fine detail Magnocellular pathway - Detection of movement, depth, flickers


Question: The following is an antiapoptotic gene

Ans. is 'c' i.e. Bcl-X Apoptosis is a pathway of cell death that is induced by a tightly regulated intracellular programme in which cells destined to die activate enzymes that degrade the cells own nuclear D.N.A and nuclear and cytoplasmic proteins.The cells plasma membrane remain intact but its structure is altered in such a way that apoptotic cell becomes an avid target for phagocytosis.The dead cell is rapidly cleared before its contents have leaked out, and therefore cell death by this pathway does not elicit an inflammatory reaction in the hostApoptosis occurs normally in many situations, and serves to eliminate unwanted or potentially harmful cells and cells that have outlived their usefulness.It is also a pathological event in conditions when cells are damaged beyond repair, especially when the damage affect the cell's D.N.A. In these situations the irreparably damaged cell is eliminated.How does apoptosis start ?Normally growth factors and other survival signals stimulate the production of antiapoptotic members of the Bcl-2 family of proteins.There are more than 20 proteins in this family, all of which function to regulate apoptosis.The two main antiapoptotic ones are Bcl-2 and BcL-X.These antiapoptotic proteins normally reside in the mitochondrial membranes and cytoplasm and prevents apoptosis.When cells are deprived of survival signals or subjected to stress, Bcl-2 and Bcl-X are lost from the mitochondrial membranes and are replaced by proapoptotic members o/the family such as Bak, Bax and Bim.This leads to increased permeability of mitochondrial membrane and the release of certain proteins which activate caspases which carries on the process of apoptosis.Proapoptic factorsAnti-apoptic factorsApaf-1 (Apoptosis activating factor -1)Cytochrome CBakBaxBimAIFP53 geneCaspasesTNFRIFas FADD (Fas associated death domain)BH3 only proteins (Bim, Bid, Bad)Smac/DIABLOBcl-2/BCl-X *FLIP *Mcl-1IAPs


Question: Peripheral giant cell granuloma occurs most commonly on the


Question: Goodpasteurs syndrome is

Goodpasture Syndrome Goodpasture syndrome is an uncommon autoimmune disease in which lung and kidney injury are caused by circulating autoantibodies against ceain domains of type IV collagen that is intrinsic to the basement membranes of renal glomeruli and pulmonary alveoli. Morphology The lungs are heavy and have areas of red-brown consolidation due to diffuse alveolar hemorrhage. Microscopic examination shows focal necrosis of alveolar walls associated with intraalveolar hemorrhage, fibrous thickening of septa, and hyperophic type II pneumocytes. There is abundant hemosiderin due to earlier episodes of hemorrhage. The characteristic linear pattern of immunoglobulin deposition (usually IgG, sometimes IgA or IgM) that is the hallmark diagnostic finding in renal biopsy specimens also may be seen along the alveolar septa. Ref: ROBBINS BASIC PATHOLOGY 10th ed Pg no: 519


Question: Hidradenitis suppurativa is a disease of

.A chronic skin condition featuring lumps in places such as the armpits or groin. The skin lesions develop as a result of inflammation and infection of sweat glands causes: The cause of HS remains unknown, and expes disagree over proposed causes.The condition probably results from a combination of genetic and environmental factors. Lesions occur in any body areas with hair follicles, although areas such as the axilla, groin, and perianal region are more commonly involved. This theory includes most of the following potential indicators: Postpubescent individuals are more likely to exhibit HS. Plugged apocrine (sweat) gland or hair follicle Excessive sweating Androgen dysfunction Genetic disorders that alter cell structure Patients with more advanced cases may find exercise intolerably painful, which may increase the rate of obesity among sufferers. The historical understanding of the disease suggests dysfunctional apocrine gland] or dysfunctional hair follicles, possibly triggered by a blocked gland, create inflammation, pain, and a swollen lesion. Ref Robbins 9/e pg 345


Question: The tensile strength of the wound stas and increase after

Wound Strength Carefully sutured wounds have approximately 70% of the strength of normal skin When sutures are removed, usually at 1 week, wound strength is approximately 10% of that of unwounded skin this increases rapidly over the next 4 weeks Wound strength reaches approximately 70% to 80% of normal by 3 month ref:-basic pathology,robbins 9th ed , page 72


Question: Systemic features of inflammation (fever & hypotension) are mediated by


Question: Irreversible injury in myocardium occurs at

Only severe ischemia lasting at least 20 to 40 minutes causes irreversible damage and myocyte death leading to coagulation necrosis. Withlonger periods of ischemia, vessel injury ensues, leading to microvascular thrombosis.( Robbins Basic Pathology, 9th edition, page 377 )


Question: Presence of epithelial pearls in spinous Layer of epithelium is characteristic of


Question: Nicoladoni sign is also known as

In medicine, the Nicoladoni sign, also Branham sign and Nicoladoni-Israel-Branham sign, is the slowing of the hea rate in response to (manual) compression of an aeriovenous fistula. Robbins 9 th edition page no. 365 onwards


Question: Hereditory spherocytosis is due to deficiency of

HS is caused by diverse mutations that lead to an insufficiency of membrane skeletal components.
The pathogenic mutations most commonly affects ankyrin, band 3, spectrin, or band 4.2.


Question: Multifactorial inheritance is most likely to play a role in

Cleft lip and cleft palate, also known as orofacial cleft, is a group of conditions that includes cleft lip (CL), cleft palate (CP), and both together (CLP).] A cleft lip contains an opening in the upper lip that may extend into the nose. The opening may be on one side, both sides, or in the middle. A cleft palate is when the roof of the mouth contains an opening into the nose. These disorders can result in feeding problems, speech problems, hearing problems, and frequent ear infections. Less than half the time the condition is associated with other disordersMultifacorial inheritance is the type of inheritance followed by traits that are determined by multiple factors both environmental and genetic. Environmental factors interact with many genes to generate a normally distributed susceptibiity.Some diseases for example myocardial infarction, congenital bih defects, cancer, diabetes, mental illnesses and Alzheimer diseases cause along with morbidity, premature moality in two out of three individuals during their lifetime. Many show clustering among families. However their inheritance pattern does not follow that of single gene disorders (Mendelian pattern of inheritance). These kind of diseases are thought to result from complex interactions between genetic and environmental factors, i.e. multifactorial inheritance pattern.


Question: Huhle cell carcinoma is a variant of

Cells with abundant granular, eosinophilic cytoplasm known as Huhle cell or oncocytic variant of follicular cytoplasm are present in follicular carcinoma. Ref: Robbins and cotrans 9e Pg 1098 Ref img


Question:
Failure of descent of thyroid analage can be seen in the
tongue

Near the base of tongue close to foramen caecum


Question: Leiden mutation is

Ans. is 'b' i.e., Mis-sense mutation Factor V Leiden (FVL) mutation is a mis-sense type of point mutation in the gene for clotting factor V. As a missense substitution of base G to base A, it changes the protein's amino acid from arginine to glutamine.It has autosomal dominant inheritance and is the most common cause of inherited thrombophilia.Factor V is one of the essential clotting factors in the coagulation cascade.FVL mutation causes activated protein C resistance, hence leading to the hypercoagulable state.It is associated with increased risk of DVT 6, recurrent miscarriages


Question: The HLA class III region genes are important elements in

*HLA class III region contains genes for early complement components C2 and C4 of classical pathway.
*Deficiency of these early components of the classical pathway viz C1, C2 and C4 is associated with autoimmune diseases like SLE and other collagen vascular diseases.
• These genes are thus, important in regulating susceptibility to autoimmune disease
• Class III genes do not participate in MHC restriction or graft rejection components.

Governing susceptibility to autoimmune diseases


Question: Multiple myeloma has been seen commonly after exposure to


Question: In HbM the position of point mutation

Ans. (b) a chain, 87th codon, Histidine - Tyrosine(Ref: Wintrobes 12th ed 1060-1070)M (met) hemoglobins are characterized by heme-iron oxidation and result in cyanosis.HbM Iwate (HBA 87th position his - tyr)

b chain, 87th codon, Histidine - Tyrosine


Question: Psamomma bodies is associated with


Question: Nasopalatine cyst arises from

Nasopalatine cyst is also known as incisive canal cyst.

A Embryonic remnants of nasopalatine duct


Question: Fibroma combined with glandular tissue is


Question: Collagen accumulated in space of Disse in case of liver cirrhosis are

In the normal liver, ECM consisting of interstitial collagens(fibril forming collagen types I, II, V and XI) is present only in the liver capsule, in poal tracts and around central veins. In cirrhosis, types I and III collagen and other ECM components are deposited in the space of disse. ROBBINS BASIC PATHOLOGY NINTH EDITION PAGE 607


Question: Adeno lymphoma refers to


Question: The earliest hematologic manifestation of megaloblastic anemia is

Microcytic anemiaMacrocytic anemiaSideroblastic anemiaIron deficiency anemiaThalassemiaAnemia of chronic disease Liver disease Hypothyroidism Folic acid & vitamin B12 deficiency Cytotoxic drugs Megaloblastic anemiaTriad - Oval macrocyte , Howel Jolly bodies , Hypersegmented neutrophilsBone marrow - hypercellular bone marrow with megaloblast along with the presence of abnormal granulocytic precursors ( giant metamyelocyte & band forms ) and large megakaryocytes with bizarre multilobate nuclei Peripheral smear - pancytopenia with presence of macrocyte (MCV>100 fl) lacking central pallor ; large hypersegmented neutrophils ( >5 lobes )(Refer: Robbins & Cotran's - Pathologic Basis of Disease, SAE, 1st edition, Vol I-pg no: 643-648)


Question: Last to recover in spinal anaesthesia

.It may be that preganglionic sympathetic fibers are more resistant to local anesthetic block than previously thought. Anesthesiologists often assume that, when a motor block is present during spinal or epidural anesthesia, sympathetic nerve transmission is blocked. Ref Robbins 9/e pg 346


Question: Pain during inflammation is mediated by

Ans. (c) Bradykinin(Ref: Robbins 9th/pg 65, 89)Functions of bradykinin:Increases vascular permeability, vasodilationSmooth muscle contraction and pain when injected into the skin.


Question: The most common leukocytoclastic vasculitis affecting children is

Henoch Schonlein PurpuraSystemic vasculitis syndrome involving small and medium size vesselsUsually seen in children (in fact it is the most common small vessel vasculitis in children)Vasculitis is caused by immune complex depositionSystemic manifestationSkinJointsAbdominal visceraRenal vasculatureTypical palpable purpuric skin lesionMost common over buttocks and exterior surface of legs and armsAhralgiaColicky abdominal pain associated with nausea, vomiting, diarrhea/constipation Melena or HematemesisProteinuria Microscopic hematuria with RBC cast in urine (Glomerulonephritis) Nephrotic syndromeMost common antibody seen in these immune complexes is IgA (IgA levels are elevated)Platelet count is normal or elevated Serum complements levels are normalPrognosis is excellent and disease is self-limiting. Lasts about six weeks and resolve without sequelae.Treatment involves administration of glucocoicoids(Prednisolone).(Refer: Harrison's Principles of Internal Medicine, 18th edition, pg no: 2797)

Mucocutaneous lymph node syndrome (Kawasaki disease)


Question: Tigered effect in myocardium is due to

.It is intracellular deposits of fat, which create grossly apparent bands of yellowed myocardium alterations with bands of darker, red-brown, uninvolved myocardium(tigeredeffect) It happens in Prolonged mod hypoxia and in Diptheretic myocarditis. Ramdas Nayak 2nd edition page no. 391


Question: Principal cell in granuloma is

Ans. is 'b' i.e., Histiocyte Granuloma is characteristic ofgranulomatous inflammation. o The major cell of granuloma is epitheloid cell which is a modified tissue macrophage (histiocyte) that has been transformed into epithelium like cell.


Question: In Myasthenia gravis, antibodies are present against

Robbins basic pathology 9th edition page no 800,heading=Myasthenia gravis Myasthenia gravis is caused by autoantibodies that block the function of postsynaptic acetyl choline nicotinic receptors at motor end plates, which results in the degradation and depletion of the receptors. ref img :


Question: Hypersensitivity vasculities seen in

The term cutaneous vasculitis is defined broadly as inflammation of the blood vessels of the dermis. Due to its heterogeneity, cutaneous vasculitis has been described by a variety of terms including hypersensitivity vasculitis and cutaneous leukocytoclastic angiitis. The typical histopathologic feature of cutaneous vasculitis is the presence of vasculitis of small vessels. Postcapillary venules are the most commonly involved vessels; capillaries and aerioles may be involved less frequently. ( Harrison&;s principle of internal medicine,18th edition,pg no. 2798)


Question: The expression of the following oncogene is associated with a high incidence of Medullary carcinoma of thyroid

(C) RET proto oncogene # p53 (also known as protein 53 or tumor protein 53), is a tumor suppressor protein that in humans is encoded by the TP53 gene.p53 is crucial in multicellular organisms, where it regulates the cell cycle and, thus, functions as a tumor suppressor that is involved in preventing cancer. As such, p53 has been described as "the guardian of the genome", the "guardian angel gene", and the "master watchman", referring to its role in conserving stability by preventing genome mutation.> HER2/neu (also known as ErbB-2) stands for "Human Epidermal growth factor Receptor 2" and is a protein giving higher aggressiveness in breast cancers. It is a member of the ErbB protein family, more commonly known as the epidermal growth factor receptor family. HER2/neu has also been designated as CD340 (cluster of differentiation 340) and p185. It is encoded by the ErbB2 gene.> Both familial and sporadic medullary forms demonstrate activating RET mutations. Sporadic medullary carcinomas, as well as FMTC, occur in adults, with a peak incidence in the fifth to sixth decades.> In humans, the protein is encoded by the RB1 gene located on 13q14.1-q14.2. If both alleles of this gene are mutated early in life, the protein is inactivated and results in development of retinoblastoma cancer, hence the name Rb


Question: The feulgen reaction is used to test

*Feulgen stain is a staining technique to detect DNA *In this procedure, the specimen is exposed to warm HCL which causes hydrolysis of DNA to produce aldehyde. Then Schiff reagent is added which reacts with aldehyde to impa red colour.


Question: The most common coagulation disorders haemophilia A and Von WilLebrand's disease are due to


Question: Cyst arising from dental lamina


Question: Ghon’s focus is found in

Ghon’s focus

In primary tuberculosis when inhaled tubercule bacilli implanted in the distal air spaces of the lower part of an upper lobe or upper part of the lower lobe, close to the pleura. This area is about 1 to 1.5 cm with caseating necrosis known as Ghon’s focus.
Ghon’s focus is one of the components of Ghon’s complex (primary complex), which consists of 3 components: -

i) Ghon’s focus (subpleural caseating lesion)
ii) Caseating hilar lymph node
iii) Draining lymphatics.
Note - Due to early bacteremia (bacillemia) seeding of tubercle bacilli may occur at the apex to produce Simon’s focus.


Question: Resection of the adjacent gut is most often required in

Chylolymphatic cystEnterogenous cystUsually congenital as a result of sequestration of lymphaticsDerived from diveiculum of mesentric border that has become sequestrated The cyst wall is thin, lacks muscular wall, not lined by mucosa Thick wall lined by mucosa Usually solitary,often unilocular with clear lymph or chyleContent is mucinousMost frequently seen in the mesentery of ileum Independent blood supplyCommon blood supply as adjacent bowel Enucleation is enoughResection anastomosis needed(Refer: Schwaz's Principles of Surgery, 9th edition, pg no: 2010)


Question: Leucopenia is characteristic of


Question: The most reliable investigation for amyloidosis is

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


Question: Apoptotic bodies are

In H&E-stained tissue sections, the nuclei of apoptotic cells show various stages of chromatin condensation and aggregation and, ultimately, karyorrhexis; at the molecular level, this is reflected in fragmentation of DNA into nucleosome-sized pieces. The cells rapidly shrink, form cytoplasmic buds, and fragment into apoptotic bodies composed of membrane-bound vesicles of cytosol and organelles.( Robbins Basic Pathology, 9th edition, page 18 )


Question: T11/2 of Haptoglobin complex is

Answer- D. 10 minutesHemoglobin-haptoglobin complexes are rapidly cleared from circulation monocytes and tissue macrophages CDl63 receptors 15.Free haptoglobin has a half-life of 5 days, whereas hemoglobin-haptoglobin complexes have a half-life of l6minutes.


Question: Patient suffering form Eagle's syndrome complains of


Question: The most common gene associated with renal cell carcinoma is

Renal cell carcinoma *Renal cancers are mostly sporadic, except for a 4% cases which appear familial *Familial renal cancers are due to mutation of VHL and MET genes*98% of all renal cancers (sporadic and familial) are due to VHL mutation encoded in chr3p*Most common cause of familial papillary renal cell carcinoma (rare disease) is MET protooncogene*Most common risk factor for all renal cancers- Tobacco*Most common type of renal cell carcinoma is clear cell carcinoma , which is followed by papillary carcinoma, chromophobe carcinoma and collecting duct carcinoma*Most common type of renal cancer in patients who develop dialysis associated cystic disease - Papillary carcinoma*VHL is a tumour suppressor gene. Mutation of both the VHL genes causes angiogenesis (by increasing expression of hypoxia inducible factor-1) and cell growth (by increasing expression of insulin like growth factor -1)*Renal cell carcinoma mostly affects the poles Microscopic findings:*Classic clinical features of renal cell carcinoma - Costoveebral pain, palpable mass and hematuria*Clear cell carcinoma -Cells with clear cytoplasm containing glycogen and lipids, delicate capillaries*Papillary carcinoma - Papillary formations, foam cells in interstitium, psammoma bodies*Collecting duct carcinoma - irregular channels lined by atypical cells and show hobnail pattern*Chromophobe cell carcinoma - cells with abundant cytoplasm impaing blue colour in Hale's colloidal iron stain(Ref: Robbins 8/e p964)


Question: Diveiculum most common site is

Sigmoid diveiculitis Diveicular disease refers to acquired pseudo diveicular outpouchings of the colonic mucosa and submucosa. Rare below 30yrs but prevalence approaches 50% beyond 60yrs. Diveicula generally are multiple and the condition is referred to as diveiculosis. PATHOGENESIS Colonic diveicula tend to develop under conditions of elevated intraluminal pressure in the sigmoid colon TEXT BOOK OF ROBBINS BASIC PATHOLOGY NINTH EDITION PAGE.586 IMAGE REF: ROBBINS BASIC PATHOLOGY NINTH EDITION FIG: 14-25 PAGE 586


Question: The four "Pyrole rings" in hemoglobin molecule are joined together by


Question: Neurofibromomatosis I is

Autosomal Dominant Inheritance Familial hypercholesterolemia Marfan syndrome Ehlers-Danlos syndrome Hereditary spherocytosis Neurofibromatosis, type 1 Adult polycystic kidney disease Autosomal Recessive Inheritance Cystic fibrosis Phenylketonuria Tay-Sachs disease Severe combined immunodeficiency a- and b-Thalassemias Sickle cell anemia X-linked Recessive Inheritance Hemophilia A Duchenne/Becker muscular dystrophy Fragile X syndrome (Robbins Basic Pathology,9th edition,pg no. 219)


Question: Aplastic anaemia is common with


Question: IgA deposition in mesangial cells arr seen in

Refer Robbins page no 923 IgA Nephropathy (Berger Disease) IgA nephropathy, characterized by the presence of prom- inent IgA deposits in the mesangial regions and recurrent hematuria, is the most common type of glomerulonephri- tis worldwide. The disease can be suspected by light microscopic examination, but the diagnosis is made only by the detection of glomerular IgA deposition (Fig. 20-19). Mild proteinuria is usually present, and the nephrotic syndrome may occasionally develop.


Question: The most striking haematological finding in agranulocytosis is


Question: Type of infarct seen in hea is

Infarcts are classified according to color and the presence or absence of infection; they are either red (hemorrhagic) or white (anemic) and may be septic or bland. White infarcts occur with aerial occlusions in solid organs with end-aerial circulation (e.g: hea, spleen, and kidney), and where tissue density limits the seepage of blood from adjoining capillary beds into the necrotic area.Ref: Robbins and Cotran Pathologic Basis of Disease; 9th edition; Chapter 4; Hemodynamic Disorders, Thromboembolic Disease, and Shock; Page no: 130


Question: The left side of the heart is responsible for pumping

The left side of the heart is slightly more muscular to have the power and strength to pump blood up through the aorta and round to the rest of the body


Question: Microalbuminemina is defined as protein level of

Refer Robbins page no Pg1120 The earliest manifestation of diabetic nephropathy is the apperacne of low amounts low amounts of albumin in the urine.. Greater than 30mg/day but less than 300 mg/day that is microalbuminuria


Question: The gene suppresses apoptosis is

Atni apoptotic Genes: BCL-2, BCL-XL, and MCL-1. Pro apoptotic Genes: BAX and BAK. Sensors: BAD, BIM, BID, Puma and Noxa.


Question: The pigment associated with hemochromatosis is


Question: Kimmelsteil wilson nodules are pathognomonic of

Nodular glomerulosclerosis also called Kimmelstein wilson nodules are Pathognomonic of Diabetic Nephropathy.


Question: Endogenous wear and tear pigment is


Question: Caspases are associated with

Ref: Robbins Pathologic Basis of Disease; 8th edition, Chapter I, Pg: 3Explanation:Caspases play a vital role in all the four options. But, most approximate answer would be apoptosis.Caspases, or cysteine-aspartic proteases or cysteine-dependent aspartate-directed proteases are a family of cysteine proteases that play essential roles in apoptosis (programmed cell death), necrosis, and inflammationBiochemical Features of ApoptosisActivation of Caspases.A specific feature of apoptosis is the activation of several members of a family of cysteine proteases named caspases.The term caspase is based on two properties of this family of enzymes: the "c" refers to a cysteine protease (i.e., an enzyme with cysteine in its active site), and "aspase'' refers to the unique ability of these enzymes to cleave after aspartic acid residues.The caspase family, now1 including more than 10 members, can be divided functionally into two groups--initiator and executioner-- depending on the order in which they are activated during apoptosis. Initiator caspases include caspase-8 and caspase-9.Several other caspases, including caspase-3 and caspase-6, serve as executioners.Like many proteases, caspases exist as inactive pro-enzymes, or zymogens, and must undergo an enzymatic cleavage to become active.The presence of cleaved, active caspases is a marker for cells undergoing apoptosis.


Question: A developmental abnormality characterized by the presence of fewer than the usual number of teeth is


Question: A 40 year old lady is diagnosed to have brain tumor in frontal lobe. The lesion is characterized by focal necrosis surrounded by ring like enhancement

Ans. (a) Glioblastoma multiforme(Ref: Robbins 9th/pg 1307, Journal of Neuro-Oncology 108 (1): 11-27)When viewed with MRI, glioblastomas often appear as ringenhancing lesions. The appearance is not specific, however, as other lesions such as abscess, metastasis, tumefactive multiple sclerosis, and other entities may have a similar appearance. But necrosis with ring enhancement Is a f/o Glioblastoma multiforme.Oligodendroglioma usually shows calcifications.


Question: The largest gene expressed in cardiac and smooth muscle is

DMD, the largest known human gene, provides instructions for making a protein called dystrophin. This protein is located primarily in muscles used for movement (skeletal muscles) and in hea (cardiac) muscle. Small amounts of dystrophin are present in nerve cells in the brain. In skeletal and cardiac muscles, dystrophin is pa of a group of proteins (a protein complex) that work together to strengthen muscle fibers and protect them from injury as muscles contract and relax. The dystrophin complex acts as an anchor, connecting each muscle cell's structural framework (cytoskeleton) with the lattice of proteins and other molecules outside the cell (extracellular matrix). The dystrophin complex may also play a role in cell signaling by interacting with proteins that send and receive chemical signals. Little is known about the function of dystrophin in nerve cells. Research suggests that the protein is impoant for the normal structure and function of synapses, which are specialized connections between nerve cells where cell-to-cell communication occurs.


Question: Most common development cyst of jaws is

Most common odontogenic cyst is periapica/l Radicular cyst
Most common developmental odontogenic cyst is dentigerous cyst


Question: Gamma Gandy bodies contain hemosiderin and

Gamna-Gandy bodies
Seen in CVC of spleen is characterised by calcific deposits admixed with haemosiderin on fibrous tissue.


Question: Acute viral hepatitis

In severe acute hepatitis, confluent necrosis of hepatocytes is seen around central veins Other options are features of chronic viral hepatitis. "The defining histologic feature of chronic viral hepatitis is mononuclear poal infiltration." There is often interface hepatitis The hallmark of severe chronic liver damage is scarring Continued scarring and nodule formation leads to the development of cirrhosis. REF: ROBBINS BASIC PATHOLOGY NINTH EDITION PAGE: 613 IMAGE REF: ROBBINS BASIC PATHOLOGY NINTH EDITION FIG: 15-7 PAGE 612


Question: Commonest variety of acute inflammation is

Ans. (c) Catarrhal inflammation(Ref: Chandrasoma taylor: 3ed: 45)Catarrhal inflammationCommonest type of inflammation QIncreased mucus secretionSeen in common cold


Question: The granuLomatous tissue that is responsible for destruction of articular surfaces of TMJ in rheumatoid arthritis is known as


Question: A 30 years old female, RBC Counts 4.5 million, MCV 55fl, TC 8000, no history of blood transfusion


Question: According to FAB classification, the minimum blast cells for diagnosis of AML are

(30): (362- Harsh mohan 6th edition)* According to revised FAB classification system a leukaemia is acute if the bone marrow consist of more than 30% blasts* WHO classification for AML has revised and lowered the cut of percentage of marrow blasts to 20% from 30% in the FAB classification for making the diagnosis of AML


Question: Visceral aneurysm is most commonly seen in

Splenic Aery Aneurysm The splenic aery is a blood vessel that supplies blood to the spleen. The spleen is an organ involved in regulating the immune system. Aneurysms of the splenic aery are the third most common type of aneurysm, but their prevalence is still low. Their overall incidence is about .1 percent. Splenic Aery Aneurysm Risk Factors Splenic aery aneurysms are more common in women than men, and these are also noted to occur in younger patients with an average age of 52 years. Other risk factors include: Lupus Multiple pregnancies Pancreatitis Polyaeritis nodosa Poal hypeension Trauma Splenic Aery Disease Symptoms


Question: Chancre redux is a clinical feature of

Chancre- primary lesion in syphilis (hard chancre)Chancre redux is the relapse of the chancre lesions in the early stage of syphilisSecondary syphilis-Cutaneous lesionsRoseolarsyphilidePapularsyphilidePsoriasiform lesion CondylomataMalignant syphilidePalm & sole lesion ( Coppery red lesion )Mucosal lesions Mucous patches Snail track ulcers Lymphadenopathy Generalized symmetrical rubbery lymphadenopathy Systemic involvement Periostitis, Ahritis Iridocyclitis, Uveitis, ChorioretinitisNephritic syndrome Late or teiary syphilis- cardiovascular lesions and tabes dorsalis seen(Ref: Ananthanarayan 9th edition, p372)


Question: DAX 1 gene Mutation is associated with

Ans. C. Congenital adrenal hypoplasiaExplanationDAX1 mutation is seen in congenital adrenal hypoplasia.DAX1 (dosage-sensitive sex reversal, adrenal hypoplasia critical region, on chromosome X, gene 1) is a nuclear receptor protein encoded by the NROBlgene.DAX1 plays an important role in the normal development of several hormone-producing tissues.The adrenal glands,The pituitary gland andHypothalamusThe testes and ovariesMutations in this gene result in both X-linked congenital adrenal hypoplasia and hypogonadotropic hypogonadism


Question: Id reaction is associated with


Question: Generalised hyper cementosis is seen in


Question: During an epidemic of hepatitis E, Fatality is maximum in


Question: One of the following is not a malignant feature


Question: Commonest carcinoma of the with multifocal origin is

Refer Robbins page no 1057 DCIS can be divided into two major architectural subtypes, comedo and noncomedo (Fig. 23-17). Some cases of DCIS have a single growth pattern, but most are comprised of a mixture of patterns. Nuclear grade and necrosis are better predictors of local recurrence and progression to invasion than architectural type. Comedo DCIS may occasionally produce vague nodularity, but more often it is detected on mammography as clustered or linear and branching areas of calcification (Fig. 23-17A). It is defined by two features: (1) tumor cells with pleomorphic, high- grade nuclei and (2) areas of central necrosis (Fig. 23-17B). Noncomedo DCIS lacks either high-grade nuclei or central necrosis. Several patterns may be seen. Cribriform DCIS may have rounded (cookie cutter-like) spaces (Fig. 23-17C) within the ducts, or a solid DCIS pattern. Micropapillary DCIS pro- duces bulbous protrusions without a fibrovascular core, often arranged in complex intraductal patterns (Fig. 23-17D). In other cases, DCIS produces true papillae with fibrovascular cores that lack a myoepithelial cell layer. Calcifications may also be seen in noncomedo forms of DCIS in association with focal necrosis or intraluminal secretions.


Question:
A lady in the second trimester underwent a hemogram and her hemoglobin was found to be 6mg%. The gynaecologist suggested for IV transfusion of packed red cells to improve the level.

The most common oral change due to nutritional anemia is


Question: The quantity of globin chain synthesis is reduced in

Heme Synthesis. Heme is synthesized in a complex series of steps involving enzymes in the mitochondrion and in the cytosol of the cell (Figure 1). The first step in hemesynthesis takes place in the mitochondrion, with the condensation of succinyl CoA and glycine by ALA synthase to form 5-aminolevulic acid (ALA) Ref Robbins 9/e pg 413


Question: Most common paraneoplastic syndrome associated with lung cancer

Paraneoplastic syndromes are signs or symptoms that occur as a result of organ or tissue damage at locations remote from the site of the primary tumor or metastases. Paraneoplastic syndromes associated with lung cancer can impair various organ functions and include neurologic, endocrine, dermatologic, rheumatologic, hematologic, and ophthalmological syndromes, as well as glomerulopathy and coagulopathy (Trousseau's syndrome). The histological type of lung cancer is generally dependent on the associated syndrome, the two most common of which are humoral hypercalcemia of malignancy in squamous cell carcinoma and the syndrome of inappropriate antidiuretic hormone secretion in small cell lung cancer. The symptoms often precede the diagnosis of the associated lung cancer, especially when the symptoms are neurologic or dermatologic. The proposed mechanisms of paraneoplastic processes include the aberrant release of humoral mediators, such as hormones and hormone-like peptides, cytokines, and antibodies. Treating the underlying cancer is generally the most effective therapy for paraneoplastic syndromes, and treatment soon after symptom onset appears to offer the best potential for symptom improvement. In this aicle, we review the diagnosis, potential mechanisms, and treatments of a wide variety of paraneoplastic syndromes associated with lung cancer.


Question: Hyperophy is a result of

Hyperophy refers to an increase in the size of cells, that results in an increase in the size of the affected organ. The hyperophied organ has no new cells, just larger cells. The increased size of the cells is due to the synthesis and assembly of additional intracellular structural components.HyperophyResult of increased production of cellular proteinsHyperplasiaResult of growth factor-driven proliferation of mature cellsAtrophy Results from decreased protein synthesis and increased protein degradation in cellsMetaplasiaResult of a reprogramming of stem cells that are known to exist in normal tissuesRef: Robbins and Cotran Pathologic; 9th edition; Chapter 2; Cellular Responses to Stress and Toxic Insults: Adaptation, Injury, and Death; Page no: 34

Increased production of cellular proteins

Growth factor-driven proliferation of mature cells

Decreased protein synthesis and increased protein degradation in cells


Question: HLA B27 is NOT seen in

Seronegative spondyloahropathies PAIR Psoriatic ahritis Ankylosing spondylitis Inflammatory bowel disease Reactive ahritis (Reiter's syndrome) Features Absence of serum autoantibodies Associated with HLA B27 Onset before 40 years Presence of uveitis, spine/large joint peripheral ahritis


Question: Characteristic histological finding in benign hypertension

Ans. (c) Hyaline arteriosclerosis(Ref: Robbins 9th/pg 490, 938-939; 8th/pg 495)a. Also called obliterative endarteritis seen in syphilis/TB/radiation, poisoning, etcb. Malignant MTc. Benign HTd. MC in marfan syndrome


Question: A pathologist examines a renal biopsy from a 45 year old man with nephrotic syndrome and requested a congo red stain to confirm the nature of an amorphous acidophillic extracellular hyalin substances localized within the mesengial matrix of the glomeruli A positive test confirms the presence of

The answer is B. A positive congo red test confirms the presence of amyloid. Apple green birefringence is abserved under polarized light.


Question: Marked reduction in the amount of dentin, widening of predentin layer, presence of large areas of interglobular dentin is a characteristic feature of

In ground sections, the thickness of the enamel varies, resulting in an irregular surface. The prism structure of the enamel is irregular or lacking, with a laminated appearance. The dentin contains clefts scattered through a mixture of interglobular dentin and amorphous material. Globular areas of poorly organized tubular dentin and scattered cellular inclusions often are seen. The pulp tissue contains free or attached stones that may exhibit tubules or consist of laminated calcification. The follicular tissue surrounding the crown may be enlarged and typically exhibits focal collections of basophilic enamel-like calcifications called enameloid conglomerates. This pattern of calcification is not specific for regional odontodysplasia and has been seen in other processes with disturbed enamel formation, such as amelogenesis imperfecta. Scattered islands of odontogenic epithelium and other patterns of intramural calcification also are seen.


Question: Commonest sites of intraabdominal abscess

The eight functional compaments in the peritoneal cavity include the following: Pelvis, Right paracolic gutter, Left paracolic gutter, Right infradiaphragmatic space ,Left infradiaphragmatic space, Lesser sac Hepatorenal space (Morrison space), Interloop spaces between small intestine loops. The paracolic gutters slope into the subhepatic and subdiaphragmatic spaces superiorly and over the pelvic brim inferiorly. In a supine patient, the peritoneal fluid tends to collect under the diaphragm, under the liver, and in the pelvis. More localized abscesses tend to develop anatomically in relation to the affected viscus. For example, abscesses in the lesser sac may develop secondary to severe pancreatitis, or periappendiceal abscesses from a perforated appendix may develop in the right lower quadrant. Small bowel interloop abscesses may develop anywhere from the ligament of Treitz to the ileum. An understanding of these anatomic considerations is impoant for the recognition and drainage of these abscesses. REFERANCE.MEDSCAP .COM


Question: Type B gastritis is

Type B gastritis mainly involves the region of antral mucosa (hence antral predominant not body predominant.) and is more common. It is also called hypersecretory gastritis due to excessive secretion of acid, commonly due to infection with H. pylori. These patients may have associated peptic ulcer. Unlike Type A gastritis, this form of gastritis has no autoimmune basis nor has an association with other autoimmune diseases. Type A is body predominant. Type AB gastritis effects the mucosal region of A as well as B types. This is the most common gastritis in all age groups. It is also called environmental gastritis, mixed gastritis, chronic atrophic gastritis. TEXTBOOK OF PATHOLOGY HARSH MOHAN 6TH EDITION PAGE NO:547


Question: The antibody seen in drug induced SLE is

(A) Anti histone antibody # Lupus erythematosus (LE): is an autoimmune disease that can affect the skin, joints, heart, lungs, kidneys, and brain. Drug-induced LE (DILE) is a variant of autoimmune disease that resolves within days to months after withdrawal of the culprit drug in a patient with no underlying immune system dysfunction.> Drugs such as procainamide, chlorpromazine, and quinidine cause the production of antinuclear antibodies against the histone dimer H2A-H2B.> Hydralazine forms antinuclear antibodies to H1 and the H3-H4 complex.> In persons with DILE, the antibodies also tend to attack histones (proteins typically found in cell nuclei); antihistone antibodies are indicated by a homogeneous pattern of antinuclear antibodies.> They are present in more than 75% of patients with DILE induced by hydralazine and procainamide.> One example of an antihistone antibody that is often implicated in DILE is immunoglobulin G (anti- DNA).> Antihistone antibodies are much more likely to indicate DILE; however, they can also appear in up to 50% of patients with SL.E.


Question: Duchenne muscular dystrophy is inherited as

X-linked Recessive Inheritance Hemophilia A Duchenne/Becker muscular dystrophy Fragile X syndrome (Robbins Basic Pathology,9th edition,pg no. 219)


Question: Heart failure cells are present in

(A) Alveoli# HEART FAILURE CELLS are siderophages (hemosiderin-containing macrophages) generated in the alveoli of patients with left heart failure or chronic pulmonary edema, when the high pulmonary blood pressure causes red cells to pass through vascular wall.> Siderophages are not specific of heart failure. They are present wherever red blood cells encounter macrophages.


Question: Best investigation for diagnosing amyloidosis

Ans. is 'a' i.e., Rectal biopsy "The most definitive investigation for Amyloidosis is biopsy".For many years rectal biopsy was the first procedure of choice.An important clinical advance was the recognition that the capillaries in the subcutaneous fat are often involved in patients with systemic amyloidosis and can often provide sufficient tissues for the diagnosis of amyloidosis.Thus, biopsy of the organ with the most severe clinical involvement is often unnecessary.For example in cardiac amyloidosis, the definitive diagnosis of the type of amyloid can be made using an endomyocardial biopsy specimen with Congo red and immunologic staining of the tissue sample.Alternatively, when a noninvasive testing suggests cardiac amyloidosis - A specific diagnosis is often made by studying a subcutaneous fat aspiration instead of endomyocardial biopsy there by avoiding an invasive procedure.When the subcutaneous fat aspiration biopsy does not provide information to reach a firm diagnosis, biopsy samples can be collected from other organs.In addition, an advantage to performing biopsy of an involved organ (e.g., kidney heart) is thatit definitively establishes a cause and effect relationship between the organ dysfunction and amyloid.It is important to realize that not all biopsy sites offer the same sensitivity.The best sites of biopsy are: -Abdominal fat pad and (90% sensitivity)Rectal mucosa (73% - 84% sensitivity)Other sites that are often sampled but have poor sensitivity for the diagnosis of amyloid include: -Salivary glandsSkinTongueGingivaStomachBone marrow


Question: This is a specimen of stalk resection of pedunculated bony swelling. Diagnosis is

Osteochondroma, also known as an exostosis, is the most common benign bone tumor; about 85% are solitary.It is a benign cailage-capped tumor that is attached to the underlying skeleton by a bony stalk. The cap is composed of benign hyaline cailage varying in thickness and is covered peripherally by perichondrium. The coex of the stalk merges with the coex of the host boneRef: Robbins Pathology; 9th edition; Page no: 1200


Question: Kupffers cells in liver are

A. i.e. (Macrophages) (54- Basic pathology 8th)Kupffer cells belonging to the reticuloendothelial systemsMarophages the dominant cells of chronic inflammation, are tissue cells derived from circulating blood monocytes, macrophages also found in(i) Liver - Kupffer cells(ii) Spleen and lymph node - Sinus histiocytes(iii) CNS - Microglial cells(iv) Lungs - Alveolar macrophages* The half life of circulating monocytes is about 1 day* Mean life of RBC's in transfused blood is - 80 days*** Langerhans cels are antigen presenting in nature*** Epitheloid cells and granular giant cells are formed by Monocyte - macrophages*** Antigen presenting cells are - Langerhan's cells Dendritic cells, B. cells, Macrophages


Question: Forensic Identification utilizes


Question: In thin basement membrane disease, the defect is in

TBM disease (also known as benign familial hematuria and thin basement membrane nephropathy) is, along with IgA nephropathy, the most common cause of blood in the urine without any other symptoms. The only abnormal finding in this diseaseis a thinning of the basement membrane of the glomeruli (filters) in the kidneys. Refer robbins 9/e


Question: Vitamin deficiency causing Spinocerebellar degeneration is

VitaminFunctionsDeficiency syndromesVitamin EMajor antioxidant; scavenges free radicalsSpinocerebellar degenerationRef: Robbins and Cotran Pathologic Basis of Disease; 9th edition; Chapter 9; Environmental and Nutritional Diseases; Page no: 442; Table 9-9


Question: 0steomas, adenomatous polyps of intestine & periampullary carcinomas are seen in

Gardner's Syndrome Gardner's syndrome is combination of familial polyposis coli and ceain extra-colonic lesions such as multiple osteomas (paicularly of the mandible and maxilla), sebaceous cysts and connective tissue tumours. mnemonics: GARDEN In FOREST Gardener syndrome Familial polyposis coli, Osteoma Retinal epithelium hyperophy Supernumerary Teeth TEXTBOOK OF PATHOLOGY 6TH EDITION HARSH MOHAN PAGE NO:585,586 IMAGE REF:


Question: In cystic fibrosis the most frequent pulmonary pathogen is

Pseudomonas aeruginosa species, in particular, colonize the lower respiratory tract, first intermittently and then chronically.


Question: A specimen from a lung biopsy reveals occasional plexiform lesions within pulmonary aerioles. This abnormality is most characteristic of

) Pulmonary vascular sclerosis refers to the vascular changes associated with pulmonary hypeension. Elevation of the mean pulmonary aerial pressure is the result of endothelial dysfunction and vascular changes. The vascular changes vary with the size of the vessel. The main aeries have atheromas that are similar to systemic atherosclerosis, but are not as severe. Medium-sized aeries show intimal thickening and neomuscularization. Smaller aeries and aerioles show intimal thickening, medial hyperophy, and reduplication of the internal and external elastic membranes. A distinctive aeriolar change, a plexiform lesion, consists of intraluminal angiomatous tufts that form webs. This pattern is thought to be diagnostic of primary hypeension The changes of pulmonary vascular sclerosis may be primary or secondary. Primary pulmonary vascular sclerosis almost always occurs in young women, who develop fatigue, syncope (with exercise), dyspnea on exeion (DOE), and chest pain. Secondary sclerosis may occur at any age, and symptoms depend on the underlying cause. Possible causes include ceain types of hea disease, such as mitral valve disease, left ventricular failure, and congenital valvular disease with left-to-right shunt, as well as ceain types of pulmonary disease, such as chronic obstructive or interstitial lung disease and recurrent pulmonary emboli. Pulmonary hypeension is also associated with diet pills (Redux and Fen-Phen), while "exotic" causes include Crotalaria spectabilis ("bush tea") and adulterated olive oil Reference: Robbins & Cotran Pathologic Basis of Disease, 9edition.


Question: Prion disease is cuased by


Question: Psoralane Ultra Violet A (PUVA) therapy is advised in

According to Rook and Colleagues the extra corporeal photochernotherapy for drug resistant pemphigus vulgaris include administration of 8-methoxypsoralen followed by exposure of peripheral blood to ultraviolet radiation. It is also used for vitiligo and graft versus host disease.


Question: Diabetic patient with liver cirrhosis and hyperpigmentation, diagnosis is

Clinical Features :Males predominate (in a ratio of 5 to 7 : 1), with slightly earlier clinical presentation, paly because physiologic iron loss (with menstruation or pregnancy) retards iron accumulation in women. In the most common forms, caused by HFE mutations, symptoms usually first appear in the fifth and sixth decades of life in men and later in women. The principal manifestations include hepatomegaly, skin pigmentation (paicularly in sun-exposed areas), deranged glucose homeostasis or frank diabetes mellitus from destruction of pancreatic islets, cardiac dysfunction (arrhythmias, cardiomyopathy), and atypical ahritis. In some patients the presenting complaint is loss of libido and impotence. The classic clinical triad of cirrhosis with hepatomegaly, skin pigmentation, and diabetes mellitus may not develop until late in the course of the disease. Death may result from cirrhosis, hepatocellular carcinoma, or cardiac disease. TEXT BOOK OF ROBBINS BASIC PATHOLOGY NINTH EDITION PAGE.630


Question: Starch is considered to be less cariogenic than monosaccharides and disaccharides because it


Question: The least radio sensitive tissue is


Question: Histamine is formed by of histi dine


Question: Daily loss of Iron per day in a healthy adult male is


Question: In a granuloma epithelioid cells are giant cells and derived from


Question: Mutation in COL4A5 chain the diagnosis


Question: Cytochrome C in apoptosis acts by

After releasing of cytochrome in cytosol, they binas to Apart 1 protein which leads to formation of a complex apoptosome. This complex binds to caspase-9 which is a critical initiator caspase of the mitochondrial pathway of apoptosis.
Also Know
Most critical organ for apoptosis = Mitochondrion
Most characteristic feature of apoptosis = Chromatin condensation
Marker for apoptosis = Annexin V
Molecular marker for apoptosis = CD 95


Question: A 25 years female presents with rubbery movable nodule in left breast during menstrual cycle. Most likely diagnosis is

B. i.e. (Fibroadenoma) (742- Basic pathology 8th)F1BRQ ADENOMA - common in young age 15-30 years of age* Solitary, discrete, freely mobile nodule with in the breast* They may enlarge late in the menstrual cycle and during pregnancy After menopause they may regres and calcify* Fibroadenomas almost never become malignant**PHYLLOIDES TUMOUR - Leaf-like gross appearance, 30-70 years of age, massive size distending the breast round to oval, bosselated* Phyllodes tumour resembles fibroadenoma except for enhanced stromal cellularity*** Most ominous change is the appearance of increased stromal cellularity with anaplasia and high mitotic activity, accompanied by rapid increase in size, usually with invasion of adjacent breast tissue by malignant stroma**INTRADUCTAL PAPILLOMA - neoplastic papillary growth within a duct, solitary, found within the principal lactiferous ducts or sinuses. Most common in 3 - 4 decades1. Appearance of serous or blood nipple discharge**2. Presence of a small sub areolar tumour a few millimeters in diameter3. Rarely nipple retractionInvasive lobular carcinoma - breast tumour is bilateral **


Question: ENaC mutation is associated with

ENac (Epithelial sodium channel)*ENac is a sodium transpo channel that is produced in the apical surface of all exocrine epithelial cells (All tracts and ducts)*The channel absorbs sodium from the luminal secretions and sent it back to the circulation thus maintaining the sodium level in blood and hence normal blood pressure.*Mutation of this ENaC channel will cause loss of sodium through luminal secretions and causes hyponatremia and hypovolemia. This in turn stimulates Renin angiotensin system causing hypeension through aldosterone. This condition is called "Liddle syndrome"*ENac is downregulated by CFTR gene in normal individuals. In cystic fibrosis, loss of CFTR causes increased expression of ENaC in all the tracts and ducts except sweat ducts. In sweat ducts, the function of ENaC channel is impaired causing "salty sweat" ( Ref: Robbins 8/e p493)


Question: The decrease in cell size refers to

Shrinkage in the size of the cell by the loss of cell substance is known as atrophy
◆ Although atrophied cells have diminished its function, they are not dead


Question: Chronic Active Hepatitis is most reliably distinguished from chronic Persistent hepatitis by the presence of

Minimal chronic hepatitis (previously called chronic persistent hepatitis).
The portal chronic inflammation is mild and is restricted to the portal triads without extension into the Liver lobule across the limiting plate.
Chronic active hepatitis → characterized by continuing necrosis of Liver cells. The severe inflammation disrupts the limiting plate.

Significant titre of antismooth muscle antibody


Question: Rootless teeth refer to


Question: Glanzmann's thrombasthenia is characterized by defective

Glanzmann's thrombasthenia - It is an autosomal recessive disorder due to deficiency/dysfunction of glycoprotein Ilb-IIla (Gp Ilb/IIIa).
Thus there is defective platelet aggregation.
Platelet aggregation is normal to ristocetin(ln constant to Bernard Soulier syndrome) but no aggregation occurs in response to standard agonists (collagen, A DP, thrombin). Other differentiating features include normal platelet count and morphology. BT is prolonged. VWF is normal.
The disease manifests at birth with increased bleeding from umbilical cord stump.


Question: Hyperacute graft rejection is

In this case preformed circulating antibody binds to graft endothelial HLA and also activates complement system.
Hence, this is Type II HS.


Question: Replacement of columnar epithelium of respiratory tract to squamous epithelium is

Metaplasia is a reversible change in which one adult cell type (epithelial/mesenchymal) is replaced by another adult cell type. Often seen in response to chronic irritation. Makes the cells able to withstand stress. Metaplasia is thought to arise by reprogramming of stem cells to differentiate along a new pathway. May result in reduced function or increased propensity for malignant transformation Two types - squamous metaplasia & columnar metaplasia. Squamous metaplasia: The normal columnar epithelial cells are focally or widely replaced by squamous epithelial cells. Eg: Chronic smokers - to survive the noxious chemicals in cigarette smoke Squamous metaplasia - columnar epithelial changes to squamous type. Eg: In chronic gastric reflux, the normal stratified squamous epithelium of lower oesophagus undergoes metaplastic transformation to gastric or intestinal type columnar epithelium. Metaplasia may also occur in mesenchymal cells but in these situations, it is generally a reaction to some pathologic alteration not an adaptive response to stress. Epithelial metaplasia is exemplified by the squamous change that occurs in the respiratory epithelium of habitual cigarette smokers (Fig. 1-5). The normal ciliated columnar epithelial cells of the trachea and bronchi are focally or widely replaced by stratified squamous epithelial cells. The rugged stratified squamous epithelium may be able to survive the noxious chemicals in cigarette smoke that the more fragile specialized epithelium would not tolerate. Although the metaplastic squamous epithelium has survival advantages, impoant protective mechanisms are lost, such as mucus secretion and ciliary clearance of paiculate matter. Epithelial metaplasia is therefore a double-edged sword. Moreover, the influences that induce metaplastic change, if persistent may predispose to malignant transformation of the epithelium In fact, squamous metaplasia of the respiratory epithelium often coexists with lung cancers composed of malignant squamous cells. It is thought that cigarette smoking initially causes squamous metaplasia, and cancers arise later in some of these altered foci. Since vitamin A is essential for normal epithelial differentiation, its deficiency may also induce squamous metaplasia in the respiratory Refer robbins 9/e p5


Question: Normal serum, Ca and alkaline PO4 are in


Question: Megaloblasticanemia occur due to deficiency of


Question: Hypopigmentation, gray streaks of hair, degranulation defect of neutrophils and neuropathy are seen in


Question: Most common antibody in autoimmune hepatitis is

Autoimmune hepatitis Indistinguishable from chronic viral hepatitis. Responds to immunosuppressive therapy Female predominance(70%) Absence of serogical evidence of viral infection Presence of other forms of autoimmune diseases like rheumatoid ahritis, thyroiditis, sjogren syndrome and ulcerative colitis. Most patients found to have circulating anti- nuclear antibodies, anti-smooth muscle antibiodies, liver/kidney microsomal antibody, anti-soluble liver/pancreas antigen. ROBBINS BASIC PATHOLOGY NINTH EDITION PAGE 620


Question: The position of the hip in a patient with posterior dislocation of hip

Position and attitude of hip pathology Flexion, Abduction, External rotationFlexion, Adduction, Internal rotation1st stage of TB hip Anterior dislocation of hip Fracture shaft of femur Polio hipHip joint effusion 2nd and 3rd stage of TB hip Posterior dislocation of hip Traumatic hip dislocation (Refer: Watson Jones Textbook of Ohopedics & Trauma, 6thedition, pg no: 901-935)


Question: Most characteristic finding in diabetic nephropathy is

Refer Robbins page no 1118 Almost all patients with Type I diabetes develop some evidence of functional change in the kidneys within two to five years of the diagnosis. About 30 to 40 percent progress to more serious kidneydisease, usually within about 10 to 30 years. Diabetic nephropathy (diabetic kidney disease) is kidney damage that results from having diabetes. Having high blood glucose levels due to diabetes can damage the pa of the kidneys that filters your blood. The damaged filter becomes 'leaky' and lets protein into your urine.


Question: Hypersensitivity vasculitis is seen in

The term cutaneous vasculitis is defined broadly as inflammation of the blood vessels of the dermis. Due to its heterogeneity, cutaneous vasculitis has been described by a variety of terms including hypersensitivity vasculitis and cutaneous leukocytoclastic angiitis. The typical histopathologic feature of cutaneous vasculitis is the presence of vasculitis of small vessels. Postcapillary venules are the most commonly involved vessels; capillaries and aerioles may be involved less frequently. ( Harrison&;s principle of internal medicine,18th edition,pg no. 2798)


Question: Least cariogenic among these


Question: It is a type of nerve cell that protects CNS from infection and become phagocytic in response to inflammation

C: Microglia helps remove bacteria and cell debris from the CNS.
A: Schwann cells form myelin sheaths around axons, or enclose unmyelinated axons in the peripheral nervous system.
B: Ependymal cells line ventricles of the brain, circulate cerebrospinal fluid; some form choroid plexuses, which produce CSF.
D: Astrocytes serves as the major supporting tissue in the CNS and contribute to the blood-brain barrier.


Question: Most common type of lupus nephritis

Diffuse proliferative nephritis (DPN) or glomerulonephritis (DPGN) is a type of glomerulonephritis that is the most serious form of renal lesions in SLE and is also the most common, occurring in 35% to 60% of patients. Most of the glomeruli show endothelial and mesangial proliferation affecting the entire glomerulus, leading to diffuse hypercellularity of the glomeruli, producing in some cases epithelial crescents that fill Bowman's space. Here in this diffuse proliferation of lupus nephritis is most common. Ref: emedicine.medscape.com


Question: Berbeck's granules are seen in

Ans. a (Langerhan cells). (Ref. Robbins, Pathologic Basis of Disease 6th/pg.685)HISTIOCYTOSIS# Histiocytosis represents clonal proliferation of antigen- presenting dendritic cells.# It is of two types:- Localized histiocytosis (70%) i.e. Eosinophilic granuloma. It is the most benign variety of langerhans cell histiocytosis.- Disseminated histiocytosis (30%)i. Hand - Schuller - Christian disease (chronic)ii. Letterer-Siwe disease (fulminant)# Age: 5-10 years most common# Location: Bone (in children) or lung (in adults) most commonly involved.# Sites of infection:- Flat bones: calvarium > mandible > ribs > pelvis > vertebrae- Long bones- Skull: Diplopic space of parietal bone (most common) affected.i. Round/ovoid punched out lesion with beveled edge ('Hole within hole' appearance) with sharply marginated without the sclerotic rim with "button sequestrum" with soft tissue mass overlying lesion (geographic skull).- Jaw: Floating tissue mass overlying lesion- Vertebra plana- Painful diaphyseal expansile lytic long bone lesions.# Pathology:- Birbeck's granules/HX bodies are characteristic pathologic feature of histiocytosis X, noted in cytoplasm of Langerhan cells.- On electron microscope they have 'tennis-racket' appearance.- These tumor cells typically express HLA-DR and CDla.DISEASESCELLULAR CHARACTERISTICS OF THE LESIONSTREATMENTClass 1(Langerhans cell histiocytosis )Langerhans cells (CDla positive) with Birbeck granulesLocal therapy for isolated lesions; chemotherapy for disseminated disease.Class II(Infection-associated hemophagocytic syndrome)Morphologically normal reactive macrophages with prominent erythrophagocytosisChemotherapy; allogeneic bone marrow transplantation.Class III (Malignant histiocytosis)Neoplastic proliferation of cells with characteristics of monocytes/ macrophages or their precursors iAntineoplastic chemotherapy, including - methotrexate, vincristine, etoposide, imatinib....are being tried.


Question: Simplex type of Epidermolysis Bullosa involves mutations in

Simplex type of Epidermolysis Bullosa involves mutations in in keratin 5 or 14.


Question: Cell involved in the immediate phase of wound healing


Question: Rosenthal fibres in astrocytoma is composed of

Well-differentiated astrocytomas are poorly defined, gray, infiltrative tumors that expand and disto the invaded brain without forming a discrete mass (Fig. 22-28, A). Infiltration beyond the grossly evident margins is always present. The cut surface of the tumor is either firm or soft and gelatinous; cystic degeneration may be seen. In glioblastoma, variation in the gross appearance of the tumor from region to region is characteristic (Fig. 22-28, B). Some areas are firm and white, others are soft and yellow (the result of tissue necrosis), and still others show regions of cystic degeneration and hemorrhage. Well-differentiated astrocytomas are characterized by a mild to moderate increase in the number of glial cell nuclei, somewhat variable nuclear pleomorphism, and an intervening feltwork of fine, glial fibrillary acidic protein (GFAP)-positive astrocytic cell processes that give the background a fibrillary appearance. The transition between neoplastic and normal tissue is indistinct, and tumor cells can be seen infiltrating normal tissue many centimeters from the main lesion. Ana- plastic astrocytomas show regions that are more densely cellular and have greater nuclear pleomorphism; mitotic figures are present. Glioblastoma has a histologic appearance similar to that of anaplastic astrocytoma, as well as either necrosis (often with pseudopalisading nuclei) or vascular proliferation ref Robbins 9/e p 842


Question: A reactant generated by neutrophils that plays an impoant role in bacterial killing is

Superoxide anion is generated when oxygen is reduced by cytoplasmic NADPH. The reduction is carried out by the enzyme NADPH oxidase, which is not a reactant but a catalyst activated in cells responding to bacteria.


Question: BRAF gene mutation is seen in

Somatic activating mutations in the proto-oncogenes BRAF or NRAS are observed in a high propoion of melanomas. These mutations, which promote cellular proliferation and survival by activating the extracellular signal-regulated protein kinase (ERK) pathway, generally are mutually exclusive, since BRAF functions downstream of RAS. (Robbins Basic Pathology, 9 th edition. page : 867)


Question: Investigation of choice to confirm sickle cell disease

HPLC is the investigation of choice to confirm the diagnosis of sickle cell anemia.

Naked eye single Tube Red Cell Osmotic Fragility test


Question: Arterial thrombosis is seen in


Question: Hyperplastic aeriolitis is seen in

Malignant hypeension, defined as blood pressure usuallygreater than 200/120 mm Hg, andoccurs in only about 5% of persons with elevated blood pressure.The basis for this turn for the worse in hypeensive subjectsis unclear, but the following sequence is suggested: The initialevent seems to be some form of vascular damage to thekidneys. This most commonly results from long-standinghypeension, with eventual injury to the aeriolar walls. Theresult is increased permeability of the small vessels to fibrinogenand other plasma proteins, endothelial injury, and plateletdeposition. This leads to the appearance of fibrinoidnecrosis of aerioles and small aeries and intravascularthrombosis. Mitogenic factors from platelets (e.g., plateletderivedgrowth factor) and plasma cause intimal hyperplasiaof vessels, resulting in the hyperplastic aeriolosclerosistypical of organizing injury of malignant hypeension and ofmorphologically similar thrombotic microangiopathies (seelater) and fuher narrowing of the lumina.Robbins Basic pathology,9th edition,pg no.539


Question: Hemolytic uremic syndrome is characterised by

HUS is a disease characterised by

Hemolytic Anemia (Microangiopathic hemolytic Anemia)
Uremia
Low platelet count


Question: "Programmed cell death" is known as

(A) Apoptosis # Apoptosis is a form of programmed cell death in multicellular organisms.> Apoptosis is one of the main types of programmed cell death (PCD), and involves an orchestrated series of biochemical events leading to a characteristic cell morphology and death.> It involves an orchestrated series of biochemical events which lead to a variety of morphological changes, including blebbing, changes to the cell membrane such as loss of membrane asymmetry and attachment, cell shrinkage, nuclear fragmentation, chromatin condensation and chromosomal DNA fragmentation.> Apoptotic process is executed in such a way as to safely dispose of cellular debris.# Cells that are induced to commit suicide:> Shrink> Develop bubble-like blebs on their surface;> Have the chromatin (DNA and protein) in their nucleus degraded> Have their mitochondria break down with the release of cytochrome c;> Break into small, membrane-wrapped, fragments.> The phospholipid phosphatidylserine, which is normally hidden within the plasma membrane, is exposed on the surface.> This is bound by receptors on phagocytic cells like macrophages and dendritic cells which then engulf the cell fragments.> The phagocytic cells secrete cytokines that inhibit inflammation (E.g., IL-10 and TGF-b)


Question: Most common cause of dry mouth in adults is


Question: Cryoprecipitate is rich in


Question: Myocarditis is caused bya) Pertussisb) Measlesc) Diptheriad) Scorpion sting


Question: Troponin T is marker of

A troponin test measures the levels of troponin T or troponin I proteins in the blood. These proteins are released when the hea muscle has been damaged, such as occurs with a hea attack. The more damage there is to the hea, the greater the amount of troponin T and I there will be in the blood


Question: HLA associated with psoriasis

Psoriasis is a long-lasting autoimmune disease which is characterized by patches of abnormal skin.] These skin patches are typically red, itchy, and scaly. They may vary in severity from small and localized to complete body coverage. Injury to the skin can trigger psoriatic skin changes at that spot, which is known as the Koebner phenomenonType 1 has a positive family history, stas before the age of 40, and is associated with the human leukocyte antigen, HLA-Cw6. Conversely, type 2 does not show a family history, presents after age 40, and is not associated with HLA-Cw6. Type 1 accounts for about 75% of persons with psoriasis.


Question: Brown tumor of bone is seen in

Primary hyperparathyroidism traditionally has been associated with a constellation of symptoms that included painful bones. Brown tumors are lesions that arises in settings of excess osteoclast activity. It is not a true neoplasm.It most commonly affects the maxilla and mandible, though any bone may be affected. Brown tumours are radiolucent on x-ray. Robbins basic pathology 9th edition page no 737,Yellow box (morphology) Brown tumors of hyperparathyroidism.


Question: Earliest reliable enzyme to increase in AMI

Ans. a (CPK-MB). (Ref. Harrisons, Medicine, 18th/ Chapter 246.)#Earliest enzyme elevated after AMI:hFABP and Myoglobin#Most specific enzyme:Troponin T (returns nomal in 5-14 dys)#Enzyme imp in Reinfarction:CPKMB (returns nomal in 2-3 dys)#Most common cause of death in AMI:VT leading to VF#Post-AMI autoimmune pericarditis (7 dys later):Dressier syndrome#Time after AMI when cardiac muscle is most subjected to rupture: 3-7 dys#Microscopic changes after AMI: - Neutrophils:1-3 dys of AMI - Lymphocytes:4-7 dys of AMI - Grabulation tissue:7-14 dys of AMIDIAGNOSIS OF AMI# In first six hours ECG is gold standard.# Changes include ST elevation (transmural ischemia) and Q waves (transmural infarct)- CPK-MB is test of choice in first 24 hours of AMI- Cardiac troponin I is used within the first 4 hours upto 7-10 days. More specific:- LDH is elevated from 2 to 7 post Ml day. LDH decrease is specific for cardiac muscles.# Radioisotope Thallium-201 scanning is used to distinguish ischemic from non-ischemic myocardium/ to detect reversible ischemia.# Radioactive stannous pyrophosphate is used to distinguish normal from damaged myocardium.# 2D-ECHO is best initial modality for assessment of valvular abnormalities, wall motion & ventricular ejection fraction (i.e. ventricular function).


Question: The type of breast carcinoma characterized by a pushing border

Medullary carcinoma is a rare subtype of carcinoma, accounting for less than 1% of breast cancers. These cancers consist of sheets of large anaplastic cells with well circumscribed, "pushing" borders Clinically, they can be mistaken for fibroadenomas ref : Robbins Basic Pathology, 9E,page-712


Question: Microarray is

A DNA microarray (also commonly known as DNA chip or biochip) is a collection of microscopic DNA spots attached to a solid surface. Scientists use DNA microarrays to measure the expression levels of large numbers of genes simultaneously or to genotype multiple regions of a genome. Each DNA spot contains picomoles (10-12 moles) of a specific DNA sequence, known as probes (or repoers or oligos). These can be a sho section of a gene or other DNA element that are used to hybridize a cDNA or cRNA (also called anti-sense RNA) sample (called target) under high-stringency conditions. Probe-target hybridization is usually detected and quantified by detection of fluorophore-, silver-, or chemiluminescence-labeled targets to determine relative abundance of nucleic acid sequences in the target. The original nucleic acid arrays were macro arrays approximately 9 cm x 12 cm and the first computerized image based analysis was published in 1981. Ref Robbins 9/e p263


Question: Caseating necrosis is seen in


Question: Oral ulcers that are painless are associated with


Question: Antibiotic prophylaxis is not recommended in


Question: Neointimal hyperplasia causes vascular graft failure as a result of hyperophy of

Vascular injury leading to endothelial cell loss or dysfunction stimulates smooth muscle cell growth and associated matrix synthesis. Healing of injured vessels involves the migration of smooth muscle cells or smooth muscle cell precursor cells into the intima. Here these cells proliferate, and synthesize ECM in much the same way that fibroblasts fill in a wound, forming a neointima that typically is covered by an intact endothelial cell layer. This neointimal response occurs with any form of vascular damage or dysfunction, including infection, inflammation, immune injury, physical trauma (e.g., from a balloon catheter or hypeension), or toxic exposure (e.g. oxidized lipids or cigarette smoke). Thus, intimal thickening is a stereotypical response of the vessel wall to any insult ( Robbins Basic Pathology, 9 th edition, page 334 )


Question: Onion peeling of renal vessels is seen in

In cases of malignant Hypertension, Concentric hyperplasia of smooth muscles will give rise to onion peel appearance.


Question: Birbeck granules are seen in the cytoplasm of

Langerhans cell histiocytosis (LCH)*Langerhans cell is a dendritic cell which is an antigen presenting cell*LCH is a clonal histiocytic disorder*Birbeck granules are present in the cytoplasm of Langerhans cell.Characteristic features of LCHPresence of Birbeck granules - Electron microscopy ( Tennis racquet appearance)Presence of enzymes like 1. a- Naphthyl Acetate Esterase 2. a- Naphthyl Butyrate Esterase 3. Acid phosphatasePresence of markers S-100, CD1a positivity HLA- DR expressionThree clinicopathological entities1.Acute disseminated LCH2.Multifocal LCH3.Unifocal LCH *Earlier Histiocytosis x term was used. This includes-Letterer-Siwe disease (generalized disease)-Hand - Schuller- Christian disease-Eosinophilic granuloma (localized lesion) However now the term LCH is preferred.Acute disseminated LCH ( Letterer- Siwe disease) - Affects children < 2 yrs-Seborrhoeic type of skin rash on front & back of trunk and scalp-Moderate hepatomegaly-Few palpable lymph nodes-Pulmonary lesions- uncommon-Bone- Lytic lesions (> 80%)-Moderate degree fever-Otitis media & mastoiditis may be seen-CNS involvement due to contiguous spread-Hematologic findings: Pancytopenia-Bone marrow: Infiltration by histiocytesMultifocal LCH - Multiple lesion involving multiple systems-Prognosis better than disseminated LCH-Fever & rash-Involvement of posterior pituitary- Diabetes insipidus-Typical Hand- Schuller Christian disease= Triad of exopthalmus+ diabetes insipidus+ calvarial defectUnifocal LCH*Focal lytic lesion in bone*Excellent prognosis(Ref: Robbins 8/e p631, 7/e p701, 702)


Question: Intestinal angiodysplasia involves

Colonic aeriovenous malformation (AVM) is one of the causes of lower GI bleeding. Unlike small vascular ectasia or angiodysplasia, colonic AVM tends to be solitary, large in size, and identified endoscopically as flat or as an elevated bright red lesion. REFERANCE.MEDSCAP.COM