Question: Chromosome involved in Myotonic Dystrophy is

(A) Chromosome 19[?]Myotonic Dystrophy:oGenetics: Myotonic Dystrophy is caused by a triple nucleotide (triplet) expansion (CTG) in the non-coding region of the myotonin gene at chromosome 19q13.3.o3 Genetic loci:-DM1: 98% of families 1 Myotonin protein kinase (DMPK); chromosome 19q 13.3; Dominant-DM 2: 1 Zinc finger protein 9; Chromosome 3q21; Dominant-DM3: 1 Chromosome 15q21-q24; Dominant.-The condition is characterized by extreme variability, anticipation & differential expansion in the maternal & paternal germline.-4-37 repeats Normal->50 repeats affected[?]Inheritance Pattern:oTypical pattern is a heterozygous affected a parent with a homozygous unaffected parent.oEvery child has 1 chance in 2 of having the diseaseoBoth sexes are affected equally.[?]Myotonic Dystrophy Type 1 (DMI):oCommonest form of adult muscular dystrophy (incidence 1:6000)oAge at onset late teensoInheritance autosomal dominant with anticipation[?]Myotonic Dystrophy (MD) is a trinucleotide repeat disease with multi-systemic involvement: muscle (myotonia & weakness), nerve, CNS (MR), heart (conduction problems), eyes (cataract), Hypersomnolence, Apathy, Cognitive impairments, Endocrine dysfunction etc.,oMyotonia refers to the slow/impaired relaxation of the muscles after voluntary contraction or electrical stimulation.GENETIC DISEASES & ASSOCIATED CHROMOSOMES*. Chromosome 1: Eliptocytosis, Rh Erythroblastosis, Porphyria cutanea tarda*. Chromosome 2: Protein C deficiency*. Chromosome 3: Protein S deficiency, Orotic aciduria*. Chromosome 4: Huntignton's disease*. Chromosome 5: Gardneris syndrome, Familial polyposis coli*. Chromosome 6: Haemochromatosis, Congenital adrenal hyperplasia (21-hydroxylase deficiency)*. Chromosome 7: Cystic fibrosis, Ehlers-Danlos syndrome (one form), Osteogenesis imperfecta (one form)*. Chromosome 8: Nil*. Chromosome 9: Galactosemia, Nail-patella syndrome*. Chromosome 10: MEN type 2*. Chromosome 11: Syndrome of Wilm's tumor, aniridia, gonadoblas- toma, retardation, Beta-thalassemia, Sickle cell anemia, Acute intermittent porphyria*. Chromosome 12: Phenylketonuria, von Willebrand's disease.*. Chromosome 13: Retinoblastoma, Wilson's disease*. Chromosome 14: Nucleoside phosphorylase deficiency, Alpha 1-antitrypsin deficiency*. Chromosome 15: Prader-Willi syndrome, Tay-Sachs disease*. Chromosome 16: Alpha-Thalaseemia, Gout, LCAT deficiency*. Chromosome 17: Growth hormone deficiency (type 1A), von Recklinghausen neurofibromatosis*. Chromosome 18: Nil*. Chromosome 19: Familial hypercholesterolemia, Familial type 3 hyperlipoproteinemia, Myotonic dystrophy; Complement C3 deficiency*. Chromosome 20: Adenosine deaminase deficiency*. Chromosome 21: Alzheimer's disease, Homocystinuria*. Chromosome 22: Metachromatic leukodystrophy, Hurler syndrome (MPS-I), Scheie's syndrome (MPS - V)


Question: Pleural mesothelioma is associated with

Ref:Textbook of pathology (Harsh mohan) 6th edition,page no.493 Asbestos exposure predisposes to a number of cancers, most impoantly bronchogenic carcinoma andmalignant mesothelioma . A few others are: carcinomas of oesophagus, stomach, colon, kidneys and larynx and various lymphoid malignancies. 1. Bronchogenic carcinoma is the most common malignancy in asbestos workers. Its incidence is 5 times higher in non-smoker asbestos workers than the nonsmoker general population and 10 times higher in smoker asbestos workers than the other smokers. 2. pleural mesothelioma is an uncommon tumour but association with asbestos exposure is present in 30 to 80% of cases with mesothelioma. The exposure need not be heavy because mesothelioma is known to develop in people living near asbestos plants or in wives of asbestos workers.


Question: Submerged teeth are


Question: HMB 45 is a tumor marker for

Malignant melanoma expresses HMB45 ,S-100 and vimentin
HMB 45 is present in melanosome and is more specific
S-100 is more sensitive but is non specific (also present in LAngerhan's cell histiocytosis, neural tumors and sarcomas like Liposarcoma and Chondrosarcoma)


Question: Squamous cell carcinoma on tongue most common site is


Question: Soft exudates are most commonly associated with

(Refer: AH Khurana, Comprehensive Textbook of Ophthalmology,5thedition,pg no: 527)


Question: The most aggressive and destructive cyst is


Question: Secondaries are common in a/e

Secondary cancers in the bone might also be called bone secondaries.Bone secondaries often develop in different bones in the body, and not all secondaries will cause symptoms or problems. Although any type of cancer can spread to the bone, the most common types that do are cancers of the: breast. Refer robbins 9/e breast


Question: Tobacco induced squamous cell carcinoma doesn't involve mutation in

Tobacco carcinogens induced cancers involve a mutation in the P53 pathway as well as proteins responsible for squamous differentiation . Conversely HPV associated squamous cell carcinomas overexpress P16.Reference: Robbins; 9th edition; Volume II; Oropharyngeal squamous cell carcinoma molecular biology; Page no: 733


Question: Earliest change in atherosclerosis is

A. i.e. (Fatty streaks) (385- 86 - Harsh Mohan 5th) (349 - Basic pathology 8th)ATHEROSCLEROSIS - is an intima- based lesion organized into a fibrous cap and an atheromatous (gruel- like) core and composed by smooth muscle cells, endothelial cells inflammatory cells, lipids and necrotic debris* Atherosclerosis is a slowly evolving lesion usually requiring many decades to become significant. However acute plaque changes {eg rupture, thrombosis or hematoma formation) can rapidly precipitate clinical sequalae (so-called - Clinical Horizon)* Early lesions in the form of diffusal internal thickening, fatty streaks and gelatinous lesions*** Earliest light microscopic changesin MI is- Waviness of the fibres***Morphological features, pathogenic events and clinical complications* Most common cause of aortic aneurysm is - Athero sclerosis*** Most common site for MI is - Anterior wall of left ventricles*** Granulation tissue appears in acute MI - At 1 weeks*** Calcification of the aortic valve is seen in - Aortic stenosis** Me - Collum's patch is diagnostic of - Rheumatic endocarditis*** Osier's node, Janueway and Roth spot seen in Subacute Bacterial endocarditis*** Most common change in atherosclerotic vessel is - Dystrophic calcification* Atherosclerosis LDL is present in LDL monocytes**


Question: Lipofuscin is associated with

o Deposition of lipofuscin in the heart is referred as brown atrophy


Question: A histologic evidence of widespread formation of globular hypocaLcified dentin and puLp horns reaching the dentinoenamel junction, absence of lamina dura around the tooth in radiograph are the characteristic features of


Question: Polygonal violaceous , well defined flat topped ,itchy papules are the primary lesions of

Lichen planus lesions are classically violaceous well defined polygonal itchy papules.


Question: Most common cytogenetic abnormality in Multiple myeloma is

Multiple myeloma/solitary plasmacytoma: Genotype: Diverse rearrangements involving IgH; 13q deletionsSalient Features: older adults with lytic bone lesions, pathologic fractures, hypercalcemia, and renal failure; moderately aggressive Plasmacytoma: isolated plasma cell masses in bone or soft tissue; indolent Reference: Robbins and Cotran Pathologic Basis of Disease; 9th edition; Chapter 13; Disorders of white cells


Question: Gene of wilsons disease is

In Wilson's disease, the initial steps of dietary absorption and transpo of copper to the liver are normal but copper accumulates in the liver rather than being excreted by the liver. The underlying defect in chromosome 13 is a mutation in ATP7B gene, the normal hepatic copper excreting gene. TEXTBOOK OF PATHOLOGY 6TH EDITION HARSH MOHAN PAGE NO:628 IMAGE REF:


Question: The cells seen after 72 hours in the infarcted area in MI are

Light microscopic finding of infarcted area 3-7 days: Beginning disintegration of dead myofibers, with dying neutrophils; early phagocytosis of dead cells by macrophages at infarct border. (Robbins basic pathology,9th edition,pg no.380)


Question: Supratemporal lental subluxation is seen in


Question: Renal calculi are commonly made up of

There are four main types of kidney stones Calcium stones are the most common type of kidney stones. They are usually made of calcium and oxalate (a natural chemical found in most foods), but are sometimesmade of calcium and phosphate. Uric acid stones form when your urine is often too acidic. Refer robbins 9/e p951


Question: Prodrornal symptoms precede 1 to 2 days before the onset of disease in


Question: "Pile of plates" appearance on angiography suggests diagnosis of

Angiography: "string of beads"/"Pile of plates" appearance of FMD is classically seen on angiography. Fibromuscular dysplasia most commonly causes small stenoses along a vessel with intervening areas of dilatation (small aneurysms), creating a "string of beads" appearance. Less commonly the stenosis has a smooth tapered appearance. Fibromuscular dysplasia also weakens the vessel wall which predisposes to dissection ref Robbins 9/e pg 678


Question: the study of neoplastic growths is referred to as

Cancers are often managed through discussion on multi-disciplinary cancer conferences where medical oncologists, surgical oncologists, radiation oncologists, pathologists, radiologists, and organ specific oncologists meet to find the best possible management for an individual patient considering the physical, social, psychological, emotional, and financial status of the patient.
It is very important for oncologists to keep updated with respect to the latest advancements in oncology, as changes in management of cancer are quite common.
All eligible patients in whom cancer progresses, and for whom no standard of care treatment options are available should be enrolled in a clinical trial


Question: Breast Ca is not a/w

Frequently, in FIBROCYSTIC CHANGES the lining cells are large and polygonal with abundant granular, eosinophilic cytoplasm and small, round, deeply chromatic nuclei. Such morphology is called apocrine metaplasia and viually always is benign. ref : Robbins Basic Pathology, 9E,page-705


Question: "Acrodermatitis enteropaihica" is seen in deficiency of

Ans. b (Zinc) (Ref. Robbins 7'h/461; Table 9.24; H-17th/ Table 71-2)Robbins 7th/p. 461Essential features of zinc deficiency are:# Distinctive rash, often around the eyes, nose, mouth, anus and distal parts.# Anorexia, often accompanied by diarrhoea# Growth retardation in children# Impaired wound healing# Hypogonadism with i reproductive capacity.# Altered immune function# Impaired night vision related to altered vitamin A metabolism# Depressed mental function# Increased incidence of congenital malformation in infants of Zn-deficient mothers.Micro and macroelementslementDeficiencyToxicityTolerable Upper (Dietary) Intake LevelBoronNo biologic function determinedDevelopmental defects, male sterility, testicular atrophy20 mg/d (extrapolated from animal data)CalciumReduced bone mass(osteoporosis)Renal insufficiency (milk-alkali syndrome), nephrolithiasis, impaired iron absorption2500 mg/d (milk-alkali)CopperAnemia, growth retardation, defective keratinization and pigmentation of hair, hypothermia, degenerative changes in aortic elastin, osteopenia, mental deteriorationNausea, vomiting, diarrhea, hepatic failure, tremor, mental deterioration, hemolytic anemia, renal dysfunction10 mg/ d (liver toxicity)ChromiumImpaired glucose toleranceOccupational: renal failure, dermatitis, pulmonary cancerNDFluorideDental cariesDental and skeletal fluorosis, osteosclerosis10 mg/d (fluorosis)IodineThyroid enlargement, T4, cretinismThyroid dysfunction, acne-like eruptions1100 g/d (thyroid dysfunction)IronMuscle abnormalities, koilonychia, pica, anemia, work performance, impaired cognitive development, premature labor, perinatal maternal mortalityGastrointestinal effects (nausea, vomiting, diarrhea, constipation), iron overload with organ damage, acute systemic toxicity45 mg/d of elemental iron (GI side effects)ManganeseImpaired growth and skeletal development, reproduction, lipid and carbohydrate metabolism; upper body rashGeneral: Neurotoxicity, Parkinson-like symptoms Occupational: Encephalitis- like syndrome, Parkinson-like syndrome psychosis, pneumoconiosis11 mg/d (neurotoxicity)MolybdenumSevere neurologic abnormalitiesReproductive and fetal abnormalities2 mg/d extrapolated from animal dataSeleniumCardiomyopathy, heart failure, striated muscle degenerationGeneral: Alopecia, nausea, vomiting, abnormal nails, emotional lability, peripheral neuropathy, lassitude, garlic odor to breath, dermatitis Occupational: Lung and nasal carcinomas, liver necrosis, pulmonary inflammation400 g/d (hair, nail changes)PhosphorousRickets (osteomalacia), proximal muscle weakness, rhabdomyolysis, paresthesia, ataxia, seizure, confusion, heart failure, hemolysis, acidosisHyperphosphatemia4000 mg/dZincGrowth retardation, taste and smell, alopecia, dermatitis, diarrhea, immune dysfunction, failure to thrive, gonadal atrophy, congenital malformationsGeneral: Reduced copper absorption, gastritis, sweating, fever, nausea, vomitingOccupational: Respiratory distress, pulmonary fibrosis40 mg/d (impaired copper metabolism)


Question: The chemical nature of the amyloid deposited in immunocyte dyscrasias with amyloidosis is


Question: Most successful application of tumor markers

Answer: b) Effect of treatment and early detection( style="font-size: 1.04761904761905em; font-family: Times New Roman, Times, serif">)Tumor markers* Just an adjunct to diagnosis, and establishing a diagnosis on the basis of tumor markers alone (especially a single result) is associated with pitfalls because of the problem of non-specificity.* Clinical uses can be broadly classified into 4 groups: screening and early detection, diagnostic confirmation, prognosis and prediction of therapeutic response and monitoring disease and recurrence.* Serum levels, in certain situations, can be used in staging, prognostication or prediction of response to therapy.* Monitoring disease is, perhaps, the most common clinical use of serum tumor markers.* Rising trend in serum levels may detect recurrence of disease well before any clinical or radiological evidence of disease is apparent ("biochemical recurrence").


Question: Most mature normoblast is

Development of the red blood cells take place in the following order: Erythroblast /Pronormoblast - Basophilic /Early Normoblast - Polychromatic/ Intermediate Normoblast - Ohochromic /Late normoblast - Reticulocyte - Red blood cell - Maturity increases & size decreases in the following order. - Thus, Ohochromic normoblast is most mature normoblast

RBC Development and Classification of Anemias


Question: Hamartoma is


Question: Waardenburg syndrome is due to mutation of

Ans. (b) PAX3 gene(Ref: Robbins 9th/pg 140; 8th/pg 140)Waardenburg syndrome (WS):Autosomal dominant inherited conditionHypopigmentation of hair, skin, and/or iris of both eyes (partial albinism); and/or congenital deafness.4 types: Types I and II are the most common forms of Waardenburg syndrome, while types III and IV are rare.Mutations in the EDN3, EDNRB, MITF, PAX3, SNAI2, and SOX10 genes can cause Waardenburg syndrome.


Question: Taurodontism is seen in


Question: Microvesicular steatohepatosis seen in

Option a, c, d have macrovesicular steatosis.


Question: Dental caries is associated with


Question: Squamous papilloma is induced by


Question: An attack of cluster headache can be aborted by

Cluster headache is unilateral and among the most painful of all headache disorders. Periorbital pain is commonly associated with autonomic symptoms including homoLateral lacrimation. Abortive medicines including the use of 100% oxygen at the outset of an episode, are often useful in confirming diagnosis. Oxygen inhalation results in rapid resolution of symptoms over 70% cases.
Triptan therapy, short courses of glucocorticoids are also effective.


Question: Carcinoma of lip


Question: Centrilobular necrosis of liver may be seen with

CCl4 is hepatotoxic. Centrilobular necrosis seen in CVC liver. Causes: right sided hea failure. Mechanism: dilatation of central veins-Transmission of increased venous pressure to the sinusoids-dilatation of sinusoids-ischemic necrosis of hepatocytes in centrilobular region. Gross: congested centrilobular area appear dark red brown, peripoal region is better oxygenated hence appear pale Microscopy: centrilobular region: congestion, hemorrhage, thickening of Central veins and fibrosis, centrilobular hepatocyte necrosis. Peripoal region: fatty change in hepatocytes. GENERAL AND SYSTEMIC PATHOLOGY RAMDAS NAYAK PGNO.89


Question: Not a chromosoal breakage syndrome

Duchenne muscular dystrophy (DMD) is a genetic disorder characterized by progressive muscle degeneration and weakness. It is one of nine types of muscular dystrophy. DMD is caused by an absence of dystrophin, a protein that helps keep muscle cells intact. Symptom onset is in early childhood, usually between ages 3 and 5. The disease primarily affects boys, but in rare cases it can affect girls.DMD has an X-linked recessive inheritance pattern and is passed on by the mother, who is referred to as acarrier.


Question: The necrotic tissue and deposits of immune complexes, complement and plasma protein produce a smudy eosinophilic deposit is termed as


Question: Aoic arch syndrome is due to

Takayasu aeritis is a granulomatous vasculitis of mediumsized and larger aeries characterized principally by ocular disturbances and marked weakening of the pulses in the upper extremities. (Robbins basic pathology,9th edition,pg no.353) Takayasu's aeritis is an inflammatory and stenotic disease of mediumand large-sized aeries characterized by a strong predilection for the aoic arch and its branches. For this reason, it is often referred to as the aoic arch syndrome. (Harrison&;&;s principle of internal medicine,18th edition,pg no.)


Question: Phacolytic glaucoma arises commonly from

Types of lens-induced glaucoma'sCausesMechanismPhacomorphicIntumescent cataract, Anterior subluxation or dislocation of LENs and spherophakia Swollen lens pushes iris forwards and obliterates the angle -secondary acute angle closure glaucoma-pupillary block and iris bombe formation Phacolytic Hypermature (Morgagnian) cataract Trabecular meshwork clogged by lens proteins and macrophages have phagocytosed the lens proteins -secondary open-angle glaucomaLens paicle glaucoma Lens paicles left after accidental. Planned ECCE, Following traumatic rupture of lens Trabecular meshwork blocked by lens paicles floating in aqueous humour-secondary open-angle glaucomaGlaucoma with phacogenic uveitis Uveitis Trabecular meshwork clogged by lens proteins and macrophages have phagocytosed the lens proteins -secondary open-angle glaucomaGlaucoma with phacoanaphylaxis Inflammatory reaction due to antigen-antibody reaction Trabecular meshwork clogged by lens proteins and macrophages have phagocytosed the lens proteins -secondary open-angle glaucoma(Refer: AH Khurana, Comprehensive Textbook of Ophthalmology, 5th edition, pg: 247-48)


Question: Lymphoplasmacytoid lymphomas may be associated with

Ans. (b) IgM(Ref: Robbins 9th/pg 598-602)Lymphoplasmacytic cell proliferation in marrow (Lymphoplasmacytic lymphoma) with secretion of IgM


Question: Most common Non Hodgkins lymphoma is

Ans. (a) Diffuse large B cell lymphoma(Ref: Robbins 9th/pg 595-596; 8th/pg 606-607)Most common Non Hodgkins lymphoma is Diffuse large B cell lymphomaDiffuse large B cell lymphoma (DLBCL)


Question:
Bone Pain, bone, cysts, fractures and renal stones are
characteristics of


Question: Ram Devi presented with generalized edema sweating and

The symptoms of the patient are d/t hypersensitivity type I reaction Type I is mediated by IgE and it flairs up within minutes.
The symptoms range from rashes to anaphylactic shock with vasodilatory hypotension and bronchiolar spasm.
Examples of type I
Eczema*
Hay fever*
Asthma*
Anaphylactic shock*
Urticaria*
A cute dermatitis *
Theobald Smith reaction *
Other hypersensitivity reactions
Type II
is characterized by an antigen-antibody reaction on the surface of a host cell*.
Mediated by IgG or IgM.
Examples
1. Blood transfusion reactions *
2. Transplant rejection *
3. Autoimmune hemolytic anaemia*
4. Autoimmune thrombocytopenic purpura *
5. Diabetes disease*
6. Good pasture’s syndrome *
7. Grave's disease*
8. Myasthenia gravis*
9. Pemphigus
0. Pernicious anaemia*
1. Rheumatic fever*
Type HI reactions
Mediated by antigen/antibody complex*.
Examples
1. PAN*
2. Post streptococcal glomerulonephritis*
3. Rheumatoid arthritis*
4. Systemic lupus erythematosus*
5. Acute viral hepatitis*
6. Penicillamine toxicity*
7. Serum sickness*
8. Arthus reaction*
Type IV reaction
Cell-mediated reaction (delayed hypersensitivity)*.
Examples
1. Tuberculosis*
2. Sarcoidosis*
3. Temporal arteritis
4. Contact dermatitis* (not that acute dermatitis in type I)
5. Lepromin test*
6. Patch test*
7. PPD*


Question: Hypovolemic shock develops after loss of


Question: The type of acute myelogenous leukemia associated with a high incidence of disseminated intravascular coagulation is


Question: The most common supernumerary tooth form is


Question: Iron absorption is increased by

Ans. (d) Ascorbic acid(Ref: Robbins 9th/pg 649-652)Iron Absorption*. Site of iron absorption: duodenum and upper jejunum (proximal small intestine) Q.*. Ferrous form (Fe2+) of Iron is absorbed Q.*. Transport of Fe2+ into enterocyte occurs via DMT1 Q.Increased byDecreased by*. Acids Q*. Ascorbic acid (Vitamin C) Q*. Amino acid containing SH-group*. Meat (these reduce Fe3+ to Fe2+)*. Alkalies*. Phosphates Q*. Phytates Q*. Tetracycline*. Presence of other food in stomach


Question: Hea failure cells are

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


Question: The following combination of drugs is best suited for daycare surgery


Question: Paroxysmal nocturnal hemoglobinuria results from acquired mutations in

Paroxysmal nocturnal hemoglobinuria (PNH) is a disease that results from acquired mutations in the phosphatidylinositol glycan complementation group A gene (PIGA), an enzyme that is essential for the synthesis of ceain membrane-associated complement regulatory proteins.PNH blood cells are deficient in three GPI-linked proteins that regulate complement activity: (1) decay accelerating factor, or CD55; (2) membrane inhibitor of reactive lysis, or CD59; and (3) C8 binding protein.Of these factors, the most impoant is CD59, a potent inhibitor of C3 convease that prevents the spontaneous activation of the alternative complement pathway.Red cells deficient in these GPI-linked factors are abnormally susceptible to lysis or injury by complement and manifests as intravascular hemolysisRobbins pathology 9e pg: 642


Question: Gingiva are enlarged in leukemia because of


Question: Most common tumor in lateral hemisphere of brain

Astrocytomas generally effect lateral hemispheres of brain. Astrocytomas are a type of cancer of the brain. They originate in a paicular kind of glial cells, star-shaped brain cells in the cerebrum called astrocytes. This type of tumor does not usually spread outside the brain and spinal cord and it does not usually affect other organs. Ref : Robbins and cotrans 9e Pg ; 1307


Question: Lifespan of transfused platelets is

Transfused platelets have an expected life-span of 3-4 days. This may be significantly reduced due to immune refractoriness, consumption, or sequestration. Most platelet products are transfused into non-bleeding thrombocytopenic patients. Thetransfusion "trigger" or threshold fortransfusion of these patients is now generally accepted to be 10,000/mL based on the results of a number of studies Ref bailey and love 27th edition ; pg 17-22


Question: Atrial myxoma commonly arises from


Question: AML with worst prognosis

AMLs with t (15;17)have best prognosis. AMLs with t (8;21)or inv (16) have relatively good prognosis with conventional chemotherapy. Poor prognosis for AMLs that follow MDS or genotoxic therapy or that occurs in adults. AMLs following MDS or exposure to DNA damaging agents have deletions or monosomies involving chromosomes 5 and 7.There fore monosomy 7 has the worst prognosis Ref:Robbins and Cotran Pathologic basis of disease.South Asia Edition -9;volume 1.page no.614


Question: MC gene involved in endometrial carcinoma

PTEN - Phosphatase & tensin homologue Cowden syndrome - AD disorder with tumours of skin appendages & increased incidence of Breast, Endometrium, Prostate & thyroid cancer Acts as TSG by serving as a break in the pro-growth PI3K/AKT pathway (MCly mutated p/w in human ca) By phosphorylating a number of substrates like BAD and MDM2, AKT enhances cell survival.


Question: A patient with Carcinoma cheek has tumor of 2.5 cms located close to and involving the lower alveolus. A single mobile homotateral node measuring 6 cm is palpable. Based on these clinical findings TNM stage of the tumor is


Question: Kaposi's sarcoma is more commonly seen in patient with


Question: Hereditary retinoblastomas develop the following chromosomal deletion

(A) 13q 14# Deletion of a small number of tightly clustered genes result in a number of genetic disorders termed as microdeletion syndromes.> Some of the important ones that have been asked include: Wilm's tumor-Aniridia complex 2 (WAGR syndrome) IIpI36 Part of (deletion of short arm of chromosome 11 Retinoblastoma 13qI4.116 (deletion of part of long arm of chromosome 13) Prader-Willi syndrome, Angelman syndrome6 15qII-136 (deletion of pa rt of long arm of chromosome 15) DiGeorge's syndrome, Velo-cardiofacial syndrome 22qII6 (deletion of part of long arm of chromosome 22)


Question: Secondary syphilis occurs after


Question: The inheritance pattern of dentinogenesis imperfecta is


Question: A linear pattern of immunoglobulin deposition along the glomerular basement membrane that can be demonstrated by immunofluorescence is typical of

In Goodpasture's syndrome, circulating antibodies reactive with the glomerular basement membrane bind in a linear pattern along the entire length of the glomerular basement membrane, which is their specific antigen. IgG is deposited in the basement membrane, along with complement. There are focal interruptions of the glomerular basement membrane as well, along with deposits of fibrin, as seen with electron microscopy Reference: Robbins & Cotran Pathologic Basis of Disease, 9edition


Question: One of the following is apoptosis inhibitor gene

Anti-apoptotic genes are BCL -2, MCL -1, BCL -XL"The pro-apoptotic proteins BAX and BAK are required for apoptosis and directly promote mitochondrial permeabilization. Their action is inhibited by the anti-apoptotic members of this family, which are exemplified by BCL2, BCL-XL, and MCL1. A third set of proteins (so-called BH3-only proteins), including BAD, BID, and PUMA, sense death-inducing stimuli and promote apoptosis by neutralizing the actions of anti-apoptotic proteins like BCL2 and MCL1"Robbins pathology 9e pg: 302


Question: Apoptosis is inhibited by

The integrity of the mitochondrial outer membrane is regulated by pro-apoptotic and anti-apoptotic members of the BCL2 family of proteins. The pro-apoptotic proteins BAX and BAK are directly promoting mitochondrial permeabilization. Their action is inhibited by the anti-apoptotic proteins BCL2 and BCL-XL. The third set of proteins, the so-called BH3-only proteins, which include BAD, BID, and PUMA, regulate the balance between the pro- and anti-apoptotic members of the BCL2 family.( Robbins Basic Pathology, 9th edition, page 189 )


Question: Gene associated with superficial papillary urothelial neoplasm

Answer- B. p16Chromosome deletions in 9p, which contains the tumor suppressor gene p16, are the only consistent finding in low grade papillary tumors and flat carcinomas in situ. Deletions in 17 p, the site of p53 gene, are often found in invasive bladder cancer.


Question: Megaloblastic anaemia occurs due to


Question: Most common ovarian tumor

Ans. (a) Serous cystadenoma(Ref: Robbins 9th/pg 1023)*Most ovarian tumors are surface epithelial (65-70%)*Serous cystadenoma is the most common surface epithelial tumor


Question: Liquefactive necrosis occurs in

i.e. (Brain): (45-Harsh mohan 6th) (15-129- Robbins & Cotran 8th)LIQUEFACTIVE (COLLIQUATIVE) NECROSIS - occurs commonly due to ischaemic injury and bacterial or fungal infections* It occurs due to degradation of tissue by the action of powerful hydrolytic enzyme.* Common examples are Infarct brain and abscess cavity* Duret hemorrhage is seen in Brain** (Duret haemorrhage is small area in bleeding in ventral & paramedian part of upper brain stem (midbrain & pons)


Question: The common site of melanoma on the orofacial skin is


Question: Retinitis pigmentosa inheritance is by

. Autosomal recessive. Digenic inheritance. Autosomal dominantExplanation :- Note: This question is ambiguous


Question: Oral Lesion associated with ulcerative colitis

In pyostomatitis vegetans, the oral lesions are one part of the syndrome, in which the patients also manifest concomitantly ulcerative colitis or other gastrointestinal disturbances.
The oral lesions consist of large numbers of broad-based papillary projections, tiny abscesses or vegetations developing in areas of intense erythema. These lesions may occur in any area of the oral cavity, although tongue involvement appears to be uncommon.


Question: Calcium blocking agents of use in the treatment of hypeension include

Nifedipine The overriding action of Nifedipine is aeriolar dilation, t.p.r. decreases and BP falls.Doesn&;t depress SA node or A-V conduction.Reflex sympathetic stimulation of hea predominates leading to tachycardia, increased contractility and C.O., coronary flow is increased.Its use is associated with higher moality among post-MI patients.Relaxant effect on the bladder, Nifedipine can increase urine voiding difficulty in elderly malesContraindicationsSide effectsHea failure 2nd or 3rd-degree hea blockTachycardia, flushingGI disturbancesHyperkalemia, edema, headache(Refer: Harrison's Principles of Internal Medicine, 18th edition, pg no: 2054-2057)


Question: Most common histological type of thyroid carcinoma is

(B) Papillary type # Morphological variants of thyroid carcinoma and their approximate frequencies are: Papillary carcinoma 75-85% Follicular carcinoma 10-20% Medullary carcinoma 5% Anaplastic carcinoma < 5%> Histology type Incidence Papillary 80% Follicular 10% Medullary 5% Anaplastic 1 %> Papillary carcinoma thyroid: Commonest carcinoma of thyroid gland (80%) Commonest carcinoma in iodine sufficient area. More common in patients with previous exposure to radiation (past childhood) Commonest age 30-40 year. Multifocal (more common) Lymph node metastases more common (i.e., lymphatic spread) Distant metastasis uncommon commonest site - lung followed by bone, liver, brain. Prognosis excellent -10 years survival (95%)


Question: Councilman bodies are seen in

In pathology, a Councilman body, also known as Councilman hyaline body or apoptotic body, is an acidophilic globule of cells that represents a dying hepatocyte often surrounded by normal parenchyma. They are found in the liver of individuals suffering from viral hepatitis, yellow fever, or other viral syndromes Refer robbins 9/e p614


Question: Bismuth intoxication is manifested as


Question: The nerve root blocked in pudendal nerve block

Pudendal nerve block, blocks sacral segments (S2-4) thus provides perineal analgesia. The anesthesia is produced by blocking the pudendal nerves near the ischial spine of the pelvis. The pudendal block gets its name because a local anesthetic, such as lidocaine or chloroprocaine, is injected into the pudendal canal where the pudendal nerve is located. Ref Robbins 9/e pg 345


Question: The most common site of metastases of osteosarcoma is


Question: Muddy brown casts are seen in

Muddy brown casts made up of epithelial cells are pathognomonic for Acute tubular necrosis.


Question: Reilly bodies are inclusion bodies seen in hurler's disease within


Question: Russel bodies are seen in

*Multiple myeloma is plasma cells disorder. These plasma cells may have intracytoplasmic inclusion called as Russel bodies and intranuclear inclusions called as Dutcher bodies.


Question: Most common organs involved in wegner's granulomatosis are

Wegner gronulomatosis now known as, granulomatosis with polyangitis is a necrotizing vasculitis characterized by a tried of.

Necrotizing gronulomar of the upper respiratory tract (ear, nose, sinuses, throat) or the lower respiratory tract (lung) or both.
Necrotizing or granulomatous vasculitis affecting small to medium - sized vessels (eg: capillorics, venuler, arterioles and arterier). Most prominent in the lungs and upper airways but involving other sites as wells.
Focal necrotizing, often crescentic, glomerulonephritis Also know that "limited" forms of this disease may be restricted to the respirotory tract,


Question: The 2nd common most supernumerary teeth is


Question: Most common aneuploidy compatible with life is

Answer- A, Down syndromeMost common aneuploidy in which infant can survive is trisomy-21 (Down syndrome)


Question: In meiosis chromosome number is


Question: Schiller Duval body is characteristic of

Yolk Sac TumorThough rare, yolk sac tumor (also known as endodermal sinus tumor) still ranks as the second most common malignant tumor of germ cell origin. Similar to the normal yolk sac, the tumor cells elaborate a-fetoprotein. Its characteristic histologic feature is a glomerulus-like structure composed of a central blood vessel enveloped by tumor cells within a space that is also lined by tumor cells (Schiller-Duval body).Ref: Robbins and Cotran Pathologic Basis of Disease; 9th edition; Chapter 22; The Female Genital Tract; Page no: 1031


Question: Most common age group affected with Infantile Colic is between

Infantile colicRule of threeCrying > 3 hours/day---- > 3 days/week for > 3 weeks.Facial grimacing, drawing up of legs and passing flatus.An infant usually outgrows colic by 3 to 4 months of age(Refer: Nelson's Textbook of Paediatrics 19thedition, pg no: chapter - 11)


Question: Inflammasome is formed in

Ans. (d) Pyroptosis(Ref: Robbins 9th/pg 58-59)Pyroptosis: Promotes the activation of inflammasomewhich activates Caspase-1Q which releases biologically active form of IL^-1 from the precursor.


Question: Macropolycyte in peripheral smear is a feature


Question: Commonest site of carcinoma of tongue


Question: Arrange the following in increasing order for risk of malignancy1.Fibroadenoma2.Sclerosing adenosis3.Atypical ductal hyperplasia4.Lobular carcinoma is situ

Lesion
Relative risk

Fibroadenoma
1%

Sclerosing adenosis
1.5-2%

Atypical ductal hyperplasia
4-5%

Atypical lobular hyperplasia
8-10%


Question: Dyskeratosis

dys*ker*a*to*sis (dis'ker-a-to'sis), 1. Premature keratinization in individual epithelial cells that have not reached the keratinizing surface layer; dyskeratotic cells generally become rounded and they may break away from adjacent cells and fall off. Dyskeratosis terms that abnormal premature keratinisation within cells below the stratum granulosum. Ref: Robbins and cotrans 9e Pg 1143


Question: Irreversible injury is due to

Irreversible Injury: Defect in membrane function in general, and plasma membrane in particular, is the most important event in irreversible cell injury in ischaemia. Oxygen deprivation causes shift of calcium from mitochondria and endoplasmic reticulum into the cytosol. Increased level of calcium in the cytosol activates endogenous phospholipases from ischaemic tissue which degrade membrane phospholipids progressively which are the main constituent of the lipid bilayer membrane. An alternate hypothesis is decreased replacement-synthesis of membrane phospholipids due to reduced ATP.
Myelin figures & cellular swelling are the changes seen in Reversible cell injury.


Question: The attachment of the Actinomyces species to the tooth surface is facilitated by


Question: The characteristic lesion of atherosclerosis is

Atherosclerosis is a intima based lesion composed of a fibrous cap and an atheromatous core: the constituents of the plaque include smooth muscle cells, ECMs, inflammatory cells, lipids and necrotic debris Robbins 9th edition page no 343

Giant cell reaction in the retina and internal elastic lamina

Organised thrombus in the affected segment

'Fibro-fatty' lesion in the intima of the blood vessels


Question: Most common cause of death in ADPKD

Hypertensive or coronary artery disease is the most common cause of death in ADPKD.


Question: 'Growth Phase' of the hair


Question: Hour glass deformity is seen in

COMPLICATIONS. Acute and subacute peptic ulcers usually heal without leaving any visible scar. However, healing of chronic, larger and deeper ulcers may result in complications like Obstruction. Development of fibrous scar at or near the pylorus results in pyloric stenosis. In the case of healed duodenal ulcer, it causes duodenal stenosis. Healed ulcers along the lesser curvatures may produce 'hourglass' deformity due to fibrosis and contraction TEXT BOOK OF HARSH MOHAN SIXTH EDITION PAGE.553. IMAGE REF:


Question: Classical pathway macrophage activating molecule

Answer- A. IFN gammaThere are two major pathways of macrophage activation:Classical macrophage activation- induced by microbial products, which engage toll like receptors & other sensors, by T cell derived signals, impoantly the cytokine IFN-yAlternative macrophage activation - induced by cytokines III & ILl3 produced by T lymphocytes & other cells. Their main function is tissue repair & secrete growth factors which cause angiogenesis, activate fibroblasts & stimulate collagen synthesis.


Question: Granuloma formation is seen in Hypersensitivity reaction type

(IV): (74- Harsh Mohan 6th edition)Type IV: Delayed Hypersensitivity (Cell Mediated Reaction)Examples1. Reaction against mycobacterial infection eg tuberculin reaction, granulomatous reaction in tuberculosis, leprosy2. Reaction against virally infected cells3. Reaction against malignant cells in the body4. Reaction against organ transplantation eg transplant rejection, graft versus host reactionType I (Anaphylactic, atopic) Type II (Cytotoxic) Type III (Immune- Complex, Arthus reaction)1. Systemic anaphylaxis (administration of antisera(ATS) and drugs (Penicilline) 1. Cytotoxic antibodies to blood cells (Auto immune haemolytic anaemia, Transfusion reactions, Erythroblastosis foctalis, ITP, Leucopcnia, drug induced (penicillin, methyl dopa, rifampicin) I. Immune complex glomerulonephritisII. Goodpasture's syndromeIII. Collagen disease (SLE, RA)IV. PANV. Drug induced vasculitis2. Local anaphylaxis (hay fever, bronchial asthma, food allergy, cutaneous, angioedema) 2. Cytotoxic antibodies to tissue components (Gravis disease, M.gravis, male sterility, Type I DM, Hyper acute reaction against organ transplant)


Question: Proliferative glomerular deposits in kidney are found in


Question: Preauricular pain, grating sensation and partial trismus are the symptoms of


Question: Hemodialysis associated with amyloid pattern


Question: Bernard Soulier syndrome is due to defect in

Bernard-Soulier syndrome (BSS), is a rare autosomal recessive bleeding disorder that causes a deficiency of glycoprotein Ib(GpIb), the receptor for von Willebrand factor Causes Mutations in GP1BA, GP1BB and GP9 Diagnostic method Flow cytometry analysis Treatment Platelet transfusion


Question:
The most common salivary gland malignant neoplasm in
bones


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

DCIS has a wide variety of histologic appearances. Architectural patterns often are mixed and include solid, comedo,n cribriform, papillary, micropapillary, and "clinging" types.The comedo subtype is distinctive and is characterized by cells with high-grade nuclei with extensive central necrosis ref : Robbins Basic Pathology, 9E,page-710 ref img


Question: Pink's disease is due to


Question: TB is associated with


Question: Anticipation is seen in

Ref: Robbin's Pathology, 9th ed. pg. 168* Anticipation is a phenomenon where by the symptoms of a genetic disorder become apparent at an earlier age as it is passed to next generation. In most cases, an increased severity of symptoms is also noted.* In triplet nucleotide repeat mutation, the DNA fragment is unstable and tends to expand further during cell division.So, in successive generations the expanded repeat increases and the manifestations of disease may worsen or may be observed at an earlier age; this phenomenon is referred to as anticipation.


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.
Syndrome associated with this disease is

Grinspan's syndrome is an interesting association of lichen planus, diabetes mellitus and vascular hypertension.


Question: Serum marker of rickets is

Amongst the given options, alkaline phosphatase is best because it is raised in all type of rickets.
The primary (Basic) investigations in a child of rickets are :-

Serum calcium
Serum phosphorus
Alkaline phosphatase

If the patient does not respond to calcium and Vit D therapy, secondary investigations are done:-

Vit D level
Serum PTH
Urinary calcium and phosphorus.


Question: MHC III codes for

Ans. (a) TNF alpha(Ref: Robbins 9th/pg 195; 8th/pg 191)MHC III: No direct role in immune system QCodes for:complement components C2, C4, properdin, factor B QTNF, HSP-70, Tyrosine hydroxylase


Question: +ve pathergy test is seen in


Question: Standard treatment of ameloblastoma

Segmental resection with 1 cm of normal bone


Question: In addition to ETEC another strain of E.coli that causes Travellers diarrhea is

.Enteropathogenic Escherichia coli (EPEC) is a non-Shiga toxin-producing strain of E. coli that causes diarrhea an "attaching and effacing" mechanism on the surface of enterocytes . In adults, EPEC diarrhea presents as watery diarrhea (sometimes associated with vomiting) in association with a low-grade fever


Question: HLA is located on aEUR'

Sho arm of chr- 6 Human leucocyte antigen is so called because it was first discovered on the leucocytes. HLA is also called Major histocompatibility complex. The histocompatibility antigens (human leukocyte antigens - HLA) are cell surface antigens that induce an immune response leading to rejection of allogrufts. The principal physiologic function of the cell surface histocompatibility molecules is to bind peptide fragments of foreign proteins for presentation to antigen specific T cells. The histocompatibility antigens are encoded by a closely linked multiallelic cluster of genes, Major histocompatibility complex (MHC) or Human leukocyte antigens complex (HLA complex). - HLA complex of genes is located on the sho arm of chromosome 6. It consists of three separate clusters of genes: HLA Complex [MHC Responses of MHC molecules Class 1 MHC class I molecules bind and process peptide that are derived from proteins synthesized within the cells, e.g. viral protein in viral infected cells and antigen of cancerous cells. These cells (cancerous or virus infected) have a tendency to display unusual, non self antigens on their surface. After binding to MHC-I, these antigens are processed and presented to cytotoxic CD-8 T cells (MHC-I restricted). Cytotoxic CD-8 T cell - MHC I reaction cause -- Graft rejection - Cell mediated cytolysis of viral infected or tumor cells. Class II Class 11 molecules present exogenous antigen (e.g. extracellular microbes, soluble proteins). These antigens are first internalized and undergo proteolytic cleavage in lysosome. Peptide generated .from this proteolytic cleavage are presented by MHC - II to CD4-T cells (MHC-II restricted). Reactions are : - Graft versus host response - Mixed leukocyte reaction Class III "The MHC class HI region contains many genes that are good candidates for the involvement in autoimmune disease". Recent data suggest that quantitative and qualitative diversities of the MHC Ill linked C4 among different ethnic groups can be impoant in susceptibility to autoimmune disease like SLE. Note ? The pa of MHC complex that code for TNF a & /land heat shock protein, is also referred as class IV MHC.


Question: Most common CNS neoplasma in HIV patient 2

Primary CNS lymphoma occurs very frequently in patients suffering AIDS and others immuno deficiency states.


Question: Leber hereditary optic neuropathy ELHUNI is caused by mutation in

Answer- A. Mitochondrial DNAMitochondrial DNA is the only non-chromosomal DNA in human cells. Mitochondrial DNA is always maternally inherited.Thus diseases caused by mutation in mitochondrial DNA are always inherited from mother to next generation.All children from affected mother will inherit the disease but it will not be tranmtitted from an affected father to his children


Question: Maximum unsaturated fatty acid is seen in

FatsPUFASafflower oil75Sunflower seed oil65Soya bean oil62Margarine 50Groundnut oil31Palm oil10Butter 3Coconut oil2(Refer: K. Park's Textbook of Preventive and Social Medicine, 24th edition, pg no: 649)


Question: Cancerous involvement is seen with


Question: Immune complex mediated reaction

Ans. is 'c' i.e., Type III reactions Type III hypersensitivity o Type III hypersensitivity reaction is antigen-antibody immune complex mediated that are deposited in postcapillary venules of various tissues with subsequent complement fixation. o Immune complexes produce tissue damage mainly be eliciting inflammation. Type III hypersensitivity may be of two types A. Systemic or generalized Immune complex disease (serum sickness) - It occurs in three phases :? Phase I --> Formation of antigen - antibody immune - complex in the blood. Phase II --> Traveling of immune complex through blood and deposition in various tissues. Phase III ---> Induction of inflammation by immune complex. Generally, common sites of deposition of immune complex incude - Skin Joints Lungs Kidney Blood vessels B. Localized immune complex disease (Ahus reaction) Ahus reaction is a localized area of tisue necrosis resulting from acute immune - complex vasculitis, usually elicited in the skin.


Question: Single gene disorder

(A) Duchenne muscle dystrophy MENDELIAN DISORDERS/SINGLE GENE DISORDERSAutosomal DominantAutosomal RecessiveX-linked RecessiveX-linked DominantFAP of colonAchondroplasiaAcute intermittent porphyriaHyperlipoproteinemia1.2,3,4HemorrhagicHSHuntington's dsMarfan's syndromeNeurofibromatosisOsteogenesis imperfectaPolydactylyvWDRetinoblastomaPeutz Zeghers syndromeOsteosclerosisMost inborn error of metabolism e.g.AlbinismAlkaptonuriaAgammaglobulinemia(Swiss type)Cystic fibrosisMaple Syrup Urine dsHemochromatosisWilson's dsPKULysosomal storage dsGlycogenesis, Gaucher's ds., PK deficiency21-Hydoxylase def,CAHb-thalessemiaSickle cell anemiaHirschsprung's diseaseHemophiliaColor blindnessG-6-PD def.(incompletely dominant (expression)DICGDAgammaglobulinemia (Bruton's)Duchenne's and Becker'sMuscle dystrophyRPHydrocephalusOrnithine transcarbamylase deficiencyVit-D resistant/ hypophosphatemicRicketsAlport syndromeFamilialHypophosphatemiaBlood group XgIncontinentia PigmentiFabry's DS


Question: Multiple periapical radiolucencies are seen in


Question: The chief cells of the stomach secrete


Question: 'Lock jaw' indicates


Question: The genetic inheritance of hemophilia is

Robims basic pathology 6th edition chapter red cells and bleeding disorders. page no.639. Haemophilia is a sex linked(X-linked) recessive disorder . So disease manifests in all males and homozygous females.


Question: MHC II is present on

MHC I is present on all nucleated cells and platelets.
MHC is present on immune cells like Macrophage, Langerhans cells, B cells.


Question: Adult polycystic kidney disease is

Ref: Robbins Pathology, 9th ed. pg. 946* ADPKD is autosomal dominant--Polycystic kidney disease.* Occurs due to mutation in PKD 1 and PKD 2 gene* MC type of mutation: PKD 1. (80-85%)* Pathological feature: Large multicystic kidney. It also involves commonly:# MC: Liver-Polycystic liver disease (40%)# Heart: Mitral valve prolapse (20-25%)# Brain: Berry aneurysm


Question: Comment on the diagnosis.


Question: Common site of hematopoiesis in fetus is

Development of the Hematopoietic System. Primitive hematopoiesis is followed by definitive hematopoiesis in mice and humans. Embryonic hematopoiesis begins in the yolk sac and changes to definitive hematopoiesis in the fetal liver. The bone marrow becomes the principal site of hematopoiesis late in gestation Ref Robbins 9/e pg 138


Question: Congenital hepatic fibrosis is a characteristic feature of

Infantile and Iuvenile forms are associated with congenital Hepatic fibrosis.


Question: Mitochondrial abnormality is seen in

Fanconi syndrome or Fanconi's syndrome is a syndrome of inadequate reabsorption in the proximal renal tubules of the kidney. The syndrome can be caused by various underlying congenital or acquired diseases, by toxicity (for example, from toxic heavy metals), or by adverse drug reactions. It results in various small molecules of metabolism being passed into the urine instead of being reabsorbed from the tubular fluid (for example, glucose, amino acids, uric acid, phosphate, and bicarbonate). Fanconi syndrome affects the proximal tubules, namely, the proximal convoluted tubule (PCT), which is the first pa of the tubule to process fluid after it is filtered through the glomerulus, and the proximal straight tubule (pars recta), which leads to the descending limb of the loop of Henle. Different forms of Fanconi syndrome can affect different functions of the proximal tubule, and result in different complications. The loss of bicarbonate results in type 2 or proximal renal tubular acidosis. The loss of phosphate results in the bone diseases rickets and osteomalacia (even with adequate vitamin D and calcium levels), because phosphate is necessary for bone development in children and even for ongoing bone metabolism in adults.


Question: MONRO's abscess are seen in

MONRO'S abscesses are seen in psoriasis form of lesions, which include, Psoriasis, Reiter Syndrome, Benign migratory glossitis and ectopic geographic tongue.


Question: Accumulation of lipoproteins in atherosclerosis in the form of

(Oxidised LDL) (499-Robbins-Pathologic basis of disease 8th)Accumulation of lipoproteins mainly LDL and its oxidized forms in the vessel wall OXIDIZED-LDL1. In ingested by macrophages through scavenger receptors distinct from the LDL receptor thus forming foam cells2. Increases monocytes accumulation in lesions3. Stimulates release of growth factors and cytokines4. Is cytotoxic to endothelial cells and smooth muscle cells5. Can induce endothelial cell dysfunctionPathogenic events in Atherosclerosis* Endothelial Injury - | vascular permeability leukocyte adhesion and thrombosis* Accumulation of lipoproteins (Mainly LDL and its oxidized forms) in the vessel wall* Monocyte adhesion to the endothelium - followed by migration into the intima and transformation into macrophages and foam cells* Plaelet adhesion* Factor release from activated platelets, macrophages and vascular wall-cells, inducing smooth muscle cell recruitment either from the media or from circulating precursors* Smooth muscle cell proliferation and ECMproduction* Lipid accumulation both extracellulary and within cells (macrophages and smooth muscle cells)Apo - B- 100 is responsible for the recognition of LDL receptor sites* Most important function of LDL is to supply cholesterol to this extrahepatic tissues. The LDL particles bind to the specific receptor pits (Identified as glycoprotein) on the cell membraneDeficiency of LDL receptors is observed in Type Ila hvperbetalipoproteinemia this disorder is associated with a very high risk of atherosclerosis (particularly coronary artery)IMPORTANT POINTS* Most common of ascending aortic aneurysm - cystic medial necrosis* Most common cause of descending aortic aneurysm and aneurysm aortic arch - Atherosclerosis.* Raised serum level of lipoprotein (a) is a predictor of Atherosclerosis (coronary and cerebro vascular disease)* In atherosclerosis, LDL is present in the LDL monocyte* In atherosclerosis, Increased LDL in monocytes- macrophages due to- LDL receptors on the macrophages* Most common cause of peripheral limb ischaemia in India is Atherosclerosis* Best predictor for future risk of cardiovascular events is hs CRP* Test for reversible cardiac ischemia is - Thallium scan* Most common change in atherosclerotic vessel is - Dystrophic calcification


Question: Ground glass cells of Hadziyannis are seen in


Question: Heart failure cells are

Ans. (c) Hemosiderin laden macrophages(Ref: Robbin's 9th/pg 115)Chronic pulmonary congestion: shows Hemosiderinladen macrophages (heart failure cells) Q


Question: Figlu test is done for

(B) (Folic acid deficiency) (285- Harshmohan 7th)A. Test for Folate deficiency - forminoglutamic acid (FIGLU) urinary excretion1. Urinary excretion of FIGLU2. Serum folate assay3. Red cell folate assayNormal range of serum folate is 6-18 ng/ml (value 4 or Less is diagnostic)B Test for vitamin B12 deficiency1. Serum vitamin B12 assay2. Shilling test" (Radio-isotop absorption test)3. Serum enzyme levelsC Thiamine deficiency - transketolase levels in blood


Question: Gemination of teeth occur due to

Division of a single tooth bud after calcification

Division of a single tooth bud before calcification

Fusion of two teeth before calcification


Question: Durck granuloma is seen in

Ans. (d) Cerebral malaria(Ref: Malaria - Page 76)In malignant cerebral malaria caused by Plasmodium falciparum, brain vessels are plugged with parasitized red cells, causing ring hemorrhage which is accompanied by necrosis of surrounding parenchyma.The damage leads to formation of Durck's granuloma - collection of microglial cells surrounding area of demylienation


Question: DOC for Chlamydia trachomatis in pregnancy

Chlamydial infections during pregnancyThe first line of treatment is erythromycin base 500mg orally, four times a day for 7 days, or amoxicillin 500mg orally three times a day for 7days. Azithromycin is an alternative; it is safe in pregnancy.(Refer: Mudaliar and Menon&;s Clinical Obstetrics, 11th edition, pg no: 253)


Question: Patient with hemophilia A have bleeding disorder because of

Hemophilia A
X - linked disorder

90% cases - deficiency of factor 8
10% cases functional defect of factor 8

Factor VIII a complex is the most important activator of factor X required for conversion of prothrombin to thrombin.

Lack of factor VIII a during activation of factor X in coagulation coscade


Question: Alveolitis sicca dolorosa is otherwise known as


Question: Port wine stain is characteristic feature of


Question: Secondary granules in neutrophil is

Neutrophils have two types of granules; primary (azurophilic) granules (found in young cells) and secondary (specific)granules (which are found in more maturecells). Specific granules are secretory vesicles found exclusively in cells of the immune system called granulocytes. It is sometimes described as applying specifically to neutrophils, and sometimes the term is applied to other types of cells.


Question: In sickle cell anaemia, there is


Question: Most important antigen initiating graft rejection

the most important consequence of direct recognition is the activation of CD8+ T cells
which recognise class I MHC molecules in the graft.Host CD4+ helper T cell may be triggered into proliferation and cytokine production by recognition of donor
class II MHC molecules  and drive an inflammatory response


Question: Saw tooth retepegs are seen in


Question: Minute 1 to 2mm hemorrhages are known as

Petechiae 1 to 2 mm Purpura > 3mmEcchymoses 1 to 2 cmRef: Robbins and Cotran Pathologic Basis of Diseases; 9th edition; Chapter 4; Hemodynamic Disorders, Thromboembolic Disease, and Shock; Page no: 122


Question: The protein in glomerular basement membrane responsible for charge dependent filtration is


Question: Commonest thyroid tumor in MEN (multiple endocrine neoplasi

Ans. is 'd' i.e., Medullary o Thyroid tumor is seen in MEN II, and is medullary carcinoma of thyroid.


Question: The most pronounced effect on the oral microflora of reduction in rate of salivary flow is a

Significant increase in number of oral bacteria

Shift towards more acidogenic microflora

Significant decrease in number of oral bacteria


Question: The most common malignant tesicular neoplasm is

Testicular neoplasms occur in roughly 6 per 100,000 males. Tumors of the testis are a heterogeneous group of neoplasms that include germ cell tumors and sex cord stromal tumors. In postpubeal males, 95% of testicular tumors arise from germ cells, and all are malignant. Most testicular tumors in postpubeal males arise from germ cell neoplasia in situ. Testicular germ cell tumors are subclassified into seminomas and nonseminomatous germ cell tumors. ref: ROBBINS BASIC PATHOLOGY 10th Ed. pg no: 693 Most common tumor of the testis: Seminoma Mixed germ cell tumor Most common testicular tumor in infant and children up to 3 years: Yolk sac tumor Most common testicular tumor in prepubeal children: Teratoma Most common testicular tumor >60 years: Lymphoma Most common bilateral tumor Primary is seminoma Secondary is lymphoma Ref: RAM DAS NAYAK EXAM PREPARATORY MANUAL FOR UNDERGRADUATES 2nd ed. pg no: 651


Question: Tzanck smear test is used in the diagnosis of

Tzanck test is also used for diagnosis of viral diseases like Herpes Zoster.


Question: Burkitt's lymphoma arises from

airway Burkitt lymphoma is a cancer of the lymphatic system, paicularly B lymphocytes found in the germinal center. It is named after Denis Parsons Burkitt, a surgeon who first described the disease in 1958 while working in equatorial Africa


Question: Most common cyst in oral region is


Question: Asteroid bodies are seen in

Sarcoidosis will show (characteristic but not pathognomonic).

Schaumann bodies are laminated, calcified proteinaceous concretions.
Asteroid bodies are stellate inclusions within giant cells.


Question: One of the following syndrome is characterized by an esophageal web with resulting dysphagia, atrophic changes in the mucous membranes of the mouth and a hypochromic microcytic anemia


Question: Salt loosing nephropathy seen in

Ans. is 'd' i.e., Interstitial nephritis


Question: Ahritis "mutilans" is a feature of


Question: Most common cause of cervical neoplasia is

Human papilloma virus *Oncogenic DNA virus which are grouped into high and oncogenic risk HPVs*High oncogenic risk HPVs(HPV16 and 18) -main cause of cervical cancers and also vaginal, vulvar, penile, anal, tonsillar and oropharyngeal carcinomas.*Low oncogenic risk HPVs (HPV 6 and 11) - causes vulvar, perineal and perianal condyloma accuminatum.*HPV produce two envelope proteins-E6 and E7. *E6 proteins inhibits p53, induce centrosome duplication, induce genomic instability and upregulates telomerase.*E7 promotes cell cycle by binding to RB and upregulates cyclin E, induce centrosome duplication and induce genomic instability (Ref: Robbins 8/e p1018)


Question: Mycosis fungoides mainly affects

Ans. c (T-cells). (Ref. Robbin, Pathology, 6,h/656, 670, 1191 & Harrison's Medicine 18th/Table 12-8.)MYCOSIS FUNGOIDES (CUTANEOUS T CELL LYMPHOMA) & /SEZARY SYNDROME# It is anindolent disorder of peripheral CD4+T-cells.# It is an indolent lymphoma with several years of eczematous or dermatitic skin lesions before the diagnosis.# The median age of onset is in the mid-fifties. It is more common in males and in blacks.# Patients are usually adults with cutaneous patches, plaques, nodules or generalized erythema.# Characteristically 3 phases are known:- Premycotic - plaque -tumor phase.# The skin lesions progress from patch stage to plaque stage to cutaneous tumors.# In advanced stages, the lymphoma can metastasize to lymph nodes and visceral organs.# Lymphoma involves erythroderma and circulating tumor cells is known as Se'zary's syndrome.# Localized early stage mycosis fungoides can be cured with RT, often total-skin electron beam irradiation# More advanced disease has been treated (palliative) with:- Topical glucocorticoids, Topical nitrogen mustard,- Psoralen with ultraviolet (PUVA), Phototherapy,- Interferon, Antibodies, Fusion toxins, and- Systemic cytotoxic therapy.


Question: Nuclear and cytoplasmic changes in the apoptotic cells is due to

(Caspases): (19, 189 Robbins 9th edition)Activation and Function of Caspases* The mitochondrial and death receptor pathway lead to the activation of the initiator caspases, caspase 9 and - 8, respectively. Active forms of these enzymes are produced and these cleave and thereby activate another series of caspases that are called the executioner caspases. These activated caspases cleave numerous targets culminating in activation of nucleases that degrade DNA and nucleoproteins. Caspases also degrade components of nuclear matrix and cytoskeleton, leading to fragmentation of cells.* Both extrinsic or intrinsic pathway result in activation of a proteolytic cascade of caspases that destroys the cell* Mitochondrial outer membrane permeabilization is regulated by the balance between pro-apoptotic (eg BAX, BAK) and anti-apoptotic molecules (BCL2, BCL-XL) BH-3 only molecules activate apoptosis by tilting the balance in favour of the pro-apoptosis molecules.* The role of BCL2 in protecting tumour cells from apoptosis* TP53 is an important gene that induces apoptosis in cells that are unable to repair DNA damages


Question: Carcinosarcoma occurs in

Carcinosarcoma is the rare combination of malignant tumour of the epithelium (carcinoma) and of mesenchymal tissue (sarcoma) such as in thyroid, lung, and uterus. Refer robbins 9/e


Question: In blood transfusion, blood group most impoant is


Question: ASCOff'S bodies are seen in

Acute rheumatic fever is characterized by discrete inflammatory foci within a variety of tissues. The myocardial inflammatory lesions--called Aschoff bodies--are pathognomonic for rheumatic fever (Fig. 10-19, B); these are collections of lymphocytes (primarily T cells), scattered plasma cells, and plump activated macrophages called Anitschkow cells occasionally punctuating zones of fibrinoid necrosis. (Robbins Basic pathology,9th edition.pg no.391)


Question: Podocytes are seen in

Reference Robbins page no Pg 900 Podocytes are cells6in the Bowman's capsule in the kidney s that wrap around the capillaries of the Glomerulus


Question: Irreversible cell injury is indicated by

The hallmark of irreversible cell injury is a loss of integrity of cell membrane and lysosomal membranes Myelin figures are phospholipid deposits formed as a result of cell membrane integrity loss; Seen in the very late phase of reversible injury and irreversible injury. Necrosis Necrosis is the type of cell death that is associated with loss of membrane integrity and leakage of cellular contents cul- minating in dissolution of cells, largely resulting from the degradative action of enzymes on lethally injured cells. The leaked cellular contents often elicit a local host reaction, called inflammation, that attempts to eliminate the dead cells and sta the subsequent repair process (Chapter 2). The enzymes responsible for digestion of the cell may be derived from the lysosomes of the dying cells themselves and from the lysosomes of leukocytes that are recruited as pa of the inflammatory reaction to the dead cells. MORPHOLOGY Necrosis is characterized by changes in the cytoplasm and nuclei of the injured cells (Figs. 1-6, left, and 1-8, C). * Cytoplasmic changes. Necrotic cells show increased eosinophilia (i.e., pink staining from the eosin dye--the E in the hematoxylin and eosin stain), attributable in pa to increased binding of eosin to denatured cyto- plasmic proteins and in pa to loss of the basophilia that is normally impaed by the ribonucleic acid (RNA) in the cytoplasm (basophilia is the blue staining from the hema- toxylin dye--the H in "H&E"). Compared with ble cells, the cell may have a more glassy, homogeneous appear- ance, mostly because of the loss of glycogen paicles. Myelin figures are more prominent in necrotic cells than during reversible injury. When enzymes have digested cytoplasmic organelles, the cytoplasm becomes vacuo- lated and appears "moth-eaten." By electron microscopy, necrotic cells are characterized by discontinuities in plasma and organelle membranes, marked dilation of mitochon- dria with the appearance of large amorphous densities, disruption of lysosomes, and intracytoplasmic myelin figures. * Nuclear changes. Nuclear changes assume one of three patterns, all due to breakdown of DNA and chromatin. The basophilia of the chromatin may fade (karyolysis), presumably secondary to deoxyribonuclease (DNase) activity. A second pattern is pyknosis, characterized by nuclear shrinkage and increased basophilia; the DNA con- denses into a solid shrunken mass. In the third pattern, karyorrhexis, the pyknotic nucleus undergoes fragmen- tation. In 1 to 2 days, the nucleus in a dead cell may completely disappear. Electron microscopy reveals pro- found nuclear changes culminating in nuclear dissolution. * Fates of necrotic cells. Necrotic cells may persist for some time or may be digested by enzymes and disappear. Dead cells may be replaced by myelin figures, which are either phagocytosed by other cells or fuher degraded into fatty acids. These fatty acids bind calcium salts, which may result in the dead cells ultimately becoming calcified. Refer robbins 9/e p834

Accumulation of calcium in endoplasmic reticulum


Question: The treatment for a child with cherubism is


Question: Ewing's sarcoma arises from

Ans. d (Primitive neuroectodermal cells). (Ref. Robbin, Pathologic Basis of Diseases 5th/833)PNETs# Ewing's Sarcoma is the highly malignant primary bone neoplasm having specific cytogenetic analysis i.e. t (11,12), characterized by small round cells (pseudo-rossets) and is thought to be a primitive neuroectodermal tumor (PNET) with 75% patients being < 20 years age and having male predilection.# Other PNETs include- Medulloblastoma,- Pineoblastoma,- Neuroblastoma,- Askin tumor,- Retinoblastoma, etc.


Question: In Troisiers sign the lymph nodes involved are


Question: Arrange the following tumours according to increasing age group A. Ewing's Sarcoma B. Osteosarcoma C. Osteoclastoma D. Chondrosarcoma

Tumours according to increasing age group A. Ewing's Sarcoma B. Osteosarcoma C. Osteoclastoma D. Chondrosarcoma


Question: Naso Labial cyst is thought to arise from

Remnants of cell rests of embryonic lacrimal duct


Question: Chromosome of RH gene is located in

The Rh blood group antigens derive from 2 genes,RHD and RHCE, thatare located at chromosomal position 1p34.1-1p36 (chromosome 1, sho arm, region 3, band 4, subband 1, through band 6). In whites, a cde haplotype with a deletion of the whole RHDgene occurs with a frequency of approximately 40%. Refer robbins


Question: The histological appearance of "lava following around boulders in dentin dysplasia" suggests

Abrupt arrest to dentin formation in crown

Abnormal dentin formation in a disorganized fashion


Question: Pinpoint hemorrhages of < 1cm diameter are known as


Question: Ham's test is used in Screening of

Ham's test is the best screening test for paroxysmal nocturnal Hemoglobinuria.


Question: Diffuse mesangial and paramesangial dense deposits on electron microscopy are seen in

Findings on electron microscopyMinimal change diseaseNo deposits are seenMPGN Type ISubendothelial dense depositsMPGN Type IIDense deposits on basement membraneIgA NephropathyType of diffuse mesangioproliferative glomerulonephritis with the involvement of mesangial cells and matrix without the involvement of capillary walls or luminaReference: Rosai and Ackerman's surgical pathology; 10th edition; Volume I; Page no: 1131


Question: Botryoid odontogenic cyst is a variant of


Question: DNA repairs defect associated with aEUR'

Xeroderma pigmentosum Genomic instability - enabler of malignancy The maintenance of integrity of information in D.N.A. molecule is of utmost impoance. Cells have developed elaborate mechanisms to monitor the integrity of the genetic material. A number of complex multisubunit enzyme systems are involved in repair of damaged DNA or to prevent any error during DNA synthesis. Despite the elaborate proofreading system employed during DNA synthesis, errors including base pairing or inseion of one to a few extra nucleotides can occur. In addition, DNA is constantly being subjected to environmental insults that cause the alteration or removal of nucleotide bases. - Base are also altered or lost spontaneously from mammalian DNA at a rate many thousands per cell per day. - If the damage is not repaired a permanent mutation (genomic instability) may be introduced that can result in any of a number of deleterious effects including loss of control over the proliferation of a mutated cell leading to cancer. Luckily cells are remarkably efficient at repairing damage done to their DNA. When there is a defect in DNA the cell cycle stops for a while, allowing the damaged DNA time for repair. If the DNA cannot be repaired it undergoes apoptosis. Most of the repair systems involve :? - Recognition of the damage on the DNA - Removal or excision of the damage - Replacement or, filling the gap left by excision using sister strand as template for DNA synthesis - Typically genomic instability occurs when both copies of the DNA repair gene are lost, however recent work has suggested that even a subset of these genes may promote cancer in haploinsufficient manner. Persons with defect in DNA repair continue to replicate damaged DNA rather than stopping to allow repair or undergoing apoptosis. -There are several inherited disorders in which genes that encode proteins involved in DNA repair are defective. - Individuals born with such inherited defects in DNA repair proteins are at a greatly increased risk of developing cancer. - The defect in DNA repair protein leads to genomic instability which enables malignancy. - DNA repairing genes themselves are not oncogenic but their abnormalities allow mutations in other genes during the process of normal cell division. Three types of DNA repair defects contributes to different types of cancers Mismatch repair Nucleotide excision repairQ Recombination repair


Question: Histological clefts in Lichen planus are

In Lichen Planus, there is degeneration of keratinocytes of stratum basale (stratum germinativum) and disruption of anchoring elements of the epithelial basement membrane and basal keratinocytes (eg: Hemi desmosomes, filaments, fibrils). This weakens the epithelial-connective tissue interface resulting in formation of histologic clefts (i.e., Max-Joseph spaces).


Question: Wermer syndrome is

Wermer syndrome is otherwise known as Multiple Endocrine neoplasia type 1 (MEN 1). It is characterised by primary hyperparathyroidism,endocrine tumours of pancreas, and abnormalities of pituitary (primarily prolactinoma). It is due to germline mutation of MEN1 tumour suppressor gene,which encodes a protein called menin. (Ref :ROBBINS text book of pathology)


Question: Most common cause of renal papillary necrosis is

Renal papillary necrosis is a form of nephropathy involving the necrosis of the renal papilla. Lesions that characterize renal papillary necrosis come from an impairment of the blood supply and from subsequent ischemic necrosis that is diffuse. In terms of cause, almost any condition that involves ischemia can lead to renal papillary necrosis. A mnemonic for the causes of renal papillary necrosis is (POSTCARDS: pyelonephritis, obstruction of the urogenital tract, sickle cell disease, tuberculosis, cirrhosis of the liver, analgesia/alcohol abuse, renal vein thrombosis, diabetes mellitus, and systemic vasculitis.) Often, a patient with renal papillary necrosis will have numerous conditions acting synergistically to bring about the disease. Refer robbins 9/e936


Question: Ameloblastoma most frequently occurs in


Question: Tumor suppressor genes BRCA1 and BRCA1 prevent tumorigenesis by acting as

Answer: d) DNA repair factors (ROBBINS 9th ED, P-291)Tumor suppressor geneFamilial syndromesSporadic cancers Inhibitors of mitogenic signaling pothwaysAPCFamilial colonic polyps and carcinomasCarcinomas of stomach, colon, pancreas melanomaNF1Neurofibromatosis type 1Neuroblastomas juvenile myeloid leukemiaNF2Neurofibromatosis type 2 (Acoustic schwannomas, Meningiomas)Schwannomas MeningiomasPTCH (Patched)Gorlin syndrome (basal cell carcinoma, medulloblastoma)Basal cell carcinoma MedulloblastomaPTEN (Phosphatase and tensin)Cowden syndromeMany carcinomas and lymphoid tumorsSMAD2, SMAD4Juvenile polyposis syndromeColon and pancreatic cancerInhibitors of cell cycle progressionRBFamilial Retinoblastoma syndromeRetinoblastoma, Osteosarcoma Ca of breast, colon, lungCDKN2AFamilial melanomaPancreatic, breast, and esophageal carcinoma, melanoma Inhibitors of "Pro-growth" Programs of Metabolism and AngiogenesisVHLVHL syndromeRenal cell carcinomaSTK11Peutz-Jeghers syndromeVariety of cancersSDHB, SDHDFamilial paraganglioma Familial pheochromocytomaParagangliomaInhibitors of Invasion and MetastasisCDH1 (E-cadherin)Familial gastric cancerGastric cancer, Lobular breast cancerEnablers of Genomic StabilityTP53 (p53)Li-Fraumeni syndromeMost human cancers DNA Repair Factors BRCA1Familial breast and ovarian carcinoma; carcinomas of male breast; (but lower than BRCA2), Cancers of prostate, pancreas, fallopian tubeRareBRCA2Familial breast and ovarian carcinoma chronic lymphocytic leukemia male breast cancer, cancer of prostate, pancreas, stomach, gallbladder, bile duct, pharynx, melanoma,RareMSH2, MLH1, MSH6HNPCCColon and endometrial cancer Unknown mechanisms WT1Wilm's tumorWilm's tumorMEN 1Multiple endocrine neoplasia 1Pituitary, pancreatic, parathyroid tumors

Inhibitors of mitogenic signaling pathways


Question: Crushmann's spirals are seen in

Bronchial asthma will show

Curschmann's spirals : whorled mucus pluge in shape of tracheal ring.
Charcot - Leyden crystals : crystalloid eosinophoil granule made up of eosinophilic protein called galectin-10.
Creola bodies : These are individual epithelial cells in the sputum.


Question: Peripoal fatty infiltration of liver is seen with

MORPHOLOGIC FEATURES. The pathologic features are common to both HBV and HCV infection and include the following lesions 1.Piecemeal necrosis. Piecemeal necrosis is defined as peripoal destruction of hepatocytes at the limiting plate (piecemeal = piece by piece). Its features in chronic hepatitis are as under: i)Necrosed hepatocytes at the limiting plate in peripoal zone. ii)Interface hepatitis due to expanded poal tract by infiltration of lymphocytes, plasma cells and macrophages. iii)Expanded poal tracts are often associated with proliferating bile ductules as a response to liver cell injury. 2.Poal tract lesions. All forms of chronic hepatitis are characterised by variable degree of changes in the poal tract. i)Inflammatory cell infiltration by lymphocytes, plasma cells and macrophages (triaditis). ii)Proliferated bile ductules in the expanded poal tracts. iii)Additionally, chronic hepatitis C may show lymphoid aggregates or follicles with reactive germinal centre TEXT BOOK OF HARSH MOHAN SIXTH EDITION PAGE.611 IMAGE REF: TEXTBOOK OF HARSH MOHAN SIXTH EDITION FIG:21-13 PAGE 612


Question: Half life of IgG is

Half-life of different immunoglobulins –
IgG - About 22 to 25 days
IgA - About 6 to 8 days
IgM - About 5 days
IgE - About 2 to 8 days
IgD - About 3 days


Question: The procedure done in cases of clinical suspicion of amyloidosis is

The diagnosis of amyloidosis is confirmed by the presence of amyloid deposition in tissue biopsy specimen. A skin punch biopsy from the lesion is the preferred confirmatory procedure. The next best choice is needle biopsy from the abdominal subcutaneous fat from the clinically normal-appearing skin may be performed. The skin and abdominal fat biopsy provide positivity in 86% to 95% of amyloidosis cases, depending upon the type of amyloidosis.In case of clinical suspicion, congo red staining of abdominal fat or other tissue is advised.Ref: Harrison&;s Principles of Internal Medicine; 19th edition; Chapter 137 Amyloidosis; Page no: 720


Question: Granular cell myoblastoma of tongue is