Download PGI PG 2020 May Path Solved Question Paper

Download PGIMER (Post Graduate Institute of Medical Education & Research, Chandigarh) 2020 May Path Solved Question Paper

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PGI Chandigarh Last 10 Years 2011-2021 Solved Question Papers (PGIMER Previous Papers)

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Following cells are part of innate immunity?
1. B-cells
2. T-cells
3. NK-cells
4. Macrophages
5. Dendritic cells
Correct Answer - C:D:E

Answer- C, D, E, NK-cells, Macrophages, Dendritic cells
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Important components of innate immunity are :-
1. Cells: Phagocytic cells (macrophages, neutrophils), dendritic cells, NK cells, eosinophils, mast cells, basophils, epithelial cells (forming epithelial barrier).
2. Complement component antimicrobial peptides
3. Pattern recognition receptors (PRn)
There are two types of PRR :
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1. Soluble PRR (Mannose receptors, C-reactive protein):
2. Surface PRR (Scavenger receptors on macrophages, Toll-like receptors).
Which of the following are type 3 hypersensitivity reactions?
1. Good Pasteur syndrome
2. Serum sickness
3. Arthus reaction
4. Asthma
5. Rheumatoid arthritis
Correct Answer - B

Answer- B. Serum sickness
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Local-Arthus reaction
- Systemic-serum sickness
- Schick test
- Polyarteritis nodosa (PAN
- Rheumatoid arthritis
- SLE
- Acute viral hepatitis
- Penicillamine toxicity
- Hyperacute graft rejection
- Type 2 lepra reaction (ENL)
- Hypersensitivity pneumonitis
- Infective endocarditis
- Henoch schonlein purpura
- Glomerulonephritis

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True regarding Down syndrome is?
1. Increased paternal age is a risk factor
2. Karyotyping is not needed in all patients
3. > 85% of affected patients have 1 more chromosome 21
4. Increased nuchal translucency
5. Associated with early onset of Alzheimer's disease
Correct Answer - B

Answer- B. Karyotyping is not needed in all patients
- Down's syndrome is the most common chromosomal disorder and most common congenital cause of mental retardation (2nd
- most common genetic cause of mental retardation is Fragile -X sydrome).
- Trisomy 21- There is an extra chromosome 21 which is due to meiotic nondisjunction in ovum.
- The most important risk factor is advanced maternal age (> 35 Years).
- Antenatal Screening for Down syndrome
Following methods are used :-
1. Triple test It includes (i) Unconjugated estrogen (estriol): decreased; (ii) Maternal serum alphafeto protein (MSAFP) :decreased; and (iii) hCG: increased
2. New markers: These are (i) Increased inhibin A in maternal blood; and (ii) Decreased PAPA (pregnancy associated plasma protein).
3. USG: It shows : (i) Increased nuchal translucency (increased nuchal fold thickness); (ii) Ductus venous flow reversed; and (iii) Nasal bone hypoplasia.
A 14 year old boy presented with hereditary spherocytosis. Which of the following indices is/are increased?
1. LDH
2. MCHC
3. MCV
4. Urine urobilinogen
5. Haptoglobin
Correct Answer - A:B:D

Answer- A, B, D LDH, MCHC, Urine urobilinogen
- MCV decreased
- MCHC increased
- LDH increased
As compared to iron deficiency anemia, which of the following is decreased in anemia of chronic disease?
1. Endogenous bone marrow iron stores
2. Serum ferritin
3. Transferrin saturation
4. TIBC
5. MCV
Correct Answer - D

Answer- D. TIBC
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- MCV/MCH- Decreased or normal
- Serum iron- Decreased
- TIBC- Decreased, normal
- Transferrin saturation- Decreased
- Serum ferritin- Normal or increased
Antibody which is/are specific for SLE?
1. ANA
2. Anti-ds DNA
3. Anti-Sm
4. Anti-histone
5. Anti-RNP
Correct Answer - B:C

Answer- B, C Anti-ds DNA, and Anti-Sm
- These are the most specific antibodies for SLE.

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Microcytosis can be seen in deficiency of?
1. Iron
2. Folic acid
3. Vitamin B12
4. Vitamin C
5. Vitamin B6
Correct Answer - A:D:E

Answer- A, D, E, Iron, Vitamin C, Vitamin B6

Seen in-
1. Iron deficiency anemia (most common cause of anemia in general and of microcytic anemia in particular)
2. Thalassemia trait
3. Other hemoglobinopathies such as hemoglobin C syndrome & hemoglobin S syndrome
4. Chronic inflammation
5. Anemia of chronic disease
6. Sideroblastic anemia
7. Deficiencies - Pyridoxin (Vit B6), vitamin C and copper
Blood tests done to see liver functions include?
1. Bilirubin
2. Uric acid
3. Alanine transaminase
4. Urea
5. Albumin
Correct Answer - A

Answer- A. Bilirubin
1. Aspartate aminotransferase/ SGOT
2. Alanine transaminase/ SGPT
3. Alkaline phosphatase
4. Gamma- Glutamyltransferase
5. Conjugated bilirubin
6. Unconjugated bilirubin
7. Albumin
Anaplasia is malignant tumor may lead to?
1. Change in nuclear size
2. Loss of cell polarity
3. Metaplasia
4. Increased mitosis
5. Malignant transformation
Correct Answer - A:B:D:E

Answer- A, B, D, E, Change in nuclear size, Loss of cell polarity, Increased mitosis, Malignant transformation

Anaplastic cells show following features :-
1. Loss of polarity
2. Increased nuclear cytoplasmic size ratio
3. Increased number of mitosis which is atypical
4. Hyperchromatosia
5. Pleomorphbm

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During inflammation, mediators involved in adhesion and movement include?

Compliment 5a
Leukotriene B4
Integrins
IL-8
L-selectin

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Correct Answer - C:E

Answer- C & E, Integrins, L-selectin

Adhesion molecules	Cells	Ligand on endothelial cells	Extravasation stage
L-selection (CD62L)	Naive T lymphocytes, other leukocytes	GlyCAM-1, CD34, MadCAM-1	Tethering/Rolling
PSGL-1	Neutrophils	E-selection (CD26E), P-Selectin (CD62P),	Tethering/Rolling
LFA-1 (?2 Integrin CD11A/CD18)	Activated T lymphocytes, other leukocytes, other leukocytes	ICAM-1 (CD54), ICAM-2 (CD102)	Tight adhesion
VLA-4 (?1 Inegrin,	Activated T leukocytes monocytes,	VCAM-1(CD106),	Tight adhesion
CD49d/CD28)	neutrophils, eosiophils, basophils	Fibronection
Mac-1 (CD11b/CD18)	Neutrophils, Monocytes, Macrophages	ICAM-1,iC3b, fibronection	Tight adhesion
LPAM-1 (37 integrin)	Effector T lymphocytes	VCAM-1 MAdCAM-1 fibronection	adhesion

Causes of unconjugated hyperbilirubinemia include?
1. Sepsis
2. Criggler-Najar syndrome
3. Rotor syndrome
4. Gilbert syndrome
5. Intravascular hemolysis
Correct Answer - A:B:D:E

Answer- A, B, D, E, Sepsis, Criggler-Najar syndrome, Gilbert syndrome, Intravascular hemolysis
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Unconjugated hyperbilirubinemia:-
- Increased production of bilirubin from hemoglobin, So that the capacity of liver to conjugate bilirubin is overwhelmed by increased production, e.g.
- Hemolytic anemia (both intravascular and extamascular)s Hereditary sphnocytosis, G6PD defciency.
- Inefrective erythropoiesis- Thalassemia, Pernicious anemia.
- Reduced hepatic uptake of bilirubin from bilirubin - albumin complex > Drugs,
- Infections:- Sepsis, UTI
- Impaired hepatic conjugation.
Major histocompatibility complexes are found on which cells?
1. Dendritic cells
2. Basophils
3. Eosinophils
4. T cells
5. RBCs
Correct Answer - A:B:C:D

Answer- A, B, C, D, Dendritic cells. Basophils, Eosinophils, T cells
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HLA complex consists of three separate clusters of genes :-
1. Class I (MHC-I)
  - Important cells with MHC-I (HLA-I) on surface are B-cells, T-cell, macrophages /monocytes, neutrophils, langerhans cells, dendritic cells, platelets (thrombocytes), epithelial cells of thymus and hepatocytes. MHC class I present antigen to cytotoxic CD-8 T cells.
2. Class II (MHC-II)
  - It comprises 'D' region (HLA-DR,HLA-DQ, HLADP).It is found only on the cells of immune system, i.e.T-cells,B-cells,langerhans cells, dendritic cells, and macrophages.
3. Class III (MHC-III)
  - Tumor necrosis factor- alpha and beta (TNF-alpha and beta).
Which of the following is NOT TRUE about mutation of p53?
1. Cell will continue to multiply
2. Cancer formation
3. Cell cycle will be arrested
4. DNA repair
5. All of the above
Correct Answer - C:D

Answer- C & D, Cell cycle will be arrested, DNA repair
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- p53 is a tumor suppressor gene.
- The major functional activities of the p53 protein are cell cycle arrest and initiation of apoptosis in response to DNA damage.
p53 causes-
1. Cell cycle arrest- there is arrest of cell cycle late in G1 phase. This allows time for DNA repair.
2. DNA repair- GADD 45 encodes a protein that is involved in DNA repair.
- p53 induces apoptosis.
- Mutation in p53 leads to loss of above protective mechanisms i,e. cell cycle arrest & DNA repair. It will lead to unarrested cell multiplication and finally carcinogenesis.
- Non-mutated (wild type) p53 reduces the chances of cancer.
Correct dyad of disease and their respective inheritance pattern include?
1. Wilson disease - autosomal recessive
2. Cystic fibrosis - autosomal dominant
3. Marfan syndrome - autosomal recessive
4. Gardner syndrome - autosomal dominant
5. Duchene muscular dystrophy - X-linked recessive
Correct Answer - A:D:E
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Answer- (A) Wilson disease - autosomal recessive (D) Gardner syndrome - autosomal dominant (E) Duchene muscular dystrophy - X-linked recessive

Autosomal recessive disorders
1. Metabolic - Cystic fibrosis, Phenyl ketonuria, Galactosemia, Homocystinuria, Lysosomal storage dis, alpha l-antitrypsin deficiency,
- Wilson disease, Hemochromatosis, Glycogen storage disorders.
- Autosomal dominant disorders
1. GIT- Familial polyposis coli, Gardner's syndrome
2. Skeletal - Marfan syndrome
- X-linked recessive disorders
1. Musculoskeletal - Duchene muscular dystrophy, Becker's dystrophy

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Psammona bodies is/are seen in -
1. Medullary ca of thyroid
2. Ependymoma
3. Papillary ca of thyroid
4. Follicular ca of thyroid
5. Meningioma
Correct Answer - C:E

Answer- C, E, Papillary ca of thyroid, Meningioma
- A psammoma body is a round collection of calcium, seen microscopically. The term is derived from the Greek word psammos meaning "sand." Psammoma bodies are commonly seen in certain tumors such as:
- Papillary thyroid carcinoma
- Papillary renal cell carcinoma
- Serous papillary ovarian adenocarcinoma (cystadenocarcinoma)
- Endometrial adenocarcinomas (Papillary serous carcinoma – 3%-4%)
- Meningioma
- Mesothelioma
- Psammoma bodies usually have a laminar appearance.
Wound healing is affected by -
1. Age
2. Nutrition
3. Dryness of wound
4. Drugs
5. Temperature
Correct Answer - A:B:C:D:E

Answer- A, B, C, D, E, Age, Nutrition, Dryness of wound, Drugs, Temperature
- Intrinsic factor
- Health status eg: diabetes
- Age factors
- Body buiJd
- Nutritional status (Protein deficiency.
- Vitamin C deficiency)
- Inadequate blood supply
Extrinsic factor-
1. Temperature
2. Desiccation and maceration
3. Infection (single most important factor)
4. Chemical stress
5. Medications eg; corticosteroids
All are major criteria for rheumatic fever except:
1. Pancarditis
2. Chorea
3. Arthritis
4. Subcutaneous nodules
5. Fever
Correct Answer - E

Answer- E. Fever
- Chorea, Arthritis and Carditis are major criteria for diagnosis of Rheumatic fever Fever is a minor criteria
- Erythema Marginatum is a major criteria and not Erythema nodosum.
Increase PT is seen with -
1. Warfarin administration
2. Factor V deficiency
3. Factor VIII deficiency
4. Factor IX deficiency
5. Vit K deficiency
Correct Answer - A:B:E

Answer- A, B, E, Warfarin administration, Factor V deficiency, Vit K deficiency
1. Bleeding time- Prolongation generally indicates the defect in platelet number or function.
2. Partial thromboplastin time (PTT)- A prolonged PTT V, VIII (factor VIIIc, Von wille brand factor, IX. X, XI, XII, prothrombin or fibrinogen.
3. Prothrombin time(PT)- PT can results from deficiency of factor V, VII, X, prothrombin or fibrinogen V, VII, X, prothrombin or fibrinogen.
4. Thrombin time- elevated in fibrinogen deficiency.
5. Vitamin K deficiency also cause prolongation of both PT and aPTT as it inhibits factor II, VII, IX and X.

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True in sickle cell anemia -
1. Splenomegaly
2. Microcytosis
3. Microcardia
4. Autosplenectomy
5. Gamma gandy bodies
Correct Answer - A:D:E

Answer- A, D, E, Splenomegaly, Autosplenectomy, Gamma gandy bodies

Chronic hemolysis

Vasoocclusive symptoms
1. Painful bone crisis
2. Hand-foot syndrome ? Dactylitis of bones of hands/feet.
3. Autosplenectomy
4. Acute painful enlargement of spleen
5. There maybe cardiomegaly and leukocytosis.
6. Gamma Gandy bodies
- There is no microcytosis in sickle cell disease.
Microscopy which can be performed with minimum optical illumination -
1. Dark field
2. Bright field
3. Phase contrast
4. Confocal
5. None
Correct Answer - A:D

Answer- A & D, Dark field, Confocal
- The light has to be reduced while using dark field & phase contrast microscope, other microscopes use full illumination.
Dark field microscopy-
- Uses a carefirlly aligned light source to minimize the quantity of directly transmitted light entering the image plane, collecting only the light scattered by the sample.
Confocal microscopy/confocal laser scanning microscopy/ laser

confocal scanning microscopy-
- Uses a scanning point of light and a pinhole to prevent out of focus light from reaching the detector.
Acanthocytes are seen in?
1. Abetalipoproteinemia
2. Severe liver disease
3. Patients with Macleod blood group
4. SLE
5. Hyperprolactinemia
Correct Answer - A:B:C

Answer- A, B, C, Abetalipoproteinemia, Severe liver disease, Patients with Macleod blood group
- Acanthocytes or spur cells, are abnormal erythrocftes which are spiculated with a few spiny or thorny projections of cytoplasm of varying size and surface distribution.
- The most frequent and most significant conditions with acanthocytosis include abetalipoproteinemia.
- McLeod red cell Phenotype.
Features of chronic myelogenous leukemia (CML)-
1. Bone marrow biopsy is necessary for diagnosis
2. Presence of BCR-ABL gene which directs the synthesis of BCR-ABL tyrosine kinase
3. Dasatinib is used in imatinib resistant cases
4. Generalized painful lymphadenopathy is presenting feature in most cases
5. Myeloblasts usually constitute more than 10% of all white cells in chronic phase
Correct Answer - A:B:C

Answer- A, B, C, Bone marrow biopsy is necessary for diagnosis, (B) Presence of BCR-ABL gene which directs the synthesis of BCR-ABL tyrosine kinase (C) Dasatinib is used in imatinib resistant cases
- Splenomegaly is present in 90%
- Imatinib, dasatinib and nilotinib specifically inhibit BCR ABL tyrosine kinase activity and reduce the uncontrolled proliferation of white cells.
- The disease is driven by the BCR-ABL1 chimeric gene product, a constitutively active tyrosine kinase.
- Common manifestations are of anemia and splenomegaly, lymphadenopathy, and extramedullary disease (skin or subcutaneous lesions)
- The bone marrow is hypercellular with marked myeloid hyperplasia and a high myeloid-to-erythroid ratio of 15-20: 1.

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True about Cystic fibrosis-
1. Occurs due CFTR gene mutation on chromosome 7
2. Meconium ileus is present in >90% cases
3. CFTR gene can be detected antenately
4. Poor body growth
5. All of the above
Correct Answer - A:C:D

Answer- A, C, D, Occurs due CFTR gene mutation on chromosome 7 (C) CFTR gene can be detected antenately (D)Poor body growth
- The primary defect in cystic fibrosis results from abnormal function of an epitheltal chloride channel protein encoded by the cystic fibrosis transmembrane conductance regulator (CFTR) gene on chromosome 7.
- Contents of the intestinal lumen are difficult to excrete which results in meconium ileus.
- Sequencing the CFTR gene is the gold standard for diagnosis of cystic fibrosis Poor body growth
True about caspases -
1. Caspases initiate apoptosis by extrinsic and intrinsic pathway
2. Caspases are protease enzyme
3. Caspases are receptor
4. Caspases inhibit apoptosis
5. Causes non enzymatic degradation of critical cellular components
Correct Answer - A:B

Answer- A, B, Caspases initiate apoptosis by extrinsic and intrinsic pathway (B) Caspases are protease enzyme
- Apoptosis results from the activation of enzymes called caspases.
- The process of apoptosis may be divided into an initiation phase (intrinsic pathway) and execution (extrinsic pathway).
Two distinct pathways converge on caspase activation:
- The mitochondrial pathway and the death receptor pathway
- Caspases are a famiy of endoproteases.
- The activation of these enzyme is tightly controlled by their production as inactive zymogens that gain catalytic activity following signaling events promoting their aggregation into dimers or macromolecular complexes"

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True about minimal change disease -
1. Hypertension is commonly present
2. Most common cause of nephrotic syndrome in adults
3. High dose steroids results in remission in most cases
4. Commonly progress to chronic renal failure
5. Reversible loss of podocyte function
Correct Answer - C:E

Answer- (C) High dose steroids results in remission in most cases (E) Reversible loss of podocyte function

Minimal change disease:
- Also k/a lipoid nephrosa, foot process disease & Nil deposit disease
- The disease sometimes follows a respiratory infection or routine prophylactic immunization'
- The onset may be preceded by an upper respiratory infection, atopic allergy or immunisation.
- The disease characteristically respond to steroid therapy
- The benign disorder is characterized by diffuse effacement of foot processes of visceral epithelial cell (podocytes).
- most frequent cause of nephrotic syndrome in children
- The visceral epithelial changes are completely reversible afrer corticosteroid therapy, concomitant with remission of the proteinuria.
- There is commonly no hypertension or hematuria.
- The appearance of acute renal failure in adults.
Feature(s) of Adult polycystic kidney disease is/are:
1. Renal enlargement
2. Small kidney
3. Spider leg deformity on intravenous urography
4. Ultrasound shows multiple cysts
5. All of the above
Correct Answer - A:C:D

Answer- A, C, D, Renal enlargement (C) Spider leg deformity on intravenous urography (D) Ultrasound shows multiple cysts
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- ADPKD is characterized by the progressive bilateral formation of renal crisis.
- Inhieritence- autosomal dominant
- Characterized by multiple expanding cysts of both kidneys.
- In gross appearance, the kidneys are bilaterally enlarged.
- The pain may result from renal cyst infection, hemorrhage, or nephrolithiasis.
- 'Intravenous urography polycystic kidney disease: The spider legs, deformity of the calyces.
Which is/are caused by protein misfolding:
1. Creutzfeldt-Jakob disease
2. Bovine spongiform encephalopathy
3. Huntington disease
4. Alzheimer disease
5. Parkinson disease
Correct Answer - A:B:C:D:E

Answer- A, B, C, D, E, Creutzfeldt-Jakob disease (B) Bovine spongiform encephalopathy (C) Huntington disease (D) Alzheimer disease (E) Parkinson disease
- The proteins fail to fold into their normal configuratory in this misfolded state, the proteins can become toxic in some way (a gain of toxic function) or they can lose their normal function which is known as protein misfolding disease.
- Such diseases as Creutzfeldt- Jakob disease, Alzheimer's disease, Parkinson's disease, prion disease, amyloidosis, Bovine spongiform encephalopathy, Huntington disease.
True about Creutzfeldt-Jakob Disease :
1. Gliosis in thalamus
2. Spongiform swelling in cerebral cortex
3. Brain atrophy in late stage
4. Slow and irregular background rhythm on EEG
5. None
Correct Answer - B:C:D

Answer- B, C, D, Spongiform swelling in cerebral cortex (C) Brain atrophy in late stage (D) Slow and irregular background rhythm on EEG
- CJD is a rare disorder that manifests clinically as a rapidly progressive dementia.
- The progression of the dementia in CJD is usually so rapid that there is little if any grossly evident brain atrophy.
- Microscopically, the hallmark is spongiform change of the cerebral cortex.
- In advanced cases there is severe neuronal loss, reactive gliosis.
- EEG abnormaltdes are present in nearly all patients, consisting of a slow and irregular background rhythm with periodic complex discharges.

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Hereditary non- polyposis colorectal cancer (HNPCC) is/ are commonly associated with-
1. Endometrial cancer
2. Cervical cancer
3. Ovarian cancer
4. Breast cancer
5. Thyroid cancer
Correct Answer - A:C

Answer- A, C, Endometrial cancer (C) Ovarian cancer
- Hereditary non- polyposis colorectal cancer (HNPCC)-
- Malignancies- Colonic, endometrial, ovarian, pancreatic, gastric.
- Inherictance- autosomal dominant
- Gene- AD MSH2, MLH1, MSH6, PMS1, PMS2
Features of Non bacterial thrombotic endocarditis (NBTE)-
1. Common in SLE
2. Present on undersurface of valve
3. Vegetative growth is large and loosely attached to valve
4. May occur after post-cardiac catheterization
5. Source of systemic emboli
Correct Answer - B:D:E

Answer- B, D, E, Present on undersurface of valve (D) May occur after post-cardiac catheterization (E) Source of systemic emboli
- These verrucae are typically small, single or multiple, brownish and occur along the line of closure of the leaflet.
- Vegetatian of NBTE is small and loosely attached to the underlying valve.
- Source of systemic emboli that produce significant infarcts in the brain, heart, spleen and kidneys.
- It frequently occurs with deep venous thrombosis, pulmonary emboli.
True about Alzheirner disease:
1. Most common cause
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This post was last modified on 11 August 2021

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