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This post was last modified on 11 August 2021

1.

Followingcellsarepartofinnateimmunity?
a)B-cells
b)T-cells
c)NK-cells

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d)Macrophages
e)Dendriticcells
CorrectAnswer-C:D:E
Answer-C,D,E,NK-cells,Macrophages,Dendriticcells
Importantcomponentsofinnateimmunityare:-

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1. Cells:Phagocyticcells(macrophages,neutrophils),dendriticcells,
NKcells,eosinophils,mastcells,basophils,epithelialcells(forming
epithelialbarrier).
2. Complementcomponentantimicrobialpeptides
3. Patternrecognitionreceptors(PRn)

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TherearetwotypesofPRR:
1. SolublePRR(MannoserecePtors,C-reactiveprotein):
2. SurfacePRR(Scavengerreceptorsonmacrophages,Toll-like
receptors).

2.Whichofthefollowingaretype3

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hypersensitivityreactions?
a)GoodPasteursyndrome
b)Serumsickness
c)Arthusreaction
d)Asthma

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e)Rheumatoidarthritis
CorrectAnswer-B
Answer-B.Serumsickness
Local-Arthusreaction
Systemic-serumsickness

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Schicktest
Polyarteritisnodosa(PAN)
Rheumatoidarthritis
SLE
Acuteviralhepatitis

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Penicillaminetoxicity
Hyperacutegraftrejection
Type2leprareaction(ENL)
Hypersensitivitypneumonitis
Infectiveendocarditis

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Henochschonleinpurpura
Glomerulonephritis

3.TrueregardingDownsyndromeis?
a)Increasedpaternalageisariskfactor
b)Karyotypingisnotneededinallpatients

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c)>85%ofaffectedpatientshave1morechromosome21
d)Increasednuchaltranslucency
e)AssociatedwithearlyonsetofAlzheimer'sdisease
CorrectAnswer-B
Answer-B.Karyotypingisnotneededinallpatients

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Down'ssyndromeisthemostcommonchromosomaldisorderand
mostcommoncongenitalcauseofmentalretardation(2nd
mostcommongeneticcauseofmentalretardationisFragile-X
sydrome).
Trisomy21-Thereisanextrachromosome21whichisdueto

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meioticnondisjunctioninovum.
Themostimportantriskfactorisadvancedmaternalage(>35
Years).
AntenatalScreeningforDownsyndrome
Followingmethodsareused:-

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1. TripletestItincludes(i)Unconjugatedestrogen(estriol):decreased;
(ii)Maternalserumalphafetoprotein(MSAFP):decreased;and(iii)
hCG:increased
2. Newmarkers:Theseare(i)IncreasedinhibinAinmaternalblood;
and(ii)DecreasedPAPA(pregnancyassociatedplasmaprotein).

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3. USG:Itshows:(i)Increasednuchaltranslucency(increasednuchal
foldthickness);(ii)Ductusvenousflowreversed;and(iii)Nasalbone
hypoplasia.

4.A14yearoldboypresentedwithhereditary
spherocytosis.Whichofthefollowing

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indicesis/areincreased?

a)LDH
b)MCHC
c)MCV
d)Urineurobilinogen

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e)Haptoglobin
CorrectAnswer-A:B:D
Answer-A,B,DLDH,MCHC,Urineurobilinogen
MCVdecreased
MCHCincreased

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LDHincreased

5.Ascomparedtoirondeficiencyanemia,
whichofthefollowingisdecreasedin
anemiaofchronicdisease?

a)Endogenousbonemarrowironstores

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b)Serumferritin
c)Transferrinsaturation
d)TIBC
e)MCV
CorrectAnswer-D

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Answer-D.TIBC
MCV/MCH-Decreasedornormal
Serumiron-Decreased
TIBC-Decreased,normal
Transferrinsaturation-Decreased

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Serumferritin-Normalorincreased

6.Antibodywhichis/arespecificforSLE?
a)ANA
b)Anti-dsDNA
c)Anti-Sm

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d)Anti-histone
e)Anti-RNP
CorrectAnswer-B:C
Answer-B,CAnti-dsDNA,andAnti-Sm
ThesearethemostspecificantibodiesforSLE.

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7.Microcytosiscanbeseenindeficiencyof?
a)Iron
b)Folicacid
c)VitaminB12
d)VitaminC

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e)VitaminB6
CorrectAnswer-A:D:E
Answer-A,D,E,Iron,VitaminC,VitaminB6
Seenin-

1. Irondeficiencyanemia(mostcommoncauseofanemiaingeneral

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andofmicrocyticanemiainparticular)
2. Thalassemiatrait
3. OtherhemoglobinopathiessuchashemoglobinCsyndrome&
hemoglobinSsyndrome
4. Chronicinflammation

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5. Anemiaofchronicdisease
6. Siderobasticanemia
7. Deficiencies-Pyridoxin(Vit86),vitaminCandcopper

8.Bloodtestsdonetoseeliverfunctions
include?

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a)Bilirubin
b)Uricacid
c)Alaninetransaminase
d)Urea
e)Albumin

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CorrectAnswer-A
Answer-A.Bilirubin
1. Aspartateaminotransferase/SGOT
2. Alaninetransaminase/SGPT
3. Alkalinephosphatase

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4. Gamma-Glutamyltransferase
5. Conjugatedbilirubin
6. Unconjatedbilirubin
7. Albumin

9.Anaplasiaismalignanttumormayleadto?

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a)Changeinnuclearsize
b)Lossofcellpolarity
c)Metaplasia
d)Increasedmitosis
e)Malignanttransformation

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CorrectAnswer-A:B:D:E
Answer-A,B,D,E,Changeinnuclearsize,Lossofcell
polarity,Increasedmitosis,Malignanttransformation
Anaplasticcellsshowfollowingfeatures:-

1. Lossofpolarity

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2. Increasednuclearcytoplasmicsizeratio
3. Increasednumberofmitosiswhichisatypical
4. Hyperchromatosia
5. Pleomorphbm

10.Duringinflammation,mediatorsinvolved

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inadhesionandmovementinclude?
a)Compliment5a
b)LeukotrieneB4
c)Integrins
d)IL-8

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e)L-selectin
CorrectAnswer-C:E
Answer-C&E,Integrins,L-selectin
Ligandon
Adhesion

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Extravasation
Cells
endothelial
molecules
stage

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cells
NaiveT
GlyCAM-1,
L-selection
lymphocytes,other

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CD34,
Tethering/Rolling
(CD62L)
leukocytes
MadCAM-1

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E-selection
(CD26E),
PSGL-1
Neutrophils
Tethering/Rolling

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P-Selectin
(CD62P),
ActivatedT
ICAM-1
LFA-1

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lymphocytes,other
(CD54),
(2Integrin
Tightadhesion
leukocytes,other

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ICAM-2
CD11A/CD18) leukocytes
(CD102)
Activated
VLA-4

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Tleukocytes
VCAM-
(1Inegrin,
monocytes,
1(CD106),

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Tightadhesion
CD49d/CD28)
Fibronection

CD49d/CD28) neutrophils,
Fibronection

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eosiophils,basophils
Neutrophils,
ICAM-
Mac-1
Monocytes,

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1,iC3b,
Tightadhesion
(CD11b/CD18) Macrophages
fibronection
VCAM-1

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LPAM-1(7
EffectorT
MAdCAM-1 adhesion
integrin)
lymphocytes

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fibronection

11.Causesofunconjugated
hyperbilirubinemiainclude?
a)Sepsis
b)Criggler-Najarsyndrome

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c)Rotorsyndrome
d)Gilbertsyndrome
e)Intravascularhemolysis
CorrectAnswer-A:B:D:E
Answer-A,B,D,E,Sepsis,Criggler-Najarsyndrome,Gilbert

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syndrome,Intravascularhemolysis
Unconjugatedhyperbilirubinemia:-
Increasedproductionofbilirubinfromhemoglobin,Sothatthe
capacityoflivertoconjugatebilirubinisoverwhelmedbyincreased
production,e.g.

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1. Hemolyticanemia(bothintravascularandextamascular)sHereditary
sphnocytosis,G6PDdefciency.
2. Inefrectiveerythropoiesis-Thalassemia,Perniciousanemia.
3. Reducedhepaticuptakeofbilirubinfrombilirubin-albumincomplex
>Drugs,

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4. Infections:-Sepsis,UTI
5. Impairedhepaticconjugation.

12.Majorhistocompatibilitycomplexesare
foundonwhichcells?
a)Dendriticcells

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b)Basophils
c)Eosinophils
d)Tcells
e)RBCs
CorrectAnswer-A:B:C:D

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Answer-A,B,C,D,Dendriticcells,Basophils,Eosinophils,T
cells
HLAcomplexconsistsofthreeseparateclustersofgenes:-
1)ClassI(MHC-I)
ImportantcellswithMHC-I(HLA-I)onsurfaceareB-cells,T-cell,

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macrophages/monocytes,neutrophils,langerhanscells,dendritic
cells,platelets(thrombocytes),epithelialcellsofthymusand
hepatocytes.MHCclassIpresentantigentocytotoxicCD-8Tcells.
2)ClassII(MHC-II)
Itcomprises'D'region(HLA-DR,HLA-DQ,HLADP).Itisfoundonly

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onthecellsofimmunesystem,i.e.T-cells,B-cells,langerhanscells,
dendriticcells,andmacrophages.
3)ClassIII(MHC-III)
Tumornecrosisfactor-alphaandbeta(TNF-alphaandbeta).

13.WhichofthefollowingisNOTTRUEabout

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mutationofp53?
a)Cellwillcontinuetomultiply
b)Cancerformation
c)Cellcyclewillbearrested
d)DNArepair

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e)Alloftheabove
CorrectAnswer-C:D
Answer-C&D,Cellcyclewillbearrested,DNArepair
p53isatumorsuppressorgene.
Themajorfunctionalactivitiesofthep53proteinarecellcyclearrest

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andinitiationofapoptosisinresponsetoDNAdamage.
p53causes-
1. Cellcyclearrest-thereisarrestofcellcyclelateinG1phase.This
allowstimeforDNArepair.
2. DNArepair-GADD45encodesaproteinthatisinvolvedinDNA

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repair.
p53inducesapoptosis.
Mutationinp53leadstolossofaboveprotectivemechanismsi,e.
cellcyclearrest&DNArepair.Itwillleadtounarrestedcell
multiplicationandfinallycarcinogenesis.

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Non-mutated(wildtype)p53reducesthechancesofcancer.

14.Correctdyadofdiseaseandtheir
respectiveinheritancepatterninclude?
a)Wilsondisease-autosomalrecessive
b)Cysticfibrosis-autosomaldominant

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c)Marfansyndrome-autosomalrecessive
d)Gardnersyndrome-autosomaldominant
e)Duchenemusculardystrophy-X-linkedrecessive
CorrectAnswer-A:D:E
Answer-(A)Wilsondisease-autosomalrecessive(D)Gardner

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syndrome-autosomaldominant(E)Duchenemuscular
dystrophy-X-linkedrecessive
Autosomalrecessivedisorders
1)Metabolic-Cysticfibrosis,Phenylketonuria,Galactosemia,
Homocystinuria,Lysosomalstoragedis,alphal-antitrypsin

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deficiency,
Wilsondisease,Hemochromatosis,Glycogenstoragedisorders.
Autosomaldominantdisorders
1.GIT-Familialpolyposiscoli,Gardner'ssyndrome
2.Skeletal-Marfansyndrome

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X-linkedrecessivedisorders
1)Musculoskeletal-Duchenemusculardystrophy,Becker's
dystrophy

15.Psammonabodiesis/areseenin-
a)Medullarycaofthyroid

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b)Ependymoma
c)Papillarycaofthyroid
d)Follicularcaofthyroid
e)Meningioma
CorrectAnswer-C:E

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Answer-C,E,Papillarycaofthyroid,Meningioma
Apsammomabodyisaroundcollectionofcalcium,seen
microscopically.ThetermisderivedfromtheGreekwordpsammos
meaning"sand."Psammomabodiesarecommonlyseenincertain
tumorssuchas:

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Papillarythyroidcarcinoma
Papillaryrenalcellcarcinoma
Serouspapillaryovarianadenocarcinoma(cystadenocarcinoma)
Endometrialadenocarcinomas(Papillaryserouscarcinoma?
3%-4%)

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Meningioma
Mesothelioma
Psammomabodiesusuallyhavealaminarappearance.

16.Woundhealingisaffectedby-
a)Age

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b)Nutrition
c)Drynessofwound
d)Drugs
e)Temperature
CorrectAnswer-A:B:C:D:E

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Answer-A,B,C,D,E,Age,Nutrition,Drynessof
wound,Drugs,Temperature
Intrinsicfactor
Healthstatuseg:diabetes
Agetactors

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BodybuiJd
Nutritionalstatus(Droteindeficiencv.
VitaminCdeficiency)
Inadequatebloodsupply
Extrinsicfactor-

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1. Temperature
2. Desiccationandmaceration
3. Infection(singlemostimportantfactor)
4. Chemicalstress
5. Medicationseg;corticosteroids

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17.Allaremajorcriteriaforrheumaticfever
except:
a)Pancarditis
b)Chorea
c)Arthritis

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d)Subcutaneousnodules
e)Fever
CorrectAnswer-E
Answer-E.Fever
Chorea,ArthritisandCarditisaremajorcriteriafordiagnosisof

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RheumaticfeverFeverisaminorcriteria
ErythemaMarginatumisamajorcriteriaandnotErythema
nodosum.

18.IncreasePTisseenwith-
a)Warfarinadministration

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b)FactorVdeficiency
c)FactorVIIIdeficiency
d)FactorIXdeficiency
e)VitKdeficiency
CorrectAnswer-A:B:E

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Answer-A,B,E,Warfarinadministration,FactorV
deficiency,VitKdeficiency

1. Bleedingtime-Prolongationgenerallyindicatesthedefectinplatelet
numberorfunction.
2. Partialthromboplastintime(PTT)-AprolongedPTTV,VIII(factor

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VIIIc,Vonwillebrandfactor,IX.X,XI,XII,prothrombinorfibrinogen.
3. Prothrombintime(PT)-PTcanresultsfromdeficiencyoffactorV,
VII,X,prothrombinorfibrinogenV,VII,X,prothrombinorfibrinogen.
4. Thrombintime-elevatedinfibrinogendeficiency.
5. VitaminKdeficiencyalsocauseprolongationofbothPTandaPTT

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asitinhibitsfactorII,VII,IXandX.

19.Trueinsicklecellanemia-
a)Splenomegaly
b)Microcytosis
c)Microcardia

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d)Autosplenectomy
e)Gammagandybodies
CorrectAnswer-A:D:E
Answer-A,D,E,Splenomegaly,Autosplenectomy,Gamma
gandybodies

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Chronichemolysis
Vasoocclusivesymptoms

1. Painfulbonecrisis
2. Hand-footsyndromeDactylitisofbonesofhands/feet.
3. Autosplenectomy

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4. Acutepainfulenlargementofspleen
5. Theremaybecardiomegalyandleukocytosis.
6. GammaGandybodies
Thereisnomicrocytosisinsicklecelldisease.

20.Microscopywhichcanbeperformedwith

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minimumopticalillumination-
a)Darkfield
b)Brightfield
c)Phasecontrast
d)Confocal

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e)None
CorrectAnswer-A:D
Answer-A&D,Darkfield,Confocal
Thelighthastobereducedwhileusingdarkfield&phasecontrast
microscope,othermicroscopesusefullillumination.

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Darkfieldmicroscopy-
Usesacarefirllyalignedlightsourcetominimizethequantityof
directlytransmittedlightenteringtheimageplane,collectingonlythe
lightscatteredbythesample.
Confocalmicroscopy/confocallaserscanningmicroscopy/laser

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confocalscanningmicroscopy-
Usesascanningpointoflightandapinholetopreventoutoffocus
lightfromreachingthedetector.

21.Acanthocytesareseenin?
a)Abetalipoproteinemia

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b)Severeliverdisease
c)PatientswithMacleodbloodgroup
d)SLE
e)Hyperprolactinemia
CorrectAnswer-A:B:C

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Answer-A,B,C,Abetalipoproteinemia,Severeliver
disease,PatientswithMacleodbloodgroup
Acanthocytesorspurcells,areabnormalerythrocfteswhichare
spiculatedwithafewspinyorthornyprojectionsofcytoplasmof
varyingsizeandsurfacedistribution.

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Themostfrequentandmostsignificantconditionswith
acanthocytosisincludeabetalipoproteinemia.
McLeodredcellPhenotype.

22.Featuresofchronicmyelogenous
leukemia(CML)-

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a)Bonemarrowbiopsyisnecessaryfordiagnosis
b)PresenceofBCR-ABLgenewhichdirectsthesynthesisof
BCR-ABLtyrosinekinase
c)Dasatinibisusedinimatinibresistantcases
d)Generalizedpainfullymphadenopathyispresentingfeaturein

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mostcases
e)Myeloblastsusuallyconstitutemorethan10%ofallwhitecells
inchronicphase
CorrectAnswer-A:B:C
Answer-A,B,C,Bonemarrowbiopsyisnecessaryfor

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diagnosis,(B)PresenceofBCR-ABLgenewhichdirectsthe
synthesisofBCR-ABLtyrosinekinase(C)Dasatinibisusedin
imatinibresistantcases
Splenomegalyispresentin90%
Imatinib,dasatinibandnilotinibspecificallyinhibitBCRABLtyrosine

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kinaseactivityandreducetheuncontrolledproliferationofwhite
cells.
ThediseaseisdrivenbytheBCR-ABL1chimericgeneproduct,a
constitutivelyactivetyrosinekinase.
Commonmanifestationsareofanemiaandsplenomegaly,

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lymphadenopathy,andextramedullarydisease(skinor
subcutaneouslesions)
Thebonemarrowishypercellularwithmarkedmyeloidhyperplasia
andahighmyeloid-to-erythroidratioof15-20:1.


23.TrueaboutCysticfibrosis-

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a)OccursdueCFTRgenemutationonchromosome7
b)Meconiumileusispresentin>90%cases
c)CFTRgenecanbedetectedantenately
d)Poorbodygrowth
e)Alloftheabove

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CorrectAnswer-A:C:D
Answer-A,C,D,OccursdueCFTRgenemutationon
chromosome7(C)CFTRgenecanbedetectedantenately
(D)Poorbodygrowth
Theprimarydefectincysticfibrosisresultsfromabnormalfunction

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ofanepitheltalchloridechannelproteinencodedbythecystic
fibrosistransmembraneconductanceregulator(CFTR)geneon
chromosome7.
Contentsoftheintestinallumenaredifficulttoexcretewhichresults
inmeconiumileus.

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SequencingtheCFTRgeneisthegoldstandardfordiagnosisof
cysticfibrosisPoorbodygrowth

24.Trueaboutcaspases-
a)Caspasesinitiateapoptosisbyextrinsicandintrinsicpathway
b)Caspasesareproteaseenzyme

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c)Caspasesarereceptor
d)Caspasesinhibitapoptosis
e)Causesnonenzymaticdegradationofcriticalcellular
components
CorrectAnswer-A:B

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Answer-A,B,Caspasesinitiateapoptosisbyextrinsicand
intrinsicpathway(B)Caspasesareproteaseenzyme
Apoptosisresultsfromtheactivationofenzymescalledcaspases.
Theprocessofapoptosismaybedividedintoaninitiationphase
(intrinsicpathway)andexecution(extrinsicpathway).

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Twodistinctpathwaysconvergeoncaspaseactivation:
Themitochondrialpathwayandthedeathreceptorpathway
Caspasesareafamiyofendoproteases.
Theactivationoftheseenzymeistightlycontrolledbytheir
productionasinactivezymogensthatgaincatalyticactivityfollowing

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signalingeventspromotingtheiraggregationintodimersor
macromolecularcomplexes"

25.Trueaboutminimalchangedisease-
a)Hypertensioniscommonlypresent
b)Mostcommoncauseofnephroticsyndromeinadults

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c)Highdosesteroidsresultsinremissioninmostcases
d)Commonlyprogresstochronicrenalfailure
e)Reversiblelossofpodocytefunction
CorrectAnswer-C:E
Answer-(C)Highdosesteroidsresultsinremissioninmost

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cases(E)Reversiblelossofpodocytefunction
Minimalchangedisease:
Alsok/alipoidnephrosa,footprocessdisease&Nildepositdisease
Thediseasesometimesfollowsarespiratoryinfectionorroutine
prophylacticimmunization'

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Theonsetmaybeprecededbyanupperrespiratoryinfection,atopic
allergyorimmunisation.
Thediseasecharacteristicallyrespondtosteroidtherapy
Thebenigndisorderischaracterizedbydiffuseeffacementoffoot
processesofvisceralepithelialcell(podocytes).

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mostfrequentcauseofnephroticsyndromeinchildren
Thevisceralepithelialchangesarecompletelyreversibleafrer
corticosteroidtherapy,concomitantwithremissionoftheproteinuria.
Thereiscommonlynohypertensionorhematuria.
Theappearanceofacuterenalfailureinadults.

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26.Feature(s)ofAdultpolycystickidney
diseaseis/are:
a)Renalenlargement
b)Smallkidney
c)Spiderlegdeformityonintravenousurography

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d)Ultrasoundshowsmultiplecysts
e)Alloftheabove
CorrectAnswer-A:C:D
Answer-A,C,D,Renalenlargement(C)Spiderlegdeformityon
intravenousurography(D)Ultrasoundshowsmultiplecysts

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ADPKDischaracterizedbytheprogressivebilateralformationof
renalcrisis.
Inhieritence-autosomaldominant
Characterizedbymultipleexpandingcystsofbothkidneys.
Ingrossappearance,thekidneysarebilaterallyenlarged.

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Thepainmayresultfromrenalcystinfection,hemorrhage,or
nephrolithiasis.
'Intravenousurographypolycystickidneydisease:Thespiderlegs,
deformityofthecalyces.

27.Whichis/arecausedbyprotein

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misfolding:
a)Creutzfeldt-Jakobdisease
b)Bovinespongiformencephalopathy
c)Huntingtondisease
d)Alzheimerdisease

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e)Parkinsondisease
CorrectAnswer-A:B:C:D:E
Answer-A,B,C,D,E,Creutzfeldt-Jakobdisease(B)Bovine
spongiformencephalopathy(C)Huntingtondisease
(D)Alzheimerdisease(E)Parkinsondisease

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Theproteinsfailtofoldintotheirnormalconfiguratoryinthis
misfoldedstate,theproteinscanbecometoxicinsomeway(again
oftoxicfunction)ortheycanlosetheirnormalfunctionwhichis
knownasproteinmisfoldingdisease.
SuchdiseasesasCreutzfeldt-Jakobdisease,Alzheimer'sdisease,

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Parkinson'sdisease,priondisease,amyloidosis,Bovinespongiform
encephalopathy,Huntingtondisease.

28.TrueaboutCreutzfeldt-JakobDisease:
a)Gliosisinthalamus
b)Spongiformswellingincerebralcortex

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c)Brainatrophyinlatestage
d)SlowandirregularbackgroundrhythmonEEG
e)None
CorrectAnswer-B:C:D
Answer-B,C,D,Spongiformswellingincerebralcortex

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(C)Brainatrophyinlatestage(D)Slowandirregular
backgroundrhythmonEEG
CJDisararedisorderthatmanifestsclinicallyasarapidly
progressivedementia.
TheprogressionofthedementiainCJDisusuallysorapidthatthere

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islittleifanygrosslyevidentbrainatrophy.
Microscopically,thehallmarkisspongiformchangeofthecerebral
cortex.
Inadvancedcasesthereissevereneuronalloss,reactivegliosis.
EEGabnormaltdesarepresentinnearlyallpatients,consistingofa

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slowandirregularbackgroundrhythmwithperiodiccomplex
discharges.

29.Hereditarynon-polyposiscolorectal
cancer(HNPCC)is/arecommonly
associatedwith-

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a)Endometrialcancer
b)Cervicalcancer
c)Ovariancancer
d)Breastcancer
e)Thyroidcancer

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CorrectAnswer-A:C
Answer-A,C,Endometrialcancer(C)Ovariancancer
Hereditarynon-polyposiscolorectalcancer(HNPCC)-
Malignancies-Colonic,endometrial,ovarian,pancreatic,gastric.
Inherictance-autosomaldominant

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Gene-ADMSH2,MLH1,MSH6,PMS1,PMS2

30.FeaturesofNonbacterialthrombotic
endocarditis(NBTE)-
a)CommoninSLE
b)Presentonundersurfaceofvalve

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c)Vegetativegrowthislargeandlooselyattachedtovalve
d)Mayoccurafterpost-cardiaccatheterization
e)Sourceofsystemicemboli
CorrectAnswer-B:D:E
Answer-B,D,E,Presentonundersurfaceofvalve(D)May

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occurafterpost-cardiaccatheterization(E)Sourceofsystemic
emboli
Theseverrucaearetypicallysmall,singleormultiple,brownishand
occuralongthelineofclosureoftheleaflet.
VegetatianofNBTEissmallandlooselyattachedtotheunderlying

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valve.
Sourceofsystemicembolithatproducesignificantinfarctsinthe
brain,heart,spleenandkidneys.
Itfrequentlyoccurswithdeepvenousthrombosis,pulmonaryemboli.

31.TrueaboutAlzheirnerdisease:

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a)Mostcommoncauseofdementiainelderly
b)Unusalbefore45yearsofage
c)Plaquesconsistsoftauprotein
d)Mayhavefamilyhistory
e)Shorttermmemoryisaffectedlessthanlong-termmemory

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CorrectAnswer-A:B:D
Answer-A,B,D,Mostcommoncauseofdementiainelderly
(B)Unusalbefore45yearsofage(D)Mayhavefamilyhistory
Alzheimer'sdisease(AD)isaslowlyprogressivediseaseofthe
brainthatischaracterizedbyimpairmentofmemoryandeventually

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bydisturbancesinreasoning,planning,language,andperception.
Alzheimer'sdiseaseisCommonin5thand6thdecade.
Trisomy21isassociatedwithalzheimer'sdementia.
Plaquecontainingbeta-amyloidpeptide,andneurofibrillarytangles
containingtauproteinoccursinneocortex.

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Thecausesincludegenetic,environmental,andlifestylefactors.
DementiaofAlzheimer'stypeisassociatedwithDepressive
symptoms,Delusions,Apraxiaandaphasia.
Recentmemoryloss(shorttermmemoryloss)isfeatureof
Alzheimer'sdisease.

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32.Negribodiesinanimalcanbebestseen
in:
a)Hippocampus
b)Basalganglia
c)Cerebralcortex

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d)Cerebellum
e)Thalamus
CorrectAnswer-A:D
Answer-A,D,Hippocampus(D)Cerebellum
Theyaremostprominentinpyramidalcellsofthehippocampusand

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Purkinjecellsofcerebellumbuthavebeenseeninnervecells
throughoutthebrainandspinalcord.

33.Trueaboutp53-
a)Hastyrosinekinaseactivity
b)Haspro-apoptoticactivity

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c)Tumoursuppressorgene
d)Hasanti-apoptoticactivity
e)None
CorrectAnswer-A:B:C
Answer-A,B,C,Hastyrosinekinaseactivity(B)Haspro-

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apoptoticactivity(C)Tumoursuppressorgene
p53isatumorsuppressorgeneanditisaproapoptoticfactor,i.e.it
promotesapoptosisifrepairofDNAdamageisunsuccessfulatG1
arrest.
Theproteinkinasesthatareknowntotargetthistranscriptional

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activationdomainofp53.

34.TrueaboutTakayasusyndrome:
a)InvolvessmallandMediumsizedvessels
b)Sharesmanyclinicalfeaturesofgiantcellarteritisifinvolves
aorta

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c)Morecommoninmalethanfemale
d)Granulomatousvasculitis
e)Alsocalledpulselessdisease
CorrectAnswer-B:C:E
Answer-B,D,E,Sharesmanyclinicalfeaturesofgiantcell

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arteritisifinvolvesaorta(D)Granulomatousvasculitis(E)Also
calledpulselessdisease
"Giantcellarteritis(GCA)isagranulomatousarteritisthat
predominantlyaffectsmedium-sizedarteriesintheheadandneck.
Itpredominantlyaffectstheaorta.

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Takayasuarteritis(Pulselessdlsease):Thediseaseaffectschiefly
youngwomen.
Takayasuarteritisisagranulomatousvasculitisofmediumsized
andlargerarteriescharacterizedprincipallybyoculardisturbances
andmarkedweakeningofthepulsesintheupperextremities.

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35.Correctmatchofstainwithtissueis/are-
a)Perls'Prussianblue-ironintissue
b)VonKossa-collagen
c)Masson'strichrome-elastinfiber
d)PAS-glycogen

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e)PAS-Acidicandneutralmucin
CorrectAnswer-A:D:E
Answer-A,Perls'Prussianblue-ironintissueD,PAS-
glycogenE,PAS-Acidicandneutralmucin
1.Masson'strichrome-Trichromehistologystains

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Canbeusedtodistinguishbetweencellularitemsandextracellular
items
Canbeusedonconnectivetissue
2.VonKossastain-usedtoindicatecalciumandcalcium
deposits

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3.Periodicacidschiff(PAS)-AMucinstain
Usedforstainingglycogen
Usedtoshowglomeruli,basementmembranes,andglycogeninthe
liver.
4.Perls'Prussianblue-Canbeusedtorevealthepresenceof

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ironinbiologicaltissues


36.Whichareinheritablemalignancies:
a)Breastcancer
b)Thyroidcancer
c)Wilmstumour

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d)Retinoblastoma
e)Prostatecancer
CorrectAnswer-A:B:C:D:E
Answer-A,B,C,D,E,Breastcancer(B)Thyroidcancer
(C)Wilmstumour(D)Retinoblastoma(E)Prostatecancer

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Breast/ovarian-Breast,ovarian,colonic,prostatic,pancreatic
Wilm'stumour-Nephroblastoma,neuroblastoma,hepatoblastoma,
rhabdomyosarcomaRetinoblastoma-Retinoblastoma,
osteosarcoma
Prostatecancer-prostate

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Cowden'ssyndrome-Breast,thyroid,gastrointestinaltract,
pancreatic

37.Trueaboutproliferalivephaseofwound
healing
a)Neutrophilsincreasesgradually

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b)Macrophageincreasesgradually
c)CollagentypeIpresentpredominantly
d)CollagentypeIIIpresentpredominantly
e)Angiogenesisoccurs
CorrectAnswer-D:E

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Answer-D,CollagentypeIIIpresent
predominantlyE,Angiogenesisoccurs
Duringproliferation,thewoundis'rebuilt'withnewgranulation
tissuewhichiscomprisedofcollagenandextracellularmatrixand
intowhichanewnetworkofbloodvesselsdevelop,aprocess

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knownas'angiogenesis'.
Maturationisthefinalphaseandoccursoncethewoundhas
closed.ThisphaseinvolvesremodellingofcollagenfromtypeIIIto
typeICellularactivityreducesandthenumberofbloodvesselsin
thewoundedarearegressanddecrease.

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38.CausesofNon-megaloblasticmacrocytic
anameia-
a)Folatedeficiency
b)Leadtoxicity
c)Hypothyroidism

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d)Liverdisease
e)VitB12deficiency
CorrectAnswer-C:D
Answer-C,D,Hypothyroidism(D)Liverdisease
Causesinclude:

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Chronicalcoholism
Liverdisease
Hypothyroidism
Reticularfibrosis
Blood.disorderslikered-cellaplasia,aplastic

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anemia,myelodysplasticsyndromesandmyeloidleukemia
Drugsasazathioprine
Pregnancy

39.GlucoselevelinCSFis/arereducedin:
a)Bacterialmeningitis

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b)Fungalmeningitis
c)Viralmeningitis
d)Tubercularmeningitis
e)Spirochetalmeningitis
CorrectAnswer-A:B:D

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Answer-A,BacterialmeningitisB,Fungal
meningitisD,Tubercularmeningitis
Normal-45-48mg/dL
Bacterialmeningitis-Markedlyreduced(low<45)
Fungalmeningitis-Markedlyreduced(low<45)

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Viralmeningitis-Normalorlow
Tubercularmeningitis-Reduced(low<45)
Spirochetalmeningitis-Normal

40.Whichoffollowingisnotclassifiedas
Primitiveneuroectodermaltumour(PNET):

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a)Retinoblastoma
b)Medulloblastoma
c)Rhabdomyosarcoma
d)Ewingsarcoma
e)Carcinoidtumour

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CorrectAnswer-A:C:D:E
Answer-A,RetinoblastomaC,RhabdomyosarcomaD,Ewing
sarcomaE,Carcinoidtumour
Embryonaltumorsorprimitiveneuroectodermaltumors(PNET)are
themostcommongroupofmalignantCNStumorsofchildhood.

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PNETgroupincludes-medulloblastoma,supratentorialPNET,
ependymoblastoma,medulloepithelioblastoma,andatypicalteratoid/
rhaboidtumor(ATRT).
Ewing'ssarcomaiscloselyrelatedtoPNET,butnotPNET.
Recently,Ewingsarcomaandprimitiveneuroectodermaltumor

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(PNET)havebeenunifiedintoasinglecategory:
TheEwingsarcomafamilytumors(ESFT)basedonsharedclinical,
morphologic,biochemicalandmolecularfeatures

41.Truestatement(s)aboutWilm'stumour-
a)Mostcommonlypresentsasasymptomaticabdominalmass

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b)Hereditarypredispositionispresentin50%cases
c)Bilateralin25%cases
d)Classictriphasiccombinationofblastemal,stromal,and
epithelialcelltypesisobserved
e)Mostcommoninchildren

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CorrectAnswer-A:D:E
Answer-A,D,E,Mostcommonlypresentsasasymptomatic
abdominalmass(D)Classictriphasiccombinationofblastemal,
stromal,andepithelialcelltypesisobserved(E)Mostcommon
inchildren

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Itisamalignanttumourofkidneywhichisseeninchildren
Tumouriscomposedofepithelialandmesothelialelements(bone,
cartilage,muscleetc)socalledasnephroblastoma(immature
embryonictissue)
Wilmstumor,alsoknownasnephroblastomaisacomplexmixed

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embryonalneoplasmofthekidneycomposedofthreeelaments:
blastema,epithelia,andstroma.
Clinicalfeatures-
Commoninfemalechildren(2-4years)
Massintheabdomen.

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Abdominaldistensionduetoenlargedkidney
Rarely,Wilm'stumourisbilateral
Hematuria

42.Suspicionofmalignancyinthyroidnodule
isindicatedbyallexcept-

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a)Femalegender
b)Dysphagia
c)Age20-40years
d)Increasingpain
e)Rapidlyenlargingsize

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CorrectAnswer-A:B:C:E
Answer-(A)Femalegender(B)Dysphagia(C)Age20-40years
(E)Rapidlyenlargingsize
Themostcommonpresentingsignofthyroidcancerisathyroid
nodule.

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SolitaryorMultiplethyroidnodules
NeckNodes
Hoarsevoiceofrecentonset
Mediastinaladenopathy
Boneorlungmetastasis

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Gender:Female>Males.
Age:
Morecommonatyoungadults.
MTCusuallydiagnosedafter60.
Ahistoryofarapidlyenlargingthyroidnoduleusuallyindicates

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hemorrhage,andthisoccurinbothbenignandmalignantdisease.

43.Featuresofirreversiblecellinjuryare
a)Lysosomalinjury
b)Pyknosis
c)Cellmembraneinjury

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d)Mitochondrialamorphousdeposits
e)Apoptoticbodies
CorrectAnswer-B:C:D:E
Answer-B,PyknosisC,CellmembraneinjuryD,Mitochondrial
amorphousdepositsE,Apoptoticbodies

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Characteristicfeaturesare-
Largeflocculentamorphousdensitiesinmitodrondriadueto
accumulationofcalcium.
Intracytoplasmicmyelinefiguresappearduringreversibleinjurybut
becomesmoreprominentinirreversibleinjury.

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Nuclearchanges:Thesearemostspecificandincludepyknosis
(nuclearcondensation),karyorrhexis(fragmentationofnucleus),and
karyolysis(nucleardissolution).
Decreasedbasophilia(duetodecreasedribonucleoprotein).
Leakageofintracellularenzymeacrossdamagedcellmembrane

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intoperiphralcirculation
Apoptoticbodiesareseeninapoptosis,whichisapatternofdeath
afterirreversibleinjury.

44.Premalignantlesionoforalcavity
includes

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a)Lichenplanus
b)Erythroplakia
c)Bowendisease
d)Behchetdisease
e)None

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CorrectAnswer-B
Answer-B.Erythroplakia
Premalignantcondition:-Leukoplakia,Erythroplakia,Speckled
erythroplakia,chronichyperplasticcandidiasis.

45.PrognosisofHead&neckcancerisbased

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on-
a)Siteofthetumor
b)Stageofthetumor
c)Etiologicalagent
d)Ageofpatient

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e)Genderofpatient
CorrectAnswer-A:B:C
Answer-(A)Siteofthetumor(B)Stageofthetumor
(C)Etiologicalagent
headandneckcancerisdeterminedbytumorlocationandstage

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andetiology.

46.Prothrombintimeiselevatedinfollowing
conditions
a)DefectinfactorXI
b)Fibrinogendefect

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c)DIC
d)FactorVIIdefect
e)VonWillebranddisease
CorrectAnswer-B:C:D
Answer-B,FibrinogendefectC,DICD,FactorVIIdefect

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Itteststheextrinsicandcommoncoagulationpathways.So,a
prolongedPTcanresultsfromdeficiencyoffactorV,
VII,X,prothrombinorfbrinogen.

47.TrueaboutDigeorgeSyndrome-
a)B-celldeficiency

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b)Defectin3rdpharyngealpouch
c)Hypoparathyroidism
d)Candidiasis
e)Thymicaplasia
CorrectAnswer-B:C:D:E

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Answer-(B)Defectin3rdpharyngealpouch
(C)Hypoparathyroidism(D)Candidiasis(E)Thymicaplasia
DigeorgesyndomeisanexampleofaTcelldeficiencythatresults
fromfailureofdevelopmentofthethirdandfourthpharyngeal
pouches.

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Clinicalfeaturesinclude-
Enhancedsusceptibility-viral,fungal(mucocutaneouscanididiasis)
andbacterialinfections
Facialabnormalities:Hypertelorism,abnormalears,shortphiltrum
andmicrognathia

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Hypocalcemictetanyduetofailureofparathyroiddevelopment
(Hypoparathyroidism).

48.Followingfindingsareseeninrheumatic
heartdisease
a)McCallumsplaque

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b)Thickeningofmitralvalve
c)Fibrousplaqueonundersurfaceofaorticvalve
d)Aschoffbodiesinmyocardium
e)None
CorrectAnswer-A:B:D

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Answer-A,McCallumsplaqueB,Thickeningofmitral
valveD,Aschoffbodiesinmyocardium
1)Acuterheumaticcarditis-
ThecharacteristichistologicalfindingofrheumaticcarditisisAschoff
bodies/orAschoffnodules.

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2)Chronicrheumaticcarditis-
Irregularthickeningofposteriorwallofleftatriumproduces
MacCallumplaque/patchduetosubendothelialcollectionofAschoff
nodules.
Endocardiuminvolvementleadstoformationofsmallwarty

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projections(verrucae)alongthelineofclosureofvalvularleaflet,
mostlyonmitralvalve.

49.Increasedreticulocytecountisseenin
a)Megaloblasticanemiaontreatmentwithhematinics
b)Acutehemorrhage

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c)Congenitaldyserythropoieticanemia
d)Hereditaryspherocytosis
e)Aplasticanemia
CorrectAnswer-A:B
Answer-A,Megaloblasticanemiaontreatmentwith

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hematinicsB,Acutehemorrhage
Acutebloodlossorhemorrhage
Postsplenectomy
Microangiopathicanemia
Autoimmunehemolyticanemia

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Hemoglobinopathy
Postanemiatreatment
vitaminB12supplementation

50.DefinitiveRiskfactorsforcarcinoma
stomachis/are-

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a)Smoking
b)Alcoholism
c)HPyloriinfection
d)Chronicatrophicgastritc
e)Partialgastrectomy

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CorrectAnswer-A:C:D:E
Answer-(A)Smoking(C)HPyloriinfection(D)Chronicatrophic
gastritc(E)Partialgastrectomy
Environmentalfactors:H.Pyloriinfection,cigarettesmoking,andlow
socioeconomicstatus.

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Hostfactors:Chronicgastritis,partialgastrectomy
lntestinalmetaplasiaisthemostsignificantprecursorlesionfor
Gastriccancer.
Geneticfactors

51.Increasedreticulocytesareseenin

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a)Aplasticanemia
b)B12deficiencyontreatmentwithhematinics
c)Irondeficiencyanemia
d)Hemolyticanemia
e)None

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CorrectAnswer-B:D
Answer-B,B12deficiencyontreatmentwith
hematinicsD,Hemolyticanemia
Acutebloodlossorhemorrhage
Postsplenectomy

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Microangiopathicanemia
Autoimmunehemolyticanemia
Hemoglobinopathy
Postanemiatreatment
vitaminB12supplementation

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52.Feature(s)ofTurnersyndromeis/are-
a)Monosomyofautosomes
b)Webbingofneck
c)Mentalretardation
d)Shortfourthmetacarpal

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e)Streakgonades
CorrectAnswer-B:D:E
Answer-(B)Webbingofneck(D)Shortfourthmetacarpal
(E)Streakgonades
45X0

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Lymphademaofdorsumofhand&fat
Looseskinfoldatnapeofneck
Shortstature
ShortNeck(withwebbingofneck)
Anomaliesear

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Broadshieldlikechestwithwidelyspacedsmallnipple
Renalanomalies(Horse-shoe,soubleorcleftrenalpelvis)Coartof
aorta

53.TrueaboutamyloidSSA-
a)Mutanttransthyretin

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b)Senilecardiacamyloidosis
c)Wildtransthyretin
d)Familialpolyneuropathy
e)Senilesystemicamyloidosis
CorrectAnswer-B:C:E

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Answer-(B)Senilecardiacamyloidosis(C)Wildtransthyretin
(E)Senilesystemicamyloidosis
SSAischaracterizedbydepositionofwild-typetransthyretin(TTR)
-basedamyloidinparenchymalorgansinelderlyindividual.
SSAiscommondisease,affectingapproximately25%oofthe

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populationgreaterthan80yearsold.
SSAischaracterizedbyamyloidosisclinicallylimitedtoheart;
therefore,initiallyitwasreferredtoassenilecardiacamyloidosis.
Thisformofcardiacamyloidosistendstorunabenignclinical
course.

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54.Parameterswhichareincreasedmore
thannormalinirondeficiencyanemia
are

a)TIBC
b)Serumferritin

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c)Transferringsaturation
d)Transferringreceptors
e)None
CorrectAnswer-A:D
Answer-A,TIBCD,Transferringreceptors

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Serumleveldecrease
TIBCincrease
Serumferrritindecrease
Redcellprotoporphyrindecrease
Serumtransferringreceptorsproteinincreased.(STFRtologof

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ferritin)

55.Amydoidassociatedprotein[AAprotein]
isseenin-
a)Multiplemyeloma
b)Dialysisassociatedamyloidosis

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c)Systemicsclerosis
d)Sjogren'ssyndrome
e)Renalcellcarcinoma
CorrectAnswer-E
Answer-ERenalcellcarcinoma

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1. Primary
2. Secondary(reactive)
ThereisdepositionofAAamyloidprotein-
Renalcellcarcinoma(hypernephroma),Hodgkinslynphoma.

56.Thefollowinglaboratoryfinding

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differentiateanemiaofchronicdisease
fromirondeficiencyanemia

a)TIBC
b)Transferringsaturation
c)Serumironlevels

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d)Decreasedutilizationofendogenousferritin
e)Alloftheabove
CorrectAnswer-A:B:D
Answer-A,TIBCB,TransferringsaturationD,Decreased
utilizationofendogenousferritin

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Haemoglobin-anaemiamildtomoderate
Bloodpicture-microcytosisandhypochromic(butmostlynormocytic
&normochromic)
Absolutevalues-MCHCislow
Reticulocytecount-low

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Redcellsurvival-shortenlifespanoferythrocytes
Bonemarrow-myeloidhyperplasia&increaseinplasmacells.
Serumiron&TIBC-low
Serumferritin-increased(mostdistinguishingfeatureofchronic
disorder)

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Otherplasmaproteins-raised

57.Trueaboutdystrophiccalcification-
a)Raisedcalciumlevel
b)Seenindead/degenerativetissue
c)SeeninSarcoidosis

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d)Seeninatherosclerosis
e)Seeninrheumaticfever
CorrectAnswer-B:D:E
Answer-(B)Seenindead/degenerativetissue(D)Seenin
atherosclerosis(E)Seeninrheumaticfever

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Dystrophiccalcificationindeadtissues-
Necrosisoftuberculosis(mostcommonwhichmaybeinlymph
nodes)
Chronicabscessinliquifactivenecrosis
Infarct

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Thrombi
Dystrophiccalcificationindegeneratedtissues
Atheromatousplaque
Psommamabodies
Heartvalvesdamagedbyrheumaticfever

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58.Whichofthefollowingcombinationsof
carcinomawiththeirgeneticmutations
aretrue-

a)Carcinomabreast-BRCA1
b)Rhabomyosarcoma-C-KIT

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c)WilmstumorWT1
d)RetinoblastomaRb
e)NeuroblastomaMYC
CorrectAnswer-A:C:D:E
Answer-(A)Carcinomabreast-BRCA1(C)WilmstumorWT1

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(D)RetinoblastomaRb(E)NeuroblastomaMYC
Carcinomasoffemalebreastandovary-BRCA1
Wilmstumor-WT-l
Retinoblastomas-RB
Gastrointestinalstromaltumors,testicularseminoma,melanoma,

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AML-C-KIT
Neuroblastoma-NMYC

59.Whichofthefollowingis/areduetonon-
disjunctionofautosomes
a)Klinefelterssyndrome

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b)Turnerssyndrome
c)Pataussyndrome
d)Edwardsyndrome
e)CriduChatsyndrome
CorrectAnswer-C:D

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Answer-C,PataussyndromeD,Edwardsyndrome
Nondisjunctionofautosomes:Downsyndrome,edwardsyndrome,
patausyndrome

60.Commonmetaphysealtumorsare-
a)Enchondroma

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b)Osteosarcoma
c)Nonossifyingfibroma
d)Osteoidosteoma
e)Osteoclastoma
CorrectAnswer-A:B

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Answer-(A)Enchondroma(B)Osteosarcoma
Osteogenicsarcoma
Unicameral(simple)bonecyst
AneurysmalbonerystoFibrouscorticaldefect
Chondrosarcoma

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Osteochondroma
Enchondroma
Osteoblastoma

61.Whichofthefollowingacutephase
protein(s)decreasesduringacute

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inflammation

a)Albumin
b)Transferrin
c)Ceruloplasmin
d)C-reactiveprotein

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e)Haptoglobin
CorrectAnswer-A:B
Answer-A,AlbuminB,Transferrin
Negativeacutephaseproteins
Theseproteinsaredecreasedduringinflammation.Important

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examplesarealbumin,prealbumin,transferrin,transcortin,
transthyretinandretinalbindingprotein

62.MalignanciesassociatedwithHIVare-
a)Kaposissarcoma
b)NHL

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c)AnalCarcinoma
d)CervicalCarcinoma
e)ColonCarcinom
CorrectAnswer-A:B:C:D
Answer-(A)Kaposissarcoma(B)NHL(C)AnalCarcinoma

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(D)CervicalCarcinoma
KaposisarcomaisthemostcommontumorinAIDS.
Non-Hodgkinlymphomas(NHLs)inAIDSare-
1. PrimaryCNSlymphoma(associatedwithEBV)
2. Burkitt'slymphoma

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Hodgkin'sdisease
Leukemia
Multiplemyeloma
CervicalCa
AnalCa

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63.Whichofthefollowingcombinationsare
true
a)Hyalinecasts-normal
b)Waxycasts-chronicpyelonephritis
c)Broadcasts-CRF

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d)RBCcasts-glomerulonephritis
e)Muddycasts-acutetubularnecrosis
CorrectAnswer-A:B:C:D:E
Answer-A,Hyalinecasts-normalB,Waxycasts-chronic
pyelonephritisC,Broadcasts-CRFD,RBCcasts-

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glomerulonephritisE,Muddycasts-acutetubularnecrosis
Hyalinecasts
Thesearethemostcommoncastsandconsistsalmostentirelyof
Tamm-Horsfallprotein
Renaltubularepithelialcellcasts

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Epithelialcellsarepresentalongwithcast
Waxycasts
Theseareseeninchronicrenaldiseases
Broadcast
Theseareseeninadvancedrenalfailure

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RBCcasts
Thereareseeninnepahriticsyndromeduetoglomenulonephritis
Muddycasts
Itispathognomonicofacutetubularnecrosis(ATN)

64.Trueregardingcastexaminationinurine

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a)Acidisadded
b)Examinedattheedgeofcoverslip
c)Sedimentisused
d)Contrifugeisnotused
e)Broadcastindicatesstasisofurineflow

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CorrectAnswer-A:C:E
Answer-A,AcidisaddedC,SedimentisusedE,Broadcast
indicatesstasisofurineflow
Thecellularelementsarebestpreservedinacid.
Theurinesedimentcanbebrokendownintocellularelements.

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Broadcasts
Formationoccursincollectingtubules:seriouskidneydisorder,
extremestasisofflow.

65.TrueaboutDubin-Johnsonsyndrome-
a)Increasedconjugatedbilirubin

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b)UsuallyassociatedwithincreasedASTandALT
c)Mutationinuridinediphosphate-glucuronyltransferasepeptide
Al
d)Decreasedbiliaryexcretionofconjugatedbilirubin
e)Autosomaldominantinheritance

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CorrectAnswer-A:D
Answer-(A)Increasedconjugatedbilirubin(D)Decreased
biliaryexcretionofconjugatedbilirubin
DuringJohnsonsyndromeisanautosomalrecessivehereditary
disorderpresentingwithconjugatedhyperbilirubinemiaduetodefect

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inhepaticexcretoryfunctionacrossthecanalicularmembraneof
hepatocyte.
DJSisatypeofcongenitalconjugatedhyperbilirubinemia.
Conjugatedbilirubinisincreasedbecauseofdefectivebiliary
excretionofbilirubinglucuronidesduetomutationincanalicular

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multidrugresistanceprotein2.

66.Trueaboutalcoholicsteatosis
a)Microvesicular
b)Macrovesicular
c)Reversible

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d)Malloryhyaline
e)Centralhyalinesclerosis
CorrectAnswer-A:B:C
Answer-A,MicrovesicularB,MacrovesicularC,Reversible
Hepaticsteatosis(Fattyliver)

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Initiallythereismicrovesicularfattychange.Latermacrovesicular
fattychangesarealsoseen.Itisreversiblestage.

67.Feature(s)ofantiphospholipidsyndrome
is/areexcept-
a)Recurrentthrombosis

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b)SLEisassociatedwithprimaryantiphospholipidsyndrome
c)Itincludestwotypesofantibodies-lupusanticoagulantand
anticardiolipinantibody
d)Foetuslossmayoccur
e)Occurd/tdefectin

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CorrectAnswer-B:C:E
Answer-(B)SLEisassociatedwithprimaryantiphospholipid
syndrome(C)Itincludestwotypesofantibodies-lupus
anticoagulantandanticardiolipinantibody(E)Occurd/tdefect
in

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Inantiphospholipidsyndromethereishypercoagulabititywhich
resultsinrecurrefltvenousandarterialthrombosis.
Peripheralyenoussystetn)DVT
CNSCerebrovascularaccident,sinusthrombosismigraine,
epilepsy.

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HematologicalThrombocytopenia,hemolyticanemia.
ObstetricsAbortionin2rd&3rdtrimester(latefetalloss)is
commonbutitmayoccuranytimeinpregnancy;recurrentabortion,
eclampsia.
PulmonaryPulmonaryembolism,pulmonaryhypertension.

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CardiacLimbman-Sackendocarditis,MI.
Dermatological>Livedoreticularis,purpura,infarct/ulceration.
OcularAmaurosis,retinalthrombosis.

AdrenalInfarction,hemorrhage.
Musculoskeletal>Avascularnecrosisofbone.

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CatastrophicantiphospholipidsydromeMultiorganinfarction.

68.TrueaboutRASoncogene-
a)TyrosinekinasehasroleinRASactivation
b)Mostcommonformofoncogeneinhumantumors
c)IthasanintrinsicGTPaseactivity

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d)Mutationmayresultincarcinomatousgrowth
e)Belongstogrowthfactorcategoryofoncogene
CorrectAnswer-A:B:C:D
Answer-(A)TyrosinekinasehasroleinRASactivation(B)Most
commonformofoncogeneinhumantumors(C)Ithasan

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intrinsicGTPaseactivity(D)Mutationmayresultin
carcinomatousgrowth
InnormalcellstheactivatedstateofthisRASproteinistransient
becausenormalRAS-proteinshaveintrinsicGTPaseactivity.
MutationintheRASproteincausespermanentactivationofRAS

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proteinwhichmayresultincarcinomatousgrowth.
ActivatedRASraf-landactitesmitogen-activatingkinase(MAP-
kinase)pathway.
PointmutationofRASfamilygenesisthesinglemostcommon
abnormalityofoncogenesinhumantumor.

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69.Trueabouthaematologicaldisorder-
a)CryoprecipitateisusedintreatmentinhaemophiliaB
b)BothPTandaPTTareincreasedinDIC
c)Intravenousgammaglobulinisusefulinimmune
thrombocytopenicpurpura

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d)HemophiliaC:X-linkeddisorder
e)PlateletcountisdecreasedinDIC
CorrectAnswer-B:C:E
Answer-(B)BothPTandaPTTareincreasedinDIC
(C)Intravenousgammaglobulinisusefulinimmune

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thrombocytopenicpurpura(E)Plateletcountisdecreasedin
DIC
1.CryoprecipitateisusedinHemophiliaA-
Itcontainsfbrinogen,factorVIIIcandvWF,andfactorXIII.
UsedinhemophiliaAandvon-Willebranddisease.

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2.PT&aPTTareincreasedinDICaldplateletcountisdecreased
Bloodfilmshowsmicroangiopathichaemolyticanaemia.
PT,thrombintime,andActivatedPartialthromboplastintimeallare
prolonged.
3.IVimmunoglobulinisusefulinITP

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IVimmunoglobulinisthetreatmentofchoiceforneonatalaswellas
childhoodITP.
4.HemophiliaCiscausedbydeficiencyoffactorXI.
Itisinheritedasanautosomalrecessivepattern.

70.Whichis/arenottumorsuppressor

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gene(s)
a)TP53
b)RB
c)CD95
d)SKT11

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e)RAS
CorrectAnswer-C:E
Answer-C,CD95E,RAS

71.Mostcommontranslocationinacute
promyelocyticleukemia(APML)is

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a)t(8:14)
b)t(9:22)
c)t(15:17)
d)t(8:21)
e)t(11:118)

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CorrectAnswer-C
Answer-C,t(15:17)
Acutepromyelocyticleukemia(M3bytheFABclassification)is
associatedwithat(15;17)(q22;q11)translocation.
Disseminatedintravascularcoagulationcanoccurinthisdisorder

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duetothereleaseofprocoagulantsubstancesfromtheleukemic
cells,especiallyduringtreatment.
Thet(4;11)(q21;q23)translocationisassociatedwithacute
lymphocyticleukemia(ALL)andundifferentiatedleukemia.
Thet(6;9)(p23;q34)translocationisfoundinsubtypesofAMLwith

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basophilia(M1,M2,M4).
Burkitt'sleukemia,whichisrelatedtoBurkitt'slymphoma,is
associatedwitht(8;14)(q24;q32).
Thet(8;21)(q22;q22)translocation(choiceD)isseeninM2
leukemia,alsoknownasacutemyeloidleukemia(AML)with

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maturation

72.Prolongationofboth-activatedpartial
thromboplastintime(aPTT)and
prothrombintime(PT)maybeseenin
factordeficiencyof-

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a)Factor2
b)Factor5
c)Factor10
d)Factor8
e)Factor9

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CorrectAnswer-A:B:C
Answer-(A)Factor2(B)Factor5(C)Factor10
Partialthromboplastintime(pTT)
Itteststheintrinsicandcommoncoagulationpathways.So,a
prolongedPTTcanresultsfromdeficiencyoffactorV,VIII(factor

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VIIIc,vonwillebrandfactor),IX,X,X,XII,prothrombinorfibrinogen.
Prothrombintime(PT)
Itteststheextrinsicandcommoncoagulationpathways.So,a
prolongedPTcanresultsfromdeficiencyoffactorV,
VII,X,prothrombinorfibrinogen.

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73.Mostcommonaneuploidycompatiblewith
lifeis
a)Downsyndrome
b)Turnersyndrome
c)Klinefelter'ssyndrome

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d)Patausyndrome
e)None
CorrectAnswer-A
Answer-A,Downsyndrome
Mostcommonaneuploidyinwhichinfantcansurviveistrisomy-21

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(Downsyndrome)

74.Smallvesselvasculitisis/are-
a)Kawasakidisease
b)IgAvasculitis
c)Carcinomaassociatedvasculitis

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d)Anti-glomerularbasementmembrane(anti-GBM)disease
e)Takayasuarteritis
CorrectAnswer-B:C:D
Answer-(B)IgAvasculitis(C)Carcinomaassociatedvasculitis
(D)Anti-glomerularbasementmembrane(anti-GBM)disease

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i)ANCApositive
Wegner'sgranulomatosis,Microscopicpolyangitis,Churgstrauss
sytdrome,Good-posturesyndrome.
ii)ANCAnegative
Henoch-Schonleinpurpura,Bechetssyndrome

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75.Whichofthefollowingis/aretrueabout
sideroblasticanaemia
a)Basophilsstipplinginleadpoisoning
b)Erythroidhypoplasiainbonemarrow
c)Pappenheimerbodiesisalwayspresent

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d)DimorphicRBC
e)IncreasedMCHC
CorrectAnswer-A:D
Answer-A,BasophilsstipplinginleadpoisoningD,Dimorphic
RBC

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Importantfeaturesofsideroblasticanemiaare:-
Ringeedsidetoblastsinbonemarrowprussionbluereaction.
Dimorphicbloodpicture,i.e.amixturemicrocytichypochromicand
macrocyticerythrocytes
Increased:Ironstores,serumferritin,serumiton,transferrin

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saturation.
Ineffectiveerythropoiesisbecauseironcannotbeincorporatedinto
erythrocytes.
otherfeature:DecreasedMCVMCHandMCHC;basophiling
stipplinginleadporsonizgAnisopoikilocytosis(varying

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sizesandabnormalshapesofRBCs),erthroidhyperplasiainbone
marrow.

76.Cancer(s)causedbyviralinfections-
a)Kaposisarcoma
b)Nasopharyngealcarcinoma

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c)Hepatocellularcancer
d)Hodgkin'slymphoma
e)All
CorrectAnswer-A:B:C:D
Answer-(A)Kaposisarcoma(B)Nasopharyngealcarcinoma

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(C)Hepatocellularcancer(D)Hodgkin'slymphoma
DNAvirusesHerpesviridaeHHV-8Kaposissarcoma
Hepadnaviridae(HBV)hepatocellularcarcinoma
Flaviviridae(HCV)hepatocellularcarcinoma
EBVassociatedmalignancies-

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Burkitt'slymphoma
Nasopharynagealcarcinoma
Hodgkin'sdisease

77.Multiplemyelomamaybeassociatedwith
a)Fanconi'ssyndrome

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b)Amyloidosis
c)Mixedcryoglobinemia
d)Castnephropathy
e)Interstitialnephritis
CorrectAnswer-A:B:C:D:E

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Answer-A,Fanconi'ssyndromeB,AmyloidosisC,Mixed
cryoglobinemiaD,CastnephropathyE,Interstitialnephritis
Factorscontributingthedamageare:-
BenceJonesproteinuriaandcastnephropathy
Amyioidosis

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Lightchainnephropathy,Glomerulopathy,tubule-interstitial
nephritis.
Vasculardisease.
Urinarytractobstruction.
Fanconi'ssyrdrome

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TypeIcryoglobulienmiaiscomposedofasinglemono-clonalIg,
usuallyIgM

78.Trueaboutautosomalrecessive
polycystickidneydisease(ARPKD)
a)CanbediagnosedinuterobyUSG

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b)Hypertensiondevelopsinlatestagesofthedisease
c)Mayproceedtorenalfailurebeforepreschoolage
d)Enlargementofkidney
e)Hematuriaisearlyfeature
CorrectAnswer-A:C:D

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Answer-A,CanbediagnosedinuterobyUSGC,Mayproceedto
renalfailurebeforepreschoolageD,Enlargementofkidney
ThepresentationinPolycysticdiseaseofkidneyischaracteristically
bilateral
Thebilateralenlargementcanhardlybemistakenonroutine

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examination
USGandCTshowmultiplecystsinbothkidneys
Thediseasemaypresentatanyagebutthemostcommonage
ofpresentationisinthe3rdor4thdecade.
Boththekidneyaregrosslyenlargedandsituatedwithmultiple

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cysts.
Childhoodpolycystickidneydiseasehasautosomalrecessive
inheritance.

79.Truestatementaboutasbestosis-
a)Mayinvolvehilarlymphnode

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b)Asbestosisbeginsinthelowerlobes
c)Pleuralplaquesconsistsofcalcifiedhyalinzedcollagenous
tissue
d)HighresolutionCTscanningisthebestimagingmethod
e)Noriskoflungcarcinoma

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CorrectAnswer-A:B:C:D
Answer-(A)Mayinvolvehilarlymphnode(B)Asbestosis
beginsinthelowerlobes(C)Pleuralplaquesconsistsof
calcifiedhyalinzedcollagenoustissue(D)HighresolutionCT
scanningisthebestimagingmethod

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Asbestosisisaninterstitiallungdiseaseduetoinhalationof
asbestosparticles.
Therearetwodistinctgeometricformsofasbestos:(i)Serpentine
(chrysolite),and(ii)Amphibole(crocidolite).
Bothserpentineandamphibolecancauseallasbestosisrelated

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diseaseexceptformesothelioma,whichisusuallyassociatedwith
amphibole.
Pleuralplaquesarethemostcommonmanifestationofasbestos
exposure.
Thereisdiffuseinterstitialfibrosismainlyinvolvinglowerlungfields.

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Thelungisinvadeddirectly,andthereisoftenmetastaticspreadto
thehilarlymphnodes.
HighresolutionCTscanningisthebestimagingmethodfor
asbestosis.

80.Feature(s)oftypeImembranoproliferative

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glomerulonephritis(MPGN)-
a)Tramtrackappearanceonlightmicroscopy
b)Subendothelialelectron-densedepositsonelectronmicroscopy
c)Immunofluorescencemicroscopyshowpositiveflorescenceof
IgGandC3ondensedeposit

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d)Intramembranousdensedepositonelectronmicroscopy
e)Mesangialhypocellularity
CorrectAnswer-A:B:C
Answer-A,Tramtrackappearanceonlight
microscopyB,Subendothelialelectron-densedepositson

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electronmicroscopyC,Immunofluorescencemicroscopyshow
positiveflorescenceofIgGandC3ondensedeposit
Onlightmicroscope,Alltypeshavefollowingsimilarfeatures.

1. TheglomeruliarehypercellularDuetoexocapillaryand
endocapillaryproliferation.

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2. Theglomerulihavelobularappearanceaccentuatedbythe
proliferatingmesangialcellsandincreasedmesangialmatrix.
3. Parietalepithelialcrescentinmanycases
4. GBMisthickened,whichismostevidentintheperipheralcapillary
loops.

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5. Theglomelularcapillarywallshowsadoublecontourortramtrack
appearancebecauseofduplicationofbasementmembraneasa
resultofnewbasementmembranesynthesis.
6. Withinthebasementmembranethereisinterpositionofcellular
elementsthatgiverisetotheappearanceofsplitbasement

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membrane.
TypeIandIIMPGNdifferintheirultrastructuralfeatures.
TypeISubendothelialdeposits.
TypeIIIntramembranousdeposition.
TypeIdisease(mostcommon)

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Idiopathic
Subacutebacterialendocarditis
TypeIIdisease(Densdepositdisease)
Idiopathic
C3nephriticfactorassociated

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Partiallipodystrophy
TypeIIIdisease
Idiopathic
Complementfactordeficiency
Systemiclupuserythematosus

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HepatitisC
Mixedcryoglubulinemia

81.Trueaboutsilicosis-
a)Lowerlobeismorecommonlyinvolved
b)Radiographicallyseenaseggshellclacification

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c)Lobarpneumoniaiscommon
d)Associatedwithanincreasedsusceptibilitytotuberculosis
e)Histologicallysilicanodulesconsistsofhyalinisedcenter
surroundedbyconcentriclaminationsofcollagen
CorrectAnswer-B:D:E

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Answer-(B)Radiographicallyseenaseggshellclacification
(D)Associatedwithanincreasedsusceptibilitytotuberculosis
(E)Histologicallysilicanodulesconsistsofhyalinisedcenter
surroundedbyconcentriclaminationsofcollagen
Silicosisisalungdiseasecausedbyinhalationofcrystallinesilicon

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dioxide(silica).
Silicosisisaslowlyprogressivedisease.
SilicosisisassociatedwithanincreasedsusceptibilitytoT.B.
Silicosisischaracterized-
NodulesintheUpperzonesofthelunghardcollagenousscars

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Radiologically,eggshellcalcificationcanbeseeninthelymph
nodes.
Histologically,silicosislesionsconsistofconcentriclayersof
hyalinizedcollagensurroundedbyadensecapsuleofmore
condensedcollagen.

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82.Tumormarkerforlungadenocarcinoma
is/are
a)Positiveforcytokeratin5
b)Positiveforcytokeratin7
c)Positiveforcytokeratin20

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d)Transthyretin(TTR)mutation
e)EGFRmutation
CorrectAnswer-B:E
Answer-B,Positiveforcytokeratin7E,EGFRmutation
Adenocarcinoma-AKT1,ALK,BRAF,EGFR,HER-2,K-RAS,MEK-

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1,MET,N-RAS
CK7(+)ve-BreastCa,PancreaticCa,CervicalCa,adenocarcinoma
oflung.

83.Whichofthefollowingis/areassociated
withsynovialcellsarcoma

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a)Translocation(9;22)(q34;q11)
b)SS18-SSX4fusiongenes
c)Translocationt(X;18)(p11;g11)
d)SS18-SSX1fusiongenes
e)None

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CorrectAnswer-B:C:D
Answer-B,SS18-SSX4fusiongenesC,Translocationt(X;18)(p1
1;g11)D,SS18-SSX1fusiongenes
Mostsynovialsarcomasshowacharacteristicchromosomal
translocationt(X:18)producingSYT-SSX1or-SSX2fusion

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genes.Thespecifictranslocationisassociatedwithpoorprognosis.
Histologichallmarkofbiphasicsynovialsarcomaisthedualliningof
differentiationofthetumorcells(eg.epitheliatlikeandspindlecells)
CalcifiedconcrectionscanbepresentonX-rays

84.Truestatementaboutprimary

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myelofibrosis
a)Hepatomegalyisthemostcommonmanifestation
b)Drytaponbonemarrowaspiration
c)Onlypotentiallycurativetreatmentisallogeneicstemcell
transplantation

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d)Splenomegalyisalmostinvariablypresent
e)Myeloblastsmaybeseeninperipheralblood
CorrectAnswer-B:C:D:E
Answer-B,DrytaponbonemarrowaspirationC,Only
potentiallycurativetreatmentisallogeneicstemcell

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transplantationD,Splenomegalyisalmostinvariably
presentE,Myeloblastsmaybeseeninperipheralblood
Thehallmarkofprimarymyelofibrosisisrapiddevelopmentof
obliterativemarrowfibrosis.
Myelofibrosissuppressesbonemarrowhematopoiesis,leadingto

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peripheralbloodcytopenias.
Peripheralbloodpictureshowsleukoerythroblastosis(erythroidand
granulocyticprecursorsinperipheralblood),andtear-drop
erythrocytes(dacrocytes).
Bonemarrowbiopsyistheinvestigationofchoice.

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Unsuccessfulbonemarrowaspirationalsocalleddrytap.
Allogmeicbonemarrowtransplantationistheonlycurativetreatment
forPMF.

85.Newerinclusionin2015WHO
classificationofsquamouscellcarcinoma

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oflunginclude(s)

a)Clearcellvariant
b)Papillarycellvariant
c)Adenocarcinomavariant
d)Nonkeratinizingvariant

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e)Lymphoepithelioma-likecarcinoma
CorrectAnswer-D
Answer-D,Nonkeratinizingvariant
Oldclassification-
Papillary

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Clearcell
Smallcell
Basaloid
NewerClassification-
KeratinizingSCC

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NonkeratinizingSCC
BasaloidSCC
Preinvasive:SCCinsitu

86.Whichofthefollowingcancause
pulmonaryembolism-

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a)Pregnancy
b)OCPuses
c)Mitralregurgitation
d)Leftventricularfailure
e)Excessiveunaccustomedexercise

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CorrectAnswer-A:B:D
Answer-(A)Pregnancy(B)OCPuses(D)Leftventricularfailure
PatientFactors
Age
Obesity

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Varicoseveins/superficialthrombophlibits
Immobility
Pregnancy
PuerPerium
High-doseoestrogentherapyorOCPuse

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Diseaseorsurgicalprocedure-
Traumaorsurgery
Malignancy
Heartfailure
Paralysisoflowerlimb

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Infection

87.Serotonin,amediatorofinflammationin
ourbody,issecreted/releasedby:
a)Leukocytes
b)Endothelialcell

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c)Mastcell
d)Platelet
e)Macrophage
CorrectAnswer-D
Answer-D.Platelet

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Serotonin:Itisfoundintheintestinalmucosa,braintissue&
platelets.
Releaseofserotonin(andhistamine)fromplateletsisstimulated
whenplateletsaggregateaftercontactwithcollagen,thrombin,
adenosinediphosphate(ADP),andantigen-antibodycomplexes.

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88.Whichofthefollowingmarker/mutation
is/areseeninpapillarycarcinomaof
thyroid:

a)Synaptophysin
b)RET/PTC

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c)P53
d)NTRK1
e)RAS
CorrectAnswer-B:D:E
Answer-B,RET/PTCD,NTRK1E,RAS

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GeneticAlterationsinThyroidNeoplasia-
RET/PTC
BRAF
TRK
RAS

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89.Autosomalrecessivedisease(s)is/are:
a)Sicklecellanaemia
b)Phenylketonuria
c)Tuberousscelerosis
d)Familialpolyposiscoli

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e)Marfansyndrome
CorrectAnswer-A:B
Answer-(A)Sicklecellanaemia(B)Phenylketonuria
1.Metabolic-
Cysticfibrosis

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Phenylketonuria
Galactosemia
Homocystinuria
Wilsondisease
Hemochromatosis

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2.Hematopoietic
Sicklecellanemia
Thalassemias
3.Endocrine
Congenitaladrenalhyperplasia

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4.Skeletal
Ehlers-Danlossyndrome
5.Nervous
Friedreichataxia
Spinalmuscularatrophy

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90.Whichofthefollowingmarkerfavours
diagnosisofpreinvasive&invasive
cervicalcancer:

a)Ki67
b)OncoproteinE6

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c)p16INK4,cyclinE,andKi-67
d)OncoproteinE8
e)None
CorrectAnswer-A:B:C
Answer-A,Ki67B,OncoproteinE6C,p16INK4,cyclinE,andKi-

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67
TheexpressionofE7determinestheinactivationofpRbwitha
consequentincreaseoffreeE2Finthecell,leadingtobothan
increaseofcyclin-dependentkinaseinhibitorpl6(p16INK4a)and
aberrantproliferation(markedbyincreasedlevelsofKi-67

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expression).

91.Whichofthefollowingis/arefeatures(s)of
lewybodydementia:
a)Plaquecontainingbeta-amyloidpeptide
b)Depositionofa-synucleinprotein

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c)Oftenresistanttostandardtreatment
d)Commoninelderly
e)Riskoffallingmaypresent
CorrectAnswer-B:C:D:E
Answer-(B)Depositionofa-synucleinprotein(C)Often

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resistanttostandardtreatment(D)Commoninelderly(E)Risk
offallingmaypresent
Alpha-synucleincontainingLewybodiesoccurinthebrainstem,
midbrain,olfactorybulb,andneocortex.
Thisisaneurodegenerativedisorderclinicallycharacterizedby

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dementiaandsignsofParkinson'sdisease.
Commoninelderly.
TheDLBclinicalsyndromeischaracterizedbyvisualhallucinations,
parkinsonism,fluctuatingalertness,falls.

92.TrueaboutAlzheimer'sdisease:

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a)Morecommoninolderage
b)Impairmentoftheabilitytoremembernewinformation
c)Mainlyaffectslongtermmemory
d)Generalcognitivebehaviorimpairedinprodromalphase
e)Atrophyoffrontal&parietallobe

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CorrectAnswer-A:B:D:E
Answer-(A)Morecommoninolderage(B)Impairmentofthe
abilitytoremembernewinformation(D)Generalcognitive
behaviorimpairedinprodromalphase(E)Atrophyoffrontal&
parietallobe

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Alzheimer'sdisease(AD)isaslowlyprogressivediseaseofthe
brainthatischaracterizedbyimpairmentofmemory.
Alzheimer'sdiseaseisCommonin5thand6thdecade.
EarlyStage-
Thisisconsideredasamild/earlystageandthedurationperiodis2-

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4years.
Frequentrecentmemoryloss.
Writingandusingobjectsbecomedifficultanddepressionand
apathycanoccur.
Secondstage-

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Thisisconsideredasamiddle/moderatestageandthedurationis2-
10years.
DementiaofAlzheimer'stypeisassociatedwithDepressive
symptoms,Delusions,Apraxiaandaphasia.
Pervasiveandpersistentmemorylossimpactslifeacrosssettings.

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Moderatestage-

Increasedmemorylossandconfusion.
Laststage-
Thisisconsideredastheseverestageandthedurationis1-3years.
Extremeproblemswithmood,behavioralproblems,hallucinations,

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anddelirium.

93.RScellhavingsameimmunophenotyping
arepresentinwhichsubtypesof
Hodgkin'slymphoma:

a)Nodularsclerosis

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b)Lymphocytepredominant
c)Lymphocyterich
d)Mixedcellularity
e)Lymphocytedepletion
CorrectAnswer-A:C:D:E

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Answer-(A)Nodularsclerosis(C)Lymphocyterich(D)Mixed
cellularity(E)Lymphocytedepletion
Inthefirstfoursubtypes-nodularsclerosis,mixedcellularity,
lymphocyte-rich,andlymphocytecells.

94.Trueaboutsurgicaljaundice:

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a)Increaseofserumbilirubin
b)Increaseacidphosphatase
c)Increasealkalinephosphatase
d)Urinebilirubinisabsent
e)Stoolsterocobilinogenabsent

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CorrectAnswer-A:C:E
Answer-A,IncreaseofserumbilirubinC,Increasealkaline
phosphataseE,Stoolsterocobilinogenabsent
Obstructivejaundice-
1.Biluribin

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Direct&Indirect-increased
2.Urinebilirubin-increased
3.Serumalbumin-generallyunchanged
4.Alkalinephosphatase-Increased
5.Sterocobilinogen-absent

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95.TrueaboutLyonisationofXchromosome:
a)InactivationofXchromosomeonlyinsomaticcell
b)InactivationofXchromosomeonlyingermcell
c)InactivationofXchromosomeinsomatic&germcellboth
d)MaximunnumberofBarrbodyisequaltoXchromosome

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e)All
CorrectAnswer-A
Answer-A.InactivationofXchromosomeonlyinsomaticcell
Infemale,oneoftwoX-chromosome(eitherpaternalormaternal)is
inactivatedduringembryogenesisasstatedinLyonhypothesis.

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Thisinactivationispassedtoallthesomaticcellwhilethegermcells
inthefemaleremainunaffected.

96.TwomostcommoncancerinIndian
womanis:
a)Carcinomabreast

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b)Carcinomacervix
c)Carcinomacolon
d)Carcinomastomach
e)Carcinomalung
CorrectAnswer-A:B

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Answer-(A)Carcinomabreast(B)Carcinomacervix
Inwomen,cancerbreast,cervixuteri,colorectum,ovary,lip&oral
cavity.

97.Prognosticfactorsforcarcinoma
esophagusis/are:

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a)Depthofinvasion
b)Lymphnodestatus
c)Tumourgrading
d)Stageofthedisease
e)All

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CorrectAnswer-E
Answer-E,All
StageThemostreliableprognosticfacforforesophagealcanceris
thestageofthetumouratthetimeofdiagnosis.
Tumoursize

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Lymphnodesstatus
Cancerhasspreadtodistantorgans
Cancerthatremainsaftersurgery
Tumourgrade

98.TrueaboutDentigerouscyst:

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a)Arisesinrelationtouneruptedteeth
b)Itmostcommonlyencroachesmaxillaryantrum
c)Mandibularthirdmolariscommonsite
d)Commoninmandible
e)All

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CorrectAnswer-A:C:D
Answer-A,ArisesinrelationtouneruptedteethC,Mandibular
thirdmolariscommonsiteD,Commoninmandible
Commoninlowerjaw(mandible)inwomen30-40years.
Itoccursinrelationtounerupted,permanent,molartooth,most

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commonlytheupperorlowerthirdmolar.

99.Whichofthefollowingisparaganglioma:
a)AdrenalPheochromocytoma
b)Extra-adrenalPheochromocytoma
c)Carotidbodytumour

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d)Carcinoidtumour
e)Glomustympanicum
CorrectAnswer-B:C:E
Answer-(B)Extra-adrenalPheochromocytoma(C)Carotidbody
tumour(E)Glomustympanicum

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Pheochromocytornaisachromaffin-cellneoplasmthatcanarisean
adrenal(adrenalmedulla)orextraadrenaltumor.
Extraadrenalpheochromocytomaisalsoreferredtoas
paraganglioma.
Thecarotidbodytumorisaprototypeofaparasympathetic

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paraganglioma.
Glomustympanicum:Mostcommontumourinmiddleear.

100.Whichofthefollowingstatement(s)
is/arecorrectexcept:
a)IncreasedPTinextrinsicpathways

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b)IncreasedaPTTininstrinsicpathways
c)Ifplateletcountis>1.5lac/microL,thennormalhomeo-stasis
present
d)BTisdecreasedinplateletabnormality
e)None

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CorrectAnswer-D
Aswer-D.BTisdecreasedinplateletabnormality
Hemostasisisspontaneousarrestofbleedingbyphysiological
Process.
Prothrombintime(PT):

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Thisassayteststheextrinsicandcommoncoagulationpathways.
Partialthromboplastintime(PTT):
Thisassayteststheintrinsicandcommonclottingpathway.
Prolongationgenerallyindicatesadefectinplateletnumbersor
function.

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101.Feature(s)ofXIIIfactordeficiencyis/are:
a)Delayedwoundclosure
b)Clotsolubilitytestsareabnormal
c)TaPTT
d)TPT

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e)TBT
CorrectAnswer-A:B
Answer-A,DelayedwoundclosureB,Clotsolubilitytestsare
abnormal
Itcharacteristicallyleadstodelayedbleedingthatoccurshoursto

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daysafterahemostaticchallenge.
Clotsolubilitytestsareabnormal.

102.PAX5is/aremarkerfor?
a)Acutemyeloidleukemia
b)T-celllymphomas

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c)Anaplasticlargecelllymphoma
d)Hodgkin'slymphoma
e)B-lymphoblasticlymphoma
CorrectAnswer-D:E
Ans.is'd'i.e.,Hodgkin'slymphoma;&`e'i.e.,B-Lyrnphoblastic

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lymphoma
[Ref:Robbins9th(SEA)/ep.590;Harrison19th/ep.699]
Pax5(B-cell-specificactivatorprotein)ismostlyexpressedinB-
lymphocytesandB-celllymphomas.Itisexpressedindeveloping
CNS,someneuroendocrinetumors,andoccasionalmyeloid

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leukemia.
Pax5stainingispositiveinmostHodgkinlymphoma,B-cellNHL,
andprecursorB-celllymphoblasticneoplasms.
Lymphoplascytoidlymphoma,smallcellcarcinomasandMerkelcell
carcinomasarealsopositive.

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T-celllymphomas,plasmacellneoplasms,multiplemyeloma,and
plasmablasticlymphomasarenegativeforPax5.

103.Trueaboutmiliarytuberculosis:
a)Occurprimarilyduetohematogenousspread
b)Miliarylesionisgenerallyofsize1-2mm

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c)Diffusebilateralcrepitationisalwayspresent
d)Onsetisgenerallyacute
e)Sputumsmearmicroscopyisnegativein80%ofcases
CorrectAnswer-A:B:E
Answer-(A)Occurprimarilyduetohematogenousspread

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(B)Miliarylesionisgenerallyofsize1-2mm(E)Sputumsmear
microscopyisnegativein80%ofcases
MiliaryTBisduetohematogenousspreadoftuberclebacilli.
Blood-bornedisseminationgivesrisetomiliaryTB.
Thelesionsareusuallyyellowishgranulomasl-2mmindiameter

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thatresemblemilletseeds(microscopicorsmall,visible).
Clinicalfeatures-
Fever,nightsweats,anorexio,weaknas,andweightlossare
presentingsymptomsinthemajorityofcases.
Patientshaveacoughandotherrespiratorysymptoms.

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Hepatomegaly,splenomegaly,andlymphadenopathy.
Eyeexamination-choroidaltubercles,whicharepathognomonicof
miliaryTB
Investigations-
Chestradiographyrevealsamiliaryreticulonodularpattern.

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Sputumsmearmicroscopyisnegativein80%ofcases.
TST(Tuberculinskintest)maybenegative.
Bronchoalveolarlavageandtransbronchialbiopsyaremorelikelyto
providebacteriologicconfirmation.

Ausculutionisfrequentlynormalbutinmoreadvanceddisease,

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widespreadcracklesareevident
Treatment-
RegimensthatareeffectivefortreatingpulmonaryTBarealso
effectivefortreatingextrapulmonarydisease.

104.Whichofthefollowingcancerspread

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primarilybyhematogenousroute:
a)Papillarycarcinomathyroid
b)Renalcellcarcinoma
c)Pheochromocytoma
d)Glioblastomamultiforme

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e)Follicularcarcinomaofthyroid
CorrectAnswer-B:C:E
Answer-(B)Renalcellcarcinoma(C)Pheochromocytoma
(E)Follicularcarcinomaofthyroid
Themostcommonlocationsofmetastasisarethelungsandbones.

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Renalcellcarcinoma:Tumourcelllinethebloodvesselwhichare
responsibleforearlybloodspreadfromRCC
Papillarycarcinomathyroid:Focioflymphaticinvasionbytumorare
oftenPresent,butnobloodvesselinvolvement
Pheochromocytomasisthepresenceofmetastases.

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Follicularcarcinomaofthyroid:Bloodbornemetastasesaremore
common.

105.PresentationofPierre-Robinsyndrome
includes:
a)Retrognathia

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b)Lowsetear
c)Prominentforehead
d)Isolatedcleftpalate
e)Glossoptosis
CorrectAnswer-A:D:E

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Answer-(A)Retrognathia(D)Isolatedcleftpalate
(E)Glossoptosis
Triadofmicrognathia,glossoptosis&cleftpalate
Cleftsoftpalate
High-archedpalate

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Jawthatisverysmallwithsmall(receding)chin
Jawthatisfarbackinthethroat

106.Trueaboutmammalianmitochondrial
DNA:
a)Containsaround16500nucleotidesequence

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b)Makesuparound3%totalcellularDNA
c)Makesuparound10%totalcellularDNA
d)Makesuparound0.3%totalcellularDNA
e)Makesuparound1%totalcellularDNA
CorrectAnswer-A:E

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Answer-(A)Containsaround16500nucleotidesequence
(E)Makesuparound1%totalcellularDNA
Inmammaliancells,mitochondrialDNAmakesuplessthan1%of
thetotalcellularDNA.
AuniquefeatureofmitochondrialDNAismaternalinheritence.

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mitochondriahavethereowngenomesconsistingofdouble-strand
mitochondrialDNA(mtDNA)moleculeconsistingofa16,569
nucleotidesequence.
mtDNAsequencecontainsatotalof37genesencoding13ETC.

107.Allaretrueaboutfocalnodular

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hyperplasiaexcept:
a)Multiplenodulemaypresent
b)Morecommoninmale
c)Maybeassociatedwithcontraceptivepillsuse
d)Hypovascularonthearterial-phaseandhypervascularonthe

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delayed-phaseCTimages
e)CTislesssensitivethanMRIindepictingthecharacteristic
centralscar
CorrectAnswer-B
Answer-B.Morecommoninmale

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FNHistypicallybenign
"FNHismostfrequentlyfoundinyoungtomiddle-agedadults,witha
strongfemalepredilection.
thelesionismultinodular
Bileductulesareusuallyfoundattheinterfacebetweenhepatocytes

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andfibrousregions.
Kupffercellsarepresent

108.HighlevelofhCGis/areseeninall
except:
a)Downsyndrome

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b)Neuraltubedefect
c)Germcelltumor
d)Gestationaltrophoblasticdisease
e)Multiplepregnancy
CorrectAnswer-B

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Answer-B.Neuraltubedefect
'HighlevelofhCGauldbedetectedin-multiplepregnancy,
hydatiformmole,choriocarcinoma,Downsyndrome,
Plasmalowerlevelsarefoundinectopicpregnancies&in
spontaneousabortion.

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hCGisproducedbythesyncytiotrophoblastoftheplacenta.

109.Humanpapillomavirusis/areassociated
withallexcept:
a)Oropharyngealtumors
b)Carcinomanasophraynx

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c)Carcinomaanalcanal
d)Carcinomapancreas
e)Carcinomacervix
CorrectAnswer-B:D
Answer-(B)Carcinomanasophraynx(D)Carcinomapancreas

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Skinwarts(Plantarwart,commonwart,flatwart&
Epidermodysplasiaverruciformis)
Papilloma(Laryngeal,Oral)
Condylomaacuminatum(genitalwart)
Oralsquamouscellcarcinoma

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Cervicalintraepithelialneoplasia(CIN)
Carcinomacervix

110.Neuroendocrinecelltumourmarkersare:
a)ChromograninA
b)CD56

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c)Neuron-specificenolase
d)Synaptophysin
e)Cytokeratin7
CorrectAnswer-A:B:C:D
Answer-A,ChromograninAB,CD56C,Neuron-specific

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enolaseD,Synaptophysin
ChromograninAisthemostwidelyused
Neuron-specificenolase(NSE)isacytosolicmarkerof
neuroendocrinedifferentiation.
Synaptophysinfoundinsmallvesiclesofneuronsand

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neuroendocrinetumors.
CD56aremarkers.

111.TrueaboutHodgkin'slymphoma:
a)Oftenlocalizedtosingleaxialgroupoflymphnode
b)Hepatomegalyisalwayspresent

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c)Contiguousspreadoflymphnode
d)Canbecuredbychemotherapy&radiotherapy
e)Commonlyresentswithpainlesslymphadenopathy
CorrectAnswer-A:C:D:E
Answer-(A)Oftenlocalizedtosingleaxialgroupoflymphnode

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(C)Contiguousspreadoflymphnode(D)Canbecuredby
chemotherapy&radiotherapy(E)Commonlyresentswith
painlesslymphadenopathy
Hodgkin'slymphomaisamalignantneoplasmoflymphoreticular
system.

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Itcaninvolvelymphnodes,spleenandliver.
Commoninmales.
ClassicdiagnosticfeatureisthepresenceofReed-Sternberg(RS)
cellsorDorothy-ReedSternbergcells.
ClassicmarkersforHodgkin'sdiseaseisCD15&CD30.

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AxiallymphaticsystemisalmostalwaysaffectedinHodgkin's
disease.
Cervical&mediastinallymphnodesareinvolvedmostfrequently.
Mostcommonlyinpatientspresentaspainless,movableandfirm
lymphadenopathy.

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Treatment-
StageI/IIclassicalHodgkin'sdisease-
Chemotherapy+fieldradiotherapy

112.Schaumannbodiesarenotseenin:
a)Sarcoidosis

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b)Histoplasmosis
c)Cryptococcosis
d)Hypersensitivitypneumonitis
e)Tuberculosis
CorrectAnswer-B:C

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Answer-B,HistoplasmosisC,Cryptococcosis
Sarcoidosis,
Hypersensitivitypneumonitis,
Berylliosis
Crohn'sdisease&tuberculosis

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113.CD30is/aremarkerfor:
a)Anaplasticlargecelllymphoma
b)Embryonalcellcarcinoma
c)SquamousCellCarcinoma
d)Seminoma

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e)Hodgkin'slymphoma
CorrectAnswer-A:B:E
Answer-(A)Anaplasticlargecelllymphoma(B)Embryonalcell
carcinoma(E)Hodgkin'slymphoma
CD30ispositiveinanaplasticlargecelllymphoma&Hodgkin's

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lymphoma.
ActivatedBcells,Tcells,andmonocytes;alsoexpressedbyReed-
SternbergcellsandvariantsinclassicalHodgkinlymphoma.

114.ChromosomalabnormalitiesinDown
syndromeis/aredueto:

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a)Nondisjunctionalofmaternalchromosome
b)Nondisjunctionalofpaternalchromosome
c)Translocationsbetweenchromosome21&14
d)Disjunctionofpaternalchromosome
e)Disjuctionofmaternalchromosome

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CorrectAnswer-A:B:C
Answer-(A)Nondisjunctionalofmaternalchromosome(B)
Nondisjunctionalofpaternalchromosome(C)Translocations
betweenchromosome21&14
Trisomy21(47,XX+21)isthemostcommon(95%)chromosomal

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abnormalityinDownsyndrome.
InDownsyndromelargefragmentof14or15or22chromosome
fuseswithlargefragmentofchromosome21Extramaterialcomes
on21anditactslikethird21stchromosomeTrisomy21.
Extrachromosomeisofmaternalinorigin.

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I%havemosaicwithsomeallhave46chromosome.
4%haverobertsoniantranslocation.
1. t(13:21)
2. t(14:21)
3. t(15:21)

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Veryrarelylongarmofchromosome21istriplicate(Partialtrisomy).

115.Allaretrueaboutintestinalpolyp
syndromeexcept:
a)Cowdendisease-Hamartomatouspolyps
b)Hereditarynonpolyposiscolorectalcarcinoma(HNPCC)-

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Multipleadenomatouspolyps
c)Peutz-Jegherssyndrome-associatedwithcoloniccarcinoma
d)Colonichyperplasticpolyphasmalignantpotential
e)Cronkhite-Canadasyndrome-mayhaveassociatedbreast
tumour

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CorrectAnswer-D
Answer-D.Colonichyperplasticpolyphasmalignantpotential
Colonichyperplasticpolypsarebeningepithelialproliferation.

116.Increasethicknessofgastricmucosal
foldisseenin:

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a)Menetrier'sdisease
b)Gastritiscystica
c)Boerhaavesyndrome
d)Zollinger-Ellisonsyndrome
e)All

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CorrectAnswer-A:B:D
Answer-(A)Menetrier'sdisease(B)Gastritiscystica
(D)Zollinger-Ellisonsyndrome
TwowelldefinedexamplesareMenetrier'sdisease&Zollinger-
Ellisonsyndrome

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Gastricglandhyperplasiasecondarytoexcessivegastrinsecretion,
inthesettingofagastrinoma.

117.Trueaboutfibrolamellarcarcinomaof
liver:
a)Betterprognosisthantypicalhepatocellularcarcinoma

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b)Associatedwithcirrhosis
c)AFP-positive
d)Occurinyoungeradults
e)Morecommoninfemales
CorrectAnswer-A:D:E

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Answer-(A)Betterprognosisthantypicalhepatocellular
carcinoma(D)Occurinyoungeradults(E)orecommonin
females
Itisadistinctivevariantofhepatocellularcarcinoma
Itisseeninyoungadults(20-40yrsofage)

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Ithasequalsexincidence
Ithasbetterprognosis
IthasnoassociationwithHBVorcirrhosis
Itisgrosslyencapsulatedmass.
AFPelevationisnotseeninFibrolamellarCa

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118.Notseeninpoststreptococcal
glomerulonephritis(PSGN):
a)Nephroticrangeproteinuria
b)Neutrophilicinfiltrationoftubules
c)Subepithelialdeposits

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d)Lineardepositsalongglomerularbasementmembrane
e)None
CorrectAnswer-A:B:D
Answer-(A)Nephroticrangeproteinuria(B)Neutrophilic
infiltrationoftubules(D)Lineardepositsalongglomerular

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basementmembrane
Ittypicallyaffectschildrenbetweentheagesof2and14years.
Itismorecommoninmales.
Poststreptococcalglomerulonephritisduetoimpetigodevelops2-6
weeksafterskininfectionandl-3weeksafterstreptococcal

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pharyngitis.
ThereisgranularsubendothelialimmunedepositsofIgG,IgM,C3,
C4andC5-9,andsubepithelialdeposits.
Clinicalfeatures-
Acutenephritiswithhematuria,pyuriaredbloodcellcasts,edema,

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hypetension,andoliguricrenalfailure.
20%ofadultshaveproteinuriainthenephroticrange.
Antibodiesinstreptococcalinfection:ASOAnti-DNAaseB,Anti-
Streptokinase,anti-Nicotinyladeninedinucleotidase&
Anti-Hyaluronidase.

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119.Bloodtransfusionreactioncanleadsto:
a)Acuteglomerulonephritis
b)Myoglobinuria
c)Hemoglobinuria
d)Transfusion-relatedacutelunginjury

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e)Acuterenaltubularnecrosis
CorrectAnswer-C:D:E
Answer-(C)Hemoglobinuria(D)Transfusion-relatedacutelung
injury(E)Acuterenaltubularnecrosis
Hemolytictransfusionreaction

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Intravascularhemolysis
Transfusion-relatedacutelunginjury(TRALI)
Renalfailure

120.Trueaboutfollicularlymphoma:
a)Lymphadenopathyisthemostcommonpresentation

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b)BCL-1positive
c)CD5positive
d)Morecommoninmalesthanfemales
e)All
CorrectAnswer-A

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Answer-A.Lymphadenopathyisthemostcommon
presentation
Itisthetumorofgerminalcentre(follicularcentre),Bcells,andis
stronglyassociatedwithchromosomaltranslocationinvolvingBcl2.
Growthpatternisnodular(follicular)ornodular(follicular)and

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diffuse.
TheneoplasticcellscloselyresemblenormalgerminalcentreB
cells,expressingCD19,CD20,CD10,surfaceIg,andBcl6.
Inmostfollicularlymphomas,centrocytespredominate.
Itusuallypresentsinmiddleageandaffectsmalesandfemales

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equal.
Themostcommonpresentationforfollicularlymphomaiswithnew
painlesslymphadenopathy.

121.TrueaboutChronicLymphocytic
Leukaemia:

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a)Mostcommonleukaemiainadult
b)Proliferationcentreispathgnomonic
c)Massivesplenomegaly
d)Radiotherapy&chemotherapyaregivenintreatment
e)None

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CorrectAnswer-A:B:C
Answer-(A)Mostcommonleukaemiainadult(B)Proliferation
centreispathgnomonic(C)Massivesplenomegaly
CLListhemostcommonformofNHL.
CLLiswhenperipheralbloodlymphocytescountisexceeding4000

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cells/L.
ThetumourcellscontainshighlevelofBCL2(inhibitsapoptosis).
Clinicalfeatures-
Splenomegaly&hepatomegaly
Hypogammaglobulinemialeadstobacterialinfectionincombination

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ofneutropenia.
Treatment-
Alkylatingdrugsascyclophosphamide
Corticosteroids
Radiotherapy&chemotherapy

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SplenectomyinAIHA

122.TrueaboutmitochondrialDNA:
a)Linear
b)Circular
c)Transmittedbymotheronly

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d)Transmittedbybothparents
e)ContainslessgenethannuclearDNA
CorrectAnswer-B:C:E
Answer-(B)Circular(C)Transmittedbymotheronly
(E)ContainslessgenethannuclearDNA

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Insexualreproduction,mitochondriaarenormallyinherited
exclusivelyfromthemother;themitochondriainmammaliansperm
areusuallydestroyedbytheeggcellafterfertilization.
UGAcodesfortryptophan,Codesfor13proteins,Circulardouble
strandedDNA,MitochondrialdiseaseoccurduetoPointMutations

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andLarge-ScaleRearrangements.
Theremaining22tRNAand2rRNA-encodinggenesarededicated
totheprocessoftranslationofthe13mtDNAencodedproteins.

123.Trueaboutautosomaldominanttypeof
inheritance:

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a)25%affected&50%carrier,ifoneparentaffected
b)50%affected&75%carrier,ifbothparentaffected
c)75%affected,ifbothparentaffected
d)50%affected,ifoneparentaffected
e)Allcarrierirrespectiveofeitheroneparentaffectedorboth

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parentaffected
CorrectAnswer-D
Answer-D.50%affected,ifoneparentaffected
Autosomaldominantdisordersaremanifestedintheheterozygous
state.

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Bothmalesandfemalesareaffected.
Becausetheallelessegregaterandomlyatmeiosis,theprobability
thatanoffspringwillbeaffectedis50%.

124.Ina-thalassemia,HbBartsissaidwhen
numberofgenelociaffectedis:

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a)1
b)2
c)3
d)4
e)None

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CorrectAnswer-D
Answer-D.4
Thealpha-thalassemiasarecausedbyinheriteddeletionsthatresult
inreducedorabsentsynthesisofalpha-globinchains.
Normally,therearefouralpha-globingenes.

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125.Whichofthefollowingcellular
componentgivespurplishbluecolour
withH&Ereagent:

a)Reticulum
b)Elastin

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c)P-selectin
d)Collagen
e)Heterochromatin
CorrectAnswer-A:E
Answer-(A)Reticulum(E)Heterochromatin

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ThemostcommonlyusedstainingsystemiscalledH&E
(HaematoxylinandEosin).
H&Econtainsthetwodyeshaematoxylinandeosin.
Eosinproducesthreedifferenthues-
Redbloodcellsstaindarkreddishorange

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Collagen(acidophilic)stainsalighterpastelpink.
Smoothmusclestainsbrightpink.
Haematoxylinisabasicdye.
Itisusedtostainacidic(orbasophilic)structuresapurplishblue.
NucleusisstainedpurplebyH&Estaining.

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126.Trueaboutglutensensitiveenteropathy:
a)Dietshouldexcludebarley,wheat&rye
b)Intestinalbiopsyisdiagonstic
c)AntiIgAendomycialantibodyisspecific
d)Mucosalhyperplasia

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e)None
CorrectAnswer-A:C
Answer-(A)Dietshouldexcludebarley,wheat&rye(C)AntiIgA
endomycialantibodyisspecific
Intolerancetogliadinacomponentofglutenpresentinwheat,

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barley,rye&oat.
Absenceorreducedheightofvilli(Flatappearance)
Crypthyperplasia,villousatrophy,Cuboidalappearanceofepithelial
cells&increasedintraepitheliallynphocytes.
Antiendomysialantibodies

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DisappearanceofIgantiendomysialantibodiesfollowinginstitution
ofaglutenfreedietisdiagnostic.
lgAantiendomysial.

127.Whichofthefollowingistrueabout
glutathione&glutathioneperoxidase:

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a)Actasscavengeroffreeradicle
b)Glutathionehasanti-oxidantproperty
c)ReducedglutathionecanchemicallydetoxifyH202
d)OxidizedglutathionecanchemicallydetoxifyH202
e)None

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CorrectAnswer-A:B:C
Answer-(A)Actasscavengeroffreeradicle(B)Glutathione
hasanti-oxidantproperty(C)Reducedglutathionecan
chemicallydetoxifyH202
IthelpsindetoxificationofH2O2byreducingit.Superoxideanion

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(O2)firstconvertedtoH2O2bysuperoxidedismutase.
H2O2isthenreducedtoH2O2byglutathioneperioxidase,a
reactionrequiresreducedglutathione.Thus,glutathionescavenges
freeradicalsandsuperoxideanion.
Aseriesofenzymesactsasfreeradical-scavengingsystemsand

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breaksdownH2O2andO2

128.Trueabouthyperacuterejectioninrenal
transplant:
a)Occurwithinfewdaysoftransplant
b)Tcellinvolvement

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c)Bloodvesselthrombosis
d)Eosinophilicinfiltration
e)Bcellinfiltration
CorrectAnswer-C
Answer-(C)Bloodvesselthrombosis

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Hperacuterejectionoccurswhenpreformedantidonorantibodiesare
presentinthecirculationoftherecipient.
Acuteantibody-mediatedrejectioniscausedbyantidonorantibodies
producedaftertransplantation.
Itismediatedbypreformedhumoralantibody.

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InacuterejectionthereisinfiItrationofT&Bcell

129.Histologicalfindingofhypertrophic
cardiomyopathyincludes:
a)Myocytedisaaray
b)Interstitialfibrosis

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c)Amyloiddepositioninmuscle
d)Myocytehypertrophy
e)Myocardialfibresarearrangedinparallelpattern
CorrectAnswer-A:B:D
Answer-(A)Myocytedisaaray(B)Interstitialfibrosis

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(D)Myocytehypertrophy
MostimportanthistologicfeaturesofthemyocardiuminHCM
are-

1. extensivemyocytehypertrophy
2. haphazarddisarrayofbundlesofmyocytes-myocytes,and

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contractileelementsinsarcomereswithincells(myofiberdisarray)
3. interstitialandreplacementfibrosis

130.Trueaboutbcl-2:
a)TApoptosis
b)Apoptosis

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c)TResistanceoftumourtotreatment
d)Onlyassociatedwithfollicularlymphoma
e)Causemeningioma
CorrectAnswer-B:C
Answer-(B)Apoptosis(C)TResistanceoftumourtotreatment

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Bcl-2inhibitsapoptosis;a(14:18)translocationresultingin
overexpressionofthebcl-2proteininBlymphocytescauses
apoptosisofneoplasticcellstobepermanentlyinhibited,producing
follicularlymphoma.

131.Trueaboutthrombusformation:

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a)Arterialthrombusgrowindirectiontowardheart
b)Venousthrombusgrowindirectiontowardheart
c)Venousthrombusformchickenfat
d)LineofZahnisseenmicroscopicallyinredthrombi
e)None

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CorrectAnswer-B:D
Answer-(B)Venousthrombusgrowindirectiontowardheart
(D)LineofZahnisseenmicroscopicallyinredthrombi
Arterialorcardiacthrombiusuallybeginatasiteofendothelial
injury.

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Venousthrombicharacteristicallyoccurinsitesofstasis.
Arterialthrombitendtogrowinaretrogradedirectionfromthepoint
ofattachment.
Venousthrombiextendinthedirectionofbloodflow(i.e.,towardthe
heart).

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Whenformedintheheartoraorta,thrombimayhavegrossly(and
microscopically)apparentlaminations,calledlinesofZahn.
Arterialthrombiareusuallyocclusive;themostcommonsite.

132.Findinginhistopathologyofbrainin
rabiesincludes:

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a)Negribody
b)Nodule
c)Neuronophagia
d)Vacuolardegenerativechanges
e)Inflammatorycell

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CorrectAnswer-A:B:C:E
Answer-(A)Negribody(B)Nodule(C)Neuronophagia
(E)Inflammatorycell
Rabiesisasevereencephalitistransmittedtohumansbythebiteof
arabiesanimal.

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Macroscopically,brainshowsintenseedemaandvascular
congestion.
Microscopically,
Widespreadneuronaldegenerationandaninflammatotyreaction
thatismostsevereintherhombencephalon.

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Negribodies,thepathognomonicmicroscopicfindingcanbefound
inpyramidalneuronsofthehippocampusandPurkinjecellsofthe
cerebellum.
PathologicstudiesshowmildinflammatorychangesintheCNSin
rabies,withmononuclearinflammatoryinfiltrationinthe

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leptomeninges,perivascularregions,andparenchyma,including
microglialnodulescalledBabesnodules.
Neuronophagiaisobservedoccasionally.

133.Trueaboutprimarybiliarycirhhosis:
a)Morecommoninfemale

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b)Periportalfibrosis
c)MaybessociatedwithRheumatoidarthritis&crohn'sdisease
d)Jaundicemaybepresent
e)All
CorrectAnswer-A:B:D

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Answer-(A)Morecommoninfemale(B)Periportalfibrosis
(D)Jaundicemaybepresent
PBCisprimarilyadiseaseofmiddle-agedwomen,withafemale
predominanceof9:l.
Antimitochondrialantibodiesarethemostcharacteristic-laboratory

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findinginPBC.
Etiology-portalinflammationandnecrosisofcholangiocytesC/F
Hypercholesterolemiaiscommon
Xanthelasma,andxanthomata
Hepatomegaly,splenomegaly,ascites,andedema.

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Developmentofjaundice
Investigations-
Thediseaseisconfirmedbyliverbiopsy,whichisconsidered
diagnosticifafloridductlesionispresent.

134.Redinfarctoccurin:

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a)Intissueswithdualcirculations
b)Occuronlywhenbotharterial&venousobstructionoccurs
simultaneously
c)Organswhicharepreviouslycongested
d)Organswithloosetissue

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e)All
CorrectAnswer-A:C:D
Answer-(A)Intissueswithdualcirculations(C)Organswhich
arepreviouslycongested(D)Organswithloosetissue
Redinfarcts(Haemorrhagic):occurwith:

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Venousocclusions(egovariantorsion);
Inloosetissues(suchaslungs);
Intissueswithdualcirculation(e.g.Lung&S.intestine)
Intissuesthatwerepreviouslycongestedbecauseofsluggish
venousoutflow.

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Whenflowisreestablilshedtoasiteofpreviousarterialocculusion
andnecrosis.

135.TrueabouthemophiliaB:
a)Factor8deficiency
b)Factor9deficiency

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c)X-linkeddisorder
d)ClinicallyindistinguishablefromhemophiliaA
e)Freshfrozenplasmagivenfortreatment
CorrectAnswer-B:C:D
Answer-(B)Factor9deficiency(C)X-linkeddisorder

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(D)ClinicallyindistinguishablefromhemophiliaA
HemophiliaisanX-linkedrecessivehemorrhagicdiseasedueto
mutationsintheF8gene(hemophiliaAorclassichemophilia)orF9
gene(hemophiliaB).
Malesubjectsareclinicallyaffected.

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Clinically,hemophiliaAandhemophiliaBareindistinguishable.
Hemophiliaisclassifiedas-
severe(<1%),
moderate(l-5%),
ormild(6-30%)

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Clinicalfeatures-
Bleedingintothejoints(hemarthrosis),softtissues,andmuscles.
Investigations-
HemophiliaB-NormalBT&PT&increasedPTT
Treatment-

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Thediseaseistreatedwithinfusionsofrecombinantfactoru.

136.Alphafetoproteinis/areincreasedin:
a)Yolksactumour
b)Seminoma
c)Dysgerminoma

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d)Non-seminoma
e)Hepatocellularcarcinoma
CorrectAnswer-A:D:E
Answer-(A)Yolksactumour(D)Non-seminoma
(E)Hepatocellularcarcinoma

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Serumalphafetoproetinleveliselevatedinnonseminomatous
testiculartumors.
Nonseminomatoustesticulartumorsinclude:
1. Yolksacorendodermalsinustumor
2. Embryonalcarcinoma

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3. Teratomas
4. Non-seminoma

137.Spindleshapedcellsis/areseeninwhich
sarcoma:
a)Osteosarcoma

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b)Chondromyosarcoma
c)Embryonalrhabdomyosarcoma
d)Leiomyosarcoma
e)Fibrosarcoma
CorrectAnswer-A:C:D:E

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Answer-(A)Osteosarcoma(C)Embryonalrhabdomyosarcoma
(D)Leiomyosarcoma(E)Fibrosarcoma
"Osteosarcoma'.Thetumourcellsmayhavevariousshapessuchas
spindledpolygonal&bizarretumourgaintcells.
Leiomyosarcomas:Theyconsistofeosinophilicspindlecellswith

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blunt-ended.
Fibrosarcoma-Malignantfibrousarrangedinaherringbonepattern.
Malignantfibroushistiocytomaofspindledfibroblastsarrangedina
storiformpatternadmixedwithlarge;ovoid,bizarremultinucleated
tumorgiantcell.

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"Embryonalrhabdomyosarcoma:consistofsheetsofbothprimitive
roundatdspindledcellsinamyxoidstroma.
"Liposarcomas-containsadipocyteswithscatteredatypicalspindle
cells.

138.FeatureofVonHippelLindausyndrome:

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a)Mutationinchromosome13
b)Mutationinchromosome3
c)Pancreaticcyst
d)Cerebellarhemangioblastoma
e)All

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CorrectAnswer-B:C:D
Answer-(B)Mutationinchromosome3(C)Pancreaticcyst
(D)Cerebellarhemangioblastoma
Thisisanautosomal-dominantdiseaseinwhichaffectedindividuals
developtumorsincerebellarhemispheres,theretina,and,less

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commonly,thebrainstemandspinalcord.
ThegeneforvonHippel-Lindaudisease,atumor-suppressorgene,
islocatedonchromosome3p25-26.
Thecerebellarcapillaryhemangioblastoma,istheneurologic
manifestationofthedisease.

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Retinalangiomas,Pheochromocytomaarealsoassociatedtumours.

139.Allarethefeature(s)ofHermansky-
pudlaksyndromeexcept:
a)Autosomaldominantinheritance
b)Oculocutaneousalbinism

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c)Bleedingdisorder
d)Pulmonaryfibrosis
e)Pain
CorrectAnswer-A
Answer-A.Autosomaldominantinheritance

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Itisarareautosomalrecessivedisorderwhichresultsin
oculocutaneousalbinism,bleedingproblemsduetoaplatelet
abnormality(plateletdysfunction),storageofanabnormalfat-protein
compound.
Chromosome10q23isaffected.

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Thereareeightclassicformsofthedisorderinwhichlasttypeof
disorderisduetogenePallidin(PLDN)
Themajorcomplicationofthedisorderispulmonaryfibrosis.

140.Differencebetweenactive&restingcell
dependonwhichphaseofcellcycle:

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a)GO
b)G1
c)G2
d)M
e)S

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CorrectAnswer-A
Answer-A.GO
Thecellcycleconsistsoffourdistinctphases-
G1phase
Sphase

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G2phase
Mphase
Quiescent/senescent-
GapO
Arestingphasewherethecellhasleftthecycleandhasstopped

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dividing.

141.Notfeature(s)ofapoptosis:
a)MediatedbyCaspases
b)InhibitionofEndonucleaseactivity
c)Membraneblebareseen

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d)Chromatincondensation
e)Associationwithinflammation
CorrectAnswer-B:E
Answer-(B)InhibitionofEndonucleaseactivity(E)Association
withinflammation

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Caspaseactivatesendonuclease(neuronalapoptosislacks
caspases,thusactivationofAIF)
MORPHOLOGICALFEATURES:
Convolutionofcellmembrane
Leadingtoformationofcytoplasmicblebs(althoughcellmembrane

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remainsintact).
Chromatincondensation(pyknosis)/nuclearcompaction
Doesnotelicitanyinflammatoryresponseduetointactcell
membrane.

142.TrueaboutIntravascularhemolysis:

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a)Increasedserumhaptoglobin
b)IncreaseStercobillininurine
c)Increaseplasmamyoglobin
d)Increasedfecalexcretionofurobilin
e)Hemosiderinuria

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CorrectAnswer-D:E
Answer-(D)Increasedfecalexcretionofurobilin
(E)Hemosiderinuria
Intravascularhemolysisismanifestedby

1. hemoglobinemia

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2. hemoglobinuria
3. jaundice
4. hemosiderinuria
Decreasedserumhaptoglobinischaracteristicofintravascular
hemolysis.

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CommonFeaturesofHemolyticDisorders-
Hbreduced
MCV,MCH-increased
Reticulocytes-increased
Bilirubin-increased

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143.Rheumaticheartdiseaseis/are:
a)Endocarditis
b)Constructivepericarditis
c)Mostcommonlyinvolvetrisucpidvalve
d)Breadbutterpericarditis

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e)Pancarditis
CorrectAnswer-A:D:E
Answer-(A)Endocarditis(D)Breadbutterpericarditis
(E)Pancarditis
AcuterheumattccarditisdurlngtheactivephaseofRFmayprogress

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tochronicrheumaticheartdisease(RHD).
DuringacuteRF,diffuseinflammationandAschoffbodiesfound
threelayersoftheheart-
pericardium,myocardiumorendocardiumlesioniscalleda
pancarditis.

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ChronicRHDischaracterizedbyorganizationoftheacute
inflammationandsubsequentfibrosis.
Thecardinalanatomicchangesofthemitral(ortricuspid)valveare
leafletthickening,commissuralfusionandshortening'and
thickeningandfusionofthetendinouscords.

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Inchronicdisease,themitralvalvelsvirtuallyalwaysabnormal.
RHDisthemostfrequentcauseofmitralstenosis.
Fibrousbridgingacrossthevalvularcommissuresandcalcification
create"fishmouth"orbuttonholestenoses.
Carditis,

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Subcutaneousnodules,
Erythemamarginatumoftheskin,and

Sydenhamchorea,aneurologicdisorderwithinvoluntary
purposeless,rapidmovements

144.Allofthethefollowingstatement(s)

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is/aretrueexcept:
a)DenevergroupF-containXchromosome
b)DenevergroupC-containXchromosome
c)DenevergroupG-containacrocentricchromosome
d)BarbodyisinactiveXchromosome

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e)Innormalfemalesgenerallyoneofthechromosomes
undergoesXinactivationinsomaticcells
CorrectAnswer-A
Answer-(A)DenevergroupF-containXchromosome
TheclassificationofchromosomesbasedonDenvergroup

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classification
Chromosome

RelativePositionof
Size
Class

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Centromere
Large
GroupA(1-3)
Metacentric
Large

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GroupB(4-5)
Submetacentric
Medium
GroupC(6-12,X)
Submetacentric

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Medium
GroupD(13-15)
Acroentric
Relatively
GroupE(16-18)

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Submetacentric
shot
GroupF(19-20)
MetacentricorSubmetacentric
short

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GroupG(21-22,Y)
Acroentric
Short

145.Percutaneousliverbiopsyis/are
contraindicatedin:

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a)Ascites
b)Hemangiomaofliver
c)Plateletcount<60000/0
d)Hepaticmetastasis
e)Echinococcuscystinliver

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CorrectAnswer-A:B:C:E
Answer-(A)Ascites(B)Hemangiomaofliver(C)Plateletcount
<60000/0(E)Echinococcuscystinliver
Thrombocytopenia
Ascites

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Difficultbodyhabitus
Suspectedhemangiona
Suspectedechinococcalinfection
Uncooperativepatient

146.TrueaboutAlcoholiccirrhosis:

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a)Predominantlymacronodularpattern
b)Bileductproliferaton
c)Mallorybodyhardlyseen
d)Disturbednormalarchitecture
e)All

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CorrectAnswer-B:C:D
Answer-(B)Bileductproliferaton(C)Mallorybodyhardlyseen
(D)Disturbednormalarchitecture
Fibrosiscanbecentilobular,pericellular,orperiportal.
Thereisdisruptionofthenormallayerarchitectureandreplacement

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oflivercellsbyregenerativenodules.
Inalcoholiccirrhosis,referredtoasmicronodular.
Withcessationofalcoholuse,largernodulesmayform,resultingin
amixedmicronodularandmacronodularcirrhosis.
Scatteredlargernodulescreatea"hobnail"appearanceonthe

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surfaceoftheliver.
TheetiologicalcluetodiagnosisintheformofMallorybodiesishard
tofindinafully-developedalcoholiccirrhosis.

147.Whichofthefollowingstatement(s)
is/aretrue:

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a)InRobertsoniantranslocationthebreaksoccurclosetothe
centromeresofeachchromosome
b)Aneuploidyisabnormalchromosomenumbercausedbyeither
gainorlossofchromosome
c)Comparativegenomichybridisation(CGH) Haploidisnormal

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isatechniquethatpermitsthedetectionof number&
chromosomalcopynumber
compositionof
chromosome
d)Haploidisnormalnumber&compositionofchromosome

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e)All
CorrectAnswer-A:B:C
Answer-(A)InRobertsoniantranslocationthebreaksoccur
closetothecentromeresofeachchromosome(B)Aneuploidy
isabnormalchromosomenumbercausedbyeithergainorloss

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ofchromosome(C)Comparativegenomichybridisation(CGH)
isatechniquethatpermitsthedetectionofchromosomalcopy
number
Aneuploidy:Anabnormalchromosomenumbercausedbyeither
gainorlossofchromosomes.

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Haploid:Onlyone-halfthenormalcomplement,thatis,23
chromosomes
Comparativegenomichybridisation(CGH)isatechniquethat
permitsthedetectionofchromosomalcopynumberchangeswithout
theneedforcellculturing.

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Robertsoniantranslocation(orcentricfusion):Itisatranslocation

Robertsoniantranslocation(orcentricfusion):Itisatranslocation
betweentwoacrocentricchromosomes.Typicallythebreakoccur
closetothecentromeresofeachchromosome.

148.AllaretrueaboutHistamineexcept:

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a)Secretedbymacrophage
b)Vasoconstrictionofarterioles
c)Smoothmusclecontraction
d)Mediateinflammation
e)None

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CorrectAnswer-A:B
Answer-(A)Secretedbymacrophage(B)Vasoconstrictionof
arterioles
'Histamineinducessmoothmusclecontractionindiversetissues.
Histamineiswidelydistributedintissues,therichestsourcebeing

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themastcells.
Histaminecausesdilationofthearteriolesandincreasesthe
permeabilityofvenules
Itactsonthemicrocirculation.

149.AllaretrueaboutLesch-Nyhan

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syndromeexcept:
a)Hyperurecaemia
b)Mentalretardation
c)Stoneproduction
d)Occurequallyinbothsexes

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e)X-linked
CorrectAnswer-D
Answer-D.Occurequallyinbothsexes
AcompletedeficiencyofHPRT,theLesch-Nyhansyndrome,is
characterizedbyhyperuricemia,self-mutilativebehavior,

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choreoathetosis,spasticity,andmentalretardation.
ThisisarareX-linkeddisorderofpurinemetabolismthatresults
fromHPRTdeficiency.
Thehyperuricemiaresultsfromurateoverproductionandcancause
uricacidcrystalluria,nephrolithiasis,obstructiveuropathy,andgouty

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arthritis.
AffectsMalesonly.
Etiology-hereditary
Treatment-
Allopurinol

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150.TrueaboutNeutrophil:
a)Engulfbacteria
b)Multilobed
c)Neutrophilgranulesareslightlybasicandstainweaklywiththe
azurophiliccomponentofRomanowskystains

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d)Neutrophiliaoccurinacutebacterialinfection
e)Primarygranulesisalsocalledspecificganules
CorrectAnswer-A:B:C:D
Answer-(A)Engulfbacteria(B)Multilobed(C)Neutrophil
granulesareslightlybasicandstainweaklywiththeazurophilic

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componentofRomanowskystains(D)Neutrophiliaoccurin
acutebacterialinfection
'Neutrophilcontainprimaryorazurophilgranules&secondaryor
specificgranules
Neutrophiliaoccurinacutebacterialinfection.

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Thenucleusofneutrophilsnormallycontainsuptofoursegments.
Characteristicfeaturesare-Condensed,multilobednucleus
Function-
Hydrolyticsubstratedegradation
Killingestedbacteria

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Regulateinflammation

151.Marker(s)ofLangerhanscell
histiocytosis:
a)CD1a
b)S100

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c)CD3
d)CD5
e)CD30
CorrectAnswer-A:B
Answer-(A)CD1a(B)S100

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TheproliferatingLangerhanscellsinLangerhanscellhistiocytosis
areHLA-DRpositiveandexpresstheCD1antigen.
ThehallmarkofLCHispositivityforS-100protein&CD1a
positivity.

152.Feature(s)offibroadenomaofbreast

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include:
a)Clearlydefinededgeonpalpation
b)Hormoneresponsivetumor
c)Containbothepithelial&stromalelements
d)Well-encapsulated

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e)Commonaftermenopause
CorrectAnswer-A:B:C:D
Answer-(A)Clearlydefinededgeonpalpation(B)Hormone
responsivetumor(C)Containbothepithelial&stromal
elements(D)Well-encapsulated

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Fibroadenomasareeasytomove,withclearlydefinededgeso
calledasbreastmouse.
Mostcommonbenignbreasttumoroffemalebreast.
Theyarefrequentlymultiple&bilateral.
Fibroadenomasarebenignsolidtumorscomposedofstromaland

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epithelialelements.
Onexcision,fibroadenomasarewell-encapsulatedmasses.
Fibroadenomasdonothavemalignantpotential.

153.Breastcanceris/areassociatedwith:
a)Familialadenomatouspolyposis

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b)Ataxia-telangiectasia
c)Peutz-Jegherssyndrome
d)Cowdendisease
e)VonHippelLindausyndrome
CorrectAnswer-B:C:D

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Answer-(B)Ataxia-telangiectasia(C)Peutz-Jegherssyndrome
(D)Cowdendisease
VonHippelLindausymdromeisnotassociatedwithbreast
carcinoma.
Familialadenomatouspolyposisisassociatedwithcolorectal

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carcinoma&someothercancerbutnotbreastcancer.
STK11/LKB1(Peutz-Jegherssyndrome)
PTEN(Cowdendisease)

154.Hyperglycemiais/areassociatedwith:
a)Cushingdisease

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b)Addisondisease
c)Pheochromocytoma
d)Hyperthyroidism
e)Acromegaly
CorrectAnswer-A:C:D:E

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Answer-(A)Cushingdisease(C)Pheochromocytoma
(D)Hyperthyroidism(E)Acromegaly
Endocrinopathiesassociatedwithhyperglycemia-
Acromegaly
Cushingsyndrome

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Hyperthyroidism
Pheochromocytoma
Glucagonoma

155.Calciumlevelisincreasedin:
a)Parathyroidadenoma

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b)Thiazidediuretics
c)Chronicrenalfailure
d)HypervitaminosisD
e)Cirrhosis
CorrectAnswer-A:B:C:D

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Answer-(A)Parathyroidadenoma(B)Thiazidediuretics
(C)Chronicrenalfailure(D)HypervitaminosisD
Hyperparathyroidism
Adenoma
Thiazidediuretics

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156.Cause(s)ofmegaloblasticanaemia
include:
a)Anticonvulsantdrugs
b)Pregnancy
c)Resectionofileum

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d)Gastrectomy
e)Crohn'sdisease
CorrectAnswer-A:B:C:D:E
Answer-All(A)Anticonvulsantdrugs(B)Pregnancy
(C)Resectionofileum(D)Gastrectomy(E)Crohn'sdisease

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I.VITAMINB1DEFICIENCY
Inadequatedietaryintakee.g.strictvegetarians,breast-fed
infants,
Malabsorption

1. Gastriccauses:perniciousanaemia,gastrectomy,congenital

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lackofintrinsicfactor.
2. Intestinalcauses:tropicalsprue,ilea!resection,Crohn's
disease,intestinalblindloopsyndrome,fish-tapeworm
infestation.
II,FOLATEDEFICIENCY

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Inadequatedietaryintakee.g.inalcoholics,teenagers,infants,old
age,poverty.
Malabsorptione.g.intropicalsprue,coeliacdisease,partial
gastrectomy,jejuna!resection,CrohIfsdisease.
Excessdemand

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1. Physiological:pregnancy,lactation,infancy.

2. Pathological:malignancy,increasedhaematopoiesis,chronic
exfoliativeskindisorders,tuberculosis,rheumatoidarthritis.
Excessurinaryfolatelosse.g.inactiveliverdisease,congestive
heartfailure.

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III.OTHERCAUSES
Impairedmetabolisme.g.inhibitorsofdihydrofolate(DHF)
reductasesuchasmethotrexateandpyrimethamine;alcohol,
congenitalenzymedeficiencies.
Unknownetiologye.g.inDiGuglielmo'ssyndrome,congenital

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dyserythropoieticanaemia,refractorymegaloblasticanaemia.


157.WhichofthefollowingisCD15&CD30
positive:
a)LymphocytepredominanceHodgkin'slymphoma
b)Mantlecelllymphoma

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c)Burkit'slymphoma
d)MixedcellularityHodgkin'slymphoma
e)DiffuselargeBcelllymphoma
CorrectAnswer-D
Answer-D.MixedcellularityHodgkin'slymphoma

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CD15-
Granulocytes;alsoexpressedbyReed-Sternbergcellsandvariants
inclassicalHodgkinlymphoma
CD30-
ActivatedBcells,Tcells,andmonocytes;alsoexpressedbyReed-

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SternbergcellsandvariantsinclassicalHodgkinlymphoma.

158.Bcellantigensare:
a)CD1
b)CD2
c)CD3

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d)CD19
e)CD20
CorrectAnswer-D:E
Answer-(D)CD19(E)CD20
CD1-CorticalthymocytesandLangerhanshistiocytes

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CD3-Thymocytes,peripheralTcells
CD19-Marrowpre-BcellsandmatureBcellsbutnotplasmacells
CD20-Marrowpre-BcellsafterCD19andmatureBcellsbutnot
plasmacells

159.Trueaboutprotooncogene:

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a)Onlyfoundinvirus
b)Onlyfoundinmalignantcell
c)Normallyinvolvedincellcycleproliferation
d)Canbeconvertedtooncogene
e)Onmutationitcausescancer

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CorrectAnswer-C:D:E
Answer-(C)Normallyinvolvedincellcycleproliferation(D)Can
beconvertedtooncogene(E)Onmutationitcausescancer
Genesthatpromoteautonomouscellgrowthincancercellsare
calledoncogenes,andtheirnormalcellularcounterpartsarecalled

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protooncogenes.
Proteinsencodedbyprotooncogenesmayfunctionasgrowthfactor
malignantsandreceptors,signaltransducers,transcriptionfactors,
andcell-cyclecomponents.

160.Thrombosisispredisposedby:

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a)ProteinSdeficiency
b)Complementdeficiency
c)Antiphospholipidantibodysyndrome
d)Homocysteinuria
e)All

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CorrectAnswer-A:C:D
Answer-(A)ProteinSdeficiency(C)Antiphospholipidantibody
syndrome(D)Homocysteinuria
Hypercoagulablestates-
Primary(Genetic)-

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ProteinCdeficiency
ProteinSdeficiency
Homozygoushomocystinuria
Secondary(acquired)-
MI

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Atrialfibrillation
Prostheticcardiacvalves
DIC
Thrombocytopenia

161.Pancytopeniacanoccurin:

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a)CML
b)Kala-azar
c)Typhoid
d)Hairycellleukemia
e)None

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CorrectAnswer-B:D
Answer-(B)Kala-azar(D)Hairycellleukemia
Primarybonemarrowdiseases-
Myelodysplasia
Paroxysmalnocturnalhemoglobinuria

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Myelofibrosis
BonemarrowlymphomaHairycellleukemia
Sarcoidosis
Tuberculosis
Leishmaniasis

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162.Non-smallcelllungcarcinomais/are
associated:
a)K-ras
b)EGFR
c)WT1

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d)P53
e)All
CorrectAnswer-A:B:D
Answer-(A)K-ras(B)EGFR(D)P53
K-RASmutationsareseenprimarilyinadenocarcinoma.

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p53andRBtumorsuppressorgenesarefrequentlymutated-
Squamouscellcarcinomas
EGFR-Adenocarcinoma

163.Cyclindependentkinase-2(CDK-2)acts
via:

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a)CyclinA
b)CyclinB
c)CyclinC
d)CyclinD
e)CyclinE

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CorrectAnswer-A:E
Answer-(A)CyclinA(E)CyclinE
FormsacomplexwithcyclinEinlateG1,whichisinvolvedinthe
G1/Stransition.
FormsacomplexwithcyclinAattheSphasethatfacilitatesthe

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G2/Mtransition.

164.Trueaboutcarotidbodytumor:
a)Slowgrowingtumour
b)Uncapsulated
c)MostlyBilateral

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d)Mostlybenign
e)All
CorrectAnswer-A:D
Answer-(A)Slowgrowingtumour(D)Mostlybenign
Raretumouroccurb/w3rd&6thdecadeoflifewithslightfemale

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preponderance
Afewarebilateral&someshowfamilialincidence
Grosslytheyaresmall,firm,darktan,encapsulatednodules
Tumoursareusuallybenignwithonlyasmallnumberofcases
producingprovenmetastases.

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Thereisoftenalonghistoryofaslowlyenlarging,painlesslumpat
thecarotidbifurcation.

165.Whichofthefollowingis/aretrueabout
autosomaldominantpolycystickidney
diseaseexcept:

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a)Manypatientsmaybeasymptomatictill3rdor4thdecade
b)Pancreaticcyst
c)Associatedwithhypertension
d)Subarachnoidhaemorrhageismostcommonextrarenal
complication

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e)None
CorrectAnswer-D
Answer-D.Subarachnoidhaemorrhageismostcommonextra
renalcomplication
ADPKDischaracterizedbytheprogressivebilateralformationof

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renalcrisis.
Inheritance-autosomaldominant
Characterizedbymultipleexpandingcystsofbothkidneys.
Ingrossappearance,thekidneysarebilaterallyenlarged.
Thepainmayresultfromrenalcystinfection,haemorrhage,or

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nephrolithiasis.
'Intravenousurographypolycystickidneydisease:Thespiderlegs,
deformityofthecalyces
Focalrenalcystsaretypicallydetectedinaffectedsubjectsbefore
30yearsofage.

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Complications-
Hematuria,flankpain,urinarytractinfection,renalstones,
hypertension


166.Epidermalgrowthfactoris/areformed
by:

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a)Platelet
b)Fibroblast
c)Mastcell
d)Endothelialcell
e)Keratinocyte

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CorrectAnswer-A:E
Answer-(A)Platelet(E)Keratinocyte
Inhealingwoundsoftheskin,EGFisproducedbykeratinocytes,
macrophages,andotherinflammatorycellsthatmigrateintothe
area.

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167.Whichofthefollowingisnotafeatureof
reversiblecellinjury?
a)Diminishedgenerationofadenosinetriphosphate(ATP)
b)Formationofamorphousdensitiesinthemitochondrialmatrix
c)Formationofblebsintheplasmamembrane

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d)Detachmentofribosomesfromthegranularendoplasmic
reticulum
e)Creationofmyelinfigures
CorrectAnswer-B
Answer-B.Formationofamorphousdensitiesinthe

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mitochondrialmatrix
Largeflocculent,amorphousdensitiesinthemitochondrialmatrix
occurasaresultofirreversiblecelldamage.
Membranedamageplaysacentralroleinthepathogenesisof
irreversiblecellinjury.

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Itismorphologicallyassociatedwithsevereswellingofthe
mitochondria,damageofplasmamembranesandswellingof
lysosomes.

168.Pericardialeffusionis/areseeninall
except:

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a)Uraemia
b)SLE
c)Rheumaticfever
d)Myxedema
e)Hyperthyroidism

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CorrectAnswer-E
Answer-(E)Hyperthyroidism
Infectious
Viral
Bacterial

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Fungal
Parasite
Rickettsia
Postinjury
Trauma

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Surgery
Myocardialinfarction
Radiation
Metabolicdiseases
Uremia

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Medications
Systemicdiseases
Rheumatoidarthritis
Systemiclupuserythematosus

Sarcoidosis

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Scleroderma
Dermatomyositis
AmyloidosisTumors
Aorticdissection

169.Whichofthefollowingis/aretrueabout

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Prothrombintime:
a)Assessextrinsicpathways
b)TinLiverdisease
c)LinVit.Kdeficiency
d)Normalvalueis2-4minute

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e)None
CorrectAnswer-A:B
Answer-(A)Assessextrinsicpathways(B)TinLiverdisease
Prothrombiatimeassayassessesthefunctionoftheproteinsinthe
extrinsicpathways.

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Normalvalue-10to14sec
Evaluationofextrinsic&commonpathway.
Increasedinoralanticoagulationtherapy,DICandliverdisease,
VitaminKdeficiency.

170.at30yrofage,bloodformingbone

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marrowarefoundin
a)Sternum
b)Sacrum
c)Pelvis
d)Upperendtibia

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e)Upperendhumerus
CorrectAnswer-A:B:C:D:E
Answer-(A)Sternum(B)Sacrum(C)Pelvis(D)Upperendtibia
(E)Upperendhumerus
Byage18onlythevertebrae,ribs,sternum,skull,pelvis,and

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proximalepiphysealregionsofthehumerusandfemur.

171.Anti-nuclearantibodiesarenotfoundin:
a)SLE
b)DiffuseScleroderma
c)Druginducedlupus

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d)Limitedsceleroderma
e)Sarcoidosis
CorrectAnswer-E
Answer-(E)Sarcoidosis
Foundin-

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Druginducedlupus
Sjogren'ssyndrome
Scleroderma
Polymyositis
Dermatomyositis

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Arthritis

172.TrueaboutThrombotic
thrombocytopenicpurpura:
a)Indirecthyperbilirubemia
b)Spherocytosiswiththrombocytopenia

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c)Scistocytosiswiththrombocytopenia
d)Thrombiformation
e)All
CorrectAnswer-A:C:D
Answer-(A)Indirecthyperbilirubemia(C)Scistocytosiswith

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thrombocytopenia(D)Thrombiformation
Itischaracterizedbyapentad-
Micromgiopathichemolyticanemia,thrombcytopenia,renalfailure,
neurologicfindings,andfever.
TTPdiagnosisincludeanincreasedlactatedehydrogenaseand

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indirectbilirubin,decreasedhaptoglobin,andincreasedreticulocyte
count.
Theperipheralsmearshouldbeexaminedforevidenceof
schistocytes.

173.Inwhichofthefollowingdiseases

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antineutrophilcytoplasmic
antibodies(ANCA)arenotfound:

a)Polyarteritisnodosa
b)Microscopicpolyangitis
c)Wegenergranulomatosis

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d)Bechetsyndrome
e)Churg-Strausssyndrome
CorrectAnswer-A:D
Answer-(A)Polyarteritisnodosa(D)Bechetsyndrome
ANCApositive

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Wegner'sgranulomatosis
Microscopicpolyarteritis
Churg'strausssyndrome
Renal-limitedvaculitis
(crescentricglomerulonephritis)

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