Download PGI PG 2020 May Path Solved Question Paper

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

1.

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Followingcellsarepartofinnateimmunity?
a)B-cells
b)T-cells
c)NK-cells
d)Macrophages
e)Dendriticcells
CorrectAnswer-C:D:E
Answer-C,D,E,NK-cells,Macrophages,Dendriticcells
Importantcomponentsofinnateimmunityare:-
1. Cells:Phagocyticcells(macrophages,neutrophils),dendriticcells,
NKcells,eosinophils,mastcells,basophils,epithelialcells(forming
epithelialbarrier).
2. Complementcomponentantimicrobialpeptides
3. Patternrecognitionreceptors(PRn)
TherearetwotypesofPRR:
1. SolublePRR(MannoserecePtors,C-reactiveprotein):
2. SurfacePRR(Scavengerreceptorsonmacrophages,Toll-like
receptors).

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2.Whichofthefollowingaretype3
hypersensitivityreactions?
a)GoodPasteursyndrome
b)Serumsickness
c)Arthusreaction
d)Asthma
e)Rheumatoidarthritis
CorrectAnswer-B
Answer-B.Serumsickness
Local-Arthusreaction
Systemic-serumsickness
Schicktest
Polyarteritisnodosa(PAN)
Rheumatoidarthritis
SLE
Acuteviralhepatitis
Penicillaminetoxicity
Hyperacutegraftrejection
Type2leprareaction(ENL)
Hypersensitivitypneumonitis
Infectiveendocarditis
Henochschonleinpurpura
Glomerulonephritis

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3.TrueregardingDownsyndromeis?
a)Increasedpaternalageisariskfactor
b)Karyotypingisnotneededinallpatients
c)>85%ofaffectedpatientshave1morechromosome21
d)Increasednuchaltranslucency
e)AssociatedwithearlyonsetofAlzheimer'sdisease
CorrectAnswer-B
Answer-B.Karyotypingisnotneededinallpatients
Down'ssyndromeisthemostcommonchromosomaldisorderand
mostcommoncongenitalcauseofmentalretardation(2nd
mostcommongeneticcauseofmentalretardationisFragile-X
sydrome).
Trisomy21-Thereisanextrachromosome21whichisdueto
meioticnondisjunctioninovum.
Themostimportantriskfactorisadvancedmaternalage(>35
Years).
AntenatalScreeningforDownsyndrome
Followingmethodsareused:-
1. TripletestItincludes(i)Unconjugatedestrogen(estriol):decreased;
(ii)Maternalserumalphafetoprotein(MSAFP):decreased;and(iii)
hCG:increased
2. Newmarkers:Theseare(i)IncreasedinhibinAinmaternalblood;
and(ii)DecreasedPAPA(pregnancyassociatedplasmaprotein).
3. USG:Itshows:(i)Increasednuchaltranslucency(increasednuchal
foldthickness);(ii)Ductusvenousflowreversed;and(iii)Nasalbone
hypoplasia.

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4.A14yearoldboypresentedwithhereditary
spherocytosis.Whichofthefollowing
indicesis/areincreased?
a)LDH
b)MCHC
c)MCV
d)Urineurobilinogen
e)Haptoglobin
CorrectAnswer-A:B:D
Answer-A,B,DLDH,MCHC,Urineurobilinogen
MCVdecreased
MCHCincreased
LDHincreased

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5.Ascomparedtoirondeficiencyanemia,
whichofthefollowingisdecreasedin
anemiaofchronicdisease?
a)Endogenousbonemarrowironstores
b)Serumferritin
c)Transferrinsaturation
d)TIBC
e)MCV
CorrectAnswer-D
Answer-D.TIBC
MCV/MCH-Decreasedornormal
Serumiron-Decreased
TIBC-Decreased,normal
Transferrinsaturation-Decreased
Serumferritin-Normalorincreased

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6.Antibodywhichis/arespecificforSLE?
a)ANA
b)Anti-dsDNA
c)Anti-Sm
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
e)VitaminB6
CorrectAnswer-A:D:E
Answer-A,D,E,Iron,VitaminC,VitaminB6
Seenin-
1. Irondeficiencyanemia(mostcommoncauseofanemiaingeneral
andofmicrocyticanemiainparticular)
2. Thalassemiatrait
3. OtherhemoglobinopathiessuchashemoglobinCsyndrome&
hemoglobinSsyndrome
4. Chronicinflammation
5. Anemiaofchronicdisease
6. Siderobasticanemia
7. Deficiencies-Pyridoxin(Vit86),vitaminCandcopper

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8.Bloodtestsdonetoseeliverfunctions
include?
a)Bilirubin
b)Uricacid
c)Alaninetransaminase
d)Urea
e)Albumin
CorrectAnswer-A
Answer-A.Bilirubin
1. Aspartateaminotransferase/SGOT
2. Alaninetransaminase/SGPT
3. Alkalinephosphatase
4. Gamma-Glutamyltransferase
5. Conjugatedbilirubin
6. Unconjatedbilirubin
7. Albumin

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9.Anaplasiaismalignanttumormayleadto?
a)Changeinnuclearsize
b)Lossofcellpolarity
c)Metaplasia
d)Increasedmitosis
e)Malignanttransformation
CorrectAnswer-A:B:D:E
Answer-A,B,D,E,Changeinnuclearsize,Lossofcell
polarity,Increasedmitosis,Malignanttransformation
Anaplasticcellsshowfollowingfeatures:-
1. Lossofpolarity
2. Increasednuclearcytoplasmicsizeratio
3. Increasednumberofmitosiswhichisatypical
4. Hyperchromatosia
5. Pleomorphbm

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10.Duringinflammation,mediatorsinvolved
inadhesionandmovementinclude?
a)Compliment5a
b)LeukotrieneB4
c)Integrins
d)IL-8
e)L-selectin
CorrectAnswer-C:E
Answer-C&E,Integrins,L-selectin
Ligandon
Adhesion
Extravasation
Cells
endothelial
molecules
stage
cells
NaiveT
GlyCAM-1,
L-selection
lymphocytes,other
CD34,
Tethering/Rolling
(CD62L)
leukocytes
MadCAM-1
E-selection
(CD26E),
PSGL-1
Neutrophils
Tethering/Rolling
P-Selectin
(CD62P),
ActivatedT
ICAM-1
LFA-1
lymphocytes,other
(CD54),
(2Integrin
Tightadhesion
leukocytes,other
ICAM-2
CD11A/CD18) leukocytes
(CD102)
Activated
VLA-4
Tleukocytes
VCAM-
(1Inegrin,
monocytes,
1(CD106),
Tightadhesion
CD49d/CD28)
Fibronection

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CD49d/CD28) neutrophils,
Fibronection
eosiophils,basophils
Neutrophils,
ICAM-
Mac-1
Monocytes,
1,iC3b,
Tightadhesion
(CD11b/CD18) Macrophages
fibronection
VCAM-1
LPAM-1(7
EffectorT
MAdCAM-1 adhesion
integrin)
lymphocytes
fibronection

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11.Causesofunconjugated
hyperbilirubinemiainclude?
a)Sepsis
b)Criggler-Najarsyndrome
c)Rotorsyndrome
d)Gilbertsyndrome
e)Intravascularhemolysis
CorrectAnswer-A:B:D:E
Answer-A,B,D,E,Sepsis,Criggler-Najarsyndrome,Gilbert
syndrome,Intravascularhemolysis
Unconjugatedhyperbilirubinemia:-
Increasedproductionofbilirubinfromhemoglobin,Sothatthe
capacityoflivertoconjugatebilirubinisoverwhelmedbyincreased
production,e.g.
1. Hemolyticanemia(bothintravascularandextamascular)sHereditary
sphnocytosis,G6PDdefciency.
2. Inefrectiveerythropoiesis-Thalassemia,Perniciousanemia.
3. Reducedhepaticuptakeofbilirubinfrombilirubin-albumincomplex
>Drugs,
4. Infections:-Sepsis,UTI
5. Impairedhepaticconjugation.

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12.Majorhistocompatibilitycomplexesare
foundonwhichcells?
a)Dendriticcells
b)Basophils
c)Eosinophils
d)Tcells
e)RBCs
CorrectAnswer-A:B:C:D
Answer-A,B,C,D,Dendriticcells,Basophils,Eosinophils,T
cells
HLAcomplexconsistsofthreeseparateclustersofgenes:-
1)ClassI(MHC-I)
ImportantcellswithMHC-I(HLA-I)onsurfaceareB-cells,T-cell,
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
onthecellsofimmunesystem,i.e.T-cells,B-cells,langerhanscells,
dendriticcells,andmacrophages.
3)ClassIII(MHC-III)
Tumornecrosisfactor-alphaandbeta(TNF-alphaandbeta).

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13.WhichofthefollowingisNOTTRUEabout
mutationofp53?
a)Cellwillcontinuetomultiply
b)Cancerformation
c)Cellcyclewillbearrested
d)DNArepair
e)Alloftheabove
CorrectAnswer-C:D
Answer-C&D,Cellcyclewillbearrested,DNArepair
p53isatumorsuppressorgene.
Themajorfunctionalactivitiesofthep53proteinarecellcyclearrest
andinitiationofapoptosisinresponsetoDNAdamage.
p53causes-
1. Cellcyclearrest-thereisarrestofcellcyclelateinG1phase.This
allowstimeforDNArepair.
2. DNArepair-GADD45encodesaproteinthatisinvolvedinDNA
repair.
p53inducesapoptosis.
Mutationinp53leadstolossofaboveprotectivemechanismsi,e.
cellcyclearrest&DNArepair.Itwillleadtounarrestedcell
multiplicationandfinallycarcinogenesis.
Non-mutated(wildtype)p53reducesthechancesofcancer.

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14.Correctdyadofdiseaseandtheir
respectiveinheritancepatterninclude?
a)Wilsondisease-autosomalrecessive
b)Cysticfibrosis-autosomaldominant
c)Marfansyndrome-autosomalrecessive
d)Gardnersyndrome-autosomaldominant
e)Duchenemusculardystrophy-X-linkedrecessive
CorrectAnswer-A:D:E
Answer-(A)Wilsondisease-autosomalrecessive(D)Gardner
syndrome-autosomaldominant(E)Duchenemuscular
dystrophy-X-linkedrecessive
Autosomalrecessivedisorders
1)Metabolic-Cysticfibrosis,Phenylketonuria,Galactosemia,
Homocystinuria,Lysosomalstoragedis,alphal-antitrypsin
deficiency,
Wilsondisease,Hemochromatosis,Glycogenstoragedisorders.
Autosomaldominantdisorders
1.GIT-Familialpolyposiscoli,Gardner'ssyndrome
2.Skeletal-Marfansyndrome
X-linkedrecessivedisorders
1)Musculoskeletal-Duchenemusculardystrophy,Becker's
dystrophy

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15.Psammonabodiesis/areseenin-
a)Medullarycaofthyroid
b)Ependymoma
c)Papillarycaofthyroid
d)Follicularcaofthyroid
e)Meningioma
CorrectAnswer-C:E
Answer-C,E,Papillarycaofthyroid,Meningioma
Apsammomabodyisaroundcollectionofcalcium,seen
microscopically.ThetermisderivedfromtheGreekwordpsammos
meaning"sand."Psammomabodiesarecommonlyseenincertain
tumorssuchas:
Papillarythyroidcarcinoma
Papillaryrenalcellcarcinoma
Serouspapillaryovarianadenocarcinoma(cystadenocarcinoma)
Endometrialadenocarcinomas(Papillaryserouscarcinoma?
3%-4%)
Meningioma
Mesothelioma
Psammomabodiesusuallyhavealaminarappearance.

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16.Woundhealingisaffectedby-
a)Age
b)Nutrition
c)Drynessofwound
d)Drugs
e)Temperature
CorrectAnswer-A:B:C:D:E
Answer-A,B,C,D,E,Age,Nutrition,Drynessof
wound,Drugs,Temperature
Intrinsicfactor
Healthstatuseg:diabetes
Agetactors
BodybuiJd
Nutritionalstatus(Droteindeficiencv.
VitaminCdeficiency)
Inadequatebloodsupply
Extrinsicfactor-
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
d)Subcutaneousnodules
e)Fever
CorrectAnswer-E
Answer-E.Fever
Chorea,ArthritisandCarditisaremajorcriteriafordiagnosisof
RheumaticfeverFeverisaminorcriteria
ErythemaMarginatumisamajorcriteriaandnotErythema
nodosum.

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18.IncreasePTisseenwith-
a)Warfarinadministration
b)FactorVdeficiency
c)FactorVIIIdeficiency
d)FactorIXdeficiency
e)VitKdeficiency
CorrectAnswer-A:B:E
Answer-A,B,E,Warfarinadministration,FactorV
deficiency,VitKdeficiency
1. Bleedingtime-Prolongationgenerallyindicatesthedefectinplatelet
numberorfunction.
2. Partialthromboplastintime(PTT)-AprolongedPTTV,VIII(factor
VIIIc,Vonwillebrandfactor,IX.X,XI,XII,prothrombinorfibrinogen.
3. Prothrombintime(PT)-PTcanresultsfromdeficiencyoffactorV,
VII,X,prothrombinorfibrinogenV,VII,X,prothrombinorfibrinogen.
4. Thrombintime-elevatedinfibrinogendeficiency.
5. VitaminKdeficiencyalsocauseprolongationofbothPTandaPTT
asitinhibitsfactorII,VII,IXandX.

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19.Trueinsicklecellanemia-
a)Splenomegaly
b)Microcytosis
c)Microcardia
d)Autosplenectomy
e)Gammagandybodies
CorrectAnswer-A:D:E
Answer-A,D,E,Splenomegaly,Autosplenectomy,Gamma
gandybodies
Chronichemolysis
Vasoocclusivesymptoms
1. Painfulbonecrisis
2. Hand-footsyndromeDactylitisofbonesofhands/feet.
3. Autosplenectomy
4. Acutepainfulenlargementofspleen
5. Theremaybecardiomegalyandleukocytosis.
6. GammaGandybodies
Thereisnomicrocytosisinsicklecelldisease.

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20.Microscopywhichcanbeperformedwith
minimumopticalillumination-
a)Darkfield
b)Brightfield
c)Phasecontrast
d)Confocal
e)None
CorrectAnswer-A:D
Answer-A&D,Darkfield,Confocal
Thelighthastobereducedwhileusingdarkfield&phasecontrast
microscope,othermicroscopesusefullillumination.
Darkfieldmicroscopy-
Usesacarefirllyalignedlightsourcetominimizethequantityof
directlytransmittedlightenteringtheimageplane,collectingonlythe
lightscatteredbythesample.
Confocalmicroscopy/confocallaserscanningmicroscopy/laser
confocalscanningmicroscopy-
Usesascanningpointoflightandapinholetopreventoutoffocus
lightfromreachingthedetector.

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21.Acanthocytesareseenin?
a)Abetalipoproteinemia
b)Severeliverdisease
c)PatientswithMacleodbloodgroup
d)SLE
e)Hyperprolactinemia
CorrectAnswer-A:B:C
Answer-A,B,C,Abetalipoproteinemia,Severeliver
disease,PatientswithMacleodbloodgroup
Acanthocytesorspurcells,areabnormalerythrocfteswhichare
spiculatedwithafewspinyorthornyprojectionsofcytoplasmof
varyingsizeandsurfacedistribution.
Themostfrequentandmostsignificantconditionswith
acanthocytosisincludeabetalipoproteinemia.
McLeodredcellPhenotype.

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22.Featuresofchronicmyelogenous
leukemia(CML)-
a)Bonemarrowbiopsyisnecessaryfordiagnosis
b)PresenceofBCR-ABLgenewhichdirectsthesynthesisof
BCR-ABLtyrosinekinase
c)Dasatinibisusedinimatinibresistantcases
d)Generalizedpainfullymphadenopathyispresentingfeaturein
mostcases
e)Myeloblastsusuallyconstitutemorethan10%ofallwhitecells
inchronicphase
CorrectAnswer-A:B:C
Answer-A,B,C,Bonemarrowbiopsyisnecessaryfor
diagnosis,(B)PresenceofBCR-ABLgenewhichdirectsthe
synthesisofBCR-ABLtyrosinekinase(C)Dasatinibisusedin
imatinibresistantcases
Splenomegalyispresentin90%
Imatinib,dasatinibandnilotinibspecificallyinhibitBCRABLtyrosine
kinaseactivityandreducetheuncontrolledproliferationofwhite
cells.
ThediseaseisdrivenbytheBCR-ABL1chimericgeneproduct,a
constitutivelyactivetyrosinekinase.
Commonmanifestationsareofanemiaandsplenomegaly,
lymphadenopathy,andextramedullarydisease(skinor
subcutaneouslesions)
Thebonemarrowishypercellularwithmarkedmyeloidhyperplasia
andahighmyeloid-to-erythroidratioof15-20:1.

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23.TrueaboutCysticfibrosis-
a)OccursdueCFTRgenemutationonchromosome7
b)Meconiumileusispresentin>90%cases
c)CFTRgenecanbedetectedantenately
d)Poorbodygrowth
e)Alloftheabove
CorrectAnswer-A:C:D
Answer-A,C,D,OccursdueCFTRgenemutationon
chromosome7(C)CFTRgenecanbedetectedantenately
(D)Poorbodygrowth
Theprimarydefectincysticfibrosisresultsfromabnormalfunction
ofanepitheltalchloridechannelproteinencodedbythecystic
fibrosistransmembraneconductanceregulator(CFTR)geneon
chromosome7.
Contentsoftheintestinallumenaredifficulttoexcretewhichresults
inmeconiumileus.
SequencingtheCFTRgeneisthegoldstandardfordiagnosisof
cysticfibrosisPoorbodygrowth

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24.Trueaboutcaspases-
a)Caspasesinitiateapoptosisbyextrinsicandintrinsicpathway
b)Caspasesareproteaseenzyme
c)Caspasesarereceptor
d)Caspasesinhibitapoptosis
e)Causesnonenzymaticdegradationofcriticalcellular
components
CorrectAnswer-A:B
Answer-A,B,Caspasesinitiateapoptosisbyextrinsicand
intrinsicpathway(B)Caspasesareproteaseenzyme
Apoptosisresultsfromtheactivationofenzymescalledcaspases.
Theprocessofapoptosismaybedividedintoaninitiationphase
(intrinsicpathway)andexecution(extrinsicpathway).
Twodistinctpathwaysconvergeoncaspaseactivation:
Themitochondrialpathwayandthedeathreceptorpathway
Caspasesareafamiyofendoproteases.
Theactivationoftheseenzymeistightlycontrolledbytheir
productionasinactivezymogensthatgaincatalyticactivityfollowing
signalingeventspromotingtheiraggregationintodimersor
macromolecularcomplexes"

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25.Trueaboutminimalchangedisease-
a)Hypertensioniscommonlypresent
b)Mostcommoncauseofnephroticsyndromeinadults
c)Highdosesteroidsresultsinremissioninmostcases
d)Commonlyprogresstochronicrenalfailure
e)Reversiblelossofpodocytefunction
CorrectAnswer-C:E
Answer-(C)Highdosesteroidsresultsinremissioninmost
cases(E)Reversiblelossofpodocytefunction
Minimalchangedisease:
Alsok/alipoidnephrosa,footprocessdisease&Nildepositdisease
Thediseasesometimesfollowsarespiratoryinfectionorroutine
prophylacticimmunization'
Theonsetmaybeprecededbyanupperrespiratoryinfection,atopic
allergyorimmunisation.
Thediseasecharacteristicallyrespondtosteroidtherapy
Thebenigndisorderischaracterizedbydiffuseeffacementoffoot
processesofvisceralepithelialcell(podocytes).
mostfrequentcauseofnephroticsyndromeinchildren
Thevisceralepithelialchangesarecompletelyreversibleafrer
corticosteroidtherapy,concomitantwithremissionoftheproteinuria.
Thereiscommonlynohypertensionorhematuria.
Theappearanceofacuterenalfailureinadults.

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26.Feature(s)ofAdultpolycystickidney
diseaseis/are:
a)Renalenlargement
b)Smallkidney
c)Spiderlegdeformityonintravenousurography
d)Ultrasoundshowsmultiplecysts
e)Alloftheabove
CorrectAnswer-A:C:D
Answer-A,C,D,Renalenlargement(C)Spiderlegdeformityon
intravenousurography(D)Ultrasoundshowsmultiplecysts
ADPKDischaracterizedbytheprogressivebilateralformationof
renalcrisis.
Inhieritence-autosomaldominant
Characterizedbymultipleexpandingcystsofbothkidneys.
Ingrossappearance,thekidneysarebilaterallyenlarged.
Thepainmayresultfromrenalcystinfection,hemorrhage,or
nephrolithiasis.
'Intravenousurographypolycystickidneydisease:Thespiderlegs,
deformityofthecalyces.

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27.Whichis/arecausedbyprotein
misfolding:
a)Creutzfeldt-Jakobdisease
b)Bovinespongiformencephalopathy
c)Huntingtondisease
d)Alzheimerdisease
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
Theproteinsfailtofoldintotheirnormalconfiguratoryinthis
misfoldedstate,theproteinscanbecometoxicinsomeway(again
oftoxicfunction)ortheycanlosetheirnormalfunctionwhichis
knownasproteinmisfoldingdisease.
SuchdiseasesasCreutzfeldt-Jakobdisease,Alzheimer'sdisease,
Parkinson'sdisease,priondisease,amyloidosis,Bovinespongiform
encephalopathy,Huntingtondisease.

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28.TrueaboutCreutzfeldt-JakobDisease:
a)Gliosisinthalamus
b)Spongiformswellingincerebralcortex
c)Brainatrophyinlatestage
d)SlowandirregularbackgroundrhythmonEEG
e)None
CorrectAnswer-B:C:D
Answer-B,C,D,Spongiformswellingincerebralcortex
(C)Brainatrophyinlatestage(D)Slowandirregular
backgroundrhythmonEEG
CJDisararedisorderthatmanifestsclinicallyasarapidly
progressivedementia.
TheprogressionofthedementiainCJDisusuallysorapidthatthere
islittleifanygrosslyevidentbrainatrophy.
Microscopically,thehallmarkisspongiformchangeofthecerebral
cortex.
Inadvancedcasesthereissevereneuronalloss,reactivegliosis.
EEGabnormaltdesarepresentinnearlyallpatients,consistingofa
slowandirregularbackgroundrhythmwithperiodiccomplex
discharges.

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29.Hereditarynon-polyposiscolorectal
cancer(HNPCC)is/arecommonly
associatedwith-
a)Endometrialcancer
b)Cervicalcancer
c)Ovariancancer
d)Breastcancer
e)Thyroidcancer
CorrectAnswer-A:C
Answer-A,C,Endometrialcancer(C)Ovariancancer
Hereditarynon-polyposiscolorectalcancer(HNPCC)-
Malignancies-Colonic,endometrial,ovarian,pancreatic,gastric.
Inherictance-autosomaldominant
Gene-ADMSH2,MLH1,MSH6,PMS1,PMS2

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30.FeaturesofNonbacterialthrombotic
endocarditis(NBTE)-
a)CommoninSLE
b)Presentonundersurfaceofvalve
c)Vegetativegrowthislargeandlooselyattachedtovalve
d)Mayoccurafterpost-cardiaccatheterization
e)Sourceofsystemicemboli
CorrectAnswer-B:D:E
Answer-B,D,E,Presentonundersurfaceofvalve(D)May
occurafterpost-cardiaccatheterization(E)Sourceofsystemic
emboli
Theseverrucaearetypicallysmall,singleormultiple,brownishand
occuralongthelineofclosureoftheleaflet.
VegetatianofNBTEissmallandlooselyattachedtotheunderlying
valve.
Sourceofsystemicembolithatproducesignificantinfarctsinthe
brain,heart,spleenandkidneys.
Itfrequentlyoccurswithdeepvenousthrombosis,pulmonaryemboli.

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31.TrueaboutAlzheirnerdisease:
a)Mostcommoncauseofdementiainelderly
b)Unusalbefore45yearsofage
c)Plaquesconsistsoftauprotein
d)Mayhavefamilyhistory
e)Shorttermmemoryisaffectedlessthanlong-termmemory
CorrectAnswer-A:B:D
Answer-A,B,D,Mostcommoncauseofdementiainelderly
(B)Unusalbefore45yearsofage(D)Mayhavefamilyhistory
Alzheimer'sdisease(AD)isaslowlyprogressivediseaseofthe
brainthatischaracterizedbyimpairmentofmemoryandeventually
bydisturbancesinreasoning,planning,language,andperception.
Alzheimer'sdiseaseisCommonin5thand6thdecade.
Trisomy21isassociatedwithalzheimer'sdementia.
Plaquecontainingbeta-amyloidpeptide,andneurofibrillarytangles
containingtauproteinoccursinneocortex.
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
d)Cerebellum
e)Thalamus
CorrectAnswer-A:D
Answer-A,D,Hippocampus(D)Cerebellum
Theyaremostprominentinpyramidalcellsofthehippocampusand
Purkinjecellsofcerebellumbuthavebeenseeninnervecells
throughoutthebrainandspinalcord.

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33.Trueaboutp53-
a)Hastyrosinekinaseactivity
b)Haspro-apoptoticactivity
c)Tumoursuppressorgene
d)Hasanti-apoptoticactivity
e)None
CorrectAnswer-A:B:C
Answer-A,B,C,Hastyrosinekinaseactivity(B)Haspro-
apoptoticactivity(C)Tumoursuppressorgene
p53isatumorsuppressorgeneanditisaproapoptoticfactor,i.e.it
promotesapoptosisifrepairofDNAdamageisunsuccessfulatG1
arrest.
Theproteinkinasesthatareknowntotargetthistranscriptional
activationdomainofp53.

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34.TrueaboutTakayasusyndrome:
a)InvolvessmallandMediumsizedvessels
b)Sharesmanyclinicalfeaturesofgiantcellarteritisifinvolves
aorta
c)Morecommoninmalethanfemale
d)Granulomatousvasculitis
e)Alsocalledpulselessdisease
CorrectAnswer-B:C:E
Answer-B,D,E,Sharesmanyclinicalfeaturesofgiantcell
arteritisifinvolvesaorta(D)Granulomatousvasculitis(E)Also
calledpulselessdisease
"Giantcellarteritis(GCA)isagranulomatousarteritisthat
predominantlyaffectsmedium-sizedarteriesintheheadandneck.
Itpredominantlyaffectstheaorta.
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
e)PAS-Acidicandneutralmucin
CorrectAnswer-A:D:E
Answer-A,Perls'Prussianblue-ironintissueD,PAS-
glycogenE,PAS-Acidicandneutralmucin
1.Masson'strichrome-Trichromehistologystains
Canbeusedtodistinguishbetweencellularitemsandextracellular
items
Canbeusedonconnectivetissue
2.VonKossastain-usedtoindicatecalciumandcalcium
deposits
3.Periodicacidschiff(PAS)-AMucinstain
Usedforstainingglycogen
Usedtoshowglomeruli,basementmembranes,andglycogeninthe
liver.
4.Perls'Prussianblue-Canbeusedtorevealthepresenceof
ironinbiologicaltissues

---

36.Whichareinheritablemalignancies:
a)Breastcancer
b)Thyroidcancer
c)Wilmstumour
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
Breast/ovarian-Breast,ovarian,colonic,prostatic,pancreatic
Wilm'stumour-Nephroblastoma,neuroblastoma,hepatoblastoma,
rhabdomyosarcomaRetinoblastoma-Retinoblastoma,
osteosarcoma
Prostatecancer-prostate
Cowden'ssyndrome-Breast,thyroid,gastrointestinaltract,
pancreatic

---

37.Trueaboutproliferalivephaseofwound
healing
a)Neutrophilsincreasesgradually
b)Macrophageincreasesgradually
c)CollagentypeIpresentpredominantly
d)CollagentypeIIIpresentpredominantly
e)Angiogenesisoccurs
CorrectAnswer-D:E
Answer-D,CollagentypeIIIpresent
predominantlyE,Angiogenesisoccurs
Duringproliferation,thewoundis'rebuilt'withnewgranulation
tissuewhichiscomprisedofcollagenandextracellularmatrixand
intowhichanewnetworkofbloodvesselsdevelop,aprocess
knownas'angiogenesis'.
Maturationisthefinalphaseandoccursoncethewoundhas
closed.ThisphaseinvolvesremodellingofcollagenfromtypeIIIto
typeICellularactivityreducesandthenumberofbloodvesselsin
thewoundedarearegressanddecrease.

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38.CausesofNon-megaloblasticmacrocytic
anameia-
a)Folatedeficiency
b)Leadtoxicity
c)Hypothyroidism
d)Liverdisease
e)VitB12deficiency
CorrectAnswer-C:D
Answer-C,D,Hypothyroidism(D)Liverdisease
Causesinclude:
Chronicalcoholism
Liverdisease
Hypothyroidism
Reticularfibrosis
Blood.disorderslikered-cellaplasia,aplastic
anemia,myelodysplasticsyndromesandmyeloidleukemia
Drugsasazathioprine
Pregnancy

---

39.GlucoselevelinCSFis/arereducedin:
a)Bacterialmeningitis
b)Fungalmeningitis
c)Viralmeningitis
d)Tubercularmeningitis
e)Spirochetalmeningitis
CorrectAnswer-A:B:D
Answer-A,BacterialmeningitisB,Fungal
meningitisD,Tubercularmeningitis
Normal-45-48mg/dL
Bacterialmeningitis-Markedlyreduced(low<45)
Fungalmeningitis-Markedlyreduced(low<45)
Viralmeningitis-Normalorlow
Tubercularmeningitis-Reduced(low<45)
Spirochetalmeningitis-Normal

---

40.Whichoffollowingisnotclassifiedas
Primitiveneuroectodermaltumour(PNET):
a)Retinoblastoma
b)Medulloblastoma
c)Rhabdomyosarcoma
d)Ewingsarcoma
e)Carcinoidtumour
CorrectAnswer-A:C:D:E
Answer-A,RetinoblastomaC,RhabdomyosarcomaD,Ewing
sarcomaE,Carcinoidtumour
Embryonaltumorsorprimitiveneuroectodermaltumors(PNET)are
themostcommongroupofmalignantCNStumorsofchildhood.
PNETgroupincludes-medulloblastoma,supratentorialPNET,
ependymoblastoma,medulloepithelioblastoma,andatypicalteratoid/
rhaboidtumor(ATRT).
Ewing'ssarcomaiscloselyrelatedtoPNET,butnotPNET.
Recently,Ewingsarcomaandprimitiveneuroectodermaltumor
(PNET)havebeenunifiedintoasinglecategory:
TheEwingsarcomafamilytumors(ESFT)basedonsharedclinical,
morphologic,biochemicalandmolecularfeatures

---

41.Truestatement(s)aboutWilm'stumour-
a)Mostcommonlypresentsasasymptomaticabdominalmass
b)Hereditarypredispositionispresentin50%cases
c)Bilateralin25%cases
d)Classictriphasiccombinationofblastemal,stromal,and
epithelialcelltypesisobserved
e)Mostcommoninchildren
CorrectAnswer-A:D:E
Answer-A,D,E,Mostcommonlypresentsasasymptomatic
abdominalmass(D)Classictriphasiccombinationofblastemal,
stromal,andepithelialcelltypesisobserved(E)Mostcommon
inchildren
Itisamalignanttumourofkidneywhichisseeninchildren
Tumouriscomposedofepithelialandmesothelialelements(bone,
cartilage,muscleetc)socalledasnephroblastoma(immature
embryonictissue)
Wilmstumor,alsoknownasnephroblastomaisacomplexmixed
embryonalneoplasmofthekidneycomposedofthreeelaments:
blastema,epithelia,andstroma.
Clinicalfeatures-
Commoninfemalechildren(2-4years)
Massintheabdomen.
Abdominaldistensionduetoenlargedkidney
Rarely,Wilm'stumourisbilateral
Hematuria

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42.Suspicionofmalignancyinthyroidnodule
isindicatedbyallexcept-
a)Femalegender
b)Dysphagia
c)Age20-40years
d)Increasingpain
e)Rapidlyenlargingsize
CorrectAnswer-A:B:C:E
Answer-(A)Femalegender(B)Dysphagia(C)Age20-40years
(E)Rapidlyenlargingsize
Themostcommonpresentingsignofthyroidcancerisathyroid
nodule.
SolitaryorMultiplethyroidnodules
NeckNodes
Hoarsevoiceofrecentonset
Mediastinaladenopathy
Boneorlungmetastasis
Gender:Female>Males.
Age:
Morecommonatyoungadults.
MTCusuallydiagnosedafter60.
Ahistoryofarapidlyenlargingthyroidnoduleusuallyindicates
hemorrhage,andthisoccurinbothbenignandmalignantdisease.

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43.Featuresofirreversiblecellinjuryare
a)Lysosomalinjury
b)Pyknosis
c)Cellmembraneinjury
d)Mitochondrialamorphousdeposits
e)Apoptoticbodies
CorrectAnswer-B:C:D:E
Answer-B,PyknosisC,CellmembraneinjuryD,Mitochondrial
amorphousdepositsE,Apoptoticbodies
Characteristicfeaturesare-
Largeflocculentamorphousdensitiesinmitodrondriadueto
accumulationofcalcium.
Intracytoplasmicmyelinefiguresappearduringreversibleinjurybut
becomesmoreprominentinirreversibleinjury.
Nuclearchanges:Thesearemostspecificandincludepyknosis
(nuclearcondensation),karyorrhexis(fragmentationofnucleus),and
karyolysis(nucleardissolution).
Decreasedbasophilia(duetodecreasedribonucleoprotein).
Leakageofintracellularenzymeacrossdamagedcellmembrane
intoperiphralcirculation
Apoptoticbodiesareseeninapoptosis,whichisapatternofdeath
afterirreversibleinjury.

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44.Premalignantlesionoforalcavity
includes
a)Lichenplanus
b)Erythroplakia
c)Bowendisease
d)Behchetdisease
e)None
CorrectAnswer-B
Answer-B.Erythroplakia
Premalignantcondition:-Leukoplakia,Erythroplakia,Speckled
erythroplakia,chronichyperplasticcandidiasis.

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45.PrognosisofHead&neckcancerisbased
on-
a)Siteofthetumor
b)Stageofthetumor
c)Etiologicalagent
d)Ageofpatient
e)Genderofpatient
CorrectAnswer-A:B:C
Answer-(A)Siteofthetumor(B)Stageofthetumor
(C)Etiologicalagent
headandneckcancerisdeterminedbytumorlocationandstage
andetiology.

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46.Prothrombintimeiselevatedinfollowing
conditions
a)DefectinfactorXI
b)Fibrinogendefect
c)DIC
d)FactorVIIdefect
e)VonWillebranddisease
CorrectAnswer-B:C:D
Answer-B,FibrinogendefectC,DICD,FactorVIIdefect
Itteststheextrinsicandcommoncoagulationpathways.So,a
prolongedPTcanresultsfromdeficiencyoffactorV,
VII,X,prothrombinorfbrinogen.

---

47.TrueaboutDigeorgeSyndrome-
a)B-celldeficiency
b)Defectin3rdpharyngealpouch
c)Hypoparathyroidism
d)Candidiasis
e)Thymicaplasia
CorrectAnswer-B:C:D:E
Answer-(B)Defectin3rdpharyngealpouch
(C)Hypoparathyroidism(D)Candidiasis(E)Thymicaplasia
DigeorgesyndomeisanexampleofaTcelldeficiencythatresults
fromfailureofdevelopmentofthethirdandfourthpharyngeal
pouches.
Clinicalfeaturesinclude-
Enhancedsusceptibility-viral,fungal(mucocutaneouscanididiasis)
andbacterialinfections
Facialabnormalities:Hypertelorism,abnormalears,shortphiltrum
andmicrognathia
Hypocalcemictetanyduetofailureofparathyroiddevelopment
(Hypoparathyroidism).

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48.Followingfindingsareseeninrheumatic
heartdisease
a)McCallumsplaque
b)Thickeningofmitralvalve
c)Fibrousplaqueonundersurfaceofaorticvalve
d)Aschoffbodiesinmyocardium
e)None
CorrectAnswer-A:B:D
Answer-A,McCallumsplaqueB,Thickeningofmitral
valveD,Aschoffbodiesinmyocardium
1)Acuterheumaticcarditis-
ThecharacteristichistologicalfindingofrheumaticcarditisisAschoff
bodies/orAschoffnodules.
2)Chronicrheumaticcarditis-
Irregularthickeningofposteriorwallofleftatriumproduces
MacCallumplaque/patchduetosubendothelialcollectionofAschoff
nodules.
Endocardiuminvolvementleadstoformationofsmallwarty
projections(verrucae)alongthelineofclosureofvalvularleaflet,
mostlyonmitralvalve.

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49.Increasedreticulocytecountisseenin
a)Megaloblasticanemiaontreatmentwithhematinics
b)Acutehemorrhage
c)Congenitaldyserythropoieticanemia
d)Hereditaryspherocytosis
e)Aplasticanemia
CorrectAnswer-A:B
Answer-A,Megaloblasticanemiaontreatmentwith
hematinicsB,Acutehemorrhage
Acutebloodlossorhemorrhage
Postsplenectomy
Microangiopathicanemia
Autoimmunehemolyticanemia
Hemoglobinopathy
Postanemiatreatment
vitaminB12supplementation

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50.DefinitiveRiskfactorsforcarcinoma
stomachis/are-
a)Smoking
b)Alcoholism
c)HPyloriinfection
d)Chronicatrophicgastritc
e)Partialgastrectomy
CorrectAnswer-A:C:D:E
Answer-(A)Smoking(C)HPyloriinfection(D)Chronicatrophic
gastritc(E)Partialgastrectomy
Environmentalfactors:H.Pyloriinfection,cigarettesmoking,andlow
socioeconomicstatus.
Hostfactors:Chronicgastritis,partialgastrectomy
lntestinalmetaplasiaisthemostsignificantprecursorlesionfor
Gastriccancer.
Geneticfactors

---

51.Increasedreticulocytesareseenin
a)Aplasticanemia
b)B12deficiencyontreatmentwithhematinics
c)Irondeficiencyanemia
d)Hemolyticanemia
e)None
CorrectAnswer-B:D
Answer-B,B12deficiencyontreatmentwith
hematinicsD,Hemolyticanemia
Acutebloodlossorhemorrhage
Postsplenectomy
Microangiopathicanemia
Autoimmunehemolyticanemia
Hemoglobinopathy
Postanemiatreatment
vitaminB12supplementation

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52.Feature(s)ofTurnersyndromeis/are-
a)Monosomyofautosomes
b)Webbingofneck
c)Mentalretardation
d)Shortfourthmetacarpal
e)Streakgonades
CorrectAnswer-B:D:E
Answer-(B)Webbingofneck(D)Shortfourthmetacarpal
(E)Streakgonades
45X0
Lymphademaofdorsumofhand&fat
Looseskinfoldatnapeofneck
Shortstature
ShortNeck(withwebbingofneck)
Anomaliesear
Broadshieldlikechestwithwidelyspacedsmallnipple
Renalanomalies(Horse-shoe,soubleorcleftrenalpelvis)Coartof
aorta

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53.TrueaboutamyloidSSA-
a)Mutanttransthyretin
b)Senilecardiacamyloidosis
c)Wildtransthyretin
d)Familialpolyneuropathy
e)Senilesystemicamyloidosis
CorrectAnswer-B:C:E
Answer-(B)Senilecardiacamyloidosis(C)Wildtransthyretin
(E)Senilesystemicamyloidosis
SSAischaracterizedbydepositionofwild-typetransthyretin(TTR)
-basedamyloidinparenchymalorgansinelderlyindividual.
SSAiscommondisease,affectingapproximately25%oofthe
populationgreaterthan80yearsold.
SSAischaracterizedbyamyloidosisclinicallylimitedtoheart;
therefore,initiallyitwasreferredtoassenilecardiacamyloidosis.
Thisformofcardiacamyloidosistendstorunabenignclinical
course.

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54.Parameterswhichareincreasedmore
thannormalinirondeficiencyanemia
are
a)TIBC
b)Serumferritin
c)Transferringsaturation
d)Transferringreceptors
e)None
CorrectAnswer-A:D
Answer-A,TIBCD,Transferringreceptors
Serumleveldecrease
TIBCincrease
Serumferrritindecrease
Redcellprotoporphyrindecrease
Serumtransferringreceptorsproteinincreased.(STFRtologof
ferritin)

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55.Amydoidassociatedprotein[AAprotein]
isseenin-
a)Multiplemyeloma
b)Dialysisassociatedamyloidosis
c)Systemicsclerosis
d)Sjogren'ssyndrome
e)Renalcellcarcinoma
CorrectAnswer-E
Answer-ERenalcellcarcinoma
1. Primary
2. Secondary(reactive)
ThereisdepositionofAAamyloidprotein-
Renalcellcarcinoma(hypernephroma),Hodgkinslynphoma.

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56.Thefollowinglaboratoryfinding
differentiateanemiaofchronicdisease
fromirondeficiencyanemia
a)TIBC
b)Transferringsaturation
c)Serumironlevels
d)Decreasedutilizationofendogenousferritin
e)Alloftheabove
CorrectAnswer-A:B:D
Answer-A,TIBCB,TransferringsaturationD,Decreased
utilizationofendogenousferritin
Haemoglobin-anaemiamildtomoderate
Bloodpicture-microcytosisandhypochromic(butmostlynormocytic
&normochromic)
Absolutevalues-MCHCislow
Reticulocytecount-low
Redcellsurvival-shortenlifespanoferythrocytes
Bonemarrow-myeloidhyperplasia&increaseinplasmacells.
Serumiron&TIBC-low
Serumferritin-increased(mostdistinguishingfeatureofchronic
disorder)
Otherplasmaproteins-raised

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57.Trueaboutdystrophiccalcification-
a)Raisedcalciumlevel
b)Seenindead/degenerativetissue
c)SeeninSarcoidosis
d)Seeninatherosclerosis
e)Seeninrheumaticfever
CorrectAnswer-B:D:E
Answer-(B)Seenindead/degenerativetissue(D)Seenin
atherosclerosis(E)Seeninrheumaticfever
Dystrophiccalcificationindeadtissues-
Necrosisoftuberculosis(mostcommonwhichmaybeinlymph
nodes)
Chronicabscessinliquifactivenecrosis
Infarct
Thrombi
Dystrophiccalcificationindegeneratedtissues
Atheromatousplaque
Psommamabodies
Heartvalvesdamagedbyrheumaticfever

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58.Whichofthefollowingcombinationsof
carcinomawiththeirgeneticmutations
aretrue-
a)Carcinomabreast-BRCA1
b)Rhabomyosarcoma-C-KIT
c)WilmstumorWT1
d)RetinoblastomaRb
e)NeuroblastomaMYC
CorrectAnswer-A:C:D:E
Answer-(A)Carcinomabreast-BRCA1(C)WilmstumorWT1
(D)RetinoblastomaRb(E)NeuroblastomaMYC
Carcinomasoffemalebreastandovary-BRCA1
Wilmstumor-WT-l
Retinoblastomas-RB
Gastrointestinalstromaltumors,testicularseminoma,melanoma,
AML-C-KIT
Neuroblastoma-NMYC

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59.Whichofthefollowingis/areduetonon-
disjunctionofautosomes
a)Klinefelterssyndrome
b)Turnerssyndrome
c)Pataussyndrome
d)Edwardsyndrome
e)CriduChatsyndrome
CorrectAnswer-C:D
Answer-C,PataussyndromeD,Edwardsyndrome
Nondisjunctionofautosomes:Downsyndrome,edwardsyndrome,
patausyndrome

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60.Commonmetaphysealtumorsare-
a)Enchondroma
b)Osteosarcoma
c)Nonossifyingfibroma
d)Osteoidosteoma
e)Osteoclastoma
CorrectAnswer-A:B
Answer-(A)Enchondroma(B)Osteosarcoma
Osteogenicsarcoma
Unicameral(simple)bonecyst
AneurysmalbonerystoFibrouscorticaldefect
Chondrosarcoma
Osteochondroma
Enchondroma
Osteoblastoma

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61.Whichofthefollowingacutephase
protein(s)decreasesduringacute
inflammation
a)Albumin
b)Transferrin
c)Ceruloplasmin
d)C-reactiveprotein
e)Haptoglobin
CorrectAnswer-A:B
Answer-A,AlbuminB,Transferrin
Negativeacutephaseproteins
Theseproteinsaredecreasedduringinflammation.Important
examplesarealbumin,prealbumin,transferrin,transcortin,
transthyretinandretinalbindingprotein

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62.MalignanciesassociatedwithHIVare-
a)Kaposissarcoma
b)NHL
c)AnalCarcinoma
d)CervicalCarcinoma
e)ColonCarcinom
CorrectAnswer-A:B:C:D
Answer-(A)Kaposissarcoma(B)NHL(C)AnalCarcinoma
(D)CervicalCarcinoma
KaposisarcomaisthemostcommontumorinAIDS.
Non-Hodgkinlymphomas(NHLs)inAIDSare-
1. PrimaryCNSlymphoma(associatedwithEBV)
2. Burkitt'slymphoma
Hodgkin'sdisease
Leukemia
Multiplemyeloma
CervicalCa
AnalCa

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63.Whichofthefollowingcombinationsare
true
a)Hyalinecasts-normal
b)Waxycasts-chronicpyelonephritis
c)Broadcasts-CRF
d)RBCcasts-glomerulonephritis
e)Muddycasts-acutetubularnecrosis
CorrectAnswer-A:B:C:D:E
Answer-A,Hyalinecasts-normalB,Waxycasts-chronic
pyelonephritisC,Broadcasts-CRFD,RBCcasts-
glomerulonephritisE,Muddycasts-acutetubularnecrosis
Hyalinecasts
Thesearethemostcommoncastsandconsistsalmostentirelyof
Tamm-Horsfallprotein
Renaltubularepithelialcellcasts
Epithelialcellsarepresentalongwithcast
Waxycasts
Theseareseeninchronicrenaldiseases
Broadcast
Theseareseeninadvancedrenalfailure
RBCcasts
Thereareseeninnepahriticsyndromeduetoglomenulonephritis
Muddycasts
Itispathognomonicofacutetubularnecrosis(ATN)

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64.Trueregardingcastexaminationinurine
a)Acidisadded
b)Examinedattheedgeofcoverslip
c)Sedimentisused
d)Contrifugeisnotused
e)Broadcastindicatesstasisofurineflow
CorrectAnswer-A:C:E
Answer-A,AcidisaddedC,SedimentisusedE,Broadcast
indicatesstasisofurineflow
Thecellularelementsarebestpreservedinacid.
Theurinesedimentcanbebrokendownintocellularelements.
Broadcasts
Formationoccursincollectingtubules:seriouskidneydisorder,
extremestasisofflow.

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65.TrueaboutDubin-Johnsonsyndrome-
a)Increasedconjugatedbilirubin
b)UsuallyassociatedwithincreasedASTandALT
c)Mutationinuridinediphosphate-glucuronyltransferasepeptide
Al
d)Decreasedbiliaryexcretionofconjugatedbilirubin
e)Autosomaldominantinheritance
CorrectAnswer-A:D
Answer-(A)Increasedconjugatedbilirubin(D)Decreased
biliaryexcretionofconjugatedbilirubin
DuringJohnsonsyndromeisanautosomalrecessivehereditary
disorderpresentingwithconjugatedhyperbilirubinemiaduetodefect
inhepaticexcretoryfunctionacrossthecanalicularmembraneof
hepatocyte.
DJSisatypeofcongenitalconjugatedhyperbilirubinemia.
Conjugatedbilirubinisincreasedbecauseofdefectivebiliary
excretionofbilirubinglucuronidesduetomutationincanalicular
multidrugresistanceprotein2.

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66.Trueaboutalcoholicsteatosis
a)Microvesicular
b)Macrovesicular
c)Reversible
d)Malloryhyaline
e)Centralhyalinesclerosis
CorrectAnswer-A:B:C
Answer-A,MicrovesicularB,MacrovesicularC,Reversible
Hepaticsteatosis(Fattyliver)
Initiallythereismicrovesicularfattychange.Latermacrovesicular
fattychangesarealsoseen.Itisreversiblestage.

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67.Feature(s)ofantiphospholipidsyndrome
is/areexcept-
a)Recurrentthrombosis
b)SLEisassociatedwithprimaryantiphospholipidsyndrome
c)Itincludestwotypesofantibodies-lupusanticoagulantand
anticardiolipinantibody
d)Foetuslossmayoccur
e)Occurd/tdefectin
CorrectAnswer-B:C:E
Answer-(B)SLEisassociatedwithprimaryantiphospholipid
syndrome(C)Itincludestwotypesofantibodies-lupus
anticoagulantandanticardiolipinantibody(E)Occurd/tdefect
in
Inantiphospholipidsyndromethereishypercoagulabititywhich
resultsinrecurrefltvenousandarterialthrombosis.
Peripheralyenoussystetn)DVT
CNSCerebrovascularaccident,sinusthrombosismigraine,
epilepsy.
HematologicalThrombocytopenia,hemolyticanemia.
ObstetricsAbortionin2rd&3rdtrimester(latefetalloss)is
commonbutitmayoccuranytimeinpregnancy;recurrentabortion,
eclampsia.
PulmonaryPulmonaryembolism,pulmonaryhypertension.
CardiacLimbman-Sackendocarditis,MI.
Dermatological>Livedoreticularis,purpura,infarct/ulceration.
OcularAmaurosis,retinalthrombosis.

---

AdrenalInfarction,hemorrhage.
Musculoskeletal>Avascularnecrosisofbone.
CatastrophicantiphospholipidsydromeMultiorganinfarction.

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68.TrueaboutRASoncogene-
a)TyrosinekinasehasroleinRASactivation
b)Mostcommonformofoncogeneinhumantumors
c)IthasanintrinsicGTPaseactivity
d)Mutationmayresultincarcinomatousgrowth
e)Belongstogrowthfactorcategoryofoncogene
CorrectAnswer-A:B:C:D
Answer-(A)TyrosinekinasehasroleinRASactivation(B)Most
commonformofoncogeneinhumantumors(C)Ithasan
intrinsicGTPaseactivity(D)Mutationmayresultin
carcinomatousgrowth
InnormalcellstheactivatedstateofthisRASproteinistransient
becausenormalRAS-proteinshaveintrinsicGTPaseactivity.
MutationintheRASproteincausespermanentactivationofRAS
proteinwhichmayresultincarcinomatousgrowth.
ActivatedRASraf-landactitesmitogen-activatingkinase(MAP-
kinase)pathway.
PointmutationofRASfamilygenesisthesinglemostcommon
abnormalityofoncogenesinhumantumor.

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69.Trueabouthaematologicaldisorder-
a)CryoprecipitateisusedintreatmentinhaemophiliaB
b)BothPTandaPTTareincreasedinDIC
c)Intravenousgammaglobulinisusefulinimmune
thrombocytopenicpurpura
d)HemophiliaC:X-linkeddisorder
e)PlateletcountisdecreasedinDIC
CorrectAnswer-B:C:E
Answer-(B)BothPTandaPTTareincreasedinDIC
(C)Intravenousgammaglobulinisusefulinimmune
thrombocytopenicpurpura(E)Plateletcountisdecreasedin
DIC
1.CryoprecipitateisusedinHemophiliaA-
Itcontainsfbrinogen,factorVIIIcandvWF,andfactorXIII.
UsedinhemophiliaAandvon-Willebranddisease.
2.PT&aPTTareincreasedinDICaldplateletcountisdecreased
Bloodfilmshowsmicroangiopathichaemolyticanaemia.
PT,thrombintime,andActivatedPartialthromboplastintimeallare
prolonged.
3.IVimmunoglobulinisusefulinITP
IVimmunoglobulinisthetreatmentofchoiceforneonatalaswellas
childhoodITP.
4.HemophiliaCiscausedbydeficiencyoffactorXI.
Itisinheritedasanautosomalrecessivepattern.

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70.Whichis/arenottumorsuppressor
gene(s)
a)TP53
b)RB
c)CD95
d)SKT11
e)RAS
CorrectAnswer-C:E
Answer-C,CD95E,RAS

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71.Mostcommontranslocationinacute
promyelocyticleukemia(APML)is
a)t(8:14)
b)t(9:22)
c)t(15:17)
d)t(8:21)
e)t(11:118)
CorrectAnswer-C
Answer-C,t(15:17)
Acutepromyelocyticleukemia(M3bytheFABclassification)is
associatedwithat(15;17)(q22;q11)translocation.
Disseminatedintravascularcoagulationcanoccurinthisdisorder
duetothereleaseofprocoagulantsubstancesfromtheleukemic
cells,especiallyduringtreatment.
Thet(4;11)(q21;q23)translocationisassociatedwithacute
lymphocyticleukemia(ALL)andundifferentiatedleukemia.
Thet(6;9)(p23;q34)translocationisfoundinsubtypesofAMLwith
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
maturation

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72.Prolongationofboth-activatedpartial
thromboplastintime(aPTT)and
prothrombintime(PT)maybeseenin
factordeficiencyof-
a)Factor2
b)Factor5
c)Factor10
d)Factor8
e)Factor9
CorrectAnswer-A:B:C
Answer-(A)Factor2(B)Factor5(C)Factor10
Partialthromboplastintime(pTT)
Itteststheintrinsicandcommoncoagulationpathways.So,a
prolongedPTTcanresultsfromdeficiencyoffactorV,VIII(factor
VIIIc,vonwillebrandfactor),IX,X,X,XII,prothrombinorfibrinogen.
Prothrombintime(PT)
Itteststheextrinsicandcommoncoagulationpathways.So,a
prolongedPTcanresultsfromdeficiencyoffactorV,
VII,X,prothrombinorfibrinogen.

---

73.Mostcommonaneuploidycompatiblewith
lifeis
a)Downsyndrome
b)Turnersyndrome
c)Klinefelter'ssyndrome
d)Patausyndrome
e)None
CorrectAnswer-A
Answer-A,Downsyndrome
Mostcommonaneuploidyinwhichinfantcansurviveistrisomy-21
(Downsyndrome)

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74.Smallvesselvasculitisis/are-
a)Kawasakidisease
b)IgAvasculitis
c)Carcinomaassociatedvasculitis
d)Anti-glomerularbasementmembrane(anti-GBM)disease
e)Takayasuarteritis
CorrectAnswer-B:C:D
Answer-(B)IgAvasculitis(C)Carcinomaassociatedvasculitis
(D)Anti-glomerularbasementmembrane(anti-GBM)disease
i)ANCApositive
Wegner'sgranulomatosis,Microscopicpolyangitis,Churgstrauss
sytdrome,Good-posturesyndrome.
ii)ANCAnegative
Henoch-Schonleinpurpura,Bechetssyndrome

---

75.Whichofthefollowingis/aretrueabout
sideroblasticanaemia
a)Basophilsstipplinginleadpoisoning
b)Erythroidhypoplasiainbonemarrow
c)Pappenheimerbodiesisalwayspresent
d)DimorphicRBC
e)IncreasedMCHC
CorrectAnswer-A:D
Answer-A,BasophilsstipplinginleadpoisoningD,Dimorphic
RBC
Importantfeaturesofsideroblasticanemiaare:-
Ringeedsidetoblastsinbonemarrowprussionbluereaction.
Dimorphicbloodpicture,i.e.amixturemicrocytichypochromicand
macrocyticerythrocytes
Increased:Ironstores,serumferritin,serumiton,transferrin
saturation.
Ineffectiveerythropoiesisbecauseironcannotbeincorporatedinto
erythrocytes.
otherfeature:DecreasedMCVMCHandMCHC;basophiling
stipplinginleadporsonizgAnisopoikilocytosis(varying
sizesandabnormalshapesofRBCs),erthroidhyperplasiainbone
marrow.

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76.Cancer(s)causedbyviralinfections-
a)Kaposisarcoma
b)Nasopharyngealcarcinoma
c)Hepatocellularcancer
d)Hodgkin'slymphoma
e)All
CorrectAnswer-A:B:C:D
Answer-(A)Kaposisarcoma(B)Nasopharyngealcarcinoma
(C)Hepatocellularcancer(D)Hodgkin'slymphoma
DNAvirusesHerpesviridaeHHV-8Kaposissarcoma
Hepadnaviridae(HBV)hepatocellularcarcinoma
Flaviviridae(HCV)hepatocellularcarcinoma
EBVassociatedmalignancies-
Burkitt'slymphoma
Nasopharynagealcarcinoma
Hodgkin'sdisease

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77.Multiplemyelomamaybeassociatedwith
a)Fanconi'ssyndrome
b)Amyloidosis
c)Mixedcryoglobinemia
d)Castnephropathy
e)Interstitialnephritis
CorrectAnswer-A:B:C:D:E
Answer-A,Fanconi'ssyndromeB,AmyloidosisC,Mixed
cryoglobinemiaD,CastnephropathyE,Interstitialnephritis
Factorscontributingthedamageare:-
BenceJonesproteinuriaandcastnephropathy
Amyioidosis
Lightchainnephropathy,Glomerulopathy,tubule-interstitial
nephritis.
Vasculardisease.
Urinarytractobstruction.
Fanconi'ssyrdrome
TypeIcryoglobulienmiaiscomposedofasinglemono-clonalIg,
usuallyIgM

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78.Trueaboutautosomalrecessive
polycystickidneydisease(ARPKD)
a)CanbediagnosedinuterobyUSG
b)Hypertensiondevelopsinlatestagesofthedisease
c)Mayproceedtorenalfailurebeforepreschoolage
d)Enlargementofkidney
e)Hematuriaisearlyfeature
CorrectAnswer-A:C:D
Answer-A,CanbediagnosedinuterobyUSGC,Mayproceedto
renalfailurebeforepreschoolageD,Enlargementofkidney
ThepresentationinPolycysticdiseaseofkidneyischaracteristically
bilateral
Thebilateralenlargementcanhardlybemistakenonroutine
examination
USGandCTshowmultiplecystsinbothkidneys
Thediseasemaypresentatanyagebutthemostcommonage
ofpresentationisinthe3rdor4thdecade.
Boththekidneyaregrosslyenlargedandsituatedwithmultiple
cysts.
Childhoodpolycystickidneydiseasehasautosomalrecessive
inheritance.

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79.Truestatementaboutasbestosis-
a)Mayinvolvehilarlymphnode
b)Asbestosisbeginsinthelowerlobes
c)Pleuralplaquesconsistsofcalcifiedhyalinzedcollagenous
tissue
d)HighresolutionCTscanningisthebestimagingmethod
e)Noriskoflungcarcinoma
CorrectAnswer-A:B:C:D
Answer-(A)Mayinvolvehilarlymphnode(B)Asbestosis
beginsinthelowerlobes(C)Pleuralplaquesconsistsof
calcifiedhyalinzedcollagenoustissue(D)HighresolutionCT
scanningisthebestimagingmethod
Asbestosisisaninterstitiallungdiseaseduetoinhalationof
asbestosparticles.
Therearetwodistinctgeometricformsofasbestos:(i)Serpentine
(chrysolite),and(ii)Amphibole(crocidolite).
Bothserpentineandamphibolecancauseallasbestosisrelated
diseaseexceptformesothelioma,whichisusuallyassociatedwith
amphibole.
Pleuralplaquesarethemostcommonmanifestationofasbestos
exposure.
Thereisdiffuseinterstitialfibrosismainlyinvolvinglowerlungfields.
Thelungisinvadeddirectly,andthereisoftenmetastaticspreadto
thehilarlymphnodes.
HighresolutionCTscanningisthebestimagingmethodfor
asbestosis.

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80.Feature(s)oftypeImembranoproliferative
glomerulonephritis(MPGN)-
a)Tramtrackappearanceonlightmicroscopy
b)Subendothelialelectron-densedepositsonelectronmicroscopy
c)Immunofluorescencemicroscopyshowpositiveflorescenceof
IgGandC3ondensedeposit
d)Intramembranousdensedepositonelectronmicroscopy
e)Mesangialhypocellularity
CorrectAnswer-A:B:C
Answer-A,Tramtrackappearanceonlight
microscopyB,Subendothelialelectron-densedepositson
electronmicroscopyC,Immunofluorescencemicroscopyshow
positiveflorescenceofIgGandC3ondensedeposit
Onlightmicroscope,Alltypeshavefollowingsimilarfeatures.
1. TheglomeruliarehypercellularDuetoexocapillaryand
endocapillaryproliferation.
2. Theglomerulihavelobularappearanceaccentuatedbythe
proliferatingmesangialcellsandincreasedmesangialmatrix.
3. Parietalepithelialcrescentinmanycases
4. GBMisthickened,whichismostevidentintheperipheralcapillary
loops.
5. Theglomelularcapillarywallshowsadoublecontourortramtrack
appearancebecauseofduplicationofbasementmembraneasa
resultofnewbasementmembranesynthesis.
6. Withinthebasementmembranethereisinterpositionofcellular
elementsthatgiverisetotheappearanceofsplitbasement

---

membrane.
TypeIandIIMPGNdifferintheirultrastructuralfeatures.
TypeISubendothelialdeposits.
TypeIIIntramembranousdeposition.
TypeIdisease(mostcommon)
Idiopathic
Subacutebacterialendocarditis
TypeIIdisease(Densdepositdisease)
Idiopathic
C3nephriticfactorassociated
Partiallipodystrophy
TypeIIIdisease
Idiopathic
Complementfactordeficiency
Systemiclupuserythematosus
HepatitisC
Mixedcryoglubulinemia

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81.Trueaboutsilicosis-
a)Lowerlobeismorecommonlyinvolved
b)Radiographicallyseenaseggshellclacification
c)Lobarpneumoniaiscommon
d)Associatedwithanincreasedsusceptibilitytotuberculosis
e)Histologicallysilicanodulesconsistsofhyalinisedcenter
surroundedbyconcentriclaminationsofcollagen
CorrectAnswer-B:D:E
Answer-(B)Radiographicallyseenaseggshellclacification
(D)Associatedwithanincreasedsusceptibilitytotuberculosis
(E)Histologicallysilicanodulesconsistsofhyalinisedcenter
surroundedbyconcentriclaminationsofcollagen
Silicosisisalungdiseasecausedbyinhalationofcrystallinesilicon
dioxide(silica).
Silicosisisaslowlyprogressivedisease.
SilicosisisassociatedwithanincreasedsusceptibilitytoT.B.
Silicosisischaracterized-
NodulesintheUpperzonesofthelunghardcollagenousscars
Radiologically,eggshellcalcificationcanbeseeninthelymph
nodes.
Histologically,silicosislesionsconsistofconcentriclayersof
hyalinizedcollagensurroundedbyadensecapsuleofmore
condensedcollagen.

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82.Tumormarkerforlungadenocarcinoma
is/are
a)Positiveforcytokeratin5
b)Positiveforcytokeratin7
c)Positiveforcytokeratin20
d)Transthyretin(TTR)mutation
e)EGFRmutation
CorrectAnswer-B:E
Answer-B,Positiveforcytokeratin7E,EGFRmutation
Adenocarcinoma-AKT1,ALK,BRAF,EGFR,HER-2,K-RAS,MEK-
1,MET,N-RAS
CK7(+)ve-BreastCa,PancreaticCa,CervicalCa,adenocarcinoma
oflung.

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83.Whichofthefollowingis/areassociated
withsynovialcellsarcoma
a)Translocation(9;22)(q34;q11)
b)SS18-SSX4fusiongenes
c)Translocationt(X;18)(p11;g11)
d)SS18-SSX1fusiongenes
e)None
CorrectAnswer-B:C:D
Answer-B,SS18-SSX4fusiongenesC,Translocationt(X;18)(p1
1;g11)D,SS18-SSX1fusiongenes
Mostsynovialsarcomasshowacharacteristicchromosomal
translocationt(X:18)producingSYT-SSX1or-SSX2fusion
genes.Thespecifictranslocationisassociatedwithpoorprognosis.
Histologichallmarkofbiphasicsynovialsarcomaisthedualliningof
differentiationofthetumorcells(eg.epitheliatlikeandspindlecells)
CalcifiedconcrectionscanbepresentonX-rays

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84.Truestatementaboutprimary
myelofibrosis
a)Hepatomegalyisthemostcommonmanifestation
b)Drytaponbonemarrowaspiration
c)Onlypotentiallycurativetreatmentisallogeneicstemcell
transplantation
d)Splenomegalyisalmostinvariablypresent
e)Myeloblastsmaybeseeninperipheralblood
CorrectAnswer-B:C:D:E
Answer-B,DrytaponbonemarrowaspirationC,Only
potentiallycurativetreatmentisallogeneicstemcell
transplantationD,Splenomegalyisalmostinvariably
presentE,Myeloblastsmaybeseeninperipheralblood
Thehallmarkofprimarymyelofibrosisisrapiddevelopmentof
obliterativemarrowfibrosis.
Myelofibrosissuppressesbonemarrowhematopoiesis,leadingto
peripheralbloodcytopenias.
Peripheralbloodpictureshowsleukoerythroblastosis(erythroidand
granulocyticprecursorsinperipheralblood),andtear-drop
erythrocytes(dacrocytes).
Bonemarrowbiopsyistheinvestigationofchoice.
Unsuccessfulbonemarrowaspirationalsocalleddrytap.
Allogmeicbonemarrowtransplantationistheonlycurativetreatment
forPMF.

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85.Newerinclusionin2015WHO
classificationofsquamouscellcarcinoma
oflunginclude(s)
a)Clearcellvariant
b)Papillarycellvariant
c)Adenocarcinomavariant
d)Nonkeratinizingvariant
e)Lymphoepithelioma-likecarcinoma
CorrectAnswer-D
Answer-D,Nonkeratinizingvariant
Oldclassification-
Papillary
Clearcell
Smallcell
Basaloid
NewerClassification-
KeratinizingSCC
NonkeratinizingSCC
BasaloidSCC
Preinvasive:SCCinsitu

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86.Whichofthefollowingcancause
pulmonaryembolism-
a)Pregnancy
b)OCPuses
c)Mitralregurgitation
d)Leftventricularfailure
e)Excessiveunaccustomedexercise
CorrectAnswer-A:B:D
Answer-(A)Pregnancy(B)OCPuses(D)Leftventricularfailure
PatientFactors
Age
Obesity
Varicoseveins/superficialthrombophlibits
Immobility
Pregnancy
PuerPerium
High-doseoestrogentherapyorOCPuse
Diseaseorsurgicalprocedure-
Traumaorsurgery
Malignancy
Heartfailure
Paralysisoflowerlimb
Infection

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87.Serotonin,amediatorofinflammationin
ourbody,issecreted/releasedby:
a)Leukocytes
b)Endothelialcell
c)Mastcell
d)Platelet
e)Macrophage
CorrectAnswer-D
Answer-D.Platelet
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
c)P53
d)NTRK1
e)RAS
CorrectAnswer-B:D:E
Answer-B,RET/PTCD,NTRK1E,RAS
GeneticAlterationsinThyroidNeoplasia-
RET/PTC
BRAF
TRK
RAS

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89.Autosomalrecessivedisease(s)is/are:
a)Sicklecellanaemia
b)Phenylketonuria
c)Tuberousscelerosis
d)Familialpolyposiscoli
e)Marfansyndrome
CorrectAnswer-A:B
Answer-(A)Sicklecellanaemia(B)Phenylketonuria
1.Metabolic-
Cysticfibrosis
Phenylketonuria
Galactosemia
Homocystinuria
Wilsondisease
Hemochromatosis
2.Hematopoietic
Sicklecellanemia
Thalassemias
3.Endocrine
Congenitaladrenalhyperplasia
4.Skeletal
Ehlers-Danlossyndrome
5.Nervous
Friedreichataxia
Spinalmuscularatrophy

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90.Whichofthefollowingmarkerfavours
diagnosisofpreinvasive&invasive
cervicalcancer:
a)Ki67
b)OncoproteinE6
c)p16INK4,cyclinE,andKi-67
d)OncoproteinE8
e)None
CorrectAnswer-A:B:C
Answer-A,Ki67B,OncoproteinE6C,p16INK4,cyclinE,andKi-
67
TheexpressionofE7determinestheinactivationofpRbwitha
consequentincreaseoffreeE2Finthecell,leadingtobothan
increaseofcyclin-dependentkinaseinhibitorpl6(p16INK4a)and
aberrantproliferation(markedbyincreasedlevelsofKi-67
expression).

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91.Whichofthefollowingis/arefeatures(s)of
lewybodydementia:
a)Plaquecontainingbeta-amyloidpeptide
b)Depositionofa-synucleinprotein
c)Oftenresistanttostandardtreatment
d)Commoninelderly
e)Riskoffallingmaypresent
CorrectAnswer-B:C:D:E
Answer-(B)Depositionofa-synucleinprotein(C)Often
resistanttostandardtreatment(D)Commoninelderly(E)Risk
offallingmaypresent
Alpha-synucleincontainingLewybodiesoccurinthebrainstem,
midbrain,olfactorybulb,andneocortex.
Thisisaneurodegenerativedisorderclinicallycharacterizedby
dementiaandsignsofParkinson'sdisease.
Commoninelderly.
TheDLBclinicalsyndromeischaracterizedbyvisualhallucinations,
parkinsonism,fluctuatingalertness,falls.

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92.TrueaboutAlzheimer'sdisease:
a)Morecommoninolderage
b)Impairmentoftheabilitytoremembernewinformation
c)Mainlyaffectslongtermmemory
d)Generalcognitivebehaviorimpairedinprodromalphase
e)Atrophyoffrontal&parietallobe
CorrectAnswer-A:B:D:E
Answer-(A)Morecommoninolderage(B)Impairmentofthe
abilitytoremembernewinformation(D)Generalcognitive
behaviorimpairedinprodromalphase(E)Atrophyoffrontal&
parietallobe
Alzheimer'sdisease(AD)isaslowlyprogressivediseaseofthe
brainthatischaracterizedbyimpairmentofmemory.
Alzheimer'sdiseaseisCommonin5thand6thdecade.
EarlyStage-
Thisisconsideredasamild/earlystageandthedurationperiodis2-
4years.
Frequentrecentmemoryloss.
Writingandusingobjectsbecomedifficultanddepressionand
apathycanoccur.
Secondstage-
Thisisconsideredasamiddle/moderatestageandthedurationis2-
10years.
DementiaofAlzheimer'stypeisassociatedwithDepressive
symptoms,Delusions,Apraxiaandaphasia.
Pervasiveandpersistentmemorylossimpactslifeacrosssettings.
Moderatestage-

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

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93.RScellhavingsameimmunophenotyping
arepresentinwhichsubtypesof
Hodgkin'slymphoma:
a)Nodularsclerosis
b)Lymphocytepredominant
c)Lymphocyterich
d)Mixedcellularity
e)Lymphocytedepletion
CorrectAnswer-A:C:D:E
Answer-(A)Nodularsclerosis(C)Lymphocyterich(D)Mixed
cellularity(E)Lymphocytedepletion
Inthefirstfoursubtypes-nodularsclerosis,mixedcellularity,
lymphocyte-rich,andlymphocytecells.

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94.Trueaboutsurgicaljaundice:
a)Increaseofserumbilirubin
b)Increaseacidphosphatase
c)Increasealkalinephosphatase
d)Urinebilirubinisabsent
e)Stoolsterocobilinogenabsent
CorrectAnswer-A:C:E
Answer-A,IncreaseofserumbilirubinC,Increasealkaline
phosphataseE,Stoolsterocobilinogenabsent
Obstructivejaundice-
1.Biluribin
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
e)All
CorrectAnswer-A
Answer-A.InactivationofXchromosomeonlyinsomaticcell
Infemale,oneoftwoX-chromosome(eitherpaternalormaternal)is
inactivatedduringembryogenesisasstatedinLyonhypothesis.
Thisinactivationispassedtoallthesomaticcellwhilethegermcells
inthefemaleremainunaffected.

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96.TwomostcommoncancerinIndian
womanis:
a)Carcinomabreast
b)Carcinomacervix
c)Carcinomacolon
d)Carcinomastomach
e)Carcinomalung
CorrectAnswer-A:B
Answer-(A)Carcinomabreast(B)Carcinomacervix
Inwomen,cancerbreast,cervixuteri,colorectum,ovary,lip&oral
cavity.

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97.Prognosticfactorsforcarcinoma
esophagusis/are:
a)Depthofinvasion
b)Lymphnodestatus
c)Tumourgrading
d)Stageofthedisease
e)All
CorrectAnswer-E
Answer-E,All
StageThemostreliableprognosticfacforforesophagealcanceris
thestageofthetumouratthetimeofdiagnosis.
Tumoursize
Lymphnodesstatus
Cancerhasspreadtodistantorgans
Cancerthatremainsaftersurgery
Tumourgrade

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98.TrueaboutDentigerouscyst:
a)Arisesinrelationtouneruptedteeth
b)Itmostcommonlyencroachesmaxillaryantrum
c)Mandibularthirdmolariscommonsite
d)Commoninmandible
e)All
CorrectAnswer-A:C:D
Answer-A,ArisesinrelationtouneruptedteethC,Mandibular
thirdmolariscommonsiteD,Commoninmandible
Commoninlowerjaw(mandible)inwomen30-40years.
Itoccursinrelationtounerupted,permanent,molartooth,most
commonlytheupperorlowerthirdmolar.

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99.Whichofthefollowingisparaganglioma:
a)AdrenalPheochromocytoma
b)Extra-adrenalPheochromocytoma
c)Carotidbodytumour
d)Carcinoidtumour
e)Glomustympanicum
CorrectAnswer-B:C:E
Answer-(B)Extra-adrenalPheochromocytoma(C)Carotidbody
tumour(E)Glomustympanicum
Pheochromocytornaisachromaffin-cellneoplasmthatcanarisean
adrenal(adrenalmedulla)orextraadrenaltumor.
Extraadrenalpheochromocytomaisalsoreferredtoas
paraganglioma.
Thecarotidbodytumorisaprototypeofaparasympathetic
paraganglioma.
Glomustympanicum:Mostcommontumourinmiddleear.

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100.Whichofthefollowingstatement(s)
is/arecorrectexcept:
a)IncreasedPTinextrinsicpathways
b)IncreasedaPTTininstrinsicpathways
c)Ifplateletcountis>1.5lac/microL,thennormalhomeo-stasis
present
d)BTisdecreasedinplateletabnormality
e)None
CorrectAnswer-D
Aswer-D.BTisdecreasedinplateletabnormality
Hemostasisisspontaneousarrestofbleedingbyphysiological
Process.
Prothrombintime(PT):
Thisassayteststheextrinsicandcommoncoagulationpathways.
Partialthromboplastintime(PTT):
Thisassayteststheintrinsicandcommonclottingpathway.
Prolongationgenerallyindicatesadefectinplateletnumbersor
function.

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101.Feature(s)ofXIIIfactordeficiencyis/are:
a)Delayedwoundclosure
b)Clotsolubilitytestsareabnormal
c)TaPTT
d)TPT
e)TBT
CorrectAnswer-A:B
Answer-A,DelayedwoundclosureB,Clotsolubilitytestsare
abnormal
Itcharacteristicallyleadstodelayedbleedingthatoccurshoursto
daysafterahemostaticchallenge.
Clotsolubilitytestsareabnormal.

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102.PAX5is/aremarkerfor?
a)Acutemyeloidleukemia
b)T-celllymphomas
c)Anaplasticlargecelllymphoma
d)Hodgkin'slymphoma
e)B-lymphoblasticlymphoma
CorrectAnswer-D:E
Ans.is'd'i.e.,Hodgkin'slymphoma;&`e'i.e.,B-Lyrnphoblastic
lymphoma
[Ref:Robbins9th(SEA)/ep.590;Harrison19th/ep.699]
Pax5(B-cell-specificactivatorprotein)ismostlyexpressedinB-
lymphocytesandB-celllymphomas.Itisexpressedindeveloping
CNS,someneuroendocrinetumors,andoccasionalmyeloid
leukemia.
Pax5stainingispositiveinmostHodgkinlymphoma,B-cellNHL,
andprecursorB-celllymphoblasticneoplasms.
Lymphoplascytoidlymphoma,smallcellcarcinomasandMerkelcell
carcinomasarealsopositive.
T-celllymphomas,plasmacellneoplasms,multiplemyeloma,and
plasmablasticlymphomasarenegativeforPax5.

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103.Trueaboutmiliarytuberculosis:
a)Occurprimarilyduetohematogenousspread
b)Miliarylesionisgenerallyofsize1-2mm
c)Diffusebilateralcrepitationisalwayspresent
d)Onsetisgenerallyacute
e)Sputumsmearmicroscopyisnegativein80%ofcases
CorrectAnswer-A:B:E
Answer-(A)Occurprimarilyduetohematogenousspread
(B)Miliarylesionisgenerallyofsize1-2mm(E)Sputumsmear
microscopyisnegativein80%ofcases
MiliaryTBisduetohematogenousspreadoftuberclebacilli.
Blood-bornedisseminationgivesrisetomiliaryTB.
Thelesionsareusuallyyellowishgranulomasl-2mmindiameter
thatresemblemilletseeds(microscopicorsmall,visible).
Clinicalfeatures-
Fever,nightsweats,anorexio,weaknas,andweightlossare
presentingsymptomsinthemajorityofcases.
Patientshaveacoughandotherrespiratorysymptoms.
Hepatomegaly,splenomegaly,andlymphadenopathy.
Eyeexamination-choroidaltubercles,whicharepathognomonicof
miliaryTB
Investigations-
Chestradiographyrevealsamiliaryreticulonodularpattern.
Sputumsmearmicroscopyisnegativein80%ofcases.
TST(Tuberculinskintest)maybenegative.
Bronchoalveolarlavageandtransbronchialbiopsyaremorelikelyto
providebacteriologicconfirmation.

---

Ausculutionisfrequentlynormalbutinmoreadvanceddisease,
widespreadcracklesareevident
Treatment-
RegimensthatareeffectivefortreatingpulmonaryTBarealso
effectivefortreatingextrapulmonarydisease.

---

104.Whichofthefollowingcancerspread
primarilybyhematogenousroute:
a)Papillarycarcinomathyroid
b)Renalcellcarcinoma
c)Pheochromocytoma
d)Glioblastomamultiforme
e)Follicularcarcinomaofthyroid
CorrectAnswer-B:C:E
Answer-(B)Renalcellcarcinoma(C)Pheochromocytoma
(E)Follicularcarcinomaofthyroid
Themostcommonlocationsofmetastasisarethelungsandbones.
Renalcellcarcinoma:Tumourcelllinethebloodvesselwhichare
responsibleforearlybloodspreadfromRCC
Papillarycarcinomathyroid:Focioflymphaticinvasionbytumorare
oftenPresent,butnobloodvesselinvolvement
Pheochromocytomasisthepresenceofmetastases.
Follicularcarcinomaofthyroid:Bloodbornemetastasesaremore
common.

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105.PresentationofPierre-Robinsyndrome
includes:
a)Retrognathia
b)Lowsetear
c)Prominentforehead
d)Isolatedcleftpalate
e)Glossoptosis
CorrectAnswer-A:D:E
Answer-(A)Retrognathia(D)Isolatedcleftpalate
(E)Glossoptosis
Triadofmicrognathia,glossoptosis&cleftpalate
Cleftsoftpalate
High-archedpalate
Jawthatisverysmallwithsmall(receding)chin
Jawthatisfarbackinthethroat

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106.Trueaboutmammalianmitochondrial
DNA:
a)Containsaround16500nucleotidesequence
b)Makesuparound3%totalcellularDNA
c)Makesuparound10%totalcellularDNA
d)Makesuparound0.3%totalcellularDNA
e)Makesuparound1%totalcellularDNA
CorrectAnswer-A:E
Answer-(A)Containsaround16500nucleotidesequence
(E)Makesuparound1%totalcellularDNA
Inmammaliancells,mitochondrialDNAmakesuplessthan1%of
thetotalcellularDNA.
AuniquefeatureofmitochondrialDNAismaternalinheritence.
mitochondriahavethereowngenomesconsistingofdouble-strand
mitochondrialDNA(mtDNA)moleculeconsistingofa16,569
nucleotidesequence.
mtDNAsequencecontainsatotalof37genesencoding13ETC.

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107.Allaretrueaboutfocalnodular
hyperplasiaexcept:
a)Multiplenodulemaypresent
b)Morecommoninmale
c)Maybeassociatedwithcontraceptivepillsuse
d)Hypovascularonthearterial-phaseandhypervascularonthe
delayed-phaseCTimages
e)CTislesssensitivethanMRIindepictingthecharacteristic
centralscar
CorrectAnswer-B
Answer-B.Morecommoninmale
FNHistypicallybenign
"FNHismostfrequentlyfoundinyoungtomiddle-agedadults,witha
strongfemalepredilection.
thelesionismultinodular
Bileductulesareusuallyfoundattheinterfacebetweenhepatocytes
andfibrousregions.
Kupffercellsarepresent

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108.HighlevelofhCGis/areseeninall
except:
a)Downsyndrome
b)Neuraltubedefect
c)Germcelltumor
d)Gestationaltrophoblasticdisease
e)Multiplepregnancy
CorrectAnswer-B
Answer-B.Neuraltubedefect
'HighlevelofhCGauldbedetectedin-multiplepregnancy,
hydatiformmole,choriocarcinoma,Downsyndrome,
Plasmalowerlevelsarefoundinectopicpregnancies&in
spontaneousabortion.
hCGisproducedbythesyncytiotrophoblastoftheplacenta.

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109.Humanpapillomavirusis/areassociated
withallexcept:
a)Oropharyngealtumors
b)Carcinomanasophraynx
c)Carcinomaanalcanal
d)Carcinomapancreas
e)Carcinomacervix
CorrectAnswer-B:D
Answer-(B)Carcinomanasophraynx(D)Carcinomapancreas
Skinwarts(Plantarwart,commonwart,flatwart&
Epidermodysplasiaverruciformis)
Papilloma(Laryngeal,Oral)
Condylomaacuminatum(genitalwart)
Oralsquamouscellcarcinoma
Cervicalintraepithelialneoplasia(CIN)
Carcinomacervix

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110.Neuroendocrinecelltumourmarkersare:
a)ChromograninA
b)CD56
c)Neuron-specificenolase
d)Synaptophysin
e)Cytokeratin7
CorrectAnswer-A:B:C:D
Answer-A,ChromograninAB,CD56C,Neuron-specific
enolaseD,Synaptophysin
ChromograninAisthemostwidelyused
Neuron-specificenolase(NSE)isacytosolicmarkerof
neuroendocrinedifferentiation.
Synaptophysinfoundinsmallvesiclesofneuronsand
neuroendocrinetumors.
CD56aremarkers.

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111.TrueaboutHodgkin'slymphoma:
a)Oftenlocalizedtosingleaxialgroupoflymphnode
b)Hepatomegalyisalwayspresent
c)Contiguousspreadoflymphnode
d)Canbecuredbychemotherapy&radiotherapy
e)Commonlyresentswithpainlesslymphadenopathy
CorrectAnswer-A:C:D:E
Answer-(A)Oftenlocalizedtosingleaxialgroupoflymphnode
(C)Contiguousspreadoflymphnode(D)Canbecuredby
chemotherapy&radiotherapy(E)Commonlyresentswith
painlesslymphadenopathy
Hodgkin'slymphomaisamalignantneoplasmoflymphoreticular
system.
Itcaninvolvelymphnodes,spleenandliver.
Commoninmales.
ClassicdiagnosticfeatureisthepresenceofReed-Sternberg(RS)
cellsorDorothy-ReedSternbergcells.
ClassicmarkersforHodgkin'sdiseaseisCD15&CD30.
AxiallymphaticsystemisalmostalwaysaffectedinHodgkin's
disease.
Cervical&mediastinallymphnodesareinvolvedmostfrequently.
Mostcommonlyinpatientspresentaspainless,movableandfirm
lymphadenopathy.
Treatment-
StageI/IIclassicalHodgkin'sdisease-
Chemotherapy+fieldradiotherapy

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112.Schaumannbodiesarenotseenin:
a)Sarcoidosis
b)Histoplasmosis
c)Cryptococcosis
d)Hypersensitivitypneumonitis
e)Tuberculosis
CorrectAnswer-B:C
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
e)Hodgkin'slymphoma
CorrectAnswer-A:B:E
Answer-(A)Anaplasticlargecelllymphoma(B)Embryonalcell
carcinoma(E)Hodgkin'slymphoma
CD30ispositiveinanaplasticlargecelllymphoma&Hodgkin's
lymphoma.
ActivatedBcells,Tcells,andmonocytes;alsoexpressedbyReed-
SternbergcellsandvariantsinclassicalHodgkinlymphoma.

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114.ChromosomalabnormalitiesinDown
syndromeis/aredueto:
a)Nondisjunctionalofmaternalchromosome
b)Nondisjunctionalofpaternalchromosome
c)Translocationsbetweenchromosome21&14
d)Disjunctionofpaternalchromosome
e)Disjuctionofmaternalchromosome
CorrectAnswer-A:B:C
Answer-(A)Nondisjunctionalofmaternalchromosome(B)
Nondisjunctionalofpaternalchromosome(C)Translocations
betweenchromosome21&14
Trisomy21(47,XX+21)isthemostcommon(95%)chromosomal
abnormalityinDownsyndrome.
InDownsyndromelargefragmentof14or15or22chromosome
fuseswithlargefragmentofchromosome21Extramaterialcomes
on21anditactslikethird21stchromosomeTrisomy21.
Extrachromosomeisofmaternalinorigin.
I%havemosaicwithsomeallhave46chromosome.
4%haverobertsoniantranslocation.
1. t(13:21)
2. t(14:21)
3. t(15:21)
Veryrarelylongarmofchromosome21istriplicate(Partialtrisomy).

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115.Allaretrueaboutintestinalpolyp
syndromeexcept:
a)Cowdendisease-Hamartomatouspolyps
b)Hereditarynonpolyposiscolorectalcarcinoma(HNPCC)-
Multipleadenomatouspolyps
c)Peutz-Jegherssyndrome-associatedwithcoloniccarcinoma
d)Colonichyperplasticpolyphasmalignantpotential
e)Cronkhite-Canadasyndrome-mayhaveassociatedbreast
tumour
CorrectAnswer-D
Answer-D.Colonichyperplasticpolyphasmalignantpotential
Colonichyperplasticpolypsarebeningepithelialproliferation.

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116.Increasethicknessofgastricmucosal
foldisseenin:
a)Menetrier'sdisease
b)Gastritiscystica
c)Boerhaavesyndrome
d)Zollinger-Ellisonsyndrome
e)All
CorrectAnswer-A:B:D
Answer-(A)Menetrier'sdisease(B)Gastritiscystica
(D)Zollinger-Ellisonsyndrome
TwowelldefinedexamplesareMenetrier'sdisease&Zollinger-
Ellisonsyndrome
Gastricglandhyperplasiasecondarytoexcessivegastrinsecretion,
inthesettingofagastrinoma.

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117.Trueaboutfibrolamellarcarcinomaof
liver:
a)Betterprognosisthantypicalhepatocellularcarcinoma
b)Associatedwithcirrhosis
c)AFP-positive
d)Occurinyoungeradults
e)Morecommoninfemales
CorrectAnswer-A:D:E
Answer-(A)Betterprognosisthantypicalhepatocellular
carcinoma(D)Occurinyoungeradults(E)orecommonin
females
Itisadistinctivevariantofhepatocellularcarcinoma
Itisseeninyoungadults(20-40yrsofage)
Ithasequalsexincidence
Ithasbetterprognosis
IthasnoassociationwithHBVorcirrhosis
Itisgrosslyencapsulatedmass.
AFPelevationisnotseeninFibrolamellarCa

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118.Notseeninpoststreptococcal
glomerulonephritis(PSGN):
a)Nephroticrangeproteinuria
b)Neutrophilicinfiltrationoftubules
c)Subepithelialdeposits
d)Lineardepositsalongglomerularbasementmembrane
e)None
CorrectAnswer-A:B:D
Answer-(A)Nephroticrangeproteinuria(B)Neutrophilic
infiltrationoftubules(D)Lineardepositsalongglomerular
basementmembrane
Ittypicallyaffectschildrenbetweentheagesof2and14years.
Itismorecommoninmales.
Poststreptococcalglomerulonephritisduetoimpetigodevelops2-6
weeksafterskininfectionandl-3weeksafterstreptococcal
pharyngitis.
ThereisgranularsubendothelialimmunedepositsofIgG,IgM,C3,
C4andC5-9,andsubepithelialdeposits.
Clinicalfeatures-
Acutenephritiswithhematuria,pyuriaredbloodcellcasts,edema,
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
e)Acuterenaltubularnecrosis
CorrectAnswer-C:D:E
Answer-(C)Hemoglobinuria(D)Transfusion-relatedacutelung
injury(E)Acuterenaltubularnecrosis
Hemolytictransfusionreaction
Intravascularhemolysis
Transfusion-relatedacutelunginjury(TRALI)
Renalfailure

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120.Trueaboutfollicularlymphoma:
a)Lymphadenopathyisthemostcommonpresentation
b)BCL-1positive
c)CD5positive
d)Morecommoninmalesthanfemales
e)All
CorrectAnswer-A
Answer-A.Lymphadenopathyisthemostcommon
presentation
Itisthetumorofgerminalcentre(follicularcentre),Bcells,andis
stronglyassociatedwithchromosomaltranslocationinvolvingBcl2.
Growthpatternisnodular(follicular)ornodular(follicular)and
diffuse.
TheneoplasticcellscloselyresemblenormalgerminalcentreB
cells,expressingCD19,CD20,CD10,surfaceIg,andBcl6.
Inmostfollicularlymphomas,centrocytespredominate.
Itusuallypresentsinmiddleageandaffectsmalesandfemales
equal.
Themostcommonpresentationforfollicularlymphomaiswithnew
painlesslymphadenopathy.

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121.TrueaboutChronicLymphocytic
Leukaemia:
a)Mostcommonleukaemiainadult
b)Proliferationcentreispathgnomonic
c)Massivesplenomegaly
d)Radiotherapy&chemotherapyaregivenintreatment
e)None
CorrectAnswer-A:B:C
Answer-(A)Mostcommonleukaemiainadult(B)Proliferation
centreispathgnomonic(C)Massivesplenomegaly
CLListhemostcommonformofNHL.
CLLiswhenperipheralbloodlymphocytescountisexceeding4000
cells/L.
ThetumourcellscontainshighlevelofBCL2(inhibitsapoptosis).
Clinicalfeatures-
Splenomegaly&hepatomegaly
Hypogammaglobulinemialeadstobacterialinfectionincombination
ofneutropenia.
Treatment-
Alkylatingdrugsascyclophosphamide
Corticosteroids
Radiotherapy&chemotherapy
SplenectomyinAIHA

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122.TrueaboutmitochondrialDNA:
a)Linear
b)Circular
c)Transmittedbymotheronly
d)Transmittedbybothparents
e)ContainslessgenethannuclearDNA
CorrectAnswer-B:C:E
Answer-(B)Circular(C)Transmittedbymotheronly
(E)ContainslessgenethannuclearDNA
Insexualreproduction,mitochondriaarenormallyinherited
exclusivelyfromthemother;themitochondriainmammaliansperm
areusuallydestroyedbytheeggcellafterfertilization.
UGAcodesfortryptophan,Codesfor13proteins,Circulardouble
strandedDNA,MitochondrialdiseaseoccurduetoPointMutations
andLarge-ScaleRearrangements.
Theremaining22tRNAand2rRNA-encodinggenesarededicated
totheprocessoftranslationofthe13mtDNAencodedproteins.

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123.Trueaboutautosomaldominanttypeof
inheritance:
a)25%affected&50%carrier,ifoneparentaffected
b)50%affected&75%carrier,ifbothparentaffected
c)75%affected,ifbothparentaffected
d)50%affected,ifoneparentaffected
e)Allcarrierirrespectiveofeitheroneparentaffectedorboth
parentaffected
CorrectAnswer-D
Answer-D.50%affected,ifoneparentaffected
Autosomaldominantdisordersaremanifestedintheheterozygous
state.
Bothmalesandfemalesareaffected.
Becausetheallelessegregaterandomlyatmeiosis,theprobability
thatanoffspringwillbeaffectedis50%.

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124.Ina-thalassemia,HbBartsissaidwhen
numberofgenelociaffectedis:
a)1
b)2
c)3
d)4
e)None
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
c)P-selectin
d)Collagen
e)Heterochromatin
CorrectAnswer-A:E
Answer-(A)Reticulum(E)Heterochromatin
ThemostcommonlyusedstainingsystemiscalledH&E
(HaematoxylinandEosin).
H&Econtainsthetwodyeshaematoxylinandeosin.
Eosinproducesthreedifferenthues-
Redbloodcellsstaindarkreddishorange
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
e)None
CorrectAnswer-A:C
Answer-(A)Dietshouldexcludebarley,wheat&rye(C)AntiIgA
endomycialantibodyisspecific
Intolerancetogliadinacomponentofglutenpresentinwheat,
barley,rye&oat.
Absenceorreducedheightofvilli(Flatappearance)
Crypthyperplasia,villousatrophy,Cuboidalappearanceofepithelial
cells&increasedintraepitheliallynphocytes.
Antiendomysialantibodies
DisappearanceofIgantiendomysialantibodiesfollowinginstitution
ofaglutenfreedietisdiagnostic.
lgAantiendomysial.

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127.Whichofthefollowingistrueabout
glutathione&glutathioneperoxidase:
a)Actasscavengeroffreeradicle
b)Glutathionehasanti-oxidantproperty
c)ReducedglutathionecanchemicallydetoxifyH202
d)OxidizedglutathionecanchemicallydetoxifyH202
e)None
CorrectAnswer-A:B:C
Answer-(A)Actasscavengeroffreeradicle(B)Glutathione
hasanti-oxidantproperty(C)Reducedglutathionecan
chemicallydetoxifyH202
IthelpsindetoxificationofH2O2byreducingit.Superoxideanion
(O2)firstconvertedtoH2O2bysuperoxidedismutase.
H2O2isthenreducedtoH2O2byglutathioneperioxidase,a
reactionrequiresreducedglutathione.Thus,glutathionescavenges
freeradicalsandsuperoxideanion.
Aseriesofenzymesactsasfreeradical-scavengingsystemsand
breaksdownH2O2andO2

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128.Trueabouthyperacuterejectioninrenal
transplant:
a)Occurwithinfewdaysoftransplant
b)Tcellinvolvement
c)Bloodvesselthrombosis
d)Eosinophilicinfiltration
e)Bcellinfiltration
CorrectAnswer-C
Answer-(C)Bloodvesselthrombosis
Hperacuterejectionoccurswhenpreformedantidonorantibodiesare
presentinthecirculationoftherecipient.
Acuteantibody-mediatedrejectioniscausedbyantidonorantibodies
producedaftertransplantation.
Itismediatedbypreformedhumoralantibody.
InacuterejectionthereisinfiItrationofT&Bcell

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129.Histologicalfindingofhypertrophic
cardiomyopathyincludes:
a)Myocytedisaaray
b)Interstitialfibrosis
c)Amyloiddepositioninmuscle
d)Myocytehypertrophy
e)Myocardialfibresarearrangedinparallelpattern
CorrectAnswer-A:B:D
Answer-(A)Myocytedisaaray(B)Interstitialfibrosis
(D)Myocytehypertrophy
MostimportanthistologicfeaturesofthemyocardiuminHCM
are-
1. extensivemyocytehypertrophy
2. haphazarddisarrayofbundlesofmyocytes-myocytes,and
contractileelementsinsarcomereswithincells(myofiberdisarray)
3. interstitialandreplacementfibrosis

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130.Trueaboutbcl-2:
a)TApoptosis
b)Apoptosis
c)TResistanceoftumourtotreatment
d)Onlyassociatedwithfollicularlymphoma
e)Causemeningioma
CorrectAnswer-B:C
Answer-(B)Apoptosis(C)TResistanceoftumourtotreatment
Bcl-2inhibitsapoptosis;a(14:18)translocationresultingin
overexpressionofthebcl-2proteininBlymphocytescauses
apoptosisofneoplasticcellstobepermanentlyinhibited,producing
follicularlymphoma.

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131.Trueaboutthrombusformation:
a)Arterialthrombusgrowindirectiontowardheart
b)Venousthrombusgrowindirectiontowardheart
c)Venousthrombusformchickenfat
d)LineofZahnisseenmicroscopicallyinredthrombi
e)None
CorrectAnswer-B:D
Answer-(B)Venousthrombusgrowindirectiontowardheart
(D)LineofZahnisseenmicroscopicallyinredthrombi
Arterialorcardiacthrombiusuallybeginatasiteofendothelial
injury.
Venousthrombicharacteristicallyoccurinsitesofstasis.
Arterialthrombitendtogrowinaretrogradedirectionfromthepoint
ofattachment.
Venousthrombiextendinthedirectionofbloodflow(i.e.,towardthe
heart).
Whenformedintheheartoraorta,thrombimayhavegrossly(and
microscopically)apparentlaminations,calledlinesofZahn.
Arterialthrombiareusuallyocclusive;themostcommonsite.

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132.Findinginhistopathologyofbrainin
rabiesincludes:
a)Negribody
b)Nodule
c)Neuronophagia
d)Vacuolardegenerativechanges
e)Inflammatorycell
CorrectAnswer-A:B:C:E
Answer-(A)Negribody(B)Nodule(C)Neuronophagia
(E)Inflammatorycell
Rabiesisasevereencephalitistransmittedtohumansbythebiteof
arabiesanimal.
Macroscopically,brainshowsintenseedemaandvascular
congestion.
Microscopically,
Widespreadneuronaldegenerationandaninflammatotyreaction
thatismostsevereintherhombencephalon.
Negribodies,thepathognomonicmicroscopicfindingcanbefound
inpyramidalneuronsofthehippocampusandPurkinjecellsofthe
cerebellum.
PathologicstudiesshowmildinflammatorychangesintheCNSin
rabies,withmononuclearinflammatoryinfiltrationinthe
leptomeninges,perivascularregions,andparenchyma,including
microglialnodulescalledBabesnodules.
Neuronophagiaisobservedoccasionally.

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133.Trueaboutprimarybiliarycirhhosis:
a)Morecommoninfemale
b)Periportalfibrosis
c)MaybessociatedwithRheumatoidarthritis&crohn'sdisease
d)Jaundicemaybepresent
e)All
CorrectAnswer-A:B:D
Answer-(A)Morecommoninfemale(B)Periportalfibrosis
(D)Jaundicemaybepresent
PBCisprimarilyadiseaseofmiddle-agedwomen,withafemale
predominanceof9:l.
Antimitochondrialantibodiesarethemostcharacteristic-laboratory
findinginPBC.
Etiology-portalinflammationandnecrosisofcholangiocytesC/F
Hypercholesterolemiaiscommon
Xanthelasma,andxanthomata
Hepatomegaly,splenomegaly,ascites,andedema.
Developmentofjaundice
Investigations-
Thediseaseisconfirmedbyliverbiopsy,whichisconsidered
diagnosticifafloridductlesionispresent.

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134.Redinfarctoccurin:
a)Intissueswithdualcirculations
b)Occuronlywhenbotharterial&venousobstructionoccurs
simultaneously
c)Organswhicharepreviouslycongested
d)Organswithloosetissue
e)All
CorrectAnswer-A:C:D
Answer-(A)Intissueswithdualcirculations(C)Organswhich
arepreviouslycongested(D)Organswithloosetissue
Redinfarcts(Haemorrhagic):occurwith:
Venousocclusions(egovariantorsion);
Inloosetissues(suchaslungs);
Intissueswithdualcirculation(e.g.Lung&S.intestine)
Intissuesthatwerepreviouslycongestedbecauseofsluggish
venousoutflow.
Whenflowisreestablilshedtoasiteofpreviousarterialocculusion
andnecrosis.

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135.TrueabouthemophiliaB:
a)Factor8deficiency
b)Factor9deficiency
c)X-linkeddisorder
d)ClinicallyindistinguishablefromhemophiliaA
e)Freshfrozenplasmagivenfortreatment
CorrectAnswer-B:C:D
Answer-(B)Factor9deficiency(C)X-linkeddisorder
(D)ClinicallyindistinguishablefromhemophiliaA
HemophiliaisanX-linkedrecessivehemorrhagicdiseasedueto
mutationsintheF8gene(hemophiliaAorclassichemophilia)orF9
gene(hemophiliaB).
Malesubjectsareclinicallyaffected.
Clinically,hemophiliaAandhemophiliaBareindistinguishable.
Hemophiliaisclassifiedas-
severe(<1%),
moderate(l-5%),
ormild(6-30%)
Clinicalfeatures-
Bleedingintothejoints(hemarthrosis),softtissues,andmuscles.
Investigations-
HemophiliaB-NormalBT&PT&increasedPTT
Treatment-
Thediseaseistreatedwithinfusionsofrecombinantfactoru.

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136.Alphafetoproteinis/areincreasedin:
a)Yolksactumour
b)Seminoma
c)Dysgerminoma
d)Non-seminoma
e)Hepatocellularcarcinoma
CorrectAnswer-A:D:E
Answer-(A)Yolksactumour(D)Non-seminoma
(E)Hepatocellularcarcinoma
Serumalphafetoproetinleveliselevatedinnonseminomatous
testiculartumors.
Nonseminomatoustesticulartumorsinclude:
1. Yolksacorendodermalsinustumor
2. Embryonalcarcinoma
3. Teratomas
4. Non-seminoma

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137.Spindleshapedcellsis/areseeninwhich
sarcoma:
a)Osteosarcoma
b)Chondromyosarcoma
c)Embryonalrhabdomyosarcoma
d)Leiomyosarcoma
e)Fibrosarcoma
CorrectAnswer-A:C:D:E
Answer-(A)Osteosarcoma(C)Embryonalrhabdomyosarcoma
(D)Leiomyosarcoma(E)Fibrosarcoma
"Osteosarcoma'.Thetumourcellsmayhavevariousshapessuchas
spindledpolygonal&bizarretumourgaintcells.
Leiomyosarcomas:Theyconsistofeosinophilicspindlecellswith
blunt-ended.
Fibrosarcoma-Malignantfibrousarrangedinaherringbonepattern.
Malignantfibroushistiocytomaofspindledfibroblastsarrangedina
storiformpatternadmixedwithlarge;ovoid,bizarremultinucleated
tumorgiantcell.
"Embryonalrhabdomyosarcoma:consistofsheetsofbothprimitive
roundatdspindledcellsinamyxoidstroma.
"Liposarcomas-containsadipocyteswithscatteredatypicalspindle
cells.

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138.FeatureofVonHippelLindausyndrome:
a)Mutationinchromosome13
b)Mutationinchromosome3
c)Pancreaticcyst
d)Cerebellarhemangioblastoma
e)All
CorrectAnswer-B:C:D
Answer-(B)Mutationinchromosome3(C)Pancreaticcyst
(D)Cerebellarhemangioblastoma
Thisisanautosomal-dominantdiseaseinwhichaffectedindividuals
developtumorsincerebellarhemispheres,theretina,and,less
commonly,thebrainstemandspinalcord.
ThegeneforvonHippel-Lindaudisease,atumor-suppressorgene,
islocatedonchromosome3p25-26.
Thecerebellarcapillaryhemangioblastoma,istheneurologic
manifestationofthedisease.
Retinalangiomas,Pheochromocytomaarealsoassociatedtumours.

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139.Allarethefeature(s)ofHermansky-
pudlaksyndromeexcept:
a)Autosomaldominantinheritance
b)Oculocutaneousalbinism
c)Bleedingdisorder
d)Pulmonaryfibrosis
e)Pain
CorrectAnswer-A
Answer-A.Autosomaldominantinheritance
Itisarareautosomalrecessivedisorderwhichresultsin
oculocutaneousalbinism,bleedingproblemsduetoaplatelet
abnormality(plateletdysfunction),storageofanabnormalfat-protein
compound.
Chromosome10q23isaffected.
Thereareeightclassicformsofthedisorderinwhichlasttypeof
disorderisduetogenePallidin(PLDN)
Themajorcomplicationofthedisorderispulmonaryfibrosis.

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140.Differencebetweenactive&restingcell
dependonwhichphaseofcellcycle:
a)GO
b)G1
c)G2
d)M
e)S
CorrectAnswer-A
Answer-A.GO
Thecellcycleconsistsoffourdistinctphases-
G1phase
Sphase
G2phase
Mphase
Quiescent/senescent-
GapO
Arestingphasewherethecellhasleftthecycleandhasstopped
dividing.

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141.Notfeature(s)ofapoptosis:
a)MediatedbyCaspases
b)InhibitionofEndonucleaseactivity
c)Membraneblebareseen
d)Chromatincondensation
e)Associationwithinflammation
CorrectAnswer-B:E
Answer-(B)InhibitionofEndonucleaseactivity(E)Association
withinflammation
Caspaseactivatesendonuclease(neuronalapoptosislacks
caspases,thusactivationofAIF)
MORPHOLOGICALFEATURES:
Convolutionofcellmembrane
Leadingtoformationofcytoplasmicblebs(althoughcellmembrane
remainsintact).
Chromatincondensation(pyknosis)/nuclearcompaction
Doesnotelicitanyinflammatoryresponseduetointactcell
membrane.

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142.TrueaboutIntravascularhemolysis:
a)Increasedserumhaptoglobin
b)IncreaseStercobillininurine
c)Increaseplasmamyoglobin
d)Increasedfecalexcretionofurobilin
e)Hemosiderinuria
CorrectAnswer-D:E
Answer-(D)Increasedfecalexcretionofurobilin
(E)Hemosiderinuria
Intravascularhemolysisismanifestedby
1. hemoglobinemia
2. hemoglobinuria
3. jaundice
4. hemosiderinuria
Decreasedserumhaptoglobinischaracteristicofintravascular
hemolysis.
CommonFeaturesofHemolyticDisorders-
Hbreduced
MCV,MCH-increased
Reticulocytes-increased
Bilirubin-increased

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143.Rheumaticheartdiseaseis/are:
a)Endocarditis
b)Constructivepericarditis
c)Mostcommonlyinvolvetrisucpidvalve
d)Breadbutterpericarditis
e)Pancarditis
CorrectAnswer-A:D:E
Answer-(A)Endocarditis(D)Breadbutterpericarditis
(E)Pancarditis
AcuterheumattccarditisdurlngtheactivephaseofRFmayprogress
tochronicrheumaticheartdisease(RHD).
DuringacuteRF,diffuseinflammationandAschoffbodiesfound
threelayersoftheheart-
pericardium,myocardiumorendocardiumlesioniscalleda
pancarditis.
ChronicRHDischaracterizedbyorganizationoftheacute
inflammationandsubsequentfibrosis.
Thecardinalanatomicchangesofthemitral(ortricuspid)valveare
leafletthickening,commissuralfusionandshortening'and
thickeningandfusionofthetendinouscords.
Inchronicdisease,themitralvalvelsvirtuallyalwaysabnormal.
RHDisthemostfrequentcauseofmitralstenosis.
Fibrousbridgingacrossthevalvularcommissuresandcalcification
create"fishmouth"orbuttonholestenoses.
Carditis,
Subcutaneousnodules,
Erythemamarginatumoftheskin,and

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Sydenhamchorea,aneurologicdisorderwithinvoluntary
purposeless,rapidmovements

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144.Allofthethefollowingstatement(s)
is/aretrueexcept:
a)DenevergroupF-containXchromosome
b)DenevergroupC-containXchromosome
c)DenevergroupG-containacrocentricchromosome
d)BarbodyisinactiveXchromosome
e)Innormalfemalesgenerallyoneofthechromosomes
undergoesXinactivationinsomaticcells
CorrectAnswer-A
Answer-(A)DenevergroupF-containXchromosome
TheclassificationofchromosomesbasedonDenvergroup
classification
Chromosome
RelativePositionof
Size
Class
Centromere
Large
GroupA(1-3)
Metacentric
Large
GroupB(4-5)
Submetacentric
Medium
GroupC(6-12,X)
Submetacentric
Medium
GroupD(13-15)
Acroentric
Relatively
GroupE(16-18)
Submetacentric
shot
GroupF(19-20)
MetacentricorSubmetacentric
short
GroupG(21-22,Y)
Acroentric
Short

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145.Percutaneousliverbiopsyis/are
contraindicatedin:
a)Ascites
b)Hemangiomaofliver
c)Plateletcount<60000/0
d)Hepaticmetastasis
e)Echinococcuscystinliver
CorrectAnswer-A:B:C:E
Answer-(A)Ascites(B)Hemangiomaofliver(C)Plateletcount
<60000/0(E)Echinococcuscystinliver
Thrombocytopenia
Ascites
Difficultbodyhabitus
Suspectedhemangiona
Suspectedechinococcalinfection
Uncooperativepatient

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146.TrueaboutAlcoholiccirrhosis:
a)Predominantlymacronodularpattern
b)Bileductproliferaton
c)Mallorybodyhardlyseen
d)Disturbednormalarchitecture
e)All
CorrectAnswer-B:C:D
Answer-(B)Bileductproliferaton(C)Mallorybodyhardlyseen
(D)Disturbednormalarchitecture
Fibrosiscanbecentilobular,pericellular,orperiportal.
Thereisdisruptionofthenormallayerarchitectureandreplacement
oflivercellsbyregenerativenodules.
Inalcoholiccirrhosis,referredtoasmicronodular.
Withcessationofalcoholuse,largernodulesmayform,resultingin
amixedmicronodularandmacronodularcirrhosis.
Scatteredlargernodulescreatea"hobnail"appearanceonthe
surfaceoftheliver.
TheetiologicalcluetodiagnosisintheformofMallorybodiesishard
tofindinafully-developedalcoholiccirrhosis.

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147.Whichofthefollowingstatement(s)
is/aretrue:
a)InRobertsoniantranslocationthebreaksoccurclosetothe
centromeresofeachchromosome
b)Aneuploidyisabnormalchromosomenumbercausedbyeither
gainorlossofchromosome
c)Comparativegenomichybridisation(CGH) Haploidisnormal
isatechniquethatpermitsthedetectionof number&
chromosomalcopynumber
compositionof
chromosome
d)Haploidisnormalnumber&compositionofchromosome
e)All
CorrectAnswer-A:B:C
Answer-(A)InRobertsoniantranslocationthebreaksoccur
closetothecentromeresofeachchromosome(B)Aneuploidy
isabnormalchromosomenumbercausedbyeithergainorloss
ofchromosome(C)Comparativegenomichybridisation(CGH)
isatechniquethatpermitsthedetectionofchromosomalcopy
number
Aneuploidy:Anabnormalchromosomenumbercausedbyeither
gainorlossofchromosomes.
Haploid:Onlyone-halfthenormalcomplement,thatis,23
chromosomes
Comparativegenomichybridisation(CGH)isatechniquethat
permitsthedetectionofchromosomalcopynumberchangeswithout
theneedforcellculturing.
Robertsoniantranslocation(orcentricfusion):Itisatranslocation

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Robertsoniantranslocation(orcentricfusion):Itisatranslocation
betweentwoacrocentricchromosomes.Typicallythebreakoccur
closetothecentromeresofeachchromosome.

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148.AllaretrueaboutHistamineexcept:
a)Secretedbymacrophage
b)Vasoconstrictionofarterioles
c)Smoothmusclecontraction
d)Mediateinflammation
e)None
CorrectAnswer-A:B
Answer-(A)Secretedbymacrophage(B)Vasoconstrictionof
arterioles
'Histamineinducessmoothmusclecontractionindiversetissues.
Histamineiswidelydistributedintissues,therichestsourcebeing
themastcells.
Histaminecausesdilationofthearteriolesandincreasesthe
permeabilityofvenules
Itactsonthemicrocirculation.

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149.AllaretrueaboutLesch-Nyhan
syndromeexcept:
a)Hyperurecaemia
b)Mentalretardation
c)Stoneproduction
d)Occurequallyinbothsexes
e)X-linked
CorrectAnswer-D
Answer-D.Occurequallyinbothsexes
AcompletedeficiencyofHPRT,theLesch-Nyhansyndrome,is
characterizedbyhyperuricemia,self-mutilativebehavior,
choreoathetosis,spasticity,andmentalretardation.
ThisisarareX-linkeddisorderofpurinemetabolismthatresults
fromHPRTdeficiency.
Thehyperuricemiaresultsfromurateoverproductionandcancause
uricacidcrystalluria,nephrolithiasis,obstructiveuropathy,andgouty
arthritis.
AffectsMalesonly.
Etiology-hereditary
Treatment-
Allopurinol

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150.TrueaboutNeutrophil:
a)Engulfbacteria
b)Multilobed
c)Neutrophilgranulesareslightlybasicandstainweaklywiththe
azurophiliccomponentofRomanowskystains
d)Neutrophiliaoccurinacutebacterialinfection
e)Primarygranulesisalsocalledspecificganules
CorrectAnswer-A:B:C:D
Answer-(A)Engulfbacteria(B)Multilobed(C)Neutrophil
granulesareslightlybasicandstainweaklywiththeazurophilic
componentofRomanowskystains(D)Neutrophiliaoccurin
acutebacterialinfection
'Neutrophilcontainprimaryorazurophilgranules&secondaryor
specificgranules
Neutrophiliaoccurinacutebacterialinfection.
Thenucleusofneutrophilsnormallycontainsuptofoursegments.
Characteristicfeaturesare-Condensed,multilobednucleus
Function-
Hydrolyticsubstratedegradation
Killingestedbacteria
Regulateinflammation

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151.Marker(s)ofLangerhanscell
histiocytosis:
a)CD1a
b)S100
c)CD3
d)CD5
e)CD30
CorrectAnswer-A:B
Answer-(A)CD1a(B)S100
TheproliferatingLangerhanscellsinLangerhanscellhistiocytosis
areHLA-DRpositiveandexpresstheCD1antigen.
ThehallmarkofLCHispositivityforS-100protein&CD1a
positivity.

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152.Feature(s)offibroadenomaofbreast
include:
a)Clearlydefinededgeonpalpation
b)Hormoneresponsivetumor
c)Containbothepithelial&stromalelements
d)Well-encapsulated
e)Commonaftermenopause
CorrectAnswer-A:B:C:D
Answer-(A)Clearlydefinededgeonpalpation(B)Hormone
responsivetumor(C)Containbothepithelial&stromal
elements(D)Well-encapsulated
Fibroadenomasareeasytomove,withclearlydefinededgeso
calledasbreastmouse.
Mostcommonbenignbreasttumoroffemalebreast.
Theyarefrequentlymultiple&bilateral.
Fibroadenomasarebenignsolidtumorscomposedofstromaland
epithelialelements.
Onexcision,fibroadenomasarewell-encapsulatedmasses.
Fibroadenomasdonothavemalignantpotential.

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153.Breastcanceris/areassociatedwith:
a)Familialadenomatouspolyposis
b)Ataxia-telangiectasia
c)Peutz-Jegherssyndrome
d)Cowdendisease
e)VonHippelLindausyndrome
CorrectAnswer-B:C:D
Answer-(B)Ataxia-telangiectasia(C)Peutz-Jegherssyndrome
(D)Cowdendisease
VonHippelLindausymdromeisnotassociatedwithbreast
carcinoma.
Familialadenomatouspolyposisisassociatedwithcolorectal
carcinoma&someothercancerbutnotbreastcancer.
STK11/LKB1(Peutz-Jegherssyndrome)
PTEN(Cowdendisease)

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154.Hyperglycemiais/areassociatedwith:
a)Cushingdisease
b)Addisondisease
c)Pheochromocytoma
d)Hyperthyroidism
e)Acromegaly
CorrectAnswer-A:C:D:E
Answer-(A)Cushingdisease(C)Pheochromocytoma
(D)Hyperthyroidism(E)Acromegaly
Endocrinopathiesassociatedwithhyperglycemia-
Acromegaly
Cushingsyndrome
Hyperthyroidism
Pheochromocytoma
Glucagonoma

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155.Calciumlevelisincreasedin:
a)Parathyroidadenoma
b)Thiazidediuretics
c)Chronicrenalfailure
d)HypervitaminosisD
e)Cirrhosis
CorrectAnswer-A:B:C:D
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
d)Gastrectomy
e)Crohn'sdisease
CorrectAnswer-A:B:C:D:E
Answer-All(A)Anticonvulsantdrugs(B)Pregnancy
(C)Resectionofileum(D)Gastrectomy(E)Crohn'sdisease
I.VITAMINB1DEFICIENCY
Inadequatedietaryintakee.g.strictvegetarians,breast-fed
infants,
Malabsorption
1. Gastriccauses:perniciousanaemia,gastrectomy,congenital
lackofintrinsicfactor.
2. Intestinalcauses:tropicalsprue,ilea!resection,Crohn's
disease,intestinalblindloopsyndrome,fish-tapeworm
infestation.
II,FOLATEDEFICIENCY
Inadequatedietaryintakee.g.inalcoholics,teenagers,infants,old
age,poverty.
Malabsorptione.g.intropicalsprue,coeliacdisease,partial
gastrectomy,jejuna!resection,CrohIfsdisease.
Excessdemand
1. Physiological:pregnancy,lactation,infancy.

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2. Pathological:malignancy,increasedhaematopoiesis,chronic
exfoliativeskindisorders,tuberculosis,rheumatoidarthritis.
Excessurinaryfolatelosse.g.inactiveliverdisease,congestive
heartfailure.
III.OTHERCAUSES
Impairedmetabolisme.g.inhibitorsofdihydrofolate(DHF)
reductasesuchasmethotrexateandpyrimethamine;alcohol,
congenitalenzymedeficiencies.
Unknownetiologye.g.inDiGuglielmo'ssyndrome,congenital
dyserythropoieticanaemia,refractorymegaloblasticanaemia.

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157.WhichofthefollowingisCD15&CD30
positive:
a)LymphocytepredominanceHodgkin'slymphoma
b)Mantlecelllymphoma
c)Burkit'slymphoma
d)MixedcellularityHodgkin'slymphoma
e)DiffuselargeBcelllymphoma
CorrectAnswer-D
Answer-D.MixedcellularityHodgkin'slymphoma
CD15-
Granulocytes;alsoexpressedbyReed-Sternbergcellsandvariants
inclassicalHodgkinlymphoma
CD30-
ActivatedBcells,Tcells,andmonocytes;alsoexpressedbyReed-
SternbergcellsandvariantsinclassicalHodgkinlymphoma.

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158.Bcellantigensare:
a)CD1
b)CD2
c)CD3
d)CD19
e)CD20
CorrectAnswer-D:E
Answer-(D)CD19(E)CD20
CD1-CorticalthymocytesandLangerhanshistiocytes
CD3-Thymocytes,peripheralTcells
CD19-Marrowpre-BcellsandmatureBcellsbutnotplasmacells
CD20-Marrowpre-BcellsafterCD19andmatureBcellsbutnot
plasmacells

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159.Trueaboutprotooncogene:
a)Onlyfoundinvirus
b)Onlyfoundinmalignantcell
c)Normallyinvolvedincellcycleproliferation
d)Canbeconvertedtooncogene
e)Onmutationitcausescancer
CorrectAnswer-C:D:E
Answer-(C)Normallyinvolvedincellcycleproliferation(D)Can
beconvertedtooncogene(E)Onmutationitcausescancer
Genesthatpromoteautonomouscellgrowthincancercellsare
calledoncogenes,andtheirnormalcellularcounterpartsarecalled
protooncogenes.
Proteinsencodedbyprotooncogenesmayfunctionasgrowthfactor
malignantsandreceptors,signaltransducers,transcriptionfactors,
andcell-cyclecomponents.

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160.Thrombosisispredisposedby:
a)ProteinSdeficiency
b)Complementdeficiency
c)Antiphospholipidantibodysyndrome
d)Homocysteinuria
e)All
CorrectAnswer-A:C:D
Answer-(A)ProteinSdeficiency(C)Antiphospholipidantibody
syndrome(D)Homocysteinuria
Hypercoagulablestates-
Primary(Genetic)-
ProteinCdeficiency
ProteinSdeficiency
Homozygoushomocystinuria
Secondary(acquired)-
MI
Atrialfibrillation
Prostheticcardiacvalves
DIC
Thrombocytopenia

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161.Pancytopeniacanoccurin:
a)CML
b)Kala-azar
c)Typhoid
d)Hairycellleukemia
e)None
CorrectAnswer-B:D
Answer-(B)Kala-azar(D)Hairycellleukemia
Primarybonemarrowdiseases-
Myelodysplasia
Paroxysmalnocturnalhemoglobinuria
Myelofibrosis
BonemarrowlymphomaHairycellleukemia
Sarcoidosis
Tuberculosis
Leishmaniasis

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162.Non-smallcelllungcarcinomais/are
associated:
a)K-ras
b)EGFR
c)WT1
d)P53
e)All
CorrectAnswer-A:B:D
Answer-(A)K-ras(B)EGFR(D)P53
K-RASmutationsareseenprimarilyinadenocarcinoma.
p53andRBtumorsuppressorgenesarefrequentlymutated-
Squamouscellcarcinomas
EGFR-Adenocarcinoma

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163.Cyclindependentkinase-2(CDK-2)acts
via:
a)CyclinA
b)CyclinB
c)CyclinC
d)CyclinD
e)CyclinE
CorrectAnswer-A:E
Answer-(A)CyclinA(E)CyclinE
FormsacomplexwithcyclinEinlateG1,whichisinvolvedinthe
G1/Stransition.
FormsacomplexwithcyclinAattheSphasethatfacilitatesthe
G2/Mtransition.

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164.Trueaboutcarotidbodytumor:
a)Slowgrowingtumour
b)Uncapsulated
c)MostlyBilateral
d)Mostlybenign
e)All
CorrectAnswer-A:D
Answer-(A)Slowgrowingtumour(D)Mostlybenign
Raretumouroccurb/w3rd&6thdecadeoflifewithslightfemale
preponderance
Afewarebilateral&someshowfamilialincidence
Grosslytheyaresmall,firm,darktan,encapsulatednodules
Tumoursareusuallybenignwithonlyasmallnumberofcases
producingprovenmetastases.
Thereisoftenalonghistoryofaslowlyenlarging,painlesslumpat
thecarotidbifurcation.

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165.Whichofthefollowingis/aretrueabout
autosomaldominantpolycystickidney
diseaseexcept:
a)Manypatientsmaybeasymptomatictill3rdor4thdecade
b)Pancreaticcyst
c)Associatedwithhypertension
d)Subarachnoidhaemorrhageismostcommonextrarenal
complication
e)None
CorrectAnswer-D
Answer-D.Subarachnoidhaemorrhageismostcommonextra
renalcomplication
ADPKDischaracterizedbytheprogressivebilateralformationof
renalcrisis.
Inheritance-autosomaldominant
Characterizedbymultipleexpandingcystsofbothkidneys.
Ingrossappearance,thekidneysarebilaterallyenlarged.
Thepainmayresultfromrenalcystinfection,haemorrhage,or
nephrolithiasis.
'Intravenousurographypolycystickidneydisease:Thespiderlegs,
deformityofthecalyces
Focalrenalcystsaretypicallydetectedinaffectedsubjectsbefore
30yearsofage.
Complications-
Hematuria,flankpain,urinarytractinfection,renalstones,
hypertension

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166.Epidermalgrowthfactoris/areformed
by:
a)Platelet
b)Fibroblast
c)Mastcell
d)Endothelialcell
e)Keratinocyte
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
d)Detachmentofribosomesfromthegranularendoplasmic
reticulum
e)Creationofmyelinfigures
CorrectAnswer-B
Answer-B.Formationofamorphousdensitiesinthe
mitochondrialmatrix
Largeflocculent,amorphousdensitiesinthemitochondrialmatrix
occurasaresultofirreversiblecelldamage.
Membranedamageplaysacentralroleinthepathogenesisof
irreversiblecellinjury.
Itismorphologicallyassociatedwithsevereswellingofthe
mitochondria,damageofplasmamembranesandswellingof
lysosomes.

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168.Pericardialeffusionis/areseeninall
except:
a)Uraemia
b)SLE
c)Rheumaticfever
d)Myxedema
e)Hyperthyroidism
CorrectAnswer-E
Answer-(E)Hyperthyroidism
Infectious
Viral
Bacterial
Fungal
Parasite
Rickettsia
Postinjury
Trauma
Surgery
Myocardialinfarction
Radiation
Metabolicdiseases
Uremia
Medications
Systemicdiseases
Rheumatoidarthritis
Systemiclupuserythematosus

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Sarcoidosis
Scleroderma
Dermatomyositis
AmyloidosisTumors
Aorticdissection

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169.Whichofthefollowingis/aretrueabout
Prothrombintime:
a)Assessextrinsicpathways
b)TinLiverdisease
c)LinVit.Kdeficiency
d)Normalvalueis2-4minute
e)None
CorrectAnswer-A:B
Answer-(A)Assessextrinsicpathways(B)TinLiverdisease
Prothrombiatimeassayassessesthefunctionoftheproteinsinthe
extrinsicpathways.
Normalvalue-10to14sec
Evaluationofextrinsic&commonpathway.
Increasedinoralanticoagulationtherapy,DICandliverdisease,
VitaminKdeficiency.

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170.at30yrofage,bloodformingbone
marrowarefoundin
a)Sternum
b)Sacrum
c)Pelvis
d)Upperendtibia
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
proximalepiphysealregionsofthehumerusandfemur.

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171.Anti-nuclearantibodiesarenotfoundin:
a)SLE
b)DiffuseScleroderma
c)Druginducedlupus
d)Limitedsceleroderma
e)Sarcoidosis
CorrectAnswer-E
Answer-(E)Sarcoidosis
Foundin-
Druginducedlupus
Sjogren'ssyndrome
Scleroderma
Polymyositis
Dermatomyositis
Arthritis

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172.TrueaboutThrombotic
thrombocytopenicpurpura:
a)Indirecthyperbilirubemia
b)Spherocytosiswiththrombocytopenia
c)Scistocytosiswiththrombocytopenia
d)Thrombiformation
e)All
CorrectAnswer-A:C:D
Answer-(A)Indirecthyperbilirubemia(C)Scistocytosiswith
thrombocytopenia(D)Thrombiformation
Itischaracterizedbyapentad-
Micromgiopathichemolyticanemia,thrombcytopenia,renalfailure,
neurologicfindings,andfever.
TTPdiagnosisincludeanincreasedlactatedehydrogenaseand
indirectbilirubin,decreasedhaptoglobin,andincreasedreticulocyte
count.
Theperipheralsmearshouldbeexaminedforevidenceof
schistocytes.

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173.Inwhichofthefollowingdiseases
antineutrophilcytoplasmic
antibodies(ANCA)arenotfound:
a)Polyarteritisnodosa
b)Microscopicpolyangitis
c)Wegenergranulomatosis
d)Bechetsyndrome
e)Churg-Strausssyndrome
CorrectAnswer-A:D
Answer-(A)Polyarteritisnodosa(D)Bechetsyndrome
ANCApositive
Wegner'sgranulomatosis
Microscopicpolyarteritis
Churg'strausssyndrome
Renal-limitedvaculitis
(crescentricglomerulonephritis)

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