Download Neet PG Pathology MCQs Question Bank
damage.Everytimeacellpreparestodivideinto2newcellsitmustduplicateitsDNA.Thisprocessisnotperfectandcopyingerrorsometimesoccurs.Fortunately,cellshaveDNArepairgeneswhichmakeproteinsthatproofreadDNA.ButifthegenesresponsiblefortherepairarefaultythentheDNAcandevelopabnormalitiesthatmayleadtocancer.Ifthereistoomuchdamagetoacell'sDNAtobefixedbytheDNArepairgenes,thetumoursuppressorgeneisresponsiblefordestroyingthecellbyaprocesscalledApoptosis.Ifthetumoursuppressorgeneisnotworking.cellswithDNAdamagewillcontinuetogrowandcaneventuallybecomecancerous. ExamplesofTumoursuppressorgene Gene Cancerassociated ?TGF Carcinomaofstomach Preceptor?E-cadherin Carcinomaofcolon ?NF-1 NeuroblastomasSchwannomaand ?NF-2 meningiomas ?APC/13 Carcinomaofstomach catenin colon,pancreas,melanomaEndometrialandprostate ?PTEN carcinoma ?SMAD2and Colon,pancreastumour?SMAD4 ?RB Retinoblastoma,osteosarcomacarcinomaofbreast,colonandLung. ?P53 Mosthumancancers ?WT-1 WilmsTumour ?P16 Pancreatic,breastandesophagealcancers
esophagealcancers ?BRCA1and Unknown?BRCA2 ?KLF6 Prostate
2.MichaelisGutmannbodiesareseenin a)>Xanthogranulomatous b)>pyelonephritis c)>Malakoplakia d)Nailpatellasyndrome CorrectAnswer-CMalakoplakia[Ref.Robbins7th/ep1027-1028]Malakoplakiaisavariantofcystitis,itisrelatedtochronicbacterialinfectionmostlybyE.colioroccasionallybyproteusspecies.Itischaracterizedbyunusualappearingmacrophagesandgiantphagosomes.Itpointstodefectinphagocyticordegradativefunctionofmacrophage.Itisapeculiarpatternofvesicalinflammatoryreactioncharacterizedmicroscopicallybysoft,yellow,slightlyraisedmucosalplaques3-4cmindiameter.Histologicallyitischaracterizedbyinfiltrationwithlargefoamymacrophageswithoccasionalmultinucleategiantcellsandinterspersedlymphocytes."ThemacrophageshaveanabundantgranularcytoplasmandthegranularityisPASpositive.Inadditiontothesehistologicalchanges,malakoplokiaisalsocharacterizedbyMichaelisGuttmanbodies.-MichaliesGuttmanbodiesareLaminatedmineralizedconcretionsresultingfromdepositionofcalciuminenlargedlysosomes.-Theyaretypicallypresentbothwithinthemacrophagesandbetweencells.-TheydemonstratepositiveresultsusingPASstainandarediastaseresistance.
diastaseresistance.-TheystainwithKossa,stainforcalciumandperlsPrussianbluestainforiron.-ImmunchistochemicalstudiesdemonstratespositiveresultsforCD68antibodies.Malakoplakiaoccurswithincreasedfrequencyinitnmunosuppressedtransplantrecipients.
3.D.I.C.isseenin: a)>Acutepromyelocyticleukemia b)>Acutemyelomonocyticleukemia c)>CMC d)>Autoimmunehemolyticanemia CorrectAnswer-AAcutepromyelocyticleukemia[Ref.Harrison16'11/ep636]DisseminatedintravascularcoagulationisassociatedwithpromyelocyticleukemiaAcutepromyelocyticleukemia(AML-M3)constitutes5-10%ofallcasesofAMLTheleukemiccellsofthesetypeofanemiaarehypergranular.Granulesoftheseleukemiccells(promyelocytes)containthromboplastinlikematerialresultinginwidespreaddisseminatedintravascularcoagulation.AlsoknowMajorityofM3casesdemonstrateareciprocaltranslocationinvolvingchromosome15and17,t(15;17)
4.InterleukinresponsibleforPyrexiais: a)IL1 b)IL3 c)IL4 d)IL8 CorrectAnswer-AIL1
5.Liquefactivenecrosisisseenin: a)Heart b)Brain c)Lungs d)Spleen CorrectAnswer-BBrain
6.Processofmigrationofleukocytesthroughtheendotheliumisthrough: a)Phagocytosis b)Pinocytosis c)Diapedesis d)Apoptosis CorrectAnswer-CThenextstepintheprocessofleukocyterecruitmentismigrationoftheleukocytesthroughtheendothelium,calledtransmigrationordiapedesis. Transmigrationofleukocytesoccursmainlyinpost-capillaryvenules.Chemokinesactontheadherentleukocytesandstimulatethecellstomigratethroughinterendothelialspacestowardthechemicalconcentrationgradient,thatis,towardthesiteofinjuryorinfectionwherethechemokinesarebeingproduced.Ref:Robbins8thedition,Chapter2.
7.Bridgingnecrosisischaracteristicallyseenin: a)Acutehepatitis b)Chronichepatitis c)Bothoftheabove d)Noneoftheabove CorrectAnswer-CAns:C.BothoftheaboveBridgingnecrosisisamoresevereformofhepatocellularinjuryinacuteviralhepatitisandmayprogresstofulminanthepatitisorchronichepatitis.Bridgingnecrosisischaracterizedbybandsofnecrosislinkingportaltractstocentralhepaticveins,onecentralhepaticveintoanother,oraportaltracttoanothertract.Inseverecasesofacutehepatitis,confluentnecrosisofhepatocytesmayleadtobridgingnecrosisconnectingportal-to-portal,central-to-central,orportal-to-centralregionsofadjacentlobules.Hepatocyteswellingandregenerationcompresssinusoids,andthemoreorlessradialarrayofhepatocyteplatesaroundterminalhepaticveinsarelost.Bridgingfibrosisisanimportantcomponentofsevereexamplesofchronicviralhepatitisandsteatohepatitis.
8.Whichofthefollowingwouldbethebestmorphologicalfeaturetodistinguish ulcerativecolitisfromCrohn'sdisease? a)Diffusedistributionsofpseudopolyps b)Mucosaledema c)Cryptabscesses d)Lymphoidaggregatesinthemucosa CorrectAnswer-APseudopolypsaremorecommonlyfoundinulcerativecolitisthanCrohn'sdisease.Thesearediscreteareasresultingfromsurvivingislandsofmucosaorheapedupgranulationtissue.Sinceinulcerativecolitisthereisdiffusemucosalinflammationthesepseudopolypsare diffuselydistributed.DistinguishingfeaturesbetweenUlcerativecolitisandCrohn'sdisease: Ulcerativecolitis Crohn'sdisease Rectalinvolvement Yes Variable Distribution Diffuse Segmentalordiffuse Terminalileum Backwashileitis Thickenedandstenosis Serosa Normal Creepingfat Mucosa Hemorrhagic Cobblestoneandlinearulcers Pseudopolyps Frequent Lesscommon Strictures No Common Fistulas No Common Lymphoidhyperplasia Infrequent Common Cryptabscess Extensive Focal
Ref:PediatricInflammatoryBowelDiseaseByPetarMamulapage227.
9.Autosomalrecessivepolycystickidneydiseaseischaracterisedbythealtered expressionof: a)Polycystin b)Nephrocystin c)Uromodulin d)Fibrocystin CorrectAnswer-DFibrocystin(polyductin)genemutationisseeninautosomalrecessivepolycystickidneydisease. Note: Polycystinmutationisassociatedwithautosomaldominantpolycystickidneydisease. Nephrocystinisrelatedtonephronophthisis. Uromodulinmutationisseeninmedullarycystickidneydisease.Ref:Harrisonsprinciplesofinternalmedicine,18thedition,Page:2356.
10.Morethan90%patientsofCRESTsyndromewiththelimitedcutaneousformof thisdisordermakewhichofthefollowingautoantibodies? a)Anti-centromere b)Anti-DNAtopoisomerasel c)Anti-double-strandedDNA d)Anti-Golgi CorrectAnswer-AAllformsofsclerodermaarethoughttohaveastrongautoimmunecomponent,andglucocorticoidsandazathioprineareusedtosuppresstheinflammatorycomplicationsofscleroderma.(Otherdrugsthatcanbeusedintherapyincludepenicillamine,whichinhibitscollagencross-linking,NSAIDSforpain,andACEinhibitorstoprotectthekidneyifhypertensionorrenaldamageoccurs).Theanti-centromereantibodyisquitespecificforCRESTsyndrome(96%ofcases),andisonlyseeninaminorityofpatientswithdiffusescleroderma(mainlythosewithRaynaud'sphenomenon)andrarelyinsystemiclupuserythematosusandmixedconnectivetissuedisease.Alsoknow: Anti-DNAtopoisomeraseI,alsocalledanti-Scl-70occurscommonly(64-75%)indiffuse scleroderma,butonlyrarelyinCRESTsyndrome. Anti-double-strandedDNAisfairlyspecificforsystemiclupuserythematosus,althoughit onlyoccursin50-60%oflupuscases. Anti-GolgiantibodiesareseenmostofteninsystemiclupuserythematosusandSj?gren syndrome.Ref:HellmannD.B.,ImbodenJr.J.B.(2013).Chapter20.Musculoskeletal&ImmunologicDisorders.InM.A.Papadakis,S.J.McPhee,M.W.Rabow(Eds),CURRENTMedicalDiagnosis&Treatment2013.
11.1to2mmhaemorrhagesinskinareknownas: a)Microbleed b)Petechiae c)Purpura d)Noneoftheabove CorrectAnswer-BMinute1-to2-mmhemorrhagesintoskin,mucousmembranes,orserosalsurfacesarecalledpetechiae.Thesearemostcommonlyassociatedwithlocallyincreasedintravascularpressure,lowplateletcounts(thrombocytopenia),ordefectiveplateletfunction(asinuremia).Ref:Robbins8theditionChapter4.
12.'Flare'inTripleresponseismediatedby: a)Axonreflex b)Arteriolardilation c)Histaminerelease d)Localhormones CorrectAnswer-AAi.e.Axonreflex
13.Medialcalcificationisseenin- a)Atherosclerosis b)Arteriolosclerosis c)Monckebergssclerosis d)Dissectinganeurysm CorrectAnswer-CAns.is'c'i.e.,MonckebergssclerosisFirstseetypesofarteriesBasedontheirsizeandstructuralfeatures,arteriesaredividedintothreetypes.LargeorElasticarteriesAortaItslargebranches,eg.-Innominate,Subclavian,commoncarotid,iliac.Pulmonaryarteries.MediumsizedormusculararteriesSmallbranchesofaortaCoronary,RenalSmallarteriesandarteriolesWithinsubstanceofthetissueNowseetheiraffection?ArteriosclerosisDontgetconfusewithatherosclerosis.Arteriosclerosismeanshardeningofarteriesbythickeningandlossofelasticityofarterialwall.oTherearethreepatternsofarteriosclerosis.AtherosclerosisCharacterizedbyintimallesions,i.e.atheromas,whichprojectintovascularlumenandmayobstructit.oThisisthemostcommon
patternofarteriosclerosis.Itinvolveselasticarteries,andlarge&mediumsizemusculararteries.ArteriolosclerosisSeeninarteriolesofpatienswithhypertensionanddiabetes.Twoanatomicvariantsarecommon-->hyalineandhyperplasticarteriolosclerosis.MonkebergmedialcalcificsclerosisItisseeninsmallandmediumsizedmusculararteries.Itisadegenerativeandapparentlynon-inflammatorydisease.Mediaofthesearteriesbecomescalcified.Itoccursinpatientsolderthan50years.
14.Changesseeninatheroscleroticplaqueat thetimeofruptureareallexcept- a)Thinfibrosiscap b)Multiplefoamcap c)Smoothmusclecellhypertrophy d)Celldebris CorrectAnswer-CAns.is'c'i.e.,SmoothmusclecellhypertrophyRuptureoccursinadvancedatheroscleroticlesion.Inadvancedatheroma,smoothmusclecellsundergoapoptosisandadvancedatheromatousplaqueoftenhavemostlyfibrouscharacterwithlackofsmoothmusclecellsthatareseeninlessadvancedlesion.
15.Atheromatouschangesofbloodvessels affectsearlyin- a)Kidney b)Heart c)Liver d)Spleen CorrectAnswer-BAns.is'b'i.e.,HeartSitesofAtherosclerosisAtheroscleroticplaquesdevelopprimarilyinelasticarteries(e.g.,aorta,carotidandiliacarteries),andlarge&mediumsizedmusculararteries(e.g.,coronaryarteryandpoplitialarteries).Indescendingorder,thevesselsmostcommonlyinvolvedare-Abdominalaorta(mostcommon)CausinganeurysmCoronaryarteries(heart)CausingMIPoplitealarteriesCausingischemicgangreneoflowerlimbs.InternalcarotidarteriesCausingstrokeaCircleofwillisVesselsusuallysparedareVesselsofupperextremitiesMesentricandrenalvessels,exceptattheirostia.
16.Whichofthefollowingisanon-modifiable riskfactorforCHD- a)Diabetes b)Smoking c)Hypertension d)Oldage CorrectAnswer-DAns.is'd'i.e.,Oldage 1. Oldageisanon-modifiableriskfactorforatherosclerosisand coronaryheartdisease(CHD). 2. Otherthree(giveninquestion)aremodifiableriskfactors.
17.Mostcommoncauseofdissecting hematomaisbecauseof- a)Hypertension b)Marfan's c)Iatrogenic d)Kawasaki CorrectAnswer-AAns.is'a'i.e.,HyertensionMorethan90%ofdissectionsoccurinmenbetweentheagesof40and60withantecedenthypertension.
18.Cysticmedialnecrosisisseenin- a)Marfanssyndrome b)FriedrichsataxiaPattern c)Downssyndrome d)Kawasakidisease CorrectAnswer-AAns.is'a'i.e.,Marfan'ssyndromeCysticmedialnecrosis(CMN)isadisorderoflargearteries,characterizedbyanaccumulationofabasophilicgroundsubstanceinthemediawithcyst-likelesions.ItisknowntooccurincertainconnectivetissuediseasessuchasMarfansyndrome,Ehlers-Danlossyndrome,andannuloaorticectasia,whichusuallyresultfromdegenerativechangesintheaorticwall.TherelationshipsbetweenCMNandcongenitalheartdefectsaswellasotherdisordershavebeenevidenced.Themechanismsarestillcontroversial,eventhoughmanymolecularstudieshavebeenconducteditischaracterizedbyelastictissuefragmentationandseparationoftheelasticandfibromuscularelementsofthetunicamediabysmallcleftlikespaceswherethenormalelastictissueislost;theseareasarefilledwiththeamorphousextracellularmatrixofconnectivetissueandresemblebutarenottrulycysts.
19.Smallvesselvasculitisare- a)ClassicalPAN b)Wegner'sgranulomatosis c)Giantcellarteritis d)All CorrectAnswer-BAns.is`b'i.e.,Wegner'sgranulomatosisInflammationofvesselwalliscalledvasculitis.oOfthesesystemicnecrotizingvasculitis,severaltypesaffecttheaortaandmediumsizedvessels,butmostaffectsmallvessels,suchasarterioles,venules,andcapillaries-->smallvesselvasculitis.LargevesselvasculitisMediumvesselvasculitisSmallvesselvasculitisoGiantcellarteritisoPolyarteritisnodosaANACApositiveANCAnegative(Temporalarteritis)oKawasakidiseaseoWegner'sgranulomatosisoBechet'ssyndromeoTakayasuarteritisoBuerger'sdiseaseoMicroscopicpolyangitisoHypersensitivityoCogansyndromeoChurgstrausssyndromeoUrticarialvasculitisoDruginducedFollowinginformationhavebeenaddedinPieofRobbinsoFollowingaresmallvesselsvasculitisandareimmune-complexmediated: 1. SLE3)Cryoglobulinemia2. Henochschonleinpurpoura4)Good-pasturedisease oFollowingsmallvesselvasculitisarepauci-immune,i.e.thereispaucityofimmunecomplexes:
1.Microscopicpolyangitis3.Chrug-strausssyndrome2.Wegenergranulomatosis
20.AllistrueaboutGiantcellarteritisexcept ? a)Involveslargetosmallsizedareteries b)Granulomatousinflammation c)Mostcommonlyinvolvedarteryisabdominalaorta d)Segmentalnatureoftheinvolvement CorrectAnswer-CAns.is'c'i.e.,MostcommonlyinvolvedarteryisabdominalaortaItisthemostcommonformofsystemicvasculitisinadults,isanacuteandchronic,oftengranulomatous,inflammationofarteriesoflargetosmallsize.Itaffectsprincipallythearteriesinthehead-especiallythetemporalarteries--butalsothevertebralandophthalmicarteriesandtheaorta,whereitmaycausethoracicaorticaneurysm
21.Raynaud'sphenomenonwhatchangeis seeninvesselsinitialstage- a)Nochange(Fibrinoid,Thrombosis) b)Thrombosis c)Fibrinoidnecrosis d)Hyalinesclerosis CorrectAnswer-AAns.is'a'i.e.,NochangeStructuralchangesinthearterialwallsareabsentexceptlateinthecourse,whenintimalthickeningcanappear.
22.ThetissueoforiginoftheKaposi's sarcomais? a)Lymphoid b)Vascular c)Neural d)Muscular CorrectAnswer-BAnsis'b'i.e.,VascularKaposiSarcomaKaposisarcomaisanintermediategrade,multicentricvascular,tumour*Thepathogenesisofkaposisarcomaiscomplex,fundamentallyitisanangioproliferativediseasethatisnotatrueneoplasticsarcoma.Itisamanifestationofexcessiveproliferationofspindlecellsthatarebelievedtobeofvascularoriginandhavefeaturesincommonwithendothelialandsmoothmusclecells.*Grossly-ThreestagesofthediseasecanbeidentifiedPatch(1ststage)Plaque(intermediatestage)LINodule(laststage)*Histologically-Thechangesarenonspecificintheearlypatchstageandmorecharacteristicinthenodularstagewhichshowsheetsofplumpproliferatingspindlecellsandendothelialinthedermisorsubcutanoustissue
23.Concentrichypertrophyofleftventricleis seenin- a)Cong.bicuspidaorticvalve b)MS c)AR d)HOCM CorrectAnswer-AAns.is'a'i.e.,Cong-BicuspidaorticvalveAorticstenosiscausespressureoverloadthatresultsinconcentrichypertrophy.oCongenitalbicuspicaorticvalvecausesvalvularaorticstenosis.
24.Whichoneofthefollowingsetsof componentsofcigarettesmokeisacausalagentofcoronaryarterydisease- a)Tarandnicotine b)Nicotineandcarbonmonoxideandtar c)CarbonmonoxideandTar d)Carbondioxide CorrectAnswer-BAns.is`b'i.e.,NicotineandcarbonmonoxideandtarMechanismsforsmoking-inducedCoronaryheartdiseaseCarbonmonoxideinducesatherogenesis.NicotinestimulationofadrenergicdriveraisingbothBPandmyocardialoxygendemand.Lipidmetabolismwithfallinprotectivehigh-densitylipoproteins.Note:Tarisassociatedwithcarcinogenesis(notatherosclerosis).ButamongstthegivenoptionsoptionbisthebestanswerasitconsistsofbothnicotineandCO.
25.EarliesthistologicalchangeinMI- a)Macrophageinfiltration b)Neutrophilicinfiltration c)Wavinessoffibers d)Coagulativenecrosis CorrectAnswer-CAns.is'c'i.e.,WavinessoffibersVariablewavinessoffibresatborderistheearliesthistologicalfinding(seetablesofpreviousexplanation).
26.7dayoldMIthemostsensitive biochemicalmarker a)TroponinIT b)CPKMB c)LDH d)Myoglobin CorrectAnswer-AAns.is'a'i.e.,TroponinITTroponinTorIisasensitivememberandreturntonormalafter7-10days(seepreviousexplanations).
27.WhichisnotseeninAschoffbodies- a)Giantcells b)Aschoffcells c)Fibroblasts d)Polymorphonuclearcells CorrectAnswer-DAns.isdi.e.,PolymorphonuclearcellsAschoffbodies:*Aschoffbodiesarefocalinflammatorylesionsseenduringacuterheumaticfever*TheyconsistoffociofswolleneosinophilliccollagensurroundedbyLymphocytes(primarilyTcells)OccasionalplasmacellsAschoffgiantcells(macrophagesofrheumaticfever)Antitschkowcells(Antischkowcellsaremodifiedmacrophageswithabundantcytoplasmandcentralroundtoovoidnucleiinwhichthechromatinisdisposedinthecentral,slenderwavyribbonlikepattern-caterpillarcells)HistiocytesFibroblasts
28.Vegetationsinlibmansacendocarditisare ? a)Largeandfragile b)Smallwartyalongthelineofclosureofvalve c)Smallormediumsizedoneitherorbothsidesofvalve d)Smallblandvegetations CorrectAnswer-CAns.is'c'i.e.,SmallormediumsizedoneitherorbothsidesofvalveSLE,mitralandtricuspidvalvulitiswithsmall,sterilevegetations,calledLibman-Sacksendocarditisisoccasionallyencountered.Thelesionsaresmallsingleormultiple,sterile,granularpinkvegetationsrangingfrom1to4mmindiameter.Thelesionsmaybelocatedontheundersurfacesoftheatrioventricularvalves,onthevalvularendocardium,onthecords,oronthemuralendocardiumofatriaorventricles.Anintensevalvulitismaybepresent,characterizedbyfibrinoidnecrosisofthevalvesubstancethatisoftencontiguouswiththevegetation.SubsequentfibrosisandseriousdeformitycanresultthatresemblechronicRHDandrequiresurgery.
29.Causesofconstrictivepericarditisis/are? a)T.B. b)SLE c)Brucellosis d)aandb CorrectAnswer-DAns.is'a'i.e.,T.B.;b'i.e.,SLECausesofconstrictivepericarditis*Tuberculosis(mostcommoncause)*Pericardialmalignancies(especiallybreast,lung)*Post-viralpericarditis(especiallyhemorrhagic)*Drugs(e.g.Hydralazine,Procainamide,minoxidil,phenytoin)*Bacterial(purulent)pericarditis*Trauma/post-cardiacsurgeryhaemopericardium*Fungalpericarditis(Histoplasmosis)*Connectivetissuedisorders(e.g.SLE,RA,Sarcoidosis)*Parasiticpericarditis(toxoplasmosis,trichonosis)*Dresslersyndrome*Mediastinalradiotherapy*Renalfailure
30.Hypertrophyis- a)Increaseincellnumber b)Increaseincellsize c)Decreaseincellnumber d)Decreaseincellsize CorrectAnswer-BAns.is'B'i.e.,IncreaseincellsizeHypertrophy*Hypertrophyreferstoanincreaseinthesizeofcellswithoutincreaseinthenumber,resultinginanincreaseinthesizeoftissue.*Hypertrophyinvolvescellenlargementwithoutcelldivision.*So,hypertrophiedorganhasjustlargercells,butnonewcells(bycontrast,inhyperplasiathereisincreaseinnumberofnewcellswithoutincreaseinsize).*NucleiinhypertrophiedcellshaveahigherDNAcontentthaninnormalcellsbecausethecellsarrestinthecellcyclewithoutundergoingmitosis.*Myocardium(heartmuscle)andskeletalmuscleundergohypertrophy.*Themostcommonstimulusforhypertrophyisincreasedworkload.Mechanismofhypertrophy*Theincreaseincellsizeisduetosynthesisofmorestructuralproteins.*Thegenesthatareinducedduringhypertrophyincludethoseencodingtranscriptionfactors(C-fos,C-jun),growthfactors(TGF-(3,TGF-1,FGF);andvasoactiveagents(a-agonists,endothelin-1,angiotensinII).*Theremayalsobeaswitchofcontractileproteinsfromadultto
fetalorneonatalforms,e.g.,duringmyocardialhypertrophy,thea-myosinheavychainisreplacedby13-formofthemyosinheavychain,whichleadstodecreasemyosineATPaseactivityandaslower,moreenergeticallyeconomicalcontraction.*Inaddition,somegenesthatareexpressedonlyinembryoniclifearere-expressedinhypertrophiedmyocardium,e.g.,intheembryonicheart,thegeneforAtrialnatriuraticpeptide(ANP)isexpressedinbothatriumandventricle.Afterbirth,ventricularregulationofthegeneisdownregulated.MyocardialhypertrophyisassociatedwithreinductionofANFgeneexpression.ANPinducessaltexcretionbykidneyLbloodvolume&pressure,decreaseworkload.Whydothesechangesoccur?*Asalreadyexplained,themostcommonstimulusformyocardialhypertrophyisincreasedworkload.*Alltheabovemorphologicalchangesthatoccurinhypertrophyeitherincreasemuscleactivity(tohandletheincreasedworkload)ordecreasetheworkloadtoheart.
31.Physiologicalhyperplasiaand hypertrophyareseensimultaneouslyin- a)Uterusinpregnancy b)Skeletalmuscleinatheleteas c)Breastatpuberty d)aandc CorrectAnswer-DAns.is'a>c'i.e.,Uterusinpregnancy>BreastatpubertyPhysiologicalhypertrophyandhyperplasia*Examplesofphysiologicallyincreasedgrowthoftissuesinclude:--Skeletalmusclehypertrophyinatheletes,bothintheskeletalmuscleoflimbs(asaresponsetoincreasedmuscleactivity)andinleftventricleofheart(asaresponsetosustainedoutflowresistance).-Hyperplasiaofbonemarrowcellsproducingredbloodcellsinindividualslivingathighaltitude;thisisstimulatedbyincreasedproductionoftheerythropoietin.-Hyperplasiaofbreastatpuberty,andinpregnancyandlactation,undertheinfluenceofestrogen,progesterone,prolactinandhumanplacentallactogen.-Hypertrophyandhyperplasiaofuterinesmoothmuscleinpregnancy,stimulatedbyestrogen.-Thyroidhyperplasiaasaconsequenceoftheincreasedmetabolicdemandofpubertyandpregnancy.Foroption'c'-"Hormonalhyperplasiaiswellillustratedbytheproliferationoftheglandularepitheliumofthefemalebreastatpubertyandduringpregnancy,usuallyaccompaniedbyenlargement(hypertrophy)oftheglandularepithelialcell"-*However,IamnotsureaboutthisstatementofRobbin's,asno
*However,IamnotsureaboutthisstatementofRobbin's,asnoothertextbookhasmentionedthatbreastatpubertyundergobothhyperplasiaandhypertrophy.
32.Thesignofreversibleinjuryinacaseof alcoholicliverdisease- a)Lossofcellmembrane b)Nuclearkaryolysis c)Cytoplasmicvacuole d)Pyknosis CorrectAnswer-CAns.is'c'i.e.,CytoplasmicvacuoleoFattychangesoccurinalcoholicsteatosis(fattyliver).Itismanifestedbyappearenceoflipidvacuoleinthecytoplasm,whichisasignofreversibleinjury.oOtherthreeoptions(lossofcellmembrane,nuclearkaryolysisandpyknosis)aresignsofirreversibleinjury
33.Incelldeath,myelinfigures,arederived from- a)Nucleus b)Cellmembrane c)Cytoplasm d)Mitochondria CorrectAnswer-BAns.is'b'i.e.,CellmembraneMyelinefiguresarecytoplasmicbodiescomposedofconcentricwhorlsofmembranes,derivedfromdamagecellmembrane.Myelinfiguresappearduringreversibleinjurybuttheyaremorepronouncedinirreversibleinjury.
34.Enzymethatprotectsthebrainfromfree radicalinjuryis- a)Myeloperoxidase b)Superoxidedismutase c)MAO d)Hydroxylase CorrectAnswer-BAns.is'b'i.e.,SuperoxidedismutaseAntioxidantmechanismsCellshavemultiplemechanismstoremovefreeradicalsandtherebyminimizinginjury.Severalnonenzymaticandenzymaticsystemscontributetotheinactivationoffreeradicalreactions.A.Non-enzymaticsystemoAntioxidants(Vit'E',VitA,VitC,glutathioneandCysteine)blocktheinitiationoffreeradicalformationandinactivatefreeradicals.oTissueproteins(transferrin,ferritin,lactoferrin,andceruloplasmin).Asalreadyexplained,ironandcoppercancatalyzetheformationoffreeradicals,thesetransportandstorageproteinsdecreasethereactivefreeironandcopper,therebyminimizingthefreeradicalformation.B.EnzymaticsystemoAseriesofenzymesactasfreeradical-scavengingsystemsandbreakdownhydrogenperoxideandsuperoxideanion.1.CatalaseoPresentinperoxisomesanddecomposesH2022H 0 2 2__________02+2H20
1. 2.Superoxidedismutase(SOD) oManganese-superoxidedismutaseispresentinmitochondria,whilecopper-zinc-superoxidedismutaseisfoundinthecytosol.oItconvertssuperoxidetoH202 202-+2HSOD2H202+02 3.GlutathioneperoxidaseoPresentinmitochondria&cytosol.oItcatalyzesfreeradicalbreakdown.H202+2GSH__GSSG+2H2020H+2GSH_>GSSG+2H20oTheintracellularratioofoxidizedglutathione(GSSG)toreducedglutathione(GSM)isareflectionoftheoxidativestateofthecell.
35.MIisatypeof- a)Coagulativenecrosis b)Liquefactivenecrosis c)Caseousnecrosis d)Fatnecrosis CorrectAnswer-AAns.is'a'i.e.,CoagulativenecrosisCoagulativenecrosis*Thisismostcommontypeofnecrosis.*Thistypeofnecrosisismostfrequentlycausedbysuddencessationofbloodflow(ischemia)inorganssuchasheart(MI),Kidney(ATN),adrenalgland,andspleen.Note:Brainistheonlyexception,i.e.,.Itistheonlysolidorganinwhichischemialeadstoliquifactivenecrosisnotcoagulativenecrosis.*Itisalsoseenwithothertypesofinjurye.g.,livernecrosisinviralhepatitis,Coagulativenecrosisofskinafterburns(Thermalinjury).*Whythereispredominantproteindenaturationandnoenzymaticdigestion?Hypoxiacausesintracellularacidosis(hasbeenexplainedearlier)-->.tpHresultsindenaturationofproteinswhichincludesnotonlystructuralproteinshutalsoenzymesSo,thereisnoenzymaticdigestion.oThenecroticcellsretaintheircellularoutlineforseveraldays.Liquefactivenecrosis*Itisthenecroticdegradationoftissuethatrapidlyundergosofteningandliquefactionbecauseoftheactionofhydrolyticenzymes.*Itoccursafter
*Itoccursafter1.Infectioni.e.,suppurativeinflammation(mostcommon).2.Ischemicnecrosisinbrain.Note:Brainlacksanysubstantialsupportivestroma,soischemicnecrosisinbrainisliquifactiveunlikeotherorganswhereitiscoagulative.*Mechanismofliquefactivenecrosis-->Microbesstimulatesaccumulationofinflammatorycellsandthesecellsreleaselysosomalenzymes.Caseousnecrosis*Itisavariantofcoagulativenecrosis.*Itismostcommonlyencounteredwhencelldeathisattributabletocertainorganismse.g.,mycobacteriumtuberculosis(TB)andfungi(Histoplasma,Coccidioidomycosis).Whyisitcalledcaseousnecrosis,notcoagulativenecrosis?*Incontrasttocoagulativenecrosiswheretissuearchitectureismaintained,incaseousnecrosis,thetissuearchitectureiscompletelyobliterated.So,ithasbeencalledcaseousbecauseofitscheesywhiteappearanceoftheareaofnecrosis.
36.Fatnecrosisiscommonin- a)Omentum b)Breast c)Retroperitonealfat d)Alloftheabove CorrectAnswer-DThereare2TypesofFatNecrosis1.Enzymaticfatnecrosis*Thisisduetoactionoflipaseonadiposetissue.*Itoccursmostfrequentlyinacutepancreatitisduetoleakageoflipase.*Dependingontheseverityofacutepancreatitis,fatnecrosismayoccurin:-Adiposetissuecontiguoustopancrease,i.e.,retroperitonealfat.-Adiposetissueinanteriormediastinum.-Bonemarrow-Omentalandabdominalfat2.NonenzymaticorTraumaticfatnecrosis*Occursduetotrauma*Isseeninsubcutaneoustissueofbreast,thigh,andabdomen.
37.Programmedcelldeathisknownas- a)Cytolysis b)Apoptosis c)Necrosis d)Proptosis CorrectAnswer-BAns.is'b'i.e.,Apoptosis*Programmedcelldeathisapoptosis.*Butrememberthisimportantfactthatnotallapoptosisareprogrammedcelldeath(readtextbelow)Apoptosis*Apoptosisispathwayofcelldeaththatisinducedbyatightlyregulatedintracellularprograminwhichcelldestinedtodieactivateenzymesthatdegradethecell'sownnuclearDNA,andnuclear&cytoplasmicproteins.*Apoptosisgenerallyinvolvessinglecellsincontrasttonecrosisthatusuallyinvolveagroupofcells.oApoptosismaybeoftwotypes?A.Physiological(mostofthetime)Programmedcelldeath.B.PathologicalUnprogrammedcelldeath.A.Physiologicalapoptosis*Deathbyapoptosisisanormalphenomenonthatservestoeliminatecellsthatarenolongerneeded.oItisimportantinthefollowingphysiologicsituation:? 1. Theprogrammeddestructionofcellsduringembryogenesis, includingimplantation,organogenesis,andmetamorphosis. 2. Hormonedependentinvolutioninadult,e.g.,endometrialcell breakdownduringmensturalcycle,ovarianfollicularatresiainthe
menopause,theregressionoflactatingbreastafterweaning,andprostaticatrophyaftercastration. 3. Celldeletioninproliferatingcellpopulationinordertomaintaina constantnumber,e.g.,intestinalcryptepithelium. 4. Deathofhostcellsthathaveservedtheirusefulpurpose,suchas neutrophilsafteranacuteinflammatoryresponse,andlymphocytesattheendofanimmuneresponse. 5. Eliminationofpotentiallyharmfulself-reactivelymphocytesin thymus. 6. CelldeathinducedbycytotoxicTcellstoeliminatevirusinfected andneoplasticcells.Samemechanismoccursingraftversushostdisease.B.Pathologicalapoptosis*Apoptosismayalsobepathological.*Whencellsaredamagedbeyondrepair,especiallywhenthedamageaffectsthecell'sDNA,theirreparablydamagedcellsareeliminated:? 1. Celldeathproducedbyinjuriesstimuli-->Radiationandcytotoxic anticancerdrugsdamageDNA,andifrepairmechanismscannotcopewiththeinjury,thecellkillsitselfbyapoptosis.Inthesesituations,eliminationofthecellmaybeabetteralternativethanriskingmutationsandtranslocationsinthedamagedDNAwhichmayresultinmalignanttransformation. 2. Cellinjuryincertainviraldiseases,e.g.,inviralhepatitis.3. Pathologicatrophyinparenchymalafterductobstruction,suchas occursinpancreas,parotidgland. 4. Celldeathintumors.
38.Inapoptosis,cytochromeCactsthrough- a)Apaf1 b)Bcl-2 c)FADD d)TNF CorrectAnswer-AAns.is'a'i.e.,Apaf1Oneoftheseproteinsiscytochromec,wellknownforitsroleinmitochondrialrespiration.Inthecytosol,cytochromeCbindstoaproteincalledApaf-1(apoptosisactivatingfactor-1),andthecomplexactivatescaspase-9.(Bc1-2andBcl-xmayalsodirectlyinhibitApaf-1activation,andtheirlossfromcellsmaypermitactivationofApaf-1).
39.Whichisactivatedfornuclear fragmentationinapoptosis- a)Caspases b)Apaf-1 c)Oxygenfreeradicals d)All CorrectAnswer-AAnsis'a'i.e.,CaspasesCaspasesandendonucleasecausechromatinfragmentationinapoptosis.Theyareinactive,sofirsttheyshouldbeactivated.Cytochrome'c'bindswithApaf-1andthiscomplexactivatescaspases.Caspasescausefragmentationofchromatinandalsoactivateendonuclease.Aboutoption'b'ThoughApaf-1helpsinactivationofcaspases,ithasnoroleinchromatinframentationandItdoesnothavetwoseprateformsactiveorinactive.Itjustformscomplexwithcytochrome'C'toactivatecaspases.
40.Inapoptosiswhichis/areinvolved- a)Apaf-1 b)Bc12 c)Caspases d)All CorrectAnswer-DAns.is'a'i.e.,Apaf-1;'b'i.e.,BCl2;'c'i.e.,CaspasesProapoptoticgenes:Apaf-1,CytochromeC,Bak,Bax,Bim,AIF,P53,Caspases,TNFRI,FAS(CD95),FADD,BH3onlyproteins(Bim,Bid,Bad),Smac/DIABLO.
41.AnnexinVisamarkerof a)Apoptosis b)Necrosis c)Artherosclerosis d)Inflammation CorrectAnswer-AAns.is'a'i.e.,ApoptosisoAnnexinVassaysprovidessimpleandeffectivemethodtodetectapoptosisataveryearlystage.oThisassaymakesadvantageofthefactthatphosphatidylserine(PS)istranslocatedfromtheinner(cytoplasmic)leafletoftheplasmamembranetotheouter(cellsurface)leafletsoonaftertheinductionofapoptosisandthattheannexinVproteinhasstrongspecificaffinityforphosphatidylserine.oPhosphatidylserineontheouterleafletisavailabletobindlabelledannexinVprovidingthebasisforasimplestainingassay.oAlloftheannexinproteinssharethepropertyofbindingcalciumandphospholipids.oAnnexinVisacauseofsyndromecalledantiphospholipidantibodysyndrome.oAnnexinVnormallyformsashieldaroundcertainphospholipidmoleculesthatblockstheirentryintocoagulation(clotting)reactions.oIntheantiphospholipidantibodysyndrome;theformationoftheshieldisdisruptedbytheabnormalantibodies.Withouttheshield,thereisanincreasedquantityofphospholipidmoleculesoncellmembranesspeedingupcoagulationreactionsandcausingtheabnormalbloodclottingcharacteristicofantiphospholipidantibodysyndrome.
42.Dystrophiccalcificationisseenin? a)Milkalkalisyndrome b)Atheromatousplaque c)Hyperparathyroidism d)VitaminAintoxication CorrectAnswer-BAns.is'b'i.e.,AtheromatousplaqueDystrophiccalcification*Whenpathologicalcalcificationtakesplaceindead,dyingordegeneratedtissue,itiscalleddystrophiccalcification.oCalciummetabolismisnotalteredandserumcalciumlevelisnormal. Dystrophiccalcificationin Dystrophiccalcificationin deadtissues degeneratedtissues 1.Incaseousnecrosisof 1. Atheromatousplague tuberculosis 2. Monkeberg'ssclerosis (mostcommonwhichmaybe 3. Psommamabodies inlymphnodes) 4. Densoldscars 2.Chronicabscessin 5. Seniledegenratedchangessuch liquifactivenecrosis asincostalcartilage,tracheal, 3.Fungalgranuloma bronchialrings,Pinealglandin 4.Infarct brain. 5.Thrombi 6. Heartvalvesdamagedby 6.Haematomas rheumaticfever. 7.Deadparasites-Cystecercosis/ToxoplasmaHydatid/Schistosoma8.Infatnecrosisofbreast&othertissues
Howdoescalcificationoccursinthesesitewithnormalserumcalcium?*Calcificationofdeadanddyingcellsandtissuesisacommonfindinginhumanpathologicconditions.*Denaturedproteinsindeadorirreversibledamagedtissuespreferentiallybindphosphateions.*Phosphateionsreactwithcalciumionstoformaprecipitateorcalciumphosphate.*Thus,necrotictissueservesasacalciumsink.
43.Calcificationofsofttissueswithoutany distrubanceofcalciummetabolismiscalled- a)Ionotrophiccalcification b)Monotrophiccalcification c)Dystrophiccalcification d)Calciuminducedcalcification CorrectAnswer-CAns.is'c'i.e.,Dystrophiccalcification
44.Trueaboutgastriclymphoma- a)NonHodgkinslymphomacommonestvariety b)Diagnosisismadebybiopsy c)H-Pylorihasdirectrelationship d)All CorrectAnswer-DAns.is'a'i.e.,NonHodgkinslymphomacommonestvariety;'b'i.e.,Diagnosisismadebybiopsy;`c'i.e.,H-PylorihasdirectrelationshipGastriclymphomaThestomachisthemostcommonsiteforextranodallymphoma.oNearlyallgastriclymphomasareB-celllymphomasofmucosa-associatedlymphoidtissue(MALTlymphoma)oMajorityofcases(80%)areassociatedwithchronicgastritisandH.Pyloriinfection.oThemoststrikingevidencelinkingH.PylorigastritistoMALTomaisthateradicationofinfectionbyantibioticsinducesdurableremissionwithlowrateofrecurrence.oGastriclymphomarepresents5%ofallgastricmalignancies.Itismostprevalentissixthdecadeoflife.oLikeothertumorsofmatureBcells,MALTomasexpressB-cellmarkersCD19andCD20.TheydonotexpressCD5,CD10andCD23.oDiagnosisismadebyendoscopicbiopsy.oGastriclymphomasarechemosensitiveandchemotherapyaloneoralongwithsurgeryisusedforthetreatmentofgastriclymphoma.Aboutoption'a'oMostcommonvarietyofgastriclymphomaisNHL(MALToma).Veryrarely,Hodgkin'slymphomamayalsooccurinstomach.
45.MostcommonsiteofGISTis- a)Ileum b)Esophagus c)Colon d)Stomach CorrectAnswer-DAns.is'd'i.e.,Stomach ? 50- Stomach --> 70% ?Small 20- intestine --> 30% Colon& 5- rectum -3 15% Esophagus ---> <5%
46.Whichofthefollowingmarkersisspecific forgastro-intestinalstomaltumor(GIST)- a)CD117 b)CD34 c)CD23 d)S-100 CorrectAnswer-AAns.is'a'i.e.,CD117lmmunohistochemistryoFollowingmarkersarepresentinGISTs:i)CD117(ckit)-->95%ii)CD34-->70%iii)Smoothmuscleactin5%CD117(ckit)isconsideredthemostspecificmarkeroCD117(ckit)immunoreactivityisthebestdefiningfeatureofGISTsdistinguishingthemfromtruesmoothmuscletumors(leiomyoma)andtumorsarisingfromneuralcrest.oAlthoughCD117(ckit)isconsideredthemostspecificmarkerforGIST,itisnotpathognomonicofGISTasothertumorsmayalsoexpressCD117.Thesetumorsincludemastcelltumor,germcelltumors(seminomas),leukemias,malignantmelanoma,angiolipomas,andsomesarcomas.
47.
AganglionicsegmentisencounteredinwhichpartofcolonincaseofHirschsprungdisease? a)Distaltodilatedsegment b)InWholecolon c)Proximaltodilatedsegment d)Inthedilatedsegment CorrectAnswer-AAns.is'a'i.e.,DistaltodilatedsegmentCongenitalaganglionicmegcolon(Hirschsprungdisease)oHirshsprungdiseaseacongenitaldisordercharacterizedbyaganglionosisofaportionoftheintestinaltract.oAnintestinalsegmentlacksbothMeissnersubmucosalandAuerbachmyentericplexuses.ThisleadstofunctionalobstructionandintestinaldilationProximaltotheaffectedsegment.oHistologicalfindingsare:-(i)Absenceofganglioncellsandgangliainthemusclewallandsubmucosaoftheaffectedsegment.(ii)Thickeningandhypertrophyofnervetrunk.oRectumisalwaysaffectedwithinvolvementofmoreproximalcolontovariableextent-->mostcasesinvolvetherectumandsigmoidonly.oProximaltotheaganglionicsegment,thecolonundergoesprogressivedilationandhypertrophy.oWithtime,theproximalinnervatedcolonmaybecomemassivelydistended-->megacolon.
48.Multipleepidermoidcystsareseenin- a)Turcot'ssyndrome b)Gardner'ssyndrome c)Peutz-Jeghersyndrome d)Familialpolyposiscoli CorrectAnswer-BAns.is'b'i.e.,Gardner'ssyndromeoGardnersyndromeincludesadenomatouspolypsofthegastrointestinaltract,desmoidtumours,osteomas,epidermoidcysts,lipomas,dentalabnormalitiesandperiampullarycarcinomas.
49.FeaturesofPeutz-Jegherssyndromeare allexcept? a)Autosomaldominant b)Mucocutaneouspigmentation c)Hamartomatouspolyp d)Highriskofmalignacy CorrectAnswer-DAns.is'd'i.e.,HighriskofmalignacyoMalignancyisrareinharmartomatouspolypsofPeutz-Jegherssyndrome.Otherthreeoptionsarecorrect(seepreviousexplanation).
50.Thefeaturesofcrohnsdiseaseareall except? a)Lymphoidhyperplasia b)Skinlesion c)Transmuralinvolvement d)CryptAbscess CorrectAnswer-AAns.is'a'i.e.,LymphoidhyperplasiaIntermittentmilddiarrhea,fever,abdominalpain(MC)Rightlowerquadrantmass,weightloss,anemiaSometimesmimicsappendicitisorbowelperforationAnalcomplaints(fissure,fistula,abscess)?frequentFat/vitaminmalabsorptionpresentRecurrenceaftersurgerycommonMalignancy(mostcommoncause)+withcoloninvolvementStringsignofKantorisseeninCrohn'sDisease.CreepingfatisafeatureofCrohn'sDisease.
51.Femaleisaffected,maleisnot.Diseaseis autosomaldominant,whatisthechanceinchildren? a)50%affected b)25%affected c)75%affected d)Allaffected CorrectAnswer-AAns.is'a'i.e.,50%AffectedIfoneoftheparent(motherorfather)isaffectedinautosomaldominantdisorder,everychildhas50%ofchanceofhavingthediseaseand50%ofchancenothavingthedisease.
52.Chanceofhavingcysticfibrosisifonly oneparentisaffectedandotherisnormal- a)25% b)50% c)70% d)80% CorrectAnswer-BAns.is'b'i.e.,50%Cysticfibrosisisanautosomalrecessivedisorder.Thus,inthegivenscenorio(question)therearetwopossibilities:-1)Oneparentaffectedandtheotherisgenotypicallynormal.Inthiscondition,nochildwillbeaffectedandallwillbecarrier.2)Oneparentaffectedandtheotherisgenotypicallycarrier(normalphenotypically).Inthiscondition,50%ofchildwillbeaffected
53.TruestatementaboutinheritenceofanX linkedrecessivetraitis- a)50%ofboysofcarriermotherareaffected b)50%ofgirlsofdiseasedfatherarecarrier c)Fathertransmitsdiseasetotheson d)Mothertransmitsthediseasetothedaughter CorrectAnswer-AAns.is'a'i.e.,50%ofboysofcarriermotherareaffectedallX-linkeddisordersareX-linkedrecessive.AsmalehasonlyoneX-chromosome,themalewithaffectedgeneonX-chromosomewillalwaysmanifestthedisease.Ontheotherhand,femalehas2X-chromosomes,heterozyogousfemalewillbecarrierbecauseofexpressionofnormalallelontheotherX-chromosome.50%boysofthecarriermotherwillbeaffected.FatherwillnottransmittthediseasetosonasboysdonotinheritX-chromosomefromfather.
54.Normalfemale,whosefatherwascolor blindmarriedanormalman.Whatarethechancesofcolorblindnessinson- a)25% b)50% c)75% d)Nochance CorrectAnswer-BAns.is'b'i.e.,50%*Fatherofthefemalewascolorblind;thatmeansshehasreceivedmutatedX-chromosomefromherfatherandsheiscarrierforcolourblindness.Ifthisfemalegivesbirthtoamalechildthereis50%chancethathewillgetthediseasebecausethecarrierfemaleiscarryingonenormalX-chromosomeandonemutatedX-chromosome.Note?*HereIwouldliketomentiononeimportantfactthatthisquestionhasbeenaskedspecificallyforthechancesofdiseaseinason.Thequestioncanbeframedinfollowingdifferentways.i)Howmanychildrenwillhavethedisease.ii)Whatarethechancesofsongettingthedisease.iii)Whatarethechancesofdaughtergettingthedisease.iv)Howmanysonwillhavethedisease.*Thus:?i)25%ofchildrenwillhavedisease.ii)50%ofson(1outof2)willhavedisease.iii)Nodaughterwillhavedisease.
iv)Chancesthatsonwillhavediseaseis50%(1outof2malechildcangetthedisease).
55.Theinheritancepatternoffamilial Retinoblastomasis- a)Autosomalrecessive b)Autosomaldominant c)X-linkeddominant d)X-linkedrecessive CorrectAnswer-BAns.is'b'i.e.,AutosomaldominantHuntingtondiseaseNeurofibro-matosisMyotonicdys-trohyTuberousscle-rosisRetinoblastoma
56.Maletomaletransmissionisseenin- a)Autosomaldominantdiseases b)Autosomalrecessive c)X-linkeddominant d)Mitochondrialdisease CorrectAnswer-AAns.is'a'i.e.,AutosomaldominantdiseaseXchromosomeisnottransmittedfromfathertoson(optioncisexcluded)andmitochondrialdisordersarealwaysmaternallyinherited(optiondisexcluded).Autosomalrecessivedisordercanbetransmittedfromfathertoson,butonlyifthemotherisalsoaffectedoratleastsheiscarrier.Ifonlymaleisaffected,autosomalrecessivedisordercannotbetransmittedtoson.Autosomaldominantdisordercanbetransmittedinanydirection:-Fromfathertosonordaughter.Frommothertosonordaughter.
57.Singlegenedisorderwhichdoesnot followmendelianinheritance- a)Sicklecellanemia b)Downsyndrome c)FragileX-syndrome d)Retinoblastoma CorrectAnswer-CAns.is'c'i.e.,FragileX-Synd.Transmissionofcertainsingle-genedisordersdoesnotfollowclassicalmendelianprinciples.Thisgroupofdisordercanbeclassifiedintofollowingcategories? 1. Diseasescausedbytriplet-repeatmutation,e.g.fragile-X syndrome,Huntingtondisease,&others. 2. Disorderscausedbymutationinmitochondrialgenes,e.g.laber heriditaryopticneuropathy. 3. Disorderassociatedwithgenomicimprinting.4. Disordersassociatedwithgonadalmosaicism.
58.Transportoflipidsfromtheintestineto othertissuesisby- a)Chylomicrons b)LDL c)HDL d)VIDL CorrectAnswer-AAns.is'a'i.e.,ChylomicronsTransportoflipidsoTherearetwopathwaysoflipidtransportinthebody?1.Transportofdietrylipid(Exogenouspathway)*Itisthetransportof1ipid.fromintestinetoliver.-Chylomicronstransportthedietrylipidfromintestinetoliver.*InDietthemajorlipidsaretriglycerideandAolesterol.*Cholesterolisabsorbedassuchinproximalsmallintestineandisesterifiedtocholesterylester(ChE).oTriglyceridesarehydrolysedbylipasestoglycerolandfattyacidswhichareabsorbedinintestine.oInsideintestinalcellstriglycerideissynthesizedbyfattyacids.-Chylomicronsaresynthesizedinthesmallintestinethatcontaintriglyceride,cholesterylester,cholesterol,phospholipidsandapoproteinB-48(apoB-48).*Thesechylomicronsaresecretedintheintestinallymphandreachthesystemiccirculationviathoracicduct.-InthecirculationApoEandApoCaretransferedtochylomicronesbyHDL,sonowchylomicronscontainApoB-48,ApoE,&ApoC.*Inthecirculation,Triglyceridesofchylomicronesarehydrolysed
bylipoproteinlipase(LPL)presentonendothelialcellsofvesselsofskeletalmuscles,adiposetissueandheart.*Thereleasedfattyacidsareutilizedlocallybythesetissues.*ThechilomicronparticleprogressivelyshrinksinsizebyactionofLPLand,cholesterol,phospholipidsandapoCaretransferredtoHDL,creatingchylomicronremnantsthatcontainsmorecholesterol,lesstriglycerides,apoE&apoB-48.*ChylomicronremnantsareremovedbyliverbytheLDLreceptorsthatrequireapoEasligand.Note-ApoC-II,thatistransferedfromHDLtochylomicronsactasacofactorforlipoproteinlipase.ApoA-VpromotesLPLmediatedtriglyceridelipolysisinVLDLandchilomicrons.2.TransportofHepaticlipids(Endogenouspathway)*VLDLissynthesizedinliverthatcontainshightriglyceride,ChE,cholesterol,phospholipidandApoB-100.*(VLDLparticlesresembelchylomicronesincompositionexceptthatVLDLcontainsApoB-100insteadofApoB-48).*VLDLparticlesaresecretedintheplasmaandaswithchylomicron,ApoEandApoCaretransferredfromHDLtoVLDL.NowVLDLcontainsApoB-100,ApoEandApoC.*Inplasma,triglyceridesofVLDLarehydrolysedbysamelipoproteinlipase(seeabove)andapoCistransferredtoHDLandtheremmantsarecalledIDL.*40-60%ofIDLisremovedbyliverviaLDLreceptormediatedendocytosis,thisprocessrequireApoEwhichactsasligandforLDLreceptors.*Remaining1DLisremodeledbyhepaticlipasetoformLDLthatcontainsmaximumcholesterol.*70%ofLDLisremovedbyliverviaLDLreceptorand30%isutilizedbyperipheraltissuesasasourceofcholesterol.
59.WhichisnotafeatureofDownssyndrome a)Clinodactyly b)Pigmentedbirthmarks c)Hypotonia d)RespiratorytractInfections CorrectAnswer-BAns.is'b'i.e.,PigmentedbirthmarksOtherclinicalfeaturesinclude:?1)General:-Mentalretardation,shortstature2)Cranio-facialBrachycephaly,epicanthicfold,protrudingtongue,smallears,upwardslopingpalpebralfissures(Mongoloidslant),strabismus,nystagmus,Brushfiedspotsiniris.3)Limbs:-Fifthfingerclinodactyly,singlepalmarcrease(simiancrease),widegapbetweenfirstandsecondtoes(sandlegap).4)Congenitalheartdisease:-CommonAVcanal,ASD(mostcommon),VSD,PDA,fallottetralogy.5)GIT:-Analatresia,Duodenalatresia,Hirschsprungdisease,annularpancreas.6)Increasedincidenceofleukemia(1%).LeukemiascommonareALL(mostcommon),AML(M7-AML)transientmyeloproliferativedisorders,andJuvenilCML.
60.Followinginjurytoabloodvessel, immediatehaemostasisisachievedby- a)Fibrindeposition b)Vasoconstriction c)Plateletadhesion d)Thrombosis CorrectAnswer-BAns.is'b'i.e.,VasoconstrictionHemostasis*Hemostasisisaphysiologicalprocesswherebybleedingishalted,thusprotectingtheintegrityofthevascularsystemaftertissueinjury.*Itisresponsibleforminimizingbloodloss.*Itiscommonlyreferredtoasstoppageofbleeding.Thehemostaticmechanismshaveseveralfunctions:?*l.Maintainbloodinfluidstatewhilecirculatingwithinthevascularsystem.*Arrestbleedingatthesiteofinjurybyformationofhemostaticplug.*Ensuretheremovalofhemostaticplugwhenhealingiscomplete.Thecomponentsofnormalhemostasisinclude:?-Bloodvessels(endothelium)-Platelets-Plasmacoagulationfactorsandtheirinhibitors.-Fibrinolyticsystem.Whenabloodvesselisinjured,severalstepsoccurinhemostasisatthesiteofinjury:?Vasoconstriction*Afterinitialinjury,thereisabriefperiodarteriolarvasoconstriction,minimizingvesseldiameterandslowingbleeding.
*Thisisduetoreflexneurogenicmechanismandaugmentedbyapotentendotheliumderivedvasoconstrictorendothelin.*Howeverthiseffectistransient,bleedingwouldresumeiftherewillnoactivationofplateletandcoagulationsystem.Primaryhemostasis*Endothelialinjuryexposeshighlythrombogenicsubendothelialextracellularmatrixtobind(adhere)withcollegenofECM.*Bindingofplateletsactivatesthesecellsandplateletsreleasesecretorygranules.*Thesesecretoryproducts(fromsecretorygranules)recruiteadditionalplateletsto(plateletplug).C.Secondaryhemostasis*Coagulationsystemisactivatedandthrombinisgenerated.*Thrombinconvertsfibrinogentofibrin.*Ultimatelytheseeventsformsanireversiblyfusedmassofplatelets,thrombinRBCsandfibrinogen-->Definitivesecondaryhemostaticplug.D.Repairofvesselsanddissolutionofclot*Theclotattractsandstimulatesthegrowthoffibroblastandsmoothmusclecellswithinthevesselwall,andbeginsrepairprocess.*Atthisstagefibrinolyticsystemisalsoactivated,resultingindissolutionoftheclot.
61.LinesofZahnoccurin- a)Postmortemclot b)Infarct c)Embolus d)Corallinethrombus CorrectAnswer-DAns.is'd'i.e.,CorallinethrombusItisseeninPrimaryplateletthrombi.
62.Anemiawithreticulocytosisisseenin- a)Hemolysis b)Irondeficiencyanemia c)VitaminB12deficiency d)Aplasticanemia CorrectAnswer-AAns.is'a'i.e.,HemolysisConditionsAcutebloodlossorhemorrhagePostsplenectomyMicroangiopathicanemiaAutoimmunehemolyticanemiaHemoglobulinopathy(Sicklecellanemiaandthalassemia)Postanemiatreatmentlikefolatesupplementation,ironsupplementation&vitaminB12,supplementation
63.Intravascularhemolysisoccursin- a)Hereditaryspherocytosis b)AcuteG6PD c)Sicklecellds d)bandc CorrectAnswer-DAns.is'b'i.e.,AcuteG6PD;'c'i.e.,SicklecelldisExtravascularhemolysisHereditaryspherocytosisThalassemiaSicklecellanemiaAutoimmunehemolyticanemia3DruginducedimmunehemolyticanemiaG-6-PDdeficiencyIntravascularhemolysisParoxysmalnocturnalhemoglobinuriaoG-6-PDdeficiencyClostridialtoxinFalciparummalariaMechanicalinjurytoredcellsDefectivecardiacvalvesThrombininmicrocirculationSicklecellanemia(minor)Note:-InG-6-PDdeficiencybothextravascularandintravascularhemolysisoccur.InSicklecellanemia,usuallythereisextravascularhemolysisbutintravascularhemolysiscanalsooccur.
64.Maximumspherocytesisseenin- a)Autoimmunehaemolyticanemia b)VitB12deficiency c)Aplasticanemia d)None CorrectAnswer-AAns.is'a'i.e.,AutoimmunehemolyticanemiaMostcommoncauseofspherocytesisimmunehemolyticanemia.
65.Theprimarydefectwhichleadstosickle cellanemiais- a)Anabnormalityinporphyrinpartofhemoglobin b)Replacementofglutamatebyvalineinn-chainofHbA c)AnonsencemutationintheI3-chainofHbA d)Substitutionofvalinebyglutamateinthea-chainofHbA CorrectAnswer-BAns.is'b'i.e.,Replacementofglutamatebyvalinein13chainofHBASicklecellanemiaSicklecellanemiaisahereditaryhemoglobinopathy,i.e.,thetypeofdiseasecharacterizedbyproductionofdefectivehemoglobin.Sicklecellanemiaresultsfrommutationin13-globingene.Itiscausedbyapointmutationatthesixthpositionofthef3-globinchainleadingtosubsitutionofavalineresidueforaglutamicacidresidueresultinginsicklehemoglobin(HbS).Sicklecellanemiaisanautosomalrecessivedisorder.oIfanindividualishomozygousforthesicklecellmutation,almostallthehemoglobinintheredcellisHbS.oInheterozyogotes,onlyabout40%ofthehemoglobinisHbS,theremainderbeingnormalhemoglobins.
66.Whichisnotafeatureofparoxysmal nocturnalhemoglobinuria- a)IncreasedLAPscore b)Thrombosis c)Thrombocytopenia d)Hemolysis CorrectAnswer-AAns.is'a'i.e.,IncreasedLAPscoreClinicalfeaturesofPNHA.Intravascularhemolysis*ThemainfeatureofPNHisincreasedintravascularhemolysisthatresultsin-HemoglobinemiaIncreasedurineurobilinogenHemoglobinuriaDecreasedserumhaptoglobinHemosiderinuriaIncreasedserumLDHIncreasedserumbilirubinThehemolysisisparoxysmalandusuallyoccursinthenightbecauseduringsleepthepHofbloodgetsslightlyreducedandacidicmediumleadstoactivationofthecomplement.B.ThrombosisInPNHthereisepsodicthrombosisduetoabsenceofCD-59onplatelets,thisresultsinexternilizationofphosphotidylserine,asiteforprothrombinasecomplexesandthusincreasethepropensityforthrombosis.*IntrabdominalveinsarethemostcommonsitesofthrombosisthatmayresultinBuddchiarysyndromeduetohepaticveinthrombosis.
C.OtherfeaturesThrombocytopeniaGranulocytopenia*DecreasedLAPscore*Normoblastichyperplasiaofbonemarrow*PNHpatientsarealsoatincreasedriskfordevelopingacutemyelogenousleukemiaandaplasticanemia.
67.Coldagglutininis- a)IgG b)IgM c)IgA d)IgD CorrectAnswer-BAns.is'b'i.e.,IgMColdagglutininhemolyticanemiaThisformofhemolyticanemiaiscausedbycoldagglutininIgMantibodies.AntibodiesreactwithRBCat0?to4?C.Bothintravascularandextravascularhemolysismayoccur.IgMantibodybindtoRBCandfixcomplementonRBCbeforecomplementmediatedhemolysisoccur.ThistransientreactionwithIgMdepositC3bonRBC.C3bactsasanopsoninisthatenhancesthephagocytosisofRBCsinmononuclearphagocyticsystemofliverandspleenextravascularhemolysis.HoweverifIgMremainsattachedtoRBC,sustainedactivationofcomplementresultsinformationoflargeamountofmembrane-attackcomplexthatdestroysRBCdirectly-->Intravascularhemolysis.Causesofcoldagglutininimmunohemolyticanemia:-Mycoplasmainfection,IMN,CMV,Influenza,HIV,Malignantlymphoma
68.Responsetoironinirondeficiency anemiaisdenotedby- a)Restorationofenzymes b)Reticulocytosis c)Increaseinironbindingcapacity d)Increaseinhemoglobin CorrectAnswer-BAns.is'b'i.e.,ReticulocytosisResponsetoirontherapyoWhenspecificirontherapyisgiven,patientsoftenshowrapidsubjectiveimprovement,withdisappearanceormarkeddiminutionoffatigue,lassitude,andothernon-specificsymptoms.Thisresponsemayoccurbeforeanyimprovmentinanemiaisobserved.Theearliesthematologicalevidenceofrecoveryisincreasereticulocytesandtheirhemoglobincontent.Thereticulocytesattainamaximalvalueonthe5thto10thdayafterinstitutionoftherapyandthereaftergraduallyreturntonormal.Thereticulocyteresponsemaynotbedetectableinmildirondeficiencyanemia.Thebloodhemoglobinlevelisthemostaccuratemeasureofthedegreeofanemiainirondeficiencyanemia.Duringtheresponsetotherapy,theredcellcountmayincreasetemporarilytovaluesabovenormal,butthehemoglobinvaluelagsbehind.Theredcellindicesmayremainabnormalforsometimeafterthenormalhemoglobinlevelisrestored.Asrecoveryoccurs,anormocyticcellpopulationgraduallyreplacesthemicrocyticpopulation;andoneoftheearlysignsofresponsetotherapyisanincreaseinRBWfrompretreatmentlevel.Whentreatmentisfullyeffective,hemoglobinreachesnormallevels
by2monthsaftertherapyisinitiated,regardlessofstartingvalues.Oftheepitheliallesionsinirondeficiency,thoseaffectingthetongueandnailsarethemostresponsivetotreatment.
69.Megaloblasticanemiaisseenin? a)ilealresection b)Crohn'sdisease c)Intestinallymphaticectasia d)aandb CorrectAnswer-DAns.is'a'i.e.,ilealresection'b'i.e.,Crohn'sdisease 1. Crohn'sdiseaseisatypeof ilitis. 2. Chronicpancreatitisisamalabsorptionstate. "About40%ofpatientswithchronicpancreatitishavevitaminB12malabsorption"
70.Theanaemiaassociatedwithleukaemiais ? a)Irondeficiency b)Megaloblastictype c)Myelophthisictype d)Allofabove CorrectAnswer-CAns.is'c'i.e.,MyelophthisistypeMyelophthisicanemiaSpace-occupyinglesionsthatdestroysignificantamountofbonemarrowordisturbthemarrowarchitecture,depressitsproductivecapacity.Thisformofanemiaisreferredtoasmyelophthisicanemia.Characteristically,immatureerythroidandmyeloidprogenitorsappearsintheperipheralblood-->Leukoerythroblastosis.CausesareMetastaticcancer(M.C.cause)Granulomatousdiseaseinfiltratingbonemarrow.Myeloproliferativedisorders(suchasmyeloidleukemia)Myelofibrosis
71.Schistocyteis/arefoundin- a)TTP b)DIC c)Severeirondeficiency d)All CorrectAnswer-DAns.isallSchistocytesAschistocyteisdefinedasanirregularlyshapederythrocytefragmentcausedbymechanicaltraumaoranintrinsicabnormalityoferythrocytes.Schistocytes:MechanismsandDiseasesShearingbyfibrinstrands:MicroangiopathichemolyticanemiaDisseminatedintravascularcoagulationHemangiosarcomaoGlomerulonephritisoMyelofibrosisHemolyticuremicsyndromeHyperspleenismTurbulentbloodflowCongestiveheartfailureoValvularstenosisCavalsyndromeinheartwormdiseaseHemangiosarcomaIntrinsicabnormalitiesChronicdoxorubicintoxicosisevereirondeficiencyanemiaPyruvatekinasedeficiencyCongenitalandacquireddyserythropoiesisMicroangiopathichemolyticanemiacanoccurin:-oExternalimpact:MarchhemoglobinuriaCardiachemolysis:Prostheticcardiacvalves
Fibrindepositinmicrovasculature:TTP,DIC,HUS
72.Helmetcellsarecharacteristicofanemia of? a)Hemolyticuremicsyndrome b)Polysplenia c)Spherocytosis d)Acanthocytosis CorrectAnswer-AAns.is'a'i.e.,HemolyticuremicsyndromeSchistocytes,helmentcells,trianglecells,burrcellsareseeninmicroangiopathichemolyticanemia(MAHA).Changesinerythrocytemorphology
73.Gammagandybodiesareseeninall except? a)Cirrhosiswithportalhypertension b)Chronicmyeloidleukemia c)Sicklecellanemia d)Thalassemia CorrectAnswer-DAns.is'd'i.e.,ThalassemiaGandy-Gammabodiesarefocioffibrosiscontainingironandcalciumsaltsdepositsonconnectivetissueandelasticfibres.Gandy-Gammabodiesareseenincongestivesplenomegalye.g.,insicklecellanemia,CMLandlivercirrhosis.
74.Increasedpermeabilityinacute inflammationisdueto- a)Histamine b)IL-2 c)TGF-P d)FGF CorrectAnswer-AAns.is'a'i.e.,Histamine*Formationofendothelialgapsinvenules,i.e.immediatetransientresponseisthemostcommonmechanismcausingincreasedvascularpermeabilityinacuteinflammation.*Mediatorsinvolvedinthismechanismare:-i)Immediate(moreimportant):Histamine,bradykinin,leukotrienes,neuropeptidesubstanceP.Somewhatdelayed:IL-1,TNF,IFN-y
75.whichofthefollowingdoesnotbelongto thefamilyofselectin? a)Pselectin b)Lselectin c)Aselectin d)Eselectin CorrectAnswer-CAns.is'c'i.e.,AselectinLeukocyteandendothelialadhesionmoleculesLeukocyteadhesionandtransmigrationareregulatedlargelybybindingofcomplementaryadhesionmoleculesontheleukocyte&endothelialsurface,andbychemicalmediators.Cytokinesaffecttheseprocessesbymodulatingtheexpressionofadhesionmoleculessothatleukocytescanfirmlyadheretoendothelium.Therearefourmolecularfamiliesofadhesionreceptors.1.SelectinSelectinsfunctioninthecelltocellinteractioni.e.,adhesionofleukocytestotheendothelium.E-selectin(CD-62E)ispresentonendothelialcellsanditbindstosialyl-lewis.(asialylatedformofoligosaccharideonleukocytes).EndothelialcellexpressionofE-selectionisahallmarkofacutecytokine-mediatedinflammation.P-selectin(CD-62P)ispresentonendotheliumandplateletsanditbindstosialyl-Lewisonleukocytes.L-selectin(CD-62L)ispresentonleukocytesanditbindstomucin-likeglycoproteinG1yCAM-Iontheendothelium.2.Immunoglobulinfamily
PresentonendotheliumICAM-1(intracellularadhesionmolecule-1)bindsto132-integrins(VLA-4)ofleukocytes.Plateletendothelialcelladhesionmolecule(PECAMorCD-31)ispresentonbothendotheliumandleukocytes.Itisthemajoradhesivemoleculefordiapedesis.3.IntegrinsIntegrinspromotecell-cellorcell-matrixinteraction(incontrasttoselectinsthatpromoteonlycell-cellinteraction)i.e.,integrinshelpinadhesionofleukocytestoendotheliumandadhesionofleukocytestoanextracellularmatrixsuchasfibronectin,vitronectin,activatedcompliment.Presentonleukocytesintegrins(VLA-4)bindtoVCAM-1oftheendothelium.P2-integrins(LFA-1andMAC-1)bindtoICAM-1oftheendothelium.4.MucinlikeglycoproteinTheseglycoproteinsarepresentintheextracellularmatrixandonthecellsurface.AnexampleisHeparansulfate,thatservesasaligandfortheleukocyteadhesionmoleculeCD-44.
76.Cell-matrixadhesionsaremediatedby? a)Cadherins b)Integrins c)Selectins d)Calmodulin CorrectAnswer-BAns.is'b'i.e.,IntegrinsCell-matrixadhesions,areusuallymediatedbyintergrinsCell-celladhesionsinAnchoringjunctionsaremediatedbycadherins.
77.Allaretrueregardingtransforminggrowth factor?pexcept- a)Proliferationforfibroblast b)Proliferationofendothelialcells c)Chemotaxisoffibroblasts d)Activationofmacrophages CorrectAnswer-DAns.is`d'i.e.,ActivationofmacrophagesAlsoseeaboveexplanation.GrowthfactorsandcytokinesinvolvedinregenerationandwoundhealingGrowthfactorEpidermalgrowthaTransforminggrowthfactora Heparin-bindingEGF Hepatocytegrowthfactor/scatterfactorVascularendothelialcellgrowthfactor(isoformsA,B,C,D)Platelet-derivedgrowthfactor(isoformsA,B,C,D)Fibroblastgrowthfactor1(acidic),2(basic),andfamilyTransforminggrowthfactor13(isoforms1,2,3);othermembersofthefamilyareBMPsandactivinFunctionsMitogenickeratinocytesandfibroblasts;stimulateskeratinocytemigrationandgranulationtissueformationSimilartoEGF;stimulatesreplicationofhepatocytesandmostepithelialcellsKeratinocytereplicationEnhancesproliferationofhepatocytes,epithelialcells,andendothelialcells;increasescellmotility,keratinocytereplicationIncreasesvascularpermeability;mitogenicforendothelialcells;
Increasesvascularpermeability;mitogenicforendothelialcells;angiogenesisChemotacticforPMNs,macrophages,fibroblasts,andsmoothmusclecells;activatesPMNs,macrophagesandfibroblasts;mitogenicforfibroblasts,endothelialcells,andsmoothmusclecells;stimulatesproductionofMMPs,fibronectin,andHA;stimulatesangiogenesisandwoundcontractionChemotacticforfibroblasts;mitogenicforfibroblastsandkeratinocytes;stimulateskeratinocytemigration,angiogenesis,woundcontractionandmatrixdepositionChemotacticforPMNs,macrophages,lymphocytesfibroblastsandsmoothmusclecells;stimulatesTIMPsynthesis,angiogenesisandfibroplasia;inhibitsproductionofMMPsandkeratinocyteproliferationKeratinocytegrowthKaFibroblastsStimulateskeratinocytemigration,proliferationfactor(alsocalledanddifferentiationFGF-7)TumornecrosisfactorTNFMacrophagesmastcells,Activatesmacrophages;regulatesotherTlymphocytescytokines,multiplefunctions
78.Maximumcollageninwoundhealingis seenat- a)Endoffirstweek b)Endofsecondweek c)Endofthirdweek d)Endof2months CorrectAnswer-BAns.is'b'i.e.,EndofsecondweekDuringsecondweekthereiscontinuedaccumulationofcollagenandproliferationoffibroblast.Maximumcollagenisseeninsecondweek.
79.Chemotaxisismediatedby- a)Histamine b)LeukotrieneB4andC5a c)LeukotrieneC4andC3a d)Bradykinin CorrectAnswer-BAns.is'b'i.e.,LeukotrieneB4andC5aChemotaxisisunidirectionallocomotionofleukocytestowardsthesiteofinjury,orientedalongachemicalgradient.Thischemicalgradientiscreatedbysubstancescalledchemoattractants(chemotacticagents),whichmaybeexogenous(bacterialproducts)orendogenous(C5a,LTB-4,IL-I,TNF,IL-8).C5aisthemostpowerfulchemo-attractant(chemokine).
80.Followinginjectionoflymphokines,the sameclassofimmunoglobulinareproduced.Thisistobereferredas- a)Groupswitching b)Clonalselection c)Hybridisation d)Classswitching CorrectAnswer-BAns.is'b'i.e.,Clonalselection*B-cellsareabletomakeaspecificantibodyagainstaspecificantigen.*ItisduetopresentofspecificreceptoronB-cells-B-cellreceptor(BCR),thatisusuallyanimmunoglobulinIgMorIgD.*AnantigeninteractswithB-cellthatshowsbestfitbyvirtueofitsBCR.*Theantigenbindstothisreceptor,andtheB-cellisstimulatedtodivideandformaclone(clonalselection).*Thiscloneofcellswillbecomeplasmacellsthatwillsecretesantibodyofaparticularspecificityandsameclass.*Although,B-cellsarethemajorsourceofantibodies(aftertheirconversionintoplasmacells),Helper-Tcellsarealsoimportant.*HelperT-cellsactivateB-cellsbysecretingcytokines(lymphokines).oInantibodyformationT-cellsareinvolvedearlierthanB-cells. Antigenexposure AntigenpresentingcellspresentthisantigentohelperTcells Tcellsareactivated
SecretionoflymphokinebyT-cells B-cellsthatcarryBCRspecifictothatantigenare,stimulated(clonal selection) B-cellsproliferateanddifferentiateintoplasmacells Plasmacellssynthesizeanimmunoglobulinofsamespecificityas thatcarriedbytheB-cellprecursors AlsoknowClassswitching*Isotypeorclassswitchingisabiologicalprocessthatchangesanantibodyfromoneclasstoanother.ForexamplefromIgM(inprimaryresponse)toIgG(insecondaryresponse).
81.MostpotentstimulatorofNaiveT-cells- a)Maturedentriticcells b)Folliculardentriticcells c)Macrophages d)B-cell CorrectAnswer-AMatureDendriticcellsMatureB-cellsandT-cellsbeforeantigenicexposurearecallednaive-BandTcellsrespectively.SequenceofeventsinactivationofnaiveTcells.Immaturedendriticcellsintheepidermisarecalledlangerhanscell.Theseimmaturedendriticcells(langerhanscells)capturetheantigenintheepidermis.Aftercapturingtheantigenthesecellssecretecytokines.Thesecytokinescauselossofadhesivenessoflangerhanscells.Langerhanscellsseparatefromeachotherandmigrateintolymphaticvessels.Inlymphaticvessel,maturationoflangerhanscellstakesplace.ThenthesematurelangerhansdendriticcellsreachtonaiveTcellsinthelymphnodesandpresentantigentothesecellsandactivatethem.
82.TrueaboutMHC-classII- a)Notinvolvedininnateimmunity b)CytotoxicT-cellinvolved c)Presentinnucleatedcells d)All CorrectAnswer-AAns.is'a'i.e.,NOTinvolvedininnateimmunityoMHCIandIIarepartofadaptiveimmunity.AmajorfunctionoftheMHCmoleculeistopresenttheantigentoTcellthatispartofadaptiveimmunity.CytotoxicTcellsareMHC-classIrestricted.MHCclassIIcomplexisfoundonlyoncellsoftheimmunesystem(classIisfoundonallnucleatedcellsandplatelets.)TheantigensbindingwithMHCIImoleculearepresentedtoCD4+Tcells.Asdiscussedearlier,helperTcells/CD4TcellsareMHCII-restricted.BcellshavebothMHCclassIandIIcomplexes.
83.Commonvariable hypogammaglobulinemiashows? a)DecreasedBcellcount b)IncreasedBcellcount c)Complimentopsinization d)Neutropenia CorrectAnswer-CAns.is'c'i.e.,NormalBcellsMostpatientswithcommonvariableimmunodeficiencyhavenormalornear-normalnumbersofBcellsinthebloodandlymphoidtissues.TheseBcells,however,arenotabletodifferentiateintoplasmacells.Theclinicalmanifestationsarecausedbyantibodydeficiency.Thefeaturecommontoallpatientsishypogammaglobulinemia,generallyaffectingalltheantibodyclassesbutsometimesonlyIgG.
84.MajorfibrilproteininPrimaryAmyloidosis is- a)AL b)AA c)Transthyretin d)Procalcitonin CorrectAnswer-AAns.is'a'i.e.,ALClassificationofamyloidosisoTheamyloidcanbeclassifiedintofollowingtwobroadgroups?1.Systemic(generalised)amyloidosisWhenamyloidosisaffectsmorethanonebodyorganorsystem.Onclinicalgrounds,thesystemic(generalised)amyloidosisissubclassifiedinto?A.PrimaryPrimaryamyloidosisoccurswhenaspecializedcellinthebonemarrow(plasmacell)spontaneouslyproduceaparticularportion,(i.e.lightchain)ofantibodyAL(amyloidlightchain).Itisthemostcommontypeofamyloidosis.B.Secondary(Reactive)Whenamyloidosisoccursasaresultofunderlyingchronicinflammatoryprocess,i.e.AAtype.Othersystemicamyloidosesdonotfallineitherofthesecategories.
85.WhichtypeofAmyloidosisiscausedby mutationofthetransthyretinprotein? a)FamilialMediterraneanfever b)Familialamyloidoticpolyneuropathy c)Dialysisassociatedamyloidosis d)Prionproteinassociatedamyloidosis CorrectAnswer-BAns.is'b'i.e.,FamilialamyloidoticpolyneuropathyTransthyretin(TTR)isnormalserumproteinthatbindsandtransportthyroxineandretinol.TTRcancausefollowingtypesofamyloidosis:?MutantTTR:-MutationinTTRcancausesyndromeoffamilialamyloidoticpolyneuropathyorfamilialamylodoticcardiomyopathy.Wild(non-mutant)TTR:-ThereisnomutationofTTRandwildtypeTTRformsfibrilswhichresultsinsenilesystemicamyloidosis(senilecardiacamyloidosis).
86.Amyloidosisismostcommonlyseenin? a)MaturityonsetDM b)TypeIDM c)TypeIIDM d)HTN CorrectAnswer-CAns.is'c'i.e.,TypeIIDMThetwobestexamplesoflocalizedamyloidosisareAlzheimer'sdiseaseandtype2diabetesmellitus.Localizedamyloiddepositionresultsfromtheproductionofauniquepolypeptide,whichcontainsanamyloidogenicsequenceandiscapableofformingabeta-pleatedsheetstructurenecessaryforthesedepositstoaggregate.Intype2diabetesitistheisletamyloidpolypeptide(IAPP)alsoknownasamylin.InAlzheimer'stheuniquepeptideisthebeta-amyloidprotein(Abeta).
87.Serumamyloidassociatedprotein,found in? a)Alzheimer'sdisease b)Chronicinflammatorystates c)Chronicrenalfailure d)Malignanthypertension CorrectAnswer-BAns.is'b'i.e.,Chronicinflammatorystatesa)ChronicinflammatoryconditionslikeRA(mostcommon),TB&leprosy,osteomyelitis,ankylosingspondylitis,IBD(Crohn'sdisease,UC),bronchiectasis.SometumorslikeRenalcellcarcinoma(hypernephroma),Hodgkinslymphoma
88.Hamartomais- a)Malignanttumor b)Metastatictissue c)Developmentmalformation d)Hemorrhageinvessel CorrectAnswer-CAns.is'c'i.e.,DevelopmentmalformationHamartomaAhamartomaisabenign(noncancerous)tumor-likegrowthconsistingofadisorganizedmixtureofcellsandtissuesnormallyfoundintheareaofbodywherethegrowthoccurs.*Forexample,hamartomaoflungcontainscartilage,bloodvessels,bronchialtypeofstructuresandlymphoidtissues.*Itisafocaldevelopmentmalformationthatresemblesaneoplasminthetissueoforigin.*But,itisnotaneoplasmbecauseitgrowsatthesamerateasthesurroundingtissuesunlikeneoplasmwhosegrowthexceedsthegrowthofsurroundingtissue.Choristoma*Choristomaistheectopicrestofnormaltissue,i.e.,thenormaltissueispresentatadifferentanatomicalsiteofthebody.*Forexample,presenceofpancreatictissueinmucosaofsmallintestine.*Normallyarrangedtissueatadifferentanatomicalsite(ectopicsite)-->Choristoma.*Abnormallyarrangedtissuepresentatnormal
site-Hamartoma
89.Overgrowthofaskinstructureata localisedregion- a)Hamartoma b)Malignanttumor c)Choriostoma d)All CorrectAnswer-AAns.is'a'i.e.,HamartomaAberrantdifferentiationmayproduceamassofdisorganizedbutmaturespecializedcellsortissueindigenoustotheparticularsite,referredtoasahamartoma.Anectopicrestofnormaltissueiscalledachoristoma.egarestofadrenalcellsunderthekidneycapsule.Whenaneoplasm,benignormalignant,producesamacroscopicallyvisibleprojectionaboveamucosalsurfaceandprojects,itistermedapolyp.
90.Excessivefibrosisintumorincalled- a)Anaplasia b)Metaplasia c)Desmoplasia d)Dysplasia CorrectAnswer-CAns.is'c'i.e.,DesmoplasiaInsometumors,parenchymalcellsstimulatetheformationofanabundantcollagenousstroma,referredtoasdesmoplasia,egscirrhouscarcinomaofbreast.
91.Whenstemcellstransformstoformcells characteristicofothertissues,theprocessiscalledas- a)De-differentiation b)Re-differentiation c)Trans-differentiation d)Sub-differentiation CorrectAnswer-CAns.is'c'i.e.,Trans-differentiationTransdifferentiation*Transdifferentiationtakesplacewhenanon-stemcelltransformintoadifferenttypeofcell,orwhenanalreadydifferentiatedstemcellcreatescellsoutsideitsalreadyestabilisheddifferentiation.*Rememberveryimportantfactthatitisthenon-stemcelloralreadydifferentiatedstemcell(i.e.maturecell)thatistransformedintoothertypeofcell.Itisnotstemcellthatistransforming.*Transdifferentiationisatypeofmetaplasia.*Then,whatisthedifferencebetweentransdifferentiationandmetaplasia.*InTransdifferentiationonlydifferentiatedstemcellistransformedintoothercelltype,whileinmetaplasiaanyofthetwo,eitherstemcellordifferentiatedcellcantransformintoothercelltype.*So,alltransdifferentiationprocessesaremetaplasia,butnotallmetaplasiaaretransdifferentiation.oMostlikelyquestionhasbeenwronglyframedhere,thereshouldbenon-stemcellinsteadofstemcellinthequestion.Anywaysanswerremainsthesame,asnootheroptionisrelatedtothistypeoftransformation.
92.Carcinomaoflung,breastmarkeris- a)CEA b)AFP c)11CG d)CA-15-3 CorrectAnswer-AAns.is'a'i.e.,CEACarcinoembryonicantigenisamarkerincancerofcolon,pancreas,lung,breast,andovary.
93.AFPisraisedin- a)Yolksactumor b)Seminoma c)Teratoma d)aandc CorrectAnswer-DAns.is'a'i.e.,Yolksactumor;'c'i.e.,teratomaAFPisaglycoproteinsynthesizednormallyearlyinfetallifebyyolksac,fetalliverandfetalGIT.Itisstructurallyandgeneticallyrelatedtoalbumin.AFPisraisedinlivercancer(hepatocellularcarcinoma),lungcarcinoma,pancreaticcarcinoma,coloncarcinoma,andnonseminomagermcelltumoroftestis/ovary(yolksactumor/endodermalsinustumor,embryonalcarcinoma,teratoma).
94.ElevatedCA-125areseenin- a)AbdominalTB b)Cacervix c)Endometriosis d)All CorrectAnswer-DAns.is'a'i.e.,AbdominalTB;'b'i.e.,Cacervix;'c'i.e.,EndometriosisElevatedlevelofCA-125isseenin*EpithelialovarianCancer*Nonovariantumors:-Cancersofendometrium,cervix,fallopiantubes,pancreas,breast,lungandcolon.*Nonmalignantconditions:-Pregnancy,mensturation,peritonitis,endometriosis,pelvicinflammatorydisease(abdominalTB)anduterinefibroids.
95.ThetumorsuppressorgeneP53induces cellarrestat- a)Mphase b)S-G2phase c)G1-Sphase d)Go-phase CorrectAnswer-CAns.is'c'i.e.,G1-SphaseFactorsactingatG,Spointare:?Stimulatorofcycle:CyclinD-CDK4(phosphorylateRBgene);cyclinE-CDK-2.Inhibitorsofcycle:TheCip/kipfamily(p21,p27,p57);INK4a/ARFfamily(p16INK4a,p14ARF,p16,p17,p18,p19
96.Majorcontributiontocachexiawith advancedcancer? a)Clathrin b)Histamine c)Interferon d)Tumor-necrosis-factor(TNF) CorrectAnswer-DAns.is'd'i.e.,Turnor-necrosisfactor(TNF)Patientswithcancercommonlysufferprogressivelossofbodyfatwhichisaccompniedbyprofoundweaknessanorexia,andanemia.Thiswastingsyndromeisreferredtoascachexia.oTNFproducedbymacrophagesorsometumorcellsisthemostimportantmediatorofcachexia.
97. HemolyticUremicSyndromeis characterizedby? a)Microangiopathichaemolyticanaemia b)PositiveCoomb'stest c)Thrombocytopenia d)aandc CorrectAnswer-DAnsis'a'i.e.,Microangiopathichemolyticanemia;'c'i.e.,ThromhocytopeniaHemolyticuremicsyndrome*Hemolyticuremicsyndromeischaracterizedbythetriadof:-Anemia(microangiopathichemolyticanemia).-Renalfailure(microangiopathyofkidneyinvolvingglomerularcapillariesandarterioles).-Thrombocytopenia(duetoplateletconsumption).*Hemolyticuremicsyndromeismostcommonischildrenunder2yearsofage.*Itusuallyfollowsanepisodeofacutegastroenterities,oftentriggeredbyEcoli.*Theprodromeisusuallyofabdominalpain,diarrhoeaandvomiting.*Shortlythereafter,signsandsymptomsofacutehemolyticanemia,thrombocytopeniaandacuterenalfailureensue.oSometimesneurologicalfindingsalsooccur.(ButusuallyabsentanddifferentiateHUSfromTTP.)oRarelyHUSmayfollowrespiratorytractinfection.Etiology*Gastrointestinalinfectionininfantswiththefollowingorganism:
*Ecoli,Shigelladysenteriae,StreptococouuspneumoniaeHematologicalfindingsinacaseofmicroangiopathichemolyticanemia:*Presenceofschistocytes(fragmentedredcells).Thisisthehallmarkofmicroangiopathichemolyticanemia.oNeutrophilleukocytosis.*Thrombocytopenia.*Hemoglobinuriaismildtomoderatewithhemosiderinuria.*Bloodureaandserumcreatininelevelsarehigh.*PTandAPTTnormal.*ElevatedserumLDH
98.Allarefeaturesofhaemolyticuremic syndrome,except- a)Hyperkalemia b)Anaemia c)Renalmicrothrombi d)Neuropsychiatricdisturbances CorrectAnswer-DAns.is'd'i.e.,neuropsychiatricmanifestationsHyperkalemiaisseeninhemolyticurenicsyndromeasaresultofrenalfailure.ABOUTNEUROPSYCHIATRICMANIFESTATIONS*NeurologicalmanifestationsareusedtodistinguishbetweenHemolyticuremicsyndromeandThromboticThrombocytopenicPurpura.*H.U.S.isdistinguishedfromT.T.Pbytheabsenceofneurologicalsymptomsandtheprominenceofacuterenalfailure.*Recentstudies,howeverhavetendedtoblurrtheseclinicaldistinctions.Manyadultpatientswith"T.T.P.lackoneormoreofthefivecriteriaandpatientswith"HUS"havefeverandneurologicaldysfunction.
99.InDIC,followingareseenexcept- a)Fibrinogendecreased b)Thrombocytopenia c)NormalAPTT d)PTelevation CorrectAnswer-CAns.is'c'i.e.,NormalAPTT
100.ShelflifeofbloodwithCPDA- a)2weeks b)3weeks c)5weeks d)8weeks CorrectAnswer-CAns.is'c'i.e.,5weeks*Oncebloodisremovedfromthedonor,itstartsasequencesofinvitrochangesthatchangeitsphysiologicalproperties.*Ensuringthebloodanditsproductstransfusionsafe,theirstorageisamust.*Themainaimistominimizedamagetostoreblood.*Additionofsomeadditivesolutionsincreasestheviabilityofblood,particularlyRBCs:AdditiveShelflifeofRBCAcid-citrate-dextrose(ACD)21daysCitratephosphatedextrose(CPD)21daysCitratephosphatedextrose-adenine(CPD-A)35daysSaline-adenine-Glucose-Mannitol(SAG-M)42days
101.Nottrueregardingfreshfrozenplasma? a)Suppliesmajorcoagulationfactors b)ABOmatchnotrequired c)ShouldbeusedinreplacementoffactorsinDIC/trauma d)Tobeusedwithin30minutesofhavingtrauma CorrectAnswer-DAns.is'd'i.e.,Tobeusedwithin30minutesofhavingtraumaFreshfrozenplasmacontainscomponentsofthecoagulation,fibrinolyticandcomplementsystemsandotherproteins.FFPcanbegivenwithoutbloodtype-matchedalthoughagglutinationreactionsarepossible,thoughveryrare.oThereisnomentionoftimeperiodwithinwhichFFPshouldbegivenaftertrauma.TherisksofFFPincludediseasetransmission,anaphylactoidreactions,alloimmunization,andexcessiveintravascularvolume,aswellastransfusionrelatedacutelunginjuryandanincreaseininfections
102.Starryskyappearanceisseenin- a)Burkittslymphoma b)CIL c)DiffuselargeBcelllymphoma d)ALCL CorrectAnswer-AAns.is'a'i.e.,BurkittslymphomaBurkittslymphomaItincludes(1)African(endemic)Burkittlymphoma,(2)sporadic(nonendemic)Burkittlymphoma,and(3)asubsetofaggressivelymphomasoccurringinindividualsinfectedwithHIV.Theinvolvedtissuesareeffacedbyadiffuseinfiltrateofintermediate-sizedlymphoidcellscontainingroundorovalnucleiwithcoarsechromatin,severalnucleoli,andamoderateamountoffaintlybasophilicoramphophiliccytoplasm.Thenuclearsizeapproximatesthatofbenignmacrophageswithinthetumor.Ahighmitoticindexistypical,asisapoptotictumorcelldeath,accountingforthepresenceofnumeroustissuemacrophageswithingestednucleardebris.Thesebenignmacrophagesarediffuselydistributedamongthetumorcellsandhaveabundantclearcytoplasm,creatingacharacteristic"starrysky"pattern.AllformsofBurkittlymphomaareassociatedwithtranslocationsofthec-MYCgeneonchromosome8.ThepartnerinthetranslocationisusuallytheIgHlocus(t(8;14))butmayalsobetheic(t(2;8))ory(t(8;22))lightchainlocus.EssentiallyallendemictumorsarelatentlyinfectedwithEBV.
103.BALLiSdueto- a)Tcells b)ImmatureBcells c)ImmatureTcells d)BothT&Bcells CorrectAnswer-BAns.is'b'i.e.,ImmatureBcellsInBALL,precursorcellsarearrestedatstagesprecedingsurfaceexpressionoflg.TheleukemicblastsalmostalwaysexpressthepanB-cellmoleculesCD19andCD10.Inveryearlypre-BcellALL;CD19istheonlyBcell-specificmarkerpresent.Earlypre-BALLisdistinguishedfromlatepre-BALLbytheabsenceofcytoplasmicIgMheavychainintheformer.
104.Whatisthechromosomaltranslocation inAMLM3- a)T(18,21) b)T(15,17) c)T(8,21) d)T(9,11) CorrectAnswer-BAns.is'b'i.e.,T(15,17) Class ChromosomalabnormalitiesMz t(8:21) M3 t(15:17) M4 inv(16)
105.Russellbodiesarefoundin- a)MultipleMyeloma b)Gonadaltumor c)Parkinsonism d)Intracranialneoplasms CorrectAnswer-AAns.is'a'i.e.,MultipleMyelomaPlasmacelltumoursarecharacterizedbydysregulatedsynthesisandsecretionofimmunoglobulin.Thissometimesleadstointracellularaccumulationofintactorpartiallydegradedimmunoglobulins.Thisproducescertainvariantsofplasmacellswhichare:FlamecellsCharacterizedbypresenceoffieryredcytoplasm.MOTTcellsCharacterizedbypresenceofmultiplebluegrapelikecytoplasmicdroplets.Besidesthesetherearecellscontainingvarietyofotherinclusionsincluding.FibrilsRusselbodies(cytoplasmic)Crystallinerods.Dutcherbodies(nuclear)
106.CDmarkerofhistiocytosisis- a)CD1A b)CD1B c)CDIC d)CD1D CorrectAnswer-AAns.is'a'i.e.,CD1AoCHIAisaTcellsurfaceantigenimportantindendriticcellpresentationofglycolipidsandlipopeptideantigens.oItisusedtodiagnoseLangerhanscellhistiocytosis.
107.Dohlebodies- a)DilatedEndoplasmicReticuluminNeutrophils b)Mitochondria c)Golgiapparatus d)Lysosomes CorrectAnswer-AAns.is'a'i.e.,DilatedendoplasmicreticuluminneutrophilsDohlebodiesarelightbluegray,bosophilicinclusionsintheperipheralcytoplasmofneutrophils.oTheyarethoughttoberemnantsoftheroughendoplasmicreticulumcontainingRNA.
108.Basophillicleucocytosisoccursin- a)AML b)ALL c)CML d)CLL CorrectAnswer-CAns.is'c'i.e.,CML
109.Nutmegliverisseenin- a)Rightsidedheartfailure b)Leftsidedheart,failure c)Increasedpulmonarypressure d)Decreasedpulmonarypressure CorrectAnswer-AAns.is'a'i.e.,RightsidedheartfailureoThecombinationofhypoperfusionandretrogradecongestion(Chronicpassivecongestion)actssynergisticallytogeneratecentrilobularhemorrhagicnecrosis.Thelivertakesonavariegatedmottledappearancereflectinghemorrhageandnecrosisinthecentrilobularregions,knowasnutmegliver.oChronicpassivecongestionisseeninRHF.
110.Histopathologyofchronichepatitis- a)Balloning b)Councilmanbodies c)Bridgingnecrosis d)All CorrectAnswer-CAns.is'c'i.e.,Bridgingnecrosis.Portaltractsshowseverechronicinflammationwithinflammatorycellsextendingintotheliverlobulesdisruptingthelimitingplateofhepatocytes.-Piecemealnecrosis-Portalfibrosis.Bridgingnecrosis-Interfacehepatitis
111.Councilmanbodiesareseenill- a)Alcoholiccirrhosis b)Wilson'sdisease c)Acuteviralhepatitis d)Autoimmunehepatitis CorrectAnswer-CAns.is'c'i.e.,AcuteviralhepatitisPathologicalfeaturesofacuteviralhepatitis1)PanlobularinfiltrationofmononuclearcellsThismononuclearinfiltrationprimarilyconsistsof-->Lymphocytes,Plasmacells,EosinophilsInflammatoryinfiltratemayspilloverintotheadjacentparenchymatocausenecrosisofperiportalhepatocytes4interfacehepatitis,canoccurinbothacuteandchronichepatitis.2)Hepaticcelldamage-Itconsitsofa)Hepaticcellnecrosis-Thenecrosisisusuallyfocalorcentirzonal.Sometimesseverenecrosissuchasbridgingorsubacutehepaticnecorsisoccurs.b)Ballooningofcells-Damagedcellsshowdiffuseswellingknownasballooningdegeneration.c)Acidophilicdegenerationofhepatocytes-Inthissinglenecroticlivercellhascoagulatedpinkcytoplasmanditshowspyknosisorkaryolysis.Thesearecalledcouncilmanbodies.
112.Pathologicalmanifestationofchronic alcoholismincludeallofthefollowingexcept- a)Piecemealnecrosis b)Balloningdegeneration c)Microvesicularfattychanges d)Centralhyalinesclerosis CorrectAnswer-AAns.is'a'i.e.,PiecemealnecrosisSteatosis(fattyliver)?Microvesicularfattychange?LaterchangestomacrovesicularfattychangeAlcoholichepatitis?Hepatocellularnecrosis?Ballooningdegeneration?Mallorybodies?Neutrophilicinfiltration?Perivenularandperisinusoidolfibrosis-->centralhyalineAlcoholiccirrhosis?Nodularity?Fibrosis
113.Wilson'sdiseaseischaracterizedby- a)Increasedserumceruloplasmin b)Decreasedcopperexcretioninurine c)Increasedcopperinliver d)Autosomaldominant CorrectAnswer-CAns.is'c'i.e.,IncreasedcopperinliverDiagnosisofWilsondiseaseThegoldstandardfordiagnosisisliverbiopsywithquantitativecopperassay-->concentrationofcopperinaliverbiopsysample>200mg/gdryweight.Othertestsare?Serumceruloplasminlevel-->lowoUrinecopperexcretion-->increasedKFringsoDNAHaplotypeanalysis.
114.Klatskintumoris- a)Nodulartypeofcholangiocarcinoma b)Fibrolamellarhepatocellularcarcinoma c)Gallbladdercarcinoma d)Hepatocellularcarcinoma CorrectAnswer-AAns.is'a'i.e.,NodulartypeofcholangiocarcinomaoAccordingtotheirlocalization,cholongiocarcinomasareclassifiedinto1.Intrahepatic(10-20%)2.Extrahepatic(80-90%)oTheextrahepaticformsincludeperihilartumorsknownasKlastkintumors,whicharelocatedatthejunctionoftherightandlefthepaticductsformingthecommonhepaticduct,anddistalducttumors.oAsubgroupofdistaltumorsariseintheimmediatevicinityofampullaofvater.Tumoroftheseregionalsoincludeadenocarcinomaofduodenalmucosaandpancreaticcarcinomaandarecollectivelyreferredtoasperiampullarycarcinomas.
115.Gallstonesinhemolyticanaemiaare- a)Pigment b)Mixed c)Cholesterol d)Anytype CorrectAnswer-AAns.is'a'i.e.,Pigment
116.Collapseoflungiscalled- a)Emphysema b)Bronchiactasis c)Atelectasis d)Bronchitis CorrectAnswer-CAns.is'c'i.e.,AtelectasisAtelectasis(collapse)Atelectasisrefersto:- 1. IncompleteexpansionoflungsNeonatalatelectasis.or2. CollapseofpreviouslyinflatedlungAcquiredatelectasis. Thisresultsinareasofrelativelyairlesspulmonaryparenchyma.AcquiredatelectasismaybedividedintoResorption(obstruction)atelectasisItisconsequenceofcompleteobstructionofanairway.Withtimetrappedoxygenintheaffectedalveoliisresorbedandcollapseoccurs.Resorptionatelectasisiscausedprincipallybyobstructionduetoexcessivesecretions(mucusplug)orexudateswithinsmallbronchiolesasseeninBronchialasthma,chronicbronchitis,Bronchiactasisandforeignbodyaspiration.CompressionatelectasisCollapseoflungoccursduetoexternalperssureonlung.Itisseenmostcommonlyinpatientswithcardiacfailurewhodeveloppleuraleffusionandinpatientswithneoplasticpleuraleffusion.ContractionatelectasisThecollapseisduetocontractureinthelungbecauseoffibroctic
changes.Exceptforcontractionatelectasis,atelectasisisareversibledisorder,i.e.collapsedlungparenchymacanbere-expanded.
117.Curshmann'scrystalsareseenin? a)Bronchialasthma b)Bronchiectasis c)Chronicbronchitis d)Wegnersgranulomatosis CorrectAnswer-AAns.is'a'i.e.,BronchialasthmaPathologyofAsthmaGross?*Lungsareoverdistendedbecauseofoverinflationandtheremaybesmallareaofatelactasis.*Themoststrikingmacroscopicfindingisocclusionofbronchiandbronchiolesbythicktenaciousmucusplugs.Histology?*Characterizedbypresenceofnumerouseosinophilsandneutrophils.Curschntanspiral-Whorlsofshedepitheliuminmucusplugs.Charcot-leydencrystals-Collectionofcrystalloidsmadeupofeosinophilicmembraneprotein.TheothercharacteristichistologicalfindingofAsthmaiscollectivelycalledAirwayremodelling,itincludes?*Thickeningofthebasementmembraneofthebronchialepithelium.*Edemaandaninflammatoryinfiltrateinthebronchialwallswithaprominenceofeosinophilsandmastcells.*Anincreaseinthesizeofsubmucosalglands.*Hypertrophyofbronchialwallmuscle.The"airwayremodelling"contributestoairflowobstruction.
118.Creolabodiesareseenin- a)Bronchialasthma b)Chronicbronchitis c)Emphysema d)Bronchiectatsis CorrectAnswer-AAns.is'a'i.e.,BronchialasthmaCreolabodiesareahistopathologicfindingindicativeofbronchialasthma.Foundinapatient'ssputum,theyareciliatedcolumnarcellssloughedfromthebronchialmucosaofapatientwithasthma.OthercommonfindingsinthesputumofasthmapatientsincludeCharcot-Leydencrystals,Curschntann'sSpirals,andeosinophils.
119.Cysticfibrosisisassociatedwithall except? a)Infertility b)Azoospermia c)Nasalpolyps d)Renalfailure CorrectAnswer-DAns.isdi.e.,RenalfailureThickviscidplugsofmucusmayalsobefoundinthesmallintestineofinfants.Sometimesthesecausesmall-bowelobstruction,knownasmeconiumileus.Chronicsinopulmonarydiseasemanifestedby:Persistentcolonization/infectionwithtypicalcysticfibrosispathogens,includingStaphylococcusaureus,nontypeableHemophilusinfluenzae,mucoidandnonmucoidPseudomonasaeruginosa,Burkholderiacepacia;Chroniccoughandsputumproduction,nasalpolyps.Azoospermiaandinfertilityarefoundin95%ofthemaleswhosurvivetoadulthood;congenitalbilateralabsenceofthevasdeferensisafrequentfindinginthesepatients.
120.Anthracosisisduetoinhalationof- a)Coaldust b)Asbestos c)Silicadust d)Beryliumdust CorrectAnswer-AAns.is'a'i.e.,CoaldustCoalworker'spneumoconiosis(Blacklung)Blacklungdisease,alsoknownascoalworker'spneumoconiosis(CWP),iscausedbylongexposuretocoaldust.oCoalworker'spneumoconiosishasfollowingspectrum.1.Asymptomaticanthracosis*Inhaledcarbanpigmentisengulfedbyalveolarorinterstitialmacrophages,whichthenaccumulateintheconnectivetissuealongthelymphatics.*Patientiscompletelyasymptomatic.2.Simplecoalworker'spneumoconiosis*Characterizedbycoalmacules(composedofcarbonladenmacrophages)andcoalnodules(carbonladenmacrophages+collegen).*Theupperlobesandupperzonesofthelowerlobesareinvolved.*Theyarelocatedprimarilyadjacenttorespiratorybronchioles,thesiteofinitialdustaccumulation.*Centriacinaremphysemamaydevelop.3.Complicatedcoalworker'spneumoconiosis*Requiresmanyyearstodevelop.*Characterizedbyintenselyblackenedmultiplescarlargerthan2cms.oThisisalsoknownasProgressivemassivefibrosis.
Remember*InCWPandsilicosisupperzonesoflungareinvolvedinitially.oInasbestosislowerlungfieldsareinvolvedinitially.
121.TrueStatementaboutsilicosis- a)Producespleuralplaque b)Associatedwithtuberculosis c)Lowerlobeinfiltration d)All CorrectAnswer-BAns.is'b'i.e.,AssociatedwithtuberculosisSilicosis3Silicosisisalungdiseasecausedbyinhalationofcrystallinesilicondioxide(silica).*Currently,itisthemostprevalentoccupationaldiseaseintheworld.*Silicosisisaslowlyprogressivedisease,usuallypresentingafterdecadesofexposureasslowlyprogressivenodularfibrosingpneumoconiosis.*Silicaoccursinbothcrystallineandamorphousformsbutcrystallineformsaremuchmorefibrogenic.Thecrystallineformarequartz,crystobalite.*Silicosisischaracterizedinitsearlystagesbynodulesintheupperzonesofthelung.Asthediseaseprogressesthesenodulesmaycoalesceintohardcollagenousscars.*Fibroticlesionsoccurinthehilarlymphnodeandpleura.Sometimesthinsheetsofcalcificationoccurinthelymphnodesandareseenradiographicallyaseegshellcalcificationi.e.(calciumsurroundingazonelackingcalcification.*Itthediseasecontinuestoprogress,expansionandcoalescenceoflesionsproduceprogressivemassivefibrosis.oHistologicallythelesionsofsilicosisconsistsofconcentriclayersofhyalinized
collagensurroundedbyadensecapsuleofmorecondensedcollagen.*Examinationofthenodulesbypolarizedmicroscopyrevealsthebirefringentsilicaparticles.*SilicosisisassociatedwithanincreasedsusceptibilitytoT.B.Itispostulatedthatsilicosisresultsindepressionofcellmediatedimmunityandthecrystallinesilicamayinhibittheabilityofpulmonarymacrophagestokillphagocytosedmycobacteria.*Nodulesofsilicotuberculosisoftendisplayacentralzoneofcaseation.
122.Pulmonaryinfarctionoccurswithall except- a)Saddleembolusatbifurcation b)Blockageof2ndand3rdgenendarteries c)Arteriolesareblocked d)None CorrectAnswer-DAns.is'd'i.e.,NoneThemorphologicconsequencesofembolicocclusionofthepulmonaryarteriesdependonthesizeoftheembolicmassandthegeneralstateofthecirculation.Largeembolimayimpactinthemainpulmonaryarteryoritsmajorbranchesorlodgeatthebifurcationasasaddleembolus.Suddendeathoftenensues,owinglargelytotheblockageofbloodflowthroughthelungs.Deathmayalsobecausedbyacutefailureoftherightsideoftheheart(acutecorpulmonale).Smallerembolicantraveloutintothemoreperipheralvessels,wheretheymaycauseinfarction.Inpatientswithadequatecardiovascularfunction,thebronchialarterialsupplycanoftensustainthelungparenchymadespiteobstructiontothepulmonaryarterialsystem.Underthesecircumstances,hemorrhagesmayoccur,butthereisnoinfarctionoftheunderlyinglungparenchyma.Onlyabout10%ofemboliactuallycauseinfarction.Althoughtheunderlyingpulmonaryarchitecturemaybeobscuredbythesuffusionofblood,hemorrhagesaredistinguishedbythepreservationofthepulmonaryalveolararchitecture;insuchcases,resorptionofthebloodpermitsreconstitutionofthepreexistingarchitecture.
123.InthestageofGreyhepatization- a)WBC'sfillthealveoli b)RBC'sfillthealveoli c)Organismsfillthealveoli d)Accumulationoffibrin CorrectAnswer-DAns.is'd'i.e.,AccumulationoffibrinPathologicalchangesofbacterialpneumoniaA.LobarpneumoniaLargeconfluentareaofthelungorentirelobesareconsolidated.Thelowerlobesareaffectedmostcommonly.Therearefourstagesoftheinflammatoryresponse(Laennec'sstages)?Stageofcongestion(initialphase)Theaffectedlobeisenlarged,heavy,darkredandcongested.Cutsurfaceexudesblood-stainedfrothyfluid.Thereisdilatationandcongestionofalveolarcapillaries.Therearefewneutrophilsandnumerousbacteriainthealveolarfluid.Stageofredhepatization(earlyconsolidation)Thetermhepatizationreferstoliver-likeconsistencyoftheaffectedlobeoncutsection.oTheaffectedlobeisredandfirm.Theedemafluidofprecedingstageisreplacedbystrandsoffibrin.Thereismarkedcellularexudateofneutrophilswithextravasationofredcells.Stageofgrayhepatization(lateconsolidation)Theaffectedlobeisgrayishbrown,firmanddry.Thefibrinstrandaredenseandmorenumerous.
Thereisprogressivedisintigrationofredcellsandneutrophils.Themacrophagesbegintoappearintheexudate.Theorganismsarelessnumerousandappearasdegeneratedforms.ResolutionThepreviouslysolidandfibrinousconstituentisliquefiedbyenzymaticaction.Granularandfragmentedstrandsoffibrininthealveolarspacesareseenduetoprogressiveenzymaticdigestion.Thereisprogressiveremovaloffluidcontentaswellascellularexudatefromtheairspaces,resultinginrestorationofnormallungparenchymawithareation.B.BronchopneumoniaPatchyareasofredorgreyconsolidation,moreoftenmultilobarandfrequentlybilateralandbasal(lowerzones)becauseoftendencyofsecretionstogravitateintolowerlobes.Thereissuppurativeexudate,consistingchieflyneutrophils,fillingbronchi,bronchiolesandadjacentalveolarspaces.Alveolarseptathickenduetocongestedcapillariesandleucocyticinfiltration.
124.Markerofsmallcellcanceroflungis- a)Chromogranin b)Cytokeratin c)Desmin d)Vimentin CorrectAnswer-AAns.is'a'i.e.,ChromograninSmallcellcarcinomacontains.Polypeptidehormoree.g.PTHlikepeptide.Neuroendocrinemarkers-4chromogranin,Synaptophysin,Leu7
125.Primarypleuraltumoris a)Mesothelioma b)Myxoma c)Lipoma d)All CorrectAnswer-AAns.is'a'i.e.,MesotheliomaPleuraltumors*Thepleuramaybeinvolvedbyprimaryorsecondarytumors.Primarytumors*Benign-->Solitaryfibroustumor(benignfibrousmesotheliomaorbenignmesotheliomaorpleuralfibroma).*Malignant-->Malignantmesothelioma.Secondarytumors*Morecommonthanprimarytumors.*Mostcommonprimarysitesarelungandbreast.
126.Bronchogenicsequestrationisseenin whichlobe- a)Leftlowerlobe b)Rightupperlobe c)Leftmiddlelobe d)Leftupperlobe CorrectAnswer-AAns.is'a'i.e.,LeftlowerlobeBronchogenicsequestrationreferstothepresenceofadiscretemassoflungtissuewithoutanynormalconnectiontotheairwaysystem.Intralobarsequestrationsarefoundmostfrequentlyintheposteriorbasalsegmentoftheleftlowerlobe.Bloodsupplytothesequesteredareaarisesnotfromthepulmonaryarteriesbutfromtheaortaoritsbranches.Extralobarsequestrationsareexternaltothelung.Foundmostcommonlyininfantsasabnormalmasslesions,theymaybeassociatedwithothercongenitalanomalies.Intralobarsequestrationsarefoundwithinthelungsubstanceandareusuallyassociatedwithrecurrentlocalizedinfectionorbronchiectasis.
127.Mostcommonmediastinaltumoris? a)Neurogenictumor b)Pericardialcyst c)Hernia d)Teratoma CorrectAnswer-AAns.is'a'i.e.,NeurogenictumorsoOverallmostcommonmediastinalmassesareneurogenictumors(20%)followedbythymomas(19%),primarycysts(18%),lymphomas(13%)andgermcelltumors(10%).oMostofthemediastinalmassesarelocatedintheanteriormediastinumfollowedbytheposterior(25%)andmiddle(19%).
128.Podocytesareseenin- a)Bowman'scapsule b)Proximalconvolutedtubule c)Distalconvolutedtubule d)Collectingtubuleofthekidney CorrectAnswer-AAns.is'a'i.e.,Bowman'scapsuleTheBowman'scapsule(capsulaglomeruli/glomerularcapsule)isacup-likesacatthebeginningoftubularcomponentofanephron.Aglomerulusisenclosedinthesac(Bowman'scapsule).FluidsfrombloodintheglomerulusarecollectedinBowman'scapsule(i.e.glomerularfiltrate)andfurtherprocessedalongthenephrontoformurine.OutsidetheBowman'scapsuletherearetwopoles.VascularpoleThesidewithafferentandefferentarterioles.UrinarypoleThesidewithproximalconvulutedtubule.InsidetheBowman'scapsule,thelayersareasfollows,frominsidetooutside?ThinlayeroffenestratedendotheliumGlomerularbasementmembranePartoftheglomerulusVisceralepithelium(Podocytes)Parietalepithelium
129.Mostcommoncauseofnephritic syndromeinadults? a)Membranoproliferativeglomerulonephritis b)FSGN c)Membranousglomerulonephritis d)None CorrectAnswer-DAns.isNoneMostcommoncauseofNephriticsyndromeisrapidlyprogressiveglomerulonephritis(Poststreptococcalandnonstreptococcalglomerulonephritis).Membranousglomeruulonephritisisthemostcommoncauseofnephroticsyndrome(notnephriticsyndrome)inadults.Minimalchangediseaseisthemostcommoncauseofnephroticsyndromeinchildren. CausesofAcuteNephriticSyndrome Primary SystemicDisease Glomerulonephritis 1. AcuteGN 1. SLE Post-streptococcal 2. PolyarteritisnodosaWegener's Non-streptococcal 3. granulomatosisHenoch-Schonlein 2. RapidlyprogressiveGN 4. purpura Membranoproliferative 3. 5 Cryoglobulinaemia GN 4. FocalGN 5. IgAnephropathy
5. IgAnephropathy
130.Thepathogenesisofacuteproliferative glomerulonephritis- a)CytotoxicT-cellmediated b)Immunecomplexmediated c)Antibodymediated d)Cell-mediated(TyperIV) CorrectAnswer-BAns.is'b'i.e.,Immunecomplexmediated*Postinfectiousacuteproliferativeglomerulonephritisisduetoimmune-complexmediated(TypeIII)hypersensitivity.
131.Crescentsarederivedfrom- a)Epithelialcells+fibrin+macrophage b)Mesangium+fibrin+macrophage c)Tubule+mesangiaum+fibrin d)Mesangiaum+fibrin CorrectAnswer-AAns.is'a'i.e.,Epithelialcells+fibrin+macrophageRenalfeaturesinRPGNCrescentformation-crescentsareformsby?*CellsParietalepithelialcells+WBCs(monocytesandmacrophages)*Fibrinstrandsareprominentbetweenthecellularlayersinthecrescents.-RuptureofGBM-SubepithelialdepositsintypeIIRPGN-LineardepositsintheGBMintypeIRPGN.
132. Mostcommoncauseofnephrotic syndromeinadults? a)Membranousglomerulonephritis b)Minimalchangedisease c)AcuteGN d)FocalGN CorrectAnswer-AAns.is'a'i.e.,MembranousglomerulonephritisMostcommoncauseofNephroticsyndromeInadultsmembranousglomerulonephritisInchildrenminimalchangedisease(lipoidnephrosis)CausesofNephroticsyndrome I. PrimaryGlomerulonephritis V Malignancy Minimalchangedisease(mostcommonin 1. 1. Carcinomas children) 2. MembranousGN(mostcommoninadults) 2. Myeloma Hodgkin's 3. MembranoproliferativeGN 3. disease 4. Focalsegmentalglomerulosclerosis VI Pregnancy Toxaemiaof 5. FocalGN pregnancy VIICirculatory 6. IgAnephropathy Disturbances1.Renalvein II Systemicdiseases thrombosis Constrictive 1. Diabetesmellitus 2. pericarditis
2. Amyloidosis VIII.Hereditarydiseases1.Alport's 3. SLE disease M. SystemicInfections 2. Fabry'sdisease Nail-patella 1. Viralinfections(HBV,HCV,HIV) 3. syndrome Bacterialinfections(bacterialendocarditis, 2. syphilis,leprosy)Protozoaandparasites(P.falciparum 3. malaria,filariasis) IV. HypersensitivityReactions 1. Drugs(heavymetalcompoundslikegold andmercury,otherdrugs likepenicillamine,trimethadioneandtolbutamide,heroinaddiction) 2. Beestings,snakebite,poisonivy
133.FrequencyofrenalinvolvementinHSP? a)20-40% b)>80% c)40-60% d)10% CorrectAnswer-CAns.is'c'i.e.,40-60%ThereportedincidenceofrenalinvolvementinHSPvariesconsiderablybetweendifferentstudies.Thismaybebecauseofthedifferentcriteriausedtodescribetheinvolvement&thevariabilityofthelengthusedtofollowup.IndifferentstudiesincidenceofpediatricrenalinvolvementinHSPwasbetween20-56%andinadults50-78%
134.AccordingtoWHO,membranous glomerulonephritisseeninSLE,is- a)ClassII b)ClassIII c)ClassIV d)ClassV CorrectAnswer-DAns.is'd'i.e.,ClassVThereareseveralversionsofWHOclassificationoflupusnephritis?1)Minimalornodetectableabnormalities(class1)2)Mesangiallupusglomerulonephritis(classII)3)Focalproliferativeglomerulonephritis(classIII)4)Diffuseproliferativeglomerulonephritis(classIV)5)Membranousglomerulonephritis(classV)
135.Subepithelialdepositsinkidneyareseen in- a)MPGN-1 b)GPS c)PSGN d)All CorrectAnswer-CAns.is'c'i.e.,PSGNGlomerulardeposits:(i)Subepithelial:oAcuteGN(likePSGN)oMembranousGNoHeymanGNoRPGN(ii)Subendothelial:(iii)Basementmembrane:(iv)Mesangium:MPGN(Type-I)SLEoAcuteON(H'1583)oMPGN(TypeII)oGoodpasturesyndromeoIgAnephropathy,HSPRememberoAnionicantigensformsubendothelialdepositsoCationicantigensformsubepithelialdepositsoNeutralantigensformmesangialdeposits
136.NottrueaboutAlport'ssyndrome- a)X-linked b)Autosomaldominant c)Nervedeafness d)Glomerulonephritis CorrectAnswer-BAns.is'b'i.e.,AutosomaldominantoAutosomaldominantformalsoexist,butitisveryrare.Thus,amongthegivenoptions,itisthebestanswer.oOtherthreeoptionsareclassicalfeaturesofAlport'ssyndrome(seepreviousexplanations).
137.Renalcellcarcinomaisrelatedtogene locatedonchromosome- a)3 b)X c)22 d)20 CorrectAnswer-AAns.is'a'i.e.,3oClearcellcarcinomaisthemostcommonrenalcellcarcinomaandisassociatedwith3pdeletion.
138.Oncocyticcarcinomaarisesfrom- a)Perivascular b)Glomerulus c)Loopofhenle d)Collectingduct CorrectAnswer-DAns.is'd'i.e.,CollectingductsOncocyticorChromophoberenalcarcinomarepresents5%ofrenalcellcancers.Itiscomposedofcellswithprominentcellmembranesandpaleeosinophiliccytoplasm,usuallywithahaloaroundthenucleus.Theyare,likethebenignoncocytoma,thoughttogrowfromintercalatedcellsofcollectingducts.oTheyhaveanexcellentprognosiscomparedwiththatoftheclearcellandpapillarycancers.
139.Histopathologyshowinglargecellswith plantlikeapperancewithperinuclearhaloisseeninwhichtypeofrenalcellcarcinoma? a)Onchocytoma b)Granularcellcarcinoma c)Angiosarcoma d)Chromophobic CorrectAnswer-DAns.is'd'i.e.,ChromophobicHistopathologicalfindingsofperinuclearhaloandplantcellappearanceareseeninchromophobecellcarcinomaofRCC.Electronmicroscopicfindingconsistingofnumerous150-300nmmicrovesiclesisthesinglemostdistinctiveanddefiningfeatureofchromophobecellca.
140.Transitionalcellcarcinomabladder causedby- a)Schistosomiasis b)Ascariasis c)Malaria d)None CorrectAnswer-AAns.is'a'i.e.,SchistosomiasisTransitionalcellcarcinoma(TCC).Thisisthecommonestcancerofthebladder.Morethan90%ofbladdertumorsarisefromtransitionalepithelial(urothelium)liningofthebladderincontinuitywiththeepithelialliningoftherenalpelvis,ureters,andthemajorpartoftheurethra.etiology:Industrialoccupations:Workersinindustriesthatproduceanilinedyes,rubber,plastic,textiles,andcablehaveahighincidenceofbladdercancer.Schistosomiasis:Thereisanincreasedriskofbladdercancer,particularlysquamouscellcarcinoma,inpatientshavingbilharzialinfestation(Schistosomahaematobium)ofthebladder.Dietaryfactors:Certaincarcinogenicmetabolitesoftryptophanareexcretedintheurineofpatientswithbladdercancer.Locallesions:Severallocallesionsinthebladderpredisposetothedevelopmentofbladdercancer.Theseincludeectopiavesicae(atrophiedbladder),vesicaldiverticulum,leukoplakiaofthebladdermucosaandurinarydiversioninthedefunctionalizedbladder.Smoking:Tobaccosmokingisassociatedwitha2to3foldincreasedriskofdevelopingbladdercancer,probablydueto
increasedurinaryexcretionofcarcinogenicsubstances.Drugs:Immunosuppressivetherapywithcyclophosphamideandpatientshavinganalgesic-abuse(phenacetin-)nephropathyhaveahighriskofdevelopingbladdercancer.
141.Allaregermcelltumorsexcept? a)Seminoma b)Leydigcelltumor c)Embryonalcarcinoma d)Endodermalsinus CorrectAnswer-BAns.is'b'i.e.,LeydigcelltumorTesticulartumor*Testiculartumorsaredividedintotwomajorcatogaries:?Germcelltumors*Seminoma*Embryonalcarcinoma*Yolksac(endodermalsinus)tumorSpermatocyticseminomaChoriocarcinomaTeratomaSexcordtumorsLeydigcellstumorSertolicelltumor*Approximately95%oftesticulartumorsaregermcelltumors.
142.Whichofthefollowinggermcelltumoris malignant? a)Leydigcelltumor b)Sertolicelltumor c)Seminoma d)Dermoidcyst CorrectAnswer-CAns.is'c'i.e.,SeminomaoAmongthegivenoptionsonlyoptionsc&daregermcelltumors.Seminomaismalignantwhiledermoidcystisbenign. Germcelltumors oMalignant-Germinoma(seminoma,dysgerminoma),embryonalcarcinoma,endodermalsinustumor(yolksactumor),choriocarcinoma,immatureteratoma.Benign-Matureteratoma,dermoidcyst.
143.Commonestinfantiletesticulartumouris ? a)Seminoma b)Teratoma c)Yolksactumor d)Dysgerminoma CorrectAnswer-CAns.is'c'i.e.,YolksactumoroMostcommontumoroftestisSeminoma.oMostcommontumoroftestisinchildhood--->yolksactumor(endodermalsinustumororinfantileembryonalcarcinoma).
144.Tennisracketcellsisseenin- a)Sarcomabotyroides b)Vaginaladenocarcinoma c)Leiomyomauterus d)Seminoma CorrectAnswer-AAns.is'a'i.e.,SarcomabotryoidsoTumorcellsofsarcomabotryoidsaresmallandhaveovalnuclei,withsmallprotrusionsofcytoplasmfromoneend,sotheyresembleatennisracket.
145.Whichisnotariskfactorofendometrial carcinoma- a)Obesity b)Smoking c)Infertility d)Tamoxifen CorrectAnswer-BAns.is'b'i.e.,SmokingEndometrialcarcinomaEndometrialcarcinomaisthemostcommoninvasivecancerofthefemalegenitaltractandaccountsfor7%ofallinvasivecancerinwomen.Thepeakincidenceisinthe55-to65-year-oldwoman.Clinicopathologicalstudies&molecularanalysissupportitsclassificationintotwomajorbroadcategories.Type-ICarcinomaMostcommontype.Majorityarewelldifferentiated&mimicproliferativeendometetrialglands.Theyareassociatedwith-obesity,diabetes,hypertension,infertilityandunopposedestrogenstimulation.Tamoxifenalsoincreasestheriskofendometrialcancer.Endometrialhyperplasiaisaprecursortoendometroidcarcinoma.MutationinPTENtumorsuppressorgenehavebeenseenin30-80%ofendometeriodcarcinoma&20%patientswithendometrialhyperplasia.Additionalmolecularchangesthatarecommonaremicrosatelliteinstability&mutationsinKRAS&betacateninoncogenes.
Type-HCarcinomaTheseoccurinwomenadecadelaterthantypeIcarcinoma.Theseusuallyariseinsettingofendometrialatropy.Theyarepoorlydifferentiated.Themostcommonsubtypeisserouscarcinoma,clearcelltype&malignantmixedmulleriantumor.Themostfrequentalterationdescribedismutationinp53tumorsuppressorgene.
146.Rokitanskiprotruberencesareseenin- a)Mucinouscarcinoma b)Teratoma c)Epidermalcystoidsadenoma d)Papillarycarcinoma CorrectAnswer-BAns.is'b'i.e.,TeratomaTeratomaoTeratomasaredividedintothreecategories:(1)Mature(benign):Mostbenignteratomasarecysticandareknownasdermoidcysts.Theseneoplasmsarepresumablyderivedfromtheectodermaldifferentiationoftotipotentialcells.Theyarebilateralin10%to15%ofcases.Characteristically,theyareunilocularcystscontaininghairandcheesysebaceousmaterial.Onsection,theyrevealathinwalllinedbyanopaque,gray-white,wrinkled,apparentepidermis.Generally,inoneareaofthecystwall,asolidprominenceisseenknownasRokitansky'sprotuberancewheretissueelementssuchastooth,bone,cartilage&variousotheroddtissuesarepresent.Onhistologicexamination,thecystwalliscomposedofstratifiedsquamousepitheliumwithunderlyingsebaceousglands,hairshafts,andotherskinadnexalstructures.Inmostcases,structuresfromothergermlayerscanbeidentified,suchascartilage,bone,thyroidtissue,andotherorganoidformations.
Dermoidcystsaresometimesincorporatedwithinthewallofamucinouscystadenoma.About1%ofthedermoidsundergomalignanttransformationofanyoneofthecomponentelements(butmostcommonly,squamouscellcarcinoma).(2)MonodermalorSpecializedTeratomasTheraregroupoftumors,themostcommonofwhicharestrumaovariiandcarcinoid.Theyarealwaysunilateral,althoughacontralateralteratomamaybepresent.Strumaovariiiscomposedentirelyofmaturethyroidtissue.Interestingly,thesethyroidalneoplasmsmayhyperfunction,causinghyperthyroidism.Theovariancarcinoid,whichpresumablyarisesfromintestinalepitheliuminateratoma,mightinfactbefunctioning,particularlyinlargetumors,producing5-hydroxytryptamineandthecarcinoidsyndrome.(3)ImmatureMalignantTeratomasTheseareraretumorsthatdifferfrombenignteratomasinthatthecomponenttissueresemblesthatobservedinthefetusorembryoratherthanintheadult.Thetumorisfoundchieflyinprepubertaladolescentsandyoungwomen.Thesegrowrapidlyandfrequentlypenetratethecapsulewithlocalspreadormetastases.Onmicroscopy,therearevaryingamountsofimmaturetissuedifferentiatingtowardcartilage,glands,bone,muscle,nerve,andothers.Animportantriskforsubsequentextraovarianspreadisthehistologicgradeoftumor,whichisbasedontheproportionoftissuecontainingimmatureneuroepithelium.
147.Proliferatingbreastmassis- a)Ductectasia b)Fibroadenoma c)Adenosis d)Papilloma CorrectAnswer-DAns.is'd'i.e.,PapillomaExamplesincludeatypicalductalhyperplasia,atypicallobularhyperplasia,andintraductalpapillomas.
148.Granulomatousmastitisiscausedbyall except- a)TB b)Fungus c)Staphylococcus d)Antibodiestomilkantigens CorrectAnswer-CAns.is'c'i.e.,StaphylococcusGranulomatousmastitis*Granulomatousinflammationispresentinlessthan1%ofallbreastbiopsyspecimens.*Thecausesincludesystemicgranulomatousdisease(e.g.,Wegenergranulomatosisorsarcoidosis)thatoccasionallyinvolvethebreast,andgranulomatousinfectionscausedbymycobacteriaorfungi.*Infectionsofthistypearemostcommoninimmunocompromisedpatientsoradjacenttoforeignobjectssuchasbreastprosthesesornipplepiercings.*Granulomatouslobularmastitisisanuncommonbreast-limiteddiseasethatonlyoccursinparouswomen.*Thegranulomatousinflammationisconfinedtothelobules,suggestingthatitiscausedbyahypersensitivityreactiontoantigensexpressedbylobularepitheliumduringlactation.
149.TypeofDCISresultinginpalpable abnormality? a)Comedocarcinoma b)NoncomedoDCIS c)Paget'sdisease d)None CorrectAnswer-CAns.is'c'i.e.,Paget'sdisease"Apalpablemassispresentin50%to60%ofwomenwithPagetdisease,andalmostallofthesewomenhaveanunderlyinginvasivecarcinoma.Incontrast,themajorityofwomenwithoutapalpablemasshaveonlyDCIS".--Robbin's*ActuallythequestionhasbeenframedwronglyasPaget'sdiseaseisnotatypeofDCIS.Itisadifferentlesion.But,ithasbeenexplainedalongwithmorphologyofDCIS.
150.ERpositivestatusinCaBreastindicates - a)Prognosis b)Etiology c)Site d)None CorrectAnswer-AAns.is'a'i.e.,PrognosisoEstrogenreceptor(ER)positivebreastcarcinomasaregenerallyslowgrowingandrespondwelltohormonaltreatment.oGeneexpressionprolifing,whichcanmeasuretherelativequantitiesofmRNAforessentiallyeverygene,hasidentifiedfivemajorpatternsofgeneexpressionininvasiveductalcarcinoma.LuminalAoThisisthelargestgroup(40-55%)whichhascharacteristicsofnormalluminalcells.oThistypeisERpositiveandHER2/neunegative.oThesecancersaregenerallyslowgrowingandrespondtohormonaltreatment.ConverselyonlyasmallnumberwillrespondtostandardchemotherapyLuminalBoThesetumorsareERpositive,hasahigherproliferativerateandoverexpressesHER2/neu--->Triple-positivecancer.oTheycomposeamajorgroupofER-positivecancersthataremorelikelytohavelymphnodemetastasesandmayrespondtostandardchemotherapy.NormalbreastlineoTheseareERpositive,HER2/neunegativeandcharacterizedby
thesimilarityoftheirgeneexpressionpatterntonormaltissue.BasallineoTheseareERnegative,PRnegative,HER2/neunegativeTriplenegative.oThesearecharacterizedbyexpressionofmarkerstypicalofmyoepithelialcells(e.g.,basalkeratins,Pcodherins,p63,orlaminin),progenitorcells,orputativestemcells(e.g.cytokeratins5and6).oManycarcinomaarisinginwomenwithBRACImutationsareofthistype.oTheseareaggressivetumors,frequentmetastasistovisceraandbraincanbeseen--->havepoorprognosis.HER2positiveoTheseareERnegativeandoverexpressHER2/neuprotein.
151.ModifiedBloomRichardsoncriteriafor CarcinomaBreastincludes- a)Desmoplasia b)Lymphovenousembolism c)Mitoticrate d)All CorrectAnswer-CAns.is'c'i.e.mitoticrateGradingofbreastcanceroPresently,mostmethodsforgradingusethepreviouslycitedthree-tieredsystemsfordescribingtumorstructureintermsoftubuleformation,nucleargradeandmitoticcount,withthelatterusuallyexpressedasthenumberofmitosisper10high-magnificationfield.oEachelementisscoredonascalefrom1to3accordingtocriteriaofthespecificgradingsystem,andthefinalgradeisdeterminedbythesumofmitosis.oTotalsof3to5indicateawell-differentiatedorlow-gradetumor;6to7,amoderatelydifferentiatedorintermediate-gradetumor;and8to9,apoorlydifferentiatedorhigh-gradetumor. oThismethodofscoringisknownastheNottinghamcombinedhistologicgradeofElston-EllismodificationoftheScarff-Bloom- Richardsongradingsystem,oftenreportedasamodifiedScaff- Bloom-Richardsongrade. ModifiedBloom-RicharsonhistologicalgradingTubuleformationoScore1:->75%oftumorhastubulesScore2:-10-75%oftumorhastubulesoScore3:-<10%oftumorhastubulesNuclearsize(nuclearpolymorphism)oScore1:-tumornucleisimilartonormalductnuclei(2-3xRBC)
oScore1:-tumornucleisimilartonormalductnuclei(2-3xRBC)Score2:-IntermediatesizenucleiScore3:-verylargenuclei,usuallyvesicularwithprominentnucleoliMitoticcountoScore1:-0-7mitosisoScore2:-8-14mitosisoScore3:->15mitosis
152.Mostcommonmalignantbone tumor- a)Osteogenicsarcoma b)Secondaries c)Osteoma d)Enchondroma CorrectAnswer-BAns.is'b'i.e.,SecondariesoSecondariesaremostcommonmalignantbonetumor.oOsteogenicsarcomaisthemostcommonprimarymalignantbonetumor.oOsteomaismostcommonbenignbonetumor.
153.Ewingssarcomaarisesfrom- a)Gcells b)Totipotentcells c)Neuroectodermalcells d)Neurons CorrectAnswer-CAns.isci.e.,NeuroectodermalcellsoHistologically,Ewing'ssarcomahasacertainresemblancetoprimitiveneuroectodermalcells,andthetumorarisesfromsuchcells.oItisararemalignancyprimarilyaffectingchildrenandadolescents.Itarisesmainlyinboneandlesscommonlyinsofttissues.oInthese,thereisacharacteristicreciprocalchromosomaltranslocation,whichleadstoanin-framefusionbetweentheEWSgeneandoneoftheETSfamilygenemembers.
154.Whichofthefollowingisthemost commonmutationinEwing'ssarcoma- a)TranslocationX:18 b)Translocation11;22 c)ActivativemutationofG5a,p,surfaceprotein d)MissensemutationinEXTI CorrectAnswer-BAns.is'b'i.e.,Translocation11;22Ewing'ssarcomaistypicallycharachterizedbyatranslocationt(11;22)(q24;q12)inupto90%ofpatients.
155.Tadpolecellscommashapedcellson histopathologyareseenin- a)Trichoepithelioma b)Spideroma c)Rhabdomyosarcoma d)Histiocytoma CorrectAnswer-CAns.is'c'i.e.,RhabdomyosarcomaHistologyofrhabdomvosarcomaThediagnosticcellofrhabdomyosarcomaisrhabdomyoblast.Rhabdomyoblastcontainseccentriceosinophilicgranularcytoplasmrichinthickandthinfilaments.oTherhabdomyoblastsmaybe?i)RoundElongatedTadpoleorStrapcells.Ithasthreevariantsii)EmbryonalAlveolariii)PleomorphicRhabdomyoblastsarepositivefordesmin,MYOD1andMyogenin.
156.Perivascularlymphocytesµglial nodulesareseenin- a)Multiplesclerosis b)HIVencephalitis c)CMVmeningitis d)Bacterialmeningitis CorrectAnswer-BAns.is'b'i.e.,HIVencephalitisoPerivascularinfiltrateoflymphocytes(andmacrophages)withmicroglialnodulesisseeninHIVencephalitis.oPerivascularinfiltrateoflymphocytes(andmonocytes)isalsoseeninmultiplesclerosis.But,microglialnodulesarecharacteristicofHIVencephalitis.
157.RegardingDandy-Walkersyndrome,all areseenexcept- a)Hydrocephalus b)Archnoidcyst c)Posteriorfossacyst d)Cerebellarvermisdeficiency CorrectAnswer-BAns.is'b'i.e.,ArachnoidcystDandy-walkermalformationoTheDandy-Walkermalformationconsistsofacysticexpansionofthe4thventricleintheposteriorfossaandmidlinecerebellarhypoplasia.oThereis:?oHydrocephalus(90%ofcases)oAgenesisofthecerebellarvermisandcorpuscallosum.oRapidincreaseinheadsizewithprominentocciput.
158.Neurofibromatosistrueall,except- a)Autosomalrecessive b)Associatedwithcataract c)Scoliosis d)Multiplefibroma CorrectAnswer-AAns.is'a'i.e.,AutosomalrecessiveNeurofibromatosiscomprisesoftwodistinctdisorders-*NeurofibromatosisI*NeurofibromatosisII*Thegenesforthesearelocatedondifferentchromosomes.*Bothareinheritedinanautosomaldominantpattern.*TheclassicalformofthediseasewithmultipleneuromasiscalledNeurofibromatosisIandiscausedbyamutationofthegeneneurofibrominonchromosome17
159.Whichofthefollowingtumorsisnot derivedfrommeninges- a)Hemangioblastoma b)Meningioma c)Fibroustumor d)Hemangiopericytoma CorrectAnswer-AAns.is'a'i.e.,HaemangioblastomaMeningealtumorsoMeningothelialtumor:Meningioma(mostcommonmeningealtumor).oMesenchymalnon-meningothelialtumors:Meningealsolitaryfibroustumor,hemangiopericytoma,meningealsarcoma,fibroushistiocytoma,meningealmelanocytoma,(melanocytictumor).
160.Mostcommoncerebellartumorin children? a)Astrocytoma b)Medulloblastoma c)Ependymoma d)DNET CorrectAnswer-AAns.is'a'i.e.,AstrocytomaoThemostcommoncerebellartumorinadultsismetastasis,whereasinchildrenthemostcommontumorisanastrocytoma.
161.Medulloblastomamostcommon metastasisisto? a)Lung b)CNS c)Liver d)Spleen CorrectAnswer-BAns.is'b'i.e.,CNSoMedullablastomaspreadthroughCSFandfrequentlymetastasizestodifferentlocationsinthebrainandspine.oExtraneuralmetastasistotherestofthebodyisrare.
162.Mostcommonsiteformedulloblastoma is- a)Cerebellum b)Pituitary c)Cerebrum d)Pinealgland CorrectAnswer-AAns.is'a'i.e.,CerebellumoMedulloblastomaisaninfratentorialtumorandoccursexclusivelyincerebellum.
163.Spongiformdegenerationofcerebral cortexoccursin- a)Creutzfeldt-Jakobdisease b)Subacutesclerosingpanencephalitis c)Fatalfamilialinsomnia d)Cerebraltoxoplasmosis CorrectAnswer-AAns.is'a'i.e.,Creutzfeldt-JakobdiseaseoOnmicroscopicexamination,inCreutzfeldt-Jakobdiseasethepathognomonicfindingisaspongiformtransformationofthecerebralcortexand,often,deepgraymatterstructures(caudate,putamen);thisconsistsofamultifocalprocessthatresultsintheunevenformationofsmall,apparentlyempty,microscopicvacuolesofvaryingsizeswithintheneuropilandsometimesintheperikaryonofneurons.Inadvancedcases,thereissevereneuronalloss,reactivegliosis,andsometimesexpansionofthevacuolatedareasintocystlikespaces("statusspongiosus").oKuruplaquesareextracellulardepositsofaggregatedabnormalprotein;theyareCongored-positiveaswellasPAS-positiveandoccurinthecerebellumincasesofGerstmann-Striiussler-Scheinkersyndrome;theyarepresentinabundanceinthecerebralcortexincasesofvariantCJD.oInallformsofpriondisease,immunohistochemicalstainingdemonstratesthepresenceofproteinase-K-resistantPrPscintissue.oFatalfamilialinsomniadoesnotshowspongiformpathology.Instead,themoststrikingalterationisneuronallossandreactivegliosisintheanteriorventralanddorsomedialnucleiofthethalamus;
neuronallossisalsoprominentintheinferiorolivarynuclei.
164.Whatisthehistologicalappearanceof braininCreutzfeldt-Jakobdisease- a)Neuronophagia b)Spongiformchangeinbrain c)Microabscesses d)Demyelination CorrectAnswer-BAns.is'b'i.e.,SpongiformchangeinbrainoTheclassichistologicappearanceinCreutzfeldt-Jakobdiseaseisspongiformchangeinthegraymatter:inallsixcorticallayersinthecerebralcortexorwithdiffuseinvolvementofthecerebellarmolecularlayer.Thesevacuolesappearglassyoreosinophilicandmaycoalesce.Neuronallossandgliosisarealsoseen.
165.Autoimmunethyroiditisisassociated withallexcept- a)DM b)Mystheniagravis c)Sly d)Psoriasis CorrectAnswer-DAns.is'd'i.e.,Psoriasis*Autoimmunethyroiditis(Hashimotothyroiditis)patientsareatincreasedriskfordevelopingotherautoimmunedisease:-i)Endocrine:Type1DM,autoimmuneadrenalitis.ii)Non-endocrine:SLE,mystheniagravis,sjogrensyndrome.*ThesepatientsarealsoatincreasedriskfordevelopmentofB-cellnon-Hodgkinlymphoma,especiallymarginalcelllymphomaofMALTlymphoma.
166.Orphanannieeyenucleiappearanceis characteristicof- a)Papillarycarcinomathyroid b)Carcinomapituitary c)Paraganglioma d)Meningioma CorrectAnswer-AAns.is'a'i.e.,PapillarycarcinomathyroidoThenucleiofpapillarycarcinomacellscontainfinelydispersedchromatin,whichimpartsanopticallyclearoremptyappearance,givingrisetothedesignationgroundglassorOrphanAnnieeyenuclei.
167.TrueaboutPsammomabodiesareall except? a)Seeninmeningioma b)Concentricwhorledappearance c)ContainsCalciumdeposits d)Seeninteratoma CorrectAnswer-DAns.is'd'i.e.,SeeninteratomaoPsammomabodiesrepresentaprocessofdystrophiccalcification.oSinglenecroticcellsmayconstituteseedcrystalsthatbecomeencrustedbythemineraldeposits.Theprogressiveacquisitionofouterlayersmaycreatelamellatedconfigurations,calledpsammomabodiesbecauseoftheirresemblancetograinsofsand.oPsammomabodiesareseenin:papillarycancerofthyroid,meningioma,papillaryserouscystadenocarcinomaofovary.
168.Tumorthatfollowsruleof10is- a)Pheochromocytoma b)Oncocytoma c)Lymphoma d)Renalcellcarcinoma CorrectAnswer-AAns.is'a'i.e.,PheochromocytomaoPheochromocytomasusuallysubscribetoaconvenient"ruleof10s":-10%ofpheochromocytomasariseinassociationwithoneofseveralfamilialsyndromes.TheseincludetheMEN-2A&MEN-2Bsyndromes,typeIneurofibromatosis,vonHippel-Lindausyndrome&Sturge-Webersyndrome.10%ofpheochromocytomasareextra-adrenal,occurringinsitessuchasorganofZuckerkandl&carotidbody,wherethesechromaffin-negativetumorsareusuallycalledparagangliomastodistinguishthemfrompheochromocytomas.10%ofnonfamilialadrenalpheochromocytomasarebilateral;thisfiguremayriseto70%incasesthatareassociatedwithfamilialsyndromes.10%ofadrenalpheochromocytomasarebiologicallymalignant,althoughtheassociatedhypertensionrepresentsaserious&potentiallylethalcomplicationofeven"benign"tumors.10%ofadrenalpheochromocytomasariseinchildhood,usuallythefamilialsubtypes,andwithastrongmalepreponderance.Thenonfamilialpheochromocytomasmostoftenoccurinadultsbetween40&60yearsofage,withaslightfemalepreponderance.
169.Whichofthefollowingismostreliable featureofmalignanttransformationofpheochromocytoma? a)Presenceofmitoticfigures b)Capsularinvasion c)Vascularinvasion d)None CorrectAnswer-DAns.isNone"Becausebenignandmalignantpheochromocytomasmayhaveanidenticalhistologicalappearance,theonlyabsolutecriterionofmalignancyismetastasis.""Thediagnosisofmalignantpheochromocytomaismadeonlywhenmetastasisisdemonstrated."
170.Tertiaryhyperparathyroidismis- a)HighPO4levelwithmetastasis b)SecondaryhyperparathyroidismwithCRF c)PrimaryhyperparathyroidismwithlowCa"levels d)Secondaryhyperparathyroidismwithchiefcelladenoma CorrectAnswer-DAns.is'd'i.e.,SecondaryhyperparathyroidismwithchiefcelladenomaDavidsonstates"InverysmallproportionofcasesofsecondaryhyperparathyroidismcontinuousstimulationoftheparathyroidmayresultinadenomaformationandautonomousPTHsecretion.Thisisknownastertiaryhyperparathyroidism".
171.Mutationinmalignantmelanoma- a)N-myc b)CDK2A c)RET d)None CorrectAnswer-BAns.is'b'i.e.,CDK2A"Inmelanomacells,numbersofmutationsand/ordysregulatedexpressionofB-RofN-Ras,CDK2A,MDM2,PTEN,p53havebeenrecognized".
172. Whichofthefollowingisnottrueabout amoebiasis? a)ALAin10%causesintropics b)Portalsystemefficientfilter c)Abscessduetosuppuration d)Abscesswallgoodforculture CorrectAnswer-CAns.is'c'i.e.,AbscessduetosuppurationAmebicliverabscessPusinamoebicliverabscessisnotduetosuppuration,butisamixtureofsloughedlivertissueandblood.Itischocolatebrownincolourandthickinconsistency(anchovysaucepus)Inthetropics2-10%oftheindividualsinfectedwithentamoebahistolyticasufferfromhepaticcomplications.Thetrophozoitesarecarriedfromthelargeintestinetotheliverbyportalvein.Intheliverthecapillarysystemactsasefficientfilterandholdstheseparasites.Incaseofamoebicliverabscessthediagnosticaspirationisdonefromtheabscesswallbecausethetrophozoitesareconfinedtotheperiphery.
173.Mostimportantprognosticfactorof wilmstumour- a)Histopathology b)Ploidyofcells c)Age<1yr d)Mutation,ofclpgene CorrectAnswer-AAns.is'a'i.e.,HistopathologyAnaplasticnuclearchangeistheonlycriterionof"unfavourable"histologyinWilm'stumorandallWilm'stumorlackingthisfeaturearedesignatedashaving"favourablehistology".Anaplasticnuclearchangereflectsextremepolypoidy&isusuallyapparentunderlowmagnification."Anaplastichistologyremainsacriticaldeterminantofadverseprognosis.Evenanaplasiarestrictedtokidneyconfersanincreasedriskofrecurrence&death,underscoringtheneedforcorrectlyidentifyingthishistologicfeatures."
174.Whichofthefollowingporphyriasisnot inheritedasanAutosomalDominantdisorder- a)AcuteIntermittentPorphyria b)CongenitalErythropoieticPorphyria c)PorphyriaCutaneaTarda d)HereditaryCoproporphyria CorrectAnswer-BAns.is'b'i.e.,Congenitalerythropoieticporphyria InheritanceofPorphyrias AutosomaldominantAutosomalRecessiveX-linkedoAcuteintermittentporphyria(AIP)oALAdehydratasedeficiencyoX-linkedprotoporphyriaoPorphyriacutaneaTarda(PCT)oCongenitalerythropoieticporphyriaoHereditarycoproporphyria(HCP)oErythropoieticprotoporphyriaoVariegateporphyria(VP)
175.Glomustumorisseenin- a)Retroperitoneum b)Softtissue c)Distalportionofdigits d)Proximalportionofdigits CorrectAnswer-CAns.is'c'i.e.,DistalportionofdigitsoItisabenignbutpainfultumorthatarisesfromthemodifiedsmoothmusclecellsoftheglomusbody,aspecializedarteriovenousanastomosisthatisinvolvedinthermoregulation.oTheyaremostcommonlyfoundinthedistalportionofthedigits,especiallyunderthefingernails.
176.AllofthefollowingaretrueaboutGout, except:- a)Occursduetoaccumulationofuratecrystalsinjoint b)Canbepptdbypyrazinamide c)Birefringementcrystalsarepresentinjoint d)Occursmoreinfemales CorrectAnswer-DAnswerisD(Occursmoreinfemales):Goutismorewidespreadinmenthaninwomen.Womenrepresentonly5-20%ofpatientswithgout.Womenareseldomaffecteduntilaftermenopause.
177.Firstchangeseeninacuteinflammation is:September2009 a)Increasedpermeability b)Vasodilation c)Neutrophilmigration d)Vasoconstriction CorrectAnswer-DAns.D:VasoconstrictionCardinalsigns:Rubor(redness)duetodilatationofarteriolesCalor(heat)Dolor(pain)duetopressureonnerveendingsbyedemafluidandchemicalmediatorbradykinineTumor(swelling)duetoedema.Functiolaesa(lossoffunction)duetoinhibitionofmovementbypainandtissuenecrosis.
178.Portalhypertensionissaidtobepresent ifportalvenouspressureismorethan:March2010 a)3-5mmHg b)5-8mmHg c)10-12mmHg d)15-20mmHg CorrectAnswer-CAns.C:10-12mmHgNormalportalpressureisgenerallydefinedbetween5and10mmHg.Portalhypertensionresultswhentheportalpressurerisesto12mmHgorgreaterandcomplicationscanarise,suchasvaricesandascites.Manyconditionsareassociatedwithportalhypertension,ofwhichcirrhosisisthemostcommoncause
179.Mostcommonsiteofhypertensive intraparenchymalhemorrhageinbrain:March2013 a)Pons b)Thalamus c)Putamen d)Cerebellum CorrectAnswer-CAns.Ci.e.PutamenSitesofintracerebralhemorrhageincludesputamen(55%),thalamus(20-3-%),cerebrllum(10%),pons(5-7%)andsubcorticalwhitematter(10-15%)
180.Negribodiesarecharacteristicof: September2008,March2013 a)Tetanus b)Rabies c)Polio d)AIDS CorrectAnswer-BAns.B:RabiesSincefirstdescribedbyNegriin1903,thepresenceoftheNegribodiesarepracticallypathognomicforrabiesandareanimportantdiagnosticfinding.Negribodiesarediscrete,intracytoplasmic,deeplyeosinophilicinclusionsthatmeasureseveralmicronsindiameter.Inabout75%ofcasesofrabiesthesecanbeseenonhematoxylinandeosinstainedsections.Theyoccurinneuronsofthebrainstem,particularlythoseinthehippocampus,andinthePurkinjecellsofthecerebellum.UltrastructuralstudieshaveshownthatNegribodyconsistsofamassofnucleocapsidssurroundedbyviralparticlesbuddingfromintracytoplasmicmembranes.Thosebodiescanbeseeninaxons,anditisinthiswaythatvirusspreadsfromthecentralnervoussystemtomanyorgansofthebody.BecauseNegribodiesareusuallyseeninintactneurons,theyarefoundawayfromtheinflammatory,nonspecificlesions.Rabiesviralantigenscanbedemonstratedininfectedcellsbymeansoffluorescentantibodytechnique.AntigenscanbeshowntobepresentincellsintheabsenceofNegribodies,andhencethistechniqueismuchmoresensitivethanthe
bodies,andhencethistechniqueismuchmoresensitivethanthesearchofsectionsofbrainforthepathognomoniccytoplasmicinclusions.
181.Mostcommonlocationofgastrinomais: September2007 a)Pancreas b)Duodenum c)Jejunum d)Gallbladder CorrectAnswer-BAns.B:DuodenumZollinger-Ellisonsyndromeisadisorderwhereincreasedlevelsofthehormonegastrinareproduced,causingthestomachtoproduceexcesshydrochloricacid.Oftenthecauseisatumor(gastrinoma)oftheduodenumorpancreasproducingthehormonegastrin.Gastrinthencausesanexcessiveproductionofacidwhichcanleadtopepticulcersinalmost95%ofpatients.Gastrinomasmayoccurassingletumorsorasmultiple,smalltumors.Aboutone-halftotwo-thirdsofsinglegastrinomasaremalignanttumorsthatmostcommonlyspreadtotheliverandlymphnodesnearthepancreasandsmallbowel.Nearly25percentofpatientswithgastrinomashavemultipletumorsaspartofaconditioncalledmultipleendocrineneoplasiatypeI(MENI).MENIpatientshavetumorsintheirpituitaryglandandparathyroidglandsinadditiontotumorsofthepancreas.
182.Lacunarcellsisseeninwhichtypeof HodgkinsLymphoma:September2010 a)Mixedcellularitytype b)Lymphocytepredominant c)NodularSclerosisType d)Alloftheabove CorrectAnswer-CAns.C:NodularSclerosisTypeReed-Sternbergcells(alsoknownaslacunarhistiocytesforcertaintypes)aredifferentgiantcellsfoundonlightmicroscopyinbiopsiesfromindividualswithHodgkin'slymphoma(akaHodgkin'sdisease;atypeoflymphoma),andcertainotherdisorders.TheyareusuallyderivedfromBlymphocytes.
183.Followingareseeninpolycythemiavera except: a)Mostcommoncauseofpolycythemia b)Increasederythropoietin c)Erythropoietinindependentgrowthofredcellprogenitors d)Intrinsicabnormalityofhematopoieticprecursors CorrectAnswer-BPolycythaemiavera(PV)isaclonaldisordercharacterizedbyincreasedproductionofallmyeloidelementsresultinginpancytosis(i.eincreasedredcells,granulocytes,platelets)intheabsenceofanyrecognizablecause.Theterm`polycythemiavera'or`polycythemiarubravera'isusedforprimaryoridiopathicpolycythemiaonlyandisthemostcommonofallthemyeloproliferativedisorders.Secondarypolycythemiaorerythrocytosis,ontheotherhand,mayoccursecondarytoseveralcausese.g.highaltitude,cardiovasculardisease,apulmonarydiseasewithalveolarhypoventilation,heavysmoking,inappropriateincreaseinerythropoietin(renalcellcarcinoma,hydronephrosis,hepatocellularcarcinoma,cerebellarhemangioblastoma,massiveuterineleiomyoma);clinicalfeatures:headache,vertigo,tinnitus,visualalterationssyncopeorevencoma.Increasedriskofthrombosisduetoacceleratedatherosclerosis.Increasedriskofhemorrhagesduetoincreasedbloodvolumeandintrinsicplateletdysfunctione.g.epistaxis,pepticulcerdiseaseSplenomegalyproducingabdominalfullness.Pruritus,especiallyafterabath
184.Mostcommonlungcancerinnon- smokersis: a)Adenocarcinoma b)Squamouscellcarcinoma c)Oatcellcarcinoma d)Noneoftheabove CorrectAnswer-AAns.A:AdenocarcinomaAdenocarcinomaaccountsfor40%ofnon-smallcelllungcancers.Itusuallyoriginatesinperipherallungtissue.Mostcasesofadenocarcinomaareassociatedwithsmoking;however,amongpeoplewhohaveneversmoked("never-smokers"),adenocarcinomaisthemostcommonformoflungcancer.Asubtypeofadenocarcinoma,thebronchioloalveolarcarcinoma,ismorecommoninfemalenever-smokers,andmayhavedifferentresponsestotreatment.
185.Mostcommonfeatureofsarcoidosison chestX-rayis:March2011,March2013 a)Pleuraleffusion b)Cavitation c)Bilateralhilarlymphadenopathy d)Pneumothorax CorrectAnswer-CAns.C:BilateralhilarlymphadenopathySarcoidosismaybediscoveredunexpectedlyonroutinechestfilmsasbilateralhilarlymphadenopathySarcoidosis/Sarcoid/Besnier-Boeckdisease/Besnier-Boeck-SchaumanndiseaseItisadiseaseinwhichabnormalcollectionsofchronicinflammatorycells(granulomas)formasnodulesinmultipleorgans.Thecombinationoferythemanodosum,bilateralhilarlymphadenopathyandarthralgiaiscalledLofgrensyndrome.ThissyndromehasarelativelygoodprognosisChestX-raychangesaredividedintofourstages 1. Stage1:Bihilarlymphadenopathy2. Stage2:Bihilarlymphadenopathyandreticulonodularinfiltrates3. Stage3:Bilateralpulmonaryinfiltrates4. Stage4:Fibrocysticsarcoidosistypicallywithupwardhilarretraction, cysticandbullouschanges
186.Multiplesinusesfrominfectionofgreat toeismainlycausedby:September2007 a)Tuberculosis b)Actinomycetes c)Trichosporum d)Histoplasmosis CorrectAnswer-BAns.B:ActinomycetesMycetomaisachroniclocalizedgranulomatousinflammatorylesioncommoninthetropicsandsub-tropics.MultiplesiAuses,softtissueswellinganddischargeofcolouredgranulescharacterizeamycetomafoot.Chronicsinusesdischarginggranulesarecausedby(1)Eumycetes(truefungi),(2)Schizomycetes,whichincludesActinomycosis(aerobichigherfilamentousbacteria)andBotryomycosis(bacterialinfection).-ActinomycosisisoftencausedbyActinomaduraorNocardiaspecieswhereinitgainsentryafterpenetratingtrauma(splinter,gravelorthornprick).Youngmalesarecommonlyaffectedand75%ofthelesionsoccurinthelowerlimbs.Thediseaseslowlyprogressesfromanoduletomultiplesinusesdischargingcolouredgranules.Involvementofboneislatefollowingdermalandsofttissuespread.-Botryomycosis(amisnomer),achronicsuppurativeinfectioniscausedbybacteriainvolvingskinorviscera.Thisrareconditionmimicsadeepmycoticinfectionandisoftencausedby
mimicsadeepmycoticinfectionandisoftencausedbyStaphylococcusorPseudomonasspeciesofbacteria.Thefeetandhandsarecommonlyaffectedandpenetratingtraumamaybeapredisposingfactor.Itusuallypresentsasanodule,sinusorulcer,whichisinitiallylocalized.Thediagnosisofactinomycosisisbasedonclinicalfindings,demonstrationofcharacteristicgranulesandcultureoftheorganismfromadeeptissuebiopsy.Immunologicalstudies(counterimmunoelectrophoresisandELISA)arealsoused.Botryomycosisisdiagnosedbasedonapositivegram'sstainandculture;negativefungalculturesanddemonstrationofthecharacteristicbotryomycoticgranulesathistopathologyfromadeepbiopsy.Inendemicareas,subcutaneousswellingwithsinusesshouldbeconsideredasmycetomaunlessprovedotherwise.Thedifferentialdiagnosisincludeschronicosteomyelitis,tuberculosisandchronicabscesses.
187.BarrbodyisNOTseenin: PGI07;WB08 a)Turnersyndrome b)Klinefeltersyndrome c)Down'ssyndrome d)Marfan'ssyndrome CorrectAnswer-AAns.TurnersyndromeBarrbody(Sex-chromatin)Itisadenselystaininginactivatedcondensed'X'chromosomethatispresentineachsomaticcellsoffemale.oItisfoundinthenucleus.Itisusedasatestofgeneticfemaleness-4itispossibletodeterminethegeneticsexofanindividualaccordingastowhetherthereisachromatinmasspresentontheinnersurfaceofthenuclearmembraneofcellswithrestingorintermitentnuclei.Rememberfollowingfactandthequestionwillseemveryeasy.Chromatidbody(Barrbodyorsexchromatin)isderivedfromoneofthetwoX-chromosomeswhichbecomesinactivated.ThenumerofBarrbodiesisthusonelessthanthenumberofX-chromosomes.
188.Compensatorymechanisminacute hemorrhage? a)Decreasedmyocardialcontractility b)Decreasedheartrate c)Increasedheartrate d)Increasedrespiratoryrate CorrectAnswer-CAns.is'c'i.e.,IncreasedheartrateCompensatorymechanismsinacutehemorrhageInacutehemorrhagethereiscompensatorysympatheticstimulationwhichcauses:?1)Generalizedvasoconstrictionwithincreasedtotalperipheralresistance(TFR).2)Increasedheartrate(tachycardia).3)Increasedcardiaccontractility.4)IncreasedreninreleasecausingsodiumandwaterretentionthroughRAAsystem.5)Shiftoffluidfromintracellularandinterstitialspaceintovascularspace.
189.Prostaglandinsareproducedby? a)Neutrophils b)Endothelium c)Macrophages d)Alloftheabove CorrectAnswer-DAns.is'd'i.e.,Alloftheabove
190.Sirtuinsareassociatedwith? a)Antioxidantmechanisminbody b)Logetivityoflifespan c)Regenerationofliverafterpartialresection d)Carcinogenesisinhuman CorrectAnswer-BAns.is'b'i.e.,Logetivityoflifespan
191.ReceptorforBDNF? a)TrK-A b)TrK-B c)TrK-C d)None CorrectAnswer-BAns.is'B'i.e.,TrK-B
192.Leukocytemigrationthrough endotheliumisinducedby? a)Selectin b)NCAM c)CCAM d)PECAM CorrectAnswer-DAns.is'd'i.e.,PECAMMigrationoftheleukocytesthroughtheendotheliumiscalledtransmigrationordiapedesis.Transmigrationofleukocytesoccursmainlyinpostcapillaryvenules.ThemoleculesinvolvedintransmigrationarememberoftheimmunoglobulinsuperfamilycalledCD31orPECAM-1(plateletendothelialcelladhesionmolecule).
193.Largegranularlymphocytesare? a)Bcells b)NKcells c)Tcell d)Plasmacells CorrectAnswer-BAns.is'b'NKcellsNullcells(Largegranularlymphocytes)NullcellsarecalledsobecausetheylackfeaturesofsurfacemarkersofbothBandTlymphocytes.Theaccountfor5to10%ofperipheralbloodlymphocytes.Theyarealsocalled"largegranularlymphocytes(LGL)"astheycontainlargeazurophiliccytoplasmicgranules.Membersofthisgroupare:a)Antibodydependentcytotoxiccells(ADCC)b)Naturalkillercells(NKCells)
194.Thymichyperplasiaisseenin? a)Thymoma b)Thymiclymphoma c)Myastheniagravis d)Scleroderma CorrectAnswer-CAns.is'c'i.e.,MystheniagravisThymichvperplasiaThetermthymichyperplasiausuallyappliestotheappearanceofB-cellgerminalcenterswithinthethymus,afindingthatisreferredtoasthymicfollicularhyperplasia.SuchB-cellfolliclesarepresentinonlysmallnumbersinthenormalthymus.Itcanoccurinanumberofchronicinflammatoryandimmunologicstates,butitismostfrequentlyencounteredinmyastheniagravis(65%to75%ofcases).SimilarthymicchangesaresometimesencounteredinGravesdisease,systemiclupuserythematosus,scleroderma,rheumatoidarthritis,andotherautoimmunedisorders.
195.Whichoneofthefollowingstatementsis correctregardingchronicgranulomatousdisease? a)Itisanautosomaldominantdisease b)Itischaracterizedbyabnormalbacterialphagocytosis c)Recurrentstreptococcalinfectionsareusualinthisdisease d)Nitrobluetetrazoliumtestisusefulforscreening CorrectAnswer-DAns.is'd'i.e.,NitrobluetetrazoliumtestisusefulforscreeningLeukocytesfromthepatientsofchronicgranulomatousdiseasefailtoreducenitrobluetetrazolium(NBT)duringphagocytosis.Thispropertyhasbeenusedasascreeningmethod(NBTtest)forthediagnosisofchronicgranulomatousdisease.Chronicgranulomatousdisease(CGD)Itisagroupofdisordersofgranulocyteandmonocyteoxidativemetabolism.InheritanceX-linked(Mostcommon)AutosomalrecessivePhagocytosisisnormalbutleukocytesdonotundergodegranulationfollowingphagocytosis.ThediminishedH202productionappearstobethemajorreasonfordefectivebactericidaldefect.MutationinthegenesforthefourproteinsthatassembleattheplasmamembraneaccountforallpatientswithCGD:Twoproteinsformtheheterodimercytochromeb-558intheplasmamembrane.
TwootherproteinsinteractwithcytochromeaftercellactivationtoformNADPHoxidaserequiredforHydrogenperoxideproduction.Thebacteriainvolvedinrecurrentinfectionsarecatalasepositivepyogenicpathogenssuchasstaphylococciandcoliforms.Catalasenegativepathogenssuchasstreptococciandpneumococciarehandlednormally.Thereisexcessiveinflammationwithgranulomasformation.
196.Lacunartypeofreedsternbergcellis seenin? a)Nodularsclerosis b)Lymphocytepredominance c)Mixedcellularity d)Lymphocytedepletion CorrectAnswer-AAns.is'a'i.e.,Nodularsclerosis
197.Activationofna?veBlymphocytesby proteinantigensis? a)TCellindependent b)NKcelldependent c)NKcellindependent d)Tcelldependent CorrectAnswer-DAns.isdi.e.,TcelldependentUponactivation,Blymphocytesproliferateandthendifferentiateintoplasmacellsthatsecretedifferentclassesofantibodieswithdistinctfunctions.AntibodyresponsestomostproteinantigensrequireTcellhelpandaresaidtobeT-dependent.ManypolysaccharideandlipidantigenscannotberecognizedbyTcellsbuthavemultipleidenticalantigenicdeterminants(epitopes)thatareabletoengagemanyantigenreceptormoleculesoneachBcellandinitiatetheprocessofB-cellactivation;theseresponsesaresaidtobeT-independent.
198.Mantouxtestisbasedonwhich hypersensitivity? a)Type1 b)Type2 c)Type3 d)Type4 CorrectAnswer-DAns.is'd'i.e.,Type4Followingaretheexamplesoftype4hypersensitivityreactions:-Type1diabetesmellitusHashimotothyroiditisCrohn'sdiseaseMultiplesclerosisContactdermatitisMantouxtest
199.Laddertearsare? a)Spiraltearsofaorticintima b)Verticaltearsofaorticintima c)Horizontaltearsofaorticintima d)Obliquetearsofaorticintima CorrectAnswer-CAns.is'c'i.e.,HorizontaltearsofaorticintimaLaddertearsarethehorizontaltearsofintimaItisinjurytoaortaduetodeceleration.Itissocalledbecauseitresemblestherungsofaladder.
200.Pendredsyndromeduetomutationof? a)Bartillin b)Pendrin c)Fibrillin d)Reticulin CorrectAnswer-BAns.is`b'i.e.,PendrinPendredsyndromeorPendreddisease:?PendredsyndromeorPendreddiseaseisageneticdisorderleadingtocongenitalbilateral(bothsides)sensorineuralhearinglossandgoitrewithoccasionalhypothyroidism.IthasbeenlinkedtomutationsinthePDSgene,whichcodesforthependrinprotein(solutecarrierfamily26,member4,SLC26A4).Thegeneislocatedonthelongarmofchromosome7(7q31).Itisanautosomalrecessivedisorder.
201.Whichofthefollowingisnottrueabout idiopathicthrombocytopenicpurpura? a)AntibodiesofIgMclass b)AutoantibodiestoGpIIb/IliaorIBIX c)Increasedmegakaryocytesinbonemarrow d)Spleenisnormalinsize CorrectAnswer-AAns.is'a'i.e.,AntibodiesofIgMclassIdopathicthrombocytopenicpurpura:?TherearetwoclinicalsubtypesofprimaryI.T.P,acuteandchronicbothareautoimmunedisordersinwhichplateletdestructionresultsfromformationofantiplateletantibodies.PathogenesisChronicITPiscausedbytheformationofautoantibodiesagainstplateletmembraneglycoproteinsmostoftenHb-lIlaorIb-IX.Inoverwhelmingmajorityofcasestheantiplateletantibodiesareofthe.IgL,class.Themechanismofplateletdestructionissimilartothatseeninautoimmunehemolyticanemias.Opsonizedplateletsarerenderedsusceptibletophagocytosisbythecellsofthemononuclearphagocytesystem.Thespleenisthemajorsiteofthedestructionofplatelets.PathologyTheprincipalmorphologiclesionsofthrombocytopenicpurpuraarefoundinthespleenandbonemarrowbuttheyarenotdiagnostic.Thepointtostressisthatdespitetheincreaseddestructionofplateletsinspleen,thespleensizeremainsnormal.
Onhistologicalexaminationthereiscongestionofthesinusoidsandhyperactivityandenlargementofthesplenicfolliclesmanifestedbytheformationofprominentgerminalcentres.Sometimesscatteredmegakaryocytesarefoundwithinthesinusesandsinusoidalwalls.Thisrepresentsaverymildformofextramedullaryhematopoiesis.Thesesplenicfindingsarenotsufficientlydistinctivetobeconsidereddiagnostic.BoneMarrowBonemarrowrevealsamodestlyincreasednumberofmegakaryocytes.Thesefindingsarenotspecificforautoimmunethrombocytopenicpurpura,butmerelyreflectacceleratedthrombopoiesis,beingfoundinmostformsofthrombocytopeniaresultingfromincreasedplateletdestruction.Theimportanceofbonemarrowexaminationistoruleoutthrombocytopeniasresultingfrombonemarrowfailure.AdecreaseinthenumberofmegakaryocytesgoesagainstthediagnosisofI.T.P.
202.Macrophageactivationsyndrome characterizedbyallexcept? a)ActivationofCD8+Tcells b)Presenceofcytokinestorm c)Itistheothernameforhemophagocyticlymphohistiocytosis d)Lowlevelsofplasmaferretin CorrectAnswer-DAns.is'd'i.e.,LowlevelsofplasmaferretinHemophagocyticLymphohistiocytosisHemophagocyticlymphohistiocytosis(HLH)isareactiveconditionmarkedbycytopeniasandsignsandsymptomsofsystemicinflammationrelatedtomacrophageactivation.Forthisreason,itisalsosometimesreferredtoasmacrophageactivationsyndrome.PathogenesisThecommonfeatureofallformsofHLHissystemicactivationofmacrophagesandCD8+cytotoxicTcells.Theactivatedmacrophagesphagocytosebloodcellprogenitorsinthemarrowandformedelementsintheperipheraltissues,whilethe"stew"ofmediatorsreleasedfrommacrophagesandlymphocytessuppresshematopoiesisandproducesymptomsofsystemicinflammation.Theseeffectsleadtocytopeniasandashock-likepicture,sometimesreferredtoas"cytokinestorm"orthesystemicinflammatoryresponsesyndrome.FamilialformsofHLHareassociatedwithseveraldifferentmutations,allofwhichimpacttheabilityofcytotoxicTcellsandNKtoproperlyformordeploycytotoxicgranules.ThemostcommontriggerforHLHisinfection,particularlywith
Epstein-Barrvirus(EBV).ClinicalFeaturesMostpatientspresentwithanacutefebrileillnessassociatedwithsplenomegalyandhepatomegaly.Hemophagocytosisisusuallyseenonbonemarrowexamination,butisneithersufficientnorrequiredtomakethediagnosis.Laboratorystudiestypicallyrevealanemia,thrombocytopenia,andveryhighlevelsofplasmaferritinandsolubleIL-2receptor,bothindicativeofsevereinflammation,aswellaselevatedliverfunctiontestsandtriglyceridelevels,bothrelatedtohepatitis.Coagulationstudiesmayshowevidenceofdisseminatedintravascularcoagulation.Ifuntreated,thispicturecanprogressrapidlytomultiorganfailure,shock,anddeath.TreatmentInvolvestheuseofimmunosuppressivedrugsand"mild"chemotherapy.PatientswithgermlinemutationsthatcauseHLHorwhohavepersistent/resistantdiseasearecandidatesforhematopoieticstemcelltransplantation.Withouttreatment,theprognosisisgrim,particularlyinthosewithfamilialformsofthedisease,whotypicallysurviveforlessthan2months.
203.HLAassociatedwithrheumatoidarthritis is? a)HLAB27 b)HLADR4 c)HLABI9 d)HLADR2 CorrectAnswer-BAns.is`b'i.e.HLADR4AssociatedwiththedevelopmentofRheumatoidarthritis?HLA-DR4?HLA-DR10?HLA-DR9 ProtectsagainstthedevelopmentofRheumatoidarthritis?HLA-DR5?HLA-DR2?HLA-DR3
204.HepatitisBassociatedwith? a)Wegener'sgranulomatosis b)Systemiclupuserythmatosus c)Polyarteritisnodosa d)Sjogrensyndrome CorrectAnswer-CAns.is'c'i.e.,PolyatrteritisnodosaThehepatitisBsurfaceantigenispresentin25%ofpatientswithPolyarteritisNodosa.HepatitisCantibodyispresentinpatientswithessentialmixedcryoglobinuriaandrarelyinpatientswithpolyarteritisnodosa.
205.NormalupperlimitofCA-125is? a)25U/ml b)45U/ml c)65U/ml d)85U/ml CorrectAnswer-AAns.is`a'i.e.,25U/mlThenormalvalueislessthan35U/mL1)Carcinoembryonicantigen(CEA)Itisaglycoproteinproducedbyfetalgut,pancreasandliver.Itisusedastumormarkerforcolorectalcancer(majoruse),lungcancer,breastcancerandovariancancer.Itisalsoincreasedinnon-neoplasticconditionslikealcoholiccirrhosis,hepatitis,IBD(CD,UC),smokingandpancreatitis.Incolorectalcanceritisusedforscreening;responseandfollowupaftersurgery(CEAshoulddiseapperin6weeksafterresection),prognosis(higherlevelssuggestshightumorburden)andtoseerecurrenceonfollowup.CEAantigenhasnocorrelationwithhepaticmetastasis.CEAlackssensitivityaswellasspecificity,hencecannotbeusedtoconfirmthediagnosis.2)Alpha-fetoprotein(AFP)Itisaglycoproteinsynthesizednormallyearlyinfetallifebyyolksac,fetalliverandfetalGIT.Itisstructurallyandgeneticallyrelatedtoalbumin.AFPisraisedinlivercancer(hepatocellularcarcinoma),lungcarcinoma,pancreaticcarcinoma,coloncarcinoma,andnon-seminomagermcelltumoroftestis/ovary(yolksac
tumor/endodermalsinustumor,embryonalcarcinoma,teratoma).AFPisalsoraisedinsomenon-neoplasticconditionslikecirrhosis,hepatitis,andpregnancy.3)Humanchorionicgonadotropin(HCG)Itisaplacentalhormonesynthesizedbysyncytiotrophoblasts.Itisglycoproteinwithtwosubunits(dimer):a-subunitand/3-subunit.ButonlythePsubunitofHCGistypicallymeasuredasatumourmarkerbecauseofspecificityofthe13subunit.Thei3subunitofHCGhasuniquesequencesthatarenotsharedwithotherhumanglycoproteinhormones.Itisdetectedbyradioimmunoassayusingantibodiestothe13chain.a-HCGisnotusedastumourmarkerbecauseaunitoftheFSH,LHandTSHareidentical.Sotherecanbecrossreactivitybetweenasubunitsofthesehormone.ThatiswhyincaseoftesticulartumoursthepatientsalsoundergosimultaneousassayofLHtobecertainthatthemarkerdetectedis13HCG.HCG(13-HCG)israisedingestationaltrophoblasticdisease(hydatidiformmoles),gonadalgermcelltumor(embryonalcarcinoma,choriocarcinoma),andpregnancy.4)CA-125MostimportantcancerwithelevatedCA-125isepithelialovariancancer.CA-125isalsoelevatedincancersofendometrium,cervix,fallopiantubes,pancreas,breast,lungandcolon.Non-neoplasticconditionscausingelevationofCA-125arepregnancy,mensturation,endometriosis,PID,abdominalTB,peritonitisanduterinefibroid.Tumormarkersfortesticular/ovariantumor 1. AFP(alpha-fetoprotein):Teratoma,Yolksactumor(endodermal sinustumor),embryonalcarcinoma. 2. HCG(humanchorionicgonadotrophin):Choriocarcinoma, embryonalcarcinoma. 3. a,-antitrypsin:Yolksactumor(endodermalsinustumor).4. Placentalalkalinephosphatase:Seminoma.5. Other:Placentallactogen,LDH.
206.Whichofthefollowinginterleukinis secretedbyThelper2cells? a)IL11 b)IL7 c)IL1 d)IL13 CorrectAnswer-DAns.is'd'i.e.,IL13A)Thelper-1(TF,')secretes4IL-2andinterferon-yB)Thelper-2(T 2 0 )secretes->IL-4,IL-5,IL-6,IL-13
207.Atopyinhypersensitivityis? a)SystemictypeIhypersensitivity b)LocaltypeIhypersensitivity c)SystemictypeIIhypersensitivity d)LocaltypeIIhypersensitivity CorrectAnswer-BAns.is`b'i.e.,LocaltypeIhypersensitivityAnaphylaxis-3Acute,potentiallyfatal,systemic.Atopy->Chronic,Nonfatal,Localized.
208.Inheritancepatternofmyotonic dystrophyis? a)Autosomalrecessive b)Autosomaldominant c)Xlinkeddominant d)Xlinkedrecessive CorrectAnswer-BAns.is`b'i.e.,AutosomaldominantMyotonicdystrophyMyotonicdystrophyisanautosomaldominantmultisys-temdisorderassociatedwithskeletalmuscleweakness,cataracts,endocrinopathy,andcardiomyopathy
209.GeneresponsibleforWilsondiseaseis situatedonwhichchromosome? a)Chromosome11 b)Chromosome12 c)Chromosome13 d)Chromosome14 CorrectAnswer-CAns.is'c'i.e.,Chromosome13WilsondiseaseisanautosomalrecessivedisordercausedbymutationoftheATP7Bgene,resultinginimpairedcopperexcretionintobile&failuretoincorporatecopperintoceruloplasmin.TheATP7Bgeneislocatedonchromosome13.
210.Antischkowcellsare? a)Modifiedmacrophages b)Modifiedneutrophils c)ModifiedBcells d)ModifiedRBCs CorrectAnswer-AAns.is'a'i.e.,ModifiedmacrophagesPathologicFeaturesofAcuteRheumaticFeverAschoffbodiesfocalinflammatorylesionsseeninacuterheumaticfeverconsistingoffociofTlymphocytes,occasionalplasmacells,andplumpactivatedmacrophages.TheseactivatedmacrophagescalledAnitschkowcells(pathognomonicforRheumaticFever)haveabundantcytoplasmandcentralround-to-ovoidnuclei(occasionallybinucleate)inwhichthechromatincondensesintoacentral,slender,wavyribbon(hencealsocalled"caterpillarcells").Pancarditis-DuringacuteRF,diffuseinflammationandAschoffbodiesmaybefoundinanyofthethreelayersoftheheart,resultinginpericarditis,myocarditis,orendocarditisVerrucaearesmall(1to2mm)vegetationsoverlyingnecroticfociandalongthelinesofclosureofvalves.oMacCallumplaquesareirregularlythickenedsubendocardiallesionsusuallyintheleftatrium.oMitralstenosis-FishMouthorButton-Holestenosis.
211.Patientwithchronichypertensionwill showfollowingchangesonhistologyofkidney a)Hyalinearteriosclerosis b)Hyperplasticarteriosclerosis c)Onionskinlesions d)Vessellumendilatation CorrectAnswer-AAns.is'a'i.e.,HyalinearteriosclerosisHypertensionisassociatedwithtwoformsofsmallbloodvesselsdisease?1.HyalinearteriolosclerosisThereishomogenous,pink,hyalinethickeningofarteriolarwall.Thelumenbecomesnarrow.Itischaracteristicofbenignhypertension.Itmayalsooccurindiabetesandaging.2.HyperplasticarteriosclerosisItischaracteristicofmalignanthypertension.Thereisconcentrentic,laminatedthickeningofarteriolarwallonionskinning.Thereismucinousintimalthickeningandfibrousintimalthickening.Theremaybeaccompaniedfibrinoiddepositswithnecrosisofthevesselswallfibrinoidnecrosis(ornecrotizingarteriolitis).Favouredsitesforhyperplasticarteriosclerosisarekidney,smallintestine,gallbladder,peripancreaticfat,andperiadrenalfat.Besidethesehypertensionalsocauses:- 1. Atherosclerosisinlargearteries.2. Degenerativechangesinthewallsoflargeandmediumarteriesthat potentiatebothaorticdissectionandcerebrovascularhemorrhage.
212.NKcellshowspresenceof? a)CD44 b)CD16 c)CD54 d)CD32 CorrectAnswer-BAns.is'b'i.e.,CD16Thesecellspossesscytotoxicactivityagainstvirusinfectedcells,tumorcellsandtransplantedforeigncells.CytotoxicityofNKcellsisneitherantibodydependentnorMHCrestricted.Activityisnonimmuneasitdoesnotrequireantigenicstimulation.NK-cellsarepositiveforCD16andCD56.NKcellsareusuallynegativeforCD3,butasubsetispositiveforCD3calledNK/T-cells.
213.Nonprofessionalantigenpresentingcell isA/E? a)Endothelialcell b)Epidermalcell c)Fibroblasts d)Redbloodcells CorrectAnswer-DAns.is'd'i.e.,RedbloodcellsNon-professionalantigenpresentingcellAnon-professionalAPCdoesnotconstitutivelyexpresstheMajorHistocompatibilityComplexclassII(MHCclassII)proteinsrequiredforinteractionwithnaiveTcells;theseareexpressedonlyuponstimulationofthenon?professionalAPCbycertaincytokinessuchasIFN-y.AllnucleatedcellsexpresstheMajorHistocompatibilityComplexclassInecessarytobeconsideredanonprofessionalAPC.Aserythrocytesdonothaveanucleus,theyareoneofthefewcellsinthebodythatcannotdisplayantigens.
214.Bloodisstoredatwhattemperaturein bloodbank? a)-2to-4degreesCelsius b)-2to0degreesCelsius c)1to6degreesCelsius d)6to12degreesCelsius CorrectAnswer-CAns.is'c'i.e.,1to6degreesCelsiusStoragetemperatureofblood:1-6?CStoragetemperatureofpackedRBCs:40?CStoragetemperatureofFFP:-20?CStoragetemperatureofplatelets:20-24?C
215.Birbeckgranulesincytoplasmisseenin ? a)Langerhanscellhistiocytosis b)Hodgkin'slymphoma c)Nonhodgkinslymphoma d)Gastrointestinalstromaltumor CorrectAnswer-AAns.is'a'i.e.,LangerhanscellhistiocytosisBirbeckgranulesarecharacteristicoflangerhanscellhistiocytosisTumourcellsinthelangerhan'scellhistiocvtosisarederivedfromdendriticcellsandexpress:S-100CD1aHLA-DRThesecellsarecharacterizedbythepresenceofbirbeckgranulesintheircytoplasmundertheelectronmicroscope,Birbeckgranuleshavepentalaminar,rodliketuularappearanceandsometimesadilatedterminalend(tennis-racketappearance)
216.Reticulocytesarestainedby? a)Supravitalstain b)Purssianbluestain c)HandEstain d)Reticulinstain CorrectAnswer-AAns.is'a'i.e.,SupravitalstainUsuallysupravitalstains(methyleneblueandBrilliantcresylblue)areusedforreticulocytes.
217.Mostcommontypeofhodgkins lymphomais? a)Lymphocytepredominant b)Lymphocytedepletion c)Nodularsclerosis d)Mixedcellularity CorrectAnswer-CAns.is'c'i.e.,NodularsclerosisBestPrognosisWorstprognosisMostcommonHLMostcommontypeHLinIndiaLeastcommontypeHLLymphocyticpredominancetype.-->Lymphocyticdepletiontype.-->Nodularsclerosistype.-->Mixedcellularitytype.Lymphocyticdepletiontype
218.Mostcommonsiteforeosinophilic granulomais? a)Radius b)Skull c)Lumbarvertebra d)Femur CorrectAnswer-BAns.is'b'i.e.,SkullThemostcommonsitesareskullbones,longbones,spinalvertebrae,mastoidandmandible.
219.Replacementofcolumnarepitheliumin respiratorytracttosquamousepitheliumis? a)Hyperplasia b)Hypoplasia c)Metaplasia d)Noneoftheabove CorrectAnswer-CAns.is`c'i.e.,MetaplasiaMetaplasiaMetaplasiaisareversiblechangeinwhichonedifferentiatedcelltypeisreplacedbyanotherdifferentiatedcelltype.Metaplasiarepresentsanadaptivesubstitutionofcellsthataresensitivetostressbycelltypesbetterabletowithstandtheadverseenvironment.
220.WhichisthebestmarkerofSLE? a)AntiSmantibodies b)AntidsDNAantibodies c)Antihistoneantibodies d)AntiRoAntibodies CorrectAnswer-BAns.is'b'i.e.,AntidsDNAantibodiesAntibodiestodouble-strandedDNAandtheSmith(Sm)antigenarevirtuallydiagnosticofSLE".
221.Mostcommoncauseofdeathin amyloidosisis? a)Heartfailure b)Renalfailure c)Sepsis d)None CorrectAnswer-AAns.is'a'i.e.,HeartFailure`Mostcommoncauseofdeathisheartfailureand/orabnormalcardiacrhythm'Essentialspathology
222.Whatistrueaboutulcerativecolitis? a)Involvesrectumandthenwholecolonbackwards b)Involvesonlycolon c)Skiplesionsseen d)Ileumnotinvolved CorrectAnswer-AAns.is-A.InvolvesrectumandthenwholecolonbackwardsUlcerativecolitis(UC)isalong-termconditionthatresultsininflammationandulcersofthecolonandrectum.
223.Executioncaspasesofapoptosisare? a)Caspase1&3 b)Caspase3&5 c)Caspase1&5 d)Caspase3&7 CorrectAnswer-DAns.is'd'i.e.,Caspase3&7
224.Neurofibromatosisshowswhichofthe followingmodeofinheritance? a)AD b)AR c)Xlinkeddominant d)Xlinkedrecessive CorrectAnswer-AAns.is'a'i.e.,ADNeurofibromatosisshowsautosomaldominantinheritancepatternSinglegenedisorders(Mendeliandisorders)typicallyfollowoneofthethreepatternsofinharitance? a. Autosomaldominanceb. Autosomalrecessive c. X-linked AutosomaldominantdisordersNormallyagenepairhastwoalleles.Whenoneallelebecomesabnormalduetomutationitiscalledheterozygousstate.Whenboththeallelesbecomeabnormalduetomutationitiscalledhomozygousstate.Autosomaldominantdisordersaremanifestedinheterozygousstate,i.e.onlyifoneallelisabnormalthediseasewillbemanifested.
225.Mostcommonsiteofglomustumoris? a)Underfingernails b)Undertoenails c)Neck d)Axilla CorrectAnswer-AAns.is'a'i.e.,UnderfingernailsGlomustumor(Glomangioma)Benigntumorarisingfromthesmoothmusclecellsoftheglomusbodywhichisanarteriovenousanastomosisinvolvedinthermoregulation.Mostcommonlypresentinthedistalportionofthedigits(underfingernails).Histologically,thereispresenceofbranchingvascularchannelsandstromacontainingnests/aggregatesofglomuscellsarrangedaroundvessels.
226.Normalreticulocytecountinnewbornis- a)0-1% b)1-1.5% c)3-6% d)6-9% CorrectAnswer-CAns.is'c'i.e.,3-6%Normalreticulocytecountinadultsis1-1.5%andinnewbornsis3-6%
227.BRCA2notassociatedwith a)breastcancer b)Prostatecancer c)Ovariancancer d)Vulvalcancer CorrectAnswer-DAns.is'd'i.e.,VulvalcancerBRCA-1erBRCA-2arecommonlyassociatedwith-->Carcinomasofovaryandbreast.LesscommonlyBRAC-2isalsoassociatedwith-->Carcinomasofcolon,prostateandpancreas.[RefRobbin'sViep.1076;ClinicalSurgerybyMichalM.Henry&JeremyN.Thompson2"a/ep.453]
228.Whichofthefollowingisnotalarge vesselvasculitiis? a)Takayasuarteritis b)Cogansyndrome c)Chrugstrausssyndrome d)Giantcellarteritis CorrectAnswer-CAns.is'c'i.e.,ChurgstrausssyndromeLargevesselvasculitis:Giantcellarteritis(temporalarteritis),Takayasuarteritis,Cogansyndrome.Mediumvesselvasculitis:PAN(classicalPAN),kawasakidisease,Buerger'sdisease.Smallvesselvasculitis:HSP,Wegner'sgranulomatosis,microscopicpolyangitis,churgstrausssyndrome,Cryoglobulinemia,SLE,idiopathiccrescenticglomerulonephritis,Bechet'ssyndrome,renallimitedvasculitis.
229.Traumatobreastcauseswhichtypeof necrosis? a)Coagualtivenecrosis b)Liquefactivenecrosis c)Caseousnecrosis d)Fatnecrosis CorrectAnswer-DAns.is'd'i.e.,FatnecrosisFatnecrosisFatnecrosismaybeoftwotypes:?EnzymaticfatnecrosisThisisduetoactionoflipaseonadiposetissue.Itoccursmostfrequentlyinacutepancreatitisduetoleakageoflipase.Dependingontheseverityofacutepancreatitis,fatnecrosismayoccurin:-aAdiposetissuecontiguoustopancrease,retroperitonealfat.Adiposetissueinanteriormediastinum.BonemarrowOmentalandabdominalfatNonenzymaticorTraumaticfatnecrosisOccursduetotraumaIsseeninsubcutaneoustissueofbreast,thigh,andabdomen.
230.Inhibinistumormarkerfor? a)Granulosacelltumor b)Malignantmelanoma c)Prolactinoma d)Breastcarcinoma CorrectAnswer-AAns.is'a'i.e.,GranulosacelltumorGranulosacelltumorispositiveforvimentin,inhibin,CD99.
231.Followingstatementistruefor hemophiliapatients? a)AllFemalesarecarriersandallmalesareaffected b)AllMalesarecarriersandallfemalesareaffected c)Femalesaremostlycarriersandallmalesareaffected d)Malesaremostlycarriersandallfemalesareaffected CorrectAnswer-CAns.is'c'i.e.,FemalesaremostlycarriersandallmalesareaffectedHemophiliaisanX-linkedrecessivehemorrhagicdiseaseduetomutationsintheF8gene(hemophiliaAorclassichemophilia)orF9gene(hemophiliaB).ThediseaseaffectsIin10,000malesworldwide,inallethnicgroups;hemophiliaArepresents80%ofallcases.Malesubjectsareclinicallyaffected;women,whocarryasinglemutatedgene,aregenerallyasymptomatic.Familyhistoryofthediseaseisabsentin30%ofcasesandinthesecases,80%ofthemothersarecarriersofthedenovomutatedallele.
232.Whichwormcausesmyocarditis? a)Trichuris b)Trichinella c)Enterobius d)Strogyloides CorrectAnswer-BAns.is'b'i.e.,TrichinellaTrichinosisisthemostcommonhelminthicdiseasecausingmyocarditis.
233.Giantplateletsareseenin? a)Bernardsouliersyndrome b)vWD c)Polycythemiarubravera d)Leukemia CorrectAnswer-AAns.is'a'i.e.,BernardsouliersyndromeBernadSoulierdisease-DefectintheplateletGpIb-IXcomplexBT,mildthrombocytopenia,deficientorlowlevelsofplateletGpIb-IXcomplexbyflowcytometryRistocetinaggregationtestisdefective
234.LEcellisseenin? a)Lupuserythmatosus b)Lupusvulgaris c)HNPCC d)Medullarycarcinomaofthyroid CorrectAnswer-AAns.is'a'i.e.,LupuserythematoususInSLE,antinuclearantibodies(ANPs)cannotpenetrateintactcells.However,nucleiareexposed,ANAcanbindtothem.Intissues,nucleiofdamagedcellsreactwithANAs,losetheirchromatinpattern,andbecomehomogeneous,toproducelupus-erythematous(LE)bodiesorhemotoxylinbodies.WhentheseLEbodiesareengulfedbyphagocyticcells(neutrophilormacrophage/monocyte),thephagocyticcellsarecalledLEcells.
235.PelgerHuetanamolyshowspresenceof ? a)Hyposegmentedneutrophil b)Hypersegmentedneutrophil c)Unsegmentedneutrophil d)Noneoftheabove CorrectAnswer-AAns.is'a'i.e.,HyposegmentedneutrophilPelgerHuetanomalyItisageneticdisorderwithanautosomaldominantinheritancepattern.ItisabloodlaminopathyassociatedwiththelaminBreceptor.Itischaracterizedbyawhitebloodcelltypeknownasaneutrophilwhosenucleusishyposegmented.Heterozygotesareclinicallynormal,althoughtheirneutrophilsmaybemistakenforimmaturecells,whichmaycausemistreatmentinaclinicalsetting.Homozygotestendtohaveneutrophilswithroundednucleithatdohavesomefunctionalproblems.
236.Sentinellymphnodebiopsyisusedfor? a)Melanoma b)Basalcellcarcinoma c)Squamouscellcarcionoma d)Thyroidcarcinoma CorrectAnswer-AAns.is'a'i.e.,MelanomaSentinellymphnodebiopsyisusedforbreastcarcinomaandmelanoma.
237.Interleukin2isproducedby a)Thelpercells1 b)Thelpercells2 c)Naturalkillercells d)Basophils CorrectAnswer-AAns.is'a'i.e.,Thelpercells1A)Thelper-1(TF,')secretes4IL-2andinterferon-yB)Thelper-2(T 2 0 )secretes->IL-4,IL-5,IL-6,IL-13
238.Popcorncellsareseeninwhichvariety ofhodgkin'sdisease? a)Nodularsclerosis b)Mixedcellularity c)Lymphocytepredominant d)Lymphocytedepletion CorrectAnswer-CAns.is'c'i.e.,LymphocytepredominantPopcorncellsarefoundinlymphocyticpredominanttypeofHodgkin'sLymphoma.
239.Shapeofbirbeckgranulesis? a)Tennisracket b)Hockeystick c)Bat d)Ball CorrectAnswer-AAns.is'a'i.e.,TennisracketUndertheelectronmicroscope,Birbeckgranuleshaveapentalaminar,rodlike,tubularappearanceandsometimesadilatedterminalendresemblingtennis-racketappearance.
240.Lipidperoxidationofpolyunsaturated lipidsofsubcellularmembranesproduces? a)Lipofuscin b)Hemosiderin c)Bothofabove d)Noneofabove CorrectAnswer-AAns.is'a'i.e.,LipofuscinLipofuscinisaninsolublepigment,alsoknownaslipochromeorwear-and-tearpigment.Lipofusciniscomposedofpolymersoflipidsandphospholipidsincomplexwithprotein,suggestingthatitisderivedthroughlipidperoxi-dationofpolyunsaturatedlipidsofsubcellularmembranes.
241.ParaneoplasticsyndromeHypercalcemia ofmalignancy,isproducedduetoectopicproductionofwhichhormonebylymphomas? a)PTHrP b)1,25dihydroxyvitaminD c)PGE2 d)Parathormone CorrectAnswer-BAns.is'b'i.e.,1,25dihydroxyvitaminDParathyroidhormone-relatedprotein(PTHrP)1,25dihydroxyvitaminDParathyroidhormone(PTH)(rare)ProstaglandinE2(PGE2)(rare)
242.HLAB51isassociatedwith? a)Behcet'sdisease b)Chrugstrausssyndrome c)Microscopicpolyangitis d)Polyarteritisnodosa CorrectAnswer-AAns.is'a'i.e.,Behcet'sdiseaseBehcet'sdisease:?Behcetdiseaseisasmall-tomedium-vesselneutrophilicvasculitisthatclassicallypresentsasaclinicaltriadofrecurrentoralaphthousulcers,genitalulcers,anduveitis.Therecanalsobegastrointestinalandpulmonarymanifestations,withdiseasemortalityrelatedtosevereneurologicinvolvementorruptureofvascularaneurysms.ThereisanassociationwithcertainHLAhaplotypes(HLAB51,inparticular)
243.PTisusedtotest? a)Extrinsicandcommonpathway b)Intrinsicandcommonpathway c)Intrinsicpathway d)Extrinsicpathwa CorrectAnswer-AAns.is'a'i.e.,ExtrinsicandcommonpathwayPatientswithhemophiliahavedeficiencyoffactorVIIIthatresultsinprolongedPTT.
244.Whichofthefollowingisnotahereditary disease? a)Neurofibromatosis b)Cretinism c)Huntingtonsdisease d)Hereditaryspherocytosis CorrectAnswer-BAns.is'b'i.e.,CretinismCretinism:?Cretinismisaconditionofseverelystuntedphysicalandmentalgrowthduetountreatedcongenitaldeficiencyofthyroidhormones(congenitalhypothyroidism)usuallyduetomaternalhypothyroidism.Thuscretinismisanonhereditarycondition.
245.Pointmutatoninwhichprotooncogeneis responsibleforthedevelopmentofgastrointestinalstromaltumor a)KIT b)ALK c)RET d)FLT3 CorrectAnswer-AAns.is'a'i.e.,KITApproximately75%to80%ofallGISTshaveoncogenic,gain-of-functionmutationsofgeneencodingthetyrosinekinasec-KIT.Approximately8%ofGISTshavemutationsthatactivatearelatedtyrosinekinase,plateletderivedgrowthfactorreceptora(PDGFRA).Consitutivelyactivec-KITorPDGFRAreceptortyrosinekinasesactivateRASandP13K/AKTpathwaysandtherebypromotetumorcellproliferation.
246.Carcinoembryonicantigenisraisedin whichofthefollowingnonneoplasticconditions- a)Hepatitis b)Pancreatitis c)Hemolyticanemia d)Ulcerativecolitis CorrectAnswer-BAns.is'b'i.e.,Pancreatitis1)NeoplasticconditionswithraisedCEA-->Colorectalcancer,lungcancer,breastcancer,ovariancancer.2)Non-neoplasticconditionswithraisedCEA-->Alcoholiccirrhosis,hepatitis,IBD(UC,CD),smoking,pancreatitisandhemolyticanemia.
247.UnderBloodsafetyprogramme compulsorytestsdoneareallexcept? a)HIV b)VDRL c)Malaria d)HepatitisE CorrectAnswer-DAns.is'd'i.e.,HepatitisEBloodsafety:?UnderBloodSafetyProgrammeallthebloodbankshavetoensurethatbeforetransfusionofbloodtothepatientthemandatorytestsforHIV,VDRL,HepatitisB,HepatitisCandMalariaaredone.
248.EBVreceptormimics? a)CD20 b)CD21 c)CD22 d)CD23 CorrectAnswer-BAns.is'b'i.e.,CD21CD21->EBVreceptor:MatureBcellsandfolliculardendriticcells.
249.Leukocyteadhesiontoendotheliumis mediatedbyallexcept? a)Lselectin b)Eselectin c)VCAM1 d)VCAM4 CorrectAnswer-DAns.is'd'i.e.,VCAM4EndothelialmoleculeP-selectinE-selectinICAM-1VCAM-1Glycam-1CD31(PECAM)
250.Boysaremorelikelytobeaffectedby whichgeneticdisorders? a)AD b)AR c)Xlinkeddominant d)Xlinkedrecessive CorrectAnswer-DAns.is'd'i.e.,XlinkedrecessiveX-linkeddisordersExceptforafewconditions,allX-linkeddisordersareX-linkedrecessive.AsmalehasonlyoneX-chromosome,themalewithaffectedgeneonX-chromosomewillalwaysmanifestthedisease.Ontheotherhand,femalehas2X-chromosomes,heterozyogousfemalewillbecarrierbecauseofexpressionofnormalallelontheotherX-chromosome.SoaboyhasmoreprobabilitytomanifestXlinkedrecessiveascomparedtogirls
251.Inceasedaccumulationoffluidinthe interstitialspaceisdescribedas? a)Edema b)Effusion c)Transudate d)Exudate CorrectAnswer-AAns.is'a'i.e.,EdemaEdema:accumulationoffluidintheinterstitialspaceEffusion:accumulationoffluidinthebodycavities
252.Classicexampleofmissensemutation? a)Thalassemia b)Sicklecelldisease c)Sideroblasticanemia d)Hemochromatosis CorrectAnswer-BAns.is'b'i.e.,SicklecelldiseaseInsicklecellanemiathereismissensetypeofpointmutation.MutationsAmutationisapermanantchangeintheDNA.Mutationsthataffectgeniicells(spermorovum)aretransmittedtoprogenyandmaygiverisetoinheriteddisease.Mutationsthataffectsomaticcellsarcnottransmittedtoprogenybutareimportantinthegenesisofcancersandcongenitalmalformations.Mutationsmaybeclassifiedintothreecategories?1.GenemutationsThevastmajorityofmutationsassociatedwithhereditarydiseasearegenemutations.Thesemayofdifferenttypesdependingwhetheritinvolvescompletegeneorsinglebase?(a)PointmutationAsinglenucleotidebaseissubustitutedbyadifferentbase.WhenapyrimidinebaseissubustitutedbyotherpyrimidinebaseorapurinebaseissubstitutedbyotherpurineTransition.Whenapurineissubstitudedbyapyrimidineorvice-versaTransversion.
Thismayalterthecodeinatripletofbases,i.e.incodonandleadstoreplacementofoneaminoacidbyanotherinthegeneproduct.Becausethesemutationsalterthemeaningofthegeneticcode,theyareoftentermedmissensemutation.ExampleissicklemutationinwhichCTCcodonin13-chainofhemoglobinthatcodesforglutamicacidischangedtoCACcodonthatcodesforvaline.Anothertypeofpointmutationisnonsensemutationinwhichapointmutationmaychangeanaminoacidcodontoastopcodon.3Exampleis13-thalassemiainwhichCAGcodoninI3-chainofhemoglobinthatcodeforglutaminischangedtostopcodonUAGafterpointmutation.(b)DeletionandinsertionsDeletionorinsertionofoneortwobaseleadtoalterationsinthereadingframeoftheDNAstrand-->frameshiftmutation.Ifthenumberofbasepairsinvovedisthreeoramultipleofthreeframshiftdoesnotoccur(becausecodonistriplet),insteadanabnormalproteinmissingoneormoreaminoacidsissynthesized.(c)TrinucleotiderepeatmutationNormallyacodonistripletietrinucleotide.Inthistypeofmutationacodon,ietrinucleotidesequenceundergoesamplificationandthesamecodonisrepeatedcontinuouslysomanytimesinthechain.ForexampleinfragileX-syndrome,CGGcodonisrepeated250-4000times,ie.thereare250-4000tandemrepeatesofCGG.2.ChromosomemutationResultfromrearrangementofgeneticmaterialthatgiverisetovisiblestructuralchangesinthechromosome.3.GenomemutationInvolveslossorgainofwholechromosome,e.g.monosomy-Turnersyndrome,trisomy-Downsyndrome.
253.Matrixmetalloproteinasesis? a)Cathepsin b)Znmetalloproteinases c)Cumetalloproteinases d)Cdmetalloproteinases CorrectAnswer-AAns.isbi.e.,ZnmetalloproteinasesTheoutcomeoftherepairprocessoftissuesisinfluencedbyabalancebetweensynthesisanddegradationofECMproteins.Afteritsdeposition,theconnectivetissueinthescarcontinuestobemodifiedandremodeled.ThedegradationofcollagensandotherECMcomponentsisaccomplishedbyafamilyofmatrixmetalloproteinases(MMPs),socalledbecausetheyaredependentonmetalions(e.g.,zinc)fortheiractivity.MMPsincludeinterstitialcollagenases,whichcleavefibrillarcollagen(MMP-1,-2and-3);gelatinases(MMP-2and9),whichdegradeamorphouscollagenandfibronectin;andstromelysins(MMP-3,-10,and,11),whichdegradeavarietyofECMconstituents,includingproteo-glycans,laminin,fibronectin,andamorphouscollagen.
254.Tauproteinseenin? a)Alzhiemer'sdisease b)Lewybodydementia c)Picksdisease d)Amylodosis CorrectAnswer-AAns.is`a'i.e.,Alzheimer'sdiseaseAlzhiemer'sdisease:?Thereisatrophyoffrontalandtemporallobestovariableextentandseverity.Thepatternofatrophycanoftenbepredictedinpartbytheclinicalsymptomatology.Theatrophicregionsofcortexaremarkedbyneuronalloss,gliosis,andthepresenceoftau-containingneurofibrillarytangles
255.Thephenomenonbywhichthecancer cellsareabletosustainandproliferateunderadverseconditionsofhypoxiais? a)Warburg b)Wanton c)Wormian d)Wolf CorrectAnswer-AAns.is'a'i.e.,WarburgOttoWarburgdescribedthebioenergeticsandmetabolicfeaturesthatpermitcancercellstosurviveunderadverseconditionssuchashypoxiaandenabletheirproliferation,progression,invasiveness,andsubsequentdistantmetastasis.ThisphenomenonisthuscalledthegrowthpromotingWarburgphenomenon.
256.Defectofglanzmann'sthrombostheniais ? a)Gp1Ib-IlIa b)GpIIIa-Ilb c)GpIla-Illb d)Gpfilb-Ila CorrectAnswer-AAns.is'a'i.e.,GpI1b-IlIaDefectinGlanzmann'strombstheniaGpIIb/IIIaDefectinBernardsouliersyndromeGpIb/IX
257.Metastaticcalcificationischaracterized by? a)Hypercalcemia b)Hypocalcemia c)Eucalcemia d)Noneoftheabove CorrectAnswer-AAns.is'a'i.e.,HypercalcemiaPathologiccalcificationsDystrophiccalcification:Depositionofcalciumatsitesofcellinjuryandnecrosis.Metastaticcalcification:Depositionofcalciuminnormaltissues,causedbyhypercalcemia(usuallyaconsequenceofparathyroidhormoneexcess)
258.Mostimportantgrowthfactorsin angiogenesis? a)PDGF b)TGFalpha c)TGFbeta d)VEGF CorrectAnswer-DAns.is'di.e.,VEGFTwomostimportantangiogenicfactorsare:i)Vascularendothelialgrowthfactor(VEGF)-->mostimportant.ii)Basicfibroblastgrowthfactor(FGF-2).
259.Necrosiswithcellbodiesretainedas ghostcellsis? a)Coagulativenecrosis b)Liquefactive c)Caseous d)None CorrectAnswer-AAns.is'a'i.e.,CoagulativenecrosisThemicroscopicanatomyofcoagulativenecrosisshowsalighterstainingtissuecontainingnonucleiwithverylittlestructuraldamage,givingtheappearanceoftenquotedas"Ghostcells"->outlinesofcellsareretainedsothatthecelltypecanstillbeidentifiedbuttheircytoplasmicandnucleardetailsarelost.
260.CellsresponsibleforGVHDis? a)ImmunocompetentTcelldonor b)ImmunocompetentTCellrecipient c)ImmunocompetentBcelldonor d)ImmunocompetentBcelldonor CorrectAnswer-AAns.is'a'i.e.,ImmunocompetentT-celldonorGraft-versus-hostdisease(GVHD):?GVHDoccurswhenimmunologicallycompetentcells(Tcells)ortheirprecursorsaretransplantedintoimmunologicallycrippledrecipients,andthetransferredcellsrecognizealloantigensinthehostandattackhosttissues.MostcommonlyinvolvedtissuesinGraftversushostdisease:-LiverSkinGut
261.Flowcytometryisdoneon a)Polycythemia b)Thrombocytosis c)Basophil d)Lymphocytes CorrectAnswer-DAns.d.Lymphocytes"Flowcytometrycanrapidlyandquantitativelymeasureseveralindividualcellcharacteristics,suchasmembraneantigensandtheDNAcontentoftumorcells.FlowcytometryhasalsoprovedusefulintheidentificationandclassificationoftumorsarisingfromTandBlymphocytesandfrommononuclear-phagocyticcells."-Robbins8/ep324
262.Personhavingheterozygoussicklecell traitisprotectedfrominfectionof: a)P.falciparum b)P.vivax c)Pneumococcus d)Salmonella CorrectAnswer-AAns.a.P.falciparumPersonhavingheterozygoussicklecelltraitisprotectedfrominfectionofP.falciparum."Peoplewhoareheterozygousforthesicklecelltrait(HbS)becomeinfectedwithP.falciparum,buttheyarelesslikelytodiefrominfection?.TheHbStraitcausestheparasitestogrowpoorlyordiebecauseofthelowoxygenconcentrations?."-Robbins8/ep387HostResistancetoPlasmodiumTwogeneralmechanismsofhostresistancetoPlasmodium:InheritedalterationsinredcellsmakepeopleresistanttoPlasmodium?.RepeatedorprolongedexposuretoPlasmodiumspeciesstimulatesanimmuneresponsethatreducestheseverityPeoplewhoareheterozygousforthesicklecelltrait(HbS)becomeinfectedwithP.falciparum,buttheyarelesslikelytodiefrominfection?.TheHbStraitcausestheparasitestogrowpoorlyordiebecauseofthelowoxygenconcentrations?.ThegeographicdistributionoftheHbStraitissimilartothatofP.falciparum?,suggestingevolutionaryselectionoftheHbStraitinpeoplebytheparasite
HbC,anothercommonhemoglobinmutation,alsoprotectsagainstseveremalariabyreducingparasiteproliferation?.HostResistancetoPlasmodium.Peoplecanalsoberesistanttomalariaduetotheabsenceofproteinstowhichtheparasitesbind?.P.vivaxentersredcellsbybindingtotheDuffybloodgroupantigen?.ManyAfricans,includingmostGambians,arenotsusceptibletoinfectionbyP.vivaxbecausetheydonothavetheDuffyantigen?.AntibodiesandTlymphocytesspecificforPlasmodiumreducediseasemanifestations.CytotoxiclymphocytesmayalsobeimportantinresistancetoP.falciparum
263.Sequenceofeventsinacute inflammation? a)VasodilatationStasisTransientvasoconstriction Increasedpermeability b)TransientvasoconstrictionStasisVasodilatation Increasedpermeability c)TransientvasoconstrictionVasodilatationStasis Increasedpermeability d)TransientvasoconstrictionVasodilatationIncreased permeabilityStasis CorrectAnswer-DAns.is'd'i.e.,TransientvasoconstrictionVasodilatationIncreasedpermeabilityStasis1)Changesinvascularcaliber(vasodilatation)Vasodilatationisoneoftheearliestmanifestationsofacuteinflammation.Sometimes,itfollowsatransientconstrictionofarterioles,(vasoconstrictions)lastingforafewseconds->Thoughvasodilatationistheearliestmanifestationofacuteinflammation,itfollowsatransientperiodofvasoconstriction.2)ChangeinvascularpermeabilityVasodilatationisquicklyfollowedbyincreasedvascularpermeability.Increasedvascularpermeabilyisthehallmarkofacuteinflammation.Thisleadstoescapeofproteinrichfluid(exudate)andleukocytesintoextravascularspace3)Changeinvascularflow(Stasis)Thelossoffluidresultsinconcentrationofredcellsandincreased
viscosityofblood-Slowerbloodflow-Stasis.
264.GenesilencingRNA? a)rRNA b)tRNA c)miRNA d)None CorrectAnswer-CAns.is'c'i.e.,miRNAAccordingtorecentsudiesaverylargenumberofgenesdonotencodeproteins.Instead,theirproductsplayimportantregulatoryfunctions.Themostrecentlydiscoveredamongthisclassofgenesarethatencodeforgene-silencingRNAs,i.e.RNAsthatdonotencodeproteinsbutinsteadinhibitgeneexpression(unlikeclassicalRNAswhichencodeforproteins)Twogene-silencingRNAsare: 1. MicroRNAs(miRNAs)2. SmallinterferingRNAs(siRNAs) 1.MicroRNA(miRNAs)Becauseoftheirprofoundinfluenceongeneregulation,miRNAsareassumingcentralimportanceinunderstandingnormaldevelopmentalpathways,aswellaspathologicconditions,suchascancer.oBycurrentestimatesthereareapproximately1000genesinhumonsthatencodesmiRNAs.TranscriptionofmiRNAgeneproducesprimarymiRNAtranscripts,whichisprocessedwithinthenucleustoformanotherstructure,calledpre-miRNA.Pre-miRNAistransportedtocytoplasmbyatransportor(Export)protein.
Dicer(anenzyme)doestheadditionalcuttingofthispre-miRNAthatareabout21-30nucleotideinlength(hencecalled"micro").AtthisstagemRNAisstilldoublestranded.Next,themiRNAunwinds,andsinglestrandsofthisduplexareincorporatedintoamultiproteincomplexcalledRNA-inducedsilencingcomplex(RISC).Base-pairingbetweenthemiRNAstrandandittargetmRNA(messengerRNA)directsRISCtoeithercausemRNAcleavageorrepressitstranslation.Inthisway,thegenefromwhichthetargetwasderivedissilenced(atapost-transcriptionlevel).AsinglemiRNAcansilencemanytargetgenes.2.SmallinterferingRNAs(siRNAs)siRNAsworkinsimilarmannerasmiRNAUnlikemiRNA,siRNAprecursorsareintroducedbyinvestigatorsintocells.siRNAarebecomingpowerfultoolsforstudyinggenefunctionandmayinthefuturebeusedtherapeuticallytosilencespecificgenes,suchasoncogenes,whoseproductsareinvolvedinneoplastictransformation.
265.Allareobstructivelungdiseaseexcept- a)Emphysema b)Interstitialfibrosis c)Asthma d)Bronchitis CorrectAnswer-BAns.is'b'i.e.,InterstitialfibrosisDiffusepulmonarydiseasesaredividedintotwocategories-Obstructivedisease(airwaydisease)Obstructivediseaseischaracterizedbyanincreaseinresistancetoairflowowingtopartialorcompleteobstructionatanylevel,fromthetracheatotherespiratorybronchioles.Examplesarechronicobstructivelungdisease(COPD-Emphysema,bronchitis),bronchiectasis,andasthma.RestrictivediseaseRestrictivediseaseischaracterizedbyreducedexpansionoflungparenchyma,withdecreasedtotallungcapacity.oItmayoccurduetotwotypesofdisorders-ChestwalldisordersinthepresenceofNormallungsNeuromusculardisorders,e.g.polio,severeobesity,pleuraldisease,kyphoscoliosis.InterstitialandinfiltrativediseasesoflungPneumoconiosis,interstitialfibrosis.
266. Centrilobularnecrosisoflivermaybe seenwith? a)Phosphorus b)Arsenic c)CCI4 d)Ethanol CorrectAnswer-CAns.is'c'i.e.,CC14Zonalnecrosis.Identicalregionsofallliverlobulesareinvolved.Itisdividedinto:-i)Centrizonal(centrilobular)necrosisNecrosisisseenaroundcentralhepaticvein.Itisseenincardiacfailure/shock,chloroformtoxicity,carbontetrachloride(ccl4)toxicity,halothaneandviralhepatitis.ii)Peripheralzonal(periportal)necrosisNecrosisisseenaroundportaltracts.Itisseenineclampsiaandphosphoruspoisoning.iii)MidzonalnecrosisItisrareandisseeninyellowfever.
267.Duringangiogenesisrecruitmentof pericytesandperiendothelialcellsisdueto a)VEGF&PDGF b)Angiopoietins,TGF&PDGF c)TGF,VEFG&PDGF d)VEGF,IL-6 CorrectAnswer-BAns.is'b'i.e.,Angiopoietins,TGF&PDGFAngiogenesisBloodvesselsformationinadultsisknownasangiogenesisorneovascularization.Itcanoccurbytwoways:?1.Angiogenesisfrompre-existingbloodvesselsThemajorstepsinthisprocessare:?VasodilatationbyNO,andVEGF-inducedincreasedpermeabilityofthepre-existingvessel.Preoteolyticdegradationofbasementmembranebymetalloproteinases(MMPs)anddisruptionofcellto-cellcontactbetweenendothelialcellsbyplasminogenactivator.Migrationofendothelialcellstowardsangiogenicstimulus.Proliferationofendothelialcells,justbehindtheleadingfrontofmigratingcells.Maturationofendothelialcells.Recruitmentofperiendothelialcells(pericytesandvascularsmoothmusclecells)toformthematurecells.2.Angiogenesisfromendothelialprecursorcells(EPCs)EPCscanberecruitedfromthebonemarrowintotissuestoinitiate
angiogenesis.GrowthfactorsinvolvedintheprocessofangiogenesisVEGFisthemostimportantgrowthfactorinadulttissuesundergoingangiogenesis.ThemostimportantreceptorforVEGFisVEGFR-2,atyrosinekinasereceptor.VEGFinducesthemigrationofEPCsinthebonemarrow,andenhancestheproliferationanddifferentiationofthesecellsatsitesofangiogenesis.FGF2canalsostimulateendothelialcellproliferation,differentiationandmigration.Newlyformedvesselsarefragileandneedtobecomestabilized,whichrequirestherecruitmentofpericytesandsmoothmusclecells(periendothelialcells).Angiopoietin1and2(Ang1&2),PDGFandTGF-/3participateinstabilizationprocess.RememberVEGFtranscriptionisregulatedbythetranscriptionfactorHIF,whichisinducedbyhypoxia.
268.Heartfailurecellsare? a)Lipofuscingranulesincardiaccells b)Pigmentedalveolarmacrophages c)Pigmentedpancreaticacinarcells d)Pigmentcellsseeninliver CorrectAnswer-BAns.is`B'i.e.,PigmentedalveolarmacrophagesHeartfailurecells(siderophages)arehemosiderincontainingmacrophagesinalveolithatareseeninleftventricularfailureanddenotepreviousepisodesofpulmonaryedema.LeftsidedheartfailureThemajormorphologicalandclinicaleffectsofLVFaredueincreasedbackpressureinpulmonarycirculationandtheconsequencesofdiminishedperipheralbloodpressureandflow.Theextracardiacorgansinvolvedcommonlyare? 1. Lung(mostcommon)2. Kidney3. Brain LungPressureinthepulmonaryveinsincreasesandtransmittedretrogradelytocapillariesandarteries.Thisresultsinpulmonarycongestionandpulmonary-edemaWetlung.Thereisperivascularandinterstitialtransdate,particularlyintheinterlobularseptaresponsibleforkerley's`B'linesonX-rays.Edematousfluidaccumulatesinalveoli.Ironcontainingproteinsandhemoglobinleakoutfromthecapillaries,andarephagocytosedbymacrophagesandconvertedto
hemosiderin.Hemosiderin-containingmacrophagesinthealveoli(calledsiderophages,orheartfailurecells)denotepreviousepisodesofpulmonaryedema.TheclinicalmanifestationsofLVFareprimarilyduetothesechangesinlungsDysnea,orthopnea,paroxysomalnocturnaldysnea.KidneyDecreasedcardiacoutputcausesareductioninrenalperfusion.Ifitissevereenoughtoimpairetheexcretionofnitrogenousproduct(BUN,Creatinine),PrerenalARF(Prerenalazotemia)maybeprecipitated.BrainReducedperfusiontobrainmaycausehypoxic/ischemicencephalopathy.
269.AllaretrueaboutPolycythemiavera except a)IncreasedvitB12 b)DecreaseLAPscore c)Leucocytosis d)Increasedplatelets CorrectAnswer-BAns.is'b'i.e.,DecreaseLAPscorePolycythemiaveraPolycythemiaveraisaneoplasmarisinginamultipotentmyeloidstermcellthatischaracterizedbyincreasedmarrowproductionoferythroid,granulocyticandmegakaryocyticelements.Thisleadstoerythrocytosis(polycythemia),granulocytosis,andthrombocytosisintheperipheralblood.Polycythemiaisresponsibleformostoftheclinicalsymptomsofpolycythemiavera.Polycythemiaveraprogenitorcellshavemarkedlydecreasedrequirementsforerythropoietinandotherhematopoieticgrowthfactors.Accordinglyserumerythropoietinlevelsinpolvuthemiaveraareverylow,whereasalmostallotherformsofabsolutepolycythemiaarecausedbyelevatedervthropoietinlevels.Clinicalmanifestations1.SymptomsduetopolycythemiaMostsymptomsarerelatedtotheincreasedredcellmassandhematocrit,i.e.,Polycythemia.Theelevationofhematocritisusuallyaccompaniedbyincreasedtotalbloodvolume,andtogetherthesetwopromoteabnormalblood
flow,particularlyonthelowpressurevenoussideofthecirculation,whichbecomesgreatlydistended.Thatresultsin-Plethoraorcynosisowingtostagnationofdeoxygenatedbloodinperipheralvessels.Headache,diziness,hypertensionandDininshedvisionfromblockadeofretinalvessels.2.SymptomsduetogranulocytosisBasophilssecretehistaminethatresultsin-IntesepruritisPepticulcerationIncreasedvit13,,,bindingcapacitybecauseofincreaseintranscobalmineI&II.3.SymptomsduetoThrombocytosisThereisincreasedriskofboththrombosisandmajorbleedingepisodes.ThrombosisDVT,MI,Stroke,Buddchiarisyndrome.BleedingUpperGIbleedingfrompepticulcer.LaboratoryfeaturesofPolvcythemiavera. IncreasedRedcellcount IncreasedVitB12binding (Polycythemia) capacity IncreasedWBCcount Increasedbloodviscocity (Leucocytosis)Increasedplateletcount DecreasedESR (Thrombocytosis)IncreasedLeucocytealkaline Hyperuricemiaduetoincreased phosphate(LAP)score turnoverofcells. Increasedhemoglobin Increasedhistaminelevel
270.Intracorpuscularhemolyticanemiais seenin? a)Autoimmunehemolyticanemia b)TIP c)Thalassemia d)Infection CorrectAnswer-CAns.is`c'i.e.,ThalassemiaIntracorpuscularhemolysis:Hereditarysphlerocytosis,G6PDdeficiency,thalassemia,sicklecellanemia,PNH.Extracorpuscularhemolysis:Microangiopathichemolyticanemia(TTP,HUS,DIC),infection(malaria),prostheticvalve,immunohemolyticanemiaandhyperplenism.
271.Gilbertsyndrome,trueallexcept? a)Causescirrhosis b)Autosomaldominant c)Normalliverfunctiontest d)Normalhistology CorrectAnswer-AAns.is'a'i.e.,CausescirrhosisGilbert'sSyndrome:?oItisanautosomaldominantcondition.oItischaracterizedbyunconjugatedhyperbilirubinemia(normallythebilirubinistransportedintolivercellsbyintracellularproteins.Intheliverbilirubinisconjugated.Thisconjugationisbroughtaboutbycertainenzymes.InGilbert'ssyndrometheseenzymesareabsentwhichcauseunconjugatedhyperbilirubinemia).Thehyperbilirubinemiaisusuallyprecipitatedbyfollowingconditions?Stress,Fatigue,Alcoholuse,reducedcalorieintake,intercurrentillness.Thehepaticbiochemicaltestsarenormalexceptforelevatedbilirubinlevel(serumbilirubinconcentrationareusually<3mg/dl) Embryonalcarcinoma Thehepatichistologyisnormal Thereisnoassociationwithcirrhosis.
272.Flexner-Wintersteinerrossetteisseenin- a)Hepatoblastoma b)Nephroblastoma c)Neuroblastoma d)Retinoblastoma CorrectAnswer-DAns.is'd'i.e.,RetinoblastomaRosettesRosettesarepathologicalfindingscharacterizedbyahaloorspokewheelarrangementofcellssurroundingacentralcoreorhub.TypeofRosette1.Flexner-WintersteinerRosettesAhaloofcellssurroundsalargelyemptycentralhubbutsmallcytoplasmicextensionfromcellsprojectintothelumen.Itischaracteristicofretinoblastoma.MayalsobeseeninMedulloblastoma,Primitiveneuroectodermaltumor,Pineoblastoma.2.HomerWrightrosettesAhaloofcellssurroundsacentralhubthatcontainsameshworkoffibres(neutrophilrichcentre).oHomer-Wrightrosettesarecharacteristicofneuroblastomasandmedulloblastomas.MayalsobeseeninPrimitiveneuroectodermaltumors(PNET),Pineoblastomas,Retinoblastomas.3.TrueependymalRosetteAhaloofcellssurroundsanemptylumen.Itischaracteristicofependymomas.4.PerivascularpseudorosettesAhaloofcellssurroundsabloodvessel.
Thetermpseudoisusedbecausethecentralstructureisnotformedfromthetumoritself,andrepresentsanonneoplasticelement.Maybeseenin-
273.Bandtestisdonein? a)RA b)SLE c)Scleroderma d)PAN CorrectAnswer-BAns.is'b'i.e.,SLEBandtest(Lupusbandtest)Lupusbandtestisdoneuponskinbiopsy,withdirectimmunofluorescencestaining,inwhich,ifpositive,IgGandcomplementdepositionsarefoundatthedermoepidermaljunction.Thistestcanbehelpfulindistinguishingsystemiclupuserythematosus(SLE)fromcutaneouslupus,becauseinSLEthelupusbandtestwillbepositiveinbothinvolvedanduninvolvedskin,whereaswithcutaneouslupusonlytheinvolvedskinwillbepositive.Theminimumcriteriaforpositivityare:Insun-exposedskin:PresenceofabandofdepositsofIgMalongtheepidermalbasementmembranein50%ofthebiopsy,intermediate(2+)intensityormore.Insunprotectedskin:Presenceofinterrupted(i.e.lessthan50%)depositsofIgMalongtheepidermalbasementmembrane,intermediate(2+)intensityormore.Thepresenceofotherimmunoglobulins(especiallyIgA)and/orcomplementproteins(especiallyC4)increasesthespecificityofapositivetest.
274.Angelmansyndromeisdueto- a)Digenicinheritence b)Inversion c)Uniparentaldisomy d)Mitochondrialdisorder CorrectAnswer-CAns.is'c'i.e.,Uniparentaldisomy PraderWillisyndrome Anglemansyndrome Paternaldeletion(Paternal Maternaldeletion(maternal genomicimprinting) genomicimprinting) Maternaluniparentaldisomy Paternaluniparentaldisomy
275.OrganellewhereH202isproducedand destroyedis? a)Peroxisome b)Lysosome c)Golgibody d)Ribosome CorrectAnswer-AAns.is'a'i.e.,PeroxisomePeroxisomeisamembraneboundorganellelfoundinalleukaryoticcells."Peroxisomescontainagroupofenzymesthatoxidizeavarietyofsubstratesandtherebyformhydrogenperoxide.TheH202thusformedisefficientlydecomposedwithintheorganellebycatalasewhichispresentinhighconcentration".LysosomescanonlyformH,02-TheycannotdegradeH202.RememberH202isproducedaswellasdestroyedinmitochondriaandcytosol.ItisproducedfromsuperoxidebyenzymeSOD.Itisdestroyedbyglutathioneperoxidase.
276.Increasedpermeabilityinacute inflammationisdueto? a)Histamine b)IL-2 c)TGF-(3 d)FGF CorrectAnswer-AAns.is'a'i.e.,HistamineFormationofendothelialgapsinvenules,i.e.immediatetransientresponseisthemostcommonmechanismcausingincreasedvascularpermeabilityinacuteinflammation.Mediatorsinvolvedinthismechanismare:-Immediate(moreimportant):Histamine,bradykinin,leukotrienes,neuropeptidesubstanceP.Somewhatdelayed:IL-1,TNF,IFN-y
277.Nottrueabouthereditaryspherocytosis a)Defectinankyrin b)DecreasedMCV c)DecreasedMCHC d)Reticulocytosis CorrectAnswer-CAns.is'c'i.e.,DecreasedMCHCLaboratoryfindingsSpherocytosis4PeripheralsmearshowsmicrospherocyteswhicharesmallRBCswithoutcentralpallor(Normallycentral1/3pallorispresentinredcells).MCV?Reticulocytosis-)Asseenwithanytypeofhemolyticanemia.MCHCT?HemoglobinIncreasedunconjugatebilirubin?SerumHeptoglobinNormaltodecreased.UrineurobilinogenT?Increasedosmoticfragility.StoolstercobilinogenT
278.Mantlecelllymphomasarepositivefor allofthefollowing,except? a)CD23 b)CD20 c)CD5 d)CD43 CorrectAnswer-AAns.is'a'i.e.,CD23MantlecelllymphomaMantlecelllymphomaisatypeofnon-HodgkinlymphomacharacterizedbythepresenceoftumorcellsthatcloselyresemblethenormalmantlezoneofB-cellsthatsurroundgerminalcenters.ImmunophenotypeofmantlecelllymphomaMantlecelllymphomaisaneoplasmofBcells.ThereforeitexpressesBcellmarker:CD19,CD20Surfaceimmunoglobulinheavychain(IgMandIgD).EithercorXlightchain.AsthetumorcellsarederivedfromtheMantlezone,theyarepositiveforBcellmarkerofmantlezonei.e.,CD-5.MantlecelllymphomaisCD23negative,thisfeaturedistinguishesitfromchroniclymphocyticleukemia(CLL)whichispositiveforbothCD5andCD23.TheothercharacteristicmarkerofmantlecelllymphomaiscyclinDI.Cytogeneticabnormalities:Mantlecelllymphomaisassociatedwithan11:14translocationinvolvingtheIgHlocusonchromosome14andthecyclinD1locusonchromosome11.ThisleadstoincreasedexpressionofcyclinD1,whichpromotesGItoSphaseprogressionduringthecellcycle.
toSphaseprogressionduringthecellcycle.65yearsoldmanwithsplenomegaly,lymphadenopathyCD-23negativeandCD-5positiveB-cellsuggestthediagnosisofmantlecelllymphoma.Clinicalfeaturesofmantlecelllymphoma:Itisusuallypresentinthefifthtoasixthdecadewithmalepreponderance.Themostcommonpresentationispainlesslymphadenopathy.Splenomegalymayoccur.Occasionally,multifocalmucosalinvolvementofthesmallbowelandcolonproduceslymphomatoidpolyposisofallformsofNHL,mantlecelllymphomaismostlikelytospreadinthisfashion.
279.Gastriccarcinomaisassociatedwithall EXCEPT? a)Inactivationofp53 b)OverexpressionofC-erb c)OverexpressionofC-met d)ActivationofRAS CorrectAnswer-DAns.is'd'ActivationofRASInthecourseofmulti-stepstomachcarcinogenesis,variousgeneticandepigeneticalterationsofoncogenes,tumor-suppressorgenes,DNArepairgenes,cellcycleregulatorsandcelladhesionmoleculesareinvolved.Geneticalterationingastriccancerinclude:Intestinaltypegastriccancer:K-rasmutation,APCmutation,pS2methylation,HMLH1methylation,pIemamethylation,p73deletionandC-erbB-2amplification. 1. Diffusetypegastriccaner:CDHIgene(E-Cadherin)mutation,K- samamplification. 2. Forbothtype:Telomerasereduction(telomeraseshortening), hTERTexpression,geneticinstability,overexpressionofthecyclinE&CDC25B&E2FIgenes,p53mutations,reducedexpression,CD44aberrabonttranscripts,andamplificationoftheC-metCyclinEgenes.Comingtoquestion:Allthegivenfourgeneticalterationsmaybeassociatedwithstomachcancer.HoweveramongthegivenoptionsK-rasisbestanswerasitisassociatedwithgastriccancerinminimumpercentage(amongstgivenoptions):Source:Textbookofmechanismofcarcinogenesisandcancer
Source:Textbookofmechanismofcarcinogenesisandcancerprevention K-rasmutation -4 <10% p53mutation 30-60% C-erbB-2amplifcation --> 20%C-metamplifciation --> 20%
280.Irreversibleinjuryinmyocardiumoccurs at? a)2minutes b)30minutes c)2hours d)5hours CorrectAnswer-BAns.is'b'i.e.,30minutesThemetabolicrateoftheheartishigh,anditsstoresofsubstratearelow.So,heartiscriticallydependentonacontinuoussupplyofoxygenandnutrients.Ischemiaofmyocardiuminducesprofoundfunctional,biochemicalandmorphologicalconsequences.Myocardialfunctionismoresensitivetoisc_hemia(lossofcontractilityoccurswithin60seconds)thanmyocardialstructure(irreversibleinjuryoccursin20-40minutes,thusmyocardialnecrosisbeginsatapproximately30minutesaftercoronaryocclusion.Keyeventsinischemiccardiacmyocytes Feature Time OnsetofATPdepletion SecondsLossofcontractility <2minutes ATPreducedto50% 10minutes ATPreducedto10% 40minutes Irrversibleinjury 2040min Microvascularinjury >1hr
281.Bonemarrowfindinginmyelofibrosis? a)Drytap(hypocellular) b)Megaloblasticcells c)Microcyticcells d)Thrombocytosis18 CorrectAnswer-AAns.is'a'i.e.,Drytap(hypocellular)MyelofibrosisThehallmarkofprimarymyelofibrosisisrapiddevelopmentofobliterativemarrowfibrosis.Myelofibrosissuppressesbonemarrowhematopoiesis,leadingtoperipheralbloodcytopenias.Thisresultsinextensiveextramedullaryhematopoiesisinthespleen,liverandlymphnode-->Splenomegalyandhepatomegaly.Bloodcellproductionfromsitesofextramedullaryhematopoisisisdisorderedandineffective-->Persistentcytopenia.PeripheralbloodpictureLeukoerythroblastosis-->Presenceoferythroidandgranulocyticprecursorsintheperipheralblood.Tear-droperythrocytes(dacrocytes)-->Fibroticmarrowdistortsanddamagesthemembranesoferythroidproginators.BonemarrowfindingsInitiallymarrowishypercellular.Withprogressionmarrowbecomeshypocellularanddiffuselyfibrotic-->Bonemarrowaspirationisadrytap.Thereisincreaselayingdownofreticulinfibrilnetwork.Cellularityofbonemarrowisdecreased,butmegakaryocytesareincreasedanddemonstratefeaturesofdysmegakaryopoiesis.
Dilatedmarrowsinusoids.
282.Schiller-Duvalbodiesisseenin a)Choriocarcinoma b)EmbryonalcellCa c)Endodermalsinustumour d)Immatureteratoma CorrectAnswer-CAns.is'c'i.e.,EndodermalsinustumorYolksactumor(endodermalsinustumororinfantileembryonalcarcinoma)-->Schiller-Duvalbodies.Leydig(interstitial)celltumor-3Reinkecrystalloids.Note:-Rienkecrystalsarealsoseeninthehiluscelltumorofovary.
283.A/EareinvolvedinMENtypeIIA? a)Parathyroid b)Adrenal c)Thyroid d)Pituitary CorrectAnswer-DAns.is'd'i.e.,PituitaryMENtype2A(Sipplesyndrome)AutosomaldominantItischaracterisedbymedullarycarcinomaofthyroid,pheochromocytomaandhyperparathyroidism.ItiscausedbymutationoftheRETproto-oncogeneincodon634.Mappedtochromosome10.Mutatedcodon-cysteinecodonType2Ahas3variants-a)MEN2Awithfamilialmedullarycarcinomathyroid(1stfeatureoftype2A)b)MEN2Awithcutaneouslichenamyloidosisc)MEN2AwithHirschsprungdisease
284.Allaregoodprognosticfactorsfor neuroblastomaexcept- a)Trk-Aexpressionabsent b)Absenceof1ploss c)Absenceof17pgain d)Absenceof11qloss CorrectAnswer-AAns.is'a'i.e.,Trk-AexpressionabsentIntratumoralcalcificationDNAploidy-Hyperdiploidornear-triploidTrk-AExpressionCD-44Expression
285.Eosinophiliainnecrosedtissueisdueto a)Coagulationofproteins b)Denaturationofenzymes c)Denaturationofprotein d)Mitochondrialdamage CorrectAnswer-CAns.is'c'i.e.,DenaturationofproteinNecroticcellsshowincreasedeosinophiliainhematoxylinandeosin(H&E)stains.Itisdueto- 1. LossofcytoplasmicRNA(orribonucleoprotein/RNP)whichbinds thebluedye,hematoxylin. 2. Denaturedcytoplasmicproteinswhichbindthereddye,eosin.
286.Macrophagesareconvertedtoepitheloid cellsbywhichcytokine? a)IL-2 b)IFN-y c)TNF-a d)TGF-(3 CorrectAnswer-BAns.is'b'i.e.,IFN-yAgranulomaisafocusofchronicinflammationconsistingofamicroscopicaggregationofmacrophagesthataretransformedintoepitheliumlikecells(epithelioidcells)surroundedbyaCollorofmononuclearleukocytes,principallylymphocytesandoccasionallyplasmacells.Frequently,theseepitheloidcellsfusetoformgiantcellsintheperipheryorsometimesinthecenterofgranuloma.PathogenesisofgranulomaImmunegranuloma(mostcommontypeofgranuloma)isatypeIVhypersensitivitythatinvolvedCD-4helperTcell.On-exposuretoparticulateantigenmacrophagesprocessandpresentthisantigentoHelperTcellsandalsosecretesIL-2.T-cellsareactivatedoncontactwiththisantigenandbyIL-2.ActivatedT-cells(helper)produceIFN-y,themajorcytokineofgranulomatousinflammation.IFN-yhasthefollowingeffectsItisthemostimportantactivatorofmacrophages.Itinducegranulomaformationbyconversionofactivatedmacrophagesintoepitheliodcellsandformationofgiantcell.AugmentthedifferentiationofT-cells.
FinallythereisformationofgranulomainducedbyIFN-y.RememberForeignbody(Nonimmune)granulomaconsistalmostentirelyofepitheloidcellsandmultinucleatedgiantcellsbutnolymphocytes.Granulomasinducedbyparasitescontainalargecomponentofeosinophils.InlymphogranulomavenerumandCatscratchdiseasegranulomashaveacharacteristiccentralneutrophilicabscesssurroundedbymacrophagesandothermononuclearcells.
287.Theprofessionalantigenpresenting cells? a)Bcells b)Dendriticcells c)Tcells d)NKcells CorrectAnswer-BAns.is'b'i.e.,DendriticcellsDendriticcellsarethemostpotentandeffectiveantigenpresentingcellsinthebody-Harrison2024MatureB-cellsandT-cellsbeforeantigenicexposurearecallednaive-BandTcellsrespectively.SequenceofeventsinactivationofnaiveTcells.Immaturedendriticcellsintheepidermisarecalledlangerhanscell.Theseimmaturedendriticcells(langerhanscells)capturetheantigenintheepidermis.Aftercapturingtheantigenthesecellssecretecytokines.Thesecytokinescauselossofadhesivenessoflangerhanscells.Langerhanscellsseparatefromeachotherandmigrateintolymphaticvessels.Inlymphaticvessel,maturationoflangerhanscellstakesplace.ThenthesematurelangerhansdendriticcellsreachtonaiveTcellsinthelymphnodesandpresentantigentothesecellsandactivatethem.
288.Allaregrowthpromotingoncogenes except? a)FGF b)TGF-a c)TGF-p d)PDGF CorrectAnswer-CAns.is'c'i.e.TGF-pGrowthfactorgenes:SIS,HST-1,INT-2,TGFa,FGF.
289.Hyperplasticarteriolitiswithnerotizing arteriolitisisseenin? a)Buerger'sdisease b)Benignhypertension c)Malignanthypertension d)Diabetes CorrectAnswer-CAns.is'c'i.e.,MalignanthypertensionHyperplasticarteriosclerosisischaracteristicallypathologicchangeseeninvesselsofthepatientsufferingfrommalignanthypertension.Arteriolesofalltheorgansinthebodycanaffectedbutfavouredsitesare1.Kidney2.SmallIntestine3.Gallbladder4.Peripancreaticfat5.Periadrenalfat.
290.Fibrosisisdueto? a)TGF- b)TNF- c)IL-7 d)IL-10 CorrectAnswer-AAns.is'a'i.e.,TGF-13"TFG-bispracticallyalwaysinvolvedasanimportantfibrogenicagent"--RobbinsMediatersinvolvedinfibrosis:?i)Growthfactors:-TGF-(3,PDGF,FGFii)Cytokines:IL-1,IL-4,TNF,IL-13
291.Insicklecellanemiaallaretrueexcept- a)Sicklecells b)Targetcells c)Howelljollybodies d)Ringedsideroblast CorrectAnswer-DAns.is'd'i.e.,RingedsideroblastLaboratoryfindingsofsicklecellanemia:?Moderatetosevereanaemia.PeripheralsmearwillshowSicklecellsTargetcellsHowell-Jollybodiesbecauseofautosplenctomy.Apostivesicklingtestwithareducingsubstancelikesodiummetabisulfite.SicklecellanemiaiscausedbyreplacementofnormalHemoglobinbysickledhemoglobin(HbS).HbSisformedbyreplacementofGlutaminebyValineatposition6ThissubstitutionreplacesthepolarGlutamineresiduewithanonpolarValine.ThereplacementofGlutaminebyValinegeneratesastickypatchonthesurfaceofHBS.ThestickypatchispresentonbothoxygenatedanddeoxygenatedHbSThedeoxygenatedHbSalsocontainsacomplementarysiteforthestickypatch.Inoxygenatedhemoglobinthiscomplementarysiteismasked.WhenHbSisdeoxygenatedthestickypatchpresentonitssurface
bindstothecomplementarypatchonanotherdeoxygenatedHbSmolecules.ThisbindingleadstopolymerizationofdeoxyhemoglobinSforminglongfibrousprecipitates.Theseextendthroughouttheerythrocyteandmechanicallydistortit,causinglysisandmultiplesecondaryclinicaleffect.So,ifHbScanbemaintainedinanoxygenatedstateoriftheconcentrationofdeoxygenatedHbScanbeminimized,formationofthesepolymerswillnotoccurandsicklingcanbeprevented(RememberthecomplementarysiteforthestickypatchremainsmaskedincaseofOxygenatedHbS).RoleofHbAinpolymerizationUnlikeHbS,HbAdoesnotcontainanystickypatch,butitdoeshaveabindingsiteforthestickypatchofHbS.ThusitcanbindtoHbSthroughitsreceptorsitebutthisbindingcannotextendthepolymerbecauseHbAdoesnotcontainanystickypatchtopromotebindingtostillanotherhemoglobinmolecule.SoHbAinterfereswiththepolymerisationandaggreationofHbSandreducestheintensityofsicklecellanemia.
292.Linitisplasticaisatypeof? a)Plasticlikeliningofstomach b)Diffusecarcinomaofstomach c)Benignulcer d)GIST CorrectAnswer-BAns.is`b'i.e.,DiffusecarcinomaofstomachLinitisplasticaInvolvementofabroadregionofthegastricwallorentirestomachbydiffusestomachcancercauselinitisplastica.ItisalsoknownasBrinton'sdisease.Theappearanceofstomachislikeleatherbottle.TheothercauseoflinitisplasticaareLyeingestionMetastaticinfiltrationofstomachSyphilisSarcoidosisNon-hodgkinlymphomaofstomach
293.Microvesicularfattyliveriscausedby? a)DM b)Valproate c)Starvation d)IBD CorrectAnswer-BAns.is'b'i.e.,ValproateSteatosisAccumulationoftriglyceridefatdropletswithintheheaptocytesisknownassteatosisorfattyliver.Itmaybeoftwotypes? 1. MicrovesicularsteatosisMultipletinydropletsaccumulatethatdo notdisplacethenucleus. 2. MacrovasicularsteatosisAsinglelargedropletaccumulatesthat displacesthenucleus.CausesofsteatosisMicrovesicularReye'ssyndromeAcutefattyliverofpregnancyJamaicanvomitingsicknessDrugs-valproicacid,tetracycline,nucleosideanaloguelman'sdiseaseLysosomalacidlipasedeficiencyCongenitaldefectsofureacycleenzymesEarlystageofalcoholiccirrhosisChronicviralhepatitisMacrovesicularAlcoholicliverdiseaseDM-->insulinresistance
LipodystrophyPEM,starvationDysbetalipoproteinemiaTPN,JejunoilealbypassInflammatoryboweldiseaseSyndromex(obesity,DM,hypertriglyceridemiaDrugs-->CCBs,syntheticestrogens,nucleosideanalogues
294.Localisedlangerhanscellshistiocytosis affectinghead&neckis? a)Letterer-siwedisease b)Pulmonarylangerhanscellhistiocytosis c)Hand-schuller-christiandisease d)Eosinophilicgranuloma CorrectAnswer-DAns.is`di.e.,EosinophilicgranulomaClinicalmanifestationsofLangerhanscellhistiocvtosis(Histocvtosis-X11.LettererSiwedisease(multifocal,multisystemLCH)Mostfrequentlypresentbefore2yearsofage.Characterizedbyinvolvementofmultiplesystem.Mostcommonpresentationiscutaneouslesionsresemblingseborrheicdermatitis.Othersarehepatosplenomegaly,lymphadenopathypulmonarylesionsanddestructivebonelesions.Extensivebonemarrowinfiltrationleadstopancytopenia.2.Eosinophilicgranuloma(UnifocalandmultifocalunisystemLCH)Involvementisrestrictedtoasinglesystemi.e.,skeletalsystemwhichmaybeunifocalormultifical.Mostcommonlyeffectedbonesareskull,vertebrae,ribs,clavicle,andfemur.3.Hand-Schuller-ChristiandiseaseCharacterizedbytriadofclaviralbonedefects,diabetesinsipidus,andexophthalmos.
295.Whichcytokineactivatemacrophages? a)IL-8 b)IFN-y c)PAF d)LeukotrieneB4 CorrectAnswer-BAns.is'b'i.e.,IFN-'yActivatedmacrophagesRecentstudiesshowthattherearetwotypesofactivatedmacrophages:?1.Classicallyactivatedmacrophages(M1)TheseareactivatedbymicrobialproductsandcytokineslikeIFN-y.Thesecellsreleaselysosomalenzymes,NO,IL-1,andIL-12.Thesecellsareinvolvedinmicrobicidalactivitiesandpathogenicinflammation.2.Alternativelyactivatedmacrophages(M2).ThesecellsareactivatedbymicrobialproductsandcytokineslikeIL-4,IL-5.ThesecellsreleaseIL-10,TGF-I3.Thesecellsareinvolvedinanti-inflamatoryactionsandwoundrepair.
296.Syphiliticaneurysmmostlyinvolve? a)Archofaorta b)Descendingaorta c)Abdominalaortaabovetherenalarteries d)Abdominalaortabelowtherenalarteries CorrectAnswer-AAns.A.ArchofaortaTheascendingaortaisthesegmentmostcommonlyaffected(50%),followedbythearch(35%)andthedescendingaorta(15%)
297.Hurthlecellcarcinomaisavariantof? a)Medullarycarcinoma b)Papillarycarcinoma c)Follicularcarcinoma d)Anaplasticcarcinoma CorrectAnswer-CAns.is'c'i.e.,FollicularcarcinomaFollicularcarcinomaSecondmostcommontypeofthyroidcancer.Hurthlecellsareseen.Differentiatedfromfollicularadenomabycapsularand/orvascularinvasion.Unlikeinpapillarycarcinoma,lymphaticspreadisrare,andvascularinvasioniscommoninfollicularcancers.Hurthlecelloroncocyticcarcinomaisavarriantoffollicularcarcinoma.PapillarythyroidcarcinomaItisthemostcommontypeofthyroidcancer.Carcinomacellshavenucleiwhichcontainfinelydispersedchromatin,whichimpartsopticallyclearoremptyappearance,givingrisetothegroundglassorOrphanAnnieeyenuclei.Invaginationofcytoplasmmaygiverisetotheappearanceofintranuclearinclusins(Pseudoinclusions)orintranucleargroovesthediagnosisofpapillarycarcinomaisbasedonthesenuclearfeatures.PsammomabodiesarepresentLymphaticmetastasismaybeseenbutinvolvementofbloodvesselsisrare.
Thenucleiofpapillarycarcinomacellscontainfinelydispersedchromatin,whichimpartsanopticallyclearoremptyappearance,givingrisetothedesignationgroundglassorOrphanAnnieeyenuclei.
298.HLAislocatedon? a)Shortarmofchr-6 b)Longarmofchr-6 c)Shortarmofchr-3 d)Longarmofchr-3 CorrectAnswer-AAns.is'a'i.e.,Shortarmofchr-6HLAcomplex(MHC)geneislocatedontheshortarmofchromosome6.Thehistocompatibilityantigens(humanleukocyteantigens-HLA)arecellsurfaceantigensthatinduceanimmuneresponseleadingtorejectionofallografts.TheprincipalphysiologicfunctionofthecellsurfacehistocompatibilitymoleculesistobindpeptidefragmentsofforeignproteinsforpresentationtoantigenspecificTcells.ThehistocompatibilityantigensareencodedbyacloselylinkedmultiallelicclusterofgenesMajorhistocompatibilitycomplex(MHC)orHumanleukocyteantigenscomplex(HLAcomplex).HLAcomplexofgenesislocatedontheshortarmofchromosome6.
299.
Classificationofaorticdissectiondependsupon? a)Causeofdissection b)Levelofaortaaffected c)Percentageofaortaaffected d)None CorrectAnswer-BAns.is'b'i.e.,LevelofaortaaffectedClassificationofAorticdissectionTheriskandnatureofseriouscomplicationsofdissectiondependstronglyonthelevelofaortaaffected,withthemostseriouscomplicationsoccuringfromtheaorticvalvetothearch.Thusaorticdissectionsaregenerallyclassifiedintotwotypes?Proximallesion(TypeA)Morecommonandmoredangerous.Involveeithertheascendingportiononlyorbothascendingandthedescendingportionofaorta.Distallesion(TypeB)Involveonlydiscendingpartdistaltosubclavianartery.
300.Thalassemiagivesprotectionagainst? a)Filaria b)Kala-azar c)Malaria d)Leptospirosis CorrectAnswer-CAns.is'c'i.e.,MalariaTypesofanemiathathaveprotectiveeffectagainstP.falciparummalaria:-G6PDdeficiency,Sicklecellanemia,Thalassemia,HbC,Pyruvatekinasedeficiency
301.Maltomaispositivefor? a)CD3 b)CD10 c)CD23 d)CD5 CorrectAnswer-CAns.is'c'i.e.,CD23Mantlecelllymphoma-?Surfaceimmunoglobulinheavychain(IgM&IgD)?CD19',CD20*?CD5(+)ve&CD23(-)vedifferentiatingfeaturefromCLL?CyclinD1
302.Terminalstageofpneumoniais a)Congestion b)Redhepatization c)Grayhepatization d)Resolution CorrectAnswer-DAns.is'd'i.e.,ResolutionIntheusualcourseofpneumonia,finalstageisresolution.However,insomeneglectedcasesfollowingcomplicationsmaydevelop-AbscessformationPleuraleffusion,pleuritisEmpyemaBecteremicdisseminationBrainabscess,endocarditis,meningitis,Organizationsupurrativearthritis.PathologicalchangesofbacterialpneumoniaA.LobarpneumoniaLargeconfluentareaofthelungorentirelobesareconsolidated.Thelowerlobesareaffectedmostcommonly.Therearefourstagesoftheinflammatoryresponse(Laennec'sstages)?1.Stageofcongestion(initialphase)Theaffectedlobeisenlarged,heavy,darkredandcongested.Cutsurfaceexudesblood-stainedfrothyfluid.Thereisdilatationandcongestionofalveolarcapillaries.Therearefewneutrophilsandnumerousbacteriainthealveolarfluid.2.Stageofredhepatization(earlyconsolidation)Thetermhepatizationreferstoliver-likeconsistencyoftheaffected
lobeoncutsection.Theaffectedlobeisredandfirm.Theedemafluidofprecedingstageisreplacedbystrandsoffibrin.Thereismarkedcellularexudateofneutrophilswithextravasationofredcells.3.Stageofgrayhepatizatioa(lateconsolidation)Theaffectedlobeisgrayishbrown,firmanddry.Thefibrinstrandaredenseandmorenumerous.Thereisprogressivedisintigrationofredcellsandneutrophils.Themacrophagesbegintoappearintheexudate.Theorganismsarelessnumerousandappearasdegeneratedforms.4.ResolutionThepreviouslysolidandfibrinousconstituentisliquefiedbyenzymaticaction.Granularandfragmentedstrandsoffibrininthealveolarspacesareseenduetoprogressiveenzymaticdigestion.Thereisprogressiveremovaloffluidcontentaswellascellularexudatefromtheairspaces,resultinginrestorationofnormallungparenchymawithareation.B.BronchopneumoniaPatchyareasofredorgreyconsolidation,moreoftenmultilobarandfrequentlybilateralandbasal(lowerzones)becauseoftendencyofsecretionstogravitateintolowerlobes..Thereissuppurativeexudate,consistingchieflyneutrophils,fillingbronchi,bronchiolesandadjacentalveolarspaces.Alveolarseptathickenduetocongestedcapillariesandleucocyticinfiltration.
303.Intestinalangiodysplasiainvolves? a)AVmalformation b)Cavernoushemangioma c)Capillaryhemangioma d)Malignanttumor CorrectAnswer-AAns.is'a'i.e.,AVmalformationAngiodvsplasiaAngiodysplasiaischaracterizedbymalformedsubmucosalbloodvessels(AVmalformation).Lesionsofangiodysplasiaareectaticnestoftortuousveins,venulesandcapillaries.Mostcommonsiteiscaecumandrightcolon.Usuallyoccursafter6thdecadeoflife.Majorpresentationisbleeding(intestinalbleeding).Pathogenesisofangiodysplasiahasbeenlinkedtomechanicalandcongenitalfactors:?1.MechanicalfactorNormaldistensionandcontractionintermittentlyoccludesubmucosalveinsandleadstodilatationandtortuosityofoverlyingvessels.Becausececumhasthelargestdiameter,itdevelopsthegreatestwalltension.Thereforececumisthemostcommonsiteforangiodysplasia.2.Genetic(developmental)factorSomedatalinkangiodysplasiawithaorticsstenosisandMeckeldiverticulumsuggestingthepossibilityofadevelopmentalcomponent.
304.Perifascicularatropyofmusclefibresis seenin? a)Steroidmyopathy b)Dermatomyositis c)Inclusionbodymyositis d)Nemalinemyopathy CorrectAnswer-BAns.is'b'i.e.,DermatomyositisDermatomyositisisaconnective-tissuediseaserelatedtopolymyositisthatischaracterizedbyinflammationofthemusclesandtheskin.Itisasystemicdisorderthatmayalsoaffectthejoints,theesophagus,thelungs,and,lesscommonly,theheart.Onthemusclebiopsy,therearetwoclassicmicroscopicfindingsofdermatomyositis.Theyare:mixedB-&T-cellperivascularinflammatoryinfiltrateandperifascicularmusclefiberatrophy.Itisassociatedwithautoantibodies,especiallyanti-Jolantibody.
305.Markerofglomustumor? a)CD-57 b)Cytokeratin c)S-100 d)CD-34 CorrectAnswer-AAns.is'a'i.e.,CD-57Glomustumorisabenignmesenchymalneoplasmofthesubcutaneoustissueofthedistalextremitiesandhead&neckregion.Immunohistochemistryshowssmoothmuscleactin,vimentin,collagenIVandCD-57,withlittletonoexpressionofneuroendocrine,endothelialorepithelialmarkers.Markersthathavebeenprovedconsistentlynegativeincludecytokeratin,synaptophysin,chromograninA,CD-31andS-100protein.Glomangioma(Glomuvenousmalformation)GlomangiomaisavariantofglomustumorItischaracterizedbymultipletumorsresemblingcavernoushemangioma,linedbyglomuscells.Glomangiomaisblue-red,extremelypainfulvascularneoplasm.Itinvolvesaglomeriformarteriovenousanastomosis(glomusbody)Itmaybefoundanywhereintheskin,mostofteninthedistalportionoffingersandtoes,especiallybeneaththenails(subungal).Secondarythrombosisandphlebolithformationmayoccurintheselesions.
306.Falseaboutwoundhealing? a)Inhibitedbyinfection b)InhibitedbyDM c)Inhibitedbyhematoma d)Inhibitedbyforeignbody CorrectAnswer-CAns.is'c'i.e.,InhibitedbyhematomaFactorscausingimpairmentofwoundhealingA.SystemicfactorsPoornutrition(proteindeficiency,vitaminCdeficiency).Metabolicabnormalities(Diabetesmellitus).Poorcirculatorystatus(Inadequatebloodsupply).Hormones,e.g.glucocorticoids.B.LocalfactorsInfectionisthesinglemostimportantfactor.Mechanicalfactors,e.g.earlymobilization.Foreignbodies(unnecessarysutures,fragmentsofsteelorglass).Woundinpoorlyvacularizedarea,e.g.foot.
307.Chromosome22deletionsyndromeis? a)Downsyndrome b)DiGeorgesyndrome c)Turnersyndrome d)Klinefeltersyndrome CorrectAnswer-BAns.is'b'i.e.,DiGeorgesyndromeChromosome22q11.2deletionsyndromeThissyndromeencompassesaspectrumofdisordersthatresultfromasmalldeletionofbandq11.2onlongarmofchromosome22.Clinicalfeaturesareconsideredtorepresenttwodifferentdisorders:?1DiGeorgesyndromeThesepatientshavethymichypoplasiawithresultantT-cellimmunodeficiency.Otherfeaturesincludeparathyroidhypoplasia(causinghypocalcemia),cardiacmalformations&facialanomalies.TBX-1gene(aT-boxtranscriptionfactor)ismostcloselyassociatedwiththissyndrome.ThetargetofTBX-1includePAX9,agenethatcontrolsthedevelopmentofthepalate,parathyroidandthymus.2VelocardiofacialsndromeThissyndromeischaracterizedbyfacialdysmorphism(prominantnose,retrognathia),cleftpalate,cardiovascularanomalies,andlearningdisabilities.
308.CreatininekinaseiselevatedinMIafter- a)2-4hrs. b)4-8hrs. c)12-24hrs d)>24hrs. CorrectAnswer-AAns.is'a'i.e.,2-4hrs Initiationof Returnto Enzyme Peak rise baseline 24 CK-MB 2-4hours 48-72hours hours TroponinTandI(TnT 48 2-4hours 7-10days Tnl) hours48 AST/SGOT In12hours 4-5days hours3-6 LDH 24hours 2weeks days
309.Bloodwhenstoredat4?Ccanbekeptfor ? a)7days b)14days c)21days d)28days CorrectAnswer-CAns.is`c'i.e.,21daysTherecommendtemperatureforstorageofbloodis1-6?C.Actuallybloodcanbestoredformorethan21days,dependinguponthetypeofadditiveused."Routinebloodstorageislimitedto21daysat1-6?Cwhentreatedwithacid-citrate-dextrose(ACD)orcitratephosphate-dextrose(CPD);and35dayswhentreatedwithcitrate-phosposphate-dextrose-adenine(CPD-A);and42dayswhentreatedwithsaline-adenine-glucose-mannital(SAG-M)"So,correctanswerofthisquestioncanbe: 1. 21days(wehaveonlythisoneintheoptions)2. 35days3. 42days(ThisisthebestanswerbecauseSAG-Mistheroutinly usedadditivethesedays).Plateletsarestoredat20-24?Cfor3-5days
310.AMLcausingGumhypertrophy? a)M1 b)M2 c)M3 d)M4 CorrectAnswer-DAns.is'd'i.e.,M4Inacuteleukemiastheclinicalfeaturesareprimarilyseenbecauseof:Replacementofnormalcellsofbonemarrowbyleukemiccellsresultinginanemia,thrombocytopenia,neutropenia.Infiltrationofleukemiccellinvariousextramedullaryorganscausing,hepalomegaly,splenomegaly.Gumhypertrophyduetoinfiltrationofgumsbyleukemiccellsisonesuchfeature.ItischaracteristicallyassociatedwithAML-M5andAML-M4i.e.(acutemonocyticleukemia).
311.Typeofnecrosisinpancreatitis? a)Fibrinoid b)Coagulative c)Fat d)Caseous CorrectAnswer-CAns.is'c'i.e.,FatFatnecrosisisseenmostfrequentlyinacutepancreatitisduetoleakageoflipase.FatnecrosisFatnecrosismaybeoftwotypes:?1.EnzymaticfatnecrosisThisisduetoactionoflipaseonadiposetissue.Itoccursmostfrequentlyinacutepancreatitisduetoleakageoflipase.Dependingontheseverityofacutepancreatitis,fatnecrosismayoccurin:-aAdiposetissuecontiguoustopancrease,retroperitonealfat.Adiposetissueinanteriormediastinum.BonemarrowOmentalandabdominalfat2.NonenzymaticorTraumaticfatnecrosisOccursduetotraumaIsseeninsubcutaneoustissueofbreast,thigh,andabdomen.
312.Resolutionofinflammationcausedby? a)TNFAlfa,IL-1andCRP b)TNFbeta,IL-6andCRP c)TNFAlfa,IL10andIL1receptorantagonist d)TNFgamma CorrectAnswer-CAns.is'c'i.e.,TNFAlfa,IL-10andIL1receptorantagonistActuallynooptionisabsolutelycorrect:IL-10isananti-inflammatorycytokineCauseresolutionofinflammationIL-1isapro-inflammatorycytokineIL-1receptorantagonismwillcauseresolutionofinflammationTNF-aisanpro-inflammatorycytokinecausesinflammationSo,inoptionC,twomediatorsarecorrectandoneisincorrectregardingresolutionofinflammation.However,amongthegivenoptionsonlyoptionCistheclosestone.ProinflammatorycytokinesMajor:-IL-1,TNF-alpha,IL-6Other:-IL-2,IL-4,IL-5,IL-6,IL-8,IL-11,IL-12,IL-15,IL-21,IL-23,ITN-gamma,GM-CSFAnti-inflammatorycytokinesIL-4,IL-10,IL-13Here,youcanconsiderIL-4aspro-inflammatorycytokine(asmorethanoneoptionscanbecorrectinPGIchandigarh).
313.Notacarcinogenforbladdercancer? a)Benzidine b)Isopropylalcohol c)Acrolein d)Phenacetin CorrectAnswer-BAns.is'b'i.e.,IsopropylalcoholRiskfactorsfortransitionalcellcarcinoma(TCC)ofbladder?Smoking-4Majoretiologicalfactor.OccupationalexposuretochemicalsNephthylaminebenzidine,anilinedyes,acrolein.Schistosomahaematobium(Bilharziasis)ItisariskfactorforbothTCC&SCC.Drugs-->PhenacetinCyclophosphamidetherapyPelvicirradiations
314.Druginducedlupusantibodiesarefound in? a)Anti-Rho b)Ds-DNA c)Anti-Sm d)Anti-histoneantibody CorrectAnswer-DAns.is'd'i.e.,AntiHistoneantibodyDruginducedlupuserythematosusAlupuslikesyndromemaydevelopinpatientsreceivingavarietyofdrugs.Procainamideandhydralazinearemostcommonoffenders.Mostpatientsdonothavesymptomsoflupuserythematosus.AntidsDNAantibodyisrareThereisanextremelyhighfrequencyofantihistoneantibodies.AlthoughmultipleorgansmaybeaffectedrenalandCNSinvolvement,usuallydoesnotoccur.
315.Donathlandsteinerantibodyisseenin? a)PNH b)Waldenstrom'smacroglobulinemia c)Paroxysmalcoldhemoglobinuri d)Malaria CorrectAnswer-CAns.is'c'i.e.,ParoxysmalcoldhemoglobinuriaParoxysmalcoldhemogjobinuria(PCH)PCHischaracterizedbyintermittentmassiveintravascularhemolysisfrequentlywithhemoglobinuriaatlowtemprature.TheautoantibodiesareofIgGclass,alsoknownasDonath-Landsteinerantibody.TheseantibodiesaredirectedagainstP-antigenonRBC.Antigenantibodycomplexontheredbloodcellactivatescomplement.Asaresult,largeamountofmembraneattackcomplexformswhichdestroysredcellsdirectlyintravascularhemolysis.Causesare:-Syphilis,Mycoplasma,Mumps,Measles,Flusyndrome
316.Cryoprecipitateisusefulin? a)HemophiliaA b)Thrombosthenia c)Afibrogenemia d)Warfarinreversal CorrectAnswer-CAns.is'c'i.e.,AfibrogenemiaCryoprecipitatewasoriginallydevelopedforthetreatmentofhemophiliaA.Itisnolongerthetreatmentofchoiceforthatdisorderbecauselessinfectiousalternativesareavailable.Atthepresenttime,Cryoprecipitateismostoftenusedforcorrectionofhypofibrinogenemiainbleedingpatients.
317.DICiscommoninwhichAML- a)Nonocytic(M5) b)Promyelocytic(M3) c)Erythrocytic(M6) d)Megakaryocytic(M7) CorrectAnswer-BAns.is'b'i.e.,PromyelocyticTumorcellsinacutepromyelocyticleukemia(M3)releaseprocoagulantandfibrinolyticfactorsthatcausedisseminatedintravascularcoagulation(DIC).
318.ExampleofApoptosisis? a)CouncilmanBodies b)GammaGandyBody c)Russellbodies d)None CorrectAnswer-AAns.is'a'i.e.,CouncilmanbodiesApoptoticbodyOneofthemurphologicalhallmarkofapoptosisistheapoptoticbodywhichiseosinophilicandmaycontainsomekarryorhecticnuclearbebris.Itisaresultofshrinkageofcytoplasmandnucleardisruption.Firstthereissurfaceblebbingandmarginationofchromatinwhichisfollowedbycellshrinkageandbreakupintosmallerapoptoticbodies.Theseapoptoticbodiesaretakenupbysurroundingcellsanddigested.Sincetheprocesswasseenforalongtimebeforethemechanismwasunderstood,apoptoticbodiesinparticularsituationsattractedspecificnames: 1. Civattebodiesorcolloidbodiesinlichenplanus.2. Kaminobodiesinmelanocyticlesions3. Councilmanbodiesinacuteviralhepatitis4. Tingiblebodies(foundsinmacrophages)inlymphoma5. Sunburncells6. Satellitedyskeratoticcells7. Eosinophilicglobules
319.Fibrinoidnecorsiswithneutrophilic infiltrationisseenin? a)PAN b)Giantcellarteritis c)Takayasuarteritis d)Wegener'sgranulomatosis CorrectAnswer-AAns.is'a'i.e.,PANAmongthegivenoptions,PANispredominantlynecrotizingvasculitis,characterizedbyfibrinoidnecrosis.DuringacutephaseofPAN,thereistransmuralinflammationwithmixedinfiltrateofneutrophils,eosinophilsandmononuclearcellswithaccompaniedfibrinoidnecrosis.Otherthreeoptionsarepredominantlygranulomatousvasculitis.
320.Mostcommonocularlymphoma? a)T-celllymphoma b)Hodgkin'slymphoma c)B-cellNHL d)PreT-celllymphoma CorrectAnswer-CAns.is'c'i.e.,B-cellNHLnon-Hodgkinlymphoma(NHL)isthemostcommontypeofocularlymphoma.
321.Cytokinecausingfever- a)IL-6 b)IFN-y c)IL-18 d)IL-4 CorrectAnswer-AAns.is'a'i.e.,IL-6PvrogenesPyrogenesaresubstancesthatcausefever.PyrogensmaybeexogenousorendogenousExogenousBacterialtoxinsEndogenousIL-1,TNF-a,IL-6,Interferons,Ciliory'sneurotropicfactorThesepyrogenesincreasethelevelofPGE2inthehypothalamusthatelevatesthethermoregulatorysetpointandcausesfever.
322.Normaltransferrinissaturatedwithiron ? a)20% b)35% c)50% d)70% CorrectAnswer-BAns.is'b'i.e.,35%Innormalindividuals,transferrinisaboutonethirdsaturatedwithiron,yieldingserumironlevelsthataverage120g/dlinmenand100g/dlinwomen.SerumferritinMostoftheferritinisstoredisdifferentorgans(liver,spleen,bonemarrow).Verysmallamountsofferritinnormallycirculateintheplasma.Sinceplasmaferritinisderivedlargelyformthestoragepoolofbodyiron,itslevelcorrelatewellwithbodyironstores.i.e.,whenthereisirondepletion,bodystoreofironisreducedthatinturnleadstodecreaseinplasmaferritin.TransferrinsaturationandironbindingcapacityIronistransportedintheplasmabytransferrin.Normallytransferrinis33%saturated(77%free)withiron,yieldserumironlevelsthataverage100-120g/dl.So,ifserumtransferrinwillbe100%saturatedtheserumironwillbe300g/dl.thatmeansthetotalironbindingcapacityoftransferrinis300to350g/dl.Whenironstoreisdepletede.g.,inirondificiencyanemia,thereisincreasedsynthesisoftransferrinthatresultsinincreasedtotaliron
bindingcapacity.Whenironstoreisrepletede.g.,anemiaofchronicdisease,thereisdecreasedsynthesisoftransferrinthatresultsindecreasedtotalironbindingcapacity.SerumtransferrinreceptorsErythroidprecursorshavereceptorsfortransferrinbywhichtheyrecieveironfromtransferrinthatisutilizedforhemoglobinsynthesis.Whenerythroidprecursorsmature,thesereceptorsareshedintoplasmaandcanbemasuredasserumtransferrinreceptorsconcentration.Inirondeficiencystate,thereisincreasederythropoisisinbonemarrowTconcentrationoferythroidprecursorthatresultsinincreasedtotalnumberoftransferrinreceptor-->Tserumtransferrinreceptorconcentration.
323.Allofthefollowing immunohistochemicalmarkersarepositiveintheneoplaticcellsofgranulocyticsarcoma,except? a)CD45RO b)CD43 c)Myeloperoxidase d)Lysozyme CorrectAnswer-AAns.is'a'i.e.,CD45ROGranulocyticsarcoms(Chloromaormyeloblastoma)Granulocyticsarcomsorchloromaisasolidtumorcomposedofmyeloblasts.AchloromaisanextramedullarymanifestationofAML,i.e.,itisasolidcollectionofleukemiccellsoccuringoutsitedofthebonemarrow.Thesetumoroftenhaveagreentintduetothepresenceofmyeloperoxidase.Chloromasaremorecommoninmonocyticdifferentiation(M4&M5type)AML.ThoughchloromasoccursmostcommonlyinpatientswithAML,theymayalsooccurinpatientwith:?MyelodysplasticsyndromeMyeloproliferativesyndromesMyelofibrosis,CML,Polycythemiavera,Essentialthrombocytosisin)Withoutconcomitantdisease,i.e.,Primarychloroma.Chloromasarepositivefor:?
CD68CD20CD117LysozymeCD43CD34Myeloperoxidase
324.Inglomerulussubendothelialdeposits areseenin? a)Goodpasturesyndrome b)IgAnephropathy c)MPGNtypeI d)MPGNtypeII CorrectAnswer-CAns.is'c'i.e.,MPGNtypeISubendothelial-MPGN(Type-1),SLE,AcuteON
325.Thromboangitisobliteransisassociated with? a)HLAB27 b)HLA-DR4 c)HLA-B5 d)HLA-DR2 CorrectAnswer-CAns.is'c'i.e.,HLA-B5Thromboangitisobliterans(Bergerdisease)Thrombangitisobliteransisadistinctivediseasethatischaracterizedbysegmental,thrombosingacuteandchronicinflammationofmediumsizedandsmallsizedarteries,andsometimessecondarilyextendingtoveinsandnerves.Thromboangitisobliteransoccursalmostexclusivelyamongheavy-cigarrete-smokingpersons.Itismorecommoninmenbutincidenceisincreasinginwomenbecauseofincreasingsmokinghabitinwomen.oBuergerdiseaseisassociatedwithHLAB-5andHLA-A9.Inthrombongitisobliteransthereisacuteandchronicsegmentalinflammationofvesselswithaccompaniedthrombosisinthelumen.Typically,thethrombuscontainsmicroabscesseswithacentralfocusofneutrophilssurroundedbygranulomatousinflammation.Later,theinflammatoryprocessextendsintocontiguousveinsandnervesandintimeallthreestructures(arteries,veinsandnerves)becomeencasedinfibroustissue,acharactersticthatisveryrarewithotherformofvasculitis.ClinicalmanifestationsThrombangitisobliteransaffectsvesselsofupperandlower
extremities.Symptomsareduetovascularinsufficiency,i.e.Ischemiaoftoes,feetandfingersthatcanleadtoulcerandfrankgangrene.Duetoneuralinvolvement,theremaybeseverepain,evenatrest.
326.WhichantibodiesinmotherwithSLEis responsibleforcongenitalheartdiseaseinchild? a)Anti-histone b)Anti-Ro&Anti-LA c)AntidsDNA d)Anti-centromere CorrectAnswer-BAns.is'b'i.e.,Anti-Ro&Anti-LAMostsensitiveAntinuclearantibody(ANA)MostspecificAntidoublestrandedanitbodyandtheantibodyagainstsmith(Sm)AssocitedwithneonatalAntiRo,AntiLAantibodylupusandcongenitalheartblockAssociatedwithlupusAntiPantibodypsychosis
327.Xerostomiaisseeninallexcept? a)Sjogrensyndrome b)RA c)Sarcoidosis d)Midlinegranuloma CorrectAnswer-DAns.is'd'i.e.,MidlinegranulomaSjogrensyndromeSjogrensyndromeisachronicdiseasecharacterizedbydryeyes(keratoconjuctivitissicca)anddrymouth(xerostomia)resultingfromimmunologicalmediateddestructionofthelacrimalandsalivaryglands.oItoccursintwoforms?Primaryform(SICCASYNDROME)Occursasanisolateddisorder.SecondryformWhenitoccursinassociationwithotherautoimmunedisorder.Itismorecommon.oAutoimmunediseasesassociatedwithsjogrensyndromeRheumatoidarthritisPrimarybiliarycirrhosisThyroiditisSLEMixedconnectivetissuediseaseSarcoidosisPolymyositisVasculitisSclerodermaChronicactivehepatitisAmongstthese,SjogrensyndromeisassociatedmostcommonlywithRA.
328.Trueregardingfibromusculardysplasia areallexcept- a)Mediumsizevessels b)OCPspredispose c)Aneurysmmayoccur d)Irregularhyperplasia CorrectAnswer-BAns.is'b'i.e.,OCPspredisposeFibromusculardysplasiaItisfocalirregularthickeningofthewallsofmediumandlargemusculararteries,includingrenal,carotid,splanchnic,andvertebralvessels.Segmentsofvesselwallarefocallythickenedbyacombinationofirregularmedialandintimalhyperplasiaandfibrosis,causingluminalstenosis.Inrenalvessels,itmaycauserenovascularhypertension.Aneurysmmaydevelopinthevesselsegmentwithattenuatedmedia,andcanruptureinsomecases.Thereisnoassociationwithuseoforalcontraceptivesorsexhormoneabnormalities.
329.NottrueaboutAlport'ssyndrome? a)X-linked b)Autosomaldominant c)Nervedeafness d)Glomerulonephritis CorrectAnswer-BAns.is'b'i.e.,AutosomaldominantAutosomaldominantformalsoexist,butitisveryrare.Thus,amongthegivenoptions,itisthebestanswer.OtherthreeoptionsareclassicalfeaturesofAlport'ssyndrome.Alport'ssyndromeAlport'ssyndromeisatypeofhereditarynephritischaracterizedby-Glomerulonephritisprogressingtochronicrenalfailure.NervedeafnessEyedefectslenticonus,lensdislocation,posteriorcataract,cornealdystrophy.MostcommonlyitisinheritedasX-linkedform.Rareautosomal-recessiveandautosomal-dominantpedigreesalsoexist.PathogenesisThereisdefectiveGBMsynthesisbecauseofproductionofabnormalcollagentypeIVunderliestherenallesions.Thedefectiscausedbymutationinthegeneencodingac-chainofcollagentypeIV.
330.Peliosishepatisiscausedbyallexcept? a)Analgesics b)Anabolicsteroids c)OCpills d)Danazol CorrectAnswer-AAns.is'a'i.e.,AnalgesicsPeliosishepatitisisarareconditioninwhichthereisprimarilysinusoidaldilatation.Thelivercontainsbloodfilledcysticspaces,eitherunlinedorlinedwithsinusoidalendothelialcells.Peliosishepatitisisassociatedwithmanydiseasesincludingcancer,TB,AIDSorposttransplantationimmunodeficiency.Itisalsoassociatedwithexposuretoanabolicsteroidsandrarely,oralcontraceptivesanddanazol.
331.Pseudo-Pelger-Huetcellsorseenin a)Hairycellleukemia b)Multiplemyeloma c)Mylodysplasticsyndrome d)Hodgkin'slymphoma CorrectAnswer-CAns.is'c'i.e.,MyelodysplasticsyndromePeripheralbloodshowsthepresenceofPseudo-Pelger-Huetcells,giantplatelets,macrocytes,poikilocytesandmonocytosis.Clinicalfeaturesareseeninonly50%patientsincludingweakness,infectionandhemorrhageduetopancytopenia.Usuallypatientsareofanoldage(meanageofonsetis>60years).Theprognosisispoor.
332.Acutephasereactantsareallexcept? a)C-reactiveprotein b)Haptaglobulin c)Endothelin d)Fibrinogen CorrectAnswer-CAns.is'c'i.e.,EndothelinAcutephaseproteins(reactants)Acutephasereactantsareaclassofproteinswhoseplasmaconcentrationincreasesordecreasesinresponsetoinflammation.Thisresponseiscalledtheacutephasereaction(acutephaseresponse)Itshouldbenotedthatacutephaseproteinsnotonlyincreaseinresponsetoinflammation;somedecreasealso 1. Proteinswhichincreaseinresponsetoinflammation-->Positive acutephaseproteins 2. ProteinswhichdecreaseinresponsetoinflammationNegativeacute phaseproteins1.PositiveacutephaseproteinsC-reactiveprotein031-globulin)ct-2microglobulina-1antitrypsinMannosebindingproteinFibrinogen,prothrombin,vWFD-dimerproteinFerritinHaptoglobulinSerumamyloidACeruloplasminDPlasminogen,FactorVIIIComplementfactors2.NegativeacutephaseproteinsCIAlbumin&PrealbuminTranscortinTransferrinRetinolbindingproteinTransthyretin
Transthyretin
333.Allaretrueaboutnon-bacterial thromboticendocarditis,except? a)Causeemboli b)Vegetation>5mm c)Noinflammatoryreaction d)Locallynondestructive CorrectAnswer-BAns.is'b'i.e.,Vegetation>5mmNonbacterialthromboticendocarditis(NBTE)NBTEischaracterizedbythedepositionofsmallsterilethrombiontheleafletsofthecardiacvalves.Thelesionsaresmall,rangingfrom1mmto5mm.Theyoccursinglyormultiplyalongthelinesofclosureofleafletorcusps.Theyarecomposedofblandthrombithatarelooselyattachedtotheunderlyingvalve.Thevegetationsarenotinvasiveanddonotelicitanyinflammatoryreaction.Thus,thelocaleffectofvegetationsisusuallyunimportantbuttheymaybethesourceofsystemicemboli.NBTEisoftenencounteredindebilitatedpatients.Itisseeninhypercoagulablestates,e.g.cancer,promyelocyticleukemia,mutinousadinocarcinomasandincreasedestrogenicstate.
334.Whichoneofthefollowingstainsis specificforAmyloid? a)PeriodicAcidschif(PAS) b)Alzerianred c)Congored d)Von-Kossa CorrectAnswer-CAns.is'c'i.e.,CongoRed"Todifferentiateamyloidfromotherhyalinedeposits(eg.Collagenandfibrin),avarietyofhistochemicaltechniquesareused,ofwhichthemostwidelyusedisCongoRed"-Robbins7'/ep.259StainingforAmyloidCongored:Itisthemostwidelyusedspecificstainforamyloid.Iodinestaining:Itisusedforunfixedspecimenorhistologicalsection.Amyloidstainsmahoganybrownandifsulfuricacidisadded,itturnsviolet.Thioflavin'T'and`S'givesecondaryimmunoflurescencewithultravioletlight.ThioflavinTismoreusefulfordemonstratingjuxtalomerularapparatusofthekidney.Metachromaticstainslikecrystalvioletandmethylvioletgiverosepinkappearance.AmyloidisPASpositive.
335.AllaretrueaboutFragileXsyndrome except? a)Largehead b)Largenose c)Largeear d)Largetestis CorrectAnswer-BAns.is'b'i.e.,LargenoseFragile-XsyndromeFragile-Xsyndromeistheprototypeofdiseasesinwhichthemutationischaracterizedbyalongrepeatingsequenceofthreenucleotides.InfragileXsyndrome,trinucleotidcrepeatmutationinvolveCGGonnoncodingregion.Clinicalfeaturesoffragile-XsyndromeMentalretardationqLongfacewithlargemandibleqHyperexntesiblejointqMitralvalveprolapseLargeevertedearsqLargetestis(macro-orchidism)HigharchedpalateFragileXsyndromeisthesecondmostcommoncauseofmentalretardation,afterDownssyndrome.
336.Concentrichypertrophyofleftventricle isseenin? a)Mitralstenosis b)Hypertension c)Aorticregurgitation d)None CorrectAnswer-BAns.is'b'i.e.,HypertensionConcentrichypertrophy-->Inpressureoverload,e.g.hypertensionandaorticstenosis.oEccentrichypertrophyInvolumeoverload,e.g.inaorticregurgitation.AdaptationsinheartThecardiacmyocyteisterminallydifferentiatedcellthatisnotabletodivide.Myocardiumcannotundergohyperplasia,i.e.increaseinthenumberofmyocyte.So,myocardiumcanadaptbyincreasingthesize(i.e.hypertrophy)ofthemyocyteinresponsetostress.Therearetwotypesofstressestoheart1.PressureoverloadOccurinhypertensionoraorticstenosis.Pressureoverloadedventriclesdevelopconcentrichypertrophyoftheleftventricle,withincreasedinwallthicknessHeartsizemayincrease.Theincreaseinwallthicknessmayreducethecavitydiameter-->ratioofcavitysizetowallthicknessdecreases.Thereisincreaseinthetransversediameter(width)ofmyocytes,butcelllengthremainsthesame.
2.VolumeoverloadAsoccursinaorticregurgitationThereisdilatationofventricularchamberalongwithincreasedthicknessofventricularwallEccentrichypertrophy.Thereisincreasebothinthetransversediameter(width)andthelengthofmyocytes.Itisduetodepositionofthesarcomeres(functionalintracellularcontractileunitofcardiacmuscles)inparalleltothelongaxisofcells.
337.Whichdoesnotcausesideroblastic anaemia? a)INH b)Chloramphenicol c)Myelodysplasticanaemia d)Mercury CorrectAnswer-DAns.is'd'i.e.,Mercury
338.Whichofthefollowingisnota myeloproliferativedisease? a)Polycythemiavers b)Acutemyeloidleukemia c)Chronicmyeloidleukemia d)Essentialthrombocytosis CorrectAnswer-BAns.is'b'i.e.,AcutemyeloidleukemiaChronicmyeloproliferativedisordersThedisordersinthisgroupare?ChronicmyeloidleukemiaEssentialthrombocytosisPolycythemiaveraPrimarymyelofibrosisThesediseasearecharacterizedbyneoplasticproliferationofmultipotentprogenitorcellthatiscapableofgivingrisetomatureerythrocytes,platelets,granulocytes,monocytesandlymphocytes.Animportantfeatureofmyeloproliferativedisordersisthatintheirterminalphasetheyarecharacterizedbymarrowfibrosisandperipheralbloodcytopenia.Allofthemcanprogressovertimetoacuteleukemia,butonlyCMLdoessoinvariably.RememberCML,Polycythemiaveraandessentialthrombocytosiscanprogresstomyelofibrosisinterminalstage.
339.Allofthefollowingareassociatedwith carcinomacolonexcept? a)Smoking b)Alcohol c)Fibrediet d)Fattyfood CorrectAnswer-CAns.is'c'i.e.,FibredietFibredietisprotectiveagainstcoloncancer(seepreviousexplanations).RiskfactorsforColoncancer 1. Dietayfactores-explainaedinpreviousquetion2. Hereditaryfactors PolyposiscoliNonopolyposisherditarycoloncancer(alsoknownasLynchsyndrome)InflammatoryboweldiseaseLongstandingIBDincreasestheriskRiskismorewithulcerativecolitisthancrohn'sdisese.Riskincreaseswiththedurationandextentofcolitis.Leftsidedcolitiscarriessomewhatlessrisk.StreptococcusbovisbacteremiaIndividualswhodevelopendocarditisorsepticemiafromthisbacteria,haveahighincidenceofoccultcolorectaltumorsandpassiblyupperGIcancersalso.OtherRiskfactorsUreterosigmoidostomyCigarettesmoking-islinkedtothedevelopmentofcolorectal
adenomas,particularlyafter>35yrsofuse.AcromegalyPelvicirradiationAspirin&otherNSAIDsusehasbeenfoudtohaveaprotectiveeffect(Chemopervention)OthersubstancefoundtohavechemoprentiveactionareOralfolicacidsupplementation,Oralcalciumsupplementation,Estrogenreplacementtherapy
340.Whichofthefollowingislabilecell? a)Cardiaccell b)Liverparenchymalcell c)Vascularendothelialcells d)Surfaceepithelium CorrectAnswer-DAns.is'd'i.e.,SurfaceepitheliumWhenacellproliferates,itpassthroughacellcycle.Cellcyclehasaseriesofphases:GphaseRestphase(Presyntheticphase)SphaseSyntheticphaseinwhichsynthesisofDNAtakesplace.G2phaseRestingphase(Postsyntheticorpostmitoticphase).MphaseMitoticphaseinwhichmitosistakesplace.GophaseWhencellisnotproliferating,itremainsinquiescentphase(Go).Basedontheirproliferativecapacity,cellsaredividedintoSGoG,1.Labilecells(Continouslydividingcells)orintermitoticcells.Havecapacitytoproliferateandregenerate.HaveveryshortGoandalmostalwaysremainincellcycle.Exampleare:-Surfaceepithelium(stratifiedsquamous)ofskin,oralcavity,vaginaandcervix.Liningmucosaofallexcretoryductsofglands(Salivarygland,pancreas,biliaryduct).ColuminarepitheliumofGITanduterus.Transitionalepitheliumoftheurinarytract.
Bonemarrowcellsandhematopoieticcells.Basalcellsofepithelia.2.Stableorquiescentorreversiblepostimitoticcells.Havelimitedcapacitytoproliferateandregenerate.RamaininGophaseofcellcyclebutcanenterinGIphasewhenstimulatedi.e.,theyusuallyremainquiescent,butproliferateinresponsetostimuli.Exampleare-Parenchymalcellsofliver,kidneyandpancreas.Mesenchymalcells,e.g.,fibroblastandsmoothmuscles.VascularendotheliumOsteoblast,chondroblastRestinglymphocytesandotherleukocytes.3.Permanentornondividingorirreversiblepostmitoticcells.Cannotdivideandregenerate.Thesecellsarenondividingandhaveleftthecellcycle,i.e.,theydonotbelongtoanyphaseofcellcycle.Exampleare-LiNeuronsCardiacmuscleSkeletalmuscle
341.Glanzmannthrombastheniaisdueto a)DecreasedGpIb b)DecreasedGpIIb/IIIa c)Anti-GpIIb/IIIaantibodies d)InhibitionordeficiencyofADAMTS13 CorrectAnswer-BAns.is.b.DecreasedGpIIb/IIIaGlanzmannthrombastheniaisanautosomalrecessivedisorder.ThereisafailureofprimaryplateletaggregationwithADPorcollagenduetoinheriteddeficiencyoftwoplateletsmembraneglycoproteins.ItiscausedduetodeficiencyofglycoproteinIIb-IIIa.
342.VitaminAisstoredin a)CellsofIto b)Hepatocyte c)Endothelialcell d)Kupffercell CorrectAnswer-AAnswerA?CellsofItoHSCs(hepaticstellatecells)(alsocalledvitaminA-storingcells,lipocytes,interstitialcells,fat-storingcellsorItocells)existinthespacebetweenparenchymalcellsandliversinusoidalendothelialcellsofthehepaticlobuleandstore50-80%ofvitaminAinthewholebodyasretinylpalmitateinlipiddropletsinthecytoplasm.
343.Apoptoticgeneis- a)Bax b)Bcl2 c)Bclx d)Mcl CorrectAnswer-BAnswer-B.Bcl2RegulationisprimarilybytheBcl-2familyofgeneslocatedonchromosome18.Somemembersofthisfamilylikebak,bid,bin,Bcl-xs(toremember,Sforstimulatingapoptosis)stimulateapoptosiswhereasotherslikeBcl-2,Bcl-xl(toremember,Lforlowerapoptosis),etcinhibitapoptosis.Genefamiliessuchascaspases,inhibitorofapoptosisproteins,Bcelllymphoma(Bcl)-2familyofgenes,tumornecrosisfactor(TNF)receptorgenesuperfamily,orp53geneareinvolved,and/orcollaborateintheprocessofapoptosis.
344.Alphaoneantitrypsinworksby a)inhibitionoftrypsin b)inhibitionoftrypsinogen c)inhibitionofelastase d)inhibitionofchymotrypsin CorrectAnswer-CAnswer-C(inhibitionofelastase)Explanation-Alpha-1antitrypsin(A1AT)isproducedintheliver,andoneofitsfunctionsistoprotectthelungsfromneutrophilelastase,anenzymethatcandisruptconnectivetissue.
345.Whichoneofthefollowingisan autosomalrecessivedisorder? a)Albinism b)Huntington'ssyndrome c)Marfan'ssyndrome d)Neurofibromatosis-1 CorrectAnswer-AAnswer-A.AlbinismExplanation-Albinismiscausedbymutationsinoneofseveralgenes,andmosttypesareinheritedinanautosomalrecessivemanner.
346.FishmouthappearanceofvalveinRHD isdueto- a)Ruptureofvalve b)Calcification&fibrosis c)Hypertrophyofventricularwall d)Noneoftheabove CorrectAnswer-BAnswer-B.Calcification&fibrosisInrheumaticheartdisease,anautoimmuneattackonthemitralvalveproducesthickeningofthevalveleaflets.Themitralvalveisoftendescribedashavinga"fish-mouth"appearance.
347.Follicularlymphomapositivity? a)Bcl-1 b)Bcl-6 c)Bcl-2 d)Noneoftheabove CorrectAnswer-CAnswer-C.Bcl-2Atranslocationbetweenchromosome14and18resultsintheoverexpressionofthebcl-2gene.Asthebcl-2proteinisnormallyinvolvedinpreventingapoptosis,cellswithanoverexpressionofthisproteinarebasicallyimmortal.Thebcl-2geneisnormallyfoundonchromosome18,andthetranslocationmovesthegeneneartothesiteoftheimmunoglobulinheavychainenhancerelementonchromosome14.
348.whatisthehistologicaldifference betweentheminUlcerativecolitis&Crohn'sdisease? a)Diffusedistributionofpseudopolyps b)Mucosaledema c)Cryptabscess d)Lymphoidaggregatesinthemucosa CorrectAnswer-CdifferencesbetweenulcerativecolitisandCrohn'sdiseaseareasfollows: ulcerativecolitis Crohnsdisease commonsite ileocolitiswithrectalsparing procolitis,rectum protective Smoking nofactors factor Appendicectomy antibioticduringthefirst commonrisk antibioticduringthefirst yearoflife,turner factors yearoflife,turnersyndrome syndrome -Methyldopa,Wiskott? riskfactor OCP,Smoking AldrichSyndrome, Tcellinvolved TH1 TH2 Earliest Erythematousmucosa macroscopic AphthousUlcer withafinegranular finding surface Wallinvolved Transmural mucosa&submucosa Pseudopolyp lesscommon mostcommon typeofulcer serpentine Collar-buttonulcers cobblestone present notpresent
cobblestone present notpresent appearance skinlesions seen notseen Creepingfat seen notseen non-caseatinggranuloma Granuloma notseen seen classical-perinatal Fistula notseen (enterocutaneous) strictures common notcommon Toxic notseen seen megacolon Cryptabscess and lessmarked moremarked destructionRosethorn seen notseen appearance Pyloricmetaplasiaisa metaplasia panethcellmetaplasia clinicalmarker Renalcalculi calciumoxalate notpresent uveitis,migratory polyarthritis,sacroiliitis, ankylosing Extraintestinal spondylitis,erythema SimilartoCrohndisease manifestations nodosum,clubbing,Primary sclerosing cholangitis Named TrueLoveWitt's criteriato -------- criteria-UC assess theseverity
349.Whatisthecauseofintracorpuscular defectsinhemolysis? a)Uremicsyndrome b)PCH c)PNH d)Portalhypertension CorrectAnswer-CAnswer-C.PNH
350.Typeofnecrosisseeninbloodvessels duetoimmunereactions- a)Coagulation b)Liquefaction c)Fibrinoid d)None CorrectAnswer-CAnswer-C(Fibrinoid)Insmallvesselvasculitis,fibrinplugsfrequentlyoccurinthevessellumen,butthetermfibrinoidisusuallyusedtorefertomaterialoutsidethelumenofavessel.Fibrinoidnecrosisalsooccursinthewallsofarteriolesinmalignanthypertension.
351.Inapatientwithlipoproteinlipase deficiency,whichofthefollowingisincreasedfollowingafattymeal? a)Chylomicron b)LDL c)HDL d)Apo-A CorrectAnswer-AAnswer-A.ChylomicronLipoproteinlipasedeficiency(TypeIhyperlipoproteinemia):isarare,autosomalrecessivedisordercausedbyadeficiencyoflipoproteinlipase.Resultinginfastingchylomicronemiaandhypertriglycerolemia.ThereisslowclearanceofchylomicronsandVLDL.LowlevelsofLDLandHDL.Thereisnoincreasedriskofcoronarydisease.
352.InWilson'sdisease,thereislessurinary excretionof- a)Phosphorus b)Methyl-Histidine c)Phosphotyrosine d)Serine CorrectAnswer-BAnswer-B.Methyl-HistidineEssentialsofDiagnosis&TypicalFeaturesofWilsondisease:AcuteorchronicliverdiseaseDeterioratingneurologicstatusKayser-FleischerringsElevatedlivercopperAbnormalitiesinlevelsofceruloplasminandserumandurinecopper.
353.WhatisthefunctionofIL1? a)Enhanceshematopoiesis b)Stimulatesmastcells c)Hasantiviralproperties d)Endogenouspyrogen CorrectAnswer-DAnswer-D(Endogenouspyrogen)wasformerlyknownaslymphocyte-activatingfactor(LAF).augmentstheactivityofmanycelltypes,especiallyTcells.isanendogenouspyrogen(EP).inducesanincreaseinacutephasereactants.isaheat-stableandpH-stablepeptidewithamolecularweightof17.5kd.occursintwoforms:IL-1?andIL-1?.
354.CEAPscoreindicates- a)Atrialdisorders b)Venousdisorder c)Neurologicaldisorde d)Traumadisorder CorrectAnswer-BAnswer-B.(Venousdisorder)ComprehensiveClassificationSystemforChronicVenousDisorders(CEAP) CEAPclassificationofchronic Clinicalclassification venousdiseaseC3 Edema C4a PigmentationoreczemaLipodermatosclerosisor C4b athrophieblanche C5 Healedvenousulcer
355.IL-1activatedby- a)Capsase1 b)Capsase3 c)Capsase8 d)Capsase5 CorrectAnswer-AAnswer-A(Capsase1)ThetwoinflammatorycytokinesactivatedbyCaspase-1areexcretedfromthecelltofurtherinducetheinflammatoryresponseinneighboringcells.
356.Parotidmassmixedconsistency a)Pleomorphicadenoma b)Sebaceouscyst c)Dermoidcyst d)All CorrectAnswer-AAnswer-A(Pleomorphicadenoma)Itisalsoknownas"Mixedtumor,salivaryglandtype",whichreferstoitsdualoriginfromepithelialandmyoepithelialelementsasopposedtoitspleomorphicappearance.
357.Krabbe'sdiseaseis- a)DeficiencyofBeta-galactosylcermidase b)Deficiencyofarylsulphatase c)Alphagalactosidase d)Acidlipase CorrectAnswer-AAnswer-A(DeficiencyofBeta-galactosylcermidase)KrabbediseaseiscausedbymutationsintheGALCgenelocatedonchromosome14(14q31),whichisinheritedinanautosomalrecessivemanner.MutationsintheGALCgenecauseadeficiencyofanenzymecalledgalactosylceramidase.
358.Whatisthechoiceoftreatmentfor idiopathicthrombocytopeniapurpura(ITP)? a)Bloodtransfusion b)Spontaneousrecovery c)IVinfusion d)Splenectomy CorrectAnswer-DAnswer-D(Splenectomy)BeneficialeffectsofsplenectomyinchronicITPareduetobothremovalofthemajorsiteofplateletdestructionandthemajorsourceofautoantibodysynthesis.
359.Mostcommonnephropathyassociated withmalignaneNis: a)Focalsegmentalglomerulosclerosis(FSGS) b)Minimalchangedisease c)IgAnephropathy d)Membranousglomerulonephritis CorrectAnswer-DAns:D.MembranousglomerulonephritisMostcommonnephropathyassociatedwithmalignancy-Membranousglomerulonephritis.In25-30%-Associatedwithmalignancy(solidtumorsofbreast,lung,colon),infection(hepatitisB,malaria,Schistosomiasis),orrheumatologicdisorderslikelupusorrarelyrheumatoidarthritis.Histopathology:Electron-densedepositsalongtheepithelialsideofthebasementmembranewitheffacementoffootprocessesoverlyingdeposits.(RefRobbins9/ep917-918;Harrison19/ep1843).
360.Whichofthefollowingcomplement factorsisamarkerofhumoralrejection? a)C3d b)C3b c)C4d d)C5a CorrectAnswer-CAns:C.C4d(Ref:Robbins9/ep234)C4dfactorisamarkerforhumoralrejection.Acuteantibody-mediatedrejectionismanifestedmainlybydamagetoglomeruliandsmallbloodvessels.Typically,thelesionsconsistofinflammationofglomeruliandperitubularcapillaries,associatedwithdepositionofthecomplementbreakdownproductC4d,whichisproducedduringactivationofthecomplementsystembytheantibody-dependentclassicalpathway.Smallvesselsmayalsoshowfocalthrombosis.
361.Mostreactivefreeradicalis: a)Peroxide b)Carboxyl c)Hydroxyl d)Superoxide CorrectAnswer-CAns:C.Hydroxyl(RefRobbins9/ep480)Hydroxylradical(*OH)isthemostpotentreactiveoxygenspecies.Mostreactiveoxygen-derivedfreeradical.PrincipalROSresponsiblefordamaginglipidsproteins&DNA.
362.Alpha-fetoproteinisatumormarkerfor a)Hepatocellularcarcinoma b)Multiplemyeloma c)Seminoma d)Breastcarcinoma CorrectAnswer-AAnswer-A.HepatocellularcarcinomaAlpha-fetoprotein(AFP)AFPisawellestabilishedtumormarkerItisaglycoprofeinsynthesizednormailyearlyinfetallifebytheyolksac,fetalliverandfetalGIT.AFPisraisedin-Carcinomas>LiverCa,LungCa,ColonCa,PancreaticCa,Non-seminomagermcelltumoroftestis.Non-neoplasticconditions>Cirrhosis,Hepatitis,Pregnancy
363.Hypercalcemiainsarcoidosisallaretrue except? a)Parathormonelevelisincreased b)PTHrPlevelisincreased c)Calcitriollevelisincreased d)Oralsteroidsareuseful CorrectAnswer-AAnswer-A.ParathormonelevelisincreasedExtrarenalsynthesisofcalcitriol[1,25(OH)2D3]iscentraltothepathogenesisofabnormalcalciummetabolisminsarcoidosis.Sarcoidosiscausesanincreaseinl,25-dihydroxyvitaminD,theactivemetaboliteofvitaminD,whichisusuallyhydrorylatedwithinthekidney,butinsarcoidosispatientshydroxylationofvitaminDcanoccuroutsidethekidneys,mainlyinsidetheimmunecellsfoundinthegranulomasandproduces1alpha,25(OH)2D3,whichisthemaincauseforhypercalcemiainsarcoidosis.PTHreleaseisinhibitedbyhypercalcaemiaandhighlevelsofcalcitriol,soPTHlevelissuppressedinsarcoidosis.
364.Tolllikereceptorsareseenon? a)Macrophages b)Naturalkillercells c)Endothelialcells d)Alloftheabove CorrectAnswer-DAnswer-D.AlloftheaboveTheToll-likereceptorsarernembraneproteinsthatrecognizeavarietyofmicrobe-derivedmoleculesandstimulateinnateimmuneresponsesagainstthemicrobes.TheToll-likereceptorsareexpressedonmanydifferentcelltypesthatparticipateininnateimmuneresponsesincluding,macrophages,dendriticcells,neutrophils,NKscells,mucosalepithelialcellsandendothelialcells.
365.Reversiblechangefromoncelltypeto otherisknownas- a)Hyperplesia b)Hypertrophy c)Metaplesia d)Dysplasia CorrectAnswer-CAns.is'c'i.e.,Metaplesia[Ref:Robbin's9th/ep.376,styep10]Metaplasiaisanadaptivechangeinwhichoneadult(mature)celltypeisreplacedbyanotheradult(mature)cell.Itiscompletelyreversible
366.Gaseousnecrosisisseenin- a)CMVinfection b)Staphylococcalinfection c)Treponemalinfection d)HSVinfection CorrectAnswer-CAns.is'c'i.e.,Treponemalinfection[RefRobbin's9`"/ep.43;Anderson's10thiep.375]Caseousnecrosisisafeatureofsyphiliswhichiscausedbytremonemalinfection.GaseousnecrosisItisavariantofcoagulativenecrosis.Itismostcommonlyencounteredwhencelldeathisattributabletoertainorganismse.g.,mycobacteriumtuberculosis(TB),syphilisandfungi(Histoplasma,Coccidioidomycosis).
367.Substanceplayingaroleintumor metastasiscascadeis a)CollagenaseIV b)TNF-alpha c)CD99 d)NM23 CorrectAnswer-AAnsis'a'i.e.CollagenaseIVVariousstepsofmetastasisandmoleculesinvolved 1. Detachmentoftumorcells-Downregulationofexpressionofeither E-cadherinsorcatenins 2. AttachementtoECM(includingbasementmembrane)-Tumorcells expressintegrinsthathelpsintheattachement. 3. DegradationofECM-proteolyticenzymes(mostimportant proteasesaremetalloproteinases(MMPs)includingcollegenaseIV). 4. Vasculardisseminationandhomingoftumorcells-Amongadhesion moleculeCD44isofparticularinterest.
368.Rbgeneislocatedonwhich chromosome? a)6 b)9 c)13 d)21 CorrectAnswer-CAns.is'c'i.e.,13[RefRobbin's9tVep.290]Retinoblastomagene(RBgene)islocatedon14bandonthelongarmofchromosome13(13q14).RBgeneisatumorsupressorgene.RetinoblastomadevelopswhenboththenormalallelesoftheRBgenesareinactiveoraltered.ItistypicalexampleofKnudson'stwohithypothesis.
369.AbsenceofUltrahepaticbileductleads towhichsyndrome? a)VonMeyenburgComplexes b)PolycysticLiverDisease c)CaroliDisease d)AlagilleSyndrome CorrectAnswer-DAnswer-D.AlagilleSyndromeItisanautosomalrecessiveconditioncharacterizedbyabsenceofbileductsinportaltractAlsocalledarteriohepaticdysplasiaCharacteristicfeatures:Geneticdisorderwithvascular,biliaryandotheranomalies.Absenceofintrahepaticbileductswithclinicalseverityrangingfromsevereneonatalcholestasismimickingbiliaryatresiatochildhoodintermittentjaundice.Progressiontocirrhosisisrare.
370.TrueaboutDentigerouscyst: a)Arisesinrelationtouneruptedteeth b)Itmostcommonlyencroachesmaxillaryantrum c)Mandibularthirdmolariscommonsite d)Commoninmandible e)All CorrectAnswer-A:C:DAnswer-A,ArisesinrelationtouneruptedteethC,MandibularthirdmolariscommonsiteD,CommoninmandibleCommoninlowerjaw(mandible)inwomen30-40years.Itoccursinrelationtounerupted,permanent,molartooth,mostcommonlytheupperorlowerthirdmolar.
371.VitaminAdeficiencyleadstometaplasia of? a)Squamousepithelium b)Columnarepithelium c)Both d)None CorrectAnswer-AAnswer-A.SquamousmetaplasiaItoccursmostfrequentlyinrespiratorytractasaresultofchronicirritationbycigarettesmoking.Thecolumnarepitheliumisreplacedbysquamousepithelium.Thissquamousmetaplasiarepresentsanattemptbythehosttorepairorprepareanepithelialtissuethathasbeendamagedbyenvironmentaltoxicantswithamoreresistanttissue.Squamousmetaplasiaisalsoencounteredinotherlocationsuchaspancreaticduct(VitAdeficiency,stonesinpancreaticduct),gallbladder(gallstones),urinarybladder(bladdercalculi,Schistosomiasis),andinendocervix.Thoughthemetaplasiaisreversible,iftheinfluencesthatpredisposetometaplasiaispersistent,malignanttransformationmayoccurinmetaplasticepithelium.
372.Nucleiarearrangedatthecellperiphery inwhichtypeofcell? a)Langhansgiantcell b)Merkelcells c)NKcells d)Neutrophils CorrectAnswer-AAnswer-A.LanghansgiantcellPeripheralnucleiareseeninLanghanstypegiantcellsLanghansgiantcellsarelargecellsfoundingranulomatousconditions.Theyareformedbythefusionofepithelioidcells(macrophages)andcontainnucleiarrangedinahorseshoe-shapedpatterninthecellperiphery.Thesecellscontain3-5nuclei.Nucleiarearrangedaroundtheperipheryintheformofahorseshoe.Thesecellsmayalsoactasprecursorsofforeignbodygiantcells.ThesecellsareseeninTB&sarcoidosis.
373.NottrueaboutVEGFis- a)Highlyspecificforendothelium b)Hypoxiapotentiatesitsexpression c)Inhibitsangiogenesis d)Helpsintumormetastasis CorrectAnswer-CAnswer-C.InhibitsangiogenesisVascularendothelialgrowthfactor(VEGF)isapotentangiogenicfactorandwasfirstdescribedasanessentialgrowthfactorforvascularendothelialcells.VEGFisup-regulatedinmanytumorsanditscontributiontotumorangiogenesisiswelldefined.Inadditiontoendothelialcells,VEGFreceptorsareexpressedonnumerousnon-endothelialcellsincludingtumorcells.Bindstoendo-specificreceptorsFlt-1andFlk-1(ofthetyrosinekinasefamily).ExpressionofVEGFpotentiatedbyhypoxiaandinactivationofp53.ThetwomostimportantangiogenicfactorsinatumorareVEGFandbasicfibroblastgrowthfactor(bFGF),thushelpingintumormetastasis.
374.Acutephasereactantsarestimulatedby - a)IL-6 b)IL-1 c)TNF-a d)Alloftheabove CorrectAnswer-DAnswer-D.AlloftheaboveInresponsetoinjury,localinflammatorycells(neutrophilgranulocytesandmacrophages)secreteanumberofcytokinesintothebloodstream,mostnotableofwhicharetheinterleukinsIL6andIL8,andTNFa.Theliverrespondsbyproducingalargenumberofacute-phasereactants.
375.Lymphotactiniswhichtypeof chemokine? a)C b)C-C c)C-X-C d)C-X3-C CorrectAnswer-CAnswer-C.C-X-CC-chemokines:-Theyarespecificforlymphocytes,e.g.lymphotactin.
376.Activecompoundsecretedby neutrophillsagainstpathogenisknownas? a)Majorbasicprotein b)Myeloperoxidase c)Hydrolase d)Proteoglycans CorrectAnswer-BAnswer-B.MyeloperoxidaseTheazurophilicgranulesofneutrophilscontaintheenzymemyeloperoxidase(MPO),whichInthepresenceofahalidesuchasCl-,convertesH202tohypochlorite(HoC1).
377.Hydroxylionsaredestroyedinthebody by? a)VitaminC b)VitaminA c)VitaminK d)VitaminD CorrectAnswer-AAnswer-A.VitaminC"VitaminCandotherwatersolublecompounds,suchasuricacid,thiolsincludingglutathioneanddihydrolipoicacidandpossiblyothersubstancessuchasmetallothionein,servetodefendagainsthydroxylradicals.VitaminE,incontrast,islesseffectiveineliminatinghydroxylradicals.
378.Mostcommoncancertooccurinorgan transplantpatientis? a)Squamouscellcarcinoma b)Melanoma c)Lungcancer d)Colorectalcancer CorrectAnswer-AAnswer-A.SquamouscellcarcinomamostcommontumorsaftertransplantNonmelanomaskincancer(SCC>BCC)(mostcommon)NHL(2ndmostcommon)LungcarcinomaKaposi'ssarcomaHCCCervicalcarcinoma
379.Exampleofcoagulativenecrosisis- a)Acutetubularnecrosis b)Stroke c)Malignanthypertension d)Acutepancreatitis CorrectAnswer-AAnswer-A.AcutetubularnecrosisThecausesofcoagulativenecrosisare: 1. Coagulativenecrosisismostfrequentlycausedbysuddencessation ofbloodflow(ischemia)insolidorganssuchasheart(MI),Kidney(ATN),Liver,adrenalgland,spleen.Amongstsolidorgansbrainistheonlyexception,i.e.,itistheonlysolidorganinwhichischemialeadstoliquefactivenecrosisandnotcoagulativenecrosis. 2. Toxicproductsofcertainbacteria,asincalfdiphtheria,necrophorus enteritisandotherformsnecrobacillosis. 3. Certainlocallyactingpoisons,e.g.,mercuricchloride.4. Mildburns(thermalinjury),whetherproducedbyheat,electricity,or x-rays. 5. Zenker'sdegenerationnecrosisofmuscle.Itoccursintyphoid. Rectusanddiaphragmaretheusualmusclesaffected
380.Trilateralretinoblastomais? a)BilateralRetinoblastomaplusmedulloblastoma b)Bilateralretinoblastomapluspineoblastoma c)Bilateralretinoblastomaplusneuroblastoma d)Bilateralretinoblastomaplusependymoma CorrectAnswer-BAnswer-B.BilateralretinoblastomapluspineoblastomaTrilateralretinoblastoma(TRb)referstothecombinationofretinoblastoma(usuallybilateral)andpineoblastoma.Thisrelationshiphighlightsthecloserelationshipbetweenthesehighlyaggressivesmallroundbluecelltumors.
381.Whatisthefirstsignofinjury? a)Mitochondrialdysfunction b)Membranedamage c)DiminishedATP d)Releaseoflysosomalenzymes CorrectAnswer-AAnswer-A.Mitochondrialdysfunctionhypoxiaisthemostcommoncauseofcellinjury.OxygenisanimportantrequirementofmitochondriafortheformationofATP;therefore,hypoxiawillresultintheearliestinvolvementofmitochondriaresultingindecreasedformationofATP.DiminishedATPconstitutesthecriticalmechanismofthecellularinjurywhichleadsto:a.IntracellularaccumulationofCa+2b.Mitochondrialdysfunctionc.Membranedamaged.Releaseoflysosomal(hydrolytic)enzymes
382.Salivaryschintigraphyisusefulin? a)Monomorphicadenoma b)Pleomorphicadenoma c)Sialidinitis d)Sjogrensyndrome CorrectAnswer-DAnswer-D.SjogrensyndromeTechnitiumpertechnetatescans(Salivaryscintigraphy)teststhesize,shapeandfunctionofthesalivaryglands.Itisuseful. 1. Tohelpdeterminethecauseofsalivaryglandswelling(e.g.bacteria orvirus). 2. Todetectablockageofthesalivaryducts.3. Todetectagrowthinthesalivaryglands(e.g.Warthin'sTumour).4. TohelpdiagnoseabnormalmouthdrynessasSjogren'sSyndrome.
383.Mostcommonsiteforectopicthyroid tissueis? a)Ovaries b)Lingual c)Infrontofhyoidbone d)Stomach CorrectAnswer-BAnswer-B.LingualByfarthemostcommonlocationisnearitsembryologicaloriginattheforamencaecum,resultinginalingualthyroid.Thisaccountsfor90%ofallcasesofectopicthyroids.
384.Blebsarefoundinwhichtypeofinjury? a)Reversible b)Irreversible c)Both d)None CorrectAnswer-AAnswer-A.ReversiblePathologicalfeaturesofreversiblecellinjuryare:Cellularswelling(earliest);lossofmicrovilli;cytoplasmicmembraneblebs;ERswelling;Myelinefigures;detachmentofribosomefromER;cytoplasmic(lipid)vacuole;clumpingofchromatin.
385.Hydropicchangeisdueto- a)Accumulationofwaterintracellularly b)Fataccumulationintracellularly c)Lysozymedegeneration d)Glycogenaccumulationintracellularly CorrectAnswer-AAnswer-A>AccumulationofwaterintracellularyHydropicchange(abominoiddegeneration,hydropicdegeneration,parenchymatousdegeneration,cloudyswelling)ofacellisdegenerativechange,inwhichthecellsswellduetoinjurytothemembraneaffectingIonictransfer,causingthecytoplasmtoappearcloudyandwatertoaccumulatebetweenthecells,withresultantSwellingofthetissue.Cellularswelling(hydropicchange)istheearliestchangeincellinjury(reversible).
386.Sphenoiddysplasiaisseenin? a)NF-1 b)Tuberoussclerosis c)Sturge-Webersyndrome d)Creutzfeldt-Jakobdisease CorrectAnswer-AAnswer-A.NF-1NF-1isdiagnosediftwooffollowingsevensarepresent: 1. Sixormorecafe-au-laitmacules:>5mminprepubertalageand> 15mminpostpubertalage. 2. Axillaryoringuinalfreckling.3. TwoormoreLischnodules(hamartomasoniris).4. Twoormoreneurofibromaoroneplexiformneurofibroma.5. Adistinctiveosseouslesion:Sphenoiddysplasiaorcorticalthinning oflongbones. 6. Opticglioma.7. AfirstdegreerelativewithNF-1.
387.Hobnailappearanceisseenin a)Clearcellcarcinoma b)Endodermalsinustumor c)HCC d)Choriocarcinoma CorrectAnswer-AAnswer-A.ClearcellcarcinomaHobnailcellisacellwithacharacteristicappearance,includingabulbousnucleusandnuclearprojectionsintothecytoplasm.Hobnailcellsarefoundinclearcellovarianadenocarcinoma,collectingductcarcinoma,andinend-stagecirrhosis
388.ChromosomeforMEN2geneis a)11q13 b)13q11 c)10811.2 d)11q10-2 CorrectAnswer-CAnswer-C.10811.2Multipleendocrineneoplasiatype1MEN111813Multipleendocrineneoplasiatype2aRET10811.2
389.X-linkedadrenoleukodystrophyis a)Fattyaciddisorder b)Lysosomalstoragedisorder c)Mucoplysaccharridoses d)Glycogendefectdisorder CorrectAnswer-AAnswer-A.FattyaciddisorderX-linkedadrenoleukodystrophy(ALD/X-ALD)isadiseaseiscausedbymutationsinABCD1,agenelocatedontheXchromosome,thatcodesforALD,aperoxisomalmembranetransporterprotein.
390.Endothelialmoleculeinvolvedinrolling is- a)ICAM1 b)VCAM1 c)CD31 d)CD34 CorrectAnswer-DAnswer-D.CD34Endothelialmolecule-MajorRoleP-selectin-RollingE-selectin-RollingandadhesionGlyCam-1,CD34-RollingICAM-1(Immunoglobulinfamily)-Adhesion,arrest,transmigrationVCAM-1(Immunoglobulinfamily)-AdhesionPECAM-1(CD-31)-Diapedesis(transmigration)
391.Stainusedfortubulinis a)Lunastain b)Cajalstain c)SiRstain d)Masson'strichrome CorrectAnswer-CAnswer-C.SiRstainfluorescentstains(SiR-ActinandSiR-Tubulin)arecellpermeablecompoundswhichstainF-actinandmicrotubules,respectively.
392.Foldingdefectisassociatedwithwhich disease a)Parkinson'sdisease b)Marfansyndrome c)Acuteintermittentporphyria d)Wermersyndrome CorrectAnswer-AAnswer-A.Parkinson'sdiseaseDefectiveproteinfoldingdisorders(DPFDs)areagroupofdiverseneurologicalandsystemicdiseasesinwhichthehallmarkpathologicaleventisthemisfolding,aggregationandaccumulationofaproteinindifferentorgans,inducingcellularapoptosis,tissuedamageandorgandysfunction.IncludesAlzheimer'sdisease,transmissiblespongiformencephalopathies,serpin-deficiencydisorders,sicklecellanemia,Huntington'sdisease,diabetestypeII,amyotrophiclateralsclerosis,Parkinson'sdisease,dialysis-relatedamyloidosis,spinocerebellarataxias,secondaryorreactiveamyloidosis,cysticfibrosisandpriondiseases.
393.Markerforneuroblastomaamongthe followingis? a)NMP22 b)ChromograninA c)LDH d)32microglobulin CorrectAnswer-BAnswer-B.ChromograninANeuroendocrinemarkersofneuroblastoma:-i)CD-56ii)Chromogranin-Aiii)Synaptophysin
394.Vasodilatationfollowingendothelial damageisdueto? a)Histamine b)IL-2 c)TGF-3 d)FGF CorrectAnswer-AAnswer-A.HistamineVasodilatation:-Histamine,prostaglandins(PGD2,PGE2),prostacyclins,serotonin,Nitricoxide,bradykinin
395.Leastdesmoplasticbreastcarcinomais a)Ductal b)Lobular c)Tubular d)Medullary CorrectAnswer-BAnswer-B.Lobular"Invasivelobularcarcinomahasatendencytospreaddiffuselyorbetweenthecollagenfibersofthebreastandproducesdesmoplasticresponse"
396.Metastasistothyroidcomesfromwhich primarysiteofmalignancy? a)Liver b)Testis c)Prostate d)Kidney CorrectAnswer-DAnswer-D.KidneyMostcommonprimarysitesarekidney,breast,lung,uterus,andmelanoma.
397.Choroidmetastasisisassociatedmost commonlywith? a)Gastriccarcinoma b)Renalcarcinoma c)Braintumor d)Bonetumor CorrectAnswer-BAnswer-B.RenalcarcinomaTumorsmostlikelytometastasizetothechoroidplexusarerenalcellcarcinomaandlungcancer.Othertumorswithdocumentedspreadtothechoroidplexusincludecolon,gastric,breast,thyroid,andbladdercancers,melanomaandlymphoma.
398.Allareassociatedwithdiabeticgangrene except? a)Wetgangrene b)Drygangrene c)Gasgangrene d)Fournier'sgangrene CorrectAnswer-CAnswer-C.GasgangreneItisabacterialinfectionthatproducesgaswithintissues.ItcanbecausedbyClostridium,mostcommonlyalphatoxinproducingClostridiumperfringens,orvariousnon-clostridialspecies.
399.Stainusedforstainingthenucleusis? a)Safranin b)Fastgreen c)Hematoxylin d)Erythrosine CorrectAnswer-CAnswer-C.HematoxylinHematoxylinstainsthecellnucleusandotheracidicstructures(suchasRNA-richportionsofthecytoplasmandthematrixofhyalinecartilage)blue,whileeosinstainscytoplasm,connectivetissueandotherextracellularsubstancespinkorred.
400.Primarygranulescontainwhichenzyme? a)Myeloperoxidase b)Hydrolases c)Lactoferrin d)PhospholipaseA2 CorrectAnswer-AAnswer-A.MyeloperoxidaseMyeloperoxidaseLysozymeAcidhydrolasesElasasesNonspecificcollegenaseBacterialpermeabilityproteinDefensin(BPI)CathepsinGPhospholipaseA2
401.Peroxidaseenzymefoundinneutrophills isusedfor- a)Macrophageactivation b)Chemotacticagent c)Microbialkilling d)Vasodilatation CorrectAnswer-CAnswer-C.MicrobialkillingPeroxidase(myeloperoxidase)isinvolvedinphagocytosis(microbialkilling).
402.Penilecarcinomaisusually? a)Squamouscellcarcinoma b)Basalcellcarcinoma c)Adenocarcinoma d)Smallcellcarcinoma CorrectAnswer-AAnswer-A.SquamouscellcarcinomaMostofpenilecancersaresquamouscellcarcinomaandariseonglansorinnersurfaceofprepuce.
403.Delayedumbilicalcorddetachment leukocytosisisseenin? a)Leukocyteadhesiondeficiency b)Chronicgranulomatousdisease c)Severecombinedimmunodeficiency d)Noneoftheabove CorrectAnswer-AAnswer-A.LeukocyteadhesiondeficiencyLeukocyteadhesiondeficiencytype1isadisorderthatcausestheimmunesystemtomalfunction,resultinginaformofimmunodeficiencyOneofthefirstsignsofleukocyteadhesiondeficiencytype1isadelayinthedetachmentoftheumbilicalcordstumpafterbirth.Innewborns,thestumpnormallyfallsoffwithinthefirsttwoweeksoflife;but,ininfantswithleukocyteadhesiondeficiencytype1,thisseparationusuallyoccursthreeweeksorlater.Also,affectedinfantsoftenhaveinflammationoftheumbilicalcordstump(omphalitis)duetoabacterialinfection.It'sduetotheabsenceofCD18antigenthat'snecessaryfortheformationofintegrins,thesubstancesthatareresponsibleforthesecondstepofleukocytemigration:adhesion.Becausetheleukocytescannotefficientlyreachthesiteofinsult,theycannotengulftheoffendingsubstance,andnopuswillbeevident.Also,asacompensatorymechanism,theremaybeexcessiveleukocytosis.
404.Collarbuttonulcerisfoundin? a)Ulcerativecolitis b)Crohn'sdisease c)Shigella d)Alloftheabove CorrectAnswer-DAnswer-D.Alloftheabove"Collarbuttonulcers",aradiologicalsign,aremanifestationsofinflammatoryprocesseswithinthebowel.Collarbuttonulcershavealsobeenobservedinthesettingofotherinflammatorybowelprocesses,suchasCrohn'sdisease,ischemiccolitis,andshigellosis.
405.Phlegmonousgastritisoccursdueto? a)H.pylori b)E.coli c)C.jejuni d)Cl.Tetani CorrectAnswer-BAnswer-B.E.coliMostcasesofphlegmonousgastritisareduetoalpha-hemolyticstreptococci,althoughpneumococci,staphylococci,Escherichiacoli,andrarely,ProteusVulgarisandClostridiumwelchiicanbethecausativeorganisms.
406.Decreaseinplasmaosmoticpressureis causeofedemain? a)CHF b)DVT c)Nephroticsyndrome d)None CorrectAnswer-CAnswer-C.NephroticsyndromeDecreasedplasmaosmoticpressureofcapillaries:Itcausesdecreasesininwarddrivingforce.ItresultsfromHypoproteinemia.Whentotalplasmaproteinisbelow5gm/dl(normal6-8gm/d1)oralbuminisbelow2.5gm/dl(normal3.5-5gm/dl)edematakesplace.Conditionscausinghypoproteinemiaarenephroticsyndrome,livercirrhosis,proteinlosingenteropathy,andPEM.
407.FalseaboutPatterson-Kelly-Brown syndromeis? a)Anemia b)Esophagealwebs c)Glossitis d)Riskfactorforadenocarcinoma CorrectAnswer-DAnswer-D.RiskfactorforadenocarcinomaPlummer-Vinsonsyndrome(PVS)(Paterson-Brown-Kellysyndromeorsideropenicdysphagia),ischaracterizedbydifficultyinswallowing,irondeficiencyanemia,glossitis,chielosis,andesophagealwebs.
408.Normaltimetakenforscarformation afterinjuryis? a)2weeks b)3weeks c)4weeks d)5weeks CorrectAnswer-CAnswer-C.4weeksImmediatelyafterincision:Incisionisfilledwithbloodclotcontainingfibinandbloodcells(including),dehydrationofsurfaceclotformsscabonsurface.Within24hours:Neutrophilsappearatthemarginofwound,whichisfilledwithbloodclot.24-48hours:Epithelialcellsmovefromwoundedgesandfuseinthemidlinebeneaththesurfacescab,producingacontinuousbutthinepitheliumlayerthatclosesthewound.Day3:Neutrophilsarereplacedbymacrophages,granulationtissueappears,collagenfibersarepresentinthemarginbutdonotbridgetheincision.Day5:Abundantgranulationtissue,maximumneovascularization,abundantcollagenwhichbridgestheincision,theepidermisrecoversitsnormalthickness.2ndweek:Diappearanceofleukocytesandedema,presenceoffibroblasts(derivedfromlocalmesenchyme)andmaximumcollagen.Endof1month:Thereisscarwhichismadeupofcellularconnectivetissuedevoidofinflammatoryinfiltratecoverednowbyintactepidermis.ThereisreplacementofcollagentypeIIIwithcollagentypeI.
collagentypeI.
409.Vitamindeficiencyassociatedwithcystic fibrosisis a)K b)B6 c)C d)B12 CorrectAnswer-DAnswer-D.B12Patientswithcysticfibrosis(CF)areatriskofdevelopingdeficienciesoffat-solublevitamins(A,D,E,andK)becauseofpancreaticinsufficiency,hepatobiliarydisease,orboth.
410.Whichtypeofhealingoccursinan incisionalwoundwithinfection? a)Primary b)Delayedprimary c)Secondary d)Tertiary CorrectAnswer-CAnswer-C.SecondaryItsproducedbysharpcuttinginstruments-knife,razor,blade,swords,chopper,axeetc.Secondaryhealingoccursinanincisionalwoundwithinfection.
411.APCgeneisinvolvedin? a)Colorectalcarcinoma b)Gastriccarcinoma c)Gastriclymphoma d)Esophagealadenocarcinoma CorrectAnswer-AAnswer-A.ColorectalcarcinomaTheAPCproteinisanegativeregulatorthatcontrolsbeta-cateninconcentrationsandinteractswithE-cadherin,whichareinvolvedincelladhesion.MutationsintheAPCgenemayresultincolorectalcancer
412.Geneforembryogenicstemcellis- a)Oct-4 b)Nanog c)GJAI d)Alloftheabove CorrectAnswer-DAnswer-D.AlloftheaboveAcommonsubsetof92geneswasidentifiedthatincludedNanog,GTCM-1,connexin43(GJA1),oct-4,andTDGF1(cripto)."
413.Complementmediatedhypersensitivity reactionis? a)Type-1hypersensitivity b)Type-2hypersensitivity c)Type-4hypersensitivity d)None CorrectAnswer-BAnswer-B.Type-2hypersensitivityTypeIIreactions(Antibodymediated)InvolveimmunoglobulinGorImmunoglobulinMboundtocellsurfaceantigen,withsubsequentcomplementfixation.
414.T-cellmediateddiseaseis? a)Asthma b)Myastheniagravis c)SLE d)Sarcoidosis CorrectAnswer-DAnswer-D.SarcoidosisTypeI(IgEmediated)EczemaHayfeverAsthmaAtopyUrticariaAnaphylacticshockAcutedermatitisTheobaldsmithphenomenonPrausnitzKusnter(PK)reactionCasonistestSchultz-DalephenomenonTypeII(IgG,IgMandcomplementmediated)BloodtransfusionreactionsErythroblastosisfetalisAutoimmunehemolyticanemiaorthrombocytopeniaoragrnulocytosis4PemphigusvulgarisGoodpasturesyndromeBullouspemphigoidPerniciousanemia
AcuterheumaticfeverDiabetesmellitusGravesdiseaseMyastheniagravisTypeIII(IgG,IgM,complementandleucocytemediated)Local-ArthusreactionSystemic-serumsicknessSchicktestPolyarteritisnodosa(PAN)RheumatoidarthritisSLEAcuteviralhepatitisPenicillaminetoxicityHyperacutegraftrejection
415.Type4hypersensitivityreactiontoTB antigenissimilartowhichofthefollowing? a)Serumsickness b)Asthma c)Myastheniagravis d)Temporalarteritis CorrectAnswer-DAnswer-D.TemporalarteritisTypeIV(T-Cellmediated)TuberculintestLepromintestSarcoidosisTuberculosisContactdermatitisGranulomatousinflammationTypeIleprareactionPatchtestTemporalarteritisJonesmotereaction(cutaneousbasophilicHSN)GraftrejectionFairleystestFrie'stest
416.NonIgEmediatedanaphylacticreaction includes- a)IgG b)IgM c)Compliments d)Alloftheabove CorrectAnswer-DAnswer-D.AlloftheaboveCytotoxicreactionscanalsocauseanaphylaxis,viacomplementactivation.Antibodies(IgGandIgM)againstredbloodcells,asoccursinamismatchedbloodtransfusionreaction,activatecomplement.Thisreactioncausesagglutinationandlysisofredbloodcellsandperturbationofmastcellsresultinginanaphylaxis
417.Totalcolonicaganglionosisisavariant of? a)Crohn'sdisease b)Ulcerativecolitis c)Hirschsprung'sdisease d)Tropicalsprue CorrectAnswer-CAnswer-C.Hirschsprung'sdiseaseHirschprungdisease(Congenitalaganglonicmegacolon)iscausedbydefectivemigrationofneuralcrestintothemesodermallayerofgut.Thereisaganglionosis(absenceofganglions)inaportionofintestinaltract.IntestinalsegmentlacksbothMeissnersubmucosalandAuerbachmyentericplexuses.
418.MHC1isinvolvedin? a)Tumorlysis b)Mixedleukocytereaction c)Autoimmunediseasesusceptibility d)Alloftheabove CorrectAnswer-AAnswer-A.TumorlysisMHCclassImoleculesarepresentonallnucleatedcells,allvirus-infectedcellscanbedetectedandeliminatedbyCD8+CytotoxicTlymphocytes.MHCclassIisresponsibleforgraftrejectionandcell-mediatedcytolysisofviralinfectedortumorcells.
419.Whichdiseaseisdiagnosedbyjejunal biopsy? a)Celiacdisease b)Intestinallymphoma c)Argentaffinomaofintestine d)Tropicalsprue CorrectAnswer-BAnswer-B.Intestinallymphomathejejunalbiopsyisusefulinthediagnosisofthefollowingdisorders:IntestinallymphomaIntestinallymphangiectasiaEosinophilicgastroenteritisAmyloidosisCrohn'sdiseaseInfectionbyoneormoremicroorganismsMastocytosisWhipple'sdisease
420.CD4isassociatedwithHLA? a)HLA1 b)HLA2 c)HLA3 d)Alloftheabove CorrectAnswer-BAnswer-B.HLA2MHC-IIrecognizesexogenousantigen(extracellularmicrobes,solubleproteins)andpresentittoCD4helperTcells(MHC-IIrestricted).MHCclassIpresentantigentocytotoxicCD-8Tcells(MHC-Irestricted).
421.AllaretrueaboutTolllikereceptors except? a)Recognizemicrobialmolecules b)Activationofimmunesystem c)Regulationofcalciumchannel d)Activationoftranscriptionfactors CorrectAnswer-CAnswer-C.RegulationofcalciumchannelToll-likereceptors(TLRs)aremicrobialsensorsthatarenamedforthefoundingmembercalledToll,whichwasdiscoveredinDrosophila.TherearetenmammalianTLRs,whichrecognizeproductsofbacteria(suchasendotoxinandbacterialDNA),viruses(suchasdouble-strandedRNA),andotherpathogens(Fig.2?3,A).TLRsarelocatedinplasmamembranesandendosomes,sotheycandetectextracellularandingestedmicrobes.Theyarecomplementedbycytoplasmicandmembranemolecules,fromseveralotherfamilies,thatalsorecognizemicrobialproducts.TLRsandtheotherreceptorsrecognizeproductsofdifferenttypesofmicrobesandthusprovidedefenseagainstessentiallyallclassesofinfectiouspathogens.Recognitionofmicrobesbythesereceptorsactivatestranscriptionfactorsthatstimulatetheproductionofseveralsecretedandmembraneproteins.Theseproteinsincludemediatorsofinflammation,antiviralcytokines(interferons),andproteinsthatpromotelymphocyteactivationandevenmorepotentimmuneresponses.
422.Bloodgroupmostcommonlyassociated withgastriccarcinomais? a)BloodGroup0 b)BloodgroupA c)BloodgroupAB d)BloodgroupB CorrectAnswer-BAnswer-B.BloodgroupAGeneticfactors:BloodgroupA,Hereditarynonpolyposiscoloncancersyndrome(HNPCC)andFamilialgastriccancersyndrome(E-cadherinmutation).
423.Themostcommonorgantobeinvolved intheacutephaseofGraftvshostdiseaseis? a)Bonemarrow b)Skin c)Liver d)Gut CorrectAnswer-BAnswer-B.SkinAcuteGraftvshostdisease(occurringdaystoweeksaftertransplantation)causesepithelialcellnecrosisinthreeprincipaltargetorgans:liver,skin,andgut.Destructionofsmallbileductsgivesrisetojaundice,andmucosalulcerationofthegutresultsinbloodydiarrhea.Cutaneousinvolvementismanifestedbyageneralized(maculopapular)rash.Histologicalfindingsare- 1. Perivascularmononuclearinfiltrates.2. Vacuolardegradationofdermo-epidermaljunction.3. Dyskeratoticcellsoreosinophilicbodiesintheepidermis.4. Epidermolysis.5. Denudationofepidermis(separationoftheepidermisfromthe dermis).
424.Autoimmunegastritisisassociatedwith deficiencyofvitamin? a)A b)B12 c)C d)D CorrectAnswer-BAnswer-B.B12Inautoimmunegastritis,twoimportantautoantibodiescausingdamageareanti-parietalcellantibodies(mostcommon)andantibodiesagainstintrinsicfactor;anti-IF(mostspecific).VitaminB-12deficiencyandperniciousanemia:DuetodeficiencyofIFcells(secretedbyparietalcells)aswellasdamageofIFbyanti-IFantibodies.
425.NormalvalueofCD4:CD8ratiois- a)0.5 b)1 c)1.5 d)2 CorrectAnswer-DAnswer-D.2AnormalCD4/CD8ratiois2.0,withCD4lymphocytesequaltoorgreaterthan400/mm3andCD8lymphocytesequalto200to800/mm3.
426.Normallysquamo-columnarjunctionis usuallylocatedat a)Distal2-3cmsofesophagus b)Proximal2-3cmsofstomach c)Inesophagusmorethan3cmsproximaltoGEJ d)Noneoftheabove CorrectAnswer-BAnswer-A.Distal2-3cmsofesophagusProximalextensionofthesquamocolumnarjunctionbeyondthedistal2-3cmsofoesphagusisabnormalandissuggestiveofBarrett'sesophagus.
427.Carcinomaassociatedmostcommonly withupperonethirdofesophagusis a)Adenocarcinoma b)SquamouscellCarcinoma c)Adeno-squamousCarcinoma d)Leiomyosarcoma CorrectAnswer-BAnswer-B.SquamouscellCarcinomaSquamouscellcarcinomaisthemostcommontypeofesophagealcarcinomaworldwideandinIndia.Itusuallyoccursinmiddle1/3rd(motcommon)andupper1/3'ofesophagus.Somemayalsoariseinlower1/3
428.AntiJo-1antibodiesareafeature associatedwith? a)SLE b)Systemicsclerosis c)Polymyositis d)Rheumatoidarthritis CorrectAnswer-CAnswer-C.PolymyositisAnti-Jo-1antibodyisamyositisspecificautoantibodymostcommonlyfoundinpatientswithidiopathicinflammatorymyopathies(UM).
429.HLAmarkerassociatedwithdiabetes mellitustype1is- a)B7 b)DR4 c)DQ3 d)DQ4 CorrectAnswer-BAnswer-B.DR4HLAassociatedwithDM1areDR3,DR4,DR8,DQ8.
430.Thezonalnecrosismostcommonly affectedinchronicpassivehepaticcongestionis? a)Central b)Peripheral c)Midzonal d)None CorrectAnswer-AAnswer-A.CentralCentrilobularhemorrhagicnecrosisiscausedbychronicpassivecongestion(CPC)duetorightheartfailure.
431.Whatisresponsibleforregenerationof livercells? a)HGF b)VEGF c)TGF-13 d)IFN-y CorrectAnswer-AAnswer-A.HGFHepatocytegrowthfactor(HGF/scatterfactor)levelsrisetohighlevelssoonafterpartialhepatectomy.Thisistheonlyfactortestedthatactsbyitselfasapotentmitogenforisolatedhepatocytesculturedinvitro.Thisfactorisalsoofcriticalimportanceindevelopmentoftheliver,astargetdeletionsofitsgeneleadtofetaldeathduetohepaticinsufficiency.
432.Expressionofageneisknownas? a)Genotype b)Phenotype c)Genome d)Morphology CorrectAnswer-BAnswer-B.PhenotypeThegenotype(Thegeneticmakeupofanindividual)ofanorganismistheinheritedmapitcarrieswithinitsgeneticcode.Thegenotypeisthepart(DNAsequence)ofthegeneticmakeupofacell.Genotypeisoneofthreefactorsthatdeterminephenotype,theothertwobeinginheritedepigeneticfactors,andnon-inheritedenvironmentalfactors.
433.Group-Dchromosomeis? a)Chromosome3 b)Chromosome6 c)Chromosome12 d)Chromosome15 CorrectAnswer-DAnswer-D.Chromosome1513-15-SixchromosomesslightlysmallerthantheCgroupwiththekinetochoresinanearterminalposition.
434.Acuteintermittentporphyriais associatedwithwhichtypeofinheritance? a)Autosomaldominant b)Autosomalrecessive c)X-linkeddominant d)X-linkedrecessive CorrectAnswer-AAnswer-A.AutosomaldominantMetabolicFamilialhypercho-lesterolemiaAcuteintermittentporphyria
435.Strawberrygallbladderisseenin a)Cholesterosis b)Primarysclerosingcholangitis c)Cholestasis d)Primarybilliarycirrhosis CorrectAnswer-AAnswer-A.CholesterosisInCholesterosis,therearedepositsofcholesterolintheepithelialcellsandinthesubmucosalmacrophages.Thisgivesappearanceofmultiplesmallyellowspotsonaredhyperplasticmuscosa,thestraberrygallbladder.
436.Inheritanceassociatedwithcongenital adrenalhyperplasia- a)AR b)AD c)XR d)XD CorrectAnswer-AAnswer-A.AREndocrine-CongenitaladrenalhyperplasiaAlbinism
437.TrueaboutRCCis? a)Mostcommonsiteislowerlobeofkidney b)Mostcommonvarietyispapillarytype c)Invasionofrenalveinismorecommonthanrenalartery d)Mostcommonsiteofmetastasisislymphnodes CorrectAnswer-CAnswer-C.InvasionofrenalveinismorecommonthanrenalarteryRenalcellcarcinomaisthemostcommonmalignanttumorofkidney.Itoccursusuallyin6thand7thdecadeoflife.Thereismalepreponderance.ImportantriskfactorsforRCCaresmoking(mostsignificant),obesity,hypertension,asbestosexposure,estrogentherapy,CRF,tuberoussclerosisandfamilialconditions(VonHippel-Lindausyndrome).RCCisanadenocarcinomaandmostcommonlyarisesfromupperpole.TheoneofthestrikingcharacteristicsofRCCistoinvaderenalveinandisassociatedwithpoorprognosis.
438.Chronicbronchitisisassociatedwith? a)Increaseinnumberofglandswithoutanychangeinsize b)Bronchiolitisobliterans c)DecreaseinReidindex d)Onlylargeairwaysareinvolved CorrectAnswer-BAnswer-B.BronchiolitisobliteransTheearliestfeatureofchronicbronchitisishypersecretionofmucusinthelargerairways,associatedwithhypertrophyofsubmucosalglandoftracheaandbronchi.Later,smallairways(smallbronchiandbronchioles)arealsoinvolvedandshowgobletcellhyperplasia,andintraluminalandperibronchialfibrosis.Inmostseverecases,theremaybeoblitrationoflumenduetofibrosisBronchiolitisobliterans.
439.Onpolarisingmicroscopy,refractile bodyinthecentreofgranulomaisseenin? a)Sarcoidosis b)Silicosis c)Tuberculosis d)Asbestosis CorrectAnswer-BAnswer-B.SilicosisHistologicallythelesionsofsilicosisconsistofconcentriclayersofhyalinizedcollagensurroundedbyadensecapsuleofmorecondensedcollagen.Examinationofthenodulesbypolarizedmicroscopyrevealsthebirefringentsilicaparticles.
440.Mostcommontypeofpneumoconiosis, associatedwithTBis? a)Silicosis b)Bysinosis c)Asbestosis d)Baggassosis CorrectAnswer-AAnswer-A.SilicosisSilicosisisassociatedwithincreasedsusceptibilitytoT.B.Itispostulatedthatsilicosisresultsinadepressionofcell-mediatedimmunity,andcrystallinesilicamayinhibittheabilityofpulmonarymacrophagestokillphagocytosedmycobacteria.Nodulesofsilicotuberculosisoftencontainacentralzoneofcaseation.
441.Mostcommoncauseofchylothoraxis? a)Trauma b)Lymphoma c)Left-sidedheartfailure d)Infections CorrectAnswer-BAnswer-B.LymphomaChylothoraxisapleuralcollectionofamilkylymphaticfluidcontainingmicroglobulesoflipid.Itresultsfromlymphformedinthedigestivesystemcalledchyleaccumulatinginthepleuralcavityduetoeitherdisruptionorobstructionofthethoracicduct.Thetotalvolumeoffluidmaynotbelarge,butchylothoraxisalwayssignificantbecauseitimpliesobstructionofthemajorlymphducts,usuallybyintrathoraciccancerlikeprimaryorsecondarymediastinalneoplasm,suchaslymphoma.
442.InheritanceassociatedwithfragileX- syndromeis- a)Autosomaldominant b)Autosomalrecessive c)X-linkeddominant d)X-linkedrecessive CorrectAnswer-CAnswer-C.X-linkeddominant'None>c'i.e.,X-linkeddominantTheunstabletripletistransmittedinanX-linkedinheritancebuttheprobabilitiesofdifferentphenotypesarefarfromtraditionalX-linkedinheritance.
443.Whichtypeofparaneoplasticsyndrome ismostcommonlyassociatedwithlungcarcinoma? a)SIADH b)Gynaecomastia c)Acanthosisnigricans d)Hypocalcaemia CorrectAnswer-AAnswer-A.SIADHSIADHisthemostcommonparaneoplasticsyndromeassociatedwithlungcarcinomaasSmallcellcarcinomaisthemostcommontypeoflungcancerassociatedwithectopichormoneproductionandparaneoplasticsyndromeandADH(CausingSIADH),ACTH(Causingcushingsyndrome)productionarepredominantlyassociatedsmallcellcarcinoma.
444.Metastasistolungscomemost commonlyfrom a)Breastcarcinoma b)Braincarcinoma c)Bonecarcinoma d)Melanoma CorrectAnswer-AAnswer-A.BreastcarcinomaMetastatictumortolungoriginatefromcarcinomainthebreast,colon,stomach,pancreas,kidney,prostate,liver,thyroid,adrenal,malegenitaltractandfemalegenitaltract.
445.Deficiencyofp53mutationismaximum inwhichlungcarcinoma? a)Smallcellcarcinoma b)Squamouscellcarcinoma c)Adenocarcinoma d)Lymphoma CorrectAnswer-BAnswer-B.Squamouscellcarcinoma-MYCandRB-smallcellcancerRASandp16-non-smallcellcancerp53-bothsmallandnon-smallcell,buthighestinsquamouscellcarcinomaK-RAS?adenocarcinoma
446.Inallergicbronchopulmonary aspergillosis,thelocationoflesionsis a)Pleura b)Bronchiandbronchioles c)Alveoli d)Alloftheabove CorrectAnswer-BAnswer-B.BronchiandbronchiolesAllergicbronchopulmonaryaspergillosis(ABPA)isaconditioncharacterizedbyahypersensitivityresponsetotheAspergillus(mostcommonlyAspergillusfumigatus).AnallergicbronchopulmonaryaspergillosisisaformoflungdiseasethatoccursinsomepeoplewhoareallergictoAspergillus.WithABPA,thisallergicreactioncausestheimmunesystemtooverreacttoAspergillusleadingtolunginflammation.ABPAcausesbronchospasm(tighteningofairwaymuscles)andmucusbuildupresultingincoughing,breathingdifficultyandairwayobstruction.italsocausesairwayinflammation,leadingtobronchiectasis--aconditionmarkedbyabnormaldilationofthebronchiandbronchioles.
447.HOXgeneisassociatedwith a)Cranio-caudaldevelopment b)Braindevelopment c)Teethformation d)Alloftheabove CorrectAnswer-AAnswer-A.Cranio-caudaldevelopmentHOXgenes(asubsetofhomeoticgenes)areagroupofrelatedgenesthatcontrolthebodyplanofanembryoalongthecranio?caudal(head-tail)axis.
448.Mostcommoncancerfoundincoalmine workers a)Analcanal b)Testicular c)Lung d)Liver CorrectAnswer-CAnswer-C.LungAmongcoalworkerpneumoconiosispatientsstandardincidenceratioofvariousimportantcarcinomas:ovary(2.0)>esophagus(1.76)Lung>(1.45)>Stomach(1.42)>Liver(1.18)>kidney(1.06)>prostate(1.02)>colorectal(1.00)>urinarybladder(0.91)>head&neck(0.87)
449.ChromosomeforABOgeneis? a)9q b)10p c)11q d)12p CorrectAnswer-AAnswer-A.9qTheABOgene(Histo-bloodgroupABOsystemtransferaseenzyme)residesonchromosome9attheband9q34.2.Histo-bloodgroupABOsystemtransferaseisanenzymewithglycosyltransferaseactivity,whichisencodedbytheABOgeneinhumans.Itisubiquitouslyexpressedinmanytissuesandcelltypes.
450.Pinkpuffersareassociatedwith? a)Emphysema b)Chronicbronchitis c)Pneumonia d)Bronchiectasis CorrectAnswer-AAnswer-A.EmphysemaA"pinkpuffer"isapersonwhereemphysemaistheprimaryunderlyingpathologyInemphysema,notonlythereislesssurfaceareaforgasexchange,thereisalsolessvascularbedforgasexchange..Thebodythenhastocompensatebyhyperventilation(the"puffer").Havelesshypoxemia(comparedtobluebloaters)andappeartohavea"pink"complexionandhence"pinkpuffer".
451.Granulomatouslungdiseaseiscaused by? a)Hypersensitivitypneumonitis b)Sarcoma c)Bronchogeniccarcinoma d)Bronchogeniccyst CorrectAnswer-AAnswer-A.HypersensitivitypneumonitisGranulomatouslungdiseasereferstoabroadgroupofinfectiousandwellasnoninfectiousconditionscharacterizedbytheformationofgranulomas.Infectious:Mycobacterial(TB&Non-TB);Fungalinfection(cryptococcus,Histoplasma,Blastomycosis,Coccidioidomycosis,Aspergillosis);ParasiticInfections.Non-infectious:Sarcoidosis;Wegnergranulomatosis;ChurgStrausssyndrome;Chronicgranulomatousdisease;Hypersensitivitypneumonitis;RA;ChronicAspirationPneumonitis;LangerhansCellHistiocytosis;substances(TalcGranulomatosis,Berylliosis)
452.TEL-AML1fusionisassociatedwith? a)CLL b)CML c)ALL d)AML CorrectAnswer-CAnswer-C.ALLTEL-AML1genefusionisthemostcommongeneticalterationinchildhoodacutelymphoblasticleukemia.Itiscreatedbybalancedtranslocationt(12:21).CytogeneticabnormalitiesassociatedwithALLaregainoffunctionmutationinNOTCH-1geneinT-cellALL.
453.CagAgeneisassociatedwith a)Hepatocellularcarcinoma b)Esophagealcarcinoma c)MALTlymphoma d)Lungcarcinoma CorrectAnswer-CAnswer-C.MALTlymphomaCagA,Agenethatcodesforanimmunodominantantigen,ispresentonlyinHelicobacterpyloristrainsthatareassociatedwithsevereformsofthegastroduodenaldisease(typeIstrains).Helicobacterpyloriisamicroaerophilicspiral-shapedlophotrichousGram-negativebacteriumthatcolonizesthegastriclumenofprimates,includinghumans.HpyloriwasidentifiedasthecauseofchronicactivegastritisandpepticulcerdiseaseinhumansandisconsideredtobeariskfactorforthedevelopmentofgastricadenocarcinomaandMALTlymphoma
454.Dutcherbodiesareseenin? a)Brain b)Liver c)Spleen d)Bonemarrow CorrectAnswer-DAnswer-D.BonemarrowDutcherbodies,whichareattributedtoimmunoglobulinfilledcytoplasminvaginatingintothenucleuscreatingtheappearanceofanintranuclearinclusion.DutcherbodiesaredescribedasintranuclearinclusionsinpatientswithWaldenstrom'smacroglobulinemia.Theinclusionsarepositiveonaperiodicacid-Schiffreactionandwerepresentinthecytoplasmaswellasthenucleus.Theyidentifiedtheinclusionsasglycoproteinandpostulatedthattheymightbechemicallyidenticaltothemacroglobulinintheplasma.
455.Trinucleotidesequenceassociatedwith spino-cerebellarataxiais? a)CTG b)CUG c)GGG d)CAG CorrectAnswer-DAnswer-D.CAGHuntington'sdisease(CAGrepeat),Spinocerebellarataxia(CAGrepeat),Friedreichataxia(GAArepeat),Fragile-X-syndrome(GGGorGCCrepeat),Dystrophiamyotonica(CTG/CUGrepeat)
456.CA-125is? a)Mucinglycoprotein b)Carcinomatransmigrationantigen c)Mucopolysaccharide d)Lipid CorrectAnswer-AAnswer-A.Mucinglycoprotein*CA-125,whichstandsfor"CancerAntigen125"alsoknownasmucin16orMUC16isaproteinthatinhumansisencodedbytheMUC16whichisamemberofthemucinfamilyglycoproteins.*Itisfoundinhighamountsinthebloodofpatientswithovariancancer.*CA-125isproducedonthesurfaceofcellsandisreleasedinthebloodstream.*Itisamongthebloodteststhatmaybeorderedbyadoctorifovariancancerissuspected.*CA-125isalsoelevatedincancersofendometrium,cervix,fallopiantubes,pancreas,breast,lungandcolon.*Non-neoplasticconditionscausingelevationofCA-125arepregnancy,menstruation,endometriosis,PID,abdominalTB,peritonitisanduterinefibroid.*referencerange:CA125is0-35units/mL(0-35kU/L).
457.Li-fraumanisyndromeoccursdueto mutationingene? a)p53 b)p16 c)p41 d)p12 CorrectAnswer-AAnswer-A.p53Li-Fraumenisyndromeisduetogermlinemutationinp-53gene.
458.Mostcommontumorsuppressorgene involvedincancergenesisis? a)Rb b)p53 c)p16 d)p73 CorrectAnswer-BAnswer-B.p53p-53isthemostcommontargetforgeneticalterationinhumantumors;Alittleover50%ofhumantumorscontainmutationinthisgene.
459.LeftsideshiftinArneth'scountisseen in? a)Megaloblasticanemia b)Septicemia c)TB d)Liverdisease CorrectAnswer-CAnswer-C.TBShifttoleft(hyperactivebonemarrow)Individualswhohavealargerpercentageofneutrophillswithfewerlobes(mainlyNI&N2)havealeftshiftwhichcanbeindicativeofdiseaseprocessessuchasinfections(pyogenicandTB),malignanttumors,hemolyticcrises,myocardialinfarction,acidosis,irradiationetc.
460.Allarepre-malignantconditionsexcept- a)Anaplasia b)Metaplasia c)Hamartoma d)Dysplasia CorrectAnswer-CAprecancerousconditionisaconditionorlesioninvolvingabnormalcellsthatareassociatedwithanincreasedriskofdevelopingintocancer.Clinically,precancerousconditionsencompassavarietyofconditionsorlesionswithanincreasedriskofdevelopingintocancer.Dysplasiaisabroadtermthatreferstotheabnormaldevelopmentofcellswithintissuesororgans.Itcanleadtoawiderangeofconditionsthatinvolveenlargedtissueorpre-cancerouscells.Anaplasiaisaconditionofcellswithpoorcellulardifferentiation,losingthemorphologicalcharacteristicsofmaturecellsandtheirorientationconcerningeachotherandtoendothelialcells.Thetermalsoreferstoagroupofmorphologicalchangesinacell(nuclearpleomorphism,alterednuclear-cytoplasmicratio,presenceofnucleoli,highproliferationindex)thatpointtoapossiblemalignanttransformation.Suchlossofstructuraldifferentiationisespeciallyseeninmost,butnotall,malignantneoplasms.Ahamartomaisabenign(noncancerous)tumorlikemalformationmadeupofanabnormalmixtureofcellsandtissuesfoundinareasofthebodywheregrowthoccurs.Itisconsideredadevelopmentalerrorandcanoccuratseveralsites.consideringtheabovetermshamartomaisnotaprecancerouscondition
461.MaximumlifeoftransfusedRBCsis a)110-120days b)80-100days c)60-80days d)50-60days CorrectAnswer-BAnswer-B.80-100daysNormalaveragelifespanofredbloodcellsinadultsisabout120days,whereasthatoftransfusedRBCsisabout50-60days"AfteranRBCtransfusion,themeanpotentiallifespanofRBCis85dayswithameanhalflifeof43?11days.
462.Softwoodexposureleadsto- a)Nasaladenocarcinoma b)Skincancer c)Livercancer d)Bladdercancer CorrectAnswer-AAnswer-A.Nasaladenocarcinoma"Thereislittledoubtthatexposuretohardwooddusts(especiallythatofbeech6,oak)inthefurnitureindustry,aswellassomedomesticsoftwoodoutsidetheindustry,isassociatedwithsino-nasalcancers.Amongtheneoplasias,nasaladenocarcinomaisthecancermostcommonlyfoundinwoodworkers."
463.Whichtestisusedforbothintrinsicand commonclottingpathways? a)Thrombintime b)Partialthromboplastintime c)Ristocetinagglutinationtest d)FDPs CorrectAnswer-BAnswer-B.Partialthromboplastintime1)Partialthromboplastintime(PTT):Itteststheintrinsicandcommoncoagulationpathways.So,aprolongedPTTcanresultsfromdeficiencyoffactorV,VIII(factorVIIIc,Vonwillebrandfactor),IX,X,XI,XII,prothrombinorfibrinogen.
464.Atwhichcellcyclecheckpointisthecell cyclehaltedifthecell'sDNAisdamaged? a)GI-S b)S-G2 c)G2-M d)GO-GI CorrectAnswer-A:CAnswer-(A)GI-S(C)G2-MTheSphaseisthepointofnoreturninthecellcycle,andbeforethecellmakesthefinalcommitmenttoreplicate,theG,/ScheckpointchecksforDNAdamage.IfDNAdamageispresent,theDNArepairmachineryandmechanismsthatarrestthecellcycleareputinmotion.ThiscausesdelayatGiScheckpoint.ThischeckpointinusedfortherepairoftheDNAwhichisdamagedafteritsreplication
465.Whichofthefollowingisapro- coagulant? a)Thrombomodulin b)ProteinC c)ProteinS d)Thrombin CorrectAnswer-DAnswer-D.ThrombinVariousfactorsinvolvedincoagulationcascodesarefactorI(fibrinogen);factorII(prothrombin);factorIII(thromboplastinortissuefactor);factorIV(calciumionsorCa");factorV(labilefactor);factorVI(accclerin);factorVII(stablefactororpreaccelerin);factorVIII(antihemophilicfactor);factorIX(christmasfactor);factorX(stuart-prowerfactor);factorXI(plasmathromboplastinantecedentorPTA);factorXII(Hagemanfactor);factorXIII(fibrinstabilizingfactororLakiLorandfactor);HMWK(highmolecularweightkinogen);prekallikrein;kallikrein;andplateletphospholipids.
466.Immunohistochemicalmarkerfor sentinelnodebiopsyforbreastcarcinomais? a)Cytokeratin b)Vimentin c)Calretinin d)CD45 CorrectAnswer-AAnswer-A.CytokeratinCytokeratin-Carcinoma
467.Scavengerreceptorsarefor? a)OxidizedLDL b)ReducedLDL c)HDL d)VLDL CorrectAnswer-AAnswer-A.OxidizedLDLOxidizedLDLhasfollowingeffects 1. Ingestedbymacrophagesthroughthescavengerreceptor,distinct fromLDLreceptors,thusformingfoamcells. 2. Increasesmonocyteaccumulationinlesions.3. Stimulatesreleaseofgrowthfactorsandcytokines.4. Iscytotoxictosmoothmusclecellsandendothelialcells
468.Characteristichistopathologicalfeature ofrheumaticheartfailureis- a)Aschoff'snodule b)McCallumnpatch c)Bread&butterpericarditis d)Shaggyvegetation CorrectAnswer-AAnswer-A.Aschoff'snoduleMicroscopically,Aschoffbodiesareareasofinflammationoftheconnectivetissueoftheheart,orfocalinterstitialinflammation.FullydevelopedAschoffbodiesaregranulomatousstructuresconsistingoffibrinoidchange,lymphocyticinfiltration,occasionalplasmacells,andcharacteristicallyabnormalmacrophagessurroundingnecroticcenters.Someofthesemacrophagesmayfusetoformmultinucleatedgiantcells.OthersmaybecomeAnitschkowcellsor"caterpillarcells,"sonamedbecauseoftheappearanceoftheirchromatin.MyocardiuminvolvementresultsinmyocarditiswithAschoffbodies.Endocardiuminvolvementleadstotheformationofsmallwartyprojections(verrucae)alongthelineofclosureofvalvularleaflets,mostlyonthemitralvalve.Theyarepathognomicfocioffibrinoidnecrosisfoundinmanysites,mostoftenthemyocardium.Initially,theyaresurroundedbylymphocytes,macrophages,andafewplasmacells,buttheyareslowlyreplacedbyafibrousscar.Aschoffbodiesarefoundinallthethreelayersoftheheart,theleastchanceinthepericardium.
469.NotafeatureofG-6PDdeficiency? a)Intravascularhemolysis b)Oxidativestress c)Membranedefect d)Bitecells CorrectAnswer-CAnswer-C.Membranedefect*Amongthedefectsinhexosemonophosphateshunt,themostcommonisG6PDdeficiency.*G6PDgeneislocatedontheXchromosomeanditsdeficiencyis,therefore,asex(X)-linkedtraitaffectingmales,whilethefemalesarecarriersandareasymptomatic.*PATHOGENESIS:Normally,redbloodcellsarewellprotectedagainstoxidantstressbecauseofanadequategenerationofreducedglutathioneviathehexosemonophosphateshunt.*IndividualswithinheriteddeficiencyofG6PD,anenzymerequiredforhexosemonophosphateshuntforglucosemetabolism,failtodevelopadequatelevelsofreducedglutathioneintheirredcells.*Theclinicalmanifestationsarethoseofacutehemolyticanemiawithinhoursofexposuretooxidantstress.*Thehemolysisis,however,self-limitingeveniftheexposuretotheoxidantiscontinuedsinceitaffectstheolderredcellsonly.
470.Prostheticvalvesarepredisposedto- a)Thromboembolism b)Infection c)Hemolysis d)Alloftheabove CorrectAnswer-DAnswer-D.AlloftheaboveThrombo-emboliceventsBleedingProstheticheartvalveobstructionorstenosisProstheticheartvalveregurgitation(valvularandparavalvular)InfectiveendocarditisHemolyticanemiaPatient-prosthesismismatch.
471.Mostfrequenttimeperiodbetween myocardialinfarctionandsubsequentmyocardialruptureis- a)3-4days b)4-8days c)1-3weeks d)3-6weeks CorrectAnswer-AAnswer-A.3-4daysMyocardialrupturemayoccuralmostanytimeduring3weeksafteracutemyocardialinfarction,butismostcommonbetweenthefirstandfourthdays,whentheinfractedwallisweakest.
472.Heinzbodiesareremovedby? a)Macrophages b)Lymphocytes c)Neutrophils d)Fibroblasts CorrectAnswer-AAnswer-A.Macrophages*TheunstablehemoglobinsarethosehemoglobinvariantsthatundergodenaturationandprecipitationwithintheredcellsasHeinzbodies.*Theygiverisetowhatisknownascongenitalnon-spherocytichemolyticanemiaorcongenitalHeinzbodyhemolyticanemia.*Thesedisordershaveeitherautosomaldominantinheritanceordevelopfromspontaneousmutations.*Theunstablehemoglobinsarisefromeitherasingleaminoacidsubstitutionintheglobinchainorduetodeletionofoneormoreaminoacidswithinthe-globinchainsothatthefirmbondingofthehaemgroupwithinthemoleculeisdisturbedleadingtotheformationofmethemoglobinandprecipitationofglobinchainsasHeinzbodies.*Heinzbodiesarenotseenafterthefirstoneortwodayssincetheyareremovedbythespleen,leadingtotheformationof`bitecells'andfragmentedredcells.*Macrophagesdetecttheantigenandremovethedamagedportionsofthecell,itsdamagedmembrane,andthedenaturedhemoglobin.*Theseareassociatedclinicallywithcongenitalhemolyticanemia,G6PDdeficiency,hemolyticanemiasecondarytodrugssuchas
phenacetin,somehemoglobinopathies(thalassemia),andaftersplenectomy.
473.Strawberrygumsareseenin a)Goodpasteur'ssyndrome b)Classicpolyarteritisnodosa c)Wegener'sgranulomatosis d)Kawasakisyndrome CorrectAnswer-CAnswer-C.Wegener'sgranulomatosisStrawberrygumsareseeninWegner'sgranulomatosis.StrawberrytongueisseeninKawasakidisease.
474.Mutationinproteinassociatedwith restrictivecardiomyopathy? a)Myosinregulatoryproteins b)Myosinbindingprotein-C c)TroponinI d)Tropomyosin CorrectAnswer-CAnswer-C.TroponinIRCM-associatedmutationshavebeenreportedinfourgenesthatencodekeysarcomericproteins/myofilaments 1. MYH7gene-13-Myosinheavychain2. TNNI3gene-CardiactroponinItype33. TNNT2gene-CardiactroponinTtype24. ACTCgene-a-actin MutationsintheTNNI3geneareoneofthemajorcausesofthiscondition.TheTNNI3geneprovidesinstructionsformakingaproteincalledcardiactroponinI,whichisfoundsolelyintheheart.CardiactroponinIisoneofthreeproteinsthatmakeupthetroponinproteincomplex,whichhelpsregulatetensing(contraction)andrelaxationoftheheartmuscle.TNNI3genemutationsassociatedwithfamilialrestrictivecardiomyopathyresultintheproductionofadefectivecardiactroponinIprotein.Thealteredproteindisruptsthefunctionofthetroponinproteincomplexanddoesnotallowtheheartmuscletofullyrelax.Asaresult,notenoughbloodenterstheventricles,leadingtoabuildupintheatriaandlungs.Theabnormalheartrelaxationandbloodflowisresponsibleformanyofthesignsandsymptomsoffamilial
restrictivecardiomyopathy.
475.Inapoptosis,proteinhydrolysisisdueto activationof a)lipases b)Transcarboxylase c)Catalase d)Caspases CorrectAnswer-DAnswer-D.CaspasesTheexecutionphaseofapoptosisInthisphase,initiatecaspases(Caspase-8&9)activateothercaspasesknownasexecutionCaspases(Caspases-3&7).Afterbeingactivatedthecaspasesactonmanycellularcomponents.Inthenucleus,thetargetofcaspaseactivationincludesproteinsinvolvedintranscription,DNAreplication,andDNArepair.Caspasesactivateendonucleases(DNAases)thatcausesdouble-strandedbreaksinDNA.
476.Executioncaspasesofapoptosisare a)Caspase1&3 b)Caspase3&5 c)Caspase1&5 d)Caspase3&7 CorrectAnswer-DAnswer-D.Caspase3&7InitiatecaspasessCaspase-8&9.ExecutioncaspasesCaspase-3&7.Initiatecaspasesareactivatedininitiationphaseofapoptosis.
477.Whichofthefollowingisnotafree radicalscavenger- a)Glutathioneperoxidase b)Superoxidedismutase c)Catalase d)Xanthineoxidase CorrectAnswer-DAnswer-D.XanthineoxidaseFreeradicalscavgers(anti-oxidants)inbody 1. Non-enzymaticVitaminsE,A&C,glutathione,cysteine, ceruloplasmin,transferrin,lactoforrin,ferritin. 2. EnzymesCatalase,superoxidedismutase,glutathione peroxidase
478.Cellularswellingwithblebsandmyelin figuresarethechangesseenin a)Reversiblecellinjury b)Irreversiblecellinjury c)Metaplasia d)Anaplasia CorrectAnswer-AAnswer-A.ReversiblecellinjuryPathologicalfeaturesofreversiblecellinjuryare:Cellularswelling(earliest);lossofmicrovilli;cytoplasmicmembraneblebs;ERswelling;Myelinefigures;detachmentofribosomefromER;cytoplasmic(lipid)vacuole;clumpingofchromatin.
479.Endothelialmoleculeparticipatingin rollingis a)CD34 b)CD65 c)CD56 d)CD100 CorrectAnswer-AAnswer-A.CD34AdhesionmoleculesinvolvedinRolling: 1. Endothelialmolecules:P-selectin,E-selectin,GlyCam-1,CD-34.2. Leucocytemolecules:Sialyl-LewisX-modifiedprotein,L-selectin.
480.Whatgeneratesintracellularsignals whencellsaresubjectedtoshearstress a)Cadherins b)Selectins c)Integrins d)Focaladhesionmolecules CorrectAnswer-DAnswer-D.FocaladhesionmoleculesFocaladhesioncomplexesarelarge(>100proteins)macromolecularcomplexesthatcanbelocalizedathemidesmosomes,andincludeproteinsthatcangenerateintracellularsignalswhencellsaresubjectedtoincreasedshearstress,suchasendotheliuminthebloodstream,orcardiacmyocytesinafailingheart.
481.Trueaboutwoundhealingwithprimary intentionis a)Byday5epidermisrecoversitsnormalthickness b)Intenseinflammatoryreaction c)Woundcontractionoccurs d)Abundantgranulationtissuegrows CorrectAnswer-AAnswer-A.Byday5epidermisrecoversitsnormalthicknessHealingbyprimaryintentionItoccursinwoundswithopposededges,e.g.,surgicalincision.Thehealingprocessfollowsaseriesofsequentialsteps:-ImmediateafterincisionIncisionalspacefilledwithbloodcontainingfibrinandbloodcells.Dehydrationofthesurfaceclotformsscabthatcoversthewound.Within24hoursNeutrophilsappearatthemarginsofwound.In24-48hoursEpithelialcellsmovefromthewoundedgesalongthecutmarginofdermis,depositingbasementmembranecomponentsastheymove.Theyfuseinthemidlinebeneaththesurfacescab,producingacontinuousbutthinepitheliumlayerthatclosesthewound.Byday3Neutrophilsarelargelyreplacedbymacrophages.Granulationtissueprogressivelyinvadestheincisionspace.Collegenfibersnowpresentinthemarginbutdonotbridgetheincision.Byday5Incisionalspaceislargelyfilledwithgranulationtissue.
Neovascularizationismaximum.Collegenfibrilsbecomemoreabundantandbegintobridgetheincision.Theepidermisrecoversitsnormalthickness.DuringsecondweekLeukocytesandedemahavedisappeared.Thereiscontinuedaccumulationofcollegenandproliferationoffibroblast.BytheendoffirstmonthScarismadeupofacellularconnectivetissuedevoidofinflammatoryinfiltratecoverednowbyintactepidermis.
482.Thedefinitionofexudateis a)Extravascularfluidthathasahighproteinconcentrationand containscellulardebris b)Extravascularfluidthathasalowproteinconcentration c)Extravascularfluidwithhighglucoseconcentration d)Extravascularfluidwithlowglucoseconcentration CorrectAnswer-AAnswer-A.ExtravascularfluidthathasahighproteinconcentrationandcontainscellulardebrisExudateisaninflammatoryfluidthatcontainshighproteincontent,cellulardebris,andspecificgravity>1.020.Itoccursduetoincreasedvascularpermeability.
483.Intuberculosisthecytokinecausing feveris a)ILI b)IL2 c)IL3 d)IL4 CorrectAnswer-AAnswer-A.ILIPyrogenesPyrogenesaresubstancesthatcausefever.PyrogensmaybeexogenousorendogenousExogenous-4BacterialtoxinsEndogenousIL-1,TNF-a,IL-6,Interferons,Ciliory'sneurotropicfactor
484.Whichacutephasereactantinduces rouleauxformation a)Creactiveprotein b)Fibrinogen c)SerumamyloidA d)IL1 CorrectAnswer-BAnswer-B.FibrinogenFibrinogenbindstoredcellsandcausesthemtoformstacks(rouleatix)thatsedimentmorerapidlyatunitgravitythandoindividualredcells.
485.HyperimmuneIgEsyndromeisalso called a)Jobssyndrome b)WiscottAldrichsyndrome c)Chediak-Higashisyndrome d)Digeorgesyndrome CorrectAnswer-AAnswer-A.JobssyndromeJob'ssyndrome,alsocalledHyper-IgEsyndromeorHyperimmunoglobulinEsyndrome,isanautosomaldominantdisorderduetomutationsinSignalTransducerandActivatorofTranscription-3(STAT-3).Thereisdefectinphagocytosis.IgElevelsareelevated.Otherimmunoglobulinsarenormal.
486.ComplementCIsynthesizedfrom- a)Liver b)Macrophage c)Intestinalepithelium d)Endothelium CorrectAnswer-CAnswer-C.IntestinalepitheliumCIissynthesizedinintestine;C2andC4aresynthesizedbymacrophages;C5andC8aresynthesizedinspleen;andC3,C6andC9aresynthesizedinliver.[Ref:ShorttextbookofmedicalmicrobiologybySatishGuptep.92]
487.Performareproducedby a)NKcell b)CytotoxicTcell c)Plasmacell d)Monocyte CorrectAnswer-AAnswer-A.NKcellPerforinsareholeformingproteins,causetransmembraneporesthroughwhichcytotoxicfactorsenterthecellanddestroyitbyapoptosis.Perforinsareproducedby:N.K.Cells[Ananthanarayan126]
488.Mostcommonknowncausesof congenitalanamoliesinhumansare a)Chromosomalaberrations b)Maternalinfections c)Drugs d)Irradiation CorrectAnswer-AAnswer-A.ChromosomalaberrationsGeneticChromosomalaberrations-10-15MendelianinheritanceEnvironmentalMaternal/placentalinfections-2-3Maternaldiseasestates-6-8Drugsandchemicals-1IrradiationsMultifactorial20-25Unknown-40-60
489.Mesotheliomaispositiveforwhich intermediatefilament a)Vimentin b)Cytokeratin c)GFAP d)Desmin CorrectAnswer-BAnswer-B.CytokeratinCytokeratin-Carcinoma,mesothelioma,Non-seminomaGCT
490.Calretininisusedin a)Mesothelioma b)Hamartoma c)Choristoma d)Chordoma CorrectAnswer-AAnswer-A.MesotheliomaCalretininandcytokeratinarepositiveincasesofmalignantmesothelioma.
491.Markerofangiosarcomais a)CD31 b)Cytokeratin c)Vimentin d)CD55 CorrectAnswer-AAnswer-A.CD31TheendothelialoriginofthesetumorscanbedemonstratedbyimmunohistochemicalstainingforCD31orvonWillebrandfactor.
492.Keratinizationandpearlformationis characteristicof a)Squamouscellcarcinoma b)Basalcellcarcinoma c)Melanoma d)Lymphoma CorrectAnswer-AAnswer-A.SquamouscellcarcinomaHistologically,squamouscellcarcinomaischaracterizedbythepresenceofkeratinizationand/orintercellularbridges.Keratinizationmaytaketheformofsquamouspearlsorindividualcellswithmarkedlyeosinophilicdensecytoplasm
493.Gradeoftumordenotes a)Degreeofdifferentiation b)Degreeofanaplasia c)Stageofdisease d)Vascularinvasion CorrectAnswer-AAnswer-A.DegreeofdifferentiationGradingisbasedonthedegreeofdifferentiationoftumorcellsandthenumberofmitosiswithinthetumor.
494.Carcinomaduetoinheritedmutationof p53protooncogene a)Lifraumenisyndrome b)Familialadenomatouspolyposis c)Retinoblastoma d)Osteosarcoma CorrectAnswer-AAnswer-A.LifraumenisyndromeLi-Fraumenisyndromeisduetomutationinp-53gene.
495.Krasmutationisseenin a)Pancreaticcarcinoma b)Prostatecarcinoma c)Gastriccarcinoma d)Hepaticcarcinoma CorrectAnswer-AAnswer-A.PancreaticcarcinomaK-RASpointmutation:Cancersofcolon,lungandPancreas.H-RASpointmutation:CancersofkidneyandbladderN-RASpointmutation:Melanomaandhematologicalmalignancies[RefRobbin's8thiep.279&7h/ep.295]
496.DICisseeninallexcept a)Carcinomapancreas b)Carcinomaprostate c)Carcinomalung d)Carcinomakidney CorrectAnswer-DAnswer-D.CarcinomakidneyCancersassociatedwithDICCapancreasCalungAcutepromyelocyticleukemiaCaprostateCaStomach
497.Histologicfindinginhyperplastic arteriosclerosis a)Concentriclayeronionskinlesion b)Mucinousintimalthickening c)Fibrinoidatherosclerosis d)Alltheabove CorrectAnswer-DAnswer-D.AlltheaboveItischaracteristicofmalignanthypertension.Thereisconcentrentic,laminatedthickeningofarteriolarwallonionskinning.Thereismucinousintimalthickeningandfibrousintimalthickening.Theremaybeaccompaniedfibrinoiddepositswithnecrosisofthevesselswallfibrinoidnecrosis.
498.Obliterativeendarteritisofthevasa vasorumofaortaisseenin a)Syphilis b)Wegener's c)Chrugstrauss d)Coldhemoglobinuria CorrectAnswer-AAnswer-A.SyphilisSyphiliticaneurysmisduetoobliterativeendarteritisthatinvolvesvasovasorumofaortainthetertiarystageofsyphilis.
499.WhichisoenzymeofLDHisseeninheart a)LDH1 b)LDH2 c)LDH3 d)LDH4 CorrectAnswer-AAnswer-A.LDH1MostprominentisoenzymedinheartmuscleisLDH-1.LDH-2is2ndmostprominentform(afterLDH1)
500.MALTomaislocatedinwhichlayerof gastrointestinaltract a)Laminapropria b)Submucosa c)Muscularispropria d)Serosa CorrectAnswer-AAnswer-A.LaminapropriaExtranodalmarginalzonelymphomaormucosa-associatedlymphoidtissuelymphoma(MALToma).Itisthemostcommonformofmarginalzonelymphoma.MALTlymphoma(MALToma)isdividedintogastric(arisinginstomach)andnon-gastric(arisinginsmallintestine,salivarygland,thyroidetc).GastricMALTomahasbeenassociatedwithH.pyloriinfection.ImmunophenotypeofMALTomasshowspositivityforCD20andCD23.TheyarenegativeforCD3,CD10andCD5.Histologically,MALTomatakesformofadenselymphocyticinfiltrateinthelaminaproprialayerofGIT.
501.Notanirreversibleinjury- a)Pyknosis b)Pyknosis c)Karyolysis d)Blebformation CorrectAnswer-DAnswer-D.BlebformationDamagetonucleuscanbeofthreeforms-Pkynosis-nuclearshrinkage&chromatincondensationandclumping.Karyorrhexis-Nuclearfragmentation.Karyolysis-decreasedbasophiliaduetodissolutionofnucleus.
502.Hyalinedegenerationisfoundin- a)MI b)Parkinson's'disease c)Yellowfeverhepatitis d)Basophiliccellofpituitary CorrectAnswer-CAnswer-C.Yellowfeverhepatitis1)Intracellularhyaline:councilmanbodiesinyellowfever2)Extracellularhyaline:nCorporaamylaceaareroundmasseofhyalineseeninprostateinelderly,brainandspinalcordofoldpeopleandoldinfarctsoflung.
503.Lipofuscinis a)Wearandtearpigment b)Fatdeposits c)Bloodpigment d)Formofcalcification CorrectAnswer-AAnswer-A.WearandtearpigmentItisaninsolublepigment,alsoknownasIandwearortearoragingpigment.Lipofuscinisnotinjurioustothecelloritsfunctions.Itsimportanceliesinbeingthetell-talesignoffreeradicalinjuryandlipidperoxidation.
504.Antiapoptoticgene a)FLIP b)P53 c)BAX d)BIM CorrectAnswer-AAnswer-A.FLIPProapoptoticgenes:Apaf-1,CytochromeC,Bak,Bax,Bim,AIF,P53,Caspases,TNFRI,FAS(CD95),FADD,BH3onlyproteins(Bim,Bid,Bad),Smac/DIABLO.Antiapoptoticgenes:BCL-2,BCL-X,Mcl-1,IAPs,FLIP
505.Skininvolvementalongwithcollarstud ulcerationinintestineonradiography.Diagnosisis- a)TBintestine b)Ulcerativecolitis c)IntestinalAmebiasis d)Crohn'sdisease CorrectAnswer-BAnswer-B.UlcerativecolitisSkininvolvementcanoccurinInflammatoryboweldiseasei.e.bothCrohn'sdiseaseandUlcerativecolitis.CollarstudulcerationisradiographicalsignofUlcerativecolitis.ULCERATIVECOLITIS:PATHOLOGY:Colonicmucosalinflammation;rectumalmostalwaysinvolved,withinflammationextendingcontinuously(noskipareas)proximallyforavariableextent;histologicfeaturesincludeepithelialdamage,inflammation,cryptabscesses,lossofgobletcells.CLINICALMANIFESTATIONSBloodydiarrhea,mucus,fever,abdominalpain,tenesmus,weightloss;thespectrumofseverity(amajorityofcasesaremild,limitedtorectosigmoid).Inseverecases,dehydration,anemia,hypokalemia,hypoalbuminemia.COMPLICATIONSToxicmegacolon,colonicperforation;cancerriskrelatedtoextentanddurationofcolitis;oftenprecededbyorcoincidentwithdysplasia,whichmaybedetectedonsurveillancecolonoscopicbiopsies.
biopsies.DIAGNOSISSigmoidoscopy/colonoscopy:mucosalerythema,granularity,friability,exudate,hemorrhage,ulcers,inflammatorypolyps(pseudopolyps).Bariumenema:lossofhaustrations,mucosalirregularity,ulcerations.
506.Solutioncurrentlyusedforliver preservationfortransplantis- a)UWsolution b)IGLsolution c)KyotoETsolution d)RossMarshalCitratesolution CorrectAnswer-AAnswer-A.UWsolutionUWsolutionhasbecomethegoldstandardlivertransplantationformanyyears."
507.Fibrosisassociatedwithlivercirrhosisis mediatedby- a)PDGF b)IFN-y c)ICAM-1 d)PcAM-l CorrectAnswer-AAnswer-A.PDGFMostimportantmediatorsinvolvedinliverfibrosis-PDGF,PAF,MMPs,TNF-a,TGF-13,IL-1.
508.Notaapoptoticgene a)P53 b)Bax c)Mcl-1 d)n-myc CorrectAnswer-DAnswer-D.n-mycProapoptoticgenes:Apaf-1,CytochromeC,Bak,Bax,Bim,AIF,P53,Caspases,TNFRI,FAS(CD95),FADD,BH3onlyproteins(Bim,Bid,Bad),Smac/DIABLO.
509.Whichofthefollowingisfalseregarding carcinoidtumor? a)Neuroendocrinetumor b)Mostcommonsiteislung c)Associatedwithserotoninproduction d)Potentiallymalignanttumor CorrectAnswer-BAnswer-B.MostcommonsiteislungCarcinoidtumorsarisefromtheneuroendocrinecells(ArgentaffincellsorKulchitskycells).ThemajorityarefoundnGItract,andmorethan40%insmallintestine(jejunum&ileum).Thetracheobronchialtreeandlungsarethenextcommonsitesinvolved.CarcinoidtumorsmayrarelyarisefromtheovaryorthymusCarcinoidtumorsarethemostcommonmalignancyoftheappendix.Allcarcinoidsareconsideredtohavemalignantpotential.About10%ofcarcinoidssecreteexcessivelevelsofarangeofhormones,mostnotablyserotonin(5-HT),leadingtocarcinoidsyndrome.ItischaracterizedbyFlushing,Diarrhea,Wheezing,Abdominalcramping,Peripheraledema
510.Caseatingnecrosisoccursin a)Brain b)liver c)kidney d)lung CorrectAnswer-DAnswer-D.lungGaseousnecrosis,avariantofcoagulativenecrosiscanbeencounteredinanyorganwherecelldeathisattributabletocertainorganismse.g.,mycobacteriumtuberculosis(TB),syphilisandfungi(Histoplasma,Coccidioidomycosis).Pulmonarytuberculosisisthemostcommoncauseofcaseousnecrosis.Thereforeanswershouldbe"lung".
511.Spreadofinfectioncauses a)Fibrinoidnecrosis b)Fatnecrosis c)Liquifactivenecrosis d)Coagulativenecrosis CorrectAnswer-CAnswer-C.LiquifactivenecrosisLiquefactiveorcolliquativenecrosisoccursduetolysosomalpermeabilityandenzymesofleukocytesdigestthetissuetransformingthetissueintoliquidviscousmass.Tissuearchitectureislost.Examplesare-Infarctbrainandabscesscavity.
512.COXtype3isaproductof- a)COXIgene b)COX2gene c)COX3gene d)Noneoftheabove CorrectAnswer-AAnswer-A.COXIgeneTheCOX-3isozymeisencodedbythesamegeneasCOX-1(PTGS1gene),withthedifferencethatCOX-3retainsanintronthatisnotretainedinCOX-1.Itisnotfunctionalinhumans.
513.Diabeticfootisassociatedwithfollowing typeofgangrene- a)Drygangrene b)Wetgangrene c)Gasgangrene d)Fournier'sgangrene CorrectAnswer-BAnswer-B.WetgangreneWhenoverlyingskinofdrygangrenoustissueisdevitalized,bacterialinfectionissuperimposedandthecoagulativenecrosisismodifiedbyliquifactivenecrosis.Morecommonlyduetovenousocclusionthenarterialocclusion.Occursindiabeticfootandbedsores
514.Unfoldedproteinmetabolismis associatedwith a)Endoplasmicreticulum b)Golgiapparatus c)Mitochondria d)Noneoftheabove CorrectAnswer-AAnswer-A.EndoplasmicreticulumTheunfoldedproteinresponse(UPR)isacellularstressresponserelatedtotheendoplasmicreticulum(ER).DiseasesamenabletoUPRinhibitionincludeCreutzfeldt-Jakobdisease,Alzheimer'sdisease,Parkinson'sdisease,andHuntington'sdisease.
515.Notanexampleofexcesstissuegrowth a)Granulationtissue b)Neoplasia c)Hyperplasia d)Fibrosis CorrectAnswer-AAnswer-A.GranulationtissueGranulationtissueisahallmarkofhealing.Itischaracterizedbyformationofnewsmallbloodvessels(angiogenesisorneovascularization)andproliferationoffibroblasts
516.1stmediatorofinflammationtobe releasedis a)Nitricoxide b)PAF c)Histamine d)IL-1 CorrectAnswer-CAnswer-C.HistamineVasoactiveaminesarepresentinpreformedstoresincellsandarethereforeamongthefirstmediatorstobereleasedduringinflammationThetwoaminesareespeciallyimportant.Theseare:-(i)Histamineand(ii)Serotonin
517.Whichofthefollowingispotassium Channelopathy- a)Hypokalemicperiodicparalysis b)Hyperkalemicperiodicparalysis c)EpisodicataxiaI d)LongQT-syndrome CorrectAnswer-AAnswer-A.HypokalemicperiodicparalysisDent'sdisease(Xlinkedproteinuria&Kidneystones)Osteopetrosis(recessiveordominant)BartersyndrometypeIIIBartersyndrometypeIV(associatedwithsensorineuraldeafness)Hyperkplexia(startledisease)JuvenilemyoclonusepilepsyEpilepsy
518.Rollingofleucocytesonendothelialcells ismediatedby a)ICAM-1 b)(3,integrin c)IL-8 d)P-selectin CorrectAnswer-DAnswer-D.P-selectinRolling&adhesion-Itisbroughtby-PselectinorCD62PECAM-1involvedinleucocytemigrationfromendothelialsurface.
519.Perioperativeshockisanexampleof a)Hypovolemicshock b)Septicshock c)Cardiogenicshock d)Neurogenicshock CorrectAnswer-AAnswer-A.Hypovolemicshock"Mostcommoncauseofhypovolemicshockishemorrhagewhichmaybeintraoperativeorpostoperative."
520.
WhichofthefollowingisnotapartofECM? a)Lectin b)Fibronectin c)Laminin d)Proteoglycans CorrectAnswer-AAnswer-A.LectinBasementmembrane(BM):-PASpositiveamorphousstructurewhichlieunderneathepitheliaofdifferentorgansandendothelialcells.ComponentsofBMarelaminin,fibronectin,tenascin,collagentypeIV,enatactin(nidogen),proteoglycan&perlecan(heparansulphate).
521.Calrexinandcalreticulinare- a)Glycoproteins b)Chaperons c)Tumormarkers d)Enzymes CorrectAnswer-BAnswer-B.ChaperonsCalreticulin&calrexinaremajorCa2+binding(storage)chaperonesintheendoplasmicreticulum.
522.Whichofthefollowingisderivedfrom fibroblastcells? a)TGF-13 b)MMP2 c)Collagen d)Angiopoietin CorrectAnswer-CAnswer-C.CollagenFibroblastsproducetheglycosaminoglycans,collagens,elasticfibers,reticularfibresandglycoproteinsthatcanbeseenintheextracellularmatrix.TheyalsoproducecytokineTSLP.
523.HDLreceptoris- a)SR-BI b)LDLR c)HDLR d)SR-82 CorrectAnswer-AAnswer-A.SR-BIHDLisremovedbyHDLreceptorsscavengerreceptorBI(SR-BI),whichmediatetheselectiveuptakeofcholesterolfromHDL.Thisreceptorismostabundantinliver,ovariesandadrenalglands.
524.Whichofthefollowingenhancesacute phaseresponse? a)a-2microglobulin b)Transferrin c)Albumin d)Retinalbindingprotein CorrectAnswer-AAnswer-A.a-2microglobulina)PositiveacutephaseproteinsTheseproteinsareincreasedduringinflammation.ImportantexamplesareC-reactiveprotein:CRP(f31-globulin),a-1antitrypsin,fibrinogen,ferritin,serumamyloidA,hepatoglobulin,ceruloplasmin,anda-2microglobulin.b)NegativeacutephaseproteinsTheseproteinsaredecreasedduringinflammation.Importantexamplesarealbumin,prealbumin,transferrin,transcortin,transthyretinandretinalbindingprotein.Generally,positiveacutephaseproteinsareconsideredasacutephaseproteins.
525.IFN-gammaisproducedby a)Neutrophills b)Macrophages c)T-cells d)B-cells CorrectAnswer-CAnswer-C.T-cellsActivatedT-cells(helper)produceIFN-y,themajorcytokineofgranulomatousinflammation.IFN-yHelperT-cellsareactivatedbyIL-2andproduceIFN-y,themajorcytokineofgranulomatousinflammationFinallythereisformationofgranulomainducedbyIFN-y.
526.Homerrosetteisseenin- a)Neurobastoma b)Nephroblastoma c)Hepatoma d)Ependymoma CorrectAnswer-AAnswer-A.NeurobastomaHomerWrightrosettesHomer-Wrightrosettesarecharacteristicofneuroblastomasandmedulloblastomas.Mayalsobeseenin-4Primitiveneuroectodermaltumors(PNET),Pineoblastomas,Retinoblastomas
527.Extremitiesarewarminwhichtypeof shock a)Hypovolemicshock b)Neurogenicshock c)Anaphylacticshock d)Cardiogenicshock CorrectAnswer-BAnswer-B.NeurogenicshockInhyperdynamicstageofsepticshockandinneurogenicshock,extremitiesarewarmduetovasodilatation.
528.Lysosomewithundigestedparticle insideisknownas- a)Residualbody b)Phagosome c)Phagolysosome d)Autophagosome CorrectAnswer-AAnswer-A.ResidualbodyThelysosomesthatpinchedofffromGolgicomplexarecalledprimarylysosomes.Afteraprimarylysosomehasfusedwiththevacuoleorvesiclecontainingthematerialtobedigested,itformsthesecondarylysosome.Aftertheprocessofdigestionhasbeencompleted,asecondarylysosomeformstheresidualbody.
529.HLA-Cw6isassociatedwith a)Myatsheniagravis b)Behcet'sdisease c)Pemphigusvulgaris d)Psoriasisvulgaris CorrectAnswer-DAnswer-D.PsoriasisvulgarisHLAassociationinpsoriasisPsoriasisvulgaris-Cw6,B13,B17,DRB1*0701/2,B37Psoriaticarthritis-B27GeneralizedpustularpsoriasisandacrodermatitiscontinuaofHallopeau-B27,B8Pustolosisofpalmsandsoles-Aw19,Bw35
530.Prusianbluedetects? a)Ferriciron b)Ferrousiron c)Glycogen d)Lipids CorrectAnswer-AAnswer-A.FerricironItistheclassicmethodfordemonstratingironintissues.Thesectionistreatedwithdilutehydrochloricacidtoreleaseferricionsfrombindingproteins
531.Sezarycellsshowwhichtlpeofnucleus- a)Pleomorphic b)Round c)Eosinophillic d)Cerebriform CorrectAnswer-DAnswer-D.CerebriformSezarycellsareneoplasticT-cellsfoundinsezarysyndrome(cutaneousT-celllymphoma).
532.MHC-2ispresentinallexcept a)Corticalmacrophages b)Medullarymacrophages c)Corticalepithelialcells d)Medullaryepithelialcells CorrectAnswer-BAnswer-B.MedullarymacrophagesCorticalmacrophages,epithelialcellsanddendriticcellsexpresshighlevelofclassIIMHCmolecule.MedullarymacrophagesexpressonlyclassIMHC,whilemedullaryepithelialcellsanddendriticcellsexpressbothclassI&IIMHCmolecules.
533.Bcellsarelocatedinwhichregionof lymphnodes a)Paracorticalregion b)Corticalfollicles c)Medullarsinuses d)Subcapsularregion CorrectAnswer-BAnswer-B.CorticalfolliclesLocationofimmunecellsinlymphnode: 1. T-cells:Paracorticalarea.2. B-cells:Corticalfollicles,germinalcenters,medullarycords.
534.PSGNisanexampleofwhichtypeof hypersensitivity a)Type-1hypersensitivity b)Type-2hypersensitivity c)Type-3hypersensitivity d)Type-4hypersensitivity CorrectAnswer-CAnswer-C.Type-3hypersensitivityGlomerulonephritis(PSGN:Post-streptococalGN)isatypeIIIhypersensitivity.
535.NumberofcriteriaforHLAmatchingare a)10 b)4 c)16 d)22 CorrectAnswer-AAnswer-A.10Atleast8HLAmarkersfortheseminimumrequirements:twoAmarkers,twoBmarkers,twoCmarkers,andtwoDRB1markers.Sometimesanadditionalmarker,calledDQ,isalsomatchedmakingit10markers.
536.Allofthefollowingarefeaturesof granulomatousthyroiditisexcept? a)Hyperthyroidism b)Hypothyroidism c)Painless d)Giantcellsonhistology CorrectAnswer-CAnswer-C.PainlessClinicalFeatures-Painfulenlargedthyroid,feverHypothyroidismMalaiseSorethroat,painreferredtothejaworear.Subacutethyroiditisisaself-limitedthyroidconditionassociatedwithatriphasicclinicalcourseofhyperthyroidism,hypothyroidism,andreturntonormalthyroidfunction
537.Organwithleastchanceofrejection a)Blood b)Kidney c)Heart d)Liver CorrectAnswer-DAnswer-D.LiverHLAmatchingplayaveryminimalroleinlivertransplantthereforeimmunerejectionislesscommoninlivertransplant.
538.Mctypeofgraftrejectionis a)Hyperacute b)Acute c)Chronic d)Acuteonchronic CorrectAnswer-CAnswer-C.Chronic"Acutegraftrejectionisthemostcommonform"
539.Infollicularcarcinomachromosomal translocationis? a)PAXS-PPARTI b)RET-PTC c)ALK-NMPI d)IAK-TEL CorrectAnswer-AAnswer-A.PAXS-PPARTIFollicular-PAX8-PPARrltranslocation
540.Trueaboutserumsicknessis a)Type2hypersensitivity b)Canleadtoleukocytoclasticvasculitis c)Hypercomplementemia d)Canoccurduetohomologousantigen CorrectAnswer-BAnswe-B.CanleadtoleukocytoclasticvasculitisSerumsicknessisatypeIIIhypersensitivity(immunecomplexmediated)reactionthatresultsfromtheinjectionofheterologousorforeignproteinorserum.Whenanantiserumisgiven,thehumanimmunesystemcanmistaketheproteinspresentforharmfulantigens.Thebodyproducesantibodies,whichcombinewiththeseproteinstoformimmunecomplexes.Thesecomplexesprecipitate,enterthewallsofbloodvessels,andactivatethecomplementcascade,initiatinganinflammatoryresponseandconsumingmuchoftheavailablecomplementcomponent3(C3).Theresultisaleukocytoclasticvasculitis.
541.Mostlethalcombinationis a)Autosomalmonosomy b)Chromosomalmonosomy c)Autosomaltrisomy d)Chromosomaltrisomy CorrectAnswer-AAnswer-A.AutosomalmonosomyAutosomalmonosomies(lossofoneautosome)areincompatiblewithfetaldevelopmentandarenotfoundinlivebirths.Onlymonosomycompatiblewithlivebirthisduetoinvolvementofsexchromosome,i.e.Turnersyndrome(45X).
542.NotafeatureofPSGN- a)HTN b)Increasedurea c)Increasedcreatinine d)NormalC3level CorrectAnswer-DAnswer-D.NormalC3levelComplementlevelisdecreasedinPSGN.Otheroptionsarecorrect.
543.AllofthefollowingaretrueaboutDown syndromeexcept a)IncidenceofRobertsoniantranslocationis1:1000 b)Extrachromosomeisofmaternalorigin c)Mostcommoncauseistrisomy21 d)Mosaicism21hasnoassociationwithmaternalage CorrectAnswer-AAnswer-A.IncidenceofRobertsoniantranslocationis1:1000CytogeneticsinDown'ssyndrome 1. Trisomy21:Itismostcommon(95%)cause.Extrachromosomeis maternalinorigin. 2. Robertsontronslocations(t22:21;t14:21;t15:21):Thisaccounts for3%(3:100)ofcases. 3. Mosaicismof21:Thisaccountsfor2%ofcases4. Partialtrisomy:Very-veryrare
544.Hypophosphatemicricketsis a)AR b)AD c)XR d)XD CorrectAnswer-DAnswer-D.XDX-linkeddominantdisordersVitamineDresistant(X-linkedhypophosphatemic)Rickets.Familialhypophosphatemia.FragileX-syndrome.Incontinentiapigmenti.Rettsyndrome.
545.Irregularscarredkidneywithpelvic dilatationisseenwith- a)Chronicpyelonephritis b)Polycystickidney c)Renalarterystenosis d)Tuberculosisofkidney CorrectAnswer-AAnswer-A.ChronicpyelonephritisPathologicalchangesofchronicpyelonephritisare: 1. Irregularscarringofkidney2. Thehallmarksofchronicpyelonephritisarecoarsecorticomedullary scarsoverlyingbluntedcalyces;dilatedpelvisandflatteningofpapillae.
546.Structureofchromosomesisstudied by? a)C-banding b)G-banding c)Q-banding d)BrdV-staining CorrectAnswer-BAnswer-B.G-bandingMetaphasecellsarethenfixedwithmethanol/glacialaceticacidmixtureandstainedbyoneoftheseveralbandingtechniques:- 1. G-Banding(Giemsabanding):Itisusedmostcommonly.2. Otherbandingtechniques:Q-Banding(Quinacrinebanding),C- Banding(Constitutivebanding),andR-Banding(ReversestainingGeimsabanding).
547.Locationofgeneonchromosomeis identifiedby a)Karyotyping b)Geneticmapping c)Microarray d)Genomicimprinting CorrectAnswer-BAnswer-B.GeneticmappingAmapofthehumangenomeallowstounderstandwheregenesarelocated.
548.Tyrosinekinasereceptorisassociated withproto?oncogene- a)RAS b)MYC c)RET d)RB CorrectAnswer-CAnswer-C.RETItisagrowthfactorreceptor(receptortyrosinekinase).RETproteinisareceptorforglialcelllinedderivedneurotrophicfactor.RETisnormallyexpressedinparafollicular'C'cellsofthyroid,adrenalmedullaandparathyroidcellprecursons.PointmutationinRETprotooncogenesisassociatedwithMEN-2A,MEN-2B,medullarythyroidcarcinomaandHirschsprungdisease.
549.IgAnephropathyisnotassociatedwith? a)FocalMesengialproliferation b)Grosshematuriawithin1-2daYs c)OnimmunofluorescencedepositscontainbothIgAandIgG d)Increasedcomplimentlevel CorrectAnswer-DAnswer-D.IncreasedcomplimentlevelComplimentlevelisnormalinIgAnephropathy.Itiscommoninchildren.Grosshematuriaisseenin1-2days.Itisatypeofmesangioproliferative(notmembranoproliferative)GN.Itisthemostcommontypeofglomerulonephritisworldwide.
550.CharacteristicfeatureofIgA nephropathy- a)Serumcomplimentlevelisnormal b)Morecommoninoldage c)ItisatFpeofmembranoproliferativeGN d)Grosshematuriapresentsafterl0days CorrectAnswer-AAnswer-A.SerumcomplimentlevelisnormalComplimentlevelisnormalinIgAnephropathy.Itiscommoninchildren.Grosshematuriaisseenin1-2days.Itisatypeofmesangioproliferative(notmembranoproliferative)GN.Itisthemostcommontypeofglomerulonephritisworldwide.
551.Whichofthefollowinghastumor promotingeffect? a)BRAC b)RB c)MYC d)p16 CorrectAnswer-CAnswer-C.MYCRAS,Mitogen-activatedproteinkinasekinase,VEGF,orAkt
552.CEAis a)Hormone b)Glycoprotein c)Enzyme d)Tumorassociatedprotein CorrectAnswer-BAnswer-B.GlycoproteinCarcinoembryonicprotein(CEA)isaglycoprotein.
553.CEAisincreasedinwhichnon- neoplasticcondition a)Hemolyticanemia b)Pancreatitis c)BPH d)Pregnancy CorrectAnswer-A:BCEA-Carcinoembryonicantigen(CEA):CEAisalsoaglycoproteinnormallysynthesizedinembryonictissueofthegut,pancreas,andliver.Theirserumlevelsarehighincancersofthegastrointestinaltract,pancreas,ovariancancerandbreast.CEAlevelsarealsoelevatedincertainnon-neoplasticconditionse.g.inulcerativecolitis,Crohn'sdisease,hepatitis,andchronicbronchitis,Alcoholiccirrhosis,smoking,pancreatitis,hemolyticanemia
554.Mostcommontnreofrenalcarcinomais - a)Clearcelltype b)Chromophobetype c)Papillarytype d)Tubulartype CorrectAnswer-AAnswer-A.ClearcelltypeClearcellcarcinomaisthemostcommontypeofrenalcanceraccountingforabout70%to80%oftherenalcellcancer.
555.Carcinomaoriginatingfromglandsis called a)Basalcellcarcinoma b)Squamouscellcarcinoma c)Adenocarcinoma d)Fibrosarcoma CorrectAnswer-CAnswer-C.AdenocarcinomaBenigntumorofglandsAdenoma.MalignanttumorofglandAdenocarcinoma.
556.Mostcommonhistologicalformoflung Cathatmetastasizesis- a)SquamouscellCA b)Adenocarcinoma c)Alveolar-carcinoma d)Smallcellcarcinoma CorrectAnswer-AAnswer-A.SquamouscellCASmallcellcarcinomasarethemostaggressiveoflungtumors,metastasizewidelyandarevirtuallyincurablebysurgicalmeans.
557.Hematologicalcarcinomaiscommonly linkedto a)Nicotine b)Benzene c)Lithium d)Alcohol CorrectAnswer-BAnswer-B.BenzeneBenzeneexposureisassociatedwithleukemia.
558.Elasticfibersoftunicamediaare secretedby a)Fibroblast b)Endothelium c)Smoothmuscle d)Externallamina CorrectAnswer-CAmswer-C.SmoothmuscleThebloodvesselsaremadeofthreelayers,calledfromtheluminalsideoutward,thetunicaintima,thetunicamediaandthetunicaadventitia. 1. Thetunicaintimaconsistsofanendotheliumandanysub- endothelialconnectivetissue.Itisseparatedfromtunicamediabyinternalelasticlamina. 2. Thetunicamediaisthelayerofconcentrically-arrangedsmooth muscle.Smoothmusclecellshavesecretorycapabilitiesandthetunicamediacontainsvaryingamountsofcollagenfibers,elasticfibers,elasticlamellae,andproteoglycanssecretedbythesmoothmusclecells.
559.Levelofwhichofthefollowingisnot elevatedinheartdisease a)LDH b)5-nucleotidase c)SGOT d)ALP CorrectAnswer-BAnswer-B.5-nucleotidase5-nucleotidaseiselevatedinliverdisease,bonediseaseandpregnancy.ALP(alkalinephosphatase)israisedincongestiveheartfailure
560.Radiotherapyinducedradiation pneumonitismediatedbyallofthefollowingexcept- a)TNF-c b)PAF c)TGF-p d)NF-kB CorrectAnswer-BAnswer-B.PAFImportantmediatorsofRadiationinducedpneumonitisareTNF-a,TGF-I3andTh2cellscytokines(IL-4,IL-5,IL-6&IL-13).mlresponse(II,-2,IFN-y)issuppressedduringradiationpneumonitis
561.Whichofthefollowingdoesnot predisposetoleukemia? a)Geneticdisorder b)Alcohol c)Smoking d)Chemicalexposure CorrectAnswer-BAnswer-B.AlcoholEtiologicalagentsareradiation,chemicals(benzene,ethyleneoxide),smokinganddrugs(alkylatingagents,topoisomeraseIIinhibitors).
562.RoutineRhtypingincludestesting? a)Aantigen b)Bantigen c)Cantigen d)Dantigen CorrectAnswer-DAnswer-D.DantigenAfterABO,themostimportantantigenintransfusionpracticeisD.TheDantigenisamemberoftheRhsystem.
563.RistocetintestingvonWillebrand diseaseshows? a)Increasedagglutination b)Decreasedagglutination c)Normalagglutination d)Noagglutination CorrectAnswer-BAnswer-B.DecreasedagglutinationAddingristocetinatafinalconcentrationof1.25g/1toplateletrichplasma(PRP)ofapatientwithvonWillebranddisease(VWD)almostinvariablyresultsinareducedagglutinationoftheplateletscomparedtoanormalPRP.
564.Osmoticfragilitytestiscommonlyused for- a)Irondeficienryanemia b)Megaloblasticanemia c)HereditaryspherocYtosis d)Aplasticanemia CorrectAnswer-CAnswer-C.HereditaryspherocYtosisIncreasedOsmoticfragility-HereditaryspherocytosisHemolyticanemia(acquiredimmune)MalariaSeverepyruvatekinasedificiency
565.WarmantibodyinAIHAis- a)IgE b)IgM c)IgG d)IgD CorrectAnswer-CAnswer-C.IgGWarmantibodyautoimmunehemolyticanemiaisthemostcommonformofautoimmunehemolyticanemia.MostcausativeantibodiesareoftheIgGclass,sometimesIgAantibodiesareculprit.
566.Whatistrueaboutsicklecell- a)Sicklingoccursbothinheterozygousandhomozygousstate b)FetalhemoglobinfacilitatesSickling c)Sicklingisreversiblewithoxygenation d)SicklingLeadstodecreasedMCHC CorrectAnswer-CAnswer-C.SicklingisreversiblewithoxygenationSicklingofredcellsisreversibleinitially,i.e.,withoxygenation,HbSdepolymerizesandcellshapenormalizes.Repeatedepisodesofdeoxygenationandsickling,membranedamageoccursandcellsbecomeirreversiblysickled,andretaintheirabnormalshapeevenwhenfulloxygenated.
567.Distinguishingfeatureofreticulocyteis- a)Constitute10%oftheredcells b)Nonucleus c)SmallerinsizethenRBCs d)MatureinlymPhnodes CorrectAnswer-BAnswer-B.NonucleusReticulocytesareimmatureredbloodcellsReticulocytesdonothaveanucleus.
568.NormalMyeloid-erythroidratiois- a)l:l b)2:l c)3:l d)4:1 CorrectAnswer-CAnswer-C.3:lBonemarrowisthemajorsourceofallhematopoieticcells(proginatorhematopoieticcells)inpost-natallife.Innormaladults,ratiooffatcellstohematopoieticcellsis1:1.Ratioofmyeloidtoerythroidis3:1.Ratiooffatcellstoerythroidcellsis4:I.
569.hL/hbloodgroup- a)lacksH-antigen b)lacksA-antigen c)lacksB-antigen d)Alloftheabove CorrectAnswer-DAnswer-D.AlloftheaboveInBombaybloodgroup(h/horOhbloodgroup)theprecursorantigen(Hantigen)isabsent,consequentlyAandBantigenswhicharederivedfrommodificationofHantigenarenotformed.Thus,BombaybloodgrouplacksH,AandBantigen.
570.AmountofbloodlossinStageIof hemorrhagicshockis- a)<10% b)<20% c)<30% d)<40% CorrectAnswer-BAnswer-B.<20%Mildhypovolemia(stage1)(<20%volumeloss):OnlymildtachycardiaistherewithnormalBPRapidlossofupto20%ofthebloodvolume,orslowlossesofevenlargeramounts,mayhavelittleimpactinhealthyadults;greaterlosses,however,cancausehemorrhagic(hypovolemic)shock
571.Whichtypeofarteryismostcommonly involvedinPAN? a)Muscular b)Pulmonary c)Skin d)GIT CorrectAnswer-AAnswer-A.MuscularPolyarteritisnodosaorclassicalpolyarteritisnodosaissystemicnecrotizingvasculitisofmediumsizedmusculararteries,butdoesnotinvolvesmallvesselsi.e.,arterioles,venulesorcapillaries.Ittypicallysparesthepulmonarycirculation.Renalarteryinvolvementisthemajorcauseofdeath.
572.Obliterativeendarteritisinvasavasorum isseenin- a)Hypertension b)Tuberculosis c)Syphilis d)SLE CorrectAnswer-CAnswer-C.SyphilisObliterativeendarteritisthatinvolvesvasovasorumofaortaisseeninthetertiarystageofsyphilis.Itmayleadtosyphiliticaneursym(leueticaneurysm).Itusuallyaffectstheproximalascendingaorta,particularlytheaorticring.Syphiliticaortitismayoccasionalyinvolvetheaorticarchordescendingaorta.
573.Heartfailurecellsareseenin- a)Pulmonaryedema b)Pulmonaryinfarction c)Pulmonaryabscess d)PulmonaryTB CorrectAnswer-AAnswer-A.PulmonaryedemaPulmonaryedema&pulmonaryinfarctioncanbedifferentiatedbythepresenceofheartfailurecellsinpulmonaryedema.HeartfailurecellsareHemosiderinladenalveolarmacrophages.Heartfailurecellsareamanifestationofpulmonarycongestionandedema(asseeninheartfailure).
574.Heartfailurecellsare a)Neutrophils b)Macrophages c)Lymphocytes d)Basophils CorrectAnswer-BAnswer-B.MacrophagesHeartfailurecellsareHemosiderinladenalveolarmacrophages.Heartfailurecellsareamanifestationofpulmonarycongestionandedema(asseeninheartfailure).Ruptureofdilatedandcongestedcapillariesmayresultinminuteintra-alveolarhemorrhages.Thebreakdownoferythrocytesliberateshaemosiderinpigmentwhichistakenupbyalveolarmacrophages,so-calledheartfailurecells,seeninthealveolarlumina.
575.LinesofZahnareseenin- a)Heart b)Lung c)Liver d)Kidney CorrectAnswer-AAnswer-A.HeartLinesofZohnCharacteristicofthrombithatisformedinheartoraorta.Theyhavevisibleandmicroscopiclaminationsproducedbyalternatingpalelayerofplateletsmixedwithfibrinanddarkerlayercontainingredbloodcells.
576.Whichproteinisdefectiveindialated cardiomyopathy? a)Myosin b)Troponin c)Tropomysoin d)Dystrophin CorrectAnswer-DAnswer-D.DystrophinDialatedcardiomyopathyoccusduetodefectivecytoskeletonproteins.Mostimportantproteininovolvedisdystrophin.Otherproteinsaffectedare:(1)Desmin;(2)MLPProteinand(3)aPcrystallineproteins
577.Whichofthefollowingisseeninyoung's syndrome? a)Azoospermia b)Bronchiectasis c)Infertility d)Alloftheabove CorrectAnswer-DAnswer-D.AlloftheaboveYoung'ssyndromeischaracterizedby: 1. Bronchiectasis2. Azoospernia&infertility3. Sinusitis4. Nasalpolypi
578.Amyloidosisoccursinallexcept a)Tuberculosis b)Chronicbronchitis c)Osteomyelitis d)Bronchiectasis CorrectAnswer-BAnswer-B.ChronicbronchitisSecondoryamyloidosisItoccurssecondarytoanassociatedinflammatoryconditionslike 1. Rheumatoidarthritis(mostcommon)2. TB&Leprosy3. Ankylosingspondylitis4. Chronicosteomyelitis5. IBD(crohndisease,ulcerativecolitis)6. Bronchiectasis Itmayalsooccurinsometumors 1. Renalcellcarcinoma(Hypernephroma)2. Hodgkinlymphoma
579.MostcommoncauseofdeathinSLEin children a)Lupusnephritis b)Lupuscerebrits c)Libmansacksendocarditis d)Anemiaandinfections CorrectAnswer-AAnswer-A.LupusnephritisMajorcausesofdeathinpediatricSLEinclude: 1. Renaldisease(lupusnephritis)2. Severediseaseflare3. Infections
580.Smallposteriorfossaseenin? a)Arnoldchiarimalformation b)Dandywalker c)Medulloblastoma d)Schizencephaly CorrectAnswer-AAnswer-A.ArnoldchiarimalformationSmallposteriorfossaarnoldchiarimalformation.Largeposteriorfossadondywalkermolformation
581.IncorrectaboutHIVassociated nephropathy? a)Proteinuria b)Shrunkenkidneys c)15%casesshowmesengialproliferation d)DevelopswhenCD4<200 CorrectAnswer-BAnswer-B.ShrunkenkidneysMostcommon(80%)kidneylesioninAIDSisFSGS(especiallycollapsingvarianti.e.collapsingglomerulopathy).ItistermedasHIVassociatednephropathy(HIVAN).Mesangioproliferative(mesangialproliferation)GNis2ndmostkidneylesionOtherkidneylesionsarediffuseproliferativeGN,MPGN,IgAnephropathy,membranousGNandminimalchangedisease.
582.PyogenicgranulomtrueA/E a)Bacterialinfection b)Bleeding c)Benigntumour d)Capillaryhemangioma CorrectAnswer-AAnswer-A.BacterialinfectionPyogenicgranuloma(PG)orlabularcapillaryhemangiomaisabenignvasculartumouroftheskinormucousmembranecharacterizedbyrapidgrowthandfriablesurface.Angiogenicgrowthfactorssuchasvascularendothelialgrowthfactors(VEGE)anddecorin,transcriptionfactors,andsignaltransductionpathways(MAPK)areoverexpressedinpyogenicgranulomas
583.Visceralaneurysmismostcommonly seenin a)Splenic b)Renal c)Hepatic d)Coronary CorrectAnswer-AAnswer-A.SplenicMostcommonvisceralarteryaneurysmissplenicarteryaneurysm.2ndmostcommonvisceralarteryaneurysmishepaticarteryaneurysm.
584.Allofthefollowingprovideprotection againstmalariaexcept- a)Duffybloodgroup b)Sicklecellanemia c)Hereditaryspherocytosis d)PNH CorrectAnswer-DAnswer-D.PNHPNHisahemolyticanemiacausedbyanacquiredintrinsicdefectinthecellmembrane.PNHresultsfromacquiredmutationthatinhibitsthesynthesisofGlycosylphospatidylinositol(GPI).
585.Thoriuminducedtumor a)Angiosarcomaofliver b)Renalcellcarcinoma c)Lymphoma d)Astrocytoma CorrectAnswer-AAnswer-A.AngiosarcomaofliverThorotrost(thoriumdioxide)iscommonlyassociatedwithliverneoplasm.ThemostcommonliverneoplasmassociatedwiththoriumexposureAngiosarcomaoftheliverCholangiocarcinomaHepatocellularcarcinoma
586.Mostcommonmalignancyoffallopian tube a)SCC b)SerousCA c)Teratoma d)Chorioca CorrectAnswer-BAnswer-B.SerousCASerous-49.5%-83.3%
587.Warthinfinkeldeycellsareseenin a)Measles b)Rubella c)Rabies d)Typhoid CorrectAnswer-AAnswer:A.MeaslesMultinucleatedcellslikeWarthinFinkeldeyareseeninMeaslesMeaslesvirusinfectsbyinvasionofrespiratoryepithelium.Localmultiplicationleadstoviremia(day2-3),thenspreadtoREsystem.TwotypesofMultinucleatedgiantcellsinbothepidermis&oralepitheliumby7-11days.WarthinFinkeldeycellsofreticuloendothelialsystemEpithelialgiantcellsofrespiratory&otherepithelia.Warthin?Finkeldeycell:TypeofgiantmultinucleatecellfoundinhyperplasticlymphnodesearlyinthecourseofmeaslesUnderthelightmicroscope,thesecellsconsistofalarge,grape-likeclusterofnuclei.AlsowithHIV-infectedindividualsandKimuradisease.Rarelyinneoplastic(e.g.lymphoma)&non-neoplasticlymphnodedisorders.Unknownorigin;Reportsofstainingwithmarkerssimilartofolliculardendriticcells,includingCD21.
588.CD59markerofwhichdisease a)PNH b)PTEN c)BRR d)Cowdensyndrome CorrectAnswer-AAnswer:A.Paroxysmalnocturnalhemoglobinuria(PNH)Paroxysmalnocturnalhemoglobinuria(PNH)isadisease,duetoacquiredmutationsin"PhosphatidylinositolGlycanComplementationGroupA"gene(PIGA)..Associatedwithdeficiencyofglycosylphosphatidylinositol(GPI)anchorproteinsalongwithabsenceofexternalsurfacemembraneproteinsattachingtoit.CD55(DAF)andCD59(MIRL)aretwosuchcomplementdefenceproteinsCD59deficiency:CommonfindinginRBCs&WBCsofpatientswithchronichemolysissufferingfromPNHDiagnosis:Thedefinitediagnosisbasedondemonstrationofasubstantialproportionofpatient'sRBChavingincreasedsusceptibilitytocomplement(C),duetothedeficiencyontheirsurfaceofproteins(particularlyCD59&CD55)
589.Opsoninis a)C3a b)C3b c)C5a d)C6 CorrectAnswer-BAnswer:B.C3bTheprocessofcoatingaforeignparticletargeting&preparingitforphagocytosisprocessis"Opsonization".Substancesinvolvedareopsonins.MainopsoninsfromcomplementsystemisC3Examplesofopsoninsinclude:Antibodies:IgGandIgAComponentsofthecomplementsystem:C3b,C4b,andiC3bMannoseBindingLectin(MBL):InitiatestheformationofC3bMembraneAttackComplex(MAC)IncludesC5b,C6,C7,C8&polymericC9Opsonization&complementproteins:MainlyC3b,iC3b&C4bC3:Mostabundantproteinofallcomplementaryproteins,CleavesintoC3aandC3bC3a-Bindsandactivatesmastcells&basophils,releasehistamine.C3b-
Mostcriticalcomponentinbothclassical&alternativepathwayC3battachestobacterialsurfacesforopsonizationbyphagocytes
590.Bernard?Souliersyndromedueto deficiencyof a)Gp2b/3a b)Gp1b c)vWf d)TNF CorrectAnswer-BAnswer:B.Gp1bBernard?Souliersyndrome(BSS)/HemorrhagicParousThrombocyticDystrophyRareautosomalrecessivecoagulopathyCausesadeficiencyofglycoprotein1b(Gp1b),receptorforvonWillebrandfactor.
591.Cowdensyndrome a)P53 b)PTEN c)Rb d)Ras CorrectAnswer-BAnswer:B.PTEN"PhosphataseandTensin"homolog(PTEN)-proteininhumansencodedbythePTENgene.Genemutationspromotesdevelopmentofcancers.Cowden'sdisease/MultipleHamartomaSyndrome-PartofPTENhamartomatumorsyndromeAnautosomaldominantsyndromeTrichilemmomas-NumeroustumorsofhairfolliclesinfaceMultiplehamartomatouspolypsinGItract.Veryhighriskofbreast&thyroidcarcinomaTreatment:B/LmastectomiesrecommendedContraindicatedaremammography&otherradiationexposureofbreasttissue
592.Chromosomeinvolvedinmyotonic dystrophyis a)Chromosome19 b)Chromosome20 c)Chromosome21 d)Chromosome22 CorrectAnswer-AAnswer:A-Chromosome19Myotonicdystrophyistransmittedbymutationinan'unstabletrinucleotiderepeatsequence'ingene19q133.Features:AnautosomaldominantdisorderMostcommonadultmusculardystrophyCharacteristicsfeature:Myopathyisdistal(incontrasttoothermyopathies-mostlyproximal).MuscleatrophyselectivelyinvolvestypeIfibresonlyAppearsby5years,causesaslowrelaxationofhandgripfollowingaforcedvoluntaryclosure.
593.TRALIoccurswithinhowmanyhoursof transfusion? a)48Hrs b)72Hrs c)6Hrs d)12Hrs CorrectAnswer-CAnswer:C-6HrsTransfusion-RelatedAcuteLungInjury(TRALI)-Syndromecharacterizedbyacuterespiratorydistressfollowingtransfusion.Symptoms:Typicallydevelopduring,orwithin6hoursoftransfusion.Rapidonsetofdyspnea&tachypnea.Associatedfever,cyanosis,&hypotension.Clinicalexamination:Revealsrespiratorydistress.PulmonarycracklesmaybepresentwithnosignsofCHForvolumeoverload.CXR-EvidenceofB/LpulmonaryedemaunrelatedtoCHF(non-cardiogenicpulmonaryedema),Bilateralpatchyinfiltratesrapidlyprogressingtocomplete"whiteout"indistinguishablefromAcuteRespiratoryDistressSyndrome(ARDS).
594.Kidneyrespondstoshockby a)Decreasesrenalbloodflow b)Increasesafferentarterioleresistance c)GFRremainsunaltered d)Perfusionofkidneyincreases CorrectAnswer-BAnswer:B-IncreasesafferentarterioleresistanceKidneyutilizesthefollowingmechanismsasaresponsetoshock:ReleaseofaldosteronefromhypoxickidneyReleaseofADHduetodecreasedeffectivecirculatingbloodvolume.ReducedGFRduetoarterioleconstrictionTissuefluidshiftintoplasmaduetoloweredhydrostaticpressure(Hypotension)
595.Whichofthefollowingisepithelialtumor ofstomach? a)Carcinoid b)Lymphoma c)GIST d)Gastricadenocarcinoma CorrectAnswer-DAnswer:D-GastricadenocarcinomaMalignantepithelialtumororiginatingfromglandularepitheliumofgastricmucosa.Aggressivelyinvadethegastricwall.Laurenclassification:Twotypesofgastricadenocarcinomaarepresent.IntestinaltypeDiffusetypeIntestinaltype-IrregulartubularstructuresDiffusetype-Mucinous&colloidal"Leather-bottlestomach"
596.IdentifyanXlinkeddisorder? a)Colorblindness b)Thalassemia c)Azoospermia d)RetinitisPigmentosa CorrectAnswer-AAnswer:A-ColorblindnessHereditarycolorblindness/AchromatopsiaTheabilitytoappreciateoneormoreprimarycolorisdefective(anomalous)orabsent(anopia)DuetomutationsinXchromosomeRed&greenpigmentconescodedbyXchromosome;Bluecodedonchromosome7MorecommoninmalesthanfemalesAcquired-(Opticnerve/maculardamage)Ishiharachart-Testred/greencolorblindness-Farnsworth100huetestOthers:Azoospermia&RetinitisPigmentosa-Y-chromosomelinkeddisorderThalassemia-Inherited(Autosomalrecessivepattern)blooddisorderscharacterizedbyabnormalhemoglobinproduction.GenesinChromosome11and16involved.
597.HAndLvarietyseenin a)Mixedcellularityhodgkin b)Lymphocytedepleted c)Lymphocytepredominance d)Nodularsclerosis CorrectAnswer-CAnswer:C-LymphocytepredominanceHodgkinlymphoma(HL)-common"MalignantLymphomas"2entities:ClassicalHL(cHL)NodularLymphocyte?predominantHL(NLPHL).Cells:ClassicalHL-HodgkinandReed/Sternberg(HRS)cellsNodularLymphocytepredominantHL-Lymphocytic&Histiocytic(L&H)cells
598.Stellategranulomaseenin a)Sarcoidosis b)Catscratchdisease c)Cryptococcosis d)Histoplasmosis CorrectAnswer-BAnswer:B-CatscratchdiseaseBacterialinfectioncausesbyBartonellahenselaeAcquiredinfectedcat/kittenscratchHistology:Characterizedbygranulomatousinflammationoflymphnodes.SkinlesiondemonstratesacircumscribedfocusofnecrosisRegionallymphnodesdemonstratefollicularhyperplasiawithcentralstellatenecrosiswithneutrophils,surroundedbypalisadinghistiocytes(suppurativegranulomas)&sinusespackedwithmonocytoidBcells,usuallywithoutperifollicularandintrafollicularepithelioidcells.
599.Whichbestexplains"Flippingeffect"? a)LDH1>LDH2 b)LDH2>LDH1 c)LDH2>LDH3 d)LDH3>LDH2 CorrectAnswer-AAnswer:A-LDH1>LDH2Lactatedehydrogenase,tetramericenzymewith4subunits,4Subunitswith2isoforms-Hisoform(Heart)&Misoform(Muscle)Heart&RBCs-LDH-1(4H);Reticuloendothelialsystem-LDH-2(3H1M)Lungs-LDH-3(2H2M)Kidneys,placenta,&pancreas-LDH-4(1H3M)Liver&striatedmuscle-LDH-5(4M)Uses:LDHlevelsaremoreinRBCHelpfulinassessmentofHemolysis/TissuebreakdownFlippingeffect:UsuallyLDH2inpredominantinserum&LDH1ispredominantinheartHigherlevelsofLDH1thanLDH2(Flippedpattern)issuggestiveofmyocardialinfarctionDamagedcardiactissuesreleaseLDH1intobloodstream.
600.Nudemiceisnotresistanttoxenograft duetoabsenceof a)Bcell b)Tcell c)Bothbandtcell d)None CorrectAnswer-BAnswer:B-TcellNudemicelacks"Thymus"&cannotgeneratematureTlymphocytes.AbsenceofT-lymphocytesmakesitunabletomountadaptiveimmuneresponsesrequiringCD4,helperTcells,CD8andcytotoxicTcells.Adaptiveimmuneresponsesthatremainunresponsivetonudemiceinclude:Antibodyformation(CD4+helperTcells)Cell-mediatedimmuneresponses(CD4+and/orCD8+Tcells)Delayed-typehypersensitivityresponses(CD4+Tcells)Killingofvirus-infectedormalignantcells(CD8+cytotoxicTcells)Graftrejection(bothCD4+&CD8+Tcells)Uses:Laboratorystudyanimal-Insightsintoimmunesystem,leukemia,solidtumors,AIDS&otherimmunedeficiencydiseases.AbsenceoffunctioningTcellspreventsthemrejectingtheallografts&Xenografts.
601.Anaplasiais a)Changingonetypeofepitheliumtoanother b)Nuclearchromatin c)Lackofdifferentiation d)Morphologicalchanges CorrectAnswer-CAnswer:C-LackofdifferentiationReferstoalackofdifferentiationinneoplasticcells.Well-differentiatedtumorsresembletheirtissueoforiginPoorly-differentiatedorundifferentiated(anaplastic)tumorcellsappearprimitiveandlackspecializationalonganyparticularcellline.
602.Whichlevelofprolactindefinitely suggestprolactinoma? a)300ng/ml b)150ng/ml c)200ng/ml d)100ng/ml CorrectAnswer-CAnswer:C-200ng/mlProlactinomasarethemostcommontypeofhyperfunctioningpituitaryadenoma.Benigntumorsofpituitaryglandproducingprolactin.Hyperprolactinemiacausesamenorrhea,galactorrhea,lossoflibido,andinfertility.Becausemanymanifestationsofhyperprolactinemia(e.g.,amenorrhea)aremoreobviousinpremenopausalwomenthaninmenorpostmenopausalwomen,prolactinomasusuallyarediagnosedatanearlierstageinwomenofreproductiveagethaninotherpersonssoaffected.Higherbloodprolactinconcentrationsareseen.mildelevationsofserumprolactin(lessthan200g/L)inapatientwithapituitaryadenomadonotnecessarilyindicateaprolactin-secretingneoplasm.
603.Laxativeabusecauseswhichofthe followingrenalstones? a)Uricacid b)Ammoniumurate c)Struvite d)Caoxalate CorrectAnswer-BAnswer:B-AmmoniumurateBasedonthechemicalnaturetwotypesofkidneystones:Calciumoxalate(majority).OthersincludeUricacid,Struvite(Infectedstones),andCystinestones(rarehereditarymetabolicdisorderCharacteristicstoneformationinlaxativeabuse:Laxativeabuseactsafactorinkidneystoneformation.LaxativeabusecausespotassiumlossAsacompensationmechanismkidneyproduceslargeamountofammonium.Resultinginformationofuncommonstonetype-ammoniumacidurate.
604.Whichofthefollowingcanresultin dactylitis a)Hemophilia b)Vonwillebranddisease1 c)Measles d)SickleCellAnemia CorrectAnswer-DAnswer:D-SickleCellAnemiaDactylitis(Hand-FootSyndrome)isseeninsicklecellanemiaSeverepainaffectingthebonesofhands,feet,orboth.Often1stsymptomofsicklecellanemiainbabies.
605.Whichchromosomeisresponsiblefor theproductionofMIF? a)Chromosome16 b)Chromosome22 c)XChromosome d)Ychromosome CorrectAnswer-DAnswer:D-YChromosomeAnti-MullerianHormone(AMH)/MullerianInhibitingFactor(MIF);Mullerian-inhibitingHormone(MIH)/Mullerian-inhibitingSubstance(MIS).AMH-DownstreamgenesregulatedbySRYpathwaySRY-Genein"Sexdeterminingregion"-shortarmofYchromosome-Testisdeterminingfactor.SecretedbySertolicellsofthetestes.TheproductionofAMHiscontrolledbytwoautosomalgeneloci.HormonecodeReceptorcode.GlycoproteinhormoneRelatedtoinhibin&activinMemberofthetransforminggrowthfactor-(TGF-)Keyrolesareingrowthdifferentiationandfolliculogenesis.
606.WhichofthefollowingconditionisNOT causedbyParvovirusB19? a)Roseolainfantum b)Aplasticanemiainsicklecelldisease c)Fetalhydrops d)Erythemainfectiosum CorrectAnswer-AAnswer:A.RoseolainfantumPrimaryinfectionbyparvovirusB19oftenproducesanacute,severe,andsometimesfatalanemiamanifestedasarapidfallinredbloodcellcountandhemoglobin.Thesepatientsmaypresentinitiallywithnoclinicalsymptomsotherthanfever;thisiscommonlyreferredtoasaplasticcrisis.Erythemainfectiosum(alsoreferredtoasfifthdiseaseoracademyrash)isamorecommondiseasethatisclearlyattributabletoparvovirusB19.ActivetransplacentaltransmissionofparvovirusB19canoccurduringprimaryinfectionsinthefirst20weeksofpregnancy,sometimesresultinginstillbirthoffetusesthatareprofoundlyanemic.Theprogresscanbesoseverethathypoxicdamagetotheheart,liver,andothertissuesleadstoextensiveedema(hydropsfetalis).
607.Whichistrueregardingataxia telangiectasia: a)IncreaseinAFP b)Increasestheriskofsquamouscellcarcinoma c)Autosomaldominant d)Noneofabove CorrectAnswer-AAnswer:A-IncreaseinAFPIncreaseinalpha-fetoproteinisobservedinAtaxiatelangiectasiaAtaxia-telangiectasia/Ataxia-telangiectasiasyndrome/Louis-BarsyndromeRare,neurodegenerative,autosomalrecessivedisordercausingseveredisability.Ataxiareferstopoorcoordination;Telangiectasiareferstosmalldilatedbloodvessels.Partsaffected:Cerebellum-movement&coordinationdifficultiesImmunesystem-Predisposingtoinfections.Geneticrepairsystem-PreventingprocessforrepairingDNA-CancerriskFeatures:Increasedincidenceoflymphoma&LeukemiaIncreasedalpha-FetoproteinlevelsOculomotorapraxia(difficultyincoordinationbetweenhead&eyemovements)Dysarthria
608.Termpathologyrefersto: a)Work b)Function c)Details d)Explains CorrectAnswer-AAns.A.WorkPathologyisthemedicaltermforthewayadiseaseworks.Thescienceofthecausesandeffectsofdiseases,especiallythebranchofmedicinethatdealswiththelaboratoryexaminationofsamplesofbodytissuefordiagnosticorforensicpurposes.
609.Leidenthrombophiliaiscausedby mutationaldeficiencyofwhichofthefollowingfactors? a)FactorV b)FactorVII c)FactorIX d)FactorX CorrectAnswer-AAns.A.FactorVFactorVLeidenthrombophiliaisaninheriteddisorderofbloodclotting.FactorVLeidenisthenameofaspecificmutation(geneticalteration)thatresultsinthrombophilia,oranincreasedtendencytoformabnormalbloodclotsinbloodvessels.FactorVLeidenisthemostcommoninheritedformofthrombophilia.
610.Aboypresentedwithmultiplenon suppurativeosteomyelitiswithsicklecellanaemia.Whatwillbethecausativeorganism? a)Salmonella b)S.aureus c)H.influenzae d)Enterobacterspecies CorrectAnswer-AAns.A.SalmonellaFollowingarethevariousmicro-organisminvolvedinosteomyelitis Agegroup Mostcommonorganisms Newborns(younger S.aureus,Enterobacterspecies,andgroupAthan4mo) andBStreptococcusspecies Children(aged4mo S.aureus,groupAStreptococcusspecies,to4y) Haemophilusinfluenzae,andEnterobacterspecies Children, S.aureus(80%),groupAStreptococcus adolescents(aged4 species,H.influenzae,andEnterobacterytoadult) species Adult S.aureusandoccasionallyEnterobacterorStreptococcusspecies Sicklecellanemia Salmonellaspeciesaremostcommonin patients patientswithsicklecelldisease
611.Positiveacidschiffmacrophagesseenin ? a)Whipplesdisease b)Crohnsdisease c)AIDS d)Noneoftheabove CorrectAnswer-AAnswer:A>Whipplesdisease.Thetraditionallaboratorydiagnosisisbasedonlightmicroscopy,whichshowsdiastase-resistant,periodicacid-Schiff(PAS)-positive,non-acid-fastgranulesin.....Thedistinctioncouldbemadebyacid-faststaining,whichispositiveforpatientsinfectedwithM.aviumandnegativeforthosewithWhipple'sdisease.
612.Whatisthecauseofmyocardialshock otherthanMI? a)acutemitralregurgitation b)ventricularseptalrupture c)isolatedrightventricularshock d)alloftheabove CorrectAnswer-DAnswer:D>AlloftheaboveLeftventriculardysfunction(LVD)-MostfrequentcauseofcardiogenicshockFollowedby,AcutemitralvalveregurgitationVentricularseptaldefectIsolatedrightventricularshockTamponade/cardiacrupture
613.WHICHISNOTCORRECT: a)MRIneededtoaccesshaemorrhage b)GCSassessmenthelpsinprognosis c)Haematomamustbeoperated d)alloftheabove CorrectAnswer-CAnswer-C.HaematomamustbeoperatedTreatmentofhematomadependsonthelocation,symptoms,andtheclinicalsituation.Somemayrequirenotreatmentatallwhileothersmaybedeemedamedicalemergency.Simpletherapiesathomemaybeutilizedintreatingsuperficial(undertheskin)hematomas.Mostinjuriesandbruisescanbetreatedwithresting,icing,compression,andelevatingthearea.ThisisrememberedbytheacronymRICE.Thesemeasuresusuallyhelptoreduceinflammationanddiminishitssymptoms.RestIce(Applytheiceorcoldpackfor20minutesatatime,4to8timesaday.)Compress(Compressioncanbeachievedbyusingelasticbandages.)Elevate(Elevationoftheinjuredareaabovetheleveloftheheartisrecommended.)MedicaltreatmentforahematomaForcertainsmallandsymptom-freehematomasnomedicaltreatmentmaybenecessary.Ontheotherhand,symptomatichematomasorthoselocatedincertainlocationssometimesrequiremedicalorsurgicaltreatment.
Eventhoughnospecificmediationisavailableforthetreatmentofhematomas,managementofanyrelatedsymptomscanbeachievedbymedications.Forexample,painfromahematomacanbetreatedwithpainmedicationssuchasacetaminophen(Tylenol).Surgicaldrainageisacommonmethodoftreatmentforcertainhematomas.
614.Genitalwartsarecausedbywhichvirus? a)Herpessimplex b)Humanpapilloma c)Cytomegalovirus d)Varicellazoster CorrectAnswer-BAns.B.HumanpapillomaGenitalwartsaresoftgrowthsthatappearonthegenitals.Genitalwartsareasexuallytransmittedinfection(STI)causedbycertainstrainsofthehumanpapillomavirus(HPV).Theseskingrowthscancausepain,discomfort,anditching.
615.Whichmetalresultsin"Saturninegout" formation? a)Cadmium b)Lead c)Beryllium d)Mercury CorrectAnswer-BAnswer:B.LeadOnemanifestationofchronicleadtoxicityistherheumatologicentityknownassaturninegout.Illicitlydistilledbeveragesmayinadvertentlycontainharmfultoxins,likemetalliclead.Leadhasbeenknowntoplayaroleinpurinemetabolism&renalinsufficiency
616.Reedsternbergcellsarefoundin a)Hodgkin'sdisease b)Sicklecellanaemia c)Thalassemia d)CML CorrectAnswer-AReedSternbergcellsareyouderivedfromBlymphocytes,classicallyconsideredcrippledgerminalcenterBcells,SeenagainstaseaofBcellswhichgivethetissueamoth-eatenappearance.Theyarelargeandareeithermultinucleatedorhaveabibbednucleus(thusresemblingan"owl'seye"appearance)withprominenteosinophilicinclusion-likenucleoli.TheyareCD30andCD15positive,usuallynegativeforCD20andCD45.ThepresenceofthesecellsisnecessaryforthediagnosisofHodgkin'slymphoma-theabsenceofReed-Sternbergcellshasveryhighnegativepredictivevalue.Theycanalsobefoundinreactivelymphadenopathy(suchasinfectiousmononucleosis,carbamazepineassociatedlymphadenopathy)andveryofteninothertypesofnon-Hodgkinlymphomas.
617.Markedbleedingisseeninwhichof followingconditions? a)VMAdisease b)HaemophiliaA c)HaemophiliaB d)ALL CorrectAnswer-DAnswer:D.ALLBleedingdisorderscanbeinheritedoracquired.Inheriteddisordersarepasseddownthroughgenetics.Acquireddisorderscandeveloporspontaneouslyoccurlaterinlife.Somebleedingdisorderscanresultinseverebleedingfollowinganaccidentorinjury.Inotherdisorders,heavybleedingcanhappensuddenlyandfornoreason.Therearenumerousdifferentbleedingdisorders,butthefollowingarethemostcommonones: HemophiliaAandBareconditionsthatoccurwhentherearelowlevelsofclottingfactorsinyourblood.Itcausesheavyorunusualbleedingintothejoints.Thoughhemophiliaisrare,itcanhavelife-threateningcomplications.FactorII,V,VII,X,orXIIdeficienciesarebleedingdisordersrelatedtobloodclottingproblemsorabnormalbleedingproblems.vonWillebrand'sdiseaseisthemostcommoninheritedbleedingdisorder.ItdevelopswhenthebloodlacksvonWillebrandfactor,whichhelpsthebloodtoclot.
618.Whichofthefollowingtrueregarding HemophiliaA a)SerumlevelsoffactorVIIIaredecreased b)DeficiencyoffactorIX c)PTincreased d)FITdecreased CorrectAnswer-AAnswer:A.SerumlevelsoffactorVIIIaredecreasedHemophiliaisanXlinkeddisorderofcoagulationcausedbythedeficiencyinacirculatingplasmaprotein.HemophiliaAiscausedbythedeficiencyoffactorVIII,andhemophiliaBiscausedbythedeficiencyoffactorIX.ItisPTTwhichisaffected(increased)andnotPT(unaffected).FactorVIIIisinvolvedintheintrinsicpathwaywhichismeasuredbyPTTandnotinextrinsicpathwaywhichismeasuredasPT.Bleedingisthecommonmanifestationofhemophiliaandthecommonbleedingmanifestationsarehemarthoses,hematomas,mucocutaneousbleeding,intracranialbleeding,hematuriaandpseudotumor.
619.Whichofthefollowingisseenin seropositiverheumatoidarthritis? a)Multiplejointsaffected b)Symmetricaljointsymptoms c)Jointpainandswelling d)All CorrectAnswer-DAnswer:D.AllPositiveforRheumatoidfactorinbloodisseropositivity.PatientswithpositiverheumatoidfactorusuallypresentwithsymptomslikeJointdeformities&disabilitySymmetricalinvolvementofjointsInflammationSwellingandpainfulinmultiplejoints,especiallyofhandsandfeet.Morningstiffness(shortterm)Developmentoffirmlumpsnearjoints-"Rheumatoidnodules"Deteriorationofbone&cartilage(X-rayfindings)
620.Whichofthefollowingisnotseenin Anteriormediastinum a)Thyroidtumour b)Thymoma c)Lymphoma d)Neurogenictumor CorrectAnswer-DAnswer:D.Neurogenictumor Theanteriormediastinumistheportionofthemediastinumanteriortothepericardiumandbelowthethoracicplane.Itformstheanteriorpartoftheinferiormediastinumcontainsthethymus,lymphnodes,andmaycontaintheportionsofaretrosternalthyroid.
MediastinalTumorsandOtherMasses Superior Anterior Posterior Middle Mediastinum Mediastinum Mediastinum Mediastinum Neurogenic Bronchogenic Lymphoma Thymoma tumors cyst Thymoma Teratoma Lymphoma Pericardialcyst Gastroenteric Thyroidlesions Lymphoma Lymphoma hernia Metastatic Thyroidlesions carcinomaParathyroid Parathyroid tumors tumors
621.Struvitestoneiscausedbywhichmetal? a)Magnesium b)Calcium c)sodium&potassium d)both(a)&(b) CorrectAnswer-AAns.A.MagnesiumStruvite,acrystallinesubstanceiscomposedofmagnesiumammoniumphosphate(MgNH4PO4?6H2O).Struviteurinarystoneshavealsobeenreferredtoas"infectionstones"and"triplephosphate"stones.Struvitestonescanbecausedbyalkalineurine,steroidtherapy,abnormalretentionofurine,aurinarytractinfection,oranotherdisorderoftheurinarytract.Therearefiveprimarytypesofcommonlyencounteredurinarystones,i.e.,calciumoxalate,calciumphosphate,magnesiumammoniumphosphate,uricacid,andcystine.
622.Whichofthefollowingstatementsabout Gravesdiseaseisfalse? a)Resultsinhyperthyroidism b)Autoimmunedisorder c)CommoninMale d)ReferredasToxicdiffusegoitre CorrectAnswer-CAns.C-CommoninmaleGraves'disease:AutoimmunesystemdisorderBothmenandwomengetaffected;Yet,10timesmorecommoninwomenthanmenAffectsyoungerwomen<40yearsResultsinoverproductionofthyroidhormones(hyperthyroidism).Signsandsymptoms:AnxietyIrritabilityHeatsensitivityIncreasedperspiration/warmandmoistskinWeightlossGoiter(Glandularenlargement)MenstrualcyclechangesErectiledysfunction/reducedlibidoGravesOphthalmopathy-Bulgingeyes-ExophthalmosGravesdermopathy-Thick,redskinonshins/topoffeet.Antibodyforgravesdisease-Thyrotropinreceptorantibody(TRAb)actsontheregulatorypituitaryhormoneinterferingthenormalsecretionofthyroxine.
TRAboverridesnormalregulationcausinganoverproductionofthyroidhormones(hyperthyroidism).
623.Whichofthefollowingisfalseabout Alzheimer'sdisease? a)Onein10peopleage65andolderhasAlzheimer'sdisease b)Alzheimer'sdiseaseiscurable c)Causedementia d)Alloftheabove CorrectAnswer-BAns.B.Alzheimer'sdiseaseiscurableAlzheimer'sdiseaseAlsocalled:seniledementia.Aprogressivediseasethatdestroysmemoryandotherimportantmentalfunctions.Memorylossandconfusionarethemainsymptoms.Currently,thereisnocureforAlzheimer's.Butdrugandnon-drugtreatmentsmayhelpwithbothcognitiveandbehavioralsymptoms.ThetreatmentsavailableforAlzheimer'sdonotsloworstoptheprogressionofthedisease,buttheymayhelpwiththesymptomsforatime.TherearethreecholinesteraseinhibitorstotreatAlzheimer's:Donepezil(Aricept)Rivastigmine(Exelon)Galantamine(Reminyl)Peoplemayexperience:Cognitive:mentaldecline,difficultythinkingandunderstanding,confusionintheeveninghours,delusion,disorientation,forgetfulness,makingthingsup,mentalconfusion,difficultyconcentrating,inabilitytocreatenewmemories,inabilitytodosimplemaths,orinabilitytorecognisecommonthingsBehavioural:aggression,agitation,difficultywithselfcare,
irritability,meaninglessrepetitionofownwords,personalitychanges,restlessness,lackofrestraint,orwanderingandgettinglostMood:anger,apathy,generaldiscontent,loneliness,ormoodswingsPsychological:depression,hallucination,orparanoiaAlsocommon:behavioralsymptoms,inabilitytocombinemusclemovements,jumbledspeech,orlossofappetite
624.WhichisnotincludedinAIDSrelated complex? a)Ectopicpregnancy b)Recurrentgenitalcandidiasis c)Generalisedlymphadenopathy d)Chronicdiarrhea CorrectAnswer-AAnswer-A.EctopicpregnancyHIVsymptoms:AIDSrelatedcomplex(ARC)ItbelongstoclassBofHIVsymptoms.ThepatientsatthisstagehavevariousdiseasesthatoccurbecausetheHIvirushasweakenedtheimmunesystem.ThefollowingHIVsignsmayhavepatientswithARC:Long-lastingdiarrhea(overfourweeks)UnintendedheavyweightlossLonglastingfeverNightsweatsBacterialinfectionscausedbybacteriaBacterialbloodpoisoning(sepsis)PhthisisHerpeszosterOralhairyleukoplakia(whitishchangesonthelateraltongueborder)FungicausedbyfungiHIVsymptoms?Women:vaginalinflammationcausedbyfungi,malignantchangesinthecervix
625.Whichofthefollowingaretheriskfactor forcutaneouslymphoma? a)Age b)Gender c)Weakenedimmunesystem d)All CorrectAnswer-DAnswer:D.AllRiskFactorsforLymphomaoftheSkinAgeAgeisanimportantriskfactorforthisdisease,withmostcasesoccurringinpeopleintheir50sand60s.Butsometypesofskinlymphomacanappearinyoungerpeople,eveninchildren.GenderandraceMost(butnotall)typesofskinlymphomaaremorecommoninmenthaninwomen.MostalsotendtobemorecommoninAfrican-Americansthaninwhites.Thereasonsforthisarenotknown.WeakenedimmunesystemSkinlymphomasmaybemorecommoninpeoplewithacquiredimmunodeficiencysyndrome(AIDS),whohaveaweakenedimmunesystem.Theymayalsobemorecommoninpeoplewhohavehadanorgantransplantsuchasaheart,kidneyorlivertransplant.Thesepeoplemusttakedrugsthatsuppresstheirimmunesystem,whichmayraisetheriskofskinlymphoma(orlymphomasinotherpartsofthebody).InfectionsInfectionwiththehumanimmunodeficiencyvirus(HIV),thevirusthatcausesAIDS,mayincreaseaperson'sriskofskinlymphoma.
626.A30-year-oldmalecamewithcomplaints ofswellingaroundthekneejoint.Histopathologicalexaminationoftheswellingdemonstratedmanygiantcellsinterspersedwithmononuclearcells.Whatistheprobablediagnosis a)Osteosarcoma b)Ewing'ssarcoma c)Giantcelltumour d)Chondrosarcoma CorrectAnswer-CCorrectans:CGCTsarelargeandred-brownandoftenshowcysticdegeneration.Theyarecomposedofuniformovalmononuclearcellsandscatteredosteoclast-typegiantcellscontaining100ormorenuclei.Mitoticfiguresaretypicallyfrequent.Necrosis,hemorrhage,andreactiveboneformationalsoarecommonlypresent.RefRobbin'sbasicsofpathology9theditionpageno.781
627.30yearsoldcamewithcomplaintsof easyfatigability,exertionaldyspnea,andweightloss.Shealsocomplainsoffrequentfalls.physicalexaminationrevealedtherewasabilateraldecreaseinvibrationsense.Herhemoglobinlevelswere8.2g%.Shewastreatedwithfolate.Heranemiaimprovedbutneurologicalsymptomsworsened.Whichofthefollowingisthemostprobablereasonforhercondition? a)Folatenotabsorbed b)Unmaskedpyridoxinedeficiency c)DeficiencyoffolatereductaseinCNS d)FolatetherapycausedrapiduseofVitB12storesaggravating symptoms CorrectAnswer-DAns:D.FolatetherapycausedrapiduseofVitB12storesaggravatingsymptomsVitaminB12isrequiredfortherecyclingoftetrahydrofolate,theformoffolatethatisneededforDNAsynthesis.Inkeepingwiththisrelationship,theanemiaofvitaminB12deficiencyisreversedwiththeadministrationoffolate.Bycontrast,folateadministrationdoesnotpreventandmay,infact,worsenthe
neurologicsymptoms
628.A30-year-oldwomanpresentswith thyroidswelling.Oninvestigations,herTSHlevelsarefoundtobeelevated.Postoperativereportsshowedlymphocyticinfiltrationandhurthlecells.Amostprobablediagnosisis? a)Gravesdisease b)Hashimoto'sthyroiditis c)Follicularcarcinoma d)Medullarycarcinomathyroid CorrectAnswer-BAns:B.Hashimoto'sthyroiditisHashimotothyroiditisisthemostcommoncauseofhypothyroidismwhichischaracterizedbygradualthyroidfailuresecondarytotheautoimmunedestructionofthethyroidgland.Itismostprevalentbetweentheagesof45and65yearsandismorecommoninwomenthaninmen,ultimatelyleadingtoavaryingdegreeoffibrosisandthyroidenlargement.ThethyroidusuallyisdiffuselyandsymmetricallyenlargedThecutsurfaceispaleandgray-taninappearance,andthetissueisfirmandsomewhatfriable.Microscopicexaminationrevealsthewidespreadinfiltrationoftheparenchymabyamononuclearinflammatoryinfiltratecontainingsmalllymphocytes,plasmacells,andwell-developedgerminalcenters.Thethyroidfolliclesareatrophicandarelinedinmanyareasby
epithelialcellsdistinguishedbythepresenceofabundanteosinophilic,granularcytoplasm,termedHurthle,oroxyphilcells.
629.Whichofthefollowingwillbeseenon cardiacbiopsyofapatientwhohadapostMIreperfusioninjury? a)Wavinessoffibres b)Eosinophiliccontractionbands c)Neutrophilsincardiaccells d)Swellingofcells CorrectAnswer-BAns:B.EosinophiliccontractionbandsMicroscopically,irreversiblydamagedmyocytessubjecttoreperfusionshowcontractionbandnecrosis;Inthispathologicprocess,intenseeosinophilicbandsofhypercontractedsarcomeresarecreatedbyaninfluxofcalciumacrossplasmamembranesthatenhancesactin-myosininteractions.
630.Lossoffootprocessisclassicalincase of? a)Membranousglomerulitis b)Segmentalglomerulosclerosis c)IgAnephropathy d)Diabeticnephropathy CorrectAnswer-BAns:B.SegmentalglomerulosclerosisFocalsegmentalglomerulosclerosis(FSGS)ischaracterizedbysclerosis,hyalinosis,adhesions/synechiaeformation,resultinginsegmentalobliterationofglomerularcapillaries.OnEM,footprocesseffacementisthepredominantfindingwithoutsignificantbasementmembraneabnormalities.ImmunofluorescenceshowsstainingforIgMandC3inscleroticareas.Juxtamedullarynephronsareaffectedfirstandhenceinadequatesamplingmaymissfocallesions.https://www.ncbi.nlm.nih.gov/books/NBK532272/
631.Whichofthefollowingfactorsplaya majorroleintheinitiationofthrombusformation? a)Vasoconstriction b)Coagulationcascadeactivation c)Plateletsactivation d)Endothelialinjury CorrectAnswer-DAns:D.EndothelialinjuryThethreeprimaryabnormalitiesthatleadtothrombusformation(calledVirchow'striad)are(1)endothelialinjury,(2)stasisorturbulentbloodflow,and(3)hypercoagulabilityoftheblood.Ref:robbins9theditionchapter4
632.A33-year-oldmanpresentswitha5- weekhistoryofcalfpain,swelling,andlow-gradefever.Serumlevelsofcreatininekinaseareelevated.Amusclebiopsyrevealsnumerouseosinophilsalsoshehadperipheralbloodeosinophilia.Whichofthefollowinginterleukinsisprimarilyresponsiblefortheincreaseineosinophilsinthispatient? a)IL2 b)IL4 c)IL1 d)IL6 CorrectAnswer-BAns:B.IL4
633.Whichofthefollowingistrueabout PAN? a)Microscopyshowsfibrinoidnecrosisinlargearteries b)ANCAispositive c)30%ofpeoplehaveHbsAgpositive d)Patienthavehypogammaglobulinemia CorrectAnswer-CAns:C.30%ofpeoplehaveHbsAgpositivePolyarteritisnodosa(PAN)isanecrotizingvasculitisinvolvingsmallandmedium-sizedmusculararteriesofmultipleorgansandtissues.Thediseaseoccursmorecommonlyinadultmalesthanfemales.Mostcommonlyaffectedorgans,indescendingorderoffrequencyofinvolvement,arethekidneys,heart,gastrointestinaltract,kidneys,andmuscle.Theconditionresultsfromimmunologicresponsetoanidentifiableantigenthatmaybebacteria(e.g.streptococci,staphylococci,mycobacteria),viruses(e.g.hepatitisBvirus,influenzavirus,CMV),malarialparasite,certaindrugs,andchemicals.ThereisnoassociationwithANCA,[7]butabout30%ofpeoplewithPANhavechronichepatitisBanddepositscontainingHBsAg-HBsAbcomplexesinaffectedbloodvessels,indicatinganimmunecomplex-mediatedcauseinthatsubset.InfectionwiththeHepatitisCvirusandHIVareoccasionallydiscoveredinpeopleaffectedbyPAN.Leukocytoclasticvasculitis,characterizedbyfibrinoidnecrosiswithneutrophilicinfiltrateinthevesselwall.Manyoftheneutrophilsarefragmented.Thisformisfoundinvasculitiscausedbydepositsofimmunecomplexes.
634.A23-year-oldmalepresentedwitha historyoffatigueandtiredness.Oninvestigation,hewasfoundtohaveHbvaluesof9gm%,MCVof101FL.peripheralsmearexaminationshowedmicrocyticRBCandhypersegmentedneutrophils.Whichismostprobableetiology a)Leadpoisoning b)Irondeficiencyanemia c)Chronicalcoholism d)Hemolyticanemia CorrectAnswer-AAns:A.LeadpoisoningFindingsMicrocyticAnemia-IronDeficiencyHypersegmentedNeutrophils-B12andFolicAcidDeficiencyYoung&NoH/oOfAlcoholConsumption[PatientcamewithahistoryofFatigueandTiredness]-ChronicAlcoholismcanberuledoutHemolyticAnemia-maydemonstrateredbloodcellfragmentscalledschistocytes,redbloodcellsthatlooklikespheres(spherocytes),and/orredbloodcellsmissingsmallpieces(bitecells).Anincreasednumberofnewlymaderedbloodcells(reticulocytes)mayalsobeasignofbonemarrowcompensationforanemia.
anemia.SoMostProbableAnswerwouldbeLeadPoisoning[Tiredness&Fatigue]
635.Whatisthemainfeatureofchemotaxis asobservedinwhitebloodcells? a)Increasedrandommovementofneutrophils b)Increasedadhesivenesstointima c)Increasedphagocytosis d)Unidirectionallocomotionofneutrophils CorrectAnswer-DAns:D.UnidirectionallocomotionofneutrophilsChemotaxisisdefinedasaunidirectionalmovementofleukocytesuptoaconcentrationgradientofchemotacticmolecules.Allgranulocytes,monocytesandtoalesserextentlymphocytesrespondtochemotacticstimuliwithvaryingratesofspeed.Chemoattractantsareexogenousorendogenous.Exogenousagentsarebacterialproducts.Endogenousmediatorsare:ComponentsofcomplementpathwayC5aProductsoflipoxygenasepathwayLTB4Cytokinesparticularlythoseofchemokinefamilies.
636.Whichofthefollowinganticancerdrugs arecompetitiveinhibitorsoftyrosinekinase? a)Imatinibandsunitinib b)Letrozole c)Bicalutamide d)Fulvestrant CorrectAnswer-AAns.is'a'i.e.,ImatinibandsunitinibMoleculartargetedagentsTyrosinekinaseinhibitorsCompetitiveinhibitorsImatinib,Nilotinib,Sunitinib,Dasatinib,Erlotinib,Gefitinib,Lapatinib,Sorafenib(Rememberallendwith'nib').MonoclonalantibodiesCetuximab,panitumumab.HER2/neu(ERBB2)inhibitorsMonoclonalantibody-Trastuzumab.TargetedantibodyGemtuzumab(antiCD-33),Rituximab(anti-CD20),Alemtuzumab(antiCD-52).Vascularendothelialgrowthfactor(VEGF)inhibitorMonoclonalantibody-Bevacizumab.ProteosomeinhibitorsBortezomib.HistonedeacetylaseinhibitorVorinostatDNA-methyltransferaseinhibitor5-azacytidine,2-deoxy-5azacytidine.All-trans-retinoicacid.Biologicalresponsemodifier-RecombinantIL-2(aldesleukin,denileukin).
637.20yearsoldmanpresentedwiththe complaintofswellingofthewristforthelasttwoyears.histopathologicalexaminationshowedspindle-shapedcellsandverocaybodieswhatisthediagnosis? a)Lipoma b)Dermoidcyst c)Neurofibroma d)Schwannoma CorrectAnswer-DAns:D.Schwannomaspindlecellsandverocaybodiesareseeninschwannomaisatumorofthetissuethatcoversnerves,calledthenervesheath.ThesetumorsdevelopfromatypeofcellcalledaSchwanncell,whichgivesthemtheirname.Schwannomasareoftennotcancerous(benign).Themostcommontypeofschwannomaisvestibularschwannoma.Itaffectsthenerveresponsibleforbalance(alsocalledthevestibularnerve).Itcancauseinnereardeafnessbecausethehearingandbalancenerveruntogether,andasthetumorgrowsitdamagesthehearingnerve(cochlearnerve).Becauseofthisdoctorusedtocallthemacousticneuromas.Microscopically,thetumoriscomposedoffibrocellularbundlesformingthewhorledpattern.Thereareareasofdenseandcompactcellularity(AntoniA
pattern)alternatingwithlooseacellularareas(AntoniBpattern).AreasofAntoniApatternshowpalisadednucleicalledVerocaybodies.Nervefibersareusuallyfoundstretchedoverthecapsulebutnotwithinthetumor.Areasofdegenerationcontainhaemosiderinandlipid-ladenmacrophages.SchwanncellscharacteristicallyexpressS-100protein.Aschwannomararelyeverbecomesmalignant.
This post was last modified on 23 November 2021