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Download JIPMER 2020 June Pathology Discussion

Download JIPMER 2020 June Pathology Discussion

This post was last modified on 31 July 2021

DNB 2020 Dec Previous Question Papers-(Diplomate of National Board) Under NBE


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Autophagy:

  • Unregulated catabolic process
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  • Degradation of damaged proteins
  • Degradation of damaged proteins and organelles
  • Anabolic process

  • Chaperone-mediated autophagy (direct translocation across the lysosomal membrane by chaperone proteins)
  • Microautophagy (inward invagination of lysosomal membrane for delivery)
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  • Macroautophagy: major form : Involves sequestration and transportation of portions of cytosol in a double membrane bound autophagic vacuole (autophagosome)

  • Formation of an isolation membrane, also called phagophore, and its nucleation; the isolation membrane is believed to be derived from the ER
  • Elongation of the vesicle
  • Maturation of the autophagosome, its fusion with lysosomes, and eventual degradation of the contents

Cancer

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Neurodegenerative disorders: Alzhenmers and Huntingtons dis

Infections: mycobacteria, Shigella and HSV-1.

IBD


Pyrogenic mediators are all except?

IL 1

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IL 6

TGF ß

Ciliary Neurotropic factor


Not a cause for endometrial cancer

Infertility

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OCP

Tamoxifen


Patient with Reticulocyte elevated and features of hepatitis with reduced hb. C/o abnormal behavior and movements. MRI showed dense deposits in basal ganglia. Likely diagnosis ?

Autoimmune hepatitis

Wilsons

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Thalassemia


  • Autosomal recessive
  • Age: 6-40 years (average: 12 years)
  • Mutation of the ATP7B gene (Chr 13) leads to:
  • Impaired copper excretion into bile
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  • Failure to incorporate copper into ceruloplasmin.

Therapy: Copper chelation therapy (with D-penicillamine or Trientine) or zinc-based therapy (which blocks uptake of copper in the gut).

Stains


After one month of wound healing, type 3 is replaced with type 1 in the ratio?

1:6

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2:5

1:3

8:3


Type of necrosis seen in autopsy of post MI patient?

Fibrinoid Necrosis

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Coagulative Necrosis

Caseous Necrosis

Liquefactive Necrosis


Ig expressed on surface of B cells

G

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A

M

E


T cell dependent activation

  • First signal: Antigen binding to B-cell receptor
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  • Second signal: Costimulation by binding off CD40L of T cells with CD40 on B cells
  • Isotype switching (production of different classes of antibodies: IgG, IgA, IgE) and Affinity maturation (high affinity for the antigen) are seen.

T cell independent response

  • Weaker immune response
  • No memory cells are generated
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  • Only IgM antibody is produced
  • Immunity is short term

In kidney transplant, which is Fully reversible once established?

Acute

Acute on chronic

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Chronic

Hyperacute rejection



Steatorrhoea with acanthocytes?

Celiac disease

Whipples disease

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Tropical sprue

Abetalipoproteinemia


Infants

Failure to thrive, diarrhea, vomiting, and fat malabsorption.

P/S: Acanthocytes with associated hemolytic anemia, reticulocytosis, and raised bilirubin levels.

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Malabsorption of fat-soluble vitamins such as Vit A, D, E, and K results in the majority of the clinical manifestations.


Vit K deficiency: Raised INR and an increased risk of bleeding.

Vit E deficiency: Neuromuscular symptoms such as ataxia, muscle weakness, dysarthria, etc. usually manifest during the first or second decades of life.

Molecular genetic testing may be required to identify and confirm mutations in the MTTP gene in these individuals.


Mendelian type of inheritance seen in which disease?

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Downs with balanced translocation

Turner's with mosaicism

Huntington with trinucleotide repeats

Fragile X syndrome


Non-fluorescent is ?

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Giemsa

Calcoflour

Auromine

Acridine orange


26 yrs male with epiphysial bone tumor shows lytic lesion with chicken-wire calcification.

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Osteoblastoma

GCT

Chondroblastoma



Which condition has high reticulocyte count ?

A) Aplastic anemia

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B) Anemia of chronic disease

C) iron deficiency anaemia

D)hemolytic anemia


A 80 year old woman . Forgetfulness in daily activities. No seizures. Which of following is seen ?

Neurofibrillary tangles

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Microscopy

  • Plaques: Deposits of aggregated Aß peptides in the neuropil
  • Tangles:
    • Aggregates of the microtubule binding protein tau
    • Demonstrated by silver (Bielschowsky) staining
    • Found in cortical neurons
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  • Hirano bodies: Intracellular aggregates of actin.

Child with bilateral conjunctivitis. Fever since 5 days and skin peeling present. Diagnosis?

Kawasaki disease

HSP

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IgA nephropathy

Leptospirosis


A child with hereditary renal disease, hematuria, proteinuria with keratoconus with hearing loss diagnosis

Alports syndrome

IgA Nephropathy

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PSGN



Glomerular pathology indicated by

Dysmorphic RBC

Hyaline cast


Anti GQ 1b antibody not seen in:

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Miller Fisher syndrome

Birkerstaff brainstem encephalitis

Guillain Barre syndrome

Acute paresis of the ocular muscles.

Autoimmune disorder that causes eye muscle weakness.

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This antibody interacts with the peripheral nerve ganglioside, Gq1b.


Call exner body seen in :

Granulosa cell tumour

Yolk sac tumor

Teratoma

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Which eyelid tumor doesn't spread through lymphatic?

SCC

BCC

Sebaceous Ca

Malignant Melanoma

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Kleihauer-Betke test positive baby has Hepatosplenomegaly. Diagnosis?

Chronic fetomateral hemorrhage

Erythroblastosis foetalis

Spherocytosis

ABO incompatibilty

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A lady who had underwent radiotherapy few months back for breast cancer came with bleeding gums. There was low platelet low hb prolonged aptt, normal PT and past history of preterm gestation.

APLA

DIC

Radiation side effect

Hemophilia A

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Complete hydatiform mole. karyotype?

46,XX

69, XXY

69, XXX


GESTATIONAL TROPHOBLASTIC DISEASE: HYDATIDIFORM MOLE

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  • Associated with an increased risk of persistent trophoblastic disease (invasive mole) or choriocarcinoma
  • Characterized histologically by cystic swelling of the chorionic villi, accompanied by trophoblastic proliferation
  • Diagnosed during early pregnancy (average 9 weeks) by pelvic sonogram
  • Higher risk in teenagers and after 35 years age
  • HCG is markedly elevated
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  • Two types: Complete and partial

  • Results from fertilization of an egg that has lost its female chromosomes
  • Genetic material is completely paternally derived
  • Fetal tissues are not found
  • Microscopically:
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Chorionic villi are enlarged with central cavitation (cisterns)

Extensive trophoblastic proliferation


Sperm motility decreased in all except

Long drive

Running

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Abstinence

Smoking


Running a minimum mean distance of 108 km/week for 12 months

In particular, sperm motility peaked after one day abstinence in men with infertility problems, but overall sperm quality began to decline after two days of abstinence.

Among men with normal sperm, overall sperm quality peaked after seven days of abstinence and declined after 10 days

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Which of the following has least risk of cholangiocarcinoma

1. Primary biliary cirrhosis

2. Primary Sclerosing Cholangitis

3. Chloronchis sinensis infestation

4. Choledochal cyst

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A patient with road traffic accident came in shock. Multiple units transfused. False statement is

Such types of blood transfusion are related to metabloic complications.

Crystalloids can maintain hemodynamic stability

RBCs improve oxygen transport to tissue and increase hematocrit by 3%

Stored RBC has higher 2,3 DPG and shift to left

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ANCA positive and Lupus antibodies positive female and purple rash on face.

SLE

APLA

Sjogrens


VNTR full-form?

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Variable Number Tandem Repeats

VNTR is a location in a genome where a short nucleotide sequence is organized as a tandem repeat. These can be found on many chromosomes, and often show variations in length (number of repeats) among individuals.

RFLP genetic markers used in linkage analysis

Forensic crime investigations, via DNA fingerprinting and the CODIS database


Patient is in fever and shock. PT and PTTK both are elevated. FDP and D-dimer raised. Diagnosis?

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DIC

Aplastic anemia

  • Most sensitive test for DIC: Elevated fibrin degraded products (FDPs)
  • Most specific: D-dimer test

Cancer cachexia is associated with ?

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Increased oxygen utilisation

TNF alpha

Cancer cachexia is associated with:

  • Equal loss of both fat and lean muscle
  • Elevated basal metabolic rate
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  • Evidence of systemic inflammation (e.g., an increase in acute phase reactants

Gene mutation associated with Pheochromocytoma and Renal cell carcinoma is:

VHL

Ataxia Telangiectasia

Bloom syndrome

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AR

Short stature

Sun-sensitive, red rash that occurs primarily over the nose and cheeks

Mild immune deficiency with increased susceptibility to infections

Insulin resistance that resembles type 2 diabetes

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Increased susceptibility to many types of cancer, especially leukemia, lymphoma and gastrointestinal tract tumors.

Male infertillity



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