NEET-PG 2015 - Pathology PYQs Practice Questions

Q: Absence of the intrahepatic bile ducts leads to which syndrome?

Alagille Syndrome. ***Alagille Syndrome*** - Characterized by the **absence of intrahepatic bile ducts**, leading to cholestasis and liver dysfunction. - Often associated with **cardiac defects** and **skeletal abnormalities**, as well as distinct **facial features**. *Von Meyenburg Complexes* - Refers to **bile duct hamartomas**, which are developmental abnormalities but do not lead to complete absence of ducts. - Typically discovered incidentally and are not associated with syndromic presentations like Alagille syndrome. *Caroli Disease* - Involves **dilated intrahepatic bile ducts** [1] and does not result in their absence; thus, it leads to **recurrent cholangitis**. - More associated with **cysts** and can lead to biliary complications rather than complete duct loss. *Polycystic Liver Disease* - Characterized by the presence of multiple **cysts** in the liver, but the intrahepatic bile ducts are typically present. - It is often associated with **kidney cysts** and systemic manifestations, not the absence of bile ducts. [Practice more Pathology PYQs on OnCourse]

Q: Which of the following is the MOST SIGNIFICANT modifiable predisposing factor for arterial thrombosis?

Cigarette smoking. ***Cigarette smoking*** - **Cigarette smoking** is a major modifiable risk factor for **atherosclerosis** and arterial thrombosis, primarily by promoting endothelial dysfunction, inflammation, and hypercoagulability. [1] - It damages the **endothelium**, leading to plaque formation and increasing the risk of **thrombotic events** such as myocardial infarction and stroke. [1] *Antiphospholipid syndrome* - This is an **autoimmune disorder** causing recurrent arterial and venous thromboses, but it is not a modifiable lifestyle factor. - While it dramatically increases thrombosis risk, therapeutic management focuses on anticoagulation rather than lifestyle modification. *Hyperlipidemia* - **Hyperlipidemia**, particularly elevated LDL cholesterol, is a significant risk factor for **atherosclerosis**, which can lead to thrombosis. [1] - However, while modifiable through diet and medication, its immediate thrombotic impact is often mediated through chronic plaque formation, whereas smoking has more direct prothrombotic effects on endothelium and platelet function. *Homocystinuria* - This is a rare, inherited **metabolic disorder** causing elevated homocysteine levels, leading to severe premature atherosclerosis and **thrombotic disease**. - It is a genetic condition and therefore not a modifiable risk factor in the same way as lifestyle choices. [Practice more Pathology PYQs on OnCourse]

Q: Which of the following is not found in DiGeorge's syndrome?

Eczema. ***Eczema*** - **Eczema** is NOT a recognized feature of **DiGeorge syndrome** (22q11.2 deletion syndrome). - While individuals with immunodeficiencies may experience various skin conditions, eczema is specifically associated with conditions like **Hyper-IgE syndrome, Wiskott-Aldrich syndrome**, or atopic disorders, not DiGeorge's. - DiGeorge's follows the **CATCH-22 mnemonic**: Cardiac defects, Abnormal facies, Thymic hypoplasia, Cleft palate, Hypocalcemia, 22q11 deletion. *Tetany* - **Tetany IS found** in DiGeorge's syndrome due to **hypocalcemia** from parathyroid gland hypoplasia or aplasia. - The lack of parathyroid hormone leads to **low serum calcium levels**, resulting in increased neuromuscular excitability and tetany. *T cell lymphopenia* - **T-cell lymphopenia IS found** in DiGeorge's syndrome due to **thymic hypoplasia or aplasia**. - The primary immunological defect is **T-cell deficiency**, leading to increased susceptibility to viral, fungal, and intracellular bacterial infections. - B-cell numbers are typically normal, though antibody responses may be impaired due to lack of T-cell help. *Mucocutaneous candidiasis* - **This IS found** in patients with DiGeorge's syndrome as an opportunistic infection due to **T-cell immunodeficiency**. - The impaired **cellular immunity** makes individuals highly susceptible to fungal infections like *Candida albicans* affecting mucous membranes and skin. [Practice more Pathology PYQs on OnCourse]

Q: Gastric carcinoma is associated with all of the following EXCEPT:

Activation of RAS. ***Activation of RAS*** - **RAS mutations** are relatively uncommon in gastric carcinoma compared to other gastrointestinal malignancies. While KRAS mutations can occur in approximately 10-15% of gastric cancers (particularly intestinal type), they are **far less frequent** than in **pancreatic adenocarcinoma** (~90%) or **colorectal carcinoma** (~40%). - In the context of gastric carcinoma, RAS pathway alterations are **not considered a major oncogenic driver** compared to the other molecular changes listed, making this the **LEAST characteristically associated** alteration. *Inactivation of p53* - **Inactivation of the p53 tumor suppressor gene** is one of the most frequent molecular events in gastric carcinoma, occurring in approximately **50-60% of cases**. - Loss of p53 function leads to genomic instability, uncontrolled cell proliferation, and resistance to apoptosis, contributing significantly to **tumorigenesis** and **poor prognosis**. *Over expression of C-met* - **Overexpression of C-MET**, a receptor tyrosine kinase for hepatocyte growth factor (HGF), is commonly observed in gastric carcinoma (30-40% of cases) and is strongly linked to **tumor growth**, **invasion**, and **metastasis**. - C-MET amplification and overexpression promote cell proliferation, survival, migration, and angiogenesis, making it an important **therapeutic target** in advanced gastric cancer. *Over expression of C-erb* - **Overexpression of C-erbB-2 (HER2/neu)** is found in approximately **10-20% of gastric adenocarcinomas**, particularly the intestinal type. - HER2 amplification or overexpression is a significant **prognostic and predictive biomarker**, and is specifically targeted by **trastuzumab** (Herceptin) therapy in HER2-positive advanced gastric cancer, improving survival outcomes. [Practice more Pathology PYQs on OnCourse]

Q: Obliterative endarteritis in vasa vasorum is seen in -

Tertiary Syphilis. ***Tertiary Syphilis*** - **Obliterative endarteritis** of the **vasa vasorum** is a hallmark pathological finding in tertiary syphilis, particularly affecting the **aorta**. - This inflammation and occlusion of the small blood vessels supplying the aorta lead to **ischemic injury** of the aortic wall, causing **aneurysms** and **aortic regurgitation**. *Essential Hypertension* - While hypertension can lead to vascular changes like **arteriolosclerosis** and **hyperplastic arteriolosclerosis**, it does not typically involve obliterative endarteritis of the vasa vasorum. - The vascular damage in essential hypertension is more generalized to smaller arteries and arterioles, not specifically the vasa vasorum. *Systemic Lupus Erythematosus* - SLE is an **autoimmune disease** that can cause **vasculitis**, but the specific pattern of obliterative endarteritis of the vasa vasorum is not characteristic. - Vascular involvement in SLE is diverse, ranging from small vessel vasculitis to accelerated atherosclerosis, but distinct from syphilitic changes. *Pulmonary Tuberculosis* - Tuberculosis is primarily an **infectious granulomatous disease** affecting the lungs and other organs; it does not typically cause obliterative endarteritis of the vasa vasorum. - Although it can cause vascular complications like **aneurysms** (e.g., Rasmussen's aneurysm) due to erosion, the underlying mechanism is not the same as syphilitic changes. [Practice more Pathology PYQs on OnCourse]

Question 1

Absence of the intrahepatic bile ducts leads to which syndrome?

Accepted Answer

Alagille Syndrome

Answer

Polycystic Liver Disease

Answer

Caroli Disease

Answer

Von Meyenburg Complexes

Question 2

Which of the following is the MOST SIGNIFICANT modifiable predisposing factor for arterial thrombosis?

Accepted Answer

Cigarette smoking

Answer

Antiphospholipid syndrome

Answer

Hyperlipidemia

Answer

Homocystinuria

Question 3

Which of the following is not found in DiGeorge's syndrome?

Accepted Answer

Eczema

Answer

Tetany

Answer

T cell lymphopenia

Answer

Mucocutaneous candidiasis

Question 4

Gastric carcinoma is associated with all of the following EXCEPT:

Accepted Answer

Activation of RAS

Answer

Over expression of C-met

Answer

Inactivation of p53

Answer

Over expression of C-erb

Question 5

Obliterative endarteritis in vasa vasorum is seen in -

Accepted Answer

Tertiary Syphilis

Answer

Essential Hypertension

Answer

Systemic Lupus Erythematosus

Answer

Pulmonary Tuberculosis

Question 6

What type of necrosis is associated with Myocardial Infarction (MI)?

Accepted Answer

Coagulative necrosis

Answer

Liquefactive necrosis

Answer

Caseous necrosis

Answer

Fat necrosis

Question 7

Which of the following is a chromosomal instability syndrome?

Accepted Answer

Bloom syndrome

Answer

Fanconi anemia

Answer

Ataxia-telangiectasia

Answer

None of the options

Question 8

Which type of white blood cell plays a primary role in cardiac remodeling and chronic inflammation in heart failure?

Accepted Answer

Macrophages

Answer

Eosinophils

Answer

T cells

Answer

B cells

Question 9

Which protein is defective in dilated cardiomyopathy?

Accepted Answer

Dystrophin

Answer

Tropomyosin

Answer

Myosin

Answer

Troponin

Question 10

Osmotic fragility test is commonly used for which of the following conditions?

Accepted Answer

Hereditary spherocytosis

Answer

Megaloblastic anemia

Answer

Aplastic anemia

Answer

Iron deficiency anemia

NEET-PG 2015 — Pathology