Solve Pathology INICET 2022 1. A 15-year-old boy presents with swelling in the upper diaphyseal part of the tibia. X-ray of the swelling showed a periosteal reaction. A histopathological image of the biopsy is given below. Immunohistochemistry was positive for synaptophysin and mic 2. What is the likely diagnosis? Osteosarcoma Metastatic neuroblastoma Ewing sarcoma Osteoclastoma None 2. The image below is indicative of which of the following tumors? Dysgerminoma Yolk sac tumor Krukenberg tumor Granulosa cell tumour None 3. In a patient with the bare lymphocytic disease, graft vs host reaction does not occur due to the MHC class II deficiency on lymphocytes MHC class I deficiency in lymphocytes Deficiency of CD4 T lymphocytes Complement deficiency None 4. Which of the following is a marker of the natural killer cell? CD 3 CD 68 CD 94 CD 25 None 5. A child presents with multiple skin lesions over the inner thigh and genital areas. It initially started as a macule and later developed to become nodules. Some nodules have central umbilication. The histology of the lesion is shown below. What would be found on biopsy? Henderson-Patterson bodies Donovan's bodies Koilocytes Multinucleate giant cells (Tzanck cells) None 6. Investigations of a patient being evaluated for leukemia revealed a WBC count of 4,50,000/μL, with eosinophilia and basophilia. What is the likely diagnosis in this case? Chronic myelogenous leukemia Chronic lymphocytic leukemia Acute lymphoblastic leukemia Acute myeloid leukemia None 7. Which of the following conditions is not caused by high-risk strains of human papillomavirus? Laryngeal papillomatosis Oropharyngeal cancer Cervical cancer Anal cancer None 8. Which of the following molecules helps the leukocytes roll over the endothelial cells in the vessels? E-selectin Cadherins Cd11a Platelet endothelial cell adhesion molecule-1 (PECAM-1) None 9. A boy presents with recurrent episodes of melena. On examination, there was eczema of the skin with multiple petechiae. His platelet count was low but RBC and WBC counts were within normal limits. Which of the following is the diagnostic investigation in this patient? Anti-platelet antibodies WASP gene mutation Electron microscopy Bone marrow biopsy None 10. Identify the given bone marrow biopsy instrument. Salah's needle Klima needle Jamshidi needle Islam needle None 11. Match the following stains and the tissue. 1-a, 2-b, 3-d, 4-c 1-b, 2-a, 3-c, 4-d 1-c, 2-a, 3-d, 4-b 1-d, 2-c, 3-b, 4-a None 12. Which of the following is not a part of innate immunity? B lymphocytes Alpha defensins Lectin pathway Gamma Delta T lymphocytes None 13. Which of the following statements are true about hereditary spherocytosis? Gallstones develop by 4-5 years of age. Splenectomy does not protect against developing gallstones. At least 25% of cases have a family history of HS. High MCH is the pathognomonic of HS. None 14. Which of the following disorders is inherited in an X-linked dominant pattern? Rett syndrome Tuberous sclerosis Huntington's disease Duchenne muscular dystrophy None 15. B cells express IgM and IgD antibodies at the same time due to which phenomenon? Somatic hypermutation Alternative RNA splicing Affinity maturation Allelic exclusion None 16. Cell-in-cell appearance is seen in: Entosis Necroptosis Apoptosis Necrosis None 17. Which of the following are true regarding sirtuins? They are one of the types of histone deacetylases. Promotes genes that increase longevity. Increases insulin sensitivity and thus glucose metabolism. They are 7 types. 1, 3 1, 2, 3 1, 2, 3, 4 2 None 18. Identify the cell marked in the image below Plasma cell Mast cell Macrophage Fibroblast None 19. Match the following cells with their locations. 1-d, 2-a, 3-d, 4-c 1-c, 2-d, 3-a, 4-b 1-a, 2-b, 3-c, 4-d 1-b, 2-a, 3-c, 4-d None 20. Which of the following cytokines is not involved in the Th1 response? IL-2 IFN gamma IL-12 IL-4 None 21. Match the malignancies in column A with the genes in column B 1-b, 2-d, 3-c, 4-a 1-d, 2-c, 3-b, 4-a 1-b, 2-c, 3-d, 4-a 1-c, 2-b, 3-d, 4-a None 22. A 19-year-old girl presents with a midline neck swelling that moves on deglutition. USG revealed a 2 cm x 2 cm nodule on the left lobe of the thyroid, extending into the strap muscles. The histopathology image is given below. What is the most likely diagnosis? Follicular CA thyroid Medullary CA thyroid Papillary CA thyroid Thyroglossal cyst None 23. How does phagolysosome cause cell death? Is both intra and extra-cellular Is a single membrane structure Can fuse with other organelles directly Fuses with a lysosome to form autophagolysosome None 24. A chronic smoker with a smoking history of 24 packs presents with breathlessness and chest pain. Further investigations revealed the presence of a lung tumor. On staining, cells are positive for chromogranin. What is the diagnosis? Squamous cell carcinoma Small cell carcinoma Large cell carcinoma Adenocarcinoma None 25. Which of the following features is not observed in pleomorphic adenoma? Perineural invasion. Keratin pearls Myoepithelial cells Chondroid differentiation None 26. Which of the following is true about proto-oncogenes? KIT has decreased expression via the tyrosine kinase signaling pathway in GIST. ERBB2 is over-expressed in association with breast carcinomas. PDGFR-B has suppressed expression in colorectal cancers. KRAS mutation is more commonly associated with small-cell lung cancer. 2 1,3 1,2,3 1,2,3,4 None 27. A 60-year-old woman presents with complaints of fatigue and dyspnea for 2 weeks. On examination, pallor was seen and hemoglobin was found to be 6 gm/dL. That finding will be seen on the peripheral smear? Target cell Microcytic hypochromic cells Poikilocytes Macrocytic cells None 28. The given peripheral smear is associated with which of the following leukemias? Acute lymphoblastic leukemia Acute myeloid leukemia Chronic lymphocytic leukemia Chronic myelogenous leukemia None 29. Which of the following statements are true about familial adenomatous polyposis? It is autosomal recessive. If not treated, 100% of the cases progress to the adenocarcinoma colon. It is associated with a gene mutation in KRAS. It is associated with congenital hypertrophy of the retinal pigment epithelium. 1 and 4 2 and 4 2 and 3 3 and 4 None 30. A patient suffering from cholelithiasis underwent cholecystectomy. The image of the specimen is shown below. Which of the following is the correct diagnosis? Gallbladder polyp Carcinoma gallbladder Strawberry gallbladder Cholesterolosis None 31. Which of the following shows maximum amplitude on thromboelastography? Platelet Extrinsic Intrinsic vWD None 32. A man presented with fever, night sweats, and weight loss for 2 months. On examination, non-tender, rubbery lymph nodes were palpable in the supraclavicular and inguinal regions on both sides. Peripheral smear showed the presence of bi-nucleated cells. Which markers will be seen in this condition? 1-CD3 2-CD30 3-CD19 4-CD15 1, 3 2, 4 1, 2 3, 4 None 33. Match the microscopic appearance in column A with the type of tumor in column B 1-c, 2-d, 3-a, 4-b 1-b, 2-d, 3-c, 4-a 1-b, 2-d, 3-a, 4-c 1-a, 2-d, 3-c, 4-b None 34. A 10-year-old boy presented with fatigue. Investigations revealed: Hemoglobin, 9 g/dL; MCV, 60 fL; MCH, 20 pg; and serum ferritin, 185 µg/L. The TLC was elevated and showed predominant lymphocytes and neutrophils. What is the likely diagnosis in this patient? Normal values: Serum Ferritin: 50-150 µg/L Mean cell volume (MCV) - 80-100 fL Mean cell Hb (MCH ) - 27-31 pg TLC - Total leukocyte count Iron deficiency anemia Sickle cell anemia Thalassemia Anemia of chronic disorder None 35. Blood transfusion requires screening of donor blood for all of the following infections except: Hepatitis C virus Hepatitis B virus Dengue Virus Human immunodeficiency virus None 36. Senile atrophy occurs due to Denervation Decreased workload Decreased nutrition Reduced blood supply None 37. The phenomenon of a differential effect of the same gene from different parents is called: Anticipation Genomic imprinting Gonadal mosaicism Incomplete penetrance None 38. Cyclooxygenase plays a role in which pathway? Prostaglandin Kreb's cycle Leukotriene Vitamin K None 39. Identify the true statement/s regarding clear cell carcinoma of the kidney Most common sporadic renal tumor Associated with loss of the long arm of chromosome 3 Arises from distal convoluted tubule Cells show intracellular accumulation of glycogen and fat 2, 3 1,3 1, 2, 4 1, 4 None 40. Metastatic calcification can be explained by all, except, Renal failure Accumulation of calcium phosphate Vitamin D deficiency Parathyroid activation/ secretion None 41. Neurosecretory bodies are seen in all except Pituitary adenoma Paraganglioma Medullary thyroid carcinoma Adrenal cortical tumor None 42. Match the cytokines with the effector cells. IL-4                A. Eosinophils IL-5                B. Mast cells IL-9                C. B cells IL-13               D. Dendritic cells 1-C; 2-A; 3-B; 4-D 1-D; 2-A; 3-C; 4-B 1-C; 2-B; 3-D; 4-A 1-D; 2-A; 3-B; 4-C None 43. All of the following are seen in anemia of chronic disease except: Low serum ferritin High serum hepcidin Chronic infection Normal iron stores None 44. The following is a histopathological image of thyroid pathology. What is the diagnosis? Papillary carcinoma of the thyroid Medullary carcinoma of the thyroid Anaplastic carcinoma of the thyroid Follicular carcinoma of the thyroid None 45. A pediatric patient is diagnosed with B cell leukemia. Which of the following are poor prognostic factors? t(9;22) t(4:11) Hyperdiploidy Age less than one year 1, 2, 3 2, 4 1, 2, 4 1, 3, 4 None 46. The Hb is 5g/dL and the absolute reticulocyte count percentage is 9%. What is the corrected reticulocyte count? 4.5 3 5 1.8 None 1 out of 46 Time's up
