Marathon Rapid Revision

of Pathology for INICET

by Dr Devesh Mishra
MBBS, MD , AIIMS
Telegram Instagram
channel
Q) An esophageal biopsy was taken from a patient with gastro esophageal reflux disease.
Which of the following is true about this biopsy specimen?
a) Squamous metaplasia and alcian blue positive at Ph 2.5.
b) Squamous metaplasia and alcian blue positive at Ph 7.5.x
c) Columnar metaplasia and alcian blue positive at Ph 2.5 X
d) Columnar metaplasia and alcian blue positive at Ph 7.5.X
san dime
 7

000
Q) Which of the following is true about irreversible cell injury :
a) Amorphous densities in the mitochondrial matrix. Rev Sirrey
.

b) Nuclear chromatin clumping. rew. Irres

c) Mitotic
X figures. Reu Irrev
d) Nuclear shrinkage Myelin Figure
.
Reversible injury
amorphous-densities .

small
I

(Rew) <largeirrer)

I
Reversible injury

· == - Fibrial grin
 Irreversible injury
↓

si -

7 I

I
Q) All of the following statements are true about necrosis except?
a) Cellular swelling will be there. v
b) Physiological X
c) Associated with cell membrane rupture. v
d) Inflammatory changes. ~
Q) In apoptosis, Apaf-1 is activated by release of which of
the following substances from the mitochondria?
a) BCL-2. Anti-Ap
= .

b) MCL-1./

c) BCL-XL.
~

d) Cytochrome C
↑
Q) Programmed cell death without caspase activation is :
a) Apoptosis.

*
b) Pyroptosis.
c) Necrosis.x
d) Necroptosis
 Apoptosis
GEg To
=

->
 MLKL :Mixed lineage kinase domain
like pseudokinase.
RIPK: Receptor Interacting Protein
Kinase

"of
varine New .
flugellatio
e
g
. .

Salmonella
Q) An 80 year old female has suffered with heart disease and cardiac atrophy. On
microscopy, perinuclear brown colored deposits were seen. Which of the following pigment
is responsible for this?
a) Hemosiderin. Y
b) Melanin. x
c) Lipofuschin
d) Calcium. -
 Befrie
-
00
Aging
Pig ⑧
.

> Oil Red O stain:

-
-
-

*
id Best-lipid-stain
↑

Iron

7 Perl’s Prussian blue staining:

Showing Ferric Iron Deposits as Bright
Blue.
Q) Regarding dystrophic calcification , which is not true?
a) Seen in metastatic lymph nodes.
b) Tissue is abnormal and calcium level is normal.
X
c) Tissue is normal and calcium level is abnormal x Metastatic
= Cal+

d) Seen in Atherosclerosis.
 1
-> Mice
Hyperbarathyroidism
.

LMCC
↑viri
-
P
.
Adenoma
RUitA
 ⑪ Alizarin Red stain showing
calcium as red deposit.

g
↑
Von Kossa stain showing I
calcium as black deposit.
Q) Which of the following is not true regarding aging ?
a) Telomere shortening is associated with aging. v
b) Free radical damage theory is most widely accepted theory of aging.
c) Sirtuin prolongs life span by increasing
X metabolism X overall metabolisml
d) Calorie restriction
X
will prolong life span.
Telomere and “Hayflick limit “
& Sirtuins:
• They are of 7 types.
• It's a type of histone deacetylase ( NAD
R Dependent deacetylases )

Calorie restriction
1 +
↑Insulin
sensitivity
,
->
Sirtuin
↑

↓
·I , ↑

↓ FR glucose metabolism
↓, Overall -

metab .
Q) Cell in Cell appearance is seen in :
a) Apoptosis. ↑
b) Emperipolesis. ofe
c) NET (Neutrophilic Extracellular trap). Y
d) Entosis
-

Il 11
(Cells are diff)

0
A
 I NET (Neutrophilic extracellular trap):
No
N • Formed during sepsis.
• Associated with bacteria infection.
• It is made up of Nuclear DNA ( not
Mitochondrial DNA)
I • It is chromatin with antibacterial enzymes.
i
Q) In cellular events of acute inflammation all are seen, except:
a) Complement involved in chemotaxis. -
7

b) ICAM-adhesion of leukocytes. - "

Es Leac
c) PECAM-activation of leukocytes I cytokines
.

d) Selectins-margination. ~
Y

I -
(4AFfining)
.
 -BR-

/
*
BMI
Q) Regarding Granulomas which of the following is not correct:
a) Interferon gamma is most important cytokine. -

b) Warthin finkeldey Giant cells are seen in measles -

falciparum
~

c) Durck’s Granuloma is seen in plasmodium vivax infection.X

X
.

d) Stellate granuloma is seen in cat scratch disease.

 Stellate Granuloma (Cat scratch
disease)
• “Stellate granuloma" or ”Stellate abscesses"
are characterized by:
a) Foci of necrosis surrounded by
b) Granulomatous inflammation with giant cells
• Seen in :
922

S
1) Cat scratch disease
Y 2) Lymphogranuloma venereum
 2
Durck granuloma (Fields's -en

stain):
-

⑨ Seen in cerebral malaria.

9
Blood vessels packed with rings of P. falciparum.
⑧00
-

=
Pigments .
A
Warthin finkeldey giant cells:
.

-
-

A
• Multinucleated giant cells.
• Seen in Measles.
• Eosinophilic viral inclusion bodies
>
-

(Both nuclear and cytoplasmic).

-
- -

• Atypical pneumonia : Hecht’s

Pneumonia
-
Q ) Which of the following is true about RNAi (RNA interference)?
a) Knocked in.
b) Knocked out."x gent. silencingRNA (NC)
-

c) Knocked down -
d) Deletion. X
Q) Identify this pattern of inheritance?
a) Autosomal recessive.
b) Autosomal dominant.
c) X linked dominant.
d) Mitochondrial inheritance
I -
Ubianity
I
-
Proteasome
I

Degrad .
Sturner-synd]
 R
&

P
R

Fi ⑮ 2
F2

Ez .

HS for chored
Hunting
=

NF-1
-
Rb
Q) A patient presented with growth failure and anemia, bone pain and
hepatosplenomegaly. Bone marrow aspirate finding is shown below in given. What
is the defect in this disorder ?
a) Glucocerebrosidase -
b) Hexosaminidase. ↑

c) Sphingomyelinase.
d) Alpha -1,4 glucosidase.
 Gaucher disease:
Gaucher cells ; macrophages

Oj
crumpled tissue paper due to
accumulation of glucocerebroside.
-

22 .
Cherry red spot in Macula Tay-Sachs disease Tay-Sachs disease
large neuron with lipid Membrane bound myelin figures
vacuolation
Cherry red spot in Macula Niemann-Pick Disease : Niemann-Pick Disease :
Numerous pale phagocytic cells Zebra bodies; distended
filled with fine confluent vacuoles lysosomes containing
(secondary lysosomes). lamellated figures.
 B) Pompe disease:
Myocardial fibres full of
glycogen seen as clear
spaces.

A) Normal myocardium:
with abundant eosinophilic cytoplasm.
Q) Karyotyping is done with all, except :
a) Blood lymphocyte
b) Blood monocyte
c) Amniotic fluid
x
d) Fetal tumor sample -
Steps of karyotyping &
Q) A karyotypic abnormality was found and shown below in given idiogram. Which of the
following is true regarding this condition ?
a) Translocation (13;21) is associated with advanced maternal age. 1
b) AML is most common leukemia in such patient X ALL-MC
.

c) VSD is most common cardiac defect X

d) Associated with APP gene. X
=
Mc<3yrs
 &
=>
Quadruble test
Q) A female patient presented with primary amenorrhea and clinical findings are given in
the Image. Most likely diagnosis will be:
a) Turner syndrome v
b) Down syndromeX
c) Klinefelter’s Syndrome MX
d) Cri Du chat syndrome X

2 R
-
 Cri Du Chat Syndrome (Partial
aneuploidy): 5p -

• ”Partial monosomy” is an imbalance of genetic

material caused by loss or gain of part of a
chromosome.
• Cri du chat syndrome is due to a partial deletion of
the short arm of chromosome 5, also called "5p
monosomy" or "partial monosomy."
Q) A 22-year-old male with gynecomastia and increased serum levels of follicle-stimulating
hormone was showing karyotype as shown below in given image . Which of the following is
not correct statement about this disorder?
a) High risk of Leukemia.
b) High risk of Male breast cancer.
c) High testosterone level X
d) High estrogen level. v

Riter
syn
 Klinefelter syndrome

Sparse facial hair, Gynecomastia and feminine

Sparse axillary hair
prognathism and short distribution of adipose tissue.
philtrum.
Q) CGH was performed on a patient, where his sample was labelled with red
fluorochrome and control was labelles with green fluorochrome. Microarray chip
obtained is given below. Which of the following is true regarding this?
a)Red : Deletion. X
b)Green: Amplification. X
c) Red: Duplication Y
-

d)Green : Duplication. I
Centina gene
-
 =
-
7 -

->
7 -

o
-

-
-
-

a
Q) PCR sequential arrangements is:
S

a) Denaturation, Elongation, Annealing

b) Annealing, Denaturation , Elongation
c) Denaturation, Annealing , Elongation.
-
-
-
->

d) Elongation, Denaturation, Annealing

-
~

Y
-

Tag I

NA-Polymeras
-
D
I
Q) Identify the cell stained with toluidine blue stain:
a) Macrophage
b) Basophil
c) Eosinophil
d) Mast cells.

Mast
Gr cells
.

=
.

↓
Q) Which of the following is not a part of innate Immunity :
a) STING pathway. =>
-

PRR
b) Lectin pathway.
c) Gamma Delta T lymphocytes. v

d) B lymphocytes
 Innate
immunity
= .

~ best

↳
Fagof

-> Viruses

↓
↑Metabolic products (Uric acdl
.

flagellin Ag .
102
• Ratio of T and B lymphocytes in
normal healthy individual = 4:1.
Q) Which of the following is not associated with Th1 cell?
A) IL 12.
-

B) IL 4 TH2
C) Interferon-gamma. W
D) TNF-alpha ~
Q) A patient was given penicillin injection for lung abscess treatment. His peripheral blood was showing
abnormal RBCs. There was no edema, facial flushing, and difficulty in breathing. Which of the following
mechanism is responsible for this hypersensitivity reaction?
a) IgE-MediatedX &HSR
b) Antibody mediated - AIHA= HER
c) Immune complex mediated. X GM/Strum Sickness
HSU .

d) Cell mediated. -> # HSR

Ans is d) IgE-Mediated
Q) Which of the following is most specific Antinuclear antibody for SLE is-
a) Anti-Sm antibody
b) Anti dsDNA-antibody. best
->

c) Anti centromere antibody. SCI (localised)

-> .

d) Anti histone antibody. (E)

(Drug-induced
Q) From the image depicted below, identify the type of ANA pattern:
a) Diffuse.
b) Speckled.
c) Centromeric ->localised Sal.

d) Nucleolar.
e
Q) Preformed antibodies are associated with:
a) Hyperacute Graft rejection
b) Acute Graft Rejection.
c) Chronic Graft Rejection.
d) Graft versus Host Disease.
Q) Which of the following genes is responsible for the regulation of T lymphocytes by the
11 11

thymus ?
a) Rb gene.
b) NOTCH. T-cell (BM)
->

c) AIRE
W

d) PAX-5. (B-cells) Bu
·
 Prevent Al (Mech) Central
organs
-> - .

Self-Ag

Entoreactive CellS .

Apoptosis .

=
Q) Familial amyloidotic polyneuropathy is due to amyloidosis of nerves
caused by deposition of
a) A Beta 2 microglobulin. ->
b) Mutant calcitonin. Medull Ra
Hemodialysis.

thyroid
.

c) Mutant transthyretin FAPV

d) Wild type transthyretin.
↓
(monmut]
·

Semile-cardiac A
.
.
 Thyroxine &
ind
-
- - - R
-

SCA
FAP
.
 R

I Congo red stain (PM):

Congo red stain (LM):
Apple green birefringence
Pink or Red colored
I
↑
Q) A two-year-old male child was admitted with recurrent bloody stools. On examination
he was having findings shown below in given images. TLC was normal with platelet count
of 20000/mm3. What will be next best step to confirm the diagnosis in this case:
a) Liver Function test. X
b) Bone marrow aspiration. X
c) Antiplatelet antibody assessment. X
d) Assessment of WASP gene Y
·
I

Eczema III
I Il Petechiae and
Purpura
Wiskolf
Aldrich
sy
Q) Which of the following is not an AIDS defining cancers?
a) Hodgkin's lymphoma
b) Non-Hodgkin's Lymphoma.v
c) Kaposi sarcoma.-
d) Invasive cancer of uterine cervix. ~
Q) A young patient was presenting with dyspnea and skin rashes after fracture of long bones. He was
admitted in emergency department and given ventilatory support for respiratory difficulties. Despite
of all supportive measures' patient succumbed to his condition. Lung postmortem examination has
revealed following findings on microscopic examination. Most likely diagnosis is ?
a) Surgical emphysema.X
b) ARDS.X
c) Amniotic fluid embolism. X
d) Fat embolism

I
fat

-
↑ Bi-cell
-
 x)
Anucleated
Squamily
n
whorls .
 11 11 -
Q) New mechanism of oncogenesis termed Oncometabolism is
associated with:
a) SHH. BCC/ Medulloblastoma
=> .

b)VHL. Clear-cellRC
=>
.

c) IDH
d)CDH-1.I
·

f Gastric
- Adca

·
Lobular ca
-
Cinactivated)
Q) Medullary carcinoma of Thyroid is due to mutation in which protooncogene?
a) RET protooncogene
b) C-KIT.
c) BRAF.
d) N-MYC.
 R

R
Q) E6 protein of human papilloma virus binds and inactivate following
protein to promotes carcinogenesis:
a) Tp53
b) RB.
c) BRAF.
d) N-Myc.
 ·

&

"
⑦ ⑦
2

-
If

&
• Recombinant HPV vaccine is based on viral
R
protein – L1 epitope (Major capsid protein).
Q) 5-Hydroxyindoleacetic acid (5-HIAA) in urine is suggestive of :
a) Medullary carcinoma of thyroid.
b) Seminoma.
c) Choriocarcinoma.
d) Carcinoid
Q ) A child has presented with proptosis and he was positive for Desmin. This marker is
related to which of the following malignancy:
a) Rhabdomyosarcoma #
b) Leiomyosarcoma. Sm - Vimentin
=>

c) Carcinoma. - spicn ->

Caytokeratio
- .

d) Neuroblastoma.

Teurofilament .
 Smootkur
=

↓
Leiomyosarcoma
:
 17 11
2
Q) All are true regarding Liquid biopsy, except :
a) Track tumours and mutations over a duration of time. -
b) Circulating tumor DNA are collected for diagnosis. ~
c) It analyzes tumor DNA by using next-generation sequencing (NGS) or PCR-
based methods.

/
d) Not- useful early tumor detection X
 11 1

(Early-deff
W
=
-
Q) Correct about Given vacutainer is ?
a) EDTA.
b) NaF.
c) Heparin
·

d) Clot activator.
Y
Ans is d) Clot activator
2xxx S

R
22
R
22
.

I
EDTA
=
Order of blood drawing vacutainers :
1) Yellow top - Blood Culture Tubes or Vials
(Sodium Polyanethol Sulfanate) (Aka
SPS)
2) Blue top - Coagulation Tubes (Sodium
citrate)
3) Red top - Serum Tubes without Clot
Activator or Gel
4) Gold or Tiger top - Serum Tubes with
Clot Activator or Gel.
5) Green top- Heparin Tubes ( Sodium
heparin or Lithium heparin)
6) Lavender top -EDTA Tubes
7) Gray top - Oxalate/Fluoride Tubes
Q ) During endothelial injury tissue factor was released to combine with which of the
following ?
a) Factor 7
-

b) Factor 8.
c) Factor 12.
d) VWF.
 Tissene factor
&
-

--
Q) Which of the following is utilized during mechanism of action of heparin like
molecules within endothelium :
a) Protein C.
b) Protein S.
c) Antithrombin III
d) Thrombomodulin.
Q) Storage temperature of RBC, Platelet, and Fresh Frozen Plasma
(FFP) are:
a) RBC 2-6 C, Platelet 20-22C, FFP -30 C -
b) RBC -30C, FFP 2-6 C, Platelet 20-22 C.
c) RBC 20-22 C, Platelet 2-6 C, FFP -30C.
d) RBC 20-22 C, FFP -10C, PLATELET 2-6 C.
Blood bag Storage temperature Shelf life
(Degree Celsius)
1) Whole blood 2 to 6 deg C 42 days
2) Packed RBC 2 to 6 deg C 42 days
3) Platelet Room temp (20 to 24 deg C) with 5 days
continuous agitation
4) FFP At -18 deg C or lower 1 year
5) Cryoprecipitate At -18 deg C or lower 1 year

Platelet agitator
222 982
I

&

Y
-

7
=
Q) Which of the following is not true in transfusion medicine:
a) Most common transfusion reaction is febrile non hemolytic transfusion reaction. T
b) Malaria can be transmitted by all blood products.
--

c) HIV-1 and HIV-2 both are screened in blood bank.

-

d) Most common cause of death in blood transfusion is TRALI ↳

TACO
Q) Massive blood transfusion will cause all except:
a) Hypercalcemia I
b) Hyperkalemia I
c) Hypokalaemia
d) Hypothermia I
-I
Q) Flow cytometry results are represented by :
a) Pie chart and dots.
b) Bar chart and Dots.
c) Line and Dots.
d) Histogram and Dots
 Y
Granulocytes

Side scatter (SC) Monocytes

Lymphocytes

X
Forward scatter (FSC)
 B

C1
C 1+ ; C 2- C 1+ ; C2+
⑬ -
CD19

C1-; C2- C 1- ; C2+

T

C2 CD 3-
 I
=>

= FC

CD54+CD55-
= -
N

E
&

I -
· CD55-
· 54 -
 S

B ALL 3
I

Terminal Deoxynucleotidyl Transferase (TdT) antibody is a

nuclear protein widely used as a marker for lymphoblastic -

leukemia.
Q) Identify the following bone marrow needle:
A) Jamshidi bone marrow biopsy needle.
B) Salah aspiration needle
-
-

C) Islams needle.
-

D) Klima needle.
 Bone Marrow Needles
Bone Marrow Aspiration Bone Marrow Biopsy (BMB)
(BMA) needles: needles:
Mnemonic : Aspirate S K I Mnemonic : Biopsy of Ja W
1) Salah and Klima needles (best) 1) Jamshidi needle (Best)
2) Islam Needle 2) Westerman-Jensen needle
Bone Marrow aspiration Needles
Islam’s needle
Salah needles Klima needles

• Klima Needle: Longitudinal screw (No side screw).

• Jamshidi needle: Long + has a handle on back + trocar.
• Salah’s Needle : Side screw.
Bone Marrow Biopsy (BMB) needles:

Jamshidi needle Westerman-Jensen Needle

Q) A malaria patient was given primaquine which has resulted in anemia. Peripheral blood was taken
and smear was seen as shown in below given image. All of the following are true about this
condition, except:
a) Heinz bodies are stained by crystal violet stain.
b) Favism can result this condition. -
↑

c) Bite cells are formed due to denatured globin. -

d) Females are commonly affectedX XLR
[M> f

Bite
Cell
=

I
HMP -

Pathway
+
EN15.

RBC

-
- -
 -
HB
Bite cells
~
.

distemont
Q ) Which of the following is not the presentation of PNH:
a) Haemolytic Anaemia v
b) Thrombosis- ·

c) Leukaemia. complication
d) Aplastic anemia
Q) Findings of a patients is given below. All are true about this anemia except:
a) Commonly due to Missense point mutation. T
b) Dactylitis is seen due to sequestration
X crisis F
c) Sodium dithionate is used for screening. I
d) Genetic sequencing is IOC. T
 -

Missense

HbA ↑

-
I

R
alt-Vaso-occlusive Crisis .
Investigation of choice for Sickle cell anemia and thalassemia
diagnosis is ::

“Globin gene sequencing by (PCR/NGS)”

Q) Which of the following is not a/w regulation of iron metabolism:
a) Hepcidin. Y
b) Hephaestin.
c) Transthyretin
d) Ceruloplasmin. EPrealbumin)
↑

↓
↓
 3

-
-

-
-

-
-
~Krist Es Sq . call
Q) All are reduced in Iron deficiency anemia EXCEPT:
a) T.I.B.C ↑
b) Percentage saturation of Transferrin.↓
c) Hepcidin.
,
d) Ferritin. ↓
 I - -

& I
I

-
Q ) A 60-Year-old female came with complaints of neurological deficits and showing Pallor on
general examination. Her peripheral blood smear finding is shown below. All are correct
about this anemia except?
a) Folate Deficiency and Vitamin B12 Deficiency is best differentiated by increased serum
Homocysteine F
↑

MMAR
b) Peripheral
· neuropathy is due to myelin damage in posterolateral tract of spinal cord.
c) Howell jolly bodies are seen. I
d) Can be seen in hypothyroidism. T

A
↓
Meg
-

↳
Megaloblastic Anemia (Vitamin B12
deficiency):

• Patchy and reversible skin

hyperpigmentation due to melanin
accumulation.
• Mainly affects knuckle pads and oral
mucosa.
-

Me A

I
.

E
> 2
[DNAJ
:
 * FA
44
=
R = S

↓
Adj

L
-

I ↑
S

A N
 tid
↑4

↑ T xi4
Q) All of the following are true about the cells given in the image shown below, except?
a) Associated with PAX-5 gene transcription factor. #
b) Associated with EBV interaction with CD21 receptor. T
⑧
c) Associated with CMV infection X
d) Cells are CD 15 and CD 30 positive. ④
 ↓

E
-
X
Q) A 15 year old boy presented with one day history of bleeding gums, subconjunctival bleed and
purpuric rash. Investigations revealed the following results: platelet 35,000 mm3; prothrombin time 25
↑

sec; partial thromboplastin time 50 sec. Peripheral smear is given below.Which of the following will be
chromosomal translocation in this leukemia? AMEM-3 =11
a) t (18, 21).
b) t (15, 17)
c) t (8, 21).
d) t (9, 11).

-
->
Q) A peripheral smear was taken from a 60-year-old male with deletion 13q and absolute lymphocyte
count of more than 5000/mm3. Peripheral smear is shown below. Which of the following is incorrect
statement.
a) IgG antibody can damage RBCs.⑰ Warm ATHA
b) Vimentin defect correlates severity.⑤
c) Persistently negative for CD 200
⑰
d) Flow cytometry is IOC. >X
↳
Smudge cells
-
 Y

~
-

(WHiD

dx <12
:

CD5+/(D23+/[D200+
↑
Q) A 56 years old male came with dragging sensation in abdomen and on examination there
was massive splenomegaly. Lab examination revealed high TLC, thrombocytosis. Peripheral
smear was showing myelocytes, metamyelocytes, promyelocytes, and band forms of CML
neutrophil as shown in below given image. Most likely it will have ? - -

a) t (9;22)
b) t (8;22).s BL
c) t (8;14).
-> I

d) t (14;18). FCL
-

↓
-

-- O
⑧
-

O
...
-
 - -
=

Blast
Crisis .
 Yo
·

3
 Maturen
- imm NO
-
-
.

so
-

00 0

Con
⑧
A

00
Q) Bone marrow aspirate of a patient is shown below in given image.
Most likely finding in this patient will be :
a) SOX-11 positive. > Mante cell L
b) t (14; 18). -> BCL-24 FCL
c) C-MYC translocation => +(b 14) BLI
:

d) BCR –ABL fusion gene. CML

=>

Burkitts
and
-

- Royal ·
Lymphoma .
6
 ⑧
- O
0
-
-

↳ ⑧
 -

↓
Ch-8
↓
translocat
[myc
Q) A 61-year-old man reports back pain for 5 months. He has no
mi
-

lymphadenopathy or splenomegaly. The serum creatinine level is high along -

- -

with bone lytic lesions and hypercalcemia. Bone marrow aspirate is shown
below. Which of the following is not correct about this condition?
A) Mott cells are with excess M protein in blue cluster of grape like pattern. I
B) Hyperdiploidy is most common cytogenetic change. T
C) Tennis racket appearance is characteristic F LCH

D) Beta-2 microglobulin is marker of tumour load.

&

emolt-cell
 s

~
⑪
↑

S
 MDE
I
->
any - I
I CRAB 4X
MM
 I
I
Tennis racket appearance of
Birkbeck granules (EM).
Tennis racket shaped structures of Birbeck
granules (electron microscopy). Seen in
Langerhans cells cytoplasm in histiocytosis x
(Langerhans cell histiocytosis).
Q) A truck driver suffering from pneumonia was showing lung histopathological
examination as shown in below given image. Most likely diagnosis is :
a) Mucor
b) Aspergillus.
c) Cryptococcus
d) TB
..
or -

Of Cryptococcal
⑧
Cryptoconsi
-

I
Crypto-
Q) A female after cold exposure developed following condition of finger tips as shown in the

HoHeary sm
image. What could be likely diagnosis ? .

a) Giant Cell Arteritis

b) Takayasu arteritis
c) Buerger’s Disease
d) Henoch Schonlein Purpura

000
 Thromboangiitis obliterans
- -

(TAO):
Segmental thrombosing
vasculitis with
& microabscess. E
0
⑧
Thrombi 7

--
-

Thromboangiitis obliterans
(TAO):
Necrosis of the distal part of
the fingers due to ischemic
damage. -
=> A X
+
+
M
 - A
by ⑦
~
-

goin
->
 I
0

↑ ↳
&

&

IgA Nephropathy
=>

& Ferrio X
 R

⑪
 Granulomatosis with
polyangiitis (formerly
Wegener granulomatosis):
Large area of necrosis has a
“geographical” pattern with serpiginous
borders and a basophilic center.

Granulomatosis with
polyangiitis:
(Wegener granulomatosis):
Chronic inflammatory cells and
giant cells including Langhans giant
cells.
Q) A 50 years old male patient has suffered Myocardial infarction and died. Autopsy was
performed and TTC (Triphenyl tetrazolium chloride) stain was applied gross specimen as
shown in given picture. Normal and viable cardiac tissue will appear:
a) Pale yellow.
b) White.
c) Red-

d) Brown.

-
↳ S
> Myoglobin
Q) A 30-year-old male patient presented with severe dyspnea on climbing staircase. On
echocardiography, it was showing mitral stenosis with left atrium hypertrophy. Histopathology
of vegetations from mitral valve is seen as given in below Image. All of the following
statements are true about this condition, except:
a) Anitschkow cells are diagnostic X
b) Caterpillar like nuclear chromatin is seen in Anitschkow cells.T
c) Aschoff's giant cell is diagnostic. I
d) Fish mouth mitral stenosis is due to fibrosis and calcification. T

As/
 j8 D
⑳
I -
*
&

+
108
S
Chronic RHD:
“Fish mouth" or “Buttonhole” shape d/t
fibrosis and calcification. (Mitral Valve
stenosis)
Q) A mother died after hearing the news of death of her son. Most
common type of cardiomyopathy associated in this patient is :
a) Hypertrophic cardiomyopathy. X
b) Dilated cardiomyopathy.
I
c) Restrictive cardiomyopathy.
d) Takostubo cardiomyopathy
gene-mut
Hypertrophic cardiomyopathy (HCM)
-
R

a XX
 -
-
DCM with Titin mutation:
E • Enlarged, bizarre, hyperchromatic nuclei (likened to “Ninja
stars”).
-

• Seen in patients with dilated cardiomyopathy caused by

titin-truncating mutations (TTN gene mutations)
Q) Match the correct answer:

A) Mesothelioma 71. Malignant pleural

effusion

B) Silicosis 2. Crazy Paving pattern

C) Caplan syndrome Y3. Coal worker
D) Asbestosis 4. Basal Lobe involved
7
Answer is ) A-1; B-2; C-3; D-4

• Crazy paving refers to the appearance of ground-glass opacity with superimposed

-

interlobular septal thickening and intralobular septal thickening, seen on chest HRCT.
• It is a non-specific finding that can be seen in a number of conditions.

• Crazy paving pattern may be seen in:

a) Pulmonary alveolar proteinosis
b) Lipoid pneumonia
c) Pneumocystis jiroveci pneumonia
d) Sarcoidosis
e) Nonspecific interstitial pneumonia
f) Silicosis
g) Cryptogenic organizing pneumonia
h) Adult respiratory distress syndrome
Caplan syndrome:

• Also known as Rheumatoid pneumoconiosis (RP).

• It is swelling (inflammation) and scarring of the lungs.

• It occurs in people with rheumatoid arthritis who have breathed in dust, such as from coal
-

(coal worker’s pneumoconiosis) or silica (Silicosis).

S
&
Q) A 45-year-old smoker presented with lung mass, and mass was biopsied. Histopathology
is shown in given Image. Which of the following will be true about this?
a) Napsin-A positive. Adza
.

b) P40 and P63 positive

c) Thyroid transcription factor-1 (TTF-1) positive. #d
d) Most common cause of superior vena cava syndrome. Small Cell

· KPO =

Sq .
< .
 -

Keratin
IH -

bearl
-
Inter
22114 law

bridging
 -

I 8
Pancoast tumors:
• Severe pain in the distribution of the ulnar nerve
and Horner syndrome (Anhidrosis, enophthalmos,
ptosis, and miosis ) on the same side as the lesion.
• Such tumors are also referred to as Pancoast
tumors.
• Squamous cell carcinoma is most
common cause of Pancoast tumours.
Superior Vena Cava syndrome (SVCS):
Symptoms includes:
• Cough, Face or neck swelling, Feeling of fullness in upper body, Swelling in
arms and hands, Shortness of breath (dyspnea).

• Small cell cancer is most common cause of

(Superior vena cava syndrome).
Q) A 42-year-old smoker male presented with lung mass, and mass was biopsied. Histopatholo
is shown in given Image. Which of the following is not true about this?
a) Most common paraneoplastic syndrome associated is Hypercalcemia ↑ I SIAPH
b) It will be positive for neurofilament. T
c) Salt and pepper like nuclear chromatin. T
d) It is associated with Azzopardi effect.

I Sica
-
-
⑪ -
N
Small

⑪ ↳
-> 08
⑧

I
W

v
1 Small cell--q
Q ) Routine urine microscopy was showing the image as given below . Most
likely it is :
a) Uric acid.
b) Calcium Oxalate crystal
c) Struvite crystal.
d) Triple phosphate.
-

-
Staghulus
Q ) A 14-year-old girl is presenting with cola colored urine. On physical examination her
blood pressure was 154/ 100 mm Hg. Her peripheral blood smear was showing
characteristic trophozoites. Renal biopsy was performed, Immunofluorescence and
electron microscopy was showing the features shown in below given image. Most likely
diagnosis in this case will be?
a) Minimal Change Disease.
b) Rapidly Progressive Glomerulonephritis.
c) Membranous nephropathy.
0
d) Acute proliferative glomerulonephritis E PSGM]
Sp
granul a r -
5
- -
HIMP
S

I
L

Fl
↑
I
 -
·
ah
↑
I
↑

22
2

-
S
-

Progres
-> 3 it A .
 -

↓ En E
-
⑧
00
Q) Renal mass was resected, and following histopathology was seen. Which of the following
statements are true regarding this tumour:
a) Loss of chromosome 1,2, 6,7, and 10 T
b) VHL gene mutation is seen. Clear R
c) Vacuoles contain both glycogen and lipid. Clear RES
d) Tumor origin is from PCT.
palace .

Ch .
RCY
Q) A 59-year-old man has had nausea and vomiting for 5 months. Upper gastrointestinal
endoscopy shows erythematous areas of mucosa with thickening of the rugal folds in the
gastric antrum. The microscopic appearance of a gastric biopsy specimen is shown in the
Image . All of the following are true about this condition except?
a) Also known as type B gastritis. I
b) Urease is virulence factor.
+

c) Warthin starry stain is used for diagnosis.

I
d) Serology is investigation of choice for diagnosis

loo
-agg
- V
ngic
 ->

Q
⑪
⑪
⑪
⑧

-
Q) A patient was allergic to wheat and he was not able to eat this.
His serological examination was positive for anti-endomysial
antibodies. Most likely diagnosis is ?
a) Giardiasis.
b) Whipple's disease.
c) Celiac sprue
d) Amebiasis.
 confirm Wis
=>
H
 =>
Whipples dis

=>

I
 WAD
↓
I
 ·
->
↑

-
-
 -

0
⑧
00 ⑧ -

- -

1
Q )A 18-year-old boy was having abdominal pain and malena from past two years. His clinical
and radiological examination has revealed the findings consistent with intussusception.
Enterotomy was performed for removing nodules and histopathology of lesion is shown
below in given image. Which of the following is most likely to be associated with this
condition:
a) Loss-of-function mutations in PTEN gene E CONDEM
b) Mutations in SMAD4 gene 3 Juvenile Pryp
c) Mutation in the STK11 gene.
d) Mutations of the APC gene (Adenomatous Polyposis Coli) FP

&
%W(
P55

-
.

000
/ 72
 Peutz-Jeghers polyp:

08 -
• Hyperplastic mucosal epithelium and

• Arborizing bands of smooth muscle.

*
• Aka Christmas tree pattern.
Q) All of the following is true about Inflammatory bowel disease except:
a) Pseudo polyp is premalignant in Ulcerative colitis i
b) Skip lesions are seen in Crohn’s disease.T
c) Transmural granuloma is seen in Crohn’s Disease. T
d) String sign of Kantor is seen in Crohn’s Disease. I
 R
N
M
-

->
/ -
-
CD
U2
 A

-
0
8
9

0
mwait
-
Granulomy
Q) A 50-year-old female presenting with right breast lump from past 9 months. She also complaints about
headaches associated with nausea for the past 2 months. An H and E stained section is shown in the
figure. Which of the following is incorrect about this breast tumour?
a) Multifocal and· bilateral metastases is common.
b) Dyscohesive tumour cells will be seen. I
-

c) Tumor cells will have Indian file pattern of arrangement.

-

d) Overexpression of E–Cadherin gene #

#
-

LC
signettings Jur
- =

0000
 ⑭

Invasive
lar
lob
,a
 Q) A 57-year-old female presented with breast mass. Gross and histopathology is shown
below. Which of the following is not true regarding this tumour?
a) Mimics Acute mastitis.
-

b) Good Prognosis⑰
⑧
c) Tumor cell will block dermal lymphatics.
-

↓
d) It is a special subtype of Invasive ductal carcinoma.
[Inflamma]
·
 Inflammatory
carcinoma.

Peau d’orange breast:

Q) A 34-year-old-female with breast cancer was showing following
Immunohistochemistry pattern. Which of the following is true regarding this
cancer?
a) Her 2 positive, good prognosis I
b) Basal type, worse prognosis X
O Brow -
Pale
c) Luminal A type, BRCA2 positive, good prognosis -

Blue
d) Luminal B type, BRCA 2 positive, bad prognosis ⑰
⑦
-

⑦ &
-
Q) A 15 years old boy presented to clinic with difficulty in coordination of movements,
abdominal pain, Hemolytic anemia and hepatitis. On further examination of eye has revealed
a brown ring in cornea as shown in below given image. Most likely diagnosis will be ?
a) Parkinson’s Disease. X
b) Wilson’s Disease
c) Alzheimer's disease. X
d) Hemochromatosis. *

-
~

Neurofsych
> 199
 B

X
Q) A 29 year old lady was showing serology report as HBsAg positive, IgM HBc positive, IgG
HBs and IgG HBe and anti HCV was negative. What will be most likely diagnosis in this case:
a) Acute HBV infections
b) Chronic HBV infections.
X HCV infections.
c) Acute
d)A
Chronic HCV infections.
Q ) A 40-year-old female presented with slowly growing thyroid swelling from the past 11
months. Histopathological examination was done, and microscopic findings of the biopsy is
given below. This patient is suffering from which of the following condition?
a) Follicular carcinoma of Thyroid.
b) Papillary Carcinoma
c) Anaplastic Carcinoma.
d) Medullary Carcinoma.
-

->
 Il

I
#
 ~
a
-
-

Medullary thyroid carcinoma (H&E stain): Medullary thyroid carcinoma:

Congo red staining ( polarized light) showing

apple green birefringence of amyloid.
-
Q ) A 40-year-old female presented with swelling around the knee joint. Knee X-Ray was
showing soap-bubble appearance. Biopsy of the lesion is showing microscopic findings as
shown in below given image. Which of the following is most likely diagnosis?
a) Osteosarcoma.
b) Ewing’s Sarcoma.
c) Tuberculosis.
d) Giant Cell Tumor

0
0
eg
~
-
 => M4

~
 ⑪

Enys
Q) A 40 years old patient came with complaints of knee joint pain and lesions on hand and
face as shown in given image. Most likely diagnosis will be:
a) Gout.X

b) Dermatomyositis
c) Polymyositis. X

d) Inclusion body myositis.

X
 ⑪Heliotrope-rash

y
"Heliotrope" (a purplish color) or lilac or red color
lesion which can occur around the eyes along with
swelling.

permit positio
-

11 Gottron's papule
Erythematous scaly papules over the knuckles and
elbows (Gottron’s sign).
↓
7
Q) An ovarian tumour histopathology is given below. Most likely true statement about
this tumor is :
a) Rokitansky protuberance is seen on gross examination. # Teratoma
b) Call Exner bodies are seen. ↑ Granulosa <211 Th
c) Alpha-1 antitrypsin is tumor marker
d) LDH and PLAP is tumour marker. Semin
②

YS]
 YST
=>

↓
Granulosa cell tumour

·
 = Teratoma :

0 -
-
Consisting of a disorganized collection
of glands, cartilage, smooth muscle,
--

and immature stroma.

S
Rokitansky protuberance
(Benign cystic teratoma) :
Q) Which of the following is most common brain hemorrhage?
a ) Subdural hemorrhage.
b) Subarachnoid hemorrhage.
c) Intracerebral hemorrhage
d) Epidural hemorrhage.
V
W v
~

MC
 3
↓

O
= Y

rupture &
-
Q) A patient presented with fever, headache, vomiting and neck rigidity. CSF sample was
analysed and it was showing mild decrease in glucose, increased protein level, and
coagulum as shown in below given image. Most likely it is:
a) Pyogenic meningitis.
b) TB meningitis
c) Viral Meningitis.
d) Meningococcal Meningitis.

fibrin-dot
Kob-web)
>
Q) Which apolipoprotein is responsible for Alzheimer's disease:
allo
a) APOE 1
strongly
m .

b) APOE 2 =>

Protective
c) APOE 3
d) APOE 4 qq
0
As -

-
Q) Brain autopsy finding of brain is shown below from a patient. Most likely it is composed of :
a) Alpha actin -> Hirano-Bodies) AD
O
b) Alpha-Synuclein
Lewy (PD
Body
=> .

c) A-PrPsc -> Prio

d) A-Beta (AB) amyloid - P
⑪
S

↓ F
Pall *

↳
 PD
⑧
-

5
-
Q) A 10-year-old patient with brain tumour came, and biopsy was taken and shown
- -

below in image. Which of the following is true:

a) It is associated with SHH gene mutation I
0 I

b) It is associated with 11
C-MYC amplification. E
c) It will never show CSF metastases. #
d) It will be showing isochromosome 17p.
FAG
↑
 -

>
0
⑪ ⑪ 088
↳

⑧
-

=> -

--
E
Q ) A soft tissue mass was resected from a patient with sensorineural deafness and tinnitus.
Histopathology is shown below in given image. Which of the following is correct about this
tumour :
a) Most commonly arise from arachnoid cap cells.
b) Pseudo palisading necrosis is diagnostic. SB /
Meningirma/
c) It has Verocay bodies in AntoniXB areas. XXf
d) Antoni A and Antoni B are biopsy findings I

IIII
Schw
-
11I -
-
⑧
- ->
-

V ↓
000000

drow-A
FAR
Gioblastoma

Astrocy
↓

Whi
 Glioblastoma
& i
Q) A patient came with ulcerated nodule on tip of nose measuring 0.7 cm. HPE of lesion is
shown below in given image. Most likely diagnosis is?
a) Bullous pemphigoid
b) Basal Cell carcinoma.
c) Squamous cell carcinoma
d) Pemphigus vulgaris
 Basal cell carcinoma (BCC).
Pearly papule: typical pearly borders
-

with telangiectasia and central

ulceration.

-
I
 Basal cell carcinoma
(aka- Rodent Ulcer):
• Nodulo-ulcerative lesions
are destructive and
tumour nibbles away the
skin like a rodent (Rodent
ulcer)!

↓ • Common site: Above the

line drawn from the angle
of mouth to pinna.
Basal cell carcinoma (BCC).

S
-

-
 -+ BP = ve
=

⑪
Pr
-
As
>

Ju
A
-
-
 -

R
-
 -

= -

&
Dermatitis herpetiformis:
Geelin
*
Dermatitis herpetiformis:

I
11

Reticulin"

R
Q) 45 female , diabetic and chronic IUCD user complained of fever and chills.
Pap smear is shown below. Most likely diagnosis will be:
a) Actinomycosis
b) Trichomonas
c) Gardenella
d) Molluscum contagiosum

O
-

I
 Actinomyces :

-
I

-
-
 ↳ cells:
Clue
-
-

&
Balt
Vaginosis
.

Gardenell
-> Both .

Partner.
Molluscum contagiosum:

2R
0
↳
⑧
t
⑧or
Q) Biopsy from a inflammatory skin lesion is shown in below given images along with clinical
findings. Which of the following is true regarding this condition:
a) Pautrier’s Microabscess will be seen. F
O
b) Tumor necrosis factor (TNF) is a major pathogenic mediator I
c) Sezary cells will be seen. F
d) Skin biopsy will show typical “Claw clutching ball appearance”. #
H
* 00

MF
=

↑
R I

= *
MF
Leun
=
MIL
Lichen Nitidus : Claw Clutching Ball
.
appearance
-
• Inflammatory dermatosis consisting of multiple,
tiny, discrete, skin-colored papules affecting
mainly children and young adults.

• Characteristic claw clutching ball appearance is

↳
due to:
a) Claw: Hyperplastic epidermis with rete ridges.
b) Ball: Aggregates of inflammatory infiltrate in the
dermis
 A

"In
Q) Which of the following is not seen in pleomorphic adenoma:

0
a) Myoepithelial cells. V

Benign
-

b) Chondroid differentiation. -
c) Keratin pearls.
d) Perineural invasion -> Carcinoma Ex-Plerom Al
4
main
Pleomorphic Adenoma has 3 components:

1) Epithelial (ductal) component forming the inner layer

of cysts and tubules
2) Myoepithelial cells as the outer layer of cysts and
tubules and scattered within the myxoid stroma.
Cytology of myoepithelial cells can be plasmacytoid,
spindled, epithelioid, clear or stellate shaped
3) Stromal component is typically myxoid, chondroid or
myxochondroid. It can also be hyalinized or fibrotic.

•Metaplastic changes may be seen, e.g. adipose

metaplasia, osseous metaplasia, squamous metaplasia
(sometimes with keratinization), sebaceous metaplasia
and mucinous metaplasia.
 Carcinoma ex pleomorphic adenoma
Squamous metaplasia in pleomorphic showing perineural invasion
adenoma of the salivary glands exhibiting
keratin pearls.

• PLAG1 (PLeomorphic Adenoma Gene-1) IHC showing diffuse nuclear positivity.

 Y
• Most common lacrimal gland tumour---- Pleomorphic adenoma

• Most common malignant lacrimal gland tumour- Adenoid cystic carcinoma

• Most common non epithelial lacrimal gland tumour- NHL

Best wishes
- -
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