AIIMS nov 2018 ,PATHOLOGY

Solution by Dr Devesh Mishra

1) In apoptosis, all are seen except:

a) Intact plasma membrane
b) Cell organelle Swelling
c) Absence of Inflammation
d) Gene mediated programmed cell death

Ans is b) Cell organelle Swelling

Morphologic Features of Apoptosis
• Earliest change in apoptosis is cell shrinkage.
• Most characteristic is “chromatin condensation” (= pyknosis).
• No inflammation due to intact cell membrane.
• Formation of cytoplasmic blebs and apoptotic bodies.
• Apoptotic bodies are cell membrane bound structures with tightly
arranged organelles with or without nuclear fragments.
• Phagocytosis of apoptotic cells or apoptotic bodies by
macrophages (end stage).

2) Immunohistochemistry marker to differentiate thymoma from ALL?

a) TdT
b) CD1a
c) CD3
d) Cytokeratin
Ans is d) Cytokeratin
Thymoma is an epithelial tumor and it will be Cytokeratin positive,
whereas TdT, CD1a, and CD3 are seen in ALL.

3) Patient came to Emergency room with severe bleeding and his

Blood group was unknown. Which of the following blood group of
FFP you will prefer for transfusion?
a) A+
b) AB
c) O-ve
d) O +ve

Ans is b) AB
If we analyse ABO blood group, we will see following thing:
“Blood Group O” will have both Anti-A and Anti-B, so FFP of this
group can be given to “O Blood group patients only.

“Blood Group A” plasma will be having anti-B, so FFP can be given

to patients who are having blood group A or O because they will not
be having group B red cells.
“Blood group B” plasma contains anti-A, so FFP and can only be
given to patients who are group B or O because they will not be
having A red cells.
Blood Group AB plasma will not be having Anti-A or Anti-B, so FFP
can be given to patients with blood group AB, A, B or O. AB blood
donors can be considered as ‘universal plasma donors.

4) Year 2018, Nobel prize in Medicine and physiology was given for
which topic?
A) CRISPER
B) Autophagy
C) Negative regulation of immune responses
D) Circadian rhythm

Ans is. C) Negative immune regulation

5) A 35-year-old male presented with proteinuria.

Immunofluorescence microscopy of renal pathology is shown below
in given image. Most likely Diagnosis will be ?

a) PSGN
b) Lupus Nephritis
c) Goodpasture syndrome
d) FSGS
Ans is b) Lupus nephritis showing full house effect.
6) Given Image is showing macrophage mediated process. Most likely
it is?

a) Autophagy
b) Emperipolesis
c) Phagocytosis
d) Necrosis

Ans is b) Emperipolesis:
 7) A Patient came with severe bleeding to emergency room. As per your
demand you have received 4 platelets concentrate and 2 Packed RBC bag
from blood bank. Patient is having single iv canula. Which of the following
should be done in this case?
a) Transfuse 2 Platelet concentrate and store Packed RBC at room temp
b) Transfuse 2 platelets concentrate and store Packed RBC between 2-4
degrees
c) Transfuse Packed RBC and store platelets concentrate at room temp
d) Transfuse Packed RBC and store platelets concentrate in 2-4 degrees.
Ans is c) Transfuse Packed RBC and store platelets concentrate at room
temp

8) Which one is involved in Antibody mediated cell mediated

cytotoxicity?
a) NK Cell, Neutrophil, eosinophil
b) Neutrophil and macrophage
c) NK cell and eosinophil
d) NK cell only
Ans is a) NK Cell, Neutrophil, macrophage
Antibody-dependent cellular cytotoxicity (ADCC) is done by NK cells.
However, it is also seen in neutrophils and eosinophil killing certain
parasitic worms like helminths via IgE antibodies.

9) Recognition of Necrotic cell during inflammation by

a) Neutrophilic extra cellular traps
b) Toll like receptor
c) P-selectin
d) Inflammasome
Ans is b) Toll like receptor.
10) Vial colour for collection of blood for glucose estimation containing
Sodium fluoride?
a) Green
b) Grey
c) Pink
d) Blue
Ans is b) Grey

11) Northern blot is used for

a) DNA
b) RNA
c) Proteins
d) Fat
Ans is b) Northern blot- RNA
Sothern for DNA.
Western blot for proteins.

12) Patient of thalassemia major on repeated blood transfusions had

history of iron overload previously treated with chelating agents. She had
history of cardiac arrythmia also. She has come for blood transfusion. Now
on starting blood transfusion patient presented with backache and felt
extreme anxiety. What is the next management?
a) Stop the blood transfusion immediately
 b) Continue blood transfusion and get ECG.
c) Check the urine for reddish discolouration.
d) Monitor vitals and continue the transfusion
Ans is a) Stop the blood transfusion immediately

13) A patient presented with of chronic diarrhoea with normal D-Xylose

test and abnormal schilling test. His duodenal biopsy was normal. Most
likely diagnosis will be?
a) Ileal disease
b) Ulcerative colitis
c) Celiac disease
d) Intestinal lymphangiectasia

Ans is a) Ileal disease.

14) Postrenal transplant patient presents with diarrhoea after 3 months,
and it was showing organism measuring 2-6-micron meter and Kinyoun
stain positive. Most likely it is caused by which of the following?
a) Balantidium coli
b) clostridium difficile
c) Cycloisospora
d) Cryptosporidium
Ans is d) Cryptosporidium.

Kinyoun method or Kinyoun stain.

● It is an acid-fast procedure used to stain any species of the genus
Mycobacterium, Nocardia and Cryptosporidium species (2-6 micron
meter)
15) Integrin connects the extracellular matrix with the actin cytoskeleton
by which macromolecule?
a) Laminin
b) Collagen
c) Fibronectin
d) Vitronectin

Ans c) Fibronectin

16) Erythropoietin acts on?

a) CFU,
b) Late erythroblast
c) Reticulocyte,
d) Blast forming unit

Ans is a) CFU

17) Specific enzyme increased in alcoholic liver disease

a) ALT
b) LDH
c) GGT
d) ALP
Ans is c) GGT

18) Cause of infertility in kartageners syndrome

a) Asthenospermia
 b) Oligospermia
c) Undescended testes
d) Epididymis blockage
Ans is a) Asthenospermia

19) A lady presented with pearly white forehead lesion from past 2
months, and similar lesions were observed in her 1 year old child also as
shown in image . Most likely cause is:

a) Scabies
b) Pox virus
c) Herpes virus
d) Coxsackie
Ans is b) Pox virus
forehead lesion is dome shaped pearly white lesions suggestive of pox virus
infection (Molluscum contagiosum)
20) Histopathology Slide with split (suprabasal blister).

a) Leprosy
b) Pemphigus vulgaris
c) Mycosis fungoides
d) TEN
Ans is b) Pemphigus vulgaris.
21) Which of the following cannot be diagnosed without positive anti-
nuclear antibodies?
a) Sjogren syndrome
b) SLE
c) Scleroderma
d) Drug induced SLE
Ans is b) SLE
22) Small amounts of repeated thin stools with mucus, subjective
feeling of fever and lower abdominal pain, with leukocytes in stool.
Most likely it is caused by?
a) Giardia
b) Entamoeba
c) Staph
d) Clostridium
Ans is b) Entamoeba (Only this organism will show stools with
mucus)

23)A Patient came with retroperitoneal mass, no history of weight

loss, anorexia. Histopathology

a) Angioid lymphoma?
b) Non-Hodgkin’s Lymphoma
 c) IgG4 disease
d) Castleman’s disease
Ans is d) Castleman’s disease
Castleman disease
• It is a group of uncommon lymphoproliferative disorders characterized by
lymph node enlargement, characteristic features on microscopic analysis
of enlarged lymph node tissue, and a range of symptoms and clinical
findings.
• Histologic features consistent with Castleman disease are categorized
into common patterns:
a) Hyaline vascular - regressed germinal centres, follicular dendritic cell
prominence or dysplasia, hypervascularity in interfollicular regions,
sclerotic vessels, prominent mantle zones with an “onion-skin”
appearance.
b) Plasmocytic – increased number of follicles with large hyperplastic
germinal centres and sheet like plasmacytosis (increased number
plasma cells).
c) Hypervascular - similar to hyaline vascular features, but seen in MCD
rather than UCD. Includes regressed germinal centres, follicular
dendritic cell prominence, hypervascularity in interfollicular regions,
and prominent mantle zones with an “onion-skin” appearance.
d) Mixed - presence of a combination of hyaline vascular, plasmocytic,
and/or Hypervascular features

24) Interferon beta production stimulated by??

a) Bacteria
b) Viruses
c) Fungi
 d) Mycoplasma

Ans is b) Viruses

25) Which is Immune privileged area.

a) Epididymis
b) Area postrema
c) Optic nerve/chiasm
d) Seminiferous tubules

Ans is d) Seminiferous tubules

26) Which of the following cells can activate a naive T-cell:

a) NK cells
b) Dendritic cells
c) Macrophages
d) B-cells
Ans is b) Dendritic cells.

27) Rashes were present over body, and it were occupying >30% of BSA.
Most likely triggering factor can be?
a) Drug Induced
b) Idiopathic
c) Bacterial Infections
d) Viral Infections
Ans is a) Drug Induced.

28) A male child presented with coarse facies ,protuberant abdomen

,frontal head enlargement, thickening of cardiac valve,
hepatosplenomegaly, hearing impairement.What is the most probable
diagnosis?
a) Hurler’s disease
b) Hunter’s disease
c) Fragile X syndrome
d) Tay Sach’s disease

Ans is b) Hunter’s disease

Clinical features of Hurlers and Hunter is nearly similar but only males will be
affected in Hunter’s disease. In this given question male gender favours
diagnosis of Hunters.

Mucopolysaccharidosis
• Due to deficiencies of enzymes that degrade glycosaminoglycans
(abundant in extracellular matrix).
• Heparin sulfate, dermatan sulfate, keratan sulfate, and chondroitin sulfate
are accumulated.
• All are autosomal recessive except MPS II (Hunter disease), which is
X-linked recessive.
• It is characterized by:
a) Coarse facial features.
b) Hepatosplenomegaly
c) Corneal clouding
d) Mental retardation.
 e) Balloon cells are distended cells with clear cytoplasm containing Pas-
positive material.
• Two is most well-characterized syndromes are:

A) Hurler syndrome (MPS I-H)

• It due to alpha-l-iduronidase deficiency.
• It's a severe form.
• Onset at 6 to 24 months and death due to cardiovascular complications by
the ages of 6 to 10 years.
B) Hunter syndrome (MPS II)
• Lacks corneal opacification.
• Milder clinical course than Hurler syndrome.