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Correct Answer - A
Ans. is 'a' i.e., Apaf 1
One of these proteins is cytochrome c, well known for its role in
mitochondrial respiration. In the cytosol, cytochrome C binds to a
protein called Apaf-1 (apoptosis activating factor-1), and the
complex activates caspase-9. (Bc1-2 and Bcl-x may also directly
inhibit Apaf-1 activation, and their loss from cells may permit
activation of Apaf-1
Correct Answer - A
Ans. is 'a' i.e., Coagulative necrosis
Coagulative necrosis
* This is most common type of necrosis.
* This type of necrosis is most frequently caused by sudden
cessation of blood flow (ischemia) in organs such as heart (MI),
Kidney (ATN), adrenal gland, and spleen.
Note: Brain is the only exception, i.e.,. It is the only solid organ in
which ischemia leads to liquifactive necrosis not coagulative
necrosis.
* It is also seen with other types of injury e.g.,liver necrosis in viral
hepatitis, Coagulative necrosis of skin after burns (Thermal injury).
Why there is predominant protein denaturation and no enzymatic
digestion ?
Hypoxia causes intracellular acidosis (has been explained earlier)
> .t pH results in denaturation ofproteins which includes not only
structural proteins hut also enzymes
So, there is no enzymatic digestion. o The necrotic cells retain their
cellular outline for several days.
Liquefactive necrosis
* It is the necrotic degradation of tissue that rapidly
undergo softening and liquefaction
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Correct Answer - B Ans.is `b'i.e., Nicotine and carbon monoxide and tar Mechanisms for smoking-induced Coronary heart disease Carbon monoxide induces atherogenesis. Nicotine stimulation of adrenergic drive raising both BP and myocardial oxygen demand. Lipid metabolism with fall in protective high-density lipoproteins. Note .. Tar is associated with carcinogenesis (not atherosclerosis). But amongst the given options option b is the best answer as it consists of both nicotine and CO
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Answer -C
Ans. is 'c' i.e., Cytoplasmic vacuole
o Fatty changes occur in alcoholic steatosis (fatty liver). It is
manifested by appearence of lipid vacuole in the cytoplasm, which is
a sign of reversible injury.
○ Other three options (loss of cell membrane, nuclear karyolysis and
pyknosis) are signs of irreversible injur
Correct Answer - B Ans.is `b'i.e., Nicotine and carbon monoxide and tar Mechanisms for smoking-induced Coronary heart disease Carbon monoxide induces atherogenesis. Nicotine stimulation of adrenergic drive raising both BP and myocardial oxygen demand. Lipid metabolism with fall in protective high-density lipoproteins. Note .. Tar is associated with carcinogenesis (not atherosclerosis). But amongst the given options option b is the best answer as it consists of both nicotine and CO
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Correct Answer- A Ans. is 'a' i.e., Cong-Bicuspid aortic valve Aortic stenosis causes pressure overload that results in concentric hypertrophy. o Congenital bicuspic aortic valve causes valvular aortic stenosis.
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Correct Answer- A Ans. is'd' i.e., All of the above Coxa vera • Coxa vera refers to reduced angle between the neck and shaft of the femur. • Coxa vera may be congenital or acquired. 1. Congenital (developmental / Infantile) coxa vera .. This is coxa vara resulting from some unknown growth anomaly at the upper femoral epiphysis. • It is noticed as a painless limp in a child who has just started walking 3. In severe cases, shortening of the leg may be obvious On examination, abduction and internal rotation of the hip are limited and the leg is short. X -rays will show a reduction in neck - shaft angle ). s. The epiphyseal plate may be too vertical. 7 There may be a separate triangle of bone in the inferior portion of the metaphysis, called Fairbank's triangle. 3. Treatment is by a subtrochanteric corrective osteotomy. 2. Aquired coxa - vera • Aquired coxa-vera is seen in '. SCFE (slipped capital femoral epiphysis) Sequelae of avascular necrosis of femoral epiphysis
• Legg-Calve Perthe's disease • Femoral neck fracture • Traumatic hip dislocation • Post reduction of CDH • Septic necrosis • Associated with pathological bone disorders Osteogenesis imperfecta Fibrous dysplasia
Correct Answer-B Ans. is `b'i.e., Nicotine and carbon monoxide and tar Mechanisms for smoking-induced Coronary heart disease Carbon monoxide induces atherogenesis. Nicotine stimulation of adrenergic drive raising both BP and myocardial oxygen demand. Lipid metabolism with fall in protective high-density lipoproteins. Note .. Tar associated with carcinogenesis (not atherosclerosis). But S! amongst the given options option b is the best answer as it consists of both nicotine and CO
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Correct Answer-A
Ans. A. CLL evolving into aggressive lymphoma .
Richter's transformation or Richter's syndrome is a complication of B cell chronic lymphocytic leukemia (CLL) or hairy cell leukemia (HCL) in which the leukemia changes into a fast-growing diffuse large B cellymphoma
Correct Answer -C Ans. is 'c' i.e., Smooth muscle cell hypertrophy • Rupture occurs in advanced atherosclerotic lesion. • In advanced atheroma, smooth muscle cells undergo apoptosis and advanced atheromatous plaque often have mostly fibrous character with lack of smooth muscle cells that are seen in less advanced lesion.
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Correct Answer -D Fibrocystin (polyductin) gene mutation is seen in autosomal recessive polycystic kidney disease.
Note: .| Polycystin mutation is associated with autosomal dominant polycystic kidney disease. • Nephrocystin is related to nephronophthisis. • Uromodulin mutation is seen in medullary cystic kidney disease. Ref: Harisons principles of internal medicine, 18th edition, Page: 2356
[9.2] A 59-year-old man is admitted to the intensive care unit for a myocar- dial infarction. He is given a ẞ-adrenergic antagonist and instructed to avoid emotional turmoil to decrease sympathetic stimulation of the heart. From a cellular perspective, sympathetic stimulation of the heart does which of the following?
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A previously healthy, 27-year-old agricultural worker develops nausea, vomiting, abdominal cramps, cough with wheezing and dyspnoea, salivation, and lacrimation 1 hour after leaving work in a field. On examination, he is afebrile with a heart rate of 50/min and blood pressure of 90/55 mm Hg. Laboratory studies show plasma cholinesterase activity less than 50% of normal. Atropine is given intravenously, and his condition improves. He was most likely exposed to which of the following substances?
A Aflatoxin
B Cyclodiene
C Dioxin
D Ergot alkaloid
E Organophosphate
Correct Answer -B
Ans. is 'b'i.e., Cell membrane
• yeline figures are cytoplasmic bodies composed of concentric
whorls of membranes, derived from damage cell membrane.
Myelin figures appear during reversible injury but they are more
pronounced in irreversible injury.
Correct Answer -D
Ans. is d i.e., Polymorphonuclear cells
Aschoff bodies
* Aschoff bodies are focal inflammatory lesions seen during acute
rheumatic fever
They consist of foci of swollen eosinophillic collagen surrounded by
Lymphocytes (primarily T cells)
Occasional plasma cells
Aschoff giant cells (macrophages of rheumatic fever)
Antitschkow cells
(Antischkow cells are modified macrophages with abundant
cytoplasm and central round to ovoid nuclei in which the chromatin
is disposed in the central, slender wavy ribbon like pattern-caterpillar
cells)
Histiocytes
Fibrobla
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Correct Answer -D
Ans. is d i.e., Polymorphonuclear cells
Aschoff bodies
* Aschoff bodies are focal inflammatory lesions seen during acute
rheumatic fever
They consist of foci of swollen eosinophillic collagen surrounded by
Lymphocytes (primarily T cells)
Occasional plasma cells
Aschoff giant cells (macrophages of rheumatic fever)
Antitschkow cells
(Antischkow cells are modified macrophages with abundant
cytoplasm and central round to ovoid nuclei in which the chromatin
is disposed in the central, slender wavy ribbon like pattern-caterpillar
cells)
Histiocytes
Fibrobla
Correct Answer -C Ans. is 'c' i.e., Waviness of fibers • Variable waviness of fibres at border is the earliest histological finding (see tables of previous explanation)
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Correct Answer - B Ans is 'b' i.e., Vascular Kaposi Sarcoma •|Kaposi sarcoma is an intermediate grade, multicentric vascular, tumour * The pathogenesis of kaposi sarcoma is complex, fundamentally it is an angioproliferative disease that is not a true neoplastic sarcoma • It is a manifestation of excessive proliferation of spindle cells that are believed to be of vascular origin and have features in common with endothelial and smooth muscle cells. * Grossly-Three stages of the disease can be identified Patch (1st stage) Plaque (intermediate stage) LI Nodule (last stage) * Histologically-The changes are nonspecific in the early patch stage and more characteristic in the nodular stage which show sheets of plump proliferating spindle cells and endothelial in the dermis or subcutanous tissue
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Correct Answer -C Ans. is 'c' i.e., Most commonly involved artery is abdominal aorta It is the most common form of systemic vasculitis in adults,is an acute and chronic, often granulomatous, inflammation of arteries of large to small size It affects principally the arteries in the head-especially the temporal arteries- but also the vertebral and ophthalmic arteries and the aorta, where it may cause thoracic aortic aneurysm
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Correct Answer - C Ans. is 'c' i.e., Most commonly involved artery is abdominal aorta It is the most common form of systemic vasculitis in adults, is an acute and chronic, often granulomatous, inflammation of arteries of large to small size It affects principally the arteries in the head-especially the temporal arteries- but also the vertebral and ophthalmic arteries and the aorta, where it may cause thoracic aortic aneurysm
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Correct Answer -C
Ans. is 'c' i.e., ASO Titre
In rheumatic fever and glomerulonephritis, retrospective diagnosis of streptococcal infection may be established by demonstrating high levels of antibodies to streptococcal toxins
• The usual test done is antistreptolysin O titration.
• ASO titres higher than 200 units are considered significant and suggests either recent or recurrent infection with streptococci.
ASO titres > 200 units do not mean rheumatic fever, it only indicates recent or recurrent infection.
Correct Answer - D Fibrocystin (polyductin) gene mutation is seen in autosomal recessive polycystic kidney disease.
Note: • Polycystin mutation is associated with autosomal dominant polycystic kidney disease. • Nephrocystin is related to nephronophthisis. .| Tromodulin mutation is seen in medullary cystic kidney disease Ref: Harrisons principles of internal medicine, 18th edition, Page: 2356.
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