Last 5 Year PYQs in Pathology for FMGE

Q1. What is the diagnosis for a 5-year-old boy who has weight loss, fever, and a painless swelling in his jaw area? CBC results indicate anemia and lymphocytosis. The image below shows biopsy findings from the swelling.​

1. Kikuchi disease
2. Infectious mononucleosis
3. Hodgkins lymphoma
4. Burkitt lymphoma

Ans. 4) Burkitt lymphoma

• The histopathological picture is of a classical Burkitt lymphoma involving a lymph node. The most characteristic finding is a “starry sky” pattern.
• At high-power magnification, the neoplastic cells are of intermediate size, similar to the size of benign histiocyte nuclei.
• The neoplastic cells have round nuclear contours, multiple nucleoli, frequent mitoses, and basophilic cytoplasm. Macrophages with engulfed pyknotic nuclei and nuclear debris are also present.

Also read: Last 5 Year PYQs in Pediatrics for FMGE

​Q2. Graft from an identical twin is called:

1. Allograft
2. Autograft
3. Isograft
4. Xenograft

Ans. 3) Isograft

• Isograft refers to tissue transplanted between genetically identical twins.

Q3. A 9-month-old boy presents with progressive pallor and abdominal distention. On investigations, hepatosplenomegaly and malar eminence are seen, and his peripheral blood smear is as shown below. He has a low Hb; the Mentzer index is found to be less than 13. What diagnosis would this signify for this patient?​

1. Megaloblastic anemia
2. Iron deficiency anemia
3. Thalassemia
4. Pernicious anemia

Ans. 3) Thalassemia

• The peripheral smear shows a microcytic hypochromic picture with target cells.
• The Mentzer index is calculated as MCV / RBC count.
• If the result is >13, iron deficiency anemia is the probable diagnosis, and a value < 13 indicates the likelihood of β-thalassemia.
• This, along with the clinical history, suggests that the child is suffering from β-thalassemia.

Also read: Last 5 Year PYQs in Ophthalmology for FMGE​

Q4. A 60-year-old male patient presented with anemia and hepatosplenomegaly. A peripheral smear showed teardrop cells, nucleated RBCs, and giant abnormal platelets. A biopsy showed marrow fibrosis and a few characteristics, as given below. The most likely diagnosis is:​

1. Polycythemia vera
2. Essential thrombocythemia
3. Primary myelofibrosis
4. Chronic myeloid leukemia​

Ans. 3) Primary myelofibrosis

• The patient presented with anemia and hepatosplenomegaly; the peripheral smear showed teardrop cells, nucleated red blood cells, and abnormally large platelets; and the bone marrow biopsy showed fibrosis and dilated sinusoids, primary myelofibrosis.
• The image shows cloud-like megakaryocytes (with small cytoplasm and hypolobated cloud-like nuclei), a characteristic feature of myelofibrosis.

Q5. A teenager developed swelling of the face, lips, and tongue and also found it difficult to breathe within a few minutes of consuming prawns. What is the type of hypersensitivity seen here?

1. Type 1
2. Type 2
3. Type 3
4. Type 4

Ans. 1) Type-1

• The above clinical case is suggestive of an anaphylactic reaction to prawns, which is a type-1 hypersensitivity reaction.
• Type I hypersensitivity is also known as an immediate reaction and involves the IgE-mediated release of antibodies against the soluble antigen.
• This results in mast cell degranulation and the release of histamine and other inflammatory mediators.

Q6. ​During wound healing, the cells that appear first, due to chemotaxis, at the site of the wound are:

1. Neutrophils
2. Monocytes
3. Macrophages
4. Lymphocytes

Ans. 1) Neutrophils

• Neutrophils are the first cells to arrive at the site of injury.
• They are brought in response to chemotactic mediators upon vessel injury.
• They appear within 24 hours, and the peak is seen on the second day.

Also read: Last 5 Year PYQs in Microbiology for FMGE

Q7. A person was brought to the emergency department with facial swelling, itching, and hypotension following a bee sting. The mentioned clinical features are due to the increase in which of the following immunoglobulins?

1. IgA
2. IgE
3. IgM
4. IgG

Ans. 2) IgE

• The patient's presentation with facial swelling, itching, and hypotension following a bee sting is a type 1 hypersensitivity reaction and is mediated by IgE.

Q8. A Rh-negative mother delivered an Rh-positive baby, and Coomb’s test was positive for the baby. What is the mechanism of hypersensitivity seen in this scenario?

1. Antigen-dependent cell cytotoxicity
2. Antibody-dependent cellular cytotoxicity
3. Antigen-antibody immune complex deposition
4. CD4 T-cell-mediated cytokine release

Ans. 2) Antibody-dependent cellular cytotoxicity

• It is a type II hypersensitivity reaction that is due to antibody-dependent cellular cytotoxicity.

Q9. Which of the following molecules helps in the adhesion of the leucocyte to the endothelium during inflammation?

1. P-selectin
2. Platelet-activating factor
3. VCAM-1
4. Complements

Ans. 3) VCAM-1

• VCAM-1 helps in the adhesion of the leucocyte to the endothelium during inflammation.

Also read: FMGE Previous Year Question Papers

Q10. What is the most probable tumor that a 22-year-old woman with a sizable growth in her right ovary, which has been determined to originate from all three germ layers based on histopathology, is experiencing?

1. Dysgerminoma
2. Teratoma
3. Thecoma
4. Theca lutein cyst

Ans. 2) Teratoma

Mature teratomas are the most common of germ cell tumors and have all 3 germ cell layers. Although they are seen at any age, they usually occur during the reproductive years. Most are cystic (mature cystic teratoma or dermoid cyst) and composed of tissue derived from ectoderm, endoderm, and mesoderm, with ectodermal derivatives such as skin and hair being the most common. Sebaceous glands are prominent.

Q11. Metastatic calcification occurs in all except?

1. Kidney
2. Fundus of the stomach
3. Pulmonary veins
4. Atheroma

Ans. 4) Atheroma

• The type of calcification seen in atheroma is dystrophic calcification.
• Metastatic calcification:
  • Metastatic calcification is caused by increased calcium phosphate in the blood and may result from hypercalcemia, hyperphosphatemia, or both.
  • It is commonly associated with hyperparathyroidism, sarcoidosis, metastatic disease, and myeloma.
• Dystrophic calcification:
  • The deposition of calcium salt in degenerated tissues in the absence of a systemic imbalance is called dystrophic calcification.
  • It is mostly associated with trauma, inflammation, or infection.

1. Autosomal Dominant
2. Autosomal Recessive
3. X-linked dominant
4. X-linked recessive

Ans. 1) Autosomal Dominant

• There is male-to-male transmission of disease; hence, it should not be X-liked.
• Every generation is affected; hence, it is the dominant pattern.

Also read: Most IMP Biochemistry PYQs for FMGE July ‘23

Q13. ​A 30-year-old pregnant woman who has the thalassemia trait visits the clinic for genetic counseling. Her husband is also confirmed to have the thalassemia trait. Considering their genetic background, what is the likelihood of their next offspring having thalassemia?

1. 100%
2. 50%
3. 75%
4. 25%

Ans. 4) 25%

• Thalassemia is inherited in an autosomal recessive pattern, i.e., it can occur when the child inherits one copy of a mutated gene from each parent.
• Both parents have the thalassemia trait:
  • 1 in 4 chance, each child they have will not inherit any mutated genes and will not have thalassemia or be able to pass it on.
  • 1 in 2 chance, each child they have will just inherit a copy of the faulty gene from one parent and be a carrier.
  • 1 in 4 children they have will inherit copies of the faulty gene from both parents and will be born with thalassemia.

Q14. What's Warthin's tumor also called?

1. Adenolymphoma
2. Pleomorphic adenoma
3. Mucoepidermoid carcinoma
4. Acinic cell carcinoma

Ans. 1) Adenolymphoma

• Warthin's tumor is also known as adenolymphoma. It's a benign tumor that most commonly occurs in the parotid gland, which is a salivary gland located in the cheek. It's characterized by its unique histological appearance, with cystic spaces and papillary projections lined by double-layered oncocytic epithelial cells and lymphoid stroma.

Q15. A 26-year-old female patient presents with a palpable thyroid nodule and occasional neck discomfort. She has no history of radiation exposure to the neck. On physical examination, a solitary, firm, non-tender thyroid nodule is noted. Ultrasound reveals a hypoechoic nodule with microcalcifications. Fine-needle aspiration biopsy is performed, and histological analysis reveals characteristic nuclear changes. What is the most common thyroid cancer in this patient?

1. Papillary carcinoma
2. Follicular carcinoma
3. Medullary carcinoma
4. Anaplastic carcinoma

Ans. 1) Papillary carcinoma

• This is the most common type of thyroid cancer, especially in young adults. It often presents as a solitary thyroid nodule, and its characteristics on ultrasound, such as hypoechoic appearance and microcalcifications, along with the patient's demographic and clinical profile, are consistent with the case described. Papillary carcinoma is known for its characteristic nuclear changes, including nuclear grooves and pseudoinclusions. It usually has an excellent prognosis with a high survival rate.

Also read: FMGE Previous Year Questions for PSM

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