Pathology Important Questions for NEET PG/FMGE

If you are a NEET PG/FMGE aspirant, you must be aware of the importance Pathology holds in helping you ace the exam. It’s crucial for you to understand diseases and their effects on the human body.

Pathology is undeniably a subject that requires you to have a strong grasp of concepts and skills to apply them in clinical scenarios. With such a vast syllabus to cover, it can be a tad difficult to determine the most relevant and high-yield topics.

This is why we’ve compiled for you a list of important pathology questions that are frequently asked in the exams. And the best part is that we have explained every question in detail. It will now be easier for you to understand the concepts and retain the information.

Without further ado, let’s explore the questions and help you prepare strategically for the exams.

Q.1 During a routine colonoscopy of a 60-year-old male, a small polyp is identified in the colon. Subsequent biopsy results confirm the presence of a hyperplastic polyp. Which characteristic is typically associated with this condition?

1. Commonly found in the right colon
2. Pathogenesis involves increased epithelial cell turnover
3. Lacks malignant potential
4. Histologically composed of immature goblet cells

Answer: 3) Lacks malignant potential

Explanation:  The characteristic of hyperplastic polyps is that they lack malignant potential.

Hyperplastic polyps:

• Lacks malignant potential (Option 3)
• Benign epithelial proliferations occurring commonly in the 6th–7th decade. 

Also read: PSM Clinical and Non-Clinical Questinos for NEET PG/FMGE

Q.2 A 32-year-old female presents to the clinic with complaints of dark urine, fatigue, and abdominal pain over the past few weeks. On examination, she has pallor and mild jaundice. Laboratory investigations reveal hemoglobinuria, elevated LDH levels, and low haptoglobin levels. Which of the following defects is most likely responsible for her condition?

1. Spectrin
2. CD 45 and CD 95
3. G6PD enzyme
4. PIGA gene

Answer: 4) PIGA gene

Explanation: The above clinical scenario suggests paroxysmal nocturnal hemoglobinuria, which is due to a mutation in the PIGA gene.

Q.3 A 70-year-old woman is being evaluated for monoclonal gammopathy. Bone marrow examination showed abnormal proliferation of plasma cells with evidence of certain microscopic features. Match the following structures with corresponding histopathological images regarding this condition.

1. Flame Cell	a)​​​
2. Mott cell	b)  ​​​​​​​​​
3. Russel bodies	c)   ​​​
4. Dutcher bodies	d)   ​​​

1. 1-d; 2-a; 3-c; 4-b
2. 1-d; 2-c; 3-a; 4-b
3. 1-c; 2-d; 3-a; 4-b
4. 1-c; 2-d; 3-b; 4-a

Answer: 2) 1-d; 2-c; 3-a; 4-b

Explanation: The patient most likely has multiple myeloma, a plasma cell neoplasm, and can present with characteristic histopathological features such as:

Inclusion Bodies Seen In Multiple Myeloma

Russel bodies:

• Location: Intracytoplasmic
• Composition:
• Esonophillic
• Round
• Dilated endoplasmic reticulum cisternae filled with condensed immunoglobulin.

Dutcher bodies

• Location: Intranuclear.

Composition: Globular inclusions containing accumulated immunoglobulin. 

Plasma Cell Variants In Multiple Myeloma

Mott cells

• Contain grape-like cytoplasmic droplets.
• Composition: Inclusion bodies, fibrils, crystalline rods, and globules.

Flame cells

• Appearance: Fiery red cytoplasm.
• Cause: High concentration of immunoglobulin as bright red granules within the cytoplasm.
• Often seen in IgA subtype myeloma.

Also read: Pathology One-Liners for Medical Students

Q.4 A 45-year-old male presents with fatigue, pruritus, and jaundice. He has a history of ulcerative colitis. Laboratory tests reveal elevated liver enzymes and conjugated hyperbilirubinemia. Imaging shows multiple bile duct strictures and dilatation. Histopathological examination from a liver biopsy is given below. Which condition is most likely responsible for these findings?​​

1. Clonorchis/Opisthorchis infection
2. Primary Biliary Cholangitis
3. Primary Sclerosing Cholangitis
4. Biliary stone obstruction

Answer: 3) Primary Sclerosing Cholangitis

Explanation: 

Primary sclerosing cholangitis (PSC) (Option 3)

Seen in 30 years old; M>F

p-ANCA positive

Associated with ulcerative colitis, HLA-B8

Intrahepatic and extrahepatic bile ducts are affected

Q.5 A 60-year-old man with poorly controlled hypertension and diabetes presents with fatigue, shortness of breath, ankle swelling, hepatomegaly, and bilateral lower extremity oedema. Labs show proteinuria and elevated serum creatinine. Which staining technique is most appropriate to confirm the diagnosis?

1. Periodic acid Schiff (PAS) stain
2. Masson trichome stain
3. Congo red stain
4. Oil red O

Answer: 3) Congo red stain

Explanation:

The clinical presentation of a patient with poorly controlled diabetes and hypertension, hepatomegaly, bilateral lower extremity oedema, proteinuria, and elevated serum creatinine highly point towards a diagnosis of AA amyloidosis, where chronic inflammation leads to the production of SAA, resulting in amyloid deposition in various organs.

Congo red stain is the most appropriate technique to confirm the diagnosis of amyloidosis.

Also read: Polycythemia Vera: Causes, Symptoms, Risk Factors, Diagnosis

Q.6 Which of the following conditions is FNAC helpful in establishing diagnosis?

1. Follicular adenoma of the thyroid 
2. Testicular cancer 
3. Hydatid cyst 
4. Medullary thyroid carcinoma 

Answer: 4) Medullary thyroid carcinoma 

Explanation:

FNAC is an initial investigation in the diagnosis of the medullary adenoma of the thyroid and other thyroid disorders. 

It is not particularly useful in establishing the diagnosis of follicular lesions as the follicular adenoma and carcinoma appear similar on fnac, and the architecture of the gland is not visible.

Q.7 A 65-year-old diabetic male presented to the hospital complaining of chronic abdominal discomfort and unexplained weight loss over the past few months. A palpable, firm mass was detected on the left upper quadrant upon physical examination. Ultrasound revealed a large mass in the left upper pole of the kidney. Due to suspicion of renal malignancy, the patient underwent a left nephrectomy. Based on the specimen obtained, what is the most likely diagnosis?​​

1. Renal oncocytoma
2. Epithelioid angiomyolipoma
3. Clear cell carcinoma
4. Urothelial carcinoma

Answer: 1) Renal oncocytoma 

Explanation:

Renal Oncocytoma:

• It is most commonly seen in > 50-year-old adults.
• It arises from the intercalated cells of the collecting ducts.
• Gross appearance: Tan or mahogany brown, with a central scar.
• Microscopy: Composed of pink eosinophilic cells with small, round, benign-appearing nuclei.

Also read: Sarcoidosis: Symptoms, Causes and Treatment

Q.8 A 58-year-old male smoker presents with a persistent cough and mild shortness of breath. Chest imaging reveals a single pulmonary nodule. A biopsy is performed, and a histopathological examination of the lung tissue shows a localized proliferation of dysplastic cells along existing alveolar septa with the lepidic pattern in the image below. What is the most likely diagnosis?

1. Carcinoma in situ
2. Adenomatous hyperplasia
3. Adenocarcinoma in situ
4. Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia

Answer: 3) Adenocarcinoma in situ

Explanation: 

• The histopathological image shows a localised proliferation of dysplastic cells along pre-existing alveolar septa, indicative of adenocarcinoma in situ (AIS) or bronchioloalveolar carcinoma which is a precancerous lesion of adenocarcinoma of the lung with severe cytologic atypia.
• AIS is an early stage of lung cancer where abnormal glandular cells are confined to the airway lining without invasion and exhibit a “lepidic growth pattern” (or butterfly on fence pattern), spreading along intact alveolar structures without invasion.

Q.9 A 50-year-old male smoker presents with painless swelling in the parotid region. Fine needle aspiration cytology (FNAC) reveals murky fluid. Which of the following histopathological features is true regarding this condition?

1. Proliferation of squamous epithelial cells with keratinisation
2. Oncocytic cells with double-layered lining
3. Neuroendocrine differentiation
4. Papillary architecture with pammoma bodies

Answer: 2) Oncocytic cells with double-layered lining

Explanation: 

• The clinical presentation and histopathological image suggest a Warthin tumour or Papillary cystadenoma lymphomatosum, a benign salivary gland tumour that typically occurs in the parotid gland.
• It is characterized by oncocytic cells with abundant eosinophilic cytoplasm, a double-layered epithelial lining (bilayered epithelial lining), and lymphoid stroma.
• This characteristic appearance is often referred to as "cystic oncocytic hyperplasia.”

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