Pathology – Frequently asked questions

diseasesDr.Amir Khalid
BHMS, MD(Hom)  Calicut.

This notes may be used for Group discussion which is also an important factor in preparation.One among you asks questions in haphazard/ rapid manner and others try to answer. This will quicken or sharpen your memory and reflexes. But not conceal any points for fear of others knowing it.  It is always said to be good to do group study.

  1. Rudolf Virchow is known as the Father of Modern Pathology
  2. Deletion of long arm of chromosome 13 in — Retinoblastoma.
  3. Loss of chromosome 22 n — Meningioma.
  4. 8- 14 Chromosomal translocation in — Burkitis lymphoma.
  5. Normal nuclear cytoplasmic ratio is 1:4.
  6. Cancer suppressor genes are located on chromosomes 13 and 11
  7. Glycoprotein that acts as tumor marker for colon cancer and pancreatic cancer is CA-19-9
  8. In CEA positive colon cancers, the period after which elevated levels of CEA indicate residual disease s 6 weeks.
  9. Marker for Ca breast is CA-i5-3.
  10. Schwannomas are associated with somatic mutations in gene NF-1.
  11. Total coagulative necrosis in M w loss of nuclei is not apparent until about 72 hours.
  12. Retinoblastoma is associated with deletion in Chromosome 13.
  13. After initial acute attack, chronic RED appears at least after 10 years.
  14. ‘Wedge shaped’ infiltrates on X-ray are diagnostic of pulmonary infarction. It appears 12-36 hours after.
  15. Length of oesophagus in newborn is 10 cm .
  16. Toxic injury of liver affects most often Zone 1.
  17. Macronodular cirrhosis is considered once nodule is greater than 3 mm.
  18. The oncogene amplified in Down’s syndrome leading to mental retardation is Ets-2.b
  19. The percentage of total cholesterol that freely circulates in plasma is 7%.
  20. For teratogenesis, peak sensitivity during embryonic period is 4-5 week.
  21. DNA sequence in any two persons reveal variation in one nucleotide for every 200-500 nucleotides.
  22. Thè  perinatal infection to erythroid precursor in bone marrow is Parvovirus C-19.
  23. In a newborn with normal surfactant production, the residual volume retained by kings after first breath is 40%.
  24. Normal human deploid fibroblasts stop proliferating in culture after 5O doublings
  25. Gaucher’s cells are glucocorebroside filled cells measuring 20-1OO mm,-and are fat negative
  26. Glucogonomas arise from the Alpha -cells of the pancreatic islets
  27. Craniopharyngiomas are tumors that arise from remnants of Rathke’s pouch.
  28. The 21-hydroxylase deficiency is most commonly found form of the adrenogenital  syndrome.
  29. Malignant hypertension is microscopically characterized by fibrinoid necrosis of arteriolar wall
  30. The most common site for intestinal amoebiasis  is caecum
  31. Fibrosis is evident by light microscopic examination when a thrombus is more than one week old.
  32. Both systemic and pulmonary embolism is seen in septal infarction.
  33. The commonest malignancy seen in immune deficiency state is lymphoreticular malignancy.
  34. Pseudomyxoma peritonei is seen with mucus secreting ovarian carcinoma.
  35. The most common complication of infective endocarditis is thromboembolism.
  36. The commonest site for amyloid deposition in intestine is colon.
  37. Villous atrophy is diagnostic of coeliac disease.
  38. The thyroid cancer most frequently metastasises to lymph nodes is papillary.
  39. Alzheiniers disease is degenerative disease which typically shows progressive atrophy of the brain particular the frontal, parietnal occipital cortex.
  40. Multiple endocrine neoplasia (MEN) are familial disorders with autosomal dominant mode of transmission
  41. MEN 11 syndrome is characterized by the occurrence of medullary carcinoma thyroid. pheochromocytomas and parathyroid hyperplasia.
  42. Affection of terminal ileum in Crohns disease is called as back wash ileitis?
  43. Ulcerative colitis is primarily a disease of mucosa.
  44. The most common lesion in Wernicke’s encephalopathy is found in the mamillary bodies.
  45. The lesion of atherosclerosis occurs mainly in abdominal aorta.
  46. A tumor arising from hum scar is most likely squamous cell carcinoma.
  47. Duct papilloma is the commonest cause of blood stained nipple discharge.
  48. Thyroid appearance of renal tubules is considered pathognomonic of chronic pyelonephritis.
  49. Periglomerular fibrosis is considered typical of chronic pyelonephritis.
  50. A reliable screening test for platelet function is clot retraction test.
  51. Exposure to vinyl chloride may develop angiosarcoma of liver.
  52. Haematuria  is characteristically seen in proliferative glomerulonephritis.
  53. ‘Russel bodies are seen in plasma cells.
  54. The cells most sensitive to ischaemia is cortical neurons.
  55. Keloids predominantly consist of dense collagen fibres.
  56. The epithelial cells of tubercle are derived from monocytes.
  57. Rosette formation is characteristically seen in Retinoblastoma.
  58. Laminin is the most abundant glycoprotein in the basement membranes
  59. Chancroid is also called “ulcus molle.’
  60. Lipoid nephrosis of the most common cause of nephrotic syndrome in childhood.
  61. Budd-chiari syndrome is produced by occlusive lesions of the Hepatic veins.
  62. Glomeruloid bodies or Schiller-Duval bodies, are commonly found in endodermal sinus tumour.
  63. K.W syndrome comprises diabetes mellitus, hypertension, albuminuria and edema.
  64. Monodermal teratomas are very uncommon and most frequently take the forms of struma ovarii or carcinoids. .
  65. Nodular melanoma is the most aggressive type of melanoma and hence carries the worst prognosis.
  66.  “Lafora syndrome” is a progressive familial myoclonic degenerative disease affecting predominantly the basal ganglia, most patients dying by the age of 30 years.
  • Lutembacher’s disease consist of a combination of an atrial septal defect and mitral stenosis
  • Almost all lysosomal storage diseases are transmitted as autosomal recessive genes.
  • Philadelphia chromosome (ph) is identifiable in more than 90% of patients with chronic myelogenous leukaemia.
  • Patients with ph-negative CML respond poorly to chemotherapy and have shorter survival than those with ph-positive CML
  • Chloromas  are tumorous masses of acute myeloblastic leukaemia.
  • Auer rods are abnormal lysosomal structures visualized as reddish rods in myeloblasts and promyelocytes.
  • Medullary carcinoma of the thyroid gland arises from parafollicular “c’ cells.
  • Achalasia of esophagus is associated with “Chagas’ disease.
  • Hyperacute rejection occurs within minutes after u and is due to cytotoxic complement dependent. pre existing antibodies in the host.
  • Papillary carcinoma is the most common malignancy of thyroid.
  • Aschoff bodies are pathognomonic of rheumatic carditis.
  • Most carcinomas of pancreas originate from the epithelial cells lining the ducts and are most often located in the head
  • Most breast tumors originate in the ducts and have the histologic appearance of infiltrating duct carcinoma.
  • The serum TSH is the most sensitive indicator of primary hypothyroidism
  • Mixed tumors e.g.mixoid parotid tumour
  • Teratomas arise from totipotential cells that retain the ability to form endodermal, ectodermal, ectodermal and mesenchymal tissue. Such tumors are found in testis and ovary.
  • Two non-neoplastic  lesions simulating tumours.
  • Choristomas Ectopic, sometimes nodular, rests of non transformed tissues (e.g Pancreatic cells under of the small bowel mucosa).
  • Hamartomas Malformations that present as a mass of disorganized tissue indigenous to the particular site (i.e. a hamartomatous nodule in the lung may contain islands of cartilage, bronchi, and blood (vessels).
  • Metastasis is the single most important feature distinguishing benign from malignant turnouts. Exception being I. Brain tuinours 2.Basal cell carcinoma of skin
  • Grading is based on the degree of differentiation and the number of mitoses within the tumour. Cancers are classified as grades   1 to IV with increasing anaplasia.
  • Staging is based on the anatomic extent of the tumour. Two methods of staging are in use now-a-days. .TNM (Tumour, Node & metastases). 2. AJC (American joint committee).
  • In Philadelphia chromosome a reciprocal balanced translocation between chromosomes 22 and usually 9(9, 22)is seen in more than 90% of cases of CML.
  • In more than 90% of cases of Burkiti’s lymphoma at (8; 14) translocation is present.
  • Deletion of chromosome 13, band q 14 is associated with retinoblastoma.
  • Deletion of chromosome II band q 13. is associated with Wilm’s tumour.
  • Gene amplification associated with cytogeneüc changes is best exemplified by neuroblastomas
  • Cancers of lung, colon and prostate are the leading causes of cancer deaths in males while in females lung, breast and colon cancers are morn common.
  • Japanese are prone to develop gastric cancer
  • In xeroderma pigmentosum, affected patients develop Ca skip in areas exposed to the ultraviolet light.
  • Clinical conditions associated with increased risk of developing cancers.
  • Cinhosis of liver—hepatocellular Ca.
  • Atrophic gastritis of pernicious anemia—stomach cancers.
  • Chronic ulcerative colitis—Ca colon.
  • Leukoplakia (oral/genital mucosa)—squamous cell carcinoma
  • Villous adenoma colon—colonic Ca.

Carcinogenic chemicals.

  1. Alkylating agents e.g. cyclophosphamide and Busulphan induced cancer.
  2. Aromatic hydrocarbons present in cigarette smoke induces lung cancer.
  3. Azodyes ( naphthylamines) induces bladder cancer
  4. Aflatoxin BI—hepato cellular carcinoma
  5. Nitrosamines and amides—gastric cancer.
  6. Asbestos—mesotheloma
  7. Vinyl chloride—angiosarcoma
  8. Saccharin & cyclamates—bladder cancer promoter,
  9. Oestrogen—endometrial carcinoma.

Radiation carcinogenesis

  1. UVR—Carcinoma & Melanoma
  2. Ionizing radiation
  3. Miners f radioactive ores have an increased risk of lung cancer.
  4. Increased risk of leukaemia in atomic bomb survivors in Japan.
  5. Therapeutic radiation of the neck in children has been associate with the later development of thyroid cancer (papillary).
  6. Note: In man there is a hierarchy of vulnerability of radiation induced neoplasms;
  7. Most common are myeloid leukaemias, followed by thyroid cancer in children.
  8. Cancer of the breast and lung are less commonly radiation induced.
  9. Skin, bone and gut are least susceptible to radiation to cause cancer lies in their ability to induce mutations. Paniculate radiations (alpha & beta Neutrons) are more carcinogenic than electromagnetic radiation (X-rays. gama Viral oncogenesis)

Causes of cachexia in cancer.

  •  Loss of appetite
  • Infections due to immunosuppression
  • Bleeding froth ulcerative lesions
  • Production of cachectin (TNE-a) by activated macrophages cachectin moblilizes body fat

Paraneoplastic syndromes It may be the earliest clinical manifestation of a neoplasm and may mimic distant spread. The most common syndromes are

  • Endocrinopathies -ectopic hormone production—(ACTH)
  • Hypercalcemia (PTH like peptide)
  • Squamous cell carcinoma lung
  • T cell leukemias or lymphomas.
  • Note—Cancer associated hypercalcemia also results from osteolysis induced by bony metastases.
  • Acanthosis nigricans—Verrucous pigmented lesion of skin is frequently associated with visceral malignancy.
  • Clubbing of fingers and hypertrophic osteoarthropathy are associated with lung cancers. e. Thromhotic diatheses resulting from production of thromboplastic substances by tumour cells may manifest as m or as vegetations in non-bacterial thrombotic endocarditis.
  • Heart failure cells are seen in pulmonary edema.
  • In the development of these cells, the initial pulmonary edema (due to LVF) leads to dilatation of intra-alveolar capillaries which in turn rupture. The minute intra-alveolar haemorrhages breakdown and phagocytosis of red blood cells leads to the formation of haemosiderin laden macrophages which are termed Heart Failure Cells.
  • Brown Induration of Lung—Name given to firm, heavy, dark brown appearance of Lungs due to long standing pulmonary congestion e.g. in mitral stenosis or CHF.

Nut-Meg Liver—A descriptive term for congestive red-blue central region of a lobule in liver parenchyma, surrounded by a zone of uncongested liver substance-due to CPC liver conditions associated.

  • Right Heart Failure
  • Obstruction to IVC
  • Obstruction to hepatic vein less common

Organs Affected in Generalised Primary Amyloidosis

  • I.Heart  5. Tongue
  • 2.Kidney            6.Larynx
  • 3.Intestine         7.Skin etc.
  • 8. Skeletal muscles

Staining reaction of amyloid material

  1. Iodine gives brown- colour and I2 followed by H2S04 gives blue colour Congo red  -red
  2. Methyl violet—rose red while other tissue becomes blue (metachromatic stain).
  3. Von-Gieson’s stain—Khaki shade
  4. PAS stain—red.
  5. Iodide green—(metachromatic stain)—violet red other stained green.
  6. H- & E stain—faintly eosinstained homogenous material.
  7. Fluorescent dyes—to demonstrate amyloid in juxta glomerular area of kidney.
  8. Immunohistological stain—to distinguish between AL and AA.

Predisposing factor for secondary amyloidosis. 1. TB of lungs, bone, joints etc

  • Chronic suppuration in lungs, bones and joints etc.
  • Syphilis
  • Rheumatic fever and rheumatoid arthritis.
  • Ulcerative colitis, Hodgkin’s disease.
  • Advanced malignancy.
  • Hansen’s disease (leprosy).

Lab diagnosis of amyloidosis

  • Congo red test
  • Rectal mucosa biopsy.
  • Gingival biopsy.
  • Biopsy of bone marrow, liver, spleen, kidney and intestine.
  • Peripheral smear examination.
  • Serum and urinary protein by immuno-electrophoresis.
  • Demonstration of Bence-Jones protein.
  • Demonstration of calcitonin.
  • Note Amyloid can be differentiated from hyaline connective tissue by its characteristic staining  with Congo red, with which it appears red and shows apple-green bipolar refringence.  Aschoff bodies are found in, Heart, Synovia of joints, Joint capsules, Tendons (Extensor aspect), Subacutaneous tissues.

Diagnosis of Acute Ml

  • ECO—Presence of pathologic Q-waves usually indicates transmural MI Also present are ST-Segment and T wave changes with alone indicate subendocardial infarct.
  • lsoenzyrne studies
  • MB isoenzyme of creatinine Kinase-highly specific and sensitive marker for MI, Elevated within 48-72 his, of M and peaks at 12-24 hours after Ml.
  • SGOT levels—begin to rise in 8 hrs after MI and peak at 18 to 36 hours to return to baseline within 3 to 4 days
  • Lactic dehydrogenase—Begins to rise 24 hours after Ml, peaks in 3 to 6 days and returns to normal only after two weeks
  • Most sensitive is LDH I: LDH 2 ratio which in inverted in MI.
  1. Ring granuloma in —Q-fever.
  2. The main feature of rapidly progressive giomenilonephritis—Epithelial crescents.
  3. The Tram track (Thickened or split) basement membrane in —Membrano-prolitèrative  glomerulonephritis.
  4. Thyroldisation of Renal tubules (Atrophic tubules with casts) in —Chronic pyelonephritis.
  5. Periglomemlar fibrosis in —Chronic pyelonephritis
  6. Michaelis Gutman bodies (Giant cells containing calcium and Iron inclusion) in Melakoplakia of urinary body (a variant of cystitis).
  7. Nebothian follicle in — Chronic Cervicitis.
  8. Flea bitten kidney —Focal Globerulonephritis.
  9. Onion skin appearance of spleen in—SLE.
  10. Hurthle cells in — Hashimatos thyroiditis.
  11. Lipofusein — wear and tear pigment.
  12. Karyorrhexia — Nuclear fragmentation.
  13. Hassel’s corpuscles in —Thymus.
  14. In oncocytoma, the oncocytes have sac like mitochondria.
  15. Left ventricular hypertrophy is said to present when the thickness of left ventricular wall is more than 15mm.
  16. Melanin like pigment in liver is — Dubin Johnson syndrome.

Psammoma Bodies in:

  • Psammomatous Meningioma.
  • Papillary carcinoma of Thyroid.
  • Pupillary serous cystadenoma of ovary.
  1. Libman Sacks endocarditis in —SLE.
  2. Amyloidosis is also known as — Beta fibrillosis.
  3. Durck’s granulomas am seen in — Malaria.
  4. Lepra cells encountered in —Lepromatous lepmsy.
  5. Microscopical]y, normal cells or tissues present in abnormal locations are referred to as Choristoma.
  6. Hyaline material consists of—Precipitated plasma proteins.
  7. Glycogen can be confirmed by PAS stain.
  8. Flame cells seen in — Multiple myeloma.
  9. Mc Callums patch is found in — Left Atrium.
  10. Melanin can be stained with Fontana stain.
  11. Bilirubin an be confirmed by —Hall’s stain.
  12. Hemosiderin is golden yellow in colour.
  13. Heart failure cells are seen in lungs, in profound anemia, fatty change in heart is —‘Thush breast or Tigered effect,
  14. In all organs, fatty change appears as Clear Vacuoles within parenchymal cells.   Fatty in growth, fatly change appears as Clear Vacuoles within parenchymal cells.
  15. Fatty in growth is most commonly encountered in Heart and Pancreas.
  16. Fat can be stained with —Sudan IV or Oil Red-O.
  17. Glycogen stained by — Bests Carmine or FAS reaction.
  18. The most common exogenous pigment is — Carbon or coal dust.
  19. Lipofuscin is — Insoluble pigment. also known as Lipochrome.
  20. The tell tale sign of free radical injury and Lipid peroxidation – Lipofuscin.
  21. Homogentisic acid is a — Black pigment, occurs in Alkaptonuria.
  22. Lipofuscin is seen in cells undergoing slow, regressive changes, and is particularly prominent in Liver and heart of ageing or patients or patients with severe malnutrition and cancer cacehxia.
  23. Lipofuscin is usually accompanied by — Organ shrinkage (Brown Atrophy).
  24. Hemosiderin is derived fro Hemoglobin.
  25. In Fenton reaction, Hydroxyl Radicals are generated by interaction of Hydrogen peroxide with Transitional metals like Iron, Copper.
  26. The major antioxidant enzymes are — Superoxide dismutase, catalase, Glutathione peroxidase.
  27. Cells sometimes respond to infection with Measles or herpes virus by the formation of Syncytial or multinucleate giant cells, caused by cell to cell fusion.
  28. Certain virus infected cells develop inclusion bodies which contain — Virions or viral proteins in nuclei or cytoplasm.
  29. Mitochondrial swelling is the first manifestation of almost all forms of injury to cells.
  30. The dead cells usually shows increased eosinophilia.
  31. Necrosis is the sum of the morphological changes that follow cell death in a living tissue or organ.
  32. Apoptosis—Morphological pattern of cell death.
  33. The earliest observed ultrastructural change in necrosis cell —A reversible clumping of the chromatin to create large aggregates attached to the nuclear membrane and to the nucleolus.
  34. Pyknosis—Progressive shrinking of nucleus and becomes transformed to a small, dense mass of tightly packed chromatin.
  35. Karyolysis—Dissolution of chromatin.
  36. Karyorrhexis—Nucleus break into many clumps (Fragmented nucleus).
  37. Acidophil or Councilman body seen in the liver in —Toxic or viral hepatitis.
  38. The most common pattern of necrosis — Coagulation necrosis.
  39. In Coagulation necrosis—Basic cellular shape is preserved with loss of nucleus.
  40. Coagulation necrosis most commonly results from sudden severe ischaemia of organ such as -Kidney, Heart, Adrenal gland.
  41. Liquefaction necrosis is from the action of —Hydrolytic enzyme.
  42. The liquefaction necrosis pattern is characteristic of—ischemic destruction of Brain tissue.
  43. Caseous necrosis is a combination of coagulative and liquefactive necrosis.
  44. Caseous necrosis is attributed to capsule of Mycobact. tuberculosis, which contains — Lipopolysacharides.
  45. Fat necrosis is due to the action of—Lipases.
  46. Fat necrosis induced by trauma, particulaily in — Breast Adipose tissue.
  47. Fat necrosis is most commonly seen in —Acute pancreatitis.
  48. In Gangrenous necrosis — Coagulative necrosis is modified by the liquefactive action of Bacteria and leukocytes.
  49. In dry gangrene—Coagulative necrosis is dominant.
  50. In wet gangrene necrosis is dominant. – –
  51. Fatty change in liver, the mostly accumulated lipid is —Thglycerides.
  52. Acute fatty liver of pregnancy is often fatal.

Fatty change is due to:

  • In alcohol poisoning — Increased esterification of fatty acids to Triglycerides.
  • In carbon tetrachioride, phosphorous poisoning and protein malnutrition —
  • Decreased Apoprotein synthesis.
  • In experimental node! of Fatty liver induced by orotic acid — Impaired secretion of lipoprolein.
  • Starvation, corticosteroids — Excessive entry of free fatty acids into the liver.
  1. Father of Modern Pathology—Virchow.
  2. Fatty change per se is Reversible.
  3. Fatty change is most often seen in —Liver and heart.
  4. Bilirubin do not contain Iron,
  5. In advanced obstructive jaundice, aggregates of pigment creates — Bile lakes.
  6. The organs in which Bilirubin accumulation is evident in Liver and Kidneys.
  7. Heiiiochrormatois of pancreas results in Diabetes mellitus,
  8. Colchcine  block the mitosis in the Metaphase.
  9. In Chediak—Higashi syndrome, there is – Impaired pathocytosis.
  10. The cytoskeleton consists of microtubules, thin actin filaments, thick Myosin filaments, Intermediate filaments.
  11. Intermediate filaments are keratin filaments, neurofilaments, glial elements vimentine, Desmin etc.
  12. In the erythrocyte, the major protein consist of spectrin, actin, protein 4.1 and ankyrin.
  13. In hereditary spherocytosis, the defect in Red cell shape is due to — abnormal or deficient spectrin. –
  14. In hypertrophy of cell. there is increase in the number of mitochondria. In atrophy there is decrease in the number of mitochondria
  15. Compensatory hyperplasia — Hyperplasia that occurs when a portion of liver is removed.
  16. Pathological calcification implies the abnormal deposition of—calcium salts, together with smaller amounts of Iron, magnesium etc.
  17. Ferrugenous bodies (Exotic, beaded dumbel forms) in lung occur in —Asbestosis.
  18. Initiation of intracellular calcification occur in the mitochondria of dead or dying cells.
  19. Metastatic calcification appears to begin in Mitochondria except in — kidney (where it develops in the basement membrane
  20. Alcoholic hyalin (Mallory body) consist of aggregates of Prekeratin Intermediate filaments.
  21. Amyloid with congo Red stain appears—Red and shows Bipolar refringence.
  22. Keratin pearl in —Squamous cell carcinoma.
  23. Pseudocartilage in —Pleomorphic adenoma.
  24. Tadpole cell in —Rhabdomyosarcoma.
  25. Rosette formation in — Neuroblastoma, Retinoblastoma.
  26. Arias Stellas reaction in — Ectopic pregnancy.
  27. One of the causes of Hypercalcemia — Addison’s disease.
  28. Antimitochondrial antibody in — Primary biliary cirrhosis.
  29. Viirucae body in —Neurilemmoma.
  30. In most types of acute inflammation, neutrophils predominate in the first 6 to 24 hours, being replaced by monocytes in 24 to 48 hours.
  31. Opsonic fragment of C3 complement – C3b.

Thromboxane A2

  1. Found in Platelets
  2. Causes platelet aggregation and blood vessel constriction. Prostacyclin: Inhibitor of platelet aggregation and causes vasodilation. Aspirin – indomethacin etc inhibit the enzyme – cyclooxygenase. Macrophages in (Mononuclear phagocytes in)
  3. Blood – Monocytes.
  4. Nervous system – Microglia.
  5. Bone – Osteoclasts.
  6. Liver – Kupffer cells.
  7. Connective tissue – Hiystiocytes.
  8. Bone marrow – Macrophages.
  9. Skin – 1 Langerhan’s cells.
  10. Lymphoid tissue –  Dendritic cells. 
  • Asteroids in giant cells in — Sarcoidosis.
  • Labile cells — Proliferate throughout life.
  • Permanent cells in—Skeletal muscle, cardiac muscle, nervous system.
  •  Commonest tumor of Appendix — Argentaffinoma
  •  Juvenile polyposis supposed to be Retention cysts.
  • Nurse cells in — Trichenella spiralis.
  • Heart failure cells (Hemosiderin laden Macrophages) in Alveolar spaces in —Congestive heart failure. Lisch nodules (pigmented Iris hamanomas) in —Neurofibromatosis.
  • Most of the known carcinogens are metabolized by the— cytochrome P dependent monooxygenases.
  • The most common type of thickening of Glomerular basement membrane is due to extensive subepithelial deposition of immune complexes, as occurs in — Membranous Glomerulonephritis
  •  The classic Glomerular basement membrane antigen is component of collagen type – IV.
  • Kidney (Electron Microscopy):
  • Subepithelial humps in— Post streptococcal Glomerulonephritis
  • Subepithelial deposits in —Membranous G.N.
  • Loss of foot process in — Lipoid nephrosis, Focal segmental Glomerulosclerosis
  • Subendothelial deposits in — Membrano proliferative G.N.
  •  Mesangial and paramesangial dense deposits of IgA nephropathy

Kidney (Light Microscopy):

  • Diffuse capillary wall thickening —Membranous G.N.
  • Lipid in Tubules in — Lipoid nephrosis.
  • Hyalinized Glomeruli in — Chronic Glomerulonephritis.
  • Splitting of basement membrane — Membrano proliferative G.N.
  1. Two Histologic Alterations that Characterise Malignant Hypertension:  Fibrinoid necrosis of arterioles,-lyperplastic arteriolitis
  2. Angiomyolipoma are common in patients with —Tuberous sclerosis.
  3. Fatty streaks appear in the aortas of all children older than one year.
  4. Ring like calcifications in the media of medium sized to small arteries of muscular type in — Monckeberg’s medial sclerosis.
  5. Te most usual site of involvement of polyarteritis nodosa — Kidney (Renal vessels).
  6. Classic polyarteritis nodosa does not affect the pulmonary circulation.
  7. Fibrinoid necrosis in — Malignant hypertension, Polyarteritis nodosa etc.
  8. In inflammation, macrophages originate from — Macrophages.
  9. Bacteria containing Hyaluronidase — Clostridium
  10. Granulation tissue is formed in the process of Healing by Secondary union.
  11. The Amyloidosis that occurs in Multiple myeloma — Primary Amyloidosis.
  12. Rodent ulcer — Basal cell carcinoma.
  13. Centrilobular necrosis of liver in —Congestive heart failure.
  14. Nut meg liver in —Congestive heart failure
  15. Cardiac sclerosis of liver in — Congestive heart failure.
  16. Carcinoid tumors in the ovary or lung may induce carcinoid syndrome without antecedent Hepatic metastases.
  17. The fact that the cardiac changes in carcinoid heart diseases are largely Right sided is explained by —Inactivation off both serotonin and bradykinin in the blood dining passage through lungs by Monoamine oxidase found in pulmonary vascular endothelium.
  18. The most common primary tumor of heart in adults — Myxomas (Commonest site – Left Atrium).
  19. The most frequent primary tumor of heart in infants and children — Rhabdomyomas.
  20. Gandy — Gamma bodies contain – Deposits of Hemosiderin and Calcium. –
  21. Autosplenectomy occur in Sickle cell anemia.
  22. Lacunar cells in Nodular sclerosis type of Hodg disease.
  23. Owl eyed nucleoli in the nucleus of Reed-Sternberg cell.
  24. Chloromas are seen most commonly in —AML.
  25. Myeloblasts are characterised by delicate nuclear chromatin three to live nucleoli and fine  azurphilic granules  in cytoplasm.
  26. Lvmphoblasts  have coarse, clumped chromatin and few nucleoli — Azurophilic granules are not present in cytoplasm.
  27. Auer rods ire Red staining, intracytoplasmic, rod like structures      in granulocytes.
  28. Massive splenomegaly is associated with —CML and hairy cell leukemia.
  29. Spontaneous rupture of spleen seen in — Infectious mononucleosis, Malaria, Typhoid fever, Leukaemia, Acute splenitis
  30. In diabetic nephropathy, the cells of the distal portions of proximal convoluted tubules contain —Glycogen (Armanni ebstien lesion).
  31. The characteristic hail mark of all syphilitic infections — obliterative endarteritis with perivascular cuffing of lymphocytes and plasma cells.
  32. The half mark of cutaneous T cell lymphoma of Mycosis fungdides type histologically is the identification of the Sezary-Lutzner cells.
  33. Polyglucoside bodies — CorDora Amylacea.
  34. Microglia can be stained by special stains like — Hortega carbonate.
  35. Brain has no lymphatic system.
  36. Subdural haemorrhage result from —rupture of bridging veins that connect the venous system of brain to the large intradural  venous sinuses.
  37. Hirano bodies in—Aizheimer’s disease;
  38. Pick bodies in —Picks disease.
  39. The most common congenital malformation of the brain in humans—Anencephaly.
  40. In Schwannomas, no nerve fibres are present in the tumor.
  41. Retinal phlebitis with candle wax drippings in or near Retinal vessels in— Sarcoidosis
  42. Dalen Fuchs nodules between Bruchs membrane and Retinal pigment epithelium in — Sympathetic uveitis.
  43. The most common primary ocular malignancy in Caucasians—Intraocular Melanomas.
  44. Fexner Wintersterier Rossettes in —Retinoblastoma.
  45. Thrombi when formed with a cardiac chamber or Aorta, they may have apparent laminations called— Lines of Zahn.
  46. Lines of Zahn are produced by— Alternating layers of pate platelets admixed with fibrin separated by dark layers containing red cells.
  47. Vericcous endocarditis—Non-bacterial bland Thrombotic vegetations seen in systemic lupus erythematosis.
  48. Chicken fat thrombus — Post mortem thrombus.
  49. Commonest site of Pblebothrombosis — deep leg veins.
  50. Infarct of Zahn — due to occlusion of intrahepatic branch of portal vein.
  51. The two most distinctive features of chronic active hepatitis — piecemeal necrosis and Bridging necrosis.
  52. Ovarian Tumors:
  53.  • Call-Exner bodies in— Granojosa cell tumours.
  54.  • Reinke crystefloids in :— Hilus cell tumor.
  55.  • Alpha fetoprotein in — Endodermal sinus tumor.
  56.  • Chronic gonadotrophin in — Dysgerminomas.
  57.   • Meigs syndrome in — Ovarian fibromas.
  58. The causes of Rapidly progressive Glomerulonephritis are SLE (lupus nephritis), PAN, Post streptococcal glomerulonephritis etc.
  59. Rapidly progressive glomerulonephritis. pathologically characterised by extensive proliferation of cells in the Bowman’s space with the formation of crescents.
  60. Von Hansemann cells in— Melakoplakia of Bladder.
  61. Macrophages containing PAS positive glycoprotein granules typically seen in — Whipples disease
  62. In membranous glomerulonephritis, the kidneys are — large, swollen and pale.
  63. Ascending infection is the most common pathway by which bacteria reach the kidney.
  64. Bazins disease is Erythema induration.
  65. Real papillary necrosis or necrotising papillitis is due to – Diabetes mellitus, analgesics like phenacetin. urinary tract obstruction.
  66. The law that regeneration is more complete in younger individuals than in older ones is Spllanzani law.
  67. Encelitis is inflammation of intra abdominal organ.
  68. Hemophilia C due to defect in synthesis of PTA or factor Xl. It is Mendelian dominant.
  69. In hemophilia, bleeding is from large vessels whereas in thrombocytopenia, it is from small capillaries. Deficiency of factors 1 and II are rarely congenital. Parahemophilia is due to deficiency of factor V.
  70. Indian file pattern of cords in Ca breast is seen in infiltrating lobular type.
  71. Pagets cells arc seen in Pagets disease ofnipple.
  72. ANCA (Anti neutrophilic cytoplasmic antibody) is seen in Polyarteritis nodosa.
  73. Alveolar haemonhage syndrome may be present in Goodpasture’s syndrome, rheumatoid arthritis, SLE, idiopathic pulmonary hemosiderosis and toxin-induced disease from penicillamine.
  74. Anitschkow myocytes (caterpiller cells) are believed to be modified fibroblasts.
  75. Aschoff node is seen in rheumatic fever in myocardium.
  76. In Bowenoid papulosis, there are numerous small velvetly papules on shaft of penis of young men probably caused by HPV.
  77. Burnt out plaques are seen in multiple sclerosis.
  78. Lines of Zahn is a characteristic appearance of laminations in thrombi when formed in aorta.
  79. Adhesion molecules on leucocytes are P-150, MO-I, LEA-I.
  80. Polypoid cells seen in hypertrophy of cardiac muscle cells are arrested 02 phase
  81. Helper T-cells interact with Class-il MHC
  82. In SLE, autoantibodies against red cells, white cells and platelets is mediated by hypersensitivity reaction type I1
  83. Rubber hose inflexibility of GIT in systemic sclerosis is commonest in lower two thirds o esophagus. The lesion most specific for SLE is subendothelial deposit.
  84. Onion skin lesion  concentric periarterial fibrosis in spleen is characteristic of SLE.
  85. Pink to gray pinpoint elevations of endocardium giving Dew drop appearance is seen in amyloidosis TB does not produce granulomas in patients of  HIV
  86. Protoncogene with GTPase activity is H -ras.
  87. Zeebra bodies are seen in Niemann Pick disease.
  88. Hard glassy’ splenomegaly may be seen in amyloidosis.
  89. The dark lines of Zahn are composed of RBC’s.
  90. Amyloid gives apple green birefringence when stained with congored.I
  91. In psoriasis, the turnover of epithelial cells is at least twice as fast that of normal skin.
  92. In situ hybridisation uses biotin to give a colorimetric detection system.
  93. Lads cells are found in Juxta glomerular apparatus.
  94. The only human DNA which lies outside to nucleus is in mitochondria.
  95. Lacunar cells are found in nodular sclerosing lymphoma.
  96. Repetitive necrosis of adjacent regions of several infarcts of varying ages yields progressive extension of an individual infract over a period of days to weeks, called Stuttering infarct.
  97. Popcorn cells or cells like elephant feet are found in lymphocytic predominant Hodgkin’s disease.
  98. Lambl’s excrescences are to aging
  99. Lewy bodies are found in Parkinsonism
  100. Leopard. Lizard or Elephant skin is seen in Oncocerciasis.
  101. Meyers-Kouvenaar bodies are found in Filariasis
  102. Mazzoni reaction is seen in oncocerciasis.
  103. Molluscum body is found in stratum conieum and stratum granulosum.
  104. Residual bodies in a cell are lysosomes.
  105. Ring abscess is found in infective endocarditis.
  106. Bite cells are seen in 0-6-P deficiency.
  107. Pigbel is caused by Cl. perfringens.
  108. In addition to Hodgkin’s disease and infectious mononucleosis, Reed Sternberg cells may be seen in mycosis fungoides. –
  109. Accumulation of RNA in cytoplasm makes it pyroninophilic.
  110. Stiff lung is seen in ARDS.
  111. Collar button lesions are characteristic of bronchia carcinoid,
  112. The oncogerie amplification seen in small cell carcinoma is Myc.
  113. Part of colon with highest wail tension is caecum.
  114. A bizarre map like pattern, leopard spotting of oesophagus is due to postmortem digestion.
  115. Commonest she of origin of lower 01 bleeding due to angiodysplasia is caecum.
  116. Most sensitive indicator of Castro esophageal reflux is pathohistology of esophagitis is intraepithelial eosinophils.
  117. APUD cells are derived from endoderm.
  118. Most abundant substance secreted in bile is bile salts.
  119. Life long immunity in HBV is due to Anti HBS.
  120. LDL clearance independent of LDL receptors occur in mononuclear phagocytic system.
  121. Electron microscopic appearance of prominent lysosomes with whorld appearance is seen in Tay Sach’s disease.
  122.  Technique most used for linkage analysis is variable number of tandem repeats.
  123. Most common cause of false negativity of RELP is Closer linkage.
  124. Uniparental disomy of paternal chromosome 15 causes Angleman syndrome.
  125. Retinoic acid causes teratogenesis by induction of fox gene.
  126. Amniotic bands are classical example of deformation.
  127. Retinoblastoma gene (RB) inactivation is seen in small cell carcinoma of lung, osteosarcoma and carcinoma of bladder
  128. Typhus nodule in brain due to focal microglial proliferation with leukocytic infiltration seen in Typhus fever is limited to grey matter.
  129. The organism with shepperd crook  appearance is leptospira interrogans.
  130. Von Hansemann’s cells are large histiocytes seen in Malakoplakia.
  131. Caplan’s nodoles are seen in rheumatoid pneumoconiosis.
  132. Carre’s osteomyelitis is non suppurative osteomyelitis resulting in increased density of shaft of a long bone. There is new bone formation but no pus cells.
  133. Glomus organ is a convoluted AV anastomosis with modified muscle cells.
  134. Michaelis-Gutmann bodies are targetoid bodies due to defective lysosomal function seen in Malalcoplakia.
  135. Brunu’s nest are rounded collections of urothelial cells found just below the urothelial surface frequently seen in normal bladder..
  136. Carcinoid tumor may also be seen in ovary and stomach in addition to appendix and intestine (SI/LI)
  137. Catheter tumor is proliferated granulation tissue in urinary bladder due to catheter.
  138. In central core disease, there is non-progressive congenital myopathy.
  139. Clear cell sarcoma usually involves foot and knee.
  140. Cytoid bodies axe fluffy white patches in retina seen in accelerated HT, SLE and dlermatomyocytis.
  141. Cytoid body is a nodular swelling in injured axon.
  142. The commonest site from where a nerve biopsy in taken is sun] nerve.
  143. In ‘dying back’ neuropathy, there is axonal degeneration.
  144. Hibernoma is a type of lipoma.
  145. Kiel classiflcation is used to classify lymphoma.
  146. Indirect serologic predictors of HIV infection are beta-2 microglobulin, Neoptrrin,Interleulcin 2- receptor, Net gene markers
  147. Endheim’s medial degeneration is also called cystic medial necrosis
  148. Kumura’s disease is epitheloid hemangioma
  149. Wertlake and Del Guercio were first observers to comment on the diagnostic value of bile cytology
  150. Postmortem clot shows ‘chicken fat’ and ‘currantjelly’ appearances
  151. Mural or parietal thrombus is nonocclusive thrombus adherent to the wall
  152. Saddle or riding thrombus is that which extends into the branches or tributaries of a vessel.
  153. Hyaline thrombus is when thrombus is a homogenous mass.
  154. CNS fungal infections are aspergillosis, candidiasis,cledosporin,cryptococcus and zigomycosis.
  155. In urine cytology. superficial cells are called umbrella cells
  156. Decoy cells’ or ‘comet cells’ with tail like cytoplasmic processes and homogenous degenerated nuclei simulating carcinoma cells
  157. Durck’s granuloma is due to aggregates of reactive astrocytosis and microghat cell proliferation seen in cerebral malaria
  158. HIV wasting syndrome is also called ‘slim diseas ‘
  159. HIV virus contains 3 group of structural proteins-gag (Group specific antigen), p coding and env (codes for envelop proteins)
  160. Gag codes for p and p 1 8, poi codes for reverse transcriptase and Env codes for synthesis of gp l2O and fgp41
  161. Non-structural genes in HIV virus are tat, art and 3’ orf
  162. HIV virus contains LTR (long terminal repeat) segments
  163. In Huntington’s disease, basal ganglia most commonly atrophied is caudate nucleus
  164. Loss of acetyl neurons in nucleus of Meynert is a feature of Alzheimer disease
  165. Verocay bodies are pathognomonic of schwanomma
  166. Hooping on silver staining is characteristic feature of primary brain lymphoma
  167. Bery aneurysm ruptures once diameter is more than 10mm
  168. Rosenthal fibres are pathognomonic of pilocytic astrocytoma
  169. Round cells with perinuclear halos are pathognomonic of oligodendroglioma
  170. Candle quattering appearance of ventricular system is pathognomonic of tuberous sclerosis
  171. Free radicals in reperfusion injury are produced by infiltrating PMN
  172. P53 dependent apoptosis is seen in irradiation
  173. Thrush breast appearance of myocardium is seen in profound anemia
  174. Cell shrinkage in a apoptosis is due to activation of glutathione peroxidase
  175. The cells with longest telomeres are sperms
  176. Feyrter cells are also called Kulchitsky cells or argentaffin cells. They belong to APUD coils or dense core granule (DCG) cells
  177. Frauzen needle is used for prostatic aspiration
  178. Bernard Soulier syndrome is an autosomal recessive taint characterized by a variable thrombocytopenia, IBT, defective
  179. Prothrombin consumption and giant platelets. Defect is in sialic acid rich protein GP I b of platelet membrane. It causes defective adhesion
  180. Gray platelet syndrome is due to abnormalities in platelet secretion
  181. Folded cell index and crowded cell index are also used for hormonal evaluation of vaginal cytology
  182. Joplin I reaction (Gel and coombs type IV) is seen in borderline leprosy and Joplin’s type II (gel and coombs type 3) is seen in lepromatous and borderline leprosy
  183. Myelin enveloping the axon is interrupted at regular intervals by funnel shaped clefts called Schmidt Lauterman clefts
  184. Renau bodies are hyaline bodies occur in endoneural compartment
  185. Mikulicz cells are seen in rhinoscleroma and they am grnular or foamy macrophages
  186. Farmer’s lung is also called Silofiller’s lung
  187. Concentric onion skin lesions is pathohistological feature  of tertiary syphilis is seen in arteri des
  188. Schiller-Duval bodies are found in endodermal sinus tumor
  189. Sherman’s paradox is typically seen in fragile X-syndrome
  190. Tamm Horsfall protein is a glycoprotein
  191. In hereditary spherocytosis, there is chief abnormality in spectrin
  192. Fibroblast proliferation is associated with LOF, FOE and PDCIF
  193. Struvite stones are composed of magnesium ammonium P04
  194. Tamm horsfall protein may be seen in acute tubular necrosis and multiple myeloma
  195. Triton tumors are malignant schwannoma
  196. Lafora bodies are seen in neurons, hepatocytes and myocytes
  197. Ferruginous bodies mainly contain asbestos
  198. Type2 muscle Fibre differs rum type I by widc Z band
  199. Heymann’s  membraneous GN is due to fixed intrinsic tissue antigen
  200. Oncocytes are also known as Hurthiel cells
  201. Parking lot inclusions are found in mitochandrial myopathy
  202. Flame cells or Mon cells are found in trypanosomiasis
  203. Ring chromosome is a type of deletion
  204. Popcorn cells are found in Hodgkin’s disease
  205. Pores of Kohn are found in alveolar wall
  206. Ring fibre is present in myotonic dystrophy
  207. Weibel-Palade bodies are characteristically contain P- selectin and von Willebrand disease
  208. Hydatid cyst is most often seen in liver, followed by lung omentum. mesentry and kidney. Calcification is common spleen liver and lungs.
  209. Oseous types are most often in upper end of femur, tibia or humerus, vertebrae and ribs.
  210. The Bends” (periarticular bubbles); t (bubbles in lungs) and “Staggers’ (involvement of inner ear) are seen in Caisson disease.
  211. Steroid myopathy is muscle fibre atrophy, affecting type 2 fibers.
  212. Sezary-Lutzner cells and Pautrier’s micro abscesses are found in Mycosis fungoides.
  213. Von Mayenburg Complexes are anomalies of biliary tree (small clusters of dilated bite ducts embedded in a fibrous, sorn times hyalinized stroma).
  214. Zebra bodies are seen in mucopolysaccharidoses.
  215. Decay cells or Comet cells with tail like cytoplasmic processes and homogenous degenerated nuclei simulate carcinoma cells
  216. Duret haemorrhages are midline haemorrhages in midbrain and pons seen in brain herniation.
  217. Ferruginous bodies are found in asbestosis.
  218. Heat-shock proteins or stress proteins alt present constitutively in normal cells, where they play an important role in normal cell metobolism. Two familes are HSP 70 and hsp 60 (also called Chaperones or chaperonins).
  219. Soap bubble lesion in brain is seen in cryptococcosis
  220. Brewer’s lung is seen in aspetgillosis
  221. Birbeck granules are found in histiocytosis X
  222. Heinz bodies are seen in C3-6-P-D deficiency.
  223. Flame cells or Mott cells are plasma cells in African trypanosomiasis.
  224. Major Basic protein (MBP) is a cationic protein of eosinophils, which has limited bactericidal activity but is cytotoxic to many parasites.
  225. Asteroid bodies are found in Sarcoidosis.
  226. Antischkow cells are found in rheumatic fever.

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