Jipmer sample questions 2019 Dr Vandana

1)Juvenile myoclonic epilepsy is d/t mutation in

A. GABRA 1

B. CHRNA 2

C. COL4A1

D. FMRI

ANS A :Juvenile myoclonic epilepsy is a condition characterized by recurrent seizures (epilepsy). This
condition begins in childhood or adolescence, usually between ages 12 and 18, and lasts into adulthood.
Mutations in one of several genes can cause or increase susceptibility to this condition. The most studied
of these genes are the GABRA1 gene and the EFHC1 gene

2)NKX3-1 immunohistochemical used for diagnosis of?

A. Prostate ca
B. Breast ca
C. Bladder ca
D. Lung ca

ANS A: NXK3-1 GENE

This gene encodes a homeobox-containing transcription factor. This transcription factor functions as a
negative regulator of epithelial cell growth in prostate tissue. Aberrant expression of this gene is
associated with prostate tumor progression

3) Russel bodies are found in

A. Neutrophils

B. Basophils

C. Mott cells

D. Mast cells

4) 4yr old boy presenting with Cryptorchidism, short stature & On auscultation, Harsh ejection systolic
murmur us heard in Pulmonary area. What is the hematological abnormality found in this condition ?

A. Transient Myeloproliferative disorder

B. Juvenile Myelomelanocytic leukemia

C. Pseudo Pelger Huet anamoly

D. Burkitt lymphoma

Ans: this is noonan syndrome . its associated with JMML

5) Most mature normoblast is

A. Orthochromic Normoblast

B. Pronormoblast

C. Polychromatic Normoblast

D. Basophilic Normoblast

ANS : MATURATION OF ERYTHROID CELLS ARE IN ORDER OF

Pronormoblast -Basophilic Normoblast- Polychromatic Normoblast- Orthochromic Normoblast

6) 5 yr old boy came with c/o Cervical lymphadenopathy. Microscopic picture of lymph node biopsy
show Starry sky appearance.Which of the following translocation is Unlikely to be seen in this condition?

A. t(2,8)

B. t(8,22)

C. t(8,14)

D. t(11,18)

Ans: c myc is present on chr 8 , so a,b,c options are correct

7. Chrosomal translocations are found In alveolar varient of rhabdomyosarcoma and the resultant
fusion protein is believed to function as
1.an activated growth factor receptor
2.an chimeric transcription factor
3.a constitutively active kinase
4.a novel growth factor

ANS : Alveolar rhabdo-

myosarcoma frequently contains fusions of the FOXO1
gene to either the PAX3 or the PAX7 gene, rearrangements
marked by the presence of (2;13) or(1;13) translocations,
respectively. PAX3 is a transcription factor that initiates
skeletal muscle differentiation, and it appears that the chi-
meric PAX3-FOXO1 fusion protein interferes with the gene
expression program that drives differentiation, a mecha-
nism similar to many of the transcription factor fusion
proteins that are found in various forms of acute leukemia.

Ans is chimeric transcription factor

8. 10 year boy with a mass in thighs diagnosed of osteosarcoma.family ho breast cancer in mother and
grandmother.his two younger siblings are at increased risk of

A. Wilms
B. Neuroblastoma
C. Hepatoblastoma
 D. Glioma

Chompret criteria for Li-Fraumeni syndrome are as follows:

• A proband who has (1) a tumor belonging to the Li-Fraumeni tumor spectrum (soft-
tissue sarcoma, osteosarcoma, premenopausal breast cancer, brain tumor,
adrenocortical carcinoma, leukemia, or bronchoalveolar lung cancer) before age
46 years and (2) at least one first- or second-degree relative with a Li-Fraumeni
tumor (except breast cancer if the proband has breast cancer) before age 56 years
or with multiple tumors [5] or
• A proband with multiple tumors (except multiple breast tumors), 2 of which belong
to the Li-Fraumeni tumor spectrum and the first of which occurred before age 46
years [6] or
• A proband who is diagnosed with adrenocortical carcinoma or choroid plexus
tumor, irrespective of family history

9.LADY WITH hb 8 gm/dl

A. Addisonian anemia
B. Banti anemia
C. Fanconi anemia
D. COOLEY anemia
If this was the given image, it looks like pernicious anemia to me with hypoersegmented
neutrophils - Addisonian anemia, also called pernicious anemia (PA)

If there is any other image , please let me know

Addisonian anemia, also called pernicious anemia (PA)

Thalassemia Major or Cooley's Anemia.

Banti anemia - Enlargement of spleen, ascites, jaundice, and the result of destruction of various
blood cells by spleen – anemia, leukopenia, thrombocytopenia, gastrointestinal bleeding – may
constitute the presenting symptoms.

10.Gene not associated with ARVD

A. plakoglobin
B. Desmoglein 2
 C. PKP2
D. DESMOGLEIN 3

ARVD is a rare form of cardiomyopathy in which the heart muscle of the right ventricle (RV) is
replaced by fat and/or fibrous tissue.
ARVC can result from mutations in at least 13 genes
Mutations in a desmosomal gene called PKP2 appear to be most common
OTHER GENES ARE :

DESMOGLEIN 3 IS ASSOCIATED WITH PEMPHIGUS VULGARIS

11.Pathology of apoptosis is associated with:

ATM-p53

P53-caspase

TNF-parthanos/PARP?

?
12.ABO incompatiblity is associated with

FFP

Cryoprecipitate

Single donor platelets

Platelet rich transfusion

13.Infantile sarcoma is associated with:

t (11;22)

t (12;15)

t(2;13)

t (11;22)

CHART POSTED ON GROUP BEFORE EXAM

14. pedigree.1

Ans: Y linkage, also known as sex linkage, or Holandric Inheritance father transferring disease to child
15. identify the pedigree

All Daughter of diseased father are affected – X L D

16. Most common inherited form of Alzheimer's

A. Presenilin 1
B. Presenilin 2
C. APP
D. desmoglein

ANS : out of APP, PSEN1, and PSEN2 mutations in early-onset Alzheimer disease PS1 >APP>PS2 in that
order..Mutations in PS-l are the most common cause of early-age-of-onset FAD， representing
perhaps 40-70% of all cases.

17. CORRECT FORMULA FOR RETICULOCYTE PRODUCTION INDEX

ANS

18. a 50 year old male with ESR 50mm/1st hour and below shown image. Translocation with worst
prognostic factor in multiple myeloma.
a. t 11,14

b t 14,16

c. .t 6,14

d.none

ans: b In the past decade, nonrandom chromosomal aberrations such as t(4;14),

t(14;16), t(14;20), amp1q21, and del 17p have been shown to be associated with
poor prognosis

19. . liver normal digram was given in that question asking about subepithelial cell

a-itocell

b-kuffercell

c-fat cell

d- macrophages
Learn to identify ito cell and kupfer cells. I presume ito cell was given

20 Which ONE of these statements is NOT TRUE concerning the haemopoietic stem cell?

A It is believed to represent approximately 1% of bone marrow cells

 B It is thought to have a CD34+CD38− phenotype

C It resembles a small to medium sized lymphocyte

D It can be transferred between individuals during the process of stem cell transplantation

ANS a: It is thought to be rare – perhaps 1 in every 20 million nucleated cells in marrow.

21.65 yr old underwent suprapubic prostatectomy and profusely bled.12 units of ?transfused.his
platelet count 5000,fibrinogen 180mg/dl,PT 12s,PT 34s.what should be done

A. Platelet transfusion
B. Cryo
C. IVIg
D. Epsilon amino caproic acid

Ans: Fibrinogen: 150-400 mg/dL is normal level .pt and ptt are normal . patient is only presenting with
thrombocytopenia.this looks like case of POST TRANSFUSION THROMBOCYTOPENIA FOLLOWING
MASSIVE TRANSFUSION . TREATMENT OF SUCH CASES IS Ivig
22. Aprimi para after 10 days of delivery present with PT-12sec,aptt-.42 SEC...how to differentiate between
pregnancy acquired hemophilia and LAC

1 8 assay

2. dilute russell viper venom time

3. Vwf assay

4. Aptt

Ans : DRVTT

Dilute Russell's viper venom time- This in vitro diagnostic test is based on the ability of the venom
of the Russell's viper to induce thrombosis. The venom contains some substances (RVV-V and
RVV-X) which directly activate factor V and factor X which turns prothrombin into thrombin in the
presence of phospholipid and calcium. This makes the test sensitive to the presence of lupus
anticoagulants, because these antibodies interfere with the clot-promoting role of phospholipid in
vitro, and their presence results in a prolonged clotting time.The dRVVT test has a higher specificity
than the aPTT test for the detection of lupus anticoagulant, because it is not influenced by
deficiencies or inhibitors of clotting factors VIII, IX or XI as the venom only activates factors V and X

23.Which of the following grows least in stored blood products

A. Yersinia enterocolitica
B. P.acnes
C. Staph aureus
D. Staph epidermidis

Ans b: Propionibacterium acnes is a gram-positive human skin commensal that prefers

anaerobic growth conditions and is involved in the pathogenesis of acne
Bacterial contamination in blood

affects up to 0.4% of red cells and 1‐2% of platelet concentrates. 

Blood may become contaminated by: -
Bacteria from the donor’s skin entering the blood unit during collection (usually staphylococci). -
Bacteraemia present in the blood of the donor during collection (e.g. Yersinia). -
Improper handling during blood processing. - Defect or damage to the blood bag. -
Thawing FFP or cryoprecipitate in a water‐bath (often contaminated). 
Some contaminants, particularly Pseudomonas species, grow at +2°C to +6°C and can survive or multipl
y in refrigerated red cell units. 
Staphylococci grow in warmer conditions and are able to proliferate in PCs which are stored at +20°C to
+24°C.  Signs usually appear rapidly after starting infusion, but may be delayed for a few hours. 
A severe reaction may be characterized by sudden onset of high fever, rigors and hypotension. 
Urgent supportive care and high‐dose intravenous antibiotics are required.

24.Correctly match the RPGN types

aType2 - 1.anti GBM

b.Type1- 2.post infectious

c.Type3- 3.wegeners

d.Type C-anca 4.microscopic polyangiitis

ans

a-2,b-1,c-4, d-3

25. A 58-year-old woman with a history of ulcerative colitis was started on mesalazine three

months before presentation. Previously, she had normal kidney function. She presented
with fever, generalized symptoms, and an elevated serum creatinine of 3.7 mg/dL
a- interstitiall nephritis

b-MPGN

c-RPGN
D-IGA nephropathy

Ans : interstitial nephritis evident by mixed inflammatory cell infiltrate with many plasma cells

26. A 14 year boy present with fever and lymphadenopathy on peripheral smear cell was given
a-ALL b-AML c-CML d-CLL

ANS : The myeloblasts are large, often with LARGE nuclei and cytoplasm shows auer rods .

27. 🍀🍀 Clover leaf cells or flower cells in

a.HTLV-1

b.HTLV -2

C.HIV

D.HCV

28. Pt with fever come to opd. Further Investigation CSF shows eosinophils.. Dx?

A. Hymenolepsis nana
B. Strongyloides
 C. Sporothrix schenckii
D. ANGIOSTRONGYLUS

Ans: Eosinophilic meningoencephalitis is caused by a variety of helminthic infections. These worm-

specific infections are named after the causative worm genera, the most common being
angiostrongyliasis, gnathostomiasis, toxocariasis, cysticercosis, schistosomiasis, baylisascariasis, and
paragonimiasis.

Strongyloidiasis IS also important cause of CSF eosinophila

Coccidioidomycosis is the most prevalent fungal cause of eosinophilic meningitis. Also associated with
CSF eosinophilia is rickettsial disease and Rocky Mountain spotted fever

CSF eosinophilia is defined by counts higher than 10 eosinophils per ml or 10% of the total CSF leukocyte
count.

H nana can also be associated with eosinophila

Sporothrix- There is usually dense cellular infiltrate comprising lymphocytes plasma cells and variable
number of epithelioid histiocytes, giant cells, and eosinophils (mixed granulomatous cellular infiltrate) in
upper- and middermis with or without fibrocapillary proliferation. Splendore-Hoeppli phenomenon,
wherein one of the several fungal elements enveloped by an eosinophilic material radiating centrifugally
in a sunburst fashion with its central portion reacting immunohistochemically with an anti-Sporothrix
schenckii antibody, perhaps represents an immunologic interaction between the host and the pathoge

29. which of these conditions are not seen in the peripheral smear

AProsthetic valve

B TTP

C.Microscopic polyangitis

D Dic
30.Cold autoantibodies have specificity for which of the following antigens?

1.p &lewis

2.Le&l/i

3.P &l/i

4.se&l/i

Question is very specific – against which antigens do cold antibody acts

Cold agglutinin disease (CAD) is a form of acquired autoimmune hemolytic anemia (AIHA) in
which cold exposure can cause clinical symptoms related to agglutination of red blood cells
(RBCs) in cold parts of the body (eg, livedo reticularis or acrocyanosis) and hemolytic anemia.
There are three major types of cold-sensitive antibodies that can cause clinical
manifestations: cold agglutinins (which cause CAD), Donath-Landsteiner antibodies (which
cause paroxysmal cold hemoglobinuria [PCH]), and cryoglobulins (which cause a vasculitic
picture):
1.cold agglutinins – Cold agglutinins are antibodies that recognize antigens on red
blood cells (RBCs) at temperatures below normal core body temperature. The antibodies
are typically immunoglobulin M (IgM) and the antigen is typically "I" or "i" on the RBC
surface.
2. Donath-Landsteiner antibodies – Donath-Landsteiner antibodies are antibodies that
recognize RBC antigens at cold temperatures, but unlike cold agglutinins, these
antibodies fix complement and cause hemolysis in the circulation (intravascular
hemolysis). The antibodies are usually IgG and they are often directed against the "P"
antigen on RBCs.
3. Cryoglobulins – Cryoglobulins are antibodies that form immune complexes in the
cold; they generally do not interact with RBCs

But if someone asks what are cold autoantibodies??- Anti-Lea, -Leb, -M, -N, and -P are
common cold antibodies but they are not symptomatic

31. IDENTIFY THE GROSS

FLEA BITTEN KIDNEY

 32. WHICH IS MORE COMMON TYPE OF BREAST CANCER
A. Brca2
B. BRCA1
C. CHEK 2
D. ATM

ANS : BRCA 2 causes luminal B cancer while BRCA 1 causes triple negative cancers . luminal cancers are
50-65% of total breast cancers

33. A pathologist receive brain(cranium) specimen for HPE. A pathologist made incision for HPE
without damaging structure. Where the incision pathologist put?
1)incision start from front of tragus
2)incision start from behind the ear
3)start from frontal lobe
4)somewhere parietal lobe

Ans : skull opening technique is called mastoid to mastoid (behind ear )