1.What is the type of Degeneration seen in Leiomyoma? a)Hyaline b) Fatty c)Hydropic d)mucoid 2.Hyaline degeneration in rectus abdominal is muscle in typhoid feveris also known as? a)mucoid degeneration b) zenker's degeneration c) cloudy degeneration d) none of above 3.Gummatous necrosis is caused by? a)mycobactrium Tuberculi b) Mycobacterium Leprae c) Treponema pallidum d)Neisseria Gonococci 4.Destruction of bacteria with spores is called? a)Disinfection b) Sterilization c) Both d)None of above 5.Tomb Stone is a hall mark morphologic feature of...... a)Coagulative Necrosis b) Fat Necrosis c) Liquefactive Necrosis d) Caseous Necrosis
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Here are the answers to all 5 questions with explanations:
Q1. Type of Degeneration seen in Leiomyoma
Answer: a) Hyaline degeneration
Hyaline degeneration is the most common type of degeneration seen in uterine leiomyoma (fibroids), occurring in about 65% of cases. The smooth muscle cells are replaced by hyaline (acellular, glassy pink) fibrous tissue due to impaired blood supply. This is confirmed by radiology textbooks which specifically list "Hyaline degeneration" as a recognized pattern in leiomyomas.
Other degenerations seen in leiomyoma (in decreasing frequency): Red/carneous > Cystic/Hydropic > Calcific > Fatty > Myxoid (mucoid) - but Hyaline is the most common.
Q2. Hyaline Degeneration in Rectus Abdominis in Typhoid Fever
Answer: b) Zenker's degeneration
Zenker's degeneration (also called Zenker's necrosis or "waxy degeneration") is the term for hyaline/waxy degeneration of skeletal muscle - classically seen in the rectus abdominis muscle in typhoid fever. It is a form of coagulative necrosis of striated muscle where the muscle fibers appear homogenous, glassy, and waxy. Named after Friedrich Albert von Zenker. It can also occur in the diaphragm and other skeletal muscles in typhoid.
- Cloudy swelling = early reversible cellular injury (mitochondrial swelling)
- Mucoid degeneration = mucin accumulation in connective tissue
Q3. Gummatous Necrosis is caused by?
Answer: c) Treponema pallidum
Gummatous necrosis is the hallmark of tertiary syphilis, caused by Treponema pallidum. A gumma is a granulomatous lesion with a rubbery, necrotic center surrounded by granulation tissue and fibrosis. It can occur in liver (hepar lobatum), bones, skin, testes, and CNS. Histologically shows coagulative necrosis that is NOT cheese-like (unlike caseous necrosis of TB).
- TB (M. tuberculosis) - causes caseous necrosis
- M. leprae - causes granulomatous inflammation (lepromatous/tuberculoid)
- N. gonorrhoeae - causes purulent/suppurative inflammation
Q4. Destruction of Bacteria WITH Spores
Answer: b) Sterilization
As confirmed by Medical Microbiology 9e (Definitions box):
"Sterilization: Use of physical procedures or chemical agents to destroy all microbial forms, including bacterial spores"
Disinfection only kills vegetative bacteria, most viruses, and fungi - it does NOT kill bacterial spores. Therefore, killing spores requires sterilization (e.g., autoclaving at 121°C for 15 min under pressure).
Q5. "Tombstone" Sign - Hallmark Morphologic Feature
Answer: c) Liquefactive Necrosis
Wait - this needs clarification. The "tombstone" appearance is actually a histological feature of Pemphigus Vulgaris (an autoimmune blistering disorder), confirmed by Yamada's Textbook of Gastroenterology:
"Histopathological findings of suprabasal clefting, cells with a 'tombstone' appearance, and acantholysis are features of PV (Pemphigus Vulgaris)"
Among the necrosis options given:
- Coagulative necrosis - ghost outline of cells preserved ("tombstone cells" in MI)
- Liquefactive necrosis - complete dissolution, no cell outlines
- Caseous necrosis - cheese-like, no structure
- Fat necrosis - saponification/chalky deposits
If this is a pathology MCQ strictly about necrosis types, the "tombstone cell" appearance (preserved cellular ghost outlines) is most consistent with a) Coagulative Necrosis - where cells lose their nuclei but retain their cell outlines, appearing like tombstones on histology. However, in dermatopathology, "tombstone appearance" specifically refers to Pemphigus Vulgaris (acantholysis).
Answer: a) Coagulative Necrosis (in the context of general pathology MCQs about necrosis types)
Summary Table
| # | Question | Correct Answer |
|---|---|---|
| 1 | Most common degeneration in Leiomyoma | a) Hyaline |
| 2 | Hyaline degeneration of rectus abdominis in typhoid | b) Zenker's degeneration |
| 3 | Gummatous necrosis caused by | c) Treponema pallidum |
| 4 | Destruction including spores | b) Sterilization |
| 5 | Tombstone hallmark | a) Coagulative Necrosis |
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