45-year-old woman having salt and pepper
appearance in skull with dentine defects and
loss of lamina dura most likely suggests
hyperparathyroidism


Radiological features of hyperparathyroidism:


◦ Classical and pathognomonic feature of
hyperparathyroidism is sub-periosteal
cortical resorption of middle phalanges,
seen especially in the second and third
fingers. This feature can also be visualised in
lateral end of clavicle and symphysis pubis
◦ Loss of lamina Dura (thin cortical bone of
tooth socket surrounding teeth is seen as
thin white line)
◦ Generalized osteopenia, thinning of cortices,
and indistinct bony trabeculae
◦ Expansile lytic lesion, otherwise known as
brown's tumor generally affecting
maxilla/mandible
◦ Salt and pepper appearance of skull

Ans. is 'd" i.e., High risk of malignacy
o Malignancy is rare in harmartomatous polyps of Peutz-Jeghers
syndrome.
. Other three options are correct

SNPs are
said to be bi-allelic.


The two most common genetic variations or
polymorphisms are


◦ Single-nucleotide polymorphisms (SNPs)
◦ Copy number variations (CNVs)


A. SNPs


◦ These are variations in a single nucleotide
that occurs at a specific position (locus) in
the genome
• They are always bi-allelic, that is, only two
choices exist at a given locus in a populati
(-CorA-).


The image below shows a C/A SNP. The upper
DNA molecule differs from the lower DNA
molecule at a single base-pair location.

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H1 Histone protein binds to the linker DNA.


Structure of chromatin:


• Within the cell nucleus, the DNA is wrapped in
1.8 loops, around a core of histone proteins
• This DNA which encircles the histone
proteins consists of 147 base pairs.
◦ The core histone proteins consist of 2 sets
each of the histone proteins H2A, H2B, H3
and H4, giving a total of 8 histone proteins
known as the histone octamer.
◦ This DNA-histone complex is known as
the nucleosome.
• The nucleosomes are connected by DNA
segments called linker DNA. Both together
constitute the chromatin, giving the
appearance of "beads on string, where the
beads represent nucleosomes and the string
represents the linker DNA.
• The H1 histone protein binds to the linker
DNA and helps stabilize the overall chromatin
architecture.
◦ Notably, the histone proteins are positively
charged, which facilitates the compaction of
the negatively charged DNA.

Based on the above keywords hint:*

Raised, shiny scar
Extends beyond original wound
Progressive growth
Type III collagen



Ans is keloid

Correct Answer - C
Malakoplakia [Ref. Robbins 7th/e p 1027-1028]
• Malakoplakia is a variant of cystitis, it is related to chronic bacterial
infection mostly by E.coli or occasionally by proteus species.
• It is characterized by unusual appearing macrophages and giant
phagosomes.
• It points to defect in phagocytic or degradative function of
macrophage.
• It is apeculiar pattern of vesical inflammatory reaction characterized
microscopically by soft, yellow, slightly raised mucosal plaques 3-4
cm in diameter.
• Histologically it is characterized by infiltration with large foamy
macrophages with occasional multinucleate giant cells and
interspersed lymphocytes.
• The macrophages have an abundant granular cytoplasm and the
granularity is PAS positive.
• In addition to these histological changes, malakoplokia is also
characterized by Michaelis Guttman bodies. - Michalies Guttman
bodies are Laminated mineralized concretions resulting from
deposition of calcium in enlarged lysosomes.
⁃ They are typically present both within the macrophages and
between cells