NEET PG 2026 Pathology Questions: PYQ-Based MCQs with Explanations

Why PYQ-Based Pathology Questions Work Better Than Random Practice

Random MCQ practice has a real limit. You can solve a hundred pathology questions and still miss the pattern because the questions were not chosen with any logic behind them. PYQ-based practice is different. It is built on what has actually shown up, again and again, across real exam cycles, so the return on your time is higher.

This matters even more for Pathology specifically, since the subject connects so tightly to Medicine, Surgery, and Paediatrics. A tumour marker question is not just a Pathology fact; it's also half of a Medicine or Surgery question waiting to happen. Once your pathology concepts are strong, you will find that two or three related clinical questions get easier along with it.

NEET PG Pathology High-Scoring Topics

Before jumping into the questions, here's where the repeat value exists:

• General pathology: cell injury, apoptosis, and adaptation

• Haematopathology: leukaemias, lymphomas, and their genetic markers

• Systemic pathology: renal, hepatic, and neoplastic conditions

• Immunopathology: hypersensitivity reactions and their clinical correlations

NEET PG 2026 Pathology Questions with Explanations

General Pathology

Q1. Which morphological feature is characteristic of apoptosis rather than necrosis?

A) Cell swelling with membrane rupture

B) Cell shrinkage with intact membrane and condensed chromatin

C) Diffuse inflammatory infiltrate

D) Coagulation of cytoplasmic proteins

Answer: B) Cell shrinkage with intact membrane and condensed chromatin. Apoptosis is an energy-dependent, programmed process, so the cell membrane stays intact and the cell breaks into apoptotic bodies rather than spilling contents and triggering inflammation the way necrosis does.

Q2. Which family of enzymes executes the apoptotic pathway?

A) Caspases

B) Matrix metalloproteinases

C) Cyclin-dependent kinases

D) Topoisomerases

Answer: A) Caspases. These cysteine-aspartate proteases cleave key cellular substrates in a controlled cascade, which is what gives apoptosis its orderly, non-inflammatory character.

Q3. Fatty change (steatosis) in the liver is best classified as which type of cellular response?

A) Irreversible cell injury

B) A form of reversible cell injury

C) Neoplastic transformation

D) Cellular hypertrophy

Answer: B) A form of reversible cell injury. Fat accumulates within hepatocytes as a response to metabolic stress, and it typically resolves once the underlying cause, alcohol, obesity, or toxins, is corrected.

Q4. Metaplasia is best defined as which of the following?

A) An irreversible change to a malignant cell type

B) A reversible change of one differentiated cell type into another

C) An increase in the number of cells in a tissue

D) An increase in the size of individual cells

Answer: B) A reversible change of one differentiated cell type into another. A classic example is the columnar-to-squamous metaplasia seen in the bronchial lining of long-term smokers, which is reversible if the stimulus is removed.

Haematopathology

Q5. Which cytogenetic translocation is characteristic of Burkitt lymphoma?

A) t(9;22)

B) t(14;18)

C) t(8;14)

D) t(15;17)

Answer: C) t(8;14). This translocation places the MYC oncogene under the control of the immunoglobulin heavy chain promoter, driving the aggressive growth characteristic of Burkitt lymphoma.

Q6. Which translocation is most associated with follicular lymphoma?

A) t(8;14)

B) t(14;18)

C) t(9;22)

D) t(11;14)

Answer: B) t(14;18). This translocation overexpresses BCL2, an anti-apoptotic protein, which helps explain the indolent but persistent nature of follicular lymphoma.

Q7. At initial presentation, Hodgkin lymphoma most commonly involves which group of lymph nodes?

A) Axillary nodes

B) Inguinal nodes

C) Cervical nodes

D) Mesenteric nodes

Answer: C) Cervical nodes. Painless cervical lymphadenopathy is the most common presenting finding in Hodgkin lymphoma, often prompting the initial biopsy.

Q8. What is the most common cytogenetic abnormality found in first-trimester spontaneous abortions?

A) Autosomal trisomy

B) Monosomy X

C) Triploidy

D) Balanced translocation

Answer: A) Autosomal trisomy. Taken together as a group, autosomal trisomies account for the largest share of chromosomally abnormal first-trimester miscarriages.

Systemic Pathology

Q9. What is the most common primary malignant tumour of the liver?

A) Hepatocellular carcinoma

B) Cholangiocarcinoma

C) Hepatoblastoma

D) Angiosarcoma of the liver

Answer: A) Hepatocellular carcinoma. It typically arises in the setting of chronic liver disease, particularly cirrhosis from hepatitis B, hepatitis C, or long-term alcohol use.

Q10. What is the most common benign tumour of the liver?

A) Cavernous haemangioma

B) Hepatic adenoma

C) Focal nodular hyperplasia

D) Bile duct hamartoma

Answer: A) Cavernous haemangioma. It's usually an incidental finding on imaging and rarely requires intervention unless it becomes symptomatic or unusually large.

Q11. What is the most common histological subtype of renal cell carcinoma?

A) Papillary RCC

B) Clear cell RCC

C) Chromophobe RCC

D) Collecting duct carcinoma

Answer: B) Clear cell RCC. It accounts for the majority of renal cell carcinomas and is classically associated with VHL gene mutations.

Q12. What is the most common primary malignant brain tumour in adults?

A) Meningioma

B) Glioblastoma multiforme

C) Medulloblastoma

D) Pituitary adenoma

Answer: B) Glioblastoma multiforme. It's an aggressive, poorly differentiated astrocytic tumour and carries one of the poorest prognoses among primary CNS malignancies.

Q13. What is the most common cause of acute pancreatitis?

A) Gallstones

B) Chronic alcohol use

C) Hypertriglyceridemia

D) Post-ERCP complication

Answer: A) Gallstones. Biliary obstruction from gallstones is the leading cause of acute pancreatitis overall, with alcohol use a close second in many populations.

Immunopathology and Hypersensitivity Reactions

Q14. Granuloma formation, as seen in tuberculosis, is a feature of which type of hypersensitivity reaction?

A) Type I

B) Type II

C) Type III

D) Type IV

Answer: D) Type IV. This is a delayed, T-cell mediated (cell-mediated) hypersensitivity reaction, distinct from the antibody-driven Types I, II, and III.

Q15. Anaphylaxis is mediated by which type of hypersensitivity reaction?

A) Type I

B) Type II

C) Type III

D) Type IV

Answer: A) Type I. IgE-mediated mast cell and basophil degranulation drives the immediate, systemic response seen in anaphylaxis.

Q16. Goodpasture syndrome is mediated by which type of hypersensitivity reaction?

A) Type I

B) Type II

C) Type III

D) Type IV

Answer: B) Type II. Antibodies directed against the glomerular and alveolar basement membrane directly damage tissue, making this a classic Type II (antibody-mediated) reaction.

Q17. Myasthenia gravis, caused by antibodies against acetylcholine receptors, is an example of which hypersensitivity type?

A) Type I

B) Type II

C) Type III

D) Type IV

Answer: B) Type II. The antibodies bind directly to the receptor, blocking normal neuromuscular transmission, which fits the Type II mechanism of direct antibody-mediated cell dysfunction.

Q18. Serum sickness is a classic example of which type of hypersensitivity reaction?

A) Type I

B) Type II

C) Type III

D) Type IV

Answer: C) Type III. Immune complexes formed between antigen and antibody deposit in tissues and trigger inflammation, which is the hallmark of Type III reactions.

Q19. Which immunohistochemical marker is used to identify tumours of epithelial origin?

A) Vimentin

B) Cytokeratin

C) Desmin

D) S-100

Answer: B) Cytokeratin. Cytokeratin is expressed by epithelial cells and their tumours, while vimentin marks mesenchymal-origin tumours, making the two markers useful for distinguishing carcinomas from sarcomas.

Q20. Contact dermatitis from substances like nickel or poison ivy is an example of which hypersensitivity type?

A) Type I

B) Type II

C) Type III

D) Type IV

Answer: D) Type IV. Like tuberculin-type reactions, contact dermatitis is a delayed, T-cell mediated response that develops over one to two days after exposure.

How to Use These NEET PG Pathology PYQ-Based Questions

Do not attempt them all in one sitting. Pathology rewards slow, careful reading more than speed, at least in the early stages of revision, because so many answer options sound logical until you actually know the distinguishing detail.

Group your revision around the pattern, not the individual fact. All four hypersensitivity-type questions above follow the same underlying logic, once you understand what separates Type I from Type II from Type III from Type IV, an entire category of NEET PG questions gets easier at once.

Once you've worked through this set, combine it with full-length practice. NEET PG previous year question papers let you see how pathology questions are distributed across a real paper. and the is built around the current 180-question, sectioned format.

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