Cell injury: lipofuscin: practice question

A Pathology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pathology · Cell injury: lipofuscin

Sample item

An 85-year-old woman dies of cancer cachexia. At autopsy the heart is small, firm and brown. Microscopy shows perinuclear golden-brown granules in myocytes that do not stain with Prussian blue. What is the pigment?

ALipofuscin, derived from peroxidation of membrane lipidsBBilirubin, from haem catabolismCHaemosiderin, from breakdown of red cellsDMelanin, synthesised from tyrosine

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Lipofuscin, derived from peroxidation of membrane lipids

Brown atrophy of the heart is caused by lipofuscin, a wear-and-tear pigment of undigested lipid and protein remnants from free radical peroxidation of membranes. It accumulates in the myocardium, liver and brain of the elderly and in atrophic organs. Haemosiderin would stain blue with Prussian blue.

Option by option

A. Lipofuscin, derived from peroxidation of membrane lipids (correct)
Correct. Prussian blue negative golden-brown perinuclear granules in a brown atrophic heart are lipofuscin.
B. Bilirubin, from haem catabolism
Bilirubin is a green-yellow bile pigment and is not found in cardiac muscle.
C. Haemosiderin, from breakdown of red cells
Haemosiderin is iron-containing and stains blue with Prussian blue.
D. Melanin, synthesised from tyrosine
Melanin is made by melanocytes and is not synthesised by cardiac myocytes.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Pathology question

What is the answer to this Pathology question?

The best answer is A, Lipofuscin, derived from peroxidation of membrane lipids. Brown atrophy of the heart is caused by lipofuscin, a wear-and-tear pigment of undigested lipid and protein remnants from free radical peroxidation of membranes.

Why is "Bilirubin, from haem catabolism" not the answer?

Bilirubin is a green-yellow bile pigment and is not found in cardiac muscle.

Why is "Haemosiderin, from breakdown of red cells" not the answer?

Haemosiderin is iron-containing and stains blue with Prussian blue.

Why is "Melanin, synthesised from tyrosine" not the answer?

Melanin is made by melanocytes and is not synthesised by cardiac myocytes.

What concept does this question test?

It tests Cell injury: lipofuscin in Pathology. It accumulates in the myocardium, liver and brain of the elderly and in atrophic organs. Haemosiderin would stain blue with Prussian blue.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Cell injury: lipofuscin?

Learn each disease as a bundle: cause, key histology, markers, and the clinical hallmark. Then use the flashcards and the other Pathology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.