Inflammation and repair: gumma of syphilis: 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 · Inflammation and repair: gumma of syphilis

Sample item

A 50-year-old man has a rubbery nodule in the liver. Histology shows a central area of coagulative necrosis surrounded by epithelioid histiocytes, lymphocytes and numerous plasma cells, with endarteritis of small vessels. What is this lesion?

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

The answer and the reasoning

B. Gumma of tertiary syphilis

A gumma is the granulomatous lesion of tertiary syphilis. It has a rubbery coagulative necrotic centre, a rim of epithelioid cells, lymphocytes and prominent plasma cells, and obliterative endarteritis. A tuberculous granuloma shows soft cheesy necrosis and sarcoid granulomas are non-necrotising.

Option by option

  • A. Sarcoid granuloma

    A sarcoid granuloma is compact and non-necrotising.

  • B. Gumma of tertiary syphilis (correct)

    Correct. Coagulative necrosis with abundant plasma cells and endarteritis is a gumma.

  • C. Caseating tuberculous granuloma

    A tuberculous granuloma has caseous necrosis, not firm coagulative necrosis.

  • D. Foreign-body granuloma

    A foreign-body granuloma surrounds refractile foreign material.

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.

More Pathology questions

Questions about this Pathology question

What is the answer to this Pathology question?

The best answer is B, Gumma of tertiary syphilis. A gumma is the granulomatous lesion of tertiary syphilis.

Why is "Sarcoid granuloma" not the answer?

A sarcoid granuloma is compact and non-necrotising.

Why is "Caseating tuberculous granuloma" not the answer?

A tuberculous granuloma has caseous necrosis, not firm coagulative necrosis.

Why is "Foreign-body granuloma" not the answer?

A foreign-body granuloma surrounds refractile foreign material.

What concept does this question test?

It tests Inflammation and repair: gumma of syphilis in Pathology. It has a rubbery coagulative necrotic centre, a rim of epithelioid cells, lymphocytes and prominent plasma cells, and obliterative endarteritis. A tuberculous granuloma shows soft cheesy necrosis and sarcoid granulomas are non-necrotising.

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 Inflammation and repair: gumma of syphilis?

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.