Inflammation and repair: 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

Sample item

A diabetic woman has recurrent E. coli urinary infection. Cystoscopy shows soft yellow-brown bladder plaques. Biopsy shows sheets of foamy macrophages with laminated, calcified basophilic inclusions. What is the diagnosis?

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

The answer and the reasoning

C. Malakoplakia

Malakoplakia is a chronic inflammation caused by defective macrophage bacterial killing. Michaelis-Gutmann bodies are calcified, partly digested bacterial remnants inside the macrophages.

Option by option

  • A. Urothelial carcinoma

    Urothelial carcinoma shows atypical urothelial cells, not macrophages with inclusions.

  • B. Schistosomal cystitis

    Schistosomal cystitis shows eggs with eosinophilic and granulomatous inflammation and squamous metaplasia.

  • C. Malakoplakia (correct)

    Correct. Foamy macrophages with Michaelis-Gutmann bodies after E. coli infection are diagnostic.

  • D. Tuberculous cystitis

    Tuberculous cystitis shows caseating granulomas with acid-fast bacilli.

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.

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Questions about this Pathology question

What is the answer to this Pathology question?

The best answer is C, Malakoplakia. Malakoplakia is a chronic inflammation caused by defective macrophage bacterial killing.

Why is "Urothelial carcinoma" not the answer?

Urothelial carcinoma shows atypical urothelial cells, not macrophages with inclusions.

Why is "Schistosomal cystitis" not the answer?

Schistosomal cystitis shows eggs with eosinophilic and granulomatous inflammation and squamous metaplasia.

Why is "Tuberculous cystitis" not the answer?

Tuberculous cystitis shows caseating granulomas with acid-fast bacilli.

What concept does this question test?

It tests Inflammation and repair in Pathology. Michaelis-Gutmann bodies are calcified, partly digested bacterial remnants inside the macrophages.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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?

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.