UG MGR UNIVERSITY CASE BASED QUESTIONS WITH
ANSWERS
CHAPTER 3
INFLAMMATION AND REPAIR
1. 25 years male had a cut injury in his hand and wound was sutured
immediately. How does healing take place in such wound? What are the
factors delaying wound healing?
CHAPTER 4
HEMODYNAMIC DISORDERS, THROMBOEMBOLIC DISEASE
AND SHOCK
1. 25 years male RTA victim presented with rapid pulse, cold clammy
cyanotic skin, tachypnea and landed in emergency ward in unconscious
state.
What is the diagnosis - Shock
Classify the disease. Write in detail about the pathogenesis,
morphology evolution of the disease.
2. 40 yr. old male presented with h/o fever, vomiting and diarrhea. Patient
had temperature of 103 degrees F. Weak rapid pulse, hypotension,
tachypnoea, cold, clammy, cyanotic skin. Blood culture gram negative
bacterial infection positive.
What is your diagnosis – Septic shock
Explain the pathogenesis and morphology.
3. 30 years female immediately after delivery went into sudden circulatory
failure. She had profuse bleeding per vaginum and from venipuncture
sites.
What is your diagnosis – Amniotic fluid embolism leading to
shock and DIC
What is the Pathophysiology?
How will you investigate this patient?
CHAPTER 6
DISEASES OF THE IMMUNE SYSTEM
1. 10 years female was administered an analgesic injection IM and
immediately collapsed.
What is the type of reaction – Immediate (Type I)
Hypersensitivity reaction
What is the pathogenesis of this reaction?
2. A 23 yrs. female presented with oral ulcers, malar rash photosentivity
and non-erosive arthritis involving both knees. Laboratory investigations
show persistent proteinuria and leucopenia.
What is your probable diagnosis – Systemic lupus
erythematosus
Discuss in detail the pathogenesis and morphology of kidney
affected by the above disorder.
CHAPTER 8
INFECTIOUS DISEASE
1. 30 years male presented with fever with rigors. He had H/o dark colored
urine after admission and also had cloudy consciousness.
What is the diagnosis – Cerebral malaria (Plasmodium
falciparum)
What is the role of peripheral smear in diagnosis?
2. 10 years male presented with evening raise of temperature, neck nodes.
His father was treated for cough with expectoration for 6 months.
What is your diagnosis - Tuberculosis
Write about pathogenesis & morphology of this illness.
CHAPTER 9
ENVIRONMENTAL AND NUTRITIONAL DISEASES
1. A 12-year boy weighing 70 kgs, doesn’t play any outdoor games and is
always in front of his play station with lot of snacks besides him.
What is he having - Obesity
What are the methods to assess it?
What is the etiopathogenesis?
Enumerate the complications?
2. 8 years female child was hailing from a poor family and was found to
have loss of muscle mass and subcutaneous fat. She was emaciated.
What is your diagnosis - Marasmus
How will you categorize nutritional disorders?
CHAPTER 12
The Heart
1. A 50 years old man collapses suddenly while climbing the stairs with
severe chest pain and profuse sweating. His ECG was abnormal.
What is your clinical diagnosis – Myocardial infarction
Discuss the etiopathogenesis of the condition.
What are the complications that may follow the condition?
Enlist the risk factors
Enlist the biochemical tests and their role in diagnosis of this
disease.
2. 47 yrs. old male presented with acute onset of dyspnea, profuse sweating
and chest pain stabbing in nature, radiating to the left shoulder. Lab
investigation revealed elevated troponin – T.
What is your diagnosis – Myocardial infarction
Morphology of the condition
Write in detail about the morphological changes that occur.
3. 50 years male sudden death, autopsy of the heart revealed gray white area
in left ventricle.
What is the diagnosis – Myocardial infarction
What are the morphological changes in heart during autopsy to
identify the age of lesion?
CHAPTER 13
DISEASES OF WHITE BLOOD CELLS, LYMPH NODES, SPLEEN &
THYMUS
1. 40 years male H/o chronic fatigue, weight loss for 6 months. O/E pallor,
marked splenomegaly (+), laboratory report shows Hb 10 GM%, TC
2,15,000/mm3. Platelets 4 lacks/cmm. Answer the following:
What is your diagnosis – Chronic myeloid leukemia
What is common genetic abnormality?
Blood and Bone Marrow findings to confirm your diagnosis?
What is the course of the disease?
Prognosis of the condition?
2. 35 years, old man was admitted with history of painless cervical and
axillary lymphadenopathy. He had history of loss of weight, fever and
night sweating and was found to have cutaneous anergy. No
hepatosplenomegaly.
What is your most probable diagnosis – Hodgkin’s lymphoma
Give the classification of the condition.
Describe the morphology of any two types.
3. 40 years male with splenomegaly on investigations had total count of
1,20,000 cells / mm3 and peripheral smear showed predominance of
myeloid precursors.
What is your diagnosis – Chronic myeloid leukemia
Draw diagram of peripheral smear.
What is the common genetic event in this condition?
4. 20 years male following antibiotic intake had total leukocyte count of
1200 cells / mm3 and absolute neutrophil count of 120 cells.
What is your diagnosis – Drug induced neutropenia
What is the pathogenesis of this condition?
5. 70-year-old women admitted with worsening anemia and pathological
fracture of the Humerus had an ESR of 120mm in 1 hour and
proteinuria. Her peripheral smear showed increased rouleaux formation.
Xray of skull showed multiple punched out osteolytic lesions.
What is the most probable diagnosis – Multiple myeloma
Write briefly on the etiopathogenesis of this disease.
Describe the Peripheral smear findings & Bone Marrow Changes
in this disease.
Enumerate the common laboratory investigations for this disease.
Enlist the complications of this disease.
6. 60 years male presented with low back ache. He had multiple lytic lesions
of bones on skeletal survey. Serum electrophoresis and bone marrow was
done to establish diagnosis.
What is your diagnosis – Multiple myeloma
What are the findings in bone marrow and electrophoresis?
Discuss in detail the molecular pathogenesis, and clinical features
of above said disorder.
CHAPTER 14
RED BLOOD CELL AND BLEEDING DISORDERS
1. 50 / male vegetarian, presented with pallor, paresthesia of extremities
O/E he had beefy tongue.
What is your diagnosis – Vitamin B12 deficiency
How will you investigate this patient further and establish the
diagnosis?
Classify RBC disorders according to etiology.
2. 20 years female had hematocrit of 20%, reticulocytosis,
hyperbilirubinemia, peripheral smear revealed anisopoikilocytosis and
target cells.
What is your diagnosis - Thalassemia
What is the pathophysiology of this disease?
CHAPTER 15
The Lung
1. A 50-year-old male presents with cough, dyspnea, and intermittent
hemoptysis for two months along with loss of weight and appetite. He is a
chronic smoker for the past 3 decades. CT chest revealed mass lesion in
the right lobe of lung.
What is your probable diagnosis – Bronchogenic carcinoma
Discuss in detail the classification, morphological features
Paraneoplastic syndromes associated with it.
2. 50 years male smoker C/o dyspnea his PET revealed FEV1 / FVC ratio of
0.5. He had barrel shaped chest.
What is your diagnosis - Emphysema
What is the etiology and pathogenesis for this disease?
3. 30 Years male with recurrent history of cough and sneezing, without
fever. Cough relieved after taking bronchodilators.
What could be the cause – Bronchial asthma
Write about the pathogenesis and morphology.
4. 55 years male chronic smoker had persistent productive cough for 3
months. He had similar episode last year too.
In which group of disorders, you will categorize them - COPD
Write briefly about the pathogenesis & morphology.
CHAPTER 17
THE GASTROINTESTINAL TRACT
1. A sixty-year-old male presented with anemia, loss of weight, persistent
abdominal pain, abdominal distension and vomiting. Upper GI endoscopy
and biopsy done.
What is the probable diagnosis – Gastric carcinoma
Discuss the etiopathogenesis and morphology of the disease.
3. A 65/M presented with bleeding PR. Colonoscopy revealed a hard mass
in rectosigmoid.
What is your diagnosis – Colorectal carcinoma
Discuss the various neoplasms arising in rectosigmoid, in detail
about morphological types and staging system.
3. 55 years male C/o weight loss and dyspepsia, endoscopy revealed an
ulcerative lesion antrum.
What is your diagnosis – Gastric carcinoma
Describe the morphologic classification and microscopic
findings.
4. 30 years male presented with heart burns and dyspepsia. A breath test and
biopsy were ordered to confirm the diagnosis.
What is your diagnosis - [Link] gastritis
Write about the morphology and complications of this disease.
CHAPTER 18
LIVER AND GALLBLADDER
1. 50 years male alcoholic presented with jaundice.
How will you investigate this patient?
What is the effect of alcohol on liver?
Write the morphology and clinical features and complications of
alcoholic liver disease.
2. 40 years obese female complaints of severe abdominal pain radiating to
the right shoulder. Ultrasound was done and she was advised
Cholecystectomy by the surgeon.
What is your diagnosis - Cholecystitis
Write in detail about the condition.
CHAPTER 20
THE KIDNEY
1. A 12-year-old boy presented with fever, nausea, oliguria and high
colored/cola colored/ smoky urine. He had sore throat three weeks back.
What is your probable diagnosis – Post streptococcal
Glomerulonephritis
Describe the etiopathogenesis and morphology of the condition
What are the relevant investigations?
Add a note on morphology of RPGN.
2. Thirteen-year-old female child had massive edema with puffiness of face
with decreased urine output.
What is the most probable diagnosis – Nephrotic syndrome
What can be the most probable renal pathology in this child?
Write in detail about minimal change disease.
3. 8 Yrs. Old boy with old scar of scabies skin lesion, with history of
Hematuria, Oliguria and Puffiness of face.
What is your probable diagnosis – Acute proliferative
glomerulonephritis
Etiopathogenesis and laboratory investigations.
4. 35 years female presented with fever with rigors, urine examination
revealed plenty of pus cells and granular cast – Pyelonephritis
What is the pathogenesis of this condition?
CHAPTER 21
THE LOWER URINARY TRACT & MALE GENITAL SYSTEM
1. 50 Yrs. old Male with painless firm Testicular swelling/ mass, with loss
of testicular sensation.
What is your probable diagnosis – Testicular tumor
Discuss classification and Etiopathogenesis.
Draw the microscope findings is this condition.
2. 80 years male presented with history of dysuria and urgency of urine.
USG shows enlarged prostate with increased PSA level – Benign
prostatic hyperplasia
What are the morphological findings in this condition?
3. 45 male presented with cauliflower like growth in the penis. He also had
multiple inguinal nodes.
What is your diagnosis – Squamous cell carcinoma of penis
Describe the microscopic appearance.
What are the preneoplastic conditions?
CHAPTER 22
THE FEMALE GENITAL TRACT
1. A 40-year female presents with post coital bleeding and foul-smelling
discharge per vagina. She lost 15% weight in 2 months, with loss of
appetite.
What is your diagnosis – Carcinoma cervix
What is the etiopathogenesis of this condition?
What are the morphological features?
2. A 60-year-old postmenopausal anorexic, cachectic woman has an
ulcerated and friable cervix that bleeds on touch. These features were
accompanied by foul smelling vaginal discharge.
What is your diagnosis - Carcinoma cervix
Discuss in detail the etiopathogenesis and morphological features
of your diagnosis.
Enlist the investigations that will enable diagnosis.
3. 15 years female presented with unilateral ovarian mass. Gross
examination of the mass revealed hair in it.
What is your diagnosis – Mature Teratoma
What is the morphology?
It belongs to which group of ovarian lesions.
Enumerate the other lesions in this group
CHAPTER 23
The Breast
1. A 44-year-old nulliparous woman presented with hard, fixed non tender
mass of about 6x4x4 cm in the upper outer quadrant of right breast with
axillary lymphadenopathy.
What is your probably diagnosis – Carcinoma breast
Enlist the risk factors
Describe the molecular classification, pathogenesis and
morphology of the above condition.
Discuss in detail the prognostic & predictive factors of your
diagnosis.
2. 55-year-old post-menopausal women presented with hard lump 6 x 6 cm
in upper outer quadrant of left breast. FNA – revealed cluster of
pleomorphic cells.
What is your clinical diagnosis – Carcinoma breast
Classify the lesion
Discuss the etiopathogenesis, molecular mechanism of
carcinogenesis of the disease.
CHAPTER 24
THE ENDOCRINE SYSTEM
1. 30 years female presented with diarrhea, weight loss, protruding eye balls
and thyromegaly – Graves disease
What is the pathogenesis and morphology of the above
condition?
2. 25 Years female presented with midline swelling neck, FNAC showed a
cystic malignant neoplasm and admitted for surgery.
What is your diagnosis – Papillary carcinoma of thyroid
Write about the nuclear findings of the lesion.
3. 50 years male who was a diabetic has developed an ulcer in the foot of
size 6 x 4 cm. His last toe was covered with necrotic slough.
What is your diagnosis – Diabetic macrovascular disease
What is the pathogenesis and pathology involved in this
complication?
4. 50 years male presented with polyuria, polydipsia his Hba1c was 8.2. He
also had oliguria and puffiness of face.
What is your diagnosis – Diabetic Nephropathy
What is the pathogenesis of the underlying disease and its
complications? What are the investigations required to confirm?
5. 20 years female presented with solitary thyroid nodule. Microscopy
revealed Orphan Annie appearance of nuclei.
What is your diagnosis – Papillary carcinoma of thyroid
Describe the Morphology of this condition.
CHAPTER 26
BONES, JOINTS & SOFT TISSUE TUMORS
1. 20 years female H/o pain, swelling, tenderness over lower and of right
femur for 3 months. Suddenly developed breathlessness during her
treatment and died, clinical autopsy conducted. Answer the following:
What is your diagnosis - Osteosarcoma
Mention two investigations to arrive at diagnosis?
Etiopathogenesis of the lesion?
Gross and Microscopic picture of the lesion?
Mention two autopsy confirmed lesions leading to death?
2. 30 years female with lytic lesion in distal Ulna and X-ray revealed soap
bubble appearance.
What is your diagnosis – Osteoclastoma (Giant cell tumor)
Morphology of this condition.
3. 15 years male presented with lytic lesion lower end of femur. X-Ray
revealed Codman’s triangle and sun ray appearance.
What is your diagnosis - Osteosarcoma
What are the genetic alterations associated with this condition?
Describe the morphology of this lesion.
Classify bone tumors and add a note on imaging findings in
various bone tumors.
CHAPTER 28
THE CENTRAL NERVOUS SYSTEM
1. 7 years male child is found lying down on the road with convulsions with
his mother. How will you react as a medical student and help them?
CHAPTER 29
THE EYE
1. 1-year male child was brought with loss of vision and mass lesion of the
eyeball. There was a family H/o sarcoma of the long bone in the sibling.
What is your diagnosis - Retinoblastoma
What is the molecular mechanism involved in this family?
Describe the normal cell cycle and how this gene affects cell
cycle.
Name 3 other genes involved in familial syndromes.
