PATHOLOGY – 2

REMEMBER ALL QUESTIONS ARE VERY IMPORTANT

RED FOR MOST IMP QUE

BLUE FOR SAME QUE BUT DIFFERENTLY ASKED

+ FOR HOW MANY TIMES IT ASK

Blood
[CASE-13 ; QUE-9M]

(1) CASE: CML

50-year-old male presented with fatigue, night sweats, weight loss and a sensation of abdominal fullness.
On physical examination, he has splenomegaly. His total leukocyte count is 1,20,000/uL with shift to left.
In differential count, 5% cells were having large granules covering their nucleus.

a) What is the most likely diagnosis? Why? 2 mark

b) Which other tests may be required to confirm the diagnosis? 2 mark

c) Explain different stages of this disease with associated laboratory findings. 6 mark

d) Classify myeloproliferative disorders. 3 mark

(2) CASE: SICKLE CELL ANEMIA

A 14-year-old boy is admitted to the hospital with a 2-day history of severe, throbbing pain in his lower
back, chest, and legs. His mother mentions that he has had similar episodes of pain in the past, usually
triggered by infections or exposure to cold. On physical examination, the boy appears pale, and
yellowish discoloration is noted in the sclera. He has mild splenomegaly and tenderness over the long
bones. His past medical history includes multiple hospitalizations for pain management and frequent
episodes of upper respiratory tract infections. Family history reveals his brother died after having some
similar kind of blood disease

Laboratory findings include: Hemoglobin: 7.5 g/dL ; Reticulocyte Count: 12% ; Perpheral smear shows
crescent shaped red cells ; Bilirubin: Total: 4.2 mg/dL, Indirect: 3.5 mg/dL. ; Hb Electrophoresis: HbS:
70%, HbA: 24%, HbF: 6%

a) What is the diagnosis? (1)

c) Write morphological changes (findings) seen in peripheral smear and spleen. (3)

d) Discuss the potential complications that can arise in this patient. (3)

e) Explain the causes behind yellow sclera and high indirect bilirubin level. (2)

f) Write the the cause of elevated reticulocyte count related to this underlying disease. (1)

(3) Cassify hemolytic anemia. Write in detail about the pathogenesis and laboratory diagnosis of beta
thalassemia major (3+3+3)

(4) Define and classify Anemia. Write laboratory diagnosis of Megaloblastic anaemia. (1+3+5)

(5) Define the leukemia. Describe the hermatologic features of acute and chronic myeloid leukemia.
(1+4+4)

(6) Describe iron metabolism. Describe etiology, investigations and differential diagnosis of microcytic
hypochromic anemia. (3 + 2 + 2 + 2)

(7) Define Anemia. Classify Hemolytic Anemia. Describe Pathogenesis and Laboratory findings of Sickle
Cell Anemia(1+૩+5)

(8) CASE: B12 ANEMIA

35 male, pure vegetarian complaints of weakness, loss of apetite, dyspnoea on exertion and tingling
numbness in lower limbs. On examination he has severe pallor and smooth beefy red tongue. What is
your diagnosis. Write the etio-pathogenesis and laboratory investigations for the same. (1+4+4)

[5M]

(1) Peripheral smear findings of chronic myeloid leukemia. ++

(1.1) Discuss the peripheral blood smear and bone marrow findings, with other relevant laboratory
markers in a patient diagnosed with chronic myeloid leukemia. (5 marks)

(2) Enumerate Plasma cell disorders. Write Laboratory diagnosis of Multiple myeloma.

(3) Describe Blood indices.

(4) Describe the pathogenesis and peripheral blood picture of sickle cell anemia. +++

(4.1) Discuss etiopathogenesis of Sickle cell anemia. Enumerate various crisis seen in sickle cell disease

(5) Describe normal hemostasis. Describe the etiopathogenesis and pathology of Immune
Thrombocytopenic Purpura

(5) von Willebrand disease.

(6.1) Classify the different types of Hodgkin lymphoma (2 marks). N. Discuss the morphology, clinical
features, and staging of Hodgkin lymphoma (3 marks).

(7) Write WHO classification of AML.

(8) Describe the peripheral blood smear findings (3 marks) and relevant laboratory markers in a patient
with an MCV greater than 110 fL.(2 marks)

Blood vessels
[5M]

(1) Define & Classify Aneurysm and write in details of Syphilitic Aneurysm. ++

(1.1) Dissecting aneurysm.

(2) Define and describe Disseminated Intravascular Coagulation & its Laboratory Findings. ++

(2.1) Write etiopathogenesis and lab findings in DIC.

CVS
[CASE-13 ; QUE-9M]

(1) CASE: MI ++++

A 70-year-old male presented in emergency with severe chest pain for the last 2 hours. The pain was
radiating to the left arm. He was complaining of dyspnea at the same time and had vomited at the start
of the pain.Pule 90/min. Respi. Rate 28/min Family history: Father died of the same pain at the age of 55
Personal history: history of smoking 5-6 cigarettes a day for 10 years

a) What is your probable diagnosis?(2 Marks)

b) Describe laboratory investigations to confirm your diagnosis (4 Marks)

c) Describe the gross and microscopic features of the heart in the above condition (5 Marks)

d) Write the complications(2 Marks)

45/male patient admitted with chest pain, palpitation and hypotension. ECG showed ST elevation.Serum
Troponin marker raised.

a) What is probable diagnosis?(1 mark). Describe the risk factors in this case. (2 marks)

b) Describe the expected gross and microscopic findings in this case?(4 marks)

c) Which type of necrosis seen in this case? Different types of necrosis. (2 marks)

d) Describe the diagnostic tests this case? (2 marks)

e) Describe possible complications in this case?(2 marks)

(1.2) Define myocardial infarction. Explain gross morphology and complications of myocardial infarction.
(1+4+4)

(2) Describe the Etiology, Predisposing factors, Pathogenesis, Morphology and Diagnosis of Infective
Endocarditis.(1+2+2+2+2)

(3) Describe the morphological findings (1+3 marks) and outline the relevant laboratory investigations (5
marks) for a patient presenting with acute substernal chest pain of ischemia of heart.

[5M]

(1) Draw and label various types of cardiac valvular vegetations.

(2) Pathogenesis of atherosclerosis.

(3) Explain consequences of portal hypertension.

(4) Write a note on cardiac and extracardiac lesions in rheumatic fever.

(5) Describe etiology, types and morphology of endometrial hyperplasia. (1+1+3 marks)

Kidney
[9M]

(1) Describe the etiopathogenesis of glomerulonephritis.

(3) Classify primary and secondary glomerular diseases (2 marks). Discuss the clinical features (1 mark),
pathogenesis (2 marks), and morphological characteristics (4 marks) of Membranoproliferative
Glomerulonephritis (MPGN). ++

(4) Define Nephritic syndrome. Enumerate its causes. Describe the etiopathogenesis gross and
microscopic features of poststreptococcal glomerulonephritis. (2+2+5)

[5M]

(1) Explain pathology of chronic pyelonephritis. ++++

(2) Wilm's tumour.

(3) Describe gross and microscopic features of Renal cell carcinoma. ++

Respiratory
[9M]

(1) Define Pneumonia. Write the classification of Pneumonia. Describe the morphology of Bacterial
Pneumonia. (1+3+5) +++

(1.1) Define and describe the etiology, pathogenesis, stages, morphology and complications of
pneumonia. (1+2+2+2+2)

(1.2) Describe the etiopathogenesis of community acquired pneumonia. Write the stages of Lobar
pneumonia with gross and microscopic features. Enumerate its complications, (3+4+2)

(2) Define Chronic obstructive pulmonary disease. Write its classification. Describe etiopathogenesis,
morphological features and specific types of Emphysema. (1+1+2+2+3) +++

(2.1) Describe Definition, Classification, Pathogenesis and Morphology of Emphysema.(1+2+3+3)

(2.2) Define and classify chronic obstructive pulmonary disease (COPD) (2 marks). Describe pathogenesis,
morphology and clinical features of patient having COPD with breathlessness and peripheral blood
eosinophilia. (3+3+1 marks).
[5M]

(1) Miliary tuberculosis.

(2) Draw and label microscopic findings in lobar pneumonia.

(3) Describe the pathogenesis and pathology of tuberculous lymphadenitis.

(4) Tabulate the difference between primary and secondary tuberculosis (5 marks)

Male
[5M]

(1) Explain pathogenesis and clinical features of BPH.

(2) Describe gross and microscopic features of Teratoma of the testis.

(3) Classify testicular tumors and describe the pathogenesis and pathology of testicular tumors. ++

(3.1) Classify testicular tumors. Enumerate the tumor markers used.

Female
(1) Classify ovarian tumors. Draw and describe morphology of mature.[9M]

(2) Classify germ cell tumors of ovary. Write a note on mature cystic teratoma.[5M] ++

Breast
(1) CASE: BREAST CARCINOMA

52 yr, old female complaints of painless lump in the breast since 6 months. The lump is irregular, firm to
hard, slightly mobile with puckering of overlying skin. (1+3+7+2= 13 marks)
1. What is the your diagnosis? (1 mark)

2. Write the etiological/ risk factors. (3 marks)

3. Write the Classification and morphologic (gross and microscopic)features. (7 marks)

4. Discuss the prognostic factors for the same. (2 marks)

[5M]

(1) Describe gross and microscopic features of Fibroadenoma of the breast.

(2) Classify Breast Carcinoma. Discuss the gross and microscopy Carcinoma. of Invasive Ductal carcinoma.
++

(2.1) Write classification of breast carcinoma. (1 marks) Discuss risk and etiologic factor of breast cancer
(4 marks).

Liver
(1) CASE: ALCHOLIC CIRROSIS

A 50-year Male with history of Chronic Alcohol Consumption presented with distended abdomen. USG
show reduced size of Liver.

a) What is probable Diagnosis?

b) Describe the Pathophysiology and Pathogenesis of this condition.

c) Describe the Morphological findings of this condition.

d) Enumerate Complications of the condition.

[9M]

(1) Tabulate the summarizing the key features of different hepatitis viruses (5 marks). Describe the
morphological changes seen in acute hepatitis (2 marks) and chronic hepatitis (2 marks). ++

[5M]

(1) Enumerate causes of cirrhosis. Explain pathogenesis of alcoholic cirrhosis. +++

(1.1) Describe the pathophysiology and pathology of alcoholic liver disease.

(3) Enumerate the viruses causing hepatitis with their mode of transmission. Discuss the viral serological
markers of Hepatitis B with its diagnostic significance.

GIT
[9M]

(1) What is inflammatory bowel disease? Explain differences between ulcerative colitis and crohn's
disease. (2+7)

(2) Write the etiopathogenesis, morphology, and complications of Peptic ulcer. (4+3+2) ++

(2.1) Describe the etiopathogenesis and clinical features of peptic ulcer disease(gastric and duodenal).
Write the gross and microscopic features. Enumerate the complications. (3+1+4+1)

[5M]

(1) Describe morphological features of Gastric carcinoma with labelled diagram.

(2) Describe Pathogenesis and Morphology of Chronic Peptic Ulcer. ++

(2.1) Describe pathogenesis, morphology and clinical features of peptic ulcer disease (2+2+1)

Endocrine
[9M]

(1) Classify Diabetes melitus. Describe Isboratory diagnosis of Diabetes melitus (3+6) +++

(1.1) Write etiologic classification of Diabetes mellitus. Describe pathogenesis of Type-1 and Type-2
diabetes mellitus. Enumerate the complications of diabetes (2 + 5 + 2)

(1.2) Write the Diagnostic Criteria for Diabetes Mellitus. Classify diabetes Mellitus. Describe the
Pathogenesis for type II DM. (2+3+4)

[5M]

(1) Explain pathology of goitre.

(3) Classify Thyroid Neoplasms. Describe morphology of Papillary Thyroid Carcinoma.

(4) Write a note on Hashimotos thyroiditis (Etiopathogenesis, clinical features including TFT and
morphology of thyroid gland).

(5) Pathogenesis of Type 2 Diabetes (T2D) in detail.

(6) How will you Investigate a 35-year-old female presented with diffuse thyroid enlargement. Discuss
briefly. (5 marks)

Skin
(1) Describe the risk factors, pathogenesis, pathology and natural history of basal cell carcinoma of the
skin.

(2) Describe the Risk factors & Microscopic features of Squamous Cell Carcinoma of the Skin. +++

EXTRA
(1) Classify bone tumors. Describe Gross and microscopic features of Giant cell tumor of bone. ++

(1.1) Classification of bone tumors.

(1.2) Classify Bone Tumors. Describe the Morphological features of GCT.

(2) Enumerate the indications and describe the principles and procedure of autologous transfusion.

(3) Describe the etiopathogenesis and pathology of oral cancer.

(4) Describe the diagnosis and progression and spread of the leiomyoma and leiomyosarcomas.

(5) Meningioma

(6) Giant cell tumor of Bone

(7) Discuss the role of Medico legal and Ethics in patient care.

(8) Define an advance directive. Describe two advance directives of 'Living will' and 'Health care proxy.
(AETCOM Compulsory) (2+3 marks)
BEST OF LUCK