Download University of Jaffna (University of Sri Lanka) MBBS (Bachelor of Medicine and Bachelor of Surgery) 2014 August Pathology Paper II Previous Question Paper
UNIVERSITY OF JAFFNA, SRI LANKA SECOND
EXAMINATION FOR MEDICAL DEGREES--PART (II)
(1 sT)-AUGUST 2014-Pathology -Paper II
Date: 06.08.2014.
Time: 03 hours
ANSWER ALL TEN QUESTIONS
Answer each question in separate answer book
1.
Briefly discuss the macroscopic appearance and
pathological squalae of the following.
1.1.
Chronic gastric ulcer.
(50Marks)
1.2.
Crohn disease of intestine.
(50Marks)
2.
2.1.A 30 year old healthy man develops high fever, productive cough
and malaise following upper respiratory tract infection. The
total leucocyte count show neutrophil leukocytosis. Chest
radiograph shows consolidations and plural effusion. The
plural aspirate is purulent.
2.1.1. What is your diagnosis?
( 5Marks)
2.1.2. Describe the pathology (macroscopy and microscopy) of the (40Marks)
above.
2.1.3. List five (5) complications of the above condition.
( 5Marks)
2.2.
A 68 year old man who has been a heavy smoker for the
past 45 years presented with a severe cough with
haemoptysis for one month. The chest radiograph showed a
right perihilar 4cm mass.
2.2.1. List five (5) different types of specimens that can be sent to (10Marks) a
histopathology laboratory from this lesion to confirm the diagnosis.
2.2.2. A diagnosis of lung carcinoma was confirmed by histology. (15Marks) List
the histological types of this carcinoma?
2.2.3. Briefly describe the pathological (macroscopy &
(25Marks)
microscopy) features of one of the histological types
mentioned in 2.2.2.
Page 1 of 5
3.
A 22 year old female is found to have mitral valve prolapse
when undergoing a routine medical examination.
3.1.
Describe the morphology (macroscopic and microscopic)
(25 Marks)
of the mitral valve in this patient.
3.2.
State the pathogenic basis of mitral valve prolapse.
(15 Marks)
3.3.
List 3 complications of mitral valve prolapsed.
(30 Marks)
3.4.
List three other conditions that can affect the mitral valve (15Marks)
function.
3.5
Briefly state how these conditions mentioned in 3.4 affect (15Marks)
the mitral valve.
4.
A 2 year old boy is brought with a painful and swollen knee
joint following a minor fall. On examination he is afebrile
and has no lymphadenopathy or hepatosplenomegaly. He is
suspected to have a bleeding diathesis. His coagulation
profile is given below.
Prothrombin time -- 12 seconds (normal 10 -- 13 seconds)
APTT -- 52 seconds (normal 28 -- 36 seconds)
Thrombin time -- 12 seconds (normal 10 -- 13 seconds)
Fibrinogen level -- 2 01 (normal 1.5 -- 4.0 Op
4.1.
What is your most likely diagnosis?
( Marks)
4.2.
List three (3) conditions that give rise to an isolated
( 15Marks)
prolonged APTT.
4.3.
What investigations would you do to confirm your
( 30Marks)
diagnosis? State the expected findings of the
investigations that you mention.
4.4.
What questions would you ask the child's mother with ( 15Marks)
regards to this bleeding disease?
4.5.
What blood products are available for treatment of this
( 10Marks)
child?
4.6.
What advice would you give the mother who wants to have ( 20Marks)
another child, regard the probability of next child having the
same bleeding disease?
Page 2 of 5
5.
5.1.A 58 year old woman sees her physician for a routine health
checkup. The only abnormality on physical examination is a
blood pressure of 160/110 mm Hg.
Urine analysis pH - 7.0
Specific gravity 1.020
Proteinuria 1+
No blood, glucose or Ketone bodies
Abdominal USS- Bilateral symmetrically small kidneys
with no masses
ANA -- Negative
Serum urea nitrogen level 8.5 mmol L
(3- 8 mmol / L)
Serum creatinine
0.41 mmoll L (0.06- 0.12 mmol /L)
Hb Al c - Normal
5.1.1. What is the most likely diagnosis?
( 10Marks)
5.1.2. Briefly describe how you arrive at the above diagnoses by
(15 Marks)
analyzing the provided information.
5.1.3. Describe the pathological features of this patient's kidney.
25Marks)
5.2.
A 45 year old lady presents to the gynecology clinic with
irregular bleeding per vagina for four months.
5.2.1. List five possible causes for her complain.
( 10Marks)
5.2.2. Briefly describe the aetiopathogenesis, and pathological
( 40Marks)
features of two (02) of the causes mentioned in 5.2.1
6.
Describe the renal changes in diabetes mellitus.
( 1 0Marks)
Page 3 of 5
7.
A 60 year old male with long standing poorly controlled
hypertension presents with a "stroke". The MRI scan reveals
a cerebral infarct.
7.1.
Define cerebrovascular disease.
10Marks)
7.2.
List three main pathogenic mechanisms that involve in the
( 1 5 Marks)
development of cerebrovascular disease.
7.3.
Describe how this patient's hypertension contributed to the
(20 Marks)
development of a cerebral infarct.
7.4.
List four (4) risk factors other than hypertension for
( 20Marks)
development of cerebrovascular disease.
7.5.
Describe the evolution and pathological appearances of a non
( 35Marks)
haemorrhagic infarct in the brain.
8.
Mention:
Two (2) differential diagnosis(DD),
One (1) aetiology for each DD
Microscopic feature of one of the differential diagnosis
and
Two (2) laboratory investigations
that will to confirm the
diagnosis in each of the following condition
8.1.
A 21 year old university student presented with loss of
50Marks)
weight, low grade fever, night sweat and enlarged cervical
lymph node of the right side.
8.2.
55 year old alcoholic male presented with anorexia, right ( 0Marks)
hypochondrial pain and palpable liver.
Ultra sound abdomen reveals a space occupying lesion.
Page 4 of 5
9.
A 68 year old previously healthy male presented with
fatigue and breathlessness on even mild exertion for three
months duration. Investigations revealed normocytic
anaemia, impaired renal function, elevated ESR and lytic
lesion on skull X-ray.
9.1.
List four(4 }causes of normocytic anaemia
( 10Marks)
9.2.
List four(4) causes of elevated ESR of more than 100.
10Marks)
9.3.
Mention the most likely cause that will explain his present ( 20Marks)
condition.
9.4.
List 2 other investigations that would be useful to confirm ( 20Marks)
the diagnosis you mentioned in9.3.
9.5.
Mention four (4) causes for the renal impairment in the
( 20Marks)
condition you mentioned in 9.3.
9.6.
Briefly describe the pathogenesis of bone lesion in the
(20 Marks)
condition you mentioned in 9.3.
10.
A 45 year old female presented with a solitary thyroid
nodule on the right side of the thyroid gland of 6 months
duration. She also complains of loss of weight and loss of
appetite for the past 1 month.
10.1. A thyroid neoplasm is suspected in this patient. List two (2)
( lOMarks)
commonest malignant neoplasms which are possible in this
patient.
10.2. Describe the histological features of the neoplasms
( 40Marks)
mentioned in 10.1.
10.3. Describe the value of FNAC and biopsy in the differential
( 20Marks)
diagnosis of neoplasms mentioned in 10.1.
10.4. List two (2) common complications that can occur after
(10 Marks)
total thyroidectomy.
10,5. List two (2) relevant blood tests that will useful to identify
( 20Marks)
the each of the complications mentioned in 10.4 and
indicate the abnormalities expected.
Page 5 of 5
This post was last modified on 19 October 2021