Download University of Jaffna (University of Sri Lanka) MBBS (Bachelor of Medicine and Bachelor of Surgery) 2019 September Pathology Paper II Previous Question Paper
UNIVERSITY OF JAFFNA, SRI LANKA SECOND EXAMINATION FOR
MEDICAL DEGREES-25 TH SEPTEMBER 2019 PATHOLOGY Paper II
Date: 25.09.2019.
Time: 03 hours
ANSWER ALL THE TEN QUESTIONS
Answer each QUESTION in separate answer book
1. A 27 year old man presented to the surgical unit with a history of
intermittent passage of blood in the stool for the past 6 months. He
mentioned that his father had undergone a total colectomy at the age of
40. Clinical examination revealed mild pallor. Colonoscopy revealed
multiple (more than 100) polyps in the large intestine. Three of the
largest polyps were biopsied and sent for histopathological examination.
1.1
State the most likely clinical diagnosis
(05Marks)
1.2
State two morphological types of polyps that histopathological
examination may reveal
(10Marks)
1.3
Describe the macroscopic and microscopic appearance of any one
type of polyp you mentioned in 1.2
(30Marks)
1.4
Name the type of malignancy that may develop in the polyps.
(05 Marks)
1.5
Name the putative gene involved in the condition you mentioned in
1.1
(05 Marks)
1.6
Briefly describe the underlying genetic mechanism leading to the
condition you mentioned in 1.1
(40Marks)
1.7
Name the likely specimen that you may receive for histopathological
examination from the surgery.
(05 Marks)
1 A 45 year old man presented to the medical ward with recurrent episodes of
right hypochondrial pain, fever and mild jaundice. The patient was subjected
to surgery after two weeks.
2.1
Mention two possible clinical conditions that are the cause of his
symptoms
(10Marks)
2.2
State one laboratory and one radiological investigation which can be
performed on this patient
(20 Marks)
2.3
State two possible samples that may be sent to the histopathology
laboratory for analysis
(20 Marks)
2.4
Describe the macroscopic and microscopic appearance of the organ
affected in any one of the condition you mentioned in 2.1
(40 Marks)
2.5
State the sequalae to the condition you described in 2.4, if the patient
was not subjected to surgery
(10 Marks)
Page 1 of 4
3.
A 45 year old female presented to the gynaecological unit with a history of
whitish vaginal discharge and contact bleeding for 3 months. She had
undergone a cervical smear 9 months ago and vaguely remembered that she
was asked to come for a repeat smear which she did not take seriously.
Colposcopic examination revealed an exophytic irregular whitish area in the
cervix which was biopsied for histopathological assessment
3.1
State one possible cause for the clinical manifestation
(1 OMarks)
3.2
Name the potential causative agent and state two types implicated
etiology
(30 Marks)
3.3
Describe briefly the mechanism of action of the causative agent in
the development of the condition you mentioned in 3.1
(30Marks)
3.4
Describe briefly the morphological changes in the progression of the
condition mentioned in 3.1
(20 - Marks)
3.5
Name the stain used for the evaluation of this patients cervical smear (10Marks)
4.
A 67 year old woman presented to the medical unit of the Jaffna
teaching hospital with dyspnea. She had a past history of a lump,
removed from her left breast 10 years ago and the histopathology
report was not available. Chest x ray revealed left pleural effusion.
4.1
Name three possible causes of pleural effusion in
(15Marks)
4.2
this patient List three laboratory investigations that can be
performed on the pleural fluid to arrive at a diagnosis
(15 Marks)
4.3
List five parameters that distinguish exudates from transudates
(25 Marks)
4.4
Describe and illustrate with a diagram the appearance of any
three types of cells you may see in any one of the condition
you have mentioned in 4.1
(45Marks)
5.
A 75 year old man was brought to the outpatient department with
severe dyspnea, and orthopnoea. On examination she had bilateral
pedal oedema and basal crepitations on auscultation.
5.1Define oedema
(1 ?Marks)
5.2State the different types of oedema based on anatomical location
(25Marks)
5.3Describe briefly the mechanism of occurrence of pulmonary
oedema in congestive cardiac failure
(25Marks)
5.4Explain briefly the reason for the clinical manifestations of
the patient
(40Marks)
Page 2 of 4
6
A 5 year old boy presented to the OPD with complaints of generalized body
swelling and passing small amounts of urine that is sometimes dark brown in
colour. His blood pressure was 170/100 Fig.
6.1
What is the most likely diagnosis
(10Marks)
6.2
Name 4 investigations that would be helpful in the diagnosis
(10Marks)
6.3
Describe the microscopic changes that occur in the kidney
(40Marks)
6.4
Describe the macroscopic and microscopic changes seen in
hypertension in the kidney
(40Marks)
7.
Briefly outline the pathological basis of
7.1
Bleeding in Disseminated Intravascular Coagulation (DIC).
(30 Marks)
7.2
Increased reticulocyte count in haemolyticanaemia.
(30 Marks)
7.3
Haemosiderinuria in intravascular haemolysis.
(40Marks)
8.
A 67 year old male presents with.backache and bone pain. The X
Ray revealed a pathological fracture and lyric lesions.
8.1
State the most likely disease you suspect and the cell involved in this (10 Marks)
disease
8.2
Describe the pathological basis for the radiological findings
(20 Marks)
8.3
List four blood tests useful in the investigation of this condition
(40 Marks)
(mention the sample type collected from the patient and the expected
findings in disease you mentioned in 8.1).
8.4
Name specific substance you expected in these patients urine and
(30 Marks)
state the pathological basis for the presence of that substance in urine
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9. A 60 year old overweight woman was admitted for an elective shoulder
repair. She also complains of feeling tired all the time. She has
constipation. Examination revealed slow ankle reflexes.
9.1
What is the diagnosis?
(10 Marks)
9.2
Mention three (03) causes for your diagnosis
(15 Marks)
9.3
Mention one (01) biochemical test to diagnose the condition
(10 Marks)
and indicate the expected findings
The day before her surgery she develops acute onset of central crushing
chest pain, radiating to her left arm. She also was sweaty and felt nauseous.
9.4
What is the diagnosis/ underlying pathology for her acute symptoms?
(10 - Marks)
9.5
Mention three (03) biochemical abnormalities you would expect
(30 Marks)
in her blood and indicate the changes
9.6
Mention two (2) causes of death of this patient
(10 Marks)
Despite treatment, she subsequently died after 2 days.
9.7
Mention the changes you would observe in her blood vessels,
(15 Marks)
kidneys and liver.
10 A 65 year , old known diabetic patient found semi-comatosed.
Physical examination revealed reduced skin turgor.
10.1. Litt three (03) causes for his clinical condition
(15 Marks)
10.2. List three (03) biochemical tests you would perform in this patient to
(30 Marks)
find out the causes you mentioned in 10.1 and indicate the
expected firidings.
A day after admission she had slurring of speech and detailed
examination revealed weakness of the left upper and lower limbs.
10.3. What is the most likely diagnosis?
(10 Marks)
10.4. State two (02) possible pathogenic mechanisms for the above
(10 Marks)
clinical condition
10.5. Mention one (01) cause for each pathogenic mechanism mentioned in (10 Marks)
10.4
10.6. Mention the pathogenesis of any one of the mechanism
(25 Marks)
you mentioned in 10.4.
Page 4 of 4
This post was last modified on 19 October 2021