Download University of Jaffna (University of Sri Lanka) MBBS (Bachelor of Medicine and Bachelor of Surgery) 2020 September Pathology Paper II Previous Question Paper
Index number.
UNIVERSITY OF JAFFNA, SRI LANKA SECOND
EXAMINATION FOR MEDICAL DEGREES--SEPTEMBR
2020 Pathology Paper II
Date: 16.09.2020.
Time: 03 hours
ANSWER ALL THE 10 QUESTIONS
Write the answers in the given space below each question.
1. A 30-year-old man who was a chronic, alcoholic from young age, with a past
history of recurrent left hypochondria! and epigastric abdominal pain radiating to
back with nausea and sometimes vomiting over the past 10 years, presented with
coma to the Accident and emergency. He was rehabilitated from alcohol
dependency 2 years ago and maintains abstinence. On admission his capillary
blood glucose was >28rnmol / L.
1.1.
What is the most likely diagnosis?
(05 Marks)
1.2.
What can be the aetiology for the condition you mentioned in 1.1?
( 05 Marks)
1.3.
Outline the pathophysiology behind this diagnosis mentioned in 1.1.
(20 marks)
1.4.
List four (04) biochemical tests you will perform in this patient at this situation and give
the expected findings.
(40 marks)
1 ..........
3 .......................................................................................................................................
4
1.5. Name one (01)non biochemical investigation that you will perform to confirm the
aetiology which you mentioned in 1.2.
(10marks)
1.6.
Outline four (04) long term complications that may occur if the condition mentioned in
1.1
is uncontrolled for a longer period. (20 Marks)
1 ................................
3
. .....................................................................................................................
4 .............................
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UNIVERSITY OF JAFFNA, SRI LANKA SECOND EXAMINATION FOR MEDICAL
DEGREE S--SEPTEMBR 2020 Pathology Paper II
2.
Haemopoiesis depend on many factors.
2.1
List the factors required for haemopoiesis and indicate one disease which relates to the
defects in each factor stated.
(15 marks)
22.
Briefly outline "haemopoiesis in patients with thalassaemia major".
(25 marks)
2.3.
List four (04) tests useful to assess haemopoiesis and expected results hi anaemia due to
marrow underproduction (marrow failure).
(15 marks)
1 ..............
3
4 .......................................................................................................................................
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2.4.
Outline the pathological basis of anaemia in thalassaemia major.
(25 marks)
2.5
Outline how beta thalassernia major and beta thalassaemia minor is cliagnosed..(20 marks)
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Index number- ...................................................................
UNIVERSITY OF JAFFNA, SRI LANKA SECOND
EXAMINATION FOR MEDICAL DEGREES--SEPTEMBR
2020 Pathology Paper II
3,
A 68- year-old man was admitted to Teaching Hospital Jaffna with a clinical suspicion of
severe iron deficiency anaemia (IDA).
3.1. Outline the pathogenesis of
3.1.1 Anaemia in iron deficiency.
(15marks)
3.1.2 Red cell changes observed in iron deficiency.
(15 marks)
3.2
Outline the expected automated full blood count (FBC) report in IDA.
(25 marks)
3.3.
Statefive (05) different questions you would ask from the patient to ascertain underlying
causeis for iron deficiency.
(15 marks)
1 ..........
I
3 ....
4 ..............................
5. ..........................
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3.4.
Outline the findings of serum iron studies in a patient with IDA.
(15 marks)
3.5.
Explain how you would monitor response to therapy.
(15 marks)
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UNIVERSITY OF JAFFNA, SRI LAN A
SECOND EXAMINATION FOR MEDICAL DEGREES--SEPTM4R 2020
Pathology Paper II
4.
A 35-year-old man presented to the surgical clinic of Teaching hospital Ja Ha with
multiple sinuses in the perianal region for 6 months duration.
4,1
List three (03) possible causes for the given clinical presentation,
(15 Marks)
1 .....
1
3 ................................................................................................................................
4.2.Briefly describe the pathogenesis of any one cause mentioned in 4.1.
(25 Marks)
4.3.
Describe settings in which chronic inflammation occurs with suitable examples.
(40 marks)
Eg
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2).
Eg.
3)
Eg.
4) ...................................................................................................
Eg.
4.4.
Name three (03) samples/tests that can be done to arrive at a diagnosis in this patient.
(15 marks)
1 .............
2 .....................................................................................................................................
3 ..................................................
4.5
Name one (01) special stain used in the laboratory to identify etiological agent in chronic
inflammation.
( 05 Marks)
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UNIVERSITY OF JAFFNA, SRI LANKA
SECOND EXAMINATION FOR MEDICAL DEGREES--SEPTMBR 2020
Pathology Paper II
5.
The surgeon wishes to commence a one stop clinic service for patients of age range 20-60
years visiting the surgical clinic at TH Jaffna with breast lumps.
5_ I
State. two (02) laboratory tests that can be offered to the patients.
(10Marks)
1. ....
5.2.
State two (02) advantages and two (02) disadvantages of the two (02) tests mentioned in
5.1.
(20 marks)
1).
Advantage :
1 .......
2 ...............
Disadvantage:
2
2).
Advantage
1 .......................................................................................................................................
Disadvantage :
5.3.
List Eve (05) pathological conditions that may be encountered in the patients of the above
age range.
(25 Marks)
1 ..................
2 ..............................
3 ................
4
5
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5_4.
Describe the macroscopy and microscopy of any one of benign conditions mentioned in
5.3.
(30 Marks)
5.5.
What is your recommendation if the surgeon requests to consider to include hormone/
molecular testing in the same clinic visit?
(10 Marks)
5.6.
Mention the suitable sample and test method to assess the hormone status in breast cancer.
(05 marks)
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UNIVERSITYOF JAFFNA, SRI LANKA
-
SECOND EXAMINATION FOR MEDICAL DEGREES--SEPT AMR 2020
Pathology Paper II
6,
Briefly explain the following.
6.1. Pathogenesis of acute appendicitis.
(20 Marks)
EL2
Systemic effects of neoplasia.
(20 Marks).
6.3.
Use oflaboratory tests in cancer diagnosis.
(20 Marks)
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6.4.
Pathogenesis of multinodular colloid goiter.
(20 marks)
6.5.
Presence of brown pigment in tissues.
(20 marks)
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UNIVERSITY OF JAFFNA, SRI LANKA
SECOND EXAMINATION FOR MEDICAL DEGREES--SEPTEMBER 2020
Pathology Paper II
A 65- year-old obese man with hypertension gave a history of recurrent episodes of
colicky abdominal pain on 2 occasions which subsided and then presented to the
emergency unit with acute generalized abdominal pain and subjected to an emergency
laparotomy. A large segment of the small intestine was gangrenous. He succumbed to
multi organ failure post operatively. The post mortem revealed extensive atheromatous
plaques in the aorta and occlusive thrombi in the mesenteric vessels.
7.1,
Briefly explain the possible reasons for the changes observed in the mesenteric vessels and
intestines.
( 15 Marks)
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7.2.
Briefly explain the risk factors of atherosclerosis,
(30 Marks)
7.3
Briefly describe the pathogenesis of atherosclerosis.
(30 Marks)
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UNIVERSITY OF JAFFNA, SRI LANK SECOND
EXAMINATION FOR MEDICAL DEGREES SEPTEMBER
2020 Pathology Paper II
7.4.
Describe the microscopic appearance of an atherosclerotic plaque.
(15 marks)
7.5.
List five (05) complications following a complicated atheromatous plaque.
(10 marks)
3 .....................................................................................................................................
4 .....................................................................................................................................
5 ......................................................................................................................................
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UNIVERSITY OF JAFFNA, SRI LANKA SECOND
EXAMINATION FOR MEDICAL DEGREFS--SEPTMBR
2020 Pathology Paper H
8.
A 35-year-old man presented to the medical unit with bilateral swelling of feet and facial
puffiness. Urine 24 hour protein was 7g. Urine microscopy examination revealed 50-60
RJEIC/HPF and presence of granular casts. Blood investigations revealed low serum
protein and complement levels, and ANA test was positive in 1:80titre. A renal biopsy
was performed.
8.1
State the most likely diagnosis and state the reason for your diagnosis.
(10 Marks)
8.2. Briefly explain the expected light microscopic appearance of the renal biopsy of this
patient.
(30 Marks)
8.3.
Explain the pathogenesis of the renal pathology / lesion of this patient.
(30 Marks)
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8.4.
State a serological test that may be useful for diagnosis mentioned in 8.1.
(10 Marks)
8.5.
Mention 2 specialized tests that will help to confirm renal lesion in this patient. (20 Marks)
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UNIVERSITY OF JAFFNA, SRI LANKA SECOND EXAMINATION
FOR MEDICAL DEGREES--SEPTEMBR 2020 Pathology Paper II
70-yeax-old man is brought to the emergency unit after coughing up several table
spoon of bright red blood_ For the last 3 months, he had a chronic nonproductive cough.
More recently, he noticed some scant blood streaked sputum. Patient has smoked one
pack of cigarettes per day for the past 35 years. He also complained increased fatigue,
decreased appetite and weight loss in the past 3 months.
9.1.
What is the most likely diagnosis?.
(O5marks)
9.2.
List three (03) causes for haernoptysis other than you
have mentioned in 9. 1. (15
marks}
9.3.
List three (03) other different clinical presentations of the condition mentioned in 9.1.
(15 marks)
9.4. List five (05) investigations that you would order to differentiate the conditions you have
mentioned in 9.1 and 9,2, and indicate the expected findings,
(20 marks)
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9.5.
Outline the histological types of the condition you have mentioned in 9.1.
( 10 marks)
Physical examination of the patient revealed left sided pleural effusion and
diagnostic thoracentesis was performed.
9.6.
List three (03) causes of pleural effusion.
(15 marks)
9.7_ List five (05) tests that can be performed in the pleural fluid to differentiate the conditions
mentioned in 9.6 and indicate the expected findings.
(20 marks)
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Index number: ...................................................................
UNIVERSITY OF JAFFNA, SRI LANKA SECOND
EXAMINATION FOR MEDICAL DEGREES--SEPTMBR 2020
Pathology Paper II
10.
Mention
1.The most likely diagnosis (05 marks),
2.One risk factor l aetiology (05 marks),
3.One complication (05 marks) and
4.The pathological changes (macroscopic and microscopic) (10 marks)
that may occur in the following conditions.
10_1. A 70-old-year man presented to the surgical ward with acute retention of urine and
was catheterized by the house officer. Digital rectal examination revealed a nodular
firm prostate. The patient was subjected to ultrasound guided prostate needle biopsy_
Serum Prostate specific antigen level was 4.2 ngiml (0 to 5,0 nemL).
1. Diagnosis: ......................
2. Risk factor / aetiologty . .........
3. Complication: ......................................................................................................
4. Pathological changes:
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10.2. A 50-year-old woman presented with Jaundice and new onset of abdominal swelling.
Her history revealed a blood transfusion in the past. Ultrasound examination of the
liver revealed irregular echogenicity demonstrating nodules.
1. Diagnosis: .............................................................................................................
2. Risk factor 1 aetiologty: ..........................................................................................
3. Complication -
4. Pathological changes:
10.3. A 35-year-old man admitted to the ward with a 1-day history of high fever.
Examination revealed a new heart murmur. The patients is an intravenous drug user.
1. Diagnosis: .............................................................................................................
2. Risk factor / aetiologty . ...............................................................................................................................................
3. Complication: .........................................
4. Pathological changes:
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Index number: ...................................................................
UNIVERSITY OF JAFFNA, SRI LANKA SECOND
EXAMINATION FOR MEDICAL DEGREES--SEPTEMBR
2020 Pathology Paper H
10.4_ A 55-year-old man presertted with progressive dysphagia for solid & liquid. The patient's
past medical history reveals severe gastro -esophageal reflux disease_
1_ Diagnosis: .......................
2. Risk factor I aetiologty:
...........................................................................................
3. Complication: ........................
4. Pathological changes:
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This post was last modified on 19 October 2021