Download The West Bengal University Of Health Sciences (WBUHS) 2nd Year MBBS Pathology Syllabus
(to be implemented from 2010 Regular Examinations)
A. Written Paper:
Paper I ? General Pathology & Hematology
Paper II ? Systemic Pathology & Clinical Pathology
Scheme of Theoretical Examination in Pathology.
Paper : 1. [General Pathology / Haematology]
Q1. Problem questions (without alternative)
10 Marks.
Q2. Comment on ; any two out of three ;
2 X 5 = 10
There shall be conceptual questions on general Pathology/ Haematology. e.g.
1. Difference between difference by primary and secondary intention in wound healing.
2. Retic count is important in diagnosis of anaemia.
Q3. Pathogenesis / Differentiation / Blood or Bone marrow picture etc.
(any two out of three: )
2 X 5 = 10
Q4. Short notes (any two out of four)
2 X 5 = 10
Paper : II [ Systemic Pathology [ Investigative Pathology]
Q1. Same as above
Q2. Same as above
Q3. Pathogenesis / investigations/ interpretations etc.
Q4. Short notes as above.
B. Oral/Viva:
There will be two tables with 7 ? marks in each table
Marks will be 15 (7 ? x 2)
Table I ? General and Systemic Pathology
Table II ? Hematology and Clinical Pathology
C. Practical:
Scheme of Practical Examination in Pathology.
Q1. Exercise on Peripheral Blood Smear
4 Marks
Q2. Exercise on Urine (2 Tests at least)
4 Marks
Q3. Exercise on Blood group / ESR / TLC / Hb estimation
4 Marks
Q4. Exercise on Histopathology slide (identification of description of the
Changes therein)
4 Marks
Q5. Exercise on Problem based card (interpretation Questions therein)
4 Marks
Q6. Exercise on Spotting 6 items (1/2 marks each)
3 Marks
(2 specimens + 2 slides + 2 instruments)
1
Q7. Practical Exercise book
2 Marks
(Should be properly signed by appropriate teachers)
Distribution of Internal Assessment marks:
Total marks ? 30
Theory ? 15
Practical ? 15
Class-tests(Continuous I.A.) = 7.5
Item cards (Continuous I.A.) = 7.5
1st Periodical I.A. ? 40
1st Periodical I.A. ? 25
2nd Periodical I.A. ? 40
2nd Periodical I.A. ? 25
3rd Periodical I.A. ? 40
3rd Periodical I.A. ? 25
Total ? 120
Total ? 75
120/16 = 7.5
10% of 75 = 7.5
Question pattern for Periodical Internal Assessment examination:
A. Theory : One paper of 40 marks
Time ? 2 hrs.
1. One clinical problem-oriented question
10 marks
2. Two short-answer questions (2-3 segments)
10 x 2 = 20 marks
3. Five short notes
2x 5 = 10 marks
B. Practical (including Oral):
C.
1st Periodical I.A. exam.
25 marks
Instruments (two)
5 x 2 = 10
Peripheral blood smear staining
5
Any two of the following three tests 5x2 = 10
( ESR, TC, Hb estimation)
2nd Periodical I.A. exam.
25 marks
Urine examination (two) 5 x 2 = 10
Problem card
5
Blood grouping
5
Instrument
5
3rd Periodical I.A. exam.
25 marks
Urine examination
5
Peripheral blood smear
5
Blood grouping / ESR /TC
5
Problem card & its interpretation
5
Identification
5
(4 HP & 1 Hematology slide)
SYLLABUS for Second Professional M.B.B.S. course in PATHOLOGY
The Syllabus for the 2nd Professional MBBS Course in Pathology is based on the Curriculum prescribed by the
Medical Council of India
A) GOAL
The broad goal of the teaching of undergraduate student in Pathology is to provide the students with a
comprehensive knowledge of the mechanisms and causes of disease, in order to enable him/her to achieve
complete understanding of the natural history and clinical manifestations of disease.
B) OBJECTIVES
a) Knowledge
At the end of the course, the student should be able to :-
2
(1)
describe the structure and ultrastructure of a sick cell, mechanisms of cell degeneration, cell death and
repair and be able to correlate structural and functional alterations.
(2) explain the pathophysiological processes which govern the maintenance of homeostasis, mechanisms of
their disturbance and the morphological and clinical manifestations associated with it.
(3) . describe the mechanisms and patterns to tissue response to injury such that she/he can appreciate the
pathophysiology of disease processes and their clinical manifestations.
(4). correlate normal and altered morphology (gross and microscopic) of different organ systems in
common diseases to the extent needed for understanding of disease processes and their clinical
significance.
b) Skills
At the end of the course, the student should be able to:-
(1) . describe the rationale and principles of technical procedures of the diagnostic laboratory tests and
interpretation of the results;
(2) perform the simple bed-side tests on blood, urine and other biological fluid samples;
(3) draw a rational scheme of investigations aimed at diagnosing and managing the cases of common
disorders;
(4) understand biochemical/physiological disturbances that occur as a result of disease in collaboration
with pre clinical departments.
c) Integration
At the end of training he/she should be able to integrate the causes of disease and relationship of different
etiological factors (social, economic and environmental) that contribute to the natural history of diseases most
prevalent in India.
Lecture classes: 100 hours
Each Lecture class will be of one hour duration. The important aspects of each topic are given below
General Pathology:
A] Cell injury and adaptations-
(7 classes)
? Causes & Mechanism of cell injury
? Macroscopic and microscopic features of reversible & irreversible cell injury
? Definition and types of necrosis - characteristics of each type of necrosis with example
? Apoptosis - definition, examples, its mechanism, morphological changes and its difference from necrosis
? Definition of gangrene - different types with morphology and examples
B] Acute Inflammation- (6 classes)
? Definition of acute inflammation and its causes
? Vascular phenomenon of inflammation
? Cellular phenomenon - chemotaxis, phagocytosis and formation of exudate
? Chemical mediators of inflammation - list, histamine, complement, arachidonic acid metabolites, brief
mention of coagulation cascade
? Morphological types of acute inflammation with examples
? Clinical & hematological manifestations and outcome of acute inflammation
C] Chronic Inflammation and granuloma -
( 4 classes)
? Chronic inflammation - definition, examples, morphology, cells of chronic inflammation with emphasis on
epithelioid cells & giant cells
? Granuloma- definition pathogenesis & description of a granuloma with special emphasis on tuberculous
granuloma
? Other types of granuloma - Syphilis, Sarcoidosis, Leprosy
? Giant cells - different types, morphology & examples
D] Tissue repair, regeneration and fibrosis - ( 6 classes)
? Cell cycle and different types of cells
? Normal cell growth
? Regeneration - role of growth factors and extracellular matrix
? Repair - role of collagen, granulation tissue, angiogenesis and fibrosis
3
? Wound healing - first and second intention
? Factors affecting wound healing
? Complications of wound healing
? Healing in bone and specialized tissue
E] Hemodynamic disorders, thrombosis and shock - ( 10 classes)
? Hyperemia and congestion - definition and morphology
? Normal hemostasis - mechanism and pathways
? Thrombosis - definition, pathogenesis, causes, morphology and fate
? Differences between Thrombophlebitis and Phlebothrombosis
? Differences between Thrombus and Clot
? Embolism & Infarction
? Oedema - definition, types, pathogenesis with examples
? Differences between Transudate and Exudate
? Shock - definition, types, pathogenesis, clinical manifestations and examples
F] Storage disorders and Amyloidosis -
( 3 classes)
? Classification of storage diseases
? Familial hypercholesterolemia, Lysosomal storage disease, Glycogen storage disease - an overview
? Amyloidosis - definition, classification, pathogenesis, staining, clinical manifestations
G] Disorders of Growth -
( 2 classes)
? Definitions of Hyperplasia, Hypertrophy, Atrophy, Metaplasia, Dysplasia, Hypoplasia with examples.
? Differences between - Hypertrophy and Hyperplasia, Atrophy and Hypoplasia
H] Neoplasia - ( 10 classes)
? Definition (Willis') and classification
? Characteristics of a malignant neoplasm
? Differences between - Benign and Malignant neoplasm, Carcinoma and Sarcoma
? Spread of a malignant tumor - Routes with example, Mechanism of spread
? Carcinogenesis - what is a carcinogen? Why carcinogenesis is a genetic event?
? Different types of carcinogens and their mechanism of action
? Molecular biology and genetics of carcinogenesis
? Systemic changes due to neoplasia - paraneoplastic syndrome
? Diagnosis of neoplasia
I] Metabolic disordersm-
( 6 classes)
? Jaundice - definition, bilirubin metabolism, classification, lab. Diagnosis,
? Diabetes Mellitus - Definition, Classification, Physiology of insulin metabolism, Pathophysiology,
Complications, Diagnosis
? Gout - definition, classification, pathophysiology, diagnosis
J] Others -
(10 classes)
? Genetics and chromosomal disorders - DNA structure, mutations, Mendelian disorders, chromosomal
structural alterations, karyotype, cytogenetic disorders, diagnosis of genetic diseases
? Immune diseases - Hypersensitivity reactions, graft rejection,
? Autoimmune disorders - mechanism, SLE, Rheumatoid arthritis
? Immunodeficiency conditions - overview
? AIDS - pathophysiology, clinical manifestations, diagnosis
? Environmental pathology - tobacco, alcohol, air pollution
? Radiation pathology -
Hematology:
A] Red Cell disorders -
( 12 classes)
? Definition, Classification of anemia- morphological & etiological
? Iron deficiency anemia - causes, pathogenesis, clinical manifestations and lab diagnosis
? Megaloblastic anemia - causes, pathogenesis, clinical manifestations and lab diagnosis
? Aplastic anemia - causes, pathogenesis, clinical manifestations and lab diagnosis
4
? Hemolytic anemia - causes, pathogenesis, clinical manifestations and lab diagnosis
? Thalassemia- types, pathogenesis, genetics, clinical features, lab diagnosis
? Structural hemoglobinopathies - Sickle cell disease, G6PD deficiency
? Other red cell disorders - polycythemia
B] Leucocyte disorders -
( 8 classes)
? Definition, Classification of Leukemia(FAB & WHO)
? Acute leukemia - causes, morphology, diagnosis
? Chronic leukemia - causes, morphology, diagnosis
? Leukemoid reaction - types, morphology, differentiation from leukemia
? Myelodysplastic syndrome - definition, classification and morphology
? Benign disorders - leucocytosis, leucopenia etc.
C] Bleeding disorders -
( 6 classes)
? Thrombocytopenia - causes, common types, approach for lab diagnosis
? ITP - causes, types, lab diagnosis
? Coagulation disorders - causes, approach for lab diagnosis
? Hemophilia - cause, types, lab diagnosis
? DIC - causes, pathogenesis, features
D] Other hematological diseases - ( 4 classes)
? Plasma cell disorders
? Hematological manifestations of some important diseases
E] Blood groups and Blood Transfusion - ( 6 classes)
? Different blood groups and their Clinical significance
? Determination of blood groups
? Significance of reverse grouping and cross-matching
? Blood donation - collection, preservation, tests performed
? Indications of Blood Transfusion
? Transfusion reactions - diagnosis
? Rational use of blood - including component therapy
Practical classes ? 80 hours
Each practical class will be of 2 hours duration. The procedures to be demonstrated and practiced are:-
A] Hematology
1. How to draw blood ? demonstration
2. Anticoagulants and their use
3. Drawing of blood film ? practice
4. Staining (Leishman) ? practice
5. Focussing the slide under microscope and identification of cells ? practice
6. ESR by Westergreen pipette ? practice
7. Total count of WBC by Neubauer chamber ? practice
8. Packed cell volume by Wintrobe's tube ? demonstration
9. Hemoglobin estimation by acid hematin method ? practice
10. Hemoglobin estimation by Drabkin's method ? demonstration
11. Bleeding time and Clotting time ? demonstration
12. Prothrombin time ? demonstration
13. Bone marrow ? demonstration of stained slides ? normal, ITP , Megaloblastic anemia
14. Blood grouping ? ABO & Rh ? practice
B] Clinical Pathology
1. Urine ? noting the physical characters, how to measure specific gravity ? practice
2. Urine ? chemical tests for Protein, Reducing substances and Ketone bodies- practice
3. Use of different stix and their interpretation - demonstration
4. Microscopic examination of urine ? practice
5. CSF ? demonstration of cell type in a normal CSF sample and a case of pyogenic meningitis
5
C] Histopathology & Cytopathology
1. Techniques of histopathology & Cytopathology (including FNAC) ? demonstration
2. H & E staining and other special staining ? demonstration
3. Demonstration of HP & Cytology slides ? along with tutorial classes in systemic pathology
D] Problem cards ? along with tutorial classes in systemic pathology
Tutorial classes ? 120 hours
Entire systemic pathology will be learned in tutorial classes along with demonstration of HP slides and
problem-based learning with the help of problem cards
System
Topics
Specimens
HP slides
Cardio-Vascular Heart failure
Mitral stenosis
Rheumatic heart disease
Atheroma aorta
Valvular heart disease
Lt. ventricular hypertro.
Atherosclerosis
Fibrinous pericarditis
Myocardial infarction
Hypertensive heart dis.
Infective endocarditis
Pericarditis
Respiratory
Pneumonia
Lobar pneumonia
Tuberculosis of lung
Pulm. Tuberculosis
Bronchiectasis
Emphysema
COPD ? Bronchial asthma,
Emphysema
Bronchiectasis, Emphysema, Chr.
Pulm. Tuberculosis ?
Bronchitis
fibrocaseous & miliary
Bronchogenic carcinoma
Bronchogenic carcinoma
Gastro-Intestinal Salivary tumors- PSA
Peptic ulcer
Pleomorphic sal.
Esophageal carcinoma
Gastric carcinoma
adenoma
Peptic ulcer
Typhoid ulcer of S.I.
Adenocarcinoma
Gastric carcinoma
Tubercular ulcer of S.I.
TB intestine
Intestinal ulcers
Colorectal cancer
Acute appendicitis
Chron's disease & Ulcerative colitis
Colorectal cancer
Renal
Glomerulonephritis ? an overview
Granular contracted kid.
Clear cell carcinoma
with nephritic & nephrotic
Large white kidney
syndrome,
Hydronephrosis
Pyelonephritis
Real cell carcinoma
Renal arteriosclerosis
Adult polycystic kidney
Hydronephrosis
Renal cell carcinoma
Bone
Pyogenic Osteomyelitis
Osteomyelitis-sequestrum
Osteogenic sarcoma
Tubercul. Osteomyelitis
TB spine
Giant cell tumor
Classification of bone tumors
Osteogenic sarcoma
Osteogenic Sarcoma, Euing's
Giant cell tumor
Sarcoma
Giant cell tumor
Osteoporosis & Rickets
Female Genital
Endometrium in health and disease ? Fibroid uterus
Proliferative endo.
TB, Menorrhagia, Hormone
Carcinoma cervix
Secretory endo.
Uterine leiomyoma
Dermoid tumor of ovary
Leiomyoma
Cervical carcinoma
Mucinous
Ovarian tumors -overview
cystadenoma
6
Hepato-Biliary
Viral hepatitis
Micro-nodular cirrhosis
Portal cirrhosis
Fatty liver
Fatty liver
Fatty liver
Portal cirrhosis
Metastatic liver
Chr. Cholecystitis
Hepatic failure
Gall stones
Hepatocellular carcinoma
Metastatic deposit in liver
Gall stones
Female Breast
Non-neoplastic diseases ? an
Carcinoma breast
Fibroadenoma
overview
Duct carcinoma
Fibroadenoma
Carcinoma breast
Male Genital
Carcinoma penis
Carcinoma Penis
Seminoma
Testicular tumors ? classification,
Seminoma of testis
Benign hyperplasia
Seminoma
Benign hyperplasia of
of Prostate
BHP
Prostate
Prostatic carcinoma ? an overview
Lymph Node
Reactive hyperplasia- an overview
Meatstatic deposit
TB lymph node
TB lymph node
Metastatic lymph node
Hodgkin's disease
NHL ? an overview
Endocrine
Thyroid ? Goitre
Colloid goiter
Hashimoto's thyroiditis
Addision's disease
Skin
Melanoma
Papilloma
Basal cell carcinoma
Melanoma
Basal cell carcinoma
Soft Tissue
Soft tissue tumors ? an overview
Lipoma
Capillary
hemangioma
Cavernous
hemangioma
Central Nervous
Meningitis ? pyogenic &
System
Tuberculous
CNS tumors?an overview
Meningioma
Syllabus for 1st Periodical I.A. examination:
Theory - General Pathology upto Disorders of growth (Item A to G)
Practical - Hematology upto hemoglobin estimation (Item 1 to 10)
Syllabus for 2nd Periodical I.A. examination:
Theory ? Rest of General Pathology (Item H. I. J), Hematology (Item A, B, C)
Practical ? Rest of Hematology (Item 11-13), Clinical Pathology (Item 1-5)
Problem cards on Hematology and Clinical Pathology
Syllabus for 3rd Periodical I.A. examination:
Theory - Systemic Pathology
Practical ? Histological & Cytological techniques (including stains), HP slides (spotting)
Problem card on systemic pathology
7
Practical Note Book will have to be submitted during Item and Part clearance
Model Question for 2nd Prof. MBBS Exam. In Pathology
Time : 2 hours
Paper ? I
Total marks ? 40
There are four groups of questions. Answer each group in separate answer papers provided.
Group ? A
1. A male child of 2 years age presents with recurrent swelling of knees which occur even after
trivial trauma. The family history shows that his maternal uncle also suffered from same
conditions.
a) What may be the possible diagnosis ?
b) How will you proceed to investigate this patient to come to a diagnosis ? 1+9=10
Group ? B
2. Define shock. Enumerate the major types of shock that we encounter in our day to day practice
Describe the pathogenesis of shock in burns.
2+2+6=10
Or
Define necrosis. Enumerate different morphological types of necrosis with two examples each.
How necrosis differs from apoptosis ?
2+5+3=10
Group ? C
3. Define neoplasia. Enumerate different types of carcinogens with two examples each. Explain
with example that carcinogenesis is a multi-step phenomena.
2+4+4=10
Or
Mention the criteria for diagnosis of Diabetes Mellitus. Describe the pathogenesis of Type 2
Diabetes. What is glycosylated Hemoglobin ?
4+4+2=10
Group ? D
4. Write short notes (any five of the following)
5x2 = 10
a) Significance of Reticulocyte count
b) Poikilocytosis
c) Peripheral blood smear findings in Chronic Myeloid Leukemia
d) Phlebothrombosis
e) Neutrophilic Alakaline Phosphatase
f) Definition and two examples of Metaplasia
Paper ? II
Time : 2 hours
Total marks ? 40
There are four groups of questions. Answer each group in separate answer papers provided.
Group ? A
1. A 45-year-old man was rushed to the hospital following an episode of crushing substernal chest
pain with breathing difficulty. An urgent ECG was done which showed elevation of ST segment
with deep Q wave.
a) What may be the possible diagnosis ?
c) What other investigations will you suggest for evaluation of this case ?
d) Enumerate the common complications that may arise in this case 1+7+2 = 10
8
Group ? B
2. Classify Glomerulonephritis. Describe the morphological changes in the kidney in a child of 10
years of age suffering from Nephrotic syndrome
4+6 =10
Or
Enumerate the viruses that can cause hepatitis. Discuss the significance of serological study in a
case of hepatitis B. Enumerate the common complications of hepatitis B infection 2+6+2=10
Group ? C
3. Classify lung tumors. Describe the morphological changes in any one of them. Enumerate the
steps of investigations to arrive at a diagnosis.
3+4+3=10
Or
Enumerate the morphological types of gastric carcinoma. Describe the Microscopical features of
any one of them. What are the common sites of spread of a gastric carcinoma ? Enumerate the
steps of diagnosis in a suspected case of gastric cancer.
2+3+2+3 =10
Group ? D
4. Write short notes (any five of the following)
5x2 = 10
a) Involucrum
b) Ghon's focus
c) CSF in pyogenic meningitis
d) Morphology of Dermoid cyst of ovary
e) PSA
f) Reed-Sternberg cell
9
Model Problem Cards:
I.
Name:
Mrs. S. Tarafdar
Age:
22 years Sex:
Female
Address:
32/1 AJC Bose Road, Kolkata ? 14
Report on examination of urine
Physical:
Appearance: Hazy
Sp. Gravity: Q. I.
Odour:
Fishy
Sediment:
Present
Chemical:
Reducing subst.
Nil
Protein:
Present
Ketone bodies:
Nil
Microscopical:
Epithelial cells:
3-4 cells / HPF
Pus cells:
10-15 cells / HPF
RBC:
2-3 cells / HPF
Casts:
Nil
Crystals:
Nil
Signature
______________________________________________________________
Q1. What is the patient likely to be suffering from?
1
Q2. What would be the specific gravity of urine in this case and why ?
1
Q3. How will you confirm the cause leading to this condition ?
1
Q4. What is the appearance of the kidney if the patient suffers for a prolonged time ?
1
II.
Name:
P. Mudi
Age:
12 years
Sex:
Female
Report of examination of Blood
Hemoglobin:
9 g/dL
ESR:
12 mm at 1 hr.
TLC:
8600/Cu. mm
DLC:
Neutrophil
53 %
Lymphocyte 39 %
Monocyte
03 %
Eosinophil
05 %
RBC:
Microcytic hypochromic
Anisocytosis +
Poikilocytosis +
Platelets:
Adequate
Signature
Q1.
What is the clinical condition of this patient ?
1
Q2. Mention two common causes that may lead to such blood picture.
1
Q3. Enumerate further tests you would like to do to come to a definite diagnosis
1
Q4.
If you examine the stool of this patient what pertinent findings may be present ? 1
10
III.
Name:
Hafiz Mondal
Age:
15 years
Sex
Male
Patient is referred from the ENT OPD of NRS Medical College for
FNAC of neck glands
Report on examination of FNAC of cervical lymph node
Smears show necrotic material and epithelioid cells in aggregate
Signature
Q1.
What is the provisional diagnosis ?
1
Q2.
How will you confirm the diagnosis ?
1
Q3.
Draw a labeled diagram of microscopic features of such lymph node 2
IV
Name:
T. Ali
Age:
24 years
Sex:
Male
Report on examination of CSF
Physical:
Appearance: Hazy
Pressure:
Coming out in jet flow
Chemical:
Glucose:
20 mg/dL
Protein:
75 mg/dL
Microscopical: Total cell count:
350 cells/cu mm
Signature
Q1.
What is the condition this patient is suffering from ?
1
Q2.
What type of cells do you expect in microscopical examination of CSF ? 1
Q3.
What are the clinical features of this condition ?
1
Q4.
What further examination you would do to find out the cause ?
1
11
Item Card
Name: Roll No. Year:
Topic
Total Marks
Marks obtained Signature of teacher
Part I: Hematology
1. Blood collection, anticoagulants, staining
10
2. TC, DC & ESR
10
3. Hb estimation,
10
4. PCV, Red cell indices, Morphological
10
classification of anemia
5. BT, CT, P Time
10
6. CML, CLL, Eosinophilia, Marrow puncture
10
needle
7. Blood grouping & Rh typing
10
Part II: Clinical Pathology
1. Urine: Physical & Chemical tests
10
2. Urine: Microscopical examination
10
3. L. P. needle and CSF study
10
Part III: Histopathology & Cytopathology
1. Histological techniques including staining
10
2. Histopathology ? Non-tumors
10
3. Histopathology - Tumors
10
4. Cytology: Exfoliative & FNAC
10
Part IV: Immunopathology
1. Pregnancy test in urine & other
10
immunological testsd
150
Marks to be computed for continuous Internal Assessment in Practical = Marks obtained / 20 =
Complete/Incomplete
Counter Signature
Signature of HOD
12
This post was last modified on 29 June 2021