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Revised Scheme for Second Professional MBBS University Examination in Pathology (to be implemented from 2010 Regular Examinations)
A. Written Paper:
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Paper I – General Pathology & HematologyPaper II – Systemic Pathology & Clinical Pathology
Scheme of Theoretical Examination in Pathology.
Paper: 1. [General Pathology / Haematology]
Q1. Problem questions (without alternative) 10 Marks.
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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.
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(any two out of three: ) 2 X 5 = 10Q4. 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
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Q3. Pathogenesis / investigations/ interpretations etc.Q4. Short notes as above.
B. Oral/Viva:
There will be two tables with 7 ½ marks in each table Marks will be 15 (7 ½ x 2)
Table I – General and Systemic Pathology
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Table II – Hematology and Clinical PathologyC. 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
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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
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(2 specimens + 2 slides + 2 instruments)Q7. Practical Exercise book 2 Marks
(Should be properly signed by appropriate teachers)
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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
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2nd Periodical I.A. – 40 2nd Periodical I.A. – 253rd 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:
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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):
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C.1st Periodical I.A. exam. 25 marks
Instruments (two) 5 x 2 = 10
Peripheral blood smear staining
Any two of the following three tests 5x2 = 10
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( ESR, TC, Hb estimation)2nd Periodical I.A. exam. 25 marks
Urine examination (two) 5 x 2 = 10
Problem card 5
Blood grouping 5
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Instrument 53rd Periodical I.A. exam. 25 marks
Urine examination 5
Peripheral blood smear 5
Blood grouping / ESR/TC 5
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Problem card & its interpretation 5Identification 5
(4 HP & 1 Hematology slide) 5
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
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A) GOALThe 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 :-
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(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.
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(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;
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(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
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Each Lecture class will be of one hour duration. The important aspects of each topic are given belowGeneral Pathology:
A] Cell injury and adaptations- (7 classes)
§ Causes & Mechanism of cell injury
§ Macroscopic and microscopic features of reversible & irreversible cell injury
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§ 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
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§ 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
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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
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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
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§ Wound healing - first and second intention
§ Factors affecting wound healing
§ Complications of wound healing
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§ Healing in bone and specialized tissueE] 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
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§ Differences between Thrombophlebitis and Phlebothrombosis§ Differences between Thrombus and Clot
§ Embolism & Infarction
§ Oedema - definition, types, pathogenesis with examples
§ Differences between Transudate and Exudate
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§ Shock - definition, types, pathogenesis, clinical manifestations and examplesF] 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
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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
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§ 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
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§ Molecular biology and genetics of carcinogenesis§ Systemic changes due to neoplasia - paraneoplastic syndrome
§ Diagnosis of neoplasia
I] Metabolic disorders- (6 classes)
§ Jaundice - definition, bilirubin metabolism, classification, lab. Diagnosis,
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§ 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
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§ 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
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§ 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
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§ Megaloblastic anemia - causes, pathogenesis, clinical manifestations and lab diagnosis§ Aplastic anemia - causes, pathogenesis, clinical manifestations and lab diagnosis
§ Hemolytic anemia - causes, pathogenesis, clinical manifestations and lab diagnosis
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§ 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)
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§ 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.
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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
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§ DIC - causes, pathogenesis, featuresD] Other hematological diseases - ( 4 classes)
§ Plasma cell disorders
§ Hematological manifestations of some important diseases
E] Blood groups and Blood Transfusion - ( 6 classes)
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§ 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
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§ 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
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1. How to draw blood – demonstration2. 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
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6. ESR by Westergreen pipette – practice7. 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
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11. Bleeding time and Clotting time – demonstration12. Prothrombin time – demonstration
13. Bone marrow demonstration of stained slides – normal, ITP, Megaloblastic anemia
14. Blood grouping – ABO & Rh – practice
B] Clinical Pathology
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1. Urine – noting the physical characters, how to measure specific gravity – practice2. 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
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C] Histopathology & Cytopathology
1. Techniques of histopathology & Cytopathology (including FNAC) – demonstration
2. H & E staining and other special staining – demonstration
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3. Demonstration of HP & Cytology slides – along with tutorial classes in systemic pathologyD] 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 --- Content provided by FirstRanker.com --- Rheumatic heart diseaseValvular heart disease Atherosclerosis Myocardial infarction Hypertensive heart dis. --- Content provided by FirstRanker.com --- Infective endocarditisPericarditis | Mitral stenosis Atheroma aorta Lt. ventricular hypertro. Fibrinous pericarditis | |
| Respiratory | Pneumonia --- Content provided by FirstRanker.com --- Pulm. TuberculosisCOPD – Bronchial asthma, Bronchiectasis, Emphysema, Chr. Bronchitis Bronchogenic carcinoma | Lobar pneumonia --- Content provided by FirstRanker.com --- BronchiectasisEmphysema Pulm. Tuberculosis – fibrocaseous & miliary Bronchogenic carcinoma | Tuberculosis of lung --- Content provided by FirstRanker.com --- Emphysema |
| Gastro-Intestinal | Salivary tumors- PSA Esophageal carcinoma Peptic ulcer Gastric carcinoma Intestinal ulcers --- Content provided by FirstRanker.com --- Chron's disease & Ulcerative colitisColorectal cancer | Peptic ulcer Gastric carcinoma Typhoid ulcer of S.I. Tubercular ulcer of S.I. --- Content provided by FirstRanker.com --- Colorectal cancer | Pleomorphic sal. adenoma Adenocarcinoma TB intestine Acute appendicitis |
| Renal | Glomerulonephritis - an overview --- Content provided by FirstRanker.com --- with nephritic & nephroticsyndrome, Pyelonephritis Renal arteriosclerosis Hydronephrosis --- Content provided by FirstRanker.com --- Renal cell carcinoma | Granular contracted kid. Large white kidney Hydronephrosis Real cell carcinoma Adult polycystic kidney | Clear cell carcinoma |
| Bone | Pyogenic Osteomyelitis --- Content provided by FirstRanker.com --- Tubercul. OsteomyelitisClassification of bone tumors Osteogenic Sarcoma, Euing's Sarcoma Giant cell tumor --- Content provided by FirstRanker.com --- Osteoporosis & Rickets | Osteomyelitis-sequestrum TB spine Osteogenic sarcoma Giant cell tumor | Osteogenic sarcoma Giant cell tumor |
| Female Genital | Endometrium in health and disease - --- Content provided by FirstRanker.com --- TB, Menorrhagia, HormoneUterine leiomyoma Cervical carcinoma Ovarian tumors -overview | Fibroid uterus Carcinoma cervix --- Content provided by FirstRanker.com --- Dermoid tumor of ovary | Proliferative endo. Secretory endo. Leiomyoma Mucinous cystadenoma |
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| Hepato-Biliary | Viral hepatitis Fatty liver Portal cirrhosis Hepatic failure --- Content provided by FirstRanker.com --- Hepatocellular carcinomaMetastatic deposit in liver Gall stones | Micro-nodular cirrhosis Fatty liver Metastatic liver --- Content provided by FirstRanker.com --- Gall stones | Portal cirrhosis Fatty liver Chr. Cholecystitis |
| Female Breast | Non-neoplastic diseases an overview Fibroadenoma --- Content provided by FirstRanker.com --- Carcinoma breast | Carcinoma breast | Fibroadenoma Duct carcinoma |
| Male Genital | Carcinoma penis Testicular tumors – classification, Seminoma BHP --- Content provided by FirstRanker.com --- Prostatic carcinoma an overview | Carcinoma Penis Seminoma of testis Benign hyperplasia of Prostate | Seminoma Benign hyperplasia --- Content provided by FirstRanker.com --- of Prostate |
| Lymph Node | Reactive hyperplasia- an overview TB lymph node Metastatic lymph node Hodgkin's disease NHL an overview | Meatstatic deposit --- Content provided by FirstRanker.com --- TB lymph node | |
| Endocrine | Thyroid - Goitre Hashimoto's thyroiditis Addision's disease | Colloid goiter | |
| Skin | Melanoma Basal cell carcinoma | Papilloma Melanoma --- Content provided by FirstRanker.com --- Basal cell carcinoma | |
| Soft Tissue | Soft tissue tumors - an overview | Lipoma Capillary hemangioma Cavernous hemangioma | |
| Central Nervous --- Content provided by FirstRanker.com --- System | Meningitis Tuberculous CNS tumors an overview Meningioma |
Syllabus for 1st Periodical I.A. examination:
Theory - General Pathology upto Disorders of growth (Item A to G)
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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
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Syllabus for 3rd Periodical I.A. examination:
Theory - Systemic Pathology
Practical – Histological & Cytological techniques (including stains), HP slides (spotting)
Problem card on systemic pathology
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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.
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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 ?
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b) How will you proceed to investigate this patient to come to a diagnosis ? 1+9=10Group - 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
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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
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OrMention 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
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a) Significance of Reticulocyte countb) Poikilocytosis
c) Peripheral blood smear findings in Chronic Myeloid Leukemia
d) Phlebothrombosis
e) Neutrophilic Alakaline Phosphatase
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f) Definition and two examples of MetaplasiaPaper - II
Time: 2 hours Total marks – 40
There are four groups of questions. Answer each group in separate answer papers provided.
Group - A
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1. A 45-year-old man was rushed to the hospital following an episode of crushing substernal chestpain 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 ?
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d) Enumerate the common complications that may arise in this case 1+7+2 = 10Group - B
2. Classify Glomerulonephritis. Describe the morphological changes in the kidney in a child of 10
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years of age suffering from Nephrotic syndrome 4+6=10Or
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
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3. Classify lung tumors. Describe the morphological changes in any one of them. Enumerate thesteps 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
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steps of diagnosis in a suspected case of gastric cancer. 2+3+2+3=10Group - D
4. Write short notes (any five of the following) 5x2 = 10
a) Involucrum
b) Ghon's focus
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c) CSF in pyogenic meningitisd) Morphology of Dermoid cyst of ovary
e) PSA
f) Reed-Sternberg cell
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Model Problem Cards:
I.
Name: Mrs. S. Tarafdar
Age: 22 years Sex: Female
Address: 32/1 AJC Bose Road, Kolkata – 14
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Report on examination of urinePhysical: Appearance: Hazy
Sp. Gravity: Q. I.
Odour: Fishy
Sediment: Present
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Chemical: Reducing subst. NilProtein: Present
Ketone bodies: Nil
Microscopical: Epithelial cells: 3-4 cells / HPF
Pus cells: 10-15 cells / HPF
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RBC: 2-3 cells/HPFCasts: Nil
Crystals: Nil
Signature
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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.
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Name: P. Mudi
Age: 12 years Sex: Female
Report of examination of Blood
Hemoglobin: 9 g/dL
ESR: 12 mm at 1 hr.
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TLC: 8600/Cu. mmDLC: Neutrophil 53%
Lymphocyte 39%
Monocyte 03%
Eosinophil 05%
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RBC: Microcytic hypochromicAnisocytosis +
Poikilocytosis +
Platelets: Adequate
Signature
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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
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III
This download link is referred from the post: WBUHS MBBS Syllabus-1st Year, 2nd Year, 3rd Year Part-I, 3rd Year Part-II || The West Bengal University Of Health Sciences
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