UNIVERSITY OF LIMPOPO

(Medunsa Campus)

Department of Anatomical Pathology

2nd Class Test for 3RD Year MB, ChB

= MARKS

DATE: 08H00 GMT on MONDAY 7 JUNE 2010

TIME: 3 hours
VENUE: Sports Centre, Medunsa Campus.

EXAMINERS: Prof. R.M. Bowen

A/Prof N.M.Bida
Drs T. Kekana, A.G. Ogunwomoju

**ANSWER SECTION A on the Computer Card

ANSWER SECTION B on the Question Paper
ANSWER SECTION C in the SEPARATE BOOK**

STUDENT PARTICULARS

NAME: ________________________________________________

NUMBER: _________________________________________________

Section A: ___________

Section B: ___________

Section C: ___________

TOTAL: ___________

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SECTION B [40 MARKS]

1. Acute inflammation is characterized by THREE main events (1.5)

A. Vasodilation and increased permeability of blood vessels
B. Fluid exudation (into the extravascular space)
C. Leucocyte extravasation.

2. SIX clinical features of acute inflammation are: (3)

A. “Calor” (Heat)
B. “Dolor” (Pain
C. “Functio laesa” (Loss of function)
D. “Rubor” (Redness)
E. “Tumor” (Swelling)
F. Excessive secretion eg from a mucous membrane in the nose

3. Name FOUR causes of papillary necrosis in the kidney

A. Diabetes Mellitus
B. Gouty nephropathy
C. Analgesic nephropathy
D. Severe acute pyelonephritis
E. Sickle cell anaemia
(2)

4. FOUR major modifiable risk factors for arteriosclerosis are: (2)

A. Diabetes mellitus
B. Hyperlipidema
C. Hypertension
D. Smoking

5. Name TWO causes of benign nephrosclerosis (2)

A. Benign hypertension
B. Diabetes Mellitus

6. THREE examples of cyanotic heart disease are: (1.5)

A. Persistent truncus arteriosus
B. Tetralogy of Fallot

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C. Total anomalous pulmonary venous connections
Transposition of great arteries
Tricuspid atresia

7. FIVE predisposing factors for bronchogenic carcinoma are: (2.5)

A. Air pollution
[Including radon gas, a decomposition product of uranium in the soil]
B. Asbestosis
C. Cigarette smoking
D. Industrial hazards (radiation, uranium, asbestos)
E. Molecular genetic (p53 mutation)
Previous pulmonary scar
[Although this is contentious; the scar may represent a desmoplastic host response – secondary to
the carcinoma]

8. FOUR types of stones found in the urinary tract include: (2)

A. Calcium stones [Calcium oxalate and calcium phosphate]
B. Uric acid stones
C. Staghorn stones [Magnesium ammonium phosphate stones; struvite stones]
D. Cystine stones

9. List the FIVE major Jones criteria useful in clinical diagnosis of rheumatic fever: (2.5)
A. Pancarditis
B. Joint Pains
C. Erythema marginatum
D. Subcuteneous nodules
E. Sydenham chorea

10. FOUR major types of emphysema include: (2)

A. Centroacinar
B. Panacinar
C. Paraseptal
D. Cicatricial

11. FOUR complications of bacterial pneumonia include: (2)

A. Lung abscess
B. Pleural effusion
C. Bronchiectesis
D. Empyema

12. FOUR histological types of bronchogenic carcinoma include: (2)

A. Squamous cell carcinoma
B. Large cell carcinoma
C. Small cell carcinoma
D. Adenocarcinoma

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13. FIVE clinical diseases in which Type 11 hypersensitivity reaction plays a role include: (2.5)
A. Autoimmune hemolytic anaemia
B. Erythroblastosis Fetalis
C. Blood transfusion reaction
D. Myasthenia Gravis
E. Pemphigus Vulgaris

14. FIVE examples of opportunistic infections commonly seen in AIDS include: (2.5)
A. Cryptococcus neoformans
B. PCP
C. Candida albicans
D. Toxoplasmosis
E. Cryptosporidiosis
F. MAC

15. FOUR major patterns of nuclear fluorescence seen in autoimmune diseases include: (2)
A. Homogenous
B. Peripheral
C. Nucleolar
D. Speckled

16. THREE major clinic-pathologic types of cardiomyopathies include: (1.5)

A. Dilated cardiomyopathy
B. Hypertrophic obstructive cardiomyopathy
C. Restrictive cardiomyopathy

17. The major components of Tetralogy of Fallot include: (2)

A. Right ventricular hypertrophy
B. Pulmonary outflow obstruction
C. Ventricular septal defect
D. Overriding of the arota

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SECTION C [20 Marks]

1. Discuss amyloidosis under the following headings

A. Definition (2)
Extracellular deposition of proteinaceous substances(eosinophilic,amorphous and hyaline)
B. Physical nature of amyloid deposit (2)
Non-branching and fibrillary in a beta-pleated sheet configuration
C. Chemical nature of amyloid deposit (2)
AL Amyloid light chain (plasma cells)
AA-Amyloid associated proteins (liver)
D. Diagnosis (2)
Congo red stain
[Salmon-pink colour on staining, with apple-green birefringence on polarization]
Thioflavin-T or –S stains
[Which require an immunofluorescence microscope]
Electron microscopy,
Specrophotometry
[8]
2. Discuss bacterial pneumonia under the following headings

A. Clinical types (2)

(i) Lobar pneumonia
(ii) Broncho-pneumonia
B. Aetiology (2)
Streptococci, Pneumococci, Staphylococci
H.influenza, Klebsiella, Pseudomonas
C. Morphology (4)
Increase in weight of the lung
Congestion
Red hepatisation
Grey hepatisation
Resolution
[8]
3. Write short notes on minimal change glomerulonephropathy (4)
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- Commonest cause of nephrotic syndrome [selective proteinuria]
- Seen commonly in children
- Normal glomeruli on LM
- E.M [effacement of visceral epithelial foot processes]
- Good response to steroid treatment