MBBS ~ 2"? YEAR Date; 12.05.2022 Internal Assessment: 1 Duration: 2Hrs Essay (2x15=30m) 1) Explain in detail abot the causes, events and morphological pattern of acute inflammation? 2) Explain in detail about the pathogenesis, types and stages of shock? Short notes (4x5=20m) 1) Calcification 2) Fracture healing, 3) Difference between apoptosis and necrosis, 4) Embolism. MCQ (20x1=20m), 1) Increase in the size of cells refers to A) Hyperplasia B) HypeMtrophy C) Atrophy D) Metaplasia. insie pathway of apoptosis takes place in chondria B) Golgi apparatus C) Lysosome D) Endoplasmic reticulum. within parenchymal cells. ‘A) Cholesterol esters B) Proteins C) Trislycerides D) Glycogen. 5 3) Steatosis describe abnormal accumulations of 4) ———- is a wear and tear pigment. ‘A) Hemosiderin B)Lipofifscin C) Melanin D) Coal dust > = ----— causes inhibition of inflammation. —F {A) Prostacyclin B) Leukotriene B4 C) ThromboxaneA2 D} Lipoxin A4 is not a component of Virehow triad. 6) — ‘A) Hyper coagulability BY Platelet activation C) Endothelial Injury D) Abnormal blood flow 7) Thrombi on heart valves are called as —-— A) Lines of Zahn B) Mural thrombi C) Heart failure cells D) Vegetation’s. 8) White infarct is not seen in ‘A) Heart B) Liver C) Spleen D) Kidney 9 - ‘A) Chaperons B) Telomeres C) Endoplasmic reticulum D) Cytokines control the proper folding of newly synthesized proteins. 1) ———~ is not seen in apoptosis. {A) Alteration in cell size B) Intact plasma membrane C) Lnffammation D) Fragmentation into nucleosome size fragments, 11) ——-— Is not the eardinal sign of inflammation ‘A) Rubor B) Dolar C) Tiflnor D) None of the above= a) —~ Cause vasodilation A) Thromboxane A2 B) Prostaglandin 12 C) Prostaglandin D2 D) Prostaglandin | 13) ——— Is the cytokine (acute inflammation) AWA BMC) ~ 17D) MAL 14) Continuousty dividing tissue is A) Stable tissue B) Permanent tissue C) Granulation tissue D) Labile tissue 5) Results from increased blood volumes with in tssues, A) Edema B) Hypere "mia C) Thrombosis D) Effusions 16) Dey n sickness results from A) Fat embol Sm B) Amniotic fuid embolism ©) Air embolism D) All the above 17) Red inf “Sa B) Lng C) Kidney D) Spleen 18) Cellular aging is duc to —_ A) DNA tea ton © Dees ic an a ) Acute phase protein : *)C~esctive potcn B) Thrombin Ci 20) Tube sen D) Serum amylofd A inflammation 1 © Scanned with OKEN Scanner(Recognized by Medi KARPAG. eal Council of Pollachi Main Ro: A and affiliated to th Internal Assessment ~ II Date: 04.06.2022 Essay: AM FACULTY OF MEDICAL SCEINC 'S AND RESEARCH 1 Dr. MGR medical University) ad, Othakkalmandapam,Coimbatore-64 1032 Time: 3Hours (1pm - 4pm) (2x15=30) 1) Define Neoplasia. Discuss in detail about the pathogenesis, pathophysiology of radiation oncogenesis. Add a note on metastasis 2) 23 year old female presented with oral ulcers, malar rash, photosensitivity and non - erosive arthritis of both knees. What is your probable diagnosis ? Discuss in detail about pathogenesis and morphology of various organs including kidney in this disorder. Short notes: 1) 2) 3) 4) 5) 6) 7) 8) 9) Lab diagnosis of Neoplasm Anti phospholipid antibody syndrome Chemical carcinogenesis Transplant rejection Write in detail about paraneoplastic syndromes Hypersensitivity reactions Oncogenic viruses Pathogenesis of amyloidosis. Pathogenesis of AIDS 10) Tumor markers (10 x5 = 50) © Scanned with OKEN ScannerKARPAGAM F . Ale coissine ACAM! noe OF MEDICAL SCEINCES AND RESEARCH Nai Cones ‘of India and affiliated to the Tamilnadu Dr.MGR medical University) achi Main Road, Othakkalmandapam,Coimbatore-641032 1) In autoimmune hemol Inauto anaemia , the following t i inate ing type of immunologic tissue A) Type | (anaphylactic) B)Type Il (cytotoxic) ” €) Type tit(immune complex) _D) Type IV (cell mediated) 2) Out of various antinuclear antibodies, pathognomonlc of SEIS A) Antibody to single - stranded DNA 3) Antibody to double ~stranded DNA * @) ©) Antibody to histones D) Antibody to nucleolar antigen 3) In-cases of renal failure on long - te following type of amyl ‘A)_ Amyloid light chain (AL) 8) Amyloid — associated protein (AA) €)_ Amyloid 82 microglobulin (AB2m) ° ) Bamyloid protein(AB) ‘amyloidosis often produces: A) Dilated cardiomyopathy 8) Constrictive cardiomyopathy, B) C) Restrictive cardiomyopathy ) Ischaemic cardiomyopathy 5) cD4 T cell count in crisis phase of HIV according to revised HIV/AIDS classification J« 200/ mieralter C) <250/ microliter ©) 500/ microliter ion of HIV during window pe! im haemodialysis, there Is development of 4) is: ‘A) <100// microliter 8) » 6) Test useful for detect! ‘A) ELISA + ) Western blot ©) CD44 cell count B) ) P24 antigen capture assay 7) Haematoxylin body represents: in) Nuclear chromatin materidl8) RNC C) Cytosoli ‘components ic components D) Cell membrane ¢) Transplantation antigens are located on portion of: ‘A) Chromosome 1 8) Chromosome 6 ¢) Chromogome9 D) Chromosome22 ¥) 9) Grave's disease isa type of: ‘a) Type | reaction B) Type! reaction ) Type lll reaction D) Type IV reaction 40) Degradation of ECM is brought ‘about by the following excey ‘A) Proteases 8) Metalloproteinases C) Free radicals D) Cathepsin D Y © Scanned with OKEN ScannerKARPA LT ah FACULTY OF MEDICAL SCEINC! ES AND RESEARCH a Seat tnd affiliated to the Tamilnadu Dr.MGR medieal University) ‘ollachi Main Road, Othakkalmandapam,Coimbatore-641032 1) Inautoimmune hemolytic anaemia , the following type of immunologic tissue injury is involved: ‘A) Type | (anaphylactic) B)Type Il (cytotoxic) ” €) Type (immune complex) _D) Type IV (cell mediated) 2) Out of various antinuclear antibodies, pathognomonic of SLE is: A) Antibody to single ~ stranded ONA B) Antibody to double ~ stranded DNA ~ 8) C)_ Antibody to histones D) Antibody to nucleolar antigen 3) Incases of renal failure on long - term haemodialy: following type of amylol 'A)_ Amyloid light chain (AL) 8) Amyloid — associated protein (AA) )_ Amyloid 82 microglobulin (AB2m) 5 D) Bamyloid protein(A8) 4) Cardiac amyloidosis often produces: A) Dilated cardiomyopathy B) Constrictive cardiomyopathy 8) ) Restrictive cardiomyopathy: ) Ischaemic cardiomyopathy 5) cD4T cell count in crisis phase of HIV according to revised HIV/AIDS classification sis, there is development of 1 B)< 200/ microliter C) <250/ microliter) 500/ microliter =) ion of HIV during window period: A) <100/ micr 6) Test useful for detecti A) ELISA + B) Western blot ©) c4+ cell count B) D) P24 antigen capture ass2¥ 7) Haematoxylin body represents: ‘A) Nuclear chromatin ‘material B) RNC C) Cytosolic components D) Cell membrane ‘components 8) Transplantation antigens are located on portion of: ‘ome 1B) Chromosome 6 C) Chromogome9 D) Chromosome22 ‘A) Chromost 9) Grave's disease Is a type of: ‘) Type | reaction B) Type l reaction C) TyPe Ill reaction D) Type IV reaction B) 10) Degradation of ECM is brought about by the following except: a) ‘A) Proteases 8) Metalloproteinases €) Free radicals D) Cathepsin D * © Scanned with OKEN Scanner@) D RESEARCH KARPAGAM FACULTY OF ae SNe fence Bettie, Recognized by Medical Council of Indi anda Seta ‘ae Pollachi Main Road, Othakkalmandapam,Coimbatore-641 11) Grading of tumours depends upon the following except: : eof Cc A) Degree of anaplasia B) Metastatic spread C) Rate of growth of cells 0) Degre differentiation, 12) The primary target of eo electrophiles idas under: oO ‘A) Cytochrome P-450 B) RNA €) DNA D) Mitochondria 13) Carcinogenic influence of radiation appears after: A)<2years 8) 2-§ years C) 5 to 10years D) >10 years 14) The following hereditary diseases have higher incidence of cancers due to inherited defect in DNA repair mechanism except: A) Ataxia telangiectasia B) ) Xeroderma pigmentosum C) Familial polyposis coli D) Oo Bloom’s syndrome. 15) Important example of tumour suppressor genes implicated in human cancers include the following expect: ‘A) RB gene B) TP53 C) APC’D) ERB -B, BY 216) An example of tumour - associated antigen (TAA) is: A) Testi specific antigen (MAGE) 8) Alpha- © Carcinoembryonic ar 17) Hy exces fetoprotein (AFP) igen (CEA) D) Prostate specific antigen (PSA) Percaleemia as a paraneoplastic syndrome is observed in the following tumors 4) Seminoma testis B) Medullary carcinoma breast c) Papillary carcinoma thyroid D) Malignant melanoma » 18) Which ofthe following viral infection is not known 0 produce any human tumours? ‘A) Polyoma virus B) EBV C) HSV D) HTLV » 19) P53: A) ates cyclins B) Activates BAX C) Activates CDKs D) Activates Bci2 20) All are matrix metalloproteinases except: A) Collagenase B) Gelatinase C) Stromelysif D) Elastase © Scanned with OKEN Scanner(os 6M, KARPAGAM FACULTY OF MEDICAL SCEINCES AND Ke SEARCH COIMBATORE ~ 641032 INTERNAL ASSESSMENT THEORY EXAMINATION tf SECOND YEAR MBBS (2020 = 2021 Bateh) DEPARTMENT OF PATHOLOGY 1e: 3Hours (pm - 4pm) Date: 02.07.2022 (2x15=30) oft: He hed beefy Essay: 1.60 years male vegetarian presented with pallor, paresthesia of extremities tongue. ‘a) What is your diagnosis? +b) How will you investigate this patient further and establish the diagnosis €) Classify RBC disorders according to etiology ‘erican woman presents in the emergency room with severe abdominal 2.423 years old African — Am significant for numerous pulmonary pain and evidence of dehydration, Her past medical history is infections, painful digits and chronic leg ulcers. USG revealed small spleen. a) Whats your diagnosis? ) Classify hemolytic anemia? ¢) Details about sickle cel disease? Short notes: (10 x5 = 50) 1. VITAMIN A deficiency 2. Hemolytic disease of newborn 3. Asbestosis 4, Microcytie hypochromic anemia 5. PCV estimation andits significance 6.Reticuloeytosis 7. polycythemia Vera 8. Anemia of chronic disease 9. Radiation injury 10, Hereditary spherocytosis,INTERN, s RNAL ASSESSMENT THEORY EXAMINATION - 11 DEPART MENT OF PATHOLOGY McQ (1.20 = 20) 2. The major pathway of ethanol metabolism in the livers via ‘A) Alcohol dehydrogenase in the SER 8) Microsomal p- 450 ©) Catalase in the peroxisomes D) None of the above 2. Lead poisoning produces the following change in red cells: A) Pappenheimer bodies 8) Howell — Jolly bodies C) Basophilic stippling D) Heinz bodies A) Hyperplasia of adipocytes only 8) Hypertrophy of adipocytes only C) Hyperplasia as wellas hypertrophy of adipocytes. D) Fatty change in liver only 4. State of hypervitaminosis occurs i ‘A) Vitamin A and B B) Vitamin 8 and C C) Vitamin Cand D D)vitamin A and D '5. Which of the following is the gene for obesity? ‘A) Rb gene B) db gene C) p53 gene D) p63 gene 6. During foetal life, hematopoiesis commences in the bone marrow by: ‘A) 2% to 3" month 8) 4" to 5!" month C) 6" to 7 month D} 7 to 8 month 7. Imiron deficiency anaemia, TIBC is: ‘A) LowB) Normal C) High D) Borderline 8. In anaemia of chronic disorders, serum ferritin is: A) Normal 8) Low C) Increased D) Absent 9. Pernicious anemia causes pathologic changes in the anatomic region of stomach as under except: A) Antrum B) Body C) Body ~ fundic area D) Fundus 10. In warm antibody autoimmune haemolytic anaemias, the antibody is commonly: A) IgA B) IgG C) IgM) Ig | | © scanned with OKEN Scanner© Scanned with OKEN ScannerINCES AND RESEARCH KARPAGAM FACULTY OF MEDICA\ COIMBATORE - 641032 INTERNAL ASSESSMENT THEORY EXAMINATION -1V COND YEAR MBBS (2020 - 2021 Batch) DEPARTMENT OF PATHOLOGY SI ‘Time: 3Hours (1pm - 4pm) Date: 06.08.2022 Essay: Short (215-30) sents with massive painless enlargement of left 1, A35 year old man pre aneous immune cervical and axillary nodes. On examination has cut Mediastinal lymph nodes are also unresponsiveness. (anergy). their enlarged, What is your diagnosis? Describe in detail various types, immunophenotypes, pathogenesis and staging. co C030 ‘lone 2. Write in detail the classification, pathogenesis morphology a! features of acute myeloid leukemia. ind clinical notes: (10 x5 = 50) 1, Complications of blood transfusion 2, DIC aie ii! 3, Von Willebrand disease 4, A35 year old lady comes with the complaints of petechial hemorrhages , nose bleeds and excessive menstrual flow. PT and APTT are normal, No splenomegaly. Platelet count is 45000/cumm. i. What is your diagnosis? <. ii, Write the salient features of the disease and morphologic changes)... 5, 50 year old male with massive splenomegaly. On investigation had total WBC count of 1,20,000 cells/cumm. Peripheral smear showed predominance of myeloid precursors. What is your diagnosis? Draw diagram of peripheral smear. What is the common genetic event in this condition? CAL 6. Glycogen storage diseases. A © Scanned with OKEN Scanner7. AS year old mentally retarded child has flat facial profile, a i palpebral fissures, epicanthic folds and single Pana crease your diagnosis? Write briefly on the condition . : 8. A65 year old man presents with lytic bone lesions , renee anaemia and hypercalcemia . ESR is 110 mm/hour. What is your , diagnosis ? Write briefly on the condition . a ep 9. Burkitt lymphoma Pond 10 Illustrate various types of chromosomal rearrangements. McQ (1x20 = 20) L.Trisomy 21 carries a higher risk of developing a.Hydrops fetalis b.Acute leukemias Colonie ruptut — d.Meckel’s diverticulum 2. Fragile x syndrome is a Autosomal dominant disorder b, multifactorial disorder © AufosomallfetessWeldiorder 4. Tinucleotide repeatnutation: » 3. Which is not a lysosomal Storage disease ? 2-Tay- sachs disease b Gaucher disease c.Wilson disease don Gierke disease 4-All are autosomal recessive disorders except: a. Cysticfibrosis * b. Familial polyposis coli c. Haemochromatosis d. Galactosemia 5.A5 year-old child developed fever, haemorrhages and repeated infections and anaemia . Her WBC count is 80,000/mm? -The most likely diagnosis is a. Acute myeloid leukemia: b. Chronic myeloid leukemia ©. Acute lymphoid leukemia d. Hairy cell leukemia &. 465 year old man gradually developed weakness and lymphadenopathy. His WBC count was 50,000/cumm. Peripheral smear and bone marrow aspirate showed predominantly small lymphocytes. He also suffered from © Scanned with OKEN Scannerautoimmun i fo re haemolytic anaemia, hepatosplenomegaly and Ytopenia, The most likely diagnosis is : a. AML b.CML c. ALU d. CLL ari ; Which of the following is a characteristic finding in Waldenstrom macroglobulinemia? a. Excessive production of immunoglobulin heavy chains b. Eczema c. Hyperviscosity of blood / d. increased levels of Ig G 8, Which of the following is usually a disorder of B lymphocytes ? a. Burkitt lymphoma b. AML c, CML d. Anaplastic large cell lymphoma 9, Which of the following is associated with an increased incidence of lymphomas ? a.Autoimmune disorders b.Obesity c.Cigarette smoking d.Colon cancer 410. Which of the following is True concerning Haemophilia A? a. Bleeding time is normal b. Mucosal bleeding is prominent d. PT is abnormal han acute illness developed haemorrhages into ultiple thrombosis.DIC was diagnosed. The most c. APTT is abnormal / 11. A 30 year old woman wit! the skin as well as signs of mi important laboratory criterion for this diagnosis is : a. Normal quantity of fibrinogen b. Normal PT * c. Elevated d- dimer d. normal platelet count 42, The type of hypersensitivity reaction in hyperacute rejection of transplanted kidney is = a.Typel b.Typell c. Type lll d. Type lV 13, Name the condition which is not hereditary ? a.Retinoblastoma b.Wilms tumour cintestinal polyp” d. Chronic myeloid leukemia 14. All are myeloproliferative neoplasms except : a. AML b.CML cc. Polycythemia vera d. Primary myelofibrosis a © Scanned with OKEN Scannerjicine in th 15. For chromosomal study, the dividing cells are arrested by colchicine in the following phase of cell cycle : a. Prophase b. Metaphase —_C. Anaphase d, Telophase 16, Numerical abnormality in chromosome accurs in the following conditions except : a.Ph chromosome in CML b.Turner syndrome ©. Klinefelter syndrome ——_d, Down syndrome 17. All are causes of splenomegaly except : a AML’ b. CML c. Malaria d. Rheumatoid arthritis 18. Sezary syndrome is the leukemic stage of : @. Mycosis fungoides - b. Hodgkin lymphoma ¢. Follicular lymphoma d. Burkitt lymphoma 19. Isotretinoin treatment is effective in which acute leukemia? 2 ALL b.AML-M2 cAML-M3 — d, AMLZ a 20. Tumour cell infiltration into the skin and gingiva are seen in: a. AML-M1 b, AML-Mm2 AML = M3 d. AML—Ma — : © Scanned with OKEN ScannerKARPAG oar RPAGAM FACULTY OF MEDICAL SCEINCES AND RESEARCH i COIMBATORE - 641032 INTERNAL ASSESSMENT THEORY EXAMINATION - V SECOND YEAR MBBS (2020 — 2021 Batch) DEPARTMENT OF PATHOLOGY Date: 03.09.2022 Time: 3Hours (1pm — 4pm) Essay: (2115-30) 1. ASO year old male presents with cough, dyspnoea, and intermittent haemoptysis for two months along with loss of weight and appetite. He Is a chronic smoker for the past 3 decades. CT chest revealed mass lesion in the right lobe of lung. a) What is your probable diagnosis? b) Discuss in detail the classification, morphological features and the Paraneoplastic syndromes associated with it. 2, A56 years male experienced a prolonged chest pain-stabbing in nature, radiating to the jaw and left arm and associated with profuse sweating a. What is your diagnosis? . Discuss in detail about the pathogenesis ¢. Add a note on morphology of involved organ. Pathogenesis and morphology of silicosis. Short notes: (10 x5 = 50) n. complains of a one month history of headache and 3. A40 year old wore! is recorded to visual disturbances. On examination, it was found that her BP wa be 220/170 mmHg. What is _ the likely diagnosis and what are the characteristic histological features associated with the lesion? 4. Aneurysm 5, Pneumoconiosis 6. Discuss the causes, pathogenesis and morphology of cardiomyopathies. 'A70 year old man complains of reduced exercise tolerance over the past 3 years. Also, occasionally he has experience chest pain on climbing upstairs. He is a smoker since many years and on examination his BP was recorded to be 190/110 mm Hg, Laboratory findings revealed high serum cholesterol levels Is of HDL cholesterol. What is the probable predisposing factor with low level causing the symptoms and what are health risks associated with it? \* att ie © scanned with OKEN Scanner8. A7 year old boy present to the OPD with recently developed subcutaneous hodules over the arms, On questioning, the parents reveal a history of acute pharyngitis 3 weeks back. The patient also complains of pain over the knee joints and hips. What isthe likely diagnosis? What is the Eiopathogenesis and Clinical features for this disease? St fa ; 9. Describé the etioloby, pathogénesid and morphology,of infective enciocardltis. Write a note on non-infected vegetations. eget Pe 10.50 years male smoker c/o dyspnea his PET revealed FEV1 / FVC ratio of 0.5. He had barrel shaped chest. What is your diagnosis? What is the etiology and pathogenesis for this disease? fram" 11. ARDS/ALI 12, Discuss etiopathogenesis and morphology of mesothelioma.INTE NTERNAL ASSESSMENT THEORY EXAMINATION - V DEPARTMENT OF PATHOLOGY mc a (1x20 0) 1, Ferruginous bodies are seen in AsSilicosis.B.Coal workers pneumoconiosis C. Asbestosis. Sarcoidosis 2. Collar button lesions are seen in A. Bronchial adenoma B. Bronchial carcin C.Adenocarcinoma lung 0. Tb bronchus 3. Major criteria in the modified Jones’ criteria include the following except: Acardtis @.Polyarthrtis ¢.Ralsed C-reactive protein 0, Subcutaneous nodules 4 Bronchogenie carcinoma has increased incidence inthe following pneumocon! ‘A.Coal workers’ pneumoconiosis _B. Silicosis C. Asbestosis D. Bagassosis 5. Emphysema associated most often with alpha 1 antitrypsin deficiency i: AApanaciear B.centracinar C.Distaacinar 0: regular 6. Bronchial carcinoid arses from: ‘AColumnar ciliated epithelium 8B. Goblet cells C.Kulchitsky cells D. Alveolar lining cells +. Which ofthe flowing condition is Marfan’ syndrome most commonly assaated with? sendocardis. 8. Resticive cardiomyopathy C.Arhythmia _D. Aetfedssecton 8, What type of cardiomyopathy is most commonly associated with the sudden death of ‘young athletes? ‘Abypertrophic cardiomyopéthy B. Restrictive cardiomyopathy C Dilated cardiomyopathy 9, What s the most frequent etiologic agent of acute infective endocarditis in Wdrug abusers? ‘streptococcus virida 8, Staphylococcus aureus staphylococcus epidermidis _. Streptococcus bovis 40, Identify the disease associated with large vessel vasculitis. A.Kawasaki disease BeTakayasu arteritis: (C.Wergener granulomatosis D.chrug Strauss Syndrome © Scanned with OKEN Scanner41. The anti-neutrophil -ytoplasmic antibo 3 are usually negative in which ofthe following condition of vasculitis? A.Microscopic Polyangitis (MPA) _B.Eosinophilic Granulomatosis with Polyangitis (EGA) Coyarteitis Nodosa (PAN) __D.Granulomatosis with Polyangitis (GPA) 12. Identify the modifiable risk factor of atherosclerosis A.Geneticfactors 8. Age €.Smoking 0. Gender 13. Kdentify the non-modifiabl ris factor of atherosclerosis: AHyperlipidemia B.Diabetes_ —_C. Hypertension D. Genetic factors 14. The type of emphysema commonly caused by lgarette smoking is APanacinar —B,Centridcinar C.Distal acinar _—_—D.Jrregular 15. Sarcoidosis A. Is caused by exposure tosilicacompounds _B.Causes caseating granulomas C. Causes bilateral hilar lymphadenopathy D.ls more common in men 16. A41-year-old female presents with recurrent severe headaches and increasing visual | problems. Physical examination reveals her blood pressure to be 220/150. Her symptoms are most likely to be associated with A. Medial calcific sclerosis BArteriosclerosis obliterans C.Hyperplastic arteriolosclérosis D. Hyaline arteriolosclerosis 17. Atherosclerosis is predominantly a disease of: C.Adventitia _D. Entire vessel wall A.Intima 8. Me 18, The most common cause of dissecting haematoma ‘A. Cystic medial necrosis of Erdheim 8. Trauma during cardiac catheterisation . Systemic hypertension , Marfan syndrome 19, Pulseless disease A, Temporal arteritis, B, Kawasaki's disease C. Takayasu arteritis: D. Buerger’s disease calcific sclerosis isa type of: 20. Mec A. Dystrophic calcification B. Metastatic calcification Both metastatic and dystrophic calcification D. Neither metastatic nor dystrophic calcification’ © Scanned with OKEN ScannerKARPAGAM FACULTY OF MEDICAL SCEINCES AND RESEARCH Internal Assessment = VI Date: 01.10.2022 Time: 3Hours (1pm ~ 4pm) ESSAY: (2x15=30) 1.Mr. X—60 year old, developed easy fatiguability weight loss and altered bowel habits. A) What is the probable diagnosis? —Colosectal Ca _ B) Write a note on the adenoma - carcinoma sequence? c) Write a note on microsatellite instability. D) Write its morphological features. E) Mention the prognostic factors? 2. Mr. X Presented to the hospital with intense acute abdomen & pain radiating to the back. Investigation revealed elevation of serum amylase levels. A) What is the diagnosis? B) Etiological factors associated with this condition. C) Mention the Proposed pathways in the pathogenesis. D) Write the Morphological features. SHORT NOTES: (10 x5 = 50) 1, 40 year old female -on endoscopy revealed a submucosal solitary Iesion arising from the stomach. — = What is the probable diagnosis ? Geslsorletwal stroma! Lunout = Write anote on Camey’s triad ? = Add a note on its morphology & diagnostic marker. 2. 25yr old male presented with peptic ulcer disease, urea breath test being positive ? = Whatis the diagnosis ? + Explain the pathogenesis & morphological features. 3. S5yr old male presented with abdominal pain, MRI — revealed numerous foe cystic lesions arising from pancreas, " Write a note on the differential diagnosis. © scanned with OKEN Scanner4, A. 34yr old male with abnormal liver function tests & iron metabolic abnormalities. Had similar history in the family members. ™ What is the diagnosis ? * Etiopathogenesis & morphology. \ 5, 38yr old female presented with abdominal pain, diarrhea, Endoscopy shows ulcerated areas alternating with normal areas in the colon. = What is the pathology? Crab aleiolenire = Desoribe the etiopathogenesis, clinical features & morphology of the disease. 6. 45yr old lady presented with malaise , lab investigations revealed elevated liver enzymes, HBS Ag +ve and features of chronic liver disease on USG abdomen. * Write a note on the morphological features of the underlying pathology. ied peri BS nr 3 7. 49yr old woman presented with episodes of diarthea, weight loss & flushing for past one year, endoscopy revealed polypoidal mass in the [ose diiodenum. = Whatis the pathology ? = Describe the clinical features & morphology of the disease. 8. A l0yrold boy presented with mucocutaneous pigmented lesions, intussuception and numerous polyps in the small intestine = What is the underlying pathology 2 1 Crom = Write a note on other hamartomatous polyps. 9. 65yr old female presented with weight loss, jaundice, pruritis , USG- enlarged gallbladder, ERCP revealed a mass arising from the bile ducts extrahepatically . 4 = Chobenye * Write a note on the morphology of the underlying disorder. 10.40yr old female had Bone marrow transplantation, followed by which she developed elevated liver enzymes. Liver biopsy revealed endothelitis & bile duct inflammation = Explain the pathogenesis of the underlying disorder. — © scanned with OKEN ScannerKARPAGAM FACULTY OF MEDICAL SCEINCES AND RESEARCH Internal Assessment ~ VII Date: 05.11.2022 Time: 3Hours (1pm ~ 4pm) ESSAY: (2x15=30) = 1) A12 year old boy presented with fever, oliguria and high coloured or cola coloured urine, He had history of skin infections (Impetigo) 6weeks back and sorethroat 3weeks back .Urine routine examination reported with mild proteinuria. Blood tests show antibodies against Group A streptococcus and decreased complement levels. a) What is your probable diagnosis? (2) % b) Describe the etiopathogenesis and clinicomorphological features of the condition.( 4+4) c) What are the relevant investigations and prognosis? (5) ‘ASS year old post-menopausal woman presented with a hard lump 6x6cm in upper outer quadrant of left breast .FNA revealed blood stained material. Microscopy report shows loose clusters of marked pleomorphic cells. a) What is your clinical diagnosis? (2). b) Discuss the etiopathogenesis, molecular mechanism of carcinogenesis of the disease (3+4). c) Discuss about investigations and prognostic factors of the disease (343). © Scanned with OKEN Scanner* 6) AGC presen SHORT NOTES: 7 (10 x5 = 50) 4) 40 year male presented with testicular mass. Classify testicular tumors and add a note on germ cell tumor of the testis. 2) A A0year old lady presented with fever, weight loss and foul smelling, vaginal discharge. On examination: cervix had a friable mass and bleeds on touch 8) What is your diagnosis? b) Prescribe role of Pap smear in cervical screening. 3) 13 year old female child had massive edema with puffiness of face with decreased urine output a) What is the probable diagnosis? 'b) Write in detail about minimal change disease 4) 30 year old lady admitted with a5 month history of vaginal bleeding after a normal pregnancy. The HCG was at a level of >209566. A pelvic ultrasound revealed an endometrial thickness of 6cm and presence of an intrauterine mass measuring 56x50x45mm with snowstorm appearance a) What is your diagnosis? b) Describe in details the pathogenesis and morphology 5) 80 year old male presented with history of dysuria and urgency of urine. USG shows enlarged prostate with mildly raised PSA level, a) What are the morphological findings in this condition? © scanned with OKEN Scanner6) A 60year of ee aces Previous history of type 2 diabetes mellitus Mplai i: dyspnea and noctung rants of Beneralized edema of one manth duration, of the tumor revealed cystic mass with tufts of hairs, sebum and cartilaginous Material a) What is your diagnosis? Detmael ep) b) Add a note on morphological features 8) A 40year old man came with the complaints of abdominal pain .On examination flank fullness noted. CT scan abdomen revealed multiple non enhancing fluid filled cysts without solid component in both kidney. a) Enumerate cystic renal diseases b) APCKD 9) 35 year old female presented with painless huge mass in the left breast. O/E no evidence of ulceration & Nipple retraction. Mammography revealed round lobulated dense mass with circumscribed margins. HPE repeated tumor exhibiting leaf like pattern. a) What is your probable diagnosis? no» b) Write gross & microscopic features of the above condition. 10) 45 year old lady presented with abdominal mass, postmenopausal bleeding cachexia and weight loss CT scan showed large mass in the right ovarian region a) What is the probable diagnosis? b) Classify ovarian neoplasm ¢) Add a note on surface epithelial ovarian tumors, ‘ © Scanned with OKEN Scannermca (1x20 = 20) 1. Which one of the following is not associated with adult polycystic kidney disease? A) Autosomal dominant inheritance B) B) Mutations involving gene affecting cell — cell matrix interactions C) C) Intracranial berry aneurysm may be present D) D) Tricuspid valve prolapse. 2. Schiller — Duval bodies are seen in A) Teratoma B) Seminoma C) Yolk sac tumour D) Chorio carcinoma 3. Kidney biopsy from a child with hemolytic uremic syndrome Characteristically presents features. A) Proliferative glomerulonephritis _ B) Thrombotic microangiopathy C) Focal segmental glomerulosclerosis. D) Minimal change disease. 4, Bilateral ovarian masses are identified on pelvic examination of a 40 year Old women for which she undergoes total abdominal hysterectomy. Pathologic examination demontrates papillary archite chree and Serous fluid. Which of the following tumor markers would be most Useful in monitoring recurrence? A) Alpha ~ Fetoprotein 8) Bombesin C) CA—125 D) PSA 5. Tramtrack appearance on histopathology of kindly as seen in ‘A) Membranous nephropathy B) Membranoproliferative glomerulonephitis C) Ig A nephropathy D) Cresentic glomerulonephritis. 6. Call Exner bodies are seen iS A) Mature teratoma _B) Endodermal sinus tumor C) Granulosa cell tumo D) Sertoli leydig cell tumot © Scanned with OKEN Scanner nee7. Allof the following about Xanthogranuloma pyelonephritis are true Except, A) On cut section yellowish nodules are seen B) Associated with Tuberculosis C) Foam cells are seen D) Giant cells are seen 8. BRCA~1 Gene is located on A) Chromosome 13 B) Chromosome 11 ©) Chromosome 17 D) Chromosome 22 9. Chocolate cyst of the ovary is: A) Haemorrhagic corpus luteum B) Ruptured local cyst C) Endometriotic cyst D) Ruptured follicular cyst. 10. Thyroidisation is a clinical features of me A) TB Pyelonephitis 8) Chronic Pyelomysbrits C) Acute pyelonephritis D) Interstitial nephritis. 11. Choriocarcinoma is characterized by all except. A) Primarily trophoblastic tumor B) It can occur following hydatiform Mole ©) Villi present D) It can metastasize to lungs. 12. Indian file pattern is seen in histopathological examination of A) Infiltrating duct carcinoma 8) Fibroadenoma C) Lobular carcinoma D) Medullary carcinoma 13. All are true about polycystic ovarian disease except A) Persistently elevated LH B) Increased LH / FSH ratio C) Increased DHEAS D) Increased prolactin . © Scanned with OKEN Scannerfenal pathology in SLE Includes all except A) Focal glomerulonephritis 8) Diffuse glomerulonephitis ©) Diffuse Membranous glomerulonephritis 0) Lipoid nephrosis. 15. Histologic hallmark of Paget's disease of nipple is A) Caseous necrosis B) Infiltration of the epidermis by malignant cells C) Atypical lobular hyperplasia D) Desmoplasia 16. Wegener's granulomatosis generally produces lesion in the ilewing Tissues except. ‘A)Nose’ B)Ears C) Lungs _D) Kidneys 17. Gleason's scoring is used for A) Carcinoma breast _B) Carcinoma prostate )Carcinoma pancreas _D) Carcinoma testis 18. A 60 year old women reports to physician for progressive fatigue, loss Of appetite and malaise for the last 2 months. An upper Gl endoscopy reveals an ulcerated mass located along greater curvature of stomach. CT Scan abdomen shows bilateral ovarian masses. Which of the Following condition this patient is most likely to have? A) Ampullary carcinoma 8) Keveentenn amen C) Serous adenoma of ovary D)Endometrial carcinoma of uterine body. 19. Alpha feto protein is not raised in which testicular tumor A) Choriocarcinoma B) Terato carcinoma’ C) Yolk sactumor D) Embryonal cell carcinoma 20. Anti GBM antibodies are seen in A) Good pasture’s syndrome _ B) RPGN ) Membranous Glomerulo nephropathy D) Minimal. 4 A © scanned with OKEN Scanner