4th Year MBBS Pathology (Special Pathology) OSPE by UHS (Set-3)

Following are the OSPE papers (Set-3) of 4th year MBBS Special Pathology UHS with  Answers/Keys.

1. Benign 
2. a. Cysts, with apocrine metaplasia b. Calcifications c. Fibrosis d. Adenosis 
3. No increased risk of CA.

1. Intra vascular hemolysis (DIC). 
2. PT, PTT, APTT 
3. Both will be increased

1. Sickle cell disease
2. a.chronic hemolysis b. microvascular occlusions c. tissue damage d. sickle shaped RBCs.

1. CML 
2. t(9;22)/ Philadelphia chromosome/ ABL-BCR gene 
3. LAP score is markedly decreased or at most just normal contrary to leukemoid reaction, in which

it is markedly increased.

1. Microcytic, hypochromic R.B.Cs with increased central pallor. Poikilocytosis (pencil cells) is also there.
2. microcytic hypochromic type of anemia 
3. 3. Causes a. Iron deficiency anemia (dec. dietary intake, inc. demand, malaborption syndromes) b. Anemia due to chronic blood loss c. Anemia of chronic disease d. Thalassemia

1. Pernicious anemia due to autoimmune gastritis/Megaloblastic anemia. ( Since numbness in scenario, so pernicious anemia here.) 
2. Vit. B12 and folic acid 
3. Tests ( write just any 2) a. Low serum B12 & Inc. methylmalonic acid in urine, if due to it. B12, as this is the case. b. Low serum folate levels, if due to folic acid def. c. Inc. serum homocystein, in both d. Schilling test positive, if due to autoimmune gastritis  

1. Invasive Carcinoma, No special type (NST)/ Invasive Ductal Carcinoma 

2. Two most common

a. Invasive ductal carcinoma b. Invasive lobular carcinoma

1. non proliferative fibrocystic change 
2. Points:a. Microcyst formation b. Fibrosis c. Apocrine metaplasia of the cells lining the wall of a large cyst the left of the picture d. Small papillary excrescences also visible

1. Adult polycystic kidney disease
2. Bilateral 
3. PKD1 on chromosome 16, is most common. Also PKD2, PKD3.

1. Acute pneumonia 

2.  a. Congested capillaries b. Extensive neutrophillic infiltrates into the alveolar spaces 

3. Streptococcus penumonea

1. Acute pneumonia at red hepatization stage 
2. Red, heavy and boggy lung. Firm, liver like consistency

1. CK MB, then Troponin I since time is between 4-12 hrs 

2. Types a. Transmural b. Non-transmural 

3. Dense fibrosis.

1. Dissecting aortic aneyrusm 

2. Hypertension 

3. Marfan Syndrome 

4. a. Hemorrhage into thoracic cavity b. Cardiac temponade 

 1. Kidney demonstrating marked hydronephrosis with nearly complete loss of cortex.
2. Calculus at Ureteropelvic junction which is causing obstruction to the flow of urine.

1. Neutrophillic infiltrate 

2. a. Coagulative necrosis b. Loss of nuclei c. Loss of striations 

1. Clear Cell carcinoma of Kidney 

2. Von Hipple Lindau disease 

3. a. Parathyroid hormone (rPTH) b. Corticosteroids c. Rennin