pathology

PATHOLOGY: CHRI- UNIVERSITY QUESTIONS

(2009-2017)
PAPER I
10M
SECTION A:
1. Def amyloidosis. Describe in detail abt etiopathogenesis and
diagnosis of amyloidosis
2. A 50 yr old male came to OPD with compliants of alternating
diarrhoea and constipation. Occult blood in stool was +.
Colonoscopy reveals Mass in the rectum,USG abdomen shows
multiple discrete nodules in the liver.
a. Give your diagnosis with reason
b. Describe molecular mechanism of spread to the Liver
c. What is the multistep pathogenesis of lesion in the rectum

Ans : Adenocarcinoma with Metastasis to liver

3. A 30 yr old male came to OPD with compliants of cough with

expectoration of 2 months duration, he gave history of Weight loss
and Night sweats. X- ray chest reveal a lesion in the right apical
lobe of Lung
a. Diagnosis with reason
b. Gross Micro of the lesion
c. Describe the progress of this lesion

Ans: TB

5. Female 25 yr undergo laprotomy with a clean surgical incision

a. What is the type of healing process named
b. phases &sequence of events in healing of such wound

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c. What are the local and systemic factors which help in

healing
ANS: Wound Healing Process
6. A 30 yr old pregnant lady presents with Exertional dyspnoea,
Tachypnoea and bilateral pedal edema
a. What are the cause of edema?
b. Discuss the path of edema
c. Describe the morphological changes in various organs
Edema
7. Define and classify thrombosis. Explain etiopathogenisis of
Thrombosis. Add a note on fate of thrombus.
8. 50 yrs old man came to the OPD with the compliants of
alternating diarrhoea & constipation, occult blood in stool was
positive, colonoscopy revealed a mass in the rectum. USG
abdomen showed multiple discrete nodules in liver.
a. Give your diagnosis with reasons
b. Describe the mech of spread of liver
c. What is the multistep pathogenesis of lesion in the
rectum.
ANS: Adenocarcinoma with Metastasis to liver
9. An 18 yo student presented with acute pain in abdomen after
diagnostic evaluation surgeon decided to perform
appendisectomy. Histopath examination of appendix showed
neutrophilic infiltration of muscularis purpura
a. Most likely diagnosis. Name underlying pathologic
process
b. Discuss cellular and vascular events of this process
Acute Inflammation
10. A 60 yo lady presents with stony hard lump in breast, fixed to
the chest wall and a palpable node in the ipsilateral axilla
a. Diagnosis. Give reasons to justify your answer
b. Pathologic process that best explains axillary adenopathy in this
case
c. Discuss in detail molecular basis of this process
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Diagnosis - CA Breast , Process-Metastasis by Lymph nodes

11. A 50 yr old hypertensive is rushed to the hospital with
substernal crushing pain & profuse sweating, he is hypotensive
on admission & expired 3 days after admission. An autopsy is
performed
a. What is the likely diagnosis?
b. What is the etiopathogen of this condition?
c. Discuss t gross & microscopic changes that is expected in the
heart at the autopsy.
ANS: MI
12. A 45 yr old male, came with compliants of altered bowel
habits for 6 months, colonoscopy revealed multiple(>100) tiny
polyps & cauliflower growth in the sigmoid.
a. What is your diagnosis?
b. What is the molecular basis of this lesion?
c. What are the lab methods available to diagnose these type of
lesions?
ANS:APC (Neoplasia)
13. A 60 yr old male presents wit ulcerated growth in his
penis, he also has enlarged left inguinal lymph nodes. A biopsy
both the growth & inguinal lymph nodes are done.
a. What is the likely diagnosis?
b. What are the microscopic findings u expect in both the tissue
biopsies?
c. Discuss t pathogenesis of the enlarged inguinal lymph nodes in
detail
CA Penis & Explain Metastasis to Lymph Nodes
Sec B
1. A 3 yr chid with severe pallor presents with abdominal
distension
a. Classify leukemia
b. Etiopath of underlying diseases
c. Diagnostic investigations
ANS: ALL
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2. A 25 yr old pregnant female with compliants of lethargy and

weakness, O\E she was pale and spoon shaped nails
a. Diagnosis with reason
b. Etiology of the condition
c. How will u investigate this case what does peripheral and
bone marrow show?
ANS:Iron Deficiency Anaimia
3. A 35 yr old male came to wd h/o lethargy. O/E he had massive
splenomegaly.His WBC count was 1,55,400/cumm.
a. Diagnosis wd reason
b. Describe haematological features
c. What are the different phases of disease
CML
4. A Child aged 10 years presents with recurrent h\o pallor and
jaundice. O\E patient had splenomegaly and foot ulcer,child also
compliants of abdominal pain and bony pains in episodes
a. Wat is the type of anemia
b. What are the peripheral blood findings and path of
underlying disease
c. What are the special Lab tests to confirm the diagnosis
Sickle Cell Anaemia
5. A 22 year old male pt presents with pallor, cheilitis,
koilonychosis, occult blood in stool answered +
a. Justify your diagnosis with reason
b. Etio of this condition
c. Relevant Investigation that will help in ur diagnosis
Iron Deficiency anaemia
6. A 35 yo male came with history of lethargy o/e. He had a
massive splenomegaly. His WBC count was 155400/cumm.
a. Give your diagnosis.
b. Describe haematological features
c. Different phases of disease
CML
7. A 25 yr old pregnant lady presented with compliants of lethargy
& weakness, O\E she was pale & spoon shaped nails.
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a. Give your diagnosis with reasons

b. What are the causes for this condition
c. How will u investigate this case? What will be the
peripheral smear & bone marrow study in this case?
Iron Deficiency Anaemia
8. A 45 yo male presented with severe weakness and massive
splenomegaly with WBC count of 2.5lks/cmm.
a. What is your diagnosis?
b. Etiopatho and patho
c. Write the investigations to confirm disease
CML
9. A 52 yo woman presents with massive splenomegaly and
marked leukocytosis. LAP score was zero.
a. Most likely diagnosis
b. Peripheral blood smear and cytogenetic findings in this
condition
ANS: CML
10. A 48yo woman presented wit massive enlargement of spleen.
Her lab report was Hb 6g, total WBC 98450 cells/cmm,
platelets 476000.
a. Most probable diagnosis
b.Peripheral smear and cytogenetic findings of condition

11. Female aged 40 yrs presented with soreness of tongue,

numbness of toes and fingers and achlorhydria. Hb 9.5g/dl.
a.Diagnosis
b.Etiology
c.Peripheral smear and bone marrow picture
Megaloblastic Anaemia
12. A 10yo boy presents with joint bleed following trivial trauma.
His maternal uncle also has similar complaints
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a.What is likely diagnosis and why?

b.Ethiopatho and lab investigation of the condition
Hemophilia
13. A 75 yr old female admitted with anemia, pathological fracture
of left humerus had an ESR of 110 mm in 1 hr, her peripheral
smear showed Increased Rouleux formation. X- Ray skull
showed multiple punched out osteolytic lesion
What is the most probable diagnosis?
Write briefly on etiopathogenesis of the disease? Lab
investigations for the disease.
Multiple Myeloma
14. A 25 year old pregnant female came with c|o fatigue &
breathelessnes. O\E she had pallor, CBC showed Hb- 6g%,
PCV-18%, MCV- 68, MCH- 24, MCHC- 27, TC- 4000,
platelet- 1.5
What is your diagnosis? Give reason
Describe the peripheral smear & BM smear findings?
What are the other investigations?
Iron Deficiency Anaemia
15. A 35 yr old lady presents with pallor, soreness in her mouth.
She had a red glossy appearing tongue. Hb- 5g%, MCV- 125 fl
What is the likely diagnosis & why? Discuss t pathogenesis of
this disease.
Describe the peripheral blood finding in the patient.
Megaloblastic anaemia
PAPER 2
Sec A
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1. 43 yo male chronic alcoholic dies after a bout of profuse

hemetemesis
a. Probable diagnosis
b. Morphological changes in target organ involved
c. Sequential events that have lead to death
Alcoholic liver Disease
2. A 55yo male chronic smoker presents with 6mths history of
cough, weight loss and dyspnoea. X ray reveals hilar shadow
and an ulceroproliferative lesion seen on bronchoscopy
a. Possible diagnosis?
b. Classify this condition
c. Morphology and behaviour of this lesion(1)
Lung Carcinoma
3. A 55 yo male in surgery OPD complaint of dyspepsia for past 6
mths. Recently he is having ball rolling sensation in epigastric
region immediately after the intake of food followed by
vomiting of undigested food after 2-3 hrs. O/e he is thin and
marasmic. Left supraclavicular fossa is full with enlarged lymph
node. Ultrasound shows multiple hyperechoic lesions in the
liver.(1)
a. Probable diagnosis and reason
b. Predisposing factors for this lesion
c. Types of various gross and microscopic features of this
lesion.
Gastric AdenoCarcinoma
4. A 55 yr old male presents with pain in the epigastric region, he
complains of significant weight loss, occasional episode of
melena in past 4 weeks, O\E he’s pale & has hard bosselated
mass in t upper epigastrium, he has enlarged left
supraclavicular lymph node
What is the likely diagnosis?
How will u investigate this patient?

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What are the likely gross & microscopic findings in the organs
affected in this patient?
Gastric adenocarcinoma
5. 60 yo female with history of loss of appetite, weight loss and
right iliac fossa mass. Colonoscopy showed ulceroproliferative
growth in ceacum. Stool occult blood is positive.
a. Diagnosis with reason
b. Etiopatho
c. Gross and microscopic features
Colorectal Carcinoma
6. 12yo male child presents history of sore throat, fever and upper
RTI. 3 weeks later he developed migratory arthritis of larger
joints, fever, palpitations and elevated CRP.
a. Gross and microscopic pathology of heart,
b. Pathogenesis of above the above
c. Complication following this disease
Rheumatic Fever
7. A 72 yo male presented with changes in bowel habit. Tarry stool
and loss of weight fatigue and weakness of 6 mths duration.
After an endoscopic biopsy of colon left sided hemicolectomy
was done.
a. What is probable diagnosis
b. Describe the etiopath and morpho of target organ involved.
Colorectal Carcinoma
8. 62 yo man develops severe chest pain on climbing stairs. His
ECG shows ST elevation. Blood level of CK-MB is elevated.
a. Most likely diagnosis
b. Risk factors and pathology and complications of this
condition
MI
9. 38 yo business executive presents with recurrent epigastric
pain that is worse at night and 1-3 hrs after meal.
a. Most likely diagnosis
b. Ethipoathogenisis, pathology, and complications.
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Peptic ulcer
10. A 52 yo lady presents with shortness of breath, productive
cough and fever, shaking chills over last 2 days. Chest x ray
shows consolidation of lower lobe of left lung.
a. Most likely diagnosis
b. Ethiopatho, pathology and complications of this conditions
Pneumonia
11. 45 yo male known diabetic was brought with history of
palpitation and syncope 1 day ago. Biochemical investigation
was done
a. Diagnosis and risk factors for this condition
b. Complications
MI
12. A 50 yr old presents with hematemesis, brought to casualty, he
has ascites & moderately enlarged spleen, USG reveals
diffusely nodular liver
a. What is the diagnosis?
b. Mention the various causes that can lead to similar
presentation
c. Describe the gross & micro of both liver & spleen in this
condition
Cirrhosis Liver
Sec B
1. A 70yo male presents with hematuria and loin pain for 1mth.
On examination right flank relieves palpable mass
a. Probable diagnosis, why?
b. Name the major types of above mentioned condition
c. Briefly about cytogenic changes in this condition
Renal cell carcinoma
2. 60 yo female presents with lump on right breast of 3 wks
duration. On examination, lump is hard with teathering
overlying skin and fixity to pectoralis. Axillary lymph nodes are
palpable. (2)
a. Diagnosis, classify the condition & molecular classifiction
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b. Morphology, etiopatho, investigations

c. Prognostic and predictive factors
Breast Carcinoma
3. A 65 yr old lady presents with hard immobile lump in her left
breast for the past 2 months, it measures 5 cm & associated with
puckering of nipple. Diagnosis, y?; Investigations; prognostic
factors.Breast carcinoma
4. a 12 yo boy complaint of excruciating non stop pain in knee
joint for past 10 days. o/e the joint is swollen warm, tender with
dilated veins over it.x ray showed a mass in metaphysic
destroying bone giving sunburst appearance with lines forming
triangle with cortex.
a. Diagnosis with reason
b. Etiopatho of factors of lesion
c. Gross and microscopic picture of this condition.
Osteosarcoma
5. 54yo female presenting with history of foul smelling discharge
and bleeding per vaginum for 6 mths, per speculum examination
showed ulceroproliferative growth in cervix.
a. Diagnosis with reason,Etiopathogenisis of disease,Gross and
microscopic features
CA cervix
6. 8 yo female child presents with sudden onset of oliguria,
hematuria, pedal and periorbital edema. O/e her BP was
150/100mm hg. She had skin impetigo. Her urine showed RBCs
a. Provisional diagnosis,Ethiopatho of disease,Pathology of
glomerulus
Nephrotic Syndrome
7. A 68 yr ol male whos known diabetic but on irregular
treatment, develops periorbital edema, bilateral pitting pedal
edema, what is the likely diagnosis & y? Discuss the lab
investigations needed to diagnose this condition. What are the
changes u expect in the kidney in this condition?
Nephrotic Syndrome

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8. A 44 yo nulliparous woman presented with hard fixed, non

tender mass of about 6X4X4cm in the upper outer quadrant of
right breast with axillary lymphadenopathy.
a. Probable diagnosis
b. Discuss in detail risk fact and patho of disease
c. Add a note on prognostic factors
Invasive Carcinoma of Breast
9. 5yo boy presents with puffiness of face and massive protenuria.
His serum albumin level is reduced. (1)
a. What is this syndrome of findings called?
b. Describe renal biopsy of this condition under following
headings a. Light microscopy b. Electron microscopy c.
Immunofluorescence
Nephrotic Syndrome
10. A 25year man presents to OPD for oliguria and hypertension.
He gives history of sore throat 2 weeks before.
a. What is this syndrome of findings called?
b. Most likely diagnosis
c. Describe renal biopsy findings of this condition under
these headings: a. Light microscopy b. Electron
microscopy c. Immunofluorescence.
Nephritic Syndrome

SHORT NOTES
CELL INJURY:
1. Name various cellular adaptation. Write in detail about
hypertrophy and hyperplasia
2. Pathologic calcification, name and explain its types with egs.
3. Necrosis. classify necrosis. add a note on necrosis in TB
4. Define necrosis. diff between necrosis and apoptosis(4)
5. types of necrosis
6. phases of apoptotic process
7. apoptosis
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INFLAMMATION & REPAIR:

8. Chemical mediators of inflammation
9. pathways of arachidonic pathway metabolism
10. prostaglandins in inflammation.
11. Cellular events of acute inflammation(1)
12. Mechanism of increased vascular permeability in
inflammation
13. morphological patterns of acute inflammation
14. Granuloma. give eg’s of chronic granulomatous
inflammation and discuss path.
15. Morph of tuberculous granuloma with diagram
16. Phagocytosis
17. Erythrocyte Sedimentation Rate(ESR)
18. TISSUE REPAIR: Wound healing by first intention(2)

HEMODYNAMIC DISORDERS:
19. pathophysiological categories of edema
20. Edema. morphological types of edema. add a note on
pulmonary edema.
21. Pathogenesis of septic shock(1)
22. Pathophysiology of hypovolemic shock
23. Thrombosis. differentiate thrombus from clot. what are
its complications
24. Define thrombus. Fate of thrombus
25. Morph & fate of Thrombus (1)
26. fat embolism
27. causes and consequence of pulmonary embolism

GENETICS DISORDERS:
28. Karyotype and clinical features of Down syndrome

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DISEASES OF THE IMMUNE SYSTEM:

29. Types of hypersensitivity. Pathogenesis of type 4
hypersensitivity
30. Type II hypersensitivity reaction
31. Classification of amyloidosis
32. mechanism of recognition and rejection of allograft

NEOPLASIA:
33. Diff between benign and malignant tumor (1)
34. Routes of tumor metastasis
35. Viral oncogenes
36. Radiation induced carcinogenesis
37. Teratoma
38. Lab diagnosis of cancer

INFECTIOUS DISEASES:
39. miliary TB
40. Primary TB(1)
41. Primary pulmonary tuberculosis-pathology(1)
HAEMATOLOGY:
RBC:
42. Hereditary spherocytosis(1)
43. Packed cell volume
44. Coombs test
45. Lab invest of hemolytic anemia
46. Acquired haemolytic anemia
47. Peripheral blood smear finding in iron deficiency anemia.
48. Diagnostic findings in iron deficiency anemia
49. Hemoglobinopathy
50. Sickle cell anemia
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51. pathogenesis of sickle cell anemia

52. lab diagnosis of Sickle Cell Anemia(1)
53. Investigation of megaloblastic anemia(1)
54. blood picture[peripheral blood smear and bone marrow
finding] in megaloblastic anemia
55. aplastic anemia
56. Fanconi anemia
57. Causes &morphology of congestive splenomegaly (path &
morph of chronic venous congestion of spleen)
58. Paroxysmal Nocturnal Hemoglobinuria (PNH)
59. molecular pathogenisis of beta thalassemia
60. Peripheral smear findings in thalassemia
61. Erythrocyte Sedimentation Rate
62. Transfusion reactions
63. blood component therapy
64. Complications of blood transfusion(2)
WBC:

65. Classify lymphoid neoplasms

66. CML(1)
67. Classify acute lymphoblastic leukemia
68. Molecular basis & peripheral blood smear findings in CML
69. Classify leukemia. How will you differentiate lymphoblast
from myeloblast
70. Acute promyelocytic leukemia
71. Leukemoid reaction(1)
72. Morphological subtypes of Hodgkin’s lymphoma
73. Agranulocytosis
74. Diagnostic criteria for multiple myeloma(1)
75. Myelodysplastic syndrome(MDS)
PLATELETS:
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76. Hemophilia A(4)

77. Peripheral blood and bone marrow findings of ITP and
add a note on lab test to confirm the diagnosis(2)
78. Chronic immune Thrombocytopenic purpura
79. lab test for bleeding disorders
80. Screening test for coagulation disorder
81. Platelet products and substitutes
82. Thrombocytopenia, Prothrombin time

HEAD & NECK: Pleomorphic adenoma

CVS: (blood vessels and heart) :
1. Consequence & complications Of MI
2. Lab diagnosis of MI(1)
3. Vegetations of cardiac valves(2)
4. pathology of infective endocarditis(1)
5. Extracardiac complication of bacterial endocarditis
6. Etiopath of Atherosclerosis
7. pathogenesis of atherosclerosis(1)
8. morphology of atheroma with its complications
9. Dissecting aneurysm
10. Etiopathogenesis of primary hypertension
11. sudden cardiac death
12. morph of rheumatic heart disease

THE LUNG
13. Stages of bacterial pneumonia
14. Gross & microscopic features of lobar pneumonia
15. Bronchiectasis(1)
16. morbid anatomy of bronchiectasis
17. Etiopathogenesis of carcinoma of lung
18. Morphological changes of lung in lobar pneumonia
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19. Etiopath of bronchial asthma

20. Emphysema
21. Etiopath of emphysema
22. Hospital acquired pneumonia

GIT:
23. Pathogenesis of crohn’s disease
24. 5 morphological difference between Crohn’s disease and
Ulcerative colitis(2)
25. Morphology of ulcerative colitis
26. H pylori gastritis(2)
27. Association of H pylori with peptic ulcer
28. Etiopath of peptic ulcer
29. Morphology of chronic gastric ulcer
30. Carcinoid tumor
31. Hirchsprung disease
32. Colonic polyps
33. Gross & microscopy of gastric cancer

LIVER:
34. Gross and microscopic structure of cirrhosis of liver
35. Pathology of alcoholic liver disease
36. Morphology of liver in alcoholic cirrhosis
37. Pathology of fatty liver
38. Lab diagnosis of hepatitis B
39. Chronic hepatitis- etiology & microscopy
40. clinicopathologic syndromes of viral hepatitis
41. etiopathogenesis of cholelithiasis(1)
42. Etiology of HepatoCellularCarcinoma

KIDNEY:

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43. Adult polycystic kidney disease

44. Renal cell carcinoma
45. Morph & molecular association of RCC
46. Hydronephrosis
47. Wilm’s tumor
48. Berger’s disease
49. kidney lesions in DM
50. rapidly progressive glomerulonephritis

MGT:
51. BPH(1)
52. Etiopath & path, morpholology of nodular hyperplasia of
prostate(1)
53. morphology of seminoma(1)
54. In Situ penile carcinoma

FGT:
55. Classification of ovarian tumor(2)
56. serous tumors of ovary
57. Morphology of teratoma of ovary(1)
58. PAP smear & its clinical utility.
59. Hydatiform mole

THE BREAST:
60. Etiology and microscopic features of CA breast
61. Phylloides tumor(2)
62. Paget disease

ENDOCRINE
63. Multiple endocrine neoplasia type 1

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64. MEN syndrome(1)

65. Morph & clinicopath features of papillary CA thyroid.
66. medullary carcinoma of thyroid
67. Complications of DM(1)
68. Graves disease
69. Hashimoto thyroiditis(2)
70. Kidney findings in DM(1)
71. Pituitary adenoma

CNS:
72. CSF findings in Acute Pyogenic Meningitis(1)
73. TB meningitis
74. Meningioma- morphology & types(1)

BONES, JOINTS, SOFT TISSUE TUMORS:

75. Osteosarcoma(1)
76. Ewings sarcoma(3) [ X ray and morphological features]
77. Morphology of giant cell tumor of bone
78. Paget disease

PERIPHERAL NERVES AND SKELETAL MUSCLE

79. Duchenne Muscular Dystrophy

THE SKIN
80. Malignant melanoma
81. Gross and microscopic feature of basal cell carcinoma

OTHERS:
82. Mycetoma foot
83. Pathological findings in scurvy
84. Harmful effects of alcohol
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“Whoever you are, or, whatever it is that you do, when you really
want something, all the universe conspires in helping you to achieve
it”
“The Bad News is Time Flies and
the GOOD news is YOU are the PILOT”
WHERE THERE IS A WILL, THERE IS A WAY.
IT IS POSSIBLE! YOU CAN DO IT!
ALL THE BEST!

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