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Lesson 2 Inflammation
Must know
1. 2. 3. 4. 5. 6. 7. 8. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11.
Differences between exudates and transudate ( From Harshmohan -baby) Diapedesis Chemotaxis - very important Phagocytosis (only the basics) Chemical mediators of inflammation (prepare yourself short notes) Arachidonic acid metabolites Granulomatous inflammation Types of giant cells and their morphology. Leukocyte transmigration Selectins (notes for 5 mrk) Integrins (notes for 5 mrk) Role of reactive oxygen intermediates in microbial killing Defects in leukocyte function Complement cascade and disorders TNF Chemokines Fibrinous inflammation Acute phase proteins Lymphedema
Liver regeneration
2. 3. 4. 5.
Angiogenesis Healing by first and second intention Factors influencing wound healing Complications of wound healing (except for wound healing questions from this lesson are rare) Growth factors Collagen Keloids Granulation tissue
Lesson 5 Genetics
Though essential in every other aspect, except the following five topics (very very important), I personally expect no other question from this lesson in university exam. Not to waste time in this lesson at the eleventh hour
Must know
1. 2. 3. 4. 5. 1.
Marfans syndrome Ehlers Danlos syndromes (only the basics) Downs syndrome (with diag) Turner syndrome (with diag) Barr body Transmission pattern and characteristics of a. Autosomal dominant b. Autosomal recessive c. X- linked recessive disorders Tay sachs disease Hurlers and hunters syndrome Von gierkes disease Sex chromatin Klinefelter Fragile X syndrome Genomic imprinting (only the basics)
Distinction questions
2. 3. 4. 5. 6. 7. 8.
Lesson 6 Immunity
Important lesson. Your knowledge of microbiology should help Must know
1. 2. 3. 4. 5. 6. 7. 8.
T- lymphocytes and B-lymphocytes Antigen presenting cells NK cells Type 1, type 2, type 3 and type4 hypersensitivity SLE (Important -only the basics) LE cell (Important -notes for 5 makrs) Kidney manifestations in SLE AIDS Full (pathogenesis, CRS involvement, natural history, aids defining conditions,
Distinction questions:
1. 2. 3. 4. 5. 6.
Cytokines: types and functions HLA molecules (notes for 5 marks) Arthus reaction for 5 marks Types and morphology of graft rejection (prepare notes for 5 marks) Anergy Digeorge syndrome
Lesson 7 neoplasia
Except for p53 and RB (important), the whole of molecular level of cancer path can be skipped exams, though you might need them for better understanding Must know
1. 2. 3. 4. 5. 6. 7. 8. 9. 1. 2. 3. 4. 5. 6.
Characteristics of benign and malignant tumors. Diff between benign and malignant tumors (as table) Metastasis: pathways of spread of tumor (very important) P53-as guardian of human genome (With diag) Retinoblastoma: two hig hypothesis of RB gene Chemical carcinogenesis (etiology, pathogenesis) Viral carcinogenesis (HPV-very important) - Important Paraneoplatic syndromes - very important Tumor markers (oncofetal antigens-very important) Differences between anaplasia and dysplasia (prepare notes for 5 marks) 5 occupational cancers with their etiologic agent Oncogenes (notes for 5 marks) Radiation carcinogenesis Tumor antigens (notes for 5 marks) Laboratory diagnosis of cancer (basic points only)
Distinction questions:
2. 3. 4. 5. 6. 7. 8. 9. 10.
Ghons complex or primary complex Ranke complex Progressive pulmonary tuberculosis Military tuberculosis Pots spine Scrofula Leprosy (types, pathogenesis and c/f) - important Stages, pathogenesis and c/f of syphilis Black water fever and cerebral malaria Typhoid fever Amoebic liver abscess Hydatid cyst Actinomycosis Madura foot Rhinosporidiosis
b. c. d. e. f. g.
Distinction questions:
All other infectious diseases (I would advice not to waste time in this lesion at the last minute. Your knowledge of micro is more than enough for handling this lesion. Tuberculosis and syphilis is all that is needed in path)
Distinction questions:
Must know:
Immune hydrops Cystic fibrosis (though important has not been asked in any question papers mostly know only the basics) 3. Wilms tumor or nephroblastoma (very important) Distinction questions: 1. Neuroblastoma 2. Phenyketonuria 3. Necrotizing enterocolitis 4. Respiratory distress syndrome
1. 2.
SYSTEMIC PATHOLOGY
Hematology
Please note that the whole of hematology account for nearly 40% of marks in paper 1. Must study topics. 10 marks or LONG CASE The pathogenesis, peripheral blood picture, bone marrow picture, other relevant morphology, INVESTIGATIONS (for investigations, you might refer to Alagappan - manual of medicine separately under each heading) , c/f of
Sickle cell disease B- thallasemia Megaloblastic anemia, esp. pernicious anemia Iron deficiency anemia Hemophilia A ALL CLL Multiple myeloma Hodgkin disease- types, pathogenesis, basic morphology of each type and their prognosis, clinical features 10. AML (In addition to the general headings, you need to know atleast the basics of FAB classification)
1. 2. 3. 4. 5. 6. 7. 8. 9.
All these 12 questions are must read for all hematology exams
Important note: Before diagnosing the case, please make sure that the age of the concerned patient coincides with the age group affected, for that particular disease, as given in Robbins. Also look for characteristic symptoms like lymphadenopathy, bone tenderness, abrupt onset, massive splenomegaly, cancer cachexia, etc. These clue words in the case are directly picked from Robbins. So dont miss the clinical features of any suspected long case. For all investigations for any long case, refer to Alagappan- manual of medicine. Again please note that more than 50% of previous paper 1 question papers have CML (massive splenomegaly) as the long answer.
-thallasemia (Just know the types, genetics of each condition and the outcome) Immuno hemolytic anemia (only the table in Robbins is more than enough) ITP
Agranulocytosis very important, highly repeated (prepare notes for 5 marks under the headingspathogenesis, morphology and c/f) Leukimoid reaction important Burkitt's lymphoma again very important Follicular lymphoma Hairy cell leukemia Reed-sternberg cell- pathogenesis, types and morphology (with diagram) - Very important Differences between Hodgkins and Non-Hodgkins lymphoma Myeloblasts morphology Morphology of MDS syndrome Gandy gamma bodies in CVC spleen The Philadelphia chromosome (Important0
2. 3. 4. 5. 1. 2. 3. 4.
Lymphoplasmacytic lymphoma (rare) Mantle cell lymphoma (rare) Sezary syndrome Histicytosis (LCL) ABO incompatibility Rh incompatibility Coombs test Packed cell volume (PCV)
5 marks:
1. 2. 3.
Mitral valve prolapse Types of angina Causes and types of pericarditis (rare)
Bronchiectais (very important) Asthma Emphysema Ca lung Squamous cell Ca, AdenoCa, Small cell, Large cell gross pathology , histology and prognosis. Local effects of tumor spread (very important. Local effects can be asked as short notes also) Pathogenesis and types of emphysema (very important) Asbestosis Pneumoconiosis (prepare notes for 5 marks) Pulmonary embolism Etiology and morphology of community acquired pneumonia (Very important) Lung abscess (important) Pancoast tumors ( highly repeated)
Types and causes of atelectasis Diffuse alveolar damage or ARDS Goodpasture syndrome (rare) Pananeoplastic syndromes, associated with lung Ca
Pleomorhic adenoma (very important 5 mark) Warthin tumor Leukoplakia and erythroplakia (premalignant lesions of oral cavity)
Distinction questions:
All these 5 questions are essential must-read for all GIT exams Please note that iron deficiency anemia in an elderly male is due to GIT cancer, unless proved otherwise. Must know in 5 marks:
Achalasia cardia Barrett cosophagus very important Types of gastritis and H. pylori as an etiological agent. Celiac disease important Adenoma colon and rectum (types, morphology, risk of malignancy, prognosis, clinical impact) FAP syndrome Staging of Colorectal carcinoma - Important Carcinoid tumors (prepare notes for 5 marks under location, morphology, c/f of carcinoid syndrome) 9. Pseudomyxoma peritonei 10. Intestinal polyps - types, morphology and prognosis - Important
1. 2. 3. 4. 5. 6. 7. 8.
Very rare:
1. 2.
More than long case, 5 marks are more important in this lesson 10 marks case:
Jaundice and portal hypertension (know the basics, the pathophysiology, clinical manifestations, morphology) 2. Hepatocellular carcinoma
1.
Viral and alcoholic hepatitis are must know topics in this lesson. Distinction questions:
1. 2. 3. 4.
Pathogenesis of ascites Indian childhood cirrhosis (refer any pediatrics book) Wilsons disease (rare) Primary biliary cirrhosis (rare)
Acute cholecystitis Very important (clue : fertile fatty female of forty) Cholelithiasis (gallstones) repeated (can also be asked as long question)
5 mark questions:
Acute Glomerulonephirits (post streptococcal) Rapid progressive GN Nephrotic syndrome pathology and pathogenesis (Very important) Minimal change disease (very important) Focal segmental glomerulosclerosis Membranoproliferative GN Basics about the pathogenesis and stages of ATN Urolithiais (Highly highly repeated) Chronic GN Acute pyelonephritis Chronic pyelonephritis pathogenesis and morphology. Granular conracted kidney (prepare notes for 5 marks) - Important
Distinction questions:
1. 2. 3. 4. 5. 6.
Both types of polycystic kidney disease and the differences between them Membranous nephropathy Kimmelstein Wilson disease or diabetic glomerulosclerosis (5 marks) Flea bitten kidney (5 marks) Pathogenesis of Hemolytic uremic syndrome (basics) Renal cell carcinoma (only basics)
Rare 5 marks:
1.
Testicular lymphoma.
Distinction questions:
1. 2. 3. 4. 5.
Pelvic inflammatory disease (5 marks) Sarcoma botyroides Menstrual changes in endometrium Brenner tumor (5 marks) Sex cord stromal tumors (prepare for 5 marks)
Mammographic signs of Ca breast Fibrocystic breast disease Just know the risk factors for Ca breast
4. 5. 6. 7. 8. 1. 2. 3.
Carcinoma in- situ (both ductal and lobular) Paget's disease (Very important) Types and morphology of invasive breast carcinoma Prognostic factors for breast Ca (Very important) Fibroadenoma (Very important) Sclerosing adenosis and radial scar Different between BRCA1 and BRCA2 Phyllodes tumor
Distinction questions:
Rare:
1. 2.
Squamous cell carcinoma (prepare notes for 5 marks) Basal cell carcinoma (5 marks) Malignant melanoma Pre malignant lesions of the skin (refer Sanjay Azad surgery) Mycosis fungoides
Lesson 26 Bones
Very important. Not to be ignored Must know:
1. 2. 3. 4. 5. 6. 7. 8.
Osteopetrosis Osteoporosis (rare know only the basics) Paget disease (Important) Osteomyelitis pyogenic and TB (potts spine) - Very important Osteosarcoma (prepare notes for both 10 and 5 marks) - Very important Chondrosaroma (5 marks) Ewing sarcoma (sure 5 marks) - Very important Giant cell tumor or osteoclastoma - Very important.
CSF findings in different types of meningitis (Read Robbins and also prepare yourself a tabular column referring to med books or applied micro notes) Brain abscess. TB menigitis Morphology, investigations and c/f Berry aneurysm (5marks) Astrocytoma Meningioma (5 marks) Schwannoma (5 marks)
Lesson 29 The eye can be read after your univ. exams! All the best. Wishing you all success.