PATHOLOGY

PRACTICAL TEST
SEMESTER IV APRIL 2010
• Answer the questions in the answer
sheets A to E as provided.
• Indicate each number of question clearly
• Each question is 3 minutes.
SECTION A
Question 1-4
 Q1
a. Identify the structure
• Section of lung lobes
a. Describe the 2
gross morphologic
features.
• Consolidated lower lobe
• Normal upper lobe
a. What is your
diagnosis ?
• Lobar pneumonia
This is microscopic picture of the
case above Q 2.
a. Describe 2 microscopic
features
• Infiltrated inflammatory cells
(neutrophils)
• Capillaries surrounding the
alveolar walls
b. What is the diagnosis ?
• Lobar
pneumonia/inflammation
c. List 3 aetiologic agents of
this condition.
• Spn, SAU, K.pneum, Hin
d. Mention 3 complications
• Chest pain
• Cough
• Fever /malaise/headache
This is an appendix removed at
surgery.
Q3
a. List 2 salient features
• Pus/purulent (arrow)
• Hyperaemia
• Hypertrophy
b. What is the most likely
diagnosis ?
• Acute appendicitis
c. List 2 specific symptoms
patient will present.
• Rebound tenderness
• Pain at the right lower
quadrant
Others Fever, vomitting.
This is a microscopic section
taken from previous case
a. Describe 2 features
Q 4.
• Infitrated neutrophils
• Heamorrhage
• Inflammed mucosal linning
b. What is your final
diagnosis ?
• Acute appendicitis
c. List two complications
which may arise from
this condition.
• Perforation (hollow
opening)
• Sepsis
• Death
SECTION B
Question 5-8
This is depicted as a malignant

a.
tumour
Q
What is the histogenesis
5.
( tissue origin) ?
Stratified squamous
epithelium of the
cervix
b. Describe 3 salient
features
1. Keratinised squamous
epith.cells, intercelular
bridges, mitotic
figures (inflam. cells)
c. What is the diagnosis ?
1. Carcinoma of the
cervix
a. Identify the structure.
Q 6.
Gross section of the
uterus
b. What abnormality does it
show ?
• Tumor masses
• Hypertrophied
myometrium
• Hemorrhage
c. What is the diagnosis ?
Leiomyoma of the
uterus
This is a microscopic Q 7.
feature of the case in Q
6 above
a. Describe 2 microscopic
features
• Smooth muscle fibre
• Hyperplasia (spindle
shaped cells)
b. What is your diagnosis
?
Leiomyoma of the
uterus
c. What is the behaviour of
this lesion ?
Begnin tumor
This is a microscopic view
of lung from an HIV Q 8.
positive patient who
died of pneumonia.
a. What salient feature
does it show ?
• Distorted alveolar wall
• Hemorrhage due to
rupture of capillaries
• Alveolar macrophages
a. What is the diagnosis ?
• CMV pneumonia
a. What is the causative
agent?
• Cytomegalovirus
(CMV)
SECTION C
Question 9-12
a. Identify the structure
Q 9.
Gross section of the
lung
b. Describe the 2 gross
abnormal features
1. Cheesy white
apperance (extensive
caseous necrosis)
2. Brownish areas, normal
c. List two differrential
diagnoses?
1. Asbestosis
2. Aspergillosis
This is microscopic feature
of the case in Q 9. Q 10.
a. Describe 3 microscopic
features
1. Langhans giant cells
2. Area of caseous necrosis
3. Infiltration of inflammatory
cells
b. What is your diagnosis ?
1. TB
c. What 2 methods would you
carry to confirm your
diagnosis ?
1. ZN Stain
2. Culture
3. Auramine stain
This is a special stain of
the case in Q 10. Q. 11
a. What is the name of
the stain ?
1. ZN Stain
b. What does it show ?
1. AFB
2. Lymphocytes
c. Name 2 species of
this agent
1. M.tuberculosis
2. M. bovis
This is a section of kidney
a. What 2 abnormalities Q 12.
does it show ?
1. Area of necrosis
2. Hemmorhage
a. What is the name given
to this condition?
1. Coagulative necrosis
a. List 2 predisposing
conditions which may
cause this change.
1. Bacterial infection
2. Renal infarction
SECTION D
Question 13-16
This is a microscopic
picture of the case
Q 13.
above.
a. Describe 2 salient
features.
1. Inflammatory cells
2. Area of coagulative
necrosis, renal
tubule fade away
a. What is the name
given to this
pathological change
?
coagulative necrosis
Q 14.
This is a lymphnode section
of 28 years old male
a . What 2 features does it
show ?
RSC, lymphocytes
b. What does the arrow
show ?
RSC
c. What is the diagnosis?
HD
 Q 15.
This is a microscopic picture of an
ulcerating tumour of skin
a. List 3 features which are
suggestive of malignancy
seen here.
• TRIPOLLAR MITOTIC FIG,
LEUKOCYTES, EDEMA
b. If this were an epithelial
tumour what would be the
diagnosis ?
• CARCINOMA OF THE SKIN
(MELANOMA)
c. How would you grade this
tumour ?
MALIGNANT TUMOR
This is autopsy liver specimen
a. Describe 2 salient
Q 16.
feature seen
• Multiple Tumors
• Necrosis
b. What is the possible
diagnosis ?
• Liver metastasis
c. By what route have these
lesions reached the site?
• Hepatic Portal vein
d. Where does it originate?
• Tumors of the GIT, skin
and pancreas
SECTION E
Question 17-20
Neck lymphnode section Q 17.
from a 5 years child with
recurrent tonsillitis
a. What 2 features does it
show ?
• Large pale germinal
centre
• Paracotical zone
b. What is the diagnosis?
• Follicular hyperplasia
c. List the 2 cells found in
the pale inner zone
• Plasma cells
• B lymphocytes
Incised fluctuant swelling Q 18.
on the chest and a
section taken.
a. Describe the salient
feature seen.
1. Hemorrhage
2. Inflammatory cells
3. edema
b. What is the diagnosis ?
1. Acute infl.
a. What 2 investigations
would you carry out to
establish the causative
agent ?
• Blood culture
This is a section of liver. Q 19.
a. Describe the microscopic
features
• Fatty vacuoles
• Few normal hepatocytes
b. What is the diagnosis ?
• Hepatic fatty change
c. Which 3 conditions may
cause this morphology of
liver cells.
• Alcoholism
• Kwashiorkor
• Diabetes mellitus
This is a section of cervical biopsy from
a 34 years old woman. Q 20.
a. What 2 features does it show ?
• Normal squamous cells of the cervix
(normochromatic left side)
• Dysplastic squamous cells
(hyperchromatic right side)
b. What is the name of this condition ?
• Cervical dysplasia
c. What is the significance of such a
lesion ?
• The road towards to neoplasia
(carcinoma of the cervix)
• This is a section of the
liver Q.21
a. Identify 3 salient
features
• Kupffer cells (spindle
shaped)
• Hepatocytes
• Hemosiderin (iron
accumulation)
b. What is the diagnosis
• Hemachromatosis
(pigment cirrhosis)
c. Mention possible causes
• Hemolytic anemia
• Excess iron intake
• Excess blood transfusion
• Impaired iron utilization
a. Identify the structure Q. 22
• Gross section of the colon
b. Identify the possible features
• Pseudopolyps
• Colonic atrophy of the lower right
portion
c. What is the diagnosis
• Ulcerative colitis
d. What is the cause?
• Idiopathic
e. Mention 2 possible complications
• Anemia
• Hypoproteinemia
• Electrolyte imbalance
• A cross-section from the
Q.23
previous case
a. Identify the salient
features
• Inflammed mucosa
grandular lumen
• Grandular infiltrated
neutrophils
• Hemorrhage
b. What is the diagnosis?
• Active ulcerative colitis
a. Identify the structure Q.24
• Gross-section of the left
ventricle of the heart
b. Identify the salient features
• Hypertrophy of the left
ventricle
• Narrowing of the ventricular
lumen
c. What is the diagnosis
• Systemic hypertension
d. Mention the possible
causes
• Increased workload
• A 51 years old male had
chronic cough and a lung
Q.25
biopsy was taken. Examine
the diapositive.
a. Describe the microscopic
findings
• Non-caseous glanuloma
• Inflammatory cells
• Epithelioid cells
• Giant cells
b. What is your diagnosis ?
• Sarcoidosis
c. Mention one complication
associated with this condition
• Pneumonia
• A 62 years old male had diabetes
mellitus and blackening of the lower Q. 26
extremities. A portion of the leg was
amputated. Examine the Dia-positive
a. Describe the Gross morphological
features
• Ischemia
• Cyanosis
b. What is this condition called ?
• Gangrenous necrosis (Dry)
c. Mention the two types of this condition
• Dry gangrenous necrosis (e.g.
diabetes mellitus)
• Wet gangrenous necrosis (e.g.
clostridium perfringes)
 Q. 27
• A 32 years old male who previously
suffered from pulmonary tuberculosis
and was successfully treated has since
recently developed increasing
dyspnoea. This is a histological section
of a biopsy taken from him.
a. Identify the organisms seen
• Aspergillus spp
b. Mention 2 mechanisms of tissue
destruction
• Invasiveness due to hyphae
• Toxic production (aflatoxin B- a
carcinogen)
c. Mention 2 stains used for the
diagnosis
• Gram stain
• India ink stain
a. Identify the structure Q.28
• A gcross section of the
heart
b. Mention 2 salient features
of the organ
• Opened pericardium
• Thin strands of fibrinous
exudates
• Purulent inflammatory
exudates
c. What is the diagnosis
• Fibrinous pericarditis
a. Identify the structure Q.29
• Cross section of the heart
showing the valves
b. Mention 2 salient features
• Irregular reddish tan
vegetations
• Deformed valves
c. What is the diagnosis?
• Acute bacterial infective
endocarditis
d. What is the possible
complication?
• Emboli formation due to
vegetation breaking off
• Heart failure
 Burkitt’s Lymphoma
“Starry Sky Appearance” (Wright stain)
 Burkitt’s Lymphoma
“Starry Sky Appearance” (H&E)