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Send Up 4th Year MBBS 2015-10-06,

Special Pathology
Allama Iqbal Medical College, Lahore
A 65 year old female presents with bilateral ovarian masses. Gross appearance reveals bilateral
lobulated ovaries. Microscopy reveals fibrous stroma with singly scattered signet ring like cells
containing mucin:
a.
What is the most likely diagnosis? (1)
b.
Classify ovarian tumors in detail. (4)
A 45 years old female presents with irregular vaginal bleeding. Endometrial curettage was
performed which reveals hyperplasia:
a.
What are the various types of endometrial hyperplasia? (2)
b.
Tabulate the differences b/w type I and type II endometrial carcinoma. (3)
A patient presents with amenorrhea. Ulatrasonography reveals no fetus in the uterus. There are
multiple grape like structures seen. Beta HCG levels are raised:
a.
What are the differences b/w partial and complete mole? (2)
b.
Give gross and microscopic features of choriocarcinoma. (3)
a.
What is the microscopic picture of glomerular changes in diabetes? (3.5)
b.
Give WHO criteria for diagnosis of diabetes mellitus. (1.5)
A 40 year old female is brought to emergency department with H/O rapid onset of respiratory
distress and cyanosis. Laboratory investigations reveal severe hypoxemia. She does not respond to
oxygen therapy and gradually develops multisystem organ failure. She is diagnosed to have ARDS.
a.
Enumerate clinical disorders associated with development of ARDS. (3)
b.
Give pathogenesis of ARDS. (2)
a.
Classify lung carcinoma. (3)
b.
Give microscopic features of carcinoid tumor of lung. (2)
A 20 years old female presents with a painless, mobile, well circumscribed hump in her left breast.
On palpation it slips between the fingers.
a.
What is the most likely diagnosis? (1)
b.
What are the microscopic findings in this breast lesion? (2)
c.
What are different types of ductal carcinoma in situ? (2)
A 40 years old female visits her physician due to diffuse , painless enlargement of thyroid gland.
Laboratory investigation shows low levels of T3 & T4 and raised TSH. She is positive for antithyroglobulin and anti-thyroid peroxidase antibodies:
a.
What is the most likely diagnosis? (1)
b.
Give pathogenesis of this disorder. (4)
A 60 year old male develops frequency of micturition, urgency , overflow incontinence and
nocturia. Digital rectal examination reveals nodular prostatic enlargement. Serum PSA is <4 ng/dl
a.
What is the most likely diagnosis? (1)
b.
How will you differentiate BPH from prostatic carcinoma microscopically? (4)
a.
Classify renal cell carcinoma. (2.5)
b.
Describe morphology of clear cell carcinoma. (2.5)
A 10 year old boy abruptly develops malaise, fever, nausea and passage of small amount of cola
colored urine two weeks following sore throat. Urine examination reveals mild proteinuria and
RBCs casts:
a.
What is the likely diagnosis? (1)
b.
Describe microscopic features of this lesion. (4)
A 35 year old female gradually develoips malaise, fatigue and generalized musculoskeletal pain.
After few months, she develops swelling, pain and morning stiffness in her metacarpophaolangial
and proximal interphalangial joint of both hands. Labortary tests are positive for rheumatic factor
and anti-CCp antibody
a.
What is the likely diagnosis? (1)
b.
Describe pathogenesis of this disorder. (4)
a.
Define muscular dystrophy. (1)
b.
Write a short note on Duchenne muscular dystrophy. (4)

Muhammad Kamran Mehwar