SPECIAL PATHOLOGY

Tutorial-1(CBD)
Blood vessel pathology
 1- A 49-year-old man is feeling well when he
visits his physician for a routine health
maintenance examination for the first time in 20
years.On physical examination, his vital signs are
temperature, 37°C; pulse, 73/min; respirations,
14/min; and blood pressure, 155/95 mm Hg. He
has had no serious medical problems and takes
no medications?
• a-What is the type of hypertension in this patient
and describe the morphology of the lesion in the
arterioles.
• b-Explain blood pressure control.
2-An 80-year-old man with a lengthy history of smoking
survived a small myocardial infarction several years
ago. He now reports chest and leg pain during
exercise. On physical examination, his vital signs are
temperature, 36.9°C; pulse, 81/min;respirations,
15/min; and blood pressure, 165/100 mm Hg.
Peripheral pulses are poor in the lower extremities.
There is a 7-cm pulsating mass in the midline of the
lower abdomen. Laboratory studies include two
fasting serum glucose measurements of 170 mg/dL
and 200 mg/dL.
• a.Which main pathologic process is responsible for the
vascular lesion in this patient?
• b.Give brief description of pathogenesis of this
process
3-While cleaning debris,a 50-year-old man cuts his right
index finger on a sharp metal part. The cut stops
bleeding within 3 minutes, but 6 hours later he notes
increasing pain in the right arm and goes to his
physician. On physical examination, his temperature
is 38°C. Red streaks extend from the right hand to the
upper arm, and the arm is swollen and tender when
palpated. Multiple tender lumps are noted in the
right axilla. A blood culture grows group A hemolytic
streptococci.
• a.What is the pathological lesion that is occurring in
this patient's right arm?
• b.Describe pathogenesis of ANCA mediated vasculitis
 SPECIAL PATHOLOGY

Tutorial-2(TBL) and assessment

Blood vessel pathology
Read questions and give the answer
 Blood vessel pathology
• What are function of endothelium
• What is meant by dysfunctional endothelium
• What are risk factors of atherosclerosis
• Discuss pathogenesis of atherosclerosis
• How do you explain plaque change
• What is aneurysm
• Explain dissection of aorta
 Blood vessel pathology
• Describe pathogenesis of aneurysm
• Describe pathogenesis of vaculitis.
• Give different stages of development of Kaposi
sarcoma
• What are different types of vasculitis.
HEART &SKIN PATHOLOGY

TUTORIAL-1(CBD)
 HEART
1-A 50-year-old man experiences episodes of severe
substernal chest pain every time he performs a task that
requires moderate exercise. The episodes have become
more frequent and severe over the past year, but they can
be relieved by sublingual nitroglycerin. On physical
examination, he is afebrile, his pulse is 78/min and
regular, and there are no murmurs or gallops. Laboratory
studies show creatinine, 1.1 mg/dL; glucose, 130 mg/dL;
and total serum cholesterol, 223 mg/dL.
• a-What pathologic lesion can be found in his coronary
arteries
• b- Give brief description of angina
 HEART
2-A54 yrs old man was admitted to the hospital for
transmural myocardial infarction. He suddenly
becomes short of breath on fourth day of
admission. Physical examination reveals
hypotension, elevated jugular pressure and
muffled heart sound. Aspirated pericardial fluid
was hemorrhagic.
• a-What lesion was responsible for these
symptoms.
• b-Enumerate complications of myocardial
infarction
 SKIN
• A 35 yr old woman has 5mm, tan to brown uniformly
pigmented macular lesions with well-defined rounded
borders on her upper arm and chest without any
symptoms since many years. A punch biopsy of the
lesion shows aggregates of uniform rounded cells
along dermoepidermal junction. Nuclei of these
nevus cells are rounded and uniform with no mitotic
activity.
• a-What is the morphologic type of this nevus?
• b-Describe microscopic features of Dysplastic nevus
• c. What are the alarming signs in a nevus that should
drag clinician’s attention towards malignant melanoma
TUTORIAL-2(TBD) AND ASSESMENT
HEART AND SKIN PATHOLOGY

READ QUESTIONS AND GIVE ANSWERS

 QUESTIONS-Heart
• What are mechanism of cardiac dysfunction
• What is pathophysiology of hypertrophy,
leading to heart failure.
• What is difference between right and left
heart failure
• What are main features of Tetrology of Fallot
• What is pink tetrology
• What is coartation of aorta
• What are consequences of ischemia
 HEART
• What are morphological type of myocardial
infarction
• What do you mean by cardiac reperfusion
• What are complications of myocardial
infarction
• What are different type of vegetation on heart
valve
• What are cardiac myopathies