Year 2 MCD 2017
SBAs
1. A 50 year old man has vomiting, peripheral blood shows target cell and what is the
condition (Anaemia of Chronic Disease, Renal disease, Liver Disease)
2. A patient with increased white cell count and increased neutrophil has pneumonia what
can you see in a peripheral blood film (Toxic granulation, atypical lymphocyte, right shift)
3. How is B12 administered (IV, SC, IM, PO)
4. A refugee with parasite infections what cells will be increased? (neutrophil, basophil,
eosinophil, monocyte)
5. A 35 year old man in the private clinic tested normal white blood count normal
haemoglobin normal platelets but HBA2 increased what is the possible diagnosis?
6. Patient with normal PT, normal platelet, increase APTT, complained severe bleeding
after tonsillectomy when younger. Factor 8 is normal, what to look next (Factor 12,
Factor 9, Factor 5, Vitamin K)
7. A middle aged male is found to have an Hb of 195 g/L (normal range 133-167). He is
found to have a low serum erythropoietin concentration. Which diagnosis does this
suggest? (Polycythaemia vera, Renal cyst)
8. What is the mechanism of action of warfarin
9. 35 year old mother pregnant 35 week old baby, need blood transfusion, what causes her
to develop anti D antibody?
10. What is the best diagnostic test for dehydration? (Urea, Creatinine, etc(
11. In the histopathology laboratory, how are sections prepared if a very urgent diagnosis is
needed in the operating theatres? (Frozen, Formalin)
12. What happens in the mutation of Ras?
13. Cancer sketch (on the right), in terms of prognosis what is it?
(high grade, low grade, malignant, well differentiated,
moderately differentiated)
14. TNM system of staging cancer what is the worst prognosis (a
list of different options)
15. hat stage of cell cycle is when DNA replicated ?
16. What is the main side effect of chemotherapy? (Alopecia,
etc)
17. Metaphase checkpoint, what is being checked for? (spindle attachment and alignment)
18. Epidermal growth factor mutation and increased cell signalling pathway without the
presence of growth factor on what is the type? (Proto oncogene/TS/oncogene)
19. Breast cancer screening what type of modality (CT, Low dose Xray, MRI)
20. what is the cytogenetic analysis of chronic myelocytic leukaemia
21. How does UV light reduce inflammatory? immune? (IL-8, B cell, Langerhan cell)
22. What condition causes impairment in DNA repair –X pigmentosum
23. Which gene most determined the response for organ transplant
24. What is anaphylaxis
25. Definition of Tumour Associated Antigen
26. What hypersensitivity disorder is the immune complex deposited in vessel walls
27. What is the mechanism of poxvirus that evade immune response?
28. What organism causes syphilis?
29. How is legionella pneumophila transmitted?
30. Definition of Nosocomial infection
J.J Teh
31. What is the most common metaparasites in the world?
ARQ
Assertion: Immune responses against tumour-expressed antigen may result in autoimmune
disease
Reason: All tumour antigens are self-proteins
Assertion: Polymorphism in gene for interferon lead to infection to otherwise mild infection
(paraphrased)
Reason: Large DNA viruses have multiple mechanisms for interferon antagonism
Assertion: All stages of cell cycle needed GF (Paraphrased)
Reason: Exit of G0 into cell cycle required GF stimulation
Assertion: In the lug, the haemoglobin molecule is in relaxed, quaternatary form.
(Paraphrased)
Reason: 2,3 DPG binding increase affinity of haemoglobin to bind to oxygen
Assertion: Increase ALP and AST level indicated cardiac problem
Reason: Normal people have low ALP, AST level
Assertion: Adenoma is a form a metaplasia
Reason: Metaplasia is reversible change from one adult cell type to another
Assertion: Apoptosis involved CASPASES, which is ysteine dependent aspartate directed
proteases
Reason: Procaspases are found in mitochondria, activated when membrane potential
changes
Assertion: Alpha thalassemia syndrome is present in utero (Paraphrased)
Reason: Alpha globin gene is one of the type of chain found in HbF in utero
SAQ
Question One: Haem
a) Low Hb, Normal WCC, Normal Platelet – name 3 clinical features and the associated
mechanisms for anaemia (3 marks)
b) She has increased reticulocytes and increase LDH – what is your top differential, explain
why she has increased reticulocytes and increased LDH (3 marks)
c) She requires packed red cells, what temperate it is stored and why? (2 marks)
d) Give two reason why she is not given whole blood transfusion? (2 marks)
Question Two: Microbiology
a) Example of Coccidiae that is important to human (lol), what condition does it cause and
give two clinical features (4 marks)
b) What are the two types of leishmaniasis and give features of each (4 marks)
c) What is the parasite vector for B and describe how? (2 marks)
J.J Teh
Question Three: Immunology
a) Define hypersensitivity and name the 3 groups of antigens affected (2 marks)
b) Fill in a table- say what each hypersensitivity is (type I-IV) and say what the mechanism is
(4 marks)
c) Give an example of a disease for type II and III and state what antigen is targeted (4
marks)
Question Four: Cancer
a) P53 is overexpressed in many cancers, despite being a tumour suppressor gene. What is
a tumour suppressor gene and what does it do? Explain how p53 overexpression leads
to cancer? (3 marks) (Greatly paraphrased)
b) Describe the function of Rb protein in cell cycle (4 marks)
c) What are the TWO functions of beta-catenin and what is the protein molecule used to
degrade it? (3 marks)
Question Five: Haem
a) Given a picture of leg with petechiae, 19yo women, Low platelet, normal WCC, normal
Hb, what is the diagnosis? (1 mark)
b) Explain the function of platelet in haemostasis using Glp1a/2a, Glp1b, Glp2b/3a (5
marks)
c) What is the MoA of aspirin? (2 marks)
d) She then developed severe anaemia, required blood transfusion, she is blood type AB,
Rh negative, but there is no AB blood in the bank, what two other things you can give?
(2 marks)
Question Six: Cancer
a) Name three types of Skin cancer (3 marks)
b) What does this show (1 mark)
c) Describe the mechanism in which UV light causes pathogenesis of skin cancer (2 marks)
d) How is HPV infection cause skin cancer? (2 marks)
e) What is epidermodysplasia verruciformis and what is the characteristic feature? (2
marks)
J.J Teh
