Pathology case compilation
Paper 1
• Case : septic shock
A 60-year-old male with a history of diabetes is admitted with fever,
confusion and weakness. He is found to have a urinary tract infection and
his blood pressure is 90/55 mmHg despite fluid resuscitation. He is having
tachycardia, tachypnea and has warm, flushed skin. Blood culture are
positive for E. coli.
1 What is the likely diagnosis of patient's current condition? Why?2
2 Enlist complications of diabetes mellitus?3
3 Explain pathogenesis of the patient's current condition.5
4 Enumerate the investigations required for further management.3
• Case : septic shock
20-year female was admitted with high grade fever and hypotension. Blood
culture showed gram negative bacteria. She died due to multiple organ
failure.
a) What is the Diagnosis?2
b) Define and Classify this condition.3
c) Discuss the Etiopathogenesis of this condition(5)
d) Discuss the Pathophysiology of this condition(4)
• Case : septic shock
A 92 yr old woman is brought unconscious to the emergency room from a
nursing home. Her BP is 70/30 mm Hg. She is febrile (38°C) and tachypneic.
Laboratory studies demonstrate a WBC count of 22000/cmm with 92%
neutrophils.
i. What will be the probable diagnosis? (2 marks)
ii. Enumerate the various types and discuss the pathophysiology of given
condition. (2+3 marks)
iii. Describe the morphological changes in this condition. (4 marks)
iv. Which other studies are indicated in the workup of given condition? (2
marks)
• Case : amyloidosis
56-year-old male admitted with history of shortness of dyspnea &
increasing productive cough for the last one month with h/o foul smelling
expectoration since last 10years. On examination he is poorly built&
nourished, temperature 100.2 degree F, pulse rate- 90/min, Respiratory rate
26/min. He has pallor, pedal edena 2+, grade2 clubbing of fingers, Blood
report showed leukocytosis, hyperlipidemia, hypoalbuminaemia and
proteinuria (4.5 gm./day). Renal biopsy done & advised for congo red stain.
(i) Give the most probable diagnosis. (1)
(ii) Write clinicopatholgicalclassification of this condition. (4)
(iii) Explain pathogenesis of this diseases (4)
(iv) Write morphological changes in kidney (2)
(iv) What are specific investigations required to confirm your diagnosis?(2)
• Case : inflammation
45-year-old diabetic male presents to the emergency department with
complaints of redness, swelling and pain around his right lower leg, which
began 2 days ago after he sustained a minor injury caused an open wound,
while working outdoors. He reports that the area has become increasingly
painful, and he has developed a fever over the past 24 hours. Upon
examination, there is localized erythema, edema, and tenderness over the
affected area. Lymphadenopathy is noted in the inguinal region. Blood
investigations show a WBC count of 18,000 cells/mm³, elevated C-reactive
protein (CRP) and neutrophilia.
a) What event/ reaction is happening at the site of injury? Define it and
mention the cardinal signs of reaction (1 mark)
b) How does local tissue respond in form of cellular and vascular event?
Discuss it in detail. (6 marks) (4
c) Discuss the various morphological patterns (types) seen in such
reaction/condition. (4 marks)
(d) Write possible outcome of this type of reaction/ condition in brief. (2
marks)
• Case : SLE
25 years female patient presented with fatigue, rashes on bridge of nose
and both cheeks, joint pain and blood picture showed pancytopenia. (13
marks)
A) What is the probable diagnosis?(1 mark)
B) Describe the etiopathogenesis of the disease. (4 marks)
C) Describe the first lab diagnostic test which was done earlier in patients
diagnosed with this disease.(3 marks)
D) Write the immunoflurescence patterns seen in blood of such patients. (1
mark)
E) Describe the morphology of major lesions seen in this disease. (4 marks)
• Case : TB
A 30-year-old female presented with a one month history of productive
cough, chest pain, evening rise fever, anorexia, and weight loss.On
examination: Cervical lymph node enlargement, multiple, matted, firm in
consistency.X-Ray Chest showed patchy areas of consolidation in the right
lung.
1) What is your diagnosis based on the above clinical finding?(2Marks)
2) Describe the pathogenesis of the given condition(4 marks)
3) Describe microscopic finding and draw a labelled diagram (4 Marks)
4) Write the difference between acute and chronic inflammation (3 Marks)
Paper 2
• Case :MI
45/male patient admitted with chest pain,palpitation and hypotension.
ECG showed ST elevation. Serum Troponin marker raised.
1. What is probable diagnosis(1 mark). Describe the risk factors in this case.
(2 marks)
2. Describe the expected gross and microscopic findings in this case?(4
marks)
3. Which type of necrosis seen in this case? Different types of necrosis.(2
marks)
4. Describe the diagnostic tests in this case? (2 marks)
5. Describe possible complications in this case?(2 marks)
• Case : MI
A 70-year-old male presented in emergency with severe chest pain for the
last 2 hours. The pain was radiating to the left arm He was complaining of
dyspnea at the same time and had vomited at the start of the pain.
Pule 90/min, Respi. Rate 28/min
Chest-creps all over the chest, no pericardial rub
Family history: Father died of the same pain at the age of 55
Personal history: history of smoking 5-6 cigarettes a day for 10 years
1) What is your probable diagnosis?(2 Marks)
2) Describe laboratory investigations to confirm your diagnosis(4 Marks)
3) Describe the gross and microscopic features of the heart in the above
condition(5 Marks)
4) Write the complications(2 Marks)
• Case : MI
A 45 years old male presented with history of chest pain radiating to left
arm & jaw. ECG was done and showed ST segment elevation.
a. What is probable diagnosis? (1 mark)
b. Enumerate the investigations to prove the diagnosis. (5 marks)
c. Describe the etiopathogenesis of this conditions. (5 marks)
d. Enumerate 4 complications that occur due to this condition. (2 marks)
• Case : CML
A 50-year-old male presented with fatigue, night sweats, weight loss and a
sensation of abdominal fullness. On physical examination, he has
splenomegaly. His total leukocyte count is 1,20,000/µL with shift to left. In
differential count, 5% cells were having large granules covering their
nucleus.
1 What is the most likely diagnosis? Why?2
2 Which other tests may be required to confirm the diagnosis?2
3 Explain different stages of this disease with associated laboratory
findings.6
4 Classify myeloproliferative disorders.3
• Case : beta thalassemia
A 14-year-old boy is admitted to the hospital with a 2-day history of severe,
throbbing pain in his lower back, chest, and legs. His mother mentions that
he has had similar episodes of pain in the past, usually triggered by
infections or exposure to cold. On physical examination, the boy appears
pale, and yellowish discoloration is noted in the sclera. He has mild
splenomegaly and tenderness over the long bones. His past medical history
includes multiple hospitalizations for pain management and frequent
episodes of upper respiratory tract infections. Family history reveals his
brother died after having some similar kind of blood disease
Laboratory findings include:
Hemoglobin: 7.5 g/dL
Reticulocyte Count: 12%
Perpheral smear shows crescent shaped red cells
Bilirubin: Total: 4.2 mg/dL, Indirect: 3.5 mg/dL
Hb Electrophoresis: HbS: 70%, HbA: 24%, HbF: 6%
a) What is the diagnosis?
b) Discuss the pathogenesis of this disease.
c) Write morphological changes (findings) seen in peripheral smear and
spleen.
d) Discuss the potential complications that can arise in this patient.
e) Explain the causes behind yellow sclera and high indirect bilirubin level.
f) Write the the cause of elevated reticulocyte count related to this
underlying disease.
• Case : cirrhosis
A 50-year Male with history of Chronic Alcohol Consumption presented with
distended abdomen. USG show reduced size of Liver.
1. What is probable Diagnosis?02
2. Describe the Pathophysiology and Pathogenesis of this condition.05
3. Describe the Morphological findings of this condition.04
4. Enumerate Complications of the condition.02
• Case : carcinoma of breast
52 yr, old female complaints of painless lump in the breast since 6 months.
The lump is irregular, firm to hard, slightly mobile with puckering of
overlying skin. (1+3+7+2=13 marks)
1. What is the your diagnosis ? (1 mark)
2. Write the etiological/ risk factors. (3 marks)
3. Write the Classification and morphologic (gross and microscopic)
features. (7 marks)
4. Discuss the prognostic factors for the same. (2 marks)
