DEPARTMENT OF PATHOLOGY

GOVERNMNET MEDICAL COLLEGE, KHAMMAM

Patient is 19 years of age and a college hosteller presented to OPD with flu-
like symptoms of headache, low-grade fever, nausea, loss of appetite, and
malaise. Her urine is dark than usual and stools are pale in color.
On examination she has temperature of 99.7°F; other vital signs were
within normal limits. Abnormal physical findings included mild icterus of
sclera and skin, abdominal tenderness, hepatomegaly, and palpable spleen.
Results of laboratory tests are

Test Patient's Results Normal Value or Range

Hematocrit (Hct) 40% 37% to 47%
Hemoglobin (Hgb) 13.3 mg/dL 12.0–16.0 mg/dL
White blood cell count 6200 cell/ 4300–10,800 cells/microliter
microliter
Aspartate aminotransferase 323 Units/L 5–40 Units/L
(AST)
Alanine aminotransferase 358 Units/L 5–35 Units/L
(ALT)
Total bilirubin 3.7 mg/dL 0.2–1.6 mg/dL
HBsAg Negative Negative
HBsAb Positive positive indicates previous disease or
immunization;
negative indicates no exposure
Anti-HAV IgM Positive Negative
Anti-HCV antibody Negative Negative
Alkaline phosphatase 85 Units/mL 30–115 Units/mL
(ALP)
Prothrombin time (PT) 11.6 seconds Control 10.4 seconds
normal is ±2.0 seconds from control)
Albumin 3.8 mg/dL 3.5–5.5 mg/dL

What is the probable diagnosis?

How do you confirm the diagnosis?

 DEPARTMENT OF PATHOLOGY
GOVERNMNET MEDICAL COLLEGE, KHAMMAM

A 48 yr. old male blood bank technician reveals hyperlipidemia on his

annual checkup, in view of which a Liver function test was done , liver
profile reveals an AST of 226 Units/L and an ALT of 282 Units/L. He. is
an alcoholic with a hepatitis profile of negative anti-HAV, negative HBs
Ag, positive HBs Ab, and positive anti-HCV.

What is your diagnosis?

What is the gold standard technique for diagnosing?

 DEPARTMENT OF PATHOLOGY
GOVERNMNET MEDICAL COLLEGE, KHAMMAM

1. Identify each of the signs and write the probable diagnosis?

 DEPARTMENT OF PATHOLOGY
GOVERNMNET MEDICAL COLLEGE, KHAMMAM

Given below is the seromarker graph .Identify the disease and explain
the infectivity with sero markers.
 DEPARTMENT OF PATHOLOGY
GOVERNMNET MEDICAL COLLEGE, KHAMMAM

30 years female with history of fever, cough with expectoration, headache and
altered sensorium.

CSF Analysis:
Colorless,
opalescent with cob web formation.
Cell count: 2000 cells/cu mm

Biochemistry:
Sugar: 20mg% (50-80mg%)
Protein: 50mg%(15-45 mg%)
Chloride: 800meq/L(120-130meq/L)

Wet preparation : Shows good number of lymphocytes.

Question:

1.What is your diagnosis?

2.Name the organisms causing this condition?

3.Name relevant investigations done for this condition?

 DEPARTMENT OF PATHOLOGY
GOVERNMNET MEDICAL COLLEGE, KHAMMAM

15 years male with history of fever, vomiting and headache

photophobia.

CSF Analysis:
Colorless, Turbid
Cell count: 5000 cells/cu mm

Biochemistry:
Sugar: 5mg% (50-80 mg%)
Protein: 70mg %( 15-45 mg %)
Chloride: 110meq (120-130meq/L)

Wet preparation: Shows good number of neutrophils.

Question:

1.What is your diagnosis?

2.Name the organisms causing this condition?

 DEPARTMENT OF PATHOLOGY
GOVERNMNET MEDICAL COLLEGE, KHAMMAM

40 years male with history of hypertension and altered

sensorium. CSF Analysis:

Reddish, opalescent, Xanthochromia

Cell count: Contaminated with RBC’s

Biochemistry:
Sugar- 70 mg% (50-80 mg %)
Protein- 70 mg%(15-45 mg%)
Chloride-750 m.eq/liter (120-130 m.eq/liter)

Wet preparation: Shows sheets of RBC’s and occasional lymphocytes.

Question:

1.What is your diagnosis?

2.What is the Etiology of this condition?

3.Name relevant investigations done for this condition.

 DEPARTMENT OF PATHOLOGY
GOVERNMNET MEDICAL COLLEGE, KHAMMAM

32 years male C/O no issues. Married life – 7 years

Physical examination Test Result Normal range

Volume 2 ml 1.5 ml
Liquefaction time 40 min 15-60 min
Appearance- Grey White or grey , viscious
PH alkaline 7.2 – 8
Microscopic examination

Sperm count 3 million >15 millions

Sperm motility 20% PR motile >30 %

Sperm viability 60% >54%

Sperm morphology 40% normal forms >4 %
Agglutination nil

Biochemical test
Fructose test positive
Acid phosphate
Leucocytes: Nil <5 /HPF
RBC: Nil

1.What is the diagnosis?

2.What are the causes of infertility?

3.Discuss about Semen Banking?

 DEPARTMENT OF PATHOLOGY
GOVERNMNET MEDICAL COLLEGE, KHAMMAM

22 year old college student was experiencing extreme fatigue with history of anemia and
intermittent blood streaked stool.
Describe peripheral smear and identify the condition.

1..Write peripheral smear report

2. What is your diagnosis?

 DEPARTMENT OF PATHOLOGY
GOVERNMNET MEDICAL COLLEGE, KHAMMAM

33 year old woman with fatigue, loss of appetite, tingling numbness of feet and
hands. Describe peripheral smear and identify the condition

1.write peripheral smear report?

2.what is your diagnosis?

 DEPARTMENT OF PATHOLOGY
GOVERNMNET MEDICAL COLLEGE, KHAMMAM

5 year old child was bought to the hospital with history of jaundice
since one year of age and episodes of severe pain in tips of fingers
and toes.
Investigations revealed:

Hemoglobin: 5 gm/dl.
PCV: 15%
RBC count : 1.7 million/cumm
Serum total Bilurubin: 2.5 mg/dl
Serum bilirubin (D) : 0.3 mg/dl

Peripheral smear:

1.What is your diagnosis ?

2.Name two special tests you would do?

3.What is the molecular defect in this condition?

 DEPARTMENT OF PATHOLOGY
GOVERNMNET MEDICAL COLLEGE, KHAMMAM

A 2-year-old child presented with a history of fever and puffiness of face

which started around peri-orbital area (which is more during morning) and
gradually progressed to rest of the face which decreases by evening. The
toddler had decreased urine output (oliguria). On examination, pitting type
of edema was present over lower limbs and swelling over face was present.
Based on the clinical presentation, biochemical parameters& urine analysis interpret
the case:

Interpretation:
 DEPARTMENT OF PATHOLOGY
GOVERNMNET MEDICAL COLLEGE, KHAMMAM

23year-old woman presents to her doctor complaining of increased urinary frequency,

dysuria and sensation of incomplete voiding since 2 days. H/O fever on and off with
chills present.
Her Complete Urine Analysis report is given below.

Correlate with the history and interpret the report:

INTERPRETATION:
 DEPARTMENT OF PATHOLOGY
GOVERNMNET MEDICAL COLLEGE, KHAMMAM

A 53 yr. old male patient working as bank manager complains of dull aching pain in hand,
with profuse sweating and chest heaviness.
The cardiac function tests done revealed the following findings, give your probable diagnosis.

TROPONIN T Elevated

CK MB Elevated
 DEPARTMENT OF PATHOLOGY
GOVERNMNET MEDICAL COLLEGE, KHAMMAM

Cervical smear revealed good number of squamous epithelial cells with large hyperchromatic
irregular nuclei. Many tadpole cells are also seen. Background shows neutrophils and necrotic
debris.

1.What is your diagnosis?

2.What is the etiology of this condition?

 DEPARTMENT OF PATHOLOGY
GOVERNMNET MEDICAL COLLEGE, KHAMMAM

25 years male with history of fever since 3 months and

loss of weight. FNAC FROM CERVICAL
LYMPHNODE
LEISHMAN STAIN & ZN STAIN:
Smears show moderately cellular aspirate comprising of good number of oval cells with
vesicular elongated nuclei in small clumps. Background shows lymphocytes and granular
necrotic debris.
ZN stain for AFB-Positive

1.What is your diagnosis?

2. What is the Etiology of this condition?

3. Name relevant investigations done for this

condition
 DEPARTMENT OF PATHOLOGY
GOVERNMNET MEDICAL COLLEGE, KHAMMAM

70 year old male patient with history of diabetes and

hypertension presented with acute severe left upper
abdominal pain with vomiting’s and nausea. Below given is
the specimen of spleen.

1.Identify the above lesion?

2.Name another organ which shows similar findings?
3.What is the major histological finding in above lesion?
 DEPARTMENT OF PATHOLOGY

GOVERNMNET MEDICAL COLLEGE, KHAMMAM

A 65 year old male patient with known history of chronic right heart failure and
tricuspid regurgitation presented with right abdominal pain. Below is the specimen of liver with
its histomorphology.

1. What is the term used to describe the liver?

2. What is the reason for this appearance?
3. What is the probable diagnosis?
 DEPARTMENT OF PATHOLOGY
GOVERNMNET MEDICAL COLLEGE, KHAMMAM

Below is the specimen of spleen and its histomorphology

1.Identify the disorder in the spleen based on the above images?

2.Name the special stains used to identify the substance deposited?
3.Describe how this substance appears under a polarizing microscope?
 DEPARTMENT OF PATHOLOGY
GOVERNMNET MEDICAL COLLEGE, KHAMMAM

55 year old chronic alcoholic presented with jaundice , protrusion of abdomen , hematemesis
examination ultrasound revealed ascites, massive splenomegaly 4 cm below the left coastal
margin with COL, upper GI endoscopy revealed esophageal varices. Splenectomy was done
which revealed…

1.What is your diagnosis?

2.What are the causes for splenomegaly?
 DEPARTMENT OF PATHOLOGY
GOVERNMNET MEDICAL COLLEGE, KHAMMAM

58 year old male k/c/o diabetes hypertension and a chronic smoker presented with blackish
discoloration of the foot, which was gradually extending upto knee joint. Doppler was done
which indicate narrowing of popliteal artery.

1.What is your diagnosis?

2.What is the etiopathogenesis of disease?
 DEPARTMENT OF PATHOLOGY
GOVERNMNET MEDICAL COLLEGE, KHAMMAM

60 year old male presented with costovertebral pain and hematuria, ultrasound examination
revealed a mass in the left kidney

1.What is your diagnosis?

2.Describethe gross and microscopic findings in the above image?
3.What is the mode of spread of this tumor?
 DEPARTMENT OF PATHOLOGY
GOVERNMNET MEDICAL COLLEGE, KHAMMAM

60 year old chronic alcoholic was admitted to emergency following an episode of massive
hematemesis. He had history of intermittent episodes of jaundice since past one year. On
examination the patient had ascites and his serum bilirubin levels were raised.

1.What is your diagnosis?

2. Discuss the etiopathogenesis?
3.What are the complications?
 DEPARTMENT OF PATHOLOGY
GOVERNMNET MEDICAL COLLEGE, KHAMMAM

55 year old female presented with severe back pain and investigations show
Serum M protein levels:3.5 gram/dl, increased serum calcium levels, hemoglobin < 10g/dl.

1.What is your diagnosis?

2.What is the criteria for diagnosis?
 DEPARTMENT OF PATHOLOGY
GOVERNMNET MEDICAL COLLEGE, KHAMMAM

40 year old female came to hospital with history of dyspepsia and epigastric pain which was
worse in the night and about 2 to 3 hours after meal during the day. She also complained of
passing tarry stools

1.What is your diagnosis?

2.describe the microscopic features seen in the image?
3.What are the complication of this condition?
 DEPARTMENT OF PATHOLOGY
GOVERNMNET MEDICAL COLLEGE, KHAMMAM

Following is the peripheral smear picture of a 21 year old female with fatigue , fever and
bleeding from gums

1. Describe the WBC findings and provide a diagnosis?

2. What are the other investigations to confirm the diagnosis?
 DEPARTMENT OF PATHOLOGY
GOVERNMNET MEDICAL COLLEGE, KHAMMAM

40 year old female presented with fatigue. On examination massive splenomegaly was found and
total WBC of 92000/cu.mm

1. Describe the WBC findings and provide a diagnosis?

2. What is the characteristic chromosomal feature in this condition?
 DEPARTMENT OF PATHOLOGY
GOVERNMNET MEDICAL COLLEGE, KHAMMAM

Following is the peripheral smear picture of 5 year old male with history of fever, generalized
lymphadenopathy, rash and organomegaly

1. Describe the WBC findings?

2. What is your diagnosis?
 DEPARTMENT OF PATHOLOGY
GOVERNMNET MEDICAL COLLEGE, KHAMMAM

65 year old female complaints of generalized body pains and fatigue

1. Describe the WBC findings?

2. What is your diagnosis?
 DEPARTMENT OF PATHOLOGY
GOVERNMNET MEDICAL COLLEGE, KHAMMAM

23 year old male patient presented with painless cervical lymphadenopathy associated with night sweats,
weight loss and general malaise. On examination mediastinal lymphadenopathy seen on x ray. Lymph
node biopsy was done and submitted.

1. What is your diagnosis?

2. What are the different morphological types?
 DEPARTMENT OF PATHOLOGY
GOVERNMNET MEDICAL COLLEGE, KHAMMAM

65 year old male patient presented with ulceroproliferative growth over right inner canthus of eye.
excision biopsy of ulcer was done.

1. Provide a possible diagnosis based on the image?

2. List at least 2 characteristic microscopic findings of the lesion
 DEPARTMENT OF PATHOLOGY
GOVERNMNET MEDICAL COLLEGE, KHAMMAM

70 year old male presented with sudden increase in the size of the mole over back associated
with pain. excision biopsy was done.

1. Provide a possible diagnosis based on the image?

2. List at least 2 characteristic microscopic findings of the lesion
 DEPARTMENT OF PATHOLOGY
GOVERNMNET MEDICAL COLLEGE, KHAMMAM

10 year old child presented with swelling and pain around and below the knee joint.knee
amputation was done

1. What is your probable diagnosis?

2. What are other variants?
 DEPARTMENT OF PATHOLOGY
GOVERNMNET MEDICAL COLLEGE, KHAMMAM

24 year old male presented with nasal mass and obstruction.

1. What is your diagnosis?