Compiled by Seow Cherng Jye & Ng Chong Jin (M4/2002-03)

Pathology TYS Page 7 of 19

Compiled by Seow Cherng Jye & Ng Chong Jin (M4/2002-03)

Contents

General Pathology / 1
Cancer / 2
Genetics / 3
Systemic Pathology
1. Cardiovascular System / 4
2. Respiratory System / 5
3. Gastrointestinal System: Upper GIT, Lower GIT, Liver, Biliary Tract,
Pancreas / 6
4. Renal System: Kidney, Lower Urinary Tract / 8
5. Male Reproductive System / 9
6. Breast and Female Reproductive System / 10
7. Endocrine System: Thyroid, Parathyroid, Adrenal / 11
8. Musculoskeletal System / 12
9. Neurological System / 13
10. Haematological and Lymphoid System / 14
Forensic Pathology
(a) Coroner System / 15
(b) Sudden and Asphyxial Death, Wound and Injuries / 15
(c) Medico-Legal/Ethics/Brain Death / 15
(d) Sexual Offences/DNA / 16
(e) Babies and Infants / 16
(f) Drugs and Toxicology / 16
Chemical Pathology
Fluid & Electrolyte Balance, Acid Base Disorders, Calcium and Phosphate / 17
Diagnostic Enzymology/Malignancy Screen / 18
Liver Function / 18
Diabetes Mellitus / 18
Dynamic Endocrine Testing, Assessment of Thyroid and Adrenal Disorders / 19
Lipids/Assessment of Hypertension / 19
General Pathology
2003 (M) / A 59 year old man presented with a chronic ulcer of the left foot. He has been diabetic for the last 10 years but has defaulted treatment on many occasions.
a)  What clinical biochemistry tests should be ordered and what results would you expect from them? ( 6 marks)
b)  Discuss the pathogenesis of the foot ulcer. (7 marks)
c)  describe the process(es) of healing in such an ulcer. (7 marks)
2001(S) / a)  A 50-year-old man collapsed and died after having been stung by a swarm of bees. Describe the cellular events that occurred and correlate these with the clinical presentation.
b)  A 12-year-old boy underwent a Mantoux test. After 72 hours, he developed reddening and induration at the site of injection. Discuss the cellular events responsible for the reaction.
2000(M) / What is edema? Describe the pathogenesis of edema in
a)  cardiac failure
b)  liver cirrhosis
c)  acute inflammation
2000 (S) / Discuss the major mechanisms involved in immunologic tissue injury, and illustrate by describing the pathology of one disease.
1999 (M) / 1)  A young man discovered that he was bleeding badly from the gums after brushing his teeth. Discuss the possible causes.
2)  Write short notes on the following:
The benefits and adverse effects of inflammation
1999 (S) / Write short notes on the following:
Granulomatous inflammation
1998 (M) / 1)  Define thrombosis. Describe the process of thrombosis, the likely appearance of the intravascular lesions and the sequelae that may ensue.
1998 (S) / Write short notes on the following:
a)  carcinoid syndrome
b)  fat embolism
1997 (S) / What are autoimmune diseases? Discuss the mechanisms of autoimmune disease, illustrating your answer with examples.
1996 (M) / 1)  Discuss the possible AIDS related findings at autopsy in an HIV-positive patient dying after a chronic illness.
2)  Define thrombosis. Give an account of thrombo-embolic disease.
1995 (M) / Discuss the mechanisms involved in wound healing. Discuss also the factors which may adversely influence this healing process.
1995 (S) / 1)  Write an essay on the classification of hypersensitivity reactions, and illustrate each type with one disease example.
2)  Short notes on
Amyloidosis
Cancer
1999 (M) / Write short notes on:
Tumour progression and heterogeneity
1999 (M) / Write short notes on:
p53 suppressor oncogene
1997 (M) / What are paraneoplastic syndromes? Illustrate your answer with examples.
1996 (M) / Write short notes on three of the following:
Dysplasia
1996 (S) / Describe the modes of spread of malignant neoplasms, and illustrate them with examples.
1995 (M) / Describe the genetic changes involved in the development of cancer. Give 3 examples of human cancers which are hereditary and describe how they are inherited.
Genetics
Systemic Pathology

1. Cardiovascular System

2002 (M) / Atherosclerosis is the leading cause of death and disability in the developed world. Explain why this should be the case, concentrating your answer on factors that predispose to atherosclerosis and the pathological complications of atherosclerosis in the different parts of the body. (Details of theories of atherogenesis are not required).
2001 (M) / Write short notes on:
Complications of infective endocarditis
2001 (S) / Write short notes on:
Pathogenesis of myocardial infarction
2000 (M) / Describe the pathogenesis of myocardial infarction and the subsequent complications that may ensue.
2000 (S) / Give an account of the pathogenesis, clinical manifestations and possible sequelae of infective endocarditis.
1999 (M) / Write short notes on:
Complications of mitral stenosis
1999 (S) / A 61-year-old male patient died as a result of longstanding systemic hypertension. Describe and explain the pathological findings that may be found at an autopsy examination of this patient.
1998 (S) / Discuss the causation and pathogenesis of infective endocarditis. What are the possible complications of this condition?
1996 (M) / Write short notes on:
Hypertensive heart disease
1996 (S) / Give an account of the pathogenesis of atherosclerosis. Discuss the complications that may arise from this condition.
1995 (M) / A patient with a long-standing history of benign hypertension developed a rapid rise of blood pressure and died. Describe the possible post-mortem findings.
1995 (S) / Write short notes on:
Polyarteritis nodosa
1993 (M) / Write short notes on:
Causes of left ventricular hypertrophy

2. Respiratory System

2002 (S) / Write short notes on:
pulmonary embolism
2001 (M) / Give an account of primary tuberculosis and its complications in children and adults.
2001 (S) / Write short notes on:
Bronchiectasis
2000 (M) / Write short notes on the following:
(a)  primary pulmonary tuberculosis
(b)  small cell carcinoma of the lung
(c)  cor pulmonale
1999 (S) / Write short notes on:
Pulmonary embolism
1998 (M) / Write short notes on:
Mesothelioma
1997 (M) / Define emphysema. Discuss the pathogenesis of the major types of emphysema and briefly mention the clinical course of this condition.
1997 (S) / Write short notes on:
Effects of asbestos exposure
1996 (S) / Write short notes on:
Primary tuberculosis
1993 (M) / What is emphysema of the lung? Discuss the pathogenesis and complications of this condition.
1993 (S) / Give an account of the pathology of bronchogenic carcinoma under the following headings:
(a)  Aetiology
(b)  Histological types
(c)  Complications

3. Gastrointestinal System

(a)  Upper GIT

2002 (M) / Describe the pathogenesis and complications of peptic ulcers.
2001 (S) / A middle-aged man complained of recurrent epigastric pain. A gastric biopsy showed the presence of Helicobacter pylori. Discuss the possible pathological consequences and complications of Helicobacter pylori infection of the stomach.
2000 (M) / Describe the pathogenesis and pathological features of the diseases associated with Helicobacter pylori.
1997 (M) / Write short notes on:
Helicobacter pylori-associated chronic gastritis.
1996 (S) / Discuss the aetiology and pathogenesis of peptic ulceration. List the complications that may arise from this condition.
1994 (S) / Discuss the pathogenesis and morphological features of peptic ulceration of the stomach and duodenum. What complications may arise from such ulceration?
1993 (S) / Write brief notes on:
Chronic gastritis.

(b)  Lower GIT

2002 (S) / Carcinogenesis is believed to be a multi-step process. Explain, using colorectal carcinoma and/or other malignancies as examples, what you understand by this statement.
1996 (M) / A patient aged 19 years presents with a right iliac fossa mass, thought clinically to be inflammatory. At operation, a carcinoma of the colon is found. Discuss the findings in the pathology of the resected specimen which could influence the management of the case.
1994 (M) / Write short notes on:
Differential diagnosis of Crohn’s disease and ulcerative colitis
1993 (M) / Give an account of the various types of polyps which may occur in the large intestine. In your answer, comment on the biological behaviour of these various types.

(c)  Liver

2002 (M) / Write short notes on:
Alcoholic liver disease
2001 (M) / A 50-year-old Indian man with a history of chronic alcohol ingestion was admitted for jaundice and abdominal distension. A diagnosis of cirrhosis was made on liver biopsy.
(a)  Describe the histological features you expect to find in the liver biopsy.
(b)  Explain the pathogenesis of jaundice and abdominal distension in the patient.
(c)  What other complications may be present in the patient?
1999 (S) / Discuss and describe the clinicopathological syndromes and potential outcomes that may occur in the liver as a result of infection by the hepatitis viruses.
1998 (S) / Describe the likely necropsy findings of a patient who has died because of cirrhosis.
1996 (M) / Write short notes on:
Cirrhosis
1995 (S) / Write an essay on hepatitis B virus (HBV) infection, and discuss the well-recognized pathological sequelae associated with this infection.
1994 (M) / Describe the spectrum of diseases caused by hepatitis B infection and the mechanisms underlying them.
1993 (M) / Write short notes on:
Pathological changes in the liver in chronic alcoholism

(d)  Biliary Tract

1999 (M) / Give an account of the aetiology, pathological features and complications of obstruction of the biliary tract.
1993 (S) / Discuss the causes of extrahepatic biliary obstruction, and the pathological effects of such obstruction on the liver.

(e)  Pancreas

2003 (M) / A 59 year old man presented with a chronic ulcer of the left foot. He has been diabetic for the last 10 years but has defaulted treatment on many occasions.
a)  What clinical biochemistry tests should be ordered and what results would you expect from them? ( 6 marks)
b)  Discuss the pathogenesis of the foot ulcer. (7 marks)
c)  describe the process(es) of healing in such an ulcer. (7 marks)
2002 (S) / A 65-year-old man with a 10-year history of poorly controlled diabetes mellitus was found dead in his room. Describe the pathological findings that you would expect to find at autopsy.
1999 (M) / An elderly man has died from longstanding diabetes mellitus. Describe and explain the pathological findings that may be found at the post-mortem examination. What do you think are the possible causes of death?
1997 (S) / 1.  An autopsy was performed on a 65-year-old man who had been suffering from diabetes mellitus for the past two decades. Discuss the possible causes of death and describe the findings at post-mortem.
2.  Insulinoma (beta-cell tumour of pancreas)
1995 (S) / Write an essay on tumours arising from the pancreas.

4. Renal System

(a) Kidney

2001 (M) / Write short notes on:
Pathogenesis of renal calculi
1996 (M) / Write short notes on:
IgA nephropathy
1996 (S) / Write short notes on:
Membranous nephropathy
1995 (S) / Write short notes on each of the following:
Crescentic glomerulonephritis
1993 (M) / Describe the pathological changes which may occur in the kidneys in diabetes mellitus. What complications may arise from these changes?
1993 (S) / Write short notes on:
Analgesic nephropathy

(b) Lower Urinary Tract

1998 (S) / Discuss the causative factors involved in the formation of urinary calculi. What pathological changes may occur in the urinary system arising from urinary calculi?
1995 (M) / Describe the epithelial tumours of the urinary bladder. Discuss their epidemiology, pathogenesis and prognostic factors.

5. Male Reproductive System

2002 (M) / Write short notes on:
Benign prostatic hyperplasia
1997 (M) / A 75-year-old man was found dead in his room. At autopsy, his prostate was found to be markedly enlarged. Describe and discuss the other findings that might possibly be found at the autopsy.
1994 (M) / Discuss the pathology, complications and chemical laboratory diagnosis of testicular tumours.
1994 (S) / Discuss the causes of enlargement of the prostate gland. Give an account of the pathological effects of prostatic obstruction.

6. Breast and Female Reproductive System

(a) Breast

2003 (M) / A 63 year old women underwent a mastectomy with axillary clearance for carcinoma of the breast. What parameters would you expect to find described in the subsequent pathology report and how would these help you to decide on her prognosis and future treatment (20 marks)
2002 (M) / A 65-year-old woman with advanced breast cancer died while undergoing palliative chemotherapy. Describe the pathological changes that you would expect to find at autopsy.
2001 (S) / A 45-year-old lady has a lump 2 cm in diameter in her right breast. Discuss the possible causes and pathology of this lump. What investigations would help to distinguish the possibilities?
1998 (M) / A 50-year-old woman had a mastectomy with axillary clearance for carcinoma of the breast. What are the pathological parameters in the specimen that would help determine or influence the management and prognosis?
1997 (S) / Give an account of the pathology of breast carcinoma, with emphasis on features of prognostic significance.

(b) Female Reproductive System

2002 (M)
1996 (S) / Write short notes on:
Endometriosis
2002 (S)
2001 (S) / Write short notes on:
Endometrial hyperplasia
2001 (M) / Discuss the concept of cervical intraepithelial neoplasia (CIN) and its relationship to invasive squamous cell carcinoma of the uterine cervix. What is the role of human papilloma virus (HPV) in this condition?
2000 (S) / Write short notes on the following:
Cervical intraepithelial neoplasia
1994 (M) / Write short notes on each of the following:
The role of human papilloma virus in the pathogenesis of disease of the cervix uteri
1994 (S) / Write brief notes on:
a)  mucinous tumours of the ovary
b)  cervical intraepithelial neoplasia

7. Endocrine System

(a) Thyroid

2003 (M) / A 45 year old woman presents with a central neck swelling that moves on swallowing. (In the questions below, parts b and c are independent of one another).
a)  What structure/organ is enlarged? List 3 differential diagnoses that may cause this enlargement. (4 marks)
b)  If cervical lymph nodes are also enlarged, what is the most likely diagnosis? (1 mark)
Describe the pathological changes that you would expect to find in a biopsy of the
enlarged lymph nodes. (7 marks)
c)  If the patient also had palpitations and an irregular pulse, what is the most likely diagnosis? ( 1 mark)
What clinical biochemistry tests should be ordered and what results would you
expect from then? (7 marks)
2002 (S) / A 40-year-old woman was found to have an enlarged right lobe of the thyroid. Discuss the differential diagnoses. What pathological investigations would help you to distinguish between the different possibilities?
2000 (S) / A 40-year-old woman presents with a thyroid nodule. Discuss the pathology of the common conditions with a view to correlating with the clinical presentation, gross and microscopic appearances and approach to management.
1999 (S) / A 50-year-old man had a non-functioning thyroid nodule. Discuss the possible pathology of this lesion.
1998 (M) / Write short notes on:
Hashimoto’s thyroiditis
1997 (M) / A 55-year-old Chinese man presents with a swelling at the left side of his neck. Discuss the differential diagnosis.
1994 (M) / A 45-year-old female presents with a lump in the left lobe of the thyroid. Give an account of the various disorders which may cause this and discuss their prognosis.

(b)  Parathyroid