Total No. = 03 pages Q.P. Code: MBN201 ae MLB.B.S. 2" Prof. 8+ 172352 (New Scheme w.e.1. 2019 admission onwards) BF/202402 Pathology - A MM. : 100 Time : 3 Hours(First 30 Min. for MCQs) Note: | Use OMR Sheet to answer Multiple Choice jions(MCQs). 2. ‘Attempt all questions. Illustrate your answers with suitable diagrams - NO SUPPLEMENTARY SHEET SHALL BE ALLOWED/PROVIDED 4. The student must write Q.P. Code in the space provided on OMR Sheet and the Title page of the Answer Bo ipt on OMR sheet) [1x20] Qi ss 1. A 10-year-old male came with a 4-day history of bloody diarrhea, On admission, significantTaboratory findings: Hb 10.5 gldL, platelets 45 x 10° /L, BUN 43 mg/dL, creatinine 2.46 mg/dL, and lactaygsdehydrogenase of S455 U/L, PT/aPTT- Normal, Schistocytes are present in peripheral blood smear. Which @Pthe following is the most probable diagnosis? a, Disseminated intravascuLar coagulation a c. Wiscott Aldrich syndrome d. Thrombotic throgibocytopenic purpura 2. A 25-year-old man is given anti-matarial prophylaxis for a trip o Africa,Over the next few weeks, he developed increasing fatigue. On physical examination, he is afebrile, and there*are no remarkable findings, CBC shows a rild normoeytic anemia, but the peripheral blood smear shows xitered “bite cells" in the population of RBCs Which of the following is the patient affected with? © = a Hereditary spherocytosis b. _Hexokinase deficiency ZZ Giucose 6 phosphate deficiency dg Autoimmune hemolytic anemia 3. Wrinkled tissue paper" cytoplasmic appearangSbf cells is characteristic of a. Von Gierke Disease Sb. Niemann Pick Disease © Gaucher Disease 4. Tay Sach Disease 4. A 38-year-old woman complaints of fatigue for the past 6 months. She had noted purple purpuric areas on her skin. There was no hepatosplenomegaly or lymphadenopathy on examination, Laboratory investigations showed hemoglobin of 7.2 g/dL, hematocrit of 21.7%, platelet count of 23 x 10°/L, WBC count of 1.31% 10 “By. Bone marrow is hypocellular with increased iron stores. Which of the following is the diagnosis? & AC Aplastic Anemii b. Storage disorder & © Myelodysplastic syndrome 4. Megaloblastic anemia 5. A 28-year-old woman has had a constant feeling of lethargy since childhood. On physicah@xamination, she is afebrile, and the spleen tip is palpable, but there is no abdominal pain or tendemess, kSiboratory studies show hemoglobin of 11.7 g/dL, platelet count of 159x10 ° /L, and WBC count of 5.39 xO. ‘The peripheral blood smear shows small round erythrocytes that lack a zone of central palo. Which of H€ folowing i the most likely diagnosis? s Glucose 6 phosphate deficiency b. Hemolytic uregite syndrome ©. Autoimmune hemolytic anemia 47 Hereditary-siherocytosis- 6. A 65-year-old female presents with burning and pain in the handycompanied by erythema, She has constant headaches and dizziness. Physical examination shows splenomegalY. Laboratory studies show Hb 21.7 g/dL; Het (65%; platelet count 450x10 /Li; and WBC count 8 x 10” /L,&Mhich of the following is the immediate treatment x for this? st a Tron therapy AGH Phlebotomy. c. Vitamin BI2 Folie acid supplementation e Page 1 of 37. A 16-year-old boy notices passage of dark urine, He has a history of multiple bacterial infections and venous thromboses for the past 10 years, including cerebral vein thrombosis in the previous year. On physical examination, his right leg is swollen and tender. CBC shows Hb 9.8 g/dL; Het 29.9%; MCV 92 f]; platelet count 150 x 106°/L; and WBC count 3.8 x 10°/L, He has reticulocytosis, and his serum haptoglobin level is very low. Which of the following is the diagnosis? & Autoimmune haemolytic anemia b, Iron deficiency anemia c.—Akaptanuria ‘3 Paroxysmal nocturnal hemoglobinuria 8. LMP4I gene plays a role in oncogenesis induced by 3, Human'T cell leukemia virus type b. Hepatitis B SO Epstein Barr virus d, Human papilloma virus 9. Apoptotic bodies can be recognized with the presence ofthese on the surface & a. phosphatidyl tyrosine b. —_phosphatidylinositol é c. _phosphatidylcholine 4 phosphatidylserine & 10. A 35-year-old, woman with history of menorrhagia started experiencing fatigue on exertion 94 palpitations for the past 9 months. On physical examination, there are no remarkable findings. Laboratory sunidies show Hb of 8.7 g/dL, Het of 30.8%, MCV of 701, platelet count of 315 x 10° /L, and WBC count of 8g 10 °/L. Which of the following is the most sensitive and cost-effective test that the physician should order ig Help determine the cause of these findings? G2 © Serum ferritin studies b. Bone marrow exgetination c. rum iron studies d. Molecular s U1. In cases of renal failure on long-term haemodialysis, there is developmenseF following type of amyloid: 8. Amyloid light chain b. _Amylajd°associated protein A Amyloid beta 2 microglobulin 4. Beta amylojeprotein 12. A 37-year-old woman diagnosed case of Crohn's disease was¢p0t responding to medical therapy, and part of the colon and terminal ileum were removed. After nearly a yege’she complains of easy fatigability. The CBC findings show Hb of 10,6 g/dL, RBC count of 2.69 x10"77L, MBF 118 fl, platelet count of 378 x 10" /L, and WBC count of 98 x 10° JL. The reticulocyte count is 0.3%. WaRh of the following conditions produces these hematologic findings? o a. Tron deficiency anemia b. Megaloblastic anemia’ ©. Sideroblastie anemia 4 Anemia of chronic disease 13. A 12-year-old boy has had worsening problems with joint mobility involving his ankles and legs, particularly his kes and ankles fr the pat 6 years, He has been receiving therapy for this condition. His elder bro had a similar condition and died at age 25 years. On physical examination, he has no visible petechiaggir areas of Purpura. Laboratory studies show that prothrombin time is normal, and partial thromboplasti tings prolonged. His platelet function studies are normal. Which of the following factor deficiency is the most p@Sible cause? a. Factor VII b. Factor VIII ¢. Tissue factor c. Factor XIL se 14. 4 36-year-old woman has a cough and fever for 1 week. On physical examination, hgPiemperature is 38.3°C and revealed splenomegaly 3 em below LCM. She has dfs erakls in all lng {ls A chest radiograph shows bilateral extensive infiltrates. CBC shows Hb 13.9 gl dL; Het 42%; MCV 89M; platelet count 210 x 10°L: and WBC count 56 x 10°/L with myetoid left shift including 1% blasts, 6% EogigSphils, and 4% basophils. LAP score is low. What is the most common mutation seen in this condition? a CALR b. JAK2 a> ¢. BCR-ABL 4. MP 15. A 4-year-old boy has appeared listless during the past weekysHle exhibits irritability when his arms or legs are touched. In the past 2 days, large ecchymoses have appeaggit on the right thigh and left shoulder. CBC shows Hb 9.3 widL; Het 28.7%; MCV 96 fl; platelet count 45 x1GS/L; and WBC count 13.9 x10°/L. The peripheral blood smear shows blasts that have PAS positive aggregates. Flow cytometry shows the phenotype of blasts to be CDI9+, TAT-, CD3-, and slg+, Which of the folloWing is the most likely diagnosis? a, Acute myeloid leukemia b. Acute lymphoblastic lymphoma Chronic myeloid leukemia Chronic lymphocytic leukemia Page 2 of 3ee 16, Grading of cancer is based on which of the following statements: a... Sire of the primary tumor b, Spread of cancer cells o regional lymph nodes. ¢.* Presence of blood born metastasis d. Degree of differentiation of tumor cells, anaplasia and number of mitosis , 17, 4.10 year-old boy has bad increasing abdominal distention and pain for the past 3 days, Abdominal CT scan shows 1a T-cm mass involving the ileocecal valve, Resected mass microscopically shows sheets of intermediate-sized lymphoid cells, with nuclei having coarse chromatin, several nucleoli, and many mitotic figures. Cytogenetic analysis shows a 1(8;14) karyotype. Flow cytometric analysis reveals 40% of the cells in S phase. The tumor shrinks dramatically after a course of chemotherapy. What is the translocation seen in this condition? a. Burkit’s Lymphoma b. Acute lymphoblastic lymphoma €. Chronic myeloid leukemia d. Chronic lymphocytic leukemia 18, Tumor Iyses syndrome (TLS) is characterized by all except a. Hyperuricemi b.— Hypercalcaemia ©. Hyperkalemia 19. Which of the following d.——Hyperphosphatemia _ F does not correctly match the tumor with its causative agent BV ad? 3. Anogenital carcinoma - HPV (Type 16 & 14).b. — Burkitts lymphoma - 4-7 Mepatoceltular carcinoma - Hepatitis A virus, d. Carcinoma stomach - Hgfreobacter pylori 20. {All of the following mutations ate associated with familial yperctoleuergt except? 3. Mutations in HMG-CoA reductase b. Mutations in L ¢. Mutations in gene encoding ApoB 4. Activating mut ‘A.28 year old female presents with history of intermittent fever, cough apdfgeneralised weakness for past 3 months. She complains of night sweats, loss of appetite and weight loss to the ile of Bkg over the last 3 months. General physical examination revealed pallor and matted cervical Iymphygdenopathy. Per abdomen Examination shows cervical lymphadenopathy and hepatosplenomegaly. Xray shox fibrocavitary lesion in right lung USG Abdomen reveals muluple enlarged lymph nodes in peripancre: igs Para-aortic ‘and peri caval location along with well | ; / defined 2.5x2.Sem mass in right iliac fossa $ [143424442] a. Whatis the possible diagnosis? TBS b Describe the histopathological findifrgs in the organs involved c. What additional laboratory tests should be done to confirm the diagnosis? 4. Discuss the pathogenesis of the underlying disease... Q3 Write short notes anz ©" "6 One HE [W7Bbly, COM DSM [sea] a. Tumour suppressor genes b. Chemical mediators of inflammatiog), ©. Classification of amyloidosis 4. Laboratory diagnosis of megalohitic anemia Qs Explain why. xg Pathogenesis of anemia in chronic diseases b. Occurence of haemolytic facies in haemolytic anemias €. Occurence of hypercalcemia in squamous cell carcinoma of lung 4. Explain pathogenesis of metaplasia ¢. Explain the pathogenesis of autosplenectomy in sickle cell anemia Qs Write short notes on(applied aspects): oe [6x3] a Pathogenesis of septic shock b. Approach to the diagnosis of acute leukemias & Tumour immunity é e Q6 Write short answer: aS 153] a Disseminated intravascular coagulation b. Pathogenesis of systemic Lupus erythematgSus(SLE) ©. Pilars of Bioethics Page 3 of 3Q.P. Code: MBN202 OMA: (22594 M.B.BS. 2" Prof. (New Scheme w.e.f. 2019 admission onwards) BF/2024/02 Pathology - B Time : 3 Hours(First 30 Min. for MCQs) 1, Use OMR Sheet to answer Multiple Choice Questions(MCQs). 2 2. Attempt all questions. Illustrate your answers with suitable diagrams é 3. NO SUPPLEMENTARY SHEET SHALL BE ALLOWED/PROVIDED _ a. Tetanus Ss Write briefly: - ea) «. Lab diagnosis of SARC CoV2 a h. Bacteriological examination of water €. Herpes zoster de Hepatitis B vaccine e ‘Standard test for syphilis Short answer (applied aspect): - [6x3] How will you diagnose a Mycetoma in microbiology laboral bh. Discuss briefly laboratory diagnosis of Primary amebic megihgoencephalitis. c. Lab diagnosis of eryptococcal meningitis. ae Write short notes: - v (5x3) ‘and hygiene b. Respect to patient sample ic Post exposure prophylaxis in rabies cea Page 3 of 3