Tutorial 4 Jan 2016 QP
Uploaded by
chinTutorial 4 Jan 2016 QP
Uploaded by
chinUNIVERSITI TUNKU ABDUL RAHMAN
Faculty
Course
Year/Semester
: Science
: Biomedical Science
: 2/1,2&3
Unit Code
Unit Title
Lecturer
: UDDD2124
: Essential Pathology
: Dr. Michelle Ng Yeen Tan
Tutorial 4
Name: __________________________________
ID:_____________________________
Answer all questions
1.
An echocardiogram of a 2 day-old baby showed presence of a small hole (5
mm) in the heart after heart murmur was detected. The pediatrician informed the
parents that the baby was suffering from a congenital heart defect and required
close monitoring. Four years later, an echocardiogram was performed again and
showed absence of the hole.
(i)
(ii)
(iii)
Identify the type of congenital heart defect that the baby was suffering and
why.
State the possible cause that led to the condition in (i).
Briefly describe what caused the closure of the heart defect in (i).
2.
A 16-year-old healthy teenager is involved in a gang fight at his school and is
stabbed in the chest which penetrates the heart. He is taken to the emergency
department and on arrival his blood pressure is barely obtainable. His lungs
are clear to auscultation. His heart sounds are barely audible. Briefly
describe the most probable cause that led to the extremely low blood pressure and
inaudible heart sound observed in this patient.
3.
Melvin is brought to the physician by his parents because he falls a lot, cannot
jump and tires easily. He has been suffering from weakness in the pelvic and
shoulder girdles and enlargement of the childs calf muscle. The serum creatine
kinase is elevated. His calf muscle biopsy shows muscle fiber necrosis,
regenerating fibers and fibrosis.
(i)
(ii)
State the most likely cause of death expected in this patient.
Identify the main cause for this patients condition.
4.
A 16-year-old boy has noted pain in his left knee after each hockey practice
session for the past month. On examination there is tenderness to palpation of his
left knee, with reduced range of motion. A plain film radiograph of the left leg
reveals a mass of the proximal tibial metaphysis that erodes bone cortex, lifting up
the periosteum where reactive new bone is apparent. The mass does not extend
into the epiphyseal region. A bone biopsy is performed and microscopic
examination shows atypical, elongated cells with hyperchromatic nuclei in an
osteoid stroma. State which neoplasms he is most likely to have.
5.
A pregnant woman has a screening ultrasound performed at 18 weeks
gestation. The fetus is appropriate in size for 18 weeks. The fetal kidneys, liver,
head, and extremities appear normal. However, the fetus has a boot-shaped heart
with a membranous ventricular septal defect, overriding aorta, and marked
pulmonary artery atresia.
(i)
State the most probably diagnosis for the fetus condition.
(ii)
What causes the abnormal shape of the fetus heart.
(iii)
If the baby were to be liveborn, state the most probable characteristic on
physical examination that most likely result from these cardiac defects and
justify your answer.
6.
An otherwise healthy 44-year-old man with no prior medical history has had
increasing back pain and right hip pain for the past decade. The pain is worse at
the end of the day. On physical examination he has bony enlargement of the distal
interphalangeal joints. A radiograph of the spine reveals the presence of
prominent osteophytes involving the vertebral bodies. There is sclerosis with
narrowing of the joint space at the right acetabulum seen on a radiograph of the
pelvis. Name the disease that he is most likely to have.
7.
An 80-year-old woman has had no major medical problems, but she has never
been physically active for most of her life. One day she falls out of bed and
immediately notes a sharp pain in her left hip. She is subsequently unable to
ambulate without severe pain. Radiographs show not only a fracture of the left
femoral head, but also a compressed fracture of T10. State the most likely
diagnosis.
8.
A 58-year-old man has the sudden onset of severe pain in his left great toe. There
is no history of trauma. On examination there is edema with erythema and pain
on movement of the left 1st metatarsophalangeal joint, but there is no overlying
skin ulceration. A joint aspirate is performed and on microscopic examination
reveals numerous neutrophils and needle-shaped crystals. Over the next 3 weeks,
he has two more similar episodes. On physical examination between these attacks,
there is minimal loss of joint mobility. Briefly describe the laboratory test finding
that is most characteristic for his underlying disease process.
