PATHOLOGY OSPE DAY 1

THUSRDAY 19/9/24

Station 1- 10 observed

• Aik teacher ke pass 2 2 stations thay. Total 5 teachers thay .

Station 11

• Fibroadenoma breast.
• Its differentials and gross morphology

Station 12

• Extra mammary Pagets disease. Its consequent carcinoma and origin of its cells.

Station 13

• Dupytrens contracture
• Its causes.

Station 14

• Hormonal levels diye we thay in form of table.

• Diagnosis was of pcos.
• Causes of primary infertility.

Station 15

• Table having deranged values of pH and pOH , In background of diabetes. Basically it was
compensated metabolic acidosis due to ketone bodies .

Station 16

• Cushings
• Uske diagnostic tests

Station 17

• Addison uske tests

Station 18 SLIDE

• I guess it was molar pregnancy

• Drug for missed abortion
• Pathology affecting maternal vasculature.

Station 19 SLIDE

• It was endometrial hyperplasia

• Modifiable risk factor
• And treatment.

Station 20 SLIDE

• It was prostatic adenocarcinoma

• What is TURP ? How does it relieve pressure and improve urine outflow.
• Specific marker .(PSA).

Observed:

• Pap smear
• Hyperprolactinemia
• Breast carcinoma (2)
• Bph
• Hyperthyroidism
• Diabetes mellitus
• Low/high dose dexamethasone test

Unobserved

• Leiomyoma
• Serous adenocarcinoma
• MNG
• Hashimoto thyroiditis
• Breast carcinomas
• Endometrial polyp
• Cervical intraepithelial neoplasia

• Cushings
• Addisons
• Hypoparathyroidism
• BPH
 • Pagets Disease
• Endometrial hyperplasia
• Cryptorchidism counselling
• Leiomyoma observed
• PCOs
• hashimoto thyroiditis
• pap smear (method nahi pocha tha preservation transport lab processing yai cheezain
pochi ti)
• What is the role of AI? (Har question k end pr)

Medullary carcinoma of breast.

• How it differs from other breast cancers. Counsel about prognosis (aggressive nature
but sensitive to chemotherapy so good prognosis)
• Calcium deficiency due to low Vitamin D. Counsel
Acromegaly diagnosis.

• What other metabolic effects would be seen. Counsel.

one gross picture of some breast specimen with multiple nodular growths..

• DDs
• progress to which malignancy
• why axillary node resection not done or something like that

Slide of molar pregnancy

• treatment of missed abortion

• maternal vascular anomalies causing preterm labour

Metabolic acidosis in type 1 diabetic

• Identify from electrolyte values.

• Cause of inc H+ and dec bicarb

Medullary carcinoma of breast

Diagnosis
Differentiating features
Does it have good or bad prognosis
●PCOS

• Diagnose
• Counsel the patient

●Undescended testes

• Cousel the parents about its side effects

• its treatment
• duration of treatment

●lipoma

• Diagnosis
• Test used to diagnose it(ultrasound)

●Addisons Disease

• Why there are dark colored pigments on buccal mucosa( due to inc melanin production)

●cushing disease scenario

• Questions yaad nahi

●picture of flapping tremors was given plus the patient had thyroidectomy 2 years back.

• What is the reason of flapping tremors(accidental removal of parathyroid gland during

thyroidectomy leading to tremors due to hypocalcemia)

●microscopic picture of molar pregnancy

• Difference between complete and partial mole

●Endometrial hyperplasia

• Questions yaad nahi

●paget's disease of vagina ki picture

• Diagnosis
• Which cells are present in it
 • Other locations where it is found(breast)

Counselling stations

• Pap smear
• Iodine deficient goitre
• Addison disease
• Hyperglycaemic patient counselling for insulin administration
• a report was given in which diagnosis of invasive ductal carcinoma was given counsel
this patient
• Insulin administration
• Hypothyroidism...guide patient about how to take levothyroxine (dose, schedule, timing )
• Cushing's syndrome (which drug given, drug interactions, toxicity)
• Pregnant patient is taking warfarin...effects on fetus... alternative therapy

addisons ka table aya tha like us mai ACTH zyada tha lkn Cortisol phir b km show how raha
tha like kuch esa wahan sy

• diagnosis
• management and i guess medicines puchi thi

cushing syndrome

• medication m aminoglutethimide aur ketoconaxole (hepatotoxic)

●multinodular goiter

• What is its immunocheistry

• Identification points

●grave disease station unobserved

Questions yaad nahi

Counselling

• Grave’s disease
• breast carcinoma counselling plus grading plus its molecular classification plus role of
mitotic index in breast carcinoma
• erythroblastosis
• oral contraceptive pills

Observed:
1.pathological lab report of osteoporosis

• Counsel. Which is the recently developed serum marker for assessment of bone
turnover activity?
2. demonstrate sample collection/processing of synovial fluid specimen...

• Vials pari thein teeno, culture bottle and syringes

• (Purple wali vile me daalna h....)
3. Polyscystic kidney disease image and the pt. was hypertensive

• Lifestyle modifications
 • (Dr faiza asked Urdu me kya kehtey hain PKD ko)
4.Osteoarthritis
5.wilms tumor counselling

• (Pattern of inheritance pooch rae thi mam)

6.Male Pt. Working in tyre industry :

• urothelial carcinoma of bladder..

• risk factors in this case for development of tumor.
• Tx options and the impact on reproductive status
7.counselling about removing a brain dead pt. from ventilator

• Legal points to consider in this regard

8.Cerebral hemorrhage picture.

• Diagnosis
• AI role in Diagnosis and Treatment

Histological slide of Glioblastoma

• Histology features
• Cell of origin
• WHO staging of tumour

Slide Pyelonephritis??

• Histology features
• Prevention measures

Slide Squamous cell carcinoma of skin

• Histological features
• Predisposing lesion

Slide of a bone based tumor excised from near ankle joint

• Diagnosis
• Histology
• Which acid HNO3 or H2SO4 is used in tissue processing
• What is the use of acid
Unobserved:

• Rheumatoid arthritis (anti CC antibodies role)

• Osteosarcoma
• Wilm's tumor
• Meningioma slide (mass attached to dura mentioned in scenario)
• Clear cell carcinoma slide
• Lipoma slide (mass on nape of neck mentioned in scenario)
• Minimal change disease
• Schistosoma hematobium
• Basal cell carcinoma
• Diabetic kidney gross microscopic morphology

Observed

• Psoriasis counseling treatment

• Lumbar puncture technique
• Breaking bad news
• Horse shoe kidney complications counseling
• Renal tuberculosis and DOTS counselling

Unobserved:

Station 1: Renal TB(identify, microscopy, treatment,counselling)

Station 2: Transitional cell carcinoma(surgical approach, role of AI, microscopic features plus
nitric acid use for bone decalcification)
Station 3: Capillary hemangioma(molecular defect, cells of origin, treatment role of AI)
Station 4: Compound nevus(identify, gross features)
Station 5: Diabetic nephropathy(gross features, identify kimmelsteil wilson nodules, treatment,
role of AI)
Station 6: Goodpasture syndrome(immunofluorescence findings and treatment)
Station 7: Squamous cell carcinoma(histology, features, treatment, precursor lesion)
Station 8: Osteomyelitis(identify, microscopic features, treatment)
Station 9: Hyaline arteriolosclerosis(identify, microscopic features, treatment)
Station 10: Osteochondroma( identify plus microscopic features, in which bones it occurs)

Observed:

Station 11: Foleys(indications, contra indications, which part of it is inserted and how to prevent
foleys from slipping out of body)
Station 12: Diabetic nephropathy(diagnosis, which food to avoid and treatmrnt)
Station 13: Renal agenesis(diagnose, complication is CKD, counselling of parents)
Station 14: Osteosarcoma(codman triangle identify, where does it originate from)
Station 15: Osteoporosis(how to tell community about its prevention)
Station 16: Osteoarthritis (counselling and prevention)
Station 17: Culture media(identify)
Station 18: Renal cell carcinoma(types and triad features, why clear cell is called clear cell
carcinoma and paraneoplastic syndromes in it)
Station 19: Parkinson Syndrome(identify, nigrostriatal pathway and substantia nigra ko identufy
karein and its treatment)
Station 20: Aseptic meningitis(bacteria causing it and why dont we culture these bacteria)