B AL

PATHOLOGY
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WBUHS PRE-PROFF SEMESTER PAPERS 2023-24

COMPILED BY ARPITA SAHA (IPGMER-SSKMH)

GENERAL PATHOLOGY & CYTOLOGY:-
VERY LONG QUESTIONS: (15 MARKS)

1) A 32-year female presented with chronic cough and right cervical lymphadenopathy.
FNAC from the lymph node show presence of granuloma. (15 marks)
a) What is the most probable diagnosis in this patient? (2mark)
b) Write down the mechanism of granuloma formation. (5 marks)
c) If this patient suffers from AIDS why granuloma is not formed. (2 marks)
d) On HP examination what is the characteristic necrosis seen in such a case and why?
(2marks)
e) Name two other condition where granuloma formation without necrosis is seen. (2
marks)
f) What special tests you will do for confirmation and treatment planning. (2 marks).
(RPHGMCH).

2) A 30 years gentle man brought to emergency Injured in a road traffic accident with low
blood pressure and multiple fractures in right leg. No external haemorrhage.
i. What is your provisional diagnosis?

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ii. How will you investigate & treat the patient? (2+5+8=15)
iii. What are the possible outcomes of the patient? (MCK)

3) A 62 years old female presenting with acute episode of chest pain and shortness of
breath. She had a history of physical trauma. following which she got bed ridden for the
past 1 month. ECHO reveals paradoxical septal motion with hyperdynamic LVE
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Biochemical tests revealed elevated D dimer and minimally raised FDP

i. What is the provisional diagnosis?

(2+3+4+4+2) SRIMS
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ii. Risk factors and the pathogenesis of the condition.
iii. Describe role of endothelium in the above condition and the complications of the above
pathology

4) A 30-year-old female patient was brought to the emergency with history of pain lower
abdomen, bleeding from gums and high fever. The patient had an abortion 3 days ago. On
examination, her blood pressure was found to be very low and respiratory rate was 40/min.
i. What is your provisional diagnosis?
ii. Describe the pathogenesis of this condition.
iii. Enumerate the different conditions with examples which can lead to "systemic
hypoperfusion with cellular hypoxia" like this case. (2+7+6) (Malda)

5) A 29-year-old pregnant lady presents with bilateral lower limb swelling that pit on
pressure. Name the underlying pathologic condition. Define it. Enumerate the
pathophysiologic categories of the condition. Discuss the pathogenesis in different
categories. Why does this change occur in this patient? What is papilloedema?
(1+1+3+6+2+2) (Purulia)
6) A 18 years old male was brought to emergency with a large lacerated wound over left
leg that could not be apposed by suture.
Describe all the stages by which the normal structure can be repaired?
What are the factors that can affect the repair?
What may be the complications? (7+4+4) IQ City

LONG QUESTIONS: 10 MARKS

1) Enumerate 8 fundamental changes in cell physiology that are hallmarks of cancer?
Name 4 microbial carcinogens with associated cancer. What is the difference between
grading and staging of tumours? (4+4+2). (RPHGMCH)

2) What are the common causes leading to Programmed cell death? Draw a flow chart
depicting mechanism of apoptosis. (4+6). (RPHGMCH)

3) Define acute inflammation. Enumerate different morphological pattern of acute

inflammation. What is the outcome of acute inflammation? Mention the steps of
angiogenesis. (2+3+2+3)(RPHGMCH)

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4) What is anasarca? Name 4 different diseases causing anasarca. Mention the
composition of the fluid in any one of such causes. (1+4+5=10) RGMCH

5) Name 4 granulomatous diseases other than tuberculosis. Name and mention salient
histological pictures of different types of granuloma. (4+6=10) RGMCH
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6) Define risk factors & pathogenesis of thrombus formation & its fate. (3+4+3=10) MCK

7) What are the vascular events in acute inflammation? Discuss the mechanism of
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increased vascular permeability in acute inflammation? (3+7) MCK

8) Define Acute Inflammation. Enumerate the chemical mediators of acute inflammation.

(10) (IPGMER)

9) Etiopathogenesis of evolution of a thrombus. (10 marks) CNMC

10) What is a granuloma? Enumerate the conditions associated with granulomatous

inflammation. Describe the pathogenesis of an immune granuloma. What is Laughan's
giant cell? (2+3+4+1) (Malda)

11) Define inflammation, what are the fates of acute inflammation. What are common
defects in leucocyte function? (2+4+4=10) (Midnapore)

12) Define neoplasia. How do you understand multistep carcinogenesis, what are the steps
of metastasis? (2+4+4) (Midnapore)

13) Etiopathogenesis and diagnosis of amyloidosis. (10 marks) (Murshidabad)

14) Describe the pathogenesis of atherosclerosis. Describe the gross and microscopic
appearance of atherosclerotic plaque and complications. (3+2+2+3= 10)
 ( MJN Coochbehar)

15) Describe the morphologic changes of malignant cells. Discuss the pathways of spread
of a malignant tumor. (4+6). (Purulia)

16) Define apoptosis. Describe the morphologic and biochemical changes in apoptosis.
What is necroptosis? (2+6+2) (Purulia)

17) What is scarring? Describe the steps of scarring. Write in brief about the factors that
influence tissue repair. (1+4+5) (diamond harbour)

18) What is metastasis? Different routes of metastasis? Mechanism of metastatic spread in

any route? Enumerate the molecular hallmarks of cancer? Why is p53 called guardian of
genome? (1+2+5+3) (Gouri devi, Durgapur)

19) What are the components of Virchow's Triad? Discuss the role of endothelium in
maintaining homeostasis. (3+7=10)

20) Define granuloma. Discuss the pathogenesis of granulomatous inflammation. Give two
examples of granulomatous condition. (2+6+2=10)

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21)Define apoptosis. Discus the two pathways involved in apoptosis. (2+8=10)
(19, 20, 21- JMN)

22) Classify shock. Write the pathogenesis of septic shock. (10) KPC

23) Cellular events of acute inflammation. (10) (Shantiniketan)

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24) Describe the healing process of fracture of long bone and its complications. (10)
(Shantiniketan)
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25) Classify lysosomal storage disorders. Write a short note on any 2 of the above storage
disorders (5+5) SRIMS

26)Enumerate the hallmarks of cancer. Briefly explain the mechanism of metastasis.

(4+6) SRIMS

27) Briefly explain the role of chemical mediators with reference to the different vascular
and cellular events in inflammation. IQ City

28) Mention the cellular and molecular hallmarks of cancer. Describe the role of any one
tumor suppressor gene. (6=4) IQ City

SHORT NOTES:- (5 MARKS)

1) Type I Hypersensitivity Reaction (IPGMER)
2) Counselling of a patient before undergoing bone marrow aspiration procedure (CNMC)
3) Atheroma (RG Kar)
4) FISH (RG Kar)
5) Pathogenesis of septic shock. (Midnapore)
6) Role of complement in acute inflammation (Sagor Dutta)
7) Genetic defect in Thalassemia. (Sagor Dutta)
8) Chemical carcinogen. (Sagor Dutta)
9) Klinefelter syndrome. (Sagor Dutta)
10) Physical and chemical properties of amyloid
11) Role of informed consent in FNAC procedure (Purulia)
12) Type 1hypersensitivity reaction. (diamond harbour)
13) Types of necrosis. (Gouri devi, Durgapur)
14) Define Para neoplastic syndrome. What is the significance of this syndrome?
15) Write the differences between healing by Ist intention & 2nd intention (19,20- JMN)
16) Type - VI hypersensitivity.
17) Packed cell volume.
18) Social and economic implication of health care as a right. (KPC)
19) Paraneoplastic Syndrome (Santiniketan)
20) Down syndrome. (Santiniketan)
21) Retinoblastoma. NBMC

EXPLAIN THE FOLLOWING: (4 MARKS)

NRS
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1) In carcinoma the multiple driver mutations are required for full manifestation of disease.

2) Rheumatic vegetations are friable and easily detachable and produces embolism in
other distal organs. NRS
3) Giant cell tumor of bones is not only giant cell containing lesions. NRS
B
4) Amyloid can be stained by various methods. CNMC
5) P -53 is called the ·Guardian of genome’ CNMC
6) Bleeding disorders and Coagulation disorders a.re not the same. CNMC
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7) Angiogenesis plays an important role in wound healing. RG Kar
8) Granuloma and granulation tissue are different. RG Kar
9) HPV in an oncogenic virus. Midnapore
10) Serum sickness is an example of type Il hypersensitivity. Midnapore
11) Healing by two intentions are not same. Midnapore
12) Edema is multifactorial in origin. Murshidabad
13) Carcinoma is a multistep process. Murshidabad
14) Tumour markers help is the diagnosis of malignant lesions. Sagor Dutta
15) Autolysis is separate entity from necrosis. Sagor Dutta
16) Paediatric small round cell tumours are of different types. (MJN Coochbehar)
17) Certain changes occur in blood with increasing duration of storage. (Purulia)
18) Th2 cells play central role in type I hypersensitivity. (Purulia)
19) Sepsis can lead to DIC. (Purulia)
20) Microscopic examination of red urine is important to identify its cause. (Purulia)
21) Caseation necrosis is not a diagnostic hallmark of granulomatous inflammation.
(diamond harbour)
22) Tumor suppressor genes are good for health. (diamond harbour)
23) Thombus and clot are not the same. Gouri Devi
24) Granulomatous inflammation and granulation tissue histomorphologically are not the
same. Gouri Devi
25) p5 is known as ‘Guardian of Genome' JNM
26) Inflammation is a double-edged sword. JMN
27) Hydatid cyst and hydatidiform mole are not the same.
28) Giant cell containing lesion and giant cell tumor of bone are different. KPC
29) All emboli are not solid in nature. KPC
30) Metaplasia is a double-edged sword. Shantiniketan
31) Transudate and Exudate are not same. Shantiniketan
32) Apoptosis is also known as Programmed cell death
33) lonising radiation is injurious to health
34) Misfolded proteins can cause cytotoxicity
35) Thrombin is a multifunctional protein. Shantiniketan
36) Autoimmune reactions may be triggered by infections. IQ City
37) All amyloid deposits have a similar appearance and staining. IQ City
38) All sex linked disorders are X linked and almost all are recessive. IQ City
39) Disseminated intravascular coagulation may occur in half of the patient with septic
shock. IQ City
40) Reperfusion of ischemia tissue paradoxically can exacerbate the injury. IQ City
41) Embolism is more common in bacterial endocarditis thst RHD.

DIFFERENCES:
1) Necrosis and Apoptosis (IPGMER)

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2) Hyperaemia and Congestion (IPGMER)
3) Leukemia and Leukemoid reaction (IPGMER)
4) Dystrophic and Metastatic Calcification (IPGMER)
5) Phlebothrombosis and Thrombophlebitis are not same. (Malda)
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HAEMATOLOGY:-
VERY LONG QUESTIONS: (15 MARKS)

1) A 70-year-old male presents with symptoms of chronic back pain. X ray spine shows
multiple osteolytic lesions. ESR was 90 mm Hg and peripheral blood smear show
excessive rouleaux formation. (15 marks)
a) What is your provisional diagnosis? (2 marks)
b) Describe the pathogenesis of the disease. (5 marks)
c) Enumerate the different clinical- pathologic patterns. (5 marks)
d) What do you mean by CRAB criteria? (2 marks)
e) Why excessive rouleaux formation seen in peripheral blood smear? (1 mark).
(RPHGMCH).

2) A 52 year old female strictly vegetarian presented with progressive weakness, pallor,
tingling and numbness of fingers.
i) What is your provisional diagnosis?
ii) What investigations do you suggest along with their findings to confirm your
diagnosis?

and koilonychias
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iii)Outline the pathogenesis of the disease. (CNMC)

3) A 45-year-old female presents to OPD with easy fatiguability and breathlessness from
two months. She complains of menorrhagia for six months. On examination she has pallor

i. What is your provisional diagnosis?

ii. Describe the pathogenesis of the condition. (2+3+6+2+2=15)
iii. How would you investigate the case to confirm the diagnosis?
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iv. Enumerate two other conditions which present similar features in peripheral smear.
v. What are reticulocytes? What is reticulocyte response? (RGMCH)

4) A 5 years old child presented with fever, cervical lymphadenopathy, and sternal
tenderness.
i) What is the provisional diagnosis?
ii) What are the lab investigation done in this case?
iii) What are the prognostic factors?
iv) Describe the WHO classification of this case? (2+6+4+3) (Kalyani & JMN)

5) A 7 years old male patient presented with , pallor, gum bleeding, lymphadenopathy.
Peripheral blood smear revealed fair number of abnormal lymphocytes.
i. What is your provisional diagnosis?
ii. How will you diagnose the case in the laboratory?
iii. Enumerate the prognostic factor. (2+8+5) (Malda)

6) A 65 years old female presented with pallor, weakness, and paraesthesia. On

examination tongue appears smooth and reddish. Laboratory examination reveals Hb
8gm/dl, MCV 110 fl. (2+5+3+5=15) (Midnapore)
i. What is your provisional diagnosis?
ii. How will you proceed for investigation to establish your diagnosis?
iii. Discuss the biology and pathogenesis of this condition.

7) Classify and describe blood group systems. Enumerate blood components and describe
their clinical uses. Enumerate the late complications of blood transfusion. (4+4+4+3 =15)
( MJN Coochbehar)

8) A 45-year-old man presents with generalized weakness, weight loss, abdominal

fullness, and gum bleeding. Peripheral blood smear shows anaemia and hyper
leucocytosis with granulocytes at all stages of maturation.
i. What is your provisional diagnosis? How will you investigate the case in the laboratory?
ii. Enlist the diagnostic features of different stages of the disease.
iii. Describe the characteristic cytogenetic abnormality found in this condition. (1+6+5+3)
(Purulia)

9) A 56 years old woman presents with fatigue, weight loss, abdominal pain and alteration
in bowel habits for last few weeks. The CBC report shows iron deficiency anaemia.
i. What is your provisional diagnosis?
ii. How will you investigate the case in laboratory?
iii. Describe the etiopathogenesis of the lesion.
iv. Discuss the prognostic factors. (1+ 5+5+4) (Purulia)

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10) A 5years old male child presented with fever, malaise, occasional epistaxis, sternal
tenderness, cervical lymphadenopathy for last month. (2+2+8+3) (diamond harbour)
i. What is your provisional diagnosis?
ii. How would you classify this disease?
iii. How would you proceed to confirm the diagnosis?
iv. What are the prognostic factors of this disease?
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11) 36 years old male with history of haemorrhoids presented with pallor , weakness and
dyspnoea. Blood examination showed Hb is 6.5 gm% with low MCV, MCH, MCI
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Probable diagnosis? Investigations to confirm the diagnosis. What are the other conditions
with similar blood picture. How will you distinguish each. (1+7+2+5) (Gouri devi,
Durgapur)

12) 18 years male presents with splenomegaly and progressive weakness for 6months.
Routing hemat reveals TLC 1lac 56 thousand per cmm with majority of the cells are
myelocytes and metamyelocyte Platelet count is 4lac 50 thousand per cmm. Provisional
diagnosis? Pathogenesis of this condition. How will you confirm the diagnosis? (Gouri
devi, Durgapur)
13) A5years old child presented with fever, cervical lymphadenopathy & sternal
tenderness.
i) What is the provisional diagnosis?
il) What are the laboratory investigations done in this case?
iii) What are the prognostic factors in this case?
iv) Describe the WHO classification of this condition. (2+6+4+3=15) JMN Kalyani

14) A40 years old person presented with pallor ; MCV=130 fl (2+8+5) JMN Kalyani
i. What is your provisional diagnosis?
ii. What are the laboratory investigations done in this case?
iii. Discuss the pathogenesis of this condition.
15) A Five-year-old boy was brought to Medicine OPD with severe pallor, recurrent
respiratory tract infection and occasional bleeding gum. On examination he had palpable
liver and spleen.
a) What is your provisional diagnosis? (2+8+5) Santiniketan
b) How will you proceed to confirm your diagnosis?
c)What are the prognostic factors affecting the outcome of the disease?

16) A 65 years Brahmin widow came to OPD with complaints of weakness and tingling and
numbness in both legs. On examination severe pallor and glossitis was noted.
What is provisional diagnosis? What are the etiologies behind the condition? How will
you investigate and confirm the diagnosis? How can you explain the cause of tingling and
numbness and in this condition? (2+4+6+3) IQ City

LONG QUESTIONS: (10 MARKS)

1) Classify anaemia on the basis of RBC morphology. Write down the PBS picture of
haemolytic anemia. Enumerate different anemias caused by RBC membrane defect and
their pathogenesis briefly. (3+2+5) SRIMS

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2) Describe the peripheral blood and bone marrow features of megaloblastic anemia. What
is schilling test? What inferences can be drawn from this test? (10) RGMCH

3) Define leukemia & its classification. How will you differentiate between a lymphoblast &
myeloblast? (2+4+4=10) MCK
B
4) Describe the Etiopathogenesis and classification of Acute Leukemia. (5+5)(IPGMER)
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5) Classify Hodgkin Lymphoma. Describe the histopathology of a common type with a
diagram. (3+7) (RGK)

6) Describe the etiopathology of beta-thalassemia. Explain the laboratory parameters with

features of PBS. (5+5)(RGK)

7) A 60 years old male patient presents with lowback pain and anaemia. His X-ray reveals
multiple osteolytic lesions. (2+8=10)
a) What is your provisional diagnosis?
b) How will you proceed to confirm the diagnosis? (SAGOR DUTTA)

8) Discuss the pathogenesis and laboratory investigations of hemolytic disease of the

newborn. (Purulia)

9) What are the causes of thrombocytopenia? Write down the pathogenesis and diagnosis
of disseminated intravascular coagulation. (3+4+3=10) (diamond harbour)

10) Haemophilia (10) (Shantiniketan)

11) Laboratory diagnosis of multiple myeloma. IQ City

SHORT NOTES: (5 MARKS)
1) ITP. (IPGMER) (Murshidabad)
2) Reed Sternberg cell. (NRS)
3) Pathogenesis of Beta thalassemia. (Midnapore)
4) Blast crisis. (Murshidabad)
5) Coombs test and its importance. ( MJN Cooch Behar)
6) Bombay blood group. (Gouri devi, Durgapur)
7) Hodgkins lymphoma. SRIMS
8) Chronic phases of Chronic myeloid leukemia. IQ City

EXPLAIN THE FOLLOWING: (4 MARKS)

1) In Thalassemia the basic pathology of anemia is ineffective erythropoiesis. NRS
2) Mismatched blood transfusion led to acute hemolytic transfusion reaction. RG Kar
3)Component separation of blood has immense role. Midnapore
4) Reticulocyte count has a role in differential diagnosis of anaemia. Midnapore
5) Microcytic hypochromic anemia may have various etiology. Murshidabad

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6) Transfusion of blood components and derivatives is better than whole blood transfusion.
7) Microspherocytes are found in peripheral blood smear of ABO incompatibility but not of
incompatibility. (30,31,32- Gouri devi)
8) PTT is prolonged in Haemophilia. JNM
9) Component separation of blood is helpful. JNM
10) RS cells are diagnostic of Hodgkin lymphoma. JNM
B
11) Importance of estimation of HbA1c. Santiniketan
12) Screening tests are essential for a safe blood transfusion Santiniketan
13) Leukaemia and Leukemoid reaction are different. Santiniketan
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CVS:-
VERY LONG & LONG QUESTIONS:

1) 50 years male suddenly experienced pain in midsternal region early in the

morning. The pain did not relieve by taking rest or taking any vasodilator. His
BP was gradually falling with perspiration and cold, clammy skin.
(1+4+5+5=15) NRS
i. What is your provisional diagnosis.
ii. What investigations you will do to have a conclusive diagnosis?
iii. Enumerate biochemical markers which will help in the diagnosis.
iv. Describe the morphological changes found in the organ involved in this
case.

2)Describe the morphological changes in heart in case of acute rheumatic

fever. (10 marks) NRS

3) Pathogenesis of Rheumatic heart disease. (10 marks) CNMC

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4) A 42 years old corporate executive suddenly felt severe precordial pain,
sweating, dizziness. He was immediately transferred to cardiac emergency.
What is your provisional diagnosis in this case? Discuss the relevant
laboratory investigations. Enumerate the underlying histopathological events in
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the myocardial tissue. (1+7+7=15) RG Kar

5) 55 years old male presented with left anterior chest pain of acute onset,
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diaphoresis, rapid thready pulse and respiratory distress". (2+3+4+6=15)
i. What is the most likely diagnosis?
ii. Discuss the risk factors and usual pathogenesis of the condition.
iii. How will you approach for diagnosis? Bankura

6) What is an infarct? Describe the factors that influence the development of

infarct. What are the morphological changes in heart after infarction? (2+4+4)
(Midnapore)

7) A 45 years old male had an attack of retrosternal chest pain and sweating
early in the morning. He had history of intermittent chest pain specially after
exertion. (2+2+5+2+4=15) (Murshidabad)
i. What is your provisional diagnosis?
ii. Enlist the risk factors and discuss etiopathogenesis and complication
iii. Enlist the biochemical test and their role in diagnosis of this case.

8) Write down the etiopathogenesis, pathological changes in heart and

complications of rheumatic carditis. (4+3+3=10) (diamond harbour)
9) A 40 years male feels sudden discomfort &tightness in chest & profuse sweating,
palpitation & become unconscious
i. What is your provisional diagnosis?
ii. How will you proceed to investigate the case?
iii. What are the possible complications the patient may face after recovery? (2+5+8)
(MCK)

SHORT NOTE: - (5 marks)

1) Pathogenesis of pannus in rheumatoid arthritis. (RG Kar)

2) Jones criteria (Bankura)
3) Comment on "Rheumatism licks the joints but bite the heart". (Burdwan)
4) Rheumatic Carditis. (Purulia)
5) Cardiac lesions of Rheumatic Heart Disease. (santiniketan )
6) Diagnostic criteria for RHD. (SRIMS)

EXPLAIN: - (4 MARKS)
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1) Rheumatic heart disease is pan carditis. (Sagor Dutta)
2) Morphology of cardiac vegetation can give a clue to diagnosis. (Gouri devi)
3) Enumerate the serological markers and their significance in Hepatitis B virus infection.
(JNM Kalyani)
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4) Atheromatous plaques are formed in branching points of major arteries. JNM
RESPIRATORY SYSTEM:-
VERY LONG AND LONG QUESTIONS:
1) Pathogenesis of bronchiectasis and emphysema in case of COPD. (10 marks) NRS

2) A 60 years old smoker suddenly develops cough, haemoptysis & chest pain for last 8
weeks. CECT reveals an irregular SOL in the lower lobe of left lung. He is also suffering
from progressive weight loss for last few months.
i) What is your provisional diagnosis?
ii) How will you approach to investigate this case?
iii) Describe the gross and microscopical findings of the commonest histological types.
(2+8+5=l5) CNMC

3) Enumerate types of lung cancer. (10 marks) (Murshidabad)

4) Briefly describe etiopathogenesis, gross and microscopic appearance and

complications of pulmonary tuberculosis. (3+2+2+3) ( MJN Coochbehar)

5) A65-year-old male smoker developed cough, occasional hemoptysis and marked weight

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loss in 4-6 weeks, Chest X-ray shows an opacity in right upper lobe. On examination one
moderately enlarged. firm lymph node was found over the neck.
i. What may be the provisional diagnosis?
ii. How will you proceed for a quick confirmation of your suspicion?
iii. How will you classify this condition histologically?
iv. What may be the complications in the case? (1+5+6+3) JIMS
B
6) Describe the pathogenesis of bronchial asthma. (10) JNM Kalyani
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7) A64 year old man, chain smoker, is suffering from chronic cough with 5 kg weight loss in
the last 3 months. Physical examination shows clubbing of fingers. Chest radiograph
shows an ill-defined 3cm. mass involving left hilum of lung. Serum calcium level is 12.3
mg/dl (2+8+5)=15 KPC
(i) What is your provisional diagnosis?
(ii) Describe the laboratory procedure for the diagnosis of the case.
(iii) Why is serum calcium elevated in this case?

8) i. Enumerate and write down briefly about different types of Interstitial lung diseases
ii. write a short note on occupational lung disease. (4+6) SRIMS

9) A 65 years old male smoker (30-pack years) has presented with H/O cough for one
month, not remitting to treatment and has coughed up blood two days ago. His plasma Na
level was found to be 132 mmol/L. (2+5+8) IQ City
i. what’s your most probable diagnosis?
ii. How would you confirm the diagnosis?
iii. Beiefly discuss the epidemiology, pathogenesis, and clinical syndrome associated
with the disease.

10) Pathogenesis and Pathology classification of Pneumonia. IQ City

11) Classify Carcinoma of Lung. Discuss briefly the diagnostic approach in a suspected
case of Lung Carcinoma. Write down morphology in brief of one commonly occurring lung
cancer. (3+4+3) NBMC

Short Note: - 5 marks

1) Carcinoid tumor of lungs (5) MCK
2) Stages of lobar pneumonia. (Gouri devi)
3) Pathogenesis of emphysema of lung. KPC
EXPLAIN: - 4 marks
1) Cystic fibrosis and ciliary dysfunction predispose to pathogenesis of
bronchiectasis. (RG Kar)
2) Asthma does not always elicit positive allergy skin test. (Purulia)
3) Squamous cell carcinoma of lung is associated with hypercalcemia. (Purulia)

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NERVOUS SYSTEM:-
1) Lab investigation for meningitis. (5) IPGMER

2) Discuss the role of CSF study in differential diagnosis of various common types of
infective meningitis. (10) Bankura

3) CSF in acute pyogenic meningitis VS CSF TB meningitis. (5) (Sagor dutta)

4) Meningioma. (5) (Purulia)

5) CSF examination helps in the evaluation of meningitis. (4)(Gouri devi)

6) Menangiomas. (5 marks) JIMS

7) CSF findings in pyogenic meningitis differ from tubercular meningitis. KPC

8) Why CSF examination is essential to diagnose a case of meningitis. Santiniketan

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RENAL PATHOLOGY:-
VERY LONG ANG LONG QUESTIONS:
1) A 30 years male comes to Urology OPD with colicky pain in left flank & haematuria
USG examination reveals a stone partially obstruct left ureter. The patient improves
with conservative treatment. After 8 months he developed polyuria, nocturia & imaging
study show enlarged & dilated kidney with thinned out cortex.
I. What is your provisional diagnosis?
ii. What are the causes of such condition?
iii. What are the possible outcomes of the patient? (2+8+5=15) MCK

2) A 6 years old boy has suddenly developed puffiness of face, oliguria and mild
hypertension about 2 weeks after recovery from sore throat.
a. What is your provisional Diagnosis?
b. Which laboratory investigations are to be done to confirm the diagnosis?
c. Describe the pathogenesis of the condition. (2+8+5) IPGMER

3) A 58 years male complained left sided flank pain with intermittent painless hematuria
for last 6 months. CT showed a heterogeneous mass in the left lower pole of kidney.

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i. What is your provisional diagnosis?
ii. What investigations you will do to have a conclusive diagnosis?
iii. Classify the disease in favour of your diagnosis.
(1+3+3+5+3=15)

iv. Describe the histological features of its most common subtype. NRS

4) 58 years old male patient presented with painless haematuria and a palpable mass in
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the loin. USG revealed a SOL in the upper pole of right kidney.
What is your provisional diagnosis? Discuss the genetic factors associated with
the disease. How will you proceed for laboratory diagnosis of the case? Discuss the
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progression and spread of the disease. (2+4+7+2=15) RG Kar

5) A 5 years old boy developed puffiness of face, oliguria, and mild hypertension 2
weeks after an attack of sore throat. (2+3+5=10) (Sagor Dutta)
a) What is your provisional diagnosis?
b) What are the clinical features of this disease?
c)What laboratory investigations need to be done today the diagnosis?

6) A 65 years old male patient presents with pain abdomen, lump, and haematuria.
i. What is your provisional diagnosis?
ii. How will you investigate the case?
iii. Describe the etiopathogenesis and prognosis of the disease.
(1+7+4+3) (MJN Coochbehar)

7) A 10 years old male patient presented with swelling in the face, legs, and scrotal area
which developed 8 days after tonsillitis treat. (1+4+5+5 = 15) (diamond harbour)
i. What is the possible diagnosis?
ii. Describe the pathological changes of involved organ in such condition.
iii. Enumerate the other condition of same clinical manifestation.
iv. Significance of blood and urine examination in this condition
8) A 6-year-old boy developed puffiness of face, oliguria, and mild hypertension two
weeks after an attack of sore throat. (2+5+5+3=15) (JIMS)
i. What is the provisional diagnosis?
ii. What is the pathogenesis of the condition?
iii. What laboratory Investigations to be done to confirm the diagnosis?
iv. Mention the fates of this condition.

9) A 5 years old child presented with anasarca & heavy proteinuria

i) What is the provisional diagnosis?
ii What are the laboratory investigations done in this case?
ili) Describe the prognosis.
iv) Describe the underlying pathogenesis responsible for heavy proteinuria in this
condition.
v) Why is there anasarca in this condition? (2+6+2+2.5+2.5=15) JNM

10) A7years old boy abruptly developed puffiness of face, oliguria, edema about
2weeks after his recovery from sore throat. (2+8+5) =15 KPC
(i) What is your provisional diagnosis?
(ii) What laboratory investigations are to be done to establish the diagnosis?
(iii) Describe the pathogenesis of the disease.

AL
11) A five-year-old boy presented in Medicine OPD with the history of puffiness of
face, scanty and high coloured urine for last fifteen days. He also had a sore throat one
month back.
i. What is your provisional diagnosis?
ii. Write down the relevant laboratory investigations and expected findings in this case.
iii. What is the pathogenesis of this disease.
B
iv. What are the outcome of such case. (2+6+5+2 = 15) (Santiniketan)

12) A72 year old male, who is known diabetic, has come to emergency with history of
HAR
pain in the lower abdomen and dribbling urination. The patient had H/O prolonged
catheterisation, per rectally a huge mass was palpated
i . What is your provisional diagnosis?
ii. How will you approach to diagnose the case.
ili. Write down briefly about the tumour markers applicable for this case and its
significance in the patients follow up
iv. Enumerate the grading system for the above pathology
(2+6+4+3) SRIMS

13) A young male aged 24 years complains of bilateral loin pain for several months and
has a history of dark cola coloured urine a week ago. Urine analysis showed microscopic
hematuria and proteinuria 2g/24 hours. (2+5+8) IQ City
i. What’s the most likely diagnosis?
ii. How would you proceed to confirm the diagnosis?
iii. Briefly describe its epidemiology, pathogenesis, pathology and prognosis.

14) A 50 years old man comes with generalised oedema with massive proteinuria and
hyperlipidemia.
i. What is your provisional diagnosis?
ii. Write briefly the etiopathogenesis of the disease.
iii. How do you confirm your diagnosis.
 iv. What are the sequel of it? (1+6+6+2) NBMC

14) compare the Nephritic syndrome and Nephrotic syndrome. (5+5) IQ City

SHORT NOTE- (5 MARKS)

1)Diabetic Nephropathy. (5) IPGMER/ NBMC
2) Spread of renal cell carcinoma. Bankura
3) RPGN. Bankura
4) Describe the pathogenesis of Diabetic Nephropathy. (Burdwan)
5) Complications of Urolithiasis. santiniketan

EXPLAIN: - 4 marks
1) Glomerulonephritis can be explained on immunological basis. CNMC
2) Nephrotic and nephritic syndromes are different entities. MJN Cooch Behar

B AL
HAR
GASTROINTESTINAL TRACT:-
VERY LONG ANG LONG QUESTIONS:
1) A 58 years male comes to surgical OPD with C/O anorexia, dyspepsia, weight loss,
pain & fullness after meal in epigastric region.
I. What is your provisional diagnosis?
ii. How will you investigate & treat the patient
iii. What are the possible outcomes of the patient? ( 2+8+5=15) MCK

2) Describe the pathogenesis of peptic ulcer disease in context to Helicobacter pylori

infection. (10 marks) NRS

3) A 45-year male presented with epigastric burning pain 2-3 hr after meal and worst at
midnight. (2+4+5+4=15) (Murshidabad)
i. What is your provisional diagnosis?
ii. Write about the risk factors and pathogenesis of this disorder.
Iii. Describe the morphology of the disease.

4). Describe the etiopathogenesis, clinical features, gross and microscopic appearance

i. Provisional diagnosis?
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of colonic carcinoma. (4+2+2+2) (MJN Cooch Behar)

5) 60 years old male with dyspepsia, pallor, rapid loss of weight, persistent epigastric
pain, palpable charged left supraclavicular lymph node.

ii. Gross and microscopic features of suspected Lesion.

B
iii. Name and state the role of any pathogenic bacteria which may be involved in the
etiopathogenesis of the disease. (2+6+2) (Gouri devi)
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6) Describe the pathogenesis of peptic ulcer. (10) JIMS

7) What are the risk factors of carcinoma colon? Describe the molecular pathogenesis
of carcinoma colon. (4 +6=10) JNM

8) Discuss the pathogenesis of peptic ulcer disease. Write down the macroscopic &
microscopic features of peptic ulcer. (6+4=10) JNM
9) Write down the aetiology, morphology, and complications of gastric ulcers
(3+4+3) (Santiniketan)

9) Define Inflammatory Bowl Disease. (2) NBMC

Write briefly the pathogenesis of IBD. (3)
Enlist the difference between Ulcerative Colitis and Crohn’s disease. (5)

SHORT NOTE: - 5 marks

1) Describe the morphology and complications of Typhoid and Tuberculous Ulcer of
Intestine. (Burdwan)
2) Causes of Rectal bleeding. (Murshidabad)
3) Gastric carcinoma. JIMS
4) Hematemesis, causes and consequences. IQ City

EXPLAIN: - 4 marks
1) Morphology of Crohn s disease and Ulcerative colitis a.re not the same. (CNMC)
2) Carcinoma colon is a genetic disorder. (Sagor Dutta)
3) Ulcerative lesion of the stomach is not always benign. (diamond harbour)
4) Crohn’s disease and ulcerative colitis have macroscopic and microscopic
differences JIMS
5) Diagnostic features of carcinoid tumour are specific. JIMS
6) Carcinoma colon is a multistep disease. Santiniketan
7) Colon cancer is a multistep process s and management of breast carcinoma. SRIMS
8) H.pyroli plays important role in GI pathology. NBMC

B AL
HAR
HEPATOBILIARY SYSTEM:
VERY LONG AND LONG QUESTIONS:
1) Pathogenesis of Alcoholic liver disease. (10 marks) CNMC

2) Enumerate the causes of cirrhosis. Mention the complications of cirrhosis Describe

the pathophysiology of ascites in cirrhosis. (2+3+5=10) RG kar

3) A 60 years old alcoholic presented with pedal edema, hematemesis, and ascites.
i. What is your provisional diagnosis?
ii. Describe the pathogenesis of the disease.
iii. Enumerate causes of ascites in this condition.
iv. What are the complications of this condition? (2+6+4+3=15) (Midnapore)

4) Write down pathogenesis of cirrhosis of liver. (10 marks) (Murshidabad)

5) A51-year-old alcoholic male gradually develops huge abdominal swelling and

dilated superficial veins over the abdomen. He presents with mild icterus and
complaints of anorexia, weight loss and thinning of extremities for long duration.
i. What is your provisional diagnosis?

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ii. How will you investigate the case in laboratory?
iii. Describe the pathogenesis.
iv. Discuss the possible complications. (1+5+4+5) (Purulia)

6) Write down the serum markers in Hepatitis B liver disease and its outcome.
B (7+3) Santiniketan
7) A 55 years old chronic alcoholic male patient came to opd presenting with bilateral pedal
oedema and ascites. (2+3+4+6) IQ City
i. What is your provisional diagnosis?
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ii. Enumerate the causes of similar presentation.
iii. Outline the pathogenetic mechanism.
iv. how will you proceed for final diagnosis in this case.

SHORT NOTE: - 5 marks

1) Pathophysiology of different signs and symptoms of cirrhosis. (Gouri devi)

EXPLAIN: - 4 marks

1) Alcoholism is not always a pre-requisite for cirrhosis. JIMS

2) Cirrhosis of liver can cause hematemesis and Malena SRIMS
3) Cirrhosis of liver is the most common pathogenesis of liver failure. IQ City
ENDOCRINE:-
VERY LONG AND LONG QUESTIONS:
1) How can you confirm diagnosis of diabetes mellitus? Discus the pathogenesis of
type I and type lI disorders. (2+4+4=10) (Bankura)

2) Describe the pathology of development of complications of diabetes. (10) (Malda)

3) Discuss the pathogenesis of multinodular goitre. Describe the morphology of

papillary thyroid carcinoma. (5+5) (Purulia)

4) A Thirty-year-old known diabetic patient developed symptoms of nausea, vomiting,

severe thirst and polyurea. He also has abdominal pain, fruity odour of breath.
i. What is your provisional diagnosis? (2+4+6+3) Santiniketan
ii. How will you establish your diagnosis by laboratory investigations
iii. What is the pathogenesis of this condition?
iv. What are the other complications of this type of patients?

5) i. Classify Diabetes mellitus

ii. Enumerate the Complication of type 1 Diabetes mellitus
B AL
iii. Write down the pathogenesis of complications of diabetes mellitus (3+3+4) SRIMS

SHORT NOTE: - 5 marks

1) Thyroid swelling is not always due to colloid goitre. (Malda)
2) Describe the Pathogenesis of diabetic ketoacidosis. JNM.
3) Hashimoto’s Thyroiditis. NBMC
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EXPLAIN: - 4 marks
1) Long term complication of diabetes. (Murshidabad)
2) Long term diabetes mellitus leads to various complications. (Sagor Dutta)
3) Glucotoxicity seems to be responsible for the long term complications of diabetes
(Purulia)
4) Goitre is more common in sub-Himalayan regions. (JNM)
5) FNAC is not sufficient to categorise follicular neoplasm of thyroid. (SRIMS)
6) SIADH may be a paraneoplastic syndrome. IQ City
BONE:-
VERY LONG AND LONG QUESTIONS: -
1) 12years old boy presents with a rapidly growing large tender swelling arising from
lower end of femur with involvement of surrounding tissue"- (2+3+4+8=15)
i. What is your provisional diagnosis?
ii. Describe the macroscopic and microscopic appearances of the lesion.
iii. How can you classify the lesion in different variants? (Bankura)

2) Discuss the morphology of giant cell tumour of bone. Enumerate the other giant cell
containing lesions of bone. (10) (Purulia)

3) A14 years old boy presented with fever, pain in right tibia with discharging sinus. X-ray
shows osteolytic lesion in upper tibia with new bone formation. (JNM)
i What is the diagnosis?
ii) Describe the underlying pathogenesis of this condition.
iii. What are the common causes of this condition?
iv) What are the names of necrosed bone and new bone found in this condition?
v) Enumerate the complications of this condition. (2 +6 +2 +2 +3=15)

SHORT NOTE :- 5 marks

B AL
4) i. Enumerate different types of osteoarticular neoplasm
ii .Describe in detail along a suitable diagram for Ewings sarcoma. (4+6) SRIMS

1) Giant cell tumor of bones. (NRS)

2) Osteogenic Sarcoma. (Burdwan)
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3) Tumours arising from end of long bone may be benign or malignant. Comment with at
least one example in each case. (Malda)
4) Sequestrum and involucrum are not same. (Murshidabad)
5) Pathogenesis of osteomyelitis. (Sagor Dutta)
6) Osteomyelitis (Santiniketan)
7) Sequestrum and involucrum. IQ City
8) Involucrum. NBMC

EXPLAIN:- 4 marks
1) Sequestrum leads to involucrum formation. JIMS
2) Osteosarcoma shows characteristic radiological appearance. JNM
3) Giant cells of GCT of bone are not neoplastic
FEMALE GENITAL TRACT:-
VERY LONG AND LONG QUESTIONS: -
1) Classify ovarian tumours. Describe gross, microscopy and clinical features of any one
variant. (4+2+2+2=10) Bankura

2) Describe the preneoplastic lesions of the cervix. Discuss the prevention of

carcinoma cervix. (5+5) (Purulia)

3) Describe the pathogenesis of carcinoma of cervix. (10) JIMS

4) Classify ovarian tumours. Describe teratoma in detail. KPC

5) What are the different stages of development of carcinoma of Cervix.

(10) Santiniketan

6) A 48-year-old? female has history of massive bleeding per vagina. On TVS, cervix was
healthy. However, an irregular mas was noted in the endometrium
i. What is your provisional diagnosis and state few other causes of bleeding per vaginum
ii. Briefly write about the subtypes of the condition and their pathogenesis
B AL
iii. Write in short about endometriosis and adenomyosis (5+7+3) SRIMS

7) A 39 years old lady comes in gynae opd with complaints of foul smelling vaginal
discharge and post coital bleeding. (1+6+1+2) NBMC
i. What is your provisional diagnosis?
ii. How do you further investigate the patient to conclude your diagnosis?
iii. What is the causative agent in this case and how it is classified?
HAR
SHORT NOTE: -
1) leiomyoma of uterus. (NRS/Burdwan)
2) Dermoid cyst of Ovary. (CNMC)
3) Aetiology of squamous cell carcinoma cervix. (Bankura)
4) Role of ATECOM in PAP screening of cervical cytology for Cervical cancer (Bankura)
5) Germ cell tumours of ovary. (Sagor Dutta)

EXPLAIN: - 4 marks
1) Palpable breast lesions are not always malignant - Explain. (Bankura)
2) Cervical Pap smear examination is na important screening tool for prevention of
cervical cancer.
3) Dysgerminoma is the ovarian counterpart of testicular seminoma. (Purulia)
4) Pathogenesis of cervical intraepithelial neoplasia. (Gouri devi)
BREAST:-
VERY LONG AND LONG QUESTIONS:-
1) A 56 years female presented with a mass in her left breast having retraction of nipple.
(2+8+5=15) IPGMER
a. What is your provisional Diagnosis?
b. Describe the Histomorphology findings mentioning different types.
c. What are the risk factors of the condition?

2) A 5 years old female presented with painless, hard fixed lump over breast. On
examination, left axillary lymph nodes are palpable. What is provisional diagnosis?
How to proceed to confirm the diagnosis with morphology of commonest type?
Enumerate important prognostic factors. (1+3+3+3=10) (Burdwan)

3) A 65 years old female came to OPD with the complaint of lump in the breast. On
examination, the overlying skin was found to be puckered and lymph nodes were
found to be enlarged in the axillary region. What is your provisional diagnosis. Name
four conditions which can present as a lump in the breast? How will you approach the
case to finalize your diagnosis? (2+4+1) (Gouri devi, Durgapur)

AL
4) A fifty years old female patient presents with a hard non tender mass of about 5cm
in diameter of upper outer quadrant of left breast with nipple retraction.
a) What is your provisional diagnosis? (2+5+4+4) (Santiniketan)
b) How will you proceed to confirm your diagnosis?
c) Mention four risk factors associated in this disease.
B
d)Enumerate four important major prognostic factors.

5) Pathogenesis and Molecular classification of Breast Carcinoma. (5+5) IQ City

HAR
SHORT NOTE: - 5 marks
1) Phyllodes tumour of breast. (RG Kar)
2) Prognostic factors of breast carcinoma. (Sagor Dutta)
3) Paget’s disease breast. NBMC

EXPLAIN: - 4 marks
1) FNAC from breast lump can differentiate between benign and malignant disease growth.
(Murshidabad)
2) All breast lumps are not malignant. (MJN Cooch Behar)
3) Breast carcinoma has a wide variety of morphologic appearances. (Purulia)
4) Role of PAP smears in screening of carcinoma of cervix. (diamond harbour)
5) Phyllodes tumor of breast is not always benign in behaviour. JIMS
6) Detection of molecular markers by IHC is important in case of carcinoma breast. JNM
7) IHC plays a pivotal role in diagnosis and management of breast carcinoma. SRIMS
MALE GENITAL SYSTEM:-
LONG QUESTIONS:- (10 MARKS)
1) Classify testicular tumors. Write down the gross and microscopic appearance of
seminoma. (10 marks) (Malda)

2) Discuss the pathogenesis of nodular hyperplasia of prostate. JIMS

EXPLAIN:- 4 marks
1) PSA as say is not a diagnostic test - Explain. Bankura
2) patient of BPH presents with hesitancy and increased frequency of micturition.
JNM Kalyani
3) Germ cell tumors of testes can show different histomorphology pattern. SRIMS
4) Pathogenesis of Nodular Hyperplasia of Prostate. NBMC

SKIN: -
SHORT NOTE: - 5 marks
B AL
1) Basal cell carcinoma. Bankura
2) Rodent ulcer. SRIMS
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ORAL CAVITY & SALIVARY: -
1) Short Note:- Pleomorphic Adenoma of salivary gland (5) MCK

AETCOME:-
1) Role of AETCOM in medical teaching (5 marks) malda
2) Role of AETCOME in medical teaching. (5 marks) (Murshidabad)
3) How do you take consent just before doing an invasive procedure/ core
needle biopsy on a female patient presenting with a breast lump.
HAR
B AL