Practical test

)OSPE(
Two minutes for each slide
male with back pain, 69 )1(
polyurea, depression. Give a
.diagnosis

Skull X-Ray showing mul-

Blood slide showing stary
tiple head lesions due to
sky apearance
Multiple Myeloma
 yrs child: pale, jaun- 7 )2(
diced, painful swelling in
hand
Peripheral blood Smear
showing sickling of RBCs

Complications
Sickle cell anemia Dactlytis *
Swelling of hands due to leg ulcers *
.dactlytis stroke *
ACS*
 yrs. female with gen- 61 )3(
eralized lymphadenopathy
WBC = 67, 000
mature lymphocytes 91%
HB% = 11 g/dl
Plt = 12o,000

?The diagnosis
Chronic lymphoblastic
Leukemia could of mature
.blood cells
peripheral blood show- *
.ing lymphocytosis
Lab Results. WBC leuko-
cytosis(mnormal)
CBC of pt C/O fatigabil-)4(
ity, paler slight jaundice and
finger numbness

.Megaloblastic anemia
complete BC with slight *
raised WBC, NEUT, BAS and
low Lym, and Eosinophils
 Child with jaun-)5(
dice, pale

...Comment
Child with distended * Hairy appearance on the skull
abdomen
Diag... Beta Thalassemia
Child with bleeding )6(
gum, swelled joints
Bleeding time high 
PT normal 
PTT prolonged 
Plt count normal 

Diag... IDIOPATHIC Thrombotic

.purpura, disease, **HIA, VWD
Ques-7

This is skull X ray & Bone marrow aspi-

ration of 55 years male presented with
.back pain , fever & loss of weight
.A- Describe each picture
?B- what is the diagnosis
 This is a blood
Ques-8
film
Hb &
electrophoresis
of 6 year old
. child

A- describe
.what you see
B- what is the
?diagnosis
C-- what are the
?complications
A. Electrophoresis slide
B. Sickle cell anemia
B. Dia
Quest 9
A. Skin snip
?A- What is this B. Onchocerciasis by
?B- what is the diagnosis volvulus
C- what are the complica-C.Hep, pigmentation,
blindness
?tions Treatment... Ivermecten
 A. Horse Shoe shaped
kidney showing stones
with inflammation fea-
.tures
B. Acute Renal failure,
RCC, pyelonephritis, ATN,
obstructive uuropathy,
Hydrometer and hy-
.dronephrosis

Quest 10
This is a kidney, longitudenally
sectioned
?A- describe it
B- what are the complications
 Ques-11

is is a foot of 35 years female from Singa suffe

om foot swelling for 5 years
Describe the foot below
- How you diagnose

A. Foot with multiple nodules with a

serosanguinous discharge(blood stained
fluid)
,B. Clinically, assessment
.Lab
 Quest 12
?A- What is this
?B- What are the complicatio

A. Whole blood on a drip

.stand
..B. Acute
Hemolytic rx, non
hemolytic, infection, and
,embolism
Iron overload, fluid over-
...,load
...Delay
 Ques-13

A- What is this
B- What is the most probable pattern of
nheritance

A. Pedigree chart showing fam-

ily tree
B. Autosomal dominance
(mendelian mode of inheri-
tance)
Ques-14

A- Describe what
you see
B- What is the
?diagnosis

A. Hb electrophoresis
B. Alpha thalassemia
 Ques-15

A. Chart showing kary-

?A- What is the above picture
otyping of the chromo-
somes
? B- Describe B. Haploid karyotype
showing Missing sister
?C- What is the diagnosis .chromatid on Y chromatid
C. Klinefelter(45)
)down syndrome(47
Ques-16
This is a chest X ray
& sputum analysis
film of 30 years old
male from Sinkat ,
he was suffering
from nocturnal
fever , chronic
cough, chest pain &
. breathlessness

A- What is the
probable
A. Pulmonary Tb
?.diagnosis
B. Film showing Ziehl
Nielsen stain showing
B- Comment on the
Mycobacterium tubercle
 Ques-17

.This a 40 years man from Kadu

A. Leonine face with mul-
tiple large nodules on the
A- Comment on the face & the
.face .histopathology picture
Slide.. Histological slide
showing giant cell granu-
.B- Give a diagnosis
.loma
.B. Lepromatous Leprosy
Ques-18

X Y

.This X a female Karyotype

A. Karyotype chart show-
ing missing on Y chromo-
.A- Describe some & missing sister
chromatids of X chro-
?B- What is the diagnosis
.matid
B. Turner syndrome
 A. Film showing hyper-
Ques-19 segemented neutrophils,
thrombocytopenia and
.reticulocytosis
B. CML, DD..IDA
C. Cytogenetic analysis
looking for ABL, BCR
(Philapdelphia chromo-
.some)

is a peripheral blood picture of 60 years female C/O: f

of weight. O/E was 12cm below the costal margin
8gm/dl. TWBC: 200,000 /cumm, Platelets: 550,000
escribe the blood film
What is your diagnosis
How you confirm the diagnosis
,Chest X Ray showing cardiomegaly
,Pneumothorax
Ques-20 This farmer
from
Al Managil 48
years he pre-
A.sented
Slide... showing granu-
with he-
lomas
B. Intestinal schistosomi-
.matemisis
asis
C. Portal hypertension,
liver Cirrhosis, Abd
varices, esophageal
varices

A- Comment on the
above Histopathology
.picture
B- What is the diagno-
?sis
Ques-21
This 60 years pa-
tient was suffer-
ing from
Morning neck
stifness, Joints
.swelling & pain
A. H
O/E: febrile, hep- joint
.atosplenomegally .atio
ESR: 130/hr X-ray
bone
bon
A- Comment on B. R
the these pictures C. F
teop
B- What is the di- fract
?agnosis join
C- What are the
complications
Ques-22

This is a bone marrow aspirate

of the patient below who came
from AL MAFAZA suffering
from fever for 4 months, loss of
.weight

A- Describe this Bone

.marrow aspirate
.B- What is the diagnosis
?C- What is the cause
A. Slide showing non flagellate Amastigote
.stains
Photo showing right abdominal swelling
.and hepatosplenomegaly
B. Visceral Leishmaniasis
,C. L. Donovani
 This 54 years man
Ques-23
has history of
diarrhoea for 3
months
He presented with
.abdominal ulcer
Stool analysis
showed the below
A. Slide.... Giemsa stain trophozoites with .picture
.two nuclei
B. Giardiasis
C. Chronic gastroenteritis, malabsorp-
.tion, bowel perforation A- describe the be-
.low film
B- What is the di-
?agnosis
C- What are the
complications
 Ques-24

This habit is
a world
..wide
A- Mention 3
neoplastic
complica-
tions
B- Account 3
non neoplas-
A. Lung cancer, esophageal ca, pan-
.creatic ca tic complica-
B. Non neoplastic... COPD, Chronic
tions
 Ques-25

This important
world wide
(hazard sign)
which usually
put in factories,
laboratories
and hospitals
A. Radioactive signs A- What is this
B. Skin cancers, leukemia and ?sign for
,lymphomas
B- Account
complications
of exposure to
.this hazards
Ques-26
Many people
around the world
use
to drink these so-
lutions

A- Account 3 non
neoplastic compli-
cations

B- Mention 2 neo-
A. Hypertension, Alcoholic liver
plastic
disease, acute complica-
pancreatitis
,B. HCC, pancreatic ca
Ques-27

A- What is the di-

agnosis of this pa-
?tient
B- How you diag-
?nose

A. HIV/AIDS
B.History, Clinical examinations,
..and Lab
To Confirm... Elisa and Western
blot
 Ques-28

his is resected abdominal aorta

- Describe
- What are the complications
A. This shows abd. aorta
with directing aneurysm
with and intima and me-
..dia tear of muscles
B. Ruptures and hemor-
rhage, compression of ad-
Ques-29

A- Describe this
diagram
B- What are the
predisposing fac-
?tors
C- What are the
?complications
A. Obstruction of pul-
monary. Trunk
B. Hyperlipidemia, preg-
nancy, continued bed
rest, polycythemia, con-
traceptives use
C. Pulmonary. Embolism,
RHD(cor pulmonale),
Ques-30

This is a
common test
done for this
man C/O:
, fever
Cough &
chest
.Pain
A. PPD tuberculin test
B. Inject 0.1 ml of PPD, wait for 48
?A- What is this test .hours and check for induration
.C. Positive tuberculin test
?B- What is the principle
D. Delayed type Hypersensitivity
C- What is the diagnosis
(IV)
Ques-31

A- comment on
these diagnostic
tools
A. Strip for RDT Falciprum malaria and Giemsa
B-Criticize
,stain slides each
.method
B. RDT
Not reliable since it does not show species den-
.sity and not specific
GIEMSA STAIN
It takes time thus is not favorable in emergency
It is the best diagnostic tool for * showing
Ques-32
This is a famous
laboratory
method
useful in the di-
agnosis of many
diseases
A- what is the
.prinicple
A. ELISA
B- HIV account 3
Principle .. Ab-Ag complex principles(III HSR)
B.
.uses
MALARIA
 Ques-33

This a left atrium of 40 years adult

who has long history of chest pain &
difficulty breathing
A- Describe the
.He was treated with penicillin
pathology
B- What is di-
?agnosis

A. Slide showing hypertro-

phy of the left atrium with
.fish mouth appearance
B. Infective endocarditis
Ques-34
This a diagnostic
.procedure
?A- What is it
B- What are the
value in parasitic
?diseases

A. Lumbar puncture
B. High opening pressure, High
protein, low glucose, turbid and
cloudy appearance, high PH,
A. Baby with moon face appear-
ance, low set ears, small eyes with
epicanthal poles, short neck, and
.macroglossia
B. Down syndrome
C. Lab...karyotyping
 Quest
Quest 36
36
A- Describe
Describe this
this A. Hypertrophied heart(both
chambers)
heart
heart B. Hypertrophic Cardiomyopa-
B- What
What is
is the
the di-
di- thy
C. ECG(impulses monitoring),
??agnosis
agnosis CXR, echocardiograph
 Quest 37
A- Comment on the above picture
.B- Account 3 possible causes
A. Left foot showing gan-
grene
B. Ishcemia, infection by
 Quest 38
This little boy came from
.Almoglad

?A- Describe what you see

?B- What is your diagnosis
?C- What are the causes
?D- How you treat

A. Boy with bow leg with windswept

.deformity
B. Rickets
..C. Vit D deficiency
 A. Bleeding Time
B. Assess the bleeding time, clin-
ical assessment for before surg-
.eries
C. Normal.. 3-8 minutes of clot-
Quest 39 ting time
A- What is this test?
B- What are the uses?
?C- How you interpret the results
 A. Microscopy showing crys-
tals
B. Renal
caliculi(nephrolithiasis)

st 40
Urinalysis of a 7 years boy showed the below picture

What is your comment

What is the possible diagnosis
Quest 41
A. Jaundice
?A- What is this B. Hemolytic anemia, liver
?B- What are the causes ,disease
C. LFT check the bilirubin
?C- How you investigate level, ERCP(Endoscopic
 Quest 42
This patient came
.from Aweel
suffering from
swelling lower limb
.for 5 years

A- What is your di-

?agnosis
B- What is the
?cause
?C- How
A. Lymphatic you treat
filariasis
B. W. Bancrofti and Brugi Malay
,C. Surgical
Drugs...DEC, Ivermectin
 A. ***microcytic nor-
mochromic RBCs
Autoimmune hemolytic***
anemia(Destruction of
RBCs)
*
B. Immunophenotyping
C. Anemia is due to de-
struction of RBCs leading
.to increase bilirubin

Quest 43
This is a blood film of 60 years woman who has generalized
fatigability, loss of weight & fever. O/E: pale & tingue of
jaundice. There was cervical lymphadenopathy &
splenomegally (4 cm)
Hb: 9 gm/dl, TWBC: 185,000/cumm, Platelets: 110,000/
cumm
.Coomb’s test was positive
A- Comment on the peripheral blood
 A. Hypersegemented neu-
trophils with target cells,
(anisocytosis and poikilocy-
tosis)
B. Serum B12 and Folic
acid
C. Megaloblastic
anemia( which type???)

Quest 44
This is a blood film of a 25 years male suffering
from fatigability, shortness of breath & abnor-
.mal sensations in the limbs
A- Comment on this blood film
B- What further investigations you request to
?reach the diagnosis
 A. Inf mononucleosis, cat
scratch disease, scrofula,
Trypanosomiasis(Winter
.bottom sign), Lymphoma
B. CBC, fine needle aspi-
ration, lymph node
.biopsy

st 45
is a 6 years boy presented with this swelling
Account 4 differential diagnosis
Outline your investigations to reach the diagnosis
Quest 46
This is a nephrectomy
specimen taken from a
.35 years male
A- Describe
?B- What is the cause
C- What is the complica-
?tion

A. Dissected kidney showing

spongy appearance with multiple
.indurations
B. (DD...PKD, Multicystic spongy
kidney disease)
C. ESRD
Quest 47
This 13 years boy was suffering from repeated attacks of
bleeding since birth. CBC only showed moderate anemia,
peripheral blood film revealed hypochromic microcytic
.RBCs, BT : (6 min), PT : (14 sec); aPTT : (75 sec)
A- What is the diagnosis
?B- What further investigations you ask for
.C- Outline the management
Quest 49 •
What is the .A
possible diag-
?nosis
What is the ap- .B
parent compli-
cation you can
?see
What could be .C
the cause for
this complica-
?tion
Quest 50
A 15 years boy presented with severe chest pain & general-
.ized fatigability
The (left) picture was taken when the patient was 6 years
.old, while the (right) is recent
?A- What further investigations you need
?B- What is your diagnosis
?C- What are the complications
Quest 51
A- Describe the above
?picture
B- What is your diag-
?nosis
C- How you investi-
?gate
Quest 52
This longitudinally sectioned intestine was removed from
a 20 years old patient who was suffering from chronic di-
arrhoea. He has one brother & 2 other relatives died at
age 35 & 40 respectively. (the left picture is the histology)
?A- What is your diagnosis
?B- What is the complication
Quest 53
.This is a blood film of 40 years patient
A- Comment
?B- What further tests you may need
C- Outline the management
quest 54
1) what this you see?
2) If this was found in
lab what could be your ? 
diagnosis
Quest 55
The below picture shows
lesions in one of the or-
gans, this is and is seen
?following what
 Keep-
ing
Hopes
A-
! Flame