Cases (2001-2017), Paper I-Paper IV

1. Paper I- 45 Years old male who is smoker for past 15 years presented with cough and
copious sputum expectoration. What are the possible diagnosis? And enumerate in detail
about one of the cause.
2. . 60 Year old male hypertensive, VDRL positive patient, presented with sudden onset of
excruciating pain anterior chest extending to back. Patient expired in casualty. What’s the
diagnosis? Write in detail about types of the lesion and morphological changes.
3. A 5 Year old boy presented with puffiness of face and massive proteinuria. What’s the
diagnosis? Write in details about pathological causes involved and discuss about any one of
the cause in detail.
4. A 15 year old boy presented with swelling in scrotum. Enumerate the pathological causes of
swelling, precursor lesions and morphology of any one of the condition.
5. A 60 year old male presented with headache and seizures. CT brain showed a ring enhancing
lesion in right frontoparietal region. Discuss the differential diagnosis. How do you confirm
the diagnosis?
6. A 50 year old gentleman who has been a diabetic for the past 10 years is found to have
albuminuria. Discuss the morphology of the renal lesion.
7. A 4 year old child presented with matted cervical lymph nodes, evening rise of temperature,
loss of appetite. FNAC of the cervical node was done. What will be the findings in FNAC
smear? What is the differential diagnosis in cytology? What are the investigations you would
suggest for confirming the diagnosis?
8. A 60 year old gentleman came to the outpatient department with a complaint that his hat
size kept changing of late. What is the probable diagnosis? Discuss the pathology of the
condition.
9. A 60 year old male was bedridden following surgery. He complained of pain in the calf
muscles on squeezing. He suddenly developed breathlessness and died. What is the
probable cause of death? What will the findings be in autopsy?
10. A 50 year gentleman hailing from West Bengal presented with nodular lesions in face and
upper limbs with hyper pigmentation of the skin. He had fever with weight loss and
hepatosplenomegaly. FNAC was done from the skin lesion. What is the probable finding in
the smear? Discuss the differential diagnosis.
11. A 65 year old male presented with bilateral painless testicular swelling. Discuss the
differential diagnosis and investigations required for confirmation of the diagnosis.
12. A 50 year old female with pain and swelling of small joints of fingers and wrists on both
sides with complaints of stiffness in the morning. What is the probable diagnosis? Discuss
the pathology and morphology of the condition with a note on the investigations for
confirming the diagnosis.
13. A post menopausal woman presented with bleeding per vaginum. Endometrial biopsy
showed endometrial hyperplasia. Ultrasound revealed a solid and cystic mass in the right
ovary. What is the probable microscopic picture of the ovarian tumour? What is the marker
for this tumour? What are the variants?
14. A 20 year old male presented with expansile osteolytic lesion in the wrist. Margins are well
circumscribed with no sclerosis. FNAC of the lesion was done. Discuss the differential
diagnosis in cytology.
15. A smoker presented with cough, haemoptysis and dyspnoea. Radiology revealed a mass in
the left lower lobe with hilar lymphadenopathy. Discuss the investigations for the diagnosis
of the lesion.
16. A 23 year old female presented with swelling in front of neck and exophthalmos. Discuss the
pathology of the lesion and investigations for confirmation of the diagnosis.
17. A 45 year old RTA patient was comatose and was put on mechanical ventilator. A. What are
the hospital acquired infections he is prone for? B. Describe the various organisms and
pathogenesis of hospital acquired Infections.
18. 25 year old PRIMI Gravida gave birth to a live fetus at 34 weeks of gestation. A. What are
the fetal, maternal causes for such an incident? B. What are the fetal complications in such a
case? [PTO]
19. 50 / F Known case of carcinoma breast received radiation for 2 months in the post operative
period. A. What are the main determinants of biologic effects of radiation? B. What are the
morphologic changes in the cells?
20. 55 / M Known hypertensive for 15 years presented with hypotension and was brought in a
state of shock. Examination revealed massive Intra Peritoneal hemorrhage. A. What is the
probable cause? B. What is the pathogenesis and morphology of this condition?
21. 35 / M was brought to ICU with core body temperature of 42 degree Celsius, A. What are the
clinical features? B. What is the pathogenesis?
22. 45 / M was complaining of chest pain for 30 minutes and was not relieved by rest. A. What
is your diagnosis? B. What is the pathogenesis and clinical course?
23. 40 / M who was a sand miner by occupation developed cough and breathlessness for 2
months. A. What is your probable diagnosis? B. What is the pathogenesis? C. What is the
morphology?
24. 35 / F was on intrauterine device and was forgotten for 10 years . She was complaining of
foul smelling vaginal discharge. A. What are the complications? B. What are the common
organisms?
25. 25 year old female presented with ovarian mass and elevated serum AFP. A. What is your
diagnosis? B. What are the other tumors in the same classification? C. What is the
morphology of this tumor?
26. 20 year old female presented with neck rigidity and CSF examination revealed Cob web
appearance on standing and lymphocytic pleocytosis. A. What is your diagnosis? B. What is
the mode of infection? C. What are the complications? D. How do you confirm the
diagnosis?
27. 60 year old female presented with pain and swelling in the right knee. Xray revealed
narrowing of joint space and osteophytes. A. What is your diagnosis? B. What is the
pathogenesis of the disease? C. What is the morphology?
28. 35 year old male presented with paroxysmal episodes of hypertension, palpitation,
headache and sweating. Imaging revealed retroperitoneal mass. Urinary VMA was elevated.
A. What is your diagnosis? B. What are the genetic syndromes associated? C. What is the
morphology? D. What are the prognostic factors?
29. 60 yr old male who is a known hypertensive presented with anaemia , fatigue and ebema &
died of renal failure. What will be the appearance of kidney on autopsy? a. Leathery
granularity on surface b. Symmetrically contracted c. Flea bitten kidney d. Irregularly scarred
kidney
30. 40 yr old male presented with mass in right testis. Histopathology showed tumor with cells
positive for c-kit & placental alkaline phosphatase. What is the tumor? a. Embryonal
carcinoma b. Seminoma c. Yolk sac tumor d. Teratoma
31. 25 yr old male presented with a solitary nodule of left lobe of thyroid with cervical
lymphadenopathy. What will be the probable cytology of the lymphnode? a. Reactive
lymphadenitis b. Follicular carcinoma deposit c. Papillary carcinoma deposit d. Benign
epithelial inclusion
32. 3 yr old female child presented with a rapidly growing orbital mass with loss of vision.
Microscopy showed small round cells and spindle cells with myxoid intercellular areas. What
is your diagnosis? a. Alveolar rhabdomyosarcoma b. Schwannoma c. Embryonal
rhabdomyosarcoma d. Retinoblastoma
33. 1. A 10-year-old boy with a family history of renal disease has auditory nerve deafness,
corneal dystrophy, and ocular lens dislocation and microscopic hematuria. Renal biopsy
shows irregular basement membrane thickening and attenuation of glomerular capillaries
with splitting of the lamina densa, increased mesangial matrix and foamyepithelial cells. The
most likely diagnosis is a . IgA nephropathy b. Alport syndrome c. Renal dysplasia d.
Goodpasture’s syndrome
34. A 60-year-old woman presented with diffuse abdominal pain for the past 2 months.
Investigations show a 3 cm adrenal mass composed of cells closely resembling adrenal
cortex. The presence of which of the following features would suggest that this mass is
malignant? a. Nuclear pleomorphism b. Increased mitotic activity c. Vascular invasion d.
Necrosis [PTO]
35. A primigravida was admitted with hypotension due to severe vaginal bleeding associated
with a low-lying placenta. Postpartum, she was unable to breast-feed her baby and
complained of pronounced fatigue. Laboratory findings include hyponatremia,
hyperkalemia, and hypoglycemia. Which of the following is she most likely to have had? a.
Adrenal haemorrhage b. Pituitary necrosis c. Bacterial infection d. Shock
36. At autopsy, the lungs of a 55 year-old showed greatly dilated bronchi and bronchioles filled
with yellowish secretions. The bronchioles could be followed upto the pleural surface. The
findings were most marked in the lower lobes. The most likely diagnosis is: a. Chronic
bronchitis b. Bronchiectasis c. Bronchial asthma d. Emphysema
37. A 44 year old male underwent renal transplantation. After one month, he was admitted with
fever, anemia, and oliguria. His serum creatinine was 2.2 a. What is your diagnosis? b.
Describe the morphology of the lesion in this case.
38. A 40 yr. old female presented with post coital bleeding for 4 months. Pap smear was done
followed by cervical biopsy. a. Discuss the differential diagnosis b. Write the morphology of
the lesion
39. A 62 year old male developed abscess in the leg for which incision and drainage was done.
The wound took long time to heal. a. Discuss the cause for delayed healing.
40. A 56 yr. old male admitted with pain over epigastric region and subscapular area , nausea,
vomiting. Serum bilirubin was 2.5 mg/dl, serum amylase was 3288 U/L a.Describe the
etiopathogenesis b.Write about the morphology of the organ involved in the lesion.
41. 1. A 10 year old boy with a family history of seasonal allergies develops erythema, itching
and swelling of the skin after an insect bite. Which of the following chemical mediators is
most responsible for this skin reaction? a) Bradykinins b) Complement c) Histamine d) Nitric
Oxide
42. A 60 year old man with alcoholic cirrhosis has ascites and pitting pedal edema in the lower
legs. The cause of the fluid accumulation is a) Decreased plasma oncotic pressure b)
Increased plasma hydrostatic pressure c) Increased vascular permeability due to Histamine.
d) Lymphatic obstruction with lymphedema
43. A 21 year old man shows bilateral raised yellow patches on the eyelids and a Xanthoma of
the Tendoachilles. He has a family history of death due to myocardial infarction and stroke
by 30 to 40 years of age. Which of the following mechanism best explains the pathogenesis
of the tendon and skin lesions? a) Decreased activation of capillary lipoprotein lipase. b)
Deficiency of apolipoprotein C-H c) Deficiency of apolipoprotein E d) Deficiency of low
density lipoprotein (LDL)receptor.
44. A 60 year old female on treatment for a NHL developed a vesiculo bullous lesion spread over
the skin of the L2 dermatome, Which of the following best characterizes the pathogenesis of
the lesion? a) Photosensitive reaction to a drug b) Reactivation of a latent virus in the
sensory dorsal Root ganglion. c) Skin invasion by malignant CD4 T cells. d) Toxin produc
45. 1. A 40 year old man with a 15 year history of Type I Diabetes Mellitus has microaneurysms
and retinal hemorrhages. Which of the following is the pathogenesis of the retinal lesions?
a) Inflammation of the optic nerve b) Microangiopathy c) Non enzymatic glycosylation. d)
Osmotic damage
46. A 35 year old man presented with fever, night sweats and weight loss. An opacity in the apex
of the right lung was biopsied which showed granulomatous (PTO) April 2012 inflammation
with central necrosis and peripheral lymphocytes and Langhan’s Giant cells. Which of the
following describes the type of necrosis that was present? a) Caseous necrosis b)
Coagulation necrosis c) Enzymatic fat necrosis d) Liquefactive necrosis
47. A 26 year old man with AIDS has experienced progressive loss of visual acuity in both eyes
for the past 4 months. Intraocular pressure was normal. The CD4 T cell count was 48 cells /
cu mm. Retinal examination showed white areas with indistinct borders. Which of the
following pathogen is the most likely causal agent? a) Candida albicans b) Cytomegalovirus c)
Toxoplasma gondii d) Human Immunodeficiency Virus
48. A 2 year old boy with Bruton’s agammaglobulinemia has recurrent pneumonia caused by
Streptococcus pneumonia. Which of the following factors is the most likely cause of
increased susceptibility to bacterial infections? a) Leukocyte adhesion molecule defect b)
Neutrophil chemotactic defect c) Neutrophil microbicidal defect. d) Neutophil opsonization
defect
49. 1. 40 year old chronic smoker, sand blaster by occupation died of road accident. At autopsy
gross examination of the lungs, shows discrete hard coalescent nodules and with foci of
cavitation. Hilar nodes are calcified a) What is the possible diagnosis? b) What is the
histopathology of the lesion? c) Describe the pathogenesis. d) Mention the associated lung
disease.
50. 45 year old bus driver a chronic smoker with H/O several episodes of chest pain died while
on duty. At autopsy, the time of death reveals within 6 hr. Heart examination shows nil
grossly abnormal findings. Post mortem angiogram shows zone of myocardial hypoperfusion
in the posterior left and right ventricles, with absent filling capillaries. a) What is the cause of
death? b) What stain was used to demonstrate the lesion in the heart? c) Describe the
Biochemical basis and microscopic features. d) Enumerate the serological assay to diagnose
the lesion.
51. 20 year old foot-ball player with history of joint pain following injury and relieved after
aspirin. a) Mention the inflammatory response. b) Describe the pathological events and the
site of action of aspirin. c) What is the risk of repeated ingestion of the drugs?
52. A 7 year old child admitted with hepatosplenomegaly with anemia and leucopenia. On
hematological examination, his bone marrow biopsy revealed clusters of large cells with
crumpy tissue paper like cytoplasm. a) Name the diagnostic cell. b) Describe the biochemical
basis of the lesion. c) Mention the pattern of inheritance. d) Describe the morphological
features and how to demonstrate the diagnostic lesion.

53. Paper II - A 25 Years old male, had met with an accident and had severe bruises in hand.
What is the type of inflammation he is likely to express and write about outcome of this
inflammation?
54. A sea diver got admitted with difficulty in breathlessness and signs of asphyxia, what is the
diagnosis, discuss about pathogenesis and sequences of the lesion and mention about other
types similar lesions?
55. An elderly lady about 45 years delivered a female baby with lymphedema of extremities and
cubitus valgus. Karyotyping revealed 45X. What is the diagnosis, what are the genetic
abnormalities, structural changes you expect? Describe in detail about molecular
pathogenesis.
56. A 30 year old lady came with the breast swelling who had a elder sister died of breast
cancer? What is the possible diagnosis? How will you confirm the diagnosis and describe in
detail about genes involved.
57. A 25 year old woman developed sneezing and wheezing after a walk in the park with many
flowering plants. What is the type of hypersensitivity reaction? Discuss the pathology of the
same.
58. A 45 year old man working in a factory producing car batteries came with complaints of
fatigue, weakness, numbness. And tingling sensation in fingers and toes. What is the
probable diagnosis? Discuss the clinical features and morphology of the condition.
59. A newborn male baby of a diabetic mother was delivered by Caesarian section. After a few
minutes of normal breathing, the baby developed difficulty in breathing and cyanosis. Baby
died after 2 days as therapy failed. Discuss the morphology of lungs at autopsy and
pathophysiology leading to it.
60. A 50 year old man returned to India after working in Egypt for 10 years. He developed
haematuria and obstructive uropathy. Bladder biopsy was done. What is the possible
findings in biopsy of the bladder in this patient? Discuss the pathology and complications of
the disease.
61. A 35 year old alcoholic presented with acute abdominal pain. His serum enzyme levels were
elevated. What is the probable diagnosis? What is the morphological change seen in
peritoneal biopsy (both gross and microscopy)?
62. A 35 year old male hailing from Kumbakonam with complaints of fever with chills and non
pitting edema of the lower limbs. What is the investigation you will advise? Discuss the
pathology of the lesion with pathogenesis, clinical features and morphology of the disease.
63. A 55 year old male who underwent renal transplant two months ago and on
immunosuppressive therapy complaints of oliguria and haematuria? On examination he had
azotemia. Patient did not survive. What is the process occurring? What is the morphology?
64. 19 year old female admitted with history of abortion carried out by native methods with
fever, rigor, cold clammy skin and falling Blood pressure. Discuss the pathophysiology of the
condition.
65. A 45 year old lady gave birth to a baby with flat facial profile, oblique palpebral fissures and
epicanthic folds. What is the probable diagnosis? Discuss the genetic aspects, clinical
features and ways of prevention.
66. A 45 year old male presented with PUO and pain in right hypochondrium. USG showed SOL
liver. Discuss the differential diagnosis. Add a note on special stains which may be useful.
67. A 12 year old boy was administered PPD injection intracutaneously. The boy developed
reddening and induration at the site of injection after 12 hours. What is the pathology of this
reaction?
68. A 2 year old child presented with abdominal mass, fever and weight loss. The child had
elevated urine levels of VMA and HVA. What is the probable diagnosis? Discuss the
prognostic factors.
69. 34 / M who was a non vegetarian (H/O taking beef) presented with sudden onset of
convulsions and on imaging was found to have space occupying lesion in the right frontal
lobe. A. What is your diagnosis? B. What is the etiopathogenesis of the above disease?
70. 40 / M presented with massive splenomegaly. Discuss the differential diagnosis.
71. 38 / F presented with acute abdominal pain and was diagnosed as torsion ovary What is the
cause for the characteristic morphology in torsion?
72. 28 / F had H/O abortion by a local person developed fever, tachycardia, BP of 60 / 40 mm Hg
and excessive bleeding PV. APTT was 25 min and platelet count was 40000 / mm3 A. What is
your diagnosis? B. What is the etiopathogenesis of the above disease?
73. 2 year old boy presented with hepatosplenomegaly, CNS involvement and muscle wasting.
Liver biopsy was done and frozen section with Fat Stain confirmed the diagnosis. A. What is
your diagnosis? B. What is the pattern of inheritance? C. What is the morphology?
74. 55 / F with H/ O hysterectomy at the age of 42 was given HRT. A. What are the merits and
demerits of HRT? 3. 4 / m with BMI - 12 kg / m2 with stunted growth and muscle wasting. A.
What is your diagnosis? B. What is the differential diagnosis? C. What is the morphology of
various organs?
75. 4 / m with BMI - 12 kg / m2 with stunted growth and muscle wasting. A. What is your
diagnosis? B. What is the differential diagnosis? C. What is the morphology of various
organs?
76. 1 month old child presented with intestinal obstruction due to meconium ileus and
prolonged neonatal jaundice. Mother of the child was complaining of abnormal sweating in
 the child. A. What is your diagnosis? B. What is the genetic defect in this condition? C. What
is the morphology of various organs?
77. 25 years old male presented with matted cervical lymph nodes and evening rise of
temperature. His ESR was 60 mm / hr with lymphocytosis. A. The diagnostic feature in
cervical node biopsy would be a. Monotonous sheets of atypical lymphocytes. b. Collar stud
abscess. c. Caseating granuloma. d. Eosinophilic abscess. B. Write about the
pathomorphology of the disease.
78. 35 year old lorry driver presented with frequent diarrhea , productive cough and loss of
weight. On investigation there was reduction in CD4 count. A. What is your diagnosis? B.
What is the cause of diarrhea? C. What is the pathogenesis of the above disease?
79. A three year old boy presented with loin mass and hematuria . A. What is your diagnosis? B.
What are the genetic alterations in this conditions? C. Mention the syndromes associated
with this condition.
80. 12 year old boy presented with short stature, bone pain and beaded ribs A. What is your
diagnosis? B. What is the pathophysiology of this condition?
81. 18 years old boy presented with fever of unknown origin, fatique and generalized
lymphadenopathy. His peripheral smear showed lymphocytosis with atypical lymphocytes. a.
What is your probable diagnosis? b. What is the specific antibody test to confirm your
diagnosis?
82. 30 years old male smoker presented with symptoms of cough with hemoptysis. X-ray chest
showed a mass lesion in the hilum of left lung. His serum calcium levels were elevated. a.
What is your diagnosis? b. What is the cause for hypercalcemia?
83. New born baby had flat to elevated reddish irregular lesions on the face. a. What is the
nature of lesion? b. Name the hereditary syndrome associated with this condition.
84. 15 year old short statured female had webbing of neck, low posterior hair line and
pigmented nevi with failure to develop secondary sex characteristics. a. What is the
syndrome? b. What is its molecular pathogenesis? c. What is the tumor that they are prone
to develop?
85. A 25 year-old-woman seeks consultation as she is concerned that several members of her
family have been affected by the onset of progressive loss of mental function and motor
coordination and choreoathetosis when they reach middle age. Genetic studies have shown
that some of these individuals have CAG trinucleotide repeat mutations. Which of the
following sites are likely to be grossly abnormal in these affected persons? a. Caudate
nucleus b. Basal ganglia c. Amygdala d. Hippocampus
86. A 19-year-old girl with a height of 135 cm, webbed neck and poorly developed secondary
sexual characteristics has a continuous murmur heard over both the front of and back of the
chest. She had claudication pain and coldness of her extremities. Which of the following
cardiovascular abnormalities is she most likely to have? a. Mitral stenosis b. Coarctation of
the aorta c. Patent ductus arteriosus d. Atrial septal defect
87. The following findings were noted at autopsy ina 49-year-old woman with a history of atrial
fibrillation The heart was enlarged with vegetations along the line of closure of the mitral
valve with partial fusion of the leaflets and thickened,shortened chordae tendineae. The left
atrium was enlarged and contained a mural thrombus. Which of the following conditions
could she have had? a. Marantic endocarditis b. Rheumatic carditis c. Infective endocarditis
d. Sytemic lupus erythematosus
88. A 23 -year-old man football player falls and hits the right side of his head against a bench. He
gets up and resumes play. He collapses about 40 minutes later. Radiology reveals a convex
area of hemorrhage centered in the right parietal region. His condition is most probably due
damage to which of the following vessels ?. a. Cavernous sinus b. Carotid artery c. Middle
meningeal artery d. Anterior cerebral artery
89. 25 years old male who was HIV positive presented with multiple red to purple papulo
nodular lesions in the lower extremeties which slowly increased in size. a. What is the
lesion? b. What is the causative organism? c. What is the role of HIV & Cytokines in this
lesion?
90. 30 years old male presented with thickening of ulnar, peroneal nerves and multiple papules
and nodules over the face. a. What is your probable diagnosis? b. What will the nerve biopsy
show in this condition? c. Name the special stain used to confirm the diagnosis?
91. 6 years old male presented with posterior mediastinal mass and multiple axillary nodes with
bone pain. Biopsy from the mass showed small round cells with finely fibrillar matrix. a.
What is your diagnosis? b. What is the cause of bone pain? c. Enumerate the differential
diagnosis?
92. 5 years old boy presented with periorbital edema and severe proteniuria. His serum
cholesterol was raised. a. Name the condition. b. What is the pathophysiology of edema in
this condition?
93. A 75 years old man admitted to the hospital with severe sub Sternal chest pain radiating to
the arm and the jaw, died on day 5 of hospitalization due to ventricular arrhythmia. At
autopsy, the left ventricle showed a pale yellow area of necrosis involving the posterior wall
and the papillary muscles in the region of distribution of the right coronary artery. The type
of necrosis is a) Caseous necrosis b) Coagulation necrosis c) Enzymatic fat necrosis d)
Fibrinoid necrosis
94. A 20 year old women with AIDS presented with a painless Non pruritic erythematous lesions
on the neck and the hard palate. Which of the following is likely to be the causative
organism? a) Cytomegalovirus b) Epstein – Barr virus c) Human herpes virus d) Human
Immunodeficiency virus
95. A Cholecystectomy was performed on a 50 year old female and as the wound was not
healing properly she was asked about her diet. Though she consumed a diet high in protein
she did not eat fruits or vegetable. Which of the following is the most likely cause for the
poor wound healing? (PTO) a) Decreased synthesis of granulation tissues b) Decreased
synthesis of type III collagen c) Decreased tensile strength of collagen d) Defect in fibrillin in
elastic tissue
96. A centrally located lung mass from a 60 year old chronic smoker shows a tumour composed
of densely packed small round to spindle cells with numerous mitoses and areas of necrosis.
Which of the following endocrinopathies is associated with this type of tumor? a) Carcinoid
syndrome b) Hypercalcemia c) Polycythemia d) Inappropriate secretion of Antidiuretic
hormone
97. A 26 year old women with third degree burns developed septic shock. With 24hours she was
bleeding from all needle puncture sites, with extensive ecchymoses and petechiae and GI
Bleeding. Lab studies showed Hb-6gm/dl., platelet count 64000/cu mm., PT 20 seconds, PTT
50 seconds and D-dimer positive. Which of the following is the most likely diagnosis? a)
 Autoimmune thrombocytopenia b) Circulating anticoagulants c) Disseminated intravascular
coagulation d) Thrombotic thrombocytopenic purpura
98. A 25 year old women with poorly controlled gestational diabetes mellitus gave birth to a
female infant who developed seizures 3 hours after birth. Which of the following hormones
is the most likely cause of this symptom? a) Cortisol b)Epinephrine c) Glucagon d) Insulin
99. A 60 year old female on alighting after an 18 hour long air travel complained of pain in the
right calf. On examination there was warmth, tenderness and modest swe1ling. Bed rest,
elevation of the affected extremity above the level of the heart and treatment with
anticoagulants are therapeutic measures for this condition. Name the condition being
treated and what is the most important reason for the treatment?
100. 16 year old female 130 cm in height presented with primary amenorrhoea. She was
obese with infantile genitalia & inadequate breast development. The karyotype of this
patient would most likely be: a) 45X b) 46XX / 46XY c) 47 XXY d) 47 XX + 21
101. 28/F presented with acute abdominal pain, diagnosed as twisted ovarian cyst and
underwent surgery. Describe the 4 10 5 etiopathogenesis and morphology of the ovary in
this case.
102. 6 months old child presented with protuberant abdomen, vomiting, fever and
deterioration of psychomotor function. Bone marrow biopsy was done and special stain also
applied 4 10 5 for confirmatory diagnosis. Describe the etiopathogenesis and morphology of
the lesion.
103. 28/M admitted with H/O focal fits in the left arm that became generalized. He had
taken antituberculous treatment irregularly. CT scan was taken. Describe the
etiopathogenesis 4 10 5 and laboratory diagnosis in this case.
104. 34/M admitted with massive splenomegaly. Discuss the differential diagnosis.

105. Paper III - A 70 year old male presented with complaints of difficulty in passing
urine and severe back ache. What’s the diagnosis? Describe about etiopathogenesis,
morphology, grading and staging of the lesion
106. A 6 months old baby presented with features of apnoea and died before
resuscitation. Enumerate the causes of the possible diagnosis and morphological changes
involved?
107. A 65 Year old male presented with swelling on right iliac fossa. USG revealed a mass
in cecum. Some distant and deep seated lymph nodes are seen in abdominal cavity. Discuss
about the possible tumors of this site and write in detail about any one of the lesion.
108. 25 Year old male presented with diabetes, skin pigmentation, loss of libido and
hepatomegaly. What is your diagnosis? Write about classification and etio-pathogenesis of
the condition.
109. . A 25 year old male, a known case of Marfan syndrome came to emergency with
sudden onset of excruciating pain in the anterior chest and radiating to the back. ECG did
not reveal any changes. What is your probable diagnosis? Discuss about the pathology and
morphology of the condition.
110. 6 year old child with h/o fever, sore throat 4 weeks ago was brought with complaints
of oliguria, smoky urine. Clinical examination revealed mild hypertension and edema. What
is the probable diagnosis? Discuss the etiopathogenesis, clinical features and morphology of
the condition.
111. A 20 year old female presented with unilateral solid ovarian mass. The tumour cells
were positive for c- kit, Oct3, Oct4. What is the probable diagnosis? Discuss the clinical
features, pathology and prognostic factors of the tumour.
112. A 45 year old lady with history of contraceptive intake for years. USG showed
solitary SOL in the liver. Discuss the differential diagnosis. A 60 year old female admitted
with ascites was found to have a pelvis mass. At laparotomy the perineum was studded with
gelatinous nodules. What is the condition called? Discuss the causes, differential diagnosis
and pathology of the same.
113. A 50 year old female presented with a huge unilateral breast mass measuring
8x6x6cm. No micro calcification was seen on mammography. Excision of the mass was done.
Grossly the lesion showed a cut cabbage appearance. What is the probable diagnosis?
Discuss the FNAC and histopathologic findings.
114. A 45 year old male presented with an indolent slowly progressing ulcerated lesion
near the left lower eyelid. A biopsy of the lesion was done. What is the probable diagnosis?
Discuss the pathologic features.
115. A 3 year old child presented with mass in the right hypochondrium. Serum AFP level
was markedly elevated. What is the probable diagnosis? Discuss the pathologic features.
116. A 18 year old girl presented with cystic SOL in the cerebellum. What is the most
probable diagnosis?
117. A 45 year old gentleman presented with insidious onset of haematuria progressing
to chronic renal failure. His brother had similar complaints. USG showed bilateral enlarged
cystic kidneys. What is the probable diagnosis? Discus the genetics, pathogenesis and clinical
features of the same.
118. A 35 year old man underwent appendicectomy. On gross examination, a bright
yellow lesion was seen in the tip of appendix. What is the probable diagnosis? Discuss the
pathology of the lesion. Add a note on special stains which may be useful in the diagnosis?
119. A 55 year old male presented with a mass in the sacrococcygeal region. FNAC
showed an aspirate of myxoid material. Discuss the differential diagnosis.
120. 40 / F presented with uterine mass and menorrhagia. Patient had hysterectomy and
gross examination revealed circumscribed soft yellow mass in the uterus of 5 cm size. A.
What is your diagnosis? B. What is the morphology? C. What is the IHC marker used?
121. 50 / F presented with lump breast of 4 cm size with pushing margins, soft in
consistency. HPE revealed sheets of large pleomorphic cells with prominent nucleoli. A.
What is your diagnosis? B. What is the prognosis of this tumor? C. What are the IHC markers
used?
122. 50 / m presented with solitary thyroid nodule and raised serum calcium. A. What is
your diagnosis? B. What are the prognostic factors of this tumor? C. What are the IHC
markers used? D. What is the genetic defect associated?
123. 55 / m presented with multiple coin shadows in the lung. Trucut biopsy of the mass
was done. Primary could not be evaluated. A. What are the differential diagnosis you can
think of? B. How will you proceed further? C. What is the Immuno Histochemistry panel you
would do?
124. 28 year old female presented with bleeding PV after a month following evacuation
of molar pregnancy and serum B HCG titer was 100000 IU / ml A. What is your diagnosis? B.
What is the morphology of this condition? C. What are the complications?
125. 70 year old male presented with dysuria, hematuria and palpable hard nodule per
rectum. Serum PSA was 100 ng / dl. A. What is your diagnosis? B. What are the morphologic
variants of this condition? C. How will you do follow up of the case?
126. 25 year old male presented with recurrent hemoptysis and hematuria, proteinuria,
edema, hypertension and azotemia. A. What is your diagnosis? B. What is the morphology of
this condition? C. What is the pathogenesis?
127. 40 year old male presented with multiple Erythematous Tense Bullae which do not
rupture easily A. What is your diagnosis? B. What is the morphology of this condition? C.
What is the differential diagnosis?
128. 30 year old female with H / O oral contraceptive intake presented with solitary
space occupying lesion in the liver. A. What is your diagnosis? B. What is the morphology of
this condition? C. What are the differential diagnosis?
129. 15 year old boy presented with swelling right knee. X ray revealed metaphyseal lytic
lesion with soft tissue extension. A. What is your diagnosis? B. What are the morphologic
variants? C. What are the prognostic factors of this condition?
130. 30 year old female presented with solitary nodule thyroid with cystic change and
cervical lymphadenopathy A. What is your diagnosis? B. What are the histologic variants? C.
What are the genetic alterations associated with this condition?
131. 5 year old boy presented with delayed walking, difficulty in getting up and
pseudohypertrophy of calf muscles. Familial inheritance pattern was noted on history
elicitation. A. What is your diagnosis? B. What is the morphology? C. What is the molecular
genetics of this condition?
132. A 35-year-old man presented with dull pain in the right knee for the past 3 months.
X- ray showed a lytic tumour involving the epiphysis and the metaphysis, eroding the
subchondral bone plate. The tumour was covered by a thin shell of reactive bone. Which of
the following tumours is this most likely to be? a. Metastatic tumour b. Chondroblastoma c.
Giant cell tumour d. Fibrous dysplasia
133. A 70-year-old woman has difficulty keeping her room in order, wanders away from
the house and has loss of memory. She has no history of seizures or trauma. What are the
most likely histopathologic findings associated with her condition? a. Infarction in the region
of the caudate nucleus b. Neurofibrillary tangles and cortical plaques c. Gliosis in the
hippocampus. d. Degeneration of the substantia nigra
134. A 35-year-old woman has a mass in the neck which is a tumour with nests of
polygonal cells in a stroma containing amyloid. Immunostaining for calcitonin is positive. She
also has hypercalcemia. Which of the following neoplasms is she most likely to have? a.
Follicular thyroid carcinoma b. Medullary thyroid carcinoma c. Parathyroid carcinoma d.
Metastatic small cell carcinoma
135. A 25-year-old woman with a history of oral contraceptives use for about 14 months
presented with frequent episodes of vaginal bleeding and a 0.7 cm polypoid mass in the
endocervical region. The ectocervix, uterus and adnexa appear normal. What is the biopsy of
this mass most likely to show? a. Benign endocervical polyp b. Endocervical adenocarcinoma
c. Clear cell carcinoma d. Microglandular hyperplasia
136. 8 years male child had a sudden onset periumbilical pain with vomiting and low
grade fever. His TWBC count was 15000 cells / cu.mm with neutrophilia of 75 %. The
diagnostic feature in the resected appendix would be a) Hyperplastic lymphoid follicles b)
 Presence of E. vermicularis in the lumen. c) Neutrophilic infiltration of the muscularis propria
d) Eosinophilic exudates in the lumen
137. A 46 year old Female presented with dysfunctional uterine bleeding and painful
nodularity of both breasts. A 10/8/6 cm right sided pelvic mass was detected. A
hysterectomy with bilateral salpingo oopherectomy was performed. The resected specimen
showed a right ovarian mass with an intact capsule which on cut section was yellowish, with
solid and cystic areas. The presence of which microscopic feature would characterize this
tumour? a) Schiller Duvall bodies b) Call Exner bodies c) Psammoma bodies d) Hyaline bodies
138. 8 years old male child presented with acute abdominal pain and bleeding per
rectum. O/E he had dark brown macules on his face and buccal mucosa. A 8 cm
pedunculated, lobulated polyp was excised from the small intestine. The presence of which
of the following histologic feature characterizes this ployp? a) Mature goblet cells and
absorptive cells b) Lymphoid follicles in the stroma c) Arborising network of smooth muscle
fibres intermixed with lamina propria d) Numerous eosinophils in the lamina propria
139. 28 year old male had trivial injury to his right hand. An X ray revealed a well
circumscribed oval lucency in the 2nd metacarpal bone surrounded by a thin rim of
radiodense bone. The characteristic histology would be the presence of a) large vascular
spaces lined by endothelial cells b) well circumscribed nodules of hyaline cartilage c) benign
spindle cells in a storiform pattern d) curvilinear woven bony trabeculae surrounded by
moderately fibroblastic proliferation
140. Paper IV - A 76 year old male had difficulty in walking and his children suspected
stroke and brought to physician. Physician diagnosed it as peripheral neuropathy. Routine
hematological investigations showed, WBC’s 3.2x109 , RBC’s 2.22 million, HB 8.5 gms%,
HCT 27%, MCV 121.6fL, MCH 38.3 pg, MCHC 31.5g/dl, RDW 18%, Platelets 115x109 ,
Reticulocytes 1.8%. Discuss about possible diagnosis, which CBC findings help the
physician to get diagnosis, what are the other tests can be done?
141. A 28 year old woman presented with history of 2 days fever, chills, sweating and
malaise. Patient had visited Ghana of Africa 3 weeks back with family and CBC showed, WBC
11x109 , HCT 25%, MCV 92fL, Platelets 176x109 , Peripheral blood smear showed, inclusions.
Write possible diagnosis, discuss the type of anemia.
142. A 25 year woman born out of consanguineous marriage, presented with ulcer,
discoloration, itching of lower leg. On examination she had splenomegaly with features of
anemia. What’s the diagnosis? What are the changes you expect in RBC’s and other tests to
confirm the diagnosis?
143. A 2-year-old child presented with platelet count of 15,000/L and had history of viral
fever. What’s the diagnosis? Write briefly about differential diagnosis and possible
investigations required to substantiate your diagnosis.
144. A 15 year old boy came with complaints of haemarthrosis. His father had similar
episodes. What is your probable diagnosis? Discuss the pathophysiology, clinical features
and management of the disorder.
145. A 19 year old girl presented with anaemia, repeated leg ulcers and auto
splenectomy. What is your diagnosis? Discuss the etiopathogenesis, pathophysiology,
diagnosis of the disease.
146. A 23 year old female presented with solitary nodule thyroid in the left lobe with
cervical lymphadenopathy. FNAC of thyroid was done. Discuss the differential diagnosis in
cytology.
147. A 50 year old lady presented with anaemia, paraesthesia of lower limbs. She had
beefy tongue. Her serum LDH was mildly elevated. What are the investigations you
recommend for arriving at a diagnosis?
148. A 10 year old boy presented with osteolytic lesion in the skull, skin nodules. FNAC of
the skin nodule showed plenty of eosinophils and histiocytes. What is the probable
diagnosis? Discuss the classification and syndromes associated.
149. A 55 year old lady with complaints of low back pain, was found to have multiple
osteolytic lesions, anaemia. Bone marrow aspiration was done. Serum electrophoresis was
advised. What is the probable diagnosis? Discuss the diagnostic criteria and prognostic
factors.
150. A 50 year old male presented with oral ulcers and bullous lesions in the face and
scalp. Skin biopsy was done. It revealed suprabasal bulla. What is the probable diagnosis?
What is the role of IF in the diagnosis of these lesions?
151. A 40 year old female presented with thyroid nodule and cervical lymph nodal
enlargement. Serum calcitonin was raised. What is the finding in FNAC of the thyroid
nodule?
152. A 45 year old male presented with anaemia, weakness and dragging sensation in the
abdomen. He had massive splenomegaly. His total count is 1,50,000. What is the probable
diagnosis? Discuss the pathology and prognostic factors in this condition.
153. 50 year old female admitted with menorrhagia and anaemia. Discuss the peripheral
smear and bone marrow findings. Add a note on other investigations for assessment of
anaemia in this patient.
154. A 20 year old male patient has a history of episodic haemolysis following intake of
anti malarial drugs. What is the probable diagnosis?
155. An elderly lady came with complaints of generalised weakness and fatigue. Her total
WBC count was 80,000 cells/ cumm with 89% lymphocytes. What is the probable diagnosis?
156. 25 year old male with recent H/O infection with WBC count of 80000 cells/cu mm.
USG abdomen – no organomegaly. A What is your diagnosis? B. What are the differential
diagnosis? C. How will you confirm your diagnosis? D. What are the other causes? (PTO)
157. 60 year old male was found to have serum ‘M’ protein of 3.5 gm / dl and lytic lesion
in vertebra. A. What is your diagnosis? B. Enumerate the other conditions in this group. C.
What is the clinical course?
158. 45 year old female had pins and needles of extremities, abdominal pain, lemon
yellow appearance of skin and glossitis. Gastric mucosal biopsy revealed atrophic gastritis.
Blood examination revealed anemia. A. What is your diagnosis? B. Enumerate the
differential diagnosis. C. What are the morphologic changes in bone marrow?
159. 30 / M presented with hemarthrosis following trivial injury and epistaxis.
Examination revealed normal platelet count, prolonged clotting time, prolonged APTT. A.
What is your diagnosis? B. What is the pathogenesis of this condition? C. What are the other
tests done for confirmation?
160. 25 year old female presents with recent h/o allergic rhinitis, urticaria and infection
with WBC count of 50 x 109 cells/ cu mm. Usg abdomen shows no organomegaly A. What is
your diagnosis? B. What are the associated conditions? C. What are the other causes?
161. 70 year old male was found to have generalised lymphadenopathy and Leukocytosis
- count 70 x 109 cells / mm3 A. What is your diagnosis? B. What is the immunophenotype of
this condition? C. What is the clinical course?
162. 45 year old female had menorrhagia, difficulty in swallowing and pitting nails. Her
blood examination revealed anemia. A. What is your diagnosis? B. Enumerate the
differential diagnosis? C. What are the morphologic changes in the bone marrow? D. What is
the cause of dysphagia?
163. 30 year female presented with fever, anemia, thrombocytopenia, renal failure and
neurological deficits A. What is your diagnosis? B. What is the pathogenesis of this
condition? C. What are the other tests done for confirmation?
164. 25 year old male with H/ O chloramphenicol intake presented with WBC count of
800 cells/ cu mm A. What is your diagnosis? B. What is the pathogenesis and morphology of
this condition? C. What are the other causes? D. What is LGL leukemia?
165. 60 year old asmptomatic male was incidentally found to have serum M protein of
2.5 gm / dl A. What is your diagnosis? B. Enumerate the other conditions in this group. C.
What is the clinical course?
166. 45 year old male had dragging sensation in left upper quadrant and discomfort after
eating. Blood examination revealed anemia, leukopenia and thrombocytopenia. A. What is
your diagnosis? B. Enumerate the differential diagnosis. C. What is the morphology of the
diseased organ?
167. 20 year old female presented with epistaxis and menorrhagia. Examination revealed
normal platelet count, prolonged bleeding time, prolonged PTT and reduced Ristocetin
cofactor activity. A. What is your diagnosis? B. What is the pathogenesis of this condition? C.
What are the other tests done for confirmation?
168. 2 years old child had severe anaemia with massive spleen. Peripheral smear showed
numerous target cells and microcytes with nucleated RBCs. a. What is the probable
diagnosis? b. What is the confirmatory lab test?
169. 50 years old male presented with generalized lymphadenopathy and
hepatosplenomegaly. Peripheral smear showed rouleaux formation and spherocytes. a. Give
your differential diagnosis. b. What is the role of Coombs test in the diagnosis?
170. 7 years old child presented with generalized lymphadenopathy,
hepatosplenomegaly and medisatinal mass. Peripheral smear showed increased WBC count
(1,20,000 cells/cu.mm) with blasts forming 80%. a. What will be the type of blast? b. What is
the probable immunophenotype?
171. Peripheral smear of a child with progressive ataxia showed numerous acanthocytes
and few nucleated RBCs. a. What is your diagnosis? b. What should be the percentage of
acanthocytes?
172. A 14-year-old boy with sickle cell anemia was admitted with pain and tenderness of
the right hip and thigh. A radiograph reveals irregular bony destruction of the femoral head.
Which of the following infectious agents is most likely responsible for his findings? a)
Pneumococus b) Streptococcus c) Salmonella d) Borrelia
173. A young healthy man has seasonal episodes of nasal congestion, sneezing and
watery eyes. There is no cough or fever but there is swelling of his nasal passages. Chemical
mediators from which of the following cell types are responsible for these features? a)
Macrophage b) NK cell c) Basophil d) Mast cell
174. Which of the following findings is most likely to be observed following splenectomy
for blunt trauma? a) Tear-drop cells b) Punctate basophilia c) Red cell inclusions d)
Elliptocytes
175. A male infant has failure to thrive and has recurrent episodes of bacterial
pneumonia with both Hemophilus influenzae and Streptococcus pneumoniae. Which of the
following diseases is he most likely to have? a) Di George syndrome b) X-linked
agammaglobulinaemia c) IgA deficiency d) Complement inactivation syndrome .
176. 42/M presented with weakness, weight loss and massive splenomegaly, Peripheral
smear was done. Describe the molecular pathogenesis, morphology, and natural history of
this case.
177. 26/M presented with weakness, shoulder pain and non-healing leg ulcer. Peripheral
smear done followed by another confirmatory test. Discuss the pathogenesis and
morphology.
178. 40/F presented with fever with rigor, and mild hepatosplenomegaly. Peripheral
smear was done for diagnosis. Discuss in detail the peripheral smear picture.
179. 42/F admitted with fever, night sweat weight loss, painless cervical
lymphadenopathy. Lymphnode biopsy was done. CD15 and CD30 positive. Describe the
morphology and molecular genetics of this disease.
180. A 48 year old man has fever, weight loss, sweating and a dragging sensation in the
abdomen. Physical examination showed massive hepatosplenomegaly. Laboratory studies
revealed normocytic anemia and thrombocytopenia and a WBC count of 110,000/cu mm,
Bone marrow aspirate was hypercellular with neutrophils in all Stages of development. < 2 %
of the WBCs were myelobalsts. Which of the following laboratory findings would most likely
to be positive? a) Leukocytes for Alkaline Phosphatase b) Leukocytes for CD 10 antigen c)
Leukocytes for Philadelphia chromosome d) Leukocytes for TRAP
181. A 45 year old man had a sudden onset pain in his right great toe. O/E the area was
red and swollen. The TC was 18000 / cu mm, with neutrophilia and 10 % band forms.
Synovial fluid microscopy would show the following crystals: a) Calcium pyrophosphate b)
Cholesterol c) Negative birefringent crystals d) Postive birefringent crystals
182. A 55 year old woman had developed multiple pigmented, pedunculated tumours
and flat oval, coffee coloured skin patches in the last 3 years. She has also had during this
period episodic attacks of headache, palpitations and profuse perspiration. Her pulse rate is
160 / min and her blood pressure 180/120 mm Hg. Which of the following tests would be
most useful in finding the cause of her Hypertension? a) Complete urinalysis b) Serum
Electrolytes c) Urine for free cortisol, 24 hours d) Urine for metanephrine, 24 hours .
183. A 4 years old boy had history of frequent respiratory infections and greasy Stools.
The child is below the normal percentile for weight & height for age. Physical examination
shows nasal polyps and coarse inspiratory rales in both lung fields that clear with coughing.
Which of the following laboratory tests is the next step in determining a diagnosis? a)
Chromosome study b) Nasal smear for eosinophils c) Stool culture d) Sweat chloride test
184. A 22 male patient was hospitalized with blood oozing from his nose and mouth. He
also had petechiae and ecchymoses all over his body. There was generalized
lymphadenopathy and hepatosplenomegaly Lab studies showed normocytic anemia,
thrombocytopenia and a Total WBC count of 32000/cu.mm The PT and PTT were prolonged.
The Peripheral smear showed hypergranular promyelocytes filled with Auer rods. The
patient is most likely to have which chromosome translocation? a) t ( 8: 14) 5 10 5 b) t ( 9:
22) c) t ( 14: 18) d) t ( 15: 17)
185. Splenectomy is the treatment for this anemia and its complications. Name the
anemia and discuss rationale for the treatment.
186. The cord blood of a Rh positive foetus is evaluated for Rh incompatibility. Which of
the following tests would be diagnostic for a hemolytic reaction? a) Hemoglobin estimation
b) Reticulocyte count c) Total Bilirubin estimation d) Direct Coombs Test
187. A 45 year old woman presented with a sore tongue, and instability while walking.
UGIE shows chronic atrophic gastritis of the fundus and body. Laboratory studies showed a
severe macrocytic anemia with pancytopenia and hyper segmented neutrophils. Which of
the following laboratory test findings most likely be reported? a) Decreased serum folate b)
Decreased serum Gastrin c) Decreased urine methyl malonic acid d) Increased Vitamin B 12
absorption after addition of intrinisic factory
188. 62/F presented with mild weakness. On examination she had cervical and
supraclavicular lymphadenopathy. Total count was 185000/µL, Peripheral smear was done.
Describe the molecular pathogenesis, morphology and prognosis for this case.
189. 36/F presented with fatigue and weakness. Peripheral smear was taken. Discuss the
morphology and etiology of the case.
190. 40/F presented with fever with rigor and mild hepatosplenomegaly. Peripheral
smear was done for diagnosis. Discuss in detail the Peripheral smear picture.
191. 42/F admitted with fever, night sweat, weight loss, painless cervical
lymphadenopathy. Lymph node biopsy was done. CD15 and CD30 positive. Describe the
morphology and molecular genetics of this disease.
193. A 16 year old boy presented with an oval 8 cm erythematous Scaly lesion over the
lower part of the back of his upper arm. The lesion was irregular in shape with indurated
elevated Hyperpigmented margin and depressed pale centre. The lesion lacked sensation.
The pathognomonic microscopic feature would be a) Hyperkeratosis and acanthosis b)
Perineuronal granulomas with nerve destruction c) Leukocytoclastic vasculitis d) Pautrier’s
microabscess
194. A 25 year old male working in battery making unit presented with Intermittent
headache and occasional colicky abdominal pain. The peripheral smear showed
hypochromic microcytic anemia with a few polychromatophilic cells. The diagnostic feature
to look for in the (PTO) peripheral smear would be the presence ofa) Target cells b) Punctate
basophilia c) Sickle cells d) Schistocytes
195. A 40 year old man with complaints of fever and fainting spells over the past 6
months states that he faints only on standing. He also complained of pain in the left upper
quadrant aggravated by inspiration and pain in the right flank. Blood pressure was normal
both when lying down and sitting up. A late diastolic murmur was heard on auscultation.
Spleen was enlarged and tender with a friction rub. Urine was positive for blood and the
sediment positive for RBCs. Which of the following is the most likely diagnosis? a) Calcific
aortic stenosis b) Hypertrophic cardiomyopathy c) Left atrial myxoma d) Pericardial effusion
196. A 30 year old female presented with fever and pain in the right shoulder. O/E a
malar rash was present. CBC showed a mild normocytic Anemia. Urine examination showed
trace proteinuria. A positive antiphospholipid antibody test was also present. The
fundamental defect in this disease is thought to be failure of the mechanisms that maintain
self tolerance. a) True b) False
197. A 42 year old man with history of alcohol abuse has a distended abdomen and
dependent pitting edema. He had a Vascular lesion on his face with a spidery appearance.
Which additional physical finding in this patient would have the same pathogenesis as the
skin lesion? a) Ascites b) Caput medusa c) Gynaecomastia d) Oesophageal varices
198. . A 70 year old man presented with persistent low grade fever of 2 months duration.
He was on treatment for hypertension for the past 2 years. CBC revealed HB 18gm / dl, Total
Count 56000 / cu mm., neutorphila with marked shift to the left, Urine sediment showed
episodic haematuria. The procedure for confirmation of the most likely diagnosis would be:
a) Chest X rayb) MRI of the abdomen c) Echocardiogram d) Electro encephalogram
199. A needle biopsy of an abdominal mass in a 2 year old male child showed small round
primitive appearing cells with dark Nuclei, scant cytoplasm and poorly defined cell borders
arranged in solid sheets. The background showed eosionophilic faintly fibrillar material. A
diagnostic feature to look for would be : a) Formation of abortive tubules or glomeruli b)
Pseudorosettes c) Alternating hyper and hypocellular areas d) Clear PAS+ cytoplasm
200. A 21 year old male had a resection of the distal Femur of the right Leg for a necrotic
metaphyseal tumour extending through the cortex into the surrounding soft tissue. When
the patient had been 2 years old a cancerous lesion had been surgical removed from his
right eye. Which of the following regulatory genes is most likely to be responsible for both
these lesions? a) BRCA1 suppressor gone b) MYC proto-oncogene c) RAS proto-oncogene d)
RB suppressor gene