Questions

a) What type of wound healing is this?

b) Describe the stages of healing by primary intention.
c) Name factors that promote good wound healing.

5 ) A 60-year-old diabetic patient develops a non-healing ulcer on the foot with

pale granulation tissue.
Questions
a) Why is wound healing delayed in this patient?
b) Describe the role of angiogenesis in wound healing.
c) Enumerate local and systemic factors affecting wound healing.

6) A patient presents with fever, dyspnea, and cough with yellow sputum. CXR
shows consolidation. Histology shows neutrophils filling alveoli.
Questions
a) Identify the pattern of inflammation.
b) Describe chemotaxis and phagocytosis of neutrophils.
c) Name cytokines involved in neutrophil recruitment.

7) A 25-year-old male develops a raised, firm, itchy scar on his chest following
minor abrasions. The scar extends beyond the original wound.
Questions
a) What abnormality of wound healing is this?
b) Explain the role of TGF-β in scar formation.
c) Differentiate hypertrophic scar and keloid.
5)A child has delayed umbilical cord separation and recurrent infections with no
pus formation.
a) Identify the defect.
b) Name the molecule affected.
c) Explain why pus formation is absent.

6) A 30-year-old woman has extensive second-degree burns. The wound is large

and irregular, and it takes several weeks to heal, leaving scars.
Questions
a) What type of wound healing is this?
b) Describe healing by secondary intention.
c) Name complications of wound healing.

7) On day 5, a postoperative patient experiences a sudden discharge of

serosanguinous fluid from the wound.
Questions
a) What is wound dehiscence?
b) What are the risk factors for dehiscence?

8) A postoperative wound shows excessive granulation tissue (“proud flesh”).

● Define granulation tissue.
● Why does excess tissue delay healing?

SECTION C — ANALYTICAL-BASED QUESTIONS

1. Compare acute inflammation and chronic inflammation based on mechanism,
predominant cells, mediators, and outcomes.
SECTION A: PROBLEM-BASED QUESTIONS
1. A 50-year-old chronic smoker presents with persistent cough.
Chest X ray shows increased bronchial markings and biopsy shows
squamous metaplasia.
a. Explain the mechanism of cellular adaptations
b. Describe metaplasia with examples
c. Add clinical significance and reversibility
2. A 45-year-old woman presents with a gradually enlarging thyroid
welling. FNAC shows features of simple goiter.
a. Describe types of cellular adaptations
b. Explain hypertrophy and hyperplasia with suitable clinical
examples
c. Describe the pathogenesis of this case
3. A 65-year-old hypertensive patient develops sudden chest pain.
ECG changes are seen, and his cardiac enzymes are elevated.
a. Describe the causes and mechanisms of reversible and
irreversible cell injury
b. Discuss the morphological and biochemical changes in
myocardial infarction.
4. A 62-year-old presents with severe chest pain radiating to the left
arm. ECG shows ST elevation and serum troponin is elevated.
a. Define reversible and irreversible cell injury
b. Explain the sequence of biochemical events in ischemic
injury
c. Describe morphological changes in myocardial infarction
9. A 12-year-old girl notices enlargement of her breasts while taking
bath.
a. What is the main physiological cause of the enlargement of
breast
b. What are its morphological features and types
c. What is the mechanism of this adaptation?
10. Gross examination of brain on autopsy of a 90-year-old man
with history of atherosclerotic disease reveals shrunken brain with
loss of brain substance.
a. Which type of cellular adaptation has occurred?
b. Give the underlying mechanism
c. Give any two other causes of this cellular adaptation with
examples
11. A 21-year-old female gives birth to her 1st baby. She started
to give breast feed right after birth and continued till 1 year with
no difficulties and complications.
a. Name and define the cellular processes that started in
breast during pregnancy that allowed her to nurse the baby
during this period
b. Give three pathological examples of this process and
describe its pathogenicity/mechanism
12. A 60-year-old male, chronic alcoholic dies in a roadside
accident. On autopsy, liver was found to be moderately enlarged,
yellowish, soft and greasy.
a. Discuss pathogenesis of the lesion
 a. Define gangrene and classify types
b. Explain pathogenesis of dry gangrene
c. Describe morphology
d. Explain clinical complications

SECTION B : SCENARIO-BASED QUESTIONS

1. A 70-year-old man in shock shows swollen hepatocytes with pale
cytoplasm on biopsy. Write a short note on hydropic change and
its change.
2. An obese woman with diabetes presents with hepatomegaly,
ultrasound shows fatty infiltration. Explain fatty change and its
mechanisms.
3. A patient with HBV hepatitis shows councilman bodies on biopsy.
Write a note on apoptosis and its morphological features.
4. A patient with acute MI undergoes biopsy showing coagulative
necrosis. Discuss coagulative necrosis with morphology.

SECTION C — ANALYTICAL-BASED QUESTIONS

1. A 55-year-old chronic smoker presents with progressive
breathlessness. Chest x-ray shows hyperinflated lungs. Explain the
mechanism of cell injury contributing to this condition.
2. A patient with severe atherosclerosis develops sudden crushing
chest pain. Troponin-I is elevated. Explain the sequence of
reversible and irreversible injury in the myocardium.
3. A 30-year-old farmer accidentally ingests organophosphates.
Discuss how free radicals cause cell injury and how the body
defends against them.
 Hemodynamic disorders, Thromboembolism
and Shock
Scenario based questions
1) A young woman in labour develops sudden
respiratory distress and seizures.
What is the most probable diagnosis?
Explain the pathogenesis
Mention the other types of emboli
2) Person experiences sudden chest pain after a long haul
flight experience.
What is the most probable diagnosis?
Explain the pathogenesis
Mention the consequences
3) A 50 year old recently diagnosed diabetic with infected
foot ulcer develops fever and has low BP.
Write the most likely diagnosis
Explain its pathogenesis
Mention the types of shock
4) A 10 year child with renal disease develops puffiness of
face and eyelid swelling.
Write the most likely diagnosis
Explain the pathogenesis

LAQ’s
1) Define shock. Mention the types. Explain the
pathogenesis of septic shock
2) Define thrombus. Mention the types. Explain the
pathogenesis
 INFECTIOUS DISEASES (CBME)

A. LONG ANSWER QUESTIONS (Problem-Based)

1. A 30-year-old male presents with chronic cough, fever, weight loss, and hemoptysis.
Chest X-ray shows cavitary lesions in the upper lobe.

a) Identify the disease.

b) Describe the etiopathogenesis.

c) Explain the morphological features.

d) Enumerate complications and correlate with clinical features.

2. A 25-year-old woman presents with prolonged fever, abdominal pain, and relative
bradycardia. Blood culture grows Salmonella typhi.

a) Describe the pathogenesis of enteric fever.

b) Explain the intestinal lesions seen in this disease.

c) Mention laboratory diagnosis and complications.

3. A 40-year-old man with recent travel history presents with fever, chills, anemia, and
altered sensorium. Peripheral smear shows Plasmodium falciparum.
a) Describe the life cycle of the parasite.

b) Explain the pathogenesis of cerebral malaria.

c) Enumerate complications.

4. A 35-year-old patient presents with recurrent infections, weight loss, and chronic
diarrhea. CD4 count is 180 cells/µL.

a) Identify the disease.

b) Describe the pathogenesis.

c) Enumerate opportunistic infections.

d) Outline laboratory diagnosis.

[Link] diagnosis of HIV infection
[Link] test – principle and interpretation

[Link] of bacterial pneumonia

[Link] of viral hepatitis (any one type)
[Link]–Neelsen stain – principle and application
[Link]

C. SHORT NOTES
(3 marks each)

1. Ghon complex
2. Miliary tuberculosis
3. Typhoid carrier state
4. Cerebral malaria

5. Acid-fast bacilli
6. CD4 count
7. Kaposi sarcoma

8. Stages of lobar pneumonia

9. Caseous necrosis
10. Durck granulomata
11. Hutchinson’s triad in congenital syphilis

D. CLINICAL CASE-BASED QUESTIONS

(5 marks each)

1. A child presents with fever, sore throat, and grayish pseudomembrane over tonsils.
a) Identify the disease

b) Name the causative organism

c) Mention complications
a) Lung lesion alone
b) Lymph node lesion alone

c) Primary lung lesion with lymph node involvement

d) Fibrosis only

4. The vector responsible for malaria transmission is:

a) Culex mosquito
b) Aedes mosquito
c) Female Anopheles mosquito

d) Sandfly

5. Widal test detects antibodies against:

a) O antigen

b) H antigen
c) O and H antigens
d) Vi antigen

6. Acid-fastness of Mycobacterium tuberculosis is due to:

a) Capsule
b) Peptidoglycan

c) Mycolic acid
d) Lipopolysaccharide

7. The most common cause of community-acquired pneumonia is:

a) Klebsiella pneumoniae
b) Staphylococcus aureus
c) Streptococcus pneumoniae

d) Mycoplasma pneumoniae
 Neoplasia
Scenario based questions:
1) A community living near an industrial plant has an unusually
high rate of bladder cancer. Discuss the potential carcinogens
involved and their mechanisms of action.
2) A patient has two different tumours: Fibroadenoma in the
breast and invasive ductal carcinoma. Compare and contrast
these tumours in terms of pathology.
3) A patient with breast cancer tests positive for BRCA1 mutation.
Discuss the roles of oncogenes and tumour suppressor genes in
cancer, using BRCA1 as an example
4) A woman undergoes mammogram that reveals a suspicious
lesion. Explain the techniques used in cancer detection, their
advantages and limitations
5) A 58-year-old male with a known case of carcinoma lung
presents with new-onset headache and seizures. MRI brain
reveals multiple ring-enhancing lesions. Further evaluation
confirms these to be metastatic deposits. Histopathological
examination of the brain lesion shows features similar to the
primary lung tumour.
A) What is meant by a metastatic signature?
B) Enumerate the steps involved in distant metastasis.
6) A 45-year-old female presents with a rapidly enlarging, painless
breast lump for 3 months. Core needle biopsy reveals an
infiltrating carcinoma. Explain the molecular basis of neoplasia
involved in this case?
7) A 52-year-old male presents with weight loss and altered bowel
habits for 4 months. Colonoscopic biopsy reveals an
adenocarcinoma. Molecular analysis shows no mutation in the
 5. Name 3 RNA oncogenic viruses and the tumours associated?
6. Discuss on cancer cachexia?
7. What are tumour antigens? Name the types?
8. Define the term dysplasia and discuss with example?
9. Define the term anaplasia and discuss with example?
Analytic questions:
1) Compare and contrast between benign and malignant tumours
2) Compare and contrast between carcinoma and sarcoma
MCQ’s:
Scenarios based MCQ’s:
1) A 35 year old woman presents with a palpable painless mass in
her breast. Biopsy shows cells resembling normal mammary
cells forming duct-like structures. The mass is well demarcated
and movable. What is the most likely diagnosis?
A) Invasive ductal carcinoma
B) Fibroadenoma
C) DCIS
D) Lobular carcinoma
2) A pathologist observes a tumour under microscope
characterised by high degree of cellular differentiation, minimal
nuclear atypia and no evidence of invasion into surrounding
tissues. Which feature best classifies this tumour?
A) Benign
B) Malignant
C) Metastatic
D) Premalignant
3) A biopsy from a patient with lung cancer shows overexpression
of EGFR gene. This finding is significant because it suggests
A) A potential target for tyrosine kinase inhibitors
 A) Direct acting carcinogen
B) Procarcinogen
C) Promoter
D) Complete carcinogen
9) In an industrial setting, workers exposed to asbestos develop
mesothelioma. Asbestos acts as
A) Initiator
B) Promoter
C) Complete carcinogen
D) Indirect carcinogen
10) A study finds that a certain food additive, when
metabolised becomes carcinogenic compound. This additive is
best described as
A) Direct acting carcinogen
B) Pro-carcinogen
C) Co-carcinogen
D) Initiator
11)A 58 year old woman with lung cancer develops Cushing’s
syndrome. This is most likely because of
A)Metastases to adrenal glands
B) Paraneoplastic syndrome
C) Direct tumour invasion of pituitary gland
D)Side effects of chemotherapy
12)A patient with pancreatic cancer experiences migratory
thrombophlebitis (Trosseau syndrome). This condition is an example
of
A) Direct tumour effect
B) Chemotherapy side effect
 D) Pleomorphism
17) Which one of the following neoplasms is highly invasive but
seldom spread by metastases?
A) Squamous cell carcinoma of skin
B) Basal cell carcinoma of skin
C) Malignant melanoma of skin
D) Papilloma of skin
18) Grading of tumours depends upon the following except
A) Degree of anaplasia
B) Metastatic spread
C) Rate of growth of cells
D) Degree of differentiation
19) Patients of xeroderma pigmentosum are prone to develop the
following cancers except
A) Squamous cell carcinoma
B) Basal cell carcinoma
C) Sweat gland carcinoma
D) Malignant melanoma
20) All are autosomal dominant inherited cancer syndromes except
A) Retinoblastoma
B) Xeroderma pigmentosum
C) HNPCC
D) Neurofibromatosis
 1) 25-year-old woman presents with primary amenorrhea. She has short stature,
webbed neck, widely spaced nipples, and streak gonads. Karyotype shows
45,XO.
Questions:
1. Identify the genetic disorder and what does karyotype shows (1)
2. Explain the cytogenetic abnormality.(1)
3. Mention two important complications associated with this condition.(2)

2. A newborn presents with hypotonia, flat facial profile, upslanting palpebral

fissures, single palmar crease, and intellectual disability. Chromosomal analysis
reveals trisomy of chromosome 21.
Questions:
1. Name the syndrome.(1)
2. What are the different cytogenetic mechanisms responsible for this
condition?(2)
3. Mention two prenatal diagnostic tests for detection.(1)

3. A 10-year-old boy has multiple café-au-lait spots, axillary freckling, and

neurofibromas. Family history reveals similar findings in the father.
Questions:
1. Identify the genetic disorder.(1)
2. What is the pattern of inheritance? (1)
3. Name the gene involved and its chromosomal location.(2)

4. Explain the types of chromosomal abnormalities with suitable examples.

[Link] structural chromosomal abnormalities with diagrams.
[Link] autosomal dominant inheritance with examples.
A. Acute lymphoblastic leukemia
B. Chronic myeloid leukemia
C. Chronic lymphocytic leukemia
D. Hodgkin lymphoma

4. Which of the following is an autosomal recessive disorder?

A. Marfan syndrome
B. Neurofibromatosis
C. Cystic fibrosis
D. Huntington disease

5. Barr body represents:

A. Inactive Y chromosome
B. Active X chromosome
C. Inactive X chromosome
D. Extra autosome

6. Cri-du-chat syndrome is caused by deletion of:

A. Short arm of chromosome 5
B. Long arm of chromosome 5
C. Chromosome 21
D. Chromosome 18

7. Which technique detects small chromosomal deletions?

A. Karyotyping
B. PCR
C. FISH
D. Western blot
 IMMUNOLOGICAL DISORDER

1. A 55 year old female has a complaint of Joint pain, Photosensitivity and malar rash for
past two months. Her urine examination shows proteinuria. Immunological profile done
which shows high titre of antinuclear antibody.
a. What is your probable diagnosis?
b. Explain the patients renal disease?
c. What are the laboratory findings in the above cases?
2. What are LE cells? Describe their morphology, mechanism of formation and clinical
utility?
3. Describe the various stages of Lupus nephritis?
4. A 40 year old male presented with swelling, sweating, flushing, palpitations and fever
after a bee sting.
a. What is your probable diagnosis?
b. Explain the patho-physiological mechanism of the disease?
5. Define hypersensitivity reactions? Write about its classification. Describe about the
etipathogenesis of delayed type hypersensitivity reaction.
6. Describe the components and mechanisms of innate immunity?
7. Describe the Major Histocompatiblity Complex (MHC) molecules? Add a note on their
function and clinical significance?
8. A 32 year old women presents to casuality with fatigue, jaundice and dark coloured urine
for the past 2 days. She recently had a urine tract infection for which she was prescribed
Ceftriaxone one week ago. A lab finding shows HB- 7g/dl, Elavated LDH and Positive
Coombs test.
a. What is your probable diagnosis?
b. Explain the patho-physiological mechanism of the disease?
9. A 25 year old man presents with fever joint pain, and a rash all over the body that started
10 days after receiving antivenom therapy for a snake bite. Examination shows painfull
and swollen wrist and knee joints. Lab findings show Raised ESR and Low C3, C4
levels.
a. What is your probable diagnosis?
b. Explain the patho-physiological mechanism of the disease?
10. Describe the mechanism of Type IV hypersensitivity reaction.
11. A 62 year old woman with acute myelogenous leukemia undergoes an allogenic boone
marrow stem cell transplantation with a five of six HLA antigen match. A month later,
she developed jaundice and a scaling rash. Her skin biopsy shows chronic inflammatory
cells and abundant keartinocytes apoptosis.
a. What is your probable diagnosis?
b. Explain the patho-physiological mechanism of the disease?