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
SECTION A: PROBLEM-BASED QUESTIONS
1) A 25-year-old man presents with a painful red swelling on his leg after a
thorn prick 3 days ago. The area is warm and tender, and thick yellow pus is
draining. CBC shows neutrophilic leukocytosis.
Flow cytometry shows increased IL-8 levels.
a) Describe the sequential cellular events in acute inflammation.
b) Explain the mechanism of pus formation in this patient.
c) Enumerate chemical mediators responsible for pain and fever.
d) List the possible outcomes of acute inflammation.
2) A 46-year-old male has a 6-month history of cough, evening rise of
temperature, and weight loss. Chest X-ray shows upper lobe cavitation. Biopsy
reveals epithelioid cell granulomas with Langhans giant cells.
a) Define granulomatous inflammation.
b) Discuss the immunological mechanisms (Th1, IFN-γ, TNF-α).
c) Draw a labeled diagram of a granuloma.
d) Write clinical significance and complications.
3) A diabetic patient presents with a chronic foot ulcer that has persisted for 4
months. The ulcer shows pale granulation tissue, necrotic base, and peripheral
neuropathy.
a) Contrast primary vs. secondary intention healing.
b) Explain why wound healing is delayed in diabetes.
c) Describe the role of macrophages in repair.
d) List the local and systemic factors that impair healing.
4) A patient underwent an appendectomy. After removal of sutures on day 7, the
wound edges appear approximated with minimal scar formation.
SECTION B : SCENARIO-BASED QUESTIONS
1. A 45-year-old male presents after MI; histology at 3 weeks shows granulation
tissue.
a. Identify this stage of healing.
b. Why does myocardium heal with a scar rather than regenerate?
c. Describe the composition of granulation tissue.
2. A patient with recurrent Neisserial infections has complement defect with low
C5–C9 levels.
a) Explain how complement contributes to inflammation.
b) What is the role of C5a?
c) What is the deficiency called?
3. A wound biopsy shows neutrophils migrating toward bacterial colonies.
a) Define chemotaxis.
b) List 4 chemotactic factors.
4) A farmer presents with fever and painful swelling of the foot after a thorn prick.
The skin is warm, red, and edematous. Pus culture shows Streptococcus pyogenes.
a) What cardinal signs of inflammation are seen?
b) Mention the mediators responsible for swelling and pain.
c) What type of exudate forms in cellulitis?
2. Explain why neutrophils are the first cells to appear in acute inflammation.
3. Explain the role of chemical mediators in producing vascular permeability
during inflammation.
4. Compare granulation tissue and granuloma based on structure, cells involved,
function, and clinical examples.
5. Compare first intention (primary) and second intention (secondary) wound
healing. Give analytical differences.
6. Explain the mechanism of fever production in inflammation.
7. Explain the mechanism of edema formation in acute inflammation.