Check list for pathology university exam and class tests. Prepared by Dr.Mani Prabhu. I can assure you that least 90% of questions will be from this bank. Make sure that you r evise all the must know topics on the day before the examination. The distinction question are for those who are more academically inclined. :)
GENERAL PATHOLOGY Lesson 1 – Cellular adaptations and cell injury. Must know 1. Metaplasia 2. Hyperplasia 3. Differences between necrosis and apoptosis (better in tabular form) 4. Morphological features of reversible and irreversible injury (with diagrams) 5. Types of necrosis with diagram (fat necrosis – most important) 6. Morphology of apoptosis 7. Mechanisms of apoptosis (Atleast the basics – prepare it for short notes) 8. Steatosis 9. Lipofuscin 10. Dystrophic and metastatic calcification (Very important. Try to prepare a table listing out the differences) 11. Gangrene. Difference between dry and wet gangrene. Distinction question (only if you have time) 1. Short notes on oxidative stress c ytoskeletal abnormalities abnormalities 2. Short notes on cytoskeletal 3. Defects in protein folding
Lesson 2 – Inflammation Must know 1. 2. 3. 4. 5. 6. 7. 8.
Differences between exudates and transudate ( From Harshmohan -baby) Diapedesis Chemotaxis - very important Phagocytosis (only the basics) Chemical mediators of inflammation (prepare yourself short notes) Arachidonic acid metabolites Granulomatous inflammation inflammation Types of giant cells and their morphology.
Distinction questions (only if you have time) 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11.
Leukocyte transmigration Selectins (notes for 5 mrk) Integrins (notes for 5 mrk) Role of reactive r eactive oxygen intermediates in microbial killing Defects in leukocyte function Complement cascade and disorders TNF Chemokines Fibrinous inflammation Acute phase proteins Lymphedema
Lesson 3 – tissue renewal and repair Must know 1.
Liver regeneration
2. 3. 4. 5.
Angiogenesis Healing by first and second intention Factors influencing wound healing Complications of wound healing (except for wound healing questions from this lesson are rare)
Distinction questions (only if you have time) 1. 2. 3. 4.
Growth factors Collagen Keloids Granulation tissue
Lesson 4 – Hemodynamic disorders Whole lesson is important. Don’t miss this lesson Must know CVC liver, spleen, lung (grass and histology) histology) Pathogenesis of thrombosis: Virchows triad Differences between arterial and venous thrombi Fate of a thrombus Difference between phlebothrombosis phlebothrombosis and thrombophlebosis thrombophlebosis Embolism: Embolism: full Red and white infarct (Very important) Septic infarcts Types and pathogenesis of septic shock (Very important -With diagram) Distinction questions 1. Stages of shock 2. Pathogenesis of cardiogenic edema 1. 2. 3. 4. 5. 6. 7. 8. 9.
Lesson 5 – Genetics Though essential in every other aspect , except the following five topics (very very important), I personally expect no other question from this lesson in university exam. Not to waste time in this lesson at the eleventh hour
Must know 1. 2. 3. 4. 5.
Marfans syndrome Ehlers – Danlos syndromes (only the basics) Downs syndrome (with diag) Turner syndrome (with diag) Barr body
Distinction questions 1.
2. 3. 4. 5. 6. 7. 8.
Transmission pattern and characteristics of a. Autosomal dominant b. Autosomal recessive c. X- linked recessive disorders Tay sachs disease Hurlers and hunters syndrome Von – gierkes disease Sex chromatin Klinefelter Fragile – X syndrome Genomic imprinting (only the basics)
Lesson 6 – Immunity Important lesson. Your knowledge of microbiology should help Must know 1. 2. 3. 4. 5. 6. 7. 8.
T- lymphocytes and B-lymphocytes Antigen presenting cells NK cells Type 1, type 2, type 3 and type4 hypersensitivity SLE (Important -only the basics) LE cell (Important -notes for 5 makrs) Kidney manifestations in SLE AIDS – Full (pathogenesis, CRS involvement, natural history, aids defining conditions,
kaposi's sarcoma) – sarcoma) – can can be asked as case (very important) 9. Amyloidosis (Prepare notes for 5 marks) - Again very i mportant 10. Difference between sago spleen and lardaceous spleen
Distinction questions: 1. 2. 3. 4. 5. 6.
Cytokines: types and functions HLA molecules (notes for 5 marks) Arthus reaction for 5 marks Types and morphology of graft rejection (prepare notes for 5 marks) Anergy Digeorge syndrome
Lesson 7 neoplasia Except for p53 and RB (important), the whole of molecular level of cancer path can be skipped exams, though you might need them for better understanding Must know 1. 2. 3. 4. 5. 6. 7. 8. 9.
Characteristics of benign and malignant tumors. Diff between benign and malignant tumors (as table) Metastasis: pathways of spread of tumor (very important) P53-as guardian of human genome (With diag) Retinoblastoma: Retinoblastoma: two hig hypothesis of RB gene Chemical carcinogenesis (etiology, pathogenesis) Viral carcinogenesis (HPV-very important) - Important Paraneoplatic syndromes - very important Tumor markers (oncofetal antigens-very i mportant)
Distinction questions: 1. 2. 3. 4. 5. 6.
Differences between anaplasia and dysplasia (prepare notes for 5 marks) 5 occupational cancers with their etiologic agent Oncogenes (notes for 5 marks) Radiation carcinogenesis Tumor antigens (notes for 5 marks) Laboratory diagnosis of cancer (basic points only)
Lesson 8 Infectious diseases Must Know: Pathogenesis, morphology, c/f and complications of TB (very very important) 1.
Other important questions in tuberculosis: a. Ghons focus
Ghons complex or primary complex Ranke complex Progressive pulmonary tuberculosis Military tuberculosis Pots spine Scrofula 2. Leprosy (types, pathogenesis and c/f) - important 3. Stages, pathogenesis and c/f of syphilis ce rebral malaria 4. Black water fever and cerebral 5. Typhoid fever 6. Amoebic liver abscess 7. Hydatid cyst 8. Actinomycosis 9. Madura foot 10. Rhinosporidiosis b. c. d. e. f. g.
Distinction questions: All other infectious diseases (I would advice not to waste time in this lesion at the last minute. Your knowledge of micro is more than enough for handling this lesion. Tuberculosis and syphilis is all that is needed in path) path)
Lesson 9 Environment and nutrition Chances of getting a question from this chapter are near to nil. If at all, you might get 1.
Rickets
Distinction questions: 1. 2.
Radiation injury PEM
Lesson 10 Infancy and childhood Again, other than Wilms tumor, chances of getting a question is less, as seen from previous papers. But still, an important lesson.
Must know: Immune hydrops Cystic fibrosis (though important has not been asked in any question papers mostly – know only the basics) 3. Wilms tumor or nephroblastoma (very important) Distinction questions: 1. Neuroblastoma 2. Phenyketonuria 3. Necrotizing enterocolitis 4. Respiratory distress syndrome 1. 2.
SYSTEMIC PATHOLOGY
Hematology Please note that the whole of hematology account for nearly 40% of marks marks in paper 1. Must study topics. 10 marks or LONG CASE The pathogenesis, peripheral blood picture, bone marrow picture, other relevant morphology, INVESTIGATIONS (for investigations, you might refer to Alagappan - manual of medicine separately under each heading) , c/f of Sickle cell disease B- thallasemia Megaloblastic anemia, esp. pernicious anemia Iron deficiency anemia Hemophilia A ALL CLL Multiple myeloma Hodgkin disease- types, pathogenesis, basic morphology of each type and their prognosis, clinical features 10. AML (In addition to the general headings, you need to know atleast the basics of FAB classification) 1. 2. 3. 4. 5. 6. 7. 8. 9.
11. CML (pathophysiology, morphology and investigations) 12. Polycythemia vera
All these 12 questions are must read for all hematology exams
Important note: Before diagnosing the case, please make sure that the age of the concerned patient coincides with the age group affected, for that particular disease, as given in Robbins. Also look for characteristic symptoms like lymphadenopathy, bone tenderness, abrupt onset, massive splenomegaly, cancer cachexia, etc. These clue words in the case are directly picked from Robbins. So don’t miss the clinical f eatures eatures of any suspected long case. For all investigations for any long case, refer to Alagappan- manual of medicine. Again please note that more than 50% of previous paper 1 question papers have CML (massive splenomegaly) as the long answer.
Short notes for Lesson 13 RBCs and platelets Must know: Classification of anemia, according to underlying pathology Heriditary spherocytosis (pathogenesis and morphology) morphology) Howell jolly bodies (prepare notes) Heinz bodies (prepare notes) Bone marrow picture in megaloblastic anemia Pathophysiology Pathophysiology of B-thalassemia Aplastic anemia- very important 5 mark- prepare notes for 5 marks, incorporating all the headings. 8. Von – willebrand disease 9. Hemophilia A and B 10. DIC – Very important. Prepare notes for 5 marks. For pathophysiology, the flow chart in Robbins is enough. 1. 2. 3. 4. 5. 6. 7.
Distinction questions in 5 marks: 1. 2. 3.
α-thallasemia (Just know the types, genetics of each condition and the outcome) Immuno hemolytic anemia (only the table in Robbins is more than enough) ITP
Short notes for Lesson 14 – WBCs Must know: Agranulocytosis – very important, highly repeated (prepare notes for 5 marks under the headingspathogenesis, morphology and c/f) 2. Leukimoid reaction – important 3. Burkitt's lymphoma – again very important 4. Follicular lymphoma 5. Hairy cell leukemia 6. Reed-sternberg cell- pathogenesis, types and morphology (with diagram) - Very important lymphoma 7. Differences between Hodgkins and Non-Hodgkins lymphoma 8. Myeloblasts – morphology 9. Morphology of MDS syndrome 10. Gandy gamma bodies in CVC spleen 11. The Philadelphia chromosome (Important0 1.
Distinction questions in 5 marks: 1.
Diffuse large B-cell lymphoma (rare)
2. 3. 4. 5.
Lymphoplasmacytic Lymphoplasmacytic lymphoma lymphoma (rare) Mantle cell lymphoma (rare) Sezary syndrome Histicytosis (LCL)
Other very important general 5 mark questions in hematology: 1. 2. 3. 4.
ABO incompatibility Rh incompatibility Coomb’s test Packed cell volume (PCV)
Lesson 11 – Blood vessels Apart from Atherosclerosis, other topics are generally gen erally not important for univ. exams. Must know: Pathogenesis of atherosclerosis – highly repeated (prepare notes for 5 marks) Morphology of atherosclerotic plaque – 5 marks Aortic dissection – 5 marks Distinction questions: 1. Types and morphology of aneurysms 2. PAN (rare) 3. Wegener's granulomatosis (very rare) 1. 2. 3.
Lesson 12 – The heart 10 marks or long questions: 1. 2. 3.
Myocardial infarction – pathogenesis, morphology, investigations and diagnosis, complications (prepare notes for 10 marks – very important) Rheumatic heart disease – pathogenetic sequence, morphology and investigations, diagnosis (Highly repeated) Infective endocarditis – etiology, morphology and diagnostic criteria (Very important)
5 marks: 1. 2. 3.
Mitral valve prolapse Types of angina Causes and types of pericarditis (rare)
Lesson 15 – The Lung 10 mark cases: 1. 2. 3. 4.
Bronchiectais (very important) Asthma Emphysema Ca lung – Squamous cell Ca, AdenoCa, Small cell, Large cell – gross pathology , histology and prognosis. Local effects of tumor spread (very important. Local effects can be asked as short notes also)
Must know in 5 marks: 1. 2. 3. 4. 5. 6. 7.
Pathogenesis and types of emphysema emphysema (very important) Asbestosis Pneumoconiosis (prepare notes for 5 marks) Pulmonary embolism Etiology and morphology of community acquired pneumonia (Very important) Lung abscess (important) Pancoast tumors ( highly repeated)
Distinction questions in 5 marks: 1. 2. 3. 4.
Types and causes of atelectasis Diffuse alveolar damage or ARDS Goodpasture syndrome (rare) Pananeoplastic syndromes, associated with lung Ca
Lesson 16 – Head and Neck All that is needed here is pleomorphic adenoma, which is seen in alternating question papers. If you are still interested, I would recommend “Warthin tumor”
Must know: 1.
Pleomorhic adenoma (very important 5 mark)
Distinction questions: 1. 2.
Warthin tumor Leukoplakia and erythroplakia (premalignant lesions of oral cavity)
Lesion 17 – The GIT Very important – important – 10 10 mark cases: 1. 2. 3. 4. 5.
Peptic ulcer (etiological factors, role of H. pylori, morphology, morphology, complications) Gastric carcinoma – etiology and risk factors, morphology and types, Virchow node metastasis, Sister Mary Joseph nodule, Krukenberg K rukenberg tumor. Crohn's disease (also 5 marks – very important) Ulcerative colitis (also 5 marks – very important) Colorectal Ca – etiology, morphology of right sided and left sided lesions, C/f, STAGING.
All these 5 questions are essential must-read for all GIT exams exa ms Please note that iron – deficiency anemia in an elderly male is due to GIT cancer, unless proved otherwise Must know in 5 marks: .
Achalasia cardia Barrett’ cosophagus – very important Types of gastritis and H. pylori as an etiological agent. Celiac disease – important Adenoma – colon and rectum (types, morphology, morphology, risk of malignancy, prognosis, clinical impact) FAP syndrome Staging of Colorectal carcinoma - Important Carcinoid tumors (prepare notes for 5 marks under location, morphology, c/f of carcinoid syndrome) Pseudomyxoma peritonei 9. Pseudomyxoma 10. Intestinal polyps polyps - types, morphology morphology and prognosis - Important Important 1. 2. 3. 4. 5. 6. 7. 8.
Distinction questions (5 marks): 1. 2.
Gatrointestinal stromal tumors Congenital megacolon
Very rare: 1. 2.
Ca Esophagus (know only the basics) Pseudomembranous Pseudomembranous colitis.
Lesson 18a – The Liver
More than long case, 5 marks are more important in this lesson 10 marks case: 1. 2.
Jaundice and portal hypertension (know the basics, the pathophysiology, clinical manifestations, morphology) Hepatocellular carcinoma
Must know in 5 marks: 1. 2. 3.
Etiology and key morphology of viral hepatitis Alcoholic liver disease – pathogenesis, different stages and morphology of each, c/f. – very important – can also be asked as 10 mark case. Metastasic lesions in liver
Viral and alcoholic hepatitis are must know topics in this lesson. Distinction questions: 1. 2. 3. 4.
Pathogenesis of ascites Indian childhood cirrhosis (refer any pediatrics book) Wilson’s disease (rare) Primary biliary cirrhosis (rare)
Lesson 18b – The Biliary tract Very important lesson. Not to be ignored. 10 mark case: 1.
Acute cholecystitis – Very important (clue : fertile fatty female of forty)
Must know in 5 mark: 1.
Cholelithiasis (gallstones) – repeated (can also be asked as long question)
Lesson 19 – The pancreas 10 mark case: 1.
Acute pancreatitis (important)
5 mark questions: 1. 2.
Chronic pancreatitis – rare Pancreatic pseudocyst – rare
Lesson 20 – The kidney Very important. Will consume lots of time. time. Better keep this one thorough before hand, and not to sit on this lesson on the day before the exam. Or else you would end up studying only “Kidney”. Must know: 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12.
Acute Glomerulonephirits (post – streptococcal) Rapid progressive GN Nephrotic syndrome – pathology and pathogenesis (Very important) Minimal change disease (very important) Focal segmental glomerulosclerosis glomerulosclerosis Membranoproliferative Membranoproliferative GN Basics about the pathogenesis and stages of ATN Urolithiais (Highly highly repeated) Chronic GN Acute pyelonephritis Chronic pyelonephritis – pathogenesis and morphology. morphology. Granular conracted kidney (prepare notes for 5 marks) - Important
Distinction questions: 1. 2. 3. 4. 5. 6.
Both types of polycystic kidney disease and the differences between them Membranous nephropathy Kimmelstein Wilson disease or diabetic glomerulosclerosis (5 marks) Flea – bitten kidney (5 marks) Pathogenesis of Hemolytic uremic syndrome (basics) Renal cell carcinoma (only basics)
Lesson 21 – The Male genital system Both male and female genital systems have been repeatedly asked in exams. Very important. Must know: 1. 2. 3. 4. 5. 6.
Germ cell tumors Seminoma – 5 mrks Very important Premalignant lesions of penis – 5 marks (Can refer Sanjay Azad surgery also) Basics about Benign prostratic hypertrophy Ca prostrate – morphology, morphology, GRADING and STAGING, investigations (PSA, PSA density, PSA velocity) - Very important Cryptorchidism
Rare 5 marks: 1.
Testicular lymphoma.
Lesson 22 The female genital tract Must know: 1. 2. 3. 4. 5. 6. 7.
Cervical intraepithelial neoplasia (CIN) Ca cervix – pathogenesis morphology morphology and staging - Very important Endometriosis and adenomyosis (5 marks) Ca endometrium (the basics) Leiomyoma Leiomyoma - Very important OVARIAN TUMORS (prepare each tumor for 5 marks marks and the entire for marks – very very – important especially germ cell tumors) - Highly repeated question Hydatidiform mole mole & differences between complete and partial mole . Choriocarcinoma - very important
Distinction questions: 1. 2. 3. 4. 5.
Pelvic inflammatory disease (5 marks) Sarcoma botyroides Menstrual changes in endometrium Brenner tumor (5 marks) Sex cord – stromal tumors (prepare for 5 marks)
Lesson 23 – The Breast High yield lesson – lesson – Ca Ca breast will keep repeating itself in some form or another. All these 8 questions are very high yield in exams. Sometime Ca breast can come as the long case too. Must know: 1. 2. 3.
Mammographic Mammographic signs of Ca breast Fibrocystic breast disease Just know the risk factors for Ca breast
4. 5. 6. 7. 8.
Carcinoma in- situ (both ductal and lobular) Paget's disease (Very important) Types and morphology of invasive breast carcinoma Prognostic factors for breast Ca (Very important) Fibroadenoma (Very important)
Distinction questions: 1. 2. 3.
Sclerosing adenosis and radial scar Different between BRCA1 and BRCA2 Phyllodes tumor
Lesson 24 – The endocrine system Except for the following questions and DIABETES (important 10 mark case), other topics can be conveniently skipped skipp ed for univ. and class exams. Must know: 1. 2. 3. 4. 5. 6. 7. 8.
Hashimotos thyroiditis Graves disease (Very important) Simple goiter Multinodular goiter (Very important) Types of Ca thyroid and morphology of papillary carcinoma thyroid Diabetes mellitus – classification, pathogenesis of type 1 and type 2, morphology, complications and investigations. Diff between type 1 and type 2. ( Very important) Cushing's syndrome (Important) Pheochromocytoma
Rare: 1. 2.
Hyperparathyroidism Adrenal insufficiency
Lesson 25 – The skin Only these FIVE questions need to be studied in this lesson. Never miss on these. Very very high yield. Must know: 1. 2. 3. 4. 5.
Squamous cell carcinoma (prepare notes for 5 marks) Basal cell carcinoma (5 marks) Malignant melanoma Pre – malignant lesions of the skin (refer Sanjay Azad – surgery) Mycosis fungoides
Lesson 26 – Bones Very important. Not to be ignored Must know: 1. 2. 3. 4. 5. 6. 7. 8.
Osteopetrosis Osteoporosis (rare know only the basics) Paget disease (Important) Osteomyelitis – pyogenic and TB (potts spine) - Very important Osteosarcoma (prepare notes for both 10 and 5 marks) - Very important Chondrosaroma (5 marks) Ewing sarcoma (sure 5 marks) - Very important Giant cell tumor or osteoclastoma - Very important.
Lesson 27 – Peripheral nervous system can be conveniently skipped. If your conscience still doesn’t agree, read it after your exams!!!
Lesson 28 – The CNS Selected questions are very important. Don’t waste time at the eleventh hour, however, reading unnecessary details. You can go to exams confidently only on ly with these questions in CNS. They
are very important. 1. 2. 3. 4. 5. 6. 7.
CSF findings in different types of meningitis (Read Robbins and also prepare yourself a tabular column referring to med books or applied micro notes) Brain abscess. TB menigitis Morphology, investigations and c/f Berry aneurysm (5marks) Astrocytoma Meningioma Meningioma (5 marks) Schwannoma (5 marks)
Lesson 29 – The eye can be read after your univ. exams! All the best. Wishing you all success.
Dr. Mani Prabhu JR, Department of Pharmacology, JIPMER
