Chart - Chart -1 a CVh: A 40 yr child admitted with history of abrupt onset of malaise, fever, URTI, Periorbital edema and passing coco colored urine since 2 days. O/E: pt. is a febrile, BP- 160/100mm Hg, HR- 85/min, RR-20/min: Urine examination showed the following features: Physical Examination: Quantity : 900 mi/day Colour : Smoky Appearance : Slightly Turbid Specific gravity 31.030 Chemical Examination: pH 7.0 Albumin : Present(+), Blood : Present(+) Sugar :Absent Ketone bodies : Absent Microscopy: Pus cells :0-1/hpf Epithelial cells : 0-I/hpf RBCs 0-20/hpf; dysmorphic RBCs. Castsand Crystals: RBC casts 1-2/hpf Answer the following questions: 1 - What is the diagnosis? 1 Mark 2-What other lab investigations should be done in above case? 2 Marks 3 - What is the prognosis in this case & mention it’s complications? 2 MarkChart — Chart -2 CUh: A 40 year old female presented with a post-coital bleeding. Cervical smear given below for interpretation (papanicolaou x 400) ree UT mf! Answer the following questions: 1 - What is the diagnosis? mark 2- What other investigations that should be done to confirm the diagnosis? = 2mark 3+ Mention Indications of PAP smear? 2markChart — Chart - 3 CU/h: A 8 yr child presented with history of generali cholesterol - 550 mg/dl. Urine examination showed the following features. Ph examination; Quantity : 1400 mi/day Colour yellow Appearance Purbid Specific gravity 31,030 Chemical Examination: pH Phe Albumin present (++++) Blood sabsent Sugar s absent Ketone bodies s absent Microscopy: Pus cells 2-3/hpf Epithelial cells :3-4/hpf RBCs sabsent Casts and Crystals: absent Answer the following questions: 1 - What is the diagnosis? 2- Enumerate the causes of above condition? 3- What is normal range of specific gravity? How is the specific gravity corrected for altered protein levels? ed edema of 12 days duration, Serum 1 mark 2 mark 2 markChart - Chart - 4 CW/h: A 55-year-old chronic smoker with K/c/o Hypertension & Diabetes was brought to emergency with complain of sudden chest pain & breathlessness since 6 hours. Chest Pain was retrosternal and radiating to left arm, Pain increases by excertion and reduces by rest On Examination: BP - 160/90 mm Hg, HR - 22/min ECG shows - Findings - ST segment elevation & T wave inversion Answer the following questions: 1 - What is the diagnosis? 1 mark 2. - Mention @ causes for the above condition? 2 marks 3. Mention a€@BD specific investigations you would like to do? & yes complications. 2 mavks eaiese> Mendon)Chart - Chart - 5 Clfh: A 2 year old child presented with splenomegaly and mild yellowish discolouration of sclera since 10 days, The following investigations were done. Urine: Bilirubin ‘Absent Urobilinogen ‘Present STOOL: Stercobilinogen ‘Present LIVER FUNCTION TESTS: Total Bilirubin: 4 mg/dl Direct : 0.2mg/dl Indirect :3.8mg/dl AST :281U/L ALT :3410/L ALKP £90 TU/L Total Protein: 7.0 g/dl Albumin 4.5 g/dl AG 12:1 Answer the following questions: 1 What is the type of jaundice? I mark \ kad ae Ademtiamaaid causes of the above condition? | 2 marks 2 marks 3 - Megatnes-agg8 differences between conjugated & unconjugated bilirubinemia \lathe‘Chart - 6 Cl/h: A 30 year old male presented with a history of fever, malaise, anorexia and yellowish discoloration of sclera since 10 days. The following investigations were done. “Urine: Bilirubin :Present Urobilinogen :Present Bilesalts :Present STOOL: Stercobilinogen ‘Present LIVER FUNCTION TESTS: Total Bilirubin: 8mg/dl Direct : 6 mg/dl Indirect : 2mg/dl AST 2432 IU/L ALT 2210 TU/L ALKP: : 130 IU/L Total Protein :7.0 g/dl Albumin 24.5 g/dl A:G 12:1 Answer the following questions: 1 - What is the typeof jaundice? 2 - NfgnErERM causes of the above condition? Whed gee. 3. - Mention @ indications of liver biopsy. mark 2 marks: 2 marksChart - ; Chart -7 ‘1 rc " : inal pain and intense CV/h: A 60 year old male presented with a history of fever, severe abdominal pal itching since 10 days. ‘The following investigations were done. Urine: Bilirubin Present Urobilinogen :Absent Bilesalts, + Present STOOL: ’ Stercobilinogen sAbsent LIVER FUNCTION TESTS: Total Bilirubin: 20mg/dl Direct : 18mg/dl Indirect :2 mg/dl AST 240 1U/L ALT 246 1U/L ALKP 2400 1U/L Total Protein Albumin AG Answer the following questions: 1 - What is the diagnosis? 01 Mark 02 Marks. 02 Marks 2- Mention @ causes of above condition? 3 - Mention @contraindications of liver biopsy.Chart —<9 Semen analysi Period of abstinence Amount Appearance Liquefaction pH” Sperm count Motility Morphology Chart - 8 3days 3 ml Grey white 15 minutes 8.0 04 millions/ml >60% of sperms are actively motile >65 % of sperms are of normal Answer the following questions: 1 - What is the diagnosis? Imark | -2- Mention indications for semen analysis? 2 mark © 3- Mention’ indications of semen cryopreservation /semen banking. , 2marksChart - CASE -9 CLINICLA HISTORY : A 42 years female present with thyroid enlargement, wt loss, exophthalomus, clubbing of fingers, T3 - 400 ng/dl (Normal 80-220 ng/dl) 4 - 25 mg/dl (Normal 5-12 mg/dl ) ‘TSH - 0.2 MIU/L (Normal 0.5 to SMIU/L) QUESTION : |.What is your diagnosis of above case? Imark 2. Mention causes of above condition 2mark 3.What is thyroid storm? Mention clinical manifestations of thyroid storm. 2markRESPONSE STATION: Clinical Pathology Ch: 260 240 220 | 200 180 | 160 140 | 120 100 80 60 Chart - 10 art Interpretation — 8 wo tsar Task: The above chart demonstrates the results of an oral glucose tolerance test in a 50 year old male. The X axis shows th glucose levels obtained in mg/dl. No fe time in minutes, while the Y axis shows plasma «What does graph A’show? 1 Mark Mention two indications of performing an oral glucose tolerance test? > Marks What investigation will help in determining glucose control over past 6-12 weeks? & Mention two causes of glycosuria, 2MarkChart—_ Chart - 11 Ci: 4 12 year old female child with repeated painful swelling of the hands and feet. PERIPHERAL SMEAR GIVEN BELOW: ww Answer the following questions: 1 - What is the diagnosis? Imark 2- List d@gar inv Sstigations necessary for the diagnosis? Dinara 3+ What are the other clinical features & why is the patients having repeated attacks of bone pain? 2markChart — Chart - 12 Clfh: one day old neonate, peripheral smear and special stain for interpretation. PERIPHERAL SMEAR SPECIAL STAIN IS DONE: Answer the following questions: 1. What is your observation & identify the cell? Imark 2. List the conditions in which it is increased? 2mark 3. Mention the special stain used & Write normal range in infants & adults? 2markChart — Chart - 13 Cilhs A 5 year old child presented with fatigue, bone pain and painless cervical and axillary lymphadenopathy. O/B: pallor and diffuse petechiae. INVESTIGATIONS: Hb 89 om % Total Leucocyte count : 85,750 cells/eumm Plateletcount 2 25,000 cells/cumm PERIPHERAL SMEAR GIVENBELOW: Answer the following questions: i Imark 1 ~ What is the diagnosis? 2 ~ Which immunochemical stains will be positive in the above case? 2mark 3 : Which are the factors associated with unfavourable prognosis? 2mark = WhiclChart — Chart - 14 CH: 420 year old mate presented With a history of bleeding gums. INVESTIGATIONS; a 28 gm % Total Leucocyte count £92,000 cellsfcumm * Plateletcount 270,000 cells/cumm. PERIPHERAL SMEAR GIVENBELOW: Answer the following questions: Wha Imark ocd en be seen in aS Se a ye pista? what ptoaagh af blots shoud es a 2. Deseril acute leukemias? it i id what is its 3. What is the cytogenetic abnormality seen in AML M3, and wi 2mark ~~ significance?Chart~ Chart - 15 Cl: A : i 4 Ci: A male “Ged 60 yrs presented with progressive anemia and pathological fracture of INVESTIGATIONS; Hb :82.em% Total Leucocyte count: 10, 000/cumm ESR : 116 mnvhr BONE MARROW GIVEN BELOW: Answer the following questions: 1 - What is the diagnosis? Imark 2. What are the laboratory and radiological findings you would expect? 2mark 3. - How do you confirm the diagnosis? —Chart — Cl/h: A 22 Share 16 year old presented with fever and chills. PERIPHERAL SMEAR GIVEN BELOW: ‘Answer the following questions: 1.What is the diagnosis? 2. What are the other causes for the above symptoms? 3.Mention other Haemoparasites? Imark 2mark 2markCSF Case No.01 4 year old boy was bought to ho: On examination. Nuchal tigidit ty is present CSF analysis shows following features- Physical Examination: Volume- 2ml, Colour/appearance-Turbid/cloudy, Chemical Examination: Protein-180mg/dl Sugar-15mg/dl, Chloride-700mg/dl Q.1. What is the probable diagnosis of this case? Q.2. What are the expected microscopic findings in this case? Q.3. Mention the two organisms causing the condition? spital with the history of fever and vomiting since 2 days. 1 Mark 2 Marks 2 Marks.“40 year old fey CSF Case No.02 ‘er and vomiting since 10 days. CSF fre ra Physical Examination; Volume-2m| Colour/appearance -Clear with cobweb Chemical Examination: 5 Protein-200mg/dI : Sugar-30mg/dl Chloride-300me/dl Q.1..What is the probable diagnosis of this case? “Q.2. What are the expected microscopic findings in this case? . Q.3. Mention causative organism and specific investigations to confirm the diagnosis? i westigi Fi Bs Me caus IMark 2 Marks 2 MarksChart ~15 we No.03 CSF ; r fever headache since 5 days. 10 year old boy was brought to hospital with history of Fever headache since 5 day On examination- Neck rigidity present. CSE analy sis shows following findi Physical Examination: Volume-2ml, Colour/Appearance - Clear to slightly turbid, Chemical examina Protein-96 mg/dl, Sugar-50 mg/dl. Chloride-720 mg/dl, Microscopy : Total cell count-40/mm3, Differential count - Lymphocytes-98% ‘eutrophils-2% QI. What is the probable diagnosis of this case? Q.2. Mention the two organisms causing the condition Q.3. What is Xanthochromia and mention two conditions causing it. 1 Mark 2 Marks: 2 MarksChart" Chart - 17 Clh: A 42 yea Told mak A years, * Presented with dittuse swelling of the left lower limb since 10 PERIPHERAL g MEAR GIVEN BELow: Answer the following questions: 1 - What is the form seen in the blood smear? 2- Mention other Haemoparasites? 3 ~ What is the drug of choice for the above condition? What isthe ideal way to collect theblood sample for the above condition?Chart " Chart 18 Clb: A 1 year old child presented with failing to tnive and irritability OF: Mongoloid facies (frontal bossing), hepatosplenomegaly were noticed, INVESTIC TONS: 5.7 gm %, Corrected WBC count: 25,000cells/c ann, NS6/ L32/M 10/2 02/BOO/NR BCH 28/1 DOWHCS, MCV:77.311, MCH: 2 MCHC: 31.72%. Plt: 1.73lakh/e.mm. PERIPHERAL SMEAR GIVEN BELOW: Answer the following questions: 1 = What is the diagnosis’? 2- List other investigations you would like to do and what findings do you expeet? 3- Mention differential diagnosis of above mentioned condition,