Pathology Mcqs Made Easy

1.
Ø Rudolf Virchow is known as the Father of Modern Pathology

2. Ø World’s A day was celebrated on December!, 1989
3.
4. Ø Deletion of long arm of chromosome 13 in — Retinoblastoma.
5.
6. Ø Loss of chromosome 22 in — Meningioma.
7.
8. Ø 8- 14 Chromosomal translocation in — Burkitis lymphoma.
9.
10. Ø Normal nuclear cytoplasmic ratio is 1:4.
11.
12. Ø Cancer suppressor genes are located on chromosomes 13 and 11
13.
14. Ø Glycoprotein that acts as tumor marker for colon cancer and pancreatic cancer is CA-19-9
15.
16. Ø In CEA positive colon cancers, the period after which elevated levels of CEA indicate
residual disease s 6 weeks.
17.
18. Ø Marker for Ca breast is CA-i5-3.
19.
20. Ø Schwannomas are associated with somatic mutations in gene NF-1.
21.
22. Ø Total coagulative necrosis in M w loss of nuclei is not apparent until about 72 hours.
23.
24. Ø Retinoblastoma is associated with deletion in Chromosome 13.
25.
26. Ø After initial acute attack, chronic RED appears at least after 10 years.
27.
28. Ø ‘Wedge shaped’ infiltrates on X-ray are diagnostic of pulmonary infarction. It appears 12-36
hours after.
29.
30. Ø Length of oesophagus in newborn is 10 cm .
31.
32. Ø Toxic injury of liver affects most often Zone 1.
33.
34. Ø Macronodular cirrhosis is considered once nodule is greater than 3 mm.
35.
36. Ø The oncogene amplified in Down’s syndrome leading to mental retardation is Ets-2.b
37.
38. Ø The percentage of total cholesterol that freely circulates in plasma is 7%.
39.
40. Ø For teratogenesis, peak sensitivity during embryonic period is 4-5 week.
41.
42. Ø DNA sequence in any two persons reveal variation in one nucleotide for every 200-500
nucleotides.
43.
44. Ø Thè perinatal infection to erythroid precursor in bone marrow is Parvovirus C-19.
45.
46. Ø In a newborn with normal surfactant production, the residual volume retained by kings
after first breath is 40%.
47.
48. Ø Normal human deploid fibroblasts stop proliferating in culture after 5O doublings
49.
50. Ø Gaucher’s cells are glucocorebroside filled cells measuring 20-1OO mm,-and are fat
negative
51.
52. Ø Glucogonomas arise from the Alpha -cells of the pancreatic islets
53.
54. Ø Craniopharyngiomas are tumors that arise from remnants of Rathke’s pouch.
55.
56. Ø The 21-hydroxylase deficiency is most commonly found form of the adrenogenital
syndrome.
57.
58. Ø Malignant hypertension is microscopically characterized by fibrinoid necrosis of arteriolar
wall
59.
60. Ø The most common site for intestinal amoebiasis is caecum
61.
62. Ø Fibrosis is evident by light microscopic examination when a thrombus is more than one
week old.
63.
64. Ø Both systemic and pulmonary embolism is seen in septal infarction.
65.
66. Ø The commonest malignancy seen in immune deficiency state is lymphoreticular
malignancy.
67.
68. Ø Pseudomyxoma peritonei is seen with mucus secreting ovarian carcinoma.
69.
70. Ø The most common complication of infective endocarditis is thromboembolism.
71.
72. Ø The commonest site for amyloid deposition in intestine is colon.
73.
74. Ø Villous atrophy is diagnostic of coeliac disease.
75.
76. Ø The thyroid cancer most frequently metastasises to lymph nodes is papillary.
77.
78. Ø Alzheiniers disease is degenerative disease which typically shows progressive atrophy of
the brain particular the frontal, parietnal occipital cortex.
79.
80. Ø Multiple endocrine neoplasia (MEN) are familial disorders with autosomal dominant mode
of transmission
81.
82. Ø MEN 11 syndrome is characterized by the occurrence of medullary carcinoma thyroid.
pheochromocytomas and parathyroid hyperplasia.
83.
84. Ø Affection of terminal ileum in Crohns disease is called as back wash ileitis?
85.
86. Ø Ulcerative colitis is primarily a disease of mucosa.
87.
88. Ø The most common lesion in Wernicke’s encephalopathy is found in the mamillary bodies.
89.
90. Ø The lesion of atherosclerosis occurs mainly in abdominal aorta.
91.
92. Ø A tumor arising from hum scar is most likely squamous cell carcinoma.
93.
94. Ø Duct papilloma is the commonest cause of blood stained nipple discharge.
95.
96. Ø Thyroid appearance of renal tubules is considered pathognomonic of chronic
pyelonephritis.
97.
98. Ø Periglomerular fibrosis is considered typical of chronic pyelonephritis.
99.
100. Ø A reliable screening test for platelet function is clot retraction test.
101.
102. Ø Exposure to vinyl chloride may develop angiosarcoma of liver.
103.
104. Ø Haematuria is characteristically seen in proliferative glomerulonephritis.
105.
106. Ø ‘Russel bodies are seen in plasma cells.
107.
108. Ø The cells most sensitive to ischaemia is cortical neurons.
109.
110. Ø Keloids predominantly consist of dense collagen fibres.
111.
112. Ø The epithelial cells of tubercle are derived from monocytes.
113.
114. Ø Rosette formation is characteristically seen in Retinoblastoma.
115.
116. Ø Laminin is the most abundant glycoprotein in the basement membranes
117.
118. Ø Chancroid is also called “ulcus molle.’
119.
120. Ø Lipoid nephrosis of the most common cause of nephrotic syndrome in childhood.
121.
122. Ø Budd-chiari syndrome is produced by occlusive lesions of the Hepatic veins.
123.
124. Ø Glomeruloid bodies or Schiller-Duval bodies, are commonly found in endodermal
sinus tumour.
125.
126. Ø K.W syndrome comprises diabetes mellitus, hypertension, albuminuria and edema.
127.
128. Ø Monodermal teratomas are very uncommon and most frequently take the forms of
struma ovarii or carcinoids. .
129.
130. Ø Nodular melanoma is the most aggressive type of melanoma and hence carries the
worst prognosis.
131.
132.
133.
134. “Lafora syndrome” is a progressive familial myoclonic degenerative disease affecting
predominantly the basal ganglia, most patients dying by the age of 30 years.
135.
136. Lutembacher’s disease consist of a combination of an atrial septal defect and mitral
stenosis
137.
138. Almost all lysosomal storage diseases are transmitted as autosomal recessive genes.
139.
140. Philadelphia chromosome (ph) is identifiable in more than 90% of patients with
chronic myelogenous leukaemia.
141.
142. Patients with ph-negative CML respond poorly to chemotherapy and have shorter
survival than those with ph-positive CML
143.
144. Chloromas are tumorous masses of acute myeloblastic leukaemia.
145.
146. Auer rods are abnormal lysosomal structures visualized as reddish rods in
myeloblasts and promyelocytes.
147.
148. Medullary carcinoma of the thyroid gland arises from parafollicular “c’ cells.
149.
150. Achalasia of esophagus is associated with “Chagas’ disease.
151.
152. Hyperacute rejection occurs within minutes after u and is due to cytotoxic
complement dependent. pre existing antibodies in the host.
153.
154. Papillary carcinoma is the most common malignancy of thyroid.
155.
156. Aschoff bodies are pathognomonic of rheumatic carditis.
157.
158. Most carcinomas of pancreas originate from the epithelial cells lining the ducts and
are most often located in the head
159.
160. Most breast tumors originate in the ducts and have the histologic appearance of
infiltrating duct carcinoma.
161.
162. The serum TSH is the most sensitive indicator of primary hypothyroidism
163.
164. Mixed tumors e.g.mixoid parotid tumour
165.
166. Teratomas arise from totipotential cells that retain the ability to form endodermal,
ectodermal, ectodermal and mesenchymal tissue. Such tumors are found in testis and ovary.
167.
168. Two non-neoplastic lesions simulating tumours.
169.
170. Choristomas Ectopic, sometimes nodular, rests of non transformed tissues (e.g
Pancreatic cells under of the small bowel mucosa).
171.
172. Hamartomas Malformations that present as a mass of disorganized tissue indigenous
to the particular site (i.e. a hamartomatous nodule in the lung may contain islands of cartilage,
bronchi, and blood (vessels).
173.
174. Metastasis is the single most important feature distinguishing benign from malignant
turnouts. Exception being I. Brain tuinours 2.Basal cell carcinoma of skin
175.
176. Grading is based on the degree of differentiation and the number of mitoses within
the tumour. Cancers are classified as grades
177.
178. 1 nto IV with increasing anaplasia.
179.
180. Staging is based on the anatomic extent of the tumour. Two methods of staging are in
use now-a-days. .TNM (Tumour, Node & metastases). 2. AJC (American joint committee).
181.
182. In Philadelphia chromosome a reciprocal balanced translocation between
chromosomes 22 and usually 9(9, 22)is seen in more than 90% of cases of CML.
183.
184. In more than 90% of cases of Burkiti’s lymphoma at (8; 14) translocation is present.
185.
186. Deletion of chromosome 13, band q 14 is associated with retinoblastoma.
187.
188. Deletion of chromosome II band q 13. is associated with Wilm’s tumour.
189.
190. Gene amplification associated with cytogeneüc changes is best exemplified by
neuroblastomas
191.
192. Cancers of lung, colon and prostate are the leading causes of cancer deaths in males
while in females lung, breast and colon cancers are morn common.
193.
194. Japanese are prone to develop gastric cancer
195.
196. In xeroderma pigmentosum, affected patients develop Ca skip in areas exposed to
the ultraviolet light.
197.
198. Clinical conditions associated with increased risk of developing cancers.
199.
200. Cinhosis of liver—hepatocellular Ca.
201.
202. Atrophic gastritis of pernicious anemia—stomach cancers.
203.
204. Chronic ulcerative colitis—Ca colon.
205.
206. Leukoplakia (oral/genital mucosa)—squamous cell carcinoma
207.
208. Villous adenoma colon—colonic Ca.
209.
210.
211.
212. Carcinogenic chemicals.
213.
214. Alkylating agents e.g. cyclophosphamide and Busulphan induced cancer.
215.
216. Aromatic hydrocarbons present in cigarette smoke induces lung cancer.
217.
218. Azodyes ( naphthylamines) induces bladder cancer
219.
220. 4.. Aflatoxin BI—hepato cellular carcinoma
221.
222. Nitrosamines and amides—gastric cancer.
223.
224. Asbestos—mesotheloma
225.
226. Vinyl chloride—angiosarcoma
227.
228. Saccharin & cyclamates—bladder cancer promoter,
229.
230. Oestrogen—endometrial carcinoma.
231.
232.
233.
234. Radiation carcinogenesis
235.
236. UVR—Carcinoma & Melanoma
237.
238. Ionizing radiation
239. o Miners f radioactive ores have an increased risk of lung cancer.
240.
241. o Increased risk of leukaemia in atomic bomb survivors in Japan.
242.
243. o Therapeutic radiation of the neck in children has been associate with the later
development of thyroid cancer (papillary).
244.
245. v Note: In man there is a hierarchy of vulnerability of radiation induced neoplasms;
246.
247. o Most common are myeloid leukaemias, followed by thyroid cancer in children.
248.
249. o Cancer of the breast and lung are less commonly radiation induced.
250.
251. v i Skin, bone and gut are least susceptible to radiation to cause cancer lies in their
ability to induce mutations. Paniculate radiations (alpha & beta Neutrons) are more
carcinogenic than electromagnetic radiation (X-rays. gama Viral oncogenesis)
252.
253.
254.
255. v Causes of cachexia in cancer.
256.
257. v • Loss of appetite
258.
259. v • Infections due to immunosuppression
260.
261. v . Bleeding froth ulcerative lesions
262.
263. v • Production of cachectin (TNE-a) by activated macrophages
264.
265. v (cachectin moblilizes body fat).
266.
267. v Paraneoplastic syndromes It may be the earliest clinical manifestation of a
neoplasm and may mimic distant spread. The most common syndromes are
268.
269. v a.Endocrinopathies -ectopic hormone production—(ACTH)
270.
271. v b.Hypercalcemia (PTH like peptide)
272.
273. o Squamous cell carcinoma lung
274.
275. o T cell leukemias or lymphomas.
276.
277. v Note—Cancer associated hypercalcemia also results from osteolysis induced by
bony metastases.
278.
279. v c. Acanthosis nigricans—Verrucous pigmented lesion of skin is frequently
associated with visceral malignancy.
280.
281. v d. Clubbing of fingers and hypertrophic osteoarthropathy are associated with lung
cancers. e. Thromhotic diatheses resulting from production of thromboplastic substances by
tumour cells may manifest as m or as vegetations in non-bacterial thrombotic endocarditis.
282.
283. v Heart failure cells are seen in pulmonary edema.
284.
285. v In the development of these cells, the initial pulmonary edema (due to LVF) leads to
dilatation of intra-alveolar capillaries which in turn rupture. The minute intra-alveolar
haemorrhages breakdown and phagocytosis of red blood cells leads to the formation of
haemosiderin laden macrophages which are termed Heart Failure Cells.
286.
287. v Brown Induration of Lung—Name given to firm, heavy, dark brown appearance of
Lungs due to long standing pulmonary congestion e.g. in mitral stenosis or CHF.
288.
289. v Nut-Meg Liver—A descriptive term for congestive red-blue central region of a lobule
in liver parenchyma, surrounded by a zone of uncongested liver substance-due to CPC liver
conditions associated.
290.
291. v • Right Heart Failure
292.
293. v • Obstruction to IVC
294.
295. v • Obstruction to hepatic vein less common
296.
297. v Organs Affected in Generalised Primary Amyloidosis
298.
299. v I.Heart 5. Tongue
300.
301. v 2.Kidney 6.Larynx
302.
303. v 3.Intestine 7.Skin etc.
304.
305. v Skeletal muscles
306.
307.
308.
309. Staining reaction of amyloid material
310.
311. § Iodine gives brown- colour and I2 followed by H2S04 gives blue colour Congo red -
red
312.
313. § Methyl violet—rose red while other tissue becomes blue (metachromatic stain).
314.
315. § Von-Gieson’s stain—Khaki shade
316.
317. § PAS stain—red.
318.
319. § Iodide green—(metachromatic stain)—violet red other stained green.
320.
321. § H- & E stain—faintly eosinstained homogenous material.
322.
323. § Fluorescent dyes—to demonstrate amyloid in juxta glomerular area of kidney.
324.
325. § Immunohistological stain—to distinguish between AL and AA.
326.
327.
328.
329. Predisposing factor for secondary amyloidosis. 1. TB of lungs, bone, joints etc
330.
331. § 1 Chronic suppuration in lungs, bones and joints etc.
332.
333. § 2. Syphilis
334.
335. § Rheumatic fever and rheumatoid arthritis.
336.
337. § Ulcerative colitis, Hodgkin’s disease.
338.
339. § Advanced malignancy.
340.
341. § Hansen’s disease (leprosy).
342.
343. Lab diagnosis of amyloidosis
344.
345. § Congo red test
346.
347. § Rectal mucosa biopsy.
348.
349. § Gingival biopsy.
350.
351. § Biopsy of bone marrow, liver, spleen, kidney and intestine.
352.
353. § Peripheral smear examination.
354.
355. § Serum and urinary protein by immuno-electrophoresis.
356.
357. § Demonstration of Bence-Jones protein.
358.
359. § Demonstration of calcitonin.
360.
361. § Note Amyloid can be differentiated from hyaline connective tissue by its
characteristic staining with Congo red, with which it appears red and shows apple-green
bipolar refringence. Aschoff bodies are found in, Heart, Synovia of joints, Joint capsules,
Tendons (Extensor aspect), Subacutaneous tissues.
362.
363.
364.
365. § Diagnosis of Acute Ml
366.
367. § ECO—Presence of pathologic Q-waves usually indicates transmural MI Also
present are ST-Segment and T wave changes with alone indicate subendocardial infarct.
368.
369. § lsoenzyrne studies
370.
371. § MB isoenzyme of creatinine Kinase-highly specific and sensitive marker for MI,
Elevated within 48-72 his, of M and peaks at 12-24 hours after Ml.
372.
373. § SGOT levels—begin to rise in 8 hrs after MI and peak at 18 to 36 hours to return to
baseline within 3 to 4 days
374.
375. § Lactic dehydrogenase—Begins to rise 24 hours after Ml, peaks in 3 to 6 days and
returns to normal only after two weeks
376.
377. § Most sensitive is LDH I: LDH 2 ratio which in inverted in MI.
378.
379. § Ring granuloma in —Q-fever.
380.
381. § The main feature of rapidly progressive giomenilonephritis—Epithelial crescents.
382.
383. § The Tram track (Thickened or split) basement membrane in —Membrano-
prolitèrative glomerulonephritis.
384.
385. § Thyroldisation of Renal tubules (Atrophic tubules with casts) in —Chronic
pyelonephritis.
386.
387. § Periglomemlar fibrosis in —Chronic pyelonephritis
388.
389. § Michaelis Gutman bodies (Giant cells containing calcium and Iron inclusion) in
Melakoplakia of urinary body (a variant of cystitis).
390.
391. § Nebothian follicle in — Chronic Cervicitis.
392.
393. § Flea bitten kidney —Focal Globerulonephritis.
394.
395. § Onion skin appearance of spleen in—SLE.
396.
397. § Hurthle cells in — Hashimatos thyroiditis.
398.
399. § Lipofusein — wear and tear pigment.
400.
401. § Karyorrhexia — Nuclear fragmentation.
402.
403. § Hassel’s corpuscles in —Thymus.
404.
405. § In oncocytoma, the oncocytes have sac like mitochondria.
406.
407. § Left ventricular hypertrophy is said to present when the thickness of left ventricular
wall is more than 15mm.
408.
409. § Melanin like pigment in liver is — Dubin Johnson syndrome.
410.
411.
412.
413. Psammoma Bodies in:
414.
415. § •Psammomatous Meningioma.
416.
417. § •Papillary carcinoma of Thyroid.
418.
419. § •Pupillary serous cystadenoma of ovary.
420.
421. § Libman Sacks endocarditis in —SLE.
422.
423. § Amyloidosis is also known as — Beta fibrillosis.
424.
425. § Durck’s granulomas am seen in — Malaria.
426.
427. § Lepra cells encountered in —Lepromatous lepmsy.
428.
429. § Microscopical]y, normal cells or tissues present in abnormal locations are referred
to as Choristoma.
430.
431. § Hyaline material consists of—Precipitated plasma proteins.
432.
433. § Glycogen can be confirmed by PAS stain.
434.
435. § Flame cells seen in — Multiple myeloma.
436.
437. § Mc Callums patch is found in — Left Atrium.
438.
439. § Melanin can be stained with Fontana stain.
440.
441. § Bilirubin an be confirmed by —Hall’s stain.
442.
443. § Hemosiderin is golden yellow in colour.
444.
445. § Heart failure cells are seen in lungs, in profound anemia, fatty change in heart is —
‘Thush breast or Tigered effect,
446.
447. § In all organs, fatty change appears as Clear Vacuoles within parenchymal cells.
Fatty in growth, fatly change appears as Clear Vacuoles within parenchymal cells.
448.
449. § Fatty in growth is most commonly encountered in Heart and Pancreas.
450.
451. § Fat can be stained with —Sudan IV or Oil Red-O.
452.
453. § Glycogen stained by — Bests Carmine or FAS reaction.
454.
455. § The most common exogenous pigment is — Carbon or coal dust.
456.
457. § Lipofuscin is — Insoluble pigment. also known as Lipochrome.
458.
459. § The tell tale sign of free radical injury and Lipid peroxidation - Lipofuscin.
460.
461. § Homogentisic acid is a — Black pigment, occurs in Alkaptonuria.
462.
463. § Lipofuscin is seen in cells undergoing slow, regressive changes, and is particularly
prominent in Liver and heart of ageing or patients or patients with severe malnutrition and
cancer cacehxia.
464.
465. § Lipofuscin is usually accompanied by — Organ shrinkage (Brown Atrophy).
466.
467. § Hemosiderin is derived fro Hemoglobin.
468.
469. § In Fenton reaction, Hydroxyl Radicals are generated by interaction of Hydrogen
peroxide with Transitional metals like Iron, Copper.
470.
471. § The major antioxidant enzymes are — Superoxide dismutase, catalase, Glutathione
peroxidase.
472.
473. § Cells sometimes respond to infection with Measles or herpes virus by the formation
of Syncytial or multinucleate giant cells, caused by cell to cell fusion.
474.
475. § Certain virus infected cells develop inclusion bodies which contain — Virions or viral
proteins in nuclei or cytoplasm.
476.
477. § Mitochondrial swelling is the first manifestation of almost all forms of injury to cells.
478.
479. § The dead cells usually shows increased eosinophilia.
480.
481. § Necrosis is the sum of the morphological changes that follow cell death in a living
tissue or organ.
482.
483. § Apoptosis—Morphological pattern of cell death.
484.
485. § The earliest observed ultrastructural change in necrosis cell —A reversible
clumping of the chromatin to create large aggregates attached to the nuclear membrane and
to the nucleolus.
486.
487. § Pyknosis—Progressive shrinking of nucleus and becomes transformed to a small,
dense mass of tightly packed chromatin.
488.
489.
490.
491. § Karyolysis—Dissolution of chromatin.
492.
493. § Karyorrhexis—Nucleus break into many clumps (Fragmented nucleus).
494.
495. § Acidophil or Councilman body seen in the liver in —Toxic or viral hepatitis.
496.
497. § The most common pattern of necrosis — Coagulation necrosis.
498.
499. § In Coagulation necrosis—Basic cellular shape is preserved with loss of nucleus.
500.
501. § Coagulation necrosis most commonly results from sudden severe ischaemia of
organ such as
502.
503. § —Kidney, Heart, Adrenal gland.
504.
505. § Liquefaction necrosis is from the action of —Hydrolytic enzyme.
506.
507. § The liquefaction necrosis pattern is characteristic of—ischemic destruction of Brain
tissue.
508.
509. § Caseous necrosis is a combination of coagulative and liquefactive necrosis.
510.
511. § Caseous necrosis is attributed to capsule of Mycobact. tuberculosis, which contains
— Lipopolysacharides.
512.
513. § Fat necrosis is due to the action of—Lipases.
514.
515. § Fat necrosis induced by trauma, particulaily in — Breast Adipose tissue.
516.
517. § Fat necrosis is most commonly seen in —Acute pancreatitis.
518.
519. § In Gangrenous necrosis — Coagulative necrosis is modified by the liquefactive
action of Bacteria and leukocytes.
520.
521. § In dry gangrene—Coagulative necrosis is dominant.
522.
523. § In wet gangrene necrosis is dominant. - -
524.
525. § Fatty change in liver, the mostly accumulated lipid is —Thglycerides.
526.
527. § Acute fatty liver of pregnancy is often fatal.
528.
529.
530.
531. Fatty change is due to: -
532.
533. § • In alcohol poisoning — Increased esterification of fatty acids to Triglycerides.
534.
535. § • In carbon tetrachioride, phosphorous poisoning and protein malnutrition —
536.
537.
538.
539. Decreased Apoprotein synthesis.
540.
541. · • In experimental node! of Patty liver induced by orotic acid — Impaired secretion of
lipoprolein.
542.
543. · • Starvation, corticosteroids — Excessive entry of free fatty acids into the liver.
544.
545. · Father of Modern Pathology—Virchow.
546.
547. · Fatty change per se is Reversible.
548.
549. · Fatty change is most often seen in —Liver and heart.
550.
551. · Bilirubin do not contain Iron,
552.
553. · In advanced obstructive jaundice, aggregates of pigment creates — Bile lakes.
554.
555. · The organs in which Bilirubin accumulation is evident in Liver and Kidneys.
556.
557. · Heiiiochrormatois of pancreas results in Diabetes mellitus,
558.
559. · Colchcine block the mitosis in the Metaphase.
560.
561. · In Chediak—Higashi syndrome, there is - Impaired pathocytosis.
562.
563. · The cytoskeleton consists of microtubules, thin actin filaments, thick Myosin
filaments, Intermediate filaments.
564.
565. · Intermediate filaments are keratin filaments, neurofilaments, glial elements
vimentine, Desmin etc.
566.
567. · In the erythrocyte, the major protein consist of spectrin, actin, protein 4.1 and
ankyrin.
568.
569. · In hereditary spherocytosis, the defect in Red cell shape is due to — abnormal or
deficient spectrin. -
570.
571. · In hypertrophy of cell. there is increase in the number of mitochondria. In atrophy
there is decrease in the number of mitochondria
572.
573. · Compensatory hyperplasia — Hyperplasia that occurs when a portion of liver is
removed.
574.
575. · Pathological calcification implies the abnormal deposition of—calcium salts, together
with smaller amounts of Iron, magnesium etc.
576.
577. · Ferrugenous bodies (Exotic, beaded dumbel forms) in lung occur in —Asbestosis.
578.
579. · Initiation of intracellular calcification occur in the mitochondria of dead or dying cells.
580.
581. · Metastatic calcification appears to begin in Mitochondria except in — kidney (where
it develops in the basement membrane
582.
583. · Alcoholic hyalin (Mallory body) consist of aggregates of Prekeratin Intermediate
filaments.
584.
585. · Amyloid with congo Red stain appears—Red and shows Bipolar refringence.
586.
587. · Keratin pearl in —Squamous cell carcinoma.
588.
589. · Pseudocartilage in —Pleomorphic adenoma.
590.
591. · Tadpole cell in —Rhabdomyosarcoma.
592.
593. · Rosette formation in — Neuroblastoma, Retinoblastoma.
594.
595. · Arias Stellas reaction in — Ectopic pregnancy.
596.
597. · One of the causes of Hypercalcemia — Addison’s disease.
598.
599. · Antimitochondrial antibody in — Primary biliary cirrhosis.
600.
601. · Viirucae body in —Neurilemmoma.
602.
603. · In most types of acute inflammation, neutrophils predominate in the first 6 to 24
hours, being replaced by monocytes in 24 to 48 hours.
604.
605. · Opsonic fragment of C3 complement - C3b.
606.
607.
608.
609. Thromboxane A2
610.
611. · Found in Platelets
612.
613. · Causes platelet aggregation and blood vessel constriction. Prostacyclin: Inhibitor of
platelet aggregation and causes vasodilation. Aspirin - indomethacin etc inhibit the enzyme -
cyclooxygenase. Macrophages in (Mononuclear phagocytes in)
614.
615. · • Blood - Monocytes.
616.
617. · • Nervous system - Microglia.
618.
619. · • Bone - Osteoclasts.
620.
621. · • Liver - Kupffer cells.
622.
623. · • Connective tissue - Hiystiocytes.
624.
625. · • Bone marrow - Macrophages.
626.
627. · • Skin - 1 Langerhan’s cells.
628.
629. · • Lymphoid tissue - ? Dendritic cells.
630.
631.
632.
633. · Asteroids in giant cells in — Sarcoidosis.
634.
635. · Labile cells — Proliferate throughout life.
636.
637. · Permanent cells in—Skeletal muscle, cardiac muscle, nervous system.
638.
639. · Commonest tumor of Appendix — Argentaffinoma
640.
641. · Juvenile polyposis supposed to be Retention cysts.
642.
643. · Nurse cells in — Trichenella spiralis.
644.
645. · Heart failure cells (Hemosiderin laden Macrophages) in Alveolar spaces in —
Congestive heart failure. Lisch nodules (pigmented Iris hamanomas) in —Neurofibromatosis.
646.
647. · Most of the known carcinogens are metabolized by the— cytochrome P dependent
monooxygenases.
648.
649. · The most common type of thickening of Glomerular basement membrane is due to
extensive subepithelial deposition of immune complexes, as occurs in — Membranous
Glomerulonephritis
650.
651. · The classic Glomerular basement membrane antigen is component of collagen type
- IV.
652.
653.
654.
655. Kidney (Electron Microscopy):
656.
657. · • Subepithelial humps in— Post streptococcal Glomerulonephritis
658.
659. · • Subepithelial deposits in —Membranous G.N.
660.
661. · • Loss of foot process in — Lipoid nephrosis, Focal segmental Glomerulosclerosis
662.
663. · • Subendothelial deposits in — Membrano proliferative G.N.
664.
665. · • Mesangial and paramesangial dense deposits of IgA nephropathy
666.
667.
668.
669. Kidney (Light Microscopy):
670.
671. · • Diffuse capillary wall thickening —Membranous G.N.
672.
673. · • Lipid in Tubules in — Lipoid nephrosis.
674.
675. · • Hyalinized Glomeruli in — Chronic Glomerulonephritis.
676.
677. · • Splitting of basement membrane — Membrano proliferative G.N.
678.
679.
680.
681. Two Histologic Alterations that Characterise Malignant Hypertension:
682.
683. Ø • Fibrinoid necrosis of arterioles
684.
685. Ø • 1-lyperplastic arteriolitis
686.
687. Ø Angiomyolipoma are common in patients with —Tuberous sclerosis.
688.
689. Ø Fatty streaks appear in the aortas of all children older than one year.
690.
691. Ø Ring like calcifications in the media of medium sized to small arteries of muscular
type in — Monckeberg’s medial sclerosis.
692.
693. Ø Te most usual site of involvement of polyarteritis nodosa — Kidney (Renal
vessels).
694.
695. Ø Classic polyarteritis nodosa does not affect the pulmonary circulation.
696.
697. Ø Fibrinoid necrosis in — Malignant hypertension, Polyarteritis nodosa etc.
698.
699. Ø In inflammation, macrophages originate from — Macrophages.
700.
701. Ø Bacteria containing Hyaluronidase — Clostridium
702.
703. Ø Granulation tissue is formed in the process of Healing by Secondary union.
704.
705. Ø The Amyloidosis that occurs in Multiple myeloma — Primary Amyloidosis.
706.
707.
708.
709. Ø Rodent ulcer — Basal cell carcinoma.
710.
711. Ø Centrilobular necrosis of liver in —Congestive heart failure.
712.
713. Ø Nut meg liver in —Congestive heart failure
714.
715. Ø Cardiac sclerosis of liver in — Congestive heart failure.
716.
717. Ø Carcinoid tumors in the ovary or lung may induce carcinoid syndrome without
antecedent Hepatic metastases.
718.
719. Ø The fact that the cardiac changes in carcinoid heart diseases are largely Right
sided is explained by —Inactivation off both serotonin and bradykinin in the blood dining
passage through lungs by Monoamine oxidase found in pulmonary vascular endothelium.
720.
721. Ø Te most common primary tumor of heart in adults — Myxomas (Commonest site -
Left Atrium).
722.
723. Ø The most frequent primary tumor of heart in infants and children —
Rhabdomyomas.
724.
725. Ø Gandy — Gamma bodies contain - Deposits of Hemosiderin and Calcium. -
726.
727. Ø Autosplenectomy occur in Sickle cell anemia.
728.
729. Ø Lacunar cells in Nodular sclerosis type of Hodg disease.
730.
731. Ø Owl eyed nucleoli in the nucleus of Reed-Sternberg cell.
732.
733. Ø Chloromas are seen most commonly in —AML.
734.
735. Ø Myeloblasts are characterised by delicate nuclear chromatin three to live nucleoli
and fine azurphilic granules in cytoplasm.
736.
737. Ø Lvmphoblasts have coarse, clumped chromatin and few nucleoli — Azurophilic
granules are not present in cytoplasm.
738.
739. Ø Auer rods ire Red staining, intracytoplasmic, rod like structures in granulocytes.
740.
741. Ø Massive splenomegaly is associated with —CML and hairy cell leukemia.
742.
743. Ø Spontaneous rupture of spleen seen in — Infectious mononucleosis, Malaria,
Typhoid fever, Leukaemia, Acute splenitis
744.
745.
746.
747. Ø In diabetic nephropathy, the cells of the distal portions of proximal convoluted
tubules contain —Glycogen (Armanni ebstien lesion).
748.
749. Ø The characteristic hail mark of all syphilitic infections — obliterative endarteritis with
perivascular cuffing of lymphocytes and plasma cells.
750.
751. Ø The half mark of cutaneous T cell lymphoma of Mycosis fungdides type
histologically is the identification of the Sezary-Lutzner cells.
752.
753. Ø Polyglucoside bodies — CorDora Amylacea.
754.
755. Ø Microglia can be stained by special stains like — Hortega carbonate.
756.
757. Ø Brain has no lymphatic system.
758.
759. Ø Subdural haemorrhage result from —rupture of bridging veins that connect the
venous system of brain to the large intradural venous sinuses.
760.
761. Ø Hirano bodies in—Aizheimer’s disease;
762.
763. Ø Pick bodies in —Picks disease.
764.
765. Ø The most common congenital malformation of the brain in humans—Anencephaly.
766.
767. Ø In Schwannomas, no nerve fibres are present in the tumor.
768.
769. Ø Retinal phlebitis with candle wax drippings in or near Retinal vessels in—
Sarcoidosis
770.
771. Ø Dalen Fuchs nodules between Bruchs membrane and Retinal pigment epithelium
in — Sympathetic uveitis.
772.
773. Ø The most common primary ocular malignancy in Caucasians—Intraocular
Melanomas.
774.
775. Ø Fexner Wintersterier Rossettes in —Retinoblastoma.
776.
777. Ø Thrombi when formed with a cardiac chamber or Aorta, they may have apparent
laminations called— Lines of Zahn.
778.
779. Ø Lines of Zahn are produced by— Alternating layers of pate platelets admixed with
fibrin separated by dark layers containing red cells.
780.
781. Ø Vericcous endocarditis—Non-bacterial bland Thrombotic vegetations seen in
systemic lupus erythematosis.
782.
783. Ø Chicken fat thrombus — Post mortem thrombus.
784.
785. Ø Commonest site of Pblebothrombosis — deep leg veins.
786.
787. Ø Infarct of Zahn — due to occlusion of intrahepatic branch of portal vein.
788.
789. Ø The two most distinctive features of chronic active hepatitis — piecemeal necrosis
and Bridging necrosis.
790.
791. Ovarian Tumors:
792.
793. Ø • Call-Exner bodies in— Granojosa cell tumours.
794.
795. Ø • Reinke crystefloids in :— Hilus cell tumor.
796.
797. Ø • Alpha fetoprotein in — Endodermal sinus tumor.
798.
799. Ø • Chronic gonadotrophin in — Dysgerminomas.
800.
801. Ø • Meigs syndrome in — Ovarian fibromas.
802.
803. Ø The causes of Rapidly progressive Glomerulonephritis are SLE (lupus nephritis),
PAN, Post streptococcal glomerulonephritis etc.
804.
805. Ø Rapidly progressive glomerulonephritis. pathologically characterised by extensive
proliferation of cells in the Bowman’s space with the formation of crescents.
806.
807. Ø Von Hansemann cells in— Melakoplakia of Bladder.
808.
809. Ø Macrophages containing PAS positive glycoprotein granules typically seen in —
Whipples disease
810.
811. Ø In membranous glomerulonephritis, the kidneys are — large, swollen and pale.
812.
813. Ø Ascending infection is the most common pathway by which bacteria reach the
kidney.
814.
815. Ø Bazins disease is Erythema induration.
816.
817. Ø Real papillary necrosis or necrotising papillitis is due to - Diabetes mellitus,
analgesics like phenacetin. urinary tract obstruction.
818.
819. Ø The law that regeneration is more complete in younger individuals than in older
ones is Spllanzani law.
820.
821. Ø Encelitis is inflammation of intra abdominal organ.
822.
823. Ø Hemophilia C due to defect in synthesis of PTA or factor Xl. It is Mendelian
dominant.
824.
825. Ø In hemophilia, bleeding is from large vessels whereas in thrombocytopenia, it is
from small capillaries. Deficiency of factors 1 and II are rarely congenital. Parahemophilia is
due to deficiency of factor V.
826.
827. Ø Indian file pattern of cords in Ca breast is seen in infiltrating lobular type.
828.
829. Ø Pagets cells arc seen in Pagets disease ofnipple.
830.
831. Ø ANCA (Anti neutrophilic cytoplasmic antibody) is seen in Polyarteritis nodosa.
832.
833. Ø Alveolar haemonhage syndrome may be present in Goodpasture’s syndrome,
rheumatoid arthritis, SLE, idiopathic pulmonary hemosiderosis and toxin-induced disease
from penicillamine.
834.
835. Ø Anitschkow myocytes (caterpiller cells) are believed to be modified fibroblasts.
836.
837. Ø Aschoff node is seen in rheumatic fever in myocardium.
838.
839. Ø In Bowenoid papulosis, there are numerous small velvetly papules on shaft of
penis of young men probably caused by HPV.
840.
841. Ø Burnt out plaques are seen in multiple sclerosis.
842.
843. Ø Lines of Zahn is a characteristic appearance of laminations in thrombi when formed
in aorta.
844.
845. Ø Adhesion molecules on leucocytes are P-150, MO-I, LEA-I.
846.
847. Ø Polypoid cells seen in hypertrophy of cardiac muscle cells are arrested 02 phase
848.
849. Ø Helper T-cells interact with Class-il MHC
850.
851. Ø In SLE, autoantibodies against red cells, white cells and platelets is mediated by
hypersensitivity reaction type I1
852.
853. Ø Rubber hose inflexibility of GIT in systemic sclerosis is commonest in lower two
thirds o esophagus. The lesion most specific for SLE is subendothelial deposit.
854.
855. Ø Onion skin lesion concentric periarterial fibrosis in spleen is characteristic of SLE.
856.
857. Ø Pink to gray pinpoint elevations of endocardium giving Dew drop appearance is
seen in amyloidosis TB does not produce granulomas in patients of HIV
858.
859. Ø Protoncogene with GTPase activity is H -ras.
860.
861. Ø Zeebra bodies are seen in Niemann Pick disease.
862.
863. Ø Hard glassy’ splenomegaly may be seen in amyloidosis.
864.
865. Ø The dark lines of Zahn are composed of RBC’s.
866.
867. Ø Amyloid gives apple green birefringence when stained with congored.I
868.
869. Ø In psoriasis, the turnover of epithelial cells is at least twice as fast that of normal
skin.
870.
871. Ø In situ hybridisation uses biotin to give a colorimetric detection system.
872.
873. Ø Lads cells are found in Juxta glomerular apparatus.
874.
875. Ø The only human DNA which lies outside to nucleus is in mitochondria.
876.
877. Ø Lacunar cells are found in nodular sclerosing lymphoma.
878.
879. Ø Repetitive necrosis of adjacent regions of several infarcts of varying ages yields
progressive extension of an individual infract over a period of days to weeks, called Stuttering
infarct.
880.
881. Ø Popcorn cells or cells like elephant feet are found in lymphocytic predominant
Hodgkin’s disease.
882.
883. Ø Lambl’s excrescences are to aging
884.
885. Ø Lewy bodies are found in Parkinsonism
886.
887. Ø Leopard. Lizard or Elephant skin is seen in Oncocerciasis.
888.
889. Ø Meyers-Kouvenaar bodies are found in Filariasis
890.
891. Ø Mazzoni reaction is seen in oncocerciasis.
892.
893. Ø Molluscum body is found in stratum conieum and stratum granulosum.
894.
895. Ø Residual bodies in a cell are lysosomes.
896.
897. Ø Ring abscess is found in infective endocarditis.
898.
899. Ø Bite cells are seen in 0-6-P deficiency.
900.
901. Ø Pigbel is caused by Cl. perfringens.
902.
903. Ø In addition to Hodgkin’s disease and infectious mononucleosis, Reed Sternberg
cells may be seen in mycosis fungoides. -
904.
905. Ø Accumulation of RNA in cytoplasm makes it pyroninophilic.
906.
907. Ø Stiff lung is seen in ARDS.
908.
909. Ø Collar button lesions are characteristic of bronchia carcinoid,
910.
911. Ø he oncogerie amplification seen in small cell carcinoma is Myc.
912.
913. Ø Part of colon with highest wail tension is caecum.
914.
915. Ø A bizarre map like pattern, leopard spotting of oesophagus is due to postmortem
digestion.
916.
917. Ø Commonest she of origin of lower 01 bleeding due to angiodysplasia is caecum.
918.
919. Ø Most sensitive indicator of Castro esophageal reflux is pathohistology of
esophagitis is intraepithelial eosinophils.
920.
921. Ø APUD cells are derived from endoderm.
922.
923.
924.
925. ¨ Most abundant substance secreted in bile is bile salts.
926.
927. ¨ Life long immunity in HBV is due to Anti HBS.
928.
929. ¨ LDL clearance independent of LDL receptors occur in mononuclear phagocytic
system.
930.
931. ¨ Electron microscopic appearance of prominent lysosomes with whorld appearance
is seen in Tay Sach’s disease.
932.
933. ¨ Technique most used for linkage analysis is variable number of tandem repeats.
934.
935. ¨ Most common cause of false negativity of RELP is Closer linkage.
936.
937. ¨ Uniparental disomy of paternal chromosome 15 causes Angleman syndrome.
938.
939. ¨ Retinoic acid causes teratogenesis by induction of fox gene.
940.
941. ¨ Amniotic bands are classical example of deformation.
942.
943. ¨ Retinoblastoma gene (RB) inactivation is seen in small cell carcinoma of lung,
osteosarcoma and carcinoma of bladder
944.
945. ¨ Typhus nodule in brain due to focal microglial proliferation with leukocytic infiltration
seen in Typhus fever is limited to grey matter.
946.
947. ¨ The organism with shepperd crook appearance is leptospira interrogans.
948.
949. ¨ Von Hansemann’s cells are large histiocytes seen in Malakoplakia.
950.
951. ¨ Caplan’s nodoles are seen in rheumatoid pneumoconiosis.
952.
953. ¨ Carre’s osteomyelitis is non suppurative osteomyelitis resulting in increased density
of shaft of a long bone. There is new bone formation but no pus cells.
954.
955. ¨ Glomus organ is a convoluted AV anastomosis with modified muscle cells.
956.
957. ¨ Michaelis-Gutmann bodies are targetoid bodies due to defective lysosomal function
seen in Malalcoplakia.
958.
959. ¨ Brunu’s nest are rounded collections of urothelial cells found just below the
urothelial surface frequently seen in normal bladder..
960.
961. ¨ Carcinoid tumor may also be seen in ovary and stomach in addition to appendix and
intestine (SI/LI)
962.
963. ¨ Catheter tumor is proliferated granulation tissue in urinary bladder due to catheter.
964.
965. ¨ In central core disease, there is non-progressive congenital myopathy.
966.
967. ¨ Clear cell sarcoma usually involves foot and knee.
968.
969. ¨ Cytoid bodies axe fluffy white patches in retina seen in accelerated HT, SLE and
dlermatomyocytis.
970.
971. ¨ Cytoid body is a nodular swelling in injured axon.
972.
973. ¨ The commonest site from where a nerve biopsy in taken is sun] nerve.
974.
975. ¨ In ‘dying back’ neuropathy, there is axonal degeneration.
976.
977. ¨ Hibernoma is a type of lipoma.
978.
979. ¨ Kiel classiflcation is used to classify lymphoma.
980.
981. ¨ Indirect serologic predictors of HIV infection are beta-2 microglobulin,
Neoptrrin,Interleulcin 2- receptor, Net gene markers
982.
983. ¨ Endheim’s medial degeneration is also called cystic medial necrosis
984.
985. ¨ Kumura’s disease is epitheloid hemangioma
986.
987. ¨ Wertlake and Del Guercio were first observers to comment on the diagnostic value
of bile cytology
988.
989. ¨ Postmortem clot shows ‘chicken fat’ and ‘currantjelly’ appearances
990.
991. ¨ Mural or parietal thrombus is nonocclusive thrombus adherent to the wall
992.
993. ¨ Saddle or riding thrombus is that which extends into the branches or tributaries of a
vessel.
994.
995. ¨ Hyaline thrombus is when thrombus is a homogenous mass.
996.
997. ¨ CNS fungal infections are aspergillosis, candidiasis,cledosporin,cryptococcus and
zigomycosis.
998.
999. ¨ In urine cytology. superficial cells are called umbrella cells
1000.
1001. ¨ Decoy cells’ or ‘comet cells’ with tail like cytoplasmic processes and homogenous
degenerated nuclei simulating carcinoma cells
1002.
1003. ¨ Durck’s granuloma is due to aggregates of reactive astrocytosis and microghat cell
proliferation seen in cerebral malaria
1004.
1005.
1006.
1007. ¨ HIV wasting syndrome is also called ‘slim diseas ‘
1008.
1009. ¨ HIV virus contains 3 group of structural proteins-gag (Group specific antigen), p
coding and env (codes for envelop proteins)
1010.
1011. ¨ Gag codes for p and p 1 8, poi codes for reverse transcriptase and Env codes for
synthesis of gp l2O and fgp41
1012.
1013. ¨ Non-structural genes in HIV virus are tat, art and 3’ orf
1014.
1015. ¨ HIV virus contains LTR (long terminal repeat) segments
1016.
1017. ¨ In Huntington’s disease, basal ganglia most commonly atrophied is caudate nucleus
1018.
1019. ¨ Loss of acetyl neurons in nucleus of Meynert is a feature of Alzheimer disease
1020.
1021. ¨ Verocay bodies are pathognomonic of schwanomma
1022.
1023. ¨ Hooping on silver staining is characteristic feature of primary brain lymphoma
1024.
1025. ¨ Bery aneurysm ruptures once diameter is more than 10mm
1026.
1027. ¨ Rosenthal fibres are pathognomonic of pilocytic astrocytoma
1028.
1029. ¨ Round cells with perinuclear halos are pathognomonic of oligodendroglioma
1030.
1031. ¨ Candle quattering appearance of ventricular system is pathognomonic of tuberous
sclerosis
1032.
1033. ¨ Free radicals in reperfusion injury are produced by infiltrating PMN
1034.
1035. ¨ P53 dependent apoptosis is seen in irradiation
1036.
1037. ¨ Thrush breast appearance of myocardium is seen in profound anemia
1038.
1039. ¨ Cell shrinkage in a apoptosis is due to activation of glutathione peroxidase
1040.
1041. ¨ The cells with longest telomeres are sperms
1042.
1043. ¨ Feyrter cells are also called Kulchitsky cells or argentaffin cells. They belong to
APUD coils or dense core granule (DCG) cells
1044.
1045. ¨ Frauzen needle is used for prostatic aspiration
1046.
1047. ¨ Bernard Soulier syndrome is an autosomal recessive taint characterized by a
variable thrombocytopenia, IBT, defective
1048.
1049. ¨ Prothrombin consumption and giant platelets. Defect is in sialic acid rich protein GP
I b of platelet membrane. It causes defective adhesion
1050.
1051. ¨ Gray platelet syndrome is due to abnormalities in platelet secretion
1052.
1053. ¨ Folded cell index and crowded cell index are also used for hormonal evaluation of
vaginal cytology
1054.
1055.
1056.
1057. ¨ Joplin I reaction (Gel and coombs type IV) is seen in borderline leprosy and Joplin’s
type II (gel and coombs type 3) is seen in lepromatous and borderline leprosy
1058.
1059. ¨ Myelin enveloping the axon is interrupted at regular intervals by funnel shaped clefts
called Schmidt Lauterman clefts
1060.
1061. ¨ Renau bodies are hyaline bodies occur in endoneural compartment
1062.
1063. ¨ Mikulicz cells are seen in rhinoscleroma and they am grnular or foamy macrophages
1064.
1065. ¨ Farmer’s lung is also called Silofiller’s lung
1066.
1067. ¨ Concentric onion skin lesions is pathohistological feature of tertiary syphilis is seen
in arteri des
1068.
1069. ¨ Schiller-Duval bodies are found in endodermal sinus tumor
1070.
1071. ¨ Sherman’s paradox is typically seen in fragile X-syndrome
1072.
1073. ¨ Tamm Horsfall protein is a glycoprotein
1074.
1075. ¨ In hereditary spherocytosis, there is chief abnormality in spectrin
1076.
1077. ¨ Fibroblast proliferation is associated with LOF, FOE and PDCIF
1078.
1079. ¨ Struvite stones are composed of magnesium ammonium P04
1080.
1081. ¨ Tamm horsfall protein may be seen in acute tubular necrosis and multiple myeloma
1082.
1083. ¨ Triton tumors are malignant schwannoma
1084.
1085. ¨ Lafora bodies are seen in neurons, hepatocytes and myocytes
1086.
1087. ¨ Ferruginous bodies mainly contain asbestos
1088.
1089. ¨ Type2 muscle Fibre differs rum type I by widc Z band
1090.
1091. ¨ Heymann’s membraneous GN is due to fixed intrinsic tissue antigen
1092.
1093. ¨ Oncocytes are also known as Hurthiel cells
1094.
1095. ¨ Parking lot inclusions are found in mitochandrial myopathy
1096.
1097. ¨ Flame cells or Mon cells are found in trypanosomiasis
1098.
1099. ¨ Ring chromosome is a type of deletion
1100.
1101. ¨ Popcorn cells are found in Hodgkin’s disease
1102.
1103. ¨ Pores of Kohn are found in alveolar wall
1104.
1105. ¨ Ring fibre is present in myotonic dystrophy
1106.
1107. ¨ Weibel-Palade bodies are characteristically contain P- selectin and von Willebrand
disease
1108.
1109. ¨ Hydatid cyst is most often seen in liver, followed by lung omentum. mesentry and
kidney. Calcification is common spleen liver and lungs.
1110.
1111. ¨ Oseous types are most often in upper end of femur, tibia or humerus, vertebrae and
ribs.
1112.
1113. ¨ The Bends” (periarticular bubbles); t (bubbles in lungs) and “Staggers’ (involvement
of inner ear) are seen in Caisson disease.
1114.
1115. ¨ Steroid myopathy is muscle fibre atrophy, affecting type 2 fibers.
1116.
1117. ¨ Sezary-Lutzner cells and Pautrier’s micro abscesses are found in Mycosis
fungoides.
1118.
1119. ¨ Von Mayenburg Complexes are anomalies of biliary tree (small clusters of dilated
bite ducts embedded in a fibrous, sorn times hyalinized stroma).
1120.
1121.
1122.
1123. ¨ Zebra bodies are seen in mucopolysaccharidoses.
1124.
1125. ¨ Decay cells or Comet cells with tail like cytoplasmic processes and homogenous
degenerated nuclei simulate carcinoma cells
1126.
1127. ¨ Duret haemorrhages are midline haemorrhages in midbrain and pons seen in brain
herniation.
1128.
1129. ¨ Ferruginous bodies are found in asbestosis.
1130.
1131. ¨ Heat-shock proteins or stress proteins alt present constitutively in normal cells,
where they play an important role in normal cell metobolism. Two familes are HSP 70 and hsp
60 (also called Chaperones or chaperonins).
1132.
1133. ¨ Soap bubble lesion in brain is seen in cryptococcosis
1134.
1135. ¨ Brewer’s lung is seen in aspetgillosis
1136.
1137. ¨ Birbeck granules are found in histiocytosis X
1138.
1139. ¨ Heinz bodies are seen in C3-6-P-D deficiency.
1140.
1141. ¨ Flame cells or Mott cells are plasma cells in African trypanosomiasis.
1142.
1143. ¨ Major Basic protein (MBP) is a cationic protein of eosinophils, which has limited
bactericidal activity but is cytotoxic to many parasites.
1144.
1145. ¨ Asteroid bodies are found in Sarcoidosis.
1146.
1147. Antischkow cells are found in rheumatic fever.
1148.
 Register
 Help

User Name Passw ord Log in
Remember Me?
 What's New?
 Forum
o New Posts
o FAQ
o Calendar
o Community
o Forum Actions
o Quick Links
 Advanced Search

 Forum
 Medical Discussion Forum
 Obstetrics & Gynaecology
 Lecture Notes
 Gynaecology: Last Moment Revision
1. If this is your first visit, be sure to check out the FAQ by clicking the link above. You may have
to register before you can post: click the register link above to proceed. To start viewing messages, select the
forum that you want to visit from the selection below.
Results 1 to 4 of 4
Thread: Gynaecology: Last Moment Revision
 Thread Tools
1. 04-10-2009, 11:22 PM#1
trimurtulu
MedicalGeek Resident
Join Date
Aug 2008
Posts
6,603
Rep Power
44
Gynaecology: Last Moment Revision
GYNAECOLOGY : LAST MOMENT

REVISION
THE MENSTRUAL CYCLE
It is the cyclical bleeding from the female genital tract which is due to the cyclical
changes during endometrium due to the secretion of ovarian hormones. A cycle is
counted from the first day of the menstrual bleeding to the first day of next menstrual
bleeding.
Menstrual cycle can be divided into four phases.
Menstrual Phase- if the ovum is not fertilized, then menstrual bleeding occurs which lasts
for about 3-5 days. There is bleeding and shedding of uterine endometrium. An average
of 50-200 ml of blood is lost during each menstrual bleeding.
Proliferative phase - here damaged endometrial lining is restored. From day 5 to 14, the
endometrium thickens and proliferates. Proliferation occurs in the glands, stroma , blood
vessels and superficial epithelium. Thickness of uterine endometrium reaches about 4
mm by about 14th day.
Ovulatory phase - ovulation occurs about the 14th day. Cervical mucus secretion
increases and it becomes thinner which helps the penetration of sperms.
Secretory phase / Luteal phase/ progestational phase – in this phase, the uterine
endometrium further thickens,glands increase in length, spiral arteries become coiled
and dilated, cervical secretions become thick and tenacious in preparation for
implantation of fertilized ovum. These changes end about 28th day of the cycle with the
onset of menstruation if the ovum is not fertilized.
Hormonal Control of the Menstrual cycle
The menstrual cycle is regulated by the hormones from the hypothalamus, pituitary and
ovaries. The hypothalamus releases gonadotropin releasing hormone which stmulates
the synthesis and release of gonadotropins ,FSH and LH. Increase FSH helps in the
development of ovarian follicles and stimulates the secretion of oestrogen from ovarian
follicles. Increase oestrogen levels causes the changes in the proliferative phase. Serum
oestrogen levels becomes peak at about 12 to 13th day. (oestrogen surge) which has a
positive feedback on the hypothalamus resulting in increased gonadotropin releasing
hormone. This in turn induces a burst of LH secretion (LH surge) from the anterior
pituitary which is the cause of rupture of mature graffian follicles to cause ovulation.
After ovulation serum LH and FSH decreases in concentration.
The corpus luteum formed from the ruptured follicle secretes progesterone. During the
secretory phase, the serum progesterone and oestrogen level rises which reduces the
secretion of FSH and LH from the anterior pituitary. Progesterone causes the main
changes during secretory phase. If pregnancy occurs, corpus luteum persists and
continue to secrete progesterone and oestrogen. But if fertilization does not occur, the
corpus luteum regresses into corpus albicans and serum oestrogen and progesterone
level decreases which causes the menstrual bleeding.
MENSTRUAL DISORDERS
1. Amenorrhoea – is the absence of menstruation which may be primary or

secondary.PRIMARY amenorrhoea is the condition where menstruation fails to begin by
the age of 16 years. Seconday amenorrhoea is the amenorrhoea in a woman after
menstruation has been established.(cryptomenorrhoea is where menstrual bleeding
occurs but remains concealed due to vaginal occlusion by a congenital septum or atresia)
amenorrhoea can also be classified as physiological and pathological.
Physiological amenorrhoea
1. Amenorrhoea before puberty
2. Amenorrhoea during pregnancy
3. During lactation
4. After menopause
Pathological Amenorrhoea
A. Defects in the genital tract
1. Vaginal atresia
2. Imperforate hymen
3. Transverse vaginal septum
4. Cervical atresia
5. Genital tuberculosis
6. Ashermann’s syndrome(amenorrhoea secondary to the trauma of the endometrium

due to vigorous curettage during procedures like abortion and MTP.
B. Defects in the ovaries

1. Ovarian dysgenesis
2. PCOD (Stein –Leventhal syndrome)
3. Premature menopause
4. Surgical removal of both ovaries
C. Chromosomal defects
1. Turner’s syndrome
D. Pituitory disorders
1. Pituitory tumors
2. pituitary infantilism
3. Hyper prolactinoma
4. Sheehan’s syndrome(post partal pituitary necrosis due to thrombosis of pituitary

blood vessels following post partum haemorrhage)
E. Gonadotropin releasing hormone deficiency causes hypothalamic amenorrhoea.
F. Disorders of adrenal glands
1. Adrenogenital syndrome (caused by a tumor or hyperplasia of adrenal cortex resulting

in excessive androgen production. )
2. Cushing’s syndrome (Cortico steroid hormones are in excess which causes

osteoporosis, hirsutism, obesity and amenorrhoea.
3. Addison’s disease.
G. Thyroid disorders
H. Nutritional factors
1. Starvation,
2. Extreme obesity
3. Anorexia nervosa
I. Drugs
1. Oral contraceptives
2. Prostaglandin inhibitors
Management:
Depends upon the underlying causes
DYSMENORRHOEA
It is the painful menstruation incapacitating the women in day today activities.
1. Spasmodic dysmenorrhoea (primary dysmenorrhoea)
here there is no identifiable pelvic pathology. May be due to cervical obstruction,

psychological factors like low pain threshold, endocrine factors like low progesterone
level, intrauterine contraceptive devices and muscular spasms. The pain begins a few
hours before or just after the onset of menstruation may last upto 12 hours and
accompanied by constitutional symptoms like chills nausea, vomiting and fainting.
2. Congestive dysmenorrhoea (secondary dysmenorrhoea)
Causes:
1. Uterine fibroid
2. Chocolate cyst of ovary
3. Pelvic endometriosis
4. Adenomyosis
5. PID
6. Salpingoophrites
Here the pain starts 3 to 5 days before menstruation and is relived by the flow..
3. Membraneous dysmenorrhoea
It is a variety of primary dysmenorrhoea characterized by shedding of large endometrial

casts during menses.
PMT
It is a condition where women suffer from excessive premenstrual symptoms which are
experienced for 7 to 10 days before the onset of menstruation.
Symptoms:
Irritability, lassitude, sleepiness, headache, nausea, constipation, frequency of

micturition , weight gain, oedema of legs, fullness and tenderness of breast etc. though
the exact aetiology is not known, the PMT is said to be due to excess of oestrogen in
relation to the progesterone.
MENORRHAGIA
Is excessive menstrual blood loss both in amount and duration.
Casuses:
Pelvic causes:
1. Uterine fibroid
2. Adenomyosis
3. Ovarian tumors
4. Pelvic endometriosis
5. PID
6. Genital TB
Endocrine causes:
1. Hypo and hyper thyroidism
2. General diseases
3. Chronic HTN
4. CCF
5. Leukaemia and purpureas
6. Liver dysfunction
IUCD (Intra Uterine Contraceptive Devices)
METRORRHAGIA
It is acyclical intermenstrual irregular uterine bleeding.
Causes:
Uterine fibroid
Uterine polyps
Ca cervix
Ca endometrium
Cervical erosion
Cervical polyp
POLYMENORRHOEA (EPIMENORRHOEA)
It is the frequent menstruation at regular intervals of 2 or 3 weeks due to the shortening

of the cycle. If it is associated with prolonged bleeding, it is called Epimenorrhagia.
Dysfunctional Uterine Bleeding
This is abnormal uterine bleeding where no organic cause can be detected and occur at
any age between menarche and menopause.
Metropathica haemorrhagica- it is irregualar anovulatory prolonged bleeding which may

last for many weeks and is painless due to the failure of ovarian response to
gonadotropins.
VAGINAL DISCHARGE
A. Physiological :
In healthy women the vagina contains a small amount of watery secretion which
contains mucus, desquamated epithelial cells, doderllains bacilli and lactic acid. It is
usually colorless.
B .Pathological”
To investigate the pathology behind the vaginal discharge, it is necessary to know the
colour, quantity, duration of time it has been present,smell, irritating or not and if it is
blood stained or not. An irritating discharge may be due to infection by the trichomonas
vaginalis or candida albicans. Yellow discharge may be due to bacterial infections,
infected cervical polyp or erosion, acute gonorrhoea, puerperal sepsis or
pyometra.Offensive vaginal discharge is characteristic of necrotic lesion of genital tract,
carcinoma of vagina, foreign bodies retained in the vagina. Blood stained discharges
occur with oestrogen deficiency, carcinoma of cervix, any ulcerated lesions and in intra
uterine pregnancies.
INFERTILITY
Is defined as failure to conceive even after one year of regular unprotected intercourse.
(Sterility is an absolute state of inability to conceive where as infertility is only a relative
state)
Infertility can be primary and secondary.
Causes of infertility
Faults in the Male
1. Defective spermatogenesis
2. Obstruction in the efferent duct
3. Sperm motility
4. Failure in depositing the sperm.
Faults in the Female:
1. Vaginal factors
a. Vaginal atresia
b. Narrow introitus
c. Transverse vaginal septum
d. Vaginal stenosis
e. Vaginismus
2. Cervical factors
1. Elongation of cervical canal
2. Obstruction of cervical canal
3. Uterine prolapse
4. Thick cervical mucus
5. Chronic cervicitis
6. Presence of antisperm antibody in cervical mucus
3. UTERINE FACTORS
1. Congenital malformations of uterus
2. Uterine fibroid
3. Adenomyosis
4. Uterine tuberculosis
5. Tubal factors
1. Tubal occlusion
2. Tubal additions
3. Loss of celia
4. Congenital tubal defects
5. Tuberculosis
6. Salpingitis
6. Ovarian factors
1. Anovulatory cycles
2. Ovarian tumors
3. PCOD
7. Endocrinal factors
1. Thyroid disturbances
2. Hypogonadotrophism
3. Corpus luteum insufficiency
4. Hyperprolactinaemia
INVESTIGATIONS OF INFERTILITY
MALE
1. Local examinations of genitals
2. Semen analysis
3. Serum hormone levels
4. Testicular biopsy
5. Chromosomal test
6. Immunological test
FEMALE
1. Detailed history taking
2. General systemic and gynaecological examinations
3. Special investigations to assess tubal, cervical, peritoneal and ovarian functions.
URINARY PROBLEMS IN GYNAECOLOGY

Retention of Urine:- the condition where urine collects in the urinary bladder but fails to
be voided out leading to stasis of urine in the bladder.
Causes:
Postoperative retention
it may be due to oedema, reflex spasm of bladder sphincter, or denervation of bladder.
Obstructive conditions like stenosis, cancer of bladder neck retention durine Puerperal
period.
Pelvic tumors
Retroverted gravid uterus
DYSURIA
Causes:
Cystitis
Urethritis
Urethral caruncle
Carcinoma of urethral meatus
Trauma to the urethra
Postoperative
Vesical calculi
Following catheterization
Radiation cystitis
INCREASED FREQUENCY OF MICTURITION
Causes:
Cystitits
Pregnancy
Ca Cervix or Vagina
Trauma during catheterization
Diabetes
STRESS INCONTINENCE
It is the involuntary escape of urine when there is sudden increase in the Intraandominal
pressure
Causes:
Incompetent urinary sphincter
Post menopausal atrophy
Lowered urethral pressure
Neurological causes
Trauma to the pelvic floor
URGE INCONTINENCE
In this condition , the women experience a sudden desire to pass urine which is unable
to control.
Causes
Cystitis
Trigonitis
Bladder stone or foreign body
Pelvic tumor
Neurological causes
UTI
It is more common in female because of the shorter urethra, proximity of the external
urethral meatus to the vaginal and anal openings, sexual intercourse, stasis or urine
during pregnancy and peurperium.
e-coli is the most common causative agent
UTERINE FIBROIDS (FIBROMYOMA/LEIOMYOMA)
Causes:
Exact aetiology is not known. But there is substantial evidence that oestrogen plays an
important role in myomas.
Types:
Intra mural fibroid (interstitial)

Subserous fibroid
Submucus fibroid
Clinical features
Majority are asymptomatic. Symptoms may depend upon the size of the tumor.
Abdominal lump. Pressure symptoms, pain, menstrual abnormalities and infertility may
be the presenting features.
Diseases of the New born
RDS (Respiratory Distress Syndrome)
Aetiology : the basic abnormality is deficiency in pulmonary surfactant. In the absence of

surfactant, the surface tension increases and alveoli collapse during expiration.
RDS appears within 6 hours of life characterized by tachyapnoea, chest retraction and
cyanosis.
Diagnosis can be confirmed by X-ray which shows ground glass mottling.
Meconeum aspiration Syndrome
Meconeum aspiration causes chemical pneumonitis or blockage of various airways. This

is common in small for date and post mature babies. They develop respiratory distress in
the first 24 hours of life.
HAEMOLYTIC DISEASE OF THE NEWBORN
The disease is characterized by excessive haemolysis of the foetal RBC. It is mostly due
to incompatibility of the foetal and maternal blood groups. They include Rh
incompatibility, ABO group incompatibility and other antigen incompatibilities.
CARCINOMAS
Ca of Female Genital Organs
Ca of Vulva
Ca of vulva contributes about 4.8% of total carcinomas of female genital organs. 3

clinical types are there
The cauliflower growth, the flat indurations and the excavated ulcer. Pruritus is a very
common complaint. Diagnosis is made by lump, pruritus and cytology.
Carcinoma Vagina
It contributes about 1.9% of all genital carcinomas. Usually seen in the upper 1/3rd of
the posterior vaginal wall as cauliflower growth or indurated ulcer.
Symptoms are pain, bleeding after coitus and later blood stained offensive discharge.
Ca Cervix
It is the most frequent of all genital tract cancers (about 30%). Occurs frequently in
multiparous women. Average age incidence is between 39 and 57. usually presents as
cauliflower like growths or excavated ulcers which causes profuse bleeding on even
slightest touch. The four main symptoms of Ca Cervix are
haemorrhage
discharge
cachexia
pain.
Ca fallopian tube
This is the rarest type of gynaecological cancer and can be managed by means of radical
surgery.
Ovarian carcinoma
This is extremely common and usually metastatic. (Krukenberg tumor- these are
bilateral ovarian tumors which have smooth and slightly bossed surfaces and are freely
movable in the pelvis.). Ovarian carcinomas usually present with pain and tender
swelling.
MEDICAL TERMINATION OF PREGNANCY (ABORTION ACT OF 1067)
According to abortion act of 1967, the circumstances in which abortion may be carried
out are as follows.
two registered medical practitioners must form in good faith about the abortion.(section
1(1))
the continuance of pregnancy would involve risk to the pregnant woman (section 1 (1-
a))
if cause injury to the physical or mental health of the pregnant woman (section 1 (1-a)
if it would cause injury to the physical or mental health of any existing children of the
pregnant woman’s family. (section 1 (1-a)
the child that is to be born would suffer from severe physical or mental abnormalities.
(section 1(1-b)
Consent:
A written consent of the patient should be obtained before conducting the MTP. If the
patient is an unmarried girl between the ages of 16to18, the patient consent is a must
rather than the parent’s consent.
If the patient is under 16, her parents should always be consulted even if the patient
forbids it. Still if the patient’s consent is not obtained MTP should not be carried out.
CARCINOMAS
Ca of Vulva

Carcinoma Vagina
Ca Cervix
haemorrhage
discharge
cachexia
pain.
Ca fallopian tube
surgery.
Ovarian carcinoma
swelling.
MEDICAL TERMINATION OF PREGNANCY (ABORTION ACT OF 1067)
out are as follows.
two registered medical practitioners must form in good faith about the abortion.(section
1(1))
the continuance of pregnancy would involve risk to the pregnant woman (section 1 (1-
a))
if cause injury to the physical or mental health of the pregnant woman (section 1 (1-a)
if it would cause injury to the physical or mental health of any existing children of the
pregnant woman’s family. (section 1 (1-a)
the child that is to be born would suffer from severe physical or mental abnormalities.
(section 1(1-b)
Consent:
Endometriosis
Is the presence of ectopic endometrium in any situation other than it normal location.
Endometriosis is confirmed when
- Lining epithelium rescembles, should have typical endometrial stroma, should respond
to oestrogen, the contents of endometrial glands is dark altered tarry blood
- The disease is one adult sexual life- peak 30-40 years of age
- Divided into internal endometriosis or adenomyosis or external endometriosis .eg.

ovaries , uterosacral ligament, abdominal scars, umbilicus, bladder etc
symptoms of adenomyosis
Menorrhagia in fairly high degree
Infertility
Large uterus
Feeling of weight in the pelvis
CYSTS OF OTHE OVARIES
1. Chocolate cyst of the ovaries – the important site of extra uterine endometriosis,
affected ovary enlarge, outer surface white and thickened. Ovary and fallopian tubes
prolapsed and fixed to the pelvis. Rupture is common with chocolate sauce like blood as
content.
Symptoms-
- Pain
- Dysmenorrhoea
- Dyspareunia
- Infertility
- Bowel and bladder symptoms
2. Retention cyst of graffian follicle
Incase of excess hCG
3. Follicular cyst
Regarded as pathological if it is more than one inch diameter.
SCLEROCYSTIC DISEASES OF OVARY (PCOD) Stein-leventhal syndrome
Virilising syndrome in young women characterized with infertility obesity hirsutism and
acne
Kruckenberg tumour
May be primary or seconday . invariably bilateral. Smooth bossed surface with

additions.
Clinical features- abdominal swelling pain , alteration in menstrual cycle, ascites, post
menopausal bleeding, fixity indicated malignancy.
ABORTION
Classification-
1. degree
a. threatened
b. inevitable
c. incomplete
d. complete
e. missed
2. cause
a. spontaneous
b. habitual
c. criminal- legal and illegal
3. infections
a. septic
b. non septic
Abortion may occur due to
a. abnormalities of foetus
b. abnormalities of placental membrane e.g. hydatidiform mole
c. disease of the mother. E.g. measles, cholera, syphilis,
d. chronic disease like HTN, nephritis
e. local abnormalities in mother.e.g. cervical incompetence, genital hyperplasia
f. drugs
g. endocrine factors
h. psychiatric disturbance
i. faults in the male like law quality sperm
HYDATIDIFORM MOLE (vesicular mole)
Chorionic villi distended with fluid forming translucent vesicles . usually abortion may
occur between 4-6th month.
Symptoms- abdominal pain, vaginal bleeding or watery dirty discharge. Complication

may follow as haemorrhage, sepsis, perforations ,chorione epithelioma which is pre
malignant.
PROLAPSE UTERUS
Normal position of uterus is one of universal anteversion and antiflexion with body of the
uterus tilted forward.
First degree prolapse descent of cervix in vagina
Second degree to the introitus
Third degree – out side the introitus
Fourth degree or procidentia – uterus completely out side
ASPHYXIA NEONATORUM
Here heart continues to beat but respiration not established. Diagnosed by APGAR
Scoring carried out every one and five minute after birth.
APGAR scoring
- heart rate
- respiratory effort
- muscle tone
- reflex irritability
- pallor of the skin
cephal haematoma- may not present in birth but develop within two to three days.
Limited by a suture to a particular bone. Soft and elastic. Does not pit on pressure.
Gradually increases in size and takes week or months to disappear.
Caput succidenum present at birth not well circumscribed . maximum at birth and gets
smaller.
CARCINOMAS
Ca of Vulva

Carcinoma Vagina
Ca Cervix
9. haemorrhage
10. discharge
11. cachexia
12. pain.
Ca fallopian tube
surgery.
Ovarian carcinoma
swelling.
MEDICAL TERMINATION OF PREGNANCY (ABORTION ACT OF

1067)
out are as follows.
11. two registered medical practitioners must form in good faith about the
abortion.(section 1(1))
12. the continuance of pregnancy would involve risk to the pregnant woman (section 1
(1-a))
13. if cause injury to the physical or mental health of the pregnant woman (section 1 (1-
a)
14. if it would cause injury to the physical or mental health of any existing children of
the pregnant woman’s family. (section 1 (1-a)
15. the child that is to be born would suffer from severe physical or mental
abnormalities. (section 1(1-b)
Consent:
MCQs
1. ------------------ type pelvis is the type with accepted with female sex
characteristics
2. The uterus grows out of the pelvis by --------- week
3. Alphafoeto proteins are synthesized in the -------------- and ----------- .
4. The bluish discolouration of the vagina during pregnancy is called -----------
.
5. Hegar’s sign is --------------
6. The soft murmur heard rarely synchronous with the foetal heart beat is
called ------
7. Aschheim and zondek test detects ----------
8. The retention of menstrual fluid in the cavity of uterus leads to ---------------
9. The most common presentation of the foetus is ---------------

10. Peurperium is a period following the delivery lasting up to ---------------
11. Elderly primi is a woman above ----------- years of age
12. Vagina is lined by --------------- epithelium
13. Vaginal ph is acidic due to the presence of --------------
14. Commonest malignancy in women in india is --------------------
15. Quickening appears at ----------- weeks
16. The most common cause of postpartum haemorrhage is------------
17. The weight of non pregnant uterus is -----------
18. The involution of uterus is completed by ------------ days
19. Other than pre-eclampsic symptoms, eclampsia is characterized by --------
20. The disease due to cystic degeneration of chorionic villi is ---------
21. The normal amount of liquor amni at term is ---------
22. ---------------- is the placenta in which the cord is attached to the margin of
the placenta.
23. The normal length of the umbilical cord is----------
24. False knots in the umbilical cord are the result of local increase of the --------
--
25. A woman is said to be habitual aborter if she has undergone ---------
consecutive abortions
26. The overlapping of skull bone seen in the x-ray in intrauterine death of
foetus is called -------------- sign
27. The most common site of ectopic pregnancy is ---------
28. The most common form of multiple pregnancy is -------------
29. Excessive traction in the delivery of the shoulder results in ---------------
30. The characteristic oedema in the haemolytic disease of the new born is
called-----
31. ‘Islands of bones in a sea of membranes’ is a particular feature of ---------
32. Umbilical cord contains ---------- arteries and ----------- veins
33. The best speculum for pelvic examination is ------------------- .
34. The glands of both sexes present in the same individual is called -------------
---
35. The condition , in which the urethra opens below the phallus is -------------
36. In turner’s syndrome the nucleus has ------- chromosomes
37. Cyclic recurrent ulceration of vulva and mouth with uveitis is called ----------
----
38. Mittelschmers refers to ------------
39. The usual position of uterus is ----------- and ----------------
40. The commonest type of fibroid uterus is -------------
41. Sharp dorsiflexion of the foot which elicit pain in deep phlebothrombosis is
called-------
42. A baby weighing less than ---------- gms at birth is classed as premature
according to the international standards
43. ‘Phlegmasia alba dolans’ is usually associated with -------------------
44. Snuffles in infants is an important and early sign of ---------------------
45. Formation of an opaque tissue behind the lens of the eyes, a few months
after birth especially in premature babies is called---------------------
46. The normal foetal heart rate is ------------
47. The commonest reason for post partem mortality is ------------
48. The basic cause of placenta accrete is ----------------
49. The bimanual examination done to assess the cephalopelvic disproportion is
called----
50. The study of nature pf uterine contraction is called ---------------
51. The most common maternal disease which is associated with hydramnios is -
-------
52. The colostrums is rich in immunoglobulin ---------
53. The most common type of episiotomy applied is -----------------
54. In cephalic presentation maximum intensity of foetal heart sound is heard ---
------
55. It is estimated that the mature milk flow is about ------------- ml/day
56. The diameter of engagement in a vertex presentation is -----------------------
----
57. Mac Donald’s rule calculates the EDC from calculating the -----------------
58. Calculate the EDC by Nagetes rule- LMP July 17th
59. In a nulliparous woman the external os of the uterus is ----------
60. Active foetal movements are felt during --------- trimester of pregnancy
61. The normal ph of vagina during reproductive period is -----------------
62. The pouch of peritoneum which separates the bladder from the uterus is ----
----
63. After ovulation, the ruptured follicle develops in to --------------
64. The hormone liberated by graffian follicle is -----------
65. Corpus luteum secretes the hormone ---------------
66. The menstrual blood does not clot, though it contains calcium, because it
does not contain ------------
67. Excessive menstrual loss with preservation of the normal cycle is -------------
-
68. In turner’s syndrome the chromosome structure is -----------
69. Hyperplasia of adrenal cortex leads to ---------------------
70. A frothy discharge from vagina is the indication of --------------------
71. The basophil adenoma of the anterior pituitary leads to ---------------
72. The most frequent type of all genital tract cancer is ----------
73. Complete prolapse of the uterus is called--------
74. Relaxin secreted by the ---------------
75. Presence of ecto endometrium in any site outside normal location is ------
-----
Answers
[HIDE]
1. Gynaecoid type
2. 12th week
3. foetal liver and yolk sac
4. Chadwick sign
5. Softening and
6. funic soufflé
7. HCG
8. Haematoma
9. Vertex
10. 6-8 weeks
11. 40 years
12. simple squamous
13. Doderlein’s bacilli
14. Carcinoma breast
15. 16th week
16. Uterine atony
17. 50 gms
18. 12 days
19. Convulsions
20. Hydatidiform mole
21. 100 ml
22. Battle dore placenta
23. 50-60 cm
24. Wharton’s jelly

25. 3 or more
26. Splading’s sign
27. Tubal
28. Twin pregnancy
29. Erb’s palsy
30. Hydrops foetalis
31. Hydrocephalus
32. 2 arteries and 1 vein
33. Bivalve speculum of cusco
34. True hermaphroditism
35. Hypospadiasis
36. 45 chromosomes
37. Behcet’s syndrome
38. Ovulation pain
39. Anteversion and anteflexion
40. Intramural
41. Homan’s sign
42. 2500 gms
43. Thromobophlebitis
44. Congenital syphillis
45. Retrocentral fibroplasias
46. 150/minute
47. Shock
48. Decidual deficiency
49. Munro – Kerr-Muller method
50. Tocography
51. Diabetes mellitus
52. A
53. Mediolateral
54. Below the umbilicus
55.850 ml/day
56. Subocciputo bregmatic presentation
57. height of the fundus
58. April 24
59. Circular
60. Last / Third
61. 4.5
62. Uterovesical pouch
63. Corpus luteum
64. Oestrogen
65. Progesterone
66. Prothrombin
67. Menorrhagia
68. 44+ X0
69. Adernogenital syndrome
70. Trichomoniasis
71. Cushing’s disease
72. Ca Cervix
73. Procidencia
74. Ovaries
75. Endometriosis
[/HIDE]
Reply With Quote

2. 04-10-2009, 11:29 PM#2
trimurtulu
MedicalGeek Resident
Join Date
Aug 2008
Posts
6,603
Rep Power
44
OBSTETRICS : LAST MOMENT REVISION

The OB and GYN part actually start with the physiological changes of mother during
pregnancy. Almost every organ and tissues of a female body undergo physiological
changes during pregnancy. The metabolic, chemical and endocrine balances of the body
gets altered.
The important changes
Changes in UTERUS and CERVIX
Increase in weight from 50 gms. To 900 gms
Increase in size from 7.5X 5X 2.5 cms to 30X 23X 20 cms
Myometrium and endometrium undergo hypertrophy. The endometrium of the pregnant

uterus is called deciduas.
Cervix becomes softer.
Cervical racemose glands secretes a tenacious mucus forming a plug (operculum) which
acts as a barrier against infections
Uterine contractions increases which are irregular, infrequent and painless(Braxton-Hicks

contractions)
CHANGES in VAGINA
Vaginal blood supply increases leaving a bluish appearance to mucosa (Jacquemier sign
or Chadwick’s sign)
the action of oestrogen increases the vaginal secretions
Vaginal pH becomes more acidic which helps to prevent infections
CHANGES in The BREAST
Breast changes are more evident in primigravida. The changes are mostly due to
oestrogen and progesterone. Oestrogen acts more on glands and ducts and progesterone
on the secretory functions of the breast.Breast changes are mostly taking place during
second and fifth months.
During second month,
Breast increases in size, bluish discolouration and more sensitiveness.errectile nipple,

deeply pigmented aerola, and prominent tubercles (Mont Gomery’s tubercles)in the
areola are noted.
During fifth month, secondary areola develops, a sticky yellow fluid may be expressed
from the nipple.
CHANGES IN THE SKIN
Mostly due to the action of the MSH of the anterior pituitary.
Depressed pinkish or slightly bluish lines (striae gravidarum) appear on the abdomen
and thighs. Sometimes pigmentation may appear on cheeks,foreheads and around eyes
which mostly disappear after the pregnancy.
WEIGHT GAIN DURING PREGNANCY
The weight gain during pregnancy is contributed by the enlarging uterus, growing foetus,
placenta, liquor amnii, acquisition of fat and water reduction. It may vary from person to
person. In general the average weight gain is 5 to 9 kg.
HAEMATOLOGICAL CHANGES
Plasma volume increases upto 1.2 litres
RBC volume increases by about 20 to 30 % (upto 350ml)
Leucocytes increases predominantly neutrophils
The total plasma proteins increases
Albumin globulin ratio is decreased to 1:1 (normal 1.7: 1)
Fibrinogen level raised by 50%
ESR level increases
Cardio vascular changes
1.Cardiac output is raised by 40%.
2. Femoral venous pressure is increased
3. The blood flow to the uterus is considerably increased.
4. Pulmonary and renal blood flow is considerably increased

5. Due to venous congestion, varicose veins tend to develop more during pregnancy.
CHANGES IN URINARY SYSTEM
Increase frequency of micturition due to antiverted uterus during the early weeks of
pregnancy and due to descent of the presenting part in the later part of pregnancy
Glycosuria is common but may not be pathological
Proteinuria should be investigated thoroughly
DIAGNOSIS OF PREGNANCY
Normal duration of pregnancy
9 months and seven days/ or 280 days or 40 weeks
First trimester - first twelve weeks
Second trimester - 13 to 28 weeks
Third trimester - 29 to 40 weeks
SIGNS AND SYMPTOMS
Amenorrhoea
Frequency of micturition
Morning sickness
Breast changes
Skin changes
Quickening (usually occurs between 16th and 20th week)
Probable signs
Abdominal enlargement
Changes in uterus
Braxton Hicks contractions
Chadwick sign
Ociander’s sign (increase pulsation felt in the lateral vaginal fornix by about the 8th
week of pregnancy)
Softening of Cervix
External and internal ballottement
Detection of hCG in urine and blood
Positive signs of pregnancy
Foetal parts and foetal movements (apprectiated by 22nd week)
Foetal heart sounds. Most conclusive sign of pregnancy heard between 18 – 20th week
for the first time.
Ultra sonic evidence . Gestation sac by 6th week, foetal heart beat -7th week, foetal
heart rate -10th week using Doppler.
Malformations detected by 18th week
CALCULATION OF THE DATE OF DELIVERY (EDD)
By adding 7days to the first day of LMP count back 3 months or count 9months forward
to reach the EDD.
Minor disorders of pregnancy
1.Morning sickness
Med. - Sepia, Puls, Nux vom, Ignatia, Phosph, Ntrum mur, Cocculus, Colchicum, Ipecac,
Symphoricarpus,
2. Acidity and Heartburn
Med- Puls, Sepia, Nux vom , Colocynth ,Staphy, Carbo veg, sulphur, Lyco, Ars alb,
Robinia
3.Back ache
Med- Kali bich , Actea, Ammon mur, Arnica, Rhustox, Bryonia, Phosph
Constipation
Varicose veins
Haemorrhoids
Fainting
PHYSIOLOGY OF LABOR
Defined as the process of expulsion of the foetus along with the placenta and the
membranes from the uterus through the birth canal.
NORMAL LABOR
A Labor is normal, if it is
1. Spontaneous in onset
2. At term
3. Vertex presentation
4. Process completed by natural unaided efforts of the mother
5. Time for first and second stages does not exceed 18 hours
6. No complications arise
PROCESS OF LABOR
The exact process of labor is not certain. But humoral and mechanical factors control
labor.
Humoral control
Oxytocin from posterior pituitary has a stimulating action on the pregnant uterus.
Oxytocin receptors are more in the myometrium.
Fall in the level of progesterone which changes the oestrogen –progesteron balance
produces uterine contractions in greater amplitude.
Increase in prostaglandins increases the rhythmic uterine activity and the hormonal
changes that initiates the parturition.
MECHANICAL
1. Uterine distension
Causes:
1.Increase in intra uterine pressure and the resultant tension enforced on uterine muscle
fibre may initiate labor.
2. The stretching of lower uterine segment by the foetal head and the pressure exerted
by it on the para cervical nerve ganglion may initiate labor.
SIGNS OF LABOR
1. Pre labor
These signs occur 2 or 3 weeks prior to the onset of labor.
1. Lightening which is the sinking of the presenting part into the pelvis
2. False pains- irregular dull pains appearing in the lower abdomen and are not
associated with uterine hardening.
3. Frequency of micturition
4. Cervix become soft and dilated
Signs of True Labor
1.True labor pains- the uterine contractions become painful which are cotrolled by the
nervous system and endocrine factors.
2. Dilatation of Cervix and cervical canal. After a dilatation of 3cms has occurred, further
dilatation occurs at the rate of 1 cm per hour.
3. Show- blood stained mucoid discharge due to the detachment of chorion is seen
within two hours of starting the labor.
4. Formation of bag of water- stretching of lower uterine segment causes a detachment

of membrane . the presenting part fix into the cervix and divide the amniotic fluid into
two. The presenting part forces the bag of membrane during contraction which may lead
to early rupture of the membrane.
STAGES OF LABOR
STAGE 1
Onset of true labor pain to full dilatation of cervix.
STAGE 2
Full dilatation of cervix and expulsion of foetus
STAGE 3
Expulsion of foetus to expulsion of placenta and its membranes
MECHANISM OF NORMAL LABOR
Engagement
Flexion of head
Internal rotation of head
Crowning
Delivery of head by extension
Restitution of head
External rotation of head
Delivery of shoulders and trunk by lateral rotation
DURATION OF LABOR
Depends on
Primigravida or multipara
Type of pelvis
Size and presentation of foetus
Strength and frequency of uterine contractions
Usually in primigravida first stage last for about 12 hours, second two hours, third one
fourth of an hour. In multipara, it is 6 hours, half and hour and one fourth of an hour
respectively.
COMPLICATIONS OF THE THIRD STAGE OF THE LABOR
POST PARTUM HAEMORRHAGE pph. pph is severe bleeding during the third stage of
labor or within 24 hours of expulsion of placenta.
causes:
Atonic uterus
Traumatic causes
Blood coagulation disorders.
signs of PPH
1.Bleeding /vagina
2. Rapid pulse
3.Pallor
4. Collapse
Management
1. Stimulation of uterus to contract by massaging
2. Emptying of uterus fully
3. Blood transfusion if necessary
4. Traumatic causes should be repaired
Homoeopathic Medicines
Caulophyllum, Actea, Pulse,Arnica, Bell, Phosoph, Ipecac, Sabina, Secale Cor.
RETAINED PLACENTA
Placenta is said to be retained, if it is not expelled even after 30 minutes of the birth of
the baby.
Causes:
Poor bearing down efforts
Distended uterus
Prolonged labor
Uterine atonicity
Hour glass contraction of uterus
Adherent placenta
MANAGEMENT
Empty the bladder with a catheter
Retained placenta should be removed
Adherent Placenta (placenta accuate) it is a rare condition in which the placenta is

directly embedded into the uterine muscles . the spongy layer of decidua is absent here.
COLLAPSE AND SHOCK
It is due to hypovolumic shock associated with haemorrhage.
Signs:
1. Pulse is rapid, soft and thready

2. Fall in blood pressure
3. Marked pallor
4. Shallow respiration
MANAGEMENT
1. Restoration of the blood volume
2. Medicinal management
PUERPERIUM
It is the period which begins with the termination of the third stage of labor and last till
the genital organs have assumed their pre-pregnancy stage which last for 6-8 weeks.
CHANGES IN UTERUS
1.Reduction in weight to 60 gms
2. Reduction in size
3. Arteries at the placenta site undergo constriction.
4. Decidua left after delivery undergoes necrosis and entire endometrium is restored by
the third week.
THE LOCHIA
The vaginal discharge during puerperium is called lochia which may extend up to 3
weeks. Persistence of red lochia and excessive amount of lochia should be considered
seriously.
The cervix never returns to the non gravid state, the external os is always patulous in a
multipara. The vaginal outlet is markedly relaxed , hymen replaced by small tabs of
tissue which cicatrise (carunculae myrtiformis) which is a characteristic sign of parity.
The perineum is relaxed,pelvic floor regain tone with a certain amount of gaping of
vulva.
The puerperal bladder has a very much increased capacity and there is oedema and
hyperaemia of the bladder mucosa. Striae gravidarum appear in the abdominal wall with
a certain amount of laxity and flabbiness of the abdominal muscles if proper exercises
are not observed.
Milk is secreted by the mother only by the second or third day of delivery. Breast
become larger, fuller, and veins become more prominent. The thin liquid secreted from
the breast during the first 48 hours is rich in fat globules, lactalbumin and lactglobulin is
called cholestrum.
Return of menstrual cycle takes place after about 10 weeks of pregnancy in most
lactating mothers; whereas in non lactating mothers it may be as early as 4 weeks.
MANAGEMENT OF NORMAL PUERPERIUM
Restoration of health of mother
To prevent infection
Promotion of breast feeding
Motivation for adopting contraceptive measures
COMPLICATION OF PUERPERIUM
1. Puerperal sepsis:
It is an infectionof genital tract occurring as a complication or abortion or child birth
Clinical features:
1.Pyrexia
2. Tachycardia
3. Brownish,profuse,foul smelling lochia
4. Large and soft uterus which is tender to touch
Treatment
Adequate rest and sleep
Diet should be high in calories and vitamins
Adequate fluid and electrolyte balance
Correction of anaemia
Medicinal Management
SUBINVOLUTION
Slowing of the process of involution is known as subinvolution.
Causes:
Retained products of conception
Fibroids
Overdistension
Caesarian section
Prolapse of uterus
Retroversion of uterus
Local uterine infections
Treatment
Treatment of the underlying cause and medicinal management
URINARY TRACT INFECTIONS
Causes:
Infections due to catheterization during labor or retention of urine
clinical features:
Fever with Chills and Rigor, Frequency of micturition, Dysuria, Anorexia, Nausea and
Vomiting.
Treatment:
1.Increase fluid intake
Medicinal management
RETENTION OF URINE
The causes are bruising and oedema of the urethra and bladder
Prolonged second stage of labor
Treatment
Women should be encouraged to pass urine within 12 hours of delivery
BREAST COMPLICATION
Acute Mastitis:
Is the inflammation of the breast which may progress into a breast abcess if not
treated.
Clinical features:
Fever with general malice and head ache, throbbing pain and tenderness in the breast
Treatment:
Frequent feeding of the baby.
VENOUS THROMBOSIS
This is characterized by formation of thrombi in the veins which may be superficial or

deep.
PULMONARY THROMBO EMBOLISM
A piece of thrombus may become detached in the veins of the pelvis or lower limbs and
travels by the inferior venacava to the right side of the heart and via the pulmonary
artery to the lungs.
Clinical features:
Sudden chest pain with respiratory distress, haemoptysis, cyanosis, hypotension,

collapse, respiratory failure and cardiac arrest. Death may occur from shock or vagal
inhibition.
HYPEREMISIS GRAVIDARUM
The term hyperemisis gravidarum is applied to the excessive vomiting which persists
beyond 4 months and very little nourishment is retained.
TOXAEMIAS OF PREGNANCY
1. A/c toxaemia of pregnancy (onset after the 24th week)
Pre eclampsia which may be mild or severe characterized by oedema, albuminura and
hypertension.
Eclampsia characterized by the above symptoms with convulsion or coma
2. C/C HYPERTENSIVE DISEASE WITH PREGNANCY
Without superimposed a/c toxaemia
i. hypertension known to have antenatal pregnancy
ii. hypertension observed inpregnancy

b. c/c hypertensive vascular disease with superimposed toxaemia
3. Unclassified toxaemia
A/C MATERNAL VIRAL INFECTIONS
Influenza
Variola or small pox
Rubella
ABORTION
Abortion is the termination of pregnancy before the foetus become viable.
Aetiology
Foetal factors
Intrinsic defects of fertilized ovum
Cystic degenerationof chorionic villli
Haemorrhage into the deciduas
Low quality sperm
Maternal factors
Infectious fevers
Hypertension
c/c nephritis
Syphilis
Diabetes
Trauma
Stress
Uterine causes
Congenital malformation of uterus
Fibroid tumors of the uterus
Retroversion of the uterus
Ovarian tumors
4. Hormonal causes
Hormonal imbalance may cause habitual abortion
Incompatibility of the blood of husband and wife may cause abortion.
Clinical features
1. Pain due to uterine contractions
2. Haemorrhage as a result of separation of ovum
3. Dilatation of cervix
4. Expulsion of part or entire ovum
Treatment
1. Removal of product of consumption when abortion is confirmed and medicinal

Management
CORD PROLAPSE
It is a condition where the umbilical cord lies below the presenting part
Diagnosis:
Feeling the cord, pulsation on vaginal examination. Sometimes cord can be seen outside
the vulva
Management:
No management is required when the baby is dead or foeatal survival rates are very
less. Otherwise cord compression reduction measures should be done to improve the
condition of the foetus.
MULTIPLE PREGNANCY
Presence of more than one foetus is refered to as multiple pregnancy.
Twin pregnancy is the commonest form. Twin pregnancy can be monozygotic or

uniovular or dizygotic or biovular. Diagnosis is confirmed by ultra sound examination.
ECTOPIC PREGNANCY
Implantation and development of foetus anywhere outside the uterine cavity is called
ectopic pregnancy. Tubal pregnancy is the commonest form
Clinical features:
Short period of amenorrhoea
Severe lower abdominal pain with or without vaginal bleeding
Fainting attacks,pallor,
Palpation through the fornix and no mass is usually felt.
PLACENTA PRAEVIA
Is the condition where the placenta is located partially or wholly within the lower uterine
segment.
Clinical features:
Sudden painless and causeless bleeding from vagina
Uterus is relaxed and non tender
Foetal heart rate is decreases when the head is pushed down into the pelvis due to the
embedded placental circulation by the pressure of the foetal head on the low lying
placenta (stallworthy’s sign)
Management:
After the diagnosis is confirmed by the ultrasound, the women are advised to take
complete rest, intercourse is prohibited and medicinal management is given.
ABRUPTIO PLACENTA
It is also called as accidental haemorrhage where the cause of bleeding is premature

separation of a normally situated placenta.
PROLONGED LABOR
Labor is said to be prolonged if the duration exceeds 24 hours. The main causes are
inefficient uterine contraction, contrcted pelvis, cervical dystocia. Malposition of foetus,
congenital anomalies,uterine inertia, poor bearing down efforts, pelvic tumors.
Management:
1. prolonged labor can be prevented by the managing the causes

accordingly.suppportive measures, maintenance of hydration, and medicinal
management can be done.
OBSTRUCTED LABOR
Labor is said to be obstructed when there is no advance of presenting part in spite of
strong uterine contractions. It may be due to mechanical obstruction due to some fault
in the birth passage or in the foetus or both

Pathology Mcqs Made Easy

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Pathology Mcqs Made Easy

Uploaded by

Copyright:

Available Formats

1.

Ø Rudolf Virchow is known as the Father of Modern Pathology

1. 04-10-2009, 11:22 PM#1

Gynaecology: Last Moment Revision

GYNAECOLOGY : LAST MOMENT

Menstrual cycle can be divided into four phases.

Hormonal Control of the Menstrual cycle

1. Amenorrhoea – is the absence of menstruation which may be primary or

amenorrhoea can also be classified as physiological and pathological.

1. Amenorrhoea before puberty

2. Amenorrhoea during pregnancy

A. Defects in the genital tract

3. Transverse vaginal septum

6. Ashermann’s syndrome(amenorrhoea secondary to the trauma of the endometrium

B. Defects in the ovaries

2. PCOD (Stein –Leventhal syndrome)

4. Surgical removal of both ovaries

4. Sheehan’s syndrome(post partal pituitary necrosis due to thrombosis of pituitary

E. Gonadotropin releasing hormone deficiency causes hypothalamic amenorrhoea.

F. Disorders of adrenal glands

1. Adrenogenital syndrome (caused by a tumor or hyperplasia of adrenal cortex resulting

2. Cushing’s syndrome (Cortico steroid hormones are in excess which causes

It is the painful menstruation incapacitating the women in day today activities.

1. Spasmodic dysmenorrhoea (primary dysmenorrhoea)

here there is no identifiable pelvic pathology. May be due to cervical obstruction,

2. Congestive dysmenorrhoea (secondary dysmenorrhoea)

2. Chocolate cyst of ovary

It is a variety of primary dysmenorrhoea characterized by shedding of large endometrial

Irritability, lassitude, sleepiness, headache, nausea, constipation, frequency of

Is excessive menstrual blood loss both in amount and duration.

1. Hypo and hyper thyroidism

5. Leukaemia and purpureas

IUCD (Intra Uterine Contraceptive Devices)

It is acyclical intermenstrual irregular uterine bleeding.

It is the frequent menstruation at regular intervals of 2 or 3 weeks due to the shortening

Dysfunctional Uterine Bleeding

Metropathica haemorrhagica- it is irregualar anovulatory prolonged bleeding which may

Infertility can be primary and secondary.

2. Obstruction in the efferent duct

4. Failure in depositing the sperm.

Faults in the Female:

c. Transverse vaginal septum

1. Elongation of cervical canal

2. Obstruction of cervical canal

4. Thick cervical mucus

6. Presence of antisperm antibody in cervical mucus

1. Congenital malformations of uterus

3. Corpus luteum insufficiency

1. Local examinations of genitals

3. Serum hormone levels

1. Detailed history taking

2. General systemic and gynaecological examinations

3. Special investigations to assess tubal, cervical, peritoneal and ovarian functions.

URINARY PROBLEMS IN GYNAECOLOGY

it may be due to oedema, reflex spasm of bladder sphincter, or denervation of bladder.

Retroverted gravid uterus

Carcinoma of urethral meatus

Trauma to the urethra

INCREASED FREQUENCY OF MICTURITION

Trauma during catheterization

Incompetent urinary sphincter

Post menopausal atrophy

Lowered urethral pressure