Check list for pathology university exam and class tests.Prepared by Dr.Mani Prabhu.

I can assure you that least 90% of questions will be from this bank. Make sure that you revise all the must know topics on the day before the examination. The distinction question are for those who are more academically inclined. :)

GENERAL PATHOLOGYLesson 1 – Cellular adaptations and cell injury.Must know

1. Metaplasia2. Hyperplasia3. Differences between necrosis and apoptosis (better in tabular form)4. Morphological features of reversible and irreversible injury (with diagrams)5. Types of necrosis with diagram (fat necrosis – most important)6. Morphology of apoptosis7. Mechanisms of apoptosis (Atleast the basics – prepare it for short notes)8. Steatosis9. Lipofuscin10. Dystrophic and metastatic calcification (Very important. Try to prepare a table listing out the

differences)11. Gangrene. Difference between dry and wet gangrene.Distinction question (only if you have time)1. Short notes on oxidative stress2. Short notes on cytoskeletal abnormalities3. Defects in protein folding

Lesson 2 – InflammationMust know

1. Differences between exudates and transudate ( From Harshmohan -baby)2. Diapedesis3. Chemotaxis - very important4. Phagocytosis (only the basics)5. Chemical mediators of inflammation (prepare yourself short notes)6. Arachidonic acid metabolites7. Granulomatous inflammation 8. Types of giant cells and their morphology.

Distinction questions (only if you have time)1. Leukocyte transmigration2. Selectins (notes for 5 mrk)3. Integrins (notes for 5 mrk)4. Role of reactive oxygen intermediates in microbial killing 5. Defects in leukocyte function 6. Complement cascade and disorders7. TNF8. Chemokines9. Fibrinous inflammation10. Acute phase proteins 11. Lymphedema

Lesson 3 – tissue renewal and repairMust know

1. Liver regeneration

2. Angiogenesis3. Healing by first and second intention4. Factors influencing wound healing5. Complications of wound healing

(except for wound healing questions from this lesson are rare)Distinction questions (only if you have time)1. Growth factors2. Collagen3. Keloids 4. Granulation tissue

Lesson 4 – Hemodynamic disordersWhole lesson is important. Don’t miss this lesson

Must know1. CVC liver, spleen, lung (grass and histology)2. Pathogenesis of thrombosis: Virchows triad3. Differences between arterial and venous thrombi4. Fate of a thrombus5. Difference between phlebothrombosis and thrombophlebosis6. Embolism: full7. Red and white infarct (Very important)8. Septic infarcts9. Types and pathogenesis of septic shock (Very important -With diagram)Distinction questions1. Stages of shock2. Pathogenesis of cardiogenic edema

Lesson 5 – GeneticsThough essential in every other aspect, except the following five topics (very very

important), I personally expect no other question from this lesson in university exam. Not to waste time in this lesson at the eleventh hourMust know

1. Marfans syndrome2. Ehlers – Danlos syndromes (only the basics)3. Downs syndrome (with diag)4. Turner syndrome (with diag)5. Barr body

Distinction questions1. Transmission pattern and characteristics of

a. Autosomal dominantb. Autosomal recessivec. X- linked recessive disorders

2. Tay sachs disease3. Hurlers and hunters syndrome4. Von – gierkes disease5. Sex chromatin6. Klinefelter7. Fragile – X syndrome8. Genomic imprinting (only the basics)

Lesson 6 – ImmunityImportant lesson. Your knowledge of microbiology should help

Must know1. T- lymphocytes and B-lymphocytes2. Antigen presenting cells3. NK cells4. Type 1, type 2, type 3 and type4 hypersensitivity 5. SLE (Important -only the basics)6. LE cell (Important -notes for 5 makrs)7. Kidney manifestations in SLE8. AIDS – Full (pathogenesis, CRS involvement, natural history, aids defining conditions,

kaposi's sarcoma) – can be asked as case (very important)9. Amyloidosis (Prepare notes for 5 marks) - Again very important10. Difference between sago spleen and lardaceous spleen

Distinction questions:1. Cytokines: types and functions2. HLA molecules (notes for 5 marks)3. Arthus reaction for 5 marks4. Types and morphology of graft rejection (prepare notes for 5 marks)5. Anergy6. Digeorge syndrome

Lesson 7 neoplasiaExcept for p53 and RB (important), the whole of molecular level of cancer path can be skipped exams, though you might need them for better understandingMust know

1. Characteristics of benign and malignant tumors.2. Diff between benign and malignant tumors (as table)3. Metastasis: pathways of spread of tumor (very important)4. P53-as guardian of human genome (With diag)5. Retinoblastoma: two hig hypothesis of RB gene6. Chemical carcinogenesis (etiology, pathogenesis)7. Viral carcinogenesis (HPV-very important) - Important8. Paraneoplatic syndromes - very important9. Tumor markers (oncofetal antigens-very important)

Distinction questions:1. Differences between anaplasia and dysplasia (prepare notes for 5 marks)2. 5 occupational cancers with their etiologic agent3. Oncogenes (notes for 5 marks)4. Radiation carcinogenesis5. Tumor antigens (notes for 5 marks)6. Laboratory diagnosis of cancer (basic points only)

Lesson 8 Infectious diseasesMust Know:Pathogenesis, morphology, c/f and complications of TB (very very important)

1. Other important questions in tuberculosis:a. Ghons focus

b. Ghons complex or primary complexc. Ranke complexd. Progressive pulmonary tuberculosise. Military tuberculosisf. Pots spineg. Scrofula

2. Leprosy (types, pathogenesis and c/f) - important3. Stages, pathogenesis and c/f of syphilis4. Black water fever and cerebral malaria5. Typhoid fever6. Amoebic liver abscess7. Hydatid cyst8. Actinomycosis9. Madura foot10. Rhinosporidiosis

Distinction questions:All other infectious diseases (I would advice not to waste time in this lesion at the last minute. Your knowledge of micro is more than enough for handling this lesion. Tuberculosis and syphilis is all that is needed in path)

Lesson 9 Environment and nutritionChances of getting a question from this chapter are near to nil. If at all, you might get

1. RicketsDistinction questions:

1. Radiation injury2. PEM

Lesson 10 Infancy and childhoodAgain, other than Wilms tumor, chances of getting a question is less, as seen from previous papers. But still, an important lesson.Must know:

1. Immune hydrops2. Cystic fibrosis (though important has not been asked in any question papers mostly – know only

the basics)3. Wilms tumor or nephroblastoma (very important)

Distinction questions:1. Neuroblastoma2. Phenyketonuria3. Necrotizing enterocolitis4. Respiratory distress syndrome

SYSTEMIC PATHOLOGYHematologyPlease note that the whole of hematology account for nearly 40% of marks in paper 1. Must study topics.10 marks or LONG CASEThe pathogenesis, peripheral blood picture, bone marrow picture, other relevant morphology, INVESTIGATIONS (for investigations, you might refer to Alagappan - manual of medicine separately under each heading) , c/f of

1. Sickle cell disease2. B- thallasemia3. Megaloblastic anemia, esp. pernicious anemia4. Iron deficiency anemia5. Hemophilia A6. ALL7. CLL8. Multiple myeloma9. Hodgkin disease- types, pathogenesis, basic morphology of each type and their prognosis, clinical

features10. AML (In addition to the general headings, you need to know atleast the basics of FAB

classification)

11. CML (pathophysiology, morphology and investigations)12. Polycythemia vera

All these 12 questions are must read for all hematology examsImportant note:Before diagnosing the case, please make sure that the age of the concerned patient coincides with the age group affected, for that particular disease, as given in Robbins. Also look for characteristic symptoms like lymphadenopathy, bone tenderness, abrupt onset, massive splenomegaly, cancer cachexia, etc. These clue words in the case are directly picked from Robbins. So don’t miss the clinical features of any suspected long case. For all investigations for any long case, refer to Alagappan- manual of medicine.Again please note that more than 50% of previous paper 1 question papers have CML (massive splenomegaly) as the long answer.Short notes for Lesson 13 RBCs and plateletsMust know:

1. Classification of anemia, according to underlying pathology2. Heriditary spherocytosis (pathogenesis and morphology)3. Howell jolly bodies (prepare notes)4. Heinz bodies (prepare notes)5. Bone marrow picture in megaloblastic anemia6. Pathophysiology of B-thalassemia7. Aplastic anemia- very important 5 mark- prepare notes for 5 marks, incorporating all the

headings.8. Von – willebrand disease 9. Hemophilia A and B10. DIC – Very important. Prepare notes for 5 marks. For pathophysiology, the flow chart in Robbins

is enough.Distinction questions in 5 marks:

1. α-thallasemia (Just know the types, genetics of each condition and the outcome)2. Immuno hemolytic anemia (only the table in Robbins is more than enough)3. ITP

Short notes for Lesson 14 – WBCsMust know:

1. Agranulocytosis – very important, highly repeated (prepare notes for 5 marks under the headings- pathogenesis, morphology and c/f)

2. Leukimoid reaction – important3. Burkitt's lymphoma – again very important4. Follicular lymphoma5. Hairy cell leukemia6. Reed-sternberg cell- pathogenesis, types and morphology (with diagram) - Very important7. Differences between Hodgkins and Non-Hodgkins lymphoma8. Myeloblasts – morphology9. Morphology of MDS syndrome10. Gandy gamma bodies in CVC spleen11. The Philadelphia chromosome (Important0

Distinction questions in 5 marks:1. Diffuse large B-cell lymphoma (rare)

2. Lymphoplasmacytic lymphoma (rare)3. Mantle cell lymphoma (rare)4. Sezary syndrome5. Histicytosis (LCL)

Other very important general 5 mark questions in hematology:1. ABO incompatibility2. Rh incompatibility3. Coomb’s test4. Packed cell volume (PCV)

Lesson 11 – Blood vesselsApart from Atherosclerosis, other topics are generally not important for univ. exams.Must know :

1. Pathogenesis of atherosclerosis – highly repeated (prepare notes for 5 marks)2. Morphology of atherosclerotic plaque – 5 marks3. Aortic dissection – 5 marks

Distinction questions:1. Types and morphology of aneurysms2. PAN (rare)3. Wegener's granulomatosis (very rare)

Lesson 12 – The heart10 marks or long questions:

1. Myocardial infarction – pathogenesis, morphology, investigations and diagnosis, complications (prepare notes for 10 marks – very important)

2. Rheumatic heart disease – pathogenetic sequence, morphology and investigations, diagnosis (Highly repeated)

3. Infective endocarditis – etiology, morphology and diagnostic criteria (Very important)

5 marks : 1. Mitral valve prolapse2. Types of angina3. Causes and types of pericarditis (rare)

Lesson 15 – The Lung10 mark cases:

1. Bronchiectais (very important)2. Asthma3. Emphysema 4. Ca lung – Squamous cell Ca, AdenoCa, Small cell, Large cell – gross pathology , histology and

prognosis. Local effects of tumor spread (very important. Local effects can be asked as short notes also)

Must know in 5 marks:1. Pathogenesis and types of emphysema (very important)2. Asbestosis3. Pneumoconiosis (prepare notes for 5 marks)4. Pulmonary embolism5. Etiology and morphology of community acquired pneumonia (Very important)6. Lung abscess (important)7. Pancoast tumors ( highly repeated)

Distinction questions in 5 marks : 1. Types and causes of atelectasis2. Diffuse alveolar damage or ARDS3. Goodpasture syndrome (rare)4. Pananeoplastic syndromes, associated with lung Ca

Lesson 16 – Head and NeckAll that is needed here is pleomorphic adenoma, which is seen in alternating

question papers. If you are still interested, I would recommend “Warthin tumor”Must know:

1. Pleomorhic adenoma (very important 5 mark)Distinction questions:

1. Warthin tumor2. Leukoplakia and erythroplakia (premalignant lesions of oral cavity)

Lesion 17 – The GITVery important – 10 mark cases:

1. Peptic ulcer (etiological factors, role of H. pylori, morphology, complications)2. Gastric carcinoma – etiology and risk factors, morphology and types, Virchow node metastasis, -

Sister Mary Joseph nodule, Krukenberg tumor.3. Crohn's disease (also 5 marks – very important)4. Ulcerative colitis (also 5 marks – very important)5. Colorectal Ca – etiology, morphology of right sided and left sided lesions, C/f, STAGING.

All these 5 questions are essential must-read for all GIT examsPlease note that iron – deficiency anemia in an elderly male is due to GIT cancer, unless proved otherwise.Must know in 5 marks:

1. Achalasia cardia2. Barrett’ cosophagus – very important3. Types of gastritis and H. pylori as an etiological agent.4. Celiac disease – important5. Adenoma – colon and rectum (types, morphology, risk of malignancy, prognosis, clinical impact)6. FAP syndrome7. Staging of Colorectal carcinoma - Important8. Carcinoid tumors (prepare notes for 5 marks under location, morphology, c/f of carcinoid

syndrome)9. Pseudomyxoma peritonei10. Intestinal polyps - types, morphology and prognosis - Important

Distinction questions (5 marks):1. Gatrointestinal stromal tumors2. Congenital megacolon

Very rare:1. Ca Esophagus (know only the basics)2. Pseudomembranous colitis.

Lesson 18a – The Liver

More than long case, 5 marks are more important in this lesson10 marks case:

1. Jaundice and portal hypertension (know the basics, the pathophysiology, clinical manifestations, morphology)

2. Hepatocellular carcinomaMust know in 5 marks:

1. Etiology and key morphology of viral hepatitis2. Alcoholic liver disease – pathogenesis, different stages and morphology of each, c/f. – very

important – can also be asked as 10 mark case.3. Metastasic lesions in liver

Viral and alcoholic hepatitis are must know topics in this lesson.Distinction questions:

1. Pathogenesis of ascites2. Indian childhood cirrhosis (refer any pediatrics book)3. Wilson’s disease (rare)4. Primary biliary cirrhosis (rare)

Lesson 18b – The Biliary tractVery important lesson. Not to be ignored.

10 mark case:1. Acute cholecystitis – Very important (clue : fertile fatty female of forty)

Must know in 5 mark:1. Cholelithiasis (gallstones) – repeated (can also be asked as long question)

Lesson 19 – The pancreas10 mark case:

1. Acute pancreatitis (important)5 mark questions:

1. Chronic pancreatitis – rare2. Pancreatic pseudocyst – rare

Lesson 20 – The kidneyVery important. Will consume lots of time. Better keep this one thorough before

hand, and not to sit on this lesson on the day before the exam. Or else you would end up studying only “Kidney”.Must know:

1. Acute Glomerulonephirits (post – streptococcal)2. Rapid progressive GN3. Nephrotic syndrome – pathology and pathogenesis (Very important)4. Minimal change disease (very important)5. Focal segmental glomerulosclerosis6. Membranoproliferative GN7. Basics about the pathogenesis and stages of ATN8. Urolithiais (Highly highly repeated)9. Chronic GN10. Acute pyelonephritis11. Chronic pyelonephritis – pathogenesis and morphology.12. Granular conracted kidney (prepare notes for 5 marks) - Important

Distinction questions:1. Both types of polycystic kidney disease and the differences between them2. Membranous nephropathy3. Kimmelstein Wilson disease or diabetic glomerulosclerosis (5 marks)4. Flea – bitten kidney (5 marks)5. Pathogenesis of Hemolytic uremic syndrome (basics)6. Renal cell carcinoma (only basics)

Lesson 21 – The Male genital systemBoth male and female genital systems have been repeatedly asked in exams. Very

important.Must know:

1. Germ cell tumors2. Seminoma – 5 mrks Very important3. Premalignant lesions of penis – 5 marks (Can refer Sanjay Azad surgery also)4. Basics about Benign prostratic hypertrophy5. Ca prostrate – morphology, GRADING and STAGING, investigations (PSA, PSA density, PSA

velocity) - Very important6. Cryptorchidism

Rare 5 marks:1. Testicular lymphoma.

Lesson 22 The female genital tractMust know:

1. Cervical intraepithelial neoplasia (CIN)2. Ca cervix – pathogenesis morphology and staging - Very important3. Endometriosis and adenomyosis (5 marks)4. Ca endometrium (the basics)5. Leiomyoma - Very important6. OVARIAN TUMORS (prepare each tumor for 5 marks and the entire for marks – very very

important – especially germ cell tumors) - Highly repeated question7. Hydatidiform mole & differences between complete and partial mole . Choriocarcinoma - very

importantDistinction questions:

1. Pelvic inflammatory disease (5 marks)2. Sarcoma botyroides3. Menstrual changes in endometrium4. Brenner tumor (5 marks)5. Sex cord – stromal tumors (prepare for 5 marks)

Lesson 23 – The BreastHigh yield lesson – Ca breast will keep repeating itself in some form or another. All

these 8 questions are very high yield in exams. Sometime Ca breast can come as the long case too.Must know:

1. Mammographic signs of Ca breast2. Fibrocystic breast disease3. Just know the risk factors for Ca breast

4. Carcinoma in- situ (both ductal and lobular)5. Paget's disease (Very important)6. Types and morphology of invasive breast carcinoma7. Prognostic factors for breast Ca (Very important)8. Fibroadenoma (Very important)

Distinction questions:1. Sclerosing adenosis and radial scar2. Different between BRCA1 and BRCA23. Phyllodes tumor

Lesson 24 – The endocrine systemExcept for the following questions and DIABETES (important 10 mark case), other

topics can be conveniently skipped for univ. and class exams.Must know:

1. Hashimotos thyroiditis2. Graves disease (Very important)3. Simple goiter4. Multinodular goiter (Very important)5. Types of Ca thyroid and morphology of papillary carcinoma thyroid6. Diabetes mellitus – classification, pathogenesis of type 1 and type 2, morphology, complications

and investigations. Diff between type 1 and type 2. ( Very important)7. Cushing's syndrome (Important)8. Pheochromocytoma

Rare:1. Hyperparathyroidism2. Adrenal insufficiency

Lesson 25 – The skinOnly these FIVE questions need to be studied in this lesson. Never miss on these.

Very very high yield.

Must know:1. Squamous cell carcinoma (prepare notes for 5 marks)2. Basal cell carcinoma (5 marks)3. Malignant melanoma4. Pre – malignant lesions of the skin (refer Sanjay Azad – surgery)5. Mycosis fungoides

Lesson 26 – BonesVery important. Not to be ignored

Must know:1. Osteopetrosis2. Osteoporosis (rare know only the basics)3. Paget disease (Important)4. Osteomyelitis – pyogenic and TB (potts spine) - Very important5. Osteosarcoma (prepare notes for both 10 and 5 marks) - Very important6. Chondrosaroma (5 marks)7. Ewing sarcoma (sure 5 marks) - Very important8. Giant cell tumor or osteoclastoma - Very important.

Lesson 27 – Peripheral nervous system can be conveniently skipped.If your conscience still doesn’t agree, read it after your exams!!!

Lesson 28 – The CNSSelected questions are very important. Don’t waste time at the eleventh hour, however, reading

unnecessary details. You can go to exams confidently only with these questions in CNS. They are very important.

1. CSF findings in different types of meningitis (Read Robbins and also prepare yourself a tabular column referring to med books or applied micro notes)

2. Brain abscess.3. TB menigitis Morphology, investigations and c/f4. Berry aneurysm (5marks)5. Astrocytoma6. Meningioma (5 marks)7. Schwannoma (5 marks)

Lesson 29 – The eye can be read after your univ. exams!

All the best. Wishing you all success.

Dr. Mani PrabhuJR, Department of Pharmacology,JIPMER