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Pathology ospe final edition
 

Pathology ospe final edition

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Pathology ospe final edition

Pathology ospe final edition

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    Pathology ospe final edition Pathology ospe final edition Presentation Transcript

    • Abbas Naseem (BDS)abbas_naseem@yahoo.comDated: Nov 5, 2010
    • By: Abbas Naseem (BDS)abbas_naseem@yahoo.com 2
    • PERFORM THE coagulase test BY SLIDE METHOD TO DETECT BOUND COAGULASE. Requirements: 1. Table 2. Chair for observer 3. Stool 4. Test organism Staphylococcus aureus 5. Glass slide 6. Marking pencil abbas_naseem@yahoo.com By: Abbas Naseem (BDS) 7. Fresh plasma 8. Plastic dropper 9. Nichrome wire loop 10. Spirit lamp/burner 11. Discarding jar 3
    • PERFORM THE CATALASE TEST BY SLIDE METHOD TODETECT THE PRESENCE OF CATALASE ENZYME IN THEPROVIDED ORGANISM. Requirements: 1. Table 2. Chair for observer 3. Stool 4. Test organism Staphylococci abbas_naseem@yahoo.com By: Abbas Naseem (BDS) 5. Negative control organism Streptococci 6. Positive control organism Staphylococci 7. Glass slide 8. Marking pencil 9. 3% H2O2 10. Plastic dropper 11. Nichrome wire loop 12. Sterile wooden sticks / glass rod 13. Spirit lamp/burner 14. Petri dish with filter paper 15. Discarding jar 4
    • PERFORM THE CATALASE TEST BY TUBE METHOD TODETECT THE PRESENCE OF CATALASE ENZYME IN THEPROVIDED ORGANISM. Requirements: 1. Table 2. Chair for observer 3. Stool 4. Test organism Staphylococci 5. Negative control organism Streptococci abbas_naseem@yahoo.com By: Abbas Naseem (BDS) 6. Positive control organism Staphylococci 7. Test tubes 8. Marking pencil 9. 3% H2O2 10. Plastic dropper 11. Nichrome wire loop 12. Sterile wooden sticks / glass rod 13. Spirit lamp/burner 14. Discarding jar 5
    • YOU ARE PROVIDED WITH SEDIMENTS OF A CENTRIFUGED URINE SPECIMEN INA TEST TUBE. PERFORM THE MICROSCOPIC EXAMINATION OF GIVENSEDIMENTS.  Requirements:  1. Table 2. Chair for observer  3. Stool 4. Binocular Microscope  5. Test tube with urine sediments. abbas_naseem@yahoo.com By: Abbas Naseem (BDS)  6. Glass slide 7. Plastic dropper  8. Glass cover slip 9. Discarder jar 6
    • PREPARE THE SMEAR FOR STAINING FROMTHE SPUTUM SPECIMEN PROVIDED TO YOU. Requirements: 1. Table 2. Chair for observer abbas_naseem@yahoo.com By: Abbas Naseem (BDS) 3. Stool 4. Sputum specimen 5. Glass slide 6. Marking pencil 7. Nichrome wire loop / wooded stick 8. Spirit lamp / burner 9. Discarding jar 7
    • YOU ARE PROVIDED WITH A URINE SPECIMEN, DETECT SUGAR IN THE SPECIMEN BY BENEDICT‟S METHOD. Requirements: 1. Table 2. Chair for observer 3. Stool 4. Urine specimen 5. Glass test tube abbas_naseem@yahoo.com By: Abbas Naseem (BDS) 6. Test tube holder 7. Spirit lamp / burner 8. Benedict‟s qualitative reagent 9. Plastic dropper 10. Pipette 5 ml or 10 ml 8
    • EXAMINE THE SPECIMEN OF URINE PROVIDED FORDETECTION OF PROTEINS BY HEAT METHOD. Requirements: Response sheet. Pen / ball point Table Chair / Stool Glass test tube abbas_naseem@yahoo.com By: Abbas Naseem (BDS) Test tube holder Spirit lamp / burner 2 % acetic acid Plastic dropper 9
    • By: Abbas Naseem (BDS)abbas_naseem@yahoo.com 10
    • By: Abbas Naseem (BDS)abbas_naseem@yahoo.com 11
    • A 8-YEAR-OLD BOY DEVELOPED SORE THROAT AND FEVER. ONEXAMINATION, GRAYISH EXUDATES (PSEUDOMEMBRANE) ISFOUND OVER TONSILS AND PHARYNX. THE CAUSATIVE AGENTIS GROWN ON A MEDIUM WHICH PRODUCES BLACKISHCOLONIES AS SHOW IN THE PHOTOGRAPH.A. IDENTIFY THE CULTURE MEDIUM AND THE MOST LIKELY THECAUSATIVE ORGANISM.B. WHY THE CAUSATIVE AGENT APPEARS BEADED ON abbas_naseem@yahoo.com By: Abbas Naseem (BDS)ALBERT‟S STAINING?C. ENLIST TWO COMPLICATION OF DISEASE CAUSED BY THISORGANISM.D. WHAT IS THE PRIMARY MECHANISM IN PATHOGENESIS OFTOXIN MEDIATED COMPLICATIONS. 12
    • A. NAME THE TEST, WHICH IS SHOWN IN THEPHOTOGRAPH.B. WHY THIS TEST IS PERFORMED?C. STRIP MARKED AS “A” CONTAINS WHATSUBSTANCE?D. IDENTIFY THE „TEST‟, „POSITIVE‟ AND„NEGATIVE‟ CONTROL AND WRITE THE abbas_naseem@yahoo.com By: Abbas Naseem (BDS)APPROPRIATE ALPHABET IN THE ANSWER FOREACH. 13
    • VIBRIO CHOLERAE PRODUCES YELLOWISHCOLONIES ON AGAR AS SHOWN IN THEPHOTOGRAPH.A. NAME THE AGAR ON WHICH V. CHOLERAE AREGROWN IN THE PHOTOGRAPH.B. THIS AGAR BELONGS TO WHICH CLASS/TYPE abbas_naseem@yahoo.com By: Abbas Naseem (BDS)OF CULTURE MEDIUM?C. COMMENT ON THE MOTILITY OF V. CHOLERAE.D. HOW WOULD YOU DIFFERENTIATE V.CHOLERAE FROM MEMBERS OFENTEROBACTERIACEAE? 14
    • A 35-YEAR-OLD LADY PRESENTED WITH COMPLAINS OF LOW-GRADE FEVER, EVENING RISE IN TEMPERATURE AND PRODUCTIVE COUGH.SHE ALSO COMPLAINS OF EASY FATIGABILITY, DECREASED APPETITE ANDMARKED WEIGHT LOSS. EXAMINATION OF THE CHEST REVEALS POSTTUSSIVEAPICAL RALES. X – RAY CHEST SHOWS A FIBRONODULAR AREA IN RIGHTAPICAL SEGMENT AND ESR IS 97 MM AT THE END OF 1ST HOUR. THESPUTUM OF THE PATIENT IS TO BE CULTURED ON THE MEDIUM PROVIDED.NAME THE GIVEN MEDIA. abbas_naseem@yahoo.com By: Abbas Naseem (BDS)NAME THE MOST LIKELY CAUSATIVE AGENT IN THIS PATIENT?NAME THE MAJOR CONSTITUENTS OF THIS MEDIUM.HOW MUCH TIME IS REQUIRED FOR VISIBLE GROWTH OF THIS ORGANISM ONTHIS MEDIUM?  Requirements:  Response sheet. Pen / ball point Table Chair / Stool  Freshly prepared LJ medium slope in a tube. 15
    • A PUS SWAB RECEIVED IN THE LABORATORY WAS INOCULATED ON BLOODAGAR, INCUBATED FOR 24 HOURS AND SMEAR IS PREPARED FROM THECOLONY OF THE BACTERIA AND STAINED WITH GRAM STAIN.EXAMINE THE SLIDE UNDER THE MICROSCOPE AND CLASSIFY THE ORGANISMON THE BASIS OF GRAM STAINING.NAME THE REAGENTS REQUIRED FOR GRAM STAINING.WRITE THREE CONDITIONS, WHICH RESULT IN GRAM VARIABILITY. Requirements: Response sheet. Pen / ball point Table abbas_naseem@yahoo.com By: Abbas Naseem (BDS) Chair / Stool Cedar wood oil Binocular Light Microscope Gram stained slide (Gram positive cocci) 16
    • SPUTUM IS RECEIVED FROM A SUSPECTED CASE OF PULMONARYTUBERCULOSIS AND STAINED SMEAR IS PROVIDED.EXAMINE THE SLIDE AND WRITE YOUR OBSERVATION.WHICH STAINING METHOD HAS BEEN OPTED FOR STAINING OF THISORGANISM?ENUMERATE THE REAGENTS USED IN THIS STAINING METHOD.NAME THE MORDANT USED IN THIS STAINING METHOD.NAME THE ORGANISM, WHICH REQUIRE MODIFIED ZN STAINING. abbas_naseem@yahoo.com By: Abbas Naseem (BDS) Requirements: Response sheet Pen / ball point Table Chair / Stool Binocular Microscope Z N stained slide positive for Mycobacterium tuberculosis. 17
    • IN A REMOTE VILLAGE OF PUNJAB, MOST OF THE POPULATION PRESENTEDWITH SIMILAR COMPLAINS OF SUDDEN ONSET OF VOMITING AND PROFUSEDIARRHEA WITH ABDOMINAL CRAMPS. ON EXAMINATION, STOOL IS LIKE RICEWATER IN APPEARANCE AND CONTAINS MUCOUS. STOOL SAMPLES ARECOLLECTED IN A TRANSPORT MEDIUM PROVIDED TO YOU AND TO BE SENT TOREFERRAL LABORATORY FOR ISOLATION OF THE CAUSATIVE ORGANISM.IDENTIFY THE TRANSPORT MEDIUM PROVIDED.WRITE THE NAME OF ENRICHMENT MEDIUM FOR STOOL SAMPLES. abbas_naseem@yahoo.com By: Abbas Naseem (BDS)WRITE TWO CHARACTERISTIC FEATURES OF TRANSPORT MEDIA.  Requirements:  Response sheet. Pen / ball point Table  Chair / Stool Alkaline peptone water 18
    • By: Abbas Naseem (BDS)abbas_naseem@yahoo.com 19
    • A. IDENTIFY THE PARASITE AND WRITE IT‟S NAME.B. NAME THE STAGE OF PARASITE INGESTED BY A SUITABLEFRESHWATER CRUSTACEAN (THE COPEPOD).C. NAME THE INFECTIVE STAGE OF PARASITE TO HUMANS.D. WHAT IS THE MAJOR COMPLICATION OF THIS PARASITE? abbas_naseem@yahoo.com By: Abbas Naseem (BDS) 20
    • CAREFULLY SEE THE LIFE CYCLE GIVEN IN THE PHOTOGRAPH AND ANSWERTHE FOLLOWING.A. NAME THE PARASITE.B. NAME TWO INTERMEDIATE HOSTS FOR THIS PARASITE.C. HOW THE DEFINITIVE HOST BECOMES INFECTED?D. WHAT LESION/DISEASE IS CAUSED BY THIS PARASITE IN HUMANS? abbas_naseem@yahoo.com By: Abbas Naseem (BDS) 21
    • CAREFULLY SEE THE LIFE CYCLE GIVEN INTHE PHOTOGRAPH AND ANSWER THEFOLLOWING.A. NAME THE PARASITE.B. HOW HUMANS BECOME INFECTEDWITH THIS PARASITE? abbas_naseem@yahoo.com By: Abbas Naseem (BDS)C. WHERE ADULT WORM LIVES INHUMANS?D. IN WHICH PARTS OF PAKISTAN, THISPARASITIC INFECTION IS COMMON? 22
    • CAREFULLY SEE THE LIFE CYCLESGIVEN IN THE PHOTOGRAPH ANDANSWER THE FOLLOWING.A. NAME THE PARASITES.B. FOR WHICH PARASITE, PIG IS abbas_naseem@yahoo.com By: Abbas Naseem (BDS)AN INTERMEDIATE HOST?C. NAME THE INFECTIVE STAGEFOR HUMANS.D. WHAT IS THE LENGTH OFPARASITE WHOSE INTERMEDIATEHOST IS CATTLE? 23
    • IDENTIFY THE PARASITE ANDWRITES ITS NAME.NAME THE INFECTIVE STAGEOF THE PARASITE.WHAT WILL BE TWO abbas_naseem@yahoo.com By: Abbas Naseem (BDS)IMPORTANT FINDINGS INBLOOD COMPLETE PICTURE? 24
    • IDENTIFY THE LIFE CYCLE ANDWRITE THE NAME OF PARASITE.HOW THE HUMANS AREINFECTED WITH THIS PARASITE? abbas_naseem@yahoo.com By: Abbas Naseem (BDS)HOW THIS PARASITICINFESTATION CAN BEDIAGNOSED IN HUMANS?WHO IS THE PRIMARY HOST OFTHIS PARASITE? 25
    • IDENTIFY THE ABOVE OVUM ANDNAME THE PARASITE.WHERE THE GRAVID FEMALE LAYSEGGS?WHAT IS THE INFECTIVE STAGE OF abbas_naseem@yahoo.com By: Abbas Naseem (BDS)PARASITE?NAME THE METHOD USED TOCOLLECT THE SPECIMEN FORMICROSCOPIC DETECTIONOF OVA. 26
    • IDENTIFY THE ABOVE OVUM ANDNAME THE PARASITE.WHERE THE ADULT WORM ISFOUND IN HUMANS? abbas_naseem@yahoo.com By: Abbas Naseem (BDS)WHAT IS THE INFECTIVE STAGE OFPARASITE?WHAT IS THE OTHER NAME GIVENTO THIS PARASITE? 27
    • IDENTIFY THE ABOVE CYST ANDNAME THE PARASITE.WHERE THE CYSTS AREFORMED?WHAT IS THE INFECTIVE STAGE abbas_naseem@yahoo.com By: Abbas Naseem (BDS)OF PARASITE?WHAT IS THE DIAGNOSTICFINDING IN ACUTE INFECTIONWITH THIS PARASITE? 28
    • EXAMINE THE EGG OF AN INTESTINAL NEMATODE FOCUSED IN THE SLIDEON THE MICROSCOPE AND WRITE ANSWERS OF THE FOLLOWING.WRITE THE NAME OF THE PARASITE HAVING THIS TYPE OF OVUM.NAME TWO IMPORTANT COMPLICATIONS OF THIS PARASITE IN HUMAN. abbas_naseem@yahoo.com By: Abbas Naseem (BDS)HOW THIS OVUM IS DIFFERENT FROM OVUM OF HOOK WORM? 29
    •  Examine the cyst of an intestinal protozoa focused in the slide on the microscope and write answers of the following. Write the name of the parasite having this type of cyst. Name two important extraintestinal lesions of this parasite in human. abbas_naseem@yahoo.com By: Abbas Naseem (BDS) How this cyst is different from cyst of E. coli? 30
    • By: Abbas Naseem (BDS)abbas_naseem@yahoo.com 31 General Pathology
    • A 30-YEAR-OLD MAN SUSTAINS LEFT FEMORAL FRACTURE IN A SKIINGACCIDENT, AND HIS LEG IS PLACED IN A PLASTER CAST. AFTER THELEG HAS BEEN IMMOBILIZED FOR SEVERAL WEEKS, THE DIAMETER OFTHE LEFT CALF HAS DECREASED.A. THIS CHANGE IS MOST LIKELY TO RESULT FROM WHICH OF THEALTERATION IN THE CALF MUSCLES? abbas_naseem@yahoo.com By: Abbas Naseem (BDS)B. ENUMERATE THREE PATHOLOGICAL CAUSES, WHICH CAN RESULTIN THIS TYPE OF CELLULAR ADAPTATION. 32
    • EXAMINE THE MICROSCOPICPHOTOGRAPH OF THE LESIONINVOLVING THE LIVER ANDANSWER THE FOLLOWING.A. IDENTIFY THE LESION? abbas_naseem@yahoo.com By: Abbas Naseem (BDS)B. NAME TWO CAUSES OFLESION?C. IS IT REVERSIBLE LESION?D. CAN IT BE MALIGNANT? 33
    • By: Abbas Naseem (BDS)abbas_naseem@yahoo.com 34
    • By: Abbas Naseem (BDS)abbas_naseem@yahoo.com 35
    • By: Abbas Naseem (BDS)abbas_naseem@yahoo.com 36
    • By: Abbas Naseem (BDS)abbas_naseem@yahoo.com 37
    • By: Abbas Naseem (BDS)abbas_naseem@yahoo.com 38
    • A 32-YEAR-OLD MAN EXPERIENCES "HEARTBURN" AND GASTRIC REFLUXAFTER EATING A LARGE MEAL. AFTER MANY MONTHS OF SYMPTOMS, HEUNDERGOES UPPER GASTROINTESTINAL ENDOSCOPY AND A BIOPSYSPECIMEN OF THE ESOPHAGEAL EPITHELIUM SHOWS INTESTINAL TYPECOLUMNAR EPITHELIUM WITH GOBLET CELLS.A. WHICH PATHOLOGIC CHANGE HAS MOST LIKELY OCCURRED?B. IS IT AN IRREVERSIBLE CONDITION?C. WRITE TWO OTHER EXAMPLES OF SUCH CHANGE IN HUMANS. abbas_naseem@yahoo.com By: Abbas Naseem (BDS) 39
    • ON A ROUTINE VISIT TO THE PHYSICIAN, AN OTHERWISE HEALTHY 51 -YEAR-OLD MAN HAS A BLOOD PRESSURE OF 150/95 MM HG. IF THEPATIENTS HYPERTENSION REMAINS UNTREATED FOR YEARS,A. WHICH CELLULAR ALTERATION/ADAPTATION WILL MOST LIKELY BESEEN IN THE MYOCARDIUM?B. IS IT A PHYSIOLOGICAL OR PATHOLOGICAL ADAPTATION?C. ENUMERATE ANY TWO PHYSIOLOGICAL EXAMPLES OF THIS TYPE abbas_naseem@yahoo.com By: Abbas Naseem (BDS)OF CELLULAR ADAPTATION INDUCED BY HORMONES. 40
    • AFTER THE BIRTH OF HER FIRST CHILD, A 19-YEAR-OLD WOMAN BREAST-FED THEINFANT FOR ABOUT 1 YEAR.A. WHICH PROCESSES THAT HAS OCCURRED IN THE BREAST DURING PREGNANCYALLOWED HER TO BREAST-FEED THE INFANT?B. ENUMERATE TWO PHYSIOLOGICAL EXAMPLES OF THIS TYPE OF ADAPTATION.C. ENUMERATE TWO PATHOLOGICAL EXAMPLES OF THIS TYPE OF ADAPTATION. abbas_naseem@yahoo.com By: Abbas Naseem (BDS)D. WRITE ANY TWO FACTORS, WHICH HELP IN THIS CELLULAR ADAPTATION. 41
    • AN OLD WOMAN REPORTED TO A GYNECOLOGIST WITH COMPLAINTSOF IRREGULAR BLEEDING AND LOW BACKACHE. SHE WAS DIAGNOSEDAS A CASE OF FIBROID UTERUS. A LARGE TUMOR WAS SURGICALLYREMOVED FROM THE UTERUS. ON SECTIONING, THE TUMORREVEALED WHITE CHALKY AREAS, WHICH FELT GRITTY AND HARD TOCUT. HISTOPATHOLOGICAL SLIDES ARE PREPARED AND A SLIDE ISPROVIDED TO YOU. EXAMINE THE SLIDE AND ANSWER THEFOLLOWING. abbas_naseem@yahoo.com By: Abbas Naseem (BDS)A. WHAT IS YOUR MOST LIKELY DIAGNOSIS?B. WRITE IDENTIFICATION POINT FOR THIS LESION.C. ENUMERATE TWO OTHER EXAMPLES OF THIS LESION. 42
    • A PET DOG BITES A YOUNG BOY ON HIS RIGHT LEG. ON EXAMINATION, THE WOUNDON THE CALF MUSCLE IS DEEP WITH LACERATED EDGES.A. WHAT IS YOUR OPINION, THIS WOUND MUST HEAL BY FIRST INTENTION OR BYSECOND INTENTION?B. ENUMERATE FOUR LOCAL FACTORS WHICH DELAY WOUND HEALING.C. ENUMERATE TWO COMPLICATIONS OF CUTANEOUS WOUND HEALING. abbas_naseem@yahoo.com By: Abbas Naseem (BDS)D. HOW LONG DOES IT TAKE FOR A SKIN WOUND TO ACHIEVE ITS MAXIMALSTRENGTH? 43
    • A 10-YEAR-OLD BOY ADMITTED IN EMERGENCY WITH FEVER, NAUSEA,LOSS OF APPETITE AND PAIN IN RIGHT ILIAC FOSSA. ONEXAMINATION, REBOUND TENDERNESS WAS POSITIVE. ONLABORATORY INVESTIGATIONS WBC 12.0 X 103 / UL, HB 12.8 G/DL,PLATELET 250X103 /UL. PATIENT WAS OPERATED AND SPECIMENSENT TO LABORATORY. HISTOPATH SLIDES ARE PREPARED AND ONESLIDE IS PROVIDED TO YOU FOR MICROSCOPIC EXAMINATION. abbas_naseem@yahoo.com By: Abbas Naseem (BDS)EXAMINE IT CAREFULLY AND ANSWER THE FOLLOWING.WHAT IS THE MOST LIKELY DIAGNOSIS?GIVE TWO POINTS OF IDENTIFICATION.ENUMERATE SIGNS OF INFLAMMATION.NAME CHEMICAL MEDIATORS RESPONSIBLE FOR PAIN. 44
    • A 45-YEAR-OLD MAN EXPERIENCED CRUSHING SUBSTERNAL CHEST PAIN AFTERARRIVING AT WORK IN THE MORNING. OVER THE NEXT 4 HOURS, THE PAINPERSISTED AND INCREASED IN INTENSITY. HE BECOMES DIAPHORETIC ANDSHORT OF BREATH. HE WAS EVACUATED TO HOSPITAL BUT DIED IN THE WAY.AUTOPSY WAS PERFORMED AND HISTOPATHOLOGICAL SLIDESARE PREPARED FROM DIFFERENT SECTIONS OF THE HEART. EXAMINE THE GIVENSLIDE AND ANSWER THE FOLLOWING. abbas_naseem@yahoo.com By: Abbas Naseem (BDS)A.WHAT IS THE MOST LIKELY DIAGNOSIS?WRITE TWO DIAGNOSTIC POINTS OF THE LESION ON MICROSCOPIC EXAMINATION.NAME TWO IMPORTANT CARDIAC MARKERS HELPFUL IN DIAGNOSIS OF THISCONDITION. 45
    • A 46-YEAR-OLD WOMAN GOES TO THE CLINICIAN FOR A ROUTINE HEALTHMAINTENANCE EXAMINATION. ON PHYSICAL EXAMINATION THERE AREENLARGED CERVICAL LYMPH NODES. TUBERCULIN SKIN TEST IS POSITIVE,LYMPH NODES REMOVED SENT TO LABORATORY FOR HISTOPATHOLOGY. THESLIDE IS PROVIDED TO YOU. EXAMINE CAREFULLY AND ANSWER THEFOLLOWING.WHAT IS THE MOST LIKELY DIAGNOSIS?NAME THE INFLAMMATORY CELL, WHICH HAS MOST IMPORTANT ROLE IN THIS abbas_naseem@yahoo.com By: Abbas Naseem (BDS)TYPE OF INFLAMMATION?WHICH TYPE OF IMMUNITY IS RESPONSIBLE FOR THIS CONDITION?WHICH TYPE OF CELL IS RESPONSIBLE FOR THIS TYPE OF IMMUNITY? 46
    • A 28-YEAR-OLD FEMALE MARRIED FOR THE LAST 2 YEARS, PRESENTSTO THE EMERGENCY WITH SPONTANEOUS ABORTION. HER ROUTINECLINICAL AND LABORATORY TESTS ARE WITHIN NORMAL LIMITSEXCEPT HB (9.8 GM/DL). PAST HISTORY REVEALED SPONTANEOUSABORTIONS TWICE BEFORE THIS. ULTRASOUND REVEALED MULTIPLESHARPLY CIRCUMSCRIBED NODULES IN THE MYOMETRIUM RANGINGFROM1.5 TO 5 CM IN DIAMETER. THE TUMORS WERE SUCCESSFULLY abbas_naseem@yahoo.com By: Abbas Naseem (BDS)REMOVED AND SENT FOR HISTOPATHOLOGY. EXAMINE THE SLIDESPROVIDED WHICH WERE PREPARED FROM THE TUMOR AND ANSWERTHE FOLLOWING.WHAT IS THE MOST LIKELY DIAGNOSIS?WRITE TWO DIAGNOSTIC POINTS.WHAT ARE TWO MAJOR COMPLICATION OF THIS TUMOR? 47
    • AN OBESE LADY OF 40 YEARS OF AGE IS SUFFERING FROMRECURRENT DULL, BORING, SOMETIMES COLICKY PAIN IN RIGHTHYPOCHONDRIUM. THE PAIN INCREASES AFTER TAKING FOODESPECIALLY FATTY FOODS. SHE WAS OPERATED ANDHISTOPATHOLOGY SLIDES ARE PREPARED FROM THE RESECTEDLESION.EXAMINE THE PROVIDED SLIDE AND ANSWER THE abbas_naseem@yahoo.com By: Abbas Naseem (BDS)FOLLOWING.A. WHAT IS MOST LIKELY DIAGNOSIS?WRITE TWO DIAGNOSTIC POINTS.ENUMERATE TWO COMPLICATIONS OF THIS LESION. 48
    • A 14-YEAR-OLD GIRL PRESENTS WITH BILATERAL PAINLESS SWELLINGIN THE NECK. SHE GIVES A HISTORY OF CHRONIC COUGH WITH LOW-GRADEFEVER. THE FEVER HAS A CLASSICAL PATTERN OF EVENING RISE. THE GIRLSUFFERS FROM MALAISE WITH PROGRESSIVE LOSS OF WEIGHT FOR THE LAST 6MONTHS. POSITIVE LAB INVESTIGATIONS REVEAL A RAISED ESR AND ASOLITARY CALCIFIED FOCUS IN HER LUNG NEAR THE HILUS IN THE X-RAY.HISTOPATHOLOGY SLIDE OF THE LESION IS PROVIDED. EXAMINE THE SLIDE AND abbas_naseem@yahoo.com By: Abbas Naseem (BDS)ANSWER THE FOLLOWING.A.WHAT IS THE MOST LIKELY DIAGNOSIS?WRITE TWO MICROSCOPIC DIAGNOSTIC POINTS.NAME TWO RAPID LABORATORY TESTS FOR ITS DIAGNOSIS. 49
    • A 60 YEARS OLD COAL WORKER PRESENTED WITH PROLONGED HISTORY OF COUGH,BLACKISH COLOR SPUTUM AND BREATHLESSNESS WHICH PROGRESS TO RESPIRATORYFAILURE. AT AUTOPSY LUNGS APPEAR BLACK.HISTOPATHOLOGY SLIDES AREPREPARED. EXAMINE THE SLIDE AND ANSWER THE FOLLOWING. WHAT IS THE MOST LIKELY DIAGNOSIS? WRITE TWO MICROSCOPIC IDENTIFICATION POINTS.ENUMERATE TWO OTHER SUBSTANCES, WHICH CAN CAUSE THIS LESION. abbas_naseem@yahoo.com By: Abbas Naseem (BDS) 50
    • NEOPLASIA A non-healing ulcer on face with raised margins was detected in an old lady, which was biopsied and slide was prepared.  What is likely diagnosis? abbas_naseem@yahoo.com By: Abbas Naseem (BDS) Write three diagnostic points of this lesion. 51
    • NEOPLASIA A 35 years old lady presents to the surgical OPD with a painless lump over the shoulder. On examination it is freely mobile. On excision it is well encapsulated. abbas_naseem@yahoo.com By: Abbas Naseem (BDS) Examine the histopathology slide prepared from the lesion provided to you. What is your diagnosis? Write two microscopic identification features of this lesion. Name the malignant variant of this lesion. 52
    • NEOPLASIA A 35 years old lady presents to the surgical OPD with a painless lump over the shoulder. On examination it is freely mobile. After excision, tumor is sent to laboratory. Museum specimen is prepared and presented to you. Identify the abbas_naseem@yahoo.com By: Abbas Naseem (BDS) lesion and answer the following. What is your diagnosis? Write two gross morphological features of this lesion. What is the most likely microscopic finding in this lesion? 53
    • NEOPLASIA A 61- year - old man has had several episodes of hematuria over the past week. He has not experienced increased urinary frequency or dysuria. On physical examination, there are no remarkable findings. Urinalysis shows 4+ hematuria. The urine culture is negative. A cystoscopy is performed and a 2 cm sessile, friable mass is seen on the right bladder wall. A biopsy specimen is abbas_naseem@yahoo.com By: Abbas Naseem (BDS) obtained and slide is provided to you. Examine the H & E stained slide carefully and answer the following. What is the most likely diagnosis? Write two microscopic features of this lesion. Enumerate the greatest risk factor in men for the development of this lesion. (TRANSITIONAL CELL CA ) 54
    • By: Abbas Naseem (BDS)abbas_naseem@yahoo.com 55
    •  1) Identify the instrument. (01) 2) What is placed under the lid? (01) 3) Name the indicator used. (01) 4) Name TWO organisms abbas_naseem@yahoo.com By: Abbas Naseem (BDS) that require anaerobic growing environment for growth. 56
    • SEROLOGY (WIDAL TEST) A 15-year-old boy reported to medical OPD with history of fever for the last three days, fever is of high grade and accompanied by vomiting and constipation. He is also complaining of headache and malaise. He was vaccinated against enteric fever (TAB vaccine) four months back. The clinician suspects enteric fever and advised blood complete picture and widal test. Blood CP revealed Hb 12.3 g%, TLC 9.4 x 109 / L and 74% polymorphs. His widal test report is TO 1/160 TH 1/320 abbas_naseem@yahoo.com By: Abbas Naseem (BDS) AO 1/80 AH 1/160 BO 1/160 BH 1/160 What is your conclusion after interpreting this report? What is the significant titer of anti O and anti H antibodies in a single widal test? Name the gold standard test for the diagnosis of enteric fever? 57
    • SEROLOGY (WIDAL TEST) A 10-year-old boy presents to the OPD physician with complaints of fever, headache, constipation and two episodes of vomiting for 10 days. On examination there are reddish spots on abdomen, with 2cm-enlarged spleen. After collecting blood for CBC & Culture, the physician ordered a Widal Test. The out come of antibodies titer was as follow. TO 1: 160 AO 1 : 20 BO 1 : 40 abbas_naseem@yahoo.com By: Abbas Naseem (BDS) TH 1 : 320 AH 1 : 40 BH 1 : 20 After interpreting the results answer the following questions. What is your diagnosis after interpretation of widal result? When would you repeat the test to get more meaningful result? Which important information from the patient will help you to interpret the result? What does AO and AH mean in widal test? 58
    • LIKE MYPRESENTATION?For Comments &Suggestions:abbas_naseem@yahoo,com Abbas Naseem Dated: Nov 5, 2010