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🔬 HIGH-YIELD PATHOLOGY QUESTION BANK

KNRUHS 2nd Year MBBS | Systemic Pathology (Last 1/3rd)

📌 SECTION 1: GIT & HEPATOBILIARY SYSTEM

Long Answer Questions (LAQ - 10 marks)

1. Describe the pathogenesis, morphology, and complications of peptic ulcer disease. How does it differ from acute gastric erosion?
2. Describe the pathology of carcinoma stomach. Add a note on Lauren's classification.
3. Classify inflammatory bowel disease. Compare and contrast Crohn's disease and Ulcerative Colitis (morphology + complications).
4. Describe the pathogenesis and morphology of liver cirrhosis. Add a note on portal hypertension.
5. Write an essay on viral hepatitis - types, pathogenesis, morphology, and progression to chronic hepatitis.

Short Answer Questions (SAQ - 5 marks)

1. Carcinoid tumor of GIT - features and carcinoid syndrome
2. Morphology of amoebic liver abscess vs pyogenic liver abscess
3. Hirschsprung disease - pathogenesis and morphology
4. Hepatocellular carcinoma (HCC) - etiology and gross morphology
5. Cholangiocarcinoma - brief note
6. Celiac disease (gluten-sensitive enteropathy) - pathology
7. Gallstones (cholelithiasis) - types, composition, complications
8. Carcinoma of colon - morphology and spread; APC gene
9. Barrett's esophagus - definition, pathology, and significance
10. Acute pancreatitis - pathogenesis (fat necrosis, saponification)
11. Primary biliary cholangitis - brief note
12. Mallory-Weiss syndrome vs Boerhaave syndrome
13. Meckel's diverticulum - rule of 2s

One-Liners / Very Short (2 marks)

• "Skip lesions" are seen in: Crohn's disease
• "Lead pipe" appearance on barium enema: Ulcerative colitis
• Most common site of carcinoid tumor: Appendix (most common), Ileum (most common symptomatic)
• Councilman bodies are seen in: Yellow fever / viral hepatitis
• Ground glass hepatocytes: Hepatitis B (HBsAg)
• Rokitansky-Aschoff sinuses: Chronic cholecystitis
• Krukenberg tumor: Gastric signet ring cell carcinoma metastasis to ovary
• "Cobblestone appearance" of mucosa: Crohn's disease

📌 SECTION 2: MALE GENITAL TRACT (MGT)

Long Answer Questions

1. Classify tumors of testis. Describe the pathology of seminoma. Mention tumor markers.
2. Write an essay on carcinoma prostate - etiology, pathology, spread, and Gleason grading.

Short Answer Questions

1. Cryptorchidism - pathology and complications (malignancy risk)
2. Teratoma of testis - types and features
3. Benign prostatic hyperplasia (BPH) - zones affected, pathology, complications
4. Hydrocele vs varicocele vs spermatocele - brief comparison
5. Mixed germ cell tumor - brief note
6. Phimosis and its complications
7. PSA - significance in prostate carcinoma

One-Liners

• Most common testicular tumor in adults: Seminoma
• Most common testicular tumor in children: Yolk sac tumor (endodermal sinus tumor)
• AFP elevated in: Yolk sac tumor, Embryonal carcinoma
• Beta-hCG elevated in: Choriocarcinoma, Embryonal carcinoma
• Prostate carcinoma most commonly arises from: Peripheral zone
• BPH most commonly arises from: Transitional zone (periurethral)
• Gleason score ≥7 = Clinically significant prostate cancer

📌 SECTION 3: FEMALE GENITAL TRACT (FGT)

Long Answer Questions

1. Describe the role of HPV in cervical carcinogenesis. Classify and describe CIN (Cervical Intraepithelial Neoplasia). Add a note on Pap smear.
2. Classify ovarian tumors. Describe the pathology of serous cystadenoma and serous cystadenocarcinoma.
3. Write an essay on endometrial carcinoma - types, etiology, pathology, and spread.

Short Answer Questions

1. Polycystic ovarian syndrome (PCOS) - pathogenesis and morphology
2. Hydatidiform mole - complete vs incomplete mole (karyotype, morphology, malignant potential)
3. Choriocarcinoma - pathology and tumor markers
4. Leiomyoma (fibroid) uterus - gross morphology, types, complications
5. Dermoid cyst (mature cystic teratoma) of ovary - contents and significance
6. Ectopic pregnancy - sites and complications
7. Bartholin cyst - brief note
8. Endometriosis - definition, common sites, complications
9. Krukenberg tumor - definition and primary site
10. Vulvar intraepithelial neoplasia (VIN) - HPV association

One-Liners

• Most common gynecological malignancy worldwide: Cervical carcinoma
• Most common gynecological malignancy in developed countries: Endometrial carcinoma
• Transformation zone of cervix is important because: Most susceptible to HPV infection, most carcinomas arise here
• Chocolate cyst of ovary = Endometrioma
• "Call-Exner bodies" seen in: Granulosa cell tumor of ovary
• Pseudomyxoma peritonei: Mucinous cystadenocarcinoma of ovary (or appendix)
• Snow storm appearance on USG: Hydatidiform mole
• Most common ovarian tumor: Serous cystadenoma
• Most common malignant ovarian tumor: Serous cystadenocarcinoma

📌 SECTION 4: BREAST PATHOLOGY

Long Answer Questions

1. Classify carcinoma breast. Describe the pathology of invasive ductal carcinoma (IDC). Add a note on spread and prognosis.
2. Discuss fibrocystic change of breast - types, pathology, and malignant potential.

Short Answer Questions

1. Fibroadenoma - gross and microscopic pathology
2. Inflammatory breast carcinoma (peau d'orange) - pathology and mechanism
3. DCIS (Ductal Carcinoma In Situ) vs LCIS - differences
4. Paget's disease of nipple - pathology and significance
5. Phyllodes tumor - pathology and behavior
6. Triple assessment of breast lump
7. Molecular subtypes of breast carcinoma (Luminal A, B, HER2, Triple negative)
8. Male breast carcinoma - brief note
9. Fat necrosis of breast - causes and features

One-Liners

• Most common benign breast tumor in young women: Fibroadenoma
• Most common breast carcinoma: Invasive ductal carcinoma (NST - No Special Type)
• "Signet ring cells" in breast: Invasive lobular carcinoma
• ER/PR positive breast carcinoma responds to: Tamoxifen / Hormonal therapy
• HER2 positive breast carcinoma treated with: Trastuzumab (Herceptin)
• Triple negative breast cancer (ER-, PR-, HER2-): Poor prognosis, BRCA1 association
• Paget cells are: Malignant cells in epidermis of nipple (adenocarcinoma cells)
• "Indian file pattern" microscopically: Invasive lobular carcinoma

📌 SECTION 5: ENDOCRINE SYSTEM

Long Answer Questions

1. Classify thyroid carcinomas. Describe the pathology of papillary thyroid carcinoma.
2. Write an essay on diabetes mellitus - types, pathogenesis, morphological changes, and complications.
3. Describe multiple endocrine neoplasia (MEN) syndromes - types and associated tumors.

Short Answer Questions

1. Graves' disease - pathogenesis, morphology, and thyroid storm
2. Hashimoto's thyroiditis - pathology and Hurthle cell change
3. Medullary thyroid carcinoma - cell of origin, amyloid, calcitonin, MEN association
4. Adrenal cortical adenoma vs carcinoma
5. Pheochromocytoma - "rule of 10s," morphology, clinical features
6. Primary hyperaldosteronism (Conn's syndrome) - features
7. Cushing syndrome - causes, pathology (adrenal changes)
8. Addison's disease - causes, morphology
9. Insulinoma - features; hypoglycemia
10. Craniopharyngioma - brief note

One-Liners

• Psammoma bodies seen in: Papillary thyroid carcinoma (also meningioma, serous papillary carcinoma ovary)
• "Orphan Annie eye" nuclei: Papillary thyroid carcinoma
• "Amyloid stroma" in thyroid: Medullary carcinoma (calcitonin-derived amyloid)
• Most common thyroid carcinoma: Papillary thyroid carcinoma (80%)
• Best prognosis thyroid carcinoma: Papillary
• Worst prognosis thyroid carcinoma: Anaplastic
• Pheochromocytoma rule of 10s: 10% bilateral, 10% malignant, 10% extra-adrenal, 10% familial, 10% in children
• MEN 1 (Wermer) = Pituitary + Parathyroid + Pancreas (3 P's)
• MEN 2A (Sipple) = Pheochromocytoma + Medullary thyroid Ca + Parathyroid
• MEN 2B = Pheochromocytoma + Medullary thyroid Ca + Mucosal neuromas + Marfanoid habitus
• Chvostek's and Trousseau's signs: Hypocalcemia (hypoparathyroidism)

📌 SECTION 6: BONE & SOFT TISSUE TUMORS

Long Answer Questions

1. Classify bone tumors. Describe the pathology of osteosarcoma - morphology, X-ray findings, spread, and prognosis.
2. Write an essay on Ewing's sarcoma - pathology, X-ray features, genetics, and treatment.

Short Answer Questions

1. Giant cell tumor (osteoclastoma) - site, X-ray (soap bubble), pathology, behavior
2. Osteochondroma (osteocartilaginous exostosis) - most common benign bone tumor
3. Chondrosarcoma - pathology and spread
4. Multiple myeloma - bone lesions (punched out), Bence-Jones protein
5. Fibrous dysplasia - monostotic vs polyostotic; McCune-Albright syndrome
6. Aneurysmal bone cyst - features
7. Liposarcoma - most common soft tissue sarcoma in adults
8. Rhabdomyosarcoma - most common soft tissue sarcoma in children
9. Synovial sarcoma - brief note; biphasic pattern
10. Ganglion cyst - location and pathology

One-Liners

• Osteosarcoma X-ray: Sunburst appearance + Codman's triangle (periosteal reaction)
• Most common primary malignant bone tumor: Osteosarcoma
• Most common bone tumor in metaphysis of long bones: Osteosarcoma
• Ewing's sarcoma: Small round blue cells, t(11;22) EWS-FLI1 fusion, "onion skin" periosteal reaction
• Age group: Osteosarcoma - 10-20 years; Ewing's - 5-15 years; Giant cell tumor - 20-40 years
• Giant cell tumor location: Epiphysis of long bones (distal femur/proximal tibia)
• Benign tumor with malignant transformation risk in multiple osteochondromatosis: Yes (hereditary multiple exostoses)
• Most common metastatic tumor to bone: Prostate (osteoblastic), Breast, Lung, Kidney, Thyroid

📌 SECTION 7: SKIN PATHOLOGY

Long Answer Questions

1. Describe the pathology of malignant melanoma - types, ABCDE criteria, Clark's levels, Breslow thickness, spread, and prognosis.
2. Classify skin tumors. Describe basal cell carcinoma and squamous cell carcinoma with differences.

Short Answer Questions

1. Psoriasis - pathology (Munro microabscesses, Auspitz sign)
2. Pemphigus vulgaris vs Bullous pemphigoid - pathology and differences
3. Actinic keratosis - premalignant lesion; association with SCC
4. Seborrheic keratosis - features and "stuck on" appearance
5. Verruca vulgaris (warts) - HPV association, koilocytes
6. Molluscum contagiosum - Henderson-Patterson bodies
7. Kaposi sarcoma - HHV-8, AIDS association
8. Mycosis fungoides (cutaneous T-cell lymphoma) - Sezary cells, Pautrier microabscesses
9. Erythema multiforme - causes, target lesion, Stevens-Johnson syndrome
10. Lichen planus - "4 P's" (Pruritic, Purple, Polygonal, Papules), Wickham striae

One-Liners

• Most common skin cancer: Basal cell carcinoma (BCC)
• Most common skin cancer to metastasize: Melanoma
• "Rodent ulcer" = Basal cell carcinoma
• "Acantholysis" (loss of cohesion of keratinocytes) in: Pemphigus vulgaris
• IgG at desmosomes (intraepidermal) = Pemphigus vulgaris
• IgG at basement membrane (subepidermal) = Bullous pemphigoid
• "Nikolsky sign" positive in: Pemphigus vulgaris (negative in bullous pemphigoid)
• ABCDE rule for melanoma: Asymmetry, Border irregularity, Color variation, Diameter >6mm, Evolution
• Melanoma arises from: Melanocytes (neural crest origin)
• Benign nevus vs melanoma - key molecular marker: BRAF V600E mutation in melanoma
• "Onion skin" arterial changes in kidney seen in: Malignant hypertension

📝 EXAM STRATEGY TIPS FOR KNRUHS

• Carcinoma cervix (HPV, CIN, Pap smear)
• Ovarian tumors (classification + serous)
• Thyroid carcinoma (especially papillary)
• Breast carcinoma (IDC, Paget's)
• Osteosarcoma + Ewing's sarcoma
• Melanoma (Clark's levels + Breslow)
• Cirrhosis + Portal hypertension
• Testicular tumors + tumor markers
• Diabetes mellitus + Pheochromocytoma
• Hydatidiform mole + Choriocarcinoma

Source: Robbins & Kumar Basic Pathology (10th ed.) | Robbins, Cotran & Kumar Pathologic Basis of Disease

• 📝 Detailed notes on any specific topic (e.g., "explain carcinoma cervix in detail")
• 🧠 Mnemonics for any section
• 📊 Comparison tables (e.g., Crohn's vs UC, BCC vs SCC)
• 🔁 Quick revision bullet points for last-minute prep

The question bank has 3 types of questions for each section:

1. 📝 Long Answer Questions (LAQ - 10 marks)

"Describe the pathogenesis, morphology, and complications of peptic ulcer disease. How does it differ from acute gastric erosion?"

2. 📝 Short Answer Questions (SAQ - 5 marks)

"Describe Paget's disease of nipple - pathology and significance"

3. 📝 One-Liners (2 marks / MCQ)

"Most common thyroid carcinoma → Papillary thyroid carcinoma (80%)"

👆 Scroll up - you will find:

• "Give me only LAQs" - I'll list just the long questions
• "Give me MCQs only" - I'll list just the one-liners
• "Questions on thyroid only" - I'll focus on one topic