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Dcmm 211:Clinical Pathology Question Paper

Dcmm 211:Clinical Pathology

Course:Clinical Medicine

Institution: Kenya Methodist University question papers

Exam Year:2012

CLINICAL PATHOLOGY (DCMM 211) 3RD TRIMESTER 2012
KENYA METHODIST UNIVERSITY

END OF 3''RD ''TRIMESTER 2012 EXAMINATIONS
SCHOOL : MEDICINE & HEALTH SCIENCES
DEPARTMENT : CLINICAL MEDICINE, SURGERY & COMMUNITY
HEALTH
UNIT CODE : DCMM 211
UNIT TITLE : CLINICAL PATHOLOGY
TIME : 3 HOURS

INSTRUCTIONS

Question One

Features of megaloblastic anaemia

* Associated with pernicious anaemia.
* Has lowered MCV (corpuscular volume) levels.
* May be due to chronic alcoholism.
* Associated with hookworm infections.
* All the above are true.

Question Two

Hormones associated with elevated glucose levels include;

* Glucogon.
* Insulin.
* Steroids.
* Anti diuretic hormone.
* Oxytocin.

Question Three

Which of the following hormones are produced by the anterior pituitary?

* Oxytocin.
* Prolactin.
* Thyroid hormone.
* Cortisol.
* Leutenizing hormone.

Question Four

Causes of primary hyperparathyroidism include;

* Parathyroid adenoma.
* Pituitary adenoma.
* Chronic renal failure.
* May be secondary to thyroidectony.
* Malabsorption syndromes in the intestines.

Question Five

Features of hyperthyroidism include;

* Weight gain.
* Fine tremors.
* Reduced appetite.
* Hyperactivity.
* Tachycardia.

Question Six

Features of acute leukaemia include;

* Mainly affect adults.
* Bone marrow is hypocellular.
* Patient may present with bleeding tendancies.
* Associated with normocytic normochronic anaemia.
* All the above are true.

Question Seven

Adverse effects of longterm steroid use include;

* Improved immune system.
* Peptic ulcer disease.
* Associated with hyperlipidaemia.
* Osteoporosis.
* Depression and psychosis.

Question Eight

Glucagon

* Produced by pancreatic beta cells.
* One of the main enzymes associated with protein digestion.
* High levels associated with hypoglycaemia.
* Stimulates protein synthesis.
* Produced from the posterior pituitary.

Question Nine

Hormones produced by the adrenal cortex include;

* Insulin.
* Aldosterone.
* Androgens.
* Nor epinephrine.
* Cortisol.

Question Ten

Features of congenital adrenal hyperplasia include

* Hypoaldosteronism.
* Hirsutism.
* Precauceous puberty.
* Feminization.
* Elevated androgen levels.

Question Eleven

Elements necessary in thyroid hormone production include;

* Tyrosine.
* Iron.
* Folate.
* Iodine.
* Cortisol.

Question Twelve

Causes of hypopituitarism include;

* Irradiation.
* Severe head injury.
* Sheehan’s syndrome.
* Conn’s syndrome.
* Pituitary adoromas.

Question Thirteen

Features of haemolytic anaemia include;

* Reduced reticulocyte count.
* May be due to autoimmune disease.
* Bone marrow suppression.
* Malaria may be a cause.
* Elevated thyroid levels.

Question Fourteen

Tumor lysis syndrome;

* Common in slow growing tumors.
* Allopurinol has no role in management.
* Hyperphosphataemia is present.
* Rehydration plays a major role in management.
* Main mode of management is by giving analgesics.

Question Fifteen

Features of type II diabetes include;

* Mainly managed by insulin.
* Common among the young age group.
* Has no genetic predisposition.
* Associated with the metabolic syndrome.
* All the above are true.

Question Sixteen

Examples of sickle cell crisis include;

* Hyperhaemolytic crisis.
* Pain crisis.
* Aplastic crisis.
* Dehydration is a risk factor to sickling crisis.
* Fracture crisis.

Question Seventeen

Haemophyllia

* Has an autosomal dominant inheritance pattern.
* Type A associated by factor 7 deficiency.
* Patients are at an increased risk of subdural haemorrhages.
* Occurs due to defects in the alpha globulin chain.
* Associated with haemathrosis.

Question Eighteen

Clinical features of diabetes mellitus include;

* Hypocalcaemia.
* Polyphagia.
* Hirsutism.
* Glycosuria.
* Ketonuria is not significant in diabetics.

Question Nineteen

Calcium metabolism

* May be impaired in renal failure.
* Rickets occur due to deficient parathyroid hormone levels.
* Thyroid hormone plays a major role.
* Calcitonin is associated with increased reabsorption of calcium from the kidneys.
* Calcitriol is mainly produced in the thyroid gland by the chief cells.

Question Twenty

Management principles in sickle cell disease include;

* Folate supplement.
* Iron supplementation.
* Use of antimalarial poplylaxis.
* Opioids should be avoided in patients with pain crisis.
* Hydration has no role in management of sickling crisis.

SHORT ANSWER QUESTIONS (60 MARKS)

Question One

List five causes of neutrophilia.

Question Two

Briefly discuss the organizational structure of the suprarenal glands and the different substances secreted by these regions.

Question Three

Briefly discuss the anabolic effects of insulin.

Question Four

Briefly discuss the pathophysiology of shecham’s syndrome.

Question Five

Outline the effects of parathyroid hormone on calcium metabolism.

Question Six

Outline complications associated with lymphomas.

Question Seven

List five causes of bone marrow failure.

Question Eight

Define the following terms and give normal failure ranges;

* Mean capuscular volume

(2.5 Marks)

* Mean capuscular haemoglobin.

(2.5 Marks)

* Packed cell volume.

(2.5 Marks)

* Mean capuscular haemoglobin concentration.

(2.5 Marks)

Question Nine

List five clinical causes of microcytic hypochromic anaemia.

Question Ten

Outline the structure of haemoglobin.

Question Eleven

List five causes of thrombocytopenia.

LONG ANSWER QUESTIONS (40 MARKS)

Question One

Discuss the hypothalamo-pituitary-gland axis as involved in andocrine homeostasis.

Question Two

Discuss sickle cell disease under the following types

* Aetiology.
* Clinical presentation.
* Diagnostic tests.
* Management and complications.

Dcmm 211:Clinical Pathology Question Paper

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