UNIVERSITI TUNKU ABDUL RAHMAN ACADEMIC YEAR 2014/2015 SEPTEMBER EXAMINATION UDDD3144 PATHOLOGY TUESDAY, 9 SEPTEMBER 2014 TIME : 2.00 PM ~4.00 PM (2 HOURS) BACHELOR OF SCIENCE (HONS) BIOMEDICAL SCIENCE Instruction to Candidates : This paper comprises TWO sections. Section A : [Total : 75 marks] Consists of THREE compulsory questions : Q1, Q2 and Q3. Each question carries 25 marks. Answer ALL questions, Section B : [Total : 25 marks} Consists of TWO questions : Q4 and Q5. Choose ONE question to answer. Marks will only be given to the first attempted question. Each question carries 25 marks. This question paper consists of 5 questions on 5 printed pages.vy UDDD3144 PATHOLOGY Section A: [Total : 75 marks} Answer ALL questions, a. (@) (b) @ (@) (b) Discuss the following cellular adaptation in relation to its physiological and/or pathological indication. (Hypertrophy (3 marks) (i) Hyperplasia (3 marks) (ii) Metaplasia (3 marks) Metaplasia and dysplasia are often observed in histopathological slide of tumour. Correlate these changes to benign and malignant tumour using multistep oncogenesis model. (5 marks) Pak Lah, a 52-year-old teacher, a diabetic patient suffered from a fall and sustained an open wound injury and hip bone fracture. The doctor indicated that his diabetic condition could affect the healing process for both open wound and hip bone fracture, Comment and elaborate on the intrinsic factors that could impair healing in Pak Lah’s diabetic condition. (6 marks) Briefly describe TNF signaling pathway in apoptotic cell death and the characteristics of apoptotic cells. (2, 3 marks) {Total : 25 marks} Describe the pathogenesis of Mycobacterium tuberculosis infection in latent and active TB infections in correlation to the diagnostic observations, (6 marks) Alex, a 20-year-old college student attended a Christian mission trip in South Sudan, was admitted to a local hospital. He was presented with tachypnea, tachycardia and high fever. His condition was suspected due to consumption of unhygienic food. Laboratory analysis also showed elevated white blood count, (i) Identify and explain the most probable diagnosis for Alex. (1, 2 marks) (ii) Describe the systemic effects of the condition stated in (i). (3 marks) This question paper consists of 5 questions on 5 printed pagesUDDD3144 PATHOLOGY 2. (Continued) ©) @ (a) (b) Kak Wook, a 50-year-old food handler, complained of leg swelling for the past few weeks during her visit to a health clinic. The doctor performed a physical examination and diagnosed her with generalised oedema, (Define cutaneous oedema and state its physical appearance. (2 marks) (ii) List and elaborate TWO (2) possible causes for generalised oedema. (2, 4 marks) Tissue invasion and metastasis are the hallmarks of malignant tumour. Briefly describe the invasion and metastatic processes. (5 marks) {Total : 25 marks] A 65-year-old female who just had an acute myocardial infarction, enquires you the ways to prevent the recurrence of acute myocardial infarction. Her laboratory test also shows that her homocysteine level is too high, () Explain the pathophysiology of an acute myocardial infarction to this patient. (5 marks) (i) Explain how angina pectoris differs from myocardial infarction in term of pathophysiology. (4 marks) (iii) Discuss how lifestyle changes can reduce the risk of acute myocardial infarction, G marks) (iv) High blood level of homocysteine (an amino acid) and Chlamydia ‘pneumoniae infection have been associated with coronary heart disease. Discuss. (4 marks) Compare and contrast THREE (3) types of obstructive lung diseases in terms of anatomic site, major pathologie changes, aetiology and sign and symptoms, (9 marks) [Total : 25 marks} This question paper consists of 5 questions on 5 printed pages.UDDD3144 PATHOLOGY Section B [Total : 25 marks} ‘Answer ONE of the following questions. Q4, fa) () (©) @) (@) (b) Serina, a 27-year-old gymnastics instructor presents with complaints of muscle weakness in her face that comes and goes, but has been getting worse over the past two months. Most notably, she complains that her “jaw gets tired” as she has difficulty in chewing and swallowing. She also notes diplopia which seems fo come on late in the evening, particularly after reading for a few minutes. At work, it has become increasingly difficult to do acrobatic moves because of upper arm weakness. Serina is treated with an anticholinesterase drug. (i) State and define the most probable diagnosis, (1, 2 marks) Gi) Explain why this young woman is experiencing difficulty in chewing and having double vision. (3 marks) (ii) Discuss how the anticholinesterase drug acts to improve Serina’s condition. (4 marks) Discuss how Helicobacter pylori causes peptic ulcer. (6 marks) Discuss the clinical and laboratory findings of a patient with a nodule in the prostate based on physical examination. (5 marks) Describe TWO (2) types of aneurysms. (4 marks) [Total : 25 marks} High blood pressure is a leading cause of kidney failure. Explain. (8 marks) Casey is a 75-year-old married female who presents to the outpatient clinic complains of ‘severe cough and left-sided chest pain that has become progressively worse over the past several days. She appears anxious and her face is flushed. The physician suspects pneumonia. (@ Define pneumonia (2 marks) Gi) Tdentify the type of pneumonia and justify your answer with possible predisposing factors that could lead to this disorder. (1, 3 marks) (iii) Identify the location in the lung that might be affected, (1 mark) This question paper consists of 5 questions on 5 printed pages.UDDD3144 PATHOLOGY QS. (b) (Continued) (iv) State TWO (2) possible aetiolo; complications for this disorder. al agents and identify the major (2, 2 marks) Diagnosing rheumatoid arthritis (RA) is difficult and there is no single test that can clearly identify RA. Thus, doctors diagnose RA based on factors that are strongly associated with the disease. State these factors, (6 marks) [Total : 25 marks} ) jon paper consists of 5 questions on 5 pr