UNIVERSITI TUNKU ABDUL RAHMAN ACADEMIC YEAR 2013/2014 SEPTEMBER EXAMINATION UDDD3144 PATHOLOGY. TUESDAY, 17 SEPTEMBER 2013 TIME : 2.00 PM — 4.00 PM (2 HOURS) BACHELOR OF SCIENCE (HONS) BIOMEDICAL SCIENCE Instruction to Candidates : Answer ALL questions. All questions carry equal marks. is question paper consists of 4 questions on 5 printed pages.UDDD3144 PATHOLOGY Qu. @ () © @ © Elaborate the following terms with an example, (@) Pathological hyperplasia (2 marks) (i) Physiological hyperplasia (2 marks) Discuss the following cellular changes, hypertrophy and dysplasia, in relation with neoplastic diseases. (4 marks) Mr. Soo, a 50-year old man suffered from chronic liver disease and his condition started to deteriorate since six months ago. He underwent liver transplantation with his son’s liver. After three months, both of them went for medical check-up to monitor their health condition, Mr. Soo was found to recover from liver failure and his son’s liver grew back to its normal size before the transplantation surgery. ()__. Identify the cell type for liver tissue and explain why it is suitable for liver transplantation, (2 marks) (i) Elaborate the physiological pathways and signals involved in triggering and sustaining liver regeneration. (S marks) Discuss the following vascular events during acute inflammation. (@ Transient vasoconstriction of arterioles (2 marks) (i) Precapillary arterioles vasodilation 2 marks) ii) Increased in endothelial cell barrier permeability. (2 marks) During inflammation, adhesion molecule aids in recruitment of leukocytes to the injury site (@) List three adhesion molecules and describe their roles in recruitment of leukocytes to the site of injury G marks) Gi) Name a chemotactic molecule that directs neutrophils to site of injury, (mark) 5 marks] [Total : This question paper consists of 4 questions on 5 printed pages.UDDD3144 PATHOLOGY Q 2, @ (b) (©) @ Histological diagnosis remains a “gold standard” to identify malignant tumours. Justify how the following histological appearance helps in determining the malignancy of tumours. @ — Anaplasia (2 marks) (i) Growth pattem (2 marks) (ii) Invasion (2 marks) (iv) Metastasis (2 marks) (v) Mitotic activity (2 marks) Ms. Jennifer was experiencing menorrhagia (prolonged menstrual period at regular intervals). She consulted her family physician regarding her condition (@) List and explain two possible causes of menorthagia, Exclude cancer in your answer. (4 marks) Gi) Suggest an invasive and a non-invasive diagnostic method for Ms Jemnifer to rule out endometrial cancer and polyps. Describe the pros and cons for the mentioned methods. (2,4 marks) Gii) Human papilloma virus (HPV) infection is one of the risk factor for cervical cancer. Elaborate the molecular mechanism of HPV in promoting cancer formation. 3 marks) List two immunological responses by the body to fight against tumour cells. (2 marks) [Total : 25 marks} Mr. Fordon was experiencing pain sensation when passing urine for the past few weeks and the pain worsened. His physician suspected that he might be suffering from renal stones. (@) List two types of kidney stones that can be found in kidney. (2 marks) Gi) Define the terms nephrolithiasis and urolithiasis (2 marks) Git) Determine which of the conditions in (ii) is most probably suffered by Mr. Fordon. Explain. (i, 1 mark) This question paper consists of 4 questions on 5 printed pagesUDDD3144 PATHOLOGY Q3. (a) (Continued) aw. ) © @ (b) (iv) Suggest two diagnostic methods that could be used to determine Mr. Fordon condition, Justify your suggestions. (2, 2 marks) Adam is enrolling for university study this November. He was requested by the admission department of the university to perform a body check-up to prove that his is physically fit to pursue his study. Physical examination and blood test results showed that he is healthy. However, the chest X-ray results indicated consolidation region at the upper right and left lobes of his lung. () The physician suspects that Adam is suffering from tuberculosis. Suggest two tests for the confirmation of this infection. (2 marks) (ii) Identify the stage of infection for Adam if he is tested positive for tuberculosis. Explain. (A, 2 marks) (iii) Elaborate the pathogenesis of tuberculosis infection that could lead to above X-ray result while Adam appears healthy, (4 marks) (iv) List a clinical condition that could also give similar X-ray result. Justify your answer. (A, 1 mark) Outline the pathogenesis of allergic asthma. (4 marks) {Total : 25 marks] Christopher was diagnosed with hypercholesterolemia and was prescribed with statin to lower his cholesterol level. However, he experiences nausea, irregular heartbeats and dark colour urine. His physician immediately stops his medication and rhabdomyolysis is suspected () Define rhabdomyolysis. (1 mark) Gi) State two other possible causes for rhabdomyolysis beside adverse drug reaction caused by statin. (2 marks) Gi) Discuss the complications arises from of rhabdomyolysis if it continues. G3 marks) Duchenne and Becker muscular dystrophies are inherited diseases characterised by progressive muscle degeneration, () Compare and contrast between Duchenne and Becker muscular dystrophies. GB marks) This question paper consists of 4 questions on 5 printed pages.UDDD3144 PATHOLOGY Q4.(b(Continued’ © Gi) Gi) Name one serum component that would increase for both conditions mentioned above and explain your answer. (2 marks) Electromyography is used for the diagnosis of muscle disorder. Discuss the relevance of this test in detecting muscular dystrophy. (3 marks) Mary, a 70-year-old lady was admitted to hospital due to hip fracture from a fall. he has both type 1 and type 2 primary osteoporosis, hence she has higher risk of sustaining fracture from fall. @ Gi) Discuss the pathogenesis of type | and type 2 primary osteoporosis that ‘occur in Mary. (4 marks) ‘The surgeon explains that Mary might need longer duration to fully heal from her hip fracture. Elaborate the stages for fracture healing and identify an intrinsic factor that would delay Mary’s fracture healing (6, 1 mark) [Total : 25 marks} This question paper consists of 4 questions on 5 printed pages.