Pathology ospe final edition

Abbas Naseem (BDS)
abbas_naseem@yahoo.com
Dated: Nov 5, 2010

By: Abbas Naseem (BDS)
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

 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 TO
DETECT THE PRESENCE OF CATALASE ENZYME IN THE
PROVIDED ORGANISM.
 Requirements:
 3. Stool 4. Test organism Staphylococci

 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 TO
DETECT THE PRESENCE OF CATALASE ENZYME IN THE
PROVIDED ORGANISM.
 Requirements:
 1. Table 2. Chair for observer 3. Stool
 4. Test organism Staphylococci
 5. Negative control organism Streptococci

 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 IN
A TEST TUBE. PERFORM THE MICROSCOPIC EXAMINATION OF GIVEN
SEDIMENTS.

 Requirements:
 3. Stool 4. Binocular Microscope
 5. Test tube with urine sediments.

 6. Glass slide 7. Plastic dropper
 8. Glass cover slip 9. Discarder jar

6

PREPARE THE SMEAR FOR STAINING FROM
THE SPUTUM SPECIMEN PROVIDED TO YOU.

 Requirements:

 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

 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 FOR
DETECTION OF PROTEINS BY HEAT METHOD.

 Requirements:
 Response sheet. Pen / ball point
 Table Chair / Stool Glass test tube

 Test tube holder Spirit lamp / burner
 2 % acetic acid Plastic dropper

9

10

11

A 8-YEAR-OLD BOY DEVELOPED SORE THROAT AND FEVER. ON
EXAMINATION, GRAYISH EXUDATES (PSEUDOMEMBRANE) IS
FOUND OVER TONSILS AND PHARYNX. THE CAUSATIVE AGENT
IS GROWN ON A MEDIUM WHICH PRODUCES BLACKISH
COLONIES AS SHOW IN THE PHOTOGRAPH.
A. IDENTIFY THE CULTURE MEDIUM AND THE MOST LIKELY THE
CAUSATIVE ORGANISM.
B. WHY THE CAUSATIVE AGENT APPEARS BEADED ON

ALBERT‟S STAINING?
C. ENLIST TWO COMPLICATION OF DISEASE CAUSED BY THIS
ORGANISM.
D. WHAT IS THE PRIMARY MECHANISM IN PATHOGENESIS OF
TOXIN MEDIATED COMPLICATIONS.

12

A. NAME THE TEST, WHICH IS SHOWN IN THE
PHOTOGRAPH.
B. WHY THIS TEST IS PERFORMED?
C. STRIP MARKED AS “A” CONTAINS WHAT
SUBSTANCE?
D. IDENTIFY THE „TEST‟, „POSITIVE‟ AND
„NEGATIVE‟ CONTROL AND WRITE THE

APPROPRIATE ALPHABET IN THE ANSWER FOR
EACH.

13

VIBRIO CHOLERAE PRODUCES YELLOWISH
COLONIES ON AGAR AS SHOWN IN THE
PHOTOGRAPH.
A. NAME THE AGAR ON WHICH V. CHOLERAE ARE
GROWN IN THE PHOTOGRAPH.
B. THIS AGAR BELONGS TO WHICH CLASS/TYPE

OF CULTURE MEDIUM?
C. COMMENT ON THE MOTILITY OF V. CHOLERAE.
D. HOW WOULD YOU DIFFERENTIATE V.
CHOLERAE FROM MEMBERS OF
ENTEROBACTERIACEAE?

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 AND
MARKED WEIGHT LOSS. EXAMINATION OF THE CHEST REVEALS POSTTUSSIVE
APICAL RALES. X – RAY CHEST SHOWS A FIBRONODULAR AREA IN RIGHT
APICAL SEGMENT AND ESR IS 97 MM AT THE END OF 1ST HOUR. THE
SPUTUM OF THE PATIENT IS TO BE CULTURED ON THE MEDIUM PROVIDED.
NAME THE GIVEN MEDIA.

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 ON
THIS 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 BLOOD
AGAR, INCUBATED FOR 24 HOURS AND SMEAR IS PREPARED FROM THE
COLONY OF THE BACTERIA AND STAINED WITH GRAM STAIN.
EXAMINE THE SLIDE UNDER THE MICROSCOPE AND CLASSIFY THE ORGANISM
ON 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

 Chair / Stool Cedar wood oil
 Binocular Light Microscope
 Gram stained slide (Gram positive cocci)

16

SPUTUM IS RECEIVED FROM A SUSPECTED CASE OF PULMONARY
TUBERCULOSIS AND STAINED SMEAR IS PROVIDED.
EXAMINE THE SLIDE AND WRITE YOUR OBSERVATION.
WHICH STAINING METHOD HAS BEEN OPTED FOR STAINING OF THIS
ORGANISM?
ENUMERATE THE REAGENTS USED IN THIS STAINING METHOD.
NAME THE MORDANT USED IN THIS STAINING METHOD.
NAME THE ORGANISM, WHICH REQUIRE MODIFIED ZN STAINING.

 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 PRESENTED
WITH SIMILAR COMPLAINS OF SUDDEN ONSET OF VOMITING AND PROFUSE
DIARRHEA WITH ABDOMINAL CRAMPS. ON EXAMINATION, STOOL IS LIKE RICE
WATER IN APPEARANCE AND CONTAINS MUCOUS. STOOL SAMPLES ARE
COLLECTED IN A TRANSPORT MEDIUM PROVIDED TO YOU AND TO BE SENT TO
REFERRAL LABORATORY FOR ISOLATION OF THE CAUSATIVE ORGANISM.
IDENTIFY THE TRANSPORT MEDIUM PROVIDED.
WRITE THE NAME OF ENRICHMENT MEDIUM FOR STOOL SAMPLES.

WRITE TWO CHARACTERISTIC FEATURES OF TRANSPORT MEDIA.

 Requirements:
 Response sheet. Pen / ball point Table
 Chair / Stool Alkaline peptone water

18

19

A. IDENTIFY THE PARASITE AND WRITE IT‟S NAME.
B. NAME THE STAGE OF PARASITE INGESTED BY A SUITABLE
FRESHWATER CRUSTACEAN (THE COPEPOD).
C. NAME THE INFECTIVE STAGE OF PARASITE TO HUMANS.
D. WHAT IS THE MAJOR COMPLICATION OF THIS PARASITE?

20

CAREFULLY SEE THE LIFE CYCLE GIVEN IN THE PHOTOGRAPH AND ANSWER
THE 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?

21

CAREFULLY SEE THE LIFE CYCLE GIVEN IN
THE PHOTOGRAPH AND ANSWER THE
FOLLOWING.
A. NAME THE PARASITE.
B. HOW HUMANS BECOME INFECTED
WITH THIS PARASITE?

C. WHERE ADULT WORM LIVES IN
HUMANS?
D. IN WHICH PARTS OF PAKISTAN, THIS
PARASITIC INFECTION IS COMMON?

22

CAREFULLY SEE THE LIFE CYCLES
GIVEN IN THE PHOTOGRAPH AND
ANSWER THE FOLLOWING.
A. NAME THE PARASITES.
B. FOR WHICH PARASITE, PIG IS

AN INTERMEDIATE HOST?
C. NAME THE INFECTIVE STAGE
FOR HUMANS.
D. WHAT IS THE LENGTH OF
PARASITE WHOSE INTERMEDIATE
HOST IS CATTLE?

23

IDENTIFY THE PARASITE AND
WRITES ITS NAME.

NAME THE INFECTIVE STAGE
OF THE PARASITE.

WHAT WILL BE TWO

IMPORTANT FINDINGS IN
BLOOD COMPLETE PICTURE?

24

IDENTIFY THE LIFE CYCLE AND
WRITE THE NAME OF PARASITE.

HOW THE HUMANS ARE
INFECTED WITH THIS PARASITE?

HOW THIS PARASITIC
INFESTATION CAN BE
DIAGNOSED IN HUMANS?
WHO IS THE PRIMARY HOST OF
THIS PARASITE?

25

IDENTIFY THE ABOVE OVUM AND
NAME THE PARASITE.

WHERE THE GRAVID FEMALE LAYS
EGGS?

WHAT IS THE INFECTIVE STAGE OF

PARASITE?

NAME THE METHOD USED TO
COLLECT THE SPECIMEN FOR
MICROSCOPIC DETECTION
OF OVA.

26

IDENTIFY THE ABOVE OVUM AND
NAME THE PARASITE.

WHERE THE ADULT WORM IS
FOUND IN HUMANS?

WHAT IS THE INFECTIVE STAGE OF
PARASITE?

WHAT IS THE OTHER NAME GIVEN
TO THIS PARASITE?

27

IDENTIFY THE ABOVE CYST AND
NAME THE PARASITE.

WHERE THE CYSTS ARE
FORMED?

WHAT IS THE INFECTIVE STAGE

OF PARASITE?

WHAT IS THE DIAGNOSTIC
FINDING IN ACUTE INFECTION
WITH THIS PARASITE?

28

EXAMINE THE EGG OF AN INTESTINAL NEMATODE FOCUSED IN THE SLIDE
ON 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.

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.

 How this cyst is different from cyst of E. coli?

30

31
General Pathology

A 30-YEAR-OLD MAN SUSTAINS LEFT FEMORAL FRACTURE IN A SKIING
ACCIDENT, AND HIS LEG IS PLACED IN A PLASTER CAST. AFTER THE
LEG HAS BEEN IMMOBILIZED FOR SEVERAL WEEKS, THE DIAMETER OF
THE LEFT CALF HAS DECREASED.
A. THIS CHANGE IS MOST LIKELY TO RESULT FROM WHICH OF THE
ALTERATION IN THE CALF MUSCLES?

B. ENUMERATE THREE PATHOLOGICAL CAUSES, WHICH CAN RESULT
IN THIS TYPE OF CELLULAR ADAPTATION.

32

EXAMINE THE MICROSCOPIC
PHOTOGRAPH OF THE LESION
INVOLVING THE LIVER AND
A. IDENTIFY THE LESION?

B. NAME TWO CAUSES OF
LESION?
C. IS IT REVERSIBLE LESION?
D. CAN IT BE MALIGNANT?

33

34

35

36

37

38

A 32-YEAR-OLD MAN EXPERIENCES "HEARTBURN" AND GASTRIC REFLUX
AFTER EATING A LARGE MEAL. AFTER MANY MONTHS OF SYMPTOMS, HE
UNDERGOES UPPER GASTROINTESTINAL ENDOSCOPY AND A BIOPSY
SPECIMEN OF THE ESOPHAGEAL EPITHELIUM SHOWS INTESTINAL TYPE
COLUMNAR 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.

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 THE
PATIENT'S HYPERTENSION REMAINS UNTREATED FOR YEARS,
A. WHICH CELLULAR ALTERATION/ADAPTATION WILL MOST LIKELY BE
SEEN IN THE MYOCARDIUM?
B. IS IT A PHYSIOLOGICAL OR PATHOLOGICAL ADAPTATION?
C. ENUMERATE ANY TWO PHYSIOLOGICAL EXAMPLES OF THIS TYPE

OF CELLULAR ADAPTATION INDUCED BY HORMONES.

40

AFTER THE BIRTH OF HER FIRST CHILD, A 19-YEAR-OLD WOMAN BREAST-FED THE
INFANT FOR ABOUT 1 YEAR.
A. WHICH PROCESSES THAT HAS OCCURRED IN THE BREAST DURING PREGNANCY
ALLOWED 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.

D. WRITE ANY TWO FACTORS, WHICH HELP IN THIS CELLULAR ADAPTATION.

41

AN OLD WOMAN REPORTED TO A GYNECOLOGIST WITH COMPLAINTS
OF IRREGULAR BLEEDING AND LOW BACKACHE. SHE WAS DIAGNOSED
AS A CASE OF FIBROID UTERUS. A LARGE TUMOR WAS SURGICALLY
REMOVED FROM THE UTERUS. ON SECTIONING, THE TUMOR
REVEALED WHITE CHALKY AREAS, WHICH FELT GRITTY AND HARD TO
CUT. HISTOPATHOLOGICAL SLIDES ARE PREPARED AND A SLIDE IS
PROVIDED TO YOU. EXAMINE THE SLIDE AND ANSWER THE
FOLLOWING.

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 WOUND
ON THE CALF MUSCLE IS DEEP WITH LACERATED EDGES.
A. WHAT IS YOUR OPINION, THIS WOUND MUST HEAL BY FIRST INTENTION OR BY
SECOND INTENTION?
B. ENUMERATE FOUR LOCAL FACTORS WHICH DELAY WOUND HEALING.
C. ENUMERATE TWO COMPLICATIONS OF CUTANEOUS WOUND HEALING.

D. HOW LONG DOES IT TAKE FOR A SKIN WOUND TO ACHIEVE ITS MAXIMAL
STRENGTH?

43

A 10-YEAR-OLD BOY ADMITTED IN EMERGENCY WITH FEVER, NAUSEA,
LOSS OF APPETITE AND PAIN IN RIGHT ILIAC FOSSA. ON
EXAMINATION, REBOUND TENDERNESS WAS POSITIVE. ON
LABORATORY INVESTIGATIONS WBC 12.0 X 103 / UL, HB 12.8 G/DL,
PLATELET 250X103 /UL. PATIENT WAS OPERATED AND SPECIMEN
SENT TO LABORATORY. HISTOPATH SLIDES ARE PREPARED AND ONE
SLIDE IS PROVIDED TO YOU FOR MICROSCOPIC EXAMINATION.

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 AFTER
ARRIVING AT WORK IN THE MORNING. OVER THE NEXT 4 HOURS, THE PAIN
PERSISTED AND INCREASED IN INTENSITY. HE BECOMES DIAPHORETIC AND
SHORT OF BREATH. HE WAS EVACUATED TO HOSPITAL BUT DIED IN THE WAY.
AUTOPSY WAS PERFORMED AND HISTOPATHOLOGICAL SLIDES
ARE PREPARED FROM DIFFERENT SECTIONS OF THE HEART. EXAMINE THE GIVEN
SLIDE AND ANSWER THE FOLLOWING.

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 THIS
CONDITION.

45

A 46-YEAR-OLD WOMAN GOES TO THE CLINICIAN FOR A ROUTINE HEALTH
MAINTENANCE EXAMINATION. ON PHYSICAL EXAMINATION THERE ARE
ENLARGED CERVICAL LYMPH NODES. TUBERCULIN SKIN TEST IS POSITIVE,
LYMPH NODES REMOVED SENT TO LABORATORY FOR HISTOPATHOLOGY. THE
SLIDE IS PROVIDED TO YOU. EXAMINE CAREFULLY AND ANSWER THE
FOLLOWING.
NAME THE INFLAMMATORY CELL, WHICH HAS MOST IMPORTANT ROLE IN THIS

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, PRESENTS
TO THE EMERGENCY WITH SPONTANEOUS ABORTION. HER ROUTINE
CLINICAL AND LABORATORY TESTS ARE WITHIN NORMAL LIMITS
EXCEPT HB (9.8 GM/DL). PAST HISTORY REVEALED SPONTANEOUS
ABORTIONS TWICE BEFORE THIS. ULTRASOUND REVEALED MULTIPLE
SHARPLY CIRCUMSCRIBED NODULES IN THE MYOMETRIUM RANGING
FROM1.5 TO 5 CM IN DIAMETER. THE TUMORS WERE SUCCESSFULLY

REMOVED AND SENT FOR HISTOPATHOLOGY. EXAMINE THE SLIDES
PROVIDED WHICH WERE PREPARED FROM THE TUMOR AND ANSWER
THE FOLLOWING.
WRITE TWO DIAGNOSTIC POINTS.
WHAT ARE TWO MAJOR COMPLICATION OF THIS TUMOR?

47

AN OBESE LADY OF 40 YEARS OF AGE IS SUFFERING FROM
RECURRENT DULL, BORING, SOMETIMES COLICKY PAIN IN RIGHT
HYPOCHONDRIUM. THE PAIN INCREASES AFTER TAKING FOOD
ESPECIALLY FATTY FOODS. SHE WAS OPERATED AND
HISTOPATHOLOGY SLIDES ARE PREPARED FROM THE RESECTED
LESION.EXAMINE THE PROVIDED SLIDE AND ANSWER THE

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 SWELLING
IN THE NECK. SHE GIVES A HISTORY OF CHRONIC COUGH WITH LOW-GRADE
FEVER. THE FEVER HAS A CLASSICAL PATTERN OF EVENING RISE. THE GIRL
SUFFERS FROM MALAISE WITH PROGRESSIVE LOSS OF WEIGHT FOR THE LAST 6
MONTHS. POSITIVE LAB INVESTIGATIONS REVEAL A RAISED ESR AND A
SOLITARY CALCIFIED FOCUS IN HER LUNG NEAR THE HILUS IN THE X-RAY.
HISTOPATHOLOGY SLIDE OF THE LESION IS PROVIDED. EXAMINE THE SLIDE AND

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 RESPIRATORY
FAILURE. AT AUTOPSY LUNGS APPEAR BLACK.HISTOPATHOLOGY SLIDES ARE
PREPARED. EXAMINE THE SLIDE AND ANSWER THE FOLLOWING.
WRITE TWO MICROSCOPIC IDENTIFICATION POINTS.
ENUMERATE TWO OTHER SUBSTANCES, WHICH CAN CAUSE THIS LESION.

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?

 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.

 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

 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

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

55

 1) Identify the instrument.
(01)
 2) What is placed under the
lid? (01)
 3) Name the indicator used.
(01)
 4) Name TWO organisms

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

 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

 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 MY
PRESENTATION?
For Comments &
Suggestions:
abbas_naseem@yahoo,com
Abbas Naseem
Dated: Nov 5, 2010

Pathology ospe final edition

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Pathology ospe final edition