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.
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