Traditional essay:
- SLE – pathogenesis, spectrum of autoantibodies, clinical features, renal findings. (4+4+4+3=15marks).
Modified essay:
- A 25 year old female presented to OP with butterfly shaped rash on the malar area, multiple joint pains and oral ulcers. She also gave a past history of one episode of seizures 2 years back.O/E- Pallor+; CVS-? Pleural rub+; Investigations-Urine-Proteins+++; Hb-7g/dL
a. What is your diagnosis? (2 marks)
b. What is the etiopathogenesis of this condition? (5 marks)
c. What are the useful investigations here? (4 marks)
d. What are the expected findings in renal biopsy in this patient? (3 marks) (2+5+4+3=15 marks)
2. A 40 year old lady, sneezes continuously every day after cleaning and dusting her house. She also complains of occasional wheezing.
a. What is the type of hypersensitivity occurring in this case?
b. Explain the mechanism of this type of hypersensitivity with a note on the mediators involved. (1+7=8 marks)
3. A 30year old male, a recipient of a donor matched renal transplant, was on an immunosuppressant medication Cyclosporine. He stopped his medication by himself after a month of the transplant. 2 weeks after stopping the medication, he developed fever, anuria, periorbital oedema and pain over the transplanted kidney.
a. What is the type of rejection occurring here?
b. Explain the mechanism?
c. Write briefly about the morphology of the kidney here?
(2+3+2=7 marks)
4. A 50 year old male who is suffering from Myasthenia Gravis, finds it difficult to maintain physical activity for more than 30mins at a stretch.
a. What is the type of hypersensitivity reaction here? (1 mark)
b. Explain the mechanism. (4 marks)
c. Give other examples. (3 marks)
5. A 12 year old girl with sickle cell anaemia needs bone marrow stem cell transplantation. A buccal swab was taken from a distant relative of hers and was a 10 by 10 HLA match.
a. What is MHC and HLA? (4 marks)
b. What is GVHD? (4 marks)
Short essay: 8 marks
1. Hypersensitivity reactions.
2. SLE – pathogenesis, clinical findings, renal findings.
3. Amyloidosis – physical and chemical properties, classification, morphology.
4. Transplant rejection.
Short answer: 4 marks
1. Lupus nephritis.
2. Type 1 hypersensitivity reaction.
3. Dealyed hypersensitivity reaction.
4. Morphology and special stains in amyloidosis.
5. Central tolerance.
6. MHC.
7. ANAs in SLE.
Name the following: 1 mark
1. Sago spleen is seen in which condition.
2. Single, firm, non-tender, raised, red lesion seen in primary syphilis is called _____________
3. Major Histo-compatibility complex in humans is called __________________
4. Type of hypersensitivity seen in Myasthenia Gravis is ____________
5. Malar rash is seen in ___________
6. Two examples for type II hypersensitivity reaction.
7. Name two ANAs seen in SLE.