Pathology Practical Examination

After revision on 4th (coming back from a quick visit to home) and 2 days of not studying anything related to pathology, today on 7th I took the Pathology practical exam.

As usual, it started with the spotters. I remember fatty liver, and peptic ulcer; WBC Pipette, bone marrow aspiration needle, Wilm's tumor, CLL. And the rest of the histopathology slides were too confusing - what I thought emphysema was probably CVC lung, and I don't even remember if I wrote the others right.

Then, I got to sit down at my chair where a chart, a peripheral smear, a discussion slide and a urine sample was waiting.

Peripheral smear was probably dimorphic anemia. I got really confused till I adjusted the condenser for the high power. (Always remember. High power, high condenser). Nevertheless I was asked the causes of eosinophilia, microcytic anemia, macrocytic anemia.

Urine - my question was a sore-throat kid with burning micturition. Proteins present, Blood absent. Had to explain how phosphate coagulum gets dissolved in acetic acid, while protein doesn't. Messed up by pouring nitric acid over urine in Heller's test, instead of adding urine to nitric acid.

(I remember the other side were being asked reducing sugar (diabetic neuritis), and ketone bodies)

The discussion slide I got was that of a 56 year old man with burning micturition. BPH was an easy find, but I didn't know about the serum markers of Prostatic cancer (which I answered in the evening - Prostate Specific Antigen, and Prostatic Acid Phosphate) or about the grading PIN-1,PIN-2.

The chart was of CSF examination with cobweb formation, increased protein, presence of lymphocytes. Straightaway TB meningitis. Had to say other inflammatory conditions in the brain.

With blood grouping, I got my answer paper soiled. The slide was kept right next to my microscope, right above the answer paper. And after I finished answering some other examiner, the slide was nowhere to be seen. :P The front page, where "RGUHS" was printed was very nicely coloured red and blue, red and yellow and red and colourless :D I almost did the same with the second slide I received too. Put the Rh on the backside of my answer paper. But luckily, by then I had found out that the group was B-ve. Had to tell the examiner about the minor blood grouping systems too.

With the morning session done, I was too stressed out having a headache, just wanted to sleep. Came back to hostel. Had lunch, and went back to college so that I don't sleep in my room.

At 2 o'clock the viva-voce started and it was very quick for everyone.

First room: Specimens on the table - Fatty liver, squamous cell carcinoma, lobar pneumonia, TB lymph node. But the questions were causes of fatty liver, define shock, types of shock, define necrosis, types of necrosis.

Second room: Specimens - Osteoclastoma, Polyp intestine, hydronephrosis etc. Questions were PIN (which I forgot earlier), describing osteoclastoma, describing polyp, classifying polyps, cause of hydronephrosis, describing the specimen.

Third room: Specimens - TB Lung, seminoma, Breast cancer, and so on. Questions - describe TB, describe seminoma, describe breast cancer. The important thing was to describe only what was visible. :D

Fourth room: Instruments. Wintrobe's, Westergren's. Had to tell the anticoagulant used. Pasteur's pipette (I never knew it was called that. My "dropper/pipette" answer didn't work)

And in about 10 minutes I was finished.

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I am a general practitioner rooted in the principles of primary healthcare. I am also a deep generalist and hold many other interests. If you want a medical consultation, please book an appointment When I'm not seeing patients, I code software, advise health-tech startups, and write blogs. Follow me by subscribing to my writings