OPERATIONAL MANUAL OF

MBBS CURRICULUM 2012

SUBJECT : PATHOLOGY

Developed By-

Bangladesh Academy of Pathology

In collaboration with
Centre for Medical Education (CME)
Directorate General of Health Services (DGHS)
Mohakhali, Dhaka-1212
April -2017
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 Acknowledgement
Curriculum is a dynamic thing it is not static. To implement that curriculum all concerned
such as teachers, students, policymakers to be more dynamic, should run smoothly with the
time with appropriate pace. This operational manual to implement the curriculum will act as a
catalyst will give momentum in implementing the curriculum. This operational manual will
help to implement the curriculum uniformly, effectively, efficiently & smoothly at all the
govt. & non govt. medical colleges under all the universities all over the country.

The enormous task for developing this operational manual on Pathology of MBBS
curriculum 2012 was firstly done by Bangladesh Academy of Pathology in consultation with
Faculty of Medicine, Dhaka University. The Bangladesh Academy of Pathology then shaired
the draft with CME. In collabotion with Bangladesh Academy of Pathology Centre for
Medical Education (CME) organized a meeting with the heads of the department of
pathology of different medical colleges of Dhaka and around due to fund constraint. Core
group comprising members from CME and Bangladesh Academy of Pathology faniallised
this manual. I express my gratitude to the Dean, Faculty of Medicine, Dhaka University and
all other persons for their all cordial co-operation, guidance all the ways since beginning up
to the completion. I would like to acknowledge Professor Dr. Md. Humayun Kabir Talukder,
Professor (Curriculum Development & Evaluation), Centre for Medical Education (CME) &
Dr. Tahmina Nargis, Assistant Professor (Medical Education), CME for there efforts in co-
coordinating this activity without which it would be difficult to complete this work. I am
grateful to all, who actively participated in this great job, specially the faculty members and
staffs of Centre for Medical Education who worked very hard and efficiently to develop this
operational manual of MBBS Curriculum for Pathology.

Professor Dr. Shaila Hossain

Director
Centre for Medical Education(CME)
Mohakhali, Dhaka – 1212
Bangladesh

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 List of Contents
Contents Page No

Acknowledgement 1

1. Common Information and Activities of Phase III 3

1.1. Basic information 3
1.2. Distribution of teaching-learning hours/days in 3rd Phase 3

1.3. Duration of Each Term 5

1.4. Overview of examination system 6
1.5. Leave 6
1.6 Calculation of certain percentage of marks from different components of 6
formative assessment to add in summative assessment
1.7. Summative Examination 7
1.8. Pre-requisite for appearing in term examination 8
1.9. Pre-requisite for appearing in Third Professional MBBS Examination 8
1.10. Examinations & distribution of marks of Third Professional Examination: 8
2:1. Departmental Objectives 9
2:2 List of Competencies to acquire 10
2.3 Teaching hours in pathology 10
2:4. Distribution of content of Pathology 11
2.5 Class Performance Record Card (Pathology-I): 17
2:6 Summative Assessment 17
A. Written 17

B. Viva (Structured Oral Examination) 22

C. Practical examination: (Total marks- 100: pass marks-60%) 27

Suggestions 33

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 Common Information & Activities of Phase III
1.1. Basic information
i) Total duration of Phase III is 12 months including Third Professional MBBS
Examination. The course is expected to start on first day of July of each
calendar year.
ii) Third Professional MBBS examination to be started on first working days of May
and November of each year.
iii) Time for integrated teaching, exam, and preparatory leave of formative &
summative assessment is common for all subjects of the phase.
iv) Assessment:
 There will be in-course item examinations, term examinations and 3rd
Professional MBBS examination for the students.
 Certain percent of marks from formative assessment (Term ending
examination and class attendance and on timely completion of item
examinations) will be added in the 3rd Professional MBBS examination in
the subject of Pathology.

1.2. Distribution of teaching-learning hours/days in 3rd Phase

i. Distribution of hours

Subject Lecture Tuto- Practic Total Formative Exam Summative exam

(hrs) rial al (hrs) Hrs Term I & Term II (3rd Professional
(hrs) MBBS exam)
Preparator Exam Preparatory Exam
y leave time leave Time

Pathology 100 110 18 228

5+5 10 +10 10 days 15
Microbiology 100 45 45 190 =10 days =20 days
days
Pharmacology 100 30 50 +20
(cl. 200
Phar)
Total 300 175 143 618

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ii. Schedule of Term ending Examination

Term I First Term exam Term II Second Term exam

Preparat Written Viva Preparat Writte Viva
ory ory n
leave Leave

Duration: 1st 6th 11th Duration : 16th 21st 25th March

March
November November November 16th March to
st
1 July to to 5 th
to 10 th
to 15th November to 20th to 24
th
30th March
15th November November November to 30th March = March
November = 5days March 5 days
= 18weeks = 18
weeks

1st and 2nd Term examination: Marks distribution-total marks-200 in each term
examination

a) Written-100 marks (SAQ-80 marks+MCQ-20 marks)

b) Oral examination-One board-(One chairperson of the board + two members )-50

marks
c) Practical examination-50 marks (OSPE-25 marks+Traditional Practical 20
marks+Practical Khata and case history-5 marks(3 for practical khata+2 marks for 4 case
histories)

 OSPE-Objective Structured Practical Examination-25 marks

 5 OSPE Station-5 marks each
 2 procedure stations and three question stations
 Procedure stations-preparation of 10% formalin for histopathology fixative, 95%
ethyl alcohol as cytopathology fixative, Focusing of histopathology slides with
probable diagnosis, Drawing of ant coagulated blood in the Westergreen tube and its
placement in the rack, Focusing of PBF for neutrophil, blast cell, pencil cell, target
cell, nucleated RBC, schistocytes etc. Sending of histopathology specimen and fill up
the requisition form, Transport of histopathology slide to nearest hospital, Transport
of FNAC or Pap's smear to nearest hospital, preparation of a peripheral blood film
(PBF), Preparation of thin and thick blood film for detection of Malarial parasite,
Performance of Benedict's test for reducing sugar and heat coagulation test for
protein, centrifuge body fluids (CSF, Pleural fluid, Peritoneal fluid)

Question stations: Gross specimen- for identification, description and probable

diagnosis, Instrument-bone marrow needle with indication, RBC and WBC pipette for

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 their use and identification of parts, Neubeaur counting chamber and its use,
hemoglobinometer, Westergreen ESR tube, Wintrobe haematocrit tube, Microtomy
blade(disposable), Ayre's spatula, Koplin jar, Tissue cassette, 20 cc syringe, paraffin
block, Test tube and its use, Benedict reagent, Esbachs albuminometer, Micropipette
and its use, H&E stained slide for identification of stain, Pap's stained slide for
identification of stain, Immunohistochemistry slide for identification, Microtome and
its use, Indications of frozen section, Touch imprint. centrifuge machine, cytospin.
Glass slide and coverslip etc.

 Traditional practical examination in Term examination:Marks-25 (50% of below

mentioned items can be given)

For Term-I(Traditional practical marks-25)

 Unstained slide for staining followed by PBF with comment or haemoglobin
estimation or ESR estimation may be given (marks- 6x1=6)
 Histopathology slides- 2 (marks- 6x2=12) (Compulsory)
 Data interpretation on acid base imbalance-2
Practical khata and case histories(3+2(four case histories)=5
For Term -II (Traditional practical examination-25)
 Histopathology slides-2(6x2)=12 marks
 Cytopathology slide(Pap's smear)-2marks
 Urine (pus cells, RBC, casts/crystal may be focused)- (marks- 2)
 Perform Benedict test and heat coagulation test for sugar and albumin in urine and
give interpretation- (marks- 2+2)
Practical khata and case histories(3+2(four case histories)=5

1.3. Duration of Each Term

i) Term I: 1st July to 15th November.
 Classes will be from 1st July to 31st October.
 First term preparatory leave: 1st November to 5th November.
 First term Exam: 6th November to 15 th November

ii) Term II : 16th November to 30th March

 Classes will be from 16th November to 15th march
 Second term preparatory leave: 16th March to 20th March.
 Second Term Exam: 21st March to 30th March.

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1.4.Overview of examination system

 Formative assessment- Two cards (Pathology-I and Pathology-II) must be completed

before Term-II examination. If any one fails in Term-I examination, he or she may be
allowed to appear in that reassessment examination after the tenure of Term-I and if
anyone fails in Term-II, immediately after Term-II examination. No student will be
allowed to appear in any reassessment examination covering absence in both term
examination. He or she must have to attend at least one Term examination timely.

 Summative examination : Third Professional MBBS examination in Pathology will

be as written, oral & practical. Summative Exam: Begins from First May of each year.

1.5. Leave
Following leaves will be granted to the students :
a. Pre-term preparatory leave : Total 10 days, 5 days before each term examination
viz. 1st November to 5th November before first term examination and 16th March to
20th March before second term examination.
b. Post-term : No space for post term exam leave.
c. Revision Classes and preparatory Leave for 3rd Professional MBBS
Examination: Total 30 days preparatory leave shall be granted to students before
Third Professional MBBS Examination viz. 1st April to 30th April.

1.6 Calculation of certain percentage of marks from different components of

formative assessment to add in summative assessment (3rd Professional MBBS
examination)

Academic performances of the students should be properly documented.

Calculation of Formative marks
 Total mark: 10
 06 marks from two term examinations.
Average marks obtained in two term examinations
o 75% and above-6
o 70%-74%-5
o 65% to 69%- 4.5
o 60 to 64%- 4.

 For class attendance 02 marks (Lecture and tutorial separately)

Marks shall be calculated as follows:
o ≥ 90% : 2 marks
o 81-90% :1.5 marks
o 75- 80% : 1 mark
o <75% : No mark

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  Card completion (marks 2)
o Two cards completed timely: 2
o If cards completed but not timely : 1

So, lowest marks of formative assessment for eligible student of Third professional MBBS
examination in Pathology:
Lowest marks in two Term exam = 04
Lowest marks in class attendance = 1
Lowest mark in card completion =1
So, lowest marks of formative assessment = 06

Without scoring this 06 marks, students are not eligible for 3rd professional MBBS
examination in Pathology.

Example: A student secured 78% in total in best two Term examinations, and has 80%
attendance and completed all the items examinations timely, his/her Formative assessment
marks will be as follows:

 For 75% marks on average=6

 For 80% attendance=1
 For completion of item examinations timely-2
i.e. 9 out of 10.

 A student will not be allowed to appear in more than two item examinations per week.
If any student remain absent on that day for illness or accident or any valid reason, he
or she may be allowed to give remaining item examinations with the permission from
Head of the Department of Pathology. He or she must produce documentary evidence
for his or her absence to the Head of the Dept. of Pathology

1.7. Summative Examination(3rd Professional MBBS examination on Pathology)

Summative examination will comprise of written (SAQ and MCQ), Structured Oral
Examination (SOE) and practical ( OSPE and traditional practical)

 Written 100= SAQ 70 + MCQ 20 +Formative 10

a) 10 marks of formative assessment of each subject will be added to the written
marks of 3rd Professional MBBS examination (section-1.7).
b) For MCQ 20 marks are allocated. OMR sheet should be provided for MCQ part
of examination. Total number of MCQ will be 20. There will be 10 MCQ from
Pathology card- I and another 10 MCQ from card Pathology card- II . 10 marks
will be allocated for each card.
 Time allocation – 30 minutes
 Type – Multiple true/ false. MCQs stem should not include all of the
above, none of the above, which of the following etc
 Each MCQ will carry 1 mark and each alternative will carry 0.2 marks
 No negative marking
 T:F should be 3:2 or 2:3

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 c) For SAQ , 70 marks are allocated:
 There will be four groups (A, B, C and D). Instructions will be given to
answer the questions in four different scripts each of which will be
examined separately by four examiners.
 Time allocation: 2 hour and 30 minutes.
 Written question should include 60% from recall and 30% from
understanding and 10% on problem based.
 SOE : Total marks for Structured Oral Examination is 100 and pass marks for SOE is
60%.
 Practical examination will include OSPE and Traditional Practical examination.
OSPE will be used for assessing skill competencies.
 The marks distribution in practical will be traditional 40 +10 (Practical note
book marks 6 in two copies 2x3; 8 (eight) case history marks 4 ) and OSPE 50.
 Pass mark in examinations is 60% of total marks. Student shall have to pass in
three compartments, that is written (MCQ + SAQ + formative), oral and
practical examination separately.
 Honors Marks: Eighty five percent (85%) marks in all the components i,e.
Written, SOE and Practical will be considered as Honors Marks.

1.8. Pre-requisite for appearing in term examination

Students shall complete all the items present in the card of that term before appearing
in the term completion examination.

1.9. Pre-requisite for appearing in Third Professional MBBS Examination

i) Must have passed 2nd Professional MBBS Examination
ii) Students must complete all the items in the two cards and pass all the term
examinations (Term-I and Term-II).
ii) Certificate from the respective head of the departments regarding students
obtaining at least 75% attendance in all classes separately (lecture, practical,
tutorial etc.) during the phase.

1.10. Examinations & distribution of marks of Third Professional Examination:

Written Exam Structured Practical Total

Subjects marks Oral Exam Exam marks Marks
(SAQ + MCQ marks Traditional OSPE Practical
+ Khata
Formative) and Case
Reports
Pathology 70+20+10 100 40 50 10 (6+4) 300
Microbiology
Pharmacology

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2.1 Departmental Objectives of Pathology

After completion of pathology course, undergraduate medical students will be able to:

 Explain basic mechanism of diseases: Etiology, pathogenesis, morphological changes

with emphasis on common diseases prevalent in Bangladesh.
 Co-relate between clinical findings and pathological changes.
 Chalk out simple investigation plan for diagnosis and follow up of diseases.
 Interpret laboratory results and understand their implication.
 Demonstrate knowledge about the use of Histopathology, FNAC, Cytological
examination, Pap smear, Frozen section and Immuno-histochemistry
 Develop attitude for further learning of the subject.
 Develop skills to perform
 TC, DC, Eosinophil count, estimation of Hb% and ESR
 Semen analysis
 Routine examination of Urine
 Microscopic examination of body fluids
 CSF examination
 Writing a requisition form for histo-pathological and cytological examination

2.2 List of Competencies to acquire:

1. Writing a histo-pathological requisition form

2. Preservation of surgical specimens in Upazila health complexes and district hospitals
and preparation of fixative for surgical specimens (10% formalin)
3. Sending of surgical specimens from Upazila health complexes and district hospitals to
nearby medical college and larger hospitals where histopathology service is available
4. Collection of Paps’ smear/ FNAC from superficial mass lesions
5. Preservation of cyto-pathological smears
6. Sending of cytopathology specimens from Upazila health complexes and district
hospitals to nearby medical college and larger hospitals where cytopathology service
is available
7. Preservation of surgical specimens for immunohistochemistry and
immunoflorescence study
8. Writing a requisition form for immunohistochemistry or immunoflorescence
examination
9. Determination of Hb%, ESR, TC & DC of WBC, total count of eosinophil, BT and
CT, preparation of stain and comment on PBF.
10. Performing routine urinary examination at health complexes

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 11. Handling and maintenance of Microscope
12. Performing semen analysis
13. Performing microscopic examination of body fluid-CSF
14. Interpretation of pathology reports and data
15. Writing advice for pathological investigations

2.3 Teaching hours in Pathology

i. Total teaching hours in General Pathology
Lecture: 35 hours
Tutorial: 18 X 2 = 36 hours
Practical: 05 x 1 = 05 hours
Total minimum teaching hours of General Pathology = 76 hours

ii. Total teaching hours in systemic pathology

Lecture 65x1 = 65 hours
Tutorial 37 x2 = 74 hours
Practical 13 x1= 13 hours
Total minimum teaching hours in Systemic Pathology = 152 hours

iii) In term I (16 wks)

Lecture: 49 hours ( Pathology-I which include General Pathology, hematopathology,
lymphoreticular system and other contents of systemic pathology)

Tutorial + Practical : 68 hours (Pathology-I which include General Pathology,

hematopathology, lymphoreticular system and other contents of Systemic Pathology)

Total teaching hours in Term-I = 117 hours

iv) In term II (16 wks)

Lecture: 51 hours ( Pathology-II which include respiratory system, CVS and other systems
of systemic pathology )

Tutorial + practical:60 hours ( Pathology-II which include rest of Systemic Pathology)

Total teaching hours in Term-II = 111 hours

Combined Teaching hours-Term -I and Term-II is 117+111=228 hours

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 v. Please follow the course contents in curriculum

2.4 Distribution of contents of Pathology course in the Two Terms

Term-I Term-II

Content Duration Content Duration

General Pathology, 16 weeks Rest of Systemic 16 weeks
Systemic Pathology(I) Lecture: 4 (four) per Pathology(II) Lecture: 4 (four) per
1. Haematolymphoid week week
2.Lymphoreticular Tutorial + Tutorial +
Practical Practical
= 02 per week = 02 per week
(tutorial and (tutorial and
practical classes will practical classes will
run simultaneously) run simultaneously)
Extra lecture classes Extra lecture classes
may be converted may be converted
into tutorial and into tutorial and
practical classes. practical classes.

2.6 Class Performance Record Card (Pathology-I):

SL Name of Item Full Pass Signature

No Marks marks- Remarks
(10) (6)
A. General Pathology
1 Introduction to Pathology, Preservation and transportation of
specimen and Tissue processing. Histopathology and
Cytopathology laboratory visit. Preparation of histopathology
and cytopathology fixative- 10% neutral buffered formalin and
95% ethyl alcohol.

2 Cell injury-Reversible cell injury and irreversible cell injury,

Cellular swelling and fatty change, Growth disturbance and
adaptive changes (atrophy, hypertrophy, hyperplasia and
metaplasia), autophagy, Growth factors, Stem cells and cellular
ageing.

3 Irreversible cell injury-necrosis, necroptosis and pyroptosis,

apoptosis, Pigment and Calcification

4 Acute inflammation (1)-Definition, advantage and disadvantage

of inflammation, cardinal signs, Vascular and cellular changes
in inflammation, mechanisms of increased vascular
permeability.

5 Acute inflammation (2)-Chemical mediators of inflammation

(arachidonic acid metabolites, cytokines, chemokines,
complements), phagocytosis

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6 Chronic inflammation-definition and causes. Granulomatous
inflammation with examples, classification of granuloma,
mechanisms of immune granuloma

7 Repair and Healing-definition, types of healing, steps of bone

healing, factors influencing wound healing, complications of
healing.

8 Edema and electrolyte disorder-definition, classification

(pathophysiological), mechanisms of edema in heart failure,
cirrhosis of liver, nephrotic syndrome and malnutrition, hyper
and hypokalamia, hypernatremia, hyponatremia

9 Hyperemia, congestion, hemorrhage and shock-Definition,

classification, examples, types of shock, pathogenesis of septic
shock, stages of shock

10 Thromboembolism and Infarction-definition, antemortem and

post mortem clot, factors influencing infarction, pathogenesis of
thrombosis, embolus-types. decompression sickness, pulmonary
embolism

11 Neoplasia (1)-definition, classification of tumor, invasion and

metastasis, familial cancers, occupational cancers, tumor
kinetics, Hallmarks of cancer,

12 Neoplasia (2) P53, Knudson's two hit theory, epigenetic

changes.

13 Neoplasia (3) Carcinogenesis-Types of carcinogen, chemical

carcinogen, Initiator and promoter of tumor, radiation induced
tumors, viral and bacterial oncogenes

14 Neoplasia (4)Tumor immunity, clinical aspect of neoplasia-

cancer cachexia, paraneoplastic syndrome, Tumor markers and
laboratory diagnosis of tumor

15 Outline of genetics-mutation and types of mutation, FISH.

Name and characteristics of autosomal dominant and recessive
disorders, Sex linked recessive disorders, Chromosomal
disorders-Down syndrome, Klinefelter syndrome, Turner
syndrome, Karyotyping,

16 Immunopathology-Tolerance, Causes and examples of

autoimmune diseases, hypersensitivity types with examples-
Anaphylactic reaction, Tuberculin test

17 Infectious disease-Tuberculosis, Leprosy, Syphilis, AIDS

18 Nutritional disorders- Definition of PEM, marasmus,

kwashiorkor, vitamin deficiency, trace elements deficiency,
obesity

19. Environmental diseases-Air pollution, health effects of outdoor

and indoor air pollution, lead poisoning, Arsenic effects, Health
effects of tobacco, Health effects of alcohol, Adverse drug
reactions, drug abuse, thermal injury, Ionizing radiation

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20. Diseases of infancy and childhood-Congenital anomalies-
causes, tumor and tumor like conditions of infancy and
childhood.

B. Systemic Pathology (I)

21 Lymphoreticular system- Causes of Lymphadenopathy,

Classify lymphoma, Differentiate Hodgkin and Non-Hodgkin
lymphoma, Staging, Diagnosis and prognosis of Hodgkin and
NHL. Causes of spleenomegaly.

22 Hematolymphoid- Hematopoiesis, Causes of leukocytosis,

eosinophilia, lymphocytosis, iron metabolism, RBC indices,
PBF, DC, TC and bone marrow examination.

23 Hematolymphoid ii) RBC Anaemia, classification, iron

deficiency, folic acid and Vitamin B12, deficiency anaemia,
Pernicious anaemia-Cause, pathogenesis, clinical features, and
Diagnosis.Myeloproliferative disorders-
polycythaemia(Definition, types, clinical features and diagnosis)

24 Hematolymphoid iii) Haemolytic anaemia- Classification and

diagnosis, Direct and indirect Coomb's test. Reticulocyte count.

25 Hematolymphoid iv) Thalassemia and aplastic anaemia-

aetiology, pathogenesis, clinical features and diagnosis

26 Hematolymphoid v. Haemorrhagic disorder-bleeding disorder

and coagulation disorders, cause, pathogenesis, clinical features
and diagnosis of ITP, hemophilia and DIC.

27 Hematolymphoid. vi Leukemia-definition, etiology,

classification, clinical features and diagnosis

28 Hematolymphoid vii. –Practical Hb estimation, ESR

29 Hematolymphoid viii –Practical DC, TC, and PBF. Bleeding

time and clotting time

30 Blood grouping & cross matching. Indications, screening and

complications of blood transfusion.

31 Acid base balance-metabolic acidosis, metabolic alkalosis,

respiratory acidosis and alkalosis, CHO metabolic disorders,
including hypo and hyperglycemia, lipid metabolic disorder,
Lipid profile, causes of hypercholesterolemia, Arterial blood gas
analysis

32 Causes of pleural, peritoneal, pericardial effusion. Examination

of body fluids-CSF, Pleural fluid, Peritoneal fluid, pericardial
fluid, Joint fluid etc. Examination of body fluids for malignant
cells.

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Class Performance record Card II(Pathology-II)

SL Name of Item Full Pass Signature

No Marks marks Remarks
(10) (6)
Systemic Pathology (II)
1 Respiratory system– Congenital anomalies, Pneumonia
and lung abscess, Pulmonary tuberculosis-
aetiology,pathogenesis,morphology, clinical features,
diagnosis and complications.

2 Respiratory system – Chronic Obstructive air way

disease,Bronchialasthma
aetiology,pathogenesis,morphology,clinical features,
diagnosis and complications.

3 Respiratory system–lung tumor, Pneumoconiosis,

Pulmonaryedema aetiology, pathogenesis, morphology,
clinical features, diagnosis and prognosis.

4 Urinary system (i) congenital disease, clinical

presentation of renal disease, renal function tests, Causes
of azotemia and uraemia, creatinine clearance test.

5 Urinary system (i) Glomerular diseases-Acute post

streptococcal glomerulonephritis-Etiopathogenesis and
clinical features, diagnosis and complications. Nephrotic
syndrome-cause, pathophysiology, clinical features and
diagnosis. Chronic glomerulonephritis

6 Urinary system (ii)Tubular disease-Acute tubular

injury/necrosis, causes of tubulointerstitial nephritis.
Pyelonephritis-acute and chronic-etiopathogenesis and
diagnosis. acute renal failure-cause and clinical course.

7 Urinary system ((iii) Renal tumors-Renal cell carcinoma-

diagnosis, Name the urinary bladder tumors-Diagnosis,
Renal stone-types and complications.

8 Urinary system –Examination of urine-Physical,

chemical, and microscopic. Causes and diagnosis of
pyuria,ketonuria,haematuria, proteinuria.
9 Diseases of urinary bladder-cystitis and name the bladder
tumors. Diagnosis of cystitis and bladder tumors.

10 GIT – Oral cavity-causes of oral ulcer and leukoplakia,

Tumors of oral cavity, Name the tumors of salivary
gland and esophagus. Diagnosis of oral cavity,
esophageal and salivary gland tumors.

14
11 GIT – Acute and chronic gastritis, Peptic ulcer and
gastric carcinoma. Diagnosis of benign and malignant
ulcer. Occult blood test.

12 GIT – small intestine-polyp and tumors, Inflammatory

bowel disease, causes of malabsorption and ulcer. Acute
appendicitis-causes, morphology, clinical features,
diagnosis and complications. Differences between a
tubercular ulcer and a typhoid ulcer

13 GIT – large gut-ulcerative colitis, amoebic ulcer,

Carcinoma of colon-etiopathogenesis, morphology and
diagnosis. Carcinoma of rectum, hemorrhoids-types,
diagnosis and complication

14 Hepatobiliary – Jaundice-definition, types, diagnosis and

complications. Acute and chronic hepatitis-cause,
morphology, diagnosis and complications, Liver abscess-
cause and diagnosis and complications, liver function
tests.

15 Hepato-biliary—Cirrhosis of liver-Aetiopathogenesis,
morphology, clinical features, diagnosis and
complications, portal hypertension, hepatic failure

16 Hepato-biliary— aetiopathogenesis,clinical features,

morphology , diagnosis of tumors of liver

17 Gall bladder-cholecystitis and cholelithiasis-

types,pathogenesis, clinical features and complications,
tumors of gall bladder.
18 MGS— Causes and complications of undescended testis,
Inflammation and Tumors of testis(seminoma), Prostate-
Inflammation, hyperplasia and tumors-
etiopathogenesis,morphology, clinical features, diagnosis
and complications, Causes of sterility and semen
analysis
19 FGS – cervix-causes of cervicitis and
sulpingitis,precancerous lesions, cervical cancer- types,
risk factors,screening,clinical features, morphology, and
diagnosis. Endometriosis, Leiomyoma of uterus,
endometrial hyperplasia and its risk, Ovary-chocolate
cyst-complications, name of tumors and tumor markers,
Morphology of teratoma.

20 FGS – placental trophoblastic tumors-classification and

diagnosis, Pregnancy test

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21 Breast—Causes of breast lump, Name the inflammatory
and fibrocystic diseases of breast, diagnosis of breast
lump

22 Breast—Classification of breast tumors, Risk factors and

prognostic factors of breast carcinoma,
benign(fibroadenoma) and malignant tumor(Duct cell
carcinoma)-morphology and diagnosis

23 Endocrine – thyroid-Causes of thyroiditis, Hashimoto

thyroiditis immuopathology, morphology, diagnosis.
Goiter-causes, pathogenesis, morphology, diagnosis and
complications.Thyroid tumors-Classification,
morphology of papillary carcinoma of thyroid.

24 Endocrine – Diabetes mellitus

Definition,classification,pathogenesis,diagnosis and
complications

25 Endocrine – OGTT-Indications, Precautions, Procedure,

and interpretation. What is IGT and GDM, Ketoacidosis-
mechanism of development,Ketone body formation and
diagnosis, of ketonuria, and HbA1C.Causes of
glycosuria, types of glycosuria, causes and
complications.

26 Name the skin inflammations, Premalignant lesions,

Tumors and Bullous lesions. How will you diagnose
inflammations, premalignant lesions, tumors and bullous
lesions of skin.

27 CNS-Meningitis, encephalitis, Subarachnoid

hemorrhage-cause, diagnosis and complications, Stroke-
types and complications, brain edema , Brain abscess,
Name the Tumors of CNS, eye and nasal cavity.

28 Bones, soft tissue, joint, peripheral nerve and skeletal

muscles disorders—classify tumor of soft tissue and
bone, osteomyelitis-types, morphology, diagnosis and
complications.Rheumatoid arthritis, osteoarthritis,
osteoporosis-pathogenesis and complications. Name of
Benign and malignant peripheral nerve sheath tumors,
Mysthania Gravis

29 An outline of autopsy-Observation of gross examination

of autopsy specimen, slide preparation and staining of
autopsy specimen-Histopathology laboratory visit

16
30 Heart and Blood vessels – Types of vasculitis, tumors of
blood vessels and atherosclerosis-Risk factors,
pathogenesis, morphology, and complications.
31 Ischemic heart disease(IHD)-types and complications,
morphological examination after MI and hypertensive
heart disease-types,cause,morphology,complication
Diagnosis of myocardial infarction-Cardiac enzymes

32 Infective endocarditis,Myocarditis and pericarditis-cause,

clinical features, diagnosis and complications.
Rheumaticfever-Pathogenesis,morphology, Diagnosis,
complications.
Name of congenital heart diseases.

2.6 : Summative Examination (3rd professional MBBS examination)

A. Written - MCQ+SAQ+formative examination

B. Viva - Structured Oral Examination(SOE)
C. Practical- OSPE and Traditional examination

A.Written

I. MCQ

For MCQ 20 marks are allocated.

– OMR sheet should be provided for MCQ part of examination.

– Total number of MCQ will be 20.
– There will be 10 MCQ from card I and another 10 MCQ from card II .
– 10 marks will be allocated for each group
– Time allocation – 30 minutes
– Type – Multiple true/ false. MCQs stem should not include all of the above,
none of the above, which of the following etc
– Each MCQ will carry 1 mark and each alternative will carry 0.2 marks
– No negative marking
– T:F should be 3:2 or 2:3

Examples of MCQ
Q. No. 1. Reversible cell injury include
T-a) Cellular swelling
T-b) fatty change
T-c) Dilation of the endoplasmic reticulum
F-d) Necrosis
F-e) Apoptosis

17
Q. No. 2. Cardiogenic shock arise from
F-a) Overwhelming microbial infections
T-b) Cardiac tamponade
T-c) Pulmonary embolism
F-d) Trauma
T-e) Myocardial infarction.

Q.No. 3. Oncofetal antigen(s)

T-a) CEA.
T-b) Alpha-fetoprotein.
F-c) calcitonin .
F-d) Human chorionic gonadotropin.
F-e) Neuron specific enolase.

Q.No. 4. Autosomal recessive disorder(s) include

F-a) Acute intermittent porphyria.
T-b) Cystic fibrosis.
T-c) Wilson disease.
F-d) Familial hypercholesterolemia.
T-e) Glycogen storage disease.

II. SAQ-70 marks are allocated: (Four groups A,B,C & D, each group 17.5 marks)

There will be four groups of questions (Groups A, B, C and D). Instructions will be given to
the students to use separate answer scripts for each group which will be examined separately
by four examiners.
 Time allocation: 2 hour and 30 minutes.

 Written questions should include 60% from recall and 30% from understanding and
10% on problem based.

 Written question will have the following instructions.

a. Answer four out of five questions (marks-5) from each group, including number
five which is compulsory (problem basesd-2.5 marks each).

b. Use separate answer script for each group.

 Outline of written question paper

Group A and B will cover Pathology card I content and Group C and D will cover
Pathology Card II content.

Sample SAQs

Q1. What is necrosis? Write down the differences between necrosis and apoptosis. Why there
is inflammation in necrosis?(1+2+2)

18
Q.2. How edema due to lymphatic obstruction occur? List three possible causes of edema due
to lymphatic obstruction (2+3)

Q3. What is hyperplasia? What are the differences between endometrial hyperplasia and
endometrial atrophy? Why endometrial hyperplasia is important ?(1+2+2)

Q.4. What is cryptorchidism? List four causes of testicular atrophy(1+4).

Q.5. What are the differences between dysplasia and carcinoma in situ? How premalignant
conditions of cervix can be diagnosed early?(3+2)

Q.6. What is wound healing? List four local causes of delayed wound healing. Why wound
healing is delayed in vitamin C deficiency?(1+2+2)

Q.7. What is keloid? Why wound healing is delayed in diabetes mellitus? What are the
complications of wound healing? (2+1+2)

Q.8. What is wound contraction? Write four differences between healing by primary intention
and secondary intention?(1+4)

Q.9. What are the differences between exudate and transudate? How blood vessel become
more permeable in acute inflammation?(2.5+2.5)

Q.10. What is granuloma? Briefly mention the pathogenesis of immune granuloma.Why there
is ceseation in tubercular granuloma?(1+3+1)

Problem based questions

Q11. A female of 29 years has presented to you with a palpable mass in her left breast. The
lump is movable, well circumscribed, not fixed to skin or areola. Ultrasonogram reveals
a solid lesion. What is your probable diagnosis? How will you proceed to diagnose such
a patient?(1+1.5)

Q.12. A 15-year-old girl presented with colicky periumbilical pain that localized later on to
right iliac fossa. Local examination reveals tenderness and muscle guard on palpation.
Her full blood count reveals neutrophil leucocytosis. What is your probable diagnosis?
(2.5).

Q13. A 65 years old man with diabetes mellitus suddenly became unconscious and brought
to the emergency room of a nearby hospital. His relatives gave the history of poorly
controlled diabetes. His urine was collected by catheterization. The urine smells
sweetish. What could be the possible cause for his unconsciousness. What test would
you like to advise for his diagnosis?(1+1.5)

Q.14. A 40 years man presented with severe anaemia. His hemoglobin was 5gm/dl,ESR-100
mm in 1st hour, PCV was reduced, TC of WBC was 1500/cumm of blood, peripheral
blood film showed pancytopenia. What could be the possible diagnosis? How will you
confirm it?(1+1.5)

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SAQ:Group A (17.5 marks)
1. cell injury/ cellular adaptation/ inflammation /Intracellular accumulation and
calcification(5)
2. neoplasia /carcinogen/child hood tumors/healing and repair(5).
3. neoplasia/ thromboembolism/ oedema/shock/hyperemia & congestion and infarction
(5)
4. genetics/Infectious disease/ Nutritional & Environmental Pathology(5)
5. Problem based question (cell inury/Inflammation/ adaptation / fluid and
hemodynamics/neoplasia/Infectious disease) (2.5)

SAQ: Group B(17.5 marks)

1. Biopsy, FNAC, Frozen section, Tissue staining and tumor diagnosis. (5)
2. Hematopathology-RBC disorders-All anaemias and polycythaemia(5)
3. Hematopathology-WBC disorders including multiple myeloma and Leukemia (5)
4. Hematopathology-Haemorrhagic disorder-ITP, Hemophilia, Blood grouping and cross
matching, Complications of blood Transfusion, screening tests before blood
transfusion (5)
5. Problem based ( Hematology). (2.5 marks)

SAQ: Group C (17.5 marks)

1. Systemic pathology(5)
2. Systemic pathology/ laboratory investigations/ (2.5+2.5)
3. Systemic Pathology / laboratory investigations (2.5+2.5)
4. Laboratory investigations (5)
5. Problem based (LFT or KFT, Semen analysis, CSF, Urine examination) (2.5marks)

SAQ: Group D (17.5marks)

1. Systemic pathology(5)
2. Systemic pathology/ laboratory investigations(2.5+2.5)
3. Systemic pathology / laboratory investigations(2.5+2.5)
4. Systemic pathology (5)
5. Problem based (Systemic pathology) (2.5marks)
**** In group C and D other than the problem based the total questions from topic no 2
and 3 will contain laboratory investigations at least 50 % by weight.

20
 Sample Question: SAQ

Third Professional MBBS Examination of May, 222

Subject: Pathology (New curriculum 2012)
Short Answer Questions (SAQ)

Full Marks: 70 Time : 2 hour 30 min.

Instruction: Answer any four out of five questions from each group of which number
five is compulsory.

Use separate answer script for each group

Group A (17.5 marks)

1. Define necrosis? Write three differences between necrosis and apoptosis. Why
inflammation does not occur in apoptosis but occur in necrosis? (1+3+1)

2. What is skip metastasis ? Differentiate benign tumor from malignant tumor with
examples? Why lymphedema of arm occur after axillary dissection in patient with
carcinoma of breast ?(1+2+2)

3. What is pulmonary embolism? Why there is "bends" and chokes in patients with
decompression sickness? Why DIC occur in amniotic fluid embolism? (1+2+2))

4. What are the characterstics of autosomal dominant disorders? Write down the clinical
features of Down syndrome.(2.5+2.5).

5. A male of 70 year man has been suffering from dry cough, weight loss, anorexia and
haemoptysis for the last four months. On examination few matted left sided cervical
lymph nodes were identified. Chest X-ray shows irregular opacity with cavitation in his
right apical region . What is your probable diagnosis? How can you confirm the
diagnosis (1.5 +1)

Group B(17.5 marks)

1. What is tumor grading and staging? Which one is more important and why ? Give an
outline of laboratory diagnosis of tumor.(1+1+3)

2. Why there is pancytopenia in megaloblastic anaemia? How will you proceed to

diagnose a case of megaloblastic anemia in the laboratory? (2+3)

3. What is leukemoid reaction? Differentiate leukemoid reaction from leukemia. (1+4)

4. A boy of 14 years has presented with haemarthrosis of left ankle joint. His maternal
ankle has got similar type of problem. How will you proceed to diagnose such a case in
the laboratory? (5)

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 5. A 65 year old male has presented with anemia, bone pain, and vertebral fracture. X- ray
shows osteolytic punched out lesions in skull bone and vertebra. What is your probable
diagnosis? How will you confirm it? (1.5 + 1)

Group C(17.5 marks)

1. What is peptic ulcer? Write down four differences between a peptic ulcer and a
malignant ulcer. (1 +4)

2. A male of 45 years complained of left sided chest pain which relieved on taking rest and
spraying nitroglycerin under his tongue. What is your probable diagnosis ? How will you
diagnose a case of myocardial infarction in the laboratory. (2.5+2.5)

3. What is nephrotic syndrome? What are the causes of nephrotic syndrome ? Why serum
creatinine is more reliable renal function test compared to blood urea? (1+1.5+2.5)

4. What is meningitis? Write down the laboratory investigations done to diagnose

bacterial, tubercular and viral meningitis. (1+4)

5. A boy of seven years presented with puffiness of face and scanty micturation for last
three days. His mother states that he also suffered from a single attack of convulsion two
days back. He gives a H/O infected scabies 1 month back? What is your probable
diagnosis? What findings do you expect in his urine examination? (1.5 +1)

Group D(17.5)
1. What is COPD? How will you differentiate obstructive airway disease from restrictive
airway diseases? Why pneumothorax occur in patients with emphysema?(1+3+1)

2. Define hepatitis and its types with examples? Tabulate the differences in laboratory
investigations among three types of jaundice. (2.5+2.5)

3. Name the tumors of breast. Why the endometriotic cyst in ovary is called Chocolate
cyst? Write down the indications of pregnancy test.( 1.5+1+2.5)

4. Name the tumors of skin? Why basal cell carcinoma is called a rodent ulcer? Which type
of growth pattern is clinically significant in case of malignant melanoma?(2+2+1)

5. A lady of 36 gives history of increased menstrual blood loss for the last three months.
USG of lower abdomen shows a submucosal mass in her uterine cavity. The mass was
removed. Cut section of mass revealed whorled appearance. What is your probable
diagnosis? How can you confirm it? (1.5 +1)

B. Viva (Structured Oral Examination)

There must be two boards (I&II). Each examinee will face two boards and twenty boxes,
ten boxes in each board. Each board will comprise of two examiners (1 internal + 1
external) . The Student will be asked to collect one card from each box. Both the two

22
 examiners of a board will give marks individually for all the 10 box for a examinee. The
student will get the average mark of the two examiners of that board. Total marks
difference of two examiners should not be more than 10% in a board. The board content
should be changed on every two days. The total marks will be combined marks of two
boards. Pass marks is 60% combinedly (Board-I and Board-II).

Contents of Board I and Board II

Board I will assess Pathology Card I which includes all chapters of General
Pathology, fluid and electrolyte imbalance covering acid base balance, electrolyte
disorders, CHO metabolic disorders, including hypo and hyperglycemia, lipid metabolic
disorder, , lymphoreticular system and hematopathology, examination of body fluid,
obesity.

Board II will assess Pathology Card II, which includes the systemic pathology
(excluding Haematolymphoid). Different items of clinical pathology will be incorporated
in the relevant chapter of systemic pathology, such as urine examination and KFT can be
included in renal system, semen analysis in male genital system, LFT in HBS, CSF
examination in CNS.

SOE – Box Distribution

Board – 1 ( Pathology card- I) (There must be minimum 20 cards in each box, each
card-5 marks)
GP1 GP2 GP3 GP4 GP5

Cell injury Inflammation Neoplasia Edema, Electrolyte Environmental&

Cellular Healing and Childhood disorders Nutritional
adaptation regeneration tumor Thrombosis Pathology, Shock,
Necrosis & Immunopathology &Embolism Haemorrhage,
Apoptosis Infectious diseases Hyperemia and Infarction, Outline
Intracellular congestion of Genetics
accumulation and Examination of body
calcification fluids, Acid- base
disorders

SP1 SP2 SP3 SP4 GP6

Haematology Hematology Hematology Practical Hematology Problem
Hemopoiesis, WBC disorders Haemorrhagic Plasma and serum, Based question on
RBC Disorders including disorders Anticoagulants items of General
including Leukemia Blood Grouping Haemoglobin Pathology
anaemias and Multiple myeloma & cross estimation, ESR,
myeloproliferativ Causes of matching Bone marrow
e disorders lymphadenopathy, Transfusion examination, PBF,
Hodgkin reactions HCT, BT, CT,PT,
lymphoma and PTT, TC, DC,
NHL, Causes of reticulocyte count,
splenomegaly Coomb's test

23
 Board- 2 (Pathology Card- II) (There must be minimum 20 cards in each box, each
card-5 marks)

SP5 SP6 SP7 SP8 SP9

Atherosclerosis GIT- Hepatobiliary Urinary system- Endocrine system-
Tumors of blood Inflammation, System-Viral Acute post
vessels hepatitis, streptococcal Hypo or hyper
Ischaemic Heart ulcer and tumors cirrhosis of glomerulonephritis,
disease(IHD) of oral cavity, liver, Nephrotic thyroidism
Endocarditis,myocar esophagus, Hepatocellula syndrome,
Stomach,intestin Hashimoto
ditis, r carcinoma pyelonephritis,Tumo
Pericarditis and e, colon and rs of kidney and Thyroiditis,
Rheumatic fever- salivary gland Jaundice bladder, Causes of
Pathogenesis, and Liver uraemia, proteinuria, Tumors of thyroid
morphology Endoscopic function hematuria and gland
complications biopsy, Tests ketonuria
Colonoscopy,
Lipid Profile Renal function
tests Diabetes mellitus &
Cardiac enzymes FNAC of complications
Salivary glands
Urine examination

SP10 SP11 SP12 SP13 SP14

Male genital system Respiratory CNS, Eye, Techniques in Problem

Testicular tumors system- ENT, Skin histopathology Based question on
Nodular hyperplasia Pneumonia, Musculoskele including items of Systemic
and tumors of COPD, tal system, use of Pathology of
Prostate Bronchogenic Bones, joints different stains, Pathology card -II
Semen analysis carcinoma and soft fixatives
Pulmonary tissue tumors. IHC
Tuberculosis Examination Frozen section
Female Genital Pleural fluid of CSF FNAC
System-Tumors of examination Pap smear
uterus and ovary,
endometriosis

Breast-Inflammation
and tumors, Risk
factors and
prognostic factors

Pregnancy test

24
 Rating Scale for SOE
3rd Prof Exam ---- Date:

Total marks - Time for each student:……

Roll Card/se Scoring of the answers
No t No
Q1 Q2 Q3 Q4 Q5 Q6 Q7 Q8 Q9 Q10 Total
Score
1

10

11

12

13

25
For example: If a student is asked the question" What is granuloma? Tell six causes of
granulomatous inflammation (2+3).

1. If the student can answer definition only-score-2

2 .If the student can answer definition and one important cause-score-2.5

3. If the student can answer definition and two important causes but one wrong cause-score-
3

4. If the student can answer definition and three important causes but no wrong cause-score-
3.5

5. If the student can answer definition and four important causes with nothing wrong with
one supplementary question on granuloma-score-4

(The student may be asked whether granuloma of sarcoidosis is caseating or

noncaseating? or How can you diagnose a case of granulomatous inflammation?)

6. If the student can answer definition and five important causes with two supplementary
questions on granuloma-score-4.5

(The student may be asked whether granuloma of sarcoidosis is caseating or

noncaseating? & can tell the mechanism of immune granuloma)

7. If the student can answer definition and six important causes with at least two
supplementary questions on granuloma and all the answers are full correct-score-5

(The student may be asked pathogenesis of immune granuloma & morphology of an

epithelioid cell or Langhan's type giant cell or differences between inflammatory giant
cell and neoplastic giant cell)

8. If the student can not answer definition but can give two to six examples only-score-1-2

9. If the student cannot answer definition but can understand granuloma as a specific form
of Chronic inflammation-score-1

10. If the student can answer definition but cannot understand whether it is a acute or chronic
inflammation or neoplasm or granulation tissue-score-1(confused)

11. If the student does not know the answer-score-0

12. If the student give wrong answer-score-0

26
C. Practical examination: (Total marks- 100: pass marks-60%)

Total marks- 100

OSPE-50 (Pathology card-I &II)

Pathology card-I=25

Slides- 2 (2x5=10)

Figures, data interpretation- 1 (1X5=5)

Instruments, reagent, Misc= 2 (2x5=10)

Pathology card-II=25

Slides- 2 (2x5=10)

Museum specimens- 2 (2x5=10)

Instruments, reagent, Misc= 1 (1x5=5)

Traditional- 40+10 marks

Traditional practicals-40 marks

(Practical note books- 2x3= 6 ; Case history 8x 0.5 =4) = 10

 OSPE- Objective Structured Practical Examination

 Number of station- 10 (5 stations should be selected from Pathology-I content and 5

stations from Pathology-II content)

 Allocation for time for each station- 2 minutes (2x10= 20 minutes)

 Allocation of marks in each station- 5.

 Fractionation of marks should be avoided. 0.5 marks or above will be considered as 1

mark and less than 0.5 mark or above will be considered zero.

 Number of procedure stations- 4 to 5.

 Number of question stations- 5 or 6.

 In the question station, some questions should be based on the information obtained at
previous station.

 Figure and models can be supplied in OSPE taken from Pathology card-I and
Pathology card-II contents.

27
  If the procedure needs more than two minutes then there may be a gap station in the
next.

 All the twelve candidates should start OSPE at a time, so two extra gap stations
should be kept for them. The last two candidates will get extra 4 minutes (2+2) to
complete the rotation.

 The examiners stays at the station while the students move from station to station.

 If necessary, the teachers of the respective department may be posted at procedure

station with the checklist provided.

 All students are assessed on the same set of questions on that day. Set of question will
be changed on subsequent days.

 Answer scripts of OSPE will be evaluated by four examiners.

 OSPE should start first on the specific day of oral and practical examinations.

 Allocation of time should be flexible i.e., 2-5 minutes can be proposed. Because some
procedures may take 5 minutes to be completed.

 In each question station, a student should drop his/her answer in the box provided
carefully writing his/her roll number. Checklist of the procedure station will be with
the observer.

 A question bank on OSPE should be created in Dean’s office so that standard of

OSPE stations can be maintained. Respective Head of the departments can take the
responsibility to collect those OSPE questions before the oral and practical
examination of 3rd Professional MBBS examination on Pathology.

 After OSPE, traditional practical should start and students will be called for oral
examination on the basis of examination roll numbers and first half will go to Board-I
and second half will go to Board-II and vise versa.

Examples of OSPE:
Procedure station
Q.1. Slide- A female of 48 years. Section from thyroid nodule (total marks- 5).

Checklist:

a. Student properly placed the slide under microscope- (mark-0.5); if not successful-
(mark-0)

b. Student properly adjusted the slide under microscope- (mark- 0.5); if not successful-
(mark- 0)

c. Identified the structure properly under microscope with two identifying points (mark-
2), if not correct- (mark-0)

d. Diagnosed correctly the supplied slide- (mark- 2); if not correct- (mark- 0).
28
Question station
Q.2. Sample- Gall bladder with stones (total marks- 5)
a. Question- Identify the specimen and give your probable diagnosis (marks- 1+1)
b. Question- Write down two histopathological changes likely to be present in it-
(marks- 2).
c. Write down two possible complications of it (marks- 2)
Question station
Q-3. Jar containing museum specimen with reagent (total marks- 5)
a. Question: Identify the reagent kept in the jar (mark-1).
b. Question: What are the actions on the specimen supplied (mark- 1)
c. Question: Name two other reagents used for the same purpose (marks- 2)
Procedure station
Q.4. A vial containing blood mixed with proper anticoagulant has been provided. Do the
procedure for estimation of ESR by Westergren method. Question: What is the normal value
of ESR in an adult male estimated by this method (5)
Checklist for the examiner (please circle):
a. Blood drawn into the ESR tube properly (by
the dropper/sucker provided)- Yes----No
b. Blood drawn up to mark 0 in ESR tube Yes----No
c. Blood filled ESR tube is placed in the stand upright- Yes----No
d. Time of estimation mentioned
(1 hour after placement of ESR tube in stand)- Yes----No

Procedure station
Q.5. Haemoglobinometer tube-containing blood mixed with N/10 HCl has been provided and
placed in a Sahli’s haemoglobinometer matching box. Estimate haemoglobin by this method.
Question: What is the normal value in an adult female- (marks- 5).
Checklist for the examiner (please circle):
a. Distilled water added drop by drop- Yes----No
b. Whether the candidate is matching or not- Yes----No
c. Value mentioned in gram & percentage- Yes----No

d. Estimation is correct Yes----No

29
Question station
Q.6. Bone marrow needle has been given (5)
a. Identify the instrument (mark- 1)
b. Write down its use (mark- 1)
c. Write the sites from where bone marrow can be aspirated in case of adults and
children (marks- 3).

 Traditional practical (Total marks-40)

 Practical examinations will be conducted by the four examiners.

 Unstained slide for staining and comment on PBF or ESR estimation by Westergren
method may be given (marks- 8x1=8)

 Stained PBF for comment-1 (marks- 5x1=5)

 Histopathology slides- 2 (marks- 8x2=16)

 Data interpretation-1 (marks-5x1=5)

 Urine (pus cells, RBC, casts/crystal may be focused)- (marks- 2)

 Perform Benedict test for sugar/ heat coagulation test for albumin in urine and give
interpretation- (marks- 4)

Practical Note Books and Case History- Total marks-10

Practical note book-(2x3)=6 + Case history-4(eight case histories)
Marks will be given on the basis of regularity of experiments done and cleanliness. Teachers
of the respective tutorial batch will ensure that the practical note books and case reports are
submitted before each Term examination. He/she should submit it to the convener for marks
during 3rd Professional MBBS Examination ( practical examination) in Pathology.

30
Preparation of mark sheets (2nd Professional Examination) envelope for tabulation.

1.Formative assessment : Formative assessment Marks should be sent to the Deputy

controller of Examinations and Two tabulators of respective University by the convener in a
separate mark sheet signed by all four examiners. It must be shown to external examiners
during beginning of 3rd Professional MBBS Examination (oral and practical part). The marks
of formative assessment should be recorded properly in a record book and also computerized
if possible.

2.Summative assessment: Written examinations: SAQ mark should be sent to Deputy

controller of examination and two tabulators of respective University separately by the four
examiners.

Distribution of SAQ script to examiners : Keys must be Provided by convener in a sealed

envelope and distributed to the following examiners.

 Board-I-Internal examiner will receive SAQ of Group-A

 Board- I-External examiner will receive SAQ of Group-B
 Board-II- Internal examiner will receive SAQ of Group-C
 Board-II-External examiner will receive SAQ of Group-D
 MCQ : MCQ answer scripts will be checked by OMR centrally at Dean's office.

3. Oral examinations :
 Oral : Marks of Board I + Marks of Board II = total oral marks.
 This total oral marks should be sent to Deputy Controller of Examinations and Two
tabulators of respective University by the convener signed by four examiners.

4. Practical examinations :
 Marks of OSPE + Traditional practical + Practical note books + case history = Total
practical marks.
 This total practical marks should be sent to Deputy Controller of Examinations and
Two tabulators of respective university by the convener signed by four examiners.

The tabulators and controller of examination will receive 21 small sealed envelopes
containing marks of
 Formative marks-three sealed envelope from convener signed by four
examiners.
 Oral marks – three sealed envelopes from convener signed by four examiners
 Practical marks- three sealed envelopes from convener signed by four
examiners
 SAQ marks – three sealed envelopes from each of four examiners of four
Groups (Group A,B,C & D)

31
 -----------------------------------------------------------Medical college.

3rd Professional MBBS Examination of-------------------------200

Subject : Pathology

Evaluation of Pathology

3rd Professional MBBS Examination

Components Marks Total marks

1. Formative assessment 10 10
2. Written examination Total written
Number = 100
MCQ 20 (FA+MCQ+SAQ)
SAQ 70 90 (10+20+70)
(Pass marks-60)
3. Practical examination
 OSPE 50
 Traditional 40 100
 Practical note 10 (Pass marks – 60)
Books + case
histories.
4. Oral examination
(Structured oral
examination)
 2 board 50+ 100
 4 examiner 50 (Pass marks – 60)
 2 internal
 2 external
Grand 300
total

After completion of examinations (oral & practical) and examining the answer scripts, it is
the responsibility of the convener (Head of the Dept. of Pathology of that center)/ examiner to
send the properly marked and sealed mark sheets to the Deputy Controller of examinations
and Two tabulators of respective University as early as possible.

32
Checklist before sending the marks :

1. Top of each mark sheet should be filled up properly (name of the examination, part –
oral/practical/written – paper & group/SAQ/MCQ, total marks of 3rd Professional
MBBS examination, subject – Pathology, written SAQ group – A, total marks – 17.5
etc.)
2. Roll number should be written serially.
3. Examinees who are absent must be mentioned against their roll numbers.
4. Use of white fluid is prohibited
5. Any overwriting should be avoided
6. Any pen through/alteration on the mark sheet should be avoided.
7. Each page of mark sheet must be signed by the four examiners except in SAQ.

Envelope :
The following points should be mentioned on the envelope

Name of the examination

Center of examination
Subject:Pathology
Oral/practical
Written-formative
Group
SAQ
All the envelope must be sealed and duly signed by the examiner with date and name with
designation. Oral, practical and formative mark sheets should be signed by all the four
examiners and similarly the envelopes are also to be signed by the four examiners.

Suggestions:
 A supervisory committee should be formed to observe the proper conduction of
examinations in different centers.
 There should not be the much variation in marking (ideally the difference should
not exceed 10%).
 For OSPE there should be check list in the procedure station with breakup of
marks.
 In course of time there should be a central bank or central questions for OSPE.
 In course of time there should be a central bank or central questions for SOE.

33