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Important Topics of all Subjects of 4th Year MBBS with Books Guide


Hematuria: Causes. Painless hematuria: Causes. Morphology of TCC. Classification & mode of spread of testicular tumors. Predisposing factors: Germ cell tumors. Seminoma, spermatocytic seminoma & Matureteratoma: gross & microscopic features. 3 serum markers for testicular mass & their value. BPH scenario: Dx, gross & microscopic features, secondary changes in kidney & LUT. Seminoma scenario: Dx, 4 risk factors.


Classification & Pathogenesis of ovarian neoplasms. Ovarian tumors associated with BRCA 1 & 2. Cervical carcinoma: Most common (based on cell of origin), Risk factors, role of HPV in pathogenesis, 2 common HPV genotypes, spectrum of precancerous lesions, grading, clinical staging. Endometriosis scenario: 3 theories of pathogenesis, important sites. Serous cystadenocarcinoma scenario: Dx, features. Fibroids scenario: Dx, sites, hormonal effects on size. Endometrial cancer: Dx, staging, risk factors.

UQs Breast

Classify breast tumors. Risk factors for breast cancer. Fibroadenoma scenario: Dx, gross & microscopic features. Invasive ductal (NST) &lobular carcinomas: Morphology. Features used in Scarff-Bloom-Richardson system. Significance of ER/PR & Her 2-neu. Prognostic factors & their relative importance in breast cancer. Noninvasive investigation to evaluate benign or malignant nature of lump breast. Define atypical hyperplasia. Risk of cancer with atypical ductalhyperplasia. Paget’s disease of breast scenario: Dx, basis. DCIS scenario: Dx, types, microscopic picture of comedocarcinoma.

UQs Musculoskeletal

Classify bone tumors. Rickets: Pathogenesis. Features of TB osteomyelitis. 2 major manifestations of Gout. Gouty arthritis scenario: Dx, pathogenesis, lab tests. Osteosarcoma scenario: Dx, sites, subtypes, morphology. Duchenne muscle dystrophy scenario: Dx, mode of inheritance, findings of muscle biopsy, definitive test. RA scenario: Dx, histological features. Ewing sarcoma scenario: Dx, gross & microscopic features.


Difference b/w concussion & brain injury. Features of cerebrovascular disease. Astrocytoma scenario: Dx & glial tumors types, histology of infiltrating astrocytoma. 3 tumors most commonly metastatic to brain. Meningioma scenario: Dx, morphology, prognostic factors. Medulloblastoma scenario: Dx, tumor spread, ominous complication. 3 microscopic abnormalities in Alzheimer’s. 2 types of acute ischemic injury to brain. 2 groups of brain infarcts.


Pathogenesis of beta thalessemia major. Hb electrophoresis results in sickle cell anemia. Mechanism of RBC sickling. Type of anemia in a women having long hx of menorrhagia, findings on peripheral smear & bone marrow exam, 3 biochemical tests. Adult reference ranges for RBCs. Morphology & diagnostic criteria of iron deficiency anemia.


Classification of WBC malignancies. Differences b/w Hodgkin & non Hodgkin lymphoma. Scenario HL: detailed morphology, types , prognosis. Scenario Burkitt’s lymphoma: Dx, morphology, prognosis. Scenario Multiple myeloma: investigations & their findings.

UQs Lungs

3 causes of pulmonary infiltrates in immunocompromised with 2 examples for each. Pulmonary infections in AIDS patients with CD4 cell count

UQs Kidney

Scenario Pyelonephritis: Dx, 5 steps in pathogenesis with diagram. Spectrum of morphological changes in diabetic nephropathy. Scenario Acute Postinfectious Glomerulonephritis: Findings on urine exam & renal biopsy, clinical course of disease. MPGN: Light & electron microscopic findings in renal biopsy. Scenario Minimal Change Disease: Dx, light, electron microscopy & immunoflorescence findings. Nephrotic syndrome features. Name the commonest childhood tumor of kidney (Wilm’s), microscopic features, prognostic factors. Causes of pre-renal azotemia.

UQs Blood Vessels

Define atherosclerosis, components of plaque, arteries commonly involved, its risk factors (You must know which are major/minor & constitutive/controllable), complications with their pathogenesis. Role of hyperlipidemia & monocytes in atherosclerosis.Define & Classify aneurysm. Etiology, morphology & clinical course: Dissecting aneurysm. Temporal arteritis scenario: Dx, DDx of granulomatous vasculitis of aorta, 3 pathogenic mechanisms in non-infective vasculitides. Kaposi sarcoma scenario: types & morphology.

UQs Heart

MI scenario: Coronary vessels & their areas of supply. Gross & microscopic picture of heart at various durations from MI. Complications & lab evaluation of MI.Mitral valve lesions in a lady with SLE.Bacterial endocarditis scenario: Dx, morphologic & clinical features, complications.RHD scenatio: Dx, morphologic & clinical features, complications.

UQs Endocrine System

Papillary ca scenario: risk factors, morphology, 3 nuclear features. Thyrotoxic crisis. DDx of thyroid lesion with follicular pattern of growth. Difference b/w follicular adenoma & ca on histopathology. Mode & side of metastasis of papillary & follicular ca thyroid. Morphology & its correlation with underlying pathology, investigations: toxic multinodular goiter. Autoimmune thyroiditis scenario: Dx, mechanism, 2 endocrine diseases associated with it. Triad of manifestations in Graves disease. Morphology of thyrotoxic thyroid & thyroid adenoma. DKA scenario: 4 clinical & 4 metabolic features. Causes of coma in DKA. Management of acute DKA. Insulin resistance.

UQs Oral Cavity & Esophagus

:Name Salivary gland tumors. Oral cancer: Risk factors & morphology of SCC. Esophageal carcinoma scenario: macroscopic growth patterns. Esophageal
SCC scenario: Histology & risk factors. Barret Esophagus scenario: Dx, histology, complication & its prediction on biopsy.

UQs Stomach

Define peptic ulcer. Mechanism of gastric ulcer. 4 major diseases associated with H pylori infection. Active inflammation features. Gastric carcinoma scenario: Dx, histology, morphologic feature important for prognosis & risk factors. Role of H pylori in gastric ulcer. UQs IntestinesEnlist ulceroinflammatory conditions.Ulcerative colitis scenario: Gross + Histological features & role of intestinal flora in pathogenesis. Crohn’s disease scenario: microscopic features. Justify need to repeat rectal biopsy in Ulcerative colitis. Intestinal carcinoid scenario (cutaneous flushes, diarrhea, cough, wheezing, hepatic mets): diagnosis, morphology and basis of symptomology. Colonic adenocarcinoma: prognostic factors & role of APC gene. Salmonella enterocolitis scenario: Gross appearance, pathogenesis & comparison with intestinal TB. Sessile, cauliflower like mass in rectum with normal mucosa around: 3 DDs & factors determining risk of malignancy in such cases. Colonic polyps: Local complication. Multiple polyposis syndromes & their significance.

UQs Liver

Causes of Jaundice. Lab tests in a case with jaundice. Sequence of development of serological markers of Hep B (acute & chronic). Extrahepatic biliary atresia: Histological features in liver & enzymes elevated in this condition. 3 liver diseases associated with chronic consumption of alcohol & histology of each. Histological features necessary for diagnosis of Cirrhosis, its causes & complications. Collagen type deposited in cirrhosis & cells producing it. Flow charts to illustrate outcome: carrier of HBC with HDV superinfection. Chart the serology: HBV acute infection with resolution. Natural course of HCV infection, tests before starting management. Role of Hep B & C in hepatic neoplasia.

UQs Biliary System & Pancreas

Define Cholelithiasis. Classify gallstones & discuss their etiology, risk factors & complications. Expected microscopic features of a removed gall stone. Complications of cholelithiasis. Complications of acute pancreatitis.

Download Complete List of all Important Questions of all Books of 4th Year MBBS