Images Flashcards
Zenker diverticulum
- Defect between stylopharyngeus and cricopharyngeus muscles
Atheroembolic petechiae
- RF: high cholesterol
Mixed cryoglobulinemia
- Palpable purpura, arthralgias, peripheral neuropathy
- Chronic viral illness: Hep B, Hep C, EBV, ZVZ
- Chronic inflammatory disease: SLE
Councilman body
- Acute Hep A / Yellow fever
- Apoptosis of hepatocytes via extrinsic apoptosis pathway
- Balooning hepatocytes & Councilman bodies
Malaria
- Chloroquine: eliminates intraerythocytic paarasites
- Primaquine: eliminates exoerythrocytic hypnozoites (P vivale, P ovale)
Left crus cerebri infarct
- Black-staining myelin
- CL UMN Sx: spastic hemiparesis
Duplex collecting system
- Complications: ureteral obstruction
- Hydronephrosis
- Recurrent UTI
Malignant melanoma
* Asymmetry w/ irregular borders
* Variable coloration
* Diameter >6 mm
Osteoporosis
* Characterized by thinned trabeculae
* Commonly a/w vertebral compression fractures
Reactivated TB
* Upper lobe consolidation
Fibromusclar dysplasia
* Renal artery stenosis
* Bead-like: alternating dilation and stenosis
Renal papillary necrosis (RPN)
- Analgesic abuse
- ADH: no effect on urine osmolarity & volume
Anemia of Chronic Disease (ACD)
- Prussian blue stain shows iron storage
- Hx of rheumatoid arthritis
Polycythemia
- Caused by COPD
- Increased density of normochromic, normocytic RBCs
Cryptococcus neoformans
- Meningitis in AIDS patients
Owl’s eye
- CMV
Thumb sign
- Haemophilus influenzae
Interstitial pneumonia
PCP pneumonia
Bullet-shaped capsid
- Rabies
Lobar pneumonia
Koilocytes
- HIV
Abducens nerve (CN VI)
Jejunum & ileum
* Jejunum: feathery appearance w/ oral contrast
* Jejunum: prominent plicaecircularis, greater mucosal surface area
Noncaseating granulomas
* Sarcoidosis (type IV HSR)
Placenta accreta
* Postpartum hemmorhage
Polycythemia
* High density of normochromic, normocytic RBCs
Retroperitoneal bowel perforation
* Free air in retroperitoneum
* PUD: duodenal ulcer perforation
Hydronephrosis
* Complication of congenital collecting system abnormalities
Medulla
A & B: Inferior cerebellar peduncle
C & D: Medial lemnisci
E $ F: Medullary pyramids
Cryptococcus neoformans
- Immunocompromised patient undergoing chemotherapy
- Narrow-based budding
- Bright red capsules stained with mucicarmine or Acid-Schiff stain
Acne vulgaris
* Follicular epidermal hyperproliferation w/ excess sebum production & bacterial overgrowth
Telangiectasias
* Small arterial malformations
Direct inguinal hernia
* Medial border: rectus abdominis muscle
CMV infection
* Owl’s eye appearance
* HUV/AIDS patient
B-thalassemia major
* Microcytic anemia
* B-globulin mutation
ADR: SMX-TMP
* Nonpruritic morbilliform rash
* Hx: Staph infection
A & B: lateral aspects of anterior parietal (postcentral gyrus) and posterior frontal lobes (postcentral gyrus)
C. prefrontal cortex
D. posterior, super temporal gyrus, Wernicke area
E. supramarginal gyrus$ inferior lateral parietal lobe
F. area anterior to premotor & supplementary cortices
G. medial aspects of anterior parietal (postcentral gyrus) & posterior frontal lobes (precentral gyrus)
H. medial parietal cortex posterior to somatosensory cortex
I. occipital lobe
Acute pyelonephrits
* Lymphocytic infiltrates in renal tubules
Multiple sclerosis
* White matter hyperintensities w/ periventricular lesions
Kawasaki disease
* Hx: fever, rush, proximal coronary artery dilation
Diabetic nephropathy
* Proteinuria
* Long-standing hyperglycemia
Left psoas abscess
* Difficulty w/ flexion
Autoimmune hemolytic anemia (AIHA)
* CLL —> autoantibodies —> warm AIHA
Chondrosarcoma
* Increased focal areas of calcification
Spleen rupture
* Motor vehicle collision
Calcified congenital bicuspid aortic valve
Myasthenic Lambert-Eaton syndrome
* Proximal muscle weakness of lower extremity
* Autoantibodies against voltage-gated Ca2+ channels on presynaptic neuron
Tinea versicolor
* Superficial epidermal Malassezia furfur infection
Distal radial fracture
Acute respiratory distress syndrome
* Type 2 pneumocytes undergo hyperplasia during recovery
Injury site causing Horner syndrome (B)
* Ptosis: left eyelid
* Miosis: left pupil
* Diminished flushing & sweating on left half of face
“Cherry-red” spot on macula
* Child: LSD (Niemann-Pick disease, Tay-Sachs disease)
* Adult: central retinal artery occlusion (CRAO)
Foam cell (lipid-laden macrophage)
* Niemann-Pick disease
Gaucher cell: lipid-laden macrophage resembling crumped tissue paper
* Gaucher disease
Globoid cell: neuronal tissue
* Metachromic leukodystrophy
Amyloidosis
* Apple-green birefringence under polarized light
* Deposits around blood vessels
Amyloidosis
* Congo red staining
* Deposits around blood vessels
Barrett esophagus
* Metaplasia: squamous to columnar epithelium
* Precursor to adenocarcinoma
Caseating granuloma
* TB infection
* Systemic mycosis
Coagulative necrosis (kidney)
* Infarction of organs except brain
Coagulative necrosis (kidney)
* Infarction of organs except brain
Dry gangrene (foot)
* Ischemia of lower limb, GI tract
Fatty change of liver
Fibrinoid necrosis (blood vessels)
* Malignant hypertension
* Vasculitis
Red/hemorrhagic infarct (testicle)
* Blood reentry in loosely organized tissue
* Pulmonary or testicular infarction
Keratomalacia
* Vitamin A deficiency
* Metaplasia: thin squamous lining of conjunctiva to stratified keratinizing squamous epithelium
Myositis ossificans
* Occurs during healing after skeletal muscle trauma
* Metaplasia: skeletal muscle to bone
Noncaseating granuloma: no central necrosis (nucleated)
* Reaction to foreign material
* Sarcoidosis
* Beryllium exposure
* Crohn disease
* Cat scratch disease
Caseating granuloma: central necrosis (anucleated)
* TB
* Fungal infections
Hereditary angioedema
* C1 inhibitor deficiency
Hemochromatosis
Medulla (upper)
A & B: inferior cerebellar peduncles
C & D: medial lemnisci
E & F: medullary pyramids
Spinal cord
A & J: fasciculus gracilis (dorsal column)
B & I: fasciculus cuneatus (dorsal column)
C & H: lateral corticospinal tracts
D & G: lateral spinothalamic tracts
E & F: anterior corticospinal tracts
Musculocutaneous nerve
* Travels between biceps brachii & brachialis muscles
Gastric mucosa
A. Gastric mucous neck cell
B. Parietal cell
C. Chief cell
D. Vascular endothelial cell
E. Perivascular fibroblast
Actinic keratosis
* Light pink, ill-defined macules w/ gritty texture in areas of prolonged sun exposure
* Precancerous: SCC
Osteoarthritis
* Joint space narrowing: asymmetric
* Subchondral sclerosis & cysts
Physis
* Cartilaginous plate between epiphysis & metaphysis near distal end of long bones
* Child (A): translucent area
* Adult (B): ossified radiopaque stripe
Scabies
* Multiple small erythematous papules frequently excoriated from scratching (intensely pruritic)
SLE
* Malar rash
SLE
* Discoid rash
Sjögren syndrome
* Lymphocytic sialadenitis
Scleroderma
* Sclerodactyly
Intestinal crypts
* Stem cell location in GI tract
Hypertrophic scar
* Excess type I collagen deposition localized to wound
Granulation tissue
* Initial phase of wound repair
* Consists of fibroblasts, capillaries, myofibroblasts
* Contains type III collagen
Keloid
* Excess type III collagen that is disproportionate to wound
Stratum basale (epidermis)
* Stem cell location in skin
Myocardial scarring
* Due to wound repair after MI
Ovarian carcinoma metastasis
* Seeding of peritoneum –> omental caking
Retinoblastoma
* Malignancy of immature retinal cells
* Both copies of RB1 TSG must be mutated
Pneumocystis jirovecii
* Methenamine silver stain confirms diagnosis
Hereditary spherocytosis
* Normocytic anemia
* Spherocytes & reticulocytes on blood smear
Bilateral hippocampal lesions
* Medial temporal lobe
* Inability to learn & recall new facts
Subdural hematoma
* Crescent-shaped fluid collection not bound by suture lines
Right bundle branch block
* Delayed right ventricle depolarization
* Widened QRS complex
Kernicterus
* Deposition of unconjugated bilirubin in basal ganglia, pons, and cerebellum of newborn
Pyelonephritis
* Interstitial inflammatory infiltrate
Fetal hydrocele
* Patent processus vaginalis results in collection of peritoneal fluid in fetal scrotum
Tubular adenoma
Transverse section of penis
A. Superficial dorsal vein
B. Tunica albuginea & Buck fascia
C. Urethra
D. Corpus cavernosum
Graves disease
* Diffuse goiter
Graves Disease
* Follicular hyperplasia
* Scalloped colloid
* Chronic inflammation
Multinodular goiter
* Enlarged thyroid w/ multiple nodules
Follicular thyroid adenoma
* Benign proliferation of thyroid follicles surrounded by fibrous capsule
Hashimoto thyroiditis
* Chronic inflammation: germinal centers (lymphoid follicles)
* Hurthle cells: eosinophilic metaplastic follicular cells
Papillary thyroid carcinoma (PTC)
* Defined by nuclear features: clear, Orphan Annie Eye nuclei & nuclear grooves
* Papillae often associated with psammoma bodies
Follicular thyroid carcinoma (FTC)
* Malignant proliferation of follicles surrounded by fibrous capsule
* Invasion of malignant cells through fibrous capsule
Psammoma bodies
* Concentric lamellated calcified structures
* Seen in papillary thyroid carcinoma, meningioma, papillary serous carcinoma of endometrium/ovary, mesothelioma
Medullary thyroid carcinoma (MTC)
* Sheets of malignant cells in an amyloid stroma
Anaplastic thyroid carcinoma
* Undifferentiated malignant cells
Nephrocalcinosis
* Metastatic calcification of renal tubules: deposition of calcium within normal tissue due to hypercalcemia
* Associated with hyperparathyroidism
Osteitis fibrosa cystica
* Fibrosis & cyst formation in bone resulting from massive bone resorption
* Associated with hyperparathyroidism
Islet of Langerhans
* Found in pancreas
* Beta cells located in center
Type 2 DM
* Amyloid deposition in islets of Langerhans
Hyaline arteriolosclerosis
* Marked thickening of arteriolar wall
* Associated with nonenzymatic glycosylation of arteriolar basement membrane in advanced DM
Nodular glomerulosclerosis
* Small kidney with scarred, granular surface
* Associated with nonenzymatic glycosylation of renal arterioles in advanced DM
Nodular glomerulosclerosis
* Nodules of pink hyaline material form in glomerular capillary loops due to increase in mesangial matrix
* Associated with nonenzymatic glycosylation of renal arterioles in advanced DM
Waterhouse-Friderichsen syndrome
* Bilateral hemorrhagic necrosis of adrenal glands
* Associated with sepsis & DIC
Pheochromocytoma
* Tumor of chromaffin cells in adrenal medulla
Cervical transformation zone
* Exocervix (left): nonkeratinizing squamous epithelium
* Endocervix (right): columnar epithelium
CIN III
* Dysplasia involving full thickness of cervical epithelium
* Hyperchromatic cells with high N:C ratio
Pap smear: CIN III
* Normal cell: small nucleus, low N:C ratio
* Dysplastic cell: large hyperchromatic nucleus, high N:C ratio
Endometriosis: ovary
* Chocolate cyst: hemorrhagic debris from cycling endometrial tissue
Endometrial hyperplasia
* Hyperplasia of glands relative to stroma
* Crowding of endometrial glands
Endometriosis: soft tissue
* Yellow-brown “gun-powder” nodules: hemorrhagic lesions from cycling endometrial tissue
Endometrial carcinoma
Endometrial carcinoma: endometrioid
* Overgrowth & crowding of disorganized endometrial glands w/ minimal stroma
* Resembles normal endometrium
Endometrial carcinoma: serous
* Papillary architecture: fibrovascular cores
* Associated with psammoma bodies
Leiomyoma / fibroids
* Benign tumor of myometrial smooth muscle
* Multiple, well-defined, white whorled masses
Ovarian follicle
1. Oocyte
2. Granulosa cells: produce estradiol
3. Theca cells: produce androgens
Corpus luteum
* Yellow color due to production of steroid hormones (high cholesterol content)
Ovarian cystadenoma
* Benign surface epithelial tumor
* Serous & mucinous subtypes
Dysgerminoma
* Large cells with clear cytoplasm & central nuclei resembling oocytes
Endodermal sinus tumor
* Schiller-Duval body: glomerulus-like proliferation of cells
Ovarian fibroma
* Benign fibroblast tumor
* Meigs syndrome: fibroma, pleural effusion, ascites
Ectopic tubal pregnancy
Placental abruption
* Premature separation of placenta from decidua
* Bleeding on maternal surface
Complete hydatiform mole
* Swollen, grape-like hydropic villi
Hydatiform mole
* Hydropic villi
Terminal duct lobular unit (TDLU)
1. Lobules
2. Terminal duct
Fibrocystic change w/ apocrine metaplasia
* Metaplastic cells: abundant pink cytoplasm, larger size
Breast fibroadenoma
* Fibrovascular projections lined by luminal epithelial & myoepithelial cells
* Well-circumscribed: sharply demarcated from normal tissue
Phyllodes tumor
* Fibroadenoma-like tumor w/ fibrous overgrowth
* Leaf-like projections
Ductal carcinoma in situ (DCIS)
* Comedo type: high-grade cells with necrosis & dystrophic calcification in center of ducts
Paget disease of the breast
* DCIS involving skin of nipple
Invasive ductal carcinoma: tubular
* Well-differentiated duct-like structures w/o myoepithelial cells
* Desmoplastic stroma: dense connective tissue
Invasive ductal carcinoma: mucinous
* Malignant cells floating in pool of mucus
Invasive ductal carcinoma: inflammatory
* Carcinoma present in dermal lymphatics: obstructs drainage
Invasive lobular carcinoma
* Malignant cells grow in single-file pattern due to lack of E-cadherin
Breast cancer: ER+ / PR+
* ER & PR: nuclear receptors
* Positive staining indicates tamoxifen sensitivity
Breast cancer: +HER2/neu amplification
* HER2/neu: cell surface receptor
* Positive staining indicates trastuzumab sensitivity
Seminoma
* Large cells w/ clear cytoplasm & central nuclei resembling spermatogonia
Seminoma
* Homogenous mass w/ no hemorrhage or necrosis
Embryonal carcinoma
* Immature, primitive cells forming glands
Embryonal carcinoma
* Hemorrhagic mass with necrosis
Choriocarcinoma
* Composed of cytotrophoblasts (1) & syncytiotrophoblasts (2)
* Resembles placental tissue but villi are absent
Normal testicle
1. Sertoli cells: line seminiferous tubules
2. Leydig cells: found in interstitium between tubules
Normal prostate
1. Glands: inner luminal cells & outer basal cells
2. Stroma
Prostatic adenocarcinoma
* Mass in posterior periphery of prostate
Prostatic adenocarcinoma
* Small glands infiltrating normal prostatic stroma
* Prominent, hyperchromatic nucleoli
Dysplastic kidney
* Cystic space lined by wall containing cartilage
Polycystic kidney disease (PKD)
* Enlarged kidney with cysts in renal cortex & medulla
Acute tubular necrosis (ATN)
* Anucleated epithelial cells detached from basement membrane
Acute interstitial nephritis (AIN)
* Inflammatory infiltrate in interstitium between renal tubules
Minimal change disease (MCD)
* Normal glomerulus
1. Bowman capsule
2. Bowman space
3. Mesangium
4. Capillary loop
5. Glomerular basement membrane
Effacement of foot processes
* Minimal change disease (MCD)
* Focal segmental glomerulosclerosis (FSGS)
Focal segmental glomerulosclerosis (FSGS)
* Sclerosis: dense pink collagen deposits
* Partial involvement of some glomeruli
Membranous nephropathy
* Thick glomerular basement membrane
Glomerulus w/ granular IF
* Due to IC deposition
* Nephrotic syndrome: membranous nephropathy, MPGN
* Nephritic syndrome: PIGN, DPGN
Membranous nephropathy
* Subepithelial IC deposits: “spike-and-dome” appearance
Diabetic nephropathy
* Kimmelstiel-Wilson nodules: dense mesangial sclerosis
Nephritic syndrome
* Hypercellular, inflamed glomeruli
Postinfectious glomerulonephritis (PIGN)
* Subepithelial humps: IC deposits
Rapidly progressive glomerulonephritis (RPGN)
* Crescent in Bowman space comprised of fibrin & macrophages
Glomerulus w/ linear IF
* Due to anti-GBM antibody
* Goodpasture syndrome
Glomerulus w/ mesangial IF
* Due to IC deposition in mesangium
* IgA nephropathy
Staghorn calculi
* Struvite (ammonium magnesium phosphate) stone in renal calyx
Renal cell carcinoma
* Gross: yellow mass
Renal cell carcinoma: clear cell type
* Polygonal clear cells w/ accumulated lipids & carbohydrates
Wilms tumor
* Malignant tumor comprised of blastema (1)
* Blastema forms primitive glomeruli, tubules (2), and stroma (3)
Flat urothelial carcinoma (UC)
* High-grade flat lesion
Papillary urothelial carcinoma (UC)
* Fibrovascular finger-like projections lined by epithelium
Lobar pneumonia
* Consolidation of entire lobe of lung
Lobar pneumonia
* Acute inflammation involving alveoli
* Frothy exudate containing neutrophils
Lobar pneumonia
* Red hepatization
* Consolidation of lung tissue due to exudate containing neutrophils & red blood cells
Bronchopneumonia
* Scattered patchy consolidation centered around bronchioles
* Multifocal & bilateral
Bronchopneumonia
* Scattered patchy consolidation centered around bronchioles
Interstitial (atypical) pneumonia
* Diffuse interstitial infiltrates
Interstitial (atypical) pneumonia
* Inflammatory infiltrate involving interstitium
* Little/no alveolar infiltrate
Chronic bronchitis
* Hypertrophy & hyperplasia of bronchial mucus glands
* Reid index: >50%
Emphysema
* Destruction of alveolar walls
Emphysema
* Destruction of alveolar walls
A1AT deficiency
* A1AT protein aggregates in hepatocytes
* Pink, PAS-positive globules
Emphysema
* Barrel chest: increased AP diameter of chest
Asthma
* Charcot-Leyden crystals: MBP aggregates in sputum
Permanent dilatation of bronchi
Idiopathic pulmonary fibrosis
* Fibrosis of lung interstitium
Asbestosis (pneumoconiosis)
* Asbestos bodies: long, golden-brown fibers with associated iron
Sarcoidosis
* Noncaseating granulomas in lung interstitium
* Collections of epithelioid histiocytes
Sarcoidosis
* Asteroid body: stellate inclusion within giant cells of granulomas
Pulmonary hypertension
* Plexiform lesions: consequence of severe long-standing pulmonary hypertension
Acute respiratory distress syndrome (ARDS)
* Alveoli lined by hyaline membranes
Acute respiratory distress syndrome (ARDS)
* “White-out” of lung on CXR
Neonatal respiratory distress syndrome (NRDS)
* Ground-glass appearance: diffuse granularity of lung
Small cell lung carcinoma (SCLC)
* Poorly differentiated small cells
Squamous cell lung carcinoma
* Keratin pearls
Squamous cell lung carcinoma
* Intercellular bridges
Squamous cell lung carcinoma
* Central location: tumor arising in main bronchus
Lung adenocarcinoma
* Columnar tumor cells forming glands
* Mucin production: blue-gray mucus in cytoplasm of some cells
Lung adenocarcinoma
* Peripheral location: tumor arising adjacent to pleura
Lung adenocarcinoma in-situ
* Columnar tumor cells growing along alveoli & bronchioles
Carcinoid tumor
* Polyp-like mass in bronchus
Carcinoid tumor
* Nests of well-differentiated neuroendocrine cells
Carcinoid tumor
* IHC: chromogranin
* Neuroendocrine tumors
Spontaneous pneumothorax
* Collapsed portion of lung resulting in shift of trachea toward side of collapse
Mesothelioma
* Tumor encasing lung
Schistocytes
* Seen in MAHAs (TTP, HUS, DIC, HELLP) & mechanical hemolysis (prosthetic valves, aortic stenosis)
CMV
* Mononuclear cell infiltrate: lymphocytes
* Infected cells with prominent basophilic nuclear inclusions & nuclear halo
Microcytic hypochromic anemia
* Small RBCs w/ increased central pallor
* Seen in IDA, anemia of chronic disease, sideroblastic anemia, thalassemia, lead poisoning
Sideroblastic anemia
* Ringed sideroblasts on Prussian blue-stained bone marrow biopsy
Target cells
* Result from increased surface area to volume ratio of RBCs
* Seen in HbC disease, aplenia, liver disease, thalassemia
Crewcut skull
* Associated with marrow expansion in skull due to B-thalassmia major
Megaloblastic anemia
* Macrocytic RBCs: macro-ovalocytes
* Hypersegmented neutrophils: >5 lobes
Howell-Jolly body
* RBC with nuclear remnants
* Seen in functional asplenia (SCD), splenectomy: spleen normally removes RBCs with nuclear remnants
`
Spherocytes
* Small, spherical RBCs w/o central pallor
* Due to decreased surface area to volume ratio
* Seen in hereditary spherocytosis, warm autoimmune hemolytic anemia
Sickle cell anemia
* Sickling occurs with hypoxemia (high altitude, acidosis), high HbS concentration (dehydration)
Hemoglobin C crystals
Bite cell
* Seen in G6PD deficiency
* Formed by removal of Heinz bodies by splenic macrophages
Heinz bodies
* Denatured & precipitated hemoglobin
* Seen in G6PD deficiency
Falciparum malaria
* Trophozoite rings within infected RBCs
Aplastic anemia
* Empty, fatty bone marrow
Infectious mononucleosis (IM)
* Atypical lymphocytes: enlarged nucleus (nucleus»_space; RBCs), abundant cytoplasm; lymphocytes resemble monocytes
* Seen in EBV & CMV infections
Acute leukemia
* Blasts: immature, large cells (size»_space; RBCs) w/ punched-out nucleoli
Acute myelogenous leukemia (AML)
* Blast: immature, large cell w/ punched-out nucleoli
* Auer rod: cytoplasmic crystal aggregate of myeloperoxidase
Acute myelogenous leukemia (AML)
* Blast: immature, large cell w/ punched-out nucleoli
* Auer rod: cytoplasmic crystal aggregate of myeloperoxidase
Acute monoblastic leukemia
* Monoblasts characteristically infiltrate gums
Chronic lymphocytic leukemia (CLL)
* Increased number of lymphocytes & smudge cells
Hairy cell leukemia
* Neoplastic mature B cells w/ filamentous, hairlike cytoplasmic projections: fuzzy appearance
Sezary syndrome
* Secondary to mycosis fungoides
* Sezary cells: lymphocytes w/ cerebriform nuclei
Chronic myeloid leukemia (CML)
* Predominant increase in granulocytes & granulocyte precursors
* Characteristic basophilia
Essential thrombocythemia (ET)
* Increased platelets
Myelofibrosis
Teardrop cell
* Seen in bone marrow infiltration: myelofibrosis
Follicular lymphoma
* Disruption of normal lymph node architecture by neoplastic follicles
* Follicles seen throughout entire lymph node (not restricted to cortex)
Follicular lymphoma
* Neoplastic follicles lacking tingible body macrophages
* Due to absence of apoptosis
Reactive follicular hyperplasia
* Follicles contain tingible body macrophages
* Indicates ongoing somatic hypermutation & apoptosis
Burkitt lymphoma
* African variant: involves jaw
Burkitt lymphoma
* Starry-sky appearance: sheets of lymphocytes w/ interspersed tingible body macrophages
* Sky: neoplastic B cells
* Stars: tingible body macrophages
Hodgkin lymphoma (HL)
* Reed-Sternberg cell: large B cell w/ owl-eye nucleus
* Owl-eye nuclei: multilobed nucleus w/ prominent nucleoli
Hodgkin lymphoma (HL): nodular sclerosis type
* Lymph node divided into nodules by bands of sclerosis
Hodgkin lymphoma (HL): nodular sclerosis type
* Lacunar cells: Reed-Sternberg cells present in lake-like spaces
Multiple myeloma
* Lytic punched-out lesions in skull
Multiple myeloma
* Rouleaux formation of RBCs
Langerhans cell histiocytosis
* Birbeck (tennis racket) granules
Coronal Brain MRI
A. Superior frontal gyrus
B. Cingulate gyrus
C. Insular cortex
D. Thalamus
E. Mesial temporal lobe
Pityriasis rosea
* Oval patches: longitudinal axes aligned w/ relaxed skin tension lines on trunk
Gout
* Tophi: MSU precipitation in tissues as yellow subdermal inclusions & masses
Gout
* Monosodium urate (MSU) crystals in synovial fluid: needle-shaped, blue (birefringent) under perpendicular light
Tension pneumothorax (left-sided)
* Contralateral tracheal deviation / mediastinal shift
* Ipsilateral hemidiaphragm depression
* Ipsilateral hemithorax expansion & widened intercostal spaces
Small bowel obstruction
* Upright abdominal XR: air-fluid levels throughout small intestine
Intestinal malrotation
* Upper GI barium study: small intestine only present within right abdomen
Normal hysterosalpingogram
* Regular contour of uterine cavity
* Narrow linear contrast stripes extending from uterus: fallopian tubes
* Spillage of contrast into peritoneal cavity: normal fallopian tube patency
Meningioma
* Along
Candida vulvovaginitis
* Vaginal discharge contains pseudohyphae
Councilman body
* Apoptotic hepatocyte: small nuclear fragment & intensely eosinophilic cytoplasm
* Seen in acute & chronic viral hepatitis
Osteoporosis
* Associated with compression fracture deformities of lumbar spine
Knee MRI
A. Subcutaneous fat
B. Anterior aspect of medial femoral condyle: PCL attachment site
C. Patellar ligament: connects patella to anterior tibial tubercle
D. Anterior cruciate ligament (ACL): connects lateral femoral condyle to anterior tibia
E. Posterior cruciate ligament (PCL): connects posterior intercondylar tibia to medial femoral condyle
Prosthetic aortic valve
* AP film: above line from left atrial appendage to right cardiophrenic recess
Prosthetic aortic valve
* Lateral film: above line from carina to cardiac apex
Squamous cell carcinoma (SCC)
* Keratin pearls
Squamous cell carcinoma of the lung
* Central location
* Cavitary lesions
* Extensive hemorrhagic necrosis
Perforated duodenal ulcer
* Upright CXR: pleuroperitoneum (free air under diaphragm)
Papillary urothelial carcinoma
* Papillary tumor in renal collecting system
Lead poisoning
* Basophilic stippling of RBCs
Acute rheumatic carditis
* Aschoff body: interstitial myocardial granuloma pathognomonic for ARF-related myocarditis
* Anitschkow cells: macrophages with characteristic caterpillar chromatin
Acute promyelocytic leukemia (APL)
* Abnormal N:C ratio
* Auer rods in cytoplasm
Axial brain MRI
A. Caudate nucleus
B. Internal capsule
C. Thalamus
D. Broca’s area
E. Primary visual cortex
Basal cell carcinoma (BCC)
* Basaloid blue islands of cells invading stroma
* Cells form peripheral palisaded pattern w/ retraction from surrounding dermis
`
Herpes zoster (shingles)
* T11 dermatome affected: band-like arc from inferior thoracic spine to anterior abdomen below umbilicus
Third-degree AV block (complete heart block)
* No relationship between P waves and QRS complexes
* Constant, regular interval between P waves & different constant, regular interval between QRS complexes w/ no relationship to each other
Meningococcal meningitis
* Gram stain of CSF: gram-negative diplococci
Wernicke encephalopathy
* Atrophy of mamillary bodies due to chronic thiamine deficiency
Dermatomyositis
* Gottron papules: pink papules over dorsal fingers
* Paraneoplastic syndrome a/w adenocarcinomas
