08/23/2017

Pathology mci screening test and indian medical examz high yield important topics study tips

By Live Dr - Wed Feb 11, 2:53 am

Pathology

Hamartomas Excessive and focal overgrowth of cells and tissues native to the organ in which it occurs
Choristoma / heterotropia Microscopically normal cells or tissues those are present in abnormal locations
giant cells disease
Langhan’s Tuberculosis

Sarcoidosis

Aschoff Rheumatic heart disease
Touton Xanthomas
Warthin-Finkeledy Measles

Staining intracellular accumulation

intracellular accumulation stain used
Fat Sudan 4, Oil red O
Glycogen PAS, Best carmine
Iron Prussian blue
Amyloid Congo red, crystal violet,

methyl green, thioflavine, toluidine blue,

DMAB nitrite.

Alcian blue Acid mucin,  mast cells
Masson Fontana Melanin
Von Kossa Calcium
Masson’s trichome Collagen
Commonest cause of hydrothorax Cardiac failure
Commonest cause of haemothorax Rupture of aortic aneurysm
Commonest cause of chylothoax Rupture of thoracic duct.

Amyloid proteins

AL Primary amyloidosis
AA Secondary amyloidosis
Beta 2 microglobulin Hemodialysis associated amyloidosis
Beta 2 amyloid protein Alzheimer’s disease
Transthyretin Hereditary amyloidosis, senile
Procalcitonin Medullary carcinoma thyroid

QUOTE CORNER

When life knocks you down you have two choices- stay down or get up.- Tom Krause

ELEVENTH HOUR PATHOLOGY                                                                                                              49

characteristic transudAte exudates
Protein <3gm %

Mostly albumin

>3 gm %

Mostly fibrinogen

Seromucin low high
Specific gravity <1.015 >1.018
Ph >7.3 <7.3
LDH Decreased Increased
Effusion LDH / serum LDH <0.6 >0.6
Effusion protein / serum protein <0.5 >0.5
Prion diseases
Kuru

Creutzfeldt Jakob

GSS

Fatal familial insomnia

Madcow disease

*Rapidly progressive dementia with myoclonus is the hallmark of Creutzfeldt-Jakob disease

Skin markers of internal malignancy
Acanthosis nigricans

Lentigines

Café-au-lait

Nevi

Pemphigoid

Dermatophytosis

Erythema gyratum repens

Erythema

HISTOPATHOLOGICAL CHARACTERISTICS OF SOME DISEASES

H-X  bodies

Birbeck granules

Langerhans cell Histiocytosis
Flexner Wintersteiner rosettes

Homer Wright rosettes

Fleurette

Retinoblastoma
Neurofibrillary  tangles

Senile / neuritic plaques

Amyloid angiopathy

Alzheimer’s disease
Lewy bodies Parkinson’s disease
Henderson Peterson bodies Molluscum contagiosum

TRIVIAL TRUTH

Our lungs inhale over two million litres of air every day, and if they were spread out, they are large enough to cover a tennis court.

ELEVENTH HOUR PATHOLOGY                                                                                                              50

HISTOPATHOLOGICAL CHARACTERISTICS OF SOME DISEASES

Bollinger bodies Fowl pox
Russell bodies Multiple myeloma
Halberstaedter Prowazeke bodies Chlamydia trachomatis
Ditcher bodies Waldenstorm macroglobulinemia
Dohle bodies Severe inflammatory disease or sepsis
Mason bodies Bronchiolitis obliterans with organizing pneumonia

GENETIC ASSOCIATIONS OF SOME CARCINOMAS.

Trk A gene Neuroblastoma (good prognosis)
RET proto oncogene Medullary carcinoma thyroid, papillary carcinoma
Rb gene (13q14) Retinoblastoma
BRCA1 Ca breast (females)

Ca ovary

APC gene Familial adenomatous polyposis coli
Chromosome 3 Renal cell carcinoma
Trisomy 17, 7, 16, loss of y Papillary renal carcinoma
11p13 Wilm’s tumor
Xp21 Duchenne muscular dystrophy
APP gene Alzheimer’s disease
Basophilic stippling Iron deficiency anemia

Lead poisoning

Thalassemia

Sideroblastic anemia

Cabot rings Severe anemia

Megaloblastic anemia

Howell Jolly bodies Post-splenectomy

Megaloblastic anemia

Leukemia

Heinz bodies Glucose-6-phosphate deficiency

Thalassemia

Acanthocytes Abetalipoproteinemia
Spiculated rbc Pyruvate  kinase deficiency
Burr cells hus

Uremia

*Reticulocytes, basophilic stippling, Howell jolly bodies and Cabot rings are stained by Romanowsky stains

Heinz bodies don’t stain by Romanowsky stains, but is demonstrated by supravital stains such as crystal violet

QUOTE CORNER

Try and fail, but don’t fail to try. Stephen Kaggwa

ELEVENTH HOUR PATHOLOGY                                                                                                              51

Types of pathologicAL calcification

Dystrophic calcification Deposition occurs in non viable or dying tissue, despite normal serum calcium levels
Metastatic calcification Deposition occurs in normal tissues due to  hypercalcemia
Centrilobular necrosis
Chronic venous congestion

Hemorrhagic shock

Carbon tetra chloride

Halothane

Acetaminophen

Rifampicin

Bromobenzene

Splenic amyloidosis

Sago spleen Deposit mostly limited to splenic follicles
Lardaceous spleen Amyloid spares the follicle and involves the walls of the splenic sinuses and connective tissue framework of the red pulp
Virchow’s triad includes
Endothelial injury

Abnormal blood flow

Hypercoagulability

Mallory bodies ARE FOUND IN
Alcoholic liver disease

Primary biliary cirrhosis

Wilson’s disease

Chronic cholestatic syndromes

Hepatocellular carcinoma

Pentad of thrombocytopeniC purpura
Fever

Thrombocytopenia

Microangopathc hemolytic anemia

Transient neurological deficits

Renal failure

TRIVIAL TRUTH

One human brain generates more electrical impulses in a single day than all of the world’s telephones put together.The brain continues to send out electrical wave signals approximately 37 hours after death.

ELEVENTH HOUR PATHOLOGY                                                                                                              52

URINE CASTS

Hyaline casts Normally present in urine
RBC casts Glomerular injury
White cell casts Interstitial nephritis / pyelonephritis
Broad granular casts Chronic renal failure
Pigment muddy brown granular casts Tubular necrosis

URINARY CRYSTALS

Uric acid crystals Envelope shaped
Uric acid dehydrate Tear drop shaped  crystals in urine
Cystine crystals Hexagonal plate shaped
Struvite crystals Rectangular prisms
Hippurate crystals Needle shaped crystals
PSGN Immunoflorescence microscopy shows diffuse granular deposition of Ig G and C3, giving rise to starry sky appearance

More extensive deposition leads to garland pattern

Type I MPGN Subendothelial and mesangial deposition Ig G and C3
Type II MPGN Dense deposit disease

Deposits within basement membrane

Deposition of C3

*Hyaline arteriosclerosis is seen in benign nephrosclerosis

Fibrinoid necrosis and hyperplastic arteriosclerosis is seen in malignant hypertension

Myelofibrosis
Characteristic dry tap

Peripheral blood shows leukoerythrocytic anemia

In bone marrow dysplastic megakaryocytes are characteristically seen

Marked splenomegaly (tear drop cells)

Cytochemical features of malignancy

Hairy cell leukemia Tartarate resistant acid phosphatase
CML Decreased Leucocyte alkaline phosphatase
Accelerated and blastic phase of CML Increased Leucocyte alkaline phosphatase
Lymphoblasts of ALL Negative for Sudan black B, myeloperoxidase, asd-chloroacetate esterase
Myelobasts of AML Positive for Sudan black B, myeloperoxidase, asd-chloroacetate esterase

QUOTE CORNER

Don’t wait. The time will never be just right.- Napoleon Hill

ELEVENTH HOUR PATHOLOGY                                                                                                            53

Psammoma bodies are seen in
Papillary carcinoma thyroid

Serous cystadenocarcinoma ovary

Meningioma

Acute rheumatic fever

Affects all the three layers of heart

Bread and butter pericarditis

The stenotic mitral valve appears like button-hole or fish mouth

Mac Callum’s patch – Rough portion of endocardium of left atrium

Characteristic distribution of erythema marginatum in rheumatic heart disease is bathing suit distribution

*Vegetations of NBTE are sterile, nondestructive, small, singly or multiple along the lines of closure of the leaflets or cusps

Bracht Wachter lesions are small abscesses sound in subacute bacterial endocarditis

*Soldier’s plaque- Chronic or healed pericarditis

*Tree barking of aortic intima-syphilitic aortitis

Cor bovinum/ cow’s heart- syphilitic aortitis

*Most common site of coronary atherosclerosis- left anterior descending branch (widow’s artery)

*Blood transfusion

Stored at 4 degrees centigrade

Those who have received HBIG – should not donate for 6 months

Those who have received Rabies vaccine -should not donate for 1 year

*Reid index=   Thickness of mucous gland layer_________________

Thickness of wall between the epithelium and cartilage

Normal ratio= 0.14 to 0.36

Increased in chronic bronchitis.

Thrombocytopenia refers to platelet count below 1 lac / cu mm

*Spontaneous bleeding occurs with platelet count below-20000/cu. Mm

*Wiskott Aldrich syndrome shows- small platelets.

TRIVIAL TRUTH

Apples, not caffeine, are more efficient at waking you up in the morning.

ELEVENTH HOUR PATHOLOGY                                                                                                              54

*Crumbling brick wall appearance-

Seen in Hailey-Hailey disease

Histological appearance due to loss of cohesion between keratinocytes

*Mycosis fungoides

T cell lymphoproliferative disorder

Histological hallmark is Sezary-Lutzner cell, which are CD 4+ T helper cells

*Von Willebrand’s factor can be assayed by-Ristocetin aggregation test

*Most sensitive and specific test for diagnosis of iron deficiency is-Serum ferritin level.

*Pathological changes found in patients of Down’s syndrome, more than 50 years, resemble-Alzheimer’s disease.

virus marker significance
HbsAg Acute or chrnoic HBV infection
IgM Anti-HBc -high titre Acute hbv infection
IgM Anti-HBc -low titre/ absent Chronic hbv infection
ig g anti hb c Past exposure to hbv
anti hbs Immunity against hbv
hbeag Continued infectious state,

Acute or chronic hbv infection

Anti Hbe Convalesecence
hbv dna Continued infectious state
Histopathological pentad of alzheimer’s disease
Neurofibriallry tangles

Neuritic plaques

Granulo-vacuolar degeneration

Amyloid angiopathy

Gliosis

Parkinson’s disease Dopamine< Acetylcholine
Schizophrenia Dopamine > Acetylcholine
Huntington’s disease Loss of gaba-ergic and Cholinergic neurons
Alzheimer’s Decreased Acetylcholine

QUOTE CORNER

Education is a progressive discovery of our own ignorance. -Will Durant

ELEVENTH HOUR PATHOLOGY                                                                                                              55

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