6 Discussion PAPER PATHOLOGY (SYSTEMIC) Ammay Hadley RENAL PATHOLOGY GLOMERULAR DISORDERS Condition ‘Special point | Clinical Light _ microscopy Immuno- fluorescence Electron microscopy MCD. FSGS MGN MPGN (Berger's PSGN (RPGN wim’ tumor ( Nephesbantornd.) epithelia) + mevordymnt = Associations 1. Beckwmn Weidner 2. vennyp Draah synd 3. whak Syndvowe Sardieere, so) Blastemad srommoce > nusoveay =e bo Mopar Lupus nephritis (LE) = I~ Te cbussll watias canine ee iil “wire loop lesions * Muthend Bet an CAs? Weer 7S" © Diabetic nephropathy 2 Citar ple tloacierosee aenesOuee, UE CE “ piffuse glomerulosclerosis “ic ramen ® BREAST PATHOLOGY st. Gallen’ classification- molecular subtyping based on gene expression profiling Subtype ER PR | Her2neu | Ki- 67 Prognosis | Familial Histology Luminal A Luminal B Her 2 neu rich Basal ct PNS AND CNS PATHOLOGY Nerve sheath tumors Tumor Histology ‘Association Special points [Schwannoma Anko Ff and Be NED \¢ spon sve veuocy Emails Info@damsdelhi.com | Website : www.damsdelhi.comDiscussion Paper- PATHOLOGY (sysremtc) [Neurofibroma [wary NFg [$100 Wve Meningioma Grade _| Histology Mitosis Special points fi Menneothelial = wo 2016 i Leos cou chavdsid | > 4 mupose) oH | iy rain imcortnn, ban Upreds The humor uu Yopiiowy Iypavdsid |? 22 pus) io OF | tg. i sr) Rosettes Type Seen in Homer Wright (jseuowielte) ~ Newsblackona, Meaulloblut”, eT [Eurnys Flexner Wintersteiner (hm) ehh lasoma, Perivascular pseudo (jsebde) |) uremcumema Ependymal ( fe) 2 LUNG ar ania + woh: oman Acute respiratory distress syndrome = Interleukins involved . IL-9 (w/c), f1-1, TWRX ~Cellsdamaged cnsabuutd and eqyalyou ~ Diffuse alveolar damage (yan) Muesay wells Pfabing moon Obstructive disorders [Condition Histological hallmark | Special, points Emphysema Anspaie enlospmunt datas fo fermnd) brnnite | Hil cenpianas Cinating ) Chronic bronchi Musa hiypieintion 15 the casbvar prding heily Index > 0-4 = Bronchiectasis Piney destruction + Abyosis ® Me site + Legh devder ree Asthma Aiwa verroduling .~ I) Sub baremanh mesh herd ingle. may niveare | Fors 1) Goblep (ey neanplonia Pneumoconiosis SD mecvoua stand bypeipiana 4) oH huyperoply® Condition Pathogenic substance | Associations (*) CWP Silicosis ARD. Lung cancer ‘Small cell Ca. ‘Squamous cell Ca. | Adenocarcinoma Prognosis Wis bee Indy msArale Genes involved [Ab ps3 bemye a, thre, Here, | EGER FANS, Mk Markers reptonchnows, core, 0s) | pyo, pi3 TOPs WAPI | Histology Ary sds! eg kanahin peasty | insane Aryyund Ctraly [Paraneoplastic syndrome | simpy, Atri Myperaleanda. Hema topical tomy? mers % Mowing 6edieg Rrodaghe,orcein, Rubeanse tid Alpha 1 anti Samin | Ma, | PAS me cvaslane renspanr anand trypsin,deficiency % | cada mualtoy pySteing ae (Monn K, AT) CARDIAC PATHOLOGY Myocardial infarction- changes ae x Duration Gross Microscopy 0-30 mins Nowe. Hee, Nome 0.5 to 4 hours ‘None. waniren 4 fibve _Uhyrnen ] 4-12 hours occamma daxk matiting 2auLy cwoputapve NUTS 12-24 hours Dark Mothing taky heupephils 1-3 days Yel imucr cone Brick vapulatne neuosis &rd reudaply) m4pilbale_ 3-7 days Hy petenit borders EAI woo phages 10 days mesg panulapn Wstue 10-14 days Carus vite (dapen) > anwehey psy | WEY. eof Usted grapued on I [2-8weeks | ownidh fo msde «tier _fomaroy Ting Lalayen duperition >2 months ney nig stag Denne wlopomms sat Valvular heart diseases www.damsdelhi.comDiscussion PaPER- PATHOLOGY (SYSTEMIC) CONDITION | MORPHOLOGICAL POINTS ‘SPECIAL POINTS MvP Grose’ Badlaaniig sp th valve | Moxgant syne mydiyanse like Maso! Myxwid dy enisabon I RHD Wag, vegefotioy alo ne une g davares —[Pihixpomane > Fithajy reddy le Pave veeraiua dryhe bien 8 | cephe embsusation dlosinee mvnduig poda. NBTE “ae fan dots alog ma Une qdasure | Cancer, | Main ousished ft 1SE “ ‘on ide By >| 5 (Litmon Stik enteaits) enim leion SEG Cardiac tumors ~ Primary Children Adults Benign Roblin) ss Mijeonna_(tstt abrum ) Malignant | Rhabelamyasavvons £ Iyfiosaewomo. TRANSFUSION MEDICINE info@damsdelhi.com | Website : www.damsdelhi.corDISCUSSION PapER- PATHOLOGY (sysremtic) Criteria for selection of donors Age: 18- 65 years Hb not less than 12 g/dL Het not less than 36% 45-55 kg- 350 mL >55 kg- 450 mL ‘SBP 100-160 mm Hg DBP 60-90 mm Hg Temperature not more than 37.5 deg C Pulse 60-100 beats/min ledical histor Pregnancy and 12 months after full term delivery- deferred During lactation- deferred Abortions- deferred till 6 months after 2” and 3” trimester abortions (Menstruation in itself should not be a cause for deferral) Infections Malaria- deferred till 3 months History of jauncide- deferred till 1 year History of being HIV, HBsAg / HCV antibody positive- permanently deferred History of intimate contact with HIV, HBsAg / HCV antibody positive individual deferred for 1year History of measles/mumps/chickenpox- deferred for 8 weeks History of influenza and URTI (Upper Respiratory Tract Infection)- deferred till 1 week after treatment Donors who give history suggestive of HIV infection such as the following - deferred permanently swollen glands persistent cough unexplained weight loss night sweats/fever skin rashes and skin infections and prolonged diarrhoea Vaccinations Individuals who have taken vaccination against TAB/TI/CHOLERA/ HEPATITIS-A - accepted if free of symptoms Those who have received Hepatitis 8 vaccination - accepted after 7 days of vaccination. Yellow fever/measles/polio - deferred for 2 weeks Rabies vaccination - deferred for 1 year. Those bitten by any animal- deferred for one year, Hepatitis B Immunoglobulin - deferred for 1 year Other histories Ingestion of Aspirin or any related medicine within three days prior to donation should preclude use of donor as a source of platelet preparation Major operations- one year after recovery info@damsdelhi.com | WebsiteDISCUSSION PAPER- PATHOLOGY (sysTEMIC) a * Minor operations- six months after recovery «History of receiving transfusion of blood or blood products- deferred for 12 months Donation interval The interval between two blood donations should be at least 12 weeks. = Atleast 48 hours must elapse after plasma pheresis or Cytapheresis before whole blood is collected from a donor + Apheresis should be done only after 90 days of whole blood collection or in an event when red cells are not returned at the end of pheresis The following colour code is used to differentiate the ABO group label Blood group 0 - Blue Blood group B - Pink Blood group A - Yellow Blood group AB ~ White Irradiation Cellular components should be irradiated in order to reduce the risk of post transfusion GVHD when a patient is identified as being at risk for GVHD = Forall immunosuppressed patients including bone marrow transplant (BMT) patients ! «When blood from a blood relative is used. ‘s_ Incase of exchange transfusion following intra uterine transfusion. 4 ‘The minimum dose delivered to the blood bag should be 25 Gy +2 Complications of massive blood transfusion + Hypothermia (most common complication) | © Hypokalemia > Hyperkalemia i + Metabolic alkalosis > acidosis © Hypocalcemia «© Hypomagnesemia © Dilutional coagulopathy (most common cause of death following massive blood transf ABO SYSTEM — BASICS ce sneer Holle Se bese Coa Fas, AMIPEROE oo Gai ty 9 ACOs > ‘ fh olige 2a Ps) wooly gladeseniingl MMAR |. Laltele, nehesig gelactocamina. added —> NAHURE _ J -yorepan gous Batlle —y0t (1,3) gat-coryl tramderase Fesoutett wo "Ag geledate wedded —2E NWTIGEN "omen WON FUNCTIONAL THATS FEAGAE i e-""" Sebdance Dijon elles RB coevct =m A Porotype nowt 0 ellde => Now contin ai. A Conga oly Wie wager 5 owny “HS OF “Bf ith © BE Ws gor edded HEY HF OTM [LG faonlay Gren info@damsdelhi.com | Website : www.damsdelhi.comAdult T Ceu Leukenva / lymphoma Tumor , Dy + Teel Sapevtevial amodeben 9. Tixprtin — Aupvale. WERE Cf > Wugily aggresive cujanenny AMPA , hopasugiencm es Oy, Lympradencpahg © Hypa (ol coma 5 poaantoplaane rypduorre fis £ > Power cely © dey Leap Mywosis furgarden ume by CDy + Teel , PAS te Cle > autanesny Aymphoma > inddlenh hunoy Muvsepie > mvawen both, epidumic ant aoe Ehdodemmobenhem > puma ce, roplvim bo ‘pidarmuc fauuuens Mino ahcaaty > uilleabin have mauienant” T cle sy cpidanns Seman sund euanemy Alin imnswemanf- + Bone Mdm) and puuphual Wael snnswemant leo cerebripom «lp (apreny like suler sys 4 bravn ) Anaplamc Iaage cou Aymphoma. 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TLE 20.000 ~2 Hae Ju.Mumuny orval Ly ryphocyter (rueaileed Lrmphory'a ) “smudge / Para chute (ely L epile cyloploam G Mute (elp ae vey bepeb and Jot vie milung Gsmege + prolymphouyiy > Auger Gp with premment pudestug “Y SBP onitee to. 1) Mesure byrmphouyle nut > Sp00 cts [ul >) Monoclonal ly mphorylig vith CLL phonslype. (1,20 7%, tote Is Cee as S weoplashe bie sialon : (Fmc? -ve) 3) Aymphorylosis shawa Se preent olteon— Cuma > dscppeas uso @ mart ) or 3 monn poumphouly in cle > zak CED - sees oe lap eel. iy: SESE [prdymphocyne teukernsa ) ; high tre nn prolianphong tty av Hsia Pe no wmmdge cel J poorer Me Press ms Tee oo ey 2 seeps ® in Js paced cle > #6 —Th dead § Life = MSe Repeated ingecrouy ue ® pagina ppnamia. 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Aymphouwsys OP) Roi ee pole neepare iat ee Pe ‘i Tad 9 ary Areas D ( fy 4 erdosped spleen avd Wey ( Eo = Tt PBS.) v ah, SO WW > Tb Thrembouphpena y (PO SDyx ope + eogenehe uae 3 Gila) ari > aan Dy Gr lt > ee » aypremmne , Mh pode dymphorrA | moshing Lv and exbarwdal odin) Amal Mowe 1 Aygo mater poy pos/s u rmrranaphenchyary subpnuuaigy By, nodule, | (Or He oe ae Dig > Megebre. © e cylin OD, re (One ” M7] Ahir 2 Ago make > SOX y 5 aupuar if egthiy Os, teettne:moupnal rene penicar + Turwr mominy B cely PMc exhanvdal nye 4) inwmsrscornplond— & alonach x Me Me ate fo Paterna mmunophuactypep COnm ) con -ve Oe eave Ox theron fice Dp Fr ins <0 Digg SY et 1 se |e ew moky 4 IRTH 2| 4 3B hype Noda) mapnal zone Aymphoma. (Malroma ) > Mc Exbanodal + : , pleas c eynginaipinal yore dani: fngen ia» SUbegy 1) Unronie ingeding py 2D yrrtoman ) Smad Me 4: iralin, op OE nlosnydia = Dil] Madnrre 2) Ame 419 Hankinon's —> mynd MALIMA Sposrens > Aan Gland Matha 0 up nie 9 TI G mation <> oatiotes Lylogenehic_Abmomabea & (1 1) oe & Cys)Hay Ce deukemia, Meo alle seukamie. venrado endptehoiis > Tuma mameny 6 ely 6m deade 4 Ue Op Hig = eed Repeated inpecdons cpevauly agp ically MyaShadesal mpecion Mowmve splenomegcty > almosy aluveyys 240n y Real pulp 1s expanded wh Addy celly cyracenenes Tasomy S may te anoualed Mut 5 BAP mulasion Rb aoice 3 VEMURA FING % hoy cep fing oytop aor has ike payecronn a Aud prosphalane \cren? | we ls fanugto penia C Pryence Tartouolte yenatw~ ag tochanshy : Tinmunop hanctypory ig rae bie puifore Sy | pitches eiesmnenitty Bmake> ¢ fon r eae. { pein S He mal cpeohe Monocyre markers > One oe Mas we 1s O13 din > dplene mayinal rere Lymphoma vu ? 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EBV ame dane Alle: LN and BM g Zmulc NAL 1 immunodprrnt 3 jy DLBCL buskitts Minosupie 2 mad see Iymphusid Cell % prammanp ravcles Deop blue “yroplarm C va ously pra cophapes wir Pash saine @ Tingible bo 2 samy sky appeaance oi 7 dy LE yophoxne, Noo 1a eigen Awe Ayrphorianke. ymphomA OLBCL Reactive (nviowlet hypeenlonte inno Plondyye ; Cg Dio f ions Li) 1h COL prBMMPerthesy Dr He BlLe ney, Dn QP G7 1 elmer 109, pwantet Jy Lon mb 4 tdi almosy 00f, |© Surrey proving bumnan Tumoy Mib1a > Wo bw Hor 6 ° nepabve S plow marke >» muchor in Ts and 16 repulaty 19; doth pede lymphoma. Re wm usminnaihin cheat = 7 60-8. fry adwanced stage bun ce vere. 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A enlaipiig arg ah mudnple 219 Ahigey Ofprenve ineame vonbravon amb apd @tibe anti COz0 Pmt "7 & Uniflee remison 1) 60- $07. g ag BtlLe fre vearayennly coop, Pzpeval 2ubly pen HiV/ jmmunovompronsied / pat hasup lan]- ealealy EBV te » paimeoy eftinion lymphoma | body carry Yymphors ynva manouorpmnnniced, Mv [KSA VE Pe ¥) mediaotral Auge a cou yap Yeung woman eave wD andyrvnad vga wd pyatr 1) iprmunodapienty type: Plaoma cel lumors @ plama cello cyfrplaom > Deep Blue on Ghemca rounded by petinucleat hip (aipece) nude > eceenincaly plated #7 (oarudined nwmabine MIP dé by Mencetly Og ( D sg Wwe 0 ng Plasme cel matkery Muthple Myeloma “Tumuy Q plaama (5 BM > moro dunal Plame velo (ee 1 ae) Pa Do bee Ge = 3 produce M compuren- prod mone dona iv g (monotlna) fo) wy —— Auivatty osteoddats 3 Bence Sry protein Fi aes “4 - bone feat Kappa > MIC Ge 5 IsA Coma > Jomada ) + Hype caloonia. Pound th Sted ea eeSE > pmubvan “Hye = 7044. M>Ie 2) Boe pains od ee sa # L u M/C aymprown efrsamn sj sical suis Posaplera, POdyrawuapasiy L SKU L Palm's L ) fem —> danele 3 ; Myper allemia = confuron , ; — 4) tatlnoy damepe > pueanpie calaaion tn kidney (UC cae ) > Bence Jing preg brie % hbuley > AL tye 4 omy [eidosis > Bacras — Fyelmopnnitrs 5) vepealed in feanny Mic (cay asa > plrephy cocag > Arepylowwo 3 Lae: Aug tr wacom dy ranma! Sg 02a tb , Ss punchion defeat 6) Bladvyy Mndancy ? Aroma] priein wae plas fur defer nol 1 ae Median Lab fous > 1) Pls > Namotyhe Mmothwowe Anemia Cc Roweaux jamal pe (stabi op RBC ) cou eykeria > Mave—tean—or es S207. G flame ce yn peuphual blard | rane (@ o PC fy BM) ay «BRT ) ) ama > >10). plasma cellg 15 BM. YW monug Plerma celBynucaate |muhnudeate pl cl Ploomablanst —> rmmatiag (indicole pon prognosis ) pleuma (tlh ohne > Russet bode hutne bode Q = O68. 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