New Delhi www.devaanshpublications.com Dr. Devesh Mishra MBBS, MD Pathology, AIIMS > © o —_l © = a High Yield Contant iret leet ala) Nile av AN ae cede Viel sDevesh Mishra did his MBBS; MD Pathology (TNMC, Mumbai), Senior residency from AIIMS, New Delhi. At present he is Director of the (DEVESH PREMIER MEDICAL ACADEMY) and taking his own Pathology lectures all over India under brand name of “Concepts in Pathology”. Every day he interacts and clear doubts with more than 1,50,000 students across the country via his famous forum on Facebook named “DEVESH PREMIER MEDICAL ACADEMY (DPMA)”. He guides and motivate more than 1,50 Lacs of students everyday through his famous Facebook page “Dr Devesh Mishra”. Dr. Devesh Mishra has also launched mobile Application in the name of DPMA 3.0 APP in which video lecture, test and Image based video discussion are provided. For any Guary ll | | ll 9TRS195253505,PATHOLOGY O 8527981551By Dr Devesh Mishra MBBS, MD, AIIMS nia Instagram DEVESH.MISHRA.SINDEX Rao} re) dak 1. CELL INJURY 2 INFLAMMATION 3. GENETICS 4. IMMUNOLOGY Ss. NEOPLASIA e. BLEEDING DISORDERS & TRANSFUSION MEICINE 7 ANEMIA 109-136 LEUKEMIA AND LYMPHOMA 137-162 q. SYSTEMIC PATHOLOGY 163 A. KIDNEY 163-175 B.CVS &BLOOD VESSELS 176-184 C.LUNG 185-197 D. CNS 198-214 E. GIT & LIVER 215-233 F. BREAST 234-236 G. MALE & FEMALE GENITAL 237-241 TRACTS H. ENDOCRINOLOGY & 242-250 MUSCULOSKELETAL PATHOLOGY 1. SKIN PATHOLOGY 251-2561. CELL INJURY Stimale + tv + Physiotog ical J Leth} Z]chronte injurious 4] Peristent Pave Leal chron pr a Atrophy 3 lybertophy J caretisia 4] Metuplacia. derns See: .S s Numbers eNo eNoMetaplasia. + Mashancem fb). [reaper “Tybee ———]}‘Boyre ay 3 MNC-Worker, GERD@ fo tok chy Fae) SeipoeAH DPMA x] Reversible PriwgEM> aud)” Cultrostnedur Fgures2-balternsDPMA tissue architec v Coagulative Necrosis _Liquefactive Necrosis Speaal types -» Necrosis Gongrene @ Caseous Far @ Abrinoig. : Fibrinoid neecrosicApoptosis.Apoptosis.Apoptosis.Morpholeg y q Apoptosis “Mechanism | AbsptosicAgarose gel electrophoresis: oOOW “Fregrammed ceii-death enes ay@® _Gnitiation ® Execution Caspase > Caspase. t p Sher —;, 9] Sntvinsio 8] Extrinsic @ _Snbrinsie path © Stress® Extrinse both © ) Ped without-C-activalion & -Cacpase t be achv.Free Radicals l aka-> Oxidants Anti-oxidants oF 14FR,ack B-Sain m. imp hypothesis —> in: 16Most_effechve method Prolong - life Span + Starts —> tet Tissue > Abn © Jissue —» Norma) © Cat > Normal eral CSS Cy18Pree a Nw ed Acute Chronic. Acute inPlammaton events —————, ¥) Vascular Z) Celular Normally a q Neutrobhh if bo @ Ce D6 64 I ete us &q ‘Celtulay events,Sg DPMA @ Prego] 3-Steps Se “oOSig DPMA SnFlammatory - mediators} TF ® cater Plasma _v y 4] ii]Histomine | Serotonin Braaykinin funchions - Aad +e Lox Cox 5-Lox (2-LOX 24PaG,— PGHe © P4ts @ TAs, @ PG YDPMA i] Fever» 2] Infiammation > 3] Sete Shock —» 4] Ca-cachexia > S| Angiogenesis -> 6] Fibrosie> F] Granuloma, —> 8] Acute phase response broking > CAPR) APR FAcute phase response protems -—%=1—_, 26@)| Chrome = inflammation elo vMechonism? Granuloma -> De} Tanctamab Giant Cou MNGC MNGCDPMA 13] , Cough|Fever | CxLN—> LN by - 24x? + Cyfotune ? 29Naked - Granuloma, Steltate -Granuloma 30¢ @: ' . Durck granuloma (H &E stain): Durck granuloma (Fields's stain): 3” Warthin Ainkeldey Giant cell Seen in 31Halt en fanulation tissue 32Masson - Fontana - stain v Tissue Collagen-ty * BONE etendone [> . carlWOrege — « Basement membrane —> [Floor a 33g Peo) OLSi> “Earhes} eel appears > Stepe" OH =u on — el de> @P ® Remodeling ds> 42g? Vitamin, J _. . Hycronylaiton of Protine"s Con L a D Start tnereacing > ) Jou), > "D Man. Strength > 353. GENETICS Cod ne Nen-toding t ® © ® ©Genehe disorters Single-gene Multiple-gene oman [rien | & Tete [Maternol] ie ‘A7 OA. > > v Vv > AR > > 1) Reduced penetrance[Retinobiastoma. | am ® Dominaut-Negative 40® Osteogenesic Finperfecta @ Ehlers Danloe [ens |O Skelett-defet Oye @ cus, i Symbols — (9) [> Oo O-O- A®@ o> OS _]1> aA > ar OrTestis ree Approach, ne Gonadol Mosaiciem v Mitochondrial Inheritance. f XLRID 4 AR] AD 4] Gonada) Mosaiciem seaeg. 4 Mitech. ink. disorders ‘T] LHON (lebere Hered. optic Neuropalhy)— Wi] CPEO = Chronic. Progressive. Extemal oPbaiiegia@ xR: Femal Male v XX x ir Ss 8 XR eeeDPMA ® xd Father v ra trepemiting disease = daughters > Oo | Sone > Ar laugh — daughtere =— Sons ‘Both soxas involved 1 Generations skipped Peed Pred 46unclassie_inh- ® Genomic -Emprinking : Paternal 0e 9 = Pate Matite. Pas ami Mottete UY Mechanism 47G-Tmp aw’ Genehe dic y yan® Trinulestite Repeat Mutations ~~ TCTNR ro THRCd d C Tarogram “Poutine- as ety bing " ' " arrest 4 wo AlKalordKPR WR K hea 3 Male (44XY) Female (44XX) ch disoner, in + ee Ten aie g 45x > i lal af sy At xXY> q ‘Vern 109 A Treomy. 219 51eee Nae oe? ® ® Wine ED “en wane core vote Ue my os trimecter Be HE G] Nuchol srickness > om Doon + 11 Bes » 3 peng esha l] Parra > ) Inhibin-A awe 52polebrl Fissures (Single ba 7: ie al . a 408 re colde gap {sme mi fea “x st finger 53ice ou ied ag CC ce 88 +e 66 f, anda Re as oe as be fe Sig DPMAJRNER'S SYNDROME) ) 3 Wie aN Wied wae a “ie wey { od % ae be { 0 2 7 ma i Low post. Wi): Broad chest wd 4 Hointine widely Spaced Ni OrWesting of @: Nek® + cogretation Aorta, Normal CTricustid valve) « Bieusbiq ‘Short 4th. ‘ Metacarel hy es y Klinefelter's syndrome: in ok of ay BE ae aa éSg DPMA : Geneke PagmorphiemPe morphic genes | @©_ SNP Single -Nucteohae Payrorphisen Microsatelli ke. Minisatellite, Mol Beieay | © Nerthem Bictting > PER, Nott > Rolf Sipe ® Southem Blotting > Denaturaton 8) nesting @ Westen Bioting > oe cio Wiest = Pisa ” Ged) 58oxroy |= sed Ci [Rome Amy tae CGH Comparaive Genomic. Hybridisahion © % On op} [Huorsphore ] Paenth “green eaeana, re 604 [Tatler - Recogration Receptors (PRR) “Tate R] [eR Pele WR OR ree) fea 61Class. > Smmune celle‘Spiel || | [Co stimul, Mol ~ Inactivation dit ~~ ot Pon Signal a] T-cells > b] B-cell >® a @ ® Yg-T- we Ne Tem Doc i o 4Erfectoy-T-cell ® @&@ @&Hypersensitivity Reaction I7 rI- mw wo Auergens Aq ° T exposure > 661 Expocwet Q 7 |W-HSR, cDy > Cel|-mestiates CDg a H.—Types of Transplant / Grafts autograft Isogratt 2 ¢ rill identical twins & ae. xenograft allogratt <>) << uN different species Graft Rejection q v v + Olyperaute © Acute © chrone (@ Quad 69a = be of ITE 7 -It> ® Cento} Tolerance. © Pespreml Toleruce, Secreta D Coutro}- deletion ii) Ceutra) Editing GE Negotive setection) — G Reeept editing) [Central - Tolerance, Vv q Cenhalldeleton ENegahve-selechon] il} Ceutra) = Recep a Editi ss ng “Tiyrnas [ AIRE -gene os Ane ane ear c= A ( ye induee Sieiuey v R ited by : 70DPMA ® ® ® ®@~direrdere Enology Mui Foctorial Pec SRDS 4 5] 4 Molecalay—Mimi Cross Reactuil ,V qj O fhe Epitope ¥v q\SLE tv tT T t © sain © wigs @ cos @ feral Othe Pesala @ ONS © Symh.or Signs © Ankiboaies © Phetosensitvity > Ro (s#4) © Poviarsitis =p Re (88-4) @ shiving ving 64 Ro S#A) Neonatel -Wuput 7 o» Ss > SSB e * Hea Boek, ears 2 @LA) @Reynausls pom -d ak OLRNP © Bycfosis <> anki “Ribosomal -P-ankiboaiesDrug -Tndued lupus Enythemalosus.SIE-ax =. ThavedimmanoPuaresane wig J] M. Sensitive ? I] M. speufie : wi) Best for de Wo ow Prognosit : @ Rim or Teriphersl IPL; @ _Diffue or Homestnews © Senet: eked: + vv Sjogren osm — foo Cotomere sya irregular © Numerous, 76 Big dank, Grean-dots Regular afeo > Nudedi= Systemic Sclerosis . Biobsy > Scleroderma, ro © diefuse @® Localisect 7DPMA[Sigma] © © _——_——_,, Glandulay Extra gland re ete eH eae Dry-eyes Drg-mowte Kerateconjumctivitis Kerstomia, SicaTagen syeron® @ Seroiegi © & + me/bet site > + ears Fag Amyiorcosis Amyloid « «Meni yong, 80Amyloid I Fee Oem: Specia) - Stan ? + length > v l | [ + diameter = F5-l0 nm 4d PAs * Non- branching fil = Toluiaine Bue @ x my- diffraction = 3 congo Red stain v [ Cojo Redon | __ ® a codineagy gD Pin Polansed) Microseaby) J aLFa 4 cg Mshaing Proteina etcorders, misting 4) Amyloidosis a] Algheimors otis Chaberon indie? No-chaperon a Paunsons ¥ a7 4] Hankiqgtons « J Fion-ais 6 cystie Fibrosis Clas siFicarion © a a © @2 ® Hemodialysis @ HeredoPamiltal = Set assoc, At = ashe mutant bwld ype. ¥ v 82| [oealised-Amyteidoeis © Brain @Endocrine ® Renal @ Spleen eos LaREDaccour SegO_DPMA Amyloidosis of spleen 90> Normal spleen Sagospleen _Lardaceous spleen Lardaceous spleen: Pale waxy translucency ina map like es pattern. Sago spleen: Gray translucent bodies resembling grains of sago. 84Hepatocytes Cooooo oo Sinusoidal tn + ‘endothelial pt ~dep. Sinusoid - Ones at io Space 4 | ia DODoso 7 Image 15.1 Liver Parenchyma me| Best sile 4 Biopsy 4 Rectal Abdomina) fat pac aspirate 85SS — Congo red stain (PM): Pink or Red Apple green birefringence -—— Amglordosis i) @) y 865. NEOPLASIA Benign Malignant ® Mowmdenalis - @® _t Rate of Growth : [ome] oma S\N _g— vy mor— 7 © Spitpetio| @ Mesenchymal Mixed @Teratoma © Hematoma, il Chorictoma,[ehoristoma/ tissue $ v ‘ " anat-Site " anat. Site, @) metastasis: Sure sign of Maly m ‘ To q 4 Lv Routes of Mets © Lymphatic @Hematogenous 88@ _voss of Differentiation > “Tixmor— progression, + jormi Metaplasia —> jasia —> Rnoplosia. a ee eee 4 @ Rosie > ; > @ News > > > ® wis > ? 2 aS 0% oo| = os |08® Limitelecs Replicotton : @) Metabolism +(@) Gene repair defect = aa @ ®@@O°8 xP uy ar ProteonogenesAGF: « ppqr-« pms 2 TAF -% 3) GER? > ERBB-L —> » ERBB-2 —> 2 RET-protoonogene —> 4) ¢-kKIT —> 3) STP. a Ras —> 3) ABL > Brae a tAke.> 92#] NuTFr Mye ¥ ¥ Lye N-Mye emyc L 5] eyeun + SDK? + aim}, Di G Bat) DAERUD + ¥ 93Non-aivding i Rb EF t Galrdiv]—_D+K-4 -> [oI phosphorylation roe an) . ee GG Ss a mM Cell-cyete-inhibitors Ly Kip cai Pie sENK 44 94® Rb-gene @® DNA-Repasr-genes @Ts2 BRAS BRCA-2,[erate genesis | ® TT wees Bewjene— Benald Bengid ine. ‘Bengene ¥ + * Asbestos + Neca} #Cadtenium v . Chemie] mabgenicty ‘er ® LB) Non-ionisi ©. sehsing [BI | uu a Cr 96@® Microbial - Ca-qenesis © HRlow @esy @HPV @® Hepakhs ® [7a markers 97“Ta-maner classifrextion ST J] Hormones 2] Engymes J oncofetol protein 4} 4igeproteins ® FNAG! # Needle size = 98® THC = Immuno- el ‘Snteimedi Filaments O cjvtrnin @ nin Odin @rasshiot @)EHh 996. BLEEDING DISORDERS & TRANSFUSION MEDICINE so & Anticogulonls —“1 VI: K- depend) cloF Factors 100101DPMA Hemophiliq @ ©) ® 102‘Platelet—disorderz se Thabo [srrvanogenie | Non -Tenmunegente y "YTOe H-gene H-Supstance 4 104DPMA « A,B, H-og —> Present on 5Sndiestions of BT 4] Lnole Blood —> 2] Packed “REC—> 3) FRP> J Syehrebite >Whole Blood / PREC Brood / © Stork trancfucion ain —> © Compete transfucion Zin -> © MC Infechons MecoD in BT. 107> 1Blood-Vowme Bin Blood -vawme Bin __ MBT- not alo v [CompircaKons | at ykr #% = Mc-CoD—> in Massive BT 4 + | Fixed component —rato 4 PRBc : Platelets ° FFP 108yer N | YN Stem-cell EPO Grythropoeihin) CFU-B, Pro Penwmaty oa Onlean we codon) Elaroais Siren) Retieulocytes 109Reliculouste COUNF ] Normal = oxi) PB-= marker of BM- “Rettcutooste. 4 » Stain -> » Best stuin -> Sup aol Stain } 3 110ourine we mgs i Sig > 1) Giemsq 3] Jenner 3] wright 4] Leishmann Evan Rue Negooe 0% 0,00 ©. Oana enn Be Sogo, ose P Oh gir cate een utGiemsa stain (Reronontny Stal ‘Retent & bide @® New Metslene Bue © Briand Crary Blue \ . Central Pallor [6°] pane pay eNormal > CP= ree + HypoaiemicAramia cP> eee 112 Wie st RNA2 DPMA REC -Indices y t L w @ Mey © McH | Mee @RDUW = Kee Pichibuiron yale 82-36 FL “S¥g] [38-249] Ks-)45 7] + : oe a ures, # Mima 4 me < > Mivereithc: A. Mev > Anemia | Morte co age sceeste: MCU IooF 4 + IDA F) Megaloblastic. A D Aplosie Anemia > acd 2 Atoka Wer dis nema of 3 Tain > ton "ore 113DPMA ® Blood © Hemorytic A @® Impaired REC ra) oes, production fe jaloblastic A or. «= > PNY > TDA D> Gerd ach A. ") Acp 4 ATHA $) Hb-disorders ORerang SRaGAF] ; > RBC memb protein > 4) Ankyrin » Spechin > Band-3 9 Giycobhorin 114DPMA He Pager & Ae mem ation No Rexibility CO c= HS-> Lab -Tnvestig JJ Mcne 4] Retieuteste count Klelo Hs = 1 Rete. count 115© aan] > = a Dirpecti food ou fee YY 4 — = Hen pathame 2 Rosa v 116DPMA EDD def. Anemig Suprevitel tin Crystal -Viole @ [PNA= Paroxysmal, Nose] Hemosiobiniriq 117Worm AHA Co AHA, Cokt—Agglutinin 118 cold-HremeayssinBole, Mywplaema-nf Goldexp > PacrR, z Serum 119© Fefel-Hemogiobin [after & wx (Ly) Ka Ye © Adult-Hb: HbA [Ks Pa]> 967. ee Hoe [x4] <25/ WA, [x,6}> <35/ “Be 120Oka Semana | 40s *“AR—> HbSA > Hbss > + Pedia + Afeco-American, 121.® Vaso-vectusive © Ablaste © Sequedahoy enseg onsig ensi¢ 122Sicae Cert Anemia PLETE RIED wy Dug Sweding ate taPfavamatia [a itd. infarstion] 123Factors of Pecting sing 124Ps. CA-diagnocie Gd U toc ‘Nuhihe Poem!eK-chain > Xo [ote v 4] 10-gene- deletion —> 2K 0 “o> J 3a ._—> 4 4K 0 ied Mee of Non-Immunog. Hydrops tei 126Mieroeg hve pochvomiec Anemia. i] ROW > 127J ces Sings Te RBC Osvesbr. Fgity al ED oO sane Sonenigt oe ¥ Tloscem Nowmal RBS Arneson, Novel ? ii Megatoblastic Anemiq CYS 128Homouysteine ee Methionine Methyl-Malonyl-t-AS A» Succinyteo-R Megalobacte Anemia. Wr Boy Folic Aad, @ se Homocysteine @ Se Methyl Malonic Acid 129DPMA Megaloblastic Anemia (Vitamin 812 deficiency): + Patchy and reversible skin hyperpigmentation due to melanin accumulation. + Mainly affects knuckle pads and oral mucosa, Megalobloshe A > PRS - Hr ng 4] Eoniect > 3} M: Shesific> q 4] McHC 130a) DPMA 131IPA Fe-Metabelicr| Vv Mostey regulator Y 132 Fe-Absp,DMT-4 = Divalent etol Transporter 4] Sr ferritin 2) TransPessiq 3] TiBe 4] 4, Satur, of Transferrin S$] HepeidinGlossits 4 Req ‘Shin Smoote Tongue > Esophageal Webs Ketone wai Bolg Seoesl faye [Broming oe Fogel) 134DPMA Glossits Esophageal Webs Koilonychia 135AeD toy infiamm Mac; y © _cyruinee © c Norm, e Normochromic Anemia © Ps> Microayte hy pochromic. Anemia 136 4) Sr.fercitin 2} Trans ferrin 3] TiBe 4] ‘|,Satee «) Tronsf 5] HepcidinSg DPMA 8. LEUKEMIA AND LYMPHOMA ° wo Classification, FH -crasi fistion}— HL NHL 137—é © Prerurior Peripher] OPreursoy OPeritheral o B-ALL @ CLL] siL o T-ALL e Dageasie ang ides © Monte call L. © Anaplastic large © FolticutovL. call-tgmph © Burkitt L. © Enteropathy “stor. © Hainy cel. L d *D © Plasma eas Myeloma Tegan Goma mm : : a ()-O« 138Nodular Ly -Predom 139[REPHE]> Pop-com Re-atls | Na TOY 3 140141142,143Good : [ Bos] 144MDs = Myelo-Dysplashe Syne 4 O Eryinrerlos- i feria © veel @ mene 145Ped Prussian Blue ehain : Roget SootyAmL @ Genetic = @ MOS ®Ra-reated QNOS Gchioroma Abn ke ‘ Ctherore a t@:21) _ ed 4) t C6: J t 0619) Mo -> Minimal aiff My» AML Zour Matwatoy mi " € Moturation M-3-> Aule. Promyeioujhic leuk, my fle. Myelo-Monoayhie. Leu, mo Ac Monoeytic Lew, Me Ae. rythrobiastie L. 3 Ae Megetarpoashicr Lb 148[FRERE +e Pompe © AueyRods + Dic 4 Faggolts © tds: as 1” PML RARA. : “Prognosis Chiovoma. = Pedig _ Me-sile> ¥ Next: inv. —> © Tmmunoph.- . Cytegenelices 149Cur 150[eme |152153 2 DPMA Stages of neutrophilic granulopoiesis: 1) Myeloblast: Most immature stage, large nucleus with several nucleoli and a nongranular cytoplasm. 2) Promyeloeyte: cell is large, with a large round nucleus, prominent nucleoli, and primary nonspecific granules. 3) Myelocyte: Cell division ceases and secondary specific granules appear in the cytoplasm. 4) Metamyelocyte : Nucleus begins to indent. 5) Band cell: forming a horseshoe shape nucleus. 6) Mature neutrophil: Muktilobulated nucleus.# Bet-2, a Bere 154DPMA BL>U-be 1551564-M- proteins Sntvacellulor accu Blue 157“e “Myeloma DeFining Events mm ax? mye NE Cer cour CRAB-crileriq 158 Flame ceil©» [oe] Ss ou M@i5s5 4 1 Fe Pe>eo), Light-chasy MRI > ! feco} Seam 15 mm Emm) sis hast "Se eal Uninvolved > Hairy Celj-lenkemiq _ "_ celt- (eusemig ¢ Me presentation . oteblasmic Rojechime. + TRAP Tarhavate resis il phosbhotase. 159O[ER ie cinta] ofbmeat] 0 fy +> Tajen > © Taya Hairy cel-Teakemig Thase conbract Mic. 160langerho Cell - Histo fosis WHo- Denduihe cell +ymor © Pediq [Peacage = 4 Pentalami ~ dilated red ike struct @ derma 161DPMA Tennis racket appearance of Birkbeck granules (EM). Tennis racket shaped structures of Birbeck granules (electron microscopy). Seen in Langerhans cells cytoplasm in histiocytosis x {Langerhans cell histiocytosis). [Rene a =] “Tadpole cell He tcfoneypMelt- C Sartoma-Boty| oldes ania of Embryonal [ Rhabdomyosaroma 162) EMIC PATHOLOGY A. KIDNEY 7 ee Me v “a Struvite « Triple _phosphaie “yg pe ‘Hog bacteriq. i CofFindd sor Prem 163® Gtomerwar- inj @ Tuhulo-interstitiol -in{ 164J mmunofluorescenee ___emtowes | Linear Granular v “8 eg:Sig DPMA Lineor, Homogenous = Granular, Hetepgenua green TFI qreen % Linger TFL Pie TH Ce Gon posture ~ Psa - Mqn a - MPGN Ricule- Proliferative GN 166j= Crescentic GN M. Choroct i [Ses ns > M.imp factor > 167DPMA 1 Mbtre of| Bm Em) 2 Wing Bm 168DPMA Lupus Nephritis, (onto) L Minimal change IL? Mesangid GN JL» Foes Proliferative GN TW Diffuse Pro. GN > Membranous GH Wo Lops Saterosing Nephntis, Memb. @! v t Tt ‘Tdiopothic. ‘Lnfections Malignencies.. Meats Hey ey HIV 4 4 + Me ayo me ayo me aed + 4 ¥ 169ea] MEN ane q =; SolM,, Perioreita| edema. Massive proleinora., Renal | =m : : et 170RGN F r + x x + hig a (oeme-aerat) . 4 Both cn 2 At peony + 0 Cyne ew Ca Ne @)« Sasénistatot ——Trhramembramus both PEGS |: Focal Seg. Glomenio Sueresis ¥ v v + Idiopathic Scarring Tnfeshou Hereditary NPHs- NPHS- L 4 a7172Rec 173DPMA Rec — fT ® Clear cet @ Papiliany ® chromoprobe @ Bewni-duct 174175B. CVS & BLOOD VESSELS Vasculitis j= Bu-wail> ——__,———, Lage ves maa veseel iat wos Giant cau Artenits 1 PAN anse 1D Kawasaki Sy Oe celnt AD Tokayace & Ni) Tao = Bungere 176Thromboangiitis obliterans (TAO): Necrosis of the distal part of the fingers due to ischemic damage. a v N Thromboangiitis obliterans (TAO): Segmental thrombosing vasculitis with microabscess. 77Atherosclerosis, M I Atherosderosi 1 coy frtony Cine ECG> Biomarkers + Earliest > 4 + M. sensitive’ [best], 178Gross: MI TT¢- ass Tribhengi- Telragolium -chloride 4 eee Nowmol ME [| LC 179DPMA Chronic RHD: “Fish mouth” or “Buttonhole” shape dit fibrosis and calcification. (Mitral Valve stenosis) 180Cardioms :—— © Restrictive ® Dilated ® Hyberhopnic, Dem $ret © ARvem ® Tranostubo cm [Reythmnogenie RV: emi 181DPMA RaxarEgutrome © Ngperkerbsis © fryternegenic Batangas Bhima 0 wong ‘+ 040. Phatopictin gene rutetion 182Sz DPMA | DCM with Titin mutation: + Enlarge, bizare, hyperchromatic nuclei ikened to “Ninja stars"). 54 * Seen inpatients with dilated cardiomyopathy caused by tiin-truncating mutations Hybertrobhic em 183184Preumonia Ais pico Atypical pr if consolidahoy Congestion Consolidation Cangeshon 185@DPMA Tybica Prewmonig ® Bronchopreumoniq © Lobar: Preum 186ARDS Acute aay Distress $3 - d PAD> Diffce Alveolar Damage a1 Hp» Hystine Memb Ddisense, 2] Shoe lung AROS fF CouD+g]—> M.imp cell in pathoganesis > 187DPMA OPD = Obstrustive Pulmonary Disease a] Bronchial Asthma. 2] Bronchiettasic 3] Chonie Bronchiks 4] Emphysema, 188Bronaial Astrea a fae eytolegy @® Bronchi ‘ectasic 189© [chron Benen] Chroni¢_ Bronchitis}, 190Centounar Panainay [Rech Tre | Tracheg BYonehi Bronchioles Terminal bronchioles Respiratory " hiveolar quer Alveoti 191Prewmoconiosi¢ 192DPMA Asbestosis v ¥ 2 me “8 Moteate 4 193@® Squamous ry re Salt cell snieapiveoe @ Adenocarcinoma (@) inte @ [Bement care] 194Rdenocaranoma ‘Squamous cel carcinoma pss 195 DPMADPMA Shral CETERA NET Enero EntocreTimoZ] 196DPMA Neuroseer = mi tory grantee DENSE Cre - granules 197Nearoglil ———————q Newroedodenna] Mesodermal © Astroyjtes —_ @ oligoctendrouytes @ Ebony —— © Epidural © Subaural © Sntracetebro| @ Sub-Arachnoid wy Pr seu Meningeal A. yridginé “ y wot) 198[CSF -anelyaie Back m| Tam Viral m + colorless ay coils ere 3) Proteins 15-50 mg]. 4] Gucose 40-0 mg], 4 Fok —> cell-count ¥ Albumino- Mucicarmine Stain 201BIg> orgoném > Broad ©@ Septote ttybhoe or f @ Aute Angle branching @ Perpenstzuter branching 202ra* > fe» mide Neuron, ‘Cluster of grpe 203(ia Cluster of grape like, Vocus + Spongiform Neurons Je qaab cic 2] Seropie F Kare. 4] Fatal familial Snsomnia, Alghe(mers disease 204ch 4 APP-gene Ce) ® Neuritfe plaque © Newrofibrillary ® Hirano bodies Tangles 205= eS % Z a 3 3 % s a 206Parlunsons dicense— pathogenesis Mis fold ing Protein v Parkinson disease 207Bruny me [Pera Bantu } Aabalts sBengn > - + Malignant > th 208Glioblastoma a I Astroastoma, tr I a wr | g 209[sere] eg] s— 00000 —3 [Peendo Fae y one 0000 ey “a Freudo| eed 210Medulloblastoma| o Mc. site —o Rosette | ———_, “Tue. O PBendo ainDPMA Meningioma, . ongin saw NF- gene mut, + Mig: 212ome 00007 000 213DPMA 214Esophagus Trauma, Motions. Boerhaav-synq weiss “teor Es] [sm [Ad | Esophageal +umor| a q © Mc-Benign te * MC Mok ne vod 4 *M¢- site > 215216*Si\ver-Based * Non-silver ‘ + > Warthin —-- Giemsq Stam Hee > Giemenes ay” Daxk-Shimd -Boatts ” é 3 ) V Best. Non-invasive. Tweet. ‘mvettig. Che v 4 Seralogy Gost Bx 1) 6 Rabid-Urense test 217c- Bentan Te Me ed Mc - Benign Ty ‘ v | c { Ebittalial Mesen: gma, Malabsorption - 3 , indromes I HatimnorK —> (same 4] Tropico] sprue 4] Celiac disease 2] Giardiasis 2] Snfomm, Bowel Disease 2] Whipple's diceate 4] Amebiasis Crohng Wleerative, Disease colitisata FELQLAL (Geren S0US0 ; . Propria. Od O >—# O _ Diastase 3s 219DPMA whibhles dis Flask Shaped Nasri -p Me ee ier | Ueer Brad sh 1m 220Entawmeba, sTropbozeite, Pr Mae like @). Coufal Promin Nudej \ EnftophagerisDPMA Cele sprue ay v v + © cecinicot ® Biopsy ® Sercigy wire JM. sencitve crgbte> a Uy mee aa. ] © Overall Mucosal thickness v Bp Lt v cD uc cohnk diceate | Ulcerative GRE ¥ wv + COT + CDT © HLA-DR «= HLADR- . Mc-site: + Me-sites 222“D Haustrations v Normal Colom, Lead pipe cgtemily = Penturess meee Colon 7 loss S| Houctrohion, v Chronic Ulcerative Colitic 224v ofits A] Juvenile Paype of itil, Meened Pages petenar chue SmAv~4 gene mut 4 a} Peuty gegher-synd : oe | LRBA|StK-I) gene mut: Fatienby Oa 8] CoWDEN- Banyan Ruvolobaty — * Piyb Fog PTEN-gene mut + Bone] seer _Medutortationa tissue dumor + @ivoblasfona. 225Peutz-Jeghers syndrome (PJS): Characteristic presence of perioral mucocutaneous pigmentation22 Nidzoud Z3> foricentral 227Sinusoid (a= Kuprrer ceils e—> Stetiabe calls & NE Shue og Disse vi Blelde calle © VitA- metsbnion 1 Sheage 6 Coungeny rt Cirrhosis > “TypeT ea TE Collagen, 228G2 DPMA Aicoholic Liver Disease @ Steotosis © Steato-epatihe © Cirrhoris Hee. 229p ‘TAleonelie Uver Disease [Bier ie, chs 4 ATP-+B-gene + 230‘Serum geruoplesmin + 180-350 mg/L (18-35 meal) | Low in 90% ayser-lischer rings 4 ‘Absent Present in >99% if neurologic or psychiatric symptoms are present Present in 30-50% in hepatic presentation ‘and presymptomatic state Use copper (24 h) as (03-08 pmol (20-50 yg) | >1.6 pmol (>100 ue) in symptomatic patents; 0.9 to >1.6 pmol (60 to >100 2) in presymptomatic patients Liver copper He (03-0. pnol/g (20-50 pe/e of | >3.1 pmol (>200 yg) (Obstructive lver | tissue) disease can cause falsepostive resus.) DNA testing of APPT gene [He ‘No mutations | “wo mutations Haplotype analysis +444 (sbings | Omatches 2 matches only) “Usefulness range: + (somewhat usefu) to ++++ (ery useful). 231[tree] Mc- tumor Mc- |> tumor -t—i Feaia Adults y y 232Sg DPMANewneauve. Tavaswe. Oduri-cIn-siam OleduarG © Ductal ca © lobutar Ca-Tn-siha ov ® Paget’ Aisense. . Cato @. Medullary OF sprang SA Tavasive lobularPeau d’orange breast due to lymphedema: | Inflamm. Ca It is a swelling occurring because of a blockage of the lymph vessels. Inflammatory ) carcinoma. Tumor show extensive invasion and proliferation within lymphatic channels, ‘causing swelling that mimies non-neoplastic Inflammatory lesions.© Her-2-ve. oye Neat Her S) ey BRA-2+} vl" aabEs [Vir eats J eerste Breas Bice ties Oa, G ciaudin.| ov YExb d E-Coah. eR (were) feel“G. MALE & FEMALE GENITAL TRACTS © Seminoma © Nen-seninoma, wv 4) Embryonol Careinoma 2% Yolk sac Ty G Endodermal Sinus Ty) 3) Teratoma d Chortocayeinoma,Yolk-Sac Tumour « Me tumor in 7 Mle :- 238re v o © usual = =o . oer ty 3) Strumq-ovarit . usw Benign Wide» 2] Ovarian careinote + Femalesee ‘Clue calls > Bactenal Vaginosis Gareenelia. Vagirolis . “ey wid Trichomonas —Uaginalis 78 240Ga ==] Re” NG «Ho» owe 241© . ® congo Red Staining ° Malignant mesenchamal tumour [retea bone natiy) © MaePBimodal age il [ee] lderly © MCcitep distal femur [metarhysis| 243Ke Rag . a ‘triangle Ariangulor Shaded bebo * cones" ond, rain} “end of Perios eum. *Slo Aggressive A © Charack bul Mow-di guoste. aa me 6 Ld « Blosay scystic © Formation of bone by Ta-cells . [Diagratig 4 © fine lace-like Pallern qjrestiisie boue 244EZDPMA Ewings Sarcoma Family Tumours, © Malig, Bowe ye primitive round cells Couk differentiation Ewing Sq + Primitive Nearoectoo Ty [ PHed] ut" eset [emg Sarcoma Fania Te] ° Me site-» Femur Diaphysis © OWion-sKin-> ea veadion yen lager of Reactive. bones a & fsa Roms — (es-rr- SFinaker aby, Cell proliferation246 DPMA ‘Smmolt -yound blue ell ty 7 onttpaen (ar ghyeg™] © Homey vunght PreudovoreHes. Sho, Neuro dipferentiotion Ewing sarcoma with PAS stain(Gat eat) [bstoodasioni * Benign (but lcty “4 ressive] © Mcsile: Femur fash 5 rere] o Females [20-Sowa) +» Red-brown mats . Gave degenoh 5 2m. ——_ @r7we0n ® Nop-Tiu-ceits unit Multnudeated oe pebeestash type -C- 248249DPMA 250Molluscum contagiosum Molluscum Cont ogtosum= oe “Ty my, (ater sy i _— Suprabaso} Blisters Row of Tombstoryes y - alo Pacman Memb. L Rebiculow Fister Palterw.Sz DPMA Lineor Bani wah 4 149 Germoepid, wDermatitic HerbehPormis. Dermatitis Herpet Fovmis 254G@DPMA Deeb pry [PERE FRI aot T,A- deposits Aermo| popitine +ips Basal cell carcinoma (aka- Rodent Ulcer): + Nodulo-ulcerative lesions are destructive and ‘tumour nibbles away the Baal skin like a rodent (Rodent ulcer)! + Common site: Above the line drawn from the angle