Images Flashcards by Federico Girardi

Zenker diverticulum
- Defect between stylopharyngeus and cricopharyngeus muscles

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Atheroembolic petechiae
- RF: high cholesterol

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Mixed cryoglobulinemia
- Palpable purpura, arthralgias, peripheral neuropathy
- Chronic viral illness: Hep B, Hep C, EBV, ZVZ
- Chronic inflammatory disease: SLE

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Councilman body
- Acute Hep A / Yellow fever
- Apoptosis of hepatocytes via extrinsic apoptosis pathway
- Balooning hepatocytes & Councilman bodies

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Malaria
- Chloroquine: eliminates intraerythocytic paarasites
- Primaquine: eliminates exoerythrocytic hypnozoites (P vivale, P ovale)

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Left crus cerebri infarct
- Black-staining myelin
- CL UMN Sx: spastic hemiparesis

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Duplex collecting system
- Complications: ureteral obstruction
- Hydronephrosis
- Recurrent UTI

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Malignant melanoma
* Asymmetry w/ irregular borders
* Variable coloration
* Diameter >6 mm

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Osteoporosis
* Characterized by thinned trabeculae
* Commonly a/w vertebral compression fractures

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Reactivated TB
* Upper lobe consolidation

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Fibromusclar dysplasia
* Renal artery stenosis
* Bead-like: alternating dilation and stenosis

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Renal papillary necrosis (RPN)
- Analgesic abuse
- ADH: no effect on urine osmolarity & volume

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Anemia of Chronic Disease (ACD)
- Prussian blue stain shows iron storage
- Hx of rheumatoid arthritis

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Polycythemia
- Caused by COPD
- Increased density of normochromic, normocytic RBCs

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Cryptococcus neoformans
- Meningitis in AIDS patients

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Owl’s eye
- CMV

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Thumb sign
- Haemophilus influenzae

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Interstitial pneumonia

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PCP pneumonia

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Bullet-shaped capsid
- Rabies

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Lobar pneumonia

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Koilocytes
- HIV

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Abducens nerve (CN VI)

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Jejunum & ileum
* Jejunum: feathery appearance w/ oral contrast
* Jejunum: prominent plicaecircularis, greater mucosal surface area

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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

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

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 >> RBCs), abundant cytoplasm; lymphocytes resemble monocytes * Seen in EBV & CMV infections

Acute leukemia * Blasts: immature, large cells (size >> 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 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

Meningioma * Located on inferior aspect of forebrain within anterior interhemispheric fissure between the frontal lobes * Well-circumscribed, extra-axial mass compressing adjacent frontal lobes & olfactory bulbs

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

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