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PTLD - #addtoyournotes

PTLD complicates solid organ or bone marrow transplantation in 1% to 10% of cases. B-cell proliferations account for 95% of cases; the others are T-cell lymphomas. PTLD encompasses at least three clinicopathologic forms: Plasmacytic hyperplasia or infectious mononucleosis-like PTLD occurs in children and young adults early after transplantation, involving lymph nodes and tonsils. It resolves with reduction in immunosuppression.Polymorphic PTLD is more aggressive and consists of clonal growth of a mixed, pleomorphic population of lymphocytes, immunoblasts, and plasma  cells that efface lymph node architecture.Monomorphic PTLD is a lymphoma, usually with the features of diffuse large B-cell lymphoma EBV is detected in 80% to 85% of all PTLD cases.PTLD is being increasingly recognised in these days with more transplant recipients  -  Get up to date changes in medicine. Added to Revision Series - Subscribe here today

Real Life Cases.

Learn from day to day cases - Medicine changes everyday. Best way is to learn the modern practices in the country. The below thyroid came for frozen section today -  reported as follicular lesionFollicular Carcinoma - Latest classification of WHOMinimally invasive Encapsulated angio invasiveWidely invasive (on gross morphology)Most common mutation - NRAS (latest WHO) Learn the latest and try to solve and practice more efficiently -  #know the updates - Subscribe here today - Pathology Revision Series

Robbins Review Vignettes

An infant born at term develops abdominal distention in the first week of life. Meconium ileus is diagnosed. The infant has persistent steatorrhea and fails to develop normally. Later in childhood, multiple respiratory tract infections lead to widespread bronchiectasis. Which of the following laboratory findings is most likely related to this child’s underlying disease? Decreased serum thyroxine levelPositive HIV serologyElevated sweat chloride levelIncreased urine homovanillic acid levelAnswer with explanation will be updated, last vignette updated in Pathology Revision series -  To Enrol - Subscribe here today

G6PD Concept !

G6Pd deficiency - Read it with me ! You will never ever forget about G6PD Deficiency. All we need to know to excel pathology is the concepts of general Pathology and a clear mind to extrapolate. Nothing else !G6PD - The defect in HMP pathway - Reduces NADP/NADPH - So the glutathione peroxidase cannot recycle - So we are going to have more free radical mediated damage to the cell. - This is the basic pathogenesis With the above and with the simple concept of how a free radical damages a cell (lipid peroxidation, DNA damage, protein denaturation) - We are going to imaging the fight between a RBC and the Free radical. Lets start.I want you to read the following lines and imagine simultaneously what you read - Your Imagination is your gift, do not lose it. RBC vs FREE Radical We shall take the first effect of Free radical - LIPID PEROXIDATION. The amount of free radical following an injury can be more or less, right. ? When the free radicals amount is more - the RBC's membrane is totally damaged and it causes lysis inside the blood stream When the free radicals amount is less - There is a partial damage to RBC membrane - Makes it a sphere - and the spherical RBC's are removed by the spleen Next we shall take the second effect of free radical - Protein denaturation. The major protein in RBC membrane is GLOBIN, lets see what happens to it. When any protein is denatured it precipitates right? (best example which i love is egg protein and denatured omlette). Same way the globin will also be precipitated. This alters the chemical nature of the product and will take up stain only by NEW METHYLENE BLUE - So it's seen as a tiny blue dot close to the membrane, ppt will settle down - giving rise to your Heinz Body As i said above the protein is altered chemically, so it is not stained in Leishmann stain. So the area close to the membrane will not take up the stain so it looks clear and unstained (Imagine a RBC in a leishmann and make an arc of clear are around Heinz bodies) - What do you get, Yes it's your amazing BITE CELLS We just finished almost the entire disease with simple imagination. And you know what you stupid MCQ's will fall under it. Now let me frame few MCQ points for you guys from above. MCQ Points Findings in smear - Spherocyte, Bite cell, Heinz bodies Hemolysis - Both intra and extra vascular I need free radicals to trigger hemolysis - So EPISODES seen post infection (the common cause obviously to increase free radicals) Self limiting disease most of the time - Inflammation settles Simple isn't ? Do not go behind MCQ's and do not be taken away by factual theories which is not used in practice, a consultant who is practising will not know theory - Will know only practically relevant points. !Read the entire pathology with me with concepts which you will not forget - Conceptualise Pathology and Medicine - Subscribe here today (Early Bird - Rs.2499/- Valid till Feb 2022 - 16 months ) 

Courses in App

Dear Students,  The wait is over - we shall be starting the entire pathology for UG's non exam going students in the app. There will be two courses. One containing - Complete lectures -  Other one with practicals. I would suggest second years to go with practicals. There was an error yesterday so had to take away from the courses temporarily.  1) Complete Pathology - Subscribe here today 2) Complete Pathology + practicals - Subscribe here today 3) Pathology Revision course  - Subscribe here today Complete lecture series will have - Live + recorded (starting from Nov 5th),  Q bank, Image bank and recall question discussion.  Regards Ranjith AR

Robbins Review Vignettes

A 3-month-old previously healthy infant was found dead by his mother late one evening. When she put him in his crib 1 hour earlier, he showed no signs of distress. The infant’s term birth had followed an uncomplicated pregnancy, and he had been feeding well and gaining weight normally. Which of the following is the medical examiner most likely to find at autopsy? Hyaline membrane diseaseCerebral cytomegalovirusTetralogy of FallotNo abnormalitiesAnswer with explanation will be updated, mornings vignette updated in Pathology Revision series -  To Enrol - Subscribe here today

Robbins Review Vignettes

A 19-year-old woman, G 2, P 1, has a screening ultrasound at 20 weeks’ gestation that shows no abnormalities. However, premature labor leads to an emergent vaginal delivery at 31 weeks. Soon after birth, the neonate develops respiratory distress requiring intubation with positive pressure ventilation. Which of the following prenatal diagnostic tests could have best predicted this neonate’s respiratory distress? Maternal serum α-fetoprotein determinationPhospholipid analysis of amniotic fluidChromosomal analysisCoombs test on cord bloodAnswer with explanation will be updated, yesterdays vignette updated -  Pathology Revision series -  To Enroll - Subscribe here today

Courses in App

Dear Students, The wait is over - we shall be starting the entire pathology for UG's non exam going students in the app. There will be two courses.One containing - Complete lectures -  Other one with practicals. I would suggest second years to go with practicals.1) Complete Pathology - Subscribe here today2) Complete Pathology + practicals - Subscribe here today3) Pathology Revision course  - Subscribe here todayComplete lecture series will have - Live + recorded (starting from Nov 5th), Q bank, Image bank and recall question discussion. RegardsRanjith AR

Robbins Review Vignettes

A 60-year-old man has experienced vague abdominal discomfort accompanied by bloating and diarrhea for the past 6 months. On physical examination, there is a midabdominal firm mass. The stool is positive for occult blood. An abdominal CT scan shows a 5 × 12 cm mass involving the wall of the distal ileum and adjacent mesentery. A laparotomy is performed, and the mass is removed. Microscopically, the mass is composed of sheets of large lymphoid cells with large nuclei, prominent nucleoli, and frequent mitoses. The neoplastic cells mark with CD19+ and CD20+ and have the BCL6 gene rearrangement. Which of the following prognostic features is most applicable to this case? Indolent disease with survival of 7 to 9 years without treatmentAggressive disease that can be cured by aggressive chemotherapyAggressive disease that does not respond to chemotherapy and transforms to acute leukemiaIndolent disease that can be cured by chemotherapyAnswer with explanation will be updated -  Pathology Revision series -  To Enroll - Subscribe here today

Image Bank Updated !

Dear Students,Have updated the image bank. There are more than 50 images in them - Labelled and marked with salient points for identification.All of you can access them - Learn - Image Bank.This week is your crucial WBC week -  The most important because you guy confuse with your CD markers  - We will learn this time in a better way - Let me make you all Pathologists. In the telegram group -  I shall give you clinical features and images -  And i want you to order which marker you want to see and why. ! That's by far the best way to learn markers ... Let become better each day :)  - If you have missed to enroll - Subscribe here todayGood morning :) 

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