Portal Triad.
Z3-pericentral
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Z2-midzonal (yellow)
Z1-periportal
Toxin-Induced
Injury ? Zone-1
Infection - Red infarct > white infarct.
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Chronic passive congestion ? Nutmeg liver.
Periportal: Congestion
Pericentral
Necrosis
Visible hepatocytes
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Dead cell
Yellow-tan
Dark Red.
Due to RBC congestion.
Chronic active
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Chronic Persistent
Limiting plate
Limiting plate
Limiting plate
Damage
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Single layer of cells
By lymphocytes
Around portal Triad.
Intact.
Chronic Hepatitis
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Autoimmune Hepatitis
Acute
Chronic
Ballooning
Ground glass.
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Bridging necrosis
HBsAg
Councilman Bodies.
Hyaline cells / Shikata cells.
Bridging necrosis
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Bridging necrosis
<<< (all other in chronic)
Only centro-Portal
Fibrosis
Fatty change, Piecemeal
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Necrosis
(m/c intracellular accumulation)
In human body
Foam TGL
Steatosis
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Microvesicular
Macrovesicular
Early alcoholic
Phosphorus Toxicity
Late alcoholic
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Reye's Syndrome
Obese
ICc
DNT
Lysosomal lipase deficiency
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TPN
Jejunoileal bypass surgery
Valproic acid Tetracycline malnutrition
Autoimmune Hepatitis - Female
> IgG - all other markers (1)
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? Responds well to Immunosuppressants
I
II
III
?
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Anti-LKM
Soluble liver Agth
ab.
Liver Kidney
muscle...
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ANA-m/sensitive
I - Hep-c.
?SMTA-
most/specific.
II - Drugs.
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III - Hep-D.
1) Excellent fibrosis
2) Hepatic Rosette.
3) Emperipolesis
Hep-C characteristic Histopath: Liver Biopsy
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1) Councilman bodies.
2) Portal tract-lymphoid aggregate (III- LN Tissue)
Hep-B Serology
Earliest marker - HbsAg
Best epidemiological - HbsAg
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I) Best Acute infection - IgM Anti-body HBC.
Best for window period.
III) Infectivity- HBeAg
Qualitative marker for viral Replication.
Quantitative - HBV DNA > HEV DNA polymerase.
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HBeAg ? anti HBeAb: Seroconversion.
Super Carrier
Simple Carrier.
HbsAg ?; HBeAg ?
HbsAg ?
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HBV-DNA ?.
HBeAg (-).
HBV-DNA (N) - mild elevation
Pre-Core mutant ? Risk of Cirrhosis / HCC :
Liver Tumors
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m/c liver tumor - Metastasis (from ColoRectal)
m/c Benign tumor - Cavernous Hemangioma
? malignancy (adult) ? HCC (Hepatoma)
? malignancy Pediatric ? Hepatoblastoma :
Spleen
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m/c malignancy
m/c tumor
Marginal zone B cell
Hemangioma
Lymphoma.
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m/c Cause of isolated splenic mets: Ovarian tumor.
m/c for splenic mets- melanoma (m/c Cause)
Tumor cells
Glomeruloid
Schiller duval body
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Yolk Sac tumor
Granulosa Cell Tumor
? estrogen - endometrial Ca.
Reinke's Crystal - Hilus cell tumor
Rokintansky Protruberance - Benign Cystic Teratoma
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Rusked malignancy - (1%) Squamous Cell Ca.
Nuclear features-dx.
Papillary Ca of thyroid
1) Optically clear nuclei (orphan annie eye)
(without nuclear chromatin)
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2) Nuclear grooving
3) Pseudo inclusions (Cytoplasm dragged into nucleus)
Rimmed Vacuoles - Inclusion Body
(Basophilic staining) myositis.
Target Fibers - Denervation atrophy (Motor neuron disease)
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Basophilic Hue of Regenerating muscle fibre
Duchenne muscular dystrophy
Nemaline Rod myopathy
E-NT Z-like Structures / Zelba Bodies
made up of a-actinin
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Floppy infant, Rod like structures on special stain
Intermittent muscular weakness - mitochondrial myopathy
muscle fibres
Ragged
Red-Ragged myofibres
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Red-damaged mitochondria
E-MT ? Packing of inclusions
Mitochondrial myopathy.
Onion bulb neuropathy
Segmental myelination & demyelination
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? CIDP- Chronic inflammatory demyelinating polyradiculoneuropathy
? Charcot-Marie tooth disease
Urine examination-
? EMC crystal - Calcium oxalate.
Shape - Calcium oxalate
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Envelope - Calcium oxalate Dihydrate
Coffin shaped - Triple phosphate.
Muddy casts + Calcium Oxalate ? ethylene glycol poisoning
Papsmear
? Superficial cells ? estrogenic phase
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Intermediate cells ? Progesterone phase.
Parabasal
Basal
Trichomonas Vaginalis. Leptothrix than filament
elongated nuclei
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Bacilli
when leptothrix ? Trichomonas usually +ve
Candida-yeast + Hyphae.
Clue cells. Basophilic Border of Squamous cells.
Actinomycetes- Cotton Ball, Sun Ray filaments [H/0-100
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cyto-Blue
Histo pink.
Translucent Vacuole like structures in Squamous cell
? Chlamydial infection
Bullous Pemphigoid ? BpAg2.
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Inflammation- cluster of mast cells.
eosinophils
Through & through Blisters, Ribbon Candy
Dermatitis Herpetiformis - Neutrophils infiltrate
only in dermal Tip
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? dermal Tip hyperimmunofluorescence
ER/PR/positivity
ER, PR IHC ? nuclear IHC positive
Braun-Dau-good prognosis.
Her2-neu- membranous. IHC.
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Bad prognosis.
This download link is referred from the post: Medical PG Handwritten Notes 1st Year, 2nd Year, 3rd Year and 4th Year (Study Material)
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