Langerhan cell histocytosis: Punched out lytic lesion Geographic skull Floating tooth Vertebra plana

Oligodendroglioma: Calcified cortical mass Seizure Histology-Fried egg appearance,chicken wire capillaries

Osteopetrosis/marble bone disease/albers schonberg disease: Defect in carbonic anhydrase 2 Bone within bone appearance Defective bone resorption Anemia,hepatosplenomegaly Erlenmeyer flask deformity Cranial nerve palsies Decreased Ca,phosphorous Increased PTH vitamin D normal

Myotonic muscular dystrophy: Autosomal dominant Myotonia in mother Infants-skeletal deformities,generalised hypotonia,weakness

Juvenile dermatomyositis: Gottron papules Proximal muscle weakness Increased CK muscle biopsy

Viral myositis: -influenza,HIV,HTLV-1,group B coxsackie Male,young patients Increased CK urine myoglobin-positive

DMD: X linked 2 to 3 yr onset Thigh muscle atropy Calf-pseudo hypertrophy Gower sign Waddling gait Dilated cardiomyopathy Intellectual impairment Increased CK PCR for dystrophin Muscle biopsy

H.pylori: gastric MALToma HIV: diffuse large B cell lymphoma Burkitts lymphoma HHV 8: Primary effusion lymphoma Kaposi sarcoma Multicentric castleman disease Hepatitis C: Lymphoplasmocytic lymphoma

Non hodgkin lymphoma: Multiple peripheral nodes Non contageous spread Mesentric nodes & waldeyer ring involved Extra nodal involvement In aids pt-primary CNS lymphoma Common non hodgkin lymphoma: <15yr-burkit lymphoma >15yr-diffuse large B cell lymphoma

Kawasaki disease/mucocutaneous lymph node syndrome: Usually self limiting Infants & <4 yrs Desquamative rash Cervical lymphadenopathy Conjuctival & oral erythema Thrombosis & acute MI Iv immunoglonin & aspirin may be given

Microscopic polyamgitis/leucocytoclastic vasculitis: Affects capillaries,small arterioles & venules MPO-ANCA necrotising glomerunephritis & pulmonary capillaritis

Takayasu arteritis: Pulseless disease Pulmonary artery-pulmonary HTN Coronary artery-MI Renal artery-systemic HTN Polyarteritis nodosa: Rapidly accelerating hypertension in renal & visceral vessels Spares pulmonary circulation

Large vessel vasculitis: Takayasu,giant cell arteritis Medium vessel vasculitis: Polyarteritis nodosa Kawasaki disease

Rhabdomyoma: Multiple,occur in ventricles Regress spontaneously 50% with tuberous sclerosis Bizarre,enlarged myocytes-spider cells

Hypertrophic cardiomyopathy: Sudden cardiac death in young adults Autosomal dominant Misense mutation -left ventricular hypertrophy>15mm on echo -asymmetric septal hypertrophy -banana shaped left ventricle

Carcinoid heart disease: -caused by bioactive compounds released by carcinoid tumors -endocardial plaque like thickening & fibrosis -tricuspid insufficiency -pulmonary stenosis -no valve destruction -myocardium not invloved

Acute endocarditis: Highly virulent organism S.aureus Stormy onset Necrotising,ulcerative invasive valvular infection on a previously normal valve Usuallly require surgery Subacute endocarditis: Streptococcus viridans,enterococci Insidious Protracted course on a damaged valve

Libman sacs endocarditis: -SLE -small to medium sized,flat,verruceus vegetations -both side of the valve leaflets -valvulitis-fibrinoid necrosis Non-bacterial thrombotic or marantic endocarditis: -malignancy,trousseu syndrome -small,single/multiple non-destructive vegetation

RHD: sterile Small,warty,firm,friable vegatations Along line of closure Antischow/caterpillar cells Mccallum plaques Infective endocarditis: Non sterile Large,bulky,friable,destructive vegetations Along cusp of valves,mural endocardium Painful osler nodes Modified duke criteria

Subepithelial deposits: Membranous nephropathy PSGN Subendothelial deposits: MPGN type 1 Lupus nephritis class 3 & 4 Mesangial deposits: IgA nephropathy Henoch scholein purpura RPGN Lupus nephritis class 1 & 2 No deposits: Minimal change disease Alport syndrome FSGS