USMLE images

[Zuhal]

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68 yo male patient presents to your clinic with postprandial pain. X-ray below, whats the dx?

 

[tiedyeddog]

Blueberry muffin rash? Congenital CMV or rubella?

yup

 

[tiedyeddog]

harder one:

Taken out of a lung.

what is it?
treatment?

 

[startswithb]

harder one:

Taken out of a lung.

what is it?
treatment?

My guess is small cell carcinoma bc of small blue cells and it's neuroendocrine and that's my association. Treatment is not surgery so chemotherapy.

 

[Jamiu22]

harder one:

Taken out of a lung.

what is it?
treatment?

Small blue cells - oat cell carcinoma.
Treatment - chemo, cos it's typically diffuse by diagnosis?

btw... the link you posted has the dx in it.. but didn't notice it until I typed this... (cost I didn't catch it the first time, lo.... decided to check) 😛

 

[tiedyeddog]

My guess is small cell carcinoma bc of small blue cells and it's neuroendocrine and that's my association. Treatment is not surgery so chemotherapy.

right on all, these are "kulchitsky" cells, the dark small blue cells of neuroendocrine tumors.

 

[startswithb]

Lung.

 

[tiedyeddog]

Lung.

Idiopathic pulmonary fibrosis?

 

[startswithb]

Idiopathic pulmonary fibrosis?

Not quite although they do look similar.

 

[CrouchingLiger]

Those look like some sort of interstitial granulomas...is that beryllium pneumoconiosis?

 

[Jamiu22]

idiopathic pulmonary fibrosis?

ards

 

[startswithb]

ards

Yes!! Hyaline membrane.

 

[startswithb]

More lung.

 

[addo]

Something interstitial going on there. is that inflammatory infiltrate?

How about this

ok, whatever this is too easy... just posting it because my ppd test turned positive 😎.... not even in 3rd year yet, what the hell?

 

[startswithb]

Yep, interstitial pneumonia.

 

[addo]

Yep, interstitial pneumonia.

viral, mycoplasma, pneumocystis or is it not an infectious interstitial pneumonia? whats going on?

 

[addo]

the look of the cells on the top is kinda specific to a couple of neoplasms... what is this? what do they call the look of those cells, and what other neoplasm fits the description?

 

[startswithb]

the look of the cells on the top is kinda specific to a couple of neoplasms... what is this? what do they call the look of those cells, and what other neoplasm fits the description?

Is it cytoplasmic clearing/halos?

 

[addo]

Is it cytoplasmic clearing/halos?

no... although i could see where youre going with that. the halo thing, thats CMV right?
this is a neoplasm

 

[CrouchingLiger]

Are those clear cells, with renal cell carcinoma? I think that still falls under the cytoplasmic clearing/halos label though.

 

[MLT2MT2DO]

the look of the cells on the top is kinda specific to a couple of neoplasms... what is this? what do they call the look of those cells, and what other neoplasm fits the description?

Oligrodendroglioma?

 

[addo]

Oligrodendroglioma?

Its a seminoma, but oligodendroglioma is the other one that shows the "fried egg" appearance.

I guess clear cell renal cell carcinoma also looks similar

 

[MLT2MT2DO]

Its a seminoma, but oligodendroglioma is the other one that shows the "fried egg" appearance.

I guess clear cell renal cell carcinoma also looks similar

Ok that makes more sense, I couldn't think outside of oligodendroglioma and for the life of me couldn't figure out what neuro cells underneath would have been

 

[tiedyeddog]

ok, whatever this is too easy... just posting it because my ppd test turned positive 😎.... not even in 3rd year yet, what the hell?

hey, me too! you starting INH?

no alcohol sucks...

 

[tiedyeddog]

cause?

 

[SLC]

cause?

Treponema Pallidum, aortitis.

 

[tiedyeddog]

Treponema Pallidum, aortitis.

yup, tree bark aorta.

 

[CrouchingLiger]

yup, tree bark aorta.

Is there anything in image A that relates to tertiary syphilis? I had the same guess just going off image B, but I'm not sure if there's anything significantly abnormal from the first image.

 

[tiedyeddog]

Is there anything in image A that relates to tertiary syphilis? I had the same guess just going off image B, but I'm not sure if there's anything significantly abnormal from the first image.

They are both showing tree bark aorta. Are you confused by the mitral valve labeling?

 

[CrouchingLiger]

Hah. Yeah i didn't even realize that was the aorta at the top. Now that I see it it makes sense, I was just distracted by the unnecessary label. It would have made so much more sense to me if mitral valve wasn't even labeled there. Thanks.

 

[tiedyeddog]

Hah. Yeah i didn't even realize that was the aorta at the top. Now that I see it it makes sense, I was just distracted by the unnecessary label. It would have made so much more sense to me if mitral valve wasn't even labeled there. Thanks.

me too, haha. It took me a minute or two before I realized what the holes the arrows are pointing out.

 

[SLC]

Hah. Yeah i didn't even realize that was the aorta at the top. Now that I see it it makes sense, I was just distracted by the unnecessary label. It would have made so much more sense to me if mitral valve wasn't even labeled there. Thanks.

The mitral valve helped me because I'm never certain whether I'm looking at Pulmonary vs. Aortic valve based on the appearance of the leaflets. But knowing that the Mitral Valve forms the lateral portion of the Left Ventricular Outflow Tract helped me realize where in the heart I really was.

For a minute, I thought the image on the left might be showing something going on in the Left Atrium, because only the mitral valve was labeled. But once I counted 3 leaflets to the left of the mitral, I knew I was looking at the Aorta/Left Ventricular Outflow Tract.

 

[tiedyeddog]

This is a drug reaction from an anti-cancer drug. Which one?

 

[ulikedaggers]

Why did this thread die?

 

[AscorbicA]

Awesome 👍

 

[Jamiu22]

Why did this thread die?

I used this thread as a way to break from monotonous studying....especially in a friendly environment. I actually enjoyed studying for step1 with threads like this (the other good one was the complicated topics thread). Good luck studying!

 

[faisal 2000]

59 y/o anemic pt presents to your clinic with a red, beefy tongue.

it is plummer-vinson syndrome

 

[Transposony]

Something interstitial going on there. is that inflammatory infiltrate?

How about this

I can see acid fast bacilli.

Gem of a thread BTW. Let's try to keep it alive.

 

[Transposony]

This is a drug reaction from an anti-cancer drug. Which one?

Vinblastine

 

[536038]

If you guys are looking for some good vignette style questions for diseases or radiography questions, Figure1 is pretty decent. It's a free smartphone app with real life photos and scans of patients taken by physicians daily that remove any identifying information, then ask you to identify the disease present. If you're on mobile, the link is here: http://download.figure1.com/winter2015?m=110
I've found it pretty useful so far when it comes to seeing classic clinical presentations of diseases.

 

[abolt18]

Bumping for those who still haven't taken the test. Nice to skim through.

 

[Dalinar]

Why aren't these stickied?

 

[Macaroon_Berry]

A really good source for looking at pics on the USMLE:
http://usmlepathslides.tumblr.com/about

 

[Macaroon_Berry]

Can someone sticky this thread so it doesn't get buried again? Very, very useful thread🙂

 

[lavenderflowers]

Bumping this thread for summer 2016 takers. Really useful!

 

[BP87]

sticky please!!!!