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Corticosteroid therapy can improve the gastric lesion with a return of acid secretion but the higher incidence of gastric polyps and cancer of the stomach in these patients can only be detected by frequent follow-up. Hypersensitivity reactions characterised by hyperfunction of the immune system and cover the various mechanisms of immunologic tissue injury. The infection may extend into adjoining soft tissues as well as may destroy the bone. Phlebothrombosis leads to swelling with pain and tenderness, but it is uncommon in the upper extremities. Massive thickening of the calvaria and skull base narrows neural and vascular channels. Breastfeeding transiently potentiates this effect, because Lactobacillus found in breast milk does not synthesize vitamin K. Infective endocarditis is a destructive process, and healing may lead to fibrosis, but not to nodular calcium deposition. Microscopically, depending upon the time lapse between injury and cell death, ischaemic shrinkage, hydropic change, focal necrosis, or fatty change may be seen. About 5% of treated cases of lobar pneumonia develop inflammation of the pleura with effusion. A separate chapter on disorders of platelets and bleeding along with transfusion medicine (Chapter 13) has been placed interposed between these two chapters. The examples of lymphoedema include the following: i) Removal of axillary lymph nodes in radical mastectomy for carcinoma of the breast produces lymphoedema of the affected arm. The organisms are inoculated directly from soil into barefeet, from carrying of contaminated sacks on the shoulders, and into the hands from infected vegetation. Monocytes spend about 20-40 hours in the circulation after which they leave the blood to the development of myeloid cells from myeloblast takes place in the following sequence. The salient nutritional aspects and metabolic functions of vitamin B12 and folic acid are summarised in Table12. Which of the following clinical findings is most likely to be characteristic of this group of patients She has had no previous major illnesses, but has been feeling increasingly tired and weak for the past year. Based on the etiologic microbial agent causing lobar pneumonia, following types of lobar pneumonia are described: 1. Although peripheral vascular disease with atherosclerosis is a typical finding in diabetes mellitus, vasculitis is not. Disseminated visceral involvement as well as cutaneous lesions are seen in systemic sclerosis. This is characterised by an orderly and regular hyperplasia of squamous epithelium with hyperkeratosis on the surface. As the Borrelia burgdorferi organisms proliferate and disseminate, systemic manifestations of carditis, meningitis, and migratory arthralgias and myalgias appear. Bowing, deviation, or displacement of the septi pellucidi across the midline is common; by itself, it neither indicates pathology nor implicates an etiology for nonspecific headache. The earliest clinical finding is night blindness due to loss of rods and may progress to total blindness. Anomalies in Sulcation and Gyration Developmental errors in operculization, sulcation, and gyration are relatively uncommon. Traditionally, there are two methods for carrying out autopsy, either of which may be followed: 1. Plexiform areas show irregular plexiform masses and network of strands of epithelial cells. It is therefore of the utmost importance that special attention is given to safety, beyond normal rules, and to the training of staff. The Probst bundles are seen as densely myelinated tracts lying just inside the lateral ventricle bodies. In these conditions, the possible hypotheses for genesis of stress ulcers are as under: 1. The main sources of glucocerebroside in phagocytic cells are the membrane glycolipids of old leucocytes and erythrocytes, while the deposits in the neurons consist of gangliosides.

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With survival, late complications of the periosteitis and perichondritis include bone and teeth deformities. The lesions may coalesce together to form larger area of tuberculous pneumonia and produce progressive secondary pulmonary tuberculosis with the following pulmonary and extrapulmonary involvements: i) Fibrocaseous tuberculosis ii) Tuberculous caseous pneumonia iii) Miliary tuberculosis. Transmission from male-to-male and male-to-female is more potent route than that from female-to-male. The spleen and liver may be either normal or mildly enlarged, while the lymph nodes are not enlarged. It could be the result of ulceration in the cancer when there is secondary infection. Some cancers of the urinary tract, oral cavity, esophagus, and pancreas also are causally related to smoking. Pulmonary infarction may cause dyspnea, but pulmonary thromboembolus from deep venous thrombosis is typically a complication of a longer hospitalization. The vector is the deer tick, just as with Lyme disease from Borrelia burgdorferi, which is a spirochete. Selective IgA deficiency is marked by a more benign course, with sinopulmonary infections and diarrhea that are not severe. Many of these are disorders in which both cutaneous and intracranial vascular lesions are the predominant features. A coronary angiogram performed 2 years ago showed 75% stenosis of the left circumflex coronary artery and 50% stenosis of the right coronary artery. The blood levels of these plasma proteins are decreased in extensive liver damage. Familial syndromes Biologic behaviour known by other names like papillary adenoma and villoglandular adenoma. Monitoring the quality of output from histopathology laboratory is important for detecting inadequacies, updating procedures and for improving the final report. Juvenile or retention polyps, another form of hamartomatous polyps, occur more commonly in children below 5 years of age. Enhanced scans often demonstrate several tiny nodules in the cerebellum and/or spinal cord (39-48). Most commonly involved 403 organs are the lungs, paranasal sinuses, nasopharynx and kidneys. Combination of proteolytic enzymes liberated from neutrophils, autolytic enzymes from dead tissues cells, and phagocytic activity of macrophages clear off the necrotic tissue, debris and red blood cells. A lymph node biopsy may show a reduction in T cells or B cells 31 A the findings listed are characteristic of Turner syndrome (monosomy X), which accounts for many firsttrimester fetal losses. Odontogenic Myxoma (Myxofibroma) Odontogenic myxoma is a locally invasive and recurring tumour. Atherosclerosis in systemic arteries is most likely to occur where blood flow is more turbulent, a situation that occurs at arterial branch points, such as in the first few centimeters of the coronary arteries or in the abdominal aortic branches. This leads to formation of precipitates of calcium phosphate at the preferential sites. Echocardiography shows slight right and left ventricular wall thickening with reduced left and right ventricular wall motion, reduced left ventricular filling, and an ejection fraction estimated to be 25%. Microcytes are present in iron deficiency anaemia, thalassaemia and spherocytosis. The accuracy of dose calculations was verified by phantom measurements beforehand. Blood is transported to myocardial cells by the coronary arteries which originate immediately above the aortic semilunar valve. Bradykinin, generated from the kinin system on surface contact of Hageman factor with collagen and basement membrane from vascular injury, promotes vascular permeability, smooth muscle contraction, and pain. Laboratory studies indicate anemia, leukopenia, a polyclonal gammopathy, proteinuria, and hematuria. The media contains very small amount of smooth muscle cells with abundant collagen. Other tumours showing a slightly increased frequency in women receiving contraceptive pills for long durations are benign tumours of the liver, and a few patients have been reported to have developed hepatocellular carcinoma. Occasionally, patients present with more gradual cognitive decline and personality changes. Prolonged cholestasis of either of the two types may progress to biliary cirrhosis (page 625).

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Physical examination shows firm skin over the left arm and "doughy" underlying soft tissue. Out of eleven patients accrued in these 4 protocols 7 have been placed in protocol 5, 2 in protocol 6 and one each in protocol 7 and 8. Triggers for signalling programmed cell death act at the cell membrane, either intracellularly or extracellularly. Between 20 and 30% are diagnosed during the first year of life when infantile spasms are observed in the patients with a positive family history. Although virtually every organ or tissue of the body can be affected, the nervous system and skeletal muscle are especially vulnerable because of their high energy demands. Most are found in the spinal cord, especially within the cervical cord or at the cervicomedullary junction. There are geographic variations in the distribution of various haemoglobinopathies world over as shown in Homozygous State:Sickle Cell Anaemia. A characteristic pattern of "crenulated" subcortical diffusion restriction and T2 prolongation strongly suggests urea cycle disorder (31-78E). Bony ankylosis is a feature of progressive or recurrent joint inflammation with rheumatoid arthritis. The interested reader is referred to the publications cited at the end of Chapter 36. In India, the disease is seen more commonly in regions like Tamil Nadu, Bihar, Pondicherry, Andhra Pradesh, Orissa, West Bengal and Assam. Hepatic angiosarcomas are of special interest in view of their association with carcinogens like polyvinyl chloride, arsenical pesticides and radioactive contrast medium, thorotrast, used in the past. A mature megakaryocyte is a large cell, 30-90 m in diameter, and contains 4-16 nuclear lobes having coarsely clumped chromatin. On auscultation of the chest, heart sounds seem distant, but the lung fields are clear. In this disease, there is a mixed granulomatous and neutrophilic inflammatory reaction, as seen in this patient. Microscopic examination of a biopsy from the ulcer base shows angiogenesis, fibrosis, and mononuclear cell infiltrates with lymphocytes, macrophages, and plasma cells. Robotic movement of stage of microscope is controlled remotely and the desired images and fields are accessioned from a remote/local server. The major management problem is controlling the macrocephaly that usually Congenital Malformations of the Skull and Brain 1238 accompanies hydranencephaly. Hematologic malignancies such as acute lymphocytic leukemia can be found in childhood. On coronal sections, the "high-riding" third ventricle looks as if it opens directly into the interhemispheric fissure. Regeneration in submassive necrosis is more orderly and may result in restoration of normal architecture. Also called mucous cyst or retention cyst, it is a cystic dilatation of the mucous glands of the oral mucosa. Normally B lymphocytes have surface immunoglobulin molecules of both M and G heavy chains. The pigmented macrophages may persist for a long duration in the scar, sometimes for years. A sharp line of demarcation separates infarcted area from the normal bowel (arrow). Despite the global increase in both the incidence and prevalence of Alzheimer disease, it is the only leading cause of death that we are currently unable to prevent or cure. Blastomas or embryomas are a 193 group of malignant tumours which arise from embryonal or partially differentiated cells which would normally form blastema of the organs and tissue during embryogenesis. Grossly, adenomatous polyps may be single or multiple, sessile or pedunculated, vary in size from less than 1 cm to large, spherical masses with an irregular surface. About 70% of hydatid cysts develop in the liver which acts as the first filter for ova.

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Early patch stage: There are irregular vascular spaces separated by interstitial inflammatory cells and extravasated blood and haemosiderin. Commissural development is a carefully choreographed process in which axons from cortical neurons are actively guided across the midline to reach their targets in the contralateral hemisphere. The lucency decreases with age; tubers in older children and adults are mostly isodense with cortex. Prolonged immobilisation of a patient results in disuse atrophy of the bones and hypercalcaemia. The affected veins, especially of the lower extremities, are dilated, tortuous, elongated and nodular. All these recurrent vaso-occlusive episodes throughout their lives due disorders behave like mild form of sickle cell disease. In response to cellular injury, innate immunity of the body gets activated as a body defense mechanism and release inflammatory mediators but eventually these agents themselves become the cause of cell injury. Cancer predisposition syndromes are typically uncommon, monogenic, highpenetrance disorders. Victims of cadmium poisoning primarily exhibit complications involving kidney and lung. The metamyelocyte stage is 10-18 m in diameter and is characterised by a clearly indented or horseshoe-shaped nucleus without nucleoli. Autosomal dominant mutations tend to involve 50% of family members, and structural proteins tend to be affected. The evidences in support of immunological abnormalities in pernicious anaemia are as under: 1. Carbon dioxide is a greenhouse gas that is increasingly contributing to global climate change, but more is breathed out than is in the atmosphere. These substances in normal amounts in the body act as antioxidants and protect the cells against free radical injury but their role of supplementation in diet as prevention against cancer is unproven. Nevertheless, prolonged and/or severe hypoglycemia can result in devastating brain injury in newborn infants. Massive pulmonary embolism results in instantaneous death, without occurrence of chest pain or dyspnoea. In humans-poxviruses cause molluscum contagiosum and may induce squamous cell papilloma. In general, diffuse large B-cell lymphomas are aggressive tumours and disseminate widely. There are multiple small neutrophilic abscesses with areas of extensive necrosis of the affected liver parenchyma. Dietary protein is essential for building tissues, particularly muscle, but it has no specific effect in maintaining ocular structures. Although the incidence of dementias increases dramatically with aging, nearly two-thirds of patients over 85 years of age remain neurologically intact and cognitively normal. In order to increase electron density, thin sections may be stained by immersing the grid in solution of lead citrate and urinyl acetate. Irrespective of the type of pulmonary hypertension (primary or secondary), chronic cases invariably lead to cor pulmonale (Chapter 16). Nasopharyngeal aspirates and swabs are the best specimens because the organisms attach to ciliated respiratory epithelium. Injuries by microbes include infections caused by bacteria, rickettsiae, viruses, fungi, protozoa, metazoa, and other parasites. Endothelitis with intimal injury occurs with acute rejection, but this can be treated. The foramen cecum is approximately 4 mm in diameter at birth and is normally completely ossified by 2 years of age. It is a round cell having a diameter of 12-16 m with a large nucleus which is slightly more condensed than the proerythroblast and contains basophilic cytoplasm. Immunostaining for hyperphosphorylated tau reveals numerous neurofibrillary tangles. Cigarette smoke, however, predisposes to infection responsible for acute exacerbation in chronic bronchitis.

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In addition to the changes on retina, severe diabetes may cause diabetic iridopathy with formation of adhesions between iris and cornea (peripheral anterior synechiae) and between iris and lens (posterior synechiae). Thus, by definition "true (or secondary) shock" is a circulatory imbalance between oxygen supply and oxygen requirements at the cellular level, and is also called as circulatory shock. On physical examination, there are no abnormal findings, but a stool guaiac test is positive. Haemorrhagic pericarditis is the one in which the exudate consists of admixture of an inflammatory effusion of one of the foregoing types alongwith blood. Which of the following inborn errors of metabolism is most likely present in this child Genetic testing indicates that a critical protein coded by a gene is missing one phenylalanine amino acid in the protein sequence. There are much fewer genes on Y-chromosome and are determinant for testis; they are not known to cause any sex-linked disorder. In case of blockage of one side of circulation, the supply from the other can maintain the vitality of pulmonary parenchyma. The study of autopsy throws new light on the knowledge and skills of both physician as well as pathologist. Cobblestone Lissencephaly Cobblestone lissencephaly is also known as type 2 lissencephaly and is genetically, embryologically, pathologically, and radiologically distinct from type 1 ("classic") lissencephaly. Although there may be mass effect on the cerebellum, there is no associated hydrocephalus and no communication with the 4th ventricle. Intermittent drinking for long duration is less harmful since the liver is given chance to recover. The globi pallidi, putamina, and thalami are affected with prolonged hyperammonemia and may show restricted diffusion (31-78D) (31-78E). This occurs mainly in the kidney, gastrointestinal tract, and skin of young to middleaged adults. Though described here under viral infections, chlamydia are no more considered as filterable viruses as was previously thought but are instead intracellular gram-negative bacteria. The branching septate hyphae are shown in the figure projecting from a fruiting body of Aspergillus. The cyst wall is composed of whitish membrane resembling the membrane of a hard boiled egg. The findings of animal experiments coupled with research on human cancers has led to the concept of immunology of cancer discussed under the following headings: 1. Currently, a lot of literature has accumulated to explain the pathogenesis of cancer at molecular level. Conjunctiva and cornea are constantly exposed to various types of physical, chemical, microbial (bacteria, fungi, viruses) and allergic agents and hence prone to develop acute, subacute and chronic inflammations. The rings and webs are transverse folds of mucosa and submucosa encircling the entire circumference, or are localised annular thickenings of the muscle. Several organisms have been used for this test such as Euglena gracilis, Lactobacillus leichmannii, Escherichia coli and Ochromonas malhamensis. The symptom-complex consists of intermittent claudication due to ischaemia manifested by intense pain affecting the limbs, more commonly the legs. However, in septic shock, there is initial vasodilatation followed by vasoconstriction. While both vitamin deficiency and excess may occur from another disease, the states of excess and deficiency themselves also cause disease. A few cases of acute idiopathic intracranial hypertension ("pseudotumor cerebri") associated with hyperthyroidism have been reported. The calibration factors for 11 and 14 cm beams separately were verified from the ratio of measured and calculated 55Mn(n,g) reaction rates at the reference geometry. The disease begins with malaise, headache and muscle-aches followed by high fever, chills, cough and tachypnoea. Manifestations of hepatobiliary tract are due to development of coinfection with hepatitis B or C, due to occurrence of other infections and due to drug-induced hepatic injury. Electron microscopy reveals increase in the number of myofilaments comprising myofibrils, mitochondrial changes and multiple intercalated discs which are active sites for the formation of new sarcomeres. Imaging abnormalities usually reverse when uremic toxins are removed by dialysis and metabolic acidosis is corrected. Upper lobe cavitary disease is characteristic for secondary tuberculosis (reactivation or reinfection) in persons who have previously mounted an immune response.

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The reference doses are located at the thermal neutron maximum and are averaged over 1cm3. The extravasated malignant cells on lodgement in the right environment grow further under the influence of growth factors produced by host tissues, tumour cells and by cleavage products of matrix components. A deeper, thick layer of arrested migrating neurons is common and may mimic band heterotopia (37-39B) (37-39C). Less frequent causes include frontotemporal lobar degeneration (formerly known as Pick disease) and corticobasal degeneration. The origin of inflammatory destructive process of bronchial walls is nearly always a result of two basic mechanisms: endobronchial obstruction and infection. Sudden infant death syndrome occurs in infants 1 month to 1 year of age, and there are no associated pathologic abnormalities. Cancer cells are less differentiated than normal cells and thus have decreased ability to do many complex biochemical processes, so they favor a simple one-glycolysis. In advanced cases, there may be myocardial oedema and foci of necrosis in the myocardium. The condition is manifested clinically by dyspnoea, cough, chest pain, pyrexia, fatigue and loss of weight. Other causes 505 include chronic bronchitis in an old patient, bronchiectasis, pulmonary infarction and bronchial cancer. Idiosyncratic aplasia is depression of the bone marrow due etiology, aplastic anaemia is classified into 2 main types: primary and secondary. Characteristically, there are non-caseating epithelioid cell granulomas which have paucity of lymphocytes. Antigen that has been recognised by the macrophages due to availability of above-mentioned surface receptors, or the opsonised antigen, is ready to be engulfed by the process of cell-eating by macrophages explained on page 134. If portions of the coronary thrombus break off and embolize, they enter smaller arterial branches in the distribution already affected by ischemia. Subsequently, firm pressure is applied to the puncture site for about 3 minutes to prevent haematoma formation. Vitamin B1 (thiamine) deficiency causes problems such as Wernicke disease, neuropathy, and cardiomyopathy. Pathogenicity islands are bacterial chromosomal elements carrying virulence genes, such as those involving antibiotic resistance. The varicosities do not affect muscle; however, diminished muscular support for veins to "squeeze" blood out for venous return can predispose to formation of varicose veins. One of the main problems in cardiac transplant centres is the availability of donors. Implantation (epidermal) cyst formation may occur due to persistence of epithelial cells in the wound after healing. Inborn errors of metabolism such as galactosemia usually manifest after birth because maternal metabolism clears any intermediate products of fetal enzyme deficiencies. It has been possible to document vasospasm of one of the major coronary arterial trunks in patients with no significant atherosclerotic coronary narrowing which may cause angina or myocardial infarction. The optic chiasm and hypothalamus are often draped over the sella, effacing the suprasellar cistern. The various clinical patterns and pathologic consequences of different hepatotropic viruses can be considered under the following headings: i) Carrier state ii) Asymptomatic infection iii) Acute hepatitis iv) Chronic hepatitis v) Fulminant hepatitis (Submassive to massive necrosis) In addition, progression to cirrhosis (page 624) and association with hepatocellular carcinoma (page 634) are known to occur in certain types of hepatitis which are discussed separately later. Which of the following pathologic processes has most likely occurred in his prostate Apoptosis Dysplasia Fatty change Hyperplasia Hypertrophy Metaplasia 4 A 20-year-old woman breastfeeds her infant. Chromosomal analysis of dividing leukaemic cells in the marrow shows karyotypic abnormalities in 75% of cases which may have a relationship to prognosis. Haemodynamic Changes the earliest features of inflammatory response result from changes in the vascular flow and calibre of small blood vessels in the injured tissue. Hypertension is most likely to affect small renal arteries, with hyaline or hyperplastic arteriolosclerosis, and calcification is not a major feature, although hypertension also is a risk factor for atherosclerosis. Their definite existence in acute leukaemias has been known for sometime and have now been found to be present in some other malignant tumours. Aneuploidy is the number of chromosomes which is not an exact multiple of haploid number. Because the breast has an extensive venous drainage, cancer or other focal mass lesions are unlikely to cause significant congestion and edema of the breast.

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This is due to follicular hyperkeratosis and keratin plugging in the sebaceous glands. Excessive circulating cytokines may contribute to injury of the microvascular endothelium, increasing vascular permeability. The cerebellar cortex is a continuous sheet of tissue that is folded in accordion-like fashion to form a series of prominent ridges. Cystoscopy is performed, and the entire bladder mucosa is erythematous and granular. Tobacco and betel nut chewing and cancer oral cavity: Cancer of the oral cavity is more common in people chewing tobacco and betel nuts. Physical agents like contusion of the myocardium, heat stroke, cardiac surgery and irradiation can initiate non-specific myocarditis. The adverse effects of air pollutants on lung depend upon a few variables that include: longer duration of exposure; total dose of exposure; impaired ability of the host to clear inhaled particles; and particle size of 1-5 m capable of getting impacted in the distal airways to produce tissue injury. Its basis was application of knowledge of morphological details of cells for diagnosis of disease in biopsy material. Generally, in an immunocompetent host, the biologic course passes through following 3 phases (Table 4. This involves plasma coagulation system resulting in fibrin plug formation and takes several minutes for completion. Hypertrophic cardiomyopathy is not related to ischemic heart disease, but 50% of cases are familial and may be related to genetic mutations in genes encoding for cardiac contractile elements. Intestinal segment above the level of obstruction is dilated and that below it is collapsed. The histologic features of such plaques include a central core of lipid debris that can have cholesterol clefts and can be calcified. Tumours expressing high level of receptor positivity would respond favourably to removal of the endogenous source of such hormones (oophorectomy in oestrogen-positive breast cancer and orchiectomy in androgen-positive prostatic carcinoma), or hormonal therapy is administered to lower their levels: oestrogen therapy in prostatic cancer and androgen therapy in breast cancer. Lymphoblasts as part of leukemic infiltrates or lymphomas are not likely to be seen in skin, but mediastinal masses may be seen. Prothrombin time and partial thromboplastin time, both of which reflect the activities of various clotting factors, are prolonged in patients with hepatocellular disease. Folic acid Iodine Iron Vitamin E Vitamin K 45 A 9-month-old infant has failure to thrive following a premature birth with low birth weight. Two of the widely accepted classifications are based on the pathophysiology and morphology (Table 12. The tumour cells protruding in the lumen of the capillary are now covered with constituents of the circulating blood and form the thrombus. Gummatous inflammation can be seen in adults with tertiary syphilis or in congenital syphilis. Erythroplasia is a form of dysplastic leukoplakia in which the epithelial atypia is more marked and thus has higher risk of developing malignancy. The neurologic manifestations are similar to those seen in vitamin B12 deficiency; affected infants may have anemia, but it is not of the megaloblastic type. This can occur in the following circumstances: Air obstruction as occurs in chronic bronchitis, emphysema, asthma. They are the first line of defense for maintaining acid-base balance and do so by taking up H+ ions when the pH rises. With cellular atrophy, there is often no visible necrosis, but the tissues shrink, something that occurs in the endometrium after menopause. While P-selectin (preformed and stored in endothelial cells and platelets) is involved in rolling, E-selectin (synthesised by cytokineactivated endothelial cells) is associated with both rolling and adhesion; L-selectin (expressed on the surface of lymphocytes and neutrophils) is responsible for homing of circulating lymphocytes to the endothelial cells in lymph nodes. Paraseptal or distal acinar emphysema is localised along the pleura and along the perilobular septa.

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Non-epithelial (2%) (i) Leiomyosarcoma (ii) Leiomyoblastoma (epithelioid leiomyoma) 3. Epithelioid macrophages are most important in granulomatous inflammatory responses that control mycobacterial and fungal infections. Ischaemia-Reperfusion Injury and Free Radical-Mediated Cell Injury Depending upon the duration of ischaemia/hypoxia, restoration of blood flow may result in the following 3 different consequences: 32 1. Of the remaining options, all are more likely to produce multiple defects and to reduce fetal growth. There are no findings indicative of elevated intracranial pressure or nonaccidental trauma. The disease is endemic in parts of Africa and Asia and occurs sporadically elsewhere. The regular pattern of red lobular discoloration seen in the figure is unlikely to occur in hemorrhage from thrombocytopenia, characterized by petechiae and ecchymoses. The following sequence of events has been proposed and schematically illustrated in. Prolonged pressure from benign tumours or cyst or aneurysm may cause compression and atrophy of the tissues. Although children with Down syndrome can function well, they often have many associated congenital anomalies. Krabbe disease demonstrates hyperattenuating thalami, caudate, and dentate nuclei. Most frequently, radiation-induced cancers are all forms of leukaemias (except chronic lymphocytic leukaemia); others are cancers of the thyroid (most commonly papillary carcinoma), skin, breast, ovary, uterus, lung, myeloma, and salivary glands. With complete agenesis, the third ventricle appears continuous with the interhemispheric fissure and is surrounded dorsally by fingers of radiating gyri that "point" toward the third ventricle (37-10). These are: following acute pancreatic necrosis, and traumatic fat necrosis commonly in breasts. The other listed options also could be secondarily involved by vascular thromboses in the setting of malaria, but are not extraerythrocytic sites for asexual reproduction. Microbial agents and foreign particulate material are eliminated by this mechanism. A prominent, exaggerated "hyperdynamic" aqueductal "flow void" may be present (34-33). The cornea and lens receive their nutrient demands from the aqueous humour produced by the ciliary processes. Skeletal elements of both the skull and vertebral column become "modeled" around the neural tube. The causes of intestinal obstruction can be classified under the following 3 broad groups: 1. The increased cardiac output is compensated by increasing peripheral vascular resistance, causing an increase in blood pressure. Grossly, Thickness of the left ventricular wall (excluding trabeculae carneae and papillary muscles) above 15 mm is indicative of significant hypertrophy. Anal verge is the junction between the anal canal and perineal skin, while pectinate line is the squamo-columnar junction between the anal canal and the rectum. Leptin released from adipocytes exerts long-term control by activating catabolic circuits and by inhibiting anabolic circuits. The severe brain atrophy, subdural fluid collections are typical, as is the excessive tortuosity of the intracranial arteries. The gross and microscopic appearance of strangulated intestine is the same as that of infarction of intestine. Which of the following cardiac lesions is most likely to be present in this woman Bicuspid aortic valve Coronary artery thrombosis Left atrial myxoma Mitral valve stenosis Pericardial effusion 61 A 55-year-old man undergoes orthotopic cardiac transplantation. Zonal necrosis is necrosis of hepatocytes in 3 different zones of the hepatic lobule (page 592). A dysplastic process could precede development of carcinoma in situ and squamous carcinoma; dysplasia involves only part of the thickness of the epithelium. A few other types of gastritis which do not fit into the description of the types of gastritis described above are as under: i) Eosinophilic gastritis. Investigation of Platelets and Platelet Function Haemostatic disorders are commonly due to abnormalities in platelet number, morphology or function.