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Finals Pictures
Examples of Malformations




A. Polydactyly (one or more extra digits) and syndactyly (fusion of digits)
B. Cleft lip (may be with or without associated cleft palate)
C. Lethal malformation (midface structures are fused or ill-formed); external
                                   dysmorphogenesis associated with severe internal
                                   anomalies such as maldevelopment of the brain and cardiac
                                   defects
Disruption by an amniotic
                          band
Disruptions (Amniotic Bands)
Oligohydramnios sequence


               Flattened facial features
               and deformed right foot
               (talipes equinovarus)
Thalidomide Babies
Fetal macrosomia in Gestational
           Diabetes
Trisomy 21 (Down’s Syndrome)
Trisomy 18 (Edward’s Syndrome)
               • unusually small head
               • back of the head is prominent
               • ears are malformed and low-
                 set
               • mouth and jaw are small (may
                 also have a cleft lip or cleft
                 palate
               • hands are clenched into fists,
                 and the index finger overlaps
                 the other fingers
               • Clubfeet (or rocker bottom
                 feet) and toes may be webbed
                 or fused
Trisomy 13 (Patau Syndrome)
Hyaline Membrane Disease




            This is hyaline membrane disease due to
            prematurity and lack of surfactant
            production from type II pneumonocytes
            within the immature lung. Note the thick
            pink membranes lining the alveolar
            spaces.
Necrotizing enterocolitis (NEC)
Necrotizing enterocolitis (NEC)



                                                                                             Pneumatosis
                                                                                             instestinalis
                                                                                             (air within
                                                                                             the intestinal
                                                                                             walls)




The plain abdominal film shows air in the portal vein, air in the bowel walls, and a large
pneumoperitoneum [subdiaphragmatic free air, perihepatic free air, double wall sign (blue
arrows), triangle sign (green arrows), and falciform ligament (red arrow)].
Hydrops Fetalis (non-immune)

           Cystic
           hygroma (in
           fetus w/
           Turner’s
           syndrome)




            Generalized edema from fluid collection in the soft tissues
            results in hydrops fetalis. Causes: Most common are "non-
            immune" types that include infections, congestive failure (from
            anemia or cardiac abnormalities), and congenital anomalies.
            Immune hydrops, from maternal antibody formed against fetal
            red blood cells, is not common when Rh immune globulin is
            employed in cases of potential Rh incompatibility.
Kernicterus
Congenital Capillary Hemangioma




   At birth                 At 2 years
                  After spontaneous regression
Capillary Hemangioma




  RBC-filled capillaries
Lymphangioma




Dilated lymphatic channels
Teratoma




Mucus-secreting glands, cartilage, bone
Neuroblastoma
Acute Myeloid Leukemia




BM expansion
Wilms Tumor, kidney
                                       nests and sheets of dark blue cells at the left
                                       with compressed normal renal parenchyma
                                       at the right




Wilms tumor of the kidney (lobulated white-tan mass), many are associated with genetic defects on
chromosome 11.
Children present with abdominal enlargement from the mass effect.
Carbon monoxide poisoning




  Cherry-red discoloration of the skin
Asbestosis

                             Asbestos
                               fiber




 Tan-white pleural plaques


                                   Asbestos fibers
                                  coated with iron
Lead Toxicity
Arsenic poisoning
Dental fluorosis
Tetracycline-stained teeth
Effects of Smoking
??????????
Liver cirrhosis in chronic alcoholism (left)
Esophageal varices associated with liver cirrhosis (right)
Stevens-Johnson Syndrome




   SJS is defined as detachment of less
  than 10% of the body surface area
Marasmus vs. Kwashiorkor
Anorexia Nervosa
Bulimia nervosa
Bitot’s spot in Vit. A deficiency
Rickets
Scurvy
Riboflavin deficiency
Chickenpox vs. Shingles
Mumps
Measles
Herpes Simplex
Cytomegalovirus




Owl-eye inclusions in the lung tissue
                                        Blueberry-muffin baby
Epstein-Barr virus
Dengue




Herman's rash – islands of white in a sea of red
Human Papilloma Virus
Cervical Cancer
Poliomyelitis
Strep throat
Diphtheria
Gram-negative intracellular diplococci
Tetanus




      Opisthotonus
(severe spastic paralysis)
Syphilis (chancre)
Entamoeba histolytica
(cause of amoebiasis)
Giardia lamblia
(Giardiasis)
Trichomonas vaginalis
   (Trichomoniasis)




          “Strawberry cervix" - cervical mucosa
          reveals punctate hemorrhages with
          accompanying vesicles or papules
Ascaris lumbricoides
(Giant intestinal roundworm)
     cause of Ascariasis
Enterobius vermicularis




           Female worms leave the rectum during the
           night and deposit eggs on the perianal
           skin, producing pruritus.
Tapeworm
Schistosomiasis
Candida albicans
(Candidiasis-oral thrush)




          Yeast cells   Pseudohyphae
Ringworm



                    Tinea cruris




   Tinea corporis
Ameloblastoma
Pleomorphic Adenoma
Warthin’s Tumor
Mucoepidermoid Carcinoma
Adenoid Cystic Carcinoma
Aneurysm

 Atherosclerotic aneurysm of
 the aorta (large "bulge“ just
 above the aortic bifurcation).
 Prone to rupture when they
 reach about 6 to 7 cm in size.
 Felt on PE as a pulsatile mass
 in the abdomen.
Arteriovenous malformation (AVM)
Atrial Septal Defect (ASD)
Ventricular Septal Defect (VSD)
Patent Ductus Arteriosus (PDA)
Tetralogy of Fallot (TOF)
Transposition of the Great Arteries
GOODLUCK! 

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