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Case 34 || Solution || Part 1

@medic_altimesMT

The answer to the given question is “Bronchial Asthma”

Obstructive Pulmonary Disorder

It is chronic, relapsing, inflammatory disorder

Due to inflammation there will be:

•Hyperactive Smooth Muscle
•Hypersecretion of mucus

Ethology of Bronchial Asthma:

ATOPY (Allergic Disorder)

Associated with Chromosome-5q (Long arm)

Genetic Association:

•IL-13 gene polymorphism (Strongest & Most consistent Association)

•ADAM-33 Gene Polymorphism

•YKL-40 protein: Directly related with Severity of Asthma

On Sputum Cytology:

3 characteristic Bodies are seen:
(Remember them as 3Cs)

A. Curschmann Spiralis
B. Charcot Leyden Crystal
C. Creola Bodies

Curschmann Spiralis:

‘Spiral-shaped mucus plugs’ from subepithelial mucous gland ducts of bronchi

(As shown in the picture)

For more updates & full explanation

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Case 34 || Solution || Part 3

@medic_altimesMT

The answer to the given question is “Bronchial Asthma”

On Gross Examination:

Mucus Plug is seen within Bronchi

Why?

Due to Hyper-secretion of mucus

⬇️

Mucus plug is formed

⬇️

This plug will obstruct the bronchi

(As shown in the picture)

For more updates & full explanation

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Case 35 || Solution

The answer to the given question is “Osteochondroma / Exostosis”

M/C Benign Bone Tumor

Not a True Bone Tumor

Age: 10-18yrs (Open Physis)

Diaphyseal Aclasia (Developmental Malformation)

Large to feel, Small on X-ray

Growth plate grows abnormally outwards

M/C site: Metaphysis of Distal Femur

Incidental Finding

Cauliflower like Growth (As shown)

Two types:

Pedunculated (With Stalk):

•Grows away from Joint
•More common

Sessile (Without Stalk)

It has a cartilagenous cap: Usually < 2cm

Majority of them regress before skeletal maturity

Usually Asymptomatic

C/F:

Pain
Palpable Swelling
Compression over adjacent neurovascular tissue

Causes of Pain:

Bursitis due to compression by lesion (M/C)
Neuro-vascular compromise
Fracture
Malignant Transformation: Chondrosarcoma

Malignant Transformation occurs when:

A. Cartilage Thickness > 2cm (in MRI)
B. Rapid increase in size
C. Growth after skeletal maturity
D. Loss of Cortico-medullary Differentiation

Management:

Wait & Watch (Mostly)

Extraperiosteal excision

➡️Indications of surgery

A. Cosmetic
B. Pain
C. Malignant Transformation
D. Joint obstruction
E. NV compromise

Additional info:

➡️2 types:

Solitary (More common)
Multiple

➡️Masada Syndrome: Multiple Osteochondromatosis of forearm
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2025/07/01 13:36:22
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