1. CMV virus in lung -- both cytoplasm and nucleus enlarged

2. CMV -- gastric biopsy with huge cells in glands

3. Fungus -- branching hyphae with septa

4. Soap bubble lesion Cryptococcus -- mucin stain in brain, thick capsule Initially starts in lung and disseminates to brain -- Verchow-Robbin’s space

5. Broad based budding Blastomycoses

6. Room temp Blastomycoses -- mold phase

7. Entamoeba histolyca -- trophozoites -- cytoplasm much larger than nucleus -- secretes perforin and creates flask shaped ulcers

8. Leprosy

9. Staph aureus sepsis in heart

10. Spinal Fluid -- neutrophils with gram (+) diplococci

11. Neuts in synovial fluid -- Neisseria gonorrhoeae in neuts -- gram (-) coccus - produces protease which inactiveate IgA

12. Gonorrheal urethral discharge

13. Endocarditis Physical exam findings? Heart murmur, splinter hemorrhages, Osler’s node

14. Coccidioides immitis -- huge spherules Cause what disease? Valley fever

15. Coccidiodomycosis -- spherule with endospores

16. Cryptococcus -- mucin stain

17. Histoplasmosis peripheral blood smear -- esp in immunocompromised pts

18. Histoplasmosis -- fibrosing mediastinum

19. Blastomycosis - verrucous lesions with central healing Contact with what animal? Beavers

20. Broad based budding Blastomyces dermatididis Neut response forming microabscesses

21. Hookworm teeth

22. Giardia lamblia -- it looks back at you Symptoms? Cramping, bloating, smelly steatorrhea

23. Ascaris worm bolus creating intestinal obstruction

24. Roundworm

25. Toxoplamosis cyst in brain -- calcifications of CT, skin rash, poor nursing, blueberry muffin baby Part of ToRCH

26. Syphilis with silver stain

27. CMV in salivary gland

28. Herpes - multinucleated cells with nuclear inclusions

29. Herpes inclusions

30. Herpes vesicles/blisters -- contagious

31. Herpes on the eye

32. Football shaped larvae in stools? Pinworm

33. Measles -- Clinical Symptoms? Koplike spots on oral mucosa, rash on trunk then extremities

34. Primary syphilitic chancre -- non-painful

35. Secondary syphilis -- also have gumma formation

36. Chlamydia -- usually silent infection -- less discharge-- mononuclear cells with vacuoles and inclusions

37. Lymphocytes with “downy” appearance, pt with elevated white count and hepatosplenomegaly Mononucleosis

38. Chronic granulomatous disease -- deficient hydrogen peroxide production, so catalase (+) bacterial infections common (S. aureus, gram (-) enterics, Pseudomonas, most fungi) -- lymph node with epitheliod cells

39. Severe oral candiasis -- can tell by rim around lesion

40. Mucor -- immunocompromised patient

41. Cystic fibrosis -- lots of PMNs in lung

42. MAI -- mycobacterium avium intracellular complex -- no gramulomas formed b/c only in immunocompromised pts

43. Fungus ball Aspergillus

45. Candida -- budding yeasts and pseudohyphae

46. Cryptosporidium -- covers surface

47. HIV -- lymphadenopathy -- follicles huge