Multiple black (pigment) #Gallstones after #Cholecystectomy. | Figure 1

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Multiple black (pigment) #Gallstones after #Cholecystectomy

They form primarily in sterile bile, associated with advanced age, chronic hemolysis, alcoholism, cirrhosis, pancreatitis & total parenteral nutrition

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RBC morphology scan #Sickle-cell-disease 18.3 #Retic count

Peripheral blood smear. Note the Target Cells

Scientists coordinated by Imperial College London have developed a study that shows how the malaria parasite penetrates the red blood cell by interacting with the receptors, the "glycophorins", of the membrane that separates the cell from the outside world. Parasites that leave the liver have molecular "engines" that aid in the penetration of the red blood cell. However, the study shows that they can still alter cell properties to get input. This allows them to make the cell wall more flexible. The researchers showed how the parasite protein responsible for cell invasion, the already known EBA175, affects the physical properties of the membrane, weakening the defense of the cell directly. However, the research revealed that differences in membrane stiffness may have an influence on parasite invasiveness. This means that cholesterol can have a protective effect against malaria infection. According to the results, red blood cells with higher cholesterol levels could be more resistant to invasion and, consequently, to parasite infection. "We found that red blood cell entry is not only due to the ability of the parasite itself, but that changes initiated by parasites in red blood cells appear to contribute to the invasion process," says Marion Koch, the study's first author.

Large lobar pneumonia with radiographic findings on CT chest of “hepatization” of the lung secondary to Streptococcus pneumoniae

A 52-year-old man presented with a 20-minute history of chest pain radiating to the left shoulder and neck, associated with dyspnea and diaphoresis. He had a history of hypertension, long-term smoking, and a sedentary lifestyle. On physical examination, bibasilar crackles were noted on lung auscultation. An electrocardiogram (ECG) was performed in the primary care setting, and the patient was promptly referred to the emergency department.

A 28-year-old woman presented with a 3-day history of intense pruritus over the lower back. She reported no recent travel or exposure to new environments. She cares for a small kennel with approximately eight dogs rescued from the streets. Physical examination revealed multiple small vesicles, some clustered and others scattered, predominantly involving the lumbar region and the left gluteal area.

A 4-month-old male infant presented with skin lesions localized to the chin for the past 3 days. Physical examination revealed multiple small pustules with surrounding inflammatory signs on the chin, along with a few scattered papules on the chest.

Patient in late teens presenting after a collapse, no chest pain, no previous cardiac history, no history of sudden death in family, are there any features in this ekg that would warrant further work-up or is this just a pediatric ekg?