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Case of the Month Form
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* Indicates required question
Name, MD/DO, PGY-(1, 2, 3 ,4)
*
Your answer
Title
*
Enter your title of choosing.
Your answer
Attending Pathologist
*
Who signed the case out?
Your answer
Clinical History
*
Please provide at least one line of clinical history.
Your answer
Lab Findings
(Optional)
Your answer
Radiologic Findings
(Optional)
Your answer
Additional Clinical Information
(Optional)
Your answer
Photomicrographs (H&E/IHC/Special Stains) / Flow Cytometry / Imaging
Please email .jpg files; if multiple, send as .zip or .rar files to
slrbimcpathology@gmail.com
In the form below include figure title/explanation (figure #-#).
Your answer
Question 1
*
What is the best diagnosis? Enter 4-5 multiple choice answers (A-D/E).
Your answer
Question 1 - Explanation
*
Provide an explanatory paragraph justifying the correct answer. (Optional: you may provide the reasons why the wrong answer choices are incorrect.)
Your answer
Question 2
*
What is the best diagnosis? Enter 4-5 multiple choice answers (A-D/E).
Your answer
Question 2- Explanation
*
Provide an explanatory paragraph justifying the correct answer. (Optional: you may provide the reasons why the wrong answer choices are incorrect.)
Your answer
Question 3
*
What is the best diagnosis? Enter 4-5 multiple choice answers (A-D/E).
Your answer
Question 3 - Explanation
*
Provide an explanatory paragraph justifying the correct answer. (Optional: you may provide the reasons why the wrong answer choices are incorrect.)
Your answer
Suggested reading references/links
*
Please provide citations or links which were used during this case presentation.
Your answer
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