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Page 30
3.b.(4)(b) In the event that there is excessive DNA damage, the TP53 suppressor gene produces protein
products that inhibit the translation of the BCl2 anti-apoptosis genes, which leads to apoptosis
of the cell.
Page 41
Figure 3-1 legend second sentence and the mother is haplotype A2B2C2D2
Page 49
D. Acquired immunodeficiency syndrome (AIDS)
1.
Epidemiology
c. Virus characteristics
(2) HIV-1 most common cause of AIDS in United States; HIV-2 more restricted (most
prevalent in Western Africa).
MN: HIV-2: more restricted than HIV-1; most prevalent in Western Africa
Page 52
Fig. 3-5: Change 4b2b to 4b2a; change C4b2b3b to C4b2aC3b; change C3bBb3b to C3bBbC3b
Page 114
First Margin note top of page, add arrow before VLDL as shown:
Kwashiorkor: fatty liver
apoB synthesis; VLDL synthesis
Second Margin note from top of page
Marasmus: total calorie deprivation; protein and CHO
Page 119
H.3.Excess intake.renal calculi composed of calcium oxalate.
Page 127
Fig. 8-2: D. Radiograph showing osteolytic lesions. Note the radiolucent areasin the midshaft of
the fibula (arrow).
Page 130
4.a. Treatment of H. pylori infections
Decreases risk for developing malignant lymphoma of the stomach (not adenocarcinoma)
Margin Note: 3rd from bottom: Rx H. pylori infection: risk for developing malignant lymphoma
Page 139
Box: 140/190 mm Hg
Page 140
Blue box: Non-pharmacologic treatment
Page 150
Fig. 9-9 legend
D. Sturge Weber syndrome. Nevus flammeus (birthmark) on the face in the distribution of the
ophthalmic and/or maxillary branch of cranial nerve V (trigeminal).
Page 161
Systolic dysfunction is characterized by(EF < 40%)
Page 161-162
Shaded area 8 sentences down from the top: aldosterone blockers) compliment
3.
a.
b.
Lungs are heavy, congested, and exude a frothy pink transudate (edema) on the cut surface or
in the airways.
Alveoli are filled with a pink staining fluid and alveolar macrophages containing hemosiderin
(heart failure cells).
(1) Latter finding implies that the pulmonary capillaries have ruptured under pressure and
RBCs entered the alveoli and were phagocytosed by alveolar macrophages.
(2) Excess iron in the macrophage binds to ferritin, which degrades into hemosiderin (rusty
colored granules with H:E stain or blue with Prussian blue stain) producing a rusty
colored sputum.
Page 182
K.4.c. Microembolization findings (occurs in > 50% of cases)
(3) Oslers nodes are painful hemorrhagic nodules on the pads of the fingers or toes (10% to
23% of cases).
(a) Although most references state that Oslers nodes are an example of an
immunocomplex vasculitis, more recent studies have contradicted that belief.
(b) Early biopsies frequently demonstrate bacteria within microabscesses without any
evidence of a vasculitis, which favors microembolization as the initial process.
(c) However, as time progresses, the microabscess become sterile and an immunemediated vasculitis develops.
Page 184
Top Margin note: Viruses: most common known cause myocarditis and pericarditis
VII.A.1.b. (1) (a) Viruses most common cause
Adenovirus, coxsackievirus, HIV, parvovirus B19, human herpesvirus-6
B.1.b. Viruses are the most common overall known cause
Last Margin note: Pericarditis delete margin note
188
D.1.b.(4) Genes involved are mapped to chromosomes 11 (most common) and 14q.
Page 199
e. Ascorbic acid DELETE e. ENTIRELY
Page 201
3.
Laboratory findings
a.
Normal to decreased MCV
(1) ACD, in some cases, presents as a normocytic anemia.
(2) It is most likely to be a microcytic anemia in the setting of rheumatoid arthritis and
Crohn disease.
Page 204
c.1. Abdominal colic with constipation
Page 213
B.1. c. Membrane protein defect results in a loss of RBC membrane ( surface/volume ratio)
and spherocyte formation.
(1) Mutation in spectrin followed by ankyrin is the most common defect.
d. Increased permeability of spherocytes to potassium and water
3. c. Increased RBC osmotic fragility
(1) Decreased surface/volume ratio in spherocytes is the most critical factor for
increased RBC osmotic fragility.
D.1.a. Acquired stem cell disease with a somatic mutation after birth in the PIG (phosphatidyl
inositol glycan) group A gene in a myeloid stem cell clone
Page 226
D.3.d.(1)(b) Atypical lymphocytes are antigenically stimulated B cells (Fig. 12-3).
Page 233
7.b. Clinical findings
(3) Vessel thrombosis may also occur.
Page 259
D.4.a. Mild cases respond to desmopressin acetate
VWF release from Weibel-Palade bodies; stabilizes circulating VIII:c
Page 260
E.5.a. Desmopressin.
VWF release from Weibel-Palade bodies; stabilizes circulating VIII:c
Page 282
V.B.4.c. Respiratory acidosis or normal Paco2
Page 288
Table 16-4
Pneumocystis jiroveci
Diffuse intra-alveolaror Giemsa stains. Serum lactate dehydrogenase (LDH) elevated
in 90% of cases (predictive of increased morbidity/mortality).
Page 290
7.a.(2) Produces a protein (cord factor) that prevents.
Page 293
3.b. Pulmonary infarction
(7) Elevation of ipsilateral hemidiaphragm (most common finding)
Page 320
N.1.c.(1) Smoking (DELETE THE REST)
(4) HPV most common risk factor
Page 329
Margin Note 4th from top of page: Rx H. pylori risk for developing gastric lymphoma not
adenocarcinoma
E.2.e.(4) Serologic tests have been discontinued.
G.1.a. Majority (> 60%) are malignant and are located in the duodenum followed by the islet
cells in the pancreas
d. Ulcers are single and in the usual locations or there may be multiple ulcers.
Page 330
Table 17-2 Copy and insert as a page into book
Epidemiology
individuals)
Helicobacter pylori
surface)
association
Complications
80% of cases.
shoulder)
Gastric outlet obstruction, pancreatitis
(posterior ulcer)
Page 338
8. Tests for bile salt/acid deficiency
Total bile acids
9. Tests for bacterial overgrowth a., b., and c. discussions are all okay and no changes need to
be made
Page 342
G.3.a.(1) Atrial fibrillation.
Add underneath:
SMA has the greatest velocity of blood flow and the most acute angle off the aorta of all the
arteries originating from the abdominal aorta.
Page 348
Table 17-7
Clinical findings
Okay as is
Page 367
Margin note 4th from the top of the page
Reyes syndrome: transaminases, ..
Margin note on bottom: Fulminant hepatic failure: transaminases
G.1.a. Viral hepatitis (most common infectious cause)
b. Acetaminophen most common overall cause fulminant liver failure
Margin Note: Fulminant hepatic failure: viral hepatitis most common infectious cause
Fulminant hepatic failure: acetaminophen most common overall cause
Page 402
Table 19-7
Post-streptococcal glomerulonephritis
Usually resolves; CRF uncommon in children but common in adults
Page 403
Table 19-10
Diffuse membranous glomerulopathy
Subepithelial.
Highest incidence renal vein and deep vein thrombosis (loss of antithrombin III in urine)
Treatment.
Page 414
B.2.g. Urine pH alterations
(1)
(2)
Page 420
Blue box; line 12:
Reads mechanisms for outflow incontinence are outflow obstruction..
Should read overflow incontinence are outflow obstructions (e.g., BPH)
Page 429
C.2.a. DHT is the prime mediator.
Causes hyperplasia of glandular and stromal cells due to increased sensitivity to DHT (see Fig.
1-14)
Page 430
4.d.(1) (e) Bladder smooth muscle hypertrophy and hyperplasia
Page 434
A.1.a.(2)(c) Decreased sperm count
Loss of seminiferous tubules (delete: and decreased testosterone)
Page 437
Table 21-1
HPV (see Fig. 21-1E)
Second most common STD (a few books say it is the most common)
Page 438
Table 21-1
Trichomonas Vaginalis Most common STD;
As an aside: the stats are Trichomonas incidence 7.4 million, HPV incidence 6 million
Page 465-466 (excerpted from new RRPath 4th ed.; copy and fold paper into book
E. Gestational trophoblastic neoplasms
1.
Hydatidiform moles
a.
Benign tumors of the chorionic villus
(a)
(b)
e.
Partial mole
(1) Normal villi are intermixed with neoplastic villi.
(2) Fetal parts are intermixed with neoplastic villi
Amnion and fetal vessels with fetal erythrocytes are present within the
mesenchyme of the villi.
MN: Partial mole: normal villi intermixed with neoplastic villi; fetal parts intermixed with
neoplastic villi
MN: Partial mole: fertilization of 23X ovum by 2 sperm either X or Y (69XXY most common)
(a) Ovum triploid (69 XXY in 70% of cases; XXX in 27% of cases)
(b) Most commonly due to fertilization 23X ovum by 2 sperm that are
either 23X or Y producing an ovum with 69XXY (most common) or
XXX.
(3) Preeclampsia in 5% of patients
(4) No risk for developing a choriocarcinoma
(5) Clinical findings
(a) Incomplete or missed abortion (90%)
(b) Vaginal bleeding (75%)
(c) Uterine enlargement 5% of patients
(d) Theca lutein cysts and hyperemesis gravidarum extremely rare
(e) Majority have beta-hCG <100,00 for gestational age
MN: Partial mole: incomplete/missed abortion; vaginal bleeding; very high -hCG for gestational
age
(6) Treatment: similar to complete mole
Page 466
2. Choriocarcinoma
c. (1) Lungs, vagina, liver brain
Page 467
X.C.1.d. Drugs
Also add tricyclic antidepressants
Page 480
2.b.(9) Increased risk of colon polyps/tumors
Page 501
3.f. Nonclassic 21 hydroxylase deficiency
(1) Cortisol and mineralocorticoid activity are normal.
Margin Note: Nonclassic 21-OHase deficiency: androgens
Page 503
2. Hyperaldosteronism
a.(3)(a) High normal to mild hypernatremia.
Page 512
E.1.e. Glycosylated hemoglobin 6.5% (45.6%) is diagnostic of diabetes
5.
e.
It can be fatal.
Treatment of EM
Page 566
I. Cerebral Edema, Pseudotumor Cerebri (Idiopathic Intracranial Hypertension)..
Page 571
II.A.2. Maternal findings
Increased maternal alfa fetoprotein (AFP) in serum or amniotic fluid in anencephaly,
meningocele, myelomeningocele, but not spinal bifida occulta
Page 581
Table 25-1 Copy and insert as a page into book
TABLE 26-1. CEREBROSPINAL FLUID (CSF) FINDINGS IN VIRAL, BACTERIAL,
AND FUNGAL MENINGITIS
CSF FEATURE
BACTERIAL
VIRAL
FUNGUS
Total cell count
Increased
Usually normal or
Usually normal or
slightly increased
slightly increased
Differential count
Predominantly
First 2448 hours,
Lymphocytes
neutrophils;
neutrophils, then
tuberculosis usually
switches to lympholymphocytes
cytes after 48 hours
CSF glucose
Decreased
Normal: exceptions
Decreased
mumps, herpes, LCM
CSF protein
Increased
Increased
Increased
Gram stain
Frequently positive
Negative
Frequently positive
(60%90%)
Culture positive (65%
90%)
LCM, lymphocytic choriomeningitis
Page 582
Change heading to Table 25-3 and line up Severe Dementia sentence as shown below
TABLE 25-3 SLOW VIRUSES AND SPONGIFORM ENCEPHALOPATHY OF THE CENTRAL
NERVOUS SYSTEM