Goljan Errata 5274x

NEW ERRATA/ADDITIONS RAPID REVIEW PATHOLOGY 3RD EDITION REVISED REPRINT (08-08-2012) Page 15 B. 2. a. (3) Smooth muscle hypertrophy (also hyperplasia) in the urinary bladder…. C.2.a.(3) Benign prostatic hyperplasia due to an increase in sensitivity to dihydrotestosterone Page 23: Copy and insert as a page into book 3. Rolling of neutrophils in the venules due to expression of selectin adhesion molecules on neutrophils and endothelial cells a. Selectins are carbohydrate-binding adhesion molecules. b. L-Selectin is located on leukocytes (e.g., neutrophils), while E-selectin and P-selectin are located on the surface of endothelial cells. (1) P-selectin is produced in the Weibel-Palade bodies in endothelial cells. (2) Weibel-Palade bodies are the ―glue factory‖ of the endothelial cells, because they synthesize P-selectin, an adhesion molecule for leukocytes) and von Willebrand’s factor, the adhesion molecule of the platelet (refer to Chapter 15). c. Interleukin-1 (IL-1) and tumor necrosis factor (TNF) stimulate the expression of selectin ligands on the surface of neutrophils (L-selectin) and the expression of selectin molecules on the surface of endothelial cells (E-selectin, P-selectin). d. Binding of circulating neutrophils to E-selectin and P-selectin molecules on endothelial cells is weak and transient causing them to ―roll‖ (bind detach, bind detach) along the endothelial surface of the venules.

Page 41 Figure 3-1 legend second sentence …and the mother is haplotype A2B2C2D2 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 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 164 Shaded area 8 sentences down from the top: …aldosterone blockers) compliment 3.

Gross and microscopic findings a. Lungs are heavy, congested, and exude a frothy pink transudate (edema) on the cut surface or in the airways. b. 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 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 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 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 288 Table 16-4 Pneumocystis jiroveci Diffuse intra-alveolar………or 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 Epidemiology

Male/female ratio 1:1

Male/female ratio 1:1

Smoking may delay healing.

Risk increased with MEN I

Risk for developing gastric cancer

Smoking may delay healing.

(increased risk with blood group A

Chronic intake NSAIDS

individuals)

Risk factors: H. pylori (most common),

Risk factors: H. pylori (most

Helicobacter pylori

chronic intake of NSAIDS, type O

common), chronic intake NSAIDS

blood group (lack blood group antigens

(synergism with H. pylori),

that are protective to the mucosal

moderate alcohol consumption

surface)

Duodenal ulcer > gastric ulcer

Duodenal ulcer > gastric ulcer

association Complications

Bleeding (most commonly ulceration Bleeding (anterior ulcer; most commonly of left gastric artery; Fig. 18-14E).

ulceration of gastroduodenal artery).

Bleeding spontaneously ceases in

Fig. 18-14E). Bleeding spontaneously

80% of cases.

ceases in 80% of cases.

Perforation (air under diaphragm,

Perforation (anterior ulcer; air under

pain radiates to left or right

diaphragm, pain radiates to left or right

shoulder; Fig. 18-14D)

shoulder) Gastric outlet obstruction, pancreatitis (posterior ulcer)

Page 338 8. Tests for bile salt/acid deficiency ● Total bile acids… Currently, it is more useful for determining bacterial overgrowth. The radioactive cholylglycine is converted by bacteria into radioactive CO2 which is increased in the breath; therefore, it should be listed under 9. Tests for bacterial overgrowth.

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

Recurrent right lower quadrant colicky pain (obstruction) with diarrhea and weight loss The rest is okay

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)

Alkaline urine pH favors crystallization of calcium- and phosphate-containing stones. Acidic urine pH favors crystallization of uric acid, cystine, stones

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 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 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 503 2. Hyperaldosteronism a.(3)(a) High normal to mild hypernatremia…. Page 512 E.1.e. Glycosylated hemoglobin 6.5% (4─5.6%) is diagnostic of diabetes Page 518 E.2.c. Dual-photon absorptiometry (1) Non invasive test that evaluates bone marrow density (BMD) (2) The World Health Organization uses a T-score to define osteoporosis. (a) It is calculated by subtracting the mean BMD (in g/cm2) of a young-adult reference population from the patient's BMD and dividing this by the standard deviation (SD) of the young-adult reference population. (b) Using the T-score, osteoporosis is defined as – 2.5 SD and below.

Page 538 Table 23-3

Please add additional sentence

Knee t injuries (Fig. 23-23C)

―Unhappy triad‖: most common internal derangement of the knee t. Valgus injury (acute): damage to the lateral meniscus, medial collateral ligament, anterior cruciate ligament. If chronic, the medial meniscus is most commonly injured rather than the lateral meniscus.

Page 561 I. Erythema multiforme (make a copy of the addition and put insert it in the book) 1. Type IV immunologic hypersensitivity reaction of skin that is triggered by 3. Stevens-Johnson syndrome (SJS) a. Recently separated from EM as a distinct entitity. b. Type IV hypersensitivity reaction that primarily involves the skin and mucous membranes (e.g., mouth, genitals) ● Infections (e.g., HIV, group A streptococcus), drugs (antibiotics most common [penicillin, sulfa drugs]), and maligancies have been implicated; however, most cases are idiopathic. c. Erosions develop on the mucous membranes and small blisters develop on purpuric or erythematous macules on the skin (different from target lesions of EM) d. It can be fatal. MN: SJS: involves skin/mucous membranes; type IV HSR 4. Toxic epidermal necrolysis syndrome (TENS) a. Idiosyncratic reaction most commonly drug-induced (e.g., sulfonamides, NSAIDS, anticonvulsants) b. May occur alone or overlap with SJS MN: TENS: necrosis, skin detachment; overlap with SJS c. Characterized by extensive areas of erythema, necrosis, and bullous detachment of the epidermis and mucous membranes exfoliation of skin d. Mucous membrane involvement can result in gastrointestinal bleeding, respiratory failure, and genitourinary complications. e. It can be fatal. 5. 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 Insert new table 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 24–48 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