FUNDAMENTALS OF t
PATHOLOGY
MEDICALCOURSEANDSTEP1REVIEW
t t t t t
FIRST EDITION t
HUSAIN A. SATTAR, MD t t t
Assistantt Professor t oft Pathology
Associate t Director t oftClinical t Pathophysiology t andt Therapeutics t Thet
University t oftChicago
Pritzkert School t oft Medicine
Chicago, t Illinois
Pathoma.com
C th ti tc ta tgt o • 2 t 0 t 1t 1
,PATHOMA.COM
Fundamentalst oft Pathology:t Medicalt Courset andt Stept t It t Review,t Firstt Edition
ISBNt 978-0-9832246-0-0
Printed t int thet Unitedt Slatest oft America.t Copyrig
htt ©t 2011t byt Patho ma t LLC.
Allt rightst reserved.t Not partt oft thist publication t mayt bet reproduced, t distributed, t ort trans mitted t in
t anyt form, t ort byt anyt means,t electronict ort mechanical, t includingt photocopying, t recording,t ort
anyt information t storaget andt retrievalt system,t without t priort permission t int writing t fromt thet publisher
t (email:t info@patho ma.com) .
Disclaimer
Fundamentalst oft Pathologyt aimst att providing t generalt principlest att pathologyt andt itst associatedt discipli
nest andt ist nott intended t ast at working t guidet tot patientt care,t drug t administration t ort treatment. t Med
icinet ist at constantlyt evolvingt fieldt andt changes t int practicet regularlyt occur.t Itt ist thet responsibility
t oft thet treatingt practitioner, t relyingt ont independent t expertiset andt knowledge t oft thet patient,t tot
determine t thet bestt treatment t andt met hod t oft application t fort thet patient.t Neithert thet publisher
t nort thet author t assume t anyt liabilityt fort anyt injury t and/o r t damage t tot persons t ort property t arisi
ngt fro m t ort relatedt tot thet materialt withint thist publication.
Furthermore, t although t caret hast beent takent tot ensure t thet accuracy t oft infor ma t io n t presentt int t
hist publication, t thet author t andt publisher t maket not representations t ort warrantiest whatsoever, t expres
st ort implied,t witht respectt tot thet completeness, t accuracyt ort currency t oft thet contents t oft thist pu
blication. t t '1t hist publication t ist nott meant t tot bet at substitutet fort thet advicet oft at physiciant ort othert
licensedt andt qualifiedt medicalt professional. t t Information t presented t int thist publication t mayt refert t
ot drugs, t devicest ort techniques t whicht aret subjectt tot government t regulation,t andt itt ist thet responsibi
lityt oft thet treatingt practitioner t tot comply t witht allt applicablet laws.
'fthist bookt ist printed t ont acid-
freet paper.t Publishedt byt Pathoma t LLC,
http://www.pathoma.com
Covert andt paget designt byt Olaft Nelson,t Chinook t Design,t Inc.t
httttp://ww tw.tchiiiooktype.com
, CONTENTS
Chaptert 1. Growtht Adaptations,t Cellulart Injury,t andt Cellt Death 1
Chaptert 2. Inflammation,t Inflammatoryt Disorders,t andt Woundt Healing .......... 11
Chaptert3, Principlest oft Neoplasia 23
Chaptert4. Hemostasist andt Relatedt Disorders 31
Chapters, Redt Bloodt Cellt Disorders 41
chapters. Whitet Bloodt Cellt Disorders _____________________________________ 53
Chaptert 7. Vasculart Pathology 65
Chapters. Cardiact Pathology 73
Chapter9. Respiratoryt Tractt Pathology 85
Chaptert 10. Gastrointestinalt Pathology 99
Chaptert 11. Exocrinet Pancreas,t Gallbladder,t andt Livert Pathology 115
Chaptert 12, Kidneyt andt Urinaryt Tractt Pathology 125
Chaptert 13. Femalet Genitalt Systemt andt Gestationalt Pathology 137
Chaptert 14. Malet Genitalt Systemt Pathology 151
Chaptert 15. Endocrinet Pathology 159
Chaptert 16. Breastt Pathology 171
Chapterl7. Centralt Nervoust Systemt Pathology 177
Chaptert IS. Musculoskeletal t Pathology 191
Chaptert 19. Skint Pathology 201
Index _________________________________________________________________ 209
, USING t THIS t BOOK
Thist workt ist intendedt ast at reviewt fort studentst duringt theirt preclinicalt yearst andt whilet preparingt fo
rt examinations,t sucht ast thet USMLEi".t Tot thist effect,t thet organizationt oft (hist bookt followst thait oft
mostt primaryt textst int thetfieldtandt parallelst thet syllabust usedt int pathophysiologytcoursest int medica
lt schoolst throughoutt thet Unitedt States.t Amplet spacet ist providedt fort studentst tot maket notest durin
gt courset studyt andt whilet viewingt thet onlinet videost thatt covert eacht sectiont oft thet textt (www.pa.t
homa.com).
Wet recommendt thatt studentst uset Fundamentalst oftPathologyt duringt theirt medicalt courses,t taki
ngt notest int thet margint ast pertinentt topicst aret covered.t Whent examt timet comest around,t theset no
test willt likelyt bet invaluable.
for t examinationt preparation,t wet suggestt studentst readt thet materialt first,t thent listent tot thet onli
net lecture,t andt thent rereadt thet materialt tot developt at solidt graspt ofteacht topic.t Onet shouldt nott be
comet disheartenedt ift theyt aret nott ablet tot retaint allt thet informationt containedt herein.t Thist dec
eptivelyt slimt volumet coverst at tremendoust amountt oft materia!,t andt repetitiont willt bet at keytaidt ast
yout progresst int yourt studies.
Ant effortt hast beent madet tot emphasizet conceptst andt principlest overt randomt facts,t thet fo
restt rathert thant thet trees.t Attentiont tot thet samet byt thet studentt willt providet at deeper,t moret meani
ngfult understandingt oft humant disease.t Wet mustt alwayst remindt ourselvest thatt ultimatelyt ourt goal
t ist tot learn,t tot share,t andt tot serve.t Fundamentalst oftPathologyt wast developedt witht thist goalt int mi
nd.
Husaitnt A,t Sattar,t MtDt
Chicago,t Illinois
ACKNOWLEDGMENTS
Thist workt wouldt nott havet beent possiblet withoutt thet supportt andt encouragementt oft thoset ar
oundt me.t Tot begint with,t It wouldt liket tot acknowledget Shaykht Zulftqart Ahmad,t whoset cleart visio
nt hast guidedt met tot horizonst It wouldt nevert havet known.t Myt familyt ist tot bet acknowledgedt tort thei
rt limitlesst sacrifice,t int particulart thet constantt encouragementt andt supportt oft myt wifet Amina,t who
t hast provedt throught thet yearst tot bet thet windt undert myt wings,t Thomast Krausz,t MDand t AliyatHu
sain,tMDt(botht ProfessorstoftPathologytatt thetUniversitytoftChicago)tdeservet particulart mentiont fort th
eirt valuablet advicet andt guidingt vision,t botht int thet developmentt oft thist bookt ast wellt ast myt ca
reer.t Specialt thankst tot thet multiplet reviewerst att medicalt centerst throughoutt thet countryt fort theirt
criticalt comments,t int particulart Mirt Basharatht Alikhan,t MDt (Pathologyt resident,t Universityt oftChi
cago)t andt Joshuat T.B.t Williamst (Classt oft2013,t Pritzkert Schoolt oftMedicine,t Universityt oftChicago
)t fort theirt extensivet review.t OlaftNelsont (Chinookt Design,t Inc.)t isttot bet commendedt forthistexcelle
nttlayoutt andt design.t Finally,t 1t wouldt bet remisst withoutt acknowledgingt myt students,t whot givet me
aningt tot whatt It do.
PATHOLOGY
MEDICALCOURSEANDSTEP1REVIEW
t t t t t
FIRST EDITION t
HUSAIN A. SATTAR, MD t t t
Assistantt Professor t oft Pathology
Associate t Director t oftClinical t Pathophysiology t andt Therapeutics t Thet
University t oftChicago
Pritzkert School t oft Medicine
Chicago, t Illinois
Pathoma.com
C th ti tc ta tgt o • 2 t 0 t 1t 1
,PATHOMA.COM
Fundamentalst oft Pathology:t Medicalt Courset andt Stept t It t Review,t Firstt Edition
ISBNt 978-0-9832246-0-0
Printed t int thet Unitedt Slatest oft America.t Copyrig
htt ©t 2011t byt Patho ma t LLC.
Allt rightst reserved.t Not partt oft thist publication t mayt bet reproduced, t distributed, t ort trans mitted t in
t anyt form, t ort byt anyt means,t electronict ort mechanical, t includingt photocopying, t recording,t ort
anyt information t storaget andt retrievalt system,t without t priort permission t int writing t fromt thet publisher
t (email:t info@patho ma.com) .
Disclaimer
Fundamentalst oft Pathologyt aimst att providing t generalt principlest att pathologyt andt itst associatedt discipli
nest andt ist nott intended t ast at working t guidet tot patientt care,t drug t administration t ort treatment. t Med
icinet ist at constantlyt evolvingt fieldt andt changes t int practicet regularlyt occur.t Itt ist thet responsibility
t oft thet treatingt practitioner, t relyingt ont independent t expertiset andt knowledge t oft thet patient,t tot
determine t thet bestt treatment t andt met hod t oft application t fort thet patient.t Neithert thet publisher
t nort thet author t assume t anyt liabilityt fort anyt injury t and/o r t damage t tot persons t ort property t arisi
ngt fro m t ort relatedt tot thet materialt withint thist publication.
Furthermore, t although t caret hast beent takent tot ensure t thet accuracy t oft infor ma t io n t presentt int t
hist publication, t thet author t andt publisher t maket not representations t ort warrantiest whatsoever, t expres
st ort implied,t witht respectt tot thet completeness, t accuracyt ort currency t oft thet contents t oft thist pu
blication. t t '1t hist publication t ist nott meant t tot bet at substitutet fort thet advicet oft at physiciant ort othert
licensedt andt qualifiedt medicalt professional. t t Information t presented t int thist publication t mayt refert t
ot drugs, t devicest ort techniques t whicht aret subjectt tot government t regulation,t andt itt ist thet responsibi
lityt oft thet treatingt practitioner t tot comply t witht allt applicablet laws.
'fthist bookt ist printed t ont acid-
freet paper.t Publishedt byt Pathoma t LLC,
http://www.pathoma.com
Covert andt paget designt byt Olaft Nelson,t Chinook t Design,t Inc.t
httttp://ww tw.tchiiiooktype.com
, CONTENTS
Chaptert 1. Growtht Adaptations,t Cellulart Injury,t andt Cellt Death 1
Chaptert 2. Inflammation,t Inflammatoryt Disorders,t andt Woundt Healing .......... 11
Chaptert3, Principlest oft Neoplasia 23
Chaptert4. Hemostasist andt Relatedt Disorders 31
Chapters, Redt Bloodt Cellt Disorders 41
chapters. Whitet Bloodt Cellt Disorders _____________________________________ 53
Chaptert 7. Vasculart Pathology 65
Chapters. Cardiact Pathology 73
Chapter9. Respiratoryt Tractt Pathology 85
Chaptert 10. Gastrointestinalt Pathology 99
Chaptert 11. Exocrinet Pancreas,t Gallbladder,t andt Livert Pathology 115
Chaptert 12, Kidneyt andt Urinaryt Tractt Pathology 125
Chaptert 13. Femalet Genitalt Systemt andt Gestationalt Pathology 137
Chaptert 14. Malet Genitalt Systemt Pathology 151
Chaptert 15. Endocrinet Pathology 159
Chaptert 16. Breastt Pathology 171
Chapterl7. Centralt Nervoust Systemt Pathology 177
Chaptert IS. Musculoskeletal t Pathology 191
Chaptert 19. Skint Pathology 201
Index _________________________________________________________________ 209
, USING t THIS t BOOK
Thist workt ist intendedt ast at reviewt fort studentst duringt theirt preclinicalt yearst andt whilet preparingt fo
rt examinations,t sucht ast thet USMLEi".t Tot thist effect,t thet organizationt oft (hist bookt followst thait oft
mostt primaryt textst int thetfieldtandt parallelst thet syllabust usedt int pathophysiologytcoursest int medica
lt schoolst throughoutt thet Unitedt States.t Amplet spacet ist providedt fort studentst tot maket notest durin
gt courset studyt andt whilet viewingt thet onlinet videost thatt covert eacht sectiont oft thet textt (www.pa.t
homa.com).
Wet recommendt thatt studentst uset Fundamentalst oftPathologyt duringt theirt medicalt courses,t taki
ngt notest int thet margint ast pertinentt topicst aret covered.t Whent examt timet comest around,t theset no
test willt likelyt bet invaluable.
for t examinationt preparation,t wet suggestt studentst readt thet materialt first,t thent listent tot thet onli
net lecture,t andt thent rereadt thet materialt tot developt at solidt graspt ofteacht topic.t Onet shouldt nott be
comet disheartenedt ift theyt aret nott ablet tot retaint allt thet informationt containedt herein.t Thist dec
eptivelyt slimt volumet coverst at tremendoust amountt oft materia!,t andt repetitiont willt bet at keytaidt ast
yout progresst int yourt studies.
Ant effortt hast beent madet tot emphasizet conceptst andt principlest overt randomt facts,t thet fo
restt rathert thant thet trees.t Attentiont tot thet samet byt thet studentt willt providet at deeper,t moret meani
ngfult understandingt oft humant disease.t Wet mustt alwayst remindt ourselvest thatt ultimatelyt ourt goal
t ist tot learn,t tot share,t andt tot serve.t Fundamentalst oftPathologyt wast developedt witht thist goalt int mi
nd.
Husaitnt A,t Sattar,t MtDt
Chicago,t Illinois
ACKNOWLEDGMENTS
Thist workt wouldt nott havet beent possiblet withoutt thet supportt andt encouragementt oft thoset ar
oundt me.t Tot begint with,t It wouldt liket tot acknowledget Shaykht Zulftqart Ahmad,t whoset cleart visio
nt hast guidedt met tot horizonst It wouldt nevert havet known.t Myt familyt ist tot bet acknowledgedt tort thei
rt limitlesst sacrifice,t int particulart thet constantt encouragementt andt supportt oft myt wifet Amina,t who
t hast provedt throught thet yearst tot bet thet windt undert myt wings,t Thomast Krausz,t MDand t AliyatHu
sain,tMDt(botht ProfessorstoftPathologytatt thetUniversitytoftChicago)tdeservet particulart mentiont fort th
eirt valuablet advicet andt guidingt vision,t botht int thet developmentt oft thist bookt ast wellt ast myt ca
reer.t Specialt thankst tot thet multiplet reviewerst att medicalt centerst throughoutt thet countryt fort theirt
criticalt comments,t int particulart Mirt Basharatht Alikhan,t MDt (Pathologyt resident,t Universityt oftChi
cago)t andt Joshuat T.B.t Williamst (Classt oft2013,t Pritzkert Schoolt oftMedicine,t Universityt oftChicago
)t fort theirt extensivet review.t OlaftNelsont (Chinookt Design,t Inc.)t isttot bet commendedt forthistexcelle
nttlayoutt andt design.t Finally,t 1t wouldt bet remisst withoutt acknowledgingt myt students,t whot givet me
aningt tot whatt It do.
