Tag Archives: Pathology
Lange’s Case Files Pathology is a book whose purpose is to integrate our knowledge of pathology for diagnosing realistic scenarios in medicine. There are 50 clinical cases written in clear USMLE-style format. For each clinical case, there are four parts: 1) a summary with straightforward answers and clinical correlations, 2) basic science concepts including objectives and definitions followed by a brief discussion of the topic of interest, 3) a few comprehensive questions that reinforce key points, and 4) “pathology pearls”, which are important take-home points. When going through each case, important information is bolded for emphasis and explanations are concise and precise—eliminating the trivial concepts that should have become second nature by the end of organ systems. This means that this book is not for learning materials, but rather more effectively used as a tool for review, reinforcement, and integration of learnt information to allow for synthesis.
Although all Case Files books may or may not fit the needs of boards review, Case Files Pathology is a book that can only help. With key take-home points and short-and-sweet explanations of case material, you should have little problem learning the essentials—the fundamental architecture of clinical pathology. For example, you may come across a case of ventricular septal defect (VSD), requiring you to utilize your knowledge of epidemiology, embryology, physiology, and the clinical presentations of cardiac defects. Of course, take note that this book is for pathophysiology and not just for lab-based pathology, so a good foundation in second year organ blocks material would make this book much more useful for synthesis of all the loosely connected information.
The downside of Case Files Path includes: 1) lack of pictures and images to allow the medical student to truly appreciate the clinical appearance of certain diseases, 2) lack of explanations for various diagnostic tests that may be useful for understanding the diagnostic and elimination process, and 3) the multiple choice review questions at the end of each case are generally very simple and superficial questions asking more for recall than synthesis, despite the fact that the case itself is pretty good at elucidating the more detailed aspects of disease.
Overall, Case Files Pathology would be great to have for some last minute studying or USMLE Step 1 board review, but definitely not for the initial phase of studying. Get the foundation down solid, and then use this book to cement everything together. As for where to use this book, it is not a useful resource for studying for medical school classes since the cases in the book is written in USMLE format rather than in the format of questions on medical school examinations. However, it is definitely a good book to have at the end of your studies for USMLE Step 1 to get the bigger picture and practice applying medical knowledge to realistic medical cases, uncertainties and all.
Histology has generally fallen out of favor and focus for many medical school curricula these days. Some med schools still have dedicated histology courses and mandatory histo labs with ridiculously priced slide sets, but most have transitioned to incorporating histology within other broader classes, and offer newer digital versions of labs. Due to this transition, as well as the driving field of pathology, countless databases and software packages have been developed to allow for histopathological visualization of electronic slides.
Whether your school’s applications allows for “real time” zooming and scrolling, or just splatters the screen with images, most software options are not particularly great at teaching the topic. All too commonly, we as med students have instructions that go along with slides and read something like “as it is clearly seen, the eosinophilic uptake shows…” Most of the time however, we have no idea what we are “clearly” looking at. Short of capturing a live histologist and forcing them to use the neon microscope arrows to directly point out key structures to make sense of it all, the next best thing is using a database that directly points to, circles, colors in, and directly labels what you need to know.
There are few free online databases out there, but the Histology Learning System from Boston University is among the best. Sure the background is a dull gray and the site navigation is a bit static, but the content and (more importantly) label system are a sure fire way to both learn and teach the material. This is especially useful when you find yourself needing to put together that annoying last minute power point presentation for some small group show-and-tell the next day.
The database breaks down all of histology by system, and also has a sitemap with every image listed. Upon loading an image, users have the option of clicking on the LABEL button to figure out what they’re actually viewing, or click on a black rectangle on the image to increase magnification (enhance!) that structure. Some structures are rather straight forward and have no enhanced images, while others can go several layers deep. Chances are, the histology professor or local guru at your medical school can recognize the BU histology database images on sight, as they are relatively well known in the community and characteristic.
Whether you need a complementary learning tool to be used with your class syllabus, a stand alone reference as you go through medical school, or a database of “normals” to contrast with pathology studying, the BU Histology website is highly recommended.
To prove your gunnery and attain bonus internet points, name the structures contained within this post by commenting here.
It is finally time to review Goljan: Epic King of Pathology. All of the legends and rumors you heard were true. He’s an arm wrestling champion, rides a white stallion around his massive pathology fun house, and can break a man’s finger clean off during rectal exam. Indeed, some believe that the mere act of saying his name aloud increases their board score by one point every time. If you don’t understand these things, it is simply because you are not yet enlightened.
Edward Goljan is a world class Pathology Chair from Oklahoma State University. Back in the day, he began doing pathology review courses for his medical students, which have been condensed over the years into the most comprehensive yet concise pathology review available. More importantly, it is perfectly tailored to the USMLE Step 1, USMLE Step 2 CK, and even USMLE Step 3 boards exams, as Dr. Goljan has further refined his teachings based on constant feedback he receives from students after they take the boards. As he states:
These notes took 25 years to put together over time. And it dwindled down to the absolute quintessence. It’s like espresso. You just have a little drop and you’re already fixed.
At some point, one of his students recorded his epic lecture series, which continues to float around the internet and med school back-alleys to this day, obtained and abused like crack for the boards. To complement his lectures, he handed out his condensed notes, mentioned above. Over time, these notes coalesced into Edward Goljan’s Rapid Review Pathology book.
The book itself is newer than the audio and has undergone further revisions, whereas the audio remains in its temporally frozen preservation.
Specific chapters of Goljan’s Rapid Review Pathology include: Cell Injury, Inflammation and Repair, Immunopathology, Hemodynamic Disorders (Acid, Base, Electrolytes, Water), Genetic and Developmental Disorders, Environmental Pathology, Nutritional Disorders, Neoplasia, Vascular, Heart, Red Blood Cells, White Blood Cells, Lymphoid Tissue, Hemostasis, Immunohematology, Upper and Lower Respiratory, Gastrointestinal, Hepatobilliary and Pancreatic, Kidneys, Lower Urinary Tract and Male Reproductive Disorders, Female Reproductive Tract and Breast Disorders, Endocrine, Musculoskeletal and Soft Tissue, Skin, Nervous System, and Special Sensory Disorders.
Goljan’s Rapid Review Pathology also comes with Student Consult, the online portal and electronic copy of the book, giving you access to all of the text remotely, as well as the images (which come in handy for powerpoint presentations). Student Consult for Rapid Review Pathology also comes with a little over 400 USMLE style pathology questions related to the book itself. However, to truly lock in the information with a fantastic complementary USMLE style pathology question bank, Robbins and Cotran’s Review of Pathology (reviewed here) is the recommended book of choice.
Robbins and Cotran Review of Pathology, 3rd Edition, AKA “Red Robbins,” is the best pathology USMLE style question bank/book for the boards, and a great complement to Goljan’s review books and audio. The true strength is mixing clinical scenarios with pathology concepts, which makes a topic that is easily boring for many medical students into a very relevant and high yield exercise in the thought process necessary for excelling in pre-clinical class exams, USMLE Step 1, USMLE Step 2 CK, and USMLE Step 3 boards.
The pertinent questions is: should this be used with a question bank such as USMLE World or Kaplan? The answer is definitively yes. At some point, you’re going to hit up Goljan (to be reviewed later), and this book is what will lock in that information with an alternate perspective on the same topics. This should not replace or be used as a substitute for a primary question bank. As for using it with “Big Robbins” or “Baby Robbins,” neither are really needed for the boards past Goljan. At times you may want to reference these resources for topics that require a bit more detail, but they are not a necessity, and can usually be borrowed from friends or the library. (Both of these will also be reviewed in more detail later.)
Robbins and Cotran Review of Pathology does a particularly good job of pulling glossy high resolution color microscopic and gross images that are actually representative of the pathology being reviewed. This really is one of the most important aspects of any pathology teaching. Explanations are thorough, including why the wrong answers are wrong, and the questions are representative of what comes up on the boards.
The three major pathology review sections are comprehensive. Unit 1, General Pathology, covers Cellular Path, Acute and Chronic Inflammation, Tissue Renewal and Repair, Regeneration, Healing, Fibrosis, Hemodynamic Disorders, Thromboembolic Disease, Shock, Genetic Disorders, Diseases of Immunity, Neoplasia, Infectious Disease, Environmental and Nutritional Diseases, and Diseases of Infancy and Childhood. Unit 2, Organ Systemic Pathology, has individual chapters on Blood Vessels, the Heart, Diseases of White Blood Cells, Lymph Nodes, the Spleen, the Thymus, Red Blood Cells and Bleeding Disorders, the Lung, Head and Neck Pathology, the Gastrointestinal Tract, Liver and Biliary Tracts, the Pancreas, the Kidney, the male and female lower urinary tract, the Breast, the Endocrine System, the Skin / Bones / Soft Tissue Tumors, Peripheral Nerve and Skeletal Muscle, the Central Nervous System, and the Eye. Clearly, all of these chapters combined hit every organ system from the large to the microscopic, but I listed them as a reference. The final Unit III, Integrative Reviews, has two long chapters on Clinical Pathology and a Final Review and Assessment that combines information from prior chapters. Robbins and Cotran Pathology Review can also be purchased for Kindle as an eBook on Amazon, but that is not recommended.