goljan errata

NEW ERRATA/ADDITIONS RAPID REVIEW

PATHOLOGY 3RD

EDITION REVISED REPRINT

(08-08-2012)

5

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

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

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)

20

N.1.c.(1) Smoking (DELETE THE REST)

(4) HPV most common risk factor

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

Smoking may delay healing.

Risk for developing gastric cancer

(increased risk with blood group A

individuals)

Risk factors: H. pylori (most

common), chronic intake NSAIDS

(synergism with H. pylori),

moderate alcohol consumption

Male/female ratio 1:1

Risk increased with MEN I

Smoking may delay healing.

Chronic intake NSAIDS

Risk factors: H. pylori (most common),

chronic intake of NSAIDS, type O

blood group (lack blood group antigens

that are protective to the mucosal

surface)

Helicobacter pylori

association

Duodenal ulcer > gastric ulcer Duodenal ulcer > gastric ulcer

Complications Bleeding (most commonly ulceration

of left gastric artery; Fig. 18-14E).

Bleeding spontaneously ceases in

80% of cases.

Perforation (air under diaphragm,

pain radiates to left or right

shoulder; Fig. 18-14D)

Bleeding (anterior ulcer; most commonly

ulceration of gastroduodenal artery).

Fig. 18-14E). Bleeding spontaneously

ceases in 80% of cases.

Perforation (anterior ulcer; air under

diaphragm, pain radiates to left or right

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.

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) Alkaline urine pH favors crystallization of calcium- and phosphate-containing stones.

(2) Acidic urine pH favors crystallization of uric acid, cystine, stones

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.

Table 23-3 Please add additional sentence

Knee joint injuries

(Fig. 23-23C)

―Unhappy triad‖: most common internal derangement of the

knee joint. 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

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

slightly increased

Usually normal or

slightly increased

Differential count Predominantly

neutrophils;

tuberculosis usually

lymphocytes

First 24–48 hours,

neutrophils, then

switches to lympho-

cytes after 48 hours

Lymphocytes

CSF glucose Decreased Normal: exceptions—

mumps, herpes, LCM

Decreased

CSF protein Increased Increased Increased

Gram stain Frequently positive

(60%–90%)

Culture positive (65%–

90%)

Negative Frequently positive

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

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