Difference between revisions of "Pathology for medical students"
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This article is an introduction to '''pathology for | This article is an introduction to '''pathology for medical students'''. | ||
==Compentencies== | ==Compentencies== | ||
===Describing injuries=== | ===Describing injuries=== | ||
*[[Gross pathologic classification of | *[[Gross pathologic classification of injuries]]. | ||
===Pre-autopsy=== | ===Pre-autopsy=== | ||
*Filling in a death certificate. | *Filling in a death certificate. | ||
**Difference between ''[[manner of death]]'' | **Difference between ''[[manner of death]]'', ''[[cause of death]]'' and ''[[mechanism of death]]''. | ||
**World Health Organization standard for death certificates. | **World Health Organization standard for death certificates. | ||
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*Identifying medical examiner cases/coroner's cases. | *Identifying medical examiner cases/coroner's cases. | ||
*Getting an [[autopsy consent]]. | *Getting an [[autopsy consent]]. | ||
**Understanding the hierarchy. | **Understanding the hierarchy and knowing it must be followed strictly. | ||
**Knowing the difference between ''executer of the estate'' and ''power of attorney for health care decisions''. | **Knowing the difference between ''executer of the estate'' and ''power of attorney for health care decisions'' (not valid after death). | ||
*Providing important clinical information. | *Providing important clinical information. | ||
**Clinical history - past medical history. | **[[Clinical history]] - past medical history. | ||
**Events leading-up to death. | **Events leading-up to death. | ||
**Provisional/suspected cause of death. | **Provisional/suspected cause of death. | ||
| Line 29: | Line 28: | ||
**Infectious cases - role of culture. | **Infectious cases - role of culture. | ||
*Interpreting [[pathology reports]]. | *Interpreting [[pathology reports]]. | ||
*Importance of providing clinical information. | |||
**Consultant for a specialist should have a ''reason for referral'' - pathology is not different. | |||
===Cancer diagnoses=== | ===Cancer diagnoses=== | ||
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Pitfalls: | Pitfalls: | ||
*The ''-oma'' endings: | *The ''-oma'' endings -- some are malignant: | ||
**''[[Melanoma]]''. | **''[[Melanoma]]''. | ||
**''[[Mesothelioma]]''. | **''[[Mesothelioma]]''. | ||
**''[[Sarcoma]]''. | |||
Implication of ''not otherwise specified'': | Implication of ''not otherwise specified'': | ||
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*[[Perineural invasion]]. | *[[Perineural invasion]]. | ||
*[[Margin status]]. | *[[Margin status]]. | ||
*Tumour size. | *Tumour size - understanding the rationale for [[diagnostic size cutoffs]]. | ||
===Techniques=== | ===Techniques=== | ||
*[[Immunohistochemical stains]]. | *[[Immunohistochemical stains]]. | ||
**[[Cancers of unknown primary]]. | **[[Cancers of unknown primary]]. | ||
*Targeted therapies | *Targeted therapies/molecular testing: | ||
**Receptors in breast cancer. | **Receptors in breast cancer (ER, PR, HER2). | ||
**Lung cancer biomarkers ([[Lung_carcinoma_with_EGFR_mutation|EGFR]], [[Lung carcinoma with ALK rearrangement|ALK]], [[PD-L1]], [[ROS1-rearranged non-small cell lung carcinoma|ROS1]]). | |||
**BRAF testing in [[malignant melanoma]]. | |||
**[[Microsatellite instability in colorectal cancer|MSI testing]] in [[colorectal cancer]]. | |||
==See also== | ==See also== | ||
Latest revision as of 13:59, 8 June 2020
This article is an introduction to pathology for medical students.
Compentencies
Describing injuries
Pre-autopsy
- Filling in a death certificate.
- Difference between manner of death, cause of death and mechanism of death.
- World Health Organization standard for death certificates.
Autopsy
- Identifying medical examiner cases/coroner's cases.
- Getting an autopsy consent.
- Understanding the hierarchy and knowing it must be followed strictly.
- Knowing the difference between executer of the estate and power of attorney for health care decisions (not valid after death).
- Providing important clinical information.
- Clinical history - past medical history.
- Events leading-up to death.
- Provisional/suspected cause of death.
- Value of doing an autopsy.
- Interpretation of autopsy reports.
- Negative autopsy.
- Inherited diseases, e.g. MEN 2A, ARVC.
Surgical pathology
- Ordering biopsies and laboratory tests.
- Infectious cases - role of culture.
- Interpreting pathology reports.
- Importance of providing clinical information.
- Consultant for a specialist should have a reason for referral - pathology is not different.
Cancer diagnoses
Definitions:
- Cancer.
- Pathologic definitions of cancer.
- Tumour.
- Not necessarily cancer.
- Locally aggressive tumours, e.g. desmoid tumour.
- Benign tumours.
Pitfalls:
- The -oma endings -- some are malignant:
Implication of not otherwise specified:
Prognostic factors:
- Stage & grade.
- Lymphovascular invasion.
- Perineural invasion.
- Margin status.
- Tumour size - understanding the rationale for diagnostic size cutoffs.
Techniques
- Immunohistochemical stains.
- Targeted therapies/molecular testing:
- Receptors in breast cancer (ER, PR, HER2).
- Lung cancer biomarkers (EGFR, ALK, PD-L1, ROS1).
- BRAF testing in malignant melanoma.
- MSI testing in colorectal cancer.