• St Andrews School

• BIO 23

TOPNOTCH MEDICAL BOARD PREP PATHOLOGY MAIN HANDOUT BY DR. KEVIN ELOMINA, DPSP

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This handout is only valid for March 2023 PLE batch. This will be rendered obsolete for the next batch since we update our handouts regularly.

TOPNOTCH MEDICAL BOARD PREP PATHOLOGY MAIN HANDOUT BY DR. KEVIN ELOMINA, DPSP Page 1 of 121

For inquiries visit www.topnotchboardprep.com.ph or email us at topnotchmedicalboardprep@gmail.com

This handout is only valid for the March 2023 PLE batch. This will be rendered obsolete for the next batch since we update our handouts regularly.

 

FOREWORD FOR TOPNOTCH PATHOLOGY

• Pathology has evolved to be one of the hardest subjects in the PLE for the

following reasons:

o Topics from other subjects (Anatomy, Physiology, Microbiology,

Pharmacology, Internal Medicine, OB-GYN) frequently appear

o Topics not mentioned in Robbins sometimes appear

o Different focus on systems per season

o Different focus on information per season (sometimes the questions focus

on morphology and buzzwords, sometimes they focus on clinical and

epidemiologic (including risk factors)

o Rare diseases are sometimes asked (which you would rarely to never

encounter in your future practice)

• Basically, it’s hard because it is UNPREDICTABLE! And that’s not our fault

(me, the program, and the students).

• The only solution to an unpredictable opponent is to know everything there

is to know about it, hence the sheer length of the main material and the lecture

video. Please understand that we are doing this not to overwhelm you. If you

are going to fault me or the program for anything, better be it because of

overpreparing you rather than the other way around. BUT

• Please DO NOT expect for the program to cover everything there is to know

about Pathology. It is taught for a year in medical school, trained for 4 years

in residency, and practiced for a lifetime, but we still know so little about it.

The goal is to know enough to pass the boards and become a competent

general practitioner.

• These are my recommendations in studying Pathology for the PLE:

o Stick to one or few materials and master them. Around 75-80% of the

seasonal feedback are in the handouts, and seasonal updates ensure

coverage of those topics previously not covered. I always see Pathoma as

your favorite, and if it works for you, then go. But if you don’t have the time,

then I recommend sticking to our materials.

o Memorize sometimes (only if needed), understand always.

o Pictures help you memorize lesions. Look at your Robbins atlases or in

Google while you are studying lesions.

o Integrate and DO NOT forget what you learned in other subjects.

Pathology is anything under the sun (including the other subjects). Be

prepared to get answers from other subjects when necessary. Integration

also reinforces information retention because it is processed in a higher

order manner.

o Manage your time wisely so that you can completely consume both the

main handout and the lecture video. The lecture video will be helpful for

visual and auditory learners. I also have some important summaries and

tips not otherwise stated in the handout. Don’t ask me to put those in the

handout. The lecture video is not an audiobook of the main handout.

• Do your best for the things you can control and pray to God (if you believe in

Him) or rely on fate for the things that you cannot. At the end of the day, it’s

all about giving it our all and then hoping that it will be enough. Best of luck,

Topnotch students! See you on the other side soon.

“Success is not final; failure is not fatal: It is the courage to continue that counts."

- Winston Churchill

MAIN REFERENCE:

Kumar V. Abbas AK. Aster JC. Turner JR. Robbins and Cotran Pathologic Basis of

Disease.10th ed. Philadelphia: Elsevier; 2020.

PATHOLOGY

By Kevin A. Elomina, MD, DPSP

Contributors: Mark Milan, MD, Frinz Moey C. Rubio, MD,

Juan Lorenzo D. Santos, MD, & Bradley Ashley G. Ong, MD

TOPIC PAGE

1. Cellular Responses to Stress 1

2. Inflammation and Repair 5

3. Hemodynamic Disorders 10

4. Genetic Disorders 13

5. Disease of the Immune System 16

6. Neoplasia 22

7. Infectious Diseases 26

8. Environmental and Nutritional Pathology 31

9. Diseases of Infancy and Childhood 34

10. Blood Vessels 37

11. Heart 42

12. WBCs, LNs, Spleen, and Thymus 49

13. Red Blood Cell and Bleeding Disorders 53

14. Lung and Pleura 59

15. Head and Neck 64

16. Gastrointestinal Tract 66

17. Liver and Gallbladder 73

18. Pancreas 79

19. Kidney 80

20. Lower Urinary Tract and Male Genital Tract 86

21. Female Genital Tract 90

22. Breast 95

23. Endocrine System 98

24. Skin 103

25. Bones, Joints, and Soft Tissue 106

26. Peripheral Nerves and Skeletal Muscles 110

27. Central Nervous System 112

28. Eye 118

1. CELLULAR RESPONSES TO STRESS

CELLULAR RESPONSES TO STRESS AND

INJURIOUS STIMULI

CELL INJURY AND CELL DEATH

Figure 2.1. Robbins and Cotran Pathologic Basis of Disease, 10th ed. 2020 (adapted)

Cells can be likened to us doctors. For example, when we (cell) entered

clerkship (stress), we developed the ability to function with less hours of

sleep (adaptation). If we (cell) got sick (cell injury), we show signs of

being sick, but eventually we may recover (reversible injury). If we (cell)

turned worse (irreversible injury), we may die (cell death).

Dr. Elomina

CELL INJURY

CAUSES

• Oxygen deprivation

• Physical agents

• Chemical agents and drugs

• Infectious agents

• Immunologic reactions

• Genetic derangements

• Nutritional imbalances

• Cellular senescence

REVERSIBLE CELL INJURY

• Functional and structural alterations in early stages or mild

forms of injury, which are correctable if the damaging stimulus

is removed

• 2 Consistent Features: Cellular swelling, Fatty change

TOPNOTCH MEDICAL BOARD PREP PATHOLOGY MAIN HANDOUT BY DR. KEVIN E  

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