GRIPE Systemic Pathology Index

Systemic Pathology
Objectives
2004-2005*
Topic** Page
61 – HEART 3
62 – VESSELS 7
63 – HEMATOPOIETIC SYSTEM 11
64 – RESPIRATORY SYSTEM 19
71 – ORAL REGION 27
72 – ALIMENTARY TRACT 29
73 – LIVER AND BILIARY TRACT 33
74 – PANCREAS 37
82 – LOWER URINARY TRACT 43
83 – MALE GENITAL SYSTEM 45
84 – FEMALE GENITAL SYSTEM 47
85 – BREAST 51
87 – DISORDERS OF FETUS AND PREGNANCY 59
88 – PEDIATRIC PATHOLOGY 61
91 – SKIN 63
92 – BONES, JOINTS, AND SOFT TISSUE 67
93 – SKELETAL MUSCLE 69
94 – NERVOUS SYSTEM 71
95 – SPECIAL SENSE ORGANS 79

*Under review as part of a project to develop a comprehensive set of national guidelines for second year pathology
students.
**Topic number refers to MCA topic designation in the GRIPE question banks.

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GRIPE Systemic Pathology Heart

61 - HEART

The student will be able to:

1. Define and use in proper context:
anastomosis cor pulmonale myocardial infarct
aneurysm coronary artery disease myocarditis
angina pectoris dextrocardia pancarditis
arrhythmia diastole pericarditis
Aschoff body Dressler syndrome Prinzmetal angina
beriberi heart disease ductus arteriosus reperfusion injury
carcinoid heart Ebstein rheumatic fever
disease anomaly/malformation rheumatic heart disease
cardiac tamponade endocardial ring abscess
cardiogenic shock fibroelastosis stenosis
cardiomyopathy endocarditis sudden cardiac death
chronic ischemic foramen ovale systole
heart disease heart failure tetralogy of Fallot
coarctation of the hemopericardium transposition of great
aorta hypertension vessels
conduction system of hypertensive heart truncus arteriosus
the heart disease unstable angina
congenital heart hypertrophy of the valvular insufficiency
disease myocardium valvular regurgitatioin
congestive heart ischemic heart disease valvular stenosis
failure Libman-Sacks vegetation
contraction band endocarditis verruca
necrosis marantic endocarditis
cor bovinum mitral valve prolapse
2. List the most common forms of heart disease in the United States
3. Compare and contrast the following:
 congestive heart failure
 high-output heart failure
 forward heart failure
 backward heart failure
 left-sided heart failure
 right-sided heart failure
 cor pulmonale
in terms of:
o etiology
o pathogenesis
o compensatory mechanisms
o morphology
o clinical features
4. Discuss cardiogenic shock in terms of:
o etiologic factors
o pathogenesis
o morphology

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GRIPE Systemic Pathology Heart

o stages
o clinical manifestations
5. Discuss congenital heart disease in terms of:
o genetic and environmental factors
o types which result in:
left-to-right vs. right-to-left shunt
cyanotic vs. acyanotic disease
o types which present in:
infancy
childhood
adulthood
6. Compare and contrast the following forms of congenital heart disease:
atrial septal defect (ASD) patent ductus arteriosus (PDA)
ostium primum transposition of the great vessels
ostium secundum coarctation of the aorta
venticular septal defect (VSD) preductal
tetralogy of Fallot postductal
endocardial cushion defects anomalous pulmonary venous return
hypoplastic left heart syndrome
in terms of:
incidence associated defects
embryologic abnormality clinical features
pathogenesis complications
gross morphology treatment
hemodynamic abnormalities prognosis
7. Discuss:
 endocarditis
 myocarditis
 pericarditis
 pericardial effusion
 cardiac tamponade
 pancarditis
in terms of:
o classification/types
o epidemiology
o etiology/pathognesis
o morphology
o clinical features
o prognosis
8. Compare and contrast::
 acute rheumatic fever.
 chronic rheumatic heart disease
in terms of:
o pathogenesis
o diagnostic criteria
o morphology (cardiac and extracardiac)

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GRIPE Systemic Pathology Heart

o complications
o laboratory findings
o clincial features
9. Compare and contrast the following forms of valvular heart disease:
calcific aortic stenosis pulmonic insufficiency
aortic insufficiency endocarditis
mitral stenosis/insufficiency infective
mitral valve prolapse noninfective
mitral annular calcification carcinoid heart disease
tricuspid insufficiency
in terms of:
o epidemiology
o etiology
o pathogenesis
o morphology (cardiac and extracardiac)
o clinical features
o complications
o prognosis
10. List long term complications associated with prosthetic heart valves
11. Compare and contrast:
 dilated (congestive) cardiomyopathy
 hypertrophic cardiomyopathy (idiopathic hypertrophic subaortic stenosis (IHSS)
 restrictive cardiomyopathy
 endomyocardial fibrosis
 eosinophilic (Loeffler) endomyocarditis
 endocardial fibroelatosis
in terms of:
o etiology
o pathogenesis
o morphology
o clinical course
12. Discuss coronary artery disease, in terms of:
o epidemiology
o risk factors
o etiologic factors
o pathogenesis
o complications
13. Discuss myocardial infarct, in terms of:
o etiologic factors
o risk factors
o pathogenesis
o morphology
evolution of morphologic changes with time
correlation of morphologic distribution of infarct with site of coronary artery
disease
o clinical, laboratory, and electrocardiographic findings with increasing time after

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GRIPE Systemic Pathology Heart

event
o complications, including timing thereof after event
o prognosis, including most common causes of death with increasing time after event
14. Discuss sudden cardiac death, in terms of:
o causes
o relationship to arrythmias
o cardiac morphology
15. Discuss the following cardiac tumors
 myxoma
 rhabdomyoma
 lipoma
 metastatic
cardiac effects of noncardiac neoplasms

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GRIPE Systemic Pathology Vessels

62 - VESSELS

The student will be able to:

1. Define and use in proper context:
aneurysm dysplasia phlebothrombosis
angiitis fibrous cap pseudoaneurysm
arteriolosclerosis fibrous plaque pyogenic granuloma
arteriosclerosis fusiform aneurysm Raynaud disease
arteriovenous fistula gangrene Raynaud
arteriovenous hemorrhoid phenomenon
malformation hypertension saccular aneurysm
arteritis leukocytoclastic superior vena cava
atheroma vasculitis syndrome
atherosclerosis lymphedema telangiectasis
deep vein thrombosis Marfan syndrome thrombophlebitis
(DVT) mycotic aneurysm varicose veins
false aneurysm obliterative vasculitis
fatty streak endarteritis
fibromuscular phlebosclerosis
2. Discuss mechanisms of blood pressure regulation, including:
 cardiac influences
 neural factors
 hormonal factors
 vasoactive agents
 renin-angiotensin system
3. Compare and contrast the following types of hypertension:
 essential
 malignant
 renovascular
 secondary
in terms of:
o etiology
o pathogenesis
o level of blood pressure elevation
o vascular morphologic findings
o clinical features
o prognosis
4. Discuss the morphologic effects of hypertension on:
 heart
 brain
 kidneys
 placenta
and enumerate the clinical consequences thereof
5. Describe the development, anatomy, and clinical consequences of the major congenital
malformations of arteries.
6. Discuss the following vascular diseases:
arteriosclerosis lymphangiitis
atherosclerosis lymphedema
arteriolosclerosis phlebothrombosis
Mönckeberg medical calcific sclerosis thrombophlebitis
vasculitis varicose veins
in terms of:
etiologic/predisposing factors complications of lesions
morphologic features fate of lesions
type and size of vessels involved clinical features and prognosis
organs involved
7. Discuss the following forms of vasculitis:
 infectious vasculitis
 giant cell (temporal) arteritis
 Takayasu arteritis
 polyarteritis nodosa
 Kawasaki (mucocutaneous lymph node) syndrome
 microscopic (hypersensitivity) polyangiitis
 Wegener granulomatosis
 thromboangiitis obliterans (Buerger disease)
in terms of:
o incidence
o age distribution
o etiology
o pathogenesis
o size, type, and distribution of vessels involved
o morphology of lesions
o laboratory findings
o clinical features, complications, and prognosis
8. Compare and contrast the following disorders:
 atherosclerotic aneurysm
 syphilitic aneurysm
 aortic dissection (dissecting hematoma)
 berry aneurysm
 Charcot-Bouchard microaneurysm
in terms of:
o incidence
o etiology
o pathogenesis
o type and distribution of vessels involved
o morphology
o clinical features
o complications and prognosis
9. Compare and contrast thoracic and abdominal aortic aneurysms on the basis of:
 etiologic factors
  incidence
 complications
10. Discuss the effects of the following on the pathogenesis and prevalence of atherosclerosis:
 age
 sex
 geographic location
 risk factors
11. Outline the development of the atherosclerotic lesion with respect to:
 pathogenic mechanisms
 morphology
 clinical manifestations
 complications
12. Compare and contrast:
 hyaline arteriolosclerosis
 hyperplastic areteriolosclerosis
in terms of:
o pathogenesis
o morphology
o clinical significance
13. Compare and contrast the following vascular tumors:
vascular ectasias glomus tumor (glomangioma)
hemangioma angiosarcoma
hemangioendothelioma bacillary angiomatosis
hemangiopericytoma Kaposi sarcoma
lymphangioma
in terms of:
o age disribution
o etiology
o pathogenesis
o morphology
o clinical features
o prognosis
GRIPE Systemic Pathology Hematopoietic System

63 – HEMATOPOIETIC SYSTEM

The student will be able to:

1. Define and use in proper context:
achlorhydria leukocytosis
acute leukemia leukoerythroblastosis
agnogenic myeloid metaplasia leukopenia
aleukemic leukemia lymphoma
amyloidosis macrocytosis
anemia marginating pool
autosplenectomy maturation/storage pool
basophilic stippling mean cell hemoglobin (MCH)
Bence Jones protein mean cell hemoglobin concentration (MCHC)
Birbeck granule (HX body) mean cell volume (MCV)
bronchus-associated lymphoid tissue (BALT) microcytosis
chronic leukemia mucosa-associated lymphoid tissue (MALT)
circulating pool myelodysplastic syndrome
coagulation myelophthisic
complete blood count (CBC) myeloproliferative disorder
cryoglobulinemia nuclear-cytoplasmic asynchrony
direct antiglobulin (Coombs) test pancytopenia
dyserythropoiesis petechiae
dysmegakaryocytopoiesis Philadelphia chromosome
ecchymoses Plummer-Vinson syndrome
erythropoiesis poikilocytosis
erythropoietin polychromasia
extramedullary hematopoiesis proliferating pool
extravascular hemolysis purpura
ferritin red cell distribution width (RDW)
G6PD screen reticulocyte count
granulocytopenia Schilling test
granulopoiesis sickle cell disease
Ham test sickle cell prep
haptoglobin sickle cell trait
hematocrit stem cell
hematoma sugar water test
hemoglobin electrophoresis thalassemia
hemostasis thrombocytopathy
hyperviscosity syndrome thrombocytopenia
hypochromia thrombocytopenia
idiopathic thrombocytopenic purpura (ITP) thrombocytosis
indirect antiglobulin (Coombs) test thrombopoiesis
ineffective hematopoiesis thrombopoietin
intravascular hemolysis thrombotic thromocytopenic purpura (TTP)
intrinsic factor total iron binding capacity (TIBC)
left shift transferrin
leukemia von Willebrand factor
leukemoid reaction
2. Define, state the significance of, and identify on a peripheral blood smear each of the following:
erythrocyte (discocyte) plasma cell
reticulocyte plasmacytoid lymphocyte
acanthocyte (spur cell) atypical lymphocyte
echinocyte (burr cell) lymphocyte
codocyte (leptocyte, target cell) lymphoblast
stomatocyte myeloblast
schistocyte Pelger-Huët cell
rouleaux pseudo-Pelger-Huët cell
ringed sideroblast Döhle body
Cabot ring basket (smudge) cell
Howell-Jolly body flame cell
Pappenheimer body grape cell (Mott cell, thesaurocyte)
Heinz body Russell body
polymorphonuclear leukocyte (PMN) Dutcher body
neutrophil hairy cell
band (stab) form Sezary cell
basophil platelet
eosinophil giant platelet
monocyte
3. Define, state the significance of, and identify on a bone marrow smear each of the following:
pronormoblast myelocyte eosinophil
normoblast metamyelocyte plasma cell
megaloblast band (stab) form lymphocyte
myeloblast neutrophil megakaryocyte
promyelocyte basophil
4. Explain:
 the concept of reference (normal) range
 the theory of the automated cell counter
 the components of the complete blood count (CBC) and its application in patient evaluation
5. Compare and contrast the reporting of leukocyte differential counts as relative percentages vs.
absolute numbers, in terms of the advantages and disadvantages of each system.
6. Discuss the stages of erythropoiesis in terms of:
 morphology of each stage
 stages in which hemoglobin is produced
 lifespan of reticulocytes and mature red blood cells
 mechanisms of degradation of senescent erythrocytes
 factors (vitamin, minerals and hormones) which influence erythropoiesis
7. Discuss the stages of granulopoiesis in terms of:
 morphology of each stage
 time to form and life span of mature granulocytes
 basic functions of the different types of maturing granulocytes
 factors which influence granulopoiesis.
8. Discuss the stages of development of lymphocytes, plasma cells, and monocytes, in terms of:
 morphology
 life span of mature forms
 functions of mature forms
 factors which influence production.
9. Discuss thrombocytopoiesis in terms of:
 morphology of megakaryocytes
  fate of megakaryocytes
 life span of platelets
 factors which influence thrombocytopoiesis
 abnormal morphologic forms of platelets and megakaryocytes
10. Discuss the following classification of anemia in terms of rationale for its use, and specific examples
in each category:
 hypochromic-microcytic
 normochromic-normocytic
 macrocytic
11. Categorize and discuss laboratory test procedures used in the diagnosis of anemia, outlining the
basic workup of a patient who presents with anemia.
12. Assess bone marrow function in the diagnosis of the anemic patient, on the basis of:
 reticulocyte count (relative, absolute, and corrected)
 serum bilirubin
 urobilinogen concentration
13. Discuss the following types of anemia:
iron deficiency anemia pernicious anemia
megaloblastic anemias anemia of chronic disease
folate deficiency anemia aplastic anemia
in terms of:
incidence marrow and peripheral blood morphology
associated risks laboratory diagnostic criteria
etiology and pathogenesis clinical features and course
14. Utilize peripheral blood and bone marrow smears to assess the deviations from normal marrow
response which occur in:
 hemolytic anemias
 nuclear maturation defects
 cytoplasmic maturation defects
 hypoproliferative anemias
15. Compare and contrast anemia secondary to acute vs. chronic blood loss in terms of:
 etiology
 pathophysiologic changes
 clinicopathologic diagnosis
16. Discuss the following types of anemia:
 sickle cell anemia
 the thalassemia disorders
 hereditary spherocytosis
 glucose-6-phosphate dehydrogenase (G6PD) deficiency
 pyruvate kinase deficiency
 paroxysmal nocturnal hemoglobinuria
 mechanical hemolytic anemia
 malaria
in terms of:
o genetics - molecular changes
o incidence
o etiology
o pathogenesis
o morphology
peripheral blood
bone marrow
 liver
spleen
o laboratory diagnosis
o clinical features and course
17. Compare and contrast warm vs. cold antibody immunohemolytic anemias in terms of:
 etiology
 pathogenesis
 associated risks-diseases
 laboratory diagnosis
 clinical features and course
18. Compare and contrast intravascular vs. extravascular hemolysis, in terms of:
 etiology
 pathogenesis
 laboratory diagnosis
 clinical findings and course
19. Compare and contrast:
 acute lymphoblastic leukemia (ALL)
 acute myeloblastic leukemia (AML)
 chronic lymphocytic leukemia (CLL)
 chronic myeloid leukemia (CML)
 hairy cell leukemia (HCL)
in terms of:
o incidence and age distribution
o cytogenetics
o morphology (bone marrow and peripheral blood)
o immunophenotyping
o laboratory diagnosis (including cytochemical stains)
o clinical features
o prognosis
20. Describe the FAB (French-American-British) classification of acute myeloblastic leukemias in terms
of:
 nomenclature
 incidence of each type
 general features of each type
21. List the major etiology and pathogenesis of the following:
leukopenia atypical lymphocytes
leukemoid reaction eosinophilia
neutropenia (relative and absolute) monocytosis
lymphocytosis (relative and absolute) basophilia
left shift leukoerythroblastic reaction
22. Distinguish between leukemia and leukmeoid reaction on the basis of:
 etiology
 pathogenesis
 laboratory data
23. Morphologically differentiate a blast form from a monocyte and lymphocyte.
24. Discuss the following myelodysplastic syndromes:
 refractory anemia
 refractory anemia with ringed sideroblasts
 refractory anemia with excess blasts (RAEB)
 refractory anemia with excess blasts in transformation (RAEB-IT)
  chronic myelomonocytic leukemia (CMML)
in terms of:
o clinical presentation
o etiology
o genetics
o morphology of peripheral blood and bone marrow
o laboratory diagnosis
o clinical course
o prognosis
25. Define and classify the myeloproliferative disorders.
26. Discuss the following myeloproliferative disorders:
 chronic myeloid leukemia
 polycythemia vera
 myeloid metaplasia with myelofibrosis
 essential thrombocythemia
in terms of:
o incidence
o clinical presentation
o genetics
o pathogenesis
o morphology-peripheral blood and bone marrow
o laboratory diagnosis
o clinical course and complications
o prognosis
27. Compare and contrast:
 polycythemia vera
 relative polycythemia
 secondary polycythemia
in terms of:
o etiology
o diagnostic criteria
o clinical course and complications
28. Describe the proper mode of submission of a lymph node biopsy to the surgical pathology laboratory
for workup of a suspected lymphoproliferative disorder.
29. Define, state the significance of, and identify in a microscopic section of a lymph node or extranodal
site of involvement each of the following:

lymphocyte (normal) Hodgkin cell

small cleaved lymphocyte Reed-Sternberg cell
large lymphocyte "popcorn" cell
macrophage lacunar cell
30. Compare and contrast:
 follicular hyperplasia
 follicular lymphoma
on the basis of:
o histologic criteria
o clinical significance
31. Discuss general features of non-Hodgkin lymphomas in terms of:
  incidence
 immunophenotyping (T vs B cells)
 morphologic patterns (diffuse vs. follicular)
 principles of:
o classification
o grading
o staging
 laboratory methods of diagnosis
 clinical features
 prognosis
 extralymphatic organs involved
 likelihood of a leukemic phase
32. Compare and contrast:
 small lymphocytic lymphoma
 follicular lymphoma
 diffuse large cell lymphoma
in terms of:
incidence clinical presentation
associated conditions laboratory diagnosis
age and sex distribution clinical features
morphology prognosis
immunophenotyping
33. Compare and contrast:
 lymphoblastic lymphoma
 small noncleaved cell (Burkitt) lymphoma
in terms of
incidence immunophenotyping
associated conditions laboratory diagnosis
age/sex distribution clinical features
morphology prognosis

34. Discuss Hodgkin disease in terms of:

classification morphology of each types
incidence of each type laboratory diagnosis
etiology clinical features
pathogenesis prognosis
35. Compare and contrast:
 non-Hodgkin lymphomas
 Hodgkin disease
in terms of:
o clinical features
o methods of staging
36. Discuss:
 mantle cell lymphoma
 marginal zone lymphoma
 peripheral T-cell lymphoma
 adult T-cell lymphoma/leukemia
 cutaneous T-cell lymphoma
in terms of:
 o definitions
o etiology
o morphology
o clinical features
37. List benign and malignant etiologies of lymphoadenopathy and splenomegaly.
38. Categorize and discuss the different types of plasma cell dyscrasias in terms of definitions and
clinical presentation.
39. Discuss multiple myeloma in terms of:
clinical presentation clinical course
etiology complications
clinicopathologic diagnosis prognosis
morphology and sites of lesions
40. Discuss Waldenström macroglobulinemia in terms of:
clinical presentation clinical course
morphology with immunophenotyping complications
associated conditions prognosis
41. Compare and contrast:
 plasmacytoma
 monoclonal gammopathy of uncertain significance (MGUS)
 heavy chain disease
in terms of:
o incidence
o clinical presentation
o clinicopathologic diagnosis
o clinical course
o differentiatiaton from multiple myeloma
42. Discuss the different laboratory procedures used in the clinicopathologic diagnosis of the different
plasma cell dyscrasias.
43. List benign and malignant etiologies of monoclonal gammopathies.
44. Discuss Langerhans cell histiocytosis in terms of:
 definition
 classification
 clinicopathologic diagnosis
 morphology
and for each type, discuss:
o age of onset
o distribution of lesions
o clinical course/prognosis
45. Classify major causes of changes in size of spleen, in terms of both increase and decrease.
46. Enumerate the gross and microscopic characteristics of involvement of the spleen by:
infarcts amyloid
sickle cell disease leukemia
extramedullary hematopoiesis lymphoma
passive congestion rupture
47. List the major complications of splenomegaly.
48. Briefly describe the morphologic features and clinical findings in:
 histiocytoses
  Gaucher disease
 Neimann-Pick disease
 Tay-Sachs disease
49. Discuss thrombocytopenia in terms of:
 differential diagnosis
 clinical features
 bone marrow morphology and
 laboratory features
50. Discuss thrombocytosis in terms of diagnosis and differential diagnosis.
51. Outline the role of platelets in normal hemostasis.
52. Outline the process for stepwise evaluation of a patient with suspected platelet disorder
53. Compare and contrast the following disorders of platelets:
Glanzmann thrombasthenia gray platelet syndrome
Chediak-Higashi syndrome von Willebrand disease
Bernard-Soulier disease HIV-associated thrombocytopenia
Hermansky-Pudlak syndrome drug-induced thrombocytopenia
in terms of:
o definition
o genetics
o laboratory features including platelet aggregation patterns
o clinical features
54. Categorize and discuss acquired disorders of platelet function in terms of etiology and pathogenesis.
55. Compare and contrast:
 idiopathic throbocytopenic purpura (ITP)
 thrombotic thrombocytpenic purpura (TTP)
 hemolytic-uremic syndrome (HUS)
in terms of:
o etiology
o pathogenesis
o clinical features
o morphologic findings
o clinicopathologic diagnosis
55. List and discuss the laboratory diagnostic procedures used to approach patients with:
 bleeding disorders
 thrombotic disorders
56. Discuss disseminated intravascular coagulopathy (DIC) in terms of:
etiologies clinical presentation and course
pathogenesis laboratory diagnosis
morphologic features complications and prognosis
GRIPE Systemic Pathology Respiratory System

64 – RESPIRATORY SYSTEM

The student will be able to:

1. Define and use in proper context:

acute interstitial pneumonia (AIP) Hamman-Rich syndrome

adult respiratory distress syndrome (ARDS) heart failure cell
allergic bronchopulmonary aspergillosis (ABPA) hemoptysis
alveolar-capillary membrane hemothorax
anthracosis histiocytosis X
asbestos honeycomb lung
asbestosis Horner syndrome
asteroid body hyaline membrane
asthma hydrothorax
atelectasis hypersensitivity pneumonitis (HP)
bagassosis hypertrophic pulmonary osteoarthropathy
barrel chest idiopathic interstitial pneumonia (IIP)
"benign mesothelioma" idiopathic pulmonary fibrosis (IPF)
bird-fancier's disease jagziekte
bleb juvenile laryngeal papillomatosis
blue bloater Loeffler syndrome
branchial cleft cyst lymphangiitic carcinomatosis
bronchial cyst Meigs syndrome
bronchiectasis middle lobe syndrome
bronchiolitis obliterans nasopharyngeal carcinoma
bronchogenic carcinoma non-small cell lung cancer (NSCLC)
bronchogenic cyst obstructive lung disease
bronchopulmonary sequestration organizing pneumonia
bulla Pancoast tumor
byssinosis paraneoplastic syndrome
Caplan syndrome pigeon-breeder's lung
Charcot-Leyden crystal pink puffer
chronic bronchitis plexiform lesion
chronic obstructive pulmonary disease (COPD) pneumoconiosis
chylothorax pneumothorax
coal macule progressive massive fibrosis (PMF)
coal nodule pulmonary edema
coin lesio pulmonary embolism
consolidation pulmonary veno-occlusive disease (PVOD)
cor pulmonale rales
cryptogenic fibrosing alveolitis (CFA) Reid index
cryptogenic organizing pneumonia (COP) restrictive lung disease
Curschmann spiral rhonchi
diffuse alveolar damage (DAD) saddle embolus
diffuse parenchymal lung disease (DPLD) scar carcinoma
dyspnea Schaumann body
emphysema severe acute respiratory syndrome (SARS)
empyema silicatosis
extrinsic allergic alveolitis (EAA) silicosis
farmer's lung silo-filler's disease
ferruginous body singers’ node
Ghon complex small airways disease
Goodpasture syndrome status asthmaticus
GRIPE Systemic Pathology Respiratory System

tension pneumothorax vocal cord nodule

tumorlet
2. Describe the mechanisms by which the following pulmonary defense mechanisms accomplish their
functions:
 nasal clearance
 laryngeal (including epiglottic) action
 tracheobronchial clearance
 alveolar clearance
3. Explain the pathogenesis of each of the following manifestations of pulmonary disease:
pain clubbing of fingers
cough hypertrophic pulmonary osteoarthropathy
dyspnea secondary polycythemia
sputum production hemptysis
cyanosis cor pulmonale
4. Discuss the following pulmonary congenital anomalies, in terms of morphology and clinical
consequences:
 agenesis
 hypoplasia
 congenital lobar overinflation ("emphysema")
 congenital cyst
 bronchopulmonary sequestration
intralobar
extralobar
5. Compare and contrast:
 obstruction (resorption) atelectasis
 compression atelectasis
 contraction atelectasis
 microatelectasis
 patchy
in regards to:
o predisposing factors
o etiology
o pathogenesis
o morphologic findings
o clinical features
6. Contrast obstructive and restrictive pulmonary disease, in terms of:
 morphologic features
 radiologic manifestations
 pulmonary function test results
 clinical manifestations
7. Compare and contrast the etiologies and effects of airflow obstruction that occur in lesions involving
the airways with those that involve the alveolar parenchyma.
8. Compare and contrast:
 emphysema
 chronic bronchitis
 bronchial asthma
 bronchiectasis
in terms of:
o etiology
GRIPE Systemic Pathology Respiratory System

o pathogenesis
o morphologic features
o radiologic features
o clinical manifestations
o complications and prognosis
9. Compare and contrast the following forms of bronchial asthma:
 atopic
 non-atopic
 drug-induced
 occupational
in terms of etiology and pathogenesis
10. Compare and contrast
centriacinar (centrolobular) emphysema interstitial emphysema
panacinar (panlobular) emphysema senile "emphysema"
paraseptal (distal acinar) emphysema congenital lobar "emphysema"
focal emphysema
in terms of:
incidence gross and microscopic morphology
age and sex distribution physiologic changes
etiology radiologic features
pathogenesis clinical presentation, course, and prognosis
11. Discuss the Reid index, in terms of a normal index vs. an index indicative of chronic bronchitis
12. Discuss respiratory bronchiolitis of smokers (small airways disease) in terms of:
 pathogenesis
 morphology
 clinical presentation
13. Discuss bronchiectasis, in terms of:
 predisposing conditions
 the types of organisms typically cultured from bronchi
 sequelae
14. Compare and contrast neonatal and adult respiratory distress syndrome in terms of:
 predisposing factors/associated conditions
 pathogenesis
 morphology
 complications
 clinical course
15. Compare and contrast the following forms of diffuse parenchymal lung disease (DPLD):
 diffuse alveolar damage (DAD)
 bronchilitis obliterans-organizing pneumonia (BOOP)
 usual interstitial pneumonia (UIP)
 desquamative interstitial pneumonia (DIP)
 lymphoid interstitial pneumonia (LIP)
 nonspecific interstitial pneumonia (NSIP)
in terms of:
synonyms radiologic features
associated diseases clinical manifestations
etiopathogenesis treatment
morphologic features prognosis
16. Discuss the following disorders:
GRIPE Systemic Pathology Respiratory System

sarcoidosis pulmonary eosinophilic granuloma

Goodpasture syndrome pulmonary infiltrates with eosinophilia (PIE)
idiopathic pulmonary hemosiderosis (IPH) lipid pneumonia
hypersensitivity pneumonitis (HP) Wegener granulomatosis
pulmonary alveolar proteinosis lymphomatoid granulomatosis
in terms of:
o associated conditions
o etiopathogenesis
o morphologic features (pulmonary and extrapulmonary)
o radiologic features
o clinical manifestations
o treatment
o prognosis
17. Discuss pulmonary invovement in autoimmune ("collagen-vascular") diseases, noting the major
morphologic manifestations in the lung of:
 systemic lupus erythematosus (SLE)
 rheumatoid arthritis (RA)
 progessive systemic sclerosis (PSS)
18. Discuss the basic pathogenesis of pneumoconioses.
19. Compare and contrast the following pneumoconioses:
 coal workers' pneumoconioses
 silicosis
 asbestosis
 berylliosis
in terms of:
o occupational exposure
o pathogenesis
o gross and microscopic morphology
o complications
o clinical course
20. Discuss the following asbestos-related lung diseases:
 fibrous pleural plaques
 pleural effusion
 asbestosis
 bronchogenic carcinoma
 malignant mesothelioma
in terms of:
o epidemiology
o etiopathogenesis
o morphology
o clinical features
o prognosis
21. Discuss the acute and chronic stages of radiation lung injury, in terms of:
 temporal features
 pathogenesis
 morphology
 consequences
22. Discuss drug-induced lung disease, enumerating drugs most commonly associated with the following
pulmonary reactions:
GRIPE Systemic Pathology Respiratory System

 bronchospasm
 pulmonary edema
 hypersensitivity pneumonitis (HP)
 eosinophilic pneumonia
 diffuse alveolar damage (DAD)
 pulmonary fibrosis
23. Enumerate the general indications for lung transplantation, and discuss the following complications
thereof:
 pulmonary infection
 acute rejection
 chronic rejection
in terms of:
o etiology
o pathogenesis
o morphology
o clinical features
24. Discuss the pulmonary features of cystic fibrosis (CF), in terms of:
 frequency of involvement of lung in CF
 pathogenesis
 morphology
 functional alterations
 clinical manifestations
 pulmonary complications
o obstructive
o infectious (including most common organisms involved)
 treatment
 prognosis
25. Compare and contrast:
 bronchopneumonia
 lobar pneumonia
 primary atypical pneumonia
 aspiration pneumonia
 lung abscess
 pulmonary infiltrates in the immunocompromised host
in terms of:
predisposing factors radiologic features
etiologic organisms clinical manifestations
pathogenesis prognosis
morphologic features
26. Describe the four classic stages of the inflammatory response in lobar pneumonia, in terms of:
 temporal features
 morphology
27. Discuss the following specific respiratory tract infections:
anthrax psittacosis
Legionnaire's disease histoplasmosis
actinomycosis coccidioidomycosis
nocardiosis blastomycosis
tuberculosis crytococossis
atypical mycobacteriosis aspergillosis
mycoplasma pneumonia mucormycosis
GRIPE Systemic Pathology Respiratory System

respiratory syncytial virus (RSV) infection severe acute respiratory syndrome (SARS)
influenza pneumonia Pneumocystis carinii pneumonia (PCP)
adenovirus pneumonia toxoplasmosis
cytomegalic inclusion disease (CID) strongyloidiasis
in terms of:
characteristics of organism morphology, including use of special stains
predisposing factors radiologic features
associated conditions clinical features
pathogenesis prognosis
28. Differentiate among tuberculosis, sarcoidosis, and granulomatous fungal disease on the basis of:
 etiopathogenesis
 morphologic features, including use of special stains
 organs involved
 radiologic features
 clinical presentation
 diagnostic tests
 laboratory findings
 prognosis
29. Discuss pulmonary edema, embolism, and infarction in terms of:
 predisposing factors and etiology
 pathogenesis
 morphologic features
 radiologic features
 clinical manifestations
30. Compare and contrast pulmonary embolism caused by:
thrombus bone marrow
fat amniotic fluid
air talc
in terms of:
predisposing factors pulmonary pathophysiology
incidence complications
morphology clinical course
31. Compare and contrast primary and secondary pulmonary hypertension, in terms of:
 predisposing factors/associated conditions
 pathogenesis
 age and sex distribution
 clinical manifestations
 size and type of vessels involved
 morphologic features (including reversible vs. irreversible lesions)
 hemodynamic consequences
 prognosis
32. Discuss:
 pulmonary circulatory disease associated with congenital heart disease
 persistent fetal ciruclation
in terms of:
o etiopathogenesis
o size and type of vessels involved
o morphologic features
o pulmonary pathophysiology
o prognosis
GRIPE Systemic Pathology Respiratory System

33. Compare and contrast the following thoracic tumors:

squamous cell carcinoma of lung pulmonary hamartoma
bronchogeneic adenocarcinoma malignant lymphoma
bronchioloalveolar carcinoma Hodgkin disease
small cell carcinoma of lung metastatic neoplasm to thorax
large cell carcinoma of lung pleural fibroma (solitary fibrous tumor)
bronchial carcinoid malignant mesothelioma of pleura
in terms of:
epidemiology clinical manifestations (pulmonary, extrapulmonary)
etiology staging
pathogenesis treatment
morphologic features prognosis
radiologic features
34. Compare central and peripheral neoplasms of the lung in terms of:
 clinical presentation
 radiographic presentation
 histologic types
 clinical course
 prognosis
35. Enumerate the different types of mediastinal masses based on location in:
 superior mediastinum
 anterior mediastinum
 posterior mediastinum
 middle mediastinum
36. Compare and contrast:
 thymoma
 malignant thymoma
 thymic carcinoma
in terms of:
o associated conditions and syndromes
o clinical presentation and course
37. List likely etiologies and expected effects on pulmonary function of:
hydrothorax pneumothorax
empyema tension pneumothorax
hemothorax pleural adhesion
chylothorax
38. Discuss pleural fluid collections on the basis of fluid type and common associations
39. List appropriate diagnostic procedures for patients clinically suspected of having pleural effusions
40. Compare and contrast:
nasal polyp juvenile laryngeal papillomatosis
sinonasal papilloma laryngeal squamous cell carcinoma
laryngeal nodule (singers' node) nasopharyngeal carcinoma
laryngeal papilloma
in terms of:
o etiology
o morphology
o clinical features
o prognosis
GRIPE Systemic Pathology Oral Region

71 - ORAL REGION

The student will be able to:

1. Define and use in proper context:
carcinoma ex pleomorphic adenoma Mikulicz syndrome
erythroplasia sicca syndrome
glossitis xerostomia
leukoplakia
2. Describe the following congenital anomalies:
 cleft lip/palate
 branchial cleft cyst
in terms of:
o embryonic developmental pathogenesis
o morphology
o clinical features
3. Describe dental caries and periodontal disease, in terms of:
 epidemiology
 etiology and pathogenesis
 complications
 prophylaxis
4. Describe the following oral lesions:
 primary herpetic gingivostomatitis
 perioral herpes simplex
 aphthous ulcer
 oral candidiasis
 hairy leukoplakia
in terms of:
o epidemiology
o etiology and pathogenesis
o clinical and morphologic features
5. State the relationship of carcinoma of the oral mucosa to:
 leukoplakia
 erythroplasia
 jagged teeth
 tobacco
 ill-fitting dentures
6. Describe the development of squamous cell carcinoma, in terms of:
predisposing factors prognosis
specific sites within organ associated predisposing lesions
morphology patterns of metastasis
clinical features and course
for each of the following anatomic sites:
lip pharynx
tongue larynx
floor of mouth trachea
GRIPE Systemic Pathology Oral Region

7. List the signs, symptoms, and usual etiology of acute epiglottitis

8. Compare and contrast laryngeal nodules ("singer's nodes") and laryngeal papillomas, in terms of:
 age of onset
 etiology
 morphology
 biologic behavior
 relationship to carcinoma
9. Describe the following salivary gland lesions:
sialadenitis adenoid cystic carcinoma
sialolithiasis mucoepidermoid carcinoma
pleomorphic adenoma (mixed tumor) adenocarcinoma
adenolymphoma (Warthin tumor) Sjogren syndrome
acinic cell tumor
in terms of:
o relative frequency
o location
o morphology
o prognosis
10. Describe the following odontogenic lesions:
 odontogenic cyst
 dentigerous cyst
 ameloblastoma
in terms of:
o pathogenesis
o morphology
o prognosis
11. List defining features and significance of the following oral lesions:
 peripheral giant cell granuloma (epulis)
 mucocele
 pyogenic granuloma ("pregnancy tumor")
12. Compare and contrast the following lesions of the nasal cavity and paranasal sinuses:
acute rhinitis sinusitis
nasal polyps mucocele
angiofibroma papilloma
Wegener granulomatosis plasmacytoma
polymorphic reticulosis (lethal midline granuloma) deviated nasal septum
olfactory neuroblastoma (esthesioneuroblastoma) carcinoma
in terms of:
o age and sex predilection
o etiology
o clinical and radiologic features
o morphology
o course and prognosis
GRIPE Systemic Pathology Alimentary Tract

72 - ALIMENTARY TRACT

The student will be able to:

1. Define and use in proper context:
achalasia gastritis, chronic idiopathic odynophagia
acute gastritis gastroesophageal reflux disease peptic ulcer
adhesion (GERD) pernicious anemia
angiodysplasia Helicobacter pylori Peutz-Jegher syndrome
appendicitis, acute hematemesis Plummer-Vinson syndrome
atresia hematochezia pseudomembranous colitis
Barrett esophagus hemorrhoids pseudomyxoma peritonei
carcinoid syndrome hernia pyloric stenosis
carcinoid tumor Hirschsprung disease reflux esophagitis
chronic gastritis hypergastrinemia Schatzki ring
chronic inflammatory bowel hyperplastic polyp signet ring cell
disease inflammatory polyp sprue (celiac, tropical,
Crohn disease intestinal metaplasia nontropical)
Curling ulcer intrinsic factor steatorrhea
Cushing ulcer intussusception stress ulcer
d-xylose absorption test ischemic enteritis or colitis superficial gastritis
diarrhea juvenile polyp transmural inflammation
diverticulum Krukenberg tumor tubular adenoma
dysentery linitis plastica ulcer
dysphagia malabsorption ulcerative colitis
dysplasia Mallory-Weiss syndrome villous adenoma
enterocolitis Meckel diverticulum Virchow node
enterotoxin Mediterranean lymphoma volvulus
erosion megacolon Whipple disease
esophageal varices melena Zenker diverticulum
esophagitis mucocele Zollinger-Ellison syndrome
gastritis, atrophic napkin ring lesion
gastritis, autoimmune necrotizing enterocolitis (NEC)
2. Describe the following disorders of the esophagus:
 esophagitis
 hiatal hernia
 achalasia
 Mallory-Weiss syndrome
in terms of:
o etiology
o pathogenesis
o clinical features and course
o morphologic features
3. Describe the clinical presentation and morphology of the following esophageal lesions:
 congenital stenosis/atresia and associated tracheal lesions
 mucosal webs
 diverticula
4. Discuss the etiology, pathogenesis, gross appearance, histopathology, clinical course, and the
route of metastasis of esophageal carcinoma.
GRIPE Systemic Pathology Alimentary Tract

5. Describe esophageal varices, their pathogenesis and typical complications.

6. Discuss the following congenital gastric anomalies:
 pyloric stenosis
 diaphragmatic hernia
 gastric heterotopia
in terms of:
o incidence
o morphology
o clinical presentation and course
7. Compare and contrast acute (erosive), autoimmune, atrophic, and chronic gastritis, in terms of:
 etiology
 pathogenesis
 morphology
 clinical presentation and course
8. Discuss the pathogenesis and the morphology of stress ulcers.
9. Contrast and compare duodenal and gastric peptic ulcers, and their typical complications.
10. Compare and contrast the following types of gastric polyp:
 hyperplasic
 fundic gland
 adenomatous
in terms of:
o incidence
o pathogenesis
o morphology
o malignant potential
11. Describe typical gross and histologic features of gastric carcinoma.
12. Discuss the epidemiology and risk factors of gastric carcinoma.
13. Correlate the pathologic findings and clinical symptoms of gastric carcinoma.
14. Discuss gastrointestinal stromal tumors (GIST), in terms of:
 histogenesis
 morphology
 prognosis
15. Discuss gastrointestinal lymphoma, in terms of:
 epidemiology
 etiology and pathogenesis
 level of the alimentary tract most frequently affected
 morphologic features
 clinical features and course
16. Compare and contrast the following diseases:
 celiac sprue
 tropical sprue
 Whipple disease
GRIPE Systemic Pathology Alimentary Tract

in terms of:
o epidemiology
o etiology
o pathogenesis
o morphology
o clinical features and course
17. Compare and contrast ulcerative colitis and Crohn disease, in terms of:
 epidemiology
 pathogenesis
 morphology
 clinical features and course
 compications
 malignant potential
18. List the most important viral, bacterial and parasitic pathogens causing enterocolitis.
19. Contrast and compare diarrheal disease caused by enterotoxin-producing bacteria and diarrhea due to
enteroinvasive microbes.
20. Compare and contrast:
 necrotizing enterocolitis (NEC)  ischemic colitis
 infectious enterocolitis  collagenous colitis
 pseudomembranous colitis  lymphocytic colitis
in terms of:
o etiology
o pathogenesis
o morphology
o clinical features and course
21. Discuss the following intestinal processes:
hernia Hirschsprung disease volvulus
adhesion diverticulosis angiodysplasia
intussusception diverticulitis
in terms of:
o age predilection
o etiology
o pathogenesis
o morphology
o clinical features and course
o complications
22. Compare and contrast the following small intestinal neoplasms:
 adenoma
 adenocarcinoma
 carcinoid
 stromal tumors
in terms of:
o benignity vs. malignancy
o morphology
GRIPE Systemic Pathology Alimentary Tract

o clinical presentations and course

23. Discuss the following types of colonic polyps:
 hyperplastic
 juvenile
 adenomas (tubular, villous, tubulovillous)
in terms of:
o incidence
o morphology
o clinical features and course
o malignant potential
24. Compare and contrast the following syndromes:
 Peutz-Jeghers syndrome
 familial adenomatous polyposis (FAP)
 Gardner syndrome
 Turcot syndrome
 Hereditary nonpolyposis colorectal cancer (Lynch) syndrome (HNPCC)
in terms of:
o genetics
o morphology, types, and malignant potential of lesions produced
o clinical features and course
25. Describe colorectal carcinoma, in terms of:
 etiology
 pathogenesis, including genetic and molecular factors
 morphology, including grading and staging criteria
 clinical features and course
26. Contrast and compare the morphology and the clinical presentation of carcinoma of the right vs. left
colon.
27. Discuss carcinoid tumors of the colon, rectum, and appendix, in terms of:
 pathogenesis
 morphology
 clinical features (including extra-colonic manifestations)
 course and prognosis
28. Describe the etiology, pathogenesis, and morphology of appendicitis, and list the most common
complications.
29. Compare and contrast:
 mucocele of appendix
 mucinous neoplasms (cystadenoma/cystadenomcarcinoma) of appendix
 pseudomyxoma peritonei
in terms of:
o interrelationships with one another
o morphology
o clinical features and course
30. List the clinical situations in which stool examination may be helpful in the diagnosis of
GRIPE Systemic Pathology Alimentary Tract

alimentary diseases.
GRIPE Systemic Pathology Liver and Biliary Tract

73 - LIVER AND BILIARY TRACT

The student will be able to:

1. Define and use in proper context:
acidophil body cirrhosis liver function test
acute yellow atrophy Councilman body macronodular cirrhosis
alcoholic hepatitis Crigler-Najjar disease Mallory body (hyaline)
alcoholic liver disease delta hepatitis massive necrosis
alpha-1-antitrypsin deficiency direct vs. indirect bilirubin micronodular cirrhosis
ascites Dubin-Johnson syndrome nutmeg liver
bile fatty liver peliosis hepatis
bile duct hamartoma focal nodular hyperplasia porcelain gallbladder
bile lake galactosemia portal hypertension
bile stones gallstone ileus primary biliary cirrhosis
biliary atresia Gilbert disease primary sclerosing cholangitis
bilirubin hemochromatosis Reye syndrome
bridging fibrosis hemosiderosis Rokitansky-Aschoff sinus
bridging necrosis hepatic coma schistosomiasis
Budd-Chiari syndrome hepatic encephalopathy secondary biliary cirrhosis
cardiac sclerosis hepatitis splenomegaly
centrilobular necrosis hepatorenal syndrome steatohepatitis
cholangitis hyperbilirubinemia steatosis
cholecystitis hypoalbuminemia strawberry gallbladder
choledocholithiasis icterus submassive necrosis
cholelithiasis interface hepatitis von Meyenburg complex
cholestasis jaundice Wilson disease
cholesterolosis kernicterus
2. Describe the formation of bile and explain the main abnormalities that could cause jaundice.
3. Discuss the following laboratory tests:
alanine aminotransferase (ALT, SGPT) anti-smooth muscle antibody
aspartate aminotransferase (AST, SGOT) bilirubin: total, conjugated, unconjugated
alkaline phosphatase (ALP) ceruloplasmin
alpha-fetoprotein gamma-glutamyl transferase (GGT)
ammonia urobilinogen
anti-mitochondrial antibody
in terms of:
o indications
o hepatobiliary parameter measured
o diseases associated with elevations thereof
4. Discuss:
 congenital hepatic fibrosis
 polycystic liver disease
in terms of:
o inheritance pattern
o etiology/pathogenesis
o clinical and laboratory features
o prognosis
GRIPE Systemic Pathology Liver and Biliary Tract

5. Compare and contrast

 Crigler-Najjar syndrome, type I  Dubin-Johnson syndrome
 Crigler-Najjar syndrome, type II  Rotor syndrome
 Gilbert syndrome
in terms of:
o inheritance pattern
o defect(s) in bilirubin metabolism
o morphology of liver
o laboratory diagnosis
o clinical features and course
6. Compare and contrast biliary atresia and neonatal hepatitis, in terms of:
 etiology and pathogenesis
 morphology
 laboratory findings
 clinical features and course
 complications
7. Describe the principal clinical and morphologic findings in chronic liver disease.
8. Compare and contrast hepatitis cause by the following viruses:
hepatitis A virus (HAV) hepatitis E virus (HEV)
hepatitis B virus (HBV) hepatitis G virus(es) (HGV)
hepatitis C virus (HCV) cytomegalovirus (CMV)
hepatitis D (delta) virus (HDV) Epstein-Barr virus (EBV)
in terms of:
o nomenclature of antigens and antibodies
o epidemiology
o modes of transmission
o incubation period
o laboratory findings
o serologic findings at various stages in course of disease
o morphologic findings
o clinical features and course, including propensity for chronicity
o carrier state
o complications
9. Classify chronic hepatitis.
10. Compare and contrast:
 alcoholic hepatitis
 nonalcoholic steatohepatitis
 viral hepatitis
 granulomatous hepatitis
 drug-induced
 toxic hepatitis
in terms of:
o etiology
o pathogenesis
o morphology
GRIPE Systemic Pathology Liver and Biliary Tract

o clinical features and course

o complications
11. Discuss the pathogenesis, morphology, and clinical course of the following alcohol-induced liver
diseases:
 fatty change (steatosis)
 alcoholic hepatitis
 fibrosis
 cirrhosis
12. Classify types of cirrhosis, in terms of:
 etiology
 pathogenesis
 morphologic pattern (gross and microscopic)
 relationship to neoplasia
13. Differentiate among the following disease processes, based on clinicopathologic data:
alcoholic cirrhosis cirrhosis due to:
postnecrotic cirrhosis hemochromatosis
primary biliary cirrhosis Wilson disease
secondary biliary cirrhosis 1-antitypsin deficiency
14. Discuss portal hypertension in terms of:
 etiologic factors
 pathogenesis
 clinical features and course
15. Compare predictable and unpredictable drug induced liver disease.
16. Classify the following hepatotoxic drugs/chemicals:
 acetaminophen
 carbon tetrachloride
 halothane
 phenothiazines
 tetracyclines
in terms of:
o whether or not toxicity is dose-related
o pattern of reaction (cholestasis vs. hepatocellular necrosis vs. fatty change)
17. Compare and contrast:
 autoimmune hepatitis
 primary biliary cirrhosis
 secondary biliary cirrhosis
 primary sclerosing cholangitis
in terms of:
associated conditions pathogenesis
incidence laboratory diagnosis
sex predilection clinical features
etiology prognosis
18. Describe typical infectious liver diseases caused by bacteria, protozoa and helminths; in terms of
clinical and morphologic findings.
GRIPE Systemic Pathology Liver and Biliary Tract

19. List causes of fatty change (steatosis) of the liver, in terms of:
 size of fat vacoules
 zonal distribution of fat
20. Describe the etiopathogenesis and consequences of:
 hepatic encephalopathy
 portal hypertension
 esophageal varices
 hepatic vein thrombosis
 ascites
21. Compare and contrast the following tumors:
bile duct hamartoma hepatocellular carcinoma
bile duct adenoma fibrolamellar variant
hepatic adenoma hepatic angiosarcoma
focal nodular hyperplasia of liver cholangiocarcinoma
hepatoblastoma metastatic carcinoma to liver
in terms of:
o relative frequency
o etiology and pathogenesis
o relation to cirrhosis
o morphology
o methods of diagnosis
o clinical findings and course
o complications
22. Describe cholelithiasis in terms of
 risk factors  morphology of stones and gallbladder
 mechanisms of stone formation  clinical features
 composition of stones  complications, including complications
of therapy
23. Compare and contrast acute and chronic cholecystitis, in terms of:
 epidemiology
 associated diseases
 morphology
 clinical findings
 complications, including complications of therapy
24. Compare and contrast empyema and hydrops of the gallbladder, in terms of:
 etiology
 pathogenesis
 morphology
 clinical findings
25. Discuss carcinoma of the gallbladder and extrahepatic bile ducts, in terms of:
 epidemiology
 relationship to cholelithiasis
 morphology
 clinical findings and course
26. Describe the indications, benefits, and hazards of liver transplantation.
GRIPE Systemic Pathology Liver and Biliary Tract

27. Describe the morphology of liver transplant rejection.

GRIPE Systemic Pathology Pancreas

74 - PANCREAS

The student will be able to:

1. Define and use in proper context:
cystic fibrosis (CF) pseudocyst somatostatinoma
CFTR mucinous cystadenoma VIPoma
mucoviscidosis mucinous PP-secreting islet cell tumor
sweat chloride test cystadenocarcinoma Whipple triad
pancreatitis insulinoma Zollinger-Ellison syndrome
amylase gastrinoma
lipase glucagonoma
2. Compare and contrast:
 exocrine pancreatic insufficiency
 endocrine pancreatic insufficiency
in terms of:
o causes
o clinical manifestations
o laboratory abnormalities
3. Discuss cystic fibrosis, in terms of:
 genetics
 primary defect
 morphologic findings in:
o pancreas
o lung
o liver
o salivary glands
o male genital tract
 laboratory manifestations
 clinical findings and course
 therapy, including gene therapy
4. List the difference between acute edematous and acute hemorrhagic pancreatitis with regard to
histopathology and clinical outcome.
5. Compare and contrast acute and chronic pancreatitis, in terms of:
 etiologic/predisposing factors
 pathogenesis
 morphologic features
 laboratory manifestations
 clinical findings and course
 complications
6. Compare and contrast adenocarcinoma of the:
 pancreatic head
 pancreatic body/tail
 ampulla of Vater
in terms of:
o incidence
o risk factors

39
GRIPE Systemic Pathology Pancreas

o morphologic features
o clinical presentation
o complications
o prognosis
7. Discuss islet cell tumors of the pancreas, in terms of:
 incidence
 morphology
 benignity vs. malignancy
 immunohistochemical characteristics
 endocrine function
 clinical features and course
8. Discuss indications and complications of pancreatic islet cell transplant.

40
GRIPE Systemic Pathology Kidney

81 - KIDNEY

The student should be able to:

1. Describe the normal anatomy (gross and microscopic) of each of the following:
 kidney
 ureter
2. Define and use in proper context:
anuria hydronephrosis pyelonephritis
azotemia Kimmelstiel-Wilson disease pyuria
bacteriuria nephrocalcin uremia
Bence-Jones protein nephrolithiasis urolithiasis
cast nephrosclerosis vonHippel-Lindau (VHL)
dysuria nocturia syndrome
glomerulonephritis oliguria "wire-loop" lesion
hematuria polycystin
hepatorenal syndrome proteinuria
3. List the criteria for the diagnosis of:
 nephritic syndrome
 nephrotic syndrome
 acute renal failure
 chronic renal failure
and list:
o the renal diseases commonly causing each of the above
o the clinical and laboratory findings in each of the above
4. Discuss the proper use of the following laboratory tests in the evaluation of urinary tract disease:
 creatinine
 urea (blood urea nitrogen, BUN)
 urinalysis
and interpret abnormalities of these parameters in clinical context
5. Discuss the following congenital renal anomalies:
 renal agenesis
 double ureter
 horseshoe kidney
 aberrant renal artery
 ectopic kidney
in terms of:
o morphology
o clinical manifestations
o complications
6. Compare and contrast the following cystic diseases of the kidney:
 autosomal dominant (adult) polycystic kidney disease
 autosomal recessive (childhood) polycystic kidney disease
 acquired (dialysis-associated) cystic disease
 in terms of:
o incidence
o etiology and pathogenesis
o morphologic (gross and microscopic) appearance
o clinical presentation, course, and prognosis
o complications
7. Define the following terms as they apply to glomerular histopathology:
 focal
 diffuse
 segmental
 global
8. Discuss the following glomerular diseases:
 minimal change disease
 membranous glomerulonephritis
 focal segmental glomerulosclerosis
 membranoproliferative glomerulonephritis
 acute proliferative (poststreptococcal, postinfectious) glomerulonephritis
 rapidly progressive glomerulonephritis
 IgA nephropathy (Berger disease)
 hereditary nephritis
 Henoch-Schönlein purpura
 chronic glomerulonephritis
in terms of:
o elative frequency
o etiology and pathogenesis
o clinical presentation, course, and prognosis
o laboratory findings
o microscopic (light, immunofluorescent, ultrastructural) appearance
9. Describe the major clinical and histopathologic findings associated with renal involvement by the
following systemic diseases:
 diabetes mellitus
 amyloidosis
 gout
 multiple myeloma
10. Discuss lupus nephritis in terms of:
 etiology and pathogenesis
 clinical presentation
 nomenclature, morphologic features, and prognosis of each of the five classes
11. Discuss the following renal tubular diseases:
 acute pyelonephritis
 chronic pyelonephritis
 xanthogranulomatous pyelonephritis
 acute drug-induced interstitial nephritis
 drug-induced analgesic nephropathy
 acute tubular necrosis
 in terms of:
o etiology and pathogenesis
o clinical presentation and course
o laboratory findings
o morphologic (gross and microscopic) appearance
o treatment and prognosis
12. Discuss the significance of unilateral renal artery disease, including:
 usual causes
 mechanism(s) of clinical effects
 morphologic changes in contralateral kidney
 tests used for detection and localization
13. Describe the pathophysiology of hypertension induced by renal artery constriction
14. Compare and contrast benign and malignant nephrosclerosis with regard to:
 pathogenesis
 morphologic (gross and microscopic) appearance
 clinical presentation, course, and prognosis
15. List the three major thrombotic microangiopathies, and describe their renal effects, with regard to:
 pathogenesis
 microscopic appearance
 clinical presentation, course, and prognosis
16. Discuss renal vein thrombosis in terms of:
 etiology/pathogenesis
 morphology
 method(s) of diagnosis
 clinical and laboratory features
17. Discuss urolithiasis in terms of:
 composition and relative incidence of various types of stones
 pathophysiologic abnormalities associated with the common types of stones
 etiology and pathogenesis of stone formation
 effect of location of stones on clinical and anatomic findings
 clinical course and complications
18. Discuss hydronephrosis in terms of:
 etiologic factors and their relative frequencies
 pathogenesis
 morphology (gross and microscopic)
 clinical course and prognosis
19. Discuss the following renal neoplasms:
 cortical adenoma
 medullary fibroma
 renal cell carcinoma
 oncocytoma
 angiomyolipoma
 Wilms tumor (nephroblastoma)
 urothelial (transitional cell) carcinoma of renal pelvis
in terms of:
o genetics/associated syndromes
o incidence
o age and sex distribution
o etiology
o morphologic (gross and microscopic) appearance
o laboratory features
o clinical presentation, course, and complications
o treatment
o routes of spread
o prognosis, including assessment of prognostic factors
GRIPE Systemic Pathology Lower Urinary Tract

82 – LOWER URINARY TRACT

The student will be able to:

1. Describe the normal anatomy (gross and microscopic) of each of the following:
 ureter
 urinary bladder
 urethra
2. Define and use in proper context:
bacteriuria epispadias pyuria
cystitis exstrophy urethral caruncle
cystitis cystica hematuria urolithiasis
cystitis glandularis hypospadias
dysuria neurogenic (cord) bladder

3. Discuss the proper use of urinalysis in the evaluation of lower urinary tract disease, and
interpret abnormalities of this test in clinical context
4. Discuss obstruction at various levels of the urinary tract in terms of:
 site and nature of lesion
 etiology and pathogenesis
 alteration in renal function
 morphologic effect on kidney
5. Discuss diverticula of the urinary bladder, in terms of:
 etiology
 pathogenesis
 morphology
 complications
6. Discuss urolithiasis in terms of:
 relative incidence of various types of stones
 pathophysiologic abnormalities associated with the common types of stones
 etiology and pathogenesis of stone formation
 effect of location of stones on clinical and anatomic findings
 clinical course and complications
7. Discuss the following congenital anomalies:
 patent urachus
 hypospadias
 epispadias
 exstrophy of the bladder
 duplications of the collecting system
 urethral valves
in terms of:
o frequency
o morphology
o complications

45
8. Compare and contrast the following inflammatory conditions:
 infectious cystitis
 interstitial cystitis
 malacoplakia
with regard to:
o etiology and pathogenesis
o clinical course and complications
o morphologic (gross and microscopic) appearance
9. Discuss the following neoplasms of the lower urinary tract:
 urothelial (transitional cell) carcinoma
 squamous cell carcinoma
 adenocarcinoma
in terms of:
o incidence
o age and sex distribution
o etiology
o morphologic (gross and microscopic) appearance
o laboratory features
o clinical presentation, course, and complications
o treatment
o routes of spread
o prognosis, including assessment of prognostic factors
GRIPE Systemic Pathology Male Genital System

83 – MALE GENITAL SYSTEM

The student will be able to:

1. Describe the normal anatomy (gross and microscopic) of each of the following:
 penis
 prostate
 testis
2. Define and use in proper context:
balanitis hematocele prostatitis
balanoposthitis hydrocele seminoma
choriocarcinoma hypospadias Schiller -Duval body
chylocele orchitis Sertoli-Leydig cell tumor
condyloma acuminatum paraphimosis smegma
cryptorchidism phimosis spermatocytic seminoma
embryonal carcinoma prepuce teratoma
epispadias prostatic intraepithelial yolk sac tumor
gonadoblastoma hyperplasia (PIN)
3. Discuss the following congenital anomalies:
 hypospadias
 epispadias
in terms of:
o frequency
o morphology
o complications
4. Discuss the following neoplasms:
 squamous cell carcinoma of penis and scrotum
 adenocarcinoma of prostate
 germ cell tumors of testis
 sex cord-stromal tumors of testis
 malignant lymphoma of testis
in terms of:
o incidence
o age distribution
o etiology
o morphologic (gross and microscopic) appearance
o laboratory features (including tumor markers)
o clinical presentation, course, and complications
o treatment
o routes of spread
o prognosis, including assessment of prognostic factors
o ovarian counterparts of testicular tumors
5. Compare and contrast the following inflammatory conditions:
 prostatitis (acute, chronic granulomatous)
 orchitis (nonspecific, mumps, granulomatous)
 torsion of spermatic cord

47
 with regard to:
o etiology and pathogenesis
o clinical course and complications
o morphologic (gross and microscopic) appearance
6. Discuss the following disorders:
 nodular hyperplasia of the prostate
 cryptorchidism
in terms of:
o incidence
o etiology
o pathognesis
o morphologic (gross and microscopic) appearance
o clinical presentation and treatment
o complications
o relationship to malignancy
7. Classify anatomically the causes of male infertility.
GRIPE Systemic Pathology Female Genital System

84 - FEMALE GENITAL SYSTEM

The student will be able to:

1. Define and use in proper context:
adenomyosis gynandroblastoma
adenosis hematosapinx
arrhenoblastoma HPV
atypical endometrial hyperplasia HSV
borderline ovarian tumor (BOT) hydrosalpinx
Brenner tumor koilocytosis
Call-Exner body kraurosis vulvae
carcinoma in situ (CIS) Krukenberg tumor
carcinosarcoma LEEP
cervical intraepithelial neoplasia (CIN) Leukoplakia
chocolate cyst low malignant potential (LMP)
choriocarcinoma luteal cyst
colposcopy malignant mixed Müllerian tumor (MMMT)
condyloma acuminatum Meigs syndrome
condyloma latum menometrorrhagia (MMR)
cone biopsy menorrhagia
curettage metrorrhagia
cysadenocarcinoma microinvasive carcinoma
cystadenofibroma nabothian cyst
cystadenoma Pap smear
dysfunctional uterine bleeding (DUB) pelvic inflammatory disease (PID)
dysgerminoma pseudomyxoma peritonei
dysmenorrhea pyosalpinx
dysplasia sarcoma botryoides
embryonal carcinoma Schiller-Duval body
endodermal sinus tumor Sertoli-Leydig cell tumor
endometriosis squamous intraepithelial lesion (SIL)
fibroma Stein-Leventhal syndrome
flat condyloma teratoma
follicular cyst thecoma
gonadoblastoma vaginal intraepithelial neoplasia (VAIN)
granulosa cell tumor vulvar intraepithelial neoplasia (VIN)
2. Describe the following congenital anomalies, including their embryologic bases:
 imperforate hymen
 bicornuate uterus
 pseudohermaphroditism
3. List the common organisms which cause:
 Bartholin abscess
 vulvitis
 vaginitis
 cervicitis
 endometritis
 salpingitis
4. Discuss the following vulvar lesions:
 Bartholin cyst
 lichen sclerosis
 squamous hyperplasia
 condyloma acuminatum
GRIPE Systemic Pathology Female Genital System

in terms of:
o etiology
o clinical presentation
o morphology
o differential diagnosis
5. Compare and contrast trichomonal and monilial vaginitis, in terms of:
 predisposing factors
 etiology
 pathogenesis
 symptoms
 methods of detection
6. Compare and contrast:
 vulvar condyloma
 vulvar and vaginal intraepithelial neoplasia (VIN, VAIN)
 carcinoma of the vulva and vagina
 sarcoma botryoides
in terms of:
o age predilection
o incidence
o etiology
o clinical presentation
o morphology
o biologic behavior
7. Define discuss general features of extramammary Paget disease, in terms of:
 clinical presentation
 morphology
 associated malignancies
 clinical course
8. Discuss vaginal adenosis and vaginal adenocarcinoma, in terms of
 epidemiology
 etiology
 pathogenesis
 morphology
 clinical significance
9. Compare and contrast the following cervical lesions:
 cervical intraepithelial neoplasia (CIN)
 microinvasive squamous cell carcinoma
 invasive squamous cell carcinoma
 adenocarcinoma
in terms of:
incidence morphology
age distribution grading and staging
risk factors clinical features
pathogenesis prognosis
diagnostic modalities for detection
10. Discuss the screening and diagnostic procedures for cervical cancer in terms of methodology,
indications, and utilization.
11. Discuss cervicovaginal cytology, in terms of:
 technique of obtaining specimen
 utility in diagnosis of inflammatory conditions
GRIPE Systemic Pathology Female Genital System

 types and significance of abnormalities

 utility in diagnosis of:
o CIN of cervix
o carcinoma of cervix
o carcinoma of endometrium
12. Outline the morphologic effects of oral contraceptive agents (oral contraceptive pills, OCP's) on the
endometrium, in relation to mode of action and possible adverse complications
13. Compare and contrast endometriosis and adenomyosis in terms of:
 incidence
 clinical presentation
 pathogenesis
 morphology
 organs involved
 complications.
14. Discuss the following endometrial processes:
 atrophy,
 hyperplasia
 polyp
in terms of:
o etiology
o morphologic types
o differentiation from one another and from neoplasia
o clinical course/significance of the different types
15. Discuss endometrial carcinoma in terms of:
incidence pathogenesis
age distribution morphology including common types
risk factors methods of detection
clinical presentation grading and staging
epidemiology prognosis
predisposing factors
16. Compare and contrast:
 endometrial stromal tumors
 myometrial leiomyoma
 myometrial leiomyosarcoma
in terms of:
o clinical presentation
o pathogenesis
o morphology
o clinical features
o prognosis
17. List the conditions which result in non-neoplastic enlargement or cysts of the ovary
18. Discuss polycystic ovarian disease in terms of clinical presentation and morphology
19. Compare and contrast the following ovarian neoplasms:
 surface epithelial tumors
o benign
o borderline
o malignant
 sex cord-stromal tumors
 germ cell tumors
GRIPE Systemic Pathology Female Genital System

 metastatic malignancy to ovary

in terms of:
incidence hormonal effects
age predilection clinical features
different types prognosis
laterality complications
morphology testicular counterparts
tumor markers
20. Compare and contrast ovarian vs. placental (gestational) choriocarcinoma, in terms of:
 cell of origin
 pathogenesis
 morphology
 clinical features
 treatment and prognosis
21. List the most common primary sites of metastatic malignancy to the ovary
22. List and differentiate among clinical etiologies of:
 pelvic pain in reproductive age group
 vaginal bleeding in reproductive age group
 vaginal bleeding in post-menopausal age group
 vulvar lesions in older women
GRIPE Systemic Pathology Breast

85 - BREAST

The student will be able to:

1. Define and use in proper context:

adenosis intraductal papilloma

blue dome cyst microcalcification
comedocarcinoma minimally invasive breast biopsy (MIBB)
cribriform pattern peau d’orange
fibrocystic change scirrhous
gynecomastia terminal duct-lobular unit (TDLU)
"Indian filing" triple test
inflammatory carcinoma
2. Describe the hormonally-induced morphologic changes which occur in the female breast during the
following stages:
 neonatal
 pubertal
 menstrual
 gestational
 lactational
 postmenopausal
3. Describe the following congenital abnormalities of the breast:
amastia asymmetric puberal enlargement
polythelia hypertrophy of male breast
polymastia acccessory breast tissue
neonatal enlargment
in terms of:
o incidence
o morphology
o clinical significance
4. Discuss the following reactive breast conditions:
fat necrosis plasma cell mastitis
acute mastitis mammary duct ectasia
periductal mastitis galactocele
granulomatous mastitis
in terms of:
o etiology
o pathogenesis
o morphology
o clinical features
o differential diagnosis
5. Discuss silicone breast implants, in terms of:
 morphologic changes in adjacent breast
 known epidemiologic relationships with autoimmune disease
6. Compare and contrast fibroadenoma and phyllodes tumor in terms of:
 incidence
 clinical presentation
 morphology
 clinical features and prognosis
7. Discuss fibrocystic change of the breast in terms of:
age predilection general morphology
incidence mammographic appearance
etiology relationship to carcinoma of the breast
clinical presentation
8. Compare and contrast the following morphologic manifestations of fibrocystic change of the breast:
 apocrine metaplasia
 sclerosing adenosis
 intraductal hyperplasia
in terms of:
o pathogenesis
o morphology
o relationship to carcinoma of the breast
9. Compare and contrast the following:
 intraductal papilloma
 intraductal hyperplasia without atypia
 intraductal hyperplasia with atypia (atypical ductal hyperplasia)
 ductal carcinoma-in-situ (DCIS, intraductal carcinoma)
 atypical lobular hyperplasia (ALH)
 lobular carcinoma-in-situ (LCIS)
in terms of:
o age predilection
o incidence
o etiology
o pathogenesis
o morphology
o pattern of spread
o methods of detection
o principles of management
o clinical features and course
o relationship to breast carcinoma, including the influence of family history thereupon
10. Discuss female mammary carcinoma in terms of:
genetics patterns of spread
risk factors methods of diagnosis
incidence clinical course
etiology staging
pathogenesis prognostic indicators
clinical presentation treatment options
gross morphology survival rates
11. Compare and contrast the following types of invasive mammary carcinoma:
 invasive ductal carcinoma, no special type (NOS)
 medullary carcinoma
 colloid (mucinous) carcinoma
 tubular carcinoma
 invasive lobular carcinoma
 Paget disease
in terms of:
o age predilection
o microscopic morphology
o grading
 o prognosis
12. Discuss the following diagnostic procedures for evaluating breast masses:
 self-examination
 mammography
 fine needle aspiration cytology
in terms of
o indications
o methodology
o general interpretative features
o relative sensitivity and specificity
13. List the most common causes of breast mass in females during the following stages of life:
 under 35 years of age
 35-50 years of age
 over 50 years of age
14. Compare and contrast the following diseases of the male breast:
 gynecomastia
 carcinoma
in terms of:
o etiology/pathogenesis
o clinical features
o prognosis
GRIPE Systemic Pathology Endocrine Glands

86 - ENDOCRINE GLANDS
The student will be able to:
1. Describe the normal embryology, anatomy, histology, and hormonal physiology of the:
pituitary gland adrenal glands parathyroid glands
thyroid gland endocrine pancreas pineal gland
2. Define and use in proper context:
17-hydroxycorticosteroids hypoparathyroidism
17-ketosteroids hypopituitarism
acromegaly hypothyroidism
Addison disease impaired glucose tolerance
adrenocorticotropin (ACTH) insulin resistance
aldosterone ionized calcium
angiotensin maturity-onset diabetes of young (MODY)
angiotensin converting enzyme metabolic syndrome (syndrome X)
angiotensinogen metanephrine/normetanephrine
bronze diabetes metyrapone test
catecholamine microalbuminuria
congenital adrenal hyperplasia (CAH) myxedema
corticotropin-releasing hormone (CRH) norepinephrine
cortisol parathyroid hormone (PTH)
cortisol binding globulin (CBG) parathyroid hormone-related protein (PTHrP)
cretinism plasma renin activity (PRA)
Cushing disease plasma renin concentration (PRC)
Cushing syndrome polydipsia/polyphagia/polyuria
dexamethasone suppression test primary aldosteronism (Conn syndrome)
diabetes insipidus primary diabetes
diabetes mellitus pseudohypoparathyroidism
diabetic ketoacidosis radioactive iodine uptake (RAIU)
ectopic ACTH radioimmunoassay
endemic goiter renin
epinephrine secondary aldosteronism
euthyroidism secondary diabetes
free thyroxine index (FTI) Sipple syndrome
gestational diabetes somatomedin (IGF)
glycosyation (glycation) somatostatin
goiter sporadic goiter
goitrogen steroid hydroxylase enzymes
growth hormone (GH) thyroglobulin
growth hormone-releasing hormone (GHRH) thyroid hormone binding ration (THBR, T3U)
humoral hypercalcemia of malignancy (HHM) thyroid stimulating hormone (TSH, thyrotropin)
hyperadrenalism thyrotoxicosis
hyperadrenocorticism thyrotropin releasing hormone (TRH)
hypercalcemia thyroxine (T4)
hyperinsulinism thyroxine binding globulin (TBG)
hyperosmolar nonketotic coma triiodothyronine (T3)
hyperparathyroidism urinary free cortisol (UFC)
hyperpituitarism vanillylmandelic acid (VMA)
hyperthyroidism Wermer syndrome
hypocalcemia Zollinger-Ellison syndrome
GRIPE Systemic Pathology Endocrine Glands

3. Compare thyroglossal duct cyst and branchial cleft cyst in terms of:
 anatomic site in the neck
 gross and microscopic features
 complications
4. Compare and contrast hyperthyroidism, hypothyroidism, and euthyroid sick syndrome (ETS) in terms
of:
 etiologies
 pathogenesis
 clinical features
 laboratory features
 complications and prognosis
5. List the commonly used thyroid function tests and their indications.
6. Compare and contrast infectious, subacute (granulomatous), subacute lymphocytic, Hashimoto’s, and
Riedel’s thyroiditis, in terms of:
 age and sex distribution
 etiology and pathogenesis
 clinical, functional, and laboratory features
 gross and microscopic features
 complications and prognosis
7. Discuss the utilization of fine-needle aspiration (FNA) of the thyroid, in terms of:
 basic methodology
 indications
 sensitivity
 specificity
8. Discuss the calcium homeostatic mechanisms.
9. Discuss hypocalcemia and hypercalcemia, in terms of:
 etiologies
 clinical presentation
 laboratory testing
10. Compare and contrast primary hyperparathyroidism, secondary hyperparathyroidism, tertiary
hyperparathyroidism, and hypoparathyroidism, in terms of:
 etiology
 pathogenesis
 clinical features
 laboratory features
 complications and prognosis
11. Discuss the biosynthesis of adrenal steroids, and the enzymatic defects which lead to adrenal
hyperplasia.
12. Name the tests used in evaluating plasma glucocorticoids, their indications, and their interpretation.
13. Discuss how plasma concentrations of cortisol and aldosterone are controlled.
14. Name the tests for evaluating adrenal androgens, their indications, and their interpretation.
15. Discuss the biosynthesis of the adrenal catecholamines and their urinary metabolites.
16. Discuss the use of growth hormone stimulation tests.
GRIPE Systemic Pathology Endocrine Glands

17. Describe the following hyperfunctional and hypofunctional conditions:

acromegaly diffuse nontoxic (simple) goiter Addison disease
gigantism multinodular goiter Waterhouse-Friderichsen syndrome
Sheehan syndrome myxedema Cushing disease
empty sella syndrome parathyroid hyperplasia hypercortisolism (Cushing syndrome)
diabetes insipidus congenital adrenal hyperplasia primary aldosteronism (Conn syndrome)
Graves disease congenital adrenal hypoplasia ectopic ACTH production
inappropriate ADH secretion 1° acute adrenocortical insufficiency
in terms of:
etiology and pathogenesis laboratory abnormalities
clinical manifestations morphology (gross and microscopic)
18. List the distinguishing features of type 1 and 2 diabetes mellitus, in terms of:
etiology and pathogenesis clinical and morphologic manifestations
genetics insulin and glucose levels
age and frequency principles of treatment
mode of onset response to insulin
19. Discuss the following lesions that may be found in diabetes mellitus:
insulitis diffuse glomerulosclerosis
amylin (islet amyloid polypeptide) deposition pyelonephritis
atherosclerosis necrotizing papillitis
diabetic microangiopathy diabetic retinopathy
fatty change of the liver diabetic cataracts
nodular (intercapillary) glomerulosclerosis glaucoma
(Kimmelstiel-Wilson disease) peripheral neuropathy
in terms of:
pathogenesis specificity for diabetes
morphologic appearance relationship to serious manifestations of diabetes
frequency in diabetes prevention and treatment
occurrence early or late in the disease
20. Outline methods of screening patients for, and following patients with, diabetes mellitus, stating
appropriate usage of the following laboratory tests:
blood glucose concentration glucose tolerance test
blood insulin concentration glycosylated (glycated) hemoglobin level
urine glucose concentration urine protein concentration
ketone bodies
21. Describe the following neoplasms:
anterior lobe pituitary neoplasms adrenal cortical carcinomas
craniopharyngioma pheochromocytoma
thyroid adenomas neoplasms of extra-adrenal paraganglia
thyroid carcinomas neuroblastoma
parathyroid adenoma ganglioneuroma
parathyroid carcinoma pancreatic islet cell neoplasms
adrenal cortical adenomas pinealomas
in terms of:
epidemiology immunohistochemical characteristics
associated syndromes endocrine function
etiology and pathogenesis complications and prognosis
GRIPE Systemic Pathology Endocrine Glands

gross and microscopic appearance

22. Describe the various types of multiple endocrine neoplasia (MEN) syndromes, in terms of clinical,
laboratory, and morphologic features, as well as prognosis.
GRIPE Systemic Pathology Disorders of Fetus and Pregnancy

87 – DISORDERS OF FETUS AND PREGNANCY

The student will be able to:

1. Define and use in proper context:
abortion gestational diabetes placenta previa
abruptio placentae gestational trophoblastic polyhydramnios
amnion disease preeclampsia
chorioamnionitis hematosalpinx sirenomelia
choriocarcinoma human chorionic syncytiotrophoblast
chorion gonadotrophin (HCG) teratogen
chorionic villi hydatidiform mole teratogenesis
circumvallate placenta macrosomia TORCH titers
cytotrophoblast malformation toxemia of pregnancy
deformation monamnionic twin-twin transfusion
diamnionic monochorionic syndrome
dichorionic oligohydramnios velamentous insertion of
eclampsia placenta accreta umbilical cod
ectopic pregnancy placenta increta
funisitis placenta percreta

2. Discuss the placenta in terms of:

 development
 normal gross and microscopic anatomy
 formation and quantity-regulating factors of:
 amniotic fluid
 human chorionic gonadotropin (HCG)
 most frequent morphologic abnormalities
3. Discuss twin placentation, in terms of:
 mechanisms of occurrence of twin pregnancies
 morphology of twin placentas
 determination of zygosity through placental examination
4. Compare contrast preeclampsia and eclampsia in terms of:
 clinical presentation
 morphology
 clinical course.
5. Discuss ascending infections and hematogenous infections of pregnancy in terms of:
 etiology
 pathogenesis
 morphology
 methods of diagnosis
6. Compare and contrast placenta previa and abruptio placentae in terms of
 morphology
 clinical presentation, course, and complications.
7. Compare and contrast:
 hydatidiform male (complete and partial)
 invasive mole
 gestational (uterine) choriocarcinoma
 ovarian choriocarcinoma
 in terms of:
 genetics
GRIPE Systemic Pathology Disorders of Fetus and Pregnancy

 incidence
 predisposing factors
 clinical presentation,
 laboratory findings
 morphology
 clinical course including follow-up and complications.
8. Discuss ectopic pregnancy in terms of:
 incidence
 risk factors
 clinical presentation
 morphology
 clinical course
 complications
and differentiate ectopic pregnancy from pelvic inflammatory disease and acute appendicitis
based on clinicopathologic data.
9. List the three major categories of factors which may underlie intrauterine growth retardation (IUGR)
of the fetus.
10. Discuss the pathogenesis of deformations, and give examples of underlying factors which may lead to
deformation by such pathogenetic mechanisms
11. List the most common birth injuries
12. List the most common congenital malformations
13. Describe the two phases of the intrauterine development of humans, and indicate the period of
greatest susceptibility to teratogenic agents
14. List the different levels at which teratogens may act in producing malformations
15. Discuss maternal diabetes mellitus in terms of:
 methods of diagnosis
 effects on fetus
GRIPE Systemic Pathology Pediatric Pathology

88 - PEDIATRIC PATHOLOGY

The student will be able to:

1. Define and use in proper context:
Apgar score hydrops fetalis
bronchopulmonary dysplasia (BPD) immature
caput succedaneum kernicterus
cephalhematoma malformation
choristoma premature
congenital small-, round-, blue-cell tumor
deformation small-for-gestational-age (SGA)
hamartoma sudden infant death syndrome (SIDS)
hereditary teratogen
heterotopia teratogenesis
hyaline membrane disease (HMD)
2. Discuss the pathogenesis of deformations, and give examples of underlying factors which may lead to
deformations via such pathogenetic mechanisms
3. List the most common birth injuries
4. State the most common cause of death in children, as well as the most common non-traumatic cause
of death in children:
 under one year of age
 between one and four years of age
 between five and fourteen years of age
5. List the most common congenital malformations
6. List the most common underlying causes of perinatal asphyxia
7. Describe the following disorders:
 fetal alcohol syndrome
 congenital rubella syndrome
 cytomegalic inclusion disease
 hemolytic disease of the newborn (HDN)
 respiratory distress syndrome (RDS) of the newborn
 bronchopulmonary dysplasia (BPD)
 necrotizing enterocolitis (NEC)
 phenylketonuria (PKU)
 galactosemia
 cystic fibrosis (CF, mucoviscidosis)
 Hirschsprung disease
 sudden infant death syndrome (SIDS)
 pediatric acquired immunodeficiency syndrome (AIDS)
in terms of:
o incidence and epidemiology
o etiology and pathogenesis
o morphology
o clinical course
8. Discuss the following pediatric neoplasms:
hemangioma medulloblastoma
lymphangioma Wilms tumor (nephroblastoma)
acute leukemia teratoma
malignant lymphoma rhabdomyosarcoma
neuroblastoma Ewing sarcoma
retinoblastoma osteosarcoma
in terms of:
o frequency
o age of onset
o role of genetics and environment
o morphology
o clinical behavior
o prognosis
GRIPE Systemic Pathology Skin

91 - SKIN

The student will be able to:

1. Define and use in proper context:
acantholysis halo nevus papule
acanthosis hereditary angioneurotic edema parakeratosis
acrochordon (HANE) Pautrier microabscess
atopic hyperkeratosis pseudoepitheliomatous
Auspitz sign intradermal nevus hyperplasia
Bowen disease junctional nevus psoriasiform
bulla Koebner phenomena pustule
comedone lentiginous Sézary cell
compound nevus lentigo target lesion
condyloma leukoplakia tinea barbae
CREST syndrome liquefactive degeneration tinea capitis
dermatitis macule tinea corporis
dermatofibroma mole tinea cruris
dyskeratosis Munro microabscess tinea pedis
eczema mycosis fungoides verruca
elastosis nevus vesicle
ephilis nodule wheal
exocytosis panniculitis
granuloma pyogenicum papillomatosis
2. Compare and contrast:
 vitiligo
 albinism
in terms of:
o etiology
o pathogenesis
o clinical presentation
o histomorphology
3. Discuss urticaria in terms of:
 types of clinical presentation
 pathogenesis
 histomorphology
4. Compare and contrast the following types of dermatitis
contact primary irritant
atopic drug-related
seborrheic exfoliative
photoeczematous
in terms of:
o anatomic site(s) involved
o clinical presentation
o etiology/pathogenesis
o histomorphology
o clinical course
5. Comapre and contrast:
 erythema multiforme
 erythema induratum
 erythema nodosum
GRIPE Systemic Pathology Skin

in terms of:
o associated conditions
o clinical presentation
o pathogenesis
o histomorphology
6. Compare and contrast:
 psoriasis
 lichen planus
 lichen simplex chronicus
in terms of:
o associated conditions
o clinical presentation
o pathogenesis
o histomorphology
7. Compare and contrast:
 pemphigus vulgaris
 bullous pemphigoid
 dermatitis herpetiformis
 cutaneous lupus erythematosis
in terms of:
o etiology
o pathogenesis
o anatomic site(s) affected
o clinical presentation
o morphology (light and immunofluorescent microscopic)
o clinical course
8. Compare and contrast:
verruca impetigo
molluscum contagiosum tinea
herpes simplex infection arthropod assaults
acne vulgaris
in terms of:
o etiology
o pathogenesis
o clinical presentation
o cutaneous structure(s) involved
o histomorphology
9. Compare and contrast:
 systemic sclerosis (scleroderma)
 CREST syndrome
 systemic lupus erythematosus (SLE)
 discoid lupus erythematosis (DLE)
in terms of:
o etiology
o pathogenesis
o clinical cutaneous manifestations
o morphology (light and immunofluorescent microscopic)
o clinical course/complications
10. Compare and contrast:
 lentigo simplex
 lentigo senilis (solar lentigo)
 lentigo maligna
in terms of:
o etiopathogensis
o age at presentation
o clinical appearance
o histomorphology
o clinical course
11. Compare and contrast
 seborrheic keratosis
 actinic keratosis
 squamous cell carcinoma
 keratoacanthoma
 basal cell carcinoma
in terms of:
age at presentation anatomic site(s)
etiology/pathogenesis clinical presentation
associated syndrome(s) histomorphology
predisposing lesion(s) biologic behavior
12. Discuss:
 basal cell nevus syndrome
 dysplastic nevus (BK mole) syndrome
in terms of:
o genetics
o clinical manifestations
13. Compare and contrast the following types of nevocellular nevi:
congenital spindle and epithelioid cell (Spitz)
junctional blue
compound halo
intradermal dysplastic
in terms of:
o clinical presentation (including age)
o histomorphology
o clinical significance
14. Compare and contrast the following types of malignant melanoma:
 lentigo maligna melanoma
 superficial spreading melanoma
 nodular melanoma
 acral lentiginous melanoma
in terms of:
o age at presentation
o etiopathogenesis
o clinical morphology
o microscopic morphology
o staging criteria (Clark and Breslow)
o clinical course
o prognosis
15. Discuss the following skin tumors (i.e., masses):
cutaneous cysts nevus flammeus
adnexal (appendage) tumors hemangioma
Merkel cell carcinoma angiosarcoma
fibrous histiocytoma Kaposi sarcoma
dermatofibrosarcoma protuberans metastatic neoplasia
in terms of:
o etiopathogenesis
o clinical presentation
o histomorphology
o clinical course
16. Compare and contrast:
 epidermolysis bullosa
 porphyria
in terms of:
o etiology
o pathogenesis
o clinical presentation
o histomorphology
17. Discuss the cutaneous manifestations of the following diseases:
leukemia diabetes mellitus
malignant lymphoma acanthosis nigricans
Langerhans cell histiocytosis xeroderma pigmentosum
mastocytosis neurofibromatosis
sarcoidosis acquired immunodeficiency syndrome (AIDS)
in terms of:
o clinical presentation
o histomorphology
o associated visceral diseases
o clinical course
GRIPE Systemic Pathology Bones, Joints, and Soft Tissue

92 – BONES, JOINTS, AND SOFT TISSUE

The student will be able to:

1. Define and use in proper context:
alkaline phosphatase Felty syndrome osteoid
Brodie abscess Heberden node osteomalacia
callus involucrum osteopenia pannus
cancellous bone lamellar bone Pott disease
chondrocyteCodman metaphysis sequestrum
triangle osteoblast synarthrosis
cortical osteocalcin synovium
bonediaphysiseburnatione osteoclast tophus
piphysis osteocyte woven bone
2. Discuss the following hereditary disorders, in terms of pathogenesis, morphology, and clinical
presentation:
achondroplasia osteochondromatosis
osteopetrosis enchondromatosis
osteogenesis imperfecta
3. Describe the morphologic sequence of normal bone growth, as well as of repair followingfracture of a
long bone. Indicate the way(s) in which age, mobility, nutritional state, andinfection influence the
repair process.
4. Discuss the following non-neoplastic bone disorders, in terms of etiology, pathogenesis, morphology,
and clinical findings and course:
osteoporosis renal osteodystrophy
Paget disease osteonecrosis
hyperparathyroidism osteomyelitis
5. Describe the following tumors (i.e., masses) of bone, joint, and soft tissue:
multiple myeloma primitive neuroectodermal tumor (PNET)
nonossifying fibroma ganglion
fibrous dysplasia synovial cyst
bone cysts (solitary and aneurysmal) pigmented villonodular synovitis
osteoma nodular fasciitis
osteoid osteoma myositis ossificans
osteoblastoma fibromatosis
osteochondroma fibrosarcoma
chondroma malignant fibrous histiocytoma
chondroblastoma lipoma
chondromyxoid fibroma liposarcoma
osteosarcoma rhabdomyosarcoma
chondrosarcoma leiomyoma
giant cell tumor of bone leiomyosarcoma
Ewing sarcoma synovial sarcoma
metastatic malignancy to bone
in terms of:
o biology (neoplastic vs. nonneoplastic, benign vs. malignant)
o age distribution
o etiology and pathogenesis
o cell type and site of origin
GRIPE Systemic Pathology Bones, Joints, and Soft Tissue

o morphologic and roentgenologic features

o clinical findings and course
6. Compare osteoarthritis (degenerative joint disease) and rheumatoid arthritis, in terms of:
age and sex incidence laboratory findings
etiology morphologic findings
pathogenesis clinical findings and course
7. Discuss the following disorders:
ankylosing spondylitis infectious arthritis
Reiter syndrome gout
psoriatic arthritis calcium pyrophosphate crystal deposition disease
juvenile rheumatoid arthritis
in terms of:
o age and sex incidence
o etiology
o pathogenesis
o findings (laboratory, morphologic, clinical)
o clinical course
GRIPE Systemic Pathology Skeletal Muscle

93 - SKELETAL MUSCLE

The student will be able to:

1. Define and use in proper context:
arthrogryposis floppy infant syndrome pseudohypertrophy
chromatolysis Gower maneuver rhabdomyolysis
dermatomyositis hypotonia ring fiber
dystrophin myopathy target fiber
dystrophy myotonia type I fiber
fasciculation nemaline rod type II fiber
fiber type grouping neuropathy Werdnig-Hoffmann disease
fibrillation ophthalmoplegia
2. Describe the structural features of normal skeletal muscle in terms of:
 gross morphology
 light microscopic appearance
 electron microscopic appearance
 histochemistry
3. Describe proper skeletal muscle biopsy procedure, in terms of:
 choice of site
 biopsy technique
 techniques of fixation, processing, staining
 common artifacts seen
 limitations
4. Describe the neuromuscular apparatus, and list disease processes and histopatholgic findings of
diseases affecting the following components:
neuron muscle
myelin blood vessel
axon supporting tissue
neuromuscular junction
5. Discuss the utility of the following:
 clinical evaluation
 electromyography
 serum levels of:
creatine kinase (CK)
aldolase
aspartate aminotransferase (AST)
 muscle biopsy
in the diagnosis of:
o neurogenic disorders
o dystrophic myopathies
o inflammatory myopaties
o congenital myopathies
o vacuolar myopathies
o metabolic myopathies
6. Discuss the following reactions of skeletal muscle:
atrophy fiber type grouping
GRIPE Systemic Pathology Skeletal Muscle

inflammatory infiltrates myophagocytosis

perifascicular atrophy fiber regeneration
segmental necrosis hypertrophy
vacuolation fibrosis
rhabdomyolysis
in the context of:
o neurogenic influence on muscle
o degenerative changes in muscle
o reparative processes in muscle
7. Compare and contrast the following types of skeletal muscle disorders:
neurogenic disorders congenital myopathies
dystrophic myopathies endocrine myopathies
inflammatory myopathies toxic myopathies
vacuolar myopathies metabolic myopathies
in terms of:
o etiology
o pathogenesis (including target cell affected)
o clinical presentation
o histopathologic findings
o prognosis
8. Compare and contrast the following types of muscular dystrophy:
 Duchenne
 Becker
 limb girdle
 myotonic
in terms of:
mode of inheritance morphologic features
age and sex incidence clinical manifestations
muscles primarily involved prognosis
pathogenesis
9. Discuss the following disorders involving skeletal muscle:
 spinal muscular atrophy
 glycogenoses
 myasthenia gravis
 Lambert-Eaton myasthenic syndrome
 AIDS-associated myopathy
 viral myositis
 trichinosis
 cysticercosis
 polymyositis
in terms of:
o etiology
o pathogenesis
o morphology
o clinical features
GRIPE Systemic Pathology Nervous System

94 - NERVOUS SYSTEM

The student will be able to:

1. Define and use in proper context:
agyria etat marbre neurofibrillary tangle
AIDS dementia gemistocytic neuronophagia
Alzheimer type II cell Gitter cell neuropathy
amyloid angiopathy gliosis Nissl substance
anencephaly glomeruloid body open head injury
Antoni A pattern granulovacuolar degeneration ophthalmoplegia
Antoni B pattern herniation pachygyria
arrhinencephaly Hirano body pachymeningitis
aseptic meningitis holoprosencephaly paresis
astrocytosis hydranencephaly parkinsonism
ataxia hydrocephalus peripheral nervous system (PNS)
Bergmann gliosis hydrocephalus ex vacuo phakomatosis
central nervous system (CNS) inborn error of metabolism Pick body
cerebral kernicterus pleiocytosis
cerebral palsy (CP) lacunar infarct polymicrogyria
cerebritis lacunar state porencephaly
cerebrospinal fluid (CSF) Lafora body presenilin
cerebrovascular accident (CVA) laminar necrosis prion
choreiform leptomeningitis prion protein (PrP)
chromatolysis leukoencephalopathy radiculitis
closed head injury leukomalacia Rosenthal fiber
concussion Lewy body rosette/pseudorosette
contrecoup injury lissencephaly satellitosis
contusion "mad cow" disease schizencephaly
corpora amylacea megalencephaly spina bifida
coup injury meningitis spongiform
cranial meningocele status marmoratus
dementia meningoencephalitis storage disease
demyelination meningomyelocele stroke
Duret hemorrhage meningovasculitis syringomyelia
dysmyelination microcephaly tabes dorsalis
encephalitis multiple sclerosis plaque transient ischemic attack (TIA)
encephalocele myelitis ulegyria
encephalomyelitis Negri body von Recklinghausen disease
encephalopathy neuritic plaque Wallerian degeneration
ependymitis neuritis watershed (border) zone
2. Describe the following CNS cells:
neurons microglia
astrocytes choroid plexus epithelial cells
oligodendrocytes schwann cells
ependymal cells
in terms of:
o derivation
o morphology
o function
GRIPE Systemic Pathology Nervous System

3. Compare CNS myelin with PNS myelin, in terms of:

 cells of elaboration
 structure and function
 reactions to injury and destruction
 regenerative potential
4. Discuss normal CSF in terms of:
 sites of formation
 circulation patterns
 sites of absorption
 pressure
 glucose and protein levels
 cell types present
5. Describe the blood-brain barrier (BBB) in terms of:
 physiologic definition
 anatomic counterparts
 morphologic alterations
 areas of absence
6. Describe the following processes:
central chromatolysis coagulative necrosis
neuronophagia caseous necrosis
axonal swelling nerve regeneration
ischemic neuronal necrosis segmental demyelination
gliosis dysmyelination
liquefactive necrosis
in terms of:
o etiology
o pathogenesis
o morphology
o clinicopathologic significance
7. Compare and contrast the following types of cerebral edema:
 cytotoxic
 vasogenic
 interstitial
in terms of:
o mechanism of formation
o morphology
o clinicopathologic significance
8. Compare and contrast the following types of heriation of the brain:
 subfalcine (cingulate gyrus)
 transtentorial (uncal)
 foraminal (tonsillar)
in terms of:
o etiopathogenesis
o morphology
o clinical findings
GRIPE Systemic Pathology Nervous System

o sequelae (morphologic and clinical)

9. Correlate destructive lesions in specific areas of the CNS with corresponding functional consequences
10. Compare and contrast:
 communicating hydrocephalus
 non-communicating hydrocephalus
 hydrocephalus ex vacuo
in terms of:
o etiopathogenesis
o morphologic findings
o clinical manifestations
11. Discuss the following congenital abnormalities:
anencephaly spina bifida/meningomyelocele
Chiari type I malformation lissencephaly
Chiari type II (Arnold-Chiari) polymicrogyria
malformation schizencephaly
Dandy-Walker malformation agenesis of corpus callosum
holoprosencephaly syringomyelia (syrinx)
porencephaly hydromyelia
encephalocele

in terms of:
o relative frequency
o gestational age of occurrence
o etiology
o pathogenesis
o morphology
o clinical features
12. Compare and contrast the following inborn errors of metabolism:
Tay-Sachs disease adrenoleukodystrophy
Niemann-Pick disease Leigh disease
Gaucher disease Canavan disease
mucopolysaccharidoses Wilson disease
Krabbe disease galactosemia
metachromatic leukodystrophy phenylketonuria (PKU)
in terms of:
o genetics
o metabolic abnormalities
o effects on neurons and glia
o morphology
o clinical features
13. Describe the effects of hypoxia/ichemia on the late gestational/perinaral brain, including the
pathophysiologic mechanisms underlying the following:
hydranencephaly multicystic encephalopathy
germinal matrix hemorrhage ulegyria
periventricular leukomalacia cerebral palsy (CP)
etat marbre (status marmoratus)
GRIPE Systemic Pathology Nervous System
14. Discuss the following processes:
cerebral contusion subdural hematoma
diffuse axonal injury subarachnoid hemorrhage
epidural hematoma intracerebral hemorrhage
in terms of:
o etiology
o pathogenesis
o morphology
o clinical course and prognosis
15. Compare and contrast the following types of central nervous system aneurysms:
 saccular ("berry")
 atherosclerotic
 Charcot-Bouchard
 mycotic
in terms of:
o incidence
o etiology
o pathogenesis
o anatomic distribution
o morphology
o clinical presentation
o complications
16. Compare and contrast the following types of CNS vascular malformations:
 arteriovenous malformation
 cavernous angioma
 capillary telangiectasia
in terms of:
o anatomic location
o morphology
o clinical manifestations
o complications
17. List the ways in which hypertension may cause destruction of brain tissue
18. Compare and contrast:
 hypertensive encephalopathy
 hypoxic encephalopathy
 multiinfarct dementia
in terms of:
o etiology
o pathogenesis
o morphology
o clinical features and course
19. Compare and contrast the following types of CNS infarct:
 nonhemorrhagic (pale, anemic)
 hemorrhagic (red)
  border zone (watershed)
 incomplete
 spinal cord
in terms of:
o predisposing conditions
o etiology
o pathogenesis
o morphologic evolution
o clinical features
o complications
20. Compare and contrast the clinical presentations of infarcts of areas supplied by the following arteries:
 middle cerebral
 vertebrobasilar
 internal carotid
21. Describe the interrelationship between hypotension and watershed infarcts
22. Explain the basis of the reperfusion theory of causation of hemorrhagic cerebral infarcts
23. Compare and contrast:
 skull fracture
 parencymal brain injury
 vascular brain injury
in terms of:
o mechanisms
o clinicopathologic effects
24. Compare and contrast open vs. closed head injury, in terms of complications and prognosis
25. Compare and contrast the following neuropathologic entities:
 pyogenic meningitis
 tuberculous/mycobacterial meningoencephalitis
 viral meningoencephalitis
 fungal meningitis
 neurosyphilis
 neuroborreliosis (Lyme disease)
 rickettsial infection
 protozoal infection
in terms of:
o predisposing factors
o etiology
o pathogenesis
o morphology
o cerebrospinal fluid findings
o clinical features and course
26. List the common bacterial agents of acute pyogenic meningitis, and the age group that each most
frequently affects
27. Compare and contrast:
 brain abscess
  subdural empyema
 extradural abscess
in terms of:
o etiology
o usual locations
o morphologic components
o pathophysiologic consequences
28. Discuss the following types of viral meningoencephalitis:
 arboviral encephalitides
 herpes simplex viral encephalitis
 varicella-zoster viral encephalitis
 cytomegalovirus (CMV) encephalitis
 poliomyelitis
 rabies
 human immunodeficiency virus (HIV) infections
HIV meningoencephalitis (subacute encephalitis)
vacuolar myelopathy
 progressive multifocal leukoencephalopathy (PML)
 subacute sclerosing panencephalitis (SSPE)
in terms of:
o predisposing factors
o epidemiology
o etiology
o pathogenesis
o morphologic features
o clinical manifestations
o prognosis
29. Discuss the following prion diseases:
 Creutzfeldt-Jakob disease (CJD)
 variant CJD (vCJD, "mad cow" disease)
 kuru
 scrapie
in terms of:
o etiology
o pathogenesis
o mode of transmission
o host immune response
o morphologic features
o clinical manifestations and course
30. Compare and contrast the following degenerative diseases:
Alzheimer disease Shy-Drager syndrome
Pick disease olivopontocerebellar atrophy
Parkinson disease Huntington disease
progressive supranuclear palsy spinocerebellar degeneration
corticobasal degeneration amyotrophic lateral sclerosis (ALS)
striatonigral degeneration Friedreich ataxia
ataxia-telangiectasia
 in terms of:
o age of onset
o etiopathogenesis
o morphology
o clinical manifestations
o prognosis
31. Describe multiple sclerosis (MS) in terms of:
 geographic distribution
 etiology
 age at onset
 distribution of lesions
 morphology
 clinical course
32. Discuss the following nervous system disorders:
kernicterus carbon monoxide poisoning
acute ethanol intoxication radiation damage
chronic ethanol abuse central pontine myelinolysis (CPM)
methanol poisoning
in terms of:
o pathogenesis
o distribution of lesions
o morphology
o clinical findings and course
33. Discuss the following nutritional disorders:
 Wernicke encephalopathy
 Korsakoff psychosis
 neuropathic beriberi
 subacute combined degeneration
in terms of:
o etiologic deficiency
o pathogenesis
o morphology
o clinical findings
34. Explain the concepts of benignity vs. malignancy, as applied to central nervous system neoplasms
35. Compare and contrast the following neoplasms:
colloid cyst of third ventricle ganglioneuroma
choroid plexus papilloma medulloblastoma
astrocytoma ganglioglioma
anaplastic astrocytoma meningioma
pilocytic astrocytoma hemangioblastoma
fibrillary astrocytoma chordoma
glioblastoma multiforme germinoma
oligodendroglioma pinoeblastoma
ependymoma pineocytoma
neuroblastoma craniopharyngioma
ganglioneuroblastoma primary CNS lymphoma
 neurofibroma malignant peripheral nerve sheath tumor
plexiform neurofibroma metastatic malignancy to CNS
schwannoma (neurilemoma)
in terms of:
genetics radiologic findings
relative frequency morphology
age distribution clinical features
etiopathogenesis prognosis
common sites of origin
36. Compare and contrast the following phakomatoses:
neurofibromatosis type 1 Sturge-Weber syndrome
neurofibromatosis type 2 ataxia-telangiectasia
tuberous sclerosis von Hippel-Lindau syndrome
in terms of:
o incidence
o genetics
o morphologic manifestations
CNS
PNS
skin
visceral
o clinical features and course
37. Discuss the following disorders of the PNS:
myasthenia gravis Refsum disease
Guillain-Barrẻ syndrome paraproteinemia-associated neuropathy
herpes zoster (shingles) spinal muscular atrophy
hereditary neuropathies compression neuropathy
diabetic neuropathy traumatic neuroma
AIDS-associated peripheral neuropathy plantar (Morton) neuroma
hereditary motor & sensory neuropathy (HMSN)
type I [Charcot-Marie-Tooth disease (CMT) 1]
type III (Dejerine-Sottas disease)
in terms of:
o etiology (including genetics, if applicable)
o pathogenesis
o morphology
o clinical findings
GRIPE Systemic Pathology Special Sense Organs

95 – SPECIAL SENSE ORGANS

The student will be able to:

1. Define and use in proper context:
arcus senilis entropion myopia
arteriovenous nicking epiphora myringitis
astigmatism esophoria nebula
blepharitis esotropia ophthalmoplegia
blepharochalasis exophthalmos otosclerosis
blindness glaucoma papilledema
buphthalmos Goldenhar syndrome phakoanaphylaxis
cataract hordeolum photophobia
chalazion hyperopia phthisis bulbi
cherry-red macula hypertelorism pinguecula
cholesteatoma hyphema presbycusis
coloboma hypopyon presbyopia
cotton-wool spots iridocyclitis proptosis
cyclitic membrane iris bombe pterygium
dacryocystitis iritis scotoma
deafness keratic precipitate sympathetic ophthalmia
diabetic retinopathy keratitis synechia
background keratoconus tinnitus
proliferative keratomalacia uveitis
drusen keratopathy vertigo
ectropion leukoma xanthelasma
emmetropia mastoiditis xerophthalmia

2. Discuss the anatomy of the orbit in general

3. Describe ocular findings in the following congenital conditions:

 trisomy 13
 trisomy 21
 congenital rubella
 congenital syphilis
4. Discuss the following inflammatory conditions of the eye and orbit:
conjunctivitis chalazion
acute (pink eye) pseudotumor
chronic dacryocystitis
inclusion keratitis
trachoma iridocyclitis
ophthalmia neonatorum granulomatous inflammation
blepharitis sympathetic ophthalmia (uveitis)
hordeolum
in terms of:
o etiology (including most common organism, if applicable)
o pathogenesis
o morphology
o natural course
GRIPE Systemic Pathology Special Sense Organs

5. Discuss the three major types of corneal stromal dystrophies, in terms of:
 genetics
 histomorphology
 clinical course
6. Compare and contrast the following types of glaucoma:
 congenital
 primary angle-closure
 secondary angle closure
 open-angle
in terms of:
o etiology
o morphology
o clinical course
7. Discuss the following degenerative conditions:
band keratopathy pinguecula
blepharochalasis pterygium
entropion arcus senilis
ectropion keratoconus
xanthelasma keratomalacia
in terms of:
o etiopathogenesis
o morphology
o clinical significance
8. Discuss cataracts with regard to:
 associated diseases
 etiology
 classification
 morphology
9. Discuss the following diseases:
 retinopathy of prematurity (retrolental fibroplasia)
 retinitis pigmentosa
 macular degeneration
 retinal detachment
in terms of:
o etiology
o morphology
o ophthalmoscopic findings
o clinical course
10. Compare and contrast the following vascular disorders:
 central retinal artery occlusion
 central retinal vein occlusion
 hypertensive retinopathy
 arteriosclerotic retinopathy
 diabetic retinopathy
background
GRIPE Systemic Pathology Special Sense Organs

proliferative
in terms of:
o incidence
o etiopathogenesis
o histomorphology
o ophthalmoscopic findings
o clinical course
11. State the ocular lesions associated with:
 vitamin A deficiency
 methanol toxicity
12. List the most frequent primary and metastatic malignancies of the:
 lid
 conjunctiva
 uvea (uveal tract)
 optic nerve
13. Discuss the following malignancies of the eye:
 malignant melanoma
 retinoblastoma
 metastatic malignancy
in terms of:
o genetics
o incidence (including age, race)
o sites of origin
o clinical presentation
o morphology
o prognosis
14. Discuss the following diseases of the optic nerve:
 papilledema
 optic neuritis
 optic atrophy
in terms of:
o etiopathogenesis
o morphology
o prognosis
15. State:
 the two most common causes of blindness in the world
 the four most common causes of blindness in the United States
16. Describe the following congenital anomalies:
 preauricular pit
 preauricular tag
 branchial cleft cyst
in terms of:
o embryonic developmental pathogenesis
o morphologic features
GRIPE Systemic Pathology Special Sense Organs

o clinical features
17. Discuss the following diseases of the external ear:
 cauliflower ear
 otitis externa
 chondrodermatitis nodularis chronicis helicis
 keloid
 myringitis
 aural polyps
 neoplasms
in terms of:
o etiology
o morphology
o clinical course
18. Discuss the following diseases of the middle ear:
 otitis media
 cholesteatoma
 chemodectoma
in terms of:
o etiopathogenesis
o morphology
o clinical course
19. Discuss the following diseases of the inner ear:
 labyrinthitis
 otosclerosis
 Meniere disease
 acoustic trauma
 endolymatic duct tumor
 acoustic schwannoma ("neuroma")
in terms of:
o associated syndromes (if any)
o age incidence
o etiopathogenesis
o morphology
o clinical features