187.620 Environmental Toxicological Pathology 4th quarter 2013
Course director: Kathy Gabrielson, 410 955-4584 kgabriel@jhmi.edu
Wednesdays and Fridays 3:00-4:50 pm (Class location varies see below- Turner concourse area or MRB)
Teaching Assistant Suzanne Martos. (smartos@jhsph.edu)
Course Requirement- daily reviews
 After each class, 2 questions and answers (based on that day’s class material) must be submitted to the
Suzanne your Teaching Assistant within 48 hours. Expect your Qs and As to be about one page of text and
figures for each lecture. Use high quality pictures.
 The final exam will come from the most representative questions. Use gross or microscopic photos of tox
pathology examples. The internet is a great source.
 End of class- submit a CD with your work, all your questions and answers, power point presentations,
Diagnosis game cases
March 27 – MRB 801
Basic pathology terminology with examples (Kathy Gabrielson)
Questions/Answers for this lecture should be based on case examples: necrosis, apoptosis, hyperplasia,
metaplasia, dysplasia, neoplasia, edema, inflammation, fibrosis, mineralization, cell loss, hypertrophy and
atrophy. Use photos or cartoons -as much visual examples as possible!
March 29 – G01
Gastrointestinal system/liver (Bak Karim)
Overview of liver structure/function, normal light microscopy, clinical pathology, examples of toxicities
April 3 – MRB 801
Gastrointestinal system (Bak Karim)
Overview to GI tract, normal light microscopy (pancreas, stomach, small and large intestines) examples of
toxicities
April 5 – G01
Urinary system (Kathy Gabrielson)
Structure/function kidney, normal light microscopy, EM normal, tubule and glomerulus, clinical pathology,
examples of toxicities
April 10 – MRB 801
Female Reproductive system (Sarah Beck)
Structure/function female reproductive tract, normal light microscopy, examples of toxicities using multiple case
presentations
Male Reproductive system (Brian Simons)
Structure/function male reproductive tract overview, normal light microscopy, examples of toxicities using
multiple case presentations
April 12 – Faculty Lounge (2nd floor MRB)
Diagnosis game #1(Kathy Gabrielson)
 5 toxicity cases will be presented from previous class material (March 27-April 10). The cases will be
printed in color and placed in a notebook (power point format) with questions and clues throughout the
case description.
 Clinical signs, pathology, histopathology and mechanisms of the toxicity will be given to help you diagnose
the case.
 Teams of 2 students will work together to solve the case. Each team will also submit one case together
(power point format) for diagnosis game #2 and #3. This case will be designed to test the other
members of the class. open book
April 17 - MRB 801
Lymphoreticular system (Taylor Reynolds)
Structure/function, normal morphology of bone marrow, spleen, lymph nodes, examples of toxicities
(Michael Trush, Case example -benzene toxicity)
Submit rough draft of PowerPoint Presentation case presentation for preliminary review to kgabriel@jhmi.edu
April 19 – G01
Cardiovascular system (Kathy Gabrielson)
Overview cardiovascular structure/function, normal light microscopy, examples of toxicities
Musculoskeletal system (Bak Karim)
Muscle and bone, normal and examples of toxicity
April 24 - Nervous system (Katie Brennan) - MRB 801
CNS basic structure of brain (diencephalon etc), cell types/function (neuron, astrocyte, microglia,
oligodendrocyte). Blood brain barrier, examples of toxicities and methods for neuropath assessment.
Nervous system PNS Patterns of neurotoxic injury. Basic structure anatomy structure, spinal cord and
peripheral nerves (light microscopy), cell types, motor and sensory neurons, schwann cells etc., examples of
toxicities and methods for neuropath assessment.
April 26 – Darner Conference Room (Turner 007)
(Kathy Gabrielson)
#1 Student PowerPoint case presentations; 15 minutes – Distribute a summary sheets for main points of ppt
for fellow class mates.
May 1 - MRB 801
Pulmonary system (Wayne Mitzner)
Overview structure/function lung correlation for lung disease, normal light microscopy / EM
Case presentation- (W. Mitzner) asthma, emphysema
May 3 – G01
Endocrine system (Taylor Reynolds)
Overview structure/function, normal light microscopy, examples of toxicities
Ocular system (Gillian Shaw)
Overview of structure/function, normal light microscopy, examples of toxicities
6 total questions
May 8 – MRB 801(Kathy Gabrielson)
Diagnosis game #2. Cases from student teams
 5 toxicity cases will be presented from entire class material (March 27-May 3). The cases will be printed in
color and placed in a notebook (power point format) with questions and clues throughout the case
description.
 Clinical signs, pathology, histopathology and mechanisms of the toxicity will be given to help you diagnose
the case.
 Teams of 2 students will work together to solve the case –open book.
May 10 (Kathy Gabrielson) – MRB 181
Final exam in class with 90% of questions from the best student questions submitted focused on learning
objectives of each lecture. 10% questions will come from the diagnosis games and student PowerPoint
Presentations.
May 15 – MRB 801 (Kathy Gabrielson)
#2 PowerPoint Case presentation.
May 17 – Faculty Lounge (2nd floor MRB)
Diagnosis game # 3 cases from student teams (Kathy Gabrielson)
 5 toxicity cases will be presented from entire class material. The cases will be printed in color and placed in
a notebook (power point format) with questions and clues throughout the case description.
Final Grade
1. Class attendance and participation 10% sign in sheet each class (1 advance excuse accepted)
2. Two case PowerPoint Presentations 20% each (40% total)
3. Diagnosis game- group projects (including 3 diagnosis games) (10% each) (30% total)
4. Final exam 10% Multiple choice- learning objectives from each class- closed book
5. 2 Submitted questions and answers for each lecture 10%6. Submit a notebook and CD (files) at final of all your Qs and As, Dx games and ppts.
Potential case examples:
Arsenic
Cadmium
pesticides
perchlorate
fluoride
oxybenzone
parabenes
butylated hydroxyanisole (BHA)
perfluorooctanoic acid (teflon)
decabromodiphenyl ether (DECA)
flame retardant
Benzene
organophosphate insecticides
ethanol
CCl4
chloroform
melamine
DES
phthalates
Amiodarone
Naphthalene
Trimethyltin
Ozone
Antiretrovirals
Mycotoxins
Aluminum
chromium
BPA
QT prolongation drugs- seldane
Carbon nanotubes and
nanoparticles and quatum dots
Autism and vaccines
Toxicity of Gulf oil spill-chemical
dispersants
Ricin
Acrylamide
1,3-dinitrobenzene
Triazoles
specific pesticides
thalidomide
Vinylcyclohexine diepoxideovotoxin .
Methylmercury
TCDD
Formaldehyde
Radon
Lead
Carbon monoxide
Vinyl chloride
Hydrofluoric acid
Asbestos
Pharmaceuticals flushed down
toilets
polychlorinated biphenyls (PCBs)
cancer therapy drugs
Fen Phen
Methamphetamine
Unfortunately there are many more
toxins out there!
Recommended resource:
Fundamentals of Toxicologic Pathology
Wanda M. Haschek, Colin G. Rousseaux, Matthew A. Wallig