Errata/Additions RR3 Pathology: Students
Page 6
3. b. In the medulla, the Na+-K+-Cl- symporter….
Page 11
Table 1-2
Bilirubin
Kernicterus (see Fig. 15-5): fat-soluble (free unbound) unconjugated….
Page 26
Table 2-1: Under Leukotrienes: Montelukast leukotriene receptor antagonist:  activity of LTC4,
LTD4, LTE4
Under IL-1, TNF and Functions: TNF is a promoter of apoptosis (refer to Chapter 1)
TNF important in formation/maintenance of granulomas
Page 50
5. d. (3) AIDS-defining malignancies
● Kaposi’s sarcoma…….primary CNS lymphoma (EBV), cervical carcinoma
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Figure 3-5 C5 convertase is correctly represented as C4b2a3b.
Page 54
I. A. 1. c. Potassium (K+ ) is the major intracellular fluid (ICF) cation.
 Phosphate (PO42-) major anion.
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Box 4-1
Last paragraph: ATII has a fourfold
Page 60
Box 4-1: top of page
1. Vasoconstriction of….
2. Stimulation of…
3. Direct stimulation of…
4. Enhances activity of H+/Na+ cotransporter in the proximal renal tubule
Page 60
A low peritubular capillary hydrostatic pressure (PH) coupled with a high oncotic pressure (PO) is
responsible for enhancing the reabsorption of solutes from the tubular lumen into the tubular cell
out into the lateral intercellular space, and into the peritubular capillary (B). This occurs when
the EABV is decreased (e.g., ECF volume depletion, or hypovolemia). A high PH coupled with a
low PO results in the loss of solutes in the urine in conditions when the EABV is increased (A;
e.g., ECF volume overload, or hypervolemia).
Page 61
MN:  EABV  FF  PO > PH
MN:  EABV  FF  PH > PO
Page 61
Fig. 4-6. Change cotransporter to symporter
Fig. 4-7 Na+-C- symporter in the early…
Page 62
Figure 4-6: Sodium, potassium, chloride symporter in the medullary segment of the thick
ascending limb. See text for description (From Goljan EF, Sloka KI: Rapid Review Laboratory
Testing in Clinical Medicine, Mosby Elsevier, 2008, p 34, Fig. 2-6).
Page 63
2. Thick ascending limb (TAL medullary segment)
b. Generation of fH2O primarily occurs in the active Na+-K+-2 Cl- symporter (Fig.
4-6)
c. Water proximal to the symporter is obligated (o).
MN: Na+-K+-2Cl- symporter: generates free water
d. Symporter separates oH2O from Na+, K+, and Cl-.
g. Ca2+ is also reabsorbed by the symporter.
h. Cl- binding site in Na+-K+-2 Cl- symporter is inhibited by loop diuretics.
MN: Cl- binding site in Na+-K+-2Cl- symporter: inhibited by loop diuretics
Shaded area discussing loop diuretics
Change both cotransporters to symporter
3. Na+-Cl- symporter…
d. Thiazides inhibit the Cl- site in the Na+-Cl- symporter
MN: Thiazides: inhibit Cl- site in Na+-Cl- symporter
Page 66
F. Potassium K+ disorders
Page 74
Table 4-9 under the Loop and thiazide discussion (2nd from the bottom under Discussion)(hypernatremia) should be changed to (hyponatremia).
Page 89
B. 1. a. Unequal separation of chromosomes in meiosis
Page 96
Table 5-4
Isotretinoin
Hearing defects……mental retardation, CNS/cardiovascular defects
Page 102
Table 6-1
Hematologic
Increased risk for acute myeloblastic leukemia
Page 105
Margin note: Oral contraceptives: most common cause of hypertension in young women; 
angiotensinogen
Page 115
C. 2. c. (2) Leptin secretion increases when adipose stores are increased
(a) Decreases food intake (via hypothalamus)
(b) Increases energy expenditure (e.g.,  -oxidation of fatty acids)
(3) Leptin secretion decreases when adipose stores are decreased
(a) Increases food intake (via hypothalamus)
(b) Decreases energy expenditure (e.g.,  -oxidation of fatty acids)
Page 116
B. 4. a. Renal failure (most common cause)
Page 123
Margin note: 2nd one down in column: Epithelial,…
Page 125
C. Nuclear features
1. Benign tumors
a.
b.
2. Malignant tumors
a. Nuclear/cytoplasmic ratio is increased, and nucleoli are prominent
b. Mitoses have normal and atypical mitotic spindles
MN: Loss of intercellular adherence  cell invasion
Page 128
3. Gynecologic cancer-related deaths (in descending order)
a. Ovary
b. Endometrium
c. Cervix
Page 132
Margin Note: Enzymes involved in dimer excision: endonuclease, exonuclease, polymerase,
ligase
Fig. 8-4. Under 4 53 synthesis of a new strand takes place (polymerase), the correct…..
Table 8-5
Polycyclic hydrocarbons
Adenocarcinoma: distal esophagus, pancreas, kidney
Page 133
C. 1. b. (1) Acute myeloblastic or chronic myelogenous leukemia
Page 134
C. 1. b. (1) Chronic high levels of tumor necrosis factor- (called cachectin)
Margin note: Hemostasis in malignancy: thrombogenic
Margin note: Signs of ectopic hormone production: hypercalcemia, hyponatremia,
hypoglycemia, hypercortisolism, polycythemia
Page 141
a. Acquired causes of hypertriglyceridemia
(1) Diabetes mellitus
 Decreased muscle and adipose CPL (enzyme induced by insulin)
Page 146
IV.Venous System Disorders
A. Saphenous venous system
1. Superficial veins drain blood into the deep veins via perforating branches.
Page 147
(1) Stasis dermatitis
(a) Orange discoloration….
(b) Caused by rupture of perforating branches
Page 150
Sturge-Weber syndrome
(Fig. 9-9D)
Nevus flammeus (“birthmark”) on the face in distribution of
cranial nerve V (trigeminal)
Page 161
Systolic dysfunction is characterized by a low ejection fraction (EF) (
the stroke volume divided by the left ventricular end-diastolic volume. The normal value ranges
from 55% to 80%. Diastolic dysfunction is characterized by normal to high (delete) EF (stiff
ventricle) and an S4 atrial gallop due to increased resistance to filling in late diastole. There is
an increase in left atrial pressure and pulmonary congestion. If left ventricular filling is
significantly impaired, cardiac output is decreased.
Page 163
Margin note: LHF: most common cause RHF
Page 176
f. (2) (c) Reversal of blood flow….
Page 195
3.c. Iron deficiency
(1) Most common microcytic anemia with an increased RDW
Page 214
Margin note: PNH: intrinsic defect, intravascular hemolysis
Page 238
MN: Nodal enlargement: <30….
Page 240
(6) Epitrochlear
● Cat-scratch disease, non-Hodgkin’s lymphoma (NHL)
(7) Hilar
(a) Metastatic lung cancer
(b) Sarcoidosis (bilateral)
Page 241
MN: last one on page correct spelling Hashimoto’s
Page 245
MN: top one on page Histiocytes: CD1 +; contain Birbeck granules
Page 254
F. 2. d. Thrombin converts fibrinogen holding platelets together to fibrin at the end of the platelet
phase
Page 260
Margin note: Circulating anticoagulant: PT and/or PTT….
F. 3. b. (2) No correction of PT and/or PTT…
3. b. (3) Correction of PT and/or PTT…
Page 276
Margin Note: Normal FEV1sec/FVC: 4/5 L = 80%
Page 279
Margin note at top: OSA: excessive snoring with…
Page 283
Margin note at top: ARDS risk:….
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Margin note at top: Bronchopneumonia: acute bronchitis with local extension into parenchyma
Page 287
Table 16-4
Under Klebsiella pneumoniae: under Discussion should be:
Typical pneumonia associated with blood-tinged, thick, mucoid sputum
Page 294
Margin note on top: Diagnosis: V/Q scan + spiral CT
Page 296
Third Margin note from top
Particle size 1-5 m: bifurcation respiratory bronchioles and alveolar ducts
Particle size < 0.5 m: alveoli
Page 315
MN: third one from top: Pre-AIDS lesions: thrush, hairy leukoplakia, aphthous ulcers
Page 316
Table 17-1: under Hairy leukoplakia and Features column: Pre-AIDS lesion (refer to Chapter 3)
Page 317
Table 17-1: under Congenital syphilis and Features column: Abnormalities involving incisors
(notched and tapered like a peg)….
Page 329
Margin Note 2nd from the bottom: ZE syndrome:  gastrin,  acid
Page 338
7. Tests to evaluate pancreatic insufficiency
a. Serum immunoreactive trypsin
(1)….
(2) Decreased concentration in chronic pancreatitis
(3) Increased concentration in early cystic fibrosis
Page 338
Margin Note 3rd from the top: Serum immunoreactive trypsin:  in chronic pancreatitis
Page 339
Margin Note 3rd from the top: Celiac disease:  anti-tTG, EMA, gliadin antibodies
Page 352
Margin Note 2nd from the top: Colon cancer: 3rd most common cause of mortality due to cancer
Margin Note bottom: FOBT: most tests do not distinguish hemoglobin from myoglobin
Page 357
Margin note 3rd from the top: Anal fissure: most are posteriorly located; anal tag marks location
Page 359
Table 18-1: First row of the table should be CB <20% not UCB <20%
Page 361
Box 18-1 First sentence. In viral hepatitis, ALT is higher…
Page 364
Table 18-5
Under “Healthy” carrier (2nd row from bottom): under column for Anti-HBc-IgM, it should be 
not +
HBsAg HBeAg HBV DNA Anti-HBc-IgM Anti-HBc-IgG Anti-HBs
Interpretation
+
+
“Healthy”



carrier
Page 370
Delete Margin note (redundant): Alcoholic hepatitis: acetaldehyde damages hepatocytes
Page 373
2. c. (2) Mesocaval shunt
● Connects the superior mesenteric vein with the vena cava
Page 378
First Margin Note
Wilson’s disease:  total serum copper;  serum/urine free copper
Page 382
First Margin Note at top: Bile: …..bicarbonate
Page 383
Margin note 6th from top: Stage 2: stone…..right scapula/shoulder
Page 387
4. c. (2) Excellent newborn screen for cystic fibrosis (increased)
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C. 4. b. Decreased serum immunoreactive trypsin
Page 393, Figure 19-1: New schematic. Copy and paste into book.
Page 394
Margin note at top of page: MN: Nephrotoxic drugs in elderly: must adjust…
Page 403
Table 19-8
Focal segmental glomerulosclerosis
Diffuse membranous
glomerulopathy (see Fig. 19-7)
Primary or secondary disease; secondary causes HIV
(most common glomerular disease; mainly in young
black males) and intravenous heroin abuse.
Most common cause of nephrotic syndrome in adults
Negative IF; …..
Nonselective…
Hypertension…
Poor prognosis…
Treatment…
Second most common cause of nephrotic syndrome in
adults
All other material is okay
Page 404
H. 1. Alport’s syndrome
a. X-linked recessive (most common); autosomal recessive/dominant types
● Mutations in -chains (3, 4, or 5) of type IV collagen in GBM
Page 422
Margin note at top of page: Embryonal rhabdomyosarcoma: most common….
Page 426
Margin note 2nd from the bottom: Testicular cancer metastasis: para-aortic…
Page 446
Margin note 4th from the bottom: Testosterone: synthesized in ovary and adrenals
Page 447
Margin note 3rd from the top: Pregnancy respiratory alkalosis due to estrogen/progesterone stimulation of
respiratory center
Page 465
E. 1. d. (4) Ovum 46, XX (90% of cases)
(a) Ovum lacks maternal chromosomes
(b) Chromosomes derived from father; duplication of 23X sperm in ovum
Page 465
E. 1. e. (2) Normal embryo is present (no chromosome abnormality)
(a) Ovum triploid (69 XXY in 70% of cases; XXX in 27% of cases)
(b) Fertilization 23X ovum by two haploid sperm or one diploid sperm
Page 482
Replace all margin note and text 131I with 123I (should be a total of 7 replacements)
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Replace all margin note and text 131I with 123I (should be a total of 2 replacements)
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Replace text 131I with 123I (should be only 1 replacement)
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Replace all margin note and text 131I with 123I (should be a total of 3 replacements)
Note: 8. c. Ablative 131I…. is okay; leave as is.
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Table 22-2
Replace table heading (top row) 131I with 123I
Page 492
Margin note 3rd from top: PTH feedback: hypocalcemia/hyperphosphatemia  PTH;
hypercalcemia/hypophosphatemia  PTH
Page 496
Table 22-4
Thiazides
Mechanism: increases early distal tubule reabsorption of calcium; always consider a
possible underlying parathyroid adenoma (order serum intact PTH)
Page 496
3.d. Decreased serum 1,25-(OH)2D
● Hypercalcemia decreases synthesis of 1-hydroxylase in proximal renal tubule
Page 497
F. 4. b. ● Hyperphosphatemia inhibits 1--hydroxylase
Table 22-5
Decreased reabsorption of phosphorus from the
Hypovitaminosis D (extrarenal
small intestine (remove and kidney)
causes)
Page 498
Margin note 2nd from top: Peripheral tissue sites to produce DHT: skin…..
Page 498
Table 22-7
Disorder
Serum calcium
Primary HPTH

Serum
phosphorus

Serum PTH

Serum 25(OH)D
N
Serum 1,25OH)2D

Page 506
Table 22-10: under somatostatinoma, change to -islet cells.
Page 510
Margin note last one at bottom: DKA electrolytes:  serum sodium (dilutional)…..
Page 523
Margin note 3rd from bottom: Alkaptonuria: homogentisic acid…
Page 527
6. c. Cevimeline (cholinergic agent with muscarinic agonist activity)
Page 537
Table 23-3
DeQuervain’s tenosynovitis
Pain on the radial aspect of the wrist aggravated by moving the
thumb
Page 538
Table 23-3
Knee joint injuries
(Fig. 23-23C)
Unhappy triad: most common internal
derangement of knee joint. Valgus injury.
Damage to medial meniscus, medial
collateral ligament, anterior cruciate
ligament; lateral meniscus also commonly
injured
Treatment: physical therapy; arthroscopic
surgery
Page 557
Margin note last one on bottom: Eczema: acute eczema weeping; chronic eczema dry
Page 573
Margin note 2nd from top: Key findings: seizures, mental retardation, angiofibromas, ash leaf lesions
Page 582
Alignment problem in Table 25-2; move Meningitis and encephalitis to Disease column
Lymphocytic
choriomeningitis
Meningitis and
encephalitis
This column is okay
Page 582 (Copy and paste into book)
TABLE 25-3 SLOW VIRUSES AND SPONGIFORM ENCEPHALOPATHY OF THE CENTRAL
NERVOUS SYSTEM
Creutzfeldt-Jakob disease (CJD)
Fatal encephalopathy due to prions (proteinaceous material
(see Fig. 25-25)
lacking RNA and DNA); in CJD, normal prion protein (PrP)
in neuronal membranes misfolds, becomes infectious, and
results in death of neurons (? apoptosis) and spongiform
change (cytoplasmic vacuoles; “bubbles and holes”);
infectious PrP resists standard sterilization techniques and
proteases.
Transmission: corneal transplants; grafts of dura mater;
improper handling of infected brain tissue; contaminated
deep implantation electrodes; ingestion of contaminated beef
from cattle with bovine spongiform encephalopathy (“mad
cow” disease)
Severe dementia; death usually occurs within 1 year
Page 585
Margin note last one on bottom: CPM: due to rapid IV correction of hyponatremia (usually in an
alcoholic)
Page 588
Margin note 1st on top: Krabbe’s disease: LSD; deficiency -galactocerebrosidase with  in galactocerebroside in lysosomes
Margin note 4th from top: AD:  phosphorylated A  neurotoxic
Margin note 5th from top: Activated GSK-3: phosphorylates A
Page 592
Margin note 2nd from bottom: Wilson’s disease: cystic degeneration of basal ganglia