21 July 2022: Textbook Updates

We have posted updates of the following topics:

Autopsy & forensics > Types of injuries > Asphyxia
by Lorenzo Gitto, M.D., Ponni Arunkumar, M.D.
Topic summary: Asphyxia: generic term that indicates a condition resulting from an interference with respiration due to the lack of oxygen in the air or in the blood, a failure of cells to utilize oxygen or a failure of the body to eliminate carbon dioxide. Types of asphyxia: suffocation (smothering, choking, confined space and vitiated atmosphere), strangulation (hanging, manual strangulation, ligature strangulation), mechanical (positional, compression), drowning, special types (autoerotic, incaprettamento, judicial hanging, mass suicide hanging). Autopsy findings: neck injuries may be observed in asphyxias with neck compression mechanisms.

Kidney nontumor > Glomerular disease > Fibrillar disease > Renal amyloidosis
by Anthony Sisk, D.O.
Topic summary: A group of insoluble proteins organized into beta pleated sheets, which deposit within extracellular spaces of a variety of tissues leading to organ dysfunction and disease. Immunofluorescence and immunohistochemistry findings can be helpful in determining amyloid type. Epidemiology, etiology, clinical features are dependent on the amyloid type. Unfavorable prognostic factors: dialysis requirement, massive proteinuria, renal failure at presentation, severe hypoalbuminemia, coexisting multiple myeloma, heavy organ involvement, IgM related monoclonal protein. Treatment based on amyloid type, underlying cause of disease and symptoms.

Kidney nontumor > Tubulointerstitial disease > Ischemic injury > Acute tubular necrosis
by Dale Davis, M.D., M.A., Astrid Weins, M.D., Ph.D.
Topic summary: Sudden decline in renal function, secondary to ischemic or toxic damage to renal tubular epithelial cells. Clinically similar to acute interstitial nephritis (AIN); histopathology needed for diagnosis. True ATN presents in 1% of hospitalized patients and ~4/10,000 of the general population; more likely to affect patients with comorbidities. Prognosis favorable unless sustained renal failure or combined with systemic issues or other underlying conditions. Underlying cause will determine route of treatment.

Laboratory Administration & Management of Pathology Practices > Qualifying board topics > Inspection and accreditation processes > Laboratory inspection and accreditation
by Mai Thy Tran, M.D., Lewis A. Hassell, M.D.
Topic summary: Laboratory accreditation refers to a stamp of approval granted to a laboratory by an external entity, intended to assure quality of processes and personnel; it generally indicates that the lab meets the standards established by the accrediting agency. Standards of performance and operation are specified by the accrediting agency. Benefits: demonstrates competence of the laboratory; assists lab employees in learning, developing a sense of pride in their work and in maintaining high standards; a tool to recognize laboratories worldwide.

Molecular markers > CSF3R
by Yan Chen Wongworawat, M.D., Ph.D., Kevin E. Fisher, M.D., Ph.D.
Topic summary: Colony stimulating factor 3 receptor. Somatic activating mutations in CSF3R are the most frequent molecular alteration in patients with chronic neutrophilic leukemia (CNL), seen in > 60% of cases. Activating mutations in CSF3R localize to 2 distinct protein domains. Inherited / germline mutations in this gene are associated with autosomal dominant hereditary neutrophilia and autosomal recessive severe congenital neutropenia 7. Coexistence of CSF3R and ASXL1 mutations is associated with a poorer prognosis in CNL.

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