Why pathology is so difficult?
Dr. Norizal M.N
M.D (UKM) Mpath(UM)
Laboratory Medicine Cluster
Universiti Teknologi MARA
Pathology
Why Pathology?
• Study of disease.
• Science of all aspects of
disease.
• Pathologists study:
– causes /etiology
– Effect to cells and tissues
– Pathogenesis
– Presentation
– monitoring
What is the problem?
• BASIC KNOWLEDGE
– Anatomy/physio/biochemi
stry
– Pathology basics
• Inflammation
• Necrosis and
degeneration
• Neoplasia
What is the problem?
• THICK BOOKS!
– Pathologic basic of disease :
1598 pages
– Basic Pathology : 960 pages
– Pocket companion : 816 pages
What is the problem?
• LECTURE NOTES
– 3 categories
• Self = good!
• Lecturer’s = useful
• Friend’s copy =
USELESS!
How should I study
PATHOLOGY?
ANSWER:
HOW DID YOU STUDY YOUR
ANATOMY/PHYSIO/BIOCHEM?
Work HARD!!
Study Tip #1 - Keep it organized.
• progresses and builds on
basic concepts
• break down the ideas into
their basic pathological steps
• Take one general topic and
list all its subtypes
underneath it.
• Keep the diagrams concise
– review them for quick
reference and
comparison
Study Tip #2 - Start with the big picture.
• Scan through chapter
• Thoroughly understood
versus the minor details
• Detailed facts – reside short-
term memory
Study Tip #3 - Know the terminology and
nomenclature.
• Pay attention to the stem of
the word.
• types of cell changes and
progression to cancer.
• Carcinoma/sarcoma/lympho
ma/melanoma
Study Tip #4 - Compare and contrast the
disease processes.
• Difference and similarity
• Many disease processes
overlap each other,
• Benign vs. Malignant,
Transudate vs. Exudate,
Grade vs. Stage, Reversible
Injury vs. Irreversible.
Study Tip #5 - Sketch diagrams and flow
charts.
• Multi-step disease processes.
• Flow charts and algorithms
over the concepts.
• Understand the progression
and mechanism of large step
• Focus and memorize the small
details of each large step.
• Mechanisms and cellular
changes
Common Resources of Learning
• Didactic Lectures
– interesting’ to completely
boring sessions
– totally ‘monotonous’
Common Resources of Learning
• PowerPoint slides
– have boundaries
– Comprehensiveness
– obsolete.
– poorly compiled
– language used is not
easy
Common Resources of Learning
• Visuals or Pictures
– One picture is equal to
thousand words
– It is a good habit to study
the picture first and then
the text.
Common Resources of Learning
• Books
– Use textbook optimally
– Difficult Initially but habit
catches
– in future – NO
PowerPoint slides
– builds up your level of
confidence and avoids
“dependency”.
Common Resources of Learning
• CDs/DVDs
• Internet
– Atlas
– Notes
– diagram
EXAMS
• MCQ
• ESSAYS/SHORT NOTES
• OSCE/OSPE
MCQ
• Knowledge tested
– Basics of disease ( age/clinicals/etc)
– Lists (cause/risks/complication/etc)
– Pathogenesis
– Pathology (macroµ)
– Clusters disease with similar
association
MCQ-Basics of disease
MCQ-clusters disease with association
Psammoma bodies are seen in
A) Follicular Ca Thyroid
B) Papillary Ca Thyroid
C) Serous cystadenoma of Ovary
D) Meningioma
E) Hepatoblastoma
MCQ-Pathogenesis
Chronic hepatitis may features:
a. interface hepatitis (“piecemeal necrosis”)
b. lobular hepatitis
c. bridging necrosis
d. portal inflammation
e. portal-portal fibrous septa
MCQ-Lists
Complication of pyelonephritis: The following viruses more frequently lead to
chronic hepatitis and cirrhosis:
a. pyonephrosis
A. Hepatitis A
b. papillary necrosis
B. Hepatitis B
c. renal stones
C. Hepatitis C
d. perinephric abscess
D. Hepatitis E
e. renal cell carcinoma
E. Epstein Barr virus
MCQ-Pathology(micro/macro)
Typical features of a squamous cell carcinoma
of the lung include :
a.Hypercalcemia
b.Central location
c.Fungating mass
d.Mucin production
e.Keratin pearls
ESSAYS & SHORT NOTES
• Essays
– Almost similar to study guide/requirements
– Usually segmented
• Eg: Define emphysema. Classify the types of emphysema
– Use charts/tables if needed
• Eg. UC vs Chron’s
• Short notes
– Specific disease
• eg. Wilson disease, gastric ulcer, acute renal failure
– Specific lesion with differentials
• Eg. Mallory hyaline, nodules in lung, giant cells
– Pathological feature
• Eg. Cirrhosis, myocardial infarct, complication of
meningitis
OSPE
• Atlas and Museums are main reference
• Past year questions
• Focus on Macro and Micro
• Answer carefully, take your time
• Write in full, list not sentence
• Don’t waste time moving!
The next step..
Are you prepared?
Rasulullah s.a.w bersabda, maksudnya:
"Siapa yang keluar untuk menuntut ilmu maka ia
berjuang fisabilillah hingga ia kembali".
Riwayat At-Tarmizi dan Ad-Darimi