Second Edition
Ramadas
Nayak
MBBS MD
Professor and Head
Department of Pathology Yenepoya Medical College Yenepoya University
Mangaluru,
Karnataka,
India
Formerly,
Head Department of Pathology Kasturba Medical College, Mangaluru Manipal University
Karnataka, India
Foreword
K
Ramnarayan
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Exam Preparatory Manual for Undergraduates—Pathology
First Edition: 2015
Second Edition: 2017
9789386261212
Printed at
fm5Dedicated to
Students who inspired me,
Patients who provided the knowledge,
My parents and family members,
fm7Foreword
“Any intelligent fool can make things bigger and more complex,” said Albert Einstein. To make things understandable and appealing is the persisting and daunting task of a passionate teacher. It is in this context that Dr Ramadas Nayak's book assumes a considerable significance. In this book, he has provided conceptual clarity that it is both astounding and amazing.
The veritable qualities of a review book include simplicity, structure, sequence, and standardization. To this, must be added another ‘s’, i.e. sympathy—sympathy for the reader who is grappling with the essentials. Dr Nayak's endeavor to have all these qualities in the book is a testimony of his expertise and experience as an effective and exemplary teacher.
I am delighted to write this Foreword to Exam Preparatory Manual for Undergraduates—Pathology, which, I am certain, will be an invaluable resource for students and teachers in pathology.
K Ramnarayan MBBS MD (Path) PG Dip. Higher Education
Vice-Chancellor
Manipal University
fm9Preface to the Second Edition
Pathology is a rapidly-expanding and ever-changing field and lays the foundation for understanding diseases. This book is an endeavor to present the vast knowledge of pathology in a lucid manner for undergraduate medical students and those undergoing training in paramedical courses. The main aim of this book is to provide a sound knowledge of pathology and hence give insight into etiology, pathogenesis, pathology and the disease course. Every attempt has been made to present information in a simplified text augmented with the use of colored illustrations, tables, text boxes and flowcharts. I have the pleasure of presenting the second edition of book which has become popular within a few months of publishing the first edition titled Exam Preparatory Manual for Undergraduates—Pathology. There was sincere request from all students, staffs, my friends and colleagues to include hematology section and nutritional disorders. Hence, hematology and clinical pathology is added as a new and nutritional disorders as Chapter 9. There was a tremendous increase in the understanding of molecular pathology and same is highlighted in all the relevant chapters. Thus, this edition is completely revised, updated, better illustrated and a complete manual for scoring high marks in all pathology examinations. In a few chapters, figures and illustrations have been replaced by better quality photomicrographs or illustrations.
Organization
This book consists of 28 chapters and is organized into three sections namely general pathology, hematology and clinical pathology, and systemic pathology.
—General pathology: It provides an overview of the basic pathologic mechanisms underlying diseases including cellular adaptations, inflammation, wound healing, chronic inflammation, hemodynamic disorders, immunological disorders, neoplasia, genetics and nutritional disorders.
—Hematology and clinical pathology: It consists of disorder of red cells, disorder of white cells and disorders of hemostasis and clinical pathology essential for the undergraduate students. This was an additional section which was not presented in the first edition of the book. With its introduction, this book becomes a complete exam manual for all students. However, students are requested to go through the second edition of the book titled Essentials in Hematology and Clinical Pathology authored by Dr Ramadas Nayak and Dr Sharada Rai for detailed knowledge of hematology and clinical pathology.
—Systemic pathology: It deals with systemic pathology with chapters devoted to diseases of various organ systems including vascular, cardiac, respiratory, gastrointestinal, liver and biliary tract, pancreas, kidney, male and female genital tract, bones, endocrines, skin and central nervous system.
After many years (more than 36 years) of teaching undergraduates, I found that undergraduate students find it difficult to understand, remember and answer the questions during examinations, in a satisfying way. There are many pathology textbooks, but undergraduates face difficulty to refresh their knowledge during examinations. This book fills the niche, to provide basic information to an undergraduate in a nutshell. The text provides all the basic information the student will ever need to know. Keywords are shown in bold words so that student can rapidly go through the book on the previous day or just before the examination. Most students are fundamentally “visually oriented”. As the saying “one picture is worth a thousand words”, it encouraged me to provide many illustrations.
How to use this book
I recommend that this book to be used by all students for understanding the basic knowledge and refresh their knowledge during examinations. The readers are requested to give more emphasis on word in bold letters which represents the key words to be remembered. One of the aims of the students after getting undergraduate degree is to fetch a good ranking in the postgraduate entrance examination. Most graduates cannot answer multiple choice questions (MCQs) in entrance examination by just reading the usual textbooks in pathology. In this book, text boxes have been designed to provide information useful in answering these MCQs. Commonly expected pathology questions during undergraduate examination is also provided at relevant places. This book can serve as a source of rapid review of pathology for even postgraduates in pathology.
Numerous illustrations, gross photographs, photomicrographs, tables, text boxes, flow charts and X-rays have been incorporated for easy understanding of the subject. Appendices provide various important bodies and its associated conditions and important cells in various lesions and pathognomonic structures in diseases. In this edition Appendix 3 is included for the reference values of various common and important laboratory tests.
fm11Preface to the First Edition
Pathology is a rapidly-expanding and ever-changing field and lays the foundation for understanding diseases. This book is an endeavor to present the vast knowledge of pathology in a lucid manner for the second year medical and dental students, and those undergoing training in paramedical courses. My aim is to provide a sound knowledge of pathology and hence give insight into etiology, pathogenesis, pathology and the disease course. Every attempt has been made to present information in a simplified text augmented with the use of colored illustrations.
Organization
This book consists of 23 chapters and is organized into two sections namely general pathology and systemic pathology.
—General pathology: It provides an overview of the basic pathologic mechanisms underlying diseases including cellular adaptations, inflammation, tissue repair, chronic inflammation, hemodynamic disorders, immunological disorders, neoplasia and genetics.
—Systemic pathology: It deals with chapters devoted to diseases and disorders of various organ systems including vascular, cardiac, respiratory, gastrointestinal, liver and biliary tract, pancreas, kidney, male and female genital tract, bones, endocrines, skin and central nervous system. For hematology section, readers are requested to refer to Rapid Review of Hematology authored by Dr Ramadas Nayak and Dr Sharada Rai and Essentials in Hematology and Clinical Pathology by Dr Ramadas Nayak, Dr Sharada Rai and Dr Astha Gupta.
After many years (more than 34 years) of teaching undergraduates, I found that undergraduate students find it difficult to understand, remember and answer the questions during examinations, in a satisfying way. There are many pathology textbooks, but undergraduates face difficulty to refresh their knowledge during examinations. This encouraged me to write a book to fill the niche, to provide basic information to an undergraduate in a nutshell. The text provides all the basic information the student will ever need to know. Keywords are shown in bold words so that student can rapidly go through the book on the previous day or just before the examination. Most students are fundamentally “visually oriented.” As the saying “one picture is worth a thousand words”, it encouraged me to provide many illustrations.
How to use this book
I recommend that this book to be used by all students for understanding the basic knowledge and refresh their knowledge during examinations. The readers are requested to give more emphasis on word in bold letters that represents the key words to be remembered. One of the aims of the students after getting undergraduate degree is to fetch a good ranking in the postgraduate entrance examination. Most graduates cannot answer multiple choice questions (MCQs) in entrance examination by just reading the usual textbooks in pathology. In this book, text boxes have been designed at the sides of main text that provide information useful in answering these MCQs. These boxes also provide commonly expected pathology questions during undergraduate examination. This book can serve as a source of review of general and systemic pathology for even postgraduates in pathology.
About 350 illustrations, 82 gross photographs, 162 photomicrographs, 152 tables, 3 X-rays and a clinical photograph have been incorporated for easy understanding of the subject. Appendices provide various important bodies and its associated conditions, important cells in various lesions and pathognomonic structures in diseases.
fm13Acknowledgments
My sincere thanks to all my family members, especially my wife Smt Rekha Nayak, my daughter Ms Rashmitha Nayak and my son-in-law Mr Ramnath Kini, who have patiently accepted my long preoccupation with this work. A special thanks to my grandson Master Rishab Kini who kept me agile throughout the preparation of this book.
- I wish to express my gratitude to Mr Yenepoya Abdulla Kunhi, Honorable Chancellor, Yenepoya University (Accredited by NAAC with “A” grade), Mangaluru, Karnataka, India, for giving me an opportunity to serve this prestigious institution. I am indebted to Mr Farhaad Yenepoya, Director of Finance, Yenepoya University (Accredited by NAAC with “A” grade), Mangaluru, for the inspiration and encouragement.
- I am grateful to Dr K Ramnarayan, former Vice-Chancellor, Manipal University, Manipal, Karnataka, for writing the foreword for the first edition and support.
- Dr Rakshatha Nayak, Tutor in Pathology, Yenepoya Medical College, a constituent of Yenepoya University (Accredited by NAAC with “A” grade), Mangaluru, for her help in editing, drawing illustrations and flow charts.
- I am thankful to all my friends who contributed fantastic images for this book. My sincere thanks to Dr Sharada Rai (Associate Professor, Department of Pathology, Kasturba Medical College, Manipal University), Dr Krishnaraj Upadhyaya [Professor, Department of Pathology, Yenepoya Medical College, a constituent of Yenopoya University (Accredited by NAAC with “A” grade), Mangaluru], Dr Krishna Prasad HV [Assistant Professor, Department of Pathology, Yenepoya Medical College, a constituent of Yenepoya University (Accredited by NAAC with “A” grade), Mangaluru], Dr Saraswathy Sreeram (Pathologist), Dr Karthik (Bengaluru), and Mr Y Ravidas Nayak (Engineer, Bengaluru).
I would like to express my gratitude to all my friends, colleagues, undergraduate and postgraduate students (Department of Pathology, Yenepoya Medical College, Mangaluru) who helped me in the different stages of preparing the manuscript; to all those who provided support, talked things over, read, offered comments and assisted in the editing, proofreading and design.
- A special thanks to Shri Jitendar P Vij (Group Chairman), Mr Ankit Vij (Group President), Mr Tarun Duneja (Director–Publishing), and Ms Chetna Malhotra Vohra (Associate Director–Content Strategy) of M/s Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, India, for publishing the book in the same format as wanted, well in time. We are grateful to Shri Jitendar P Vij, for unmasking our talent as authors.
- I would like to offer a huge appreciation to the wonderful work done by Ms Sunita Katla (Publishing Manager), Ms Samina Khan (Executive Assistant to Director–Publishing), Mr Rajesh Sharma (Production Coordinator), Ms Seema Dogra (Cover Designer), Ms Geeta Rani Barik (Proofreader), Mr Anil Kumar Kumawat (Graphic Designer) and Mr Raj Kumar (DTP operator) of M/s Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, India.
- I thank Mr Venugopal V (Bengaluru) and Mr Vasudev H (Mangaluru) of M/s Jaypee Brothers Medical Publishers (P) Ltd, Bengaluru Branch, Karnataka, for taking this book to every corner of Karnataka.
- Last but definitely not the least, a thank you to my undergraduate and postgraduate students. Without you, I would not write. You make all my books possible.
There are many more people I could thank, but space, and modesty compel me to stop here.
fm14Images Contribution
- I am extremely grateful to all my friends who willingly provided required images for this book.
- Dr Jagadish Rao PP, MBBS, MD, Diplomate NB, PGDCFS, Dip. Cyber Law, PGCTM, MNAMS, District Medicolegal Consultant (Government Wenlock District Hospital), and Associate Professor, Forensic Medicine and Toxicology, Kasturba Medical College (Affiliated to Manipal University), Mangaluru, Karnataka, India.
- Dr Seethalakshmi NV, Professor, Department of Pathology, Amrita Institute of Medical Sciences, Ponekkara PO, Kochi, Kerala, India.
- Dr N Jayaram, Anand Diagnostic Laboratory, Blue Cross Chambers, Infantry Road Cross, Bengaluru, Karnataka, India.
- Dr Annie Jojo, Professor and Head, Department of Pathology, Amrita Institute of Medical Sciences, Ponekkara PO, Kochi, Kerala, India.
- Dr Raghupathi AR, Former Professor and Head, Department of Pathology, Bangalore Medical College and Research Center, Bengaluru, Karnataka, India.
- Dr Sonali Ullal, Associate Professor, Department of Radiodiagnosis, Kasturba Medical College (Affiliated to Manipal University), Mangaluru, Karnataka, India.
- Dr Veena Shenoy, MD, Chief, Pathology and Laboratory Medical Services, VAMC, Jackson, MS.
- Dr T Reba Philipose, Professor, Department of Pathology, AJ Institute of Medical Science, Mangaluru, Karnataka, India.
- Dr Tanuj Kanchan, Professor, Department of Forensic Medicine and Toxicology, All India Institute of Medical Sciences, Jodhpur.
- Dr Sureh Kumar Shetty, Honorary State Medicolegal Consultant, Government of Karnataka and Professor and Head, Department of Forensic Medicine and Toxicology, Kasturba Medical College (Affiliated to Manipal University), Mangaluru, Karnataka, India.
- Dr Mahesh H Karigoudar, Professor, Department of Pathology, BLDE University, Shri BM Patil Medical College, Bijapur, Karnataka, India.
- Dr Surendra Nayak Kapadi, MD, Department of Histopathology, Ministry of Health, Maternity Hospital, Sabha Area, Kuwait.
- Dr Pamela Sequeira Prabhu, Neuropathologist and Ambulatory Medical Director, TriHealth Laboratories, Cincinnati, OH, USA, Associate Professor at the Wright State School of Medicine, and Grandview Medical Center, Dayton, OH, USA.
- Dr Maria Frances Bukelo, MD, Lecturer of Pathology, St. John's Medical College, Bengaluru, Karnataka, India.
- Dr Janaki M, MD, DGO, DFWCD, Professor and Head, Department of Pathology, Santhiram Medical College, Nandyal, Kurnool, India.
- Dr Krishna Pasad HV, Assistant Professor, Department of Pathology, Yenepoya Medical College, A constituent of Yenepoya University, Deralakatte, Mangaluru, Karnataka, India.
- Dr Krishnaraj Upadhyaya, Professor, Department of Pathology, Yenepoya Medical College, A constituent of Yenepoya University, Deralakatte, Mangaluru, Karnataka, India.
- Dr RGW Pinto (Professor and Head), Dr Premila de Sousa Rocha (Associate Professor) and Dr Shruti U Shetye (Post graduate student) Department of Pathology, Goa Medical College, Bambolim, Goa, India.