pathology for dental students

Somehow, I got today and tomorrow turned around, and I thought that our review session for exam 4 was tomorrow, when it was actually scheduled for today! I apologize for the confusion. Rather than having the review session tomorrow, when some of you may have other commitments, I am going to post the PowerPoint that I would have used tomorrow, along with some comments I would have made in class (these will be in the "notes" pages, in the bottom pane in the normal view in PowerPoint). Please email me if you have any questions.

I wish we would have had more time to finish our lecture on Wednesday; we had to rush through diabetes and the MEN syndromes, and I didn't feel I was able to cover them adequately. I have two handouts, one on diabetes and one on the MEN syndromes, that will hopefully make things clear. Feel free to use them if they help - but remember I will test only on information in the lecture PowerPoint, so don't go memorizing a whole bunch of other stuff. I would highly suggest you go through the boards review questions below, even if you are not concerned about boards at this point, because the answers contain some nice explanations (if I do say so myself) of the differences between the MEN syndromes and Addison's disease and some other stuff too. Feel free to email me with any questions you have about this material, or anything else.

Some of you have mentioned feeling overwhelmed by the amount of information covered in yesterday's CNS lectures. I put together a summary of the lectures that may help you organize the material. I haven't seen Dr. Santa Cruz's test questions yet, but I did hear her comment in the beginning about learning basic concepts, so I think if you try to understand the material to the level of detail present in the summary, that should serve you well for the test. Dr. Santa Cruz also has a handout (posted on our Lectures page) that has more detail, if you need explanations. Please email me and let me know if there are additional concepts or terms that I didn't cover in the summary (or didn't cover fully). I hope this helps.

More board review questions, this time on nervous system stuff.

Questions adapted from Dental Decks and Dental Stax. Intended for educational purposes only. No form of these questions may be sold or otherwise duplicated under penalty of law. There, that should do it.

1. A common cause of subdural hematoma is:

A. Viral infection

B. Bacterial infection

C. Traumatic injury

D. Primary brain neoplasm

2. The cause of multiple sclerosis is:

A. Viral

B. Bacterial

C. Fungal

D. Unknown

3. The most common cause of encephalitis is:

A. Viral infection

B. Bacterial infection

C. Fungal infection

D. Traumatic injury

4. Which lipid storage disease results from lack of sphingomyelinase and can lead to severe neurologic impairment in children?

A. Gaucher's disease

B. Fabry's disease

C. Tay-Sachs disease

D. Niemann-Pick disease

Check out the answers and explanations.

I hope everyone had a wonderful Thanksgiving! I had Thanksgiving dinner with my relatives, one of whom has Marfan Syndrome. You may recall that patients with MEN 2B may exhibit a Marfanoid habitus (check out which famous person may have had this syndrome - scroll down the page). My uncle let me take some photos of his hands - take a look so you know what you might see in a patient with true Marfan Syndrome someday.

This week we have two quizzes: quiz 7 (on endocrine, nervous system, and developmental) and quiz 8 (on musculoskeletal). Instead of taking the two of them on successive days, we'll be taking both of them on Wednesday, 12/3. That should be a more streamlined way to do it (plus you get one more day to study). The change is posted on our lecture schedule.

I can't believe it's December already. I archive our entries every month (check out the September, October and November archives) so this page doesn't get too long. But there are some entries from the last few days of November that I wanted to make sure you all saw, in case you hadn't logged in since before Thanksgiving - I've included them below. Also, if you didn't get a chance to see 1) boards review part 7 (endocrine), 2) your scores for the course so far, 3) the video of the world's tallest man, 4) the study on oxytocin and stress, or 5) the story of the little girl with hypothyroidism due to iodine deficiency, take a look back at the November archive.

Part 9 of our little board review series (adapted from Dental Decks and Dental Stax), this time on developmental pathology. This is a very short one: only one question in both decks! Not that the other stuff is off-limits - you still should know Marfan and Down Syndromes (and probably Klinefelter and Turner Syndromes) for the boards.

1. Which syndrome is also called Trisomy 18?

A. Down syndrome

B. DiGeorge syndrome

C. Patau syndrome

D. Edward syndrome

E. Prader-Willi syndrome

The answer and explanation are here.

One of the questions on quiz 8 has three correct answers! Here it is:

4. Which one of the following radiographic features is associated with Paget’s disease?

A. Unilocular radiolucencies

B. Ground glass

C. Cotton wool *

D. Hypercementosis

E. Osteopenia

The correct answer was C (cotton wool); but then (before I passed out the quiz) I noticed that D (hypercementosis) was also listed as a feature of Paget's on slide 44 of Dr. Koutlas' presentation. So when we scored your quizzes, we counted both C and D as correct. Then it turned out that in a radiology lecture this week, you learned that Paget's can also show a ground glass pattern on x-ray. So - three correct answers: B, C, and D. We're rerunning the quiz and I will post the new results as soon as they're back.

I put together a summary of today's lectures that I thought might be helpful as you're studying for tomorrow's quiz (if you're taking it) and for the exam. This summary is about as detailed as you should get when studying. Also, remember: no photos. If a particular morphologic feature was stressed in class, there may be a question on it - but there will be no pictures. Let me know if you have questions.

There was a question on quiz 8 that turned out to have more than one correct answer. Here is the question:

Which one of the following radiographic features is associated with Paget's disease?

A. Unilocular radiolucencies

B. Ground glass

C. Cotton wool

D. Hypercementosis

E. Osteopenia

The correct answer was supposed to be C (cotton wool), and that answer is still correct. However, we're also accepting D (hypercementosis), because on slide 44 of Dr. Koutlas' presentation, he lists both a cotton wool appearance and hypercementosis as features of Paget's. And, since you recently had a radiology lecture in which Paget's disease was said to have a ground glass appearance, I checked with Dr. Koutlas and he agrees that B (ground glass) is also true. We are rerunning the quizzes with the addition of B as a correct answer (the initial quiz scores were tallied using both C and D as correct answers), and I'll post the updated results here as soon as they come back.

I've had some comments on the total points possible for exam 2. Originally, the exam was worth 50 points. There were three questions for which I gave the class credit (see my 10.30 post for an explanation of each question). I raised the total points for the exam as well - from 50 to 53. In Duluth, in my other life at the medical school, when points are credited to the whole class, the total exam points are increased correspondingly in order to keep the top possible score 100% (to avoid the situation in which a student could get 53 out of 50 points, for example). So I followed the same procedure for us.

However, I can see the logic in keeping the total points at 50. It would help your grade more if we kept the total points at 50 rather than raising it to 53, which would kind of negate the effect of the three additional points everyone got.

So - I am going to drop the total number of points for exam 2 back down to 50. That brings the total number of points for the course to 314. The cutoffs for A, B, and C now are 289, 267, and 235, respectively.

Thank you, everyone, for making this class so enjoyable (for me!). It's been a pleasure and an honor to be in class with you and to get to know you. If there's anything I can do to help you as you get ready for boards - or if you just have a burning pathology question - my email's always open. I wish you all the best in your remaining time here, and in your careers beyond.

The results for quiz 9 are posted. There was one question that was problematic. It was a question about basal cell carcinoma, and the point of the question was to get you to recall the fact that basal cell carcinoma virtually never metastasizes. Well, the correct answer read, "Never" - which is not technically true. It should have read "Virtually never." So everyone got one extra point added to their quiz score.

Here is the PowerPoint review for exam 4. I changed some parts of it a bit so it's more interactive - more questions rather than just data. Remember to look at the notes pages (below the slide pane) for the answers and other stuff. Let me know if you have questions.

The final grades are all done and posted. Everyone passed! You all did a great job. Please note that if you would like to review your exam, you'll need to do that by Monday the 22nd, because we'll be off for the Holidays starting on Tuesday.

The grades for exam 4 are also posted. There was one question that most people got wrong:

You are seeing a patient with DiGeorge syndrome. Which of the following is this patient at risk for?

A. Obesity

B. Infections

C. Diabetes

D. Pancreatic insufficiency

E. Infertility

The correct answer is B, infections. I think it's important for you to know that patients with DiGeorge syndrome are usually immunodeficient (in addition to all their other abnormalities, they usually have a very hypoplastic - or absent - thymus). We talked about this way back in immunology, and I mentioned it in the exam 4 review (slide 62), but it isn't addressed in Dr. Dolan's lecture. Since I've said that the exam reviews are optional, it perhaps wasn't fair to test on a concept that was only in the exam review and not in the main lecture notes. So I've added a point to everyone's score for this question. Your exam 4 score and final grade reflect this addition.