Is Robbins Pathology Good
Helen Drewski
A good Qbank (like USMLE World) works, but I think the very best way to review pathology is the Robbins and Cotran Review of Pathology, the question-book-companion of the big Robbins that many/most schools use. Benefits of this book:
The point is this: there is so much material on Shelf and Step exams that literally anything you learn could be useful. Time and brain space are the limiting factors, so what you need is an efficient study aid. For the NBME Pathology Shelf, I had four days off to study. The Robbins question book is roughly 400 pages. I was able to do 100 pages a day and then follow it up with a few tables in the First Aid (important cytokines, for example), and that was 100% sufficient for Shelf purposes.
Pathology is probably one of the most daunting subjects to prepare for. It is also, the one subject whose knowledge you must retain even for clinical exams. A good foundation in basic medical pathology will serve you well during your career as well as help you ace exams in school. We review here, some of the most recommended, and popular pathology books and resources for medical students as well as allied health professionals.
Pathoma by Dr. Sattar is widely considered as the must have book to prepare for USMLE step 1 pathology. It has almost everything you need to know, and when used along with his video lecture course, it provides an excellent basis for board preparation. Most student rely on pathoma plus anki decks and find that it is enough to score well on board exams.
The following books are must haves for you initial foray into pathology. They provide the necessary foundation for the beginner. We recommend these smaller tomes rather than the larger textbook versions by the same authors. Pathology is already a daunting subject and starting with a 1,000 to 2,000 page book can be a bit much for most. These books can easily be finished along with lectures and are often the textbooks required by most medical schools.
Robbins basic pathology is easy to read and provides excellent explanations that we have found easy to remember years later. When later paired with a quick review book like pathoma the explantions given by Dr. Sattar and the facts repeated in popular anki decks become easy to grasp and retain.
Award Eligibility: Eligible candidates for the ASIP Robbins Distinguished Educator Award must be an active ASIP member in continuous good standing for at least five years immediately prior to nomination. The typical nominee for the Robbins Distinguished Educator Award will have accumulated substantial accomplishments in pathology education and will be mid-career or senior investigators (Associate Professor or full Professor or equivalent). In some cases, nominees may be inactive (retired or partially retired). Nominees should have sustained and significant contributions to the Society (through leadership and/or participation in Society activities/programs).
Here are gathered the various references to illustrative examples of pathology that may be found scattered in context elsewhere in this study guide. Within each system, organs are listed from proximal to distal.
[Tongue.] Clinically, the oral cavity provides an easy opportunity for revealing examination of a mucosal surface. For an extreme example (candidiasis), see WebPath (gross image) and WebPath (micrograph).
[Salivary glands.] Autoimmune involvement of salivary glands in Sjogren's syndrome is associated with inflammation, atrophy, and fibrosis. See WebPath or Milikowski & Berman's Color Atlas of Basic Histopathology, p. 220.
[Esophagus.] Epithelial continuity is critical for normal function. A breach in the epithelium creates an ulcer. For an image of an esophageal ulcer, see WebPath or Milikowski & Berman's Color Atlas of Basic Histopathology, pp. 162-163.
[Esophagus.] Esophageal epithelium may be transformed to a simple columnar form in the condition called Barrett's esophagus. The epithelium is variously described as resembling that of gastric mucosa (i.e., with tubular glands) or of intestinal mucosa (i.e., with goblet cells). The cause of this condition remains uncertain, but it may represent a metaplastic response to chronic inflammation (caused, e.g., by gastric reflux). Barrett's esophagus can be associated with esophageal obstruction from scarring and/or carcinoma. (For images, go to WebPath and/or see Milikowski & Berman's Color Atlas of Basic Histopathology, pp. 234-236.)
[Esophagus.] In the esophagus, the submucosal vascular plexus includes especially large venous spaces. These may enlarge into esophageal varices, especially in cases of portal hypertension (an increase in pressure in the portal vein, due to cirrhosis). Such varices carry a substantial risk of rupture with fatal bleeding into the esophageal lumen. (For more, go to WebPath or see Robbins Pathologic Basis of Disease.)
[Liver.] Failure of adequate venous drainage from the liver leads to chronic passive congestion, with blood backing up in centrilobular areas. This gives rise to a gross appearance picturesquely labelled "nutmeg liver". For images of congested liver, see WebPath (gross) and WebPath (microscopic), or Milikowski & Berman's Color Atlas of Basic Histopathology, pp. 302.
[Liver.] In human liver, the appearance of connective tissue extending out from portal areas is pathological, the defining characteristic of cirrhosis. For images of cirrhosis, see WebPath or Milikowski & Berman's Color Atlas of Basic Histopathology, pp. 284ff.
[Gall bladder.] Inflammation of the gall bladder is a fairly common problem. For an image of cholecystitis, see WebPath or Milikowski & Berman's Color Atlas of Basic Histopathology, p. 308.
[Pancreas.] In pancreatitis, the appearance of the pancreas may be altered by inflammatory infiltrate in the stroma. In acute pancreatitis, release of pancreatic enzymes can cause proteolytic digestion and associated haemorhagic necrosis. Chronic pancreatitis can lead to atrophy and fibrosis of the parenchyma. For print images, see Milikowski & Berman's Color Atlas of Basic Histopathology, pp. 304-306.
[Small intestine.] The structure of the intestinal mucosa may be altered by pathological processes. Examples include ischemic enteritis or necrotizing enterocolitis, both characterized by necrosis of the mucosa (see WebPath and WebPath), and malabsorption enteropathy (celiac sprue), characterized by blunting or loss of villi with concommitant loss of absorptive surface area, increased crypt length, and inflammatory infiltrate in lamina propria (see WebPath or Milikowski & Berman's Color Atlas of Basic Histopathology, p. 256, or Robbins Pathologic Basis of Disease.)
[Small intestine.] The brush border of the intestinal epithelium not only facilitates absorption, it also provides a site of attachment for pathogens. For an example (cryptosporidia), see WebPath.
[Stem cells.] The importance of stem cells in the intestinal crypts is illustrated by recovery from cholera. The cholera toxin kills the intestinal epithelium, leading to loss of bodily fluid across the mucosa, copious diarrhea, massive dehydration, and death within a few days. However, if patients can be kept hydrated for those few days, epithelial replacement by stem cell division will restore normal function.
[Testis.] Infertility due to atrophy of the testicular tubules can result from a number of causes, ranging from undescended testes (cryptorchidism) to inflammation (orchitis) to malnutrition or hormonal imbalance. For images, see WebPath and WebPath or see Milikowski & Berman's Color Atlas of Basic Histopathology, pp. 426-427.
[Pituitary.] Pituitary adenomas may be "benign" (i.e., not malignant) but can nevertheless cause significant problems either from excess hormone production or from mass effect (e.g., crowding the optic chiasm). For illustration, see WebPath.
[Pancreatic islets.] Diabetes may result from immunological destruction of islet cells. For images, see WebPath (diabetes I) and WebPath (diabetes II), or Milikowski & Berman's Color Atlas of Basic Histopathology, p. 469.
Histology for Pathologists (1998), Sternberg.
An exceptionally detailed (and exceptionally thick) textbook of histology, with emphasis on normal structure. Although this is a reference for specialists (as the title suggests), this text is a good source for answers to details which may not be found in any of the standard introductory textbooks.
Once completed the Course, the Student will have a thorough knowledge and understanding of the etio-pathogenetic factors underlying the basic structural and functional alterations in humans, and the relative response mechanisms, at the different levels of integration (molecules, cells, tissues, organisms).
Students are also expected to be able to apply this knowledge, integrated with information from previous Courses, to the comprehension of the pathophysiology of common human pathologies.
The Course will provide scientific bases to the practice of medicine, defined as the capability to identify clinical conditions affecting human beings and to promote preventive or therapeutic to implement individual and community health. The Course will concern:
- Cell Pathology
- Molecular Pathology
- Tissue responses to cell injury: inflammation, hemostasis, repair
- General pathophysiology
Interactive oral lectures, based on the explanation of the main conceptual frame of each subject, supported by graphical presentations which will be available to the students on the Elly platform. This material will be useful to support the individual learning process but, by no means, should be considered sufficient for the preparation of the exam. Examples taken from the medical practice will be provided together with bibliographic references so as to stimulate students to raise questions, to go in depth in subjects of interest or to provide answers to simple problems presented by the teacher. The course will be integrated with optional laboratory practice.