Goljan RR path Errors.

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Teejay

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I just wanted to start this thread for those of us who are using Goljan RR for step one study.
On page 443, it says that prolactin enhances testosterone synthesis and spermatogenesis.
I thought this was the opposit since Prolactin inhibits GnRH which inturn decreases LH and FSH. BRS phys 3rd edition 262 also says Prolactin inhibits spermatogenesis.
Anyone has an answer for this discrepancy?

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p. 412
Nephrotic disease table:

I'm pretty sure Type I MPGN should present with subendothelial ICs and not subepithelial. Subendothelial corroborates with First Aid and Robbins qbook. Please correct me if I'm wrong.
 
p. 412
Nephrotic disease table:

I'm pretty sure Type I MPGN should present with subendothelial ICs and not subepithelial. Subendothelial corroborates with First Aid and Robbins qbook. Please correct me if I'm wrong.


hahaha, thanks for pointing these things out guys! I just think it's funny when we change stuff like this in our books, like we would have had every word memorized anyways:) . Don't get me wrong, I went straight to my book and wrote it in.
 
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p. 412
Nephrotic disease table:

I'm pretty sure Type I MPGN should present with subendothelial ICs and not subepithelial. Subendothelial corroborates with First Aid and Robbins qbook. Please correct me if I'm wrong.

Yes, it's subendothelial --- that's how the "tram tracks" form.
 
p.154
Abetalipoproteinemia is autosomal recessive, not dominant.
Triglycerides - not chylomicrons - accumulate in villi (the disease is a defect of chylomicron assembly). - Robbins

p. 358
Hyperplastic polyp is classified as a non-neoplastic polyp only (not hamartomatous) - Robbins
Juvenile polyps, retention polyps, and Peutz-Jeghers polyps are non-neoplastic, hamartomatous polyps. Also, juvenile polyps are called retention polyps if they occur in an adult. - Robbins
Peutz-Jeghers polyps are located predominantly in the small intestine (64 to 96%), stomach (24 to 49%), and colon (60%), so I guess the blue note about it being the only syndrome without colonic polyps is wrong - Cecil's, Robbins
 
p551-552: Goljan has several errors regarding the differences between pemphigus vulgaris and bullous pemphigoid. Here are the facts from the derm text on MDConsult:

PV = large, flaccid blisters; oral lesions are common (most common presenting complaint); POSITIVE Nikolsky sign (i.e., pressing on blisters bursts them)

BP = small, tense blisters; oral lesions are rare; NEGATIVE Nikolsky sign

The Nikolsky-sign confusion got me no less than 2 questions wrong on QBank.
 
In page 505-Primary hyperparathyroidism, he says that hypercalcemia causes diastolic hypertension which is basically from volume expansion. However, i've read that hypercalcemia actually causes volume contraction by causing nephrogenic diabetes insipidus through loss of medullary gradient required for urine concentration in the distal tubule. Hence patients who have hypercalcemia from ailments like humoral hypercacemia of malignancy are treated with volume repletion.
So this sounds like a contradiction in terms of concepts. Any explanation of this concept discrepancy would be appreciated.
 
p. 138 Tumor growth rate stated to be "Equivalent to 10^-9 cells", should be "10^9 cells".


p. 142 States Knudson's "two-hit" model for retinoblastoma as "one-hit" theory.


p. 145 Refers to "Table 8-1" for DNA repair genes, when they are actually listed in Table 8-4 on p. 145.
 
In page 505-Primary hyperparathyroidism, he says that hypercalcemia causes diastolic hypertension which is basically from volume expansion. However, i've read that hypercalcemia actually causes volume contraction by causing nephrogenic diabetes insipidus through loss of medullary gradient required for urine concentration in the distal tubule. Hence patients who have hypercalcemia from ailments like humoral hypercacemia of malignancy are treated with volume repletion.
So this sounds like a contradiction in terms of concepts. Any explanation of this concept discrepancy would be appreciated.

I don't think it says anything about volume expansion as being the cause, and I think it's more related to the serum concentration itself (perhaps increasing the contraction of the vascular smooth muscle, although I'm not certain so correct me if I'm wrong). It just says "diastolic HTN due to hypercalcemia". Where are you getting the volume expansion aspect from? Are you saying because of renal failure?
 
Page 395: "Creatinine is filtered in the kidneys and is not reabsorbed or secreted"

Creatinine IS secreted by the kidneys, which is why creatinine clearance tends to overestimate GFR by ~ 10%.
 
Geez, found another on the next page (396): in the blue chart it says that minimal change disease is an example of nephritic syndrome. Minimal change disease is usually associated with nephrOtic syndrome (see page 412).
 
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Hey folks. We actually have Goljan as our pathology teacher, and these are his corrections to date:

PAGE 106 MARGIN NOTE INCORRECT
Triple marker for Down syndrome: decrease arrow AFP, * increase arrow hCG, decrease arrow urine estriol
Get rid of the word unconjugated and replace with estriol.

Page 412, Table 19-8 under Type I MPGN, change subepithelial deposit to subendothelial

Corrected version should read:
Figure 25-17 page 585: Coronal section (B) shows atrophy of the caudate, putamen, and globus pallidus when compared with a normal coronal section (A).

Page 182 under (7) Tet spell
(a) Sudden increase in hypoxemia and cyanosis

Table 19-7
Change IgA glomerulonephritis to IgA glomerulopathy

TABLE 19-1 Types of Proteinuria
Type Definition Causes
Glomerular Nephritic syndrome: protein > 150 mg/24 hours Damage of GBM: nonselective proteinuria
but < 3.5 g/24 hours with loss of albumin and globulins; example is post- streptococcal glomerulonephritis

Nephrotic syndrome: protein > 3.5 g/24 hours Damage of GBM: Loss of negative charge of GBM: GBM: selective proteinuria with loss of albumin and not
globulins; example is minimal change disease

I have sent him a link to this site, and hopefully we will get some resolution, as he is really good about getting back with students about errata.

Any chance we can sticky this and first aid corrections for ease of access?
 
pg 352. Hesselbach's Triangle should read: "Medial border of triangle is rectus abdominis, lateral border is inferior epigastric artery, inferior border is inguinal ligament."
 
Hey folks. We actually have Goljan as our pathology teacher, and these are his corrections to date:

PAGE 106 MARGIN NOTE INCORRECT
Triple marker for Down syndrome: decrease arrow AFP, * increase arrow hCG, decrease arrow urine estriol
Get rid of the word unconjugated and replace with estriol.

Page 412, Table 19-8 under Type I MPGN, change subepithelial deposit to subendothelial

Corrected version should read:
Figure 25-17 page 585: Coronal section (B) shows atrophy of the caudate, putamen, and globus pallidus when compared with a normal coronal section (A).

Page 182 under (7) Tet spell
(a) Sudden increase in hypoxemia and cyanosis

Table 19-7
Change IgA glomerulonephritis to IgA glomerulopathy

TABLE 19-1 Types of Proteinuria
Type Definition Causes
Glomerular Nephritic syndrome: protein > 150 mg/24 hours Damage of GBM: nonselective proteinuria
but < 3.5 g/24 hours with loss of albumin and globulins; example is post- streptococcal glomerulonephritis

Nephrotic syndrome: protein > 3.5 g/24 hours Damage of GBM: Loss of negative charge of GBM: GBM: selective proteinuria with loss of albumin and not
globulins; example is minimal change disease

I have sent him a link to this site, and hopefully we will get some resolution, as he is really good about getting back with students about errata.

Any chance we can sticky this and first aid corrections for ease of access?
thanks a lot for getting the corrections straight from the man....much appreciated
 
Wow, only a couple of his listed errors appears on this thread. Phassett, was this list of yours from Dr. Goljan a partial listing? Because it seems like we are catching way more than this. Glad you brought it to his attention, though.

Hey folks. We actually have Goljan as our pathology teacher, and these are his corrections to date:

PAGE 106 MARGIN NOTE INCORRECT
Triple marker for Down syndrome: decrease arrow AFP, * increase arrow hCG, decrease arrow urine estriol
Get rid of the word unconjugated and replace with estriol.

Page 412, Table 19-8 under Type I MPGN, change subepithelial deposit to subendothelial
Corrected version should read:
Figure 25-17 page 585: Coronal section (B) shows atrophy of the caudate, putamen, and globus pallidus when compared with a normal coronal section (A).

Page 182 under (7) Tet spell
(a) Sudden increase in hypoxemia and cyanosis

Table 19-7
Change IgA glomerulonephritis to IgA glomerulopathy

TABLE 19-1 Types of Proteinuria
Type Definition Causes
Glomerular Nephritic syndrome: protein > 150 mg/24 hours Damage of GBM: nonselective proteinuria
but < 3.5 g/24 hours with loss of albumin and globulins; example is post- streptococcal glomerulonephritis

Nephrotic syndrome: protein > 3.5 g/24 hours Damage of GBM: Loss of negative charge of GBM: GBM: selective proteinuria with loss of albumin and not
globulins; example is minimal change disease

I have sent him a link to this site, and hopefully we will get some resolution, as he is really good about getting back with students about errata.

Any chance we can sticky this and first aid corrections for ease of access?
 
hey are these errors only in his book (RR '07) , and not the other notes?
 
p. 145 Refers to "Table 8-1" for DNA repair genes, when they are actually listed in Table 8-4 on p. 145.



actually, in Table 8-1, the DNA repair genes are listed under "Autosomal recessive syndromes with defects in DNA repair" I think that is what he was referring to.
 
The deal with the list I posted is this: we basically use this as our text, and given that we have only been using it since January, the list reflects errata that have been addressed as we are covering the material. The source of the items I have posted are directly from Dr. Goljan.

I forwarded him a link regarding this thread, and requested he review and address items on it as he sees fit. After cross-referencing most of the items that have been put up, I tend to agree with many of the recommended changes.
 
hey are these errors only in his book (RR '07) , and not the other notes?

The list I posted refers to errata in RR Pathology 2nd Edition. As far as "the notes", I am not sure what you are referring to. If you are in his class, you can always cross-reference last semester's notes with the RR text fairly easily - frankly, I have not had the time or inclination to do so yet, but probably will as I start reviewing them.
 
actually, in Table 8-1, the DNA repair genes are listed under "Autosomal recessive syndromes with defects in DNA repair" I think that is what he was referring to.

Hi Lekky, table 8-1 shows "Autosomal recessive syndromes with defects in DNA repair", and describes the syndromes without being explicit about the genes involved. The repair genes are in fact included in the descriptions of the "Autosomal dominant cancer syndromes", but the fact that they are involved in DNA repair is not mentioned. Again, this fact is listed in table 8-4. So, while it may not be an actual error, it just seems a little confusing the way it is.
 
The deal with the list I posted is this: we basically use this as our text, and given that we have only been using it since January, the list reflects errata that have been addressed as we are covering the material. The source of the items I have posted are directly from Dr. Goljan.

Makes sense, thank you phassett.
 
p. 583 about alzheimers...small error...but still an error...

the book says that alpha and beta secretases cleave APP into non-harmful fragments (ie not b-amyloid) and that only Gamma-secretase cleaves it into AB.

actually gamma and beta secretases cleave it into AB, whereas only alpha-secretase cleaves it into the non-harmful fragments
 
umm...that's a big NO! has nothing to do with dense deposit or immune complex deposits...has to do with the interposition of mesangial cell processes in the basement membrane. :)

agreed.
 
On page 328 it says that the main causes of exudative tonsilitis are due to viral causes. I was under the impression that bacterial are more likely to have exudate- at least that is true for Strep pyogenes. Is this an error or am I just missing something? Thanks
 
On page 328 it says that the main causes of exudative tonsilitis are due to viral causes. I was under the impression that bacterial are more likely to have exudate- at least that is true for Strep pyogenes. Is this an error or am I just missing something? Thanks

you're missing something.

adenovirus and EBV are very common causes of exudative tonsillitis...more common than bacterial causes.
 
Page 395: "Creatinine is filtered in the kidneys and is not reabsorbed or secreted"

Creatinine IS secreted by the kidneys, which is why creatinine clearance tends to overestimate GFR by ~ 10%.


I don't foresee this simplification being addressed. For all practical and clinical purposes it doesn't matter, especially to a 2nd year student when this detail is unlikely to be on boards. And when serum creatinine is actually overestimated by standard serum assays and negates much of the 10% (until you start getting into serum creatinine levels above ~2.0)

This is all clinically speaking of course.
 
I just wanted to start this thread for those of us who are using Goljan RR for step one study.
On page 443, it says that prolactin enhances testosterone synthesis and spermatogenesis.
I thought this was the opposit since Prolactin inhibits GnRH which inturn decreases LH and FSH. BRS phys 3rd edition 262 also says Prolactin inhibits spermatogenesis.
Anyone has an answer for this discrepancy?

It seems like prolactin is at least required for spermatogenesis: http://www.ncbi.nlm.nih.gov/entrez/..._uids=16411067&query_hl=8&itool=pubmed_docsum

This paper says that high levels of prolactin alters spermatogenesis and can cause oligospermia:
http://www.ncbi.nlm.nih.gov/entrez/...t_uids=9691632&query_hl=8&itool=pubmed_docsum

So I think it's a case where the right amount of prolactin enhances spermatogenesis whereas too much will inhibit it, just as you guessed. Has anyone found anything more substantial to confirm this?
 
P. 110 says that with Alcoholism there is a decrease in NADH but it should be "Increased". Alcohol metabolism produces NADH and the three things listed afterward all enhanced and utilize NADH.
 
page 335, very bottom:

It says that achalasia from Chagas' disease is caused by destruction of ganglion cells by leishmanial forms. But Chagas' disease is caused by Trypanosoma cruzi, not Leishmania.

I'm no parasite classification expert, so someone please correct me if I'm wrong.
 
page 335, very bottom:

It says that achalasia from Chagas' disease is caused by destruction of ganglion cells by leishmanial forms. But Chagas' disease is caused by Trypanosoma cruzi, not Leishmania.

I'm no parasite classification expert, so someone please correct me if I'm wrong.

You're correct :thumbup: :thumbup: . I cross-checked with Micro Made R Simple and Robbins.
 
Pg 544, Under Leprosy.
It says that the tuberculiod type leads to autoamputation. I was under the impression that the lepromatous type causes the autoamputation. I checked Micro Made R Simple and the only place it mentions resorption of fingers and toes was on the lepromatous type.
I may be wrong but somebody could still look it up just to be on the safe side.:confused:
 
Pg 544, Under Leprosy.
It says that the tuberculiod type leads to autoamputation. I was under the impression that the lepromatous type causes the autoamputation. I checked Micro Made R Simple and the only place it mentions resorption of fingers and toes was on the lepromatous type.
I may be wrong but somebody could still look it up just to be a the safe side.:confused:

Robbins (6th ed, p387) describes autoamputation in association with the tuberculoid type.
 
Trypanosoma cruzi occurs in blood as a trypomastigote and in reticuloendothelial and other tissue cells typically as a leishmanial form, the amastigote. The amastigote form lacks flagella but retains the kinetoplast, which permits its differentiation from other intracellular organisms such as Toxoplasma and Histoplasma.

From http://www.histopathology-india.net/Chaga.htm
 
Trypanosoma cruzi occurs in blood as a trypomastigote and in reticuloendothelial and other tissue cells typically as a leishmanial form, the amastigote. The amastigote form lacks flagella but retains the kinetoplast, which permits its differentiation from other intracellular organisms such as Toxoplasma and Histoplasma.

From http://www.histopathology-india.net/Chaga.htm

Ok, I stand corrected. He says it again on pg. 351, under Hirschsprung's dz, "...destruction of ganglion cells by leishmania." Capital Leishmania is the genus, lower-case leishmania is the amastigote.
 
Minor point: p. 203
Lab findings for iron deficiency anemia:
(3) Microcytic and normocytic cells with decreased central area of pallor.

On the next page the picture shows an increased central area of pallor and with less Hb in the cell per unit volume I'd say he probably meant to say "increased".
 
I have been instructed by Dr. Goljan to post the following errata on this site. This is directly from him with no interpretation from me, and addresses many of the aforementioned items you have brought to his attention:

If you want me to catalogue and bring more to him for review, you can always PM me. I will try to bring up new stuff I see.


ERRATAS AND CLARIFICATION


Page 106
Margin note
Triple marker for Down syndrome: decreased AFP, increased hCG, decreased urine estriol

Page 129
Table 7-3
Thiamine (vitamin B1)
Korsakoff’s psychosis: antegrade and retrograde

Page 138
D. Growth rate
3. Thirty doubling…
• Equivalent to 109 (superscript)…..

Page 142
Table 8-1
Autosomal dominant cancer syndromes
(two-hit theory)

Page 145
5. DNA repair genes (see Table 8-1 and Table 8-4)

Page 154
4. Apolipoprotein B deficiency (abetalipoproteinemia)
a. Autosomal recessive

Page 182
Tetralogy of Fallot
(7) Tet spells
(a) Sudden increase in hypoxemia and cyanosis

Page 352
Table 17-7
Under Hernia
Direct
Medial border of triangle is rectus abdominis muscle, lateral border is inferior epigastric artery, inferior border is inguinal ligament

Page 358
c. Peutz-Jeghers polyposis
(1) Autosomal dominant
(2) Polyps predominate in the small bowel; less common in stomach and colon
MN: Peutz-Jeghers polyposis: predominance of small intestine polyps
In Anderson’s textbook of Pathology and Sabiston’s Surgery, Peutz-Jeghers polyps are listed as hamartomas, because they are a non-neoplastic overgrowth of normal tissue. In all the major texts, the small intestine is listed as the most common site for the polyps. They are less common in stomach and colon. Key point is that it is the only hereditary polyposis syndrome with polyps more common in the small intestine than the colon.

Juvenile polyps are listed as hamartomatous polyps in Anderson’s Pathology and Morson Gastrointestinal Pathology. They are sometimes called retention polyps.

Hyperplastic polyps are non-neoplastic polyps that some purists consider hamartomas and others a type of metaplasia, with mucosa resembling small bowel. The key point is that they are non-neoplastic and do not transform into cancer.

Page 396
Table 19-1
Glomerular
Nephritic syndrome: protein > 150 mg/ Damage of GBM: non-selective proteinuria with loss of albumin and
24 hours but < 3.5 g/24 hours globulins; example is post-streptococcal glomerulonephritis

Nephrotic syndrome: protein > 3.5 g/ Loss of negative charge on GBM: selective proteinuria with loss of
24 hours albumin and not globulins; example is minimal change disease

I moved the causes of glomerular proteinuria to line-up with nephritic and nephrotic.
The original table was not intended to match up the cause of glomerular proteinuria with an example of a nephritic syndrome and nephrotic syndrome. Because this has caused confusion, I changed diffuse membranous glomerulopathy, the most common cause of nephrotic syndrome in adults, to post-streptococcal glomerulonephritis and lined this up with nephritic syndrome and minimal change disease, the most common cause of nephrotic syndrome in children, with nephrotic syndrome. In the original table, it looked like I was implying that minimal change disease was an example of glomerular injury in the nephritic syndrome, which is of course, incorrect.

Page 395
B. Serum creatinine
2. Creatinine is filtered in the kidneys and not reabsorbed or secreted
This sentence is a generality and is true at the normal concentration of creatinine. It was not part of a discussion of renal failure or of variations of creatinine in emaciated individuals versus muscular people or the effect of drugs on the measurement of serum creatinine. It is true that at high serum levels of creatinine, some is secreted into the urine, so it overestimates the creatinine clearance in renal failure; however, many other tests help corroborate the severity of the renal failure like serum calcium, phosphorus, BUN, and electrolytes showing hyperkalemia and metabolic acidosis. However, irrespective of this, the creatinine clearance is a more practical and cost effective test even though it is not a perfect clearance substance like inulin.

Page 409
Table 19-7
Change IgA glomerulonephritis to IgA glomerulopathy

Page 412
Table 19-8
Type I MPGN
Subendothelial ICs

Page 443
3. Prolactin
a. Prolactin enhances testosterone function and spermatogenesis.
A number of articles discuss the important role that prolactin normally has in promoting the function of the testis and accessory structures. Prolactin receptors are present in the Leydig cells, differentiating germ cells in the seminiferous tubules, and all of the accessory structures. Specifically, in the Leydig cells, prolactin is important in inducing and maintaining LH receptors; which enhances testosterone function. It also directly has an effect on enhancing spermatogenesis. When prolactin is increased, it shuts off GnRH; which, in turn, decreases testosterone production (LH effect) and spermatogenesis (FSH) effect.

Page 504 Table 22-3
Pseudohypoparathyroidism: autosomal dominant

Page 505 Clarification
Hypertension in hypercalcemia:
Hypertension is seen with increased frequency in patients with hypercalcemia (e.g., primary hyperparathyroidism). It may be caused by renal insufficiency and/or calcium-mediated vasoconstriction of arterioles.

Page 537
Table 23-3
Compartment syndrome
Volkmann’s ischemic contracture: supracondylar fracture of humerus….

Page 551-552
2. Pemphigus vulgaris (page 551)
c. Intraepithelial vesicles are located above the basal layer (suprabasal).
(3) Positive Nikolsky sign
• Outer epidermis separates from basal layer with minimal pressure
3. Bullous pemphigoid (page 552)
b. Vesicles are subepidermal.
(3) Negative Nikolsky sign
The oral mucosa is involved in one-third of cases, which is not rare as one medical student suggested on an Internet site. This was a really bad mistake in editing, because I had in correct in the notes I used to teach students with before the book came out.

Page 583
2. Role of beta-amyloid (Abeta) protein
b. Defects in degradation of APP by secretases cause an increase in Abeta
(1) Alpha-secretases cleave APP into fragments that cannot produce Abeta
(2) Beta and gamma-secretases cleave APP into fragments that are converted to Abeta.
Beta secretases first must cleave (“clip”) the APP and then subsequent cleavage by gamma secretases produces Abeta, which forms amyloid that is neurotoxic.

Page 585
Figure 25-17
Coronal section (B) shows (leave out dilated lateral ventricle and) atrophy of the caudate, putamen, and globus pallidus when compared with a normal coronal section (A).
A different picture was placed in there during publication, but the original discussion was not changed. The above is a correct discussion of the new picture.
 
phasset, you are the best! Thanks again, and convey my sincerest thanks to Dr. Goljan. :)
 
I sounded as though his book is set for republishing in March, and he is going to try to include as many errata corrections as possible - not sure what the time lag is between submission & corrrection for these.

Keep them coming though - makes for a better book in the end.
 
P. 110 says that with Alcoholism there is a decrease in NADH but it should be "Increased". Alcohol metabolism produces NADH and the three things listed afterward all enhanced and utilize NADH.

I think he's referring to the "reduced" form of the molecule.
 
Yep, EtOH abuse = increased NADH/NAD+ ratio. NADH is the reduced form of NAD+, which leads to the fatty change of the liver, yes?
 
I sounded as though his book is set for republishing in March, and he is going to try to include as many errata corrections as possible - not sure what the time lag is between submission & corrrection for these.

Keep them coming though - makes for a better book in the end.

I guess i should be given a little share of the profits then :rolleyes:. Anyways, thank Dr Goljan tremendously unbehalf of all of us for being so dedicated and committed in what he does best.
 
P. 110 says that with Alcoholism there is a decrease in NADH but it should be "Increased". Alcohol metabolism produces NADH and the three things listed afterward all enhanced and utilize NADH.[/QUOTE said:


to clarify, on p. 110 he says nothing about "decreased" NADH he says...

Important products of alcohol metabolism: "reduced NADH"
 
Pg 54,
Total confusion in this one:confused: . In Wiskott-aldrich syndrome, he says there is normal IgG and Increased IgA and IgE. First aid says you have normal IgE and harrisons say you have normal IgA..
Who do we believe now?
 
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