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LWBK713-FM-i-xvi.qxd 7/23/10 7:55 PM Page i Aptara High-Yield Histopathology SECOND EDITION LWBK713-FM-i-xvi.qxd 7/23/10 7:55 PM Page ii Aptara LWBK713-FM-i-xvi.qxd 7/23/10 7:55 PM Page iii Aptara High-Yield Histopathology SECOND EDITION Ronald W. Dudek, PhD Professor Department of Anatomy and Cell Biology Brody School of Medicine East Carolina University Greenville, North Carolina LWBK713-FM-i-xvi.qxd 7/23/10 7:55 PM Page iv Aptara Acquisitions Editor: Crystal Taylor Product Manager: Catherine Noonan Manufacturing Manager: Margie Orzech Designer: Terry Mallon Vendor Manager: Bridgett Dougherty Compositor: Aptara, Inc. Second Edition Copyright © 2011, 2008 Lippincott Williams & Wilkins, a Wolters Kluwer business. 351 West Camden Street Two Commerce Square, 2001 Market Street Baltimore, MD 21201 Philadelphia, PA 19103 Printed in China All rights reserved. This book is protected by copyright. No part of this book may be reproduced or transmitted in any form or by any means, including as photocopies or scanned-in or other electronic copies, or utilized by any information storage and retrieval system without written permission from the copyright owner, except for brief quotations embodied in critical articles and reviews. Materials appear- ing in this book prepared by individuals as part of their official duties as U.S. government employees are not covered by the above-mentioned copyright. To request permission, please contact Lippincott Williams & Wilkins at 530 Walnut Street, Philadelphia, PA 19106, via email at [email protected], or via website at lww.com (products and services). 987654321 Library of Congress Cataloging-in-Publication Data Dudek, Ronald W., 1950– High-yield histopathology / Ronald W. Dudek.—2nd ed. p. ; cm. Includes bibliographical references and index. ISBN 978-1-60913-015-2 1. Histology, Pathological—Outlines, syllabi, etc. I. Title. [DNLM: 1. Histology—Outlines. 2. Pathology—Outlines. QS 518.2 D845ha 2011] RB32.D83 2011 611Ј.018—dc22 2010025885 DISCLAIMER Care has been taken to confirm the accuracy of the information present and to describe generally accepted practices. However, the authors, editors, and publisher are not responsible for errors or omissions or for any consequences from application of the information in this book and make no warranty, expressed or implied, with respect to the currency, completeness, or accuracy of the contents of the publication. Application of this information in a particular situation remains the professional responsibility of the practitioner; the clinical treatments described and recommended may not be considered absolute and universal recommendations. The authors, editors, and publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accordance with the current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any change in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new or infrequently employed drug. Some drugs and medical devices presented in this publication have Food and Drug Administration (FDA) clearance for limited use in restricted research settings. It is the responsibility of the health care provider to ascertain the FDA status of each drug or device planned for use in their clinical practice. To purchase additional copies of this book, call our customer service department at (800) 638-3030 or fax orders to (301) 223-2320. International customers should call (301) 223-2300. Visit Lippincott Williams & Wilkins on the Internet: http://www.lww.com. Lippincott Williams & Wilkins customer service representatives are available from 8:30 am to 6:00 pm, EST. LWBK713-FM-i-xvi.qxd 7/23/10 7:55 PM Page v Aptara I would like to dedicate this book to my mother, Lottie Dudek, who was born on November 11, 1918. Through the years my mother raised her children, maintained a loving marriage, and worked 40 hours per week. In the year 2004, society would describe such a person as a “liberated woman” or “supermom.” I would like to acknowledge that my mother was a “supermom” 20 years before the word was fashionable. A son cannot repay a mother. My hope is that “I love you and thank you” will suffice. v LWBK713-FM-i-xvi.qxd 7/23/10 7:55 PM Page vi Aptara LWBK713-FM-i-xvi.qxd 7/23/10 7:55 PM Page vii Aptara Preface High-Yield Histopathology does more than just review histology. The questions on the USMLE Step 1 cross traditional course boundaries, making it difficult to identify a question that is “strictly histology.” Many USMLE Step 1 questions fall into the categories such as histopatholo- gy, histophysiology, histomicrobiology, and histopharmacology. To write a review book on basic, traditional histology would not be helpful to the student preparing for the USMLE Step 1 since there are no basic traditional histology questions on the exam. In this regard, High-Yield Histopathology reviews important histology concepts as a gateway to the pathology, physiology, microbiology, and pharmacology of clinically relevant topics. In addition, many students have commented that cell biology topics have been well represented on the USMLE Step 1. To this end, I have included Chapter 1 (Nucleus), Chapter 2 (Cytoplasm and Organelles), and Chapter 3 (Cell Membrane) with up-to-date and clinically relevant informa- tion. I would appreciate any comments or suggestions concerning High-Yield Histopathology, espe- cially after you have taken the USMLE Step 1 exam, that you think might improve the book. You may contact me at [email protected]. vii LWBK713-FM-i-xvi.qxd 7/23/10 7:55 PM Page viii Aptara LWBK713-FM-i-xvi.qxd 7/23/10 7:55 PM Page ix Aptara Contents Preface . .vii 1 Nucleus . .1 I. Nuclear Envelope . .1 II. Apoptosis . .1 III. Nucleolus . .1 IV. Chromatin . .2 V. Chromosomes . .2 VI. Types of DNA Damage and DNA Repair . .3 VII. Clinical Importance of DNA Repair . .3 VIII. Cell Cycle . .4 IX. Proto-Oncogenes and Oncogenes . .8 X. Tumor Suppressor Genes . .10 XI. Oncofetal Antigens and Tumor Markers . .11 XII. Transcription in Protein Synthesis . .11 XIII. Processing the RNA Transcript into mRNA . .11 XIV. Selected Photomicrographs . .13 2 Cytoplasm and Organelles . .18 I. Cytoplasm . .18 II. Ribosomes . .18 III. Rough Endoplasmic Reticulum (rER) . .19 IV. Translation . .20 V. Golgi Complex . .22 VI. Smooth Endoplasmic Reticulum (sER) . .22 VII. Mitochondria . .22 VIII. Lysosomes . .25 IX. Peroxisomes . .25 X. Cytoskeleton . .27 XI. Lipofuscin . .28 XII. Hemosiderin . .28 XIII. Glycogen . .29 XIV. Selected Photomicrographs . .31 3 The Cell Membrane: Eicosanoids and Receptors/Signal Transduction . .36 I. The Lipid Component of the Cell Membrane . .36 II. The Protein Component of the Cell Membrane . .38 III. Membrane Transport Proteins . .38 ix LWBK713-FM-i-xvi.qxd 7/23/10 7:55 PM Page x Aptara x CONTENTS IV. G Protein–linked Receptors . .42 V. Types of G Protein–linked Receptors . .44 VI. Enzyme–linked Receptors . .46 VII. Low–density Lipoprotein (LDL) Receptor . .48 4 Epithelium . .49 I. Introduction . .49 II. Classification of Epithelium . .49 III. Apical Region . .50 IV. Lateral Region . .51 V. Basal Region . .52 VI. Clinical Considerations . .52 VII. Selected Photomicrographs . .54 5 Connective Tissue . .55 I. Introduction . .55 II. Ground Substance . .55 III. Fibers . .55 IV. Cells . .56 V. Clinical Considerations . .58 VI. Selected Photomicrographs . ..