Northeast Campus

Pathology

PATH 9301

Faculty Director: Ann K. Brown, M.D.

Offered: All periods
Positions: 1/period

Objectives of the Elective:

1. Surgical pathology - proper handling, gross description, taking of correct blocks for microscopic examination, the microscopic description, and diagnosis of disease states.
2. Taking the clinical history, gross findings and microscopic into consideration, ability to cut proper blocks, describe microscopic, and diagnose a diseased appendix, a diseased gallbladder, a diagnostic D&C, a skin biopsy or rectal biopsy, a breast biopsy, a uterus, a stomach, colon or small bowel, etc.
3. Frozen sections - examine tissue at surgery with use of the cryostat, take quick frozen sections, stain them and assist in the diagnosis and become familiar with the positive aspects of frozen section and the pitfalls and limitations of this technique (when to wait).
4. Autopsy pathology - do or assist doing an autopsy in which the student will make a clinical summary from the clinical history, physical findings, x-ray, and laboratory work on the hospital chart. He/she will make a gross description of the autopsy findings and render a gross autopsy diagnosis. Following this he will cut tissue sections and, with the pathologist, prepare a final diagnosis and clinical pathological correlation.
5. Hematology - become familiar and assist with synthesizing clinical information with evaluation of the peripheral smear, the bone marrow preparations and bone marrow sections, the use of each and coming to a diagnosis and/or conclusion in hematology. Become familiar with special techniques as they are utilized during this period.
6. Cytogenetics - become familiar with methods of chromosome analysis including the growth, harvesting and staining; and by growing his or her own chromosomes, harvest and stain them, and following photography prepare a basic karyotype with ordinary staining and Giemsa banding. Clinical cases as they evolve during this student's time will be utilized ad lib.

Standards of Performance (Outcomes) Indicating Attainment of Objectives:

1. Surgical Pathology -- With the use of manuals, books and assistance of pathologist and/or resident pathologist, you will describe, cut sections and evaluate microscopic sections and come to diagnostic conclusions. You or one of the pathologists will select the basic surgical specimens and you will carry out all the steps by yourself. This then will be critiqued by a pathologist.
2. Frozen Sections -- You will assist in describing, cutting and diagnosis of frozen sections at the pathology departments of the University of North Dakota and the United Hospital.
3. Autopsy Pathology -- Attendance at autopsies, including review of the clinical chart, observing gross autopsy procedures, such as cutting the tissue blocks and observing microscopic descriptions. A case will be selected for you to perform a gross description, the gross anatomic diagnosis, the microscopic description and final autopsy diagnosis and clinical pathological correlation.
4. Hematology -- By participating with the pathologist and evaluating all parameters in morphological hematology.
5. By observing the techniques in the cytogenetics laboratory, you will be able under supervision, to grow your own chromosomes, harvest them and take photographs of the typical spread and prepare a karyotype according to standard and banding techniques.
6. Other non-objectified -- will assist in other areas, with regular participation in daily surgical pathology with attempt made for the students to see all interesting and unusual surgical pathology cases
7. An in-depth presentation probably in the a.m. between 9:30 and 10:30 -- 1) renal biopsy, 2) liver disease, 3) chronic pulmonary disease, 4) coronary atherosclerosis and the complications, 5) pathology of the cervix uteri, 6) early complications of pregnancy, 7) electrophoresis, 8) basic hematology, 9) pediatric hematology, 10) bleeding disease, 11) thyroid disease, 12) endometrial pathology, 13) gestational trophoblastic disease, and 14) pathology of cerebrovascular disease.

Criteria for Grading:

1. Perceived fund of knowledge in this subject area before the rotation begins and at the completion of the rotation.
2. Performance during rotation.
3. Interaction with the technical personnel.