ABPath Pediatric Pathology study guide
ABPath Pediatric Pathology · Work through your exam, one topic at a time.
The Pediatric Pathology subspecialty examination is offered by the American Board of Pathology as a one-day, computer-based certification exam for pathologists seeking subspecialty certification in pediatric pathology. Per the ABPath exam description, it combines Written and Practical sections with Virtual Microscopy (VM) sections; there are no glass slides, only VM. The ABPath Pediatric Pathology study guide has 12 sections and about 2,942 words.
01Embryologic Principles
Candidates must be fluent in the timing and mechanisms of gastrulation, neurulation, branchial arch derivatives, and the embryologic origins of each organ system, because most malformation questions reduce to "what failed, and when." Know the neural crest as a migratory population giving rise to melanocytes, Schwann cells, odontoblasts, adrenal medulla, and conotruncal septation elements; disruptions here explain neurocristopathies such as Hirschsprung disease and DiGeorge spectrum. Understand the embryologic clock: teratogenic windows map to organogenesis (roughly weeks 3–8), while later insults produce growth and maturation defects rather than structural ones.
286 words, about 1 min02Fetal and Childhood Growth and Development
Master the vocabulary of growth: small for gestational age (SGA) vs intrauterine growth restriction (IUGR) vs constitutionally small ; symmetric vs asymmetric growth restriction. Symmetric restriction reflects early (often chromosomal or infectious) insults with proportional reduction in head and body, while asymmetric restriction reflects late placental insufficiency with head sparing.
270 words, about 1 min03Maternal-Fetal Interactions
Understand maternal-fetal immunologic tolerance, placental transfer of IgG (predominantly third trimester), and the consequences for neonatal immunity and passive antibody-mediated disease (e.g., alloimmune thrombocytopenia, neonatal lupus from maternal autoantibodies). Know how maternal conditions-diabetes, hypertension, thyroid disease, and autoimmune disease-shape fetal development and placental histology.
263 words, about 1 min04Placental and Amniotic Fluid Abnormalities
Know normal placental development, cord insertion variants, and the gross and microscopic correlates of placental insufficiency: villous hypoplasia, distal villous immaturity, infarction, and maternal vascular malperfusion. Understand amniotic fluid volume as a functional readout-oligohydramnios from renal agenesis or prolonged rupture, polyhydramnios from impaired swallowing (esophageal atresia, neurologic impairment) or diabetes.
239 words, about 1 min05Intrauterine Demise, Perinatal and Iatrogenic Problems
Approach stillbirth systematically: maternal history, placental examination, autopsy, karyotype/microarray, and infection workup. Understand mechanisms of fetal death-placental insufficiency, cord accidents, infection, hemorrhage (fetomaternal), chromosomal anomalies, and maternal disease.
209 words, about 1 min06Congenital Malformations and Complexes
Organize malformations by mechanism: malformation (intrinsic developmental defect), disruption (extrinsic destruction of normal tissue, e.g., amniotic band), deformation (mechanical distortion), and dysplasia (abnormal tissue organization). Know major complexes and associations-VACTERL, CHARGE, and specific sequences-and the distinction between syndromic and isolated malformations.
220 words, about 1 min07Metabolic, Nutritional and Immunologic Disorders
Know newborn screening principles and the disorders it targets: aminoacidopathies, fatty acid oxidation defects, organic acidemias, and endocrine disorders (congenital hypothyroidism, CAH). Understand that many inborn errors present with acute metabolic crisis -hypoglycemia, hyperammonemia, metabolic acidosis-and that the autopsy may be grossly normal, making biochemical and genetic testing essential.
233 words, about 1 min08Infectious Diseases
Master congenital and perinatal infections (TORCH and beyond), their timing-dependent effects, and characteristic pathology. Early infection → malformation and growth restriction; late infection → active inflammation and organ damage.
197 words, under 1 min09Pediatric Neoplasia
Know the pediatric tumor spectrum and its contrast with adult cancers: embryonal tumors (neuroblastoma, Wilms tumor, hepatoblastoma, medulloblastoma, retinoblastoma) versus hematologic malignancies (ALL, lymphoma). Understand translocation-defined tumors and their diagnostic ancillary tests (e.g., Ewing sarcoma, alveolar rhabdomyosarcoma, synovial sarcoma).
200 words, about 1 min10Ancillary Testing: IHC, Flow Cytometry, Cytogenetics and Molecular
Understand the indications, limits, and interpretation of ancillary tests in pediatric pathology: immunohistochemistry for lineage (CD45, desmin, myogenin, WT1, synaptophysin), flow cytometry for leukemia/lymphoma immunophenotyping and minimal residual disease, cytogenetics (karyotype, FISH) and molecular testing (PCR, sequencing, microarray). Know when each is appropriate-FISH for rapid targeted loci, karyotype for structural/ploidy, microarray for copy-number and congenital anomalies.
203 words, about 1 min11Pediatric Laboratory Medicine
Know pediatric-specific laboratory issues: age-dependent reference intervals (especially for hemoglobin, leukocytes, and chemistries), capillary vs venous sampling, and the effect of hemolysis and small volumes. Understand neonatal hematology-physiologic anemia, physiologic nadir, and the high fetal hemoglobin fraction.
203 words, about 1 min12Autopsy and Forensic Pathology
Understand the purposes of pediatric autopsy: cause of death, identification of heritable disease, quality assurance, and family counseling. Know the techniques-external and internal examination, organ weights and measurements, radiography, and ancillary studies (microbiology, genetics, toxicology).
419 words, about 2 min