Iraqi Board Pathology study plan

Explain the biochemical and morphologic sequence of reversible versus irreversible cell injury, including ATP depletion, mitochondrial permeability transition, calcium influx, free radical damage, and the point of no return.

Distinguish necrosis subtypes (coagulative, liquefactive, caseous, fat, fibrinoid, gangrenous) by mechanism and typical tissue setting, and contrast them with apoptosis including caspase pathways and apoptotic body clearance.

Map the acute inflammatory response step by step: vasodilation, increased permeability, leukocyte margination-rolling-adhesion (selectins, integrins), transmigration, chemotaxis, phagocytosis, and leukocyte granule contents.

Classify chemical mediators of inflammation (histamine, prostaglandins, leukotrienes, cytokines, complement, kinins) by source, trigger, and principal effect, and predict the consequence of blocking each class.

Differentiate healing by primary versus secondary intention, granulation tissue formation, wound contraction, scar maturation, and the local and systemic factors that cause delayed or excessive repair.

Apply the hallmarks of neoplasia to distinguish benign from malignant tumors using differentiation, anaplasia, pleomorphism, mitotic activity, invasion, and metastasis.

Describe the multistep model of carcinogenesis (initiation, promotion, progression), oncogene activation, tumor suppressor loss (RB, TP53, APC), and DNA repair defect syndromes.

Explain the metastatic cascade and route of spread (lymphatic versus hematogenous versus transcoelomic) for common carcinomas, and name the most frequent metastatic sites for breast, lung, prostate, and colorectal primaries.

Analyze hemodynamic disorders: the Virchow triad, thrombus versus postmortem clot, embolus types, infarction morphology, and the stages of shock with their compensatory and decompensatory physiology.

Interpret paraneoplastic syndromes and tumor markers in terms of tumor type and limitations of specificity and sensitivity.

Correlate gross and microscopic findings with clinical presentation for the major non-neoplastic diseases of lung, kidney, liver, heart, and gastrointestinal tract.

Compare the histologic patterns of glomerular disease (proliferative, membranous, crescentic, sclerosing) and link each to its typical immunofluorescence and clinical syndrome.

Differentiate the principal patterns of hepatic injury (steatosis, hepatitis, bridging necrosis, cirrhosis) and their causes, including viral, alcoholic, metabolic, and autoimmune.

Describe the morphologic criteria used in surgical pathology reporting: margin assessment, lymphovascular invasion, perineural invasion, grading systems, and synoptic reporting elements.

Explain frozen section indications, limitations, and the causes of discrepancy with permanent sections.

Apply a systematic diagnostic approach to gynecologic cytology: adequacy, transformation zone sampling, Bethesda squamous and glandular categories, and management implications of ASC-US, LSIL, HSIL, and AGC.

Interpret non-gynecologic cytology specimens (serous effusions, urine, thyroid FNA, lymph node FNA) using pattern recognition and the Milan and International System reporting categories.

Explain the role of ancillary testing in cytology, including HPV testing and p16/Ki-67 dual stain, and the causes of false-negative cervical samples.

Distinguish the histologic features of the common gynecologic malignancies (squamous cell carcinoma, adenocarcinoma, endometrial carcinoma, ovarian surface epithelial tumors) and their precursor lesions.

Recognize the cytologic and histologic mimics that generate the most frequent diagnostic errors in gynecologic and thyroid specimens.

Interpret complete blood count and peripheral smear findings in anemia, including red cell indices, reticulocyte response, and the morphologic classification of microcytic, normocytic, and macrocytic anemia.

Classify and differentiate the leukemias and lymphomas by morphology, immunophenotype, cytogenetics, and clinical behavior, including the distinction between acute leukemia, chronic myeloproliferative neoplasms, and indolent lymphomas.

Explain bone marrow aspiration and trephine biopsy indications, adequacy assessment, and the morphologic approach to a marrow replaced by tumor or fibrosis.

Evaluate coagulation laboratory tests (PT, aPTT, mixing studies, fibrinogen, D-dimer, platelet function) and reason through the inherited and acquired bleeding and thrombotic disorders.

Interpret core clinical chemistry analytes (sodium, potassium, acid-base, renal function, liver enzymes, cardiac troponin, glucose, lipids) in terms of preanalytical, analytical, and pathophysiologic causes of abnormal results.

Describe the pathogenic mechanisms and characteristic tissue reactions of the major bacterial, mycobacterial, fungal, viral, and parasitic infections encountered in pathology specimens.

Recognize the morphologic patterns of infection (suppurative, granulomatous, necrotizing, viral cytopathic change, inclusion bodies) and match each pattern to a differential of organisms.

Explain the principles of antimicrobial susceptibility testing, culture interpretation, and the significance of contamination versus colonization versus infection.

Apply immunopathology concepts: hypersensitivity types I to IV, autoimmune disease mechanisms, primary immunodeficiency classification, and the pathology of transplant rejection.

Explain pretransfusion testing, ABO and Rh compatibility, antibody screening and identification, crossmatch, and the causes and investigation of acute and delayed transfusion reactions.

Select appropriate immunohistochemical markers for common diagnostic dilemmas (carcinoma of unknown primary, sarcoma versus carcinoma, lymphoma versus carcinoma, mesothelial versus adenocarcinoma, and prostate versus urothelial).

Interpret molecular diagnostic techniques (PCR, real-time PCR, sequencing, FISH, karyotyping, microarray) and explain their indications, limitations, and specimen requirements.

Apply basic genetics to inheritance patterns, cytogenetic abnormalities, and the molecular basis of common inherited cancer syndromes.

Describe the medicolegal autopsy: jurisdiction, consent, indications, external examination, evisceration technique, ancillary studies, and the structure of the autopsy report.

Interpret postmortem changes (livor, rigor, algor, decomposition) and the pathology of common forensic entities including asphyxia, sharp and blunt force injury, firearm wounds, and poisoning.

Explain quality assurance in the pathology laboratory: internal and external quality control, proficiency testing, turnaround time monitoring, specimen identification and tracking, and root cause analysis of errors.

Describe accreditation requirements, laboratory safety, and the ethical duties of the pathologist including informed consent, confidentiality, error disclosure, and conflicts of interest.

Rehearse the highest-yield concepts from General and Systemic Pathology through spaced retrieval rather than rereading.

Complete timed mixed-domain practice under exam conditions and analyze errors by domain to identify residual weak areas.