Rubin’s Pathology Clinicopathologic Foundations of Medicine 7th Edition PDF
162.66 MB PDF
Students and instructors have complementary roles and needs as participants in the educational process. This book is intended to help modern medical students learn—and to help instructors teach—pathology as a foundation of clinical medicine.
So much has happened to change what and how medical students are taught. Medicine is rapidly being transformed, in part by the pace of scientific advance, and in part by the world around us. These forces reshape the subject matter and how it is presented. They also require that we consider carefully what we expect students of medicine to master.
Thus, this book’s purpose is to teach pathology and disease pathogenesis to medical students. It is not geared to residents or fellows in pathology, nor to bench scientists. Our goal is to prepare future medical practitioners—cardiologists, pediatricians, gerontologists and so forth—for their specialties, not for ours. We do this by helping them to understand how diseases happen and how they appear. We provide a foundation on which future clinicians of all specialties can build and, we hope, a sense of excitement for medical advances yet to come.
Perhaps the hardest—and at the same time the most important—challenge facing us in preparing this textbook is determining what should not be stressed, that is, what is better left for more specialized texts in biochemistry, molecular biology, pathology subspecialities and so on. Even as we try to avoid such superfluities as unproven hypotheses, abstruse discussions, medical minutiae and details of scientific experiments that fill some other textbooks, the amount of information remains overwhelming. We therefore applied a filter throughout this book, a question we asked both in writing our own chapters (Chapters 1, 5 and 8) and in editing the work of our superb contributors: what do students of medicine need to know in order to be good doctors, to prepare them for a lifetime of professional learning and to understand how advances in the medical sciences will affect their patients?
We stress the interrelatedness of the many medical disciplines. Traditional pathology texts have a section of basic principles, followed by a section covering each of the several organs in turn. This is no longer enough. Many processes and diseases affect multiple organ systems and are best understood and taught as such. It does not suffice, for example, only to describe aging as a series of separate effects on cells in culture or on the brain or on the cardiovascular system. As we can attest from personal experience, aging—apart from the very dubious wisdom that some people believe accompanies it—affects almost everything an individual does and can do. Its impact on one organ system is inextricably linked to its effects on others. It, and similar processes that affect multiple organ systems, is thus best approached against the background of the whole person, not just individual organs.
Accordingly, we have added a new section on systemic conditions: processes that affect whole human beings, not just their kidneys, lungs or joints. These include new chapters on aging (Chapter 10), autoimmune diseases (Chapter 11), sepsis (Chapter 12) and pregnancy (Chapter 14), plus amyloidosis (Chapter 15) and obesity, diabetes and metabolic syndrome (Chapter 13), which appeared in past editions. These are among the most important processes that doctors will have to understand in approaching patients. These integrated presentations should greatly facilitate how these topics are taught and, hopefully, understood. Organspecific chapters still cover respective manifestations of these processes.
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