I would like to attempt to explain the logic behind the new iphone app, the Notebook of Medicine.
Medicine is basically the interaction between (Neuro)ectodermal, mesodermal, and endodermal elements.
An excess of any in a normal anatomical area is termed a hamartoma, and when in an abnormal location it is termed a choristoma.
Neuroectoderm admixed with mesoderm is termed entities like adenofibroma, neurofibroma, or ectomesenchymomas.These may all have benign, premalignant, and malignant forms.
Mesodermal elements admixed with each other is termed a mesenchymoma. Examples are lipofibroma, osteochondroma, angiolipoma etc.Again these may all take benign, premalignant, and malignant forms.
Next mesodermal bone marrow cells lines are use to "attack/defend" individual mesodermal and neuroectodermal organs
Basophilic proliferations admixed with the organ or peripheral blood
Eosinophilic proliferations admixed with the organ or peripheral blood
Acute/Chronic Eosinophilic Leukemia
Eosinophilic "Organitis" ~ eosinophilic appendicitis, or eosinophilic pancreatitis
Eosinophilic Dermatitis (Well's Syndrome)
Eosinophilic Granuloma (Kimura's Disease)
Fibroblastic proliferations admixed with the organ
Histiocytic proliferations admixed with the organ or peripheral blood
Acute/Chronic Histiocytic Leukemia
Histiocytic "Organitis" ~ Histiocytic Appendicitis, or Histiocytic Pancreatitis
Histiocytic Sarcoma/Langerhans Cell Sarcomas/Dendrocytic Sarcomas
Lymphocytic proliferations admixed with the organ or peripheral blood
Acute/Chronic Lymphocytic leukemia
Lymphocytic "Organitis" ~ Lymphocytic Appendicitis, or Lymphocytic Pancreatitis
Mast Cell proliferations admixed with the organ or peripheral blood
Acute/Chronic Mast cell leukemia
Benign/Malignant Systemic Mastocytosis
Mast cell sarcoma
Megakaryocytic proliferations admixed with the organ or peripheral blood
Acute/Chronic Megakaryocytic Leukemia
Neutrophilic proliferations admixed with the organ or peripheral blood
Acute/Chronic Neutrophilic Leukemia
Neutrophilic "Organitis" ~ Neutrophilic Appendicitis, or Neutrophilic Pancreatitis
Neutrophilic (Myeloid) Sarcoma
Neutrophilic dermatitis (pyoderma gangrenosum/Sweet's syndrome)
Plasmacytic proliferations (plasma cells and antibodies) admixed with the organ or peripheral blood
Acute/Chronic Plasma Cell Leukemia
Plasma cell sarcoma
RBC's/Erythrocytic proliferations admixed with the organ or peripheral blood
Acute/Chronic Erythrocytic Leukemias
These cell lines are also used to defend the body against would-be attackers. So
Eosinophils attack parasites
Histiocytes attack foreign bodies
Lymphocytes attack viruses
Neutrophils attack bacteria
Plasma Cells make antibodies that can attack foreign bodies OR the body itself (autoimmune diseases)
When antiobodies attack the Dermal-Epidermal junction it is termed lupus, graft versus host diease, lichen planus, and dermatomyositis
Lastly, we have a limited number of nouns and adjectives (~200) that can be used to describe the morphologies of tumors.
We can describe the cell types, like clear cell, signet ring cells, rhabdoid cells, or balloon cells.
We can describe the background stroma, like sclerotic, hypercellular, hyalinized or inflammatory stroma.
We can describe a type of metaplasia or mesenchymal differentiation, like osseous metaplasia or chondrosarcomatous differentiation.
All that is left is to describe the type of carcinoma and the organ. Then we just pick and choose the adjectives to go with them. For instance
Adenocarcinoma of the appendix, with mucoepidermoid differentiation and osteosarcomatous differentiation
Adenocarcinoma of the pancreas, with signet ring cell-type differentiation and inflammatory stroma
Clear Cell Squamous cell carcinoma of the larynx, with chondrosarcomatous differentiation
Hypercellular clear cell adenocarcinoma of the prostate gland, with inflammatory stroma
Of course, medicine is much more complicated than this, but if you can begin with an understanding of it, learning it will be a breeze!
The Notebookofmedicine was created as a new way to LEARN, and not just memorize medicine. I was always frustrated that there were so many books
that all said basically the same thing. I wanted it all in one place. Plus whenever I would attend a lecture or conference, they too would
place their own spin on things, and I had no way of keeping it all together. Like most of you it took me twenty years to finally throw away
my medical school notes. But not only could I not read my own hand writing from 20 yrs ago, I had no way to look for anything. Where were my notes for the
spleen, hemochromatosis, anemia, Lupus etc.? The real pisser was, THEY WERE GREAT NOTES! My professors had great ways of presenting things. But they were
lost to me, FOREVER!
Not any-more. You will have the advantages I did not. It has taken me 10 hours a day for 10 years, but I have given you a usable outline of medicine.
You now have the sky-scrapper, and whenever you enter any room, just add furniture. Best part, you can always go back to the same place.
You can also add not just text, but pictures, videos, test questions, CME etc and share (or not share) all of your experiences with a private group
or the ENTIRE WORLD!
Dr. Kenneth A Wallace III, M.D.
Board Certified in Emergency Medicine, Dermatology and Mohs Surgery