Summer in Morgantown is pretty different from the regular school year. This is the season for routine maintenance, repairs and road work while most of the students are gone. It also means the personal rapid transit system (PRT) isn’t running :’) Luckily I have an e-bike to get me to the important places, but I will admit it takes creative navigation to stay off the major roads as much as possible. I haven’t had any bad experiences with nasty drivers so far, but I’m not about to push my luck if a road doesn’t have a bike lane. If everything goes according to plan, I should be getting a used car delivered from Carvana tomorrow, a 2009 Subaru legacy, a fitting car for a grad student (it’s not fancy, but it works reliably!)
Beyond classes, I’m enjoying the quiet side of being a student. Life is a little simpler when you know that your main priorities are #0 personal well-being and #1 Schoolwork. It’s been a very long time since I had anything resembling a routine, as the work hours at my previous job sort of precluded it. So it’s nice to know that my main responsibilities are to wake up at the same time every day, go to bed at night, try my best to work hard and learn new things in the middle bits. (And go easy on myself when sometimes these things don’t quite happen).
Inspired by an email subscription list called PathologyBites, I’m going to start off my blog posts talking about some specific concepts or diseases in the field of pathology. Since I’ve been studying the gastrointestinal system recently, today’s subject is Celiac disease!
What is Celiac disease?
Celiac disease is an immune system disorder with a genetic component. It is also sometimes called celiac sprue, or gluten-sensitive enteropathy and is triggered when the patient consumes food containing gluten, such as wheat, rye or barley. It affects the small intestine, specifically the second portion of the duodenum or the proximal jejunum, since these areas are exposed the most to gluten.
Some cases of celiac disease go unnoticed if the patient doesn’t have any symptoms, in which case it is termed either “silent” or “latent” celiac, depending on whether or not there are microscopic changes in the gut.
How does it happen?
Without getting too deep into biochemistry, the pathogenesis of celiac includes both innate and adaptive immunity. This means that the immune system is using tools that are always ready to respond AND using tools that are especially adapted for responding to components of gluten and the molecules that interact with gluten (more specifically, these would be the antibodies anti-gliadin, anti-endomysium and anti-tissue transglutaminase).
How is it diagnosed?
Since the symptoms of celiac can be very similar to many other gastrointestinal conditions, pathologists look at both histology and serology to make a diagnosis. This means that they are evaluating the microscopic appearance of the small intestine wall and looking for the presence of antibodies in the blood.
Moving on, here is what summer semester looks like:
Human anatomy 2:
Picking up directly where we left off last semester, we will be covering the lower limb, Head, and Neck in anatomy. This class is already feeling less daunting than last semester, as we have a better understanding of what is going to be expected of us, and had a chance to develop some study strategies. Because this is the first cohort that is joining in on the anatomy class originally for physician assistants, there have been some kinks to work out in terms of content that is relevant for pathologists assistants. The good news is, the faculty is actively working to optimize the class for both cohorts, and not just for the next class either, but for our cohort as well! The class coordinator for human anatomy has already sat down with the pathologists assistant cohort and asked what the professors can do differently this semester to make sure we get what we need from the course.
Systemic pathology:
Simply put, this class is everything you could ever have wanted (or not wanted) to know about most every disease known to medical science. Last semester we worked through roughly the first 10 chapters of the pathology holy book, Robbins and Cotran’s Pathologic Basis of Disease. Now we are applying those concepts from spring to better understand all the different illnesses, disorders, and syndromes (oh my!) This is a “flipped” class, meaning that we are mostly teaching ourselves the content through recorded lectures, powerpoints and reading, and meeting three times a week to turn in assignments, ask questions, and play a quiz game called Kahoot to review the material.
In brief, here are the organ systems we are going to be covering: Bone and soft tissue, Pancreas, gastrointestinal, head and neck, endocrine, skin, lower urinary and male reproductive, breast, (*gasps for breath*) heart, lung, peripheral nervous system, liver and gallbladder, female reproductive, central nervous system and kidney.
Clinical Pathology seminar:
Clinical pathology is the sibling of anatomic pathology. In the anatomic pathology lab, we handle solid tissue specimens, while clinical pathology is everything liquid you can get from a body. The sub-disciplines of clin path are hematology/coagulation, chemistry, microbiology, urinalysis, and blood banking. Before coming to this program, I worked in clinical pathology labs, so this class features some very familiar content for me. The class itself is going to feature plenty of guest lecturers and we will be taking quizzes before lecture on the content covered the previous week.
In addition to classes we also have cryostat lab time available to us, we sign up for time slots and can go in for a little over an hours to practice cutting frozen sections. And of course another round of gross room rotations so we can continue to apply a little bit of what we are learning.
Lastly, I wanted to acknowledge that there is a lot of Rough News happening in the world right now, (shocking, I know) and I’d like to say that I’ve been hitting the streets, campaigning for a better world, being the change I want to see. But the truth is, being a grad student means sometimes you don’t have a lot to give. I keep my eyes peeled for ways to contribute, but my main hope is that by investing in myself right now, I will have more to offer in the coming years to support the important causes out there. To those people who are offering up their time, money, and energy to make positive change, THANK YOU. Know that the next graduating class of laboratory professionals will be here for you when you need a swift and accurate diagnosis.
-Rizzo