M231- Outline

Dr.Huda M. Zahawi, FRC.Path.(Co-ordinator)

Lecture Topics : Cell Injury Inflammation & Repair Neoplasia Hemodynamic Disorders,Thrombosis

& Shock

Book : Robbins Basic Pathology

Labs : 2-3 Labs / topic Clinical cases for discussion Web Path Internet teaching used Not more than 1/3 of all sessions

absence Exams :

First , Second & Final Exams MCQ format Lab questions with pictures included in each exam Marks : 40 / 40/ 60 Make up is usually in short essay

format

Introduction to Pathology

Dr.H.Zahawi,FRC.Path2010

What is Pathology ?

Study of disease by scientific methods Individual’s reaction to injury & its effect on

body Effect recognized by structural &functional changes PATHOPHYSIOLOGY Result is either compensated ,

decompensated or causes death . Links basic science to clinical practice

Branches of Pathology

Anatomic pathology : Study of tissues or cells - Postmortem Examination ( autopsy ) - Forensic Pathology - Surgically removed specimens - Cytology of smears, Fine Needle

Aspiration Clinical pathology : - Clinical chemistry - Hematology - Microbiology - Immunology - Genetics

How Pathology is taught General pathology : studies mechanism & the

characteristics of principle types of disease processes e.g.

- cell injury - inflammation - neoplasia Systemic pathology : studies specific diseases in

specific organ systems. e.g. - lung abscess - breast cancer

Steps in study of diseases

Epidemiological aspects Etiology: identifiable cause of disease - Intrinsic : genetic - Extrinsic : acquired - Idiopathic Pathogenesis : Sequence of events in the

response of cells& tissues to the etiological agent, from the initial stimulus to the final expression of disease. This response can be studied morphologically, biochemical, immunologically or at molecular level.

Pathological & clinical features including biochemical tests, radiological findings

INTEGRATE ALL INFORMATION !!!!!

Complications & sequelae : Events taken during the disease

process that may impair full recovery

Treatment

Prognosis : A forecast as to the probable result of

an attack of disease and the prospect of recovery.

To aid diagnosis , study morphology :

Samples for study include cells, biopsy or whole organ :

- Gross or macroscopic appearance - Histological or microscopic appearance - Electron microscopy or ultrastructure Genetic & molecular methods may aid

diagnosis

Sample case A 60 year old woman with a lump in

the neck of 6 months duration. Patient has fever & raised BMR ( ESR) On examination she also had enlarged inguinal lymph nodes. Further investigations were within

normal

Biopsy was taken i.e. tissue removed for microscopic

examination

Follicular Lymphoma

Genetic Studies : Translocation t18: 14

Diagnosis : Follicular Lymphoma

Treatment : Chemotherapy Prognosis : Good Therefore : PATHOLOGY AIDS IN DIAGNOSIS

& MANAGEMENT OF DISEASE PROCESSES

Cellular Injury (year 2010 )

Dr. Huda M.Zahawi, FRC.Path.

Topic Outline

Causes of cell injury Types of Injury Priciples & Mechanisms of cell injury Outcome : ?Reversible ? Irreversible Morphology Adaptation to Injury Patterns & types of Cell Death Process of Aging

Cellular Injury & Adaptation Normal cell is in a steady dynamic

state “Homeostasis” :

The ability or tendency of an organism or cell to maintain internal equilibrium by adjusting its physiological processes.

Cells are constantly exposed to stresses.

Normal physiologic stress Severe stresses: injury results, and

alters the normal steady state of the cell, consequently,

It can survive in a damaged state and adapt to the injury

(reversible injury or adaptation) It can die (irreversible injury or cell death).

NORMALCELL

STRESS INJURY

AtrophyHypertophyHyperplasiaMetaplasia

Cellular swellingVacuolar change

Fatty change

Necrosis

Apoptosiss

IrreversibleIrreversibleinjuryinjury

ReversibleReversibleinjuryinjury

AdaptationAdaptation

Causes of Cell Injury

Hypoxia and ischemia Free radicals Chemical agents Physical agents Infections Immunological reactions Genetic defects Nutritional defects Aging