SUBJECT

CODE STATUS

BASIC PATHOLOGY
SBD 2013 pre-requisite

Biochemistry &
Anatomy and Physiology CREDIT 3 (2 + 1)

LECTURER: MDM SALWANA MD HASSAN

ASSESSMENT
Quizzes (5) Assignments (2) Lab (Practical + test) Mid Semester Exam Final Semester Exam 10% 10% 10% 30% 40%

TOPICS
1 2 3 4 5

TEACHING PLAN DETAILS

Introduction to Basic Pathology Tissue Response to Injury Inflammation Degeneration & Regeneration Necrosis MID SEMESTER EXAM

ASSESEMENT

Quiz 1 Quiz 2

Quiz 3

6 7 8 9 10 11 12

Neoplasm Blood Vessel Abnormalities Shock and Edema Radiation Pathology Miscellaenous Conditions Trauma & Fractures Histology Diagnostic Techniques, Histochemistry and Immunohistochemistry in Disease Diagnosis

Quiz 4 Quiz 5

Assignment 1 Assignment 2

Synopsis
i. Give basic knowledge about common diseases. ii. Highlight the basic concepts & principles of tissues response to injury iii. Understanding of common diseases and clinical terminology iv. Emphasize the relationship between the cause, lesion & sign in disease that can be observed grossly & microscopically.

References :
1. Harsh Mohan. Textbook of Pathology. (2007) Jaypee. 2. Rubin, E., (2009), Essential of Rubins Pathology, Lippincott Williams & Wilkins.

CHAPTER 1

INTRODUCTION TO PATHOLOGY

Topic Outcomes
At the end of this lecture, students are able to : 1. Describe orally the division of pathology 2. Explain orally the history of pathology 3. Describe in written all the terminologies in the pathological field 4. Explain in graph the cellular responses to cell injury 5. Explain the common techniques used based on classification of pathology

INTRODUCTION TO PATHOLOGY
What is Pathology? The study of disease The study of suffering Study of structural & functional changes in disease Broadest sense study of how the organs and tissues of a health body the basis of normal anatomy and physiology - change to those of a sick person

 Pathology deals with knowledge of ; What cause disease? How disease start? Progresses Explain the reason for signs & symptoms of patient

 In hospital, pathology - concerned with performance and interpretation of laboratory procedures. TWO (2) main divisions of pathology in hospital environment: (i) Clinical pathology (biochemical and microbiologic etc procedures performed on body fluid Laboratory procedures) (ii) Anatomic pathology (structure abnormalities of cells and tissues gross and microscopic examination)

 Specialized types of pathology : (a) Forensic pathology Application of medical knowledge to legal issues determining whether death (natural / unnatural causes) (b) Transfusion medicine safety of collection, storage and transfusion of blood components (c) Experimental pathology basic scientific research into cellular components

 Pathologist assist medical management of patient by providing diagnosis by examination of specimens taken from patients Commonly, pathology is equated to lab testing Pathologist identify : Changes in the gross or microscopic Appearance of cells & tissues

As GENERAL, the classification of pathology is divided into: General Pathology The mechanisms & characteristic of the principle types of disease process e.g. inflammation, tumors etc. Systemic Pathology The descriptions of specific diseases as affect individual organs or organ systems e.g. respiratory system

Major subdivisions of clinical pathology:

Histopathology; investigate & diagnose of disease from the examination of tissues Cytopathology; investigate & diagnose of disease from the examination of isolated cells Haematology; study of disorders of the cellular & coagulable components of blood Microbiology; study of infectious disease & the organisms responsible for them

 Immunology; study of specific defense mechanisms of the body Chemical pathology; study & diagnose of disease from the chemical changes in tissues & fluids Genetics; study of abnormal chromosomes & genes Toxicology; study of the effects of known or suspected poisons Forensic pathology; application to pathology to legal purposes e.g. investigation of death in suspicious circumstances

PATHOLOGICAL TERMINOLOGIES

Disease vs. Illness

Disease
Opposite of health Is loss of ease to the body (dis-ease) Entity with a cause Expression of discomfort due to structural and functional abnormality Factors causing disease: Environmental (External Factors) e.g. physical, chemical, nutritional, infections, psychological Genetic (Internal Factors) ages, genes.

 Disease which present since birth are called Congenital diseases All other diseases are known as Acquired disease Disease which occur in families are known as Familial disease

Illness
The reaction of the individual to disease in the form of symptoms (complaints of the patient) and the physical signs (elicited by the clinician)

Language used in pathology: Patient person affected by disease Lesions - Characteristic changes in tissues and cells produced by disease in an individual or experimental animal Pathologic changes & morphology consists of examination of diseased tissues can be recognised with naked eyes (gross or macroscopic changes) or studied by microscopic examination of tissues

 Pathology of disease is formally studied under 4 subdivisions:

Etiology

Pathogenesis Symptoms Physical signs

 Etiology- Study of cause/causative agent of disease Pathogenesis- Study of disease progression or evolution Symptoms - Study of functional implications of the lesion felt by the patient Physical signs - Study of functional implications of the lesion felt by the patient and those discovered by the clinician

What physicians always do towards patients :

Diagnosis Prognosis Treatment Prevention

 Diagnosis the clinical significance of the morphologic and functional changes together with results of other investigations help to arrive at an answer to what is wrong Prognosis what is going to happen to the patient Treatment What can be done about the disease Prevention what should be done to avoid complications and spread the disease

Autopsy vs. Biopsy

Autopsy? A surgical procedure after death Autopsies are useful for: Determining the cause of death Education of undergrad & postgrad Research into the causes & mechanisms of disease Biopsy? Sample of tissue or fluid taken for the purpose of diagnosis 2 major types: Tissue biopsy Cytological biopsy (fluids)

CELLULAR RESPONSES TO CELL INJURY

NORMAL CELL
Increased functional demand Mild to moderate stress

Severe, persistent stress

ADAPTATIONS
ATROPHY HYPERTROPHY HYPERPLASIA METAPLASIA DYSPLASIA Stress removed

REVERSIBLE CELL INJURY

DEGENERATIONS SUBCELLULAR ALTERATION INTRACELLULAR ACCUMULATIONS
Stress removed

IRREVERSIBLE CELL INJURY

NORMAL CELL RESTORED

REPAIR AND HEALING

CELL DEATH

HISTORY OF PATHOLOGY
From religious beliefs to rational approach (Antiquity to AD 1500) Era of gross pathology (AD 1500 to 1800) Era of technology development and cellular pathology (AD 1800 to 1950s) Modern pathology (1950s to dawn of 21st century)

COMMON TECHNIQUES IN PATHOLOGY

Autopsy pathology Surgical pathology Special stains Enzyme histochemistry Basic microscopy (light, fluorescence, dark field) Electron microscopy (TEM, SEM) Immunoflouresence Immunohistochemistry Cytogenetics Molecular pathology (PCR, microarray) Cell proliferation analysis (Flow cytometry) Computers in pathology laboratory