• SUBJECT BASIC PATHOLOGY • CODE SBD 2013• STATUS pre-requisite

Biochemistry &

Anatomy and Physiology• CREDIT 3 (2 + 1)

LECTURER: MDM SALWANA MD HASSAN

ASSESSMENT

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

TEACHING PLANTOPICS DETAILS ASSESEMENT

1 Introduction to Basic Pathology

2 Tissue Response to Injury Quiz 1

3 Inflammation Quiz 2

4 Degeneration & Regeneration

5 Necrosis Quiz 3

MID SEMESTER EXAM

6 Neoplasm Quiz 4

7 Blood Vessel Abnormalities Quiz 5

8 Shock and Edema

9 Radiation Pathology

10 Miscellaenous Conditions

11 Trauma & Fractures Assignment 1

12 Histology Diagnostic Techniques, Histochemistry and Immunohistochemistry in Disease Diagnosis

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 : References : 1.Harsh Mohan. Textbook of Pathology.

(2007) Jaypee.2.Rubin, E., (2009), Essential of Rubin’s

Pathology, Lippincott Williams & Wilkins.

CHAPTER 1CHAPTER 1

INTRODUCTION TO INTRODUCTION TO PATHOLOGYPATHOLOGY

Topic OutcomesAt the end of this lecture, students are able to :1. Describe orally the division of pathology2. Explain orally the history of pathology3. Describe in written all the terminologies in the

pathological field4. Explain in graph the cellular responses to cell

injury 5. Explain the common techniques used based on

classification of pathology

INTRODUCTION TO PATHOLOGYINTRODUCTION 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 medicinesafety 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 TERMINOLOGIESPATHOLOGICAL TERMINOLOGIES

Disease vs.

Illness

DiseaseDisease• 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

IllnessIllness• 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 :

DiagnosisDiagnosis

PrognosisPrognosis

TreatmentTreatment

PreventionPrevention

• 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 Autopsy

vs.vs.

BiopsyBiopsy

Autopsy?– A surgical procedure after death– Autopsies are useful for:

Determining the cause of deathEducation of undergrad & postgradResearch into the causes & mechanisms of disease

Biopsy?– Sample of tissue or fluid taken for the purpose of

diagnosis– 2 major types:

Tissue biopsyCytological biopsy (fluids)

CELLULAR RESPONSES TO CELL INJURY

NORMAL CELL

ADAPTATIONS

REVERSIBLE CELL INJURY

IRREVERSIBLE CELL INJURYATROPHY

HYPERTROPHY HYPERPLASIA METAPLASIA DYSPLASIA

•DEGENERATIONS•SUBCELLULAR ALTERATION

•INTRACELLULAR ACCUMULATIONS

Increased functional demand

Mild to moderate stress Severe, persistent stress

NORMAL CELL

RESTORED

REPAIR AND HEALING

CELL DEATH

Stress removed Stress

removed

HISTORY OF PATHOLOGY

Modern pathology (1950s to dawn of

21st century)

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)

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