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MID 2163PATHOLOGY
DIVISIONS OF PATHOLOGY
GENERAL PATHOLOGY
SYSTEMICPATHOLOGY
CLINICALPATHOLOGY
ANATOMIC PATHOLOGY
SURGICALPATHOLOGY
PATHOPHYSIOLOGY
General Pathology
Also called investigative pathology experimental pathology theoretical pathology
General Pathology Foundation of pathologyStudy of the mechanisms of disease –
etiology & pathogenesis The common changes in all tissues
1. INTRODUCTION TO PATHOLOGY2. CELL INJURY & ADAPTATIONS3. TISSUE INJURY4. HEALING5. HAEMODYNAMIC DISEASES6. NEOPLASIA7. INFECTIOUS & PARASITIC DISEASES
INTRODUCTION TO
PATHOLOGY
What is??
-PATHOLOGY-
“study of disease by scientific method”
pathos : suffering or disease~logos : study of
Objective of Pathology
To identify and describe the different parts of a
disease process
Disease???Abnormal variation in structure or function of
any part of body
Pathology...
Explain the disease by studying the 4 aspects of the disease:
1. Etiology2. Pathogenesis3. Morphological changes4. Functional derangement &
clinical significance
Etiologyaitia: cause
~logos: study
“study of causation or origin of disease”
EtiologyWhy things occur?Factors that produce/predispose toward a
certain disease or disorderCause of disease
– primary etiology: known– idiopathic: unknown
Help in diagnosis, understanding and treatment of disease
Etiology2 major etiological factors
– Genetic: age, genes– Acquired: infectious, environmental,
nutritional etcEtiology is followed by pathogenesis
Pathogenesispathos: disease
genesis: creation
“mechanism / development of
disease”
PathogenesisProcess of diseaseStarting from the initial stimulus to the
ultimate expression of disease− the origin & development of disease:
acute, chronic, recurrent
Gross & microscopic structure, function, chemistry and molecular mechanism
PathogenesisTypes of pathogenesis include
− Microbial infection, inflammation, malignancy & tissue breakdown
Most disease caused by multiple pathogenetical process together
− Example: cancer – multiple pathogenesisPathogensis leads to morphological changes
Morphological Changes
“structural alterations”
Morphological ChangesStructural alterations in cells or tissue
that occur following the pathologenetic mechanisms
− the characteristic of disease or condition− changes maybe specific to a disease− thus, it help the pathologist to identify &
diagnose the disease
Morphological ChangesThe changes can be seen with
● Naked eye – gross morphologic changes● Under microscope – microscopic changes
Morphological changes will lead to functional alteration and the clinical signs & symptoms of disease
Functional Derangement &
Clinical Significance
Functional Derangements
Disturbance of normal function of the organ due to the morphological changes
Determine the clinical features, course and prognosis of a disease
Clinical SignificanceClinical manifestations
● Signs● Symptoms● Prognosis
SignsObjective indication of some medical fact
or characteristic− the characteristic of disease or condition− changes maybe specific to a disease− thus, it help the pathologist to identify &
diagnose the disease
SymptomsSubjective – e.g: stomachache, lower
back pain, fatigue = can be sensed by the patient
3 main types of symptoms− Chronic : long lasting/recurrent
− Relapsing : affected by symptoms again
− Remitting : symptoms improve & sometimes fade away completely
SymptomsAsymptomatic – NO symptom
– Asymptomatic disease condition• Disease present but there ar no
symptom• e.g: Ca Breast
– Asymptomatic infection• Infected person may transmit the
diasease to others• Cause complication that unrelatede
to the infection• e.g: STD – AIDS, genital warts
PrognosisMedical term to describe the likely
outcome of an illnessComplete prognosis include expected time,
function and description of disease course
– Help to determine to attempt certain treatments or withold
Certain test for prognostic indicatorEstimators to describe prognoses =
progression-free survival, survival rate & survival time
Causes of Disease
Can be caused by environmental factors,
genetic factors or combination of the two
Environmental FactorsPhysical agentsChemicalsNutritional dificiencies & excessesInfections and infestationsImmunological factorsPsycogenic factors
Environmental FactorsPhysical agents
– Apply excess energy in any form to the body
– e.g: trauma, radiation, extreme temperature, electric power
Chemicals– Chemical agents = chemically induced
injury
– Effects = toxic to all cell (cyanide), act locally at site of application (strong acids), toxic to certain organ esp liver & kidney
Environmental FactorsNutritional dificiencies & excesses
– Dificiencies • poor supply, interference of absorption,
inefficient transport within the body or defective utilization – major class of food or essential elements
– Excess - obese
Environmental FactorsInfections and infestations
– Infected by viruses, bacteria, fungi, protozoa, metazoa
– Cell destruction directly when infection happen – virus & protozoa
– Destruction from toxins by the infecting agent – diphteria, tetanus
– General or localize effects
Environmental FactorsImmunological factors
– Abnormal immune system• Hypersensitivity reaction : exaggerated
immune response to an antigen – bronchial asthma
• Immunodificiency : increase susceptibility to different diseases – AIDS
• Autoimmunity : abnormal (exaggerated) immune reaction against self antigens - SLE
Environmental FactorsPsycogenic factors
– Mental stress imposed by condition of life
– Maybe contributory factors in some group of diseases
Genetic FactorsHereditary factors that are inherited
genetically from parentsMutation in chromosomes
Course of Disease
“the series of events in a disease incident in a patient”
The natural history of the disease
(if no intervention from other factors)
EXPOSURE
BIOLOGICALONSET
CLINICALONSET
PERMANENTDAMAGE
DEATH
Exposure – Exposure to various risk
– The causative agents
Latency period– Period between exposure and biological
onset of disease
Biological onset– Marks the initiation of disease process
– NO sign or symptom
– May remain asymptomatic or subclinical (no clinical manifestations) or may lead to overt clinical diasease
Incubation period– Variable period of time without any obvious
signs or symptoms from the time of exposure
Clinical onset of disease– Signs and symptoms become apparent
– Expression of disease may be variable in severity or in range of manifestations
Onset of permanent damageDeath
– Clinical death
– Biological death
Clinical DeathOccurs when heart stop beating – cardiac
arrestReversible transmission between life and
biological deathDefinition: period of respiratory,
circulatory and brain arrest during which initiation of resuscitation can lead to recovery
Clinical DeathSigns
– No pulse or blood pressure = completely unresponsive to the most painful stimulus
– Pupils widely dilated
– Recovery can occur with resuscitation
Biological DeathSure sign of deathSets in after clinical deathIrreversible state of cellular destructionManifest with irreversible cessation of
– circulatory and respiratory functions– all functions of the entire brain
including brainstem
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