Pathology, Lecture 1: Introduction To Pathology (tafree3'/notes) 3y612l

Introduction Huda Deeb M. Of 10 19/9/2009 Pathology Zahawi Zahran ‫قروش‬

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" ‫" بسم الله الرحمن الرحيم‬ 19/9/2010 ‘’ The first lecture in Pathology course ‘’

Introduction of Pathology It is the study of diseases by scientific methods , and basically it really describes the individual reaction of injury and it’s effect in the body , so when you have an injury in the body however what is the type of deficiency , you will have responses in the body , they change from the normal Physiology to an abnormal Physiology . And in this case , what you will be studying is the abnormal correlated to the normal , and this is recognized by both the structural and functional changes . The structural changes : you look at the changes in the cells , and in some cases it may involve electron microscopic deficiency . And also , you will study some of the changes like Biochemical changes and Hematological changes , happening once alone or happening together , all of this is called Phathophysiology because it is an abnormal Physiological . The result of this injury it could be compensated , decompensated or it could be Death . Compensated : the patient will recover and the case will be well , or partially recovering with residual disfunction or being die . All of this means , that Phathological studying will be described to clinical practice . We in the hospital when receive a sample from a patient , we usually study tissues , and get up with the results , and based on this diagnosis the finishing will be a Surgery or medication or together . So , it is a link to the clinical theory .

Branches of pathology Anatomic pathology : Study of tissues or cells , and this includes a number of things: - Postmortem Examination ( autopsy ) : [ is a medical procedure that consists of a thorough examination to determine the cause and manner of death and to evaluate any disease or injury that may be present ] …… (wikipedia) . - Forensic Pathology (‫ )الطب الشرعي‬: If anyone wants to investigate the cause of the death , if it is because of another reason than the normal . - Surgically removed specimens : A small piece of tissue taken from the body , and making our Diagnosis on it , or we can take the hollow organ . - Cytology : It is the study of individual cells , it can seen in a smear from any area , or by Needle Aspiration , this by a fine needle , sticking it into the area , and then remove cells , looking to them by the Microscope , and it give probably in some cases a rapid diagnosis not like the other ways . Actually , one of the other ways to do that is what we called “ Frozen Sections “ .

Clinical pathology : It deals with clinical Chemistry , Biochemistry , Hematology , Microbiology , Immunology and Genetics . Now , - Clinical chemistry : deals with sugar , lipids . - Immunology : deals with Hemoglobin , Nutrophiles and so on , and by the level of these component we can know the causes of the diseases . - Microbiology : deals with bacteria , viruses , fungi and so on .

Now about general pathology : It studies mechanism & the characteristics of principle types of disease processes for example cell injury inflammation and neoplasia Then in the systemic pathology : it is more discussed in a clinical form , for example if we talk about cell inflammation and take for example the respiratory system , we study lung abscess and we will see what abscess looks like , this is in the tissues , you will see . what Pneumonia looks like which is infection in the lung Breast cancer it’s an example of neoplasia (neoplasia come from new and plasia which mean new so it’s a new tissue or what we call it . (tumor

Steps in study of diseases Epidemiological is a disease in a community , for example if you take the TB (Tuberculosis) , you know that the TB occurs in a certain community , frequently they are poor and so an … it might occur in AlRamtha and don’t occur in Amman because they have a different kind . of food water and this is what we call it Epidemiology .Etiology is identifying cause of disease * Some diseases called intrinsic inter body not from outside & this is . usually genetic for example hemophilia , it’s a genetic disease Some diseases called extrinsic come from outside could be anything . its acquired from wounds , foods … mainly anything outside Now sometimes you don’t have any identify of the cause of the disease , we call it idiopathic , you don’t know the cause of this !! . disease . For example : cancer

Pathogenesis : Its name from - patho. Which means pathology genesis. Means the production of pathology , how the pathology is . produced It is (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

Steps in study diseases : - Epidemiological aspects - Etiology - Pathogenesis Complications & sequelae - Treatment - Prognosis * Epidemiology : is the study of diseases in populations of humans or other animals, specifically how, when and where they occur. * Etiology : It’s the Identifiable cause of disease , and it’s can be divided to : - Intrinsic ( genetic ) : and it’s belong to the body only . - Extrinsic : acquired from the environment - Idiopathic : the cause is “ UNKNOWN “ . * 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. The Pathological & clinical features including biochemical tests, and the radiological findings should INTEGRATE ALL INFORMATION so u can know the diagnosis . - You think about the Complications & Sequelae, and it’s the events during the disease process that may impair full recovery which mean what may happen later . - Treatment - Prognosis : mean a forecast as to the probable result of an attack of disease and the prospect of recovery, and it’s describe the likely outcome of an illness .

To aid in diagnosis , study morphology : * We get Samples for study, include cells, biopsy or whole organ : - Gross or macroscopic appearance . - Histological or microscopic appearance . - Electron microscopy or ultra structure . * Genetic & molecular methods may aid diagnosis . ---------------------------------------------------------------------------And here we have a sample case which may be a little interesting, and this is what u get in the clinical lab : - 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 * [ Note : BMR ( basal metabolic rate )( ‫ ( سرعة ترسيب الدم‬: it’s the sedimentation rate of blood and it indicate the disease which raised BMR indicate that there is something wrong and indicate to disease ] . - Biopsy was taken by a needle , ( i.e. ) tissue removed for microscopic examination ---------------------------------------------------------------------------Here is the work : * Genetic Studies : Translocation t 18: 14 . ( 1 of students ask the doctor about this numbers and she said that this indicate an abnormality and we will deal with this in future ) . * Diagnosis : Follicular Lymphoma . * Treatment : Chemotherapy . * Prognosis : Good !! Therefore : PATHOLOGY AIDS IN DIAGNOSIS & MANAGEMENT OF DISEASE PROCESSES .

--------------------------------------------------------------------------And now we talk about CELL INJURIES , and this is the topic outline : - Causes of cell injury . - Types of Injury . - Principles & Mechanisms of cell injury . - Morphology . - Outcome : ?Reversible ? Irreversible . - 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 . * It is … [ Dynamic steady state ].

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) .

Causes of Cell Injury : - Hypoxia and ischemia radicals - Chemical agents agents - Infections Immunological reactions

- Free - Physical -

- Genetic defects defects - Aging

-Nutritional

‘’ Sorry if there is any mistake ‘’ ‘’ Thanks to my friends ‘’

Done by : Deeb Zahran