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    Introduction to pathology Introduction to pathology Presentation Transcript

    • Introduction to Pathology Cell Adaptation, Injury and Death By Noel C. Santos, M.D.
    • LEARNING OBJECTIVES
    • Introduction to Pathology
      • Define Pathology
      • Give the two main divisions of Pathology
      • Give the four aspects of disease process
    • Cell Adaptation
      • Define and review the concept of normal homeostasis
      • Define cellular adaptation
      • Give the six types of adaptive response that may occur in a cell
    • Cell Injury
      • Define cell injury
      • Enumerate the general categories of the cause of cell injury
      • Give the two main phase of cell injury
      • Give the basic principles of cell injury
      • Give the general biochemical mechanisms of cell injury
      • Discuss the events that occur during ischemia with hypoxia
      • Discuss the events that occur during ischemia with reperfusion
      • Discuss the events that occur in free radical-induced cell injury
      • Discuss the mechanisms of chemical injury
      • Give the morphologic changes that occur during reversible cell injury
      • Enumerate and discuss each of the subcellular responses to cell injury
    • Cell Death
      • Define cell death
      • Give the principal patterns of cell death in response to lethal and/or acute cell injury
      • Discuss the causes, biochemical features and mechanisms of apoptosis
      • Give examples of apoptosis
      • Give the morphologic changes of cells that undergo apoptosis
      • Give the morphologic changes that occur during irreversible cell injury and cell death
      • Enumerate the morphologic types of necrosis, and give examples
      • Give the morphologic cellular alterations in response to sublethal and/or chronic cell injury
    • Pathology
      • Definition:
        • “ pathos” = “suffering” or “disease”
        • “ logos” = “study”
      • “ study of diseases”
      • study of the structural and functional causes of human disease.
    • Main Divisions of Pathology
      • BASIC or GENERAL PATHOLOGY
      • SYSTEMIC PATHOLOGY
      • CLINICAL PATHOLOGY
      • ANATOMIC PATHOLOGY
      • PATHOPHYSIOLOGY
      • SURGICAL PATHOLOGY
    • Four Aspects of Disease Process
      • ETIOLOGY – cause of a disease
      • PATHOGENESIS – mechanism/s of disease development
      • MORPHOLOGIC CHANGE – structural alterations induced in cells, tissues, organs, systems, body
      • FUNCTIONAL DERANAGEMENT and CLINICAL SIGNIFICANCE – functional consequences of the morphologic changes
    • HOMEOSTASIS
      • “ steady state – normal function where there is a balance between physiologic demands and the constraints of cell structure and metabolic capacity.”
      • MAINTAINED STATE OF VIABILITY OR VITALITY
    • THE CELL
      • Can alter their functional state in response to modest stress, maintain the steady state
      • More excessive physiologic stresses or adverse pathologic stimuli
        • ADAPTATION
        • INJURY: Reversible or Irreversible
        • DEATH
    • Normal Cell Cell Adaptation Cell Injury Reversible Irreversible Cell Death Hypoxia Infectious Chemical Physical Immunologic Genetic Nutritional Imbalance Duration Strength Intensity
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    • ADAPTATION
      • Stressful stimuli induce a new state that changes the cell
      • Preserves the cell’s viability
        • HYPERPLASIA
        • HYPERTROPHY
        • ATROPHY
        • INVOLUTION
        • METAPLASIA
        • DYSPLASIA
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    • CELL INJURY
      • REVERSIBLE
        • Pathologic cell changes that can be restored to normal state
      • IRREVERSIBLE
        • Stress exceeds the capacity to adapt
        • “ point of no return”
        • Permanent changes – DEATH
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    • CELL DEATH
      • 2 patterns
        • NECROSIS
          • Always pathologic
          • Severe cell swelling
          • Denaturation and coagulation of proteins
          • Breakdown of cellular organelles
          • Cell rupture
          • Large number cells in the adjoining tissue are affected
        • APOPTOSIS
          • May be physiologic
          • Activation of internal “suicide” program
          • Orchestrated disassembly of cell components
          • Minimal disruption of the surrounding tissue
          • Chromatin condensation/fragmentation
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    • Morphologic Types of Necrosis
      • Coagulation
      • Liquefaction
      • Caseation
      • Enzymatic Fat
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