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1 introduction Presentation Transcript

  • 1. MID 2163 PATHOLOGY
  • 2. DIVISIONS OF PATHOLOGY GENERAL PATHOLOGY SYSTEMIC PATHOLOGY CLINICAL PATHOLOGY ANATOMIC PATHOLOGY SURGICAL PATHOLOGY PATHOPHYSIOLOGY
  • 3. General Pathology
    • Also called
      • investigative pathology
      • experimental pathology
      • theoretical pathology
  • 4. General Pathology
    • Foundation of pathology
    • Study of the mechanisms of disease – etiology & pathogenesis
    • The common changes in all tissues
  • 5. 1. INTRODUCTION TO PATHOLOGY 2. CELL INJURY & ADAPTATIONS 3. TISSUE INJURY 4. HEALING 5. HAEMODYNAMIC DISEASES 6. NEOPLASIA 7. INFECTIOUS & PARASITIC DISEASES
  • 6. INTRODUCTION TO PATHOLOGY
  • 7. What is?? -PATHOLOGY-
    • “ study of disease by scientific method”
    pathos : suffering or disease ~logos : study of
  • 8. Objective of Pathology
    • To identify and describe the different parts of a disease process
  • 9. Disease???
    • Abnormal variation in structure or function of any part of body
  • 10. Pathology...
    • Explain the disease by studying the 4 aspects of the disease:
      • Etiology
      • Pathogenesis
      • Morphological changes
      • Functional derangement & clinical significance
  • 11. Etiology
    • aitia : cause
    • ~logos : study
    “ study of causation or origin of disease”
  • 12. Etiology
    • Why things occur?
    • Factors that produce/predispose toward a certain disease or disorder
    • Cause of disease
      • primary etiology: known
      • idiopathic: unknown
    • Help in diagnosis, understanding and treatment of disease
  • 13. Etiology
    • 2 major etiological factors
      • Genetic: age, genes
      • Acquired: infectious, environmental, nutritional etc
    • Etiology is followed by pathogenesis
  • 14. Pathogenesis
    • pathos : disease
    • genesis : creation
    “ mechanism / development of disease”
  • 15. Pathogenesis
    • Process of disease
    • Starting 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
  • 16. Pathogenesis
    • Types of pathogenesis include
      • Microbial infection, inflammation, malignancy & tissue breakdown
    • Most disease caused by multiple pathogenetical process together
      • Example: cancer – multiple pathogenesis
    • Pathogensis leads to morphological changes
  • 17. Morphological Changes “ structural alterations”
  • 18. Morphological Changes
    • Structural 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
  • 19. Morphological Changes
    • The 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
  • 20. Functional Derangement & Clinical Significance
  • 21. Functional Derangements
    • Disturbance of normal function of the organ due to the morphological changes
    • Determine the clinical features, course and prognosis of a disease
  • 22. Clinical Significance
    • Clinical manifestations
      • Signs
      • Symptoms
      • Prognosis
  • 23. Signs
    • Objective 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
  • 24. Symptoms
    • Subjective – 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
  • 25. Symptoms
    • Asymptomatic – 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
  • 26. Prognosis
    • Medical term to describe the likely outcome of an illness
    • Complete prognosis include expected time, function and description of disease course
      • Help to determine to attempt certain treatments or withold
    • Certain test for prognostic indicator
    • Estimators to describe prognoses = progression-free survival , survival rate & survival time
  • 27. Causes of Disease Can be caused by environmental factors, genetic factors or combination of the two
  • 28. Environmental Factors
    • Physical agents
    • Chemicals
    • Nutritional dificiencies & excesses
    • Infections and infestations
    • Immunological factors
    • Psycogenic factors
  • 29. Environmental Factors
    • Physical 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
  • 30. Environmental Factors
    • Nutritional 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
  • 31. Environmental Factors
    • Infections 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
  • 32. Environmental Factors
    • Immunological 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
  • 33. Environmental Factors
    • Psycogenic factors
      • Mental stress imposed by condition of life
      • Maybe contributory factors in some group of diseases
  • 34. Genetic Factors
    • Hereditary factors that are inherited genetically from parents
    • Mutation in chromosomes
  • 35. 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)
  • 36. EXPOSURE BIOLOGICAL ONSET CLINICAL ONSET PERMANENT DAMAGE DEATH
  • 37.
    • 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
  • 38.
    • 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 damage
    • Death
      • Clinical death
      • Biological death
  • 39. Clinical Death
    • Occurs when heart stop beating – cardiac arrest
    • Reversible transmission between life and biological death
    • Definition: period of respiratory, circulatory and brain arrest during which initiation of resuscitation can lead to recovery
  • 40. Clinical Death
    • Signs
      • No pulse or blood pressure = completely unresponsive to the most painful stimulus
      • Pupils widely dilated
      • Recovery can occur with resuscitation
  • 41. Biological Death
    • Sure sign of death
    • Sets in after clinical death
    • Irreversible state of cellular destruction
    • Manifest with irreversible cessation of
      • circulatory and respiratory functions
      • all functions of the entire brain including brainstem