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COURSE: GENERAL PATHOLOGY
CLASS: MDIII
SEMESTER: Spring (Jan-Apr, 2013)
COORDINATOR: Associate Professor Dr. Reza Farhour
Email: [email protected]
COURSE DESCRIPTION:
Pathology is the study of structural and functional abnormalities that are expressed as
diseases of organs and systems. Traditionally, the discipline is divided into general pathology
and systemic pathology; the former focuses on the fundamental cellular and tissue
responses to pathologic stimuli, while the latter examines the particular responses of
specialized organs.
Knowledge & understanding of pathology is essential for all doctors as this subject forms the
bridge preclinical sciences & clinical subjects and it involves the investigation of the causes
(etiology) of disease as well as the underlying mechanisms (pathogenesis) that result in the
presenting signs and symptoms of the patient.
In MED III & IV the pathological basis of all diseases is thought which will help student in
rational treatment of patients.
Saint James School of Medicine
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COURSE OBJECTIVES:
By the end of the course, the medical student will be able to:
a. Knowledge (theory) 1. Understand the concepts of cell injury & changes produced thereby in different tissues & organs & the body’s capacity for healing 2. Understand the normal homeostatic mechanisms, the derangement of these mechanisms & the effects on human systems. 3. Understand the etiopathogenesis, the pathological effects & clinic-pathological correlation of common infectious & non-infectious diseases. 4. Understand the concept of neoplasia with reference to etiology, gross & microscopic features, diagnosis & prognosis in different tissues & organs of the body. 5. Have knowledge of common immunological disorders & their resultant effect on the human body.
b. Skill (Practical in pathology)
1. be conversant with the organization & functioning of the laboratories & should be aware of the safety precautions to be taken in the laboratories. 2. be aware of the common methods of collection of samples for hematological & bio-
chemical investigations & anticoagulants to be used. They should be conversant with the methods of collection of the body fluids for cytological examinations.
3. have knowledge of sample collection & methods of processing of samples & common histological techniques including H & E staining.
4. have knowledge of application & significance of frozen section.
5. identify as spotters the common histopathological, hematological & cytological slides & specimens & charts & their interpretations.
c. Behavior (attitude)
1. utilize the services of a clinical laboratory in the diagnosis and management of a clinical case.
2. understand a laboratory report and explain it to the patient.
3. be aware of lab safety, biomedical waste disposal, handling of specimen in taking care of the self and patients and other personnel.
4. understand ethical practices
5. utilize blood bank services its ethical aspects, pros and cons of transfusion.
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SUMMARY OF COURSE CONTENTS:
NO CHAPTER
1 CELL INJURY AND CELL DEATH, CELLULAR ADAPTATIONS
2 INFLAMMATION
3 TISSUE RENEWAL, REPAIR and REGENERATION
4 HEMODYNAMICS, SHOCK
5 GENETIC DISORDERS
6 IMMUNOPATHOLOGY
7 NEOPLASIA
8 INFECTIOUS DISEASES
9 ENVIROMENTAL AND NUTRITIONAL DISEASES
10 DISEASES OF INFANCY AND CHILDHOOD
11 HEMATOPOIETIC AND LYMPHOID SYSTEM
DETAILS OF COURSE CONTENTS:
1. CELL INJURY AND CELL DEATH a. Definitions b. Causes of cell injury c. Mechanisms of cell injury d. Necrosis e. Apoptosis f. Sub cellular alterations in cell injury g. Intracellular accumulations h. Pathologic calcification i. Hyaline change j. Cellular aging k. Adaptations l. Atrophy m. Hypertrophy n. Hyperplasia o. Metaplasia
2. INFLAMMATION
a. Definitions
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b. Types of inflammation c. Acute inflammation d. Chronic inflammation
3. REGENERATION
a. Control of normal Cell Proliferation and Tissue Growth b. Stem Cells c. Cell Cycle d. Mechanisms of Cell Growth e. Mechanims of Tissue regeneration f. ECM g. Healing by Repair, Scar formation and Fibrosis
4. HEMODYNAMICS
a. Edema b. Hyperemia, congestion, hemorrhage c. Hemostasis d. Thrombosis e. Embolism f. Infarction g. Shock
5. GENETIC DISORDERS a. Definitions b. Mutations c. Mendelian disorders d. Multifactorial inheritance e. Chromosomal abnormalities
6. DISEASES OF IMMUNITY
a. Defense mechanisms b. Types of immunity c. Cells of immunity d. Cytokines and functions e. HLA f. Hypersensitivity g. Transplant rejections h. Autoimmune disorders i. Immunodeficiency j. amyloidosis
7. NEOPLASIA
a. Definitions b. Components of tumors c. Naming of tumors d. Classification of tumors e. Characteristics of benign and malignant tumors f. Metastasis g. Cancer epidemiology
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h. Carcinogenesis i. Cancer etiology j. Clinical aspects of neoplasia
8. INFECTIOUS DISEASES
a. general principles of microbal pathogenesis b. New and Emerging Infectious Diseases c. Immune Evasion by Microbes d. Viral Infections e. Bacterial Infections
9. ENVIRONMENTAL DISORDERS and NUTRITIONAL DISORDERS
a. Protein Energy Malnutrition b. Vitamin deficiencies c. Obesity d. Physical injuries e. Radiation injuries f. Personal exposures g. Chemical injuries
10. DISEASES OF INFANCY AND CHILDHOOD
a. Causes of death in infancy and childhood b. Birth weight and gestational age c. IUGR d. Congenital anomalies e. Respiratory Distress Syndrome f. Erythroblastosis fetalis g. Inborn errors of metabolism h. Cystic fibrosis i. Sudden Infant Death Syndrome j. Tumors
11. HEMATOPOIETIC AND LYMPHOID SYSTEM a. Development & Maintenance of Hematopoietic Tissues b. Disorders of White Cells
i. Leukopenia ii. Reactive (Inflammatory) proliferations of white cells iii. Neoplastic proliferation of white cells
c. Spleen i. Splenomegaly ii. Neoplasms iii. Congenital anomalies iv. Rupture
d. Thymus i. Developmental disorders ii. Thymic hyperplasia iii. Thymomas
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e. Anemias f. Polycytemia g. Bleeding disorders, Hemorrhagic diathesis
TEACHING LEARNING METHODS:
The teaching learning activities during the pathology course will be carried out through 1. Lectures 2. Practicals 3. Tutorials 4. Case based team work 5. Integrated teaching 6. Self directed learning
ASSESSMENT:
The assessment format consists of 5 main sections:
1. Attendance: Students must attend all lectures on a regular basis. Minimum of 80%
attendance for every month is mandatory. Any student falling short of 80% attendance will
not be allowed to take the exam.
2. Assignment
3. Practical
4. Quiz
5. Exam
Marks distribution of all assessment:
ASSESSMENT WEIGHTEGE %
Assignment 10
Practical 5
Quiz 5
Exam 80
TOTAL 100
7 GRADING:
Grades will be based on the total assessment mark
Final grade will be an aggregate of all the four exams & courseworks
The grading scale is as follows:
SCORE GRADE
< 70% FAIL (F)
70-79% C
80-89% B
90-100% A
EXAMINATION SCHEDULE:
a) PATTERN:
TYPE OF QUESTIONS MULTIPLE CHOICE (MCQs & BAQs)
NO OF QUESTIONS 50
DURATION 1 HOUR
b) CHAPTERS:
EXAM I 1,2,3
EXAM II 4,5,9
EXAM III 7, 10
EXAM IV 6,8, 11
c) EXAM DATES;
EXAM I May 25th & 28th 2012
EXAM II June 22nd & 25th 2012
EXAM III July 20th & 23rd 2012
EXAM IV 20th Aug & 22nd Aug 2012
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RECOMMENDED TEXT BOOKS:
1. Kumar V.,Abbas A.K.,Fausto N, Aster,J.C (ed) 2010,Robbins and Cotran pathologic
basis of disease. 8 ed. Elsevier, Philadelphia.
2. Rubin R.,Strayer (ed), 2008,Rubin’s Pathology ed.Lippincott Williams, Baltimore.
3. Mohan H., 2010, Text book of pathology, 6ed.Jaypee publications, New Delhi.
4. Stephen J. McPhee, Gary D. Hammer, (ed) 2010, Pathophysiology of Disease: An
Introduction to Clinical Medicine, Sixth Edition, McGraw-Hill
5. Arthur S.Schneider, Philip A.Szanto, 2002, Board Review Series Pathology , 4th
ed., Lippincott Williams
6. Edward F.Goljan, Rapid Review Pathology, second ed., Mosby
7. Bruce A. Fenderson, Review Of Pathology Illustrated Q&A, 2nd Ed , Lippincott
Williams
Online Sources:
1. http://sinoemedicalassociation.org/pathologylectures/ (take password from Dr.
Hammoudi)
2. http://library.med.utah.edu/WebPath/webpath.html (For MCQs, Slides, case
Study)
3. http://www.path.uiowa.edu (For Virtual Slides)
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LECTURE SCHEDULE: Spring 2013
Wk Day DATE CHAPTER TOPIC Professor
1 Tuesday 8.1.2013 Registration & Orientation
Wednesday 9.1.2013 INTRODUCTION TO
PATHOLOGY
DEFINITIONS, ETIOLOGY,
PATHOGENESIS
Dr. HAMMOUDI
Thursday 10.1.2013 ADAPTATIONS OF CELLULAR
GROWTH AND
DIFFERENTIATION
HYPERTROPHY, HYPERPLASIA,
ATROPHY, METAPLASIA
Dr. HAMMOUDI
Friday 11.1.2013 CELL INJURY AND CELL DEATH MECHANISMS OF CELL INJURY
AND CELL DEATH
Dr. HAMMOUDI
Monday 14.1.2013 CELL INJURY AND CELL DEATH MORPHOLOGICAL ALTERATIONS IN
CELL INJURY AND NECROSIS
Dr. HAMMOUDI
2 Tuesday 15.1.2013 CELL INJURY AND CELL DEATH APOPTOSIS, AUTOPHAGY,
INTRACELLULAR ACCUMULATIONS,
PATHOLOGIC CALCIFICATIONS,
AGING
Dr. HAMMOUDI
Wednesday 16.1.2013 INFLAMMATION QUIZ 1 B 1,
ACUTE INFLAMMATION,
MEDIATORS OF INFLAMMATION,
Dr. HAMMOUDI
Thursday 17.1.2013 INFLAMMATION OUTCOMES OF ACUTE
INFLAMMATION
Dr. HAMMOUDI
Friday 18.1.2013 INFLAMMATION CHRONIC INFLAMMATION, CELLS
MEDIATORS, OUTCOMES
Dr. HAMMOUDI
Monday 21.1.2013 INFLAMMATION SYSTEMIC EFFECTS OF
INFLAMMATION AND
CONSEQUENCES OF EXCESSIVE
INFLAMMATION
Dr. HAMMOUDI
3 Tuesday 22.1.2013 TISSUE RENEWAL,
REGENERATION AND REPAIR
STEM CELLS, CELL CYCLE,
MECHANISMS OF TISSUE
REGENERATION
Dr. HAMMOUDI
Wednesday 23.1.2013 TISSUE RENEWAL,
REGENERATION AND REPAIR
QUIZ 2 B 1,
ECM, HEALING BY REPAIR,
ANGIOGENESIS
Dr. HAMMOUDI
Thursday 24.1.2013 Dr. HAMMOUDI
10 Friday 25.1.2013 EXAM I CHAPTER 1,2 & 3 Dr. HAMMOUDI
Monday 28.1.2013 Or EXAM I CHAPTER 1,2 & 3 Dr. HAMMOUDI
4 Tuesday 29.1.2013 HEMODYNAMIC DISORDERS EDEMA, Hyperemia, Hemorrhage Dr. FARHOUR
Wednesday 30.1.2013 HEMODYNAMIC DISORDERS HEMOSTASIS AND THROMBOSIS
,EMBOLISM
Dr. FARHOUR
Thursday 31.1.2013 HEMODYNAMIC DISORDERS HEMOSTASIS AND THROMBOSIS
,EMBOLISM
Dr. FARHOUR
Friday 1.2.2013 HEMODYNAMIC DISORDERS INFARCTION , SHOCK Dr. FARHOUR
Monday 4.2.2013 NUTRITIONAL DISORDERS QUIZ 1 B 2,
VITAMIN DEFICIENCES A, D, C, B1,
THIAMINE
Dr. FARHOUR
5 Tuesday 5.2.2013 NUTRITIONAL DISORDERS DIETARY INSUFFICIENCY , Dr. FARHOUR
Wednesday 6.2.2013 NUTRITIONAL DISORDERS OBESITY Dr. FARHOUR
Thursday 7.2.2013 NUTRITIONAL DISORDERS INJURY BY THERAPEUTIC DRUGS
AND DRUG ABUSE, PHYSICAL
INJURIES
Dr. FARHOUR
Friday 8.2.2013 NUTRITIONAL DISORDERS AIR POLLUTION, METALS Dr. FARHOUR
Monday 11.2.2013 GENETIC DISORDERS QUIZ 2 B 2,
IONIZING RADIATION, TOBACCO,
ALCOHOL
Dr. FARHOUR
6 Tuesday 12.2.2013 GENETIC DISORDERS IONIZING RADIATION, TOBACCO,
ALCOHOL
Dr. FARHOUR
Wednesday 13.2.2013 GENETIC DISORDERS DEFINITIONS, MUTATIONS,
MENDELIAN DISORDERS
Dr. FARHOUR
Thursday 14.2.2013 GENETIC DISORDERS MULTIGENIC, CHROMOSOMAL
DISORDERS
Dr. FARHOUR
Friday 15.2.2013 GENETIC DISORDERS SINGLE-GENE DISORDERS WITH
NONCLASSIC INHERITANCE
Dr. FARHOUR
Monday 18.2.2013 GENETIC DISORDERS MOLECULAR DIAGNOSIS OF
GENETIC DISEASES
Dr. FARHOUR
7 Tuesday 19.2.2013 REVISION CHAPTERS 4,5 & 9 Dr. FARHOUR
Wednesday 20.2.2013 REVISION CHAPTERS 4,5 & 9 Dr. FARHOUR
11 Thursday 21.2.2013 Dr. FARHOUR
Friday 22.2.2013 EXAM II Chapters 4, 5 & 9 Dr. FARHOUR
Monday 25.2.2013 Or EXAM II Chapters 4, 5 & 9 Dr. FARHOUR
8 Tuesday 26.2.2013 NEOPLASIA NOMENCLATURE,
CHARACTERISTICS OF BENIGN AND
MALIGNANT NEOPLASMS,
METASTASES
Dr. HAMMOUDI
Wednesday 27.2.2013 NEOPLASIA EPIDEMIOLOGY OF CANCER Dr. HAMMOUDI
Thursday 28.2.2013 NEOPLASIA MOLECULAR BASIS OF CANCER,
ONCOGENES
Dr. HAMMOUDI
Friday 1.3.2013 NEOPLASIA MECHANISMS OF INVASION AND
METASTASES
Dr. HAMMOUDI
Monday 4.3.2013 PUBLIC HOLIDAY
9 Tuesday 5.3.2013 NEOPLASIA MULTISTEP CARCINOGENESIS,
CANCEROGENIC AGENTS Dr. HAMMOUDI
Wednesday 6.3.2013 NEOPLASIA GENOMIC INSTABILITY Dr. HAMMOUDI
Thursday 7.3.2013 NEOPLASIA HOST DEFENCE AGAINST TUMORS Dr. HAMMOUDI
Friday 8.3.2013 NEOPLASIA CLINICAL ASPECTS OF NEOPLASIA Dr. HAMMOUDI
Monday 11.3.2013 NEOPLASIA Quiz 1 B 3,REVIEW Dr. HAMMOUDI
10 Tuesday 12.3.2013 DISEASES OF INFANCY &
CHILDHOOD
CONGENITAL ABNORMALITIES Dr. HAMMOUDI
Wednesday 13.3.2013 DISEASES OF INFANCY &
CHILDHOOD
DISORDERS OF PREMATURITY Dr. HAMMOUDI
Thursday 14.3.2013 DISEASES OF INFANCY &
CHILDHOOD
PERINATAL INFECTIONS Dr. HAMMOUDI
Friday 15.3.2013 DISEASES OF INFANCY &
CHILDHOOD
FETAL HYDROPS Dr. HAMMOUDI
Monday 18.3.2013 DISEASES OF INFANCY &
CHILDHOOD
INBORN ERRORS OF METABOLISM
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Dr. HAMMOUDI
11 Tuesday 19.3.2013 DISEASES OF INFANCY &
CHILDHOOD
SIDS and Tumors Dr. HAMMOUDI
Wednesday 20.3.2013 REVISION Quiz 2 B 3, Dr. HAMMOUDI
12 Chapter 7 & 10
Thursday 21.3.2013 Dr. HAMMOUDI
Friday 22.3.2013 EXAM III Chapters 7 & 10 Dr. HAMMOUDI
Monday 25.3.2013 Or EXAM III Chapters 7 & 10 Dr. HAMMOUDI
12 Tuesday 26.3.2013 IMMUNOPATHOLGY DEFENCE MECHANISMS, TYPES OF
IMMUNITY, ANTIGEN,ANTIBODY
Dr. FARHOUR
Wednesday 27.3.2013 IMMUNOPATHOLGY DUALITY OF IMMUNE SYSTEM,
Ag+Ab BINDING
Dr. FARHOUR
Thursday 28.3.2013 IMMUNOPATHOLGY HYPERSENSITIVITY- I & II, III, IV Dr. FARHOUR
Friday 29.3.2013 Public Holiday
Public Holiday Monday 1.4.2013
13 Tuesday 2.4.2013 IMMUNOPATHOLGY TRANSPLANT REJECTIONS,
AUTOIMMUNE DISEASES – SLE,
SJOGREN SYNDROME, SYSTEMIC
SCLEROSIS, INFLAMMATORY
MYOPATHIES,
Dr. FARHOUR
Wednesday 3.4.2013 IMMUNOPATHOLGY PRIMARY IMMUNODEFICIENCY,
AQUIRED IMMUNODEFICIENCY
(AIDS), AMYLOIDOSIS
Dr. FARHOUR
Thursday 4.4.2013 HEMATOPOIETIC AND LYMPHOID SYSTEM
Quiz 1 B 4,
Development & Maintenance of Hematopoietic Tissues
, Disorders of White Cells
Dr. FARHOUR
Friday 5.4.2013 HEMATOPOIETIC AND LYMPHOID SYSTEM
Disorders of White Cells Dr. FARHOUR
Monday 8.4.2013 HEMATOPOIETIC AND LYMPHOID SYSTEM
Spleen , Thymus Dr. FARHOUR
14 Tuesday 9.4.2013 HEMATOPOIETIC AND LYMPHOID SYSTEM
Anemia, Polycytemia Dr. FARHOUR
Wednesday 10.4.2013 HEMATOPOIETIC AND LYMPHOID SYSTEM
Bleeding disorders, Hemorrhagic diathesis
Dr. FARHOUR
Thursday 11.4.2013 HEMATOPOIETIC AND LYMPHOID SYSTEM
Bleeding disorders, Hemorrhagic diathesis
Dr. FARHOUR
Friday 12.4.2013 HEMATOPOIETIC AND LYMPHOID
SYSTEM Quiz 2 B 4, Dr. FARHOUR
13 Review
Monday 15.4.2013 INFECTIOUS DISEASES CATEGORIES OF INFECTIOUS
AGENTS, DIAGNOSTIC
TECHNIQUES
Dr. FARHOUR
15 Tuesday 16.4.2013 INFECTIOUS DISEASES MECHANISMS OF CELL INJURY
INDUCED BY INFECTIOUS AGENTS
AND HOST RESPONSE , ACUTE AND
CHRONIC VIRAL INFECTIONS
Dr. FARHOUR
Wednesday 17.4.2013 INFECTIOUS DISEASES BACTERIAL INFECTIONS INDUCED
BY GRAM POSITIVE AND NEGATIVE
MICROORGANISMS
Dr. FARHOUR
Thursday 18.4.2013 INFECTIOUS DISEASES INFECTIONS INDUCED BY OTHER
BACTERIA, FUNGAL,
Dr. FARHOUR
Friday 19.4.2013 INFECTIOUS DISEASES PARASITIC INFECTIONS , Dr. FARHOUR
Monday 22.4.2013 REVISION Quiz 3 B 4,
Chapter 6 & 8, 11
Dr. FARHOUR
Tuesday 23.4.2013 Dr. FARHOUR
Wednesday 24.4.2013 Exam IV Chapters 6 & 8, 11 Dr. FARHOUR
Friday 26.4.2013 Or Exam IV Chapters 6 & 8, 11 Dr. FARHOUR
