Course Contents Of General Pathology Cell Injury & Death A brief recall of important aspects of normal cell structure.

Aetiology and Pathogenesis of cell injury: general biochemical mechanisms, hypoxia/ischemia/reperfusion injury, free radical-induced cell injury, chemical and viralinduced cell injury. Systemic effects of cell injury Types: Reversible and irreversible cell injury. Structural changes of reversible and irreversible cell injury, macroscopic, microscopic and ultrastructural appearances. Reversible cell injury: Types, Sequential changes, Cellular swellings, Vacuolation, Hyaline changes. Irreversible cell injury: a) Necrosis: definition, causes, types (Coagulative N: definition, causes, gross and microscopic appearances, fate. Caseation N: gross, microscopic, example. Fat N: enzymatic & traumatic, site and mechanism. Gangrene: Types, etiology, description of each type. b) Apoptosis: definition, causes, morphology and mechanisms

Intracellular Accumulations-Fatty changes, Protein accumulations, Glycogen accumulations. Pigments. Disorders of pigment such as bilirubin, melanin, and haemosiderin; Lipofuschin pigment. Disorders of Exogenous pigments, examples

Pathological calcification: definition, gross, microscopic appearances, types (dystrophic , metastatic, idiopathic ) and examples for each

Cellular adaptations to injury Growth disturbances: atrophy, hypertrophy, hyperplasia, metaplasia, dysplasia. Subcellular alterations: lysosomes, endoplasmic reticulum, mitochondria and cytoskeletal changes. Heat shock proteins. Extracellular Pathology: Pathology of collagen, elastin, basement membranes.

Tissue Responses to Injury Inflammation Definition, causes, types, cells and mediators involved. Acute inflammation. Definition, classical clinical features. Morphologic variants of acute inflammation (Acute non suppurative : definition & example. Acute suppurative ; causes: mechanisms, characters of pus , types (localized & diffuse) Vascular and cellular events. Chemical mediators. Special macroscopic appearances in certain tissues. Abscess formation. Beneficial and harmful effects of inflammation. Sequelae. The lymphatic system in inflammation. Systemic effects. Defects in the inflammatory response.

Chronic inflammation. Definition. Causes of chronic inflammation; primary causes and as a sequel to acute inflammation. Types. Classification: nonspecific and granulomatous with examples. Cells of chronic inflammation; central role of the macrophage. Granulomatous inflammation: definition of a granuloma; causes; morphology. Special macroscopic appearances in certain tissues. Chronic ulceration. Sequelae. Healing, Regeneration & Repair Labile, stable and permanent cells. Stem cells. Healing by regeneration with complete restitution. Healing by repair (+ - regeneration) with scar formation. Organisation by granulation tissue and fibrosis.

Healing of skin wounds: healing by first intention, healing by second intention. Complications; contractures, keloid. Factors influencing wound healing. Healing of bone fractures: organisation of haematoma, callus formation, lamellar bone formation, remodelling. Factors affecting fracture healing. Complications of fractures. Healing in the gastrointestinal tract, peritoneum and other tissue spaces, liver, kidney, muscle and neural tissue.

Hemodynamic Disturbances

Oedema: Definition, fluid collections in body cavities.

Pathophysiological categories of oedema. Morphology. Clinical importance.

Hyperaemia and Congestion: Causes, morphology and clinical importance. Chronic Venous Congestion: of particular organs: Lung, Systemic- Liver, Spleen. Causes, Pathogenesis, Gross features and microscopic features.

Haemorrhage: brief overview of causes, terminology and clinical significance.

Ischemia: definition, causes, effects on tissues and the modifying effects of duration of ischaemia, and differing susceptibilities of tissues. Clinical importance.

Thrombosis: definition. Distinction from clot. Components of a thrombus. Predisposing factors to thrombus formation. Virchow's triad. Morphology. Arterial thrombosis. Venous thrombosis. Thrombi on heart valves. Fate of thrombi: fibrinolysis, organization, recanalization, calcification. Clinical effects of arterial and venous thrombosis. Disseminated intravascular coagulation.

Embolism: definition, types, causes, common sites and effects. Infarction: definition, causes, morphology of infarcts, variations seen in different organs, organization and repair.

Factors effecting the development of an infarct.

Gangrene: definition, types (Dry, moist, infective) Clinical importance. Shock: definition, types of shock, causes, stages of shock, tissue changes in shock, clinical manifestations.

Immunopathology Immune system: General concepts Hypersensitivity: Types and examples; mediators namelyantibody and cell mediated tissue injury with examples. Immunodeficiency: Primary immunodeficiency. Secondary immunodeficiency including HIV infection. AIDS- Aetiology, Modes of transmission, Diagnostic procedures, types, associated infections (CMV, TB, etc..), protozoal, toxoplasma, neoplasia (Kaposi sarcoma, lymphoma)

Autoimmune diseases: Organ specific and non-organ specific such as polyarteritis nodosa, Hashimotos disease, Sjogrens syndrome, Polymyositis-Dermatomyositis, Scleroderma. Organ transplantation: Immunologic aspects, basis of rejection and graft versus host reaction.

Extra Cellular accumulations: Amyloidosis-Classification, Pathogenesis, Pathology including special stains.

Infections Definition, cause, types, effects.Types of reaction in tissues to the presence of an organism. Interaction with hosts and immune state. Toxaemia, bacteraemia, septicaemia, pyaemia Bacterial Infections: General pathology of diseases caused by bacteria, viruses, fungi, parasites. Tuberculosis: Primary & secondary, lung, intestine, urinary tract, bone and vertebrae (cold abscess), nervous system Leprosy: TL, LL Syphilis : 1ry. 2ry., 3ry., congenital, cardiovascular, neural Viral, Fungal & Parasitic Diseases Viral diseases: , Herpes, Measles Fungal disease : Moniliasis, Actinomycosis Parasitic diseases: Bilharziasis: pathology and immunology, large intestine, liver, urinary tract, cardiopulmonary, CNS. Filariasis. Entamoeba histolytica

Neoplasia:

Developmental growth disorders: hamartoma, choristoma agenesis, aplasia, hypoplasia

Definition, general features of neoplasm Classification of neoplasm: according tissue of origin, tumor behavior, degree of differentiation, grading system Features of benign tumors: mode of growth, rate of growth, gross, microscopic appearance, effects and complications Features of malignant tumor: mode of growth, rate of growth, gross picture, microscopic appearance, modes of spread of malignant tumours ( Direct ,hematogenous, lymphatic, transcoelomic, implantation)

Carcinogenesis: definition, carcinogenic agents (chemical, viral & bacterial, radiation)

Precancerous lesions Effects of malignant tumors (local & general effects) Factors affecting tumor prognosis: (Tumor grade, tumor staging systems, type of tumor, site of tumor, efficiency of immune system, early diagnosis and treatment)

Epithelial tumors: Benign epithelial tumors: Papilloma: types, gross, microscopic, Adenoma: types, gross, microscopic Carcinoma: definition, origin, gross, microscopic types

(differentiated & undifferentiated) Squamous cell carcinoma: site, origin, predisposing factors, gross , microscopic, spread

Mesenchymal tumors: Nomenclature, Benign mesenchymal tumors: fibroma, lipoma Sarcoma: definition, origin, gross, microscopic. Examples Difference between carcinoma & sarcoma Carcinoma in situ & locally malignant tumors: definition & examples

Tumors of pigmented cells: Nevus: site, gross, microscopic, types Melanoma: origin, sites, gross, microscopic, spread

Embryonic tumors: definition & examples

Methods of tumor diagnosis: cytology, biopsy, tumor markers