Introduction to pathology 2016

course 2 credit hour Three instuctors: Dr Heyam Awad, Dr Mazen Al Salihi and Dr Manar Hajeer Section 4,5,6 coordinator: Dr H Awad

Reference Robbins basic pathology Ninth edition Chapters in this course 1,2,5 Web Path Internet teaching http://library.med.utah.edu/WebPath/EXAM/MULTGEN/examidx.htm

Course description lecture topic 1 introduction 2-5 Cell injury Chapter 1, page 2-28 6-10 inflammation Chapter 2, page 29-58 11-14 repair Chapter 2, page 58-72 15-25 neoplasia Chapter 5, page 161-214

Tutors and lecture distribution Section4 section5 section6 Cell injury Dr Mazen Dr Manar Dr Manar inflammation Dr Heyam repair neoplasia

Lecture Ch/Pg 1. Course Orientation & Introduction 2. Homeostasis, Adaptation, & Cell Death Principles Adaptive Responses (Hypertrophy, Hyperplasia, Atrophy, Metaplasia) Cell Injury (reversible/irriversible) Cell Death Morphology of Cell Death Ch1 Pg. 1-5 Pg. 8-11 3. Cell Injury & Death Causes Principles & mechanisms (Mitochondria, Ca2+, Free radicals & ROS, Membrane damage) Mechanisms in practice (Hypoxia Ischemia, Reperfusion, Chemical) Pg. 6-7 Pg. 11-18 4. Apoptosis Definition Mechanisms (Mitochondrial, Death receptor) Mechanisms in practice (Growth factor deprivation, DNA damage, Protein damage, role in immunity) Necroptosis Pg. 18-22 5. Autophagy Intracellular accumulations Pathologic calcification Cellular aging Pg. 22-28

lecture topics pages 6. Inflammation Overview of inflammation and Vascular changes 29-34 7. inflammation Cellular events in inflammation 35-40 8. Chemical mediators..1 Cell derived mediators 44-50 9. Chemical mediators 2 Plasma derived mediators Morphology of acute inflammation 50-53 43-44 10. Chronic inflammation and systemic effects of inflammation 53-59

Lecture Ch/Pg 11. Cell proliferation in tissue repair Overview of tissue repair Cell proliferation Stem cells Growth factors Ch2 Pg. 58-62 12. Role of the ECM in tissue repair Extracellular matrix Structure Components Function Regeneration in tissue repair Overview of tissue response to injury - revisited Pg. 63-65 13 & 14 Scarring & Fibrosis Steps Angiogenesis Activation of fibroblasts & ECM deposition Maturation & remodelling Factors influencing tissue repair Clinical examples Pg. 66-72 15. Neoplasia Definition & Nomenclature Benign & Malignant neoplasia Characteristics Differentiation & Anaplasia Rate of growth Local invasion Metastasis Ch5 Pg. 161-169

Lecture Ch/Pg 16. Epidemiology & introduction to the molecular biology of cancer Epidemiology Environment Age Heredity Acquired pre-neoplastic lesions Pg. 169-173 17. Genetics & epigenetics of cancer Molecular Biology of Cancer (introduction) Karyotypic changes Translocation Deletion Amplification Aneuploidy miRNA Epigenetic changes (methylation) Molecular Biology of Cancer (initiation & progression) Hallmarks of Cancer (introduction) Pg. 173-178 18. Hallmarks of Cancer - Growth & Growth inhibition Growth factors & their receptors Signal transduction & transcription Cell cycle control (cyclins & CDKs) The first tumor suppressor gene: RB Pg. 178-184 19. Hallmarks of Cancer - Growth inhibition & Evasion of death Guardian of the genome: p53 TGFβ signalling Contact inhibition: NF2 & APC Evasion of cell death Pg. 185-190

Lecture Ch/Pg 20. Hallmarks continued Limitless replicative potential Development of sustained angiogenesis Ability to invade and metastasize Pg. 190-195 21. New Hallmarks Reprogramming Energy Metabolism Evasion of the Immune System Genomic instability Inflammation Pg. 195-198 22. Etiology of cancer Chemical Radiological Microbial Oncogenic viruses H. Pylori Pg. 198-204 23. Tumor immunity Tumor antigens Cell mediated immunity Immune surveillance & evasion Pg. 204-207 24. Clinical aspects of neoplasia Systemic effects Grading & staging Lab diagnosis including molecular methods Pg. 207-213

evaluation Midterm exam… at week 7.. 40 marks Final exam……50 marks Attendance… 10 marks

Contact details Dr Manar hajeer E-mail: M.hajeer83@hotmail.com Office hours: 10-11 Mondays Office: third floor , JUH

Contact details Dr Heyam Email: h_awad@ju.edu.jo Office hors: 10-11 Mondays Office: third floor , JUH Lectures will be available on my website page a day before they are delivered. PLEASE bring a pen and papers to my lectures!!!!

RULES!! No talking No mobile phones No eating Strict attendance policy.. الحرمان مطبق...الرجاء الالتزام

More rules!! Dr Mazin: read the lecture topic from the book before you come to the lecture. Dr Heyam: bring your brain with you please, strictly, no talking ( or whispering) during lectures. Dr Manar: NO SIDE TALKS PLEASE

More rules No swapping between sections allowed.

What is pathology The study (logos) of suffering or disease (pathos). The study of the structural, biochemical, and functional changes in cells, tissues, and organs that are involved by disease.

Why pathology is important A bridge between the basic sciences and clinical medicine. Uses molecular, microbiologic, immunologic, and morphologic techniques trying to reach a diagnosis and explanation.

Divisions General pathology: reactions of cells and tissues to abnormal stimuli. Cell injury, inflammation and repair, hemodynamic disorders, genetic disorders, immune system diseases, infectious disease and environmental diseases. Systemic pathology: alterations in specialized organs and tissues in diseased status.

Aspects of disease Epidemiological aspects Etiology/ cause: Genetic: mutations Acquired: infectious, nutritional, chemical..

Aspects of disease Pathogenesis: sequence of events in the response of cells or tissues to the etiologic agent, from the initial stimulus to the ultimate expression of the disease. (mechanism).

Aspects of disease Molecular and morphologic changes: structural alterations in cells or tissues. Molecular and immunologic aspects of the disease/tissue/organ. Clinical features including biochemical tests, physical findings, radiological findings Complications & sequelae : Treatment Prognosis

Classification of Pathology Anatomical/ surgical pathology or histopathology: Gross examination and microscopic examination to reach a diagnosis. Clinical pathology: hematology, microbiology, immunology and biochemistry.

Anatomic pathology Histopathology. Cytopathology. Autopsy. Subspecialties: neuropathology, dermatopathology, oral pathology……

Diagnosis in Histopathology Biopsies: excisional and incisional. Smears: exfoliative and fine needle aspiration.