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Last update: doc. MUDr. Eva Sticová, Ph.D. (26.09.2017)
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Last update: MUDr. Iveta Matějovská, CSc. (21.06.2012)
Pathology:Acquisition of basic knowledge about general principles of pathological processes and appropriate medical terminology. Pathophysiology: Primary goal of the subject is to teach student theoretical and practical application of obtained knowledge of physiological processes on pathological states when pathophysiological mechanisms develop. Secondary objective is to educate student to be able to apply skills and knowledge in the field of special experimental pathology and mainly to be competent in clinical tutoring. |
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Last update: prof. MUDr. Radoslav Matěj, Ph.D. (11.12.2019)
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Last update: MUDr. Iveta Matějovská, CSc. (21.06.2012)
Lectures, seminars, practical exercises, basics of methodological work with case reports |
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Last update: doc. MUDr. Jan Polák, Ph.D. (30.09.2023)
Requirements for the credit of General Foundations of Pathology and Pathophysiology
Pathology Credit Requirements 1) The attendance at practical training is mandatory. The short term absence due to relevant reasons is excusable in 10% of the total extent of teaching (6 teaching units, i.e. three seminars and three practices). The long term absence is solved individually.
2) Basic knowledge of general pathology is required and will be continuously and randomly checked during the practical training by the group teacher.
3) Oral histopathology test held by group teacher at the end of the Pathology Course. Students should correctly describe 2 slides. The slide examination can be repeated twice (3 attempts together). The student who fails will take an oral retake exam by the head of the department or his deputy; a student, who fails this oral exam, will not get credit for school year 2019-2020.
4) Successful completion of a final written test composed of 90 questions. Successful completion means to answer correctly at least 60 questions. The general pathology test will be written collectively on the last lecture, on January 22, 2020. One possibility to retake the written test will be scheduled for those students who do not pass the first one successfully. If a student fails to complete successfully the written test(s), he/she will take oral exam by the head of the department or his deputy; A student, who fails this oral examination will not get credit for school year 2019-2020.
After meeting all above-mentioned requirements (paragraphs 1-4), a student is awarded a credit of general pathology.
If a student has not received the credit from pathology, he/she has to repeat the whole course and fulfil again all above mentioned criteria. Students who repeat exam only and have already received the credit can repeat the whole practical course only with the individual permission of the head of department or his/her authorized representative. prof. MUDr. Radoslav Matěj, Ph.D.
26.9.2019
GENERAL FOUNDATIONS OF PATHOLOGY AND PATHOPHYSIOLOGY Pathophysiology Credit Conditions for the year 2023 – 2024 The fundamental condition for attending the course is the successful completion of the subjects Cellular Foundations of Medicine and Structure and Function of the Human Body. The credit consists of three components that need to be fulfilled: Attendance: Per the dean's orders no. 11/2005 and 6/2006, absence from the mandatory classes held at the Institute of Pathophysiology can be excused for two topics. Replacement of mandatory education is possible with another group, only after agreement with the respective teacher. Replacement after the completion of all practicals and seminars is no longer possible (until the next year) – the exception is absence due to documented illness. Attendance is also checked for any distance learning; therefore, students are required to log in with their names. Evaluation: The evaluation of students takes into account both the work during the year (A) i.e., continuous and final credit test + ACCEPT work, accounting for 50% of the final grade (the ACCEPT work contributes 15% to the "performance during the year" grade, 25% is the classification of the interim test, and 60% is the classification of the credit test) and the performance in the final exam (B), also accounting for 50% of the final grade. The final grade for the subject of pathophysiology will be determined as the average of both grades, i.e., (A+B)/2 (A=grade from work during the year, B=grade from the exam). In the case of an undecided result (e.g., an average grade of 1.5), the examiner will use auxiliary grades + and – for the evaluation of the final exam, leading to rounding up or down. Tests: I. Interim test: In the eighth week of the semester, a test will be written from the discussed curriculum. The date of the test is stated in the schedule. Knowledge from lectures and seminars is presumed for successful completion. If a student fails, they will be re-examined orally from the test content. The test (or examination) will be classified 1-3 (plus failed = 4) according to the points achieved: 1=100-90% points, 2=75-90%, 3=50-75%, 4<50% points). II. Credit test in the fourteenth week: Students can write the credit test only after successfully completing the first test. The test will cover knowledge from the entire semester. The test can be written a total of three times (2 corrective attempts). If a student fails, they will be re-examined orally from the test content. The test (or examination) will be classified 1-3 (plus failed = 4) according to the points achieved: 1=100-90% points, 2=75-90%, 3=50-75%, 4<50% points). ACCEPT work (AritifiCal intelligenCE in pathoPhysiology for studenTs): The assignment is summarized in a separate document (ACCEPT work assignment.docx or a link here. The purpose of the work is to: • Integrate generative artificial intelligence tools into teaching and critically assess their possibilities. Introduce students to the basics of working with generative AI. Termín beginning of ACCEPT assignments is 9.10.2023 od 8:00 If a student did not obtain credit and is repeating the year, they must complete the course in its entirety. Students who are only repeating the exam and obtained credit in the previous school year can only attend mandatory education after prior agreement with the head of the institute or his appointed representative (due to capacity reasons). Recommended study materials: Lectures, seminars, and practicals Materials and presentations on the Education server C.M. Porth: Pathophysiology: concepts of altered health states (Wolters Kluwer Health/Lippincott Williams & Wilkins, 2009) K.L. McCance: The Biologic Basis for Disease in Adults and Children (Elsevier - Health Sciences Division, 2018) Internet resources e.g.: https://fyziologie.trimed.cz/; https://www.youtube.com/channe... https://www.wikilectures.eu/w/... https://www.wikilectures.eu/w/...
EXAM OUT OF “GENERAL FOUNDATIONS OF PATHOLOGY AND PATHOPHYSIOLOGY”
To be able to apply for the exam, the student will have both credits; from pathology and pathophysiology. The extent of knowledge required for the exam is defined by exam questions and by the contents of lectures and seminars. It is assumed that the student will acquire some knowledge through self-study or will be able to apply the knowledge acquired in other study fields.
The exam is oral. The student selects 2 questions from the basics of pathology and 2 questions from the basics of pathological physiology. If the student fails in one of the subjects, the next term will be rehearsed again from both of the subjects. |
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Last update: prof. MUDr. Radoslav Matěj, Ph.D. (25.09.2019)
Schedule practical exercises in the academic year 2019/2020 Week 1: Microscopy - staining methods and tissue processing Introduction and distribution of seminars students Week 2: Microscopy - necrosis , apoptosis Methodology of the obduction Case report Week 3: Microscopy - Metabolism of fats , protein, amyloid . Seminar ( Student presentations ) Necropsy Week 4: Microscopy - Pigments, calcification, crystals. Case report Necropsy Week 5: Microscopy - disorders of circulation Case report Seminars ( student presentations ) Necropsy Week 6: Microscopy - acute inflammation Case report Necropsy Week 7: Microscopy - inflammation and chronic granulomatous Case report Week 8: Microscopy - Selected mucosal inflammation and interstitial Case report Necropsy Week 9: Microscopy - Pseudotumors , precancerous Case report Necropsy Week 10: Microscopy - Mesenchymal tumors Case report Necropsy Week 11: Microscopy - Epithelial tumors Case report Necropsy Week 12: Microscopy - neuroectodermal tumors - tumors of the CNS , PNS Case report Necropsy Week 13: Microscopy - germ cell tumors and tumors of endocrine tissues Case report Necropsy
Week 14: Microscopy - leukemia, lymphoma Credit examination
Week 15: Credit week
General foundations of Pathology and Pathophysiology Pathology lectures
YEAR III - 2019-2020
Week 1 Tue 1. 10. 9.45-11,15 Introduction. Disease, etiology, pathogenesis, 327 Cell and tissue pathology: Apoptosis, necrosis, atrophy (prof. Mandys)
THu 3.10. 9,45-11,15 Disorders of the secretory process 327 Pathology of organelles: mitochondria, peroxisomes (MUDr. Hůlková)
Week 2 Tue 8.10. 9.45-11,15 Pathology of organelles: lysosomes. SYLL Disorders of glycogen turnover. Steatoses. (MUDr. Hůlková)
Thu 10.10. 9,45-11,15 Amyloidosis. Pathology of fibroplastic process (prof. Mandys) 327
Week 3 Tue 15.10. 9,45-11,15 Clonal composition of tissues, disorders of differentiation. Atrophy. BUR Morphology of water and mineral dysbalance (prof. Mandys)
Thue 17.10. 9,45-11,15 Pathologic calcification, stone formation. Crystals. Stone formation. BUR Exogenous and endogenous pigments (prof. Mandys)
Week 4 Tue 22.10. 9.45-11,15 Causes and consequences of circulatory failure (MUDr.Šach) Shock – types
THU 24.10. 9,45-11,15 Causes and mechanisms of inflammation. (doc.Vernerová) JON Types of inflammatory process
Week 5 Tue 29.10. 9.45-11,15 Inflammation chronic and granulomatous (prof. Mandys) BUR TB, syphilis, leprosy, sarcoidosis
THU 31.10. 9,45-11,15 Mucosal inflammation. Respiratory and digestive tract. (MUDr. Kujal) JON
Week 6 Tue 5. 11. 9.45-11,15 Mucosal and superficial inflammation (MUDr. Šach) BUR Genitourinary system. Skin. Serous membranes
THU 7.11. 9,45-11,15 Interstitial Inflammation I. BUR Heart, blood vessels, breast, salivary glands, pancreas, liver.(MUDr. Hrudka)
Week 7 Tue 12.11. 9.45-11,15 Interstitial Inflammation II. JON Kidneys, reproductive system, CNS, bones, joints (MUDr. Eis)
THU 14.11. 9,45-11,15 Progressive changes - tissue repair (prof. Mandys) 327 Pseudotumors. Hypertrophy and hyperplasia
Week 8 Tue 19.11. 8-9,30 Tumors - introduction. Oncogenesis Neoplastic transformation of cells. (prof. Mandys) 327 Precancerous conditions and lesions. Biological properties of tumors, TNM
THU 21.11 9,45-11,15 Mesenchymal tumors - the basic characteristics (prof. Matěj) 327
Week 9 Tue 26. 11. 9.45-11,15 Epithelial tumors - the basic characteristics (prof. Mandys) 327 THU 28.11. 9,45-11,15 Neuroectodermal tumors, CNS tumors (doc. Matěj) 327 Week 10 Tue 3. 12. 9.45-11,15 Germinal and mixed tumors. Mesothelioma (MUDr. Šach) JON
THU 5.12. 9,45-11,15 Tumors of mucosas and glandular epithelium I. (prof.Mandys) JON Respiratory tract, digestive tract
Week 11 Tue 10.12. 9.45-11,15 Tumors of the glandular and surface epithelium. (prof. Mandys) BUR Mamma, urinary tract, skin
TH 12.12. 9,45-11,15 Tumors of the parenchymatous organs 327 Lungs, liver, salivary glands, pancreas, prostate, uterus (MUDr. Šach)
Week 12 Tue 17. 12. 9.45-11,15 Tumors of the mesoderm and endocrine tissues (prof. Mandys) SYLL
TH 19.12. 19,45-11,15 Myeloproliferative syndrome, myelodysplasia (doc. Vernerová) JON Week 13 Tue 7. 1. 9.45-11,15 Ethiological pathology, pneumoconiosis (prof. Mandys) BUR TH 9.1. 9.45-11,15 Leukemia, lymphomas (doc. Vernerová) 327
Week 14 Tue 14.1. 9.45-11,15 Etiological pathology -bacterial infections . Etiological pathology – viral and mycotic infections parasites (prof. Mandys) BUR Th 16.1. 9,45-11,15 Disorders of immune reations. (prof. Mandys) JON Week 15 Tue 21. 1. 9.45-11,15 Disorders of development. Congenital anomalies (prof. Mandys) BUR WED 22.1. 11,30-13 CREDIT TEST BUR
Pathophysiology: Lectures:
15. Consultations
Practicals:
General fundamentals of pathophysiology for general medicine
SYLLABUS
Water balance Water body compartments and osmolality of body fluids Changes in volume and osmolality of the compartments when administering iso-, hyper- and hypotonic solutions (consequences / significance) Definition of hydration and volemia, the significance of their changes for the clinic Dehydration of hypo-, iso-, and hyperosmolar, clinical examples Hyperhydration of hypo-, iso- and hyperosmolar, clinical examples Mechanisms of endocrine regulation of the water management (ADH, RAAS, ANP) Endocrine disorders of water management: - Diabetes insipidus, central and peripheral, SIADH - Secondary hyperaldosteronism, Conn's syndrome, Addison's crisis Mechanisms of edema formation: hydrostatic pressure (venous), oncotic pressure, capillary permeability, lymphatic drainage Causes of edema: cardiac, venous, hepatic, renal, malnutrition, inflammatory, lymphatic Ascites - possible mechanisms of formation (portal hypertension ...) Compartment syndrome - examples, consequences
Pathophysiology of sodium, potassium and calcium Endocrine causes of changes in potassium and sodium metabolism (effect of pharmacological blockage of RAAS) Causes of potassium concentration changes: potassium intake and excretion disorders, potassium transfer between compartments Consequences of potassium concentration changes: neuromuscular irritation, cardiovascular symptoms/ECG changes, renal significance in potassium metabolism Possibilities of hyperkalemia therapy Control of calcium metabolism: parathormone, calcitriol, calcitonin; free and bound calcium Primary and secondary hyperparathyroidism, hypoparathyroidism Manifestations of parathyroid hormone and calcitriol changes Non-hormonal causes of calcemia changes: metastasis, paraneoplastic tumors, renal failure Consequences of calcemia changes: neuromuscular irritability, renal tubular disordres and stones, smooth muscle contraction, cardiovascular effects/ECG changes, CNS effects Causes of hyponatraemia; iso-/hypertonic hyponatraemia Consequences of hyponatremia and its therapy
ABB disorders Determination of acid-base balance disorders; anion gap and its significance Metabolic acidosis - causes: ketoacidosis, lactate, toxic, renal, hyperchloremic (diarrhea, RTA) Metabolic alkalosis - causes: hypochloraemic (diuretic, vomiting), hyperaldosteronism, hypovolemia, (hypoproteinaemia) Causes and consequences of respiratory ABB disorders, therapy options Compensation of individual types of ABB disorders: lungs, kidney, liver Detection of combined ABB disorders, examples Relation of ABB disorders and ion concentrations, influence of ions on ABB changes - potassium, unbound calcium, sodium, chlorides
Systemic hypertension, pulmonary hypertension Blood pressure regulation, factors determining systolic x diastolic pressure, pressor and depressor factors Essential hypertension, risk factors Long-term complications of systemic hypertension: - Myogenic reflex, hyperplasia of vessel media - hypertension fixation, endothelial dysfunction, changes in baroreceptors - Heart hypertrophy, heart failure - Vascular, cerebrovascular damage - Hypertensive nephropathy; retinopathy Acute changes in blood pressure in systemic circulation - consequences: Acute heart failure, myocardial infarction, hypertensive encephalopathy, CMP, nephropathy, retinopathy Secondary hypertension: - Renovascular; Renoparenchymatous - Endocrine: primary hyperaldosteronism, Cushing's syndrome, pheochromocytoma, acromegaly, hyperparathyroidism, thyreopathy - Neurogenic (e.g. stress, intracranial hypertension) - Hypertension in sleep apnea syndrome - Next: Coarctation of the aorta, medical (e.g. Serotonin syndrome), preeclampsia and eclampsia Pathophysiology of pulmonary hypertension (pre-capillary, post-capillary, hyperkinetic), primary and secondary (causes) Control of perfusion in pulmonary and systemic circulation (differences)
Respiratory regulation disorders, respiratory muscle disturbances and their innervation (examples of diseases) Function of central and peripheral chemoreceptors, examples of their disorders and their function Apnoic pauses (practice) - What determines the length of free apnea? Hypercapnia, causes and consequences Sleep apnea syndrome: Obstructive and central type, effects of apnea on the body Pathological breathing patterns: Cheyne-Stokes breathing, Kussmaul's breathing
Overview of respiratory gas exchange in the lungs (ventilation, diffusion, perfusion) and its disorders: -Hypoventilation (definitions, examples of causes), hyperventilation - Limitations of diffusion (examples of causes), alveolo-capillary difference – physiological and pathophysiological - V/Q mismatch: right to left shunt and dead space, changes in blood gases, hypoxic vasoconstriction Blood gas transport disorders, saturation hemoglobin curve, meth-Hb and carboxy-Hb Effects of high altitude Hypoxia, definition and division, differences: - Hypoxic hypoxia (summary of causes) - Transport/anemic hypoxia (basic mechanisms of anemia, examples, compensation) - Circulatory: ischemic and stagnant (local and global causes) - Histotoxic Compensation and adaptation of the organism to hypoxia, side effects of adaptation Central and peripheral cyanosis, mechanism of origin
Shock states Shock - definition, shock Index Clinical signs of shock (skin perfusion, diuresis etc.) Hemodynamic characteristics of different types of shock (venous return, cardiac output, vascular resistance): - Hypovolemic shock: causes, consequences of bleeding due to amount of blood loss, compensation - Cardiogenic, obstructive (examples) - Distributive: anaphylactic, septic, neurogenic; mechanism of origin Compensatory mechanisms (baroreceptor reflex, neurohumoral activation, capillary changes), importance of different types of shock Phases of shock, decompensation, microcirculation disorders Organ changes in shock (kidney, splanchnic area, lungs, brain), MODS
Inflammation and Stress Local response to tissue damage, vascular, plasmatic and cellular component, local inflammatory manifestations General signs of inflammation, function of acute phase proteins The importance of interleukins in pathophysiology, clinical examples Fever (mechanism of onset and consequences); hyperthermia Sepsis, septic shock, SIRS Mild chronic inflammation as the cause of the disease?
Stressor, stress axes, stress hormones and their effects Acute stress reaction (allostasis), cardiovascular and metabolic changes The relationship between stress reaction and shock Consequences of chronic stress, increased sympathetic tone and metabolic syndrome (sleep apnea)
Vegetative nervous system Anatomy of the sympathetic and parasympathetic nervous system, mediators and receptors Effect of sympathetic and parasympathetic system on organs, regulation of perfusion (nerve x humoral) Possibilities of therapeutic activation of parasympathetic system: deep breathing, vagal maneuvers: Valsalva's maneuver Schellong test: practical execution and interpretation Vasovagal and orthostatic syncopy Examples of vegetative nervous system disorders, clinical manifestations Horner’s triad (syndrome), pheochromocytoma, Shy-Drager syndrome and others Vegetative system disorder due to poisoning, nicotinic and muscarinic effects Examples: organophosphates, atropine, muscarine, cocaine
Consciousness ARAS, the difference between quantitative and qualitative disturbances of consciousness Glasgow coma scale (limits) Mechanisms of intracranial and metabolic consciousness disorders (examples) Vegetative state, locked-in syndrome, brain death Transient disturbance of consciousness - causes of syncope and collapse ECG Cardiac conduction system and heart muscle, action potentials Basic ECG curves, limb and chest leads Determination of the electrical axis of the heart; signs of left and right ventricular hypertrophy Description of ECG curves: rhythm, action, frequency, heart rate, intervals, morphological changes of ECG curves Heart conduction disturbances: AV blocks and Tawara bundle branch block, pre-excitation syndrome STEMI and NSTEMI; the development of ECG changes in cardiac ischemia Localization of MI changes - anteroseptal / lateral / inferior infarcts ECG changes in kalemia and calcemia changes Disturbances of membrane potential in the heart, extra- and intra-cardiac causes of arrhythmias Impaired heart signal generation (ectopic pacemaker, alternative rhythms, reentry)
Metabolism Glycemia, its regulation and disorders Acute complications of diabetes mellitus Diabetes mellitus (type comparison) Chronic complications of diabetes mellitus Starvation (types), causes and consequences Refeeding syndrome Metabolic syndrome (mechanism of onset, consequences) Obesity (measurement, causes, consequences, complications) The importance of fatty tissue in health and illness Qualitative and quantitative nutritional disorders (examples) Catabolic states (overview)
Immobilization Syndrome: - Definitions and causes - Consequences for cardiovascular, respiratory, gastrointestinal and excretory systems - Changes in metabolism - Osteoporosis; sarcopenia; pressure sores
General causes and consequences of acute organ failure - heart - lungs - kidneys |
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Last update: doc. MUDr. Eva Sticová, Ph.D. (26.09.2017)
Successful completion (passing of the credits and exams) of subjects: Cellular Basis of Medicine and Structure and functions of human body. |