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Basic course of General Pathology provides the students general principals of Pathology as a science and includes common of diseases. The course pay attention to exact terminology, stresses relation between symptoms and signs of diseases and they relation to etiology and therapeutic consequences.
Pathological physiology is aimed on the general principles of development and course of the disease. Pathophysiology is the subject interconnecting theoretical and clinical tutoring and it is essential for students? education in the terms of application of theoretical medicine to praxis.
Last update: Sticová Eva, doc. MUDr., Ph.D. (26.09.2017)
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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. Last update: Matějovská Iveta, MUDr., CSc. (21.06.2012)
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Last update: Matěj Radoslav, prof. MUDr., Ph.D. (11.12.2019)
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Lectures, seminars, practical exercises, basics of methodological work with case reports Last update: Matějovská Iveta, MUDr., CSc. (21.06.2012)
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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 2024-2025 The basic condition for attending the course is successful completion of the courses Cellular Basis of Medicine and Structure and Function of the Human Body.
The credit consists of three components that must be fulfilled: 1. active participation in the compulsory classes, 2. successful completion of the midterm and final (credit) test and 3. preparation of an independent work (see below). If the learner has not received credit and is repeating the year, he/she must complete the course in its entirety. Learners who are repeating only the exam and have received credit in the previous academic year may attend the required course only by prior arrangement with the department chair or his/her designee (for capacity reasons).
Assessment: learners' assessment is based equally on work during the year (A) and performance in the final oral examination (B). The final grade is the average of the A and B grades, except that in the case of a grade = 1.5 or 2.5, the final classification may be rounded down (better final grade) based on the result of the oral examination (classification 2+ or 3+, the examiner will use the + and - signs to assess the final examination). The grade for "work during the year" (A) is weighted 15% by the independent work score, 25% by the interim test score and 60% by the final (credit) test score.
1. Presentation According to the Dean's Order No. 11/2005 and 6/2006, it is possible to excuse absence from the full-time teaching that takes place at the Department of Pathophysiology on two topics. Substitution of compulsory teaching is possible with another circle, only after PRIOR arrangement with the respective lecturer and his/her approval. Substitution is no longer possible after all practicals and seminars have been completed. In very exceptional and duly justified cases worthy of special consideration (e.g. long term illness), it is possible to replace a missed attendance after the end of the teaching of a given topic by working on a paper according to the assignment of the teacher. It also checks attendance at any distance learning sessions, so students are required to log in with their name (university login).
If the learner fails the test, he/she will be tested orally on the content of the test and will also be graded with points (max. 120 points, min. score listed above).
II. Credit test: regular term in the fifteenth week (20.1.2025, from 16:00) and remedial term (28.1.2025, from 11:00) - are listed in the timetable. Students may take the credit test only after successfully completing the midterm test. The content of the test will be the knowledge from the entire semester corresponding to the specified learning outcomes. The test can be taken a maximum of two times (regular + make-up dates see above, other dates will not be announced). The result of the test is classified with points. The maximum number of points achievable in the test is 60. The minimum score for passing the test will be set by the Cohen method at 60% of the score corresponding to the 90th percentile of test scores of all learners. Learners who fail the test even in the remedial term will be tested and graded orally to the same extent.
3. Independent work The individual work of students is one of the conditions for the award of credit and enters into the evaluation of the work of students during the year with a weight of 15% and is thus reflected in the final overall grade. Detailed description, registration and submission of the selected work is done in Moodle at this link In the academic year 2024/2025, there are 3 types of individual work for students to choose from, whichever they want to pursue, according to their own preferences and focus. All assignment types assume some level of collaboration between 2-5 learners. Detailed assignment and description is given for each category of work in Moodle. 1) ACCEPT MCQs - working with generative artificial intelligence to create high quality multiple-choice questions 2) Work ACCEPT DATA MANAGEMENT - work with generative artificial intelligence to create a Python script focused on data management, analysis and presentation 3) Case reports - analysis of case reports with elaboration of answers to given questions
The enrolment of all works is possible only through Moodle. The outputs of all papers will be assessed after submission exclusively through the upload of the final paper in the Moodle environment. A maximum of 15 points can be awarded for all types of work. Uploading of work is done by one workgroup member for the whole group (the system does not allow multiple entries per workgroup). The deadline for submission of the finalised work is 15.12. 23:59 (after that the submitted work cannot be changed in any way).
In order to be eligible for the exam, students must have completed credit in both pathology and pathophysiology. The range of knowledge required for the examination is defined by the learning outcomes reflected in the examination questions. It is assumed that the learner will have acquired some knowledge through self-study (study materials and resources provided) and will be able to apply the knowledge they have gained from studying other subjects. The examination is oral. The learner chooses 2 questions from the basics of pathology and 2 questions from the basics of pathological physiology. If the student fails in one subject, he/she will be tested again in both subjects in the next term. Recommended study materials: For each topic taught (lecture + practical), specific learning outcomes are developed, including recommended study literature and resources, or materials developed by teachers on the topic. The learning outcomes are posted on the Teaching server. General Resources: Internet sources such as: Last update: Polák Jan, doc. MUDr., Ph.D. (29.09.2024)
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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 Last update: Matěj Radoslav, prof. MUDr., Ph.D. (25.09.2019)
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Successful completion (passing of the credits and exams) of subjects: Cellular Basis of Medicine and Structure and functions of human body. Last update: Sticová Eva, doc. MUDr., Ph.D. (26.09.2017)
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