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Questions and Answers
What is the primary objective of a pathologist when examining tissues?
Why is diagnosis considered key for clinicians?
What does etiology refer to in the context of disease?
Which of the following is NOT a component of pathogenesis?
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What constitutes the gross picture in a pathological examination?
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What is the significance of prognosis in clinical practice?
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Which of the following statements about the fate of a disease condition is true?
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What do both diagnosis and prognosis in medicine rely on?
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Which of the following correctly defines irreversible cell injury?
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What is the primary cause of hypoxic cell injury?
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How do exogenous chemicals typically induce cell injury?
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What is the primary focus of pathology?
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What happens during acute cellular swelling due to hypoxic injury?
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Which of the following is NOT a part of the epidemiological study of diseases?
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What are free radicals characterized by?
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Which of the following is NOT a cause of cell injury and death?
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What does general pathology study?
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What is the term used for the earliest recognizable change following cellular injury?
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Which of the following is an example of systemic pathology?
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What occurs during programmed cell death?
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What does the term 'lesion' refer to in pathology?
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Which of the following best describes the role of a pathologist?
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What is the objective of general pathology?
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Which of the following is a subtype of experimental pathology?
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What defines irreversible cell injury?
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Which free radical is primarily generated through the dismutation of superoxide?
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Which mechanism is NOT a result of free radical damage in cells?
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What is one characteristic of accidental cell death (necrosis)?
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Apoptosis is described as a process that primarily targets which type of cells?
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What common factor contributes to the generation of hydroxyl ions (OH)?
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Which of the following is not a physiological significance of apoptosis?
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What role does the enzyme superoxide dismutase play regarding superoxide?
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Study Notes
Pathology: Study of Disease
- Pathology is the scientific study of disease, focusing on how healthy tissues and organs change in a sick individual.
- It is a foundational subject within the medical field, providing understanding of disease processes.
Scope of Pathology
- Clinical Pathology: The study of disease in living individuals.
- Experimental Pathology: The study of disease in laboratory settings.
- Molecular Pathology: Study of disease at the level of molecules.
- Forensic Pathology: The study of disease in relation to legal matters.
- Subdivisions: Histopathology, cytopathology, hematology, microbiology, immunology, chemical pathology, genetic pathology, toxicology, and forensic pathology.
General Pathology vs. Systemic Pathology
- General Pathology: Focuses on common cellular changes that occur across all tissue types. This includes inflammation, cancer and aging.
- Systemic Pathology: Focuses on disease-specific changes within individual organ systems. Examples include goiter, pneumonia, and breast cancer.
- Lesion: An abnormal structural change in the body caused by an irritant.
Pathologist Role
- A pathologist can be a medical doctor (MD) specializing in pathology or a doctor with a doctorate degree (PhD) trained for lab procedures.
- They identify, name and interpret lesions found in tissue samples, ultimately aiming to reach a diagnosis.
Why Clinicians Need Pathology
- The foundation for diagnosing, treating, preventing and controlling disease lies in understanding its characteristics.
- The ability to identify lesions and their causes within the body (either living or deceased), as well as understanding their pathogenesis, is crucial for proper medical decision-making.
Understanding the Disease
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Etiology - The cause of a disease.
- Predisposing Factors: Contributing factors that influence the development of a disease.
- Exciting Factor: The immediate trigger for the disease.
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Etiology Causes
- Environmental Agents: Physical, chemical, nutritional, infectious, immunological, psychological
- Genetic Factors: Age, genes
- Multifactorial: Diseases caused by multiple factors (e.g., Diabetes, Hypertension, Cancer)
- Pathogenesis - The mechanism by which the causative agent produces changes in the tissues.
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Pathological Picture - The observed characteristics of a disease.
- Gross Picture (Macroscopic): Changes evident through naked-eye examination.
- Microscopical Picture (Histopathology): Changes observed under a microscope.
- Advanced Techniques: Electron microscopy, immunohistochemistry, cytogenetics, molecular studies.
- Prognosis - The anticipated outcome of a disease, influenced by pathogenesis and the ability to visualize the disease process.
- Fate - The ultimate outcome of the disease, either cure or death.
- Complications - Additional pathological changes that occur during or after the usual course of the disease.
Cell Injury and Cell Death
- Cell Injury: Any biochemical or structural alteration that impairs normal cell function.
- Reversible Cell Injury (Cell Swelling): Early stage of injury, often marked by swelling of cells.
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Irreversible Cell Injury (Cell Death): The point at which cell damage becomes permanent and leads to cell destruction.
- Apoptosis (Programmed Cell Death): Regulated process of cell death, serves to eliminate damaged or unwanted cells with minimal host response.
- Necrosis (Accidental Cell Death): Uncontrolled cell death caused by factors like injury.
Causes of Cell Injury and Death
- Oxygen Deprivation (Hypoxia): Lack of oxygen, interferes with cellular energy production.
- Deprivation of Essential Nutrients: Lack of water, food molecules, negatively impacts cell function.
- Chemical Agents: Chemicals can damage cell membranes or interfere with metabolic processes.
- Infectious Agents: Pathogens can invade and disrupt cellular functions.
- Immunologic Reactions: Immune responses, while protective, can sometimes damage cells.
- Genetic Disorders (Congenital Malformations): Inherited genetic defects can lead to cell dysfunction.
- Physical Agents: Trauma, extreme temperatures, and radiation can cause cell injury.
- Free Radicals: Unstable molecules with a single unpaired electron that can damage cell components.
- Aging: Over time, cells accumulate damage that can contribute to cell death.
Hypoxic Cell Injury
- Acute Cellular Swelling: An initial response to hypoxia, characterized by cells taking in water and swelling.
- Mechanism: Hypoxia damages mitochondria, disrupting ion balance. The cell loses potassium and accumulates sodium, leading to water influx and swelling.
Cell Injury Induced By Chemicals
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Mechanism:
- Chemicals can bind directly to critical cellular components, damaging cell membranes or disrupting energy production.
- Chemicals can be transformed into more reactive metabolites that generate free radicals.
Free Radicals and Cell Damage
- Free Radicals: Highly reactive molecules with an unpaired electron, making them unstable and prone to reacting with other molecules.
- Types: Superoxide (O2-), Hydrogen peroxide (H2O2), Hydroxyl ions (OH-)
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Damage Mechanisms:
- Lipid Peroxidation of Membranes: Free radicals can damage cell membranes.
- DNA Fragmentation: Leads to apoptosis and cancer.
- Protein Cross-linking: Can damage cell membranes.
Irreversible Cell Injury (Cell Death)
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Apoptosis (Programmed Cell Death):
- Significance: Crucial for normal tissue turnover, elimination of damaged cells, and response to pathological stimuli.
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Necrosis (Accidental Cell Death):
- Mechanism: Characterized by enzymatic degradation of the nucleus and cytoplasm, resulting in cell death.
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