RCSI FFP1-19 Introduction to Pathology 2023 PDF

RCSI Royal College of Surgeons in Ireland Coláiste Ríoga na Máinleá in Éirinn Introduction to Pathology Year 1 Course FFP1-19 Lecturer Professor Paul Mu...

RCSI Royal College of Surgeons in Ireland Coláiste Ríoga na Máinleá in Éirinn Introduction to Pathology Year 1 Course FFP1-19 Lecturer Professor Paul Murray Date September 2023  LEARNING OUTCOMES Describe what pathology is and list the subspecialties and its clinical relevance to medicine and surgery and patient management Differentiate between macroscopical and microscopical evaluation of tissue Explain the purpose of performing an autopsy Differentiate between a coroner's autopsy and a hospital autopsy Describe the methods of assessment used in pathology Outline terminology used in pathology Describe the types of tissue sampling and the way in which tissue is processed and examined macroscopically and microscopically  PATHOLOGY STAFF Part-time Clinical Tutor Dr Eman AlJufairi Senior Clinical Lecturer Part-time Clinical Tutor Dr Fatima AlHashimi Dr Raja AlYusif Part-time Clinical Tutor Dr Zainab Toorani Part-time Clinical Tutor Brig. Prof. Abdullah Darwish  WELCOME TO PATHOLOGY The basis of clinical medicine – learning the difference between healthy and diseased states To understand disease must know how the normal body works Understanding disease (pathology) allows us to get better insights into: – Why disease presents in a certain way – Potential complications of a given disease – Prognosis – Management – Treatment – Causes of death  In clinical practice, pathology provides the definitive diagnosis to allow optimal management of the patient How does the pathologist make a diagnosis? www.rcpath.org  PATHOLOGY: A VARIETY OF SUBSPECIALTIES Histopathology Haematology Microbiology Chemical Pathology Immunology  THE ROLE OF A PATHOLOGIST Diagnostician – Microscopy, – genomics, – digital pathology Teacher Researcher Ethical issues now a real issue e.g., consent for the use of human tissue for teaching and research Pathologists are custodians of human tissue that is sent to the lab’  THE COMPLETE GUIDE TO BECOMING A PATHOLOGY DOCTOR Check it out on BMJ careers website Pathologists are at the interface of science and medicine and prevent, diagnose and treat disease by examining body fluids and tissue samples https://www.bmj.com/careers/article/the-co mplete-guide-to-becoming-a-pathology-doc tor  HISTOPATHOLOGY IN CLINICAL PRACTICE Macroscopic and microscopic evaluation of tissue to provide a definitive diagnosis – e.g., cancer or not cancer Crucial to patient diagnosis and management Crucial to an understanding of medicine  THE EVOLVING ROLE OF THE PATHOLOGIST Multidisciplinary meetings Digital pathology and artificial intelligence  WHAT DOES A PATHOLOGY LAB’ DO? Specimen and request form received Macroscopic assessment Microscopic assessment Staining – to decide what cells are present/not present in the tissue (immunohistochemistry, fluorescent in-situ hybridisation (FISH)) Molecular testing for genetic abnormalities Digital imaging and storage Pathology report issued +/- MDM (Multidisciplinary discussion) Request Form  THE LANGUAGE OF PATHOLOGY Gross – intact large specimen/organ Histology- the study of the microscopic structure of tissues Sectioning of tissue – cutting tissue into thin slices to allow microscopic examination of the tissue NOW LET’S LOOK AT SOME PATHOLOGY SPECIMENS FROM PATIENTS Gross examination of resected colon Which pieces do we sample? Liver with metastasis HOW DOES CANCER LOOK UNDER THE MICROSCOPE? CYTOPATHOLOGY- THE PATHOLOGY OF CELLS Microscopical evaluation of cells – Bronchial washings – Cervical smears – Pleural fluid – Fine needle aspirates  AUTOPSY Postmortem examination is performed to define the cause of death In 20% of cases, premortem diagnosis is inaccurate Exclude foul play Teaching opportunity Informed consent required Coroner’s autopsy: Coroner orders an autopsy to exclude foul play Next of kin cannot refuse Hospital autopsy: Performed with the permission of the next of kin  Infarct Hear t Brain- meningitis  HAEMATOPATHOLOGY Analysis of blood samples, bone marrow and lymph nodes to diagnose disease Investigation of – Anaemia – Leukaemia – Lymphomas – Bleeding – Blood transfusion  RCSI PATHOLOGY CONTENT Histopathology Haematopathology Chemical pathology Molecular pathology Digital pathology  PATHOLOGY CURRICULUM - A VARIETY OF LEARNING OPPORTUNITIES Lectures, case studies, MDT Clinicopathological conferences Postmortem tutorial Computer assisted learning/CALPATH on MOODLE  APPROACH TO MCQS MCQs are based on lecture material You must attend lectures to get the best understanding of the material – reading the slides will not be enough! Reviewing lecture material alongside CALPATH gives you the best chance to truly understand the topic You cannot learn pathology off – you need to develop an understanding of the topic so you can make the best attempt at MCQs  PATHOLOGY - YEAR 1 Foundations for Practice (FFP) 1 and 2 – Basic pathology e.g., inflammation, neoplasia – Haematolymphoid Haemostasis and thrombosis, anaemia, neoplastic – Molecular pathology Systemic pathology in system based modules  LECTURES Backbone of Teaching – Mix of teaching methods – Interactive case-based approach Building blocks of knowledge – Taught in a clinically relevant manner – Helps you identify the more important material  USEFUL WEBSITES Name Web URL address Comments Medscape www.medscape.co Good resource m MedEdPORTAL | www.mededportal. Publications – great for AAMC org students and educators WEBPATH http://library.med. Image bank similar to utah.edu/WebPath CALPath. Very good /webpath.html#M resource ENU USMLE www.usmle.org Info on the 3 step examination for USMLE National Board www.nbme.org Good resource of Medical Examiners Student Consult www.studentconsu Resource for reading and lt.com purchasing medical text- books online. Lots of bonuses included  USEFUL SOCIETIES & RESOURCES Royal College of Pathology https://www.rcpath.org/ College of American Pathologists https://www.cap.org/ Bahrain Pathology Association https://www.bhmedsoc.com/bms-associations.php RCSI Pathology Society Watch this space  PATHOMA Excellent tool for learning pathology Student feedback has been very positive Provided by RSCI for USMLE preparation Another useful resource is Pathology by Osmosis by Elsevier (www.osmosis.org)  FINALLY! We appreciate feedback on the material and its organisation If we do not know there is a problem, we cannot fix it Enjoy this wonderful subject. Pathology will give you the ability to “visualise” your patients’ problems Prof Paul Murray – [email protected]