Pathology Lec (1-2) PDF

INTRODUCTION TO PATHOLOGY 'Father of Pathological Anatomy', and also as 'Founder of Pathology' DEVELOPMENT OF PATHOLOGY Renaissance period...

INTRODUCTION TO PATHOLOGY 'Father of Pathological Anatomy', and also as 'Founder of Pathology' DEVELOPMENT OF PATHOLOGY Renaissance period William Harvey (English physician) Israelites 1578 –1657 15th century “Father of Physiology” Recognized zoonotic diseases and practiced meat inspection Renaissance period William Harvey (English physician) Egyptians Described the vascular system and blood 4000 BC circulation Began to influence medicine He contributed advancely to comparative Employed skull surgery and embalming anatomy and embryology practices to preserved many mummies Renaissance period Greeks Anton van Leeuwenhoek 4000 BC Dutch natural history student “Fathers or Originators of Clinical Medicine” 1632 – 1723 Elucidated the principles of clinical Importance of microscope in the study of observation and cremation of dead tissues Hippocrates (Greek physician) Jean Fernel (French physician) 460-375 BC 1497 –1558 “Father of Medicine” First compiler of medical literature He based humoral theory of disease on 4 writings formed the 'First Textbook in elements of Greek philosophy namely: air, Pathology water, fire and earth introduced the term "physiology" First to describe diseases according to Aristotle (Greek philosopher) organs or parts of the body 384-323 BC “Father of Zoology" and "Originator of Andreas (Belgian physician) Modern Anatomy and Physiology” 1543 Worked on the Publication of a complete Claudius Galen (Greek physician) textbook on human anatomy, which began 131 – 205 AD the era of Modern Medicine Greek physician who practiced in Rome “Father of Anatomy” Giovanni Battista Morgagni (Italian anatomist) Worked on meat inspection but not on 1682-1771 human autopsy making some of his works “Founder of Pathologic Anatomy” inaccurate Worked on the publication of the Seats and Causes of Disease Cornelius Celsus (Roman Patrician) Performed 700 autopsies, which began the 30 BC – 38 AD era of Modern Pathology Described the Cardinal signs of First to correlate pathological alterations in inflammation: redness, swelling, heat and the dead with clinical signs and symptoms by pain the individual during life Renatus Vegetius (Roman veterinarian) Marie Francois Xavier Bichat (French anatomist & 450-500 AD physiologist) “Father of Veterinary Medicine” 1771-1802 Concept of animal disease “Father of Histology” first author to write a textbook devoted Foundation of histology where he used exclusively to veterinary medicine – 'Book of putrefaction, maceration, cooking and the Veterinary Art’ chemical disintegration using acids and bases Antonio Benivieni (Italian physician) a pioneer in reporting postmortem Jacques Labessie de Solleysel (French writer) examinations 1617 – 1680  published the first complete book on Study of animal diseases (Pasteurellosis, veterinary medicine entitled “Le Parfait Chicken cholera, Anthrax, Rabies, etc) Marechal” Immunization is important in giving protection Claude Bourgelat (French veterinarian) 1712 –1779 Robert Koch (German chemist) Law practitioner but is interested in horses 1843 – 1910 and wrote “Elements and Hippiartry and New Established the “Koch’s postulate”, which Knowledge of Equine Medicine” provides a specific microorganism as the Eradicated strangles in the French army cause of a specific disease and established the first Modern Veterinary School in Lyon, France on January 1, 1762 Edwin Klebs (German– American pathologist) 1834 – 1913 John Hunter (Scottish anatomist & surgeon) Virchow’s student and assistant who 1728 – 1793 demonstrated the importance of bacteria in “First Experimental Pathologist” infectious diseases (Tuberculosis, Anthrax and Extensive studies on blood and Syphilis) in pathology inflammation, gunshot wounds and venereal Diptheria bacillus (Corynebacterium disease diphtheria) is known as the Kleb’s- Loffler He worked on syphilis that caused his death bacillus Carl Rokitansky (German) (Austrian physician) Julius Cohnheim (German experimental histologist 1804 – 1878 and pathologist) “Supreme Descriptive Pathologist” 1839 – 1884 Lived in Vienna who established structural “Originator or Father of Modern basis of disease and necropsy technique Experimental Pathology” (Rokitansky technique) Revealed the vascular alterations that are the basis of the inflammatory response Johannes Mueller (German physiologist) 1801 – 1858 Linus Carl Pauling (American chemist) “Greatest medical teacher of the 1901 nineteenth century” “Father of Molecular Biology” His famous students include Theodore provided a molecular understanding of Schwann, Matthias Scleiden, Jacob Henle genetic disorders and Rudolf Virchow Champion in using megadoses of Vitamin C for controlling the common cold, and the Rudolf Virchow (German pathologist) general use of chemotherapy for the cure of 1821 – 1902 mental disease like schizophrenia “Father of Cellular Pathology” the “Father of Modern Pathology” Worked on the publication of "Cellular DEFINITION Pathologie” in 1858 Famous for his discussion of thrombosis, PATHOLOGY embolism, infarction, tumor growth and Abnormal biology (broadest sense) spread, chronic inflammation and many Study of disease (pathos meaning suffering; others that forms the basis of modern logos means science). Concerns of study pathology include etiology, pathogenesis and structural and functional changes brought about by Ignaz Philipp Semmelweiss (Hungarian physician) the disease and with its final effects on the 1818 – 1865 body Worked on the separation of infectious Study of basic disease processes (cellular from non-infectious patients and tissue responses to injury) sufficiently to Hospital sanitation provide a diagnosis Louis Pasteur (French chemist) BASIC DISEASE PROCESSES - are actually tissue 1822 – 1895 responses to injury “Originatorr of Bacteriology” EXAMPLES Proposed germ theory of diseases Degeneration and necrosis  Inflammation and healing MICROSCOPIC PATHOLOGY OR HISTOPATHOLOGY Growth disorders (undergrowth and overgrowth) OR CELLULAR PATHOLOGY Developmental disorders (congenital and examination of prepared diseased tissue postnatal) slides using the microscope SURGICAL PATHOLOGY COMPONENTS OF THE DISEASE PROCESS FORMING study of biopsied material THE FOUNDATION OF PATHOLOGY CLINICAL PATHOLOGY Etiology use certain laboratory procedures Pathogenesis (hematology, cytology, serum chemistry, Lesion clinical endocrinology, urinalysis, fecalysis) in Clinical consequences supporting or denying a diagnosis HUMORAL PATHOLOGY TOOLS OF PATHOLOGY antibody alterations in an individual due to eyes disease Hands of the pathologist CHEMICAL PATHOLOGY Light microscope chemical alterations of body fluids and Electron microscope tissues due to disease Histochemical stains PHYSIOLOGICAL PATHOLOGY study of altered function (motility, digestion, WAYS OF RECOGNIZING PATHOLOGY excretion, metabolism, etc.) of an organ Observation and detection or diagnosis of an MOLECULAR PATHOLOGY alteration (lesion) newly emerging subspecialty dealing with Detection of structural (morphology) abnormality the molecular and genetic basis of disease Laboratory study is often called Clinical Pathology with the help of advances in biotechnology or Laboratory Medicine TECHNOLOGIES FOR MODERN PATHOLOGY REQUIREMENTS FOR RECOGNIZING PATHOLOGY DNA and RNA isolation and quantitation Very good background of normal College of Probe production and labeling Veterinary Science and Medicine subjects Polymerase chain reaction (PCR) and reverse (Anatomy, Physiology and Biochemistry) transcription – PCR (RT-PCR) Understanding of disease and its pathogenesis Southern and Northern blot analysis Pulsed-field Use of the different senses gel electrophoresis Smell Immunofluorescence chemiluminescence Visualization Palpation – touching and feeling Pulse field gel electrophoresis Incision – cutting Accepted as gold standard for the differentiation of strains of food borne MAJOR FIELD OR SPECIALTY IN PATHOLOGY pathogens ELISA plate and microwell arrays GENERAL PATHOLOGY In situ hybridization traditional academic subdivision of DNA sequence analysis and ribotyping pathology that deals with basic alterations Oligonucleotide sequencing and analysis (lesions) in tissues and the mechanisms of Microsatelitte allele assessment disease production Restriction fragment length polymorphism analysis SPECIAL PATHOLOGY Mutation screening and genetic data basing application of the basic alterations learned in General Pathology to the various specific diseases of the individual Examples of Special Pathology Neuropathology Pulmonary pathology Renal pathology EXPERIMENTAL PATHOLOGY production of lesions by experimentation mostly used in research works MACROSCOPIC OR GROSS PATHOLOGY examination of an individual by systematic dissection with the use of naked eyes VOCABULARY HEALTH state of well being of an individual living in complete harmony with his environment INFECTION result of pathogen invasion and growth COLONIZATION VIRULENCE establishment of the pathogen at the degree of pathogenicity appropriate portal of entry PATHOPHYSIOLOGY first stage of microbial infection study of disordered functions by modified DISEASE disease culmination of various defects, LESION abnormalities, excesses, deficiencies and observed structural or sometimes functional injuries at cellular and tissue level resulting in abnormality or alteration in a tissue clinically apparent dysfunction PATHOGNOMONIC LESION DISORDER an alteration that indicates without doubt disturbance or derangement of regular or the cause of a particular disease normal physical or mental health or function Negri body is a pathognomonic lesion for ❖ Skin disease – viral infection rabies ❖ Skin disorder – vitiligo LESION of Tuberculosis. ❖ Gynandromorphism Granuloma - collection of immune ❖ obesity cells known as macrophages STRESS LESIONS of Fasciolosis any stimulus or succession of stimuli of such Hepatic necrosis and fibrosis with magnitude that tends to disrupt the multifocal black fluke pigment homeostasis of an organism Black parasitic debris in the liver may be considered an injury when the Lesions of Parvoviral Infection mechanism of adjustment fails or becomes Hemorrhagic enteritis disproportionate or there is incoordination Myocarditis INJURY CLINICAL SIGN any stress that disrupts the structure or objective evidence or a physical function of an organism manifestation of tissue change that can be ANOMALY observed and measured by a veterinarian or disturbance of development of an organ or a medical doctor a portion of an organ Examples include fever and diarrhea PATHOGENS observable; skin vesicles, jaundice disease causing organisms Clinical signs of tuberculosis viruses, bacteria, fungi, protozoa, parasites, ❖ emaciation; protein(prion) ❖ enlarged lymph node; ETIOLOGY study of the cause of the disease Clinical signs of Fasciolosis PATHOGENESIS ❖ Bottle jaw edema and origin and course of development of a anemia respectively; disease covering the sequence of events in ❖ Emaciation cellular and tissue responses to injury CLINICAL SIGNS of Parvoviral Infection PATHOGENECITY ❖ Bloody diarrhea ability to produce disease in a host ❖ Vomiting CLINICAL SYMPTOM based on sound anatomical, chemical and subjective change that is not apparent to physiological investigation forming the basis the observer of modern medicine Examples include pain and malaise (a EMPIRIC MEDICINE vague feeling of body discomfort) based on experience and observation SYNDROME. rather than on systematic logic or scientific a group of symptoms and signs which when proof considered together are presumed to RECOVERY characterize a disease or lesion return to the state of rest, equilibrium or Down syndrome health from a state of fatigue, stress or illness Trisomy in chromosome 21 DEATH DIAGNOSIS cessation of life nature or conclusion of a disease Concern of the clinician or veterinarian MODULE 2- TYPES OF ANIMAL DISEASE MORPHOLOGIC OR LESION DIAGNOSIS dominant lesions in animal’s tissues DISEASE ❖ Hemorrhagic enteritis culmination of various defects, ETIOLOGIC DIAGNOSIS abnormalities, excesses, deficiencies and provides the precise cause of a disease injuries at cellular and tissue level resulting in ❖ Parvoviral enteritis clinically apparent dysfunction DIFFERENTIAL DIAGNOSIS a condition that impairs normal tissue a listing of which diseases may be involved function as a result of infection in a sick animal and the determination of failure of the animal to counteract the stimuli which disease is responsible for the illness or stresses or insults where it is subjected 1. Coronavirus infection leading to injury or illness 2.Hookworm infection Exciting cause PROGNOSIS - immediate factor (germ or pathogen) prediction of the probable course and responsible for a particular disease outcome of a disease Contributory or predisposing cause Chance of survival of a sick animal whether - factor which renders the disease more good or bad serious like poor nutrition, climate, age and Is it good or bad? fatigue Concern of the owner BIOPSY DEVELOPMENT OF DISEASE removal and examination of tissue 1. Incubation period obtained the from living animal - time interval between the actual infection HISTOPATHOLOGY and the first appearance of signs and study of microscopically visible changes in symptoms diseased tissue 2. Prodromal period CYTOPATHOLOGY - appearance of the first mild signs and study of microscopically alterations within symptoms cells demonstrated by exfoliative (shedding) 3. Period of illness cytolology technique - disease is at its height and all the signs and ❖ Tuberculosis (giant cell in the lungs) symptoms of the disease are apparent ❖ Vaginal mass imprint (TVT) 4.Period of decline ❖ Lung lavage (pulmonary - signs and symptoms subside adenocarcinoma) 5.Period of convalescence NECROPSY OR POST-MORTEM EXAM OR AUTOPSY - body returns to its prediseased state and systematic dissection of an individual after health is restored death necessary to establish a diagnosis Necropsy is usually used in veterinary medicine Autopsy is used in human medicine MORBID CHANGES alterations in tissue or organ found at necropsy that are the results of disease SCIENTIFIC MEDICINE  TYPES OF DISEASES Based on cause Infectious diseases - caused by pathogens or germs like viruses, bacteria, protozoa and fungi, and helminths. Contagious diseases – Infectious diseases that that are transmissible individual to another thru from one direct or indirect contact INFECTIOUS and CONTAGIOUS DISEASES ❖ Infectious Canine hepatitis ❖ Canine Infectious tracheobronchitis ❖ Contagious bovine pleuropneumonia ❖ Contagious ecthyma MODES OF DISEASE TRANSMISSION INFECTIOUS but NON-CONTAGIOUS DISEASEs Diseased animals ❖ Tetanus Polluted streams or other bodies of water ❖ Botulism Vehicles used to transport animals Non-infectious diseases Carrier animals -may result from one or more of the following Carrion feeders (dog, birds) conditions: Arthropods (mosquitoes, ticks) Mechanical ailments - flesh wounds or ⎯ Soft tick Ornithodorus maubata as important rupture vector of African swine fever Digestive disturbances - bloat, ingestion of ⎯ Mosquito Culex sp. as transmitter of hardware or dental failure Japanese B encephalitis ⎯ Fly Tabanus sp. as transmitter of surra TYPES OF DISEASES Airborne pathway Intoxications of either chemical (lead, arsenic, Contaminated facilities and handling equipment nitrates, insecticides) or plant origin (Chromoleana spp.) MODES OF ENTRY OF PATHOGENS TO THE BODY Nutritional deficiencies (lack of fat, proteins, Respiratory tract vitamins, minerals), or nutritional excesses Wound contamination Cell growth - malignant or benign Mucous membranes of the eyes Genetic disorder like sickle cell anemia Genital tract (mating or parturition) Metabolic disorder (Diabetes mellitus or Teat canal (lactating females) acetonemia) Navel cord Contaminated instruments TYPES OF DISEASES Insect bites Based on severity or duration Acute disease TERMINATION OF DISEASE -quick and short-lived condition, - (African Full recovery swine fever Avian influenza, anthrax, FMD) Partial recovery Chronic disease – a matter of careful consideration when - a slow and longer lasting condition (Bovine deciding the course of action with a sick Tb, Johne’s dss) animal, particularly protracted chronic Subacute (chronic active) disease disease - a condition between acute and chronic Death (Anthrax) Peracute disease REQUIREMENTS FOR THE STUDY OF DISEASE – a condition that kills the host quickly Nature of the pathogen (etiology) (Anthrax) Establishment of the disease Progression of the disease Latent disease Effect on the organism in terms of function and – a condition where the causative agent structural alterations remains inactive for a time but then End effect which is recovery or death becomes active to produce symptoms or signs of the disease TYPES OF DISEASES Primary infection Based on occurrence – acute infection that causes the initial illness Epidemic (cold) - a disease spreading among people in a Secondary infection relatively short period of time – one caused by an opportunist microbes Epizootic after the primary infection has weakened the – an extensive outbreak of disease of animals body’s defenses (Rhinitis is a sequela to cold) which is widely prevalent in contagious areas Inapparent (subclinical) infection -FMD, Avian Influenza – one that does not cause any noticeable Endemic illness (Elaephora poeli parasitic infection in – a disease constantly present in a cattle heart or aorta) population of humans in a locality Enzootic IDIOPATHIC DISEASES - spreading of disease in animals and is No established causes and have not been continuously present among groups of experimentally reproduced (Koch’s animals without fast spreading postulate) -Pneumonic Pasteurellosis; Lymphosarcoma Examples: Pandemic ❖ Necrotic pancreatitis or its sequelae – an epidemic disease that occurs worldwide ❖ Equine serum hepatitis (AIDS, COVID 19) ❖ Chronic (active) progressive hepatitis Panzootic ❖ Most of the neoplasms - animal disease that spreads rapidly over a IATROGENIC DISEASES very large area and affects many animals in caused by clinician a short period of time, across a large region breaching of the barriers protective or even worldwide (FMD, H5N1 bird flu) epithelial Sporadic Examples: – a disease that suddenly appears and ❖ Repeated or even single jugular disappears affecting one or more animals venipuncture - Sporadic Bovine Encephalomyelitis ; ❖ Indwelling catheters may produce Lymphoid Leukosis valvular damage NOSOCOMIAL (HOSPITAL ACQUIRED) INFECTIONS Incidence Are acquired as a result of a hospital stay – number of new cases in a given Factors involved : population. More valid to acute, short-term ❖ Microorganisms in the hospital diseases (Rabies) environment Prevalence ❖ Compromised or weakened status of – number of old and new cases. It is more the host commonly used for chronic diseases (African ❖ Chain of transmission in the hospital Swine fever, Avian influenza, Hog cholera, GENETIC DISEASES ND) Affect a critical process of fetal development leading to early fetal death TYPES OF DISEASES Based on extent of host involvement Commonly recessive traits - (heterozygous Local infection animal may be phenotypically normal while – invading microorganisms are limited to a carrying a mutated gene) relatively small area of the body Systemic or generalized infection Some defects are sex-linked (recessive - microorganisms or their products are spread gene associated with the condition is throughout the body by the blood or situated on the X or female chromosome ex. lymphatic system Hemophilia in dog) Bacteremia - presence of bacteria in the blood Errors in chromosome number or assortment Septicemia where the chromosomes may break or be – spread of multiplying pathogenic duplicated microorganisms and their toxins through circulating blood Examples which are incompatible with life Toxemia 1.Rod-cone dysplasia of dogs and sheep – presence of toxins in the blood  2.Spider lamb syndrome (hereditary limb - Ataxia remodelling deformity in some breeds of sheep) - Conjunctivitis processes 3.Von Willebrand disease - Skin lesions - artery and vein 4.Severe combined immunodeficiency of - Respiratory degeneration Arabian horses ailments - dehydration 5.Duchenne muscular dystrophy - Susceptibility to - central nervous infection system Diagnosis is by karyotyping or identification of - Hydrocephalus depression abnormal genes or gene products - Cleft palate - joint pain Rod-cone dysplasia VITAMIN D Spider lamb syndrome in sheep Signs of Deficiency Signs of Excess - Rickets - Anorexia Lactose intolerance (deletion of lactase) - lethargy - weakness - of muscle tone - Vomiting Lysosomal storage diseases (Fabry’s disease) - swelling and - calcification of - inborn errors of metabolism (lack of a bending soft tissue specific enzyme activity) resulting in the - mineralization accumulation of precursor substrates of long bones (glycogen, polysaccharides, (glycogen, - dry and brittle mucopolysaccharides, glycoproteins and hair the like) within the cell - muscle atrophy - Symptomatic female shows the classic whorl-like deposits in the basal layer of the VITAMIN E corneal epithelium Signs of Deficiency Signs of Excess - Degeneration of - Cystinuria (accumulation of amino acids skeletal muscle; - cystine excreted in the urine) of Dachshund - Reproductive failure Dalmatian is prone to uric acid urinary bladder - Retinal stones due to defective hepatocellular uptake of degeneration uric acid that can’t convert uric acid to allantoin - Steatitis - Dermatomyositis Ways of damaging DNA individual bases strand breaks (single or double) VITAMIN K altered base sequences Signs of Deficiency Signs of Excess abnormal cross-links between base pairs - coagulopathy - Hypersensitivity reaction METABOLIC ALTERATION -Results of nutritional imbalance VITAMIN B1 (THIAMINE) Altered lipid metabolism (fatty liver Signs of Deficiency Signs of Excess syndrome in cats and hepatic lipidosis in - Failure to grow, - cattle, sheep, Shetland ponies and miniature - Weight loss, horses) caused by fasting - And Vitamin A deficiency in cats neurological Iron deficiency in piglets abnormalities in -Protein energy malnutrition delays healing by the puppies and following mechanisms: cats decreased production of antibodies (ventroflexion) depressed complement system - Damage to the depressed cell-mediated immunity nervous system -Hormonal imbalances and paraneoplastic and the heart in syndromes disturb homeostasis and may cause adult dogs disease VITAMIN A VITAMIN B2 (RIBOFLAVIN) Signs of Deficiency Signs of Excess Signs of Deficiency Signs of Excess - Anorexia - Imbalance in - Anorexia - - Body weight loss bone - Weight loss  - Muscular VITAMIN B12 (COBALAMIN) weakness Signs of Deficiency Signs of Excess - Flaking - Poor growth - dermatitis - Weight loss - Eye lesions - Anemia - CATARACT IN CATS CALCIUM (Ca) - CORNEAL Signs of Deficiency Signs of Excess OPACITY IN - Nutritional - Different of DOGS secondary types hyperparathyroidism skeletal VITAMIN B6 (PYRIDOXINE) - significant aberrations, Signs of Deficiency Signs of Excess decreases in bone especially - Anorexia and - Impairment of mineral content, in growing weight loss in motor control which can result in puppies of puppies and balance major skeletal large - Convulsions - Muscle abnormalities breeds - Muscle weakness twitching PHOSPHORUS (P) - Anemia in adult Signs of Deficiency Signs of Excess dogs - Reduced - weight gain NIACIN B3 - Poor appetite Signs of Deficiency Signs of Excess - Bowing and - Anorexia - Bloody feces swelling of - Weight loss - convulsions forelimbs in - Irritation and puppies inflammation of the lips, cheeks, MAGNESIUM (Mg) and throat Signs of Deficiency Signs of Excess (ulcerations) - Reduction in - Urolith formation - Salivation weight gain, in cats - Bloody diarrhea irritability, and convulsions in PANTOTHENIC ACID B5 puppies Signs of Deficiency Signs of Excess - hyperextension - Erratic food - of carpal joints intake and hind-leg - Sudden paralysis later in prostration or life coma - Rapid SODIUM (Na) respiratory and Signs of Deficiency Signs of Excess heart rates - Restlessness - - Convulsions; - Increased heart gastrointestinal rate, water symptoms intake, and - Reduced hemoglobin antibody concentration production - Dry and tacky - Poor growth mucous - Fatty liver membranes BIOTIN B7 POTASSIUM (K) Signs of Deficiency Signs of Excess Signs of Deficiency Signs of Excess - Scaly dermatitis - - Poor growth - and restlessness at first in puppies  - Paralysis of neck PHYSICAL AGENT muscles and Trauma rear legs and - any force or energy applied to the body general Common in large animals during confinement and weakness later shipping in life. EXTRINSIC OR EXTERNAL INANIMATE CHLORIDE (Cl) PHYSICAL AGENT Signs of Deficiency Signs of Excess - Reduced - Traumatic lesions weight gain and Effects of sunburn weakness in ❖ keratinocyte swelling puppies ❖ blistering of the epidermis ❖ inflammatory response in the dermis IRON (Fe) Signs of Deficiency Signs of Excess Hyperthermia (high environmental temperature) - Poor growth - Dangerous Leads directly to water loss leading to - pale mucous oxidative increase in blood pH, hemoglobin membranes reactions that concentration and erythrocyte counts - Lethargy lead to - Weakness gastrointestinal In heatstroke, degenerative changes in the - diarrhea and other tissue myocardium, renal tubules and brain damage Malignant hyperthermia COPPER (Cu) associated with problem in ryanodine Signs of Deficiency Signs of Excess receptor Hypothermia (low body temperature) - Loss of hair - due to exposure to cold weather especially pigmentation seen in poorly nourished animals - Anemia In human, cold damage is through: ZINC (Zn) cellular injury Signs of Deficiency Signs of Excess intracellular water crystallization - Poor growth - temperature-induced protein changes - Anorexia membrane damage - Testicular vascular impairment atrophy vasoconstriction – causes hypoperfusion and stasis - Parakeratosis endothelial injury – causes thrombosis and vascular - Achromotrichia integrity thromboembolism SELENIUM (Se) Radiation injury (electromagnetic radiation) UV Signs of Deficiency Signs of Excess x-rays - Anorexia - Pulmonary gamma rays - Depression edema particle radiation - Dyspnea - Coma Effects of radiation - Muscular Cell swelling (endoplasmic reticulum vacuolation degeneration and mitochondrial swelling) Chromosomal damage (breakage, deletion and COBALT (Co) translocation) Signs of Deficiency Signs of Excess - Poor growth - - Anemia IODINE (I) Signs of Deficiency Signs of Excess - Goiter -