Darunee Jintakanon Department of Pathology Faculty of Medicine, KKU 365 330 General Pathology Introduction Darunee Jintakanon Department of Pathology Faculty of Medicine, KKU

Pathology คือ อะไร? ทำไมต้องเรียน? เรียนอย่างไร? ต้องการพื้นฐานความรู้ใดบ้าง จะได้ใช้วิชานี้เมื่อไร? อย่างไร?

พยาธิวิทยา Pathology คือ อะไร? Pathology = Pathos + Logos Suffering Study Study of Disease พยาธิวิทยา

ทำไมต้องเรียน? จะได้ใช้วิชานี้เมื่อไร? diagnosis

Abnormal stage of body  Disease Disorderly function (show off as abnormal sign and symptom) of organ system of body (cell, tissue, organ)

Sign = objective symptom of disease Symptom = subjective sign of disease Ascites, cachexia, cough, dysphagia, fever, gynecomastia, hemoptysis, hepatomegaly, splenomegaly, icterus, lymphadenopathy, palmar erythema Chest pain, dizziness, loss of appetite, weakness, numbness, headache, toothache

The concept of disease Environmental factors Inability to adapt Hypertrophy /hyperplasia Atrophy Metaplasia Change with adaptation Environmental factors Lesion Structural change Cell Tissue Organ Inability to adapt Injury Death Signs Functional change Symptoms Genetic factors

The general main causes of disease ii Congenital Diseases Acquired Diseases Inflammation: appendicitis, TB Hemodynamic disorder : shock, MI Growth disorders Neoplasia: lung CA Injury, disordered repair: fracture, aspirin induced PU Genetic Non genetic Non neoplastic: BPH Immune disorder: AIDS, Graves’ disease Inherited : cystic fibrosis Environmental : rubella assoc mal- Metabolic disorders: DM Spontaneous : Down’s syndrome Accidental : cerebral palsy ~ birth hypoxia Degeneration: osteoarthritis * Familial diseases * Abnormal Growth & Development Cushing’s syndrome ~ X steroids Iatrogenic disease Aplastic anemia ~ chloramphenicol

~ medical technologists Scope of Pathology Anatomical Pathology Clinical Pathology clinical chemistry clinical hematology/blood banking clinical microbiology surgical pathology cytopathology forensic pathology Oral and maxillofacial pathology Pathologists ~ medical technologists Veterinary pathology is concerned with animal disease Phytopathology is the study of plant diseases.

A combination both anatomical and clinical pathology is known as general pathology

General pathology also called investigative pathology, experimental pathology or theoretical pathology is a broad and complex scientific field which seeks to understand the mechanisms of injury to cells and tissues, as well as the body's means of responding to and repairing injury

Anatomical pathology is concerned with the diagnosis of disease based on the gross, microscopic, and molecular examination of organs, tissues, and whole bodies (autopsy). The anatomical pathologists typically do not see patients directly, but rather serve as consultants to other physicians

Surgical pathology – study & dx diseases by gross and microscopic examination of surgical specimens (as well as biopsy) Cytopahology –study and dx diseases on cellular level, the most common use of cytopathology is the Pap smear to detect cervical cancer Forensic pathology – concerned with determining cause of death, usually for criminal law cases and civil law cases in some jurisdictions

Clinical pathology is concerned with the diagnosis of disease based on the laboratory analysis of bodily fluids such as blood and urine, using the tools of chemistry, microbiology, hematology and molecular pathology Clinical pathologist works in close collaboration with medical technologists

THEORETICAL STUDY 1. Etiology ( causes of diseases ) เรียนอย่างไร? Main object is to know the nature of DISEASE by study as the following :- 1. Etiology ( causes of diseases ) 2. Pathogenesis (mechanism of diseases) 3. Pathological changes : structural change  Lesion

THEORETICAL STUDY 4. Clinical feature : functional & structural changes  symptoms & signs of patients 5. Complication 6. Prognosis ( prediction the future of victim)

Etiology S.aureus Pathogenesis Morphological and functional features HBV Smoking , Polycyclic AHC Pathogenesis Acute inflammation Immune reaction to virus infected cells Increased renin production Genetic mutation Morphological and functional features Boil Cirrhosis Lung cancer High BP Complications & sequelae Liver failure Cerebral hemorrhage Septicemia Metastasis

เรียนอย่างไร? TACTICAL STUDY ศึกษาโดย “เปรียบเทียบ” ระหว่างสิ่งปกติ กับ สิ่งซึ่งผิดปกติไปจากธรรมชาติของมนุษย์ เปรียบเทียบสิ่งเดียวกัน ชนิดเดียวกันในเรื่อง โครงสร้าง และ หน้าที่การทำงาน ของอวัยวะ เนื้อเยื่อ และเซลล์ นั้น

ตัวอย่างการเปรียบเทียบ Structure Normal squamous cell VS abnormal squamous cell Function of organ, tissue, cell Normal blood sugar VS abnormal blood sugar

ตัวอย่างการเปรียบเทียบ

ตัวอย่างการเปรียบเทียบ

Techniques of Pathology Biochemical Microbiological Hematological Cell/ tissue culture

Learning objective 1. The meaning of pathology and scope of pathology. 2. How to study the pathology? 3. Techniques of Pathology 4. The general main causes of disease

REFERENCES 1. General and systematic Pathology, 4th edition, edited by J.C.E.Underwood, “Introduction to Pathology” 2. Concise Pathology, 3rd edition, edited by P. Chandrasoma ; C.R. Taylor, Introduction : The Discipline of Pathology, pp xiii – xiv 3. Robbins and Cotran Pathologic Basis of Disease, 7th edition, edited by Kumar; Abbas; Fausto; “Introduction to Pathology” pp 4

Basic medical science and clinicopathological correlation Surgery Prognosis Medical Treatment Prophylaxis or prevention Management Other Clinical Dx Aortic valve stenosis with left sided failure Solution of problem dyspnea, crepitation, murmur Clinical problem Murmur heart sound Pathology : Disease, Heart valve stenosis Structural changes Functional changes Circulation disturbed Cardiac hypertrophy Strength of heart pump Compensate: to be normal C.O. HR Pump failure Over compensate: exhaust Irregular HR Complication: pulmonary congestion Pulmonary edema Dyspnea, crepitation