Pathology learning objectives
General constructive objectives:
1.
By the end of this course the students are able to understand the basic
concepts (aetiology, pathogenesis, morphology and complications) of:
2.
General pathology related to cellular injury, infection, inflammation and
repair, genetic disorders, immune response, circulatory disorders,
vitamin deficiencies, growth disturbances and neoplasia.
1.
Systemic pathology related to diseases of the organ systems with special
concern to diseases of the heart and blood vessels, respiratory system, renal
system, gastro-intestinal system, liver and biliary tract, blood and
lymphoid system, male and female genital systems, endocrine system,
bone and muscular system and nervous system.
Specific learning objectives:
A) General Pathology:
1. Inflammation:
1-Define inflammation and know its purpose
2- Mention the different types of injurious agents of inflammation.
3- List the main (vascular and cellular) events of acute inflammation
4- Describe the general and local signs of acute inflammation
5- Enumerate types of acute inflammation and give example of each type.
6-Define chronic inflammation. List the settings under which it arises.
7. Describe features and types of granulomatous inflammation. Give
examples of diseases associated with this pattern of response.
2. Repair
1- Classify cells according to their capability of division
2-Describe the phases of healing of a surgical wound
3- Mention the factors that affect wound healing.
4- List the complications of wound healing.
3. Cell injury (degeneration & necrosis)
1- List the causes of cell injury.
2- Mention the differences between reversible and irreversible cell injury.
3- Describe hydropic and cloudy swelling of cells.
4- Outline features of main storage disease (fatty change), possible
mechanisms in pathogenesis in fatty liver.
5- Define necrosis and enumerate its types
6- List the situations in which apoptosis occurs.
7- Differentiate apoptosis from necrosis.
4. Circulatory Disturbances:
1- Define the term thrombus and list types of thrombi.
2- Enumerate fate and complications of a thrombi.
3. Define the term embolus and list the types of emboli.
4- Define ischaemia and infarction. List their major causes and types.
5- Define gangrene and enumerate its types.
6- Define hemorrhage and enumerate its types.
5. Immunity & hypersensitivity:
1- Define immunity and hypersensitivity
2- Enumerate types of hypersensitivity and give example of each type.
3- Define autoimmunity and describe the mechanism of autoimmune
diseases
4- list the causes and types of immune-deficiency states.
6. Infectious diseases:
A. acute bacterial infection
1- Define toxaemia, bacteraemia, septicaemia and pyaemia
2- Mention the steps in the pathogenesis of pyaemia.
4- Enumerate common causes of systemic and portal pyaemia.
B. Tuberculosis
1- Enumerate method of infection in tuberculosis and list the possible
primary sites
2- Describe the primary tuberculous complex and mention its fate
3- Mention the inflammatory cells in forming the tubercle and their
function
4- Give an account on methods of spread of tuberculous infection
5- Compare between primary and secondary pulmonary tuberculosis.
E. Parasitic diseases:
1- Describe body response against Bilharzial infection
2- Discuss bilharzial lesions in different organs of the body.
3- Enumerate bilharzial lesion of the urinary bladder (gross & microscopic) with
their complications.
4- List the precancerous lesion in bilharzial cystitis.
5- Describe gross and microscopic features of intestinal bilharziasis and its
complications.
6- Mention the types of bilharzial liver fibrosis and its complications.
7. Disturbances of growth:
1- Define the terms hypertrophy, hyperplasia, atrophy, hypoplasia,
agenesis and metaplasia, with example of each
2- Mention and describe disorders leading to diminished growth such as:
Atrophy, Hypoplasia, Aplasia, and Agenesis
3- Mention and describe disorders characterized by increased growth such
as: Hypertrophy, and Hyperplasia
4- Define the term dysplasia and carcinoma in situ. Outline their role as
precursors of invasive malignancy
8. Tumors (neoplasia):
1- Define the terms neoplasia, anaplasia and differentiation
2- Give a brief classification of benign and malignant neoplasms according
to their tissue of origin
3- Compare between benign and malignant neoplasms regarding the gross,
microscopic and behavioral characters.
4- Define metastasis and describe the steps involved in metastatic spread
5- Outline the main routs by which malignant neoplasm’s metastasize and
the preferential sites to which particular neoplasms spread
B- Systemic pathology:
1.
CVS:
1. Define and classify arteriosclerosis.
2. List the risk factors and explain the pathogenesis of atherosclerosis and
describe the morphology of atheromatous lesions.
3. Enumerate the complications of atherosclerosis.
4. Explain the pathogenesis of essential hypertension and describe the cardiac
and vascular pathology and complications that it produces.
5. List the causes of secondary hypertension
6. Compare in a table form between benign and malignant hypertension
7. Define and classify aneurysms and describe their clinical effects.
8. Define and classify vasculitis.
9. Describe the pathogenesis of vasculitis in general, and pathogenesis,
morphology and clinical features of polyarteritis nodosa and giant cell arteritis
in particular.
10. List the causes of congestive heart failure and describe its pathogenesis
11.Tabulate the differences between right vs. left heart failure.
12.Classify ischemic heart disease and describe its pathogenesis.
13.Explain the pathogenesis, morphology, fate, and complications of
myocardial infarction.
14. Explain the pathogenesis of acute rheumatic fever and rheumatic heart
disease.
15. Describe the morphologic changes of acute and chronic rheumatic heart
disease.
16. Define infective endocarditis.
17. Describe the pathogenesis and morphologic changes of acute and subacute
infective endocarditis and their cardiac and extra-cardiac complications.
18. Define myocarditis, list its causes and describe its morphology and list its
complications.
19. Define and classify congenital heart diseases and describe their
pathogenesis.
20. List the causes of pericarditis and describe the morphology of acute and
chronic pericarditis.
21. List the tumors of the heart and relate their location and morphology to the
clinical features that they produce.
22. Describe the morphology of tumors of blood vessels with emphasis on
hemangiomas and Kaposi sarcoma and its various types with their associations.
23. Define primary and secondary varicose veins. List their causes, risk factors,
and complications.
B. Respiratory system:
1.
Describe the etiology, pathogenesis and complications of inflammatory and
allergic conditions affecting the nose and paranasal sinuses.
2. Describe the pathology of pharyngitis, tonsillitis, and rhinoscleroma and list
their complications.
3. List the tumors affecting the nose and nasopharynx and mention the causes and
risk factors and describe the morphology of nasopharyngeal carcinoma.
4. Classify the tumors of the larynx and outline their histopathological features.
6. Define atelectasis and pneumothorax and describe their types.
7. Classify pulmonary edema and describe its pathogenesis.
8. Define cor pulmonale, pathogenesis, and complications and list the causes of
acute and chronic cor pulmonale.
9. Describe the basic pathological mechanisms in COPD.
10. Define bronchial asthma, classify it and list the triggers for attacks of intrinsic
and extrinsic bronchial asthma. Explain the pathology of asthma including the
mechanisms and resulting effects.
11. Describe the gross and microscopic changes that occur during the progression
of chronic
12. Define emphysema and list its types. List the risk factors, explain
pathogenesis, describe morphologic changes and list complications of
emphysema with correlation to clinical features.
13. Define chronic bronchitis, list factors associated with chronic bronchitis.
Explain pathogenesis, describe morphologic changes and complications.
Compare between chronic bronchitis and emphysema.
14. List environmental conditions that are related to interstitial lung disease
15. Define bronchiectasis, List the factors that predispose to bronchiectasis and
describe its pathogenesis
16. Describe the gross and microscopic features of bronchiectasis.
17. Define cystic fibrosis, and explain its pathogenesis. Explain correlation
between cystic fibrosis and bronchiectasis.
18. Define pneumoconiosis. List the various occupational lung diseases .Explain
the pathogenesis, gross and microscopic features of silicosis and asbestosis as
prototypes of occupational lung diseases.
19. Define pleural effusion, list its causes and state its complications
20. Describe the term empyema. Describe the origin of an empyema. List the
common causes of exudative and transudative pleural effusions
21. Define pneumonia, bronchopneumonia, lobar pneumonia and atypical
pneumonia.
22. List the pathological differences between bronchopneumonia and lobar
pneumonia.
23. Describe atypical pneumonia and explain the differences in the morphology,
clinical features and course of the disease.
24. Enumerate the common tumors of the lungs. List the risk factors associated
with lung cancer.
25. Describe the morphology of different types of lung cancer as well as their
location. Relation between lung cancers and paraneoplastic syndromes.
C. GIT :
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20.
Describe the etiology, pathogenesis and histopathologic features of
inflammatory and reactive conditions affecting the oral cavity.
Define and describe leukoplakia with its histopathologic features as well as its
role as precancerous lesions.
Describe the etiology, gross and microscopic features of squamous cell
carcinoma of the oral cavity and lips.
Define sialadenitis and list its types and complications.
Describe morphology of sialadenitis with special reference to mumps.
Classify tumors of salivary glands and describe their morphology with
emphasis on pleomorphic adenoma and muco-epidermoid carcinoma.
Describe the esophageal lesions associated with motor dysfunction with their
complications.
List the causes, and describe the morphology and complications of esophageal
varices.
Describe esophagitis as regards types, pathologic features and effects
Describe the pathogenesis, gross and microscopic changes seen in reflux
esophagitis, Barrett's esophagus and subsequent adenocarcinoma of the
esophagus.
Describe the etiology, pathogenetic factors and morphological features of
acquired and congenital pyloric stenosis.
Define gastritis and give its causative factors as well as morphology of acute
and chronic gastritis with particular emphasis on Helicobacter associated and
autoimmune gastritis and list their complications.
Define peptic ulcer; give its locations in stomach and other parts of the
GIT. Explain its pathogenesis and describe its morphology and
complications.
Classify tumors and tumor-like conditions of the stomach; describe
their risk factors, and the gross and microscopic features of early and
advanced gastric carcinoma.
Describe the differences between the intestinal and diffuse variety of
advanced gastric carcinoma.
Differentiate between Crohn’s disease and ulcerative colitis.
Describe the pathogenesis, morphology, and clinical features of the infectious
enterocolitis and colitis including Typhoid and Amoebic colitis.
Classify the malabsorption syndrome and describe the pathogenesis
morphology of malabsorption due to Celiac and tropical sprue
Define intestinal obstruction and list the causes of the acute and chronic types
Define the following terms: intussception, volvulus, paralytic ileus.
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Describe the pathogenesis and morphology of ischemic bowel disease.
Classify tumors & tumor-like conditions of small and large intestine, list their
risk factors.
Define polyp, enumerate its types and describe the differences between
neoplastic and non-neoplastic polyps of the gut.
Describe the morphology of adenomas of the gut and explain why it is
thought that most carcinomas of the gut arise from pre-existing adenomas.
Describe the morphology, grading and staging of cancer of the gut with
emphasis on adenocarcinoma of the colon and rectum.
Define carcinoid tumors and the carcinoid syndrome and give the morphology
and histopathological diagnosis of these tumors.
Describe the etiology, pathogenesis and morphology of acute appendicitis and
list its complications.
List the tumors of the appendix and describe the morphology of carcinoid
tumors of the appendix.
Describe etio-pathogenesis and morphology of acute and chronic pancreatitis
and carcinomas of the exocrine pancreas.
List the causes of upper and lower GIT bleeding.
Describe the etio-pathogenesis and types of peritonitis
Define ascites and list its causes
D. Liver:
1.
Define and classify jaundice on pathological basis and list the its causes
2.
Describe the pathological features of the hemolytic, hepatocellular and
obstructive types
3.
List the causes of acute hepatitis
4.
Discuss the pathogenesis and morphological features of acute viral hepatitis
5.
Demonstrate the pathological features of chronic hepatitis
6.
List the main causes of hepatic fibrosis
7.
Describe the pathogenesis of portal hypertension
8.
List the common causes of liver cirrhosis
9.
Describe the pathological features of a cirrhotic liver
10. List the complications of liver cirrhosis.
11. Describe the pathological changes occurred in the spleen due to liver cirrhosis.
12. Explain how liver cirrhosis leads to hepatocellular carcinoma (HCC)
13. Explain the pathogenesis of hepatocellular dysfunction (hepatic failure)
14. Describe the types of gall stones and the morphological features of acute and
chronic cholecystitis and cholelithiasis.
15. Describe the pathogenesis and morphology of carcinoma of the gall bladder
E. Renal system:
1. List the causes of prerenal, renal and postrenal azotemia
2. Explain the pathologic changes occurring in fluid & electrolyte balance in
chronic renal failure
3. Explain the effects of chronic failure on different body systems and organs.
4. List the congenital anomalies of the kidney.
5. Classify and compare and contrast the different cystic diseases of the kidney
on the basis of age of onset, inheritance, pathologic features, clinical features
and complications as well as prognosis.
6. Classify glomerular diseases.
7. Explain the mechanisms of glomerulonephritis.
8. Describe the clinicopathologic features of the nephrotic syndrome.
9. List the causes of nephrotic syndrome.
10. Describe the characteristic light microscopic (LM), immunofluorescence
(IF), and electron microscopic (EM) findings minimal change disease
(MCD)
11. Describe the characteristic light microscopic and EM findings of focal
segmental glomerulosclerosis (FSGS)
12. Define membranous GN, and describe the morphologic glomerular
changes of MGN by LM, IF, and EM.
13.
List the glomerulonphritides that are more likely to cause acute nephritic
Syndrome.
14.
Describe the characteristic light microscopic features of
Membranoproliferative glomerulonephritis (MPGN)
15. Describe etio-pathogenesis of acute poststreptococcal (postinfectious)
glomerulonephritis (GN), and explain the possible mechanisms of injury.
16.
Describe the typical light microscopic (LM), immunofluorescence (IF),
and electron microscopic (EM) features in postinfectious GN.
17.
Describe the common clinical presentation of rapidly progressive
(crescentic) glomerulonephritis (RPGN).
18.
Describe the major histologic glomerular findings in RPGN.
19.
Define hematuria and list its causes.
20.
List the major causes of tubulointerstitial diseases.
21.
Explain in detail the etiology and pathogenesis of urinary tract infections.
22.
Describe the gross and microscopic changes in acute PN, including
necrotizing papillitis.
23.
Describe the characteristic gross and microscopic features of chronic PN.
24.
Describe the composition of the most common forms of renal stones.
25.
List the favored sites for formation of stones.
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List the complications of urolithiasis.
Describe the renal changes and effects of the following systemic diseases
on the kidney: DM, Gout, SLE, and amyloidosis.
Explain why patients with hypertension get renal failure and why patients
with renal failure get hypertension.
Describe the gross and microscopic features of benign and malignant
nephrosclerosis.
With respect to renal cell carcinoma, describe:
a. The gross and microscopic morphologic appearance.
b. Typical clinical features, especially the classic triad.
c. mode of spread
d. associated paraneoplastic syndromes, especially polycythemia
Describe the histologic types and typical clinical features of carcinoma of
the renal pelvis.
Explain the genetics and pathogenesis of Wilms tumor of the kidney.
Describe the gross and microscopic features of Wilms tumor, its mode of
spread and its prognosis.
List the causes of ureteritis and list the causes of ureteric obstruction.
Explain the effects of unilateral and bilateral obstruction.
Define cystitis and describe the pathogenesis of cystitis.
Describe the causes, morphology and signs and symptoms of cystitis.
Classify tumors of the urinary bladder.
Describe the gross and microscopic features of urothelial carcinoma of the
urinary bladder, their behavior, mode of spread and clinical features
produced.
List the intrinsic and extrinsic causes of obstruction of the urinary bladder
and the effects.
F. Endocrine:
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6.
List the types of pituitary adenomas and describe their morphology.
List the causes of hypopituitarism .
Classify thyroiditis and describe the pathogenesis, complications and
morphology of Hashimotos thyroiditis in particular.
Define Graves’ disease and describe its pathogenesis and morphology and
correlate with the clinical features.
Describe different types of goiters and their pathology and clinical features.
Classify tumors of thyroid gland and describe the morphology and clinical
features of thyroid adenoma and thyroid carcinoma
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Describe causes, pathology, clinical features and complication of parathyroid
hypo and hyperfunction.
Describe etiology, pathophysiology, clinical features and complications of
adrenocortical hyperfunction and hypofunctions.
Describe etiology, pathophysiology , clinical features and complications of
adrenomedullary lesions
Define DM, classify it and describe its pathogenesis of different types.
Describe the morphological changes of blood vessels in different organs in
DM.
G. Male genital system:
1.
Describe the gross and microscopic features of condyloma acuminatum,
carcinoma-in-situ and squamous cell carcinoma of external genital tract.
2. Describe the inflammatory and infectious conditions affecting the testis.
3. Describe the causes and pathological effects of torsion of testes.
4. Classify tumors of the testis and describe the morphologic differences
between seminomatous and non-seminatous tumors.
5. Classify prostatitis and describe the morphologic and clinical features of
prostatitis.
6. Describe the incidence, etiology, pathogenesis and complications of benign
nodular enlargement of the prostate.
7. Describe the incidence, etiology, pathogenesis, grading and complications of
prostatic carcinoma.
H. Female genital system:
1.
Describe acute and chronic cervicitis.
2. Describe the pathogenesis, risk factors, clinical features and morphology of
squamous cell carcinoma of cervix.
3.
Describe the terms used in dysfunctional uterine bleeding and list its
causes.
4.
Describe endometritis with special references to T.B endometritis.
5.
Define endometriosis; explain the theories of endometriosis and its
morphology and complications.
6.
Describe endometrial polyps.
7.
Describe the three types of endometrial hyperplasia.
8.
Describe risk factors, etiology, clinical features, morphology and
pathogenesis of endometrial carcinoma as well its morphology.
9.
Describe the morphology and clinical features of leiomyomas of the uterus.
10. List the differences between leiomyoma and leiomyosarcoma of the uterus.
11. Classify tumors and tumor like lesions of the ovary
12. Describe the pathogenesis and morphology of surface epithelium tumors,
teratomas and granulose theca cell tumors
I. Breast:
1. List the inflammatory breast lesions and mention their etiology
2. Describe the morphology of the inflammatory breast lesions with special
reference to breast abscess, duct ectasia and fat necrosis.
3. List the proliferative breast lesions and mention their etiology.
4. Describe the morphology of the proliferative breast lesions with special
reference to fibrocystic changes.
5. Explain the relationship between fibrocystic changes of the breast and breast
cancer.
6. Classify breast tumors
7. Describe the morphology of the benign breast tumors with special reference to
fibroadenoma and intraductal papilloma
8. List the risk factors of breast cancer
9. List the histological classification of breast cancer.
10. Explain the prognostic factors of the breast cancer with special reference to:
stage at the time of diagnosis, histological features & Estrogen-receptor status
11. Describe the gross and microscopic features of different breast carcinoma
with special reference to: in situ ductal carcinoma, in situ lobular carcinoma,
invasive duct carcinoma, invasive lobular carcinoma & Paget’s disease of the
breast
J. Blood and lymphatic system:
a. Red blood cells (anemias):
1.
Define anemia and classify anemia on an etiologic and morphological basis
and give the major examples in each category.
2. List causes of iron deficiency anemia.
3. Explain the pathophysiologic effects of iron-deficiency anemia.
4. List the major causes of vitamin B12 & folate deficiency.
5. Explain the pathogenesis of megaloblastic anemias.
6. Describe the bone marrow cellularity and peripheral blood counts in
aplastic anemia.
7. List the major causes of aplastic anemia.
8. Review the pathogenesis and hematologic findings of anemia of
chronic disease.
9. Describe the mechanism of anemia of renal failure and how this
differs from all other forms of anemia.
10.Compare and contrast extravascular and intravascular hemolysis.
11.Describe the peripheral blood and bone marrow changes seen in
response to excessive red cell destruction.
b. White blood cells:
1. Leukopenia:
1. Define leucopenia; list the causes of neutropenia and its clinical
manifestations.
2. Leukocytosis:
1.
List the major causes of leukocytosis affecting neutrophils, eosinophils,
lymphocytes, and monocytes.
Explain the terms ‘shift to the left’ or ‘shift to the right’ and describe their
significance
2.
C. Lymph nodes:
1.
2.
List the causes of lymph node enlargement
Describe the causes of acute & chronic no-specific lymphadenitis.
Lymphoid Neoplasia:
1.
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6.
Describe the main categories of lymphoid neoplasia as described in the
World Health Organization (WHO) classifications.
List the commonly encountered forms of lymphoid neoplasia.
Compare and contrast Hodgkin lymphoma (HL) and non-Hodgkin
lymphomas (NHL) clinically and histologically.
Describe the histologic hallmark of HL.
Describe the microscopic features of Reed-Sternberg cell and its variants.
Give its likely origin.
Describe the basis of the histologic classification of HL and how this
relates to the natural history of HL.
K. Bone and joints:
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List the types of bone fractures and their common causes.
Describe the sequence of gross and microscopic changes in the natural
healing process of bone fracture.
List and define the different metabolic diseases of bone and explain the
etiologic and associated predisposing factors for the two disorders common
in the elderly (osteoporosis and osteomalacia) as well as rickets (the
counter part of the latter in children).
Describe the pathological differences between osteoporosis and
osteomalacia.
Describe the complications of osteoporosis, osteomalacia and rickets.
Classify tumors and tumor-like conditions of bone
Describe pathological features of the following benign tumors of bone:
Chondroma
Osteoma
Osteochondroma
Describe pathological features of the following malignant tumors of bone:
Chondrosarcoma
Osteosarcoma
Giant cell tumor (osteoclastoma)
Ewing's sarcoma
Describe pathological features of the following tumor like lesions of bone:
Fibrous bone defect
Myositis ossificans
Explain the sequence of events and the corresponding gross and
microscopic changes and complications seen in acute and chronic
osteomyelitis and septic arthritis.
Describe the pathology of tuberculous osteomylietis with special emphasis
on psoas abscess; list the other possible pathways and outcomes of psoas
abscess.
List the inflammatory conditions affecting joints.
Describe the etiologic factors and pathogenetic sequence of events in
rheumatoid arthritis, osteoarthritis, gouty arthritis, septic arthritis,
tuberculous arthritis, psoriatic arthritis and describe their complications.
L. CNS:
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Describe the pathological characteristics of epidural, subdural and
subarachnoid hemorrhages
Describe CNS aneurysms. List their types, causes and effects
Describe the morphology and pathogenesis of brain infarction.
Give a list of demyelination diseases of the nervous system
Describe the etiology and pathological findings of multiple sclerosis
List neurodegenerative diseases of the nervous system and explain their
pathogenesis
Describe the pathogenesis and pathological findings of Alzheimer's disease
Classify CNS & PNS neoplasms
Describe the morphological features of the common intracranial neoplasms
Describe the pathological effects of CNS & PNS tumors
Discuss the etiology of peripheral neuropathy
List the causes and effects of intracranial space occupying lesions
Discuss the pathology of hydrocephalus
Describe the pathology of brain abscess
Describe the pathological features of encephalitides