1
COURSE: GENERAL PATHOLOGY
CLASS: MDIII
SEMESTER: SPRING 2015
Course Director: Dr Podcheko
Email: apodcheko@mail.sjsm.org
Course Instructor: Dr. Tsivis
Course Description: Pathology is the study of diseases. Pathology is divided into General Pathology and
Systemic Pathology. General pathology deals with the basic concept of various disease processes in the body, like the causes and mechanisms of disease and the associated alterations in the structure and function. Systemic pathology deals with the disease process affecting various systems and specific organs in the body.
Pathology bridges the basic medical sciences and the clinical disciplines. Moreover, it is a cornerstone discipline in medical education. In short, an understanding of pathology is an essential pre-requisite in understanding medicine, as pathology has - for well over a century - played a pivotal role in our understanding of disease, its principles underpinning many of our teachings in medicine and surgery.
The word 'pathology' finds its etymological origin in the Greek pathos (suffering, as in disease) and logos (reason, as in systematic study). Pathology is best learned by a systematic approach, first by learning the language of the discipline and then by understanding the function of the various processes.
Increasingly, the understanding of cell and organ functions plays an important role in the understanding of disease processes and the treatment of disease. Initially, some of the 'language' must be memorized in the same way that the alphabet must be learned by rote; however, the appreciation of the way the
'pathology words' are constructed requires an understanding of mechanisms, in essence, an awareness of 'how things are put together and work together'. This is the fundamental principle in the understanding of the discipline of pathology. The major problems in understanding pathology are its hard-to-recognize basics and terms, the variety of morphologic presentations of a single disease entity, and the complex interconnections between pathology and other clinical specialties.
Human pathology is relatively meaningless as an isolated discipline. Like medicine, pathology is not a clearly delineated science. It owes its development to successive intellectual and technical borrowings from nearby disciplines such as anatomy, physiology, physics, chemistry, microbiology, immunology, genetics, and cell and molecular biology. For this reason, pathology reflects closely the body of knowledge gradually acquired in each of these disciplines. As such, histology, gross anatomy, genetics, embryology, molecular biology, microbiology, physiology, and biochemistry are, in turn, essential prerequisites for an understanding of disordered structure and function. Pathology must also be correlated with the clinical disciplines to imbue it with practical meaning. Without these prerequisites standards of learning are undermined and without the clinical correlation the relevance of the discipline diminishes, as pathology embraces all disciplines of medicine while at the same time drawing heavily on the physical sciences. The modern pathologist is called upon to integrate these multiple disciplines on a daily, indeed case-by-case, basis. Pathology taught out of context descends to mere remote learning.
The student must first understand the normal histologic structures in an organ in the context of its normal physiologic function. Then, the student must be able to relate the abnormal histology (i.e. histopathology) to clinical findings, both subjective (patient complaints) and objective (physical examination findings). The organ or system is highly organized on both the gross and microscopic
* subject to change

2 levels. There must also be an awareness of the mechanisms that cause a disruption of the normal cellular architecture. The clinical history and physical examination are critical to putting the pathologic findings into context.
The student must become proficient at working back and forth between histologic changes, clinical findings and disease processes. The best way to acquire this skill is to think in terms of mechanisms of disease and not just memorize key words. It is the understanding of the underlying pathophysiology of the disease that allows the physician-scientist to make rational predictions of the natural history of a disease process.
Under the heading of General Pathology (Pathology I) we will study the following pathological processes: 1) Cellular Injury, Adaptation and Death; 2) Acute and Chronic Inflammation; 3) Tissue
Repair: Cell Regeneration and Fibrosis; 4) Hemodynamic Disorders; 5) Genetic Disorders; 6)
Immunopathology; 7) Nutritional Pathology;
8)Principles of Infectious pathology; 9) Neoplasia; 10) Pediatric and Developmental Pathology
(Disorders of Infancy and Childhood); 11) Environmental Pathology.
In addition, the course also includes:
1) Red Blood Cell and Coagulation Disorders; 2) White Blood Cell Disorders 3) Skin Disorders*
Course Purpose and Objectives: By the end of the course, the medical student is expected to:

Learn the basic principles of disease processes (General Pathology) and be able to apply these principles to the study of particular diseases in various tissues, organs and systems of the body
(Systemic Pathology)

To develop an understanding of the causes and mechanisms of disease and the associated alterations of structure and function

Correlate the pathological changes with the clinical picture

Observe and analyze pathology with clinical disciplines and microscopic levels
The emergent doctor needs to develop an awareness of the role of pathology (i.e. laboratory medicine) in the management of disease, ultimately being able to: o Understand and explain the basic mechanisms underlying the major disease processes. o Use knowledge of pathological principles in order to formulate possible diagnoses on the basis of a patient' history and findings on clinical examination. o Know when and how to request a laboratory investigation (e.g. a biopsy, a clinical pathology laboratory assay, an autopsy) o Understand the significance of a result or report that comes back from the pathology laboratories. o Explain the result or report to a patient when so authorized.
Student Outcomes and Core Competencies
See Learning Objectives (Appendix) for intended learning outcomes (ILOs).
Six core domains of medical student competencies that target learning within the educational curriculum for the MD Degree have been developed and proposed by the Association of American Medical Colleges
(AAMC) and the Liaison Committee for Medical Education (LCME), upon which the SJSM core competences are modeled. As they relate to pathology, they may be summarized as:
Systems-Based Practice
Students must demonstrate an awareness of - and responsiveness to - the larger context and system of health care and the ability to effectively call on system resources to provide pathology services that
* subject to change

3 are of optimal value.
Professionalism
Students must demonstrate tolerance and consideration for the concerns and opinions of others, a commitment to carrying out professional responsibilities, adherence to ethical principles, and sensitivity to a diverse patient population.
Interpersonal and Communication Skills
The student must be able to provide information using effective nonverbal, oral and writing skills with patients, patients' families, colleagues and other members of the health care tem. In essence, the student must develop interpersonal and communication skills that result in effective relationships, information exchange and learning with other health care providers, patients, and patients' families.
Relationship-Centered Care
The student must be able to interpret results of common anatomic and clinical pathology studies, so as to demonstrate an ability to provide appropriate and effective care in the context of pathology services.
Improvement in Practice
The student must demonstrate the ability to use information technology to manage information, access on-line medical information, and support their own educational endeavors. The student must be able to utilize clinical and scientific information in the continuing medical education (CME) process of determining priorities and care decisions for patients.
Tenets of Medicine
The student must know the various causes (e.g. genetic, developmental, microbiologic, autoimmune, neoplastic, degenerative, traumatic, cognate [epidemiological and socio-behavioral]) of illnesses and the ways in which they affect the body (pathogenesis) in the context of established and evolving biomedical and clinical sciences. The student must know the altered structure and function ( pathology and pathophysiology) of the body and its major organ systems as observed in various diseases and conditions.
Methods of Instruction
Lectures, labs and case studies and virtual microscopy platform.
The recent versions of my lectures will be available for download: https://www.sjsm.org/moodle/login/index.php
Policy on the Use of Electronics:
Moodle /emails is the mechanism for electronic communication between the faculty and students. a) This includes professors posting assignments, announcements and information pertinent to the course (e.g.,
Powerpoint presentations, teaching aids, grades, etc.). Powerpoint slides for an upcoming lecture will be posted for student access prior to that presentation. These Powerpoint files are for the exclusive use of the students as a complement to the course and the information described in the book. That is, they are not for posting or distribution. b) Students will use Moodle to submit assignments and can use it to submit questions to the faculty. This is by no means the sole basis for student-faculty interactions. Indeed, faculty members encourage students to talk with them in their office either in an in prompt or scheduled manner. Faculty have posted office hours. c) Out of respect for each other and the professors, students may not communicate electronically during class with classmates, others, or the media without the explicit permission of the instructor. Furthermore, students may not record any part of the lecture or other proceedings without the explicit permission of the instructor . This includes audio and video recordings and photographs. If a student breaks any of these policies, his/her equipment may be confiscated for the remainder of the class, the block, or the semester and more severe disciplinary action may be taken. d) No electronic will be allowed for playing games, texting, facebooking, twitting, shopping or any related. Your computer , tablets and tabloids are only allow to follow the lecture or to look for answers. Any student found playing
* subject to change

4
games, texting, facebooking, twitting, shopping or any related will be expelled from the course without discussion. e) Any students found cheating on the test will be excused without any discussion, have a nice life.
Recommended Texts
RECOMMENDED TEXT BOOKS:
1. Robbins and Cotran Pathologic Basis of Disease, Professional Edition, 9e by Vinay Kumar MBBS MD FRCPath (Author), Abul K. Abbas MBBS (Author), Jon C. Aster MD PhD (Author)
2. Rubin's Pathology: Clinicopathologic Foundations of Medicine 7th Edition
3. Illustrated Q&A Review Of Rubin's Pathology, 2nd Ed
4. Robbins and Cotran Review of Pathology, 4th Edition
Additional Learning Resources
RECCOMENDED WEB Applications:
1.
Webpath : http://library.med.utah.edu/WebPath/webpath.html
2.
Virtual Slide Box Iowa University: http://www.path.uiowa.edu/virtualslidebox/
3.
Pathology Lectures and seminars: a.
http://www.gopathdx.com (require free registration to view and download lectures) b.
http://www.medicalschoolpathology.com
4.
Iphone, Ipod, Ipad : Rubin’s Pathology Flash Cards (free app)
Student Feedback
The student-teacher relationship should presage a good patient-doctor relationship. While the pathologist may not teach in the presence of a living patient, teaching should nevertheless exemplify good interpersonal skills. These include not only the effective communication of relevant clinical knowledge, but the willingness to listen to, understand and address student concerns. Students are not merely empty vessels that require filling, but are responsive and responsible individuals with different needs, interests and social backgrounds. Student feedback is always welcomed and the department greatly appreciates open-minded and unprejudiced evaluation ("formative assessment") that can help to improve our education process.
Evaluation, Assessment Methods, Grading Policy, Criteria and Scales
Students will be evaluated on the "application of knowledge" basis (summative assessment). All theoretical and laboratory examination questions will be presented as clinical vignettes and all of them will be either interpretation or problem-solving items; there will be no questions of the straight
"identify" nature. In other words, you will be asked to show your "higher order" skills, rather than just rote memory and recall of factual information.
All the questions are related to intended learning outcomes (i.e. learning objectives), correspond to
USMLE Step 1 Content Outline (http://www.usmle.org/Examinations/step1/step1_ content.html) as well as to general and systemic pathology objectives for undergraduate medical education proposed by the Group for Research in Pathology Education (GRIPE) (http://peir.net/griper), and are written adhering to National Board of Medical Examiners (NBME) guidelines as published in that organization's monograph Constructing Written Test Questions r For the Basic and Clinical Sciences, 3 Edition
(Revised), 2002.
ATTENDANCE POLICY:

Students must attend at least 80% of lectures

Attendance may be monitored on a daily basis by assigning short, “in-class” quizzes at the random time within the lecture/lab time slot
* subject to change

5

Student must read/review appropriate textbook chapter and download the lecture slides before the lecture (Link is above)

Any student falling short of 80% attendance please refer to the Attendance policy of SJSM
Anguilla
MCQs Quizzes:
1.
Every day for attendance records purposes only (including one quiz for each lab session)
2.
Once during block, a 50 questions MCQ quiz will be assigned from 3:10-4:15pm instead of a laboratory session (second Friday of the block, unless another date is indicated by course coordinator)
3.
For students who missed quiz and did not provide LOA approved by Dean or medical/legal note explaining the absence, quiz will not be administered. A missed quiz result in a zero in calculation of final score for the block.
4.
For students who missed quiz and have valid LOA/medical/legal note the quiz will not administered but calculation of block score will be done using the following formula: 10% from labs+90% from written exam, for block 4 – 30% from poster presentation and 70% from written exam.
Laboratory Sessions:
1.
Problem Based Learning
2.
Review of pathology slides: real and virtual
3.
Discussion and review of clinical vignettes from USMLE world and other test banks
4.
Labs will be held once a week for each batch of 45 students between 3-5pm on Friday. The other batch of 45 students will be having multiple choice question class or a revision depending on the professor for the first hour and vice versa*
Pathology Research Posters presentations:
1.
Only for Block 4
2.
Students will be assigned into several groups by course facilitator
3.
Course instructor will assign a specific research topic to each group (topics of research presentations will be available at the beginning of Block 3 and will pertain to 30% of block
IV)
4.
Students will have to prepare a poster and present it during poster session evaluated by
SJSM faculty members at the end of Block IV.
EXAMINATION PATTERN: c) EXAM DATES;
EXAM I
EXAM II
EXAM III
EXAM IV
RETAKE EXAM
Friday, January 30
Friday, February 27
Friday, March 27
Tuesday, April 21
Friday, May 8th
TYPE OF QUESTIONS
NO OF QUESTIONS
DURATION
GRADING:
MULTIPLE CHOICE
50
1 HOUR
* subject to change

6
Grading for course will be provided based on the following schedule:
Block 1 Block 2 Block 3 Block 4
80% from Block MCQ exam *
80% from Block MCQ exam*
80% from Block MCQ exam*
60% from Block
MCQ exam*
10% from lab activities
10% from lab activities
10% from lab activities
30% from
Poster
Presentation
10% from Quiz
A
10% from Quiz
B
10% from Quiz
C
10% from Quiz
D
Final course score and grade will be calculated based on the following formula:
Final course score=(A+B+C+D)/4
*Note: Curving will be performed only if average score for MCQ exam in the group is below 70.
Curving will be done only for MCQ exams. Aim of curving is to reach average score 70 in the tested population. The following formula will be used for curving: Curved Score=100-A(100-You Raw
Score) A could be between 0-1.
No curving for quizzes, labs and poster presentations!
The grading scale is as follows:
SCORE GRADE
< 70%
70-79%
80-89%
90-100%
FAIL (F)
C
B
A

Please note carefully the dates and the assigned classrooms for each examination as they are posted on the notice board or specified by course coordinator

No breakdown of examination questions will be given.

No early exams for any circumstances

Students who missed Block exam and have valid LOA will be allowed to write exam in the first week of next block classes
Wk Day
1 Wednesday
Thursday
Friday
DATE
01/7
01/08
01/09
CHAPTER TOPIC
Professor
INTRODUCTION TO
PATHOLOGY
ADAPTATIONS OF CELLULAR
GROWTH AND
DIFFERENTIATION
DEFINITIONS, ETIOLOGY,
PATHOGENESIS
HYPERTROPHY, HYPERPLASIA,
ATROPHY, METAPLASIA
Dr.
PODCHEKO
Dr.
PODCHEKO
MECHANISMS OF CELL INJURY
AND CELL DEATH
Dr.
PODCHEKO
MORPHOLOGICAL ALTERATIONS Dr.
* subject to change

2 Monday
Tuesday
Wednesday
Thursday
Friday
3 Monday
Tuesday
Wednesday
Thursday
Friday
4 Monday
Tuesday
Wednesday
THURSDAY
Friday
Monday
5 Tuesday
Wednesday
Thursday
Friday
6 Monday
Tuesday
01/12
01/13
01/14
01/15
01/16
01/19
01/20
01/21
01/22
01/23
01/26
02/3
02/4
02/5
02/6
02/9
02/10
7
CELL INJURY AND CELL
DEATH
INFLAMMATION
TISSUE RENEWAL,
REGENERATION AND REPAIR
IN CELL INJURY AND NECROSIS PODCHEKO
APOPTOSIS, AUTOPHAGY, Dr.
INTRACELLULAR
ACCUMULATIONS, PATHOLOGIC
CALCIFICATIONS, AGING
PODCHEKO
ACUTE INFLAMMATION,
MEDIATORS OF
INFLAMMATION,
Dr.
PODCHEKO
OUTCOMES OF ACUTE
INFLAMMATION
CHRONIC INFLAMMATION,
CELLS MEDIATORS, OUTCOMES
CHRONIC INFLAMMATION,
CELLS MEDIATORS, OUTCOMES
Dr.
PODCHEKO
Dr.
PODCHEKO
Dr.
PODCHEKO
SYSTEMIC EFFECTS OF
AND
CONSEQUENCES OF EXCESSIVE
INFLAMMATION
Dr. TSIVIS
Dr. TSIVIS
Dr. TSIVIS
Dr. TSIVIS
Dr. TSIVIS
STEM CELLS, CELL CYCLE,
MECHANISMS OF TISSUE
REGENERATION
QUIZ 1
MECHANISMS OF TISSUE
REGENERATION
ECM, HEALING BY REPAIR,
ANGIOGENESIS
Dr. TSIVIS
Dr. TSIVIS
Wednesday
01/27
01/28
01/29
01/30
02/02
02/11
Thursday 02/12
* subject to change
HEMODYNAMIC DISORDERS
EDEMA, Hyperemia,
Hemorrhage
HEMOSTASIS AND
THROMBOSIS ,EMBOLISM
HEMOSTASIS AND
THROMBOSIS ,EMBOLISM
INFARCTION , SHOCK
NUTRITIONAL DISORDERS
Forensic pathology
VITAMIN DEFICIENCES A, D, C,
B1, THIAMINE DIETARY
INSUFFICIENCY
OBESITY,
Dr. Tsivis
Dr. TSIVIS
Dr. TSIVIS
Dr. TSIVIS
Dr.
PODCHEKO
Dr.
PODCHEKO
INJURY BY THERAPEUTIC DRUGS
AND DRUG ABUSE, PHYSICAL
INJURIES
Dr.
PODCHEKO
Dr.
PODCHEKO
Dr.

Friday
7 Monday
Tuesday
Wednesday
Thursday
Friday
8 Monday
Tuesday
Wednesday
Thursday
Friday
Monday
9 Wednesday
Thursday
Friday
10 Monday
Tuesday
Wednesday
Thursday
Friday
11 Monday
Tuesday
Wednesday
Thursday
03/17
03/18
03/19
Friday 03/20
* subject to change
02/13
02/16
02/17
02/18
02/19
02/20
02/23
02/24
02/25
02/26
02/27
03/02
03/04
03/05
03/06
03/09
03/10
03/11
03/12
03/13
03/16
8
GENETIC DISORDERS
AIR POLLUTION, METALS
IONIZING RADIATION,
TOBACCO, ALCOHOL
DEFINITIONS, BASIC REVIEW
GENETICS , MUTATIONS,
MENDELIAN DISORDERS
DEFINITIONS, MUTATIONS,
MENDELIAN DISORDERS
PODCHEKO
Dr.
PODCHEKO
Dr. Tsivis
Dr. Tsivis
Dr. Tsivis
MULTIGENIC, CHROMOSOMAL
DISORDERS
SINGLE-GENE DISORDERS WITH
NONCLASSIC INHERITANCE
QUIZ 2
MOLECULAR DIAGNOSIS OF
GENETIC DISEASES
MOLECULAR DIAGNOSIS OF
GENETIC DISEASES
Dr. Tsivis
Dr. Tsivis
Dr.
PODCHEKO
Dr.
PODCHEKO
Dr.
PODCHEKO
th
NEOPLASIA
NOMENCLATURE,
CHARACTERISTICS OF BENIGN
AND MALIGNANT NEOPLASMS,
METASTASES
EPIDEMIOLOGY OF CANCER
MOLECULAR BASIS OF CANCER,
ONCOGENES
MECHANISMS OF INVASION
AND METASTASES
Dr. TSIVIS
Dr. TSIVIS
Dr. TSIVIS
Dr. TSIVIS
DISEASES OF INFANCY &
MULTISTEP CARCINOGENESIS,
CANCEROGENIC AGENTS
GENOMIC INSTABILITY
HOST DEFENCE AGAINST
TUMORS
Dr. TSIVIS
Dr. TSIVIS
Dr. TSIVIS
CLINICAL ASPECTS OF
NEOPLASIA
CLINICAL ASPECTS OF
NEOPLASIA
CONGENITAL ABNORMALITIES
Dr. TSIVIS
Dr. TSIVIS
CONGENITAL ABNORMALITIES Dr.
PODCHEKO
DISORDERS OF PREMATURITY Dr.
PODCHEKO
PERINATAL INFECTIONS Dr.
PODCHEKO
FETAL HYDROPS Dr.

12 Monday
Tuesday
Wednesday
Friday
Monday
13 Tuesday
Wednesday
Thursday
Friday
14 Monday
Tuesday
Wednesday
Thursday
Friday
15 Monday
Tuesday
Wednesday
Thursday
Friday
16 Monday
Tuesday
Thursday
03/23
03/24
03/25
03/27
03/30
03/31
04/01
04/02
04/03
04/06
04/07
04/08
04/09
04/10
04/13
04/14
04/15
04/16
04/17
04/20
04/21
04/23
* subject to change
CHILDHOOD
9
QUIZ 3
INBORN ERRORS OF
METABOLISM I
SIDS and Tumors
SIDS and Tumors
PODCHEKO
Dr.
PODCHEKO
Dr.
PODCHEKO
Dr.
PODCHEKO
IMMUNOPATHOLGY
Immunology basic review
DEFENCE MECHANISMS, TYPES
OF IMMUNITY,
ANTIGEN,ANTIBODY
DUALITY OF IMMUNE SYSTEM,
Ag+Ab BINDING
HYPERSENSITIVITY- I & II, III, IV
IMMUNOPATHOLGY
TRANSPLANT REJECTIONS,
AUTOIMMUNE DISEASES – SLE,
SJOGREN SYNDROME, SYSTEMIC
SCLEROSIS, INFLAMMATORY
MYOPATHIES,
,
Dr. Tsivis
Dr. Tsivis
Dr. Tsivis
Dr.
PODCHEKO
PRIMARY IMMUNODEFICIENCY
AQUIRED IMMUNODEFICIENCY
(AIDS), AMYLOIDOSIS,
Dr.
PODCHEKO
HEMATOPOIETIC AND
LYMPHOID SYSTEM
Blood basic cell review
Development & Maintenance of
Hematopoietic Tissues
, Disorders of White Cells
Spleen , Thymus
Anemia, Polycytemia
Bleeding disorders, Hemorrhagic diathesis, leukemias
QUIZ 4
Dr.
PODCHEKO
Dr.
PODCHEKO
Dr.
PODCHEKO

10
LAB SCHEDULE
LAB STARTS :
LAB 1 , 2, 3: -SLIDES REVIEW
-MEDICAL LAB ASSESSMENT AND INTERPRETATION
-FORENSIC PATHOLOGY
LAB 3 : PRESENTATION ON CLINICAL PATHOLOGICAL CASES, STUDENTS MUST MEET WITH THE INSTRUCTOR PRIOR TO
PRESENTATION.
Appendix: Pathology 1 Intended Learning Outcomes:
The following are the intended learning outcomes (ILOs) / learning objectives for the Pathology 1 course. The given learning objectives are detailed enough to serve as guidelines for purposes of study.
Please note that all learning objectives may not necessarily be covered fully in the lecture materials; students are strongly encouraged to become active, self-directed learners and to use recommended texts
(as well as supplementary materials provided by faculty) to gain a comprehensive understanding of pathologic processes and to be able to optimally answer questions on both SJSM examinations and the
NBME Subject Examination ("Shelf Exam") in pathology.
K1. Knowledge and understanding of the principles of Evidence Based
Medicine.
K2. Knowledge and understanding of the principles of Evidence Based
Medicine.
K3 Knowledge and understanding of the etiology, pathology, signs and symptoms, natural history, and prognosis of common mental and physical disorders in all age groups listed in the appendix and designed as “common”.
K4 Knowledge and understanding of common diagnostic procedures, indications, contraindications and limitations listed in appendix 2.
Knowledge of the appropriate use of laboratory techniques ,hygiene and sanitization, asepsis, infection control and transmission.
K7 Knowledge and understanding of the principles of health maintenance, education, prevention and screening. Knowledge and understanding of the epidemiology of common diseases and conditions and systematic approaches in reducing the incidence and prevalence of those diseases
K13 Knowledge and understanding of molecular, biochemical, and cellular mechanisms of maintaining homeostasis.
K14 Knowledge and understanding of the clinical presentation of the common
(listed in appendix 1) diseases and conditions as well as immediately life-threatening injuries, cardiac, pulmonary, or neurological conditions regardless of etiology, and appropriate initial treatment.
* subject to change

11
K15 Knowledge and understanding of the most frequent clinical, laboratory, roentgenologic, and pathologic manifestations of common diseases.
K18 Interpret the results of commonly used diagnostic procedures.
S4 The ability to formulate an appropriate di-erential diagnosis. The ability to interpret and integrate the history and physical examination ndings to arrive at an appropriate diagnosis or di-erential diagnosis
S5 The ability to formulate e-ective management plans (diagnostic, treatment, and prevention strategies) for diseases and other health problems. The ability to select the most appropriate and cost-e-ective diagnostic procedures.
S7 The ability to perform routine technical procedures specic to the medical speciality. Perform practical exercises that entail accurate observation of biomedical phenomenon and critical analyses of data.
S18 The ability to apply Evidence Based Medicine principles to clinical decision
Making
AB5 The ability to seek help, when needed, to deal with academic, personal, or interpersonal problems.
AB7 The ability to seek help, when needed, to deal with academic, personal, or interpersonal problems.
K21 Knowledge and understanding of the need and value of consultations and referrals. Knowledge and understanding of the ways of continuous improvements, self-reection, critical self-appraisal and lifelong learning
AB8 Recognize the need to engage in lifelong learning and the commitment to engage in lifelong learning in order to maintain sucient familiarity with scienti-c advances to ensure they are integrated appropriately with patient care.
AB9 The ability to recognize personal educational needs, to select and utilize appropriate learning resources, apply principles of evidence based medicine, the capacity to recognize and accept limitations in one’s knowledge and clinical skills, and a commitment to continuously improve one’s knowledge and ability
AB11 The ability to demonstrate personal responsibility, reliability, dependability, open-mindedness, and curiosity
AB12 Effective communication skills: besides English language pro-ciency, to demonstrate the capability to utilize verbal and non-verbal communication specic to culture, gender, and patient understanding.
Learning Objectives of the Course of Cellular Injury, Adaptation and Death
At the end of the course the student will be able to:
1
2
3
4
5
Define adaptation and cell injury
Discuss the most common
Describe general causes of cell injury mechanisms of cell injury
Explain mechanisms of hypoxic/ischemic, free-radical-induced
Describe, recognize, and differentiate electron microscopy of and chemical injuries reversible and irreversible cell injury
6 Define necrosis and apoptosis; explain the difference between necrosis and apoptosis
7
8
Explain mechanisms of necrosis
Recognize morphological features of necrosis.
9 a.
Define and differentiate the following
Coagulative necrosis types of necrosis
* subject to change

12 b. с d. e. f. g.
Liquefactive necrosis
Gangrenous necrosis
Caseous necrosis
Enzymatic fat necrosis
Traumatic fat necrosis
Fibrinoid necrosis
In term of a. Causes and mechanisms b) Gross and microscopic appearance c) Outcomes
1
2
3
4
5
Differentiate physiologic and pathologic apoptosis
Describe mechanisms of apoptosis
Recognize light and electron microscopic presentation of apoptosis
Discuss (given) examples of defective and increased apoptosis
List causes, and discuss significance and morphological presentation of lipofuscinosis; recognize its morphological features
15. Describe and recognize the following cytoskeletal abnormalities a. b.
Beta-myosin
Cytokeratin in cardiomyocytes in hepatocytes
6
7
8
1
2
3
4
5 с
Neurofibrillary tangles in neurons
Define physiologic hyperplasia; discuss examples
Define pathologic hyperplasia; explain the given examples; recognize morphologic features
Define physiologic hypertrophy; discuss the given examples
Define pathologic hypertrophy; explain the given examples; recognize morphological features
Define physiologic atrophy; discuss the given examples
21. Define pathologic atrophy; explain the given examples; recognize morphological features a. Define and differentiate marasmus and cachexia
Define metaplasia; describe the given examples, recognize morphological features
Define dysplasia; explain principles of identification
List causes; discuss mechanisms and significance of fatty liver; recognize morphological changes; differentiate fatty change and cellular swelling
Define atherosclerosis; describe its mechanisms and recognize its macroscopic changes 9
10 Define and differentiate hemosiderosis and hemochromatosis; describe their causes and significance; recognize morphological changes including use of special stains for identification
11 Define metastatic and dystrophic calcifications; describe their causes and mechanisms; recognize morphological changes; differentiate metastatic and dystrophic calcium deposits
12 Define cellular aging; describe its structural and biochemical changes; discuss replicative senescence, genes influencing the aging process and accumulation of metabolic and genetic damage
Learning Objectives of the Course of Acute and Chronic Inflammation
* subject to change

1
2
3
4
5
At the end of the course the student will be able to:
13
Define and differentiate
Define and differentiate chronic inflammation
List causes of inflammation; discuss steps in
Define and differentiate
Discuss steps of inflammation acute and exudate and and repair pathogenesis of acute inflammation transudate vascular reactions, leukocyte migration and mediators involved
1
2
3
4
Explain
Describe
Explain
Explain defects in inflammatory response leukocyte activation, steps of due to mediator insufficiency phagocytosis, and bactericidal systems congenital and acquired defects in leukocyte function tissue injury (as a step in inflammatory response) and its mechanisms
5
6
Discuss
List outcomes of acute inflammation main mediators activation, fever, and pain involved into vasodilation, vascular permeability, chemotaxis, leukocyte
12. Describe, recognize, and differentiate the following main patterns of acute inflammation
(including causes, morphology and microorganism identification) a. b.
Serous inflammation
Fibrinous inflammation с
Suppurati ve i. Define pus and abscess d.
Ulcera tion
1
2
Enumerate cells involved into chronic inflammation and describe their function
14. Describe, recognize, and differentiate the following patterns of chronic inflammation
(including causes, morphology, and outcomes) a. b.
Chronic non-specific inflammation
Chronic purulent inflammation с Granulomatous inflammation i. Epithelioid and giant cells ii. TBgranuloma iii. Cat-scratch granuloma iv. v.
Syphilitic gumma
Leprosy vi. Sarcoid granuloma vii. Foreign body granuloma
Explain acute phase response, discuss its components (details) and mediators involved
1
2
Define and differentiate sepsis, bacteremia, and septicemia
Define lymphangitis, lymphadenitis, and reactive lymphadenopathy
Learning Objectives of the Course of Tissue Repair: Cell Regeneration and Fibrosis
At the end of the course the student will be able to:
* subject to change

14
5
6
7
8
1
2
3
4
Define and differentiate
List major
List major
List major
Explain repair, regeneration growth factors receptors collagen and describe their function involved into regulation of cell proliferation nuclear transcriptional factors cell cycle checkpoints
Enumerate
Discuss types of and and describe their function cell cycle activators and inhibitors healing and explain their function and stages of collagen synthesis
Explain the following stages of healing: angiogenesis, fibroblast migration and proliferation, tissue remodeling, and wound contraction
9 Define granulation tissue; discuss its structure and maturation; recognize its morphological features
10 Define and recognize wound healing by 1 and 2 intention
11 List and discuss factors affecting wound healing
12 Discuss and recognize the following complications of wound healing: dehiscence, hypertrophic scar, keloid, exuberant granulations, and contraction
Learning Objectives of the Course of Genetic Disorders
At the end of the course the student will be able to
1. Give examples of each of the following types of genetic disorders: a. simple (autosomal) dominant b. simple
(autosomal) recessive с sex-linked recessive in terms of: a. mode of inheritance b. molecular biology of their associated defects с clinicopathologic correlation d. relevant complications
2. Describe and compare the following genetic disorders: a. Marfan syndrome b. Ehlers-Danlos syndrome с neurofibromatosi s (NF) 1 and 2 d. familial hypercholesterole mia in terms of: a. genetic mechanism of inheritance b. pathogenesis с clinicopathologic correlation
3. Discuss chromosomal abnormalities, in terms of:
* subject to change

15 a. pathogenesis b. classification с specific features of the more common examples
4. Distinguish on the basis of karyotype and clinicopathologic correlation among the following chromosomal aberrations: a. trisomy 21 (Down) b. trisomy 13 (Patau) с trisomy 18 (Edwards) d. Turner (X,O) e. Klinefelter (XXY) f. tripleX female g. double Y male
1
5. Compare translocation and mosaic types of Down syndrome on the basis of: a. karyotype b.
m l fa ct or s с in at er na he rit an ce
Describe the role of prenatal screening in Down syndrome.
7. Discuss the following lysosomal storage disorders: a. Tay-Sachs disease b. Gaucher disease с Pompe disease (type
II glycogenosis) in terms of:
* subject to change

16 a. enzyme deficiency b. accumulating metabolite с key phenotypic features
8. Discuss the prototype chromosomal deletion syndrome: a. Cri-du-chat (5p-)
9. Discuss the microdeletion syndromes: a. Prader-Willi syndrome (PWS) b. Angelman syndrome
(AS) in terms of: a. genetic mechanism of inheritance b. pathogenesis с clinicopathologic correlation
10. Discuss trinucleotide repeat expansion (TRE) syndromes: a. myotonic dystrophy b. fragile X syndrome с Huntington disease in terms of: a. genetic mechanism of inheritance b. pathogenesis с clinicopathologic correlation
11. Discuss the prototype disorder of germline mosaicism (Duchenne muscular dystrophy) Learning Objectives of the Course of Immunopathology
At the end of the course the student will be able to:
1. Compare and contrast the four (4) types of immunologically-mediated (hypersensitivity) disorders, in terms of a. terminology b. pathogenesis с examples d. definition e. mediators involved f. morphologic features g. stimulating antigens h. cells involved i. clinical features
2. Compare and contrast the following types of type II hypersensitivity reaction: a. complement dependent b. antibody-dependent cell mediated cytotoxicity
* subject to change

17 с antibody-mediated cellular dysfunction in terms of: a. pathogenesis b. examples с histopathology d. clinical features
3. Compare and contrast delayed-type hypersensitivity and T cell-mediated cytotoxicity in terms of: a. definitions b. pathogenesis с clinical examples
4. Compare and contrast the following types of transplant rejection:
* subject to change

18 a. hyperacute rejection b. acute cellular rejection с acute humoral rejection d. chronic rejection in terms of: a. etiology b. pathogenesis (immunologic mechanism) с histopathology
5. Discuss bone marrow transplantation as the prototype of graft versus host disease (GVHD), in terms of: a. pathogenesis b. morphology
(apoptosis) с clinical presentation d. complications
6. Discuss the following autoimmune disorders a. systemic lupus erythematosus (SLE) b. discoid lupus erythematosus
(DLE) с drug-induced lupus erythematosus d. Sjogren syndrome e. systemic sclerosis (scleroderma) f. CREST syndrome g. mixed connective tissue disease in terms of: a. incidence b. prevalence с genetic factors d. age and sex association e. diagnostic criteria f. etiology g. pathogenesis h. laboratory diagnosis i. morphology j. clinical course k. prognosis
7. Describe the basic patterns (classes) of lupus nephritis, in terms of: a. terminology (WHO classification)
* subject to change

19 b. relative frequency с morphology (light, immunofluorescent, and electron microscopic)
8. Correlate each of the following patterns of immunofluorescent staining for antinuclear antibodies with the specific antibody represented by each, and disease(s) associated with each: a. homogeneous (diffuse) b. rim
(peripheral) с speckled d. nucleolar
9. List the major autoimmune disease(s) with which each of the following autoantibodies is most frequently associated: a. antinuclear (ANA) a. anti-Smith (Sm) b. anti-double-stranded
DNA с antiphospholipid d. antihistone e. anti-SS-A (Ro) and anti-SS-B (La)
* subject to change

20 f. anti-Scl-70 g.
anticentromer e h. anti-nuclear
RNP
10. Compare and contrast the following immunodeficiency syndromes: a. common variable immunodeficiency b. DiGeorge syndrome (thymic hypoplasia) с severe combined immunodeficiency d. isolated ("selective") IgA deficiency in terms of a. genetics b. etiology с pathogenesis d. immunologic defect e. morphology f. clinical features g. methods of diagnosis h. complications and prognosis
11. Discuss HIV infection and acquired immunodeficiency syndrome (AIDS), in terms of: a. definition i. j. k. b. incidence с epidemiology d. e. risk factors etiology f. g. pathogenesis immunologic defects h. laboratory testing diagnostic criteria clinical categories associated infections and neoplasms l. morphology m. complications and prognosis
12. Discuss Kaposi sarcoma (KS), in terms of: a. definition b. с incidence pathogenesis d. e. f. risk factors epidemiology morphology
* subject to change

21 g. etiology
(KSHV/HHV-8) h. diagnostic criteria i. complications and prognosis j. k. immunologic defects associated disorders
13. Define amyloidosis, describe its pathogenesis, recognize the important clinicopathologic associat ions of systemic and localized amyloidosis, and describe special stains for histopathologic identification of amyloid.
Learning Objectives of the Course of Hemodynamic Disorders
At the end of the course the student will be able to:
1
2
4
Define
Describe development of retention
3 Describe development of localized edema in impaired lymph flow and in inflammation and repair
Define edema, list its etiologic factors, and discuss its mechanisms and significance generalized edema transudate, exudate, anasarca, and in congestive heart failure, hypoalbuminemia, and sodium ascites
* subject to change

22
5
6
7
8
Differentiate transudate and exudate
Define physiologic arterial hyperemia and give examples
Define pathologic arterial hyperemia and give examples
Define venous hyperemia; differentiate generalized and localized venous hyperemia; differentiate acute and chronic venous hyperemia
9 Explain mechanism of generalized venous hyperemia and its relation to congestive heart failure
10 Explain mechanism of acute pulmonary venous hyperemia; describe, and recognize its clinical and morphologic feature (from a case given or slide shown)
11 Explain mechanism of chronic pulmonary venous hyperemia, describe and recognize its clinical and morphologic features (from a case given or slide shown)
12 Explain mechanism of "nutmeg liver", describe and recognize its morphologic features (from a case given or slide shown)
13 Define hemorrhage, bleeding, hematoma, petechia, ecchymosis, purpura, bruise, hematochezia, melena, hematemesis, menorrhagia, hemoptysis, and epistaxis
14 List and discuss mechanisms of bleeding/hemorrhage and their significance
15 Define thrombosis and differentiate it from hemostasis
16 Describe phases of normal hemostasis, role of platelets and endothelium in hemostasis
17 Describe coagulation cascade
18 List fibrinolytic substances; indicate blood factors affected by the following: protein C and S, tissue factor pathway inhibitor, thrombomodulin, PgI2, NO, and tPA
19 Discuss components of "Virchov/s triad" and their significance; list several etiologies for acquired thrombotic states
20. Discuss the following coagulation abnormalities a. FV gene mutation b. с d.
Prothrombin gene mutation
Heparin-induced thrombocytopenia
Antiphospholipid antibody syndrome
20 Describe homocysteinemia and its role in thrombosis
21 Define von Willebrand disease, Glanzmann thrombasthenia, and Bernard-Soulier syndrome
22 Discuss origin/location of thrombi, their structure, contents, outcomes, and significance
23 Recognize morphologic features of thrombi and differentiate them from postmortem clots (from a case given or slide shown)
24 Define disseminated intravascular coagulation (DIC), list its causes, and discuss its mechanism
25 Discuss and recognize clinical and morphologic features of DIC (from a case given or slide shown)
26 Define embolism/embolus, give different classification systems of embolism
1
2
Explain paradoxical embolism
List organs associated with red and white embolism; indicate a possible prognostic implication
30. Discuss the following types of embolism e. Pulmonary thromboembolism: origin, mechanism, clinical and morphological presentations, and outcomes
* subject to change

23 f. Systemic thromboembolism: origin and outcomes g. Thrombobacterial embolism: origin and outcomes h. Air embolism: predisposing conditions, mechanisms, and cause of lethal outcome i. Nitrogen embolism: predisposing conditions and mechanisms, clinical and morphologic manifestations i. j.
Caisson disease: bone changes
Fat embolism: origin, manifestations, and morphologic identification
1
2 i. Fat embolism syndrome: mechanism, clinical and morphologic manifestations
Define ischemia and infarction; discuss their causes, major outcomes, and significance
Explain evolution of morphological changes in myocardial infarction, recognize myocardial infarction, and identify its duration (from a case given or slide shown)
3
4
Define shock and explain its significance
Describe causes and mechanisms of different types of shock: cardiogenic, hypovolemic, anaphylactic, neurogenic, and septic
5 Discuss clinical and morphological manifestations of different stages of shock
6 Recognize morphological changes of "shock" lungs and "shock" kidneys (from a case given or slide shown)
Learning Objectives to General Pathology of Infectious Diseases
At the end of the course the student will be able to:
* subject to change

6
7
8
3
4
5
24
1 Define and differentiate "normal flora" and "pathogens"
2 Explain and differentiate the following events in host-pathogen relationship: exposure, colonization, infection, and disease
Recognize the most common microscopic and staining characteristics used for different types of pathogens
Describe and explain the mechanisms specific to microorganism-induced damage of host tissues
Discuss and recognize the following types of inflammatory response and their major causative agents: suppurative, mononuclear, granulomatous, cytopathic-cytoproliferative, necrotizing, fibrinous, hemorrhagic, pseudomembranous, ulcerative, and chronic inflammation with scarring
Define "systemic inflammatory response syndrome"; list its clinical criteria
Define and differentiate "sepsis" and "septic shock"; pathogenesis and their pathologic features
Explain pathogenesis of septic shock, describe its clinical and morphological manifestations; recognize structural changes seen in the kidneys, lungs, and adrenals of patients with septic shock; list causes of death
Learning Objectives of the Course of Neoplasia
At the end of the course the student will be able to:
1. Define a. b. с d.
Neoplasia, neoplasm, tumor, and cancer
Benign tumor and malignant tumor, and tumor of intermediate malignancy
Carcinoma, squamous cell carcinoma, transitional cell carcinoma,
Adenoma, polyp, and papilloma and adenocarcinoma f. g. h. i.
e. Carcinoma in situ
Fibroma, lipoma, hem/lymphangioma, and other benign mesenchymal tumors
Sarcoma
Tumors of embryonic origin
Teratoma, hamartoma, and choristoma
2. List a. b. с d.
Most common cancers in males and females
Most common cause of cancer death in males and females
Most common cancers in childhood, early adulthood, and late adulthood
Most common occupational carcinogens and related cancers
1
2
3
4
5
6
Discuss mechanisms of
Discuss
Define
Define loss of differentiation tissue and cellular atypia; monoclonality increased growth rate and anaplasia and its morphologic criteria describe their significance; recognize their morphological features and discuss its significance
Describe features and background of tumor progression
Explain local growth of benign and malignant tumors and discuss its significance in the distant spread of malignant tumors
7 Discuss all possible routs of metastasis
8
9
Define recurrence
Explain and discuss its significance effects of tumors on host secondary infection)
(related to location, production of hormones, ulceration and bleeding, and and discuss its significance
* subject to change

1
2
3
25
10 Define cachexia and discuss its mechanisms
11 Define and discuss given paraneoplastic syndrome
Differentiate benign and malignant tumors
Differentiate carcinoma and sarcoma
(from a case given or slide shown)
(from a case given or slide shown)
Differentiate teratoma, hamartoma, choristoma, and benign tumors
1
2
Explain principles of cancer grading and its significance
Explain principles of cancer staging and its significance; interpret TMN and AJC staging systems
19. Describe the following acquired precancerous conditions a. Chronic inflammation
4
5
6
3 b. с d.
Hyperplasia
Atrophy/hypoplasia
Metaplasia
Explain dysplasia and Ca in situ and their significance; recognize their morphologic features in different epithelial tissues
21. Describe and recognize the following genetic predisposing conditions a. Inherited cancer syndromes: retinoblastoma, familial adenomatous polyposis (FAP) coli, and neurofibromatosis type 1 b.
(NF1)
Familial cancers: breast and ovarian cancers associated with BRCA1 and BRCA2 mutation
List cancers associated with defective DNA repair
Discuss the concept of protoonco-/oncogenes, and oncoproteins
Discuss the concept of antioncogenes and antioncoproteins
25. Discuss the following components of the cell cycle a. b.
CDKs с
Phases, checkpoints
Cyclins and d. e. f.
CDK inhibitors
RB gene/protein
TP53
ATM protein g. MDM2
Describe growth factors, their receptors and role in carcinogenesis; understand mechanisms of 7 transcription regulation
8 Define Her2/Neu (ERB-B2) and explain its role in breast cancer treatment
9 Describe signal transducing proteins of RAS-RAF-MAP kinase pathway and their role in carcinogenesis
10 Discuss role of ABL and ABL-BCR hybrid in pathogenesis of CML and explain their role in treatment of CML
11 List nuclear transcription factors; give examples of MYC family mutations and cancer induced
12 Explain role of Cyclin D and CDK4 in carcinogenesis
13 Explain role of RB gene/protein in carcinogenesis; differentiate hereditary and spontaneous mutations of RB gene and associated cancers
* subject to change

26
14 Discuss role of TP53 in carcinogenesis; list the components of Li-Fraumeni syndrome
15 Describe APC-B-catenin and TGF-B pathways, and role of their members in carcinogenesis
16 Describe apoptosis and possible ways of evasion of apoptosis in carcinogenesis, role of BCL-2 family
36. Discuss the following hereditary predisposing conditions, their genetics, manifestations, and induced cancers a. b.
Hereditary non-polyposis colon cancer (HNPCC)
Xeroderma pigmentosum с
Ataxia-teleangiectasia
17 Describe limitless replicative potential of neoplastic cells and role of telomerases
38. List major genetic mechanisms of carcinogenicity and explain the following examples a. Point mutations: RAS b. Translocations: t(8;14), t(9;22), t(11;14), and t(14;18) с
Amplifications: cyclin D, ERBB2, MYC d. Promoter hypermethylation: p16INF4a and BRCA1
18 Explain the concept of multistep carcinogenesis
19 Describe tumor angiogenesis and list major angiogenic factors
20 Explain metastatic cascade, its steps, and mechanism of extravasation
21 List major direct and indirect chemical carcinogens, describe their mechanism, and list induced cancers
22 Define promoters; describe their role in carcinogenesis, and give examples
23 Discuss radiation-induced carcinogenesis; list types of induced cancers; describe hereditary anomalies associated with susceptibility to ionizing radiation
24 Discuss UVL-induced carcinogenesis, list types of induced cancers; describe hereditary anomalies associated with increased susceptibility to UVL-radiation
25 Discuss the concept of viral-induced carcinogenesis; describe carcinogenesis induced by the following viruses:
HTLV-1, HPV, EBV,
HBV, and HCV
26 Describe role of H. pylori infection in the development of gastric carcinoma and mantle cell lymphoma
27 Describe role of aflatoxin B1 in the development of hepatocellular carcinoma
28 List the most significant laboratory (tissue and serum) markers of cancer and interpret their diagnostic value.
Learning Objectives of the Course of RBC and Coagulation Disorders
At the end of the course the student will be able to:
1 Define "anemia"; describe approach to classification of anemias
2. Explain causes and mechanisms of formation, and recognize the following RBC abnormalities a. Changes in RBC size
2 b. Changes in Hb concentration с RBC inclusion bodies i. Special stains for identification
Discuss cause, clinical, hematological (PBS and BM), and morphological features of acute posthemorrhagic
* subject to change

3
4
5
27 anemia; recognize blood, bone marrow, and visceral organ changes (from a case given or slide shown)
Explain common features of hemolytic anemias in terms of mechanisms, clinical, hematological, and morphological manifestations
5. Discuss etiology, pathogenesis, clinical, hematological (PBS and BM) and morphological features, special tests (if any), complications and causes of death (if any); recognize blood, bone marrow, and visceral organ changes (from a case given or slide shown) of the following hemolytic anemias a. Hereditary spherocytosis b. Sickle cell anemia i. Acute chest syndrome i. Microorganisms associated with с (3-Thalassemia (major and minor) d. cx-Thalassemia (HbH disease) e. G6PD-deficiency anemia i. Black water fever f. Paroxysmal nocturnal hemoglobinuria g. Autoimmune hemolytic anemia (warm, cold agglutinin, and cold hemolysin) h. Hemolytic transfusion reaction i. Hemolytic disease of newborn j. Anemia from mechanical trauma to RBCs (microangiopathic anemia) i. Disseminated intravascular coagulation i. i.
Thrombotic-thromocytopenic purpura
Hemolytic-uremic syndrome
Explain common features of anemias of diminished erythropoiesis in terms of mechanisms, clinical, hematological and morphological manifestations
7. Discuss etiology, pathogenesis, clinical, hematological (PBS and BM), and morphological features, special tests (if any), complications and causes of death (if any); recognize blood, bone marrow, and visceral organ changes (from a case given or slide shown) of the following anemias of diminished erythropoiesis a. Iron-deficiency anemia i. i.
Biochemical criteria of iron deficiency b. Anemia of chronic disease с
Sideroblastic anemia
Differential diagnosis of microcytic hypochromic anemias d. i.
Folateand vitamin B12-deficiency anemia
Clinical criteria for differential diagnosis e. Aplastic anemia i. Pure RBC aplasia; conditions associated with f. Myelophthisic anemia
Describe major categories of bleeding disorders: fragility of vascular wall, platelet deficiency and dysfunction, and derangement of coagulation factors; discuss their causes, mechanisms and hematological manifestations including coagulation
* subject to change

28 tests
9. Discuss etiology, pathogenesis, clinical, hematological (PBS and BM) and morphological features, coagulation tests, complications and causes of death (if any); recognize blood, bone marrow and visceral organ organs changes
(from a case given or slide shown) of the following bleeding disorders a. Bleeding due to fragility of vascular wall b. Disseminated intravascular coagulation с Idiopathic thrombocytopenic purpura d. Thrombotic thrombocytopenic purpura e. Hemolytic-uremic syndrome f. Heparin-induced thrombocytopenia g. Aspirin-induced thrombocytopenia h. Vitamin K deficiency i. von-Willebrand disease j. Hemophilia
A
Learning Objectives of the Course of WBC Disorders
At the end of the course the students will be able to:
1 Define "neutropenia" and "agranulocytosis", list causes, describe clinical and morphological manifestations
* subject to change

2
3
4
5
29
Define "neutrophilia", "leukemoid reaction", "eosinophilia", "monocytosis" and "lymphocytosis", list their causes and describe hematological manifestations
3. Discuss etiology, pathogenesis, hematological, clinical and morphological features, and complications of infectious mononucleosis; from a case given or slide shown recognize its hematological and morphological manifestations i. Explain associations between infectious mononucleosis, Burkitt lymphoma and nasopharyngeal carcinoma; indicate distinguishing criteria for each of them
Describe three morphological patterns of chronic non-specific lymphadenitis, list their causes
Describe cause, clinical and morphological features of cat-scratch disease, from a case given or slide shown identify its etiologic agent and recognize morphological manifestations
Define and differentiate "leukemia" and "lymphoma"; explain the formation of clinical syndromes in patients with leukemias
7. Discuss cellular and tissue origin, genetic abnormalities, epidemiology (if any), immunological markers, characteristic hematological, clinical and morphological features, and prognosis; recognize hematological and morphological manifestations (from a case given or slide shown) of the following non-Hodgkin lymphoid neoplasias of B-cell origin a. Acute lymphoblastic leukemia/lymphoma (along with pre-B and pre-T ALL) b. Chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL) i Differentiate from ALL с Mantle cell lymphoma d. Burkitt lymphoma e. Diffuse large B-cell lymphoma (DLBCL) f. Follicular lymphoma i. Differentiate from reactive follicular hyperplasia g. Extranodal marginal zone lymphoma i. Differentiate from mantle cell lymphoma h. Multiple myeloma and plasmacytoma j. Lymphoplasmacytic lymphoma (Waldenstrom's macroglobulinemia) i Differentiate from multiple myeloma k. Hairy cell leukemia i Differentiate from CLL
8. Discuss cellular and tissue origin, genetic abnormalities, epidemiology (if any), immunological markers, characteristic hematological, clinical and morphological features, and prognosis; recognize hematological and morphological manifestations (from a case given or slide shown) of the following T/NK-cell neoplasias a. Pre-T acute leukemia/lymphoma (along with pre-B ALL) b. Angioimmunoblastic lymphoma с Mycosis fungoides and Sezary syndrome d. Adult T-cell leukemia/lymphoma e. Peripheral T-cell lymphoma, unspecified f. Anaplastic large cell lymphoma
* subject to change

1
2
30 i Differentiate from DLBCL g.
Extranodal NK/T-cell lymphoma (lethal midline granuloma) i Why is the term "Lethal Midline Granuloma" misleading?
Define "Hodgkin disease"; describe its cellular, epidemiology, immunological markers, explain characteristic hematological, clinical and morphological features, staging and prognosis of the disease in general and its each variant separately; recognize morphological manifestations of nodular sclerosis and mixed cellularity variants (from a case given or slide shown)
10. Discuss clonal origin, genetic abnormalities, immunological and cyto-/histochemical markers, characteristic hematological, clinical and morphological features, and prognosis; recognize hematological and morphological manifestations (from a case given or slide shown) of the following myeloid neoplasias a. Acute myeloid leukemia i. M1, M3, and M5 variants separately b. Chronic myeloid leukemia i. Progression and blast crisis с Polycythemia vera d. Myelofibrosis with myeloid metaplasia e. Essential thrombocytopenia
Define "myelodysplastic syndrome"; explain its causes and genetic abnormalities; describe classification of
MDS into primary and secondary one; discuss its major hematological, clinical and morphological features, and prognosis; recognize its hematological
* subject to change

31 manifestations (from a case given or slide shown)
Learning Objectives of the Course of Pediatric and Developmental Pathology
At the end of the course the student will be able to:
1 List the age spans and indicate the ages involved by the major fetal / neonatal / infantile / pediatric clinicopathologic processes.
2
2. Discuss fetal demise and infant mortality; state the most common cause of childhood mortality, as well as the most common non-traumatic cause of death in children: a. under one year of age b. с between one and four years of age between five and fourteen years of age
List the most common congenital anomalies observed in the US; list several major etiologic factors related to congenital anomalies, with relevant clinicopathologic examples
4. a.
Define, recognize and explain mechanisms of the following congenital anomalies: agenesis b. dysraphia (neural tube defects) с aplasia d. e. atresia hypoplasia f. diabetic embryopathy g. rubella embryopathy h. fetal alcohol syndrome i. thalidomide embryopathy j.
5. general features of TORCH infections
Define and recognize malformation, disruption, deformation, sequence, and syndrome, and give appropriate clinicopathologic examples of underlying factors which may lead to deformation by such pathogenetic mechanisms, as in: a. b. prune belly sequence
Potter sequence
3 Define low birth weight (LBW), very low birth weight (VLBW), extremely low birth weight (ELBW), small for gestational age (SGA), and large for gestational age (LGA)
4
5
List the major categories of factors which may underlie intrauterine growth restriction (IUGR)
List clinicopathologic conditions observed in neonates which are associated with placental factors maternal factors of the fetus and
6
7
Discuss principal causes, mechanisms, complications, and significance of
Describe, discuss and interpret APGAR score prematurity
11. Describe predisposing factors and significance of different types of birth injury; define, recognize and differentiate the following birth injuries: a. b. caput succedaneum cephalhematoma
* subject to change

32
8
9 с intracranial hemorrhage
Discuss neonatal asphyxia (asphyxia neonatorum)
List transplacental infections; discuss general clinicopathologic manifestations of the TORCH infections, including characteristic features of each
10 Identify the defining clinicopathologic manifestations of congenital toxoplasmosis, congenital syphilis, congenital rubella syndrome, cytomegalic inclusion disease, neonatal herpesvirus and congenital herpesvirus infection, and parvovirus
B19 infection.
15. Discuss congenital and perinatal infections (ascending and hematogenous) in terms of: a. b.
etiology s с pathogenesi morpholog y d. methods of diagnosis
11 Define and discuss neonatal sepsis
12 Define and discuss respiratory distress syndrome (RDS) of the newborn; describe its predisposing factors and clinicopathologic manifestations; recognize hyaline membrane
13 List modulators of type II pneumocyte surfactant synthesis
14 Discuss the role of the lecithin/sphingomyelin (L/S) ratio in terms of fetal lung maturity and list the modulators of type II pneumocyte surfactant synthesis
20. Define bronchopulmonary dysplasia (BPD), in terms of: a. etiology
* subject to change

b. c.
33 pathogenesis clinicopathologic manifestations
21. Define retinopathy of prematurity (ROP), in terms of: a. etiology b. pathogenesis с clinicopathologic manifestations
22. Define necrotizing enterocolitis (NEC), in terms of: a. predisposing factors b. clinicopathologic and radiologic manifestations
23. Describe germinal matrix hemorrhage (GMH) - intraventricular hemorrhage (IVH), in terms of: a. etiology b. pathogenesis с clinicopathologic and radiologic manifestations
24. Define fetal hydrops, with special reference to hemolytic disease of the newborn
(HDN), in terms of: a. etiology b. pathogenesis с clinicopathologic manifestations d. prophylactic and therapeutic implications
23. Define phenylketonuria (hyperphenylalaninemia, PKU), in terms of: a. etiology b. pathogenesis с clinicopathologic manifestations d. neonatal screening e. prevention and treatment
24. Define galactosemia, in terms of: a. etiology b. pathogenesis с clinicopathologic manifestations d. prevention and treatment 25.Discuss cystic fibrosis (CF, mucoviscidosis), in terms of: a. genetics b. primary defect c morphologic findings in pancreas, lung, liver, salivary glands, and male genital tract d. laboratory manifestations e. carrier screening panels f. neonatal screening protocols g. clinical findings and course, complications, and causes of death
26. Define sudden infant death syndrome (SIDS), in terms of: a. etiologic hypotheses b. diagnostic
* subject to change

34 criteria с autopsy findings
27. Describe autosomal recessive ("infantile") polycystic kidney disease (ARPKD), in terms of: a. genetics b. clinicopathologic features
28. Describe Hirschsprung disease, in terms of: a. etiology b. genetics с pathogenesis d. diagnostic criteria
1 List major factors that differentiate childhood malignant neoplasms from those of the adult
* subject to change

35
30. Recognize and describe the following benign vascular tumors: a. hemangioma and associated syndromes (von Hippel-Lindau, Kasabach-Merritt) b. lymphangioma с Sturge-Weber syndrome
31. Describe neuroblastoma, in terms of: a. genetics b. morphologic findings с classification
2 d. prognostic criteria
Define significance nephrogenic rest and describe its pathogenetic
33. Discuss Wilms tumor (WT, nephroblastoma), in terms of: a. genetics b. predisposing conditions / associated syndromes с WAGR syndrome d. Denys-Drash syndrome e. Beckwith-Widemann syndrome f clinicopathologic manifestations g. prognostic criteria
34. Discuss the following pediatric neoplasms: a. b. retinoblastoma (RB) rhabdomyosarcoma (RMS) с sacrococcygeal teratoma
(SCT) in terms of: a. incidence b. etiology с age of d. onset e. morpholo gy
Learning Objectives of the Course of Nutritional Diseases
At the end of the course the student will be able to:
1 Define "marasmus"; discuss its causes and clinical manifestations
2
3
Define "kwashiorkor"; discuss its causes and clinical manifestations
Describe the clinical manifestations encountered with deficiencies and toxicity of the major trace minerals: iron, zinc, iodine, selenium, and copper
4 Explain the principal functions of vitamin A; describe the clinical manifestations of vitamin A deficiency and intoxication
5 Describe vitamin D metabolism; discuss the causes and pathophysiology of vitamin D deficiency and intoxication; discuss the clinical manifestations of rickets and osteomalacia
* subject to change

6
7
8
9
36
Explain the principal functions of vitamin C; discuss the clinical manifestations of scurvy
Explain the principal functions of thiamine; discuss the clinical manifestations seen in the thiamine deficiency states: dry beriberi, wet beriberi, and Wernicke-Korsakoff syndrome
List the principal clinical manifestations seen with the deficiency and, if any, intoxication of the following vitamins: niacin, pyridoxine, folate, and cyanocobalamin
Describe causes, pathophysiology and clinical manifestations of the following eating disorders: anorexia nervosa, bulemia, and obesity
Learning Objectives for Environmental Pathology
At the end of the course the student will be able to:
1. Describe the pathology, metabolism and toxicity of: a. b. с d.
Cocaine
Heroin
Methamphetamine
Ecstasy (MDMA)
* subject to change

37 e.
Ethanol f. Methanol g. Ethylene h. glycol
1
2
Discuss the rapidly rising problem of prescription drug abuse
Describe the adverse health effects of chronic tobacco use, including passive smoke exposure and smokeless tobacco use
3 Discuss the complications of chronic intravenous drug abuse
4
5
Describe the acute and chronic effects of ethanol abuse
Discuss the toxic effects of readily available over-the-counter medications
7. Describe the effects of naturally occurring toxins including mushroom poisoning, snake venom, spider bites and scorpion stings
6
7
8
9
List the effects of potential poisoning agents such as cyanide, arsenic, lead and organophosphates
Discuss the potential hazards associated with SCUBA diving
Discuss the pathophysiology of drowning and its associated risk factors
Describe the pathology of environmental heat and cold exposure (hyperthermia and hypothermia)
10 Discuss the symptoms and treatment of altitude sickness
11 Describe the effects of radiation exposure
12 Categorize the grading of thermal burns and describe the effects of smoke inhalation
13 Discuss the various effects of electrical current on the human body
14 Describe the effects of police restraint and the use of electromuscular disruption devices (EMDD) such as
TASER
15 Discuss the different categories of asphyxia (chemical, mechanical, positional, compression, obstruction)
18. Differentiate between the following categories of traumatic injury: a. Blunt force injury (abrasion, laceration, contusion) b. Sharp force injury (stab wound, incised wound) с Projectile injury (gunshot wound, shotgun wound)
16 Discuss the effects that environmental disease and injury have on the insurance and health care industry
* subject to change