Intro to Clinical Pathology/Medicine

What did people back then used to think were the cause of disease?

bad spirits, worms, intestional decay, punishment from the gods

What are the 4 “humors” that Greek Medicine revolved around

blood, phlegm(blood plasma), yellow bile (billirubin), and black bile (grey sediment from platelets and clotting factors)

Imhotep

First known physican, “Shepherd of the anus” , “ the one who comes in peace”

Hippocrates

“Father of Medicine”, created the Hippocratic Oath, and developed four humors theory

Who is speculated to be the author of the Edwin Smith Papyrus?

Imhotep

What is “Physican” in Hieroglyphics

Man + Pot+ Lancet

Celsus

Roman physcian, Identified the four cardinal signs of inflammation

Galen

Greek Physican to roman gladiators, writing shaped medicine for 1500 years, describes nerves, blood, and urine

Rudolf Virchow

Father of modern Pathology, first “cellular pathologist”, regonized lukemia, Virchows Node, pulmonary thromboembolism

Edward Jenner

Developed first vaccination ( cowpox to protect from smallpox)

Ignaz Semmelweis

Introduced handwashing and hygeine practices in hospitals; reduced maternal death

Robert Koch

Founder of bacteriology; discovered TB, cholera, anthrax

Louis Pasteur

developed vaccines, pasteurization, and studied fermentation

Joseph Lister

Father of antiseptic surgery, used phenol for sterlization

George Papanicolaou

Developed pap smear for early cervical cancer detection

Alexander Fleming

discovered penicillin and reserach lysozyme

How are diseases usually detected?

signs and symptoms

what are signs?

Can be seen by a doctor that is detected by clinical tests

what are symptoms?

reported by the patient and cannot be measured

Some diseases are….

1. genetic predisposition

2. acquired

3. seen by eye

4. visible only with medical tests, imaging

What are the four pillars to understanding disease?

1. Disease Etiology

2. Pathogenesis

3. Lesion

4. Functional Changes

Disease Etiology

The cause of the disease

Pathogenesis

The disease process

Lesion

structual/morphological tissue changes

Functional Changes

Organ impairment leading to symptoms

How do you recognize disease?

1. reported by pt.

2. Gross examination

3. Histologic examination

4. Labratory examination

5. Specalized sexaminations

What are the 4 cardinal signs of acute inflamation?

Rubor, Tumor, Calor, Dolor ( Rudy takes Calvins Dog)

Rubor

redness

Tumor

Swelling

Calor

heat

Dolor

pain

What is the fifth cardinal sign of inflammation by Galen?

Functio laesa = impaired function (GOUT)

what happens in the 0-4 hr mark for inflammation?

preformed factors (antibodies) (Rubor, Calor)

What happens in 4-48hr mark for inflammation?

influx of neutrophils (Rubor, Calor, Dolor, Tumor)

What happens in the 24-96hr mark for inflammation?

Influx of macrophages ( Rubor, Calor, Dolor, Tumor, Functio Leasa)

What happen sin the <96 hr mark in inflammation?

adaptive immunity from T cells to Inflammatory site ( Dolor, Tumor, Functio Laesa)

What is the first step in diagnosis?

assess if its an emergency/life-threatning situation

What is a non-invasive procedure?

Does not break the skin

What is an invasive procedure?

Breaks the skin

Examples of non-invasive procedures?

X-ray, ultrasound, MRI, CT, ECG

Examples of an invasive procedure?

blood draw, spinal tap, biopsy, endoscopy

What are common blood tests?

CBC, CMP, plasma protein, antibodies, hormones, drugs

CBC(complete blood count)

measures RBC, WBC, Hb, platelets

CMP(complete metabolic panel)

electrolytes, glucose, kidney, liver enzymes

What % does red blood cells take?

70%

What % does white blood cells take?

20-30%

Normal Value for WBC

4.5-11

Normal Value for Platlet

150-450

What makes up the red blood cell?

platlets and hemoglobin

What makes up the white blood cell?

Granulocytes: neutrophils, esinophils, basophils Agranylocytes: monocytes, lympocyes

suffix for increase

-osis or -illia

suffix for decrease

-nia

ECG,EKG

measures heart activity

EEG

measures brain activity

EMG

measures muscle activity

SA node (sinoatrial node)

Natural pacemaker of the heart.

AV node ( atrioventricular node)

Conducts signal from atria to ventricles

P wave

Atrial depolarization

QRS Complex

Ventricular depolarization

T Wave

Ventricular repolarization.

Ventricular Flutter

250–300 bpm, sinusoidal waves

Ventricular Fibrillation

no clear electrical activity

ST elevation

sign of heart attack

Who discovered X-Ray?

Wihelm Rocentgen

How are X-rays and ionizing radiation measured in?

Sievert(Sv) but rem

What is Sievert used to measure?

the radiation dose to human body

1 Sv =

100 rem

1 rem =

0.01 Sv

What do X-rays measure?

tissues but NO bones and metal

How does an X-ray work?

1. X rays machine sends ray through body

2. Different tisues block ray differently

3. A dector records the pattern

CT Scan

Rotating X-ray scanner creating serial images for 3D reconstruction; higher radiation dose than plain X-ray

Contrast-enhanced imaging

Contrast materials highlight structures (e.g., blood vessels, brain aneurysms).

Nuclear Medicine

Radioactive tracers (e.g., I-131) injected; concentrated in high-activity tissues (e.g., thyroid, cancer).

MRI (Magnetic Resonance Imaging)

Uses strong magnets and radiofrequency (RF) pulses; great for soft tissue.

How can MRI weighted based on structure enhancer

1. T1 - fat (anatomy)

2. T2 - fat and water (pathology) (“WW2 = Water is White in T2”).

Gadolinium contrast

used in MRI that enhances blood vessels, tumors using a bright signal

Ultrasound

High-frequency sound waves (>20,000 Hz) create echoes based on tissue density that humans cant hear; painless, safe, used for heart, vessels, and organs.

Positron Emission Tomography (PET)

injection of radioactive material using gamma rays

Biopsy

Removal of tissue for analysis

Histology

Microscopic examination of intact tissuestructure

Cytology

Examination of single cells that are usually recoevred and tissue structure is not preseerved

What do pathologist do to process tissue?

remove tissue by needle or surgery and perserve it in a fixative or frozen for examination by the pathologist

Frozen Section

Rapid freezing of tissue during surgery for immediate results.

H&E stain

Hematoxylin (blue nuclei), Eosin (pink cytoplasm).

PAS stain

Highlights glycogen, fungi.

Masson’s Trichrome stain

Highlights collagen

Immunofluorescence staining

Identifies specific molecules (e.g., immunoglobulins in glomerulonephritis).

What does failure of adaptive mechanism lead to?

cell injury or cell death

Macroscopic changes

Visible at organ level (e.g., hypertrophy, atrophy, dysplasia, fatty change, calcification, pigmentation)

Microscopic Changes

Seen at cellular level (e.g., inclusions like fat, iron, lipofuscin; multinucleation; apoptosis; necrosis)

Mallory Bodies

Hyaline inclusions in the liver

Hypertrophy

Increase in cell size(increased demand or chronic stimulation)

Hyperplasia

Increase in cell number(increased demand or chronic stimulation)

Atrophy

Decrease in cell size/organ size (caused by inactivity, loss of innervation, reduced blood supply, aging, lack of hormones)

Metaplasia

Reversible change where one cell type is replaced by another; increases risk of cancer.(chronic injury)

Physiological atrophy

loss of hormonal stimulation, developmental gene regulation

Pathologic atrophy

inactivity, loss of innervation, loss of perfusion/blood supply, lack of nutrition, loss of hormonal stimulation, aging, pressure

What kind of cells are the body mostly lined by?

Epithelial cells

Squamous epithelium

Lining of body cavities, alveoli, vessels

Columnar epithelium

Found in gut, gallbladder, uterus, upper respiratory tract.