Pathophysiology 2

Data

Official data in SubjectManager for the following academic year: 2024-2025

Topic

Pathophysiology 2 deals with the etiology, time-course and clinical symptoms, as well as with possible pharmacological and other interventions in disorders of the gastrointestinal system, energy balance, intermediary metabolism and endocrine systems.

Lectures

• 1. Basic concepts of gerontology - Balaskó Márta
• 2.

  Swallowing and esophageal disorders

  - Müller Katalin Eszter
• 3. Disorders of gastric filling and emptying. Vomiting - Hegyi Eszter
• 4.

  Ulcer disease

  - Mikó Alexandra
• 5. Dysmotilities. Ileus - Hegyi Eszter
• 6. Maldigestion, malabsorption. Diarrhea - Hegyi Eszter
• 7.

  Forms of pancreatitis

  - Párniczky Andrea
• 8. Liver: metabolic functions and detoxication. Jaundice - Hegyi Eszter
• 9. Portal hypertension, ascites, cirrhosis - Hegyi Eszter
• 10. Hepatic coma - Hegyi Eszter
• 11. Factors and changes of energy balance. Body mass - Balaskó Márta
• 12. Full starvation - Balaskó Márta
• 13. Partial starvation - Balaskó Márta
• 14. Negative energy balance, sarcopenia. Abnormalities of body composition - Balaskó Márta
• 15. Obesity - Balaskó Márta
• 16. Cardiorespiratory adaptation to work I - Balaskó Márta
• 17. Cardiorespiratory adaptation to work II - Balaskó Márta
• 18.

  Peripheral neuropathies. Pathophysiology of pain.

  - Garami András
• 19. Disorders of cold defense - Garami András
• 20. Disorders of warm defense - Garami András
• 21. Fever and sickness behavior - Garami András
• 22. Pathophysiology of carbohydrate metabolism - Balaskó Márta
• 23. Diabetes mellitus (DM) syndrome - Balaskó Márta
• 24. Type-1 DM: etiology, pathogenesis, pathomechanism - Balaskó Márta
• 25. Type-2 DM: etiology, pathogenesis, pathomechanism - Balaskó Márta
• 26. Acute complications of DM, diabetic coma - Balaskó Márta
• 27. Late complications of DM - Balaskó Márta
• 28. Hypoglycemia - Balaskó Márta
• 29. Disorders of protein and amino acid and nucleic acid metabolism - Burzánné Pétervári Erika
• 30. Pathophysiology of alcohol effects. Liver toxins. - Balaskó Márta
• 31.

  Disorders of lipid metabolism

  - Ollmann Tamás
• 32.

  Dyslipidemias

  - Ollmann Tamás
• 33.

  Atherosclerosis

  - Ollmann Tamás
• 34.

  Disorders of the hypothalamo-pituitary system

  - Péczely László Zoltán
• 35.

  Hyperprolactinemia. Disorders of growth

  - Péczely László Zoltán
• 36.

  Thyroid hyperfunctions

  - Balaskó Márta
• 37.

  Thyroid hypofunctions

  - Balaskó Márta
• 38.

  Disorders of the adrenal medulla. Pheochromocytoma.

  - Balaskó Márta
• 39.

  Hypofunction of the adrenal cortex

  - Balaskó Márta
• 40.

  Hyperfunction of the adrenal cortex. Glucocorticoid treatment

  - Ollmann Tamás
• 41.

  Complex endocrinopathies. M.E.N. Adrenogenital syndrome

  - Ollmann Tamás
• 42.

  Disorders of the pathyroid gland, Ca and bone

  - Ollmann Tamás

Practices

• 1. Complex analysis of energy balance (demonstration) I
• 2. Complex analysis of energy balance (demonstration) II
• 3. Spiroergometry demonstration I
• 4. Spiroergometry demonstration II

Seminars

• 1. Recommendations in human nutrition
• 2. Diet. Enteral and parenteral nutrition
• 3. Macro- and micronutrients
• 4. Vitamins
• 5. Age-related specificities of salt/water balance
• 6. Age-related specificities of acid/base balance
• 7. Physical activity, inactivity. Factors connected with lifestyle/age
• 8. Immobilisation syndrome
• 9. Disorders of consciousness, coma
• 10. Acute loss of consciousness
• 11. Case reports (ethylene glycol- or mushroom-intoxication)
• 12. Case reports (septic shock, traumatic shock)
• 13. Case reports (type-1 diabetic coma)
• 14. Case reports (type-2 diabetic coma)
• 15. Case reports (late complications of DM, aspects of therapy in DM)
• 16. Case reports (hypoglycemic coma)
• 17. Case reports (heat stroke)
• 18. Case reports (acute stress ulcer)
• 19. Case reports (pericarditis, anemia)
• 20. Case reports (pathological changes in pregnancy)
• 21. Case reports (cirrhosis)
• 22. Case reports (pancreatitis)
• 23. Case reports (complications of osteoporosis)
• 24. Case reports (hyperthyroidism in the elderly)

Reading material

Obligatory literature

M. Székely (ed.): Basic Concepts in Pathophysiology, Medicina Publishing House, Budapest, 2019

Literature developed by the Department

Koller Á.: 606 minimum-questions, PTE ÁOK, 2010

M. Székely (ed.): Basic Concepts in Pathophysiology, ÁOK PTE, 2007

Lecture slides will also be uploaded to TEAMS.

Notes

M. Székely (ed.): Basic Concepts in Pathophysiology, ÁOK PTE, 2007

Recommended literature

S. Silbernagl, F. Lang : Color Atlas of Pathophysiology, Thieme Stuttgart - New York, 2000

Harrison: The Principles of Internal Medicine, 18th edition, (respective chapters), McGraw-Hill 2015

Conditions for acceptance of the semester

None

Mid-term exams

A compulsory multiple choice midterm test is organized during the second half of the second semester. In case of absence or lower than 34% score, a 4th exam question is added to the final exam. The Midterm Test can not be retaken.

Making up for missed classes

Students can make up for their absence by participating at the seminar of another group on the same week. Students may be absent from 2 seminars (4 times 45 minutes).

Exam topics/questions

Questions for THE final exam:

FROM FIRST SEMESTER

1.      Cardiovascular adaptation in health and disease.

2.      Causes and forms of heart failure.

3.      Forward failure symptoms (left- and right-sided) in heart failure.

4.      Backward failure symptoms (left- and right-sided) in heart failure.

5.      High output cardiac failure.

6.      Vasovagal syncope.

7.      Definition and classification of circulatory shock. Pathophysiology of development, phases and characteristics of microcirculation.

8.      Hypovolemic shock: causes and hemodynamics.

9.      Cardiogenic shock: causes and hemodynamics.

10.  Distributive shock: causes and hemodynamics.

11.  Organ manifestations of shock.

12.  Pathogenesis of coronary insufficiency. Risk factors.

13.  Pathomechanism and consequences of acute myocardial infarction.

14.  Cerebral hypoxia, ischemia, stroke.

15.  Pulmonary circulation, pulmonary hypertension.

16.  General pathophysiology and classification of systemic hypertension - age and blood pressure.

17.  Role of the kidneys in the development of hypertension. Effects of hypertension on the kidneys.

18.  Hypertension and the adrenal gland.

19.  Primary hypertension: characteristics and etiological factors.

20.  Consequences of hypertension.

21.  Orthostatic hypotension in the young and the elderly.

22.  Active heterotopic abnormalities (premature beats).

23.  Passive heterotopy: causes, forms and consequences.

24.  Supraventricular and a-v junctional blocks.

25.  Forms and importance of intraventricular conduction abnormalities.

26.  Pre-excitation syndromes.

27.  Forms and consequences of tachycardia.

28.  Signs of chronic or acute overload in the ECG (hypertrophy, strain).

29.  ECG in acute myocardial infarction.

30.  Atrial flutter, atrial fibrillation.
Ventricular flutter, ventricular fibrillation.

31.  Disorders of the control of breathing. Age-dependent changes. Sleep-apnea syndrome.

32.  The work of breathing. Abnormalities of elastic resistance, restrictive disorders.

33.  Alveolar hypoventilation: causes and consequences.

34.  Acute and chronic alveolar hyperventilation.

35.  Ventilation-perfusion mismatch (V/Q): causes and consequences.

36.  Disorders of alveolo-capillary diffusion. Hepatopulmonary syndrome.

37.  Disorders of oxygen transport (abnormal hemoglobin, CO-poisoning, methemoglobinemia).

38.  Forms and mechanisms of hypoxia. Ways of compensation - cyanosis.

39.  Causes and consequences of increased airway resistance - causes and consequences of chronic obstructive pulmonary disease (COPD) - emphysema.

40.  Dyspnea. Cough.

41.  Forms, general pathophysiology and consequences of anemia.

42.  Aplastic anemia and anemias of complex etiology in disease states.

43.  Deficiency anemias.

44.  Hemolytic anemias.

45.  Polycythemias, polyglobulias.

46.  Bleeding abnormalities due to platelet or vascular factors.

47.  Congenital and acquired coagulopathies.

48.  Thrombosis: causes and consequences.

49.  Disseminated intravascular coagulation (DIC).

50.  Granulocytes in inflammatory processes.

51.  Pathophysiology of glomerular filtration.

52.  Disorders of tubular functions.

53.  Proteinuria.

54.  Hyposthenuria, asthenuria, osmotic diuresis.

55.  Chronic renal failure: causes, characteristics and progression.

56.  Metabolic disorders and organ dysfunctions in uremia.

57.  Uremic coma.

58.  Acute renal failure: occurrence, general features - extrarenal uremia. Prerenal azotemia. Postrenal failure.

59.  Acute tubular nephropathy.

60.  Acute diffuse glomerulonephritis.

61.  Compensation of pH-abnormalities (plasma and intracellular puffers, respiration, kidney) and their disturbances.

62.  Metabolic acidosis: causes, compensation, consequences.

63.  Metabolic alkalosis: causes, compensation, consequences.

64.  Respiratory acidosis and alkalosis: causes, compensation, consequences.

65.  Disorders of potassium balance. Hypo- and hyperkalemia.

66.  States of decreased extracellular volume, and their consequences.

67.  States of elevated extracellular volume: causes, mechanisms and consequences.

68.  Hyperosmolarity, hypertonicity. Forms, causes, consequences.

69.  Hypotonicity: pathogenesis and consequences.

FROM SECOND SEMESTER

1.      Disorders of chewing, swallowing and esophagus functions - the gastro-esophageal reflux disease.

2.      Disorders of gastric filling and emptying.

3.      Vomiting (acute, chronic).

4.      Peptic ulcer. Stress-ulcer in the elderly.

5.      Specific malabsorption syndromes (level or substrate of disorder).

6.      Complex malabsorption syndromes.

7.      Diarrhea: causes, pathophysiological forms, consequences.

8.      Bowel obstruction (ileus).

9.      Obstipation, subileus, diverticulosis. GIT motility disorders.

10.  Acute pancreatitis: pathophysiology and consequences.

11.  Pathophysiology of chronic pancreatitis.

12.  Disorders of intermediary metabolism in general liver cell damage.

13.  Jaundice.

14.  Cirrhosis: causes, mechanisms and consequences.

15.  Portal hypertension.

16.  Ascites and hepatorenal syndrome.

17.  Hepatic coma.

18.  Pathophysiology of alcohol effects.

19.  Physical activity, inactivity, immobilization syndrome. Factors from lifestyle and age.

20.  Water-soluble vitamins.

21.  Fat-soluble vitamins.

22.  Complete starvation: occurrence and process.

23.  Partial starvation, accelerated forms of energetic insufficiency - anorexia nervosa. Refeeding.

24.  Protein deficiency. Protein-calorie malnutrition. Senile sarcopenia.

25.  Obesity: criteria, classification and epidemiology.

26.  Etiology and pathogenesis of obesity.

27.  Consequences of obesity. Therapeutic possibilities.

28.  Metabolic syndrome.

29.  Cold-defense and cold-induced disorders.

30.  Warm-defense and heat-induced disorders.

31.  Heat stroke and malignant hyperthermia.

32.  Pathogenesis of fever. Fever and sickness-behavior. The biological value of fever.

33.  Hyperglycemia and glucose-tolerance tests. Diagnosis of diabetes mellitus.

34.  Basic characteristics and forms of diabetes mellitus syndrome.

35.  General pathobiochemistry of diabetes mellitus syndrome.

36.  Etiology and pathogenesis of 1DM.

37.  Etiology and pathogenesis of 2DM.

38.  Diabetic ketoacidosis (DKA) and ketoacidotic coma.

39.  Diabetic hyperosmolar syndrome (HHS) and coma.

40.  Late complications of diabetes mellitus: Diabetic micro- and macro-vascular disorders.

41.  Hypoglycemia.

42.  Disturbances of amino acid metabolism.

43.  Gout.

44.  Pathobiochemistry of LDL-metabolism. Primary and secondary hyperlipoproteinemia.

45.  Disorders of the hypothalamo-pituitary system. Pituitary insufficiency.

46.  Pituitary adenomas, hyperprolactinemia.

47.  Pathophysiology of growth.

48.  Hyperthyroidism. Specialities in the elderly.

49.  Hypothyroidism. Specialities in the elderly.

50.  Goiters.

51.  Pheochromocytoma.

52.  Adrenal (cortex) insufficiency.

53.  Primary hyperaldosteronism amd other states with mineralocorticoid excess.

54.  Secondary hyperaldosteronism.

55.  Glucocorticoid hyperfunctional states.

56.  Pathophysiological aspects of glucocorticoid therapy.

57.  Parathyroid abnormalities.

58.  Hypocalcemia, hypercalcemia.

59.  Osteoporosis, osteomalacia.

60.  Disturbances of consciousness, vigilance. Coma. Acute unconsciousness.

61.  Principles of exercise testing (spiro-ergometry). Anaerobic threshold and maximal oxygen consumption during exercise.

Oral final exam. Occasionally, assorted questions from the "606 minimum-questions" booklet also have to be answered: from 5 minimum questions students have to give correct answers to 4 at least, to be able to continue the oral exam. The final exam consists of 3 questions (one card) and the analysis of 1 ECG record as well as that of 1 case report. (Similar case-reports are discussed extensively during the course of the second semester.) The oral ECG exam that has to be successfully passed until the 13th week of the semester, represents 20 % of the final exam.

Examiners

• Balaskó Márta
• Burzánné Pétervári Erika
• Csupor Dezső
• Garami András
• Ollmann Tamás
• Székely Miklós

Instructor / tutor of practices and seminars

• Balaskó Márta
• Garami András
• Hegyi Eszter
• Ollmann Tamás
• Pham-Dobor Gréta
• Tóth Luca