Pathophysiology 1

Data

Official data in SubjectManager for the following academic year: 2022-2023

Course director

Number of hours/semester

lectures: 42 hours

practices: 8 hours

seminars: 20 hours

total of: 70 hours

Subject data

  • Code of subject: OAP-KO1-T
  • 5 kredit
  • General Medicine
  • Pre-clinical modul
  • autumn
Prerequisites:

OAA-BH2-T completed , OAA-EL2-T completed , OAP-PA1-T parallel

Exam course:

no

Course headcount limitations

min. 5 – max. 180

Topic

Pathophysiology-1 connects basic functional and clinical subjects. Together with other preclinical subjects, it deals mainly with etiology, time-course, clinical symptoms and possible pharmacological or other interventions related to abnormalities of the cardiovascular, respiratory, hematological and renal systems, as well as with disorders of salt/water and pH balance.

Lectures

  • 1. Basic concepts of translational medicine. - Dr. Hegyi Péter
  • 2. Circulatory failures - Dr. Balaskó Márta
  • 3. Heart failure: causes, forms - Dr. Balaskó Márta
  • 4. Heart failure: clinical manifestations - Dr. Balaskó Márta
  • 5. Peripheral circulatory failure. Syncope - Némethné Dr. Tóth Ildikó
  • 6. Circulatory shock: forms, pathophysiology, hemodynamics - Némethné Dr. Tóth Ildikó
  • 7. Organ manifestations of circulatory shock - Némethné Dr. Tóth Ildikó
  • 8. Hypertension: definition, forms - Dr. Garai János
  • 9. Hypertension: causes, consequences - Dr. Garai János
  • 10. Tissue ischemia, reperfusion - Dr. Garai János
  • 11. Pathophysiology of coronary circulation - Dr. Garai János
  • 12. Pathophysiology of acute myocardial infarction. - Dr. Garai János
  • 13. Characteristics of brain blood flow - Dr. Garai János
  • 14. Pathophysiology of brain blood flow - Dr. Garai János
  • 15. Pathophysiology of pulmonary circulation. Primary nad secondary pulmonary hypertension. - Dr. Garai János
  • 16. Disorders of the regulation of breathing - Burzánné Dr. Pétervári Erika
  • 17. Mechanics of respiration: abnormalities - Dr. Balaskó Márta
  • 18. Work of respiration and its disorders - Dr. Balaskó Márta
  • 19. Ventilation and its abnormalities - Dr. Balaskó Márta
  • 20. Disorders of diffusion - Dr. Balaskó Márta
  • 21. Pulmonary perfusion, V/Q mismatching - Dr. Balaskó Márta
  • 22. Disorders of oxygen transport - Dr. Balaskó Márta
  • 23. Hypoxia, respiratory failure - Dr. Balaskó Márta
  • 24. Mechanisms of dyspnea - Dr. Balaskó Márta
  • 25. Erythropoiesis. General pathophysiology of anemias - Dr. Balaskó Márta
  • 26. Deficiency anemias - Dr. Balaskó Márta
  • 27. Hemolytic anemias - Dr. Balaskó Márta
  • 28. Polycythemia, polyglobulia - Dr. Balaskó Márta
  • 29. Leukocyte dysfunctions - Dr. Balaskó Márta
  • 30. Disorders of hemostasis - Dr. Balaskó Márta
  • 31. Thrombosis. DIC - Dr. Balaskó Márta
  • 32. Excretory and non-excretory renal functions - Dr. Garami András
  • 33. Glomerular functions and their disorders - Dr. Garami András
  • 34. Tubular dysfunctions - Dr. Garami András
  • 35. Disorders of the amount and composition of urine - Dr. Garami András
  • 36. Failure of renal excretory function, uremia - Dr. Garami András
  • 37. Chronic renal failure, ESRF - Dr. Garami András
  • 38. Acute renal failure - Dr. Garami András
  • 39. Peripheral neuropathies. Pathophysiology of pain - Dr. Garami András
  • 40. Tissue damage, reactive responses, inflammation, lymphatic circulation - Dr. Garai János
  • 41. Trauma/sepsis: definitions, causes - Dr. Garai János
  • 42. Trauma/sepsis: pathophysiology - Dr. Garai János

Practices

  • 1. Methods of ECG recording
  • 2. ECG recording and analysis
  • 3. Analysis of pH-parameters I
  • 4. Analysis of pH-parameters II
  • 5. Metabolic/respiratory acidosis/alkalosis I
  • 6. Metabolic/respiratory acidosis/alkalosis II
  • 7. Tests of respiratory functions
  • 8. Evaluation of lung function tests

Seminars

  • 1. Place, connections of pathophysiology. Basic ideas in pathophysiology
  • 2. Basics of ECG abnormalities, methods of analysis
  • 3. Abnormalities of axis, rhythm and rate I
  • 4. Abnormalities of axis, rhythm and rate II
  • 5. Disorders of impulse formation I
  • 6. Disorders of impulse formation II
  • 7. Disorders of impulse conduction I
  • 8. Disorders of impulse conduction II
  • 9. Disorders of oxygen supply to the myocardium I
  • 10. Disorders of oxygen supply to the myocardium II
  • 11. Hypertrophy, complex ECG disorders
  • 12. ECG signs of abnormalities of ionic balance
  • 13. Analysis of case reports connected with disorders of the cardiovascular system
  • 14. Analysis of case reports connected with disorders of the respiratory system
  • 15. Metabolic/respiratory acidosis and alkalosis I
  • 16. Metabolic/respiratory acidosis and alkalosis II
  • 17. Pathophysiology of salt- and water-balance I
  • 18. Pathophysiology of salt- and water-balance II
  • 19. Disorders of volume regulation
  • 20. Disorders of osmoregulation

Reading material

Obligatory literature

Székely Miklós (editor) Basic concepts in pathopysiology. 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

Conditions for acceptance of the semester

Maximum of 15 % absence allowed

Mid-term exams

A compulsory multiple choice midterm test is organized during the second half of the first semester. In case of absence or lower than 34% score, a 4th exam question is added to the semester 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

Cardiovascular adaptation in health and disease.
Distribution of cardiac output and its disorders in the young and the elderly.
Causes and forms of heart failure.
Forward failure symptoms (left- and right-sided) in heart failure.
Backward failure symptoms (left- and right-sided) in heart failure.
High output cardiac failure.
Vasovagal syncope.
Definition and classification of circulatory shock. Pathophysiology of development, phases and characteristics of microcirculation.
Hypovolemic shock: causes and hemodynamics.
Cardiogenic shock: causes and hemodynamics.
Distributive shock: causes and hemodynamics.
Organ manifestations of shock.
Tissue hypoxia, ischemia, reperfusion and tissue metabolism.
Pathogenesis of coronary insufficiency. Risk factors.
Pathomechanism and consequences of acute myocardial infarction.
Cerebral hypoxia, ischemia, stroke.
Pulmonary circulation, pulmonary hypertension.
General pathophysiology and classification of systemic hypertension - age and blood pressure.
Role of the kidneys in the development of hypertension. Effects of hypertension on the kidneys.
Hypertension and the adrenal gland.
Primary hypertension: characteristics and etiological factors.
Consequences of hypertension.
Orthostatic hypotension in the young and the elderly.
Active heterotopic abnormalities (premature beats).
Passive heterotopy: causes, forms and consequences.
Supraventricular and a-v junctional blocks.
Forms and importance of intraventricular conduction abnormalities.
Pre-excitation syndromes.
Forms and consequences of paroxysmal tachycardia.
Signs of chronic or acute overload in the ECG (hypertrophy, strain).
Primary and secondary repolarization abnormalities in the ECG.
ECG in acute myocardial infarction.
Atrial or ventricular flutter, atrial or ventricular fibrillation.
Principles/evaluation of respiratory function tests. Characteristics and parameters of abnormal breathing mechanics.
Disorders of the control of breathing. Age-dependent changes. Sleep-apnea syndrome.
The work of breathing. Abnormalities of elastic resistance, restrictive disorders.
Alveolar hypoventilation: causes and consequences.
Acute and chronic alveolar hyperventilation.
Ventilation-perfusion mismatch (V/Q): causes and consequences.
Disorders of alveolo-capillary diffusion. Hepatopulmonary syndrome.
Disorders of oxygen transport (abnormal hemoglobin, CO-poisoning, methemoglobinemia).
Forms and mechanisms of hypoxia. Ways of compensation - cyanosis.
Causes and consequences of increased airway resistance - causes and consequences of chronic obstructive pulmonary disease (COPD) - emphysema.
Partial or complete respiratory failure.
Dyspnea.
Forms, general pathophysiology and consequences of anemia.
Aplastic anemia and anemias of complex etiology in disease states.
Deficiency anemias.
Hemolytic anemias.
Polycythemias, polyglobulias.
Bleeding abnormalities due to platelet or vascular factors.
Congenital and acquired coagulopathies.
Thrombosis: causes and consequences.
Disseminated intravascular coagulation (DIC).
Granulocytes in inflammatory processes.
Pathophysiology of glomerular filtration.
Disorders of tubular functions.
Proteinuria.
Hyposthenuria, asthenuria, osmotic diuresis.
Chronic renal failure: causes, characteristics and progression.
Metabolic disorders and organ dysfunctions in uremia.
Uremic coma.
Acute renal failure: occurrence, general features - extrarenal uremia. Prerenal azotemia. Postrenal failure.
Acute tubular nephropathy.
Acute diffuse glomerulonephritis.
Compensation of pH-abnormalities (plasma and intracellular puffers, respiration, kidney) and their disturbances.
Metabolic acidosis: causes, compensation, consequences.
Metabolic alkalosis: causes, compensation, consequences.
Respiratory acidosis and alkalosis: causes, compensation, consequences.
Disorders of potassium balance. Hypo- and hyperkalemia.
States of decreased extracellular volume, and their consequences.
States of elevated extracellular volume: causes, mechanisms and consequences.
Hyperosmolarity, hypertonicity. Forms, causes, consequences.
Hypotonicity: pathogenesis and consequences.
Tissue injury, inflammation, lymphatic circulation.
Definitions and causes of sepsis and trauma.

Oral exam. Occasionally, assorted questions from the "606 minimum-questions" booklet may be asked on the semester exam: from 5 minimum questions students have to give correct answers to at least 4, to be able to continue the oral exam. At the oral exam students take a card of 3 questions and they have to analyze 1 ECG record.

Examiners

  • Burzánné Dr. Pétervári Erika
  • Dr. Balaskó Márta
  • Dr. Garai János
  • Dr. Garami András
  • Dr. Hegyi Eszter
  • Dr. Székely Miklós

Instructor / tutor of practices and seminars

  • Dr. Balaskó Márta
  • Dr. Garai János
  • Dr. Garami András
  • Dr. Hegyi Eszter
  • Dr. Horváth-Szalainé Dr. Rostás Ildikó
  • Dr. Tóth Luca
  • Dr. Varjú-Solymár Margit