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Pathology for Dental Students 1

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Data

Official data in SubjectManager for the following academic year: 2019-2020

Course director

Dr. Tamás TORNÓCZKI (tornoczki.tamas@pte.hu), associate professor

Department of Pathology

Subject data

Code of subject: OSP-PO1-T  |  4 credit  |  Dentistry |  Pre-clinical module  |  autumn

Prerequisites: OSA-FAY-T completed , OSA-EF2-T completed , OSA-MXO-T completed

Exam course: yes

Number of hours/semester

28 lectures + 0 practices + 28 seminars = total of 56 hours

Course headcount limitations

min. 5 – max. 10 person

Topic

Basic pathological cellular responses underlying the various disease processes are taught during this course. These are discussed in the following seven main chapters: necrosis, degeneration, accumulation, growth disturbances, acute and chronic inflammation, circulation, immune pathology and general oncology. The most common and most important diseases are also discussed in details during the lectures and seminars.
The main educational task of this subject is to have the students understand the disease concepts as the unity of macroscopy, microscopy, clinical signs and symptoms, genetic and laboratory changes; factors that shape the clinicopathological thinking about diseases.
The general pathology course will form the very basis for the systemic / organ pathology as well as the subsequent clinical studies by teaching the etiology, pathogenesis and pathomechanism together with the gross morphological and microscopical changes of the various diseases. During this activity the principal and methodology of the diagnostic pathology will be covered.
The theoretical part of the subject consists of 2 lectures a week (28 lectures altogether). The practical part includes 2x45 min. practice a week (altogether 14x90 min. in the course of the semester), which begins with 4x90 min. autopsy (4 practices), followed by 10 histopathology (10 practices).

Lectures

  • 1. I. INTRODUCTION, POSTMORTEM CHANGES, NECROSIS (4 LECTURES) Postmortal changes. Cell injury and cell death. Causes of cell injury. Necrosis. Ultrastructural, light microscopical and gross changes - Dr. Tornóczki Tamás
  • 2. Patterns of necrosis: coagulation and liquefactive necrosis. Organ examples. - Dr. Tornóczki Tamás
  • 3. Clinicopathology of AMI - Dr. Tornóczki Tamás
  • 4. Caseous necrosis and adiponecrosis. Apoptosis: morphology, pathomechanism - Dr. Tornóczki Tamás
  • 5. II. DEGENERATION, ACCUMULATION, PIGMENTS, CALCIFICATION (4 LECTURES)  Degenerations - Dr. Vida Livia
  • 6. Endogenous pigments - Dr. Vida Livia
  • 7. Exogenous pigments. Accumulation. - Dr. Vida Livia
  • 8. Calficiation, lithiasis, amyloidosis. - Dr. Vida Livia
  • 9. III. GROWTH DISTURBANCES (3 LECTURES) Regressive changes: atrophy. Organ examples. Classification of cells according to the mitotic capacity - Dr. Kereskai László
  • 10. Progressive changes: hyperplasia and hypertrophy 1. - Dr. Kereskai László
  • 11. Progressive changes: hyperplasia and hypertrophy 2. - Dr. Kereskai László
  • 12. IV. PATHOLOGY OF CIRCULATION (4 LECTURES) Oedema, hyperemia and congestio - Dr. Kajtár Béla
  • 13. Haemorrhages - Dr. Kajtár Béla
  • 14. Thrombosis and embolisation - Dr. Kajtár Béla
  • 15. Hypertension, Shock - Dr. Kajtár Béla
  • 16. V. INFLAMMATIONS (4 LECTURES) Definition of acute inflammation, cellular and vascular reactions - Dr. Kajtár Béla
  • 17. Clinicopathological forms of acute inflammation - Dr. Kajtár Béla
  • 18. Chronic inflammation - Dr. Kajtár Béla
  • 19. Granuloma, granulomatous inflammation - Dr. Kajtár Béla
  • 20. VI. IMMUNOPATHOLOGY (3 LECTURES) Hypersensitivity reactions - Dr. Kereskai László
  • 21. Autoimmune diseases - Dr. Kereskai László
  • 22. Immundeficiencies, transplantation immunology - Dr. Kereskai László
  • 23. VII. ONCOPATHOLOGY (6 LECTURES) Neoplasia, nomenclature, definitions. Benign and malignant behaviour of tumours. Terminology (nomenclature) of neoplasms. Definition of metaplasia, dysplasia and their relation to neoplasia. Organ examples. Anaplasia - Dr. Tornóczki Tamás
  • 24. Tumor growth, local spread and metastasis, types of metastases, grading and staging. Paraneoplastic syndromes. Tumor incidence and mortality. - Dr. Tornóczki Tamás
  • 25. Oncogenes, protooncogenes, oncoproteines, growth factor and growth factor receptor oncogenes (RET, KIT, PDGFR),growth factor receptor overexpression (ERBB1, ERBB2), organ examples. - Dr. Tornóczki Tamás
  • 26. Oncoproteins and ncogenes in signaltransduction: RAS and RAS signal proteins. Examples for oncogene with non-receptor tyrosine kinase function. The myc oncogene. Types and their changes and role in tumours (c-myc, n-myc). - Dr. Tornóczki Tamás
  • 27. Tumor supressor genes: RB and p53. Their role in tumorigenesis. - Dr. Tornóczki Tamás
  • 28. Chemical and radiation cancerogenesis. Microbial carcinogenesis: RNA and DNA viruses. Helicobacter pylori. - Dr. Tornóczki Tamás

Practices

Seminars

  • 1. Autopsy practice
  • 2. Autopsy practice
  • 3. Autopsy practice
  • 4. Autopsy practice
  • 5. Autopsy practice
  • 6. Autopsy practice
  • 7. Autopsy practice
  • 8. Autopsy practice
  • 9. Necrosis 1.
  • 10. Necrosis 1.
  • 11. Necrosis 2. Degenerations.
  • 12. Necrosis 2. Degenerations.
  • 13. Accumulations
  • 14. Accumulations
  • 15. Growth disturbances
  • 16. Growth disturbances
  • 17. Pathology of circulation 1
  • 18. Pathology of circulation 1
  • 19. Pathology of circulation 2
  • 20. Pathology of circulation 2
  • 21. Acute inflammation
  • 22. Acute inflammation
  • 23. Chronic inflammation
  • 24. Chronic inflammation
  • 25. Oncopathology 1
  • 26. Oncopathology 1
  • 27. Oncopathology 2
  • 28. Oncopathology 2

Reading material

Obligatory literature

V. Kumar: Robbins Basic Pathology, 2014

Literature developed by the Department

Lecture slides are found on the homepage of Department of Pathology.

Notes

Recommended literature

Conditions for acceptance of the semester

Maximum two absences, which means 2 practices, are allowed! Absences exceeding this rate (15% of the histopathology classes) in either semester will result in not signing the gradebook! Each missed seminar has to be made up for with another group in the same week.

Mid-term exams

One macropreparation, one histological slide and a theoretical question will be given to the students at the examination by the end of the first semester.

Making up for missed classes

Maximum two absences, which means 2 practices, are allowed! Absences exceeding this rate (15% of the histopathology classes) in either semester will result in not signing the gradebook! Each missed seminar has to be made up for with another group in the same week.

Exam topics/questions

PREPARATIONS

I. NECROSIS
1. Anaemic infarct of the heart
2. Haemorrhagic infarct of the small intestine
3. Gangraena sicca of the toes
4. Cerebral abscess
5. Acute pancreatitis with fat necrosis

II. DEGENERATIONS, ACCUMULATIONS, PIGMENTS
6. Steatosis hepatis
7. Aortic atherosclerosis with aneurysm
8. Haemochromatosis
9. Cholelithiasis, chronic cholecystitis and empyema
10. Nodular calcified aortic stenosis

III. GROWTH DISTURBANCES
11. Atrophia cerebri
12. Hypertrophia dilatativa ventriculi sinistri cordis
13. Cor pulmonale chronicum
14. Hyperplasia prostatae

IV. PATHOLOGY OF CIRCULATION
15. Cerebral apoplexy
16. Cerebral purpure
17. Abdominal aortic aneurysm – parietal thrombosis
18. Left atrial “ball” thrombus

V. INFLAMMATIONS
19. Fibrinous pericarditis - cor villosum
20. Pseudomembranous colitis
21. Lobar pneumonia
22. Bronchopneumonia
23. Pulmonary abscess
24. Miliary tuberculosis
25. Phthisis cavernosa

VI. ONCOPATHOLOGY
26. Fibroadenoma of the breast
27. Carcinoma of the breast
28. Leiomyoma of the uterus
29. Dermoid cyst
30. Rectal polyp
31. Rectal adenocarcinoma
32. Pulmonary metastases


SLIDES

I. NECROSIS
1. Recent infarct of the heart
2. Haemorrhagic infarct of the lung

II. DEGENERATION, ACCUMULATION, PIGMENTS, CALCIFICATION
3. Steatosis hepatis
4. Haemosiderosis of the liver
5. Amylidosis of the liver
6. Silicosis

III. GROWTH DISTURBANCES
7. Prostatic hyperplasia
8. Endometrial hyperplasia

IV. PATHOLOGY OF CIRCULATION
9. Pulmonary oedema
10. DIC – Fibrin thrombi in the kidney
11. Central hemorrhagic necrosis

V. INFLAMMATIONS
12. Fibrinous pericarditis
13. Pseudomembranous colitis
14. Purulent meningitis
15. Acute appendicitis
16. Sarcoidosis
17. Miliary tuberculosis

VI. ONCOPATHOLOGY
18. Cervical intraepithelial neoplasia CIN III
19. Squamous cell carcinoma of the lower lip
20. Adenocarcinoma metastasis in a lymph node



THEORETICAL QUESTIONS

I. POSTMORTAL CHANGES, NECROSIS
1. Cell injury and cell death. Causes of cell injury. Necrosis. Ultrastructural, light microscopical and gross changes. Apoptosis: morphology, pathomechanism.
2. Patterns of necrosis: coagulation type. Organ examples.
3. Patterns of necrosis: colliquation type. Organ examples.
4. Caseous necrosis and adiponecrosis

II. DEGENERATION, ACCUMULATION, PIGMENTS
5. The definition and types of degenerations. Parenchymal and fatty degeneration. Organ examples
6. Pathomorphology, pathogenesis and complications of atherosclerosis Aneurysm types
7. Exogenous and endogenous pigments. Anthracosis. Silicosis.
8. Hemoglobinogenic pigments I. Different forms of jaundice and cholostasis, morphology, differential diagnostics.
9. Hemoglobinogenic pigments II. Pathological forms of iron storage Endogenous nonhemoglobinogenous pigments: lipofuscin, melanin, homogentisinic acid.
10. Dystrophic and metastatic calcification. Organ manifestations. Pathomechanism and clinicopathological forms of stone formation
11. Amyloidosis.

III. GROWTH DISTURBANCES
12. Causes of atrophy; general gross morphology and microscopical characteristics. Pathomechanism of atrophy. Definition of atrophy, hypoplasia, aplasia, agenesia. Osteoporosis.
13. Definition, types and organ examples of hyperplasia. Definition of hypertrophy (causes, morphology, changes at cell cycle)
14. Left ventricular hypertrophy. Causes, sequential compensatory changes and functional consequences. Cor pulmonale chronicum.

IV. PATHOLOGY OF CIRCULATION
15. Definition of edema, pathomechanism (Starling law), clinical forms
16. Classification of haemorrhages based on pathomechanism, clinical forms. Congestion and hyperemia.
17. Thrombosis and embolus: definitions, casues, types and clinical consequences
18. Causes, types and pathomechanisms of shock. Disseminated intravascular coagulation (DIC).
19. Clinicopathological classification of hypertension and complications

V. INFLAMMATIONS
20. Vascular and cellular mechanisms of acute inflammations
21. Clinicopathological classification of acute inflammation based upon exudate types. Organ examples.
22. Definition, causes, cellular and humoral mechanisms of chronic inflammation.
23. Pathogenesis and clinicopathology of tuberculosis
24. Granuloma, granulomatous inflammation


VI. IMMUNPATHOLOGY
25. Mechanisms of hypersensitivity reactions, examples of related disorders
26. Pathogenesis of autoimmune disorders. Systemic lupus (SLE)
27. Transplantation immunity. Aquired immundeficiency syndrome (AIDS)

VII. ONCOPATHOLOGY
28. Neoplasia, nomenclature, definitions. Definition of metaplasia and dysplasia, organ examples and their connections with neoplasia
29. General characteristics of benigh and malignant tumors, anaplasia, tumor growth, local spread and metastasis, types of metastases
30. Incidence and mortality of cancers. Grading és staging. Paraneoplastic syndromes.
31. Oncogenes, protooncgenes, oncoproteins, growth factor and growth factor receptor oncogenes (RET, KIT, PDGFR), overexpression of normal growth factor receptors (ERBB1, ERBB2). Organ examples.
32. Oncogenes and oncoproteins in signal transduction: RAS and RAS signal proteins. Examples of oncogenes wih non receptor tirosine kinase activity, examples. The myc oncogene: types, their changes and roles in tumors (c-myc, n-myc)
33. Tumor supressor genes: RB and p53 genes and their roles in tumorignesis. Neurofibromatosis, NF1.
34. Chemical and radiation cancerogenesis. Mikrobial carcinogenesis: RNA és DNA viruses, Helicobacter pylori

The Department of Pathology reserves the right to propose minor modifications in the curriculum

Examiners

  • Dr. Czina Márton
  • Dr. Fincsur András
  • Dr. Kajtár Béla
  • Dr. Kálmán Endre
  • Dr. Kereskai László
  • Dr. Semjén Dávid
  • Dr. Smuk Gábor
  • Dr. Tornóczki Tamás
  • Dr. Vida Livia

Instructor / tutor of practices and seminars

  • Dr. Bogner Barna István
  • Dr. Czina Márton
  • Dr. Gyömörei Csaba
  • Dr. Kajtár Béla
  • Dr. Kaszás Bálint
  • Dr. Kereskai László
  • Dr. Pap Anita
  • Dr. Semjén Dávid
  • Dr. Smuk Gábor
  • Dr. Tornóczki Tamás
  • Dr. Vida Livia