1
UNIT 1.1: DEFINITION OF TERMS CLINICAL MANIFESTATIONS .
Pathology– study(logos) of disease(pathos) - Functional consequences of the disease
– study of structural, biochemical, and functional changes in ● The end results of genetic, biochemical, and structural changes
cells, tissues, and organs that underlie disease in cells and tissues are functional abnormalities which lead to
● Purpose: ○ Clinical manifestations (symptoms & signs)
○ It attempts to explain why’s and wherefores of the ○ Its progression (clinical course & outcome)
sign and symptoms manifested by patients
○ Provides a rational basis for clinical care and therapy DISEASE PROCESS:
● Bridge between the basic sciences and clinical medicine - For every disease there is a cause (etiology) which interacts
● Scientific foundation for all of medicine with the living system
- How this interaction takes place is the Pathogenesis and
2 TRADITIONAL DIVISION OF PATHOLOGY - The actual changes because of that interaction are the
1. General Pathology– concerned with common reactions of cells Morphologic changes
and tissue to injurious stimuli. - The structural changes affected on the cells alter their function
● Not tissue specific are manifested as functional derangements and clinical
● Ex: Inflammation caused by bacterial infection manifestations. They may either be signs (objective
appears similar in most tissues. manifestation) or symptoms (subjective manifestations).
2. Systemic Pathology– examines the alterations and underlying - From the start of the disease to its eventual resolution, disability
mechanisms in organ specific diseases or death is the progression of the disease which is referred to
● Ex. Ischemic heart disease as the clinical course and outcome.
4 aspects of disease process that form the core of BASIC TERMS IN PATHOLOGY
pathology 1. Disease, Disorder, Syndrome
ETIOLOGY . ● Disease- a pathophysiological response to internal and external
- Cause factors
2 kinds of etiology ○ Abnormalities in systemic functions become the basis
● Genetic– inherited mutations, and disease associated gene for diagnosis and treatment.
variants, or polymorphisms ○ Abnormalities cause both physical and emotional
● Acquired– due to: signs and symptoms as well as pain, dysfunction,
○ Infectious agents distress, social problems or death
○ Nutritional deficiency ○ Ex. Cardiovascular disease
○ Chemical poisons ● Disorder- A disruption of the disease to the normal or regular
○ Physical agents functions in the body or a part of the body
○ Abnormality in immunological reactions ○ Ex. Arrhythmia is a disorder arising from the disease
○ Psychological factors Cardiovascular disease.
—> classifying disease as being caused by one or other has less of a —>Arrhythmia is not a disease; it is a disorder
majority application. characterized with irregular heartbeat that occurs
—> most common afflictions like cancer or atherosclerosis are because of having cardiovascular disease.
multifactorial and arise from the effects of various external triggers on ○ Disorders can be classified as:
genetically susceptible individuals. ■ Mental
—> relative contribution of inherited susceptibility and external influences ■ Physical
varies in different diseases. ■ Genetic
PATHOGENESIS . ■ Emotional
- Sequence of biochemical and molecular events that follow ■ Behavioral
the exposure of cells or tissues to injurious agent ■ structural
● One of the main domains of pathology ● Syndrome- Refers to a disease or a disorder that has more
than one identifying feature or symptom.
MORPHOLOGIC CHANGES . ○ Ex Down's syndrome- distinctive physical features at
- Structural alterations induced in thee cells and organs of the birth due to an extra copy of chromosome 21
body that are either characteristic or diagnostic of an etiologic
process 2. Diagnosis, Prognosis
● Used traditionally by diagnostic pathology to determine the ● Diagnosis- determination of the nature of a disease expressed
nature of a disease and to follow its progression in a concise manner
● Limited by morphologically identical lesions arising from distinct ● Prognosis- probable outcome of a disease in a living
molecular mechanisms such as study of tumors, breast cancers individual. o It is the clinicians estimate of the severity and
that are morphologically indistinguishable from each other but possible result of a disease
have widely different courses, therapeutic response and ○ A forecast of the probable course and outcome of a
prognosis disease, especially of the chances of recovery
—-> molecular analysis like next generation sequencing has begun to
reveal genetic differences that predict tumor behavior as well as their 3. Acute, Chronic
therapeutic response. ● Acute- Sudden onset or rapid course
—-> new technological advances, the use of “omics” technologies ○ Short (often less than a month) clinical course
(genomics, proteomics, metabolomics) to study pathogenic mechanisms ○ Usually respond to therapy and return to a state of
are now available. complete, normal or premorbid state
ANDRADA, K P. MLS 222
, 2
■ Bronchitis,
■ appendicitis,
■ Upper respiratory tract infections UNIT 1.2: CELLULAR RESPONSE TO STRESS & TOXIC
● Chronic- Slow onset or long duration
INSULTS: ADAPTATION, INJURY AND DEATH
■ Asthma,
■ COPD, CELLULAR ADAPTATION .
■ Diabetes Mellitus,
■ Chronic Kidney disease
4. Idiopathic, Iatrogenic, Nosocomial, Community acquired
● Idiopathic- a disease with no identifiable cause
○ A diagnosis of exclusion.
○ There is limited literature describing the methodology
to define a disease with no clear diagnostic criteria.
● Iatrogenic- pathology caused by a physician and their
treatment.
○ Ex. Retained forceps after abdominal surgery causing
intestinal obstruction.
● Community acquired infection- infection acquired outside a
healthcare facility.
● Nosocomial- hospital acquired infection.
○ Occurs within 48 hours of hospital admission , 3 days
of discharge or 30 days of operation.
Homeostasis
5. Non-communicable, communicable, infectious, contagious - Changes that may happen to cell
● Non communicable diseases (NCD)- Diseases that are not - Cell try to survive, however stimuli may put in a situation where
transmitted through contact with an infected or afflicted person. its ability to keep itself normal may be stretched
○ They are caused by various genetic, physiological, - Leading to difficulty in maintaining normal function of
environmental, and behavioral factors cell
○ 4 main types of NCD’s (WHO) 3 things to be considered if cell got injured:
■ Cancer - Cardiovascular diseases 1. Duration (transient, progressive)
■ Chronic Respiratory diseases (Asthma and 2. Intensity of stimuli (Mild, Severe)
COPD) 3. Type of cell
■ Diabetes HOMEOSTASIS IS: .
● Communicable diseases- diseases that can be spread from 1. Differentiation and Specialization .
one organism to another. This includes spread from one person
to person or animal to humans (zoonotic).
The manner of spread can be described by 2 terms
○ Infectious- to affect contaminated someone with
pathogenic microorganisms.
Major ways of spread:
○ Direct contact with an infected person,
animal or their discharges (saliva;body
fluids such as blood, urine, semen;
respiratory droplets/ aerosols )
○ Direct contact with contaminated object
○ Contaminated food or water ● Stem cells— precursor before turning into specialize
○ Disease carrying insects (Vectors) ○ Cell that could turn into different types of mature cells
● Contagious- spread through direct bodily contact ○ Mature cells— undergoes differentiation first
with an infected person, their discharges or an object ○ Can replace dead cells (necrotic cells)
or surface they have contaminated. ○ Functions are dependent on the niches
○ From Latin ‘contagio’--touching, contact Ex:
—> All communicable diseases are infectious but not all are contagious. ■ Erythroblast– immature (differentiation)
—> An infectious disease is contagious when it spreads through direct, ■ Erythrocyte– mature (specialization)
bodily contact with an infected person, their discharges, or an object or ■ WBC– involved in immunity, but if too much patient will be
surface they have contaminated. immunocompromised (has something to do with differentiation)
Malaria is infectious because it is caused by a parasite, but it is not – cells are developing at fast rate
contagious because a vector is needed to transmit the infection. Tetanus – cells are immature and could not perform their function
is infectious but not contagious because you do not get it by shaking
hands with someone who has tetanus. ● Niche cell— maintains stem cells
COVID 19 is both infectious and contagious because you can get directly ○ Area that surrounds stem cells
from a person by aerosol spray and from inanimate objects contaminated ○ Maintain the function of tissue after cell have died
with a discharge from an infected person. ○ Fixed anatomical compartments that provide
specialize environment to regulate:
ANDRADA, K P. MLS 222
, 3
1. Rate of stem cell proliferation– determine the fate of stem cell 2. Sugar concentration in blood drop, stimulating the pancreas to
daughters from exhaustion or death stop releasing insulin and instead release glucagon
2. Formation and activity of niches– carefully regulated to ensure 3. Postabsorptive state in liver cells, muscle cells, adipose cells
appropriate stem cell function. Niches form at discrete a. Glycogenesis releases glucose in the blood, returning
development times (during development they appear as blood glucose concentrations to homeostasis. Ketone
needed) oxidation also releases lipids and additional glucose,
- Their appearance often enables the establishment or which body cells can use to generate ATP.
recruitment of stem cells at particular anatomic locations
- Function either:
● Homeostatically by continually replacing short-lived
mature cells that are lost because of normal cell
turnover
● Facultatively by replacing differentiated cells only in
response to injury or disease, stem cell niches must
be dynamic enough to provide proper developmental
and physiological cues to regulate stem cells
behavior normally and to mobilize stem cell activity in
response to acute pathological conditions
○ Deficient niche function may cause the loss of
deregulation of tissue stem cells
○ Niche dysfunction contributes to age-associated
deficiencies of stem cell function and because niche
cells normally control stem cell division, loss of input
from the niche may permit overproliferation of stem
cells, predisposing to malignant transformation
2. State of Metabolism .
3. Availability of Metabolic Substrate .
●
In pyruvic acid, it can enter as Acetyl CoA in citric acid
○ Acetyl CoA is the end point
● Then pwede na pumasok kapag nag glycolysis
○ Proteins undergo glycolysis to form ketones
2 Phases of Metabolism
ABSORPTIVE STATE . 1. Anabolism– Absorptive state
1. Digested nutrients enter the bloodstream from the intestines. ● Need energy to build up (storing)
Blood sugar concentration rises 2. Catabolism– Post-absorptive state
2. Release of digested nutrients into the blood stimulates insulin ● Produce energy to breakdown
release by the pancreas. Insulin increases the uptake of
—> They work together, while anabolism is happening,
glucose by all body cells, reducing blood glucose concentration
back to homeostasis
catabolism follows.
3. Absorptive state in liver cells, muscle cells,adipose cells
CELL CYCLE CHECKPOINTS
a. Liver cells convert excess glucose to glycogen for
- Monitor the accuracy of cell division by checking the integrity of
storage via the intermediary glucose-6-phosphate.
DNA and chromosomes, and ensuring that each phase of the
Amino acids are also converted into ketone bodies
cell cycle is completed before moving on to the next.
that can later be converted to acetyl CoA when
needed.
● G1/S checkpoint: checks that cell is large enough and has
b. Muscle cells convert excess glucose to glycogen for
enough nutrients to divide
storage via the intermediary glucose-6-phosphate.
● G2/M checkpoint: Checks that DNA replication has occurred
Amino acids are used to synthesize actin and myosin,
properly
rebuilding muscle fibers
● Metaphase/anaphase checkpoint: Checks that chromosomes
c. Adipose cells store excess lipids, increasing fat
are attached to the mitotic spindle
reserves.
○ Checkpoint failure:
POSTABSORPTIVE STATE .
■ The cell cycle is arrested at the checkpoint
1. No nutrients enter the bloodstream from the digestive system
ANDRADA, K P. MLS 222
UNIT 1.1: DEFINITION OF TERMS CLINICAL MANIFESTATIONS .
Pathology– study(logos) of disease(pathos) - Functional consequences of the disease
– study of structural, biochemical, and functional changes in ● The end results of genetic, biochemical, and structural changes
cells, tissues, and organs that underlie disease in cells and tissues are functional abnormalities which lead to
● Purpose: ○ Clinical manifestations (symptoms & signs)
○ It attempts to explain why’s and wherefores of the ○ Its progression (clinical course & outcome)
sign and symptoms manifested by patients
○ Provides a rational basis for clinical care and therapy DISEASE PROCESS:
● Bridge between the basic sciences and clinical medicine - For every disease there is a cause (etiology) which interacts
● Scientific foundation for all of medicine with the living system
- How this interaction takes place is the Pathogenesis and
2 TRADITIONAL DIVISION OF PATHOLOGY - The actual changes because of that interaction are the
1. General Pathology– concerned with common reactions of cells Morphologic changes
and tissue to injurious stimuli. - The structural changes affected on the cells alter their function
● Not tissue specific are manifested as functional derangements and clinical
● Ex: Inflammation caused by bacterial infection manifestations. They may either be signs (objective
appears similar in most tissues. manifestation) or symptoms (subjective manifestations).
2. Systemic Pathology– examines the alterations and underlying - From the start of the disease to its eventual resolution, disability
mechanisms in organ specific diseases or death is the progression of the disease which is referred to
● Ex. Ischemic heart disease as the clinical course and outcome.
4 aspects of disease process that form the core of BASIC TERMS IN PATHOLOGY
pathology 1. Disease, Disorder, Syndrome
ETIOLOGY . ● Disease- a pathophysiological response to internal and external
- Cause factors
2 kinds of etiology ○ Abnormalities in systemic functions become the basis
● Genetic– inherited mutations, and disease associated gene for diagnosis and treatment.
variants, or polymorphisms ○ Abnormalities cause both physical and emotional
● Acquired– due to: signs and symptoms as well as pain, dysfunction,
○ Infectious agents distress, social problems or death
○ Nutritional deficiency ○ Ex. Cardiovascular disease
○ Chemical poisons ● Disorder- A disruption of the disease to the normal or regular
○ Physical agents functions in the body or a part of the body
○ Abnormality in immunological reactions ○ Ex. Arrhythmia is a disorder arising from the disease
○ Psychological factors Cardiovascular disease.
—> classifying disease as being caused by one or other has less of a —>Arrhythmia is not a disease; it is a disorder
majority application. characterized with irregular heartbeat that occurs
—> most common afflictions like cancer or atherosclerosis are because of having cardiovascular disease.
multifactorial and arise from the effects of various external triggers on ○ Disorders can be classified as:
genetically susceptible individuals. ■ Mental
—> relative contribution of inherited susceptibility and external influences ■ Physical
varies in different diseases. ■ Genetic
PATHOGENESIS . ■ Emotional
- Sequence of biochemical and molecular events that follow ■ Behavioral
the exposure of cells or tissues to injurious agent ■ structural
● One of the main domains of pathology ● Syndrome- Refers to a disease or a disorder that has more
than one identifying feature or symptom.
MORPHOLOGIC CHANGES . ○ Ex Down's syndrome- distinctive physical features at
- Structural alterations induced in thee cells and organs of the birth due to an extra copy of chromosome 21
body that are either characteristic or diagnostic of an etiologic
process 2. Diagnosis, Prognosis
● Used traditionally by diagnostic pathology to determine the ● Diagnosis- determination of the nature of a disease expressed
nature of a disease and to follow its progression in a concise manner
● Limited by morphologically identical lesions arising from distinct ● Prognosis- probable outcome of a disease in a living
molecular mechanisms such as study of tumors, breast cancers individual. o It is the clinicians estimate of the severity and
that are morphologically indistinguishable from each other but possible result of a disease
have widely different courses, therapeutic response and ○ A forecast of the probable course and outcome of a
prognosis disease, especially of the chances of recovery
—-> molecular analysis like next generation sequencing has begun to
reveal genetic differences that predict tumor behavior as well as their 3. Acute, Chronic
therapeutic response. ● Acute- Sudden onset or rapid course
—-> new technological advances, the use of “omics” technologies ○ Short (often less than a month) clinical course
(genomics, proteomics, metabolomics) to study pathogenic mechanisms ○ Usually respond to therapy and return to a state of
are now available. complete, normal or premorbid state
ANDRADA, K P. MLS 222
, 2
■ Bronchitis,
■ appendicitis,
■ Upper respiratory tract infections UNIT 1.2: CELLULAR RESPONSE TO STRESS & TOXIC
● Chronic- Slow onset or long duration
INSULTS: ADAPTATION, INJURY AND DEATH
■ Asthma,
■ COPD, CELLULAR ADAPTATION .
■ Diabetes Mellitus,
■ Chronic Kidney disease
4. Idiopathic, Iatrogenic, Nosocomial, Community acquired
● Idiopathic- a disease with no identifiable cause
○ A diagnosis of exclusion.
○ There is limited literature describing the methodology
to define a disease with no clear diagnostic criteria.
● Iatrogenic- pathology caused by a physician and their
treatment.
○ Ex. Retained forceps after abdominal surgery causing
intestinal obstruction.
● Community acquired infection- infection acquired outside a
healthcare facility.
● Nosocomial- hospital acquired infection.
○ Occurs within 48 hours of hospital admission , 3 days
of discharge or 30 days of operation.
Homeostasis
5. Non-communicable, communicable, infectious, contagious - Changes that may happen to cell
● Non communicable diseases (NCD)- Diseases that are not - Cell try to survive, however stimuli may put in a situation where
transmitted through contact with an infected or afflicted person. its ability to keep itself normal may be stretched
○ They are caused by various genetic, physiological, - Leading to difficulty in maintaining normal function of
environmental, and behavioral factors cell
○ 4 main types of NCD’s (WHO) 3 things to be considered if cell got injured:
■ Cancer - Cardiovascular diseases 1. Duration (transient, progressive)
■ Chronic Respiratory diseases (Asthma and 2. Intensity of stimuli (Mild, Severe)
COPD) 3. Type of cell
■ Diabetes HOMEOSTASIS IS: .
● Communicable diseases- diseases that can be spread from 1. Differentiation and Specialization .
one organism to another. This includes spread from one person
to person or animal to humans (zoonotic).
The manner of spread can be described by 2 terms
○ Infectious- to affect contaminated someone with
pathogenic microorganisms.
Major ways of spread:
○ Direct contact with an infected person,
animal or their discharges (saliva;body
fluids such as blood, urine, semen;
respiratory droplets/ aerosols )
○ Direct contact with contaminated object
○ Contaminated food or water ● Stem cells— precursor before turning into specialize
○ Disease carrying insects (Vectors) ○ Cell that could turn into different types of mature cells
● Contagious- spread through direct bodily contact ○ Mature cells— undergoes differentiation first
with an infected person, their discharges or an object ○ Can replace dead cells (necrotic cells)
or surface they have contaminated. ○ Functions are dependent on the niches
○ From Latin ‘contagio’--touching, contact Ex:
—> All communicable diseases are infectious but not all are contagious. ■ Erythroblast– immature (differentiation)
—> An infectious disease is contagious when it spreads through direct, ■ Erythrocyte– mature (specialization)
bodily contact with an infected person, their discharges, or an object or ■ WBC– involved in immunity, but if too much patient will be
surface they have contaminated. immunocompromised (has something to do with differentiation)
Malaria is infectious because it is caused by a parasite, but it is not – cells are developing at fast rate
contagious because a vector is needed to transmit the infection. Tetanus – cells are immature and could not perform their function
is infectious but not contagious because you do not get it by shaking
hands with someone who has tetanus. ● Niche cell— maintains stem cells
COVID 19 is both infectious and contagious because you can get directly ○ Area that surrounds stem cells
from a person by aerosol spray and from inanimate objects contaminated ○ Maintain the function of tissue after cell have died
with a discharge from an infected person. ○ Fixed anatomical compartments that provide
specialize environment to regulate:
ANDRADA, K P. MLS 222
, 3
1. Rate of stem cell proliferation– determine the fate of stem cell 2. Sugar concentration in blood drop, stimulating the pancreas to
daughters from exhaustion or death stop releasing insulin and instead release glucagon
2. Formation and activity of niches– carefully regulated to ensure 3. Postabsorptive state in liver cells, muscle cells, adipose cells
appropriate stem cell function. Niches form at discrete a. Glycogenesis releases glucose in the blood, returning
development times (during development they appear as blood glucose concentrations to homeostasis. Ketone
needed) oxidation also releases lipids and additional glucose,
- Their appearance often enables the establishment or which body cells can use to generate ATP.
recruitment of stem cells at particular anatomic locations
- Function either:
● Homeostatically by continually replacing short-lived
mature cells that are lost because of normal cell
turnover
● Facultatively by replacing differentiated cells only in
response to injury or disease, stem cell niches must
be dynamic enough to provide proper developmental
and physiological cues to regulate stem cells
behavior normally and to mobilize stem cell activity in
response to acute pathological conditions
○ Deficient niche function may cause the loss of
deregulation of tissue stem cells
○ Niche dysfunction contributes to age-associated
deficiencies of stem cell function and because niche
cells normally control stem cell division, loss of input
from the niche may permit overproliferation of stem
cells, predisposing to malignant transformation
2. State of Metabolism .
3. Availability of Metabolic Substrate .
●
In pyruvic acid, it can enter as Acetyl CoA in citric acid
○ Acetyl CoA is the end point
● Then pwede na pumasok kapag nag glycolysis
○ Proteins undergo glycolysis to form ketones
2 Phases of Metabolism
ABSORPTIVE STATE . 1. Anabolism– Absorptive state
1. Digested nutrients enter the bloodstream from the intestines. ● Need energy to build up (storing)
Blood sugar concentration rises 2. Catabolism– Post-absorptive state
2. Release of digested nutrients into the blood stimulates insulin ● Produce energy to breakdown
release by the pancreas. Insulin increases the uptake of
—> They work together, while anabolism is happening,
glucose by all body cells, reducing blood glucose concentration
back to homeostasis
catabolism follows.
3. Absorptive state in liver cells, muscle cells,adipose cells
CELL CYCLE CHECKPOINTS
a. Liver cells convert excess glucose to glycogen for
- Monitor the accuracy of cell division by checking the integrity of
storage via the intermediary glucose-6-phosphate.
DNA and chromosomes, and ensuring that each phase of the
Amino acids are also converted into ketone bodies
cell cycle is completed before moving on to the next.
that can later be converted to acetyl CoA when
needed.
● G1/S checkpoint: checks that cell is large enough and has
b. Muscle cells convert excess glucose to glycogen for
enough nutrients to divide
storage via the intermediary glucose-6-phosphate.
● G2/M checkpoint: Checks that DNA replication has occurred
Amino acids are used to synthesize actin and myosin,
properly
rebuilding muscle fibers
● Metaphase/anaphase checkpoint: Checks that chromosomes
c. Adipose cells store excess lipids, increasing fat
are attached to the mitotic spindle
reserves.
○ Checkpoint failure:
POSTABSORPTIVE STATE .
■ The cell cycle is arrested at the checkpoint
1. No nutrients enter the bloodstream from the digestive system
ANDRADA, K P. MLS 222
