introduction pathology - a branch of medicine studying diseases outer and inner factors causing...
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Introduction
• Pathology - a branch of medicine studying diseases
• outer and inner factors causing diseases - etiology(TB - caused by Mycobacterium tuberculosis)
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Introduction
• how and why - development - pathogenesis(infectious endocarditis - thrombembolism -
multiple abscesses)
• related disciplines: anatomy, histology, microbiology, clinical chemistry, hematology, laboratory medicine
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• autopsy
• search for changes in dead patients, correlation with clinical symptoms - feed-back
• educational role
• chronic toxicity studies (pharmaceutic industry)
• pathological autopsy is different from anatomic autopsy and forensic autopsy
• gross examination, microscopy, special methods (cultivation, chemical tests, etc.)
Methods used in pathology
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• biopsy (surgical pathology)
• 80% of workload
• since 1950!
• microscopical diagnostics, for living patients
• histology, cytology (exfoliative-Pap test; fluids, fine needle aspiration cytology)
Methods used in pathology
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• specimens:
• fluids (physiological - urine; pathological - pus, ascites)
• endoscopic samples (gastroscopy, colonoscopy, bronchoscopy, etc.)
• tru-cut needle biopsy (liver, kidney, prostate)
• diagnostic excisions (skin, breast, pancreas)
• entire organs (hysterectomy, mastectomy, lung resection, colectomy)
• pathological dx = golden standard (important for treatment) (A. Hailey: Final diagnosis)
Methods used in pathology
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How to handle specimen for
histology• fixation (×frozen section)
• clinical information (identification!!!!; symptoms; preliminary diagnosis; what do you expect from pathologist)
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History of pathology• Vesalius
• 1475 - Sixtus IV. - permits to use cadavers in teaching of medical students
• 1485 - Clement VII. - the same
• 18th cent. - Jean Baptist Morgagni (1682-1772) - 700 autopsies - case reports - clinico-morphologic correlations - founder of modern
pathology
• 19th cent. - Karl Rokitanski (Austria) - born 1804 in Hradec Králové, University of Vienna, 50 000 of autopsies - only gross examination
• Rudolf Virchow - founder of modern pathology (classification of tumors, mitosis, apoptosis, causal relationships) - Berlin (Charité)
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• our country:
• Jesenius 1600, 1605 - two public autopsies
• Prof. Jaroslav Hlava - end of 198th cent. - his last pupil was Dr. Antonin Fingerland (1900-1999)
• 1928 - Dept. of Pathology in Hradec Králové - inspiration = Mayo Clinic (clinicopathologic conferences, close cooperation,
continuous education)
History of pathology
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Organization of education
• general pathology - main principles
• systemic pathology - diseases and pathologic processes in different organ systems
• lectures - www.lfhk.cuni.cz/patanat (Aleš Ryška, MD, PhD; Karel Dědič, MD, PhD)
• practical classes - Karel Dědič, MD, PhD (excursion at the Department, autopsy, surgical pathology, microscopy)
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• textbooks:
• Basic Pathology (Cumar, Cotran, Robbins)
• Oral Pathology (van der Waal, van der Kwast)
• you MUST know before start of your practical classes: normal anatomy, normal histology of most important organs, basic embryology, normal physiology)
Organization of education
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• pay close attention to other disciplines!!! (pathophysiology, microbiology, biology, biochemistry)
• credits - examination of histologic slides
• exam - lectures, practicals, Robbins, van der Waal
• 49 583 3748 Dr. Ryška
• 49 583 2287 Dr. Dědič
• 49 583 2611 Mrs. Hejnová (secretary)
Organization of education
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Good luck !