Transcript Mini-Med School 2001

Pathology:
a. The Study of Disease
b. A Clinical Specialty
Why the teaching of concepts and mechanisms of disease is
important at the high school level.
The basic principles of general pathology.
Application of the principles and methods of pathology to the
diagnosis, as well as the understanding of disease.
The potential career pathways for pathologists.
Biology
•
•
•
•
•
•
•
Health
Order
Symbiosis
Homeostasis
Growth
Circulation
Hormones
Pathology
Disease
Disorder
Parasitism
Host Defense
Neoplasia
Infarction
Endocrine Diseases
WHY INCLUDE DISEASE PRINCIPLES
IN HIGH SCHOOL CURRICULUM?
A. IT’S IMPORTANT
•
•
•
•
B.
•
C.
•
•
•
•
•
Confront disease in their daily lives
Inundated by disease (mis)information
(news, entertainment)
New threats to be faced
(emerging pathogens, bioterrorism)
Increasing complexity of medical care
(informed consumers)
IT’S INTERESTING
Focus on themselves & their bodies
(as well as frogs and paramecia)
IT’S REINFORCING
Observation & Classification
Conceptualization & Abstraction,
Explanation & Prediction
Application
(Career choices)
Integration of both
sides of the force
GENERAL PATHOLOGY
There are general principles that apply to
the various diseases
• Finite set of patterns of injury
• Similar physiologic and morphologic consequences
of different injuries
• Small number of reparative processes
HOST DEFENSE
Injury
Protective Response
Inflammation
Repair
Immunity
mediators
Inflammation is an immediate reaction to damage
that limits it directly, helps focus an immune
reaction, and sets the stage for subsequent repair.
Fibrosis
Regeneration
Resolution
INFLAMMATION & IMMUNITY
INFLAMMATION
vessels
serum factors
cells
Inflammatory/Immune Cells
IMMUNE RESPONSE
antibodies
activated cells
cytokines
EFFECTOR FUNCTIONS OF THE
IMMUNE SYSTEM
Antibody-Mediated
•Precipitation
•Neutralization
•Complement activation
•Mask Receptors
•Enhance Phagocytosis
•Activate leukocytes
•ADCC
Cytokine-Mediated
Cell-Mediated
Cytotoxic T cells
Activated NK Cells
Activated Macrophages
•Cell destruction
•Cell proliferation
•Cell movement
•Cell differentiation
•Cell activation
LYMPHOCYTES LEAVING A BLOOD VESSEL
CANCER
POSITION TITLE: MALIGNANT CELL
Job Description
•
•
•
•
•
•
•
Survive and proliferate locally
Invade adjacent tissue
Induce supporting stroma and blood supply
Gain access to the circulation
a. Cross basement membrane
b. Cross endothelium
Leave circulation
a. Cross endothelium
b. Cross basement membrane
Colonize new location
Survive and proliferate at distant site
CANCER OF PANCREAS
GROSS PHOTOGRAPH MICROPHOTOGRAPH
THE KISS OF DEATH
CAUSES OF CANCER
SOME GENERAL CAUSES
SOME SPECIFIC CAUSES
•Sweeping chimneys
•Using aniline dyes
•Smoking cigarettes
•Building ships in WWII
•Renovating old houses
•Breathing
•Drinking
•Eating
•Working
•Sunshine
•Sex
•Doctors
SOME UNDERLYING CAUSES
•Loss of negative growth signals
•Excessive production of growth factors
•Decreased (normal) cell death
•Loss of spatial constraints
Physical Exam
Patient
Internist
Pathologist
Radiologist
Surgeon
Normal Breast
MAMMOGRAM
BREAST CANCER
DIAGNOSTIC SURGICAL PROCEDURES
• Fine Needle Aspiration (FNA)
• Needle Core Biopsy
• Excision Biopsy
CANCER CELLS BY CYTOLOGY
TISSUE
EXAMINATION
FINAL DIAGNOSIS
PROCESSING
S-01-10
SLIDE PREPARATION
BREAST CARCINOMA- THROUGH MICROSCOPE
DETECTION & IDENTIFICATION
METHODS
ANTIBODIES AS DETECTION AGENTS
•
•
Immunohistochemistry
Immunofluorescence
DNA AS PROBES
•
•
•
In situ hybridization
DNA sequencing
Polymerase Chain Reaction
Amplification of signal with biotin
IMMUNOHISTOCHEMISTRY
FLUORESCENT IN SITU HYBRIDIZATION (FISH)
MOLECULAR IDENTIFICATION
•Cellular phenotypes
•Differentiation stages
•Tumor classification
•Gene activation & RNA expression
•Detection of proteins, nucleotide
sequences, mutations
•Exogenous pathogens
•Altered proteins
APPENDIX: INTEGRATION OF PATHOLOGY
AND BIOLOGY CURRICULUM
UNIT 1: WHAT IS BIOLOGY?
Module 1: Basic Aspects of Pathology
•The relationship between homeostasis and response to damage
•Self-protection: inflammation, immunity, & repair
•How organisms adapt to functional losses
•How we study disease, and what tools are available
•The use of biological principles to treat disease
UNIT 2: PRINCIPLES OF ECOLOGY
Module 2: The Ecology of Disease
•Distinguishing self from non-self
•How populations resist injury by adaptation
•How populations resist injury by evolution
•Infectious diseases as predators
•How do humans experience symbiosis and parasitism
INTEGRATION OF PATHOLOGY & BIOLOGY CURRICULUM
UNIT 3: THE LIFE OF CELLS
Module 3: Cellular Pathology
•How does the cell maintain a boundary around it, other cells &
the outside world?
•What happens when these boundaries are breached?
•Susceptibility of organelles to damage & disturbances of cellular metabolism
•What triggers a cell to divide and how can this stimulus become defective?
•What are the consequences of uncontrolled cell proliferation?
•How we study disease, and what tools are available?
•The use of biological principles to treat disease
UNIT 4: GENETICS
Module 4: The Genetics of Disease
•How can diseases be inherited?
•Does heredity play a role in diseases that are not inherited?
•Do different populations have different risk factors?
•The difference between germ cell and somatic cell mutation
•What are the principles of genetic engineering?
INTEGRATION OF PATHOLOGY & BIOLOGY CURRICULUM
UNIT 5: EVOLUTION
Module : Evolutionary Forces in Disease
•The forces driving molecular evolution in animals & pathogens
•Information transfer without DNA (prions & retroviruses)
•Do disease organisms co-evolve with their hosts and/or evolve
to take advantage of new hosts
•What are the differences between evolution & genetic engineering?
UNIT 6: DIVERSITY OF LIFE
Module 6: diversity of Disease
•What are the different kinds of pathogenic agents (pathogens)?
•How do we classify infectious organisms?
•Differences in the response to different kinds of pathogens
•How do different individuals respond differently to
the same or similar pathogens?