Syllabus of pathohysiology

3rd year, general medicine

Department of Pathophysiology, Faculty of Medicine in Pilsen, Charles University

2020/2021

(see also the web of the department: http://patofyziologie.lfp.cuni.cz/?lang=en)

The student knows the facts in the field of general and special pathophysiology, can present and logically organize them, recognize and evaluate their importance, name examples of described phenomena. The student is oriented in the problem and can explain pathophysiological mechanisms of diseases, explain how and why pathological processes happen and develop. The student can find and explain a context and relations between knowledge of various areas of pathophysiology, understand and use interrelationships of individual organ systems in normal as well as pathological states. The student has knowledge of subjects which pathophysiology follows up on, i.e. anatomy, histology, embryology, biology chemistry and biochemistry, biophysics, physiology and microbiology. The student can use this knowledge to understand pathophysiology and can find and explain their relations.

General pathophysiology

Introduction to the subject

Definition of the content of the subject, sections of the subject, relations to other subjects of the medical study, methods of pathophysiology as a science

History of pathophysiology

Definition of basic terms, definition of the terms health and disease

Etiology, the main views on the etiology of diseases

Iatrogenic, idiopathic, multifactorial diseases

Pathogenesis

General pathogenetic mechanisms, models of pathological states

Role of physiological regulatory mechanisms in the pathogenesis of diseases

Physiological and pathological parameters and phenomena, normal state versus pathology

Disease and its course

Disease, pathological state, nosological unit, symptom, objective and subjective manifestations of diseases, syndrome

Stages of a disease, forms of disease course, outcomes of a disease

Prognosis of diseases

Etiological factors

Classification of etiological factors

Etiological versus risk factors

Influenceable and uninfluenceable etiological factors

Intrinsic etiological factors

- Definition, explanation of term inborn and hereditary (disease, disorder)

- Age, sex, circadian rhythmicity, congenital factors as etiological and risk factors of diseases - their basis, mechanisms of their role in disease development, examples of diseases

- Epigenetics – definition, mechanisms, sensitive periods, examples of diseases with epigenetic basis or participation

- Heredity

- Basic terms

- Types of mutations, types and mechanisms of mutation effects

- Types of heredity, their basis and principles, mechanisms of relation between alleles

- Examples of hereditary diseases

Extrinsic etiological factors

- Physical factors

- Mechanical influences

- Injuries, types of wound and their characters and specific features, wound healing and its disturbances, pathophysiological aspects of wound treatment, traumatic shock and its provoking factors and mechanisms of its development

- Pressure of the environment (e.g. atmosphere) and its changes

- Acute and chronic adaptations on the higher altitude

- Altitude disease, barotrauma, decompression illness – causes, pathogenesis, manifestations and consequences, prevention

- Hyperbaric oxygenotherapy – principles, application, mechanisms of its effects, risks

- Noise, infrasound, ultrasound

- Kinetosis

- Electric current

- Direct and alternating current, tissue as a part of an electric circuitry, biological effects of direct and alternating electric current, mechanisms of effect, comparison of effects and their level in direct and alternating electric current, electric current injuries, factors influencing character and intensity of the organism affection, principles of safety

- Thermic influences

- General and local (including general response of the organism) impact of cold and heat - burns (degrees – their characteristics and consequences, the second burn shock), frostbites (degrees – their characteristics and consequences), trench-foot syndrome, hypothermia, insolation, hyperthermia

- Radiation – ionizing and non-ionizing

- Classification of radiation, effects of different kinds of radiation on the organism and its mechanisms, radiation illness

- Chemical factors

- Toxins

- Ways of entrance, mechanisms of effects, toxicity quantification, elimination of toxins, manifestation of intoxication

- Examples of important toxic substances and their effects (heavy metals, arsenic, cyanides, carbon monoxide, nitric and nitrous compounds, organophosphates, curare and its derivates, opiates, barbiturates, anticoagulants, main plant and animal poisons)

- Corrosive substances and their effect

- Teratogenic, mutagenic and cancerogenic substances

- Mechanisms and consequences of their influence, examples

- Free radicals – their extrinsic and intrinsic sources, examples of free radicals, mechanisms of their action, consequences,

- Biological factors

- Animals, plants, fungi – negative (toxicity, injuries, source of infections) and positive effects on human health

- Infections

- Classification (prions, viruses, bacteria, molds, protozoa, multicellular parasites – worms, mites, insects), characteristics of individual groups of infectious agents

- Transfer mechanisms of infections and penetration of infectious agents into the organism, mechanisms of pathological effect of microorganisms and multicellular parasites

- Factors determining sensitivity and resistance to infectious diseases

- Examples of infectious diseases

- Coexistence of human organism with microorganisms, examples of positive influence of microorganisms on the human (e.g. enteric microbioma)

- Social factors – examples, mechanisms of effects

Mutual influences and interactions of etiological factors

Developmental disorders

Stages of the ontogenetic development

Altricial and precocious types of the development

Factors determining the individual's development and its disorders

Mechanisms of developmental disorders

Critical developmental periods

Diseases and disorders linked to a certain age, changes of the reactivity and resistance dependent on age

Gametopathy, blastopathy, embryopathy, fetopathy, perinatal damage – causes, mechanisms, character of the disorders, examples

Teratogenic factors and effects

Normal and impaired CNS development and factors that affect it, brain growth spurt

Growth disorders

Nanism, gigantism, proportional and disproportional growth disorders

Causes and mechanisms of growth disorders

Influence of nutrition and the environment

Hereditary growth disorders

Growth disturbances of the endocrine origin

Aging

Basic concepts (gerontology, geriatrics, demographic aging, maximum life span, average life span, life expectancy)

Causes and mechanisms of aging, theory of aging

Manifestations of aging, changes in the ageing organism

Social and health aspects of aging, age-related illness, specifics of therapy in aged patients

Abnormal course of aging, diseases with accelerated ageing

Factor influencing the course of aging

Terminal states, death

Definition of death, clinical and biological death

Thanatology

Cell death and its mechanisms and causes, tissue death, death of an individual, brain death

Signs of death, determining the death of an individual

Causes and mechanisms of death

Philosophical, ethical, psychological, social aspects of death, euthanasia, dysthanasia

Dying and its stages

Lazarus syndrome

Persistent vegetative state, locked-in syndrome

Stress

The definition of stress, the concept of general adaptation syndrome and its history

Basic concepts - stress, stressor, eustress, distress

Stress phases

Stress response scheme, mechanisms, roles of components of the stress axes in individual stress phases

Humoral and metabolic changes during the stress response

The importance of stress for the organism

Relation of stress to pathogenesis of disease

Stress diseases - definition, mechanisms of origin, examples

Stress axes disturbances

The relationship between stress and shock

Psychosomatic and behavioral medicine, psychoneuroimmunology

Pathophysiology of immunity

Immunity mechanisms and their classification

Classification of disorders and diseases of the immune system

Immunodeficiency

- Causes, pathogenesis, symptoms and consequences, characteristics and examples of dis