Syllabus
SYLABUS OF PATHOLOGICAL PHYSIOLOGY
GENERAL
Health, illness, death – definition, symptom/syndrome/disease, stages of a disease, extrinsic and intrinsic causes of diseases, clinical and biological death, signs of brain death
Disorders of temperature control – fever, hyperthermia and its consequences, hypothermia and reaction of the body
Edema – Starling forces, generalized (heart failure, hypoproteinemia) versus localized (inflammatory, venostatic, lymphostatic)
Concrements, colic - concrement formation (types, saturation of fluid, AB balance), characteristics of different types of colic and their propagation, other consequences of concrements
Icterus – causes (prehepatal, hepatal, posthepatal), diagnostics, complication
Acidosis – metabolic, respiratory, causes, compensation, consequences (influence on ICF)
Alkalosis - metabolic, respiratory, causes, compensation, consequences (influence on ICF)
Hyperhydration – iso/hyper/hypo-osmolar, causes, consequences (lung and brain edema)
Dehydration – iso/hyper/hypo-osmolar, causes, consequences (blood viscosity, hypovolemic shock)
Disorders of K+ and Cl- metabolism, relation to AB balance – causes, ICF/ECF, resting membrane potential, arrhythmias, sceletal muscles
Disorders of Ca, P metabolism - parathyroid glands, relation between Ca and P, parathormon, vitamin D, calcitonin, causes and consequences (tetany, calcifiation)
Classification of hypoxias – hypoxic, ischemic, anemic, histotoxic, diffusion distance
Intoxication – CO, kyanids, nitrates, organophosphates, botulism, alcohol, methanol, paracetamol, amanitin, faloidin, salicyláty, digitalis, atropin
AB balance testing – pH, respiratory (CO2) and metabolic component (BE, HCO3-), AG, Cl-corr, principals of blood sampling and measurement
BLOOD
Anemic syndrome – symptoms (paleness, fatigue, dyspnea), compensatory mechanisms
Anemias caused by erytrocytes loss - chronic posthemorrhagic (causes – GIT, urogenital system), hemolytic (causes), lack of iron, chronic disease anemia (hypersplenism, renal insufficience, liver, tumors)
Anemias caused by impaired hematopoesis – bone marrow disorders, erytropoetin, Fe, B12
Hyperviscosity – causes (polyglobulia, CML, paraprotein), symptoms (CNS, heart, cyanosis, thrombosis/bleeding)
Disorders of hemostasis – conditions related to hypercoagulation or bleeding diathesis, innate and acquired disorders
DIC – causes, pathogenesis and consequences
Hematologic testing - complete blood count, morfologic classification of anemia, percentages of the types of WBCs, erythrocyte sedimentation rate, tests of hemostasis (Quick, aPTT)
CIRCULATION
Pathophysiology of arteries – narrowing and obstruction, aneurysms, atherosclerosis (pathogenesis, symptoms)
Pathophysiology of cappilaries and veins – edemas, specific features of venous flow, thrombosis (deep venous thrombosis, thrombophlebitis), chronic venous insufficiency, varixes, embolism
Primary arterial hypertension – mechanisms of BP regulation, BP values, decreased compliance of large arteries, causes (CO, kidneys, sympaticus, endothelium), consequences, principals of therapy
Secondary hypertension – renal (parenchyma, renovascular), endocrine (types), hypertension during pregnancy
Hypovolemic shocks, compensatory mechanisms – types, stages of shocks, compensatory mechanisms and circulation failure causes, organ consequences, principles of therapy
Distributive shocks – septic, anaphylactic, neurogenic, causes of vasodilation (NO), principles of therapy
Acute heart failure – factor influencing CO, left/right side failure, causes, cardiogenic shock, central venous pressure, symptoms, diagnostics (EF, CVP), principles of therapy
Chronic heart failure – classification of heart failure, causes, compensatory mechanisms (Frank-Starling´s law), molecular mechanisms, principles of therapy
Disorders of coronary circulation, clinical forms of ischemic heart disease – determinants of myocardial oxygen supply, coronary bed flow, causes, acute coronary syndrome and chronic forms of IHD
Acute myocardial infarction – causes, consequences of coronary flow arrest, symptoms, principles of diagnostics (ECG, laboratory findings) and therapy, life threatening complications of MI
Hemodynamics of valvular defects – causes of valvular defects, volume and pressure overload, consequences (heart failure, pulmonary hypertension)
Hemodynamics of congenital heart defects – without shunt (coarctation), with shunt (septal defects, PDA, Fallot´s tetralogy), factors influencing hemodynamics
Disturbances of impulse conduction in the heart and cardias arrhythmias, including ECG findings – causes (disturbances of AP conduction - blocks, ectopic AP generation, reentry), consequences, principles of therapy
Testing of cardiovascular system – BP, ECG, echocardiography, Holter monitoring, myocardial perfussion scintigraphy, ergometry (ischemia, anaerobic treshold)
Characteristics of pathological ECG recordings - myocardial hypertrophy, ischemic changes, ions imbalance - K+ and Ca2+
KIDNEY
Disturbances of renal blood flow – causes of decreased and increased renal blood flow, consequences, autoregulation and its changes
Disorders of glomerular filtration – quantitative and qualitative
Disorders of tubular transport – innate and acquired, symptoms and consequences(ability to concentrate, ions imbalace, AB balance)
Nephrotic and nephritic syndrome – patogenetic mechanisms and symptoms, consequences, principles of therapy
Acute renal failure – causes (prerenal, renal, postrenal), phases (oliguric, polyuric), consequences (disturbances of ECF, ions, AB balance, uremia)
Chronic renal failure - causes, consequences, compensatory mechanisms, chronic cardiorenal and renocardial syndrome, hepatorenal syndrome
Disorders of urinary tract – incontinence, urine retention, vesikoureteral reflux, urolithiasis
Dialysis: principles and effect – hemodialysis and peritoneal dialysis, principles, indications, advantages and disadvantages
Testing of renal function – urinalysis (casts, protein, hematuriy, glucose), GFR and eGFR, fractional excretion, ability to concentrate, urodynamic tests
RESPIRATION
Changed compliance of lung and respiratory system - causes, consequences – components of lung compliance (elasticity, surface tension), static and dynamic measurement, work of breathing, atelectasis
Changed airway resistance – factors affected airway resistance, extrathoracic and intrathoracic (air trapping, equal pressure point), consequencesof increased airway resistance (work of breathing, V/Q)
Pneumothorax – causes, classification, consequences (tension type), mechanism of reabsorption, therapy
Defense lung reflexes – sneezing, protective apnoea, cough (causes, complications)
Control of breathing in respiratory diseases - ventilatory response to hypoxia and hypercapnia – central and peripheral receptors, izoventilatory response, changed respiratory regulation in chronic hypercapnia, pathologic respiratory patterns (Cheyne-Stokes´, Biot´s, Kussmaul´s)
Disturbances of alveolar ventilation, respiratory insufficiency – hypo- and hyperventilation, causes, consequences - respiratory insufficiency (partial/global, latentn/manifest), AB dysbalance, tetany, dyspnea
Hypobaria, hyperbaria – adaptation to life in high mountains, high altitude sickness, pulmonary and brain edema, chronic high altitude sickness, nitrogen narcosis, decompression sickness
Artificial ventilation, oxygenotherapy – volume or pressure controled, assist-control mode, PEEP, high frequency oscillatory ventilation, ways of oxygen administration, hyperbaric, side effects
Inequalities of ventilation-perfusion ratio – physiologic non-uniformity, hypoxic pulmonary vasoconstriction, causes of unequal ventilation and perfusion, consequences (venous adózní příměs, alveolární mrtvý prostor)
Diffusion impairment, lung edema – diffusion path prolongation, decrease of diffusion area, transfer factor, interstitial and alveolar lung edema, its causes and consequences
Pulmonary embolism – causes, consequences according degree of embolism (acute, chronic), diagnostics, principles of therapy
Pulmonary hypertension – causes of increased pulmonary resistance, types (precapilar, postcapilar, hyperkinetic), impact on vascular morphology, principles of therapy
Bronchial asthma – changed mechanics of breathing, paroxysmal obstruction (air trapping, equal pressure point), causes (bronchial hyperreactivity), eosinophilic inflammation, consequences (hypoxemia, cor pulmonale, status astmaticus), principles of therapy
Obstructive pulmonary diseases, especially COPD – changed mechanics of breathing, pathogenesis of emphysema and bronchitis, clinical forms (pink puffers, blue bloaters), principles of therapy
Restrictive pulmonary diseases – pulmonary fibrosis, pneumonia, RDS, ARDS – causes nad consequences of restriction (mechancs of breathing, pulmonary hypertension), patophysiology of ARDS a RDS
Lung function tests - spirometry, bronchoconstriction and bronchodilation tests, blood gases, transfer factor, expired nitric oxide
ENDOCRINOLOGY
Disturbances of hormonal regulations – hypothalamic-pituitary axis (primary, secondary and tertiary disorders), feedback loop, causes of hypo- and hyperfunction
Disorders of adenohypophysis – regulatory hormones, growth hormone, prolactin, panhypopituitarism
Cushing’s syndrome – causes (ACTH dependent, independent, iatrogenic), consequences of increased glucocorticoid levels (obesity, muscle atrophy, diabetes, hypertension, immunosuppression, striae, osteoporosis, CNS)
Addison’s disease, disorders of mineralocorticoids – causes and consequences of increased mineralocorticoid levels, hypocorticalism, Addisonian crisis
Disorders of adrenal medulla, stress – causes and consequences of increased catecho