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
The subject content consists of general and special pathophysiology, i.e. general principles of pathological phenomena, etiology and pathogenesis of disorders of particular organs and organ systems and particular diseases including explanation of relations between normal and pathological processes in various organ systems and on various levels of the organism. Practical skills related to basic medical approaches in the context of theoretical knowledge are also taught.
Knowledge of subjects which pathophysiology follows up on, i.e. anatomy, histology, embryology, biology chemistry and biochemistry, biophysics, physiology and microbiology, is an integral part of pathophysiology and are interrelated and used for explanation of principles of diseases and pathological processes.