GENERAL PATHOLOGY SYLLABUS: 3rd. Sem.

2011-02 CONTENT: - Introduction - Professor - Program, learning objectives & references - Lectures (power point) - Evaluation I.- Introduction: The Pathology course is one of the most important subjects in medicine and is composed of two major sections: General & Systemic pathology. The first is oriented towards the study of the basis of disease (formerly anatomical, currently genetic, immunologic, molecular, etc.). The second is related to the study of the most important diseases by organs and systems. II.- Professor: This section (general pathology) is on charge of R. Hugo Martinez Lozano, M.D. and pathologist. III.- General pathology program, learning objectives and references: Room: Auditorium & 112. Time: See details below. #: 1 TOPICS & REFERENCES: Welcome Introduction to pathology Cellular responses to stress & noxious stimuli Cellular adaptations of growth & differentiation Cell injury & death. Part I - Introduction - Causes - Morphologic alterations - Mechanisms of cell injury & necrotic cell death Ref: pp. 4-23 & lectures information Cell injury & death. Part II - Clinical-Pathologic correlations - Apoptosis - Intracellular accumulations Ref: pp. 23-38 & lectures information Inflammation I (Acute & chronic) General features Historical highlights Acute inflammation - Stimuli - Reaction of blood vessels - Reaction of leukocytes End of acute inflammation Ref: pp. 44-56 & lectures information DATE : July 18, 8-10 hs.

July 19, 9 & 13 hs.

July 19, 14 hs. & July 20, 9 hs.

Inflammation II Mediators - General features - Cell-derived & plasma protein-derived Outcomes of acute inflammation Ref: pp. 56-68 & lectures information Inflammation III (Chronic inflammation) - Causes - Morphology (cells) - Granulomatous Systemic effects of inflammation Consequences of defective or excessive inflammation ... & some aspects of tissue repair Ref: pp. 70-75, 79-87, 92-94, 106-108 & lectures information Hemodynamic disorders I General features Edema Hyperemia & congestion Hemorrhage Ref: pp. 111-114 & lectures information Hemodynamic disorders II Thrombosis D.I.C. Embolism Infarction Shock Ref: pp. 121-133 & lectures information Genetic disorders I General features Mutation Mendelian disorders - Transmission patterns - Biochemical & molecular basis - Disorders asociated with defects in: - Structural proteins - Receptor proteins Ref: pp. 136-149 & lectures information Genetic disorders II Disorders associated with defects in - Enzymes - Regulators of cell growth Multifactorial disorders Ref: pp. 149-158 & lectures information

July 20, 13-15 hs.

July 21, 9 & 13 hs.

July 22, 8 & 13 hs.

July 25, 8 & 13 hs.

July 26, 8-10 hs.

July 27, 9 & 13 hs.

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Genetic disorders III Cytogenetic disorders - Types of ch. Rearrangements - Disorders involving: - Autosomes - Sex chromosomes - Single disorders with nonclassic inheritance - Triplet-repeat mutations - Mitochondrial genes mutations - Genomic imprints Ref: pp. 161-173 & lectures information Disorders of immunity I General features of the immune system - Innate & adaptive - Cells & tissues - Mechanisms (HLA) Disorders of the immune system: - Hypersensitivity reactions: I, II, III, IV. Ref: pp- 184-208 & lectures information Disorders of immunity II Autoimmune diseases - Immune tolerance - Mechanisms of autoimmunity - SLE - RA - SS - Scleroderma Ref: pp. 208-226 & lectures information Disorders of immunity III Immunologic deficiency syndromes - Primary - Secondary - AIDS Ref: pp. 231-249 & lectures information

July 28, 8 & 13 hs.

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July 29, 8 & 13 hs.

12

Aug 01, 8 & 13 hs.

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Aug 02, 8 & 13 hs.

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Neoplasia I Aug 03, 8 & 13 hs. General features Definitions, nomenclature Biology of tumor growth (characteristics of benign & malignant nature) Epidemiology Predisposition to cancer Ref: pp. 260-276 & lectures information Neoplasia II Aug 03, 14 hs. & Aug 04, 8 hs. Molecular basis of cancer - Normal cell cycle - 7 fundamental changes that determine malignant phenotype & discussion of the first 4 of them. Ref: pp. 276-296 & lectures information

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First workshop First partial exam of pathology (topics 1-15)

Aug 4, 13-15 hs & Aug 5, 8 & 13 hs Aug 8, 8-10 hs. Aug 8, 13-15 hs.

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Neoplasia III Angiogenesis, Invasion & metastasis & Defects in DNA repair Molecular basis of multi-step carcinogenesis Carcinogenic agents & their mechanisms - Chemical - Radiation - Microbial Ref: pp. 297-316 & lecutures information Neoplasia IV - Neoplasias & the immune system - Clinico-pathologic consequences: Tumoral effects - Local & hormonal - Cachexia - Paraneoplastic syndromes - Grading & staging - Diagnosis of cancer - Cytology - Conventional histopathology: - Biopsy - Surgical specimens - Special techniques: - Immunohistochemistry - Flow cytometry - Tumor markers Ref: pp. 316-327 & lectures information Infectious diseases I General features History Categories of infectious agents Special techniques for dx. Trasmission & dissemination of microbes Mechanisms of injury: - Viral - Bacterial - Effects of host immunity Immune evasion Infection in immunosuppressed hosts Patterns of response to infection Ref: pp. 332-336, 338-348 & lectures information

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Aug 9 & 10, 8-9 hs.

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Aug 11 & 12, 8-9 hs.

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Infectious diseases II - Viral infections: Transient, latent, productive & transforming Bacterial infections - Gram (+) - Gram (-) Mycobacteria - TB - Atypical - Leprosy Ref: pp. 348-373 & lectures information Infectious diseases III Spirochetes - Syphilis - Lyme dis. Anaerobic bacteria - Clostridia Obligate intracellular bacteria - Chlamydia - Rickettsia Fungal infections - Yeasts - Molds Parasitic infections - Protozoa - Metazoa (Infestations) Ref: pp. 374-395 & lectures information

Aug 15, 8 & 13 hs.

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Aug 15, 14 hs. & Aug 16, 8 hs

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Infectious diseases IV Aug 17, 8-10 hs. Emerging & re-emerging infectious diseases - General features - Old diseases - New diseases - Infections with increased frecuency - Re-emerging diseases - Major concerns - Some notes on bioterrorism Ref: pp. 336-337, review of the chapter & a lot of lectures information Selected topics on environmental pathology Aug 18 & 19, 9-10 hs. The global burden of disease + climate change Toxicity of chemical & physical agents Metals & environmental pollutants Addictions: - Tobbacco - Alcohol - Sedative-hypnotics - Stimulants - Opioids UV radiation Ref: pp. 400-408, 410-414, 417-419, & lectures information

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Pathology of nutrition Dietary insufficiency - Protein-energy malnutrition - Anorexia nervosa & bulimia - Vitamin def. - ADEK - Thiamine - Riboflavine - Niacin - Vit C - Folate - Mineral def. - Zinc - Selenium - Some notes on diet, cancer & atherosclerosis Ref: pp. 427-438, 443-444 & lectures information Diseases of the Infancy & childhood I General features Congenital anomalies Birth wight & gestational age Birth injuries Perinatal infections Neonatal RDS Necrotizing enterocolitis GM-intraventricular hemorrhage Fetal hydrops Ref: pp. 447-462 & lectures information

Aug 22 & 23, 9-10 hs.

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Aug 24, 8 & 13 hs.

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Diseases of Infancy & childhood II Aug 24, 14 hs. & Aug 25, 8 hs Some inborn errors of metabolism & genetic disorders - PKU - Galactosemia - CF SIDS Benign neoplasias - Hemangiomas, lymphangiomas. - Teratomas. Malignant neoplasias - Incidence & types - The neuroblastic tumors - Wilms tumor Ref: pp. 462-481 & lectures information Second Workshop Second partial exam of pathology (topics 18-29) Aug 25 & 26, 13-15 hs. Aug 29, 8-10 hs.

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RECOMMENDED TEXTBOOK: Dr. Damjanov says The book is the course... and we agree with him. Our main textbook is: 1. Robbins & Cotrans PATHOLOGIC BASIS OF DISEASE, 8th edition, 2010 As an alternative reference you have: 2. Rubins PATHOLOGY, Clinicopathologic foundations of medicine 5th edition, 2008. Review books are exactly that... something to review (for instance, few weeks before the USMLE) AND DO NOT REPLACE THE TEXTBOOKS. 3. We also recommend, in order to review morphological images, an atlas such as: Milikowski & Bermans COLOR ATLAS OF BASIC HISTOPATHOLOGY, 1st. ed., 1997. 4. The systemic pathology chapters of our textbooks, and Cecils Medicine, 23rd. Ed. IMPORTANT: IN EVERY TOPIC, PAY SPECIAL ATTENTION TO THE MEDICAL (CLINICAL) SIGNIFICANCE, WITH PARTICULAR EMPHASIS ON THE DISEASES (CLINICOPATHOLOGIC CASES) DISCUSSED IN EACH LECTURE. IV).- Lectures: I will give, on the first day of the general pathology section, this syllabus & my power points to the president of the group. V).- Evaluation: The general pathology section will be evaluated in the first and second partial exams of the patology course (see above). In this section you will not see recycled exams. Every exam will evaluate the correspondant course. Old exams as well as question books may be means for exercise but they are not references nor good sources of knowledge. You will not see those particular questions in the USMLE nor in my exams. Every hour you spend reading old exams is a waste of precious time and puts yourselves in great disadvantage both in your medical preparation, as well as in your future performance in the steps. I recommend you the following: 1.- Study to become good physicians 2.- Study to understand (you will need deep understanding to pass the USMLE) 3.- Study on a daily basis (you should have begun to prepare your step 1 since the 1st semester.) If you do so, as a consequence, you will also pass your courses. We all share the same interest... the study of medicine, thus, I am sure that we will learn together and we will enjoy very much this experience.

R. Hugo Martnez Lozano, M.D.