Pathology

Marks distribution of Assessment of Pathology:
Total marks – 300
• Written=100 (MCQ (SBA+MTF) 20+ (SAQ+SEQ) 70 + Formative Assessment Marks- 10)
• Structured Oral Examination= 100
• Practical and OSPE =100

 

Learning Objectives and Course Contents in Pathology Term I A- General Pathology, Hematolymphoid System (Term-1A)
Contents
Introduction to pathology:
Core:
• Introduction to different branches of pathology
• Definition of etiology, morphology, and pathogenesis

 

Cell injury:
Core:
• Cause of cell injury
• Reversible and irreversible injury: mechanism
• Mechanism of hypoxic injury
• Name of free radical , target of free radical and scavenging system (name of the anti-oxidant), definition of reperfusion injury
• Definition of necrosis and apoptosis, types of necrosis and morphologic feature with examples

 

Additional:
• Mechanism of free radical injury and reperfusion injury, apoptosis
• Consequences of mitochondrial dysfunction and loss of calcium homeostasis

 

Pigments and calcification Core:
• Pathological calcification- dystrophic and metastatic: definitions with examples.
• Different intracellular pigmentation particularly their name

 

Additional:
Mechanism of calcification

 

Acute Inflammation
Core:
• Causes and cardinal signs or features of acute inflammation;
• Vascular and cellular events Chemical mediators and their function
• Morphological patterns of acute inflammation
• Outcome of acute inflammation
• Local and systemic effect of acute inflammation

 

Additional:
• Recruitment of leukocytes
• Role of complement, coagulation and kinin system
• Mechanism of neutrophil recruitment
• Recognition of microbes and dead tissue
• Defects in leukocyte function
• How the chemical mediator works

 

Chronic inflammation:
Core:
• Cause
• Difference with acute inflammation
• Role of macrophage
• Examples of granulomatous lesion
• Type of granuloma
• Mechanism of granuloma
Additional- Giant cells

 

Repair and healing:
Core:
• Definition of healing, repair, and regeneration
• Steps of cutaneous wound healing,
• Factors influencing wound healing
• Complications of wound healing,
• Fracture healing
• Nerve regeneration

 

Additional:
• Stem cell
• Growth cycle
• Extracellular matrix

 

Edema and electrolyte disorder
Core:
• Pathophysiology of oedema
• Mechanism of oedema in cirrhosis, renal disease and heart failure
• Examination of body fluids such as pleural effusion, ascitic fluid
• Electrolyte disorder: causes of metabolic acidosis, metabolic alkalosis, respiratory acidosis & respiratory alkalosis

 

Hyperemia, congestion and hemorrhage and Shock
Core:
• Definition of hyperemia, congestion and hemorrhage
• Cause of passive Congestion in lung and liver
• Shock: type, pathogenesis of septic shock, stages

 

Additional:
• Morphology of passive congestion in lung and liver
• Mechanism of compensation in shock

 

Thrombosis and embolism:
Core:
• Mechanism of thrombosis
• fate of thrombus,
• Clinical consequence of venous thrombosis, arterial and cardiac thrombosis
• DIC

 

Embolism and infarction
Core:
• Definition of embolism
• Pulmonary embolism: source and consequence
• Systemic thromboembolism: source and consequence
• Air embolism, fat embolism, amniotic fluid embolism: source and consequence
• Infarct: definition, types, factors influencing the formation of infarct

 

Growth disturbance and adaptive change
Core:
• Adaptive change
• Definitions and examples of atrophy, metaplasia, hypertrophy, hyperplasia

 

Additional:
Mechanism of the adaptive changes

 

Neoplasia
Core:
• Definition and characteristics of neoplasia
• Nomenclature
• Features of benign and malignant tumor
• Spread of tumor
• Genetic predisposition of cancer
• Example of proto-oncogene, cancer suppressor gene
• Precancerous conditions

 

Additional:
• Molecular basis of cancer
• Multiple steps of carcinogenesis,

 

Carcinogenesis
Core:
• Chemical carcinogen: classification
• Tumor: initiation and promotion
• Microbiologlogical carcinogen: name and the cancer associated with them
• Name of the radiant energy and the cancer associated with them

 

Additional:
Mechanism of the carcinogenesis of the viruses and radiant energy particularly of HPV and EBV and H pylori

 

Tumor immunity and clinical aspects of neoplasia and laboratory diagnosis of tumor
Core:
• Tumor antigen
• Antitumor mechanism
• Immune surveillance
• Cancer cachexia
• Paraneoplastic syndrome
• Grading and staging of tumor: basis and their use
• Laboratory diagnosis: role of FNAC, cytological examination, pap smear, frozen section and immunohistochemistry

 

Additional:
• Mechanism of immune surveillance
• Paraneoplastic syndrome
• Molecular diagnosis of cancer

 

Genetics
Core:
• Basic definitions, mutation, type,
• Classification of genetic disease,
• Mendelian disorder: characteristics and examples,
• features of down syndrome, turner syndrome and Klinefelter syndrome and hermaphrodite
• Name of the tools for diagnosis of genetic disease karyotype, FISH, PCR.

 

Additional:
• Biochemical and molecular basis of single gene disorder, lysosomal storage disease
• Single gene disorder non-classical inheritance
• Indications of prenatal diagnosis

 

Immunopathology
Core:
• Name of immune deficiency diseases
• Autoimmune diseases: name of the organ specific auto immune diseases and the basic pathogenesis (name of the antibody)
• Name of the diagnostic tools

 

Infectious Disease
Core:
• Lesions produced by tuberculosis, leprosy and syphilis
• Name of the diagnostic tools

 

Nutritional disorders
Core:
• Bone changes in deficiency states
• Features of vitamin A, Vit B12 and folic acid deficiency

 

Additional:
• Iron metabolism
• Vitamin A and D metabolism
• Vitamin B12 and folic acid deficiency mechanism

 

Environmental diseases and hazards
Core:
• Diseases associated with smoking, arsenics, radiation hazard

 

Term-1B – General Pathology, Hematolymphoid System (Term-1B)
3. Lymphoreticular
Core:
• Causes of lymphadenopathy, Outline of classification of NHL
• Hodgkin and non-Hodgkin lymphomas: Classification, morphology

 

Additional:
• Immune diagnosis of Hodgkin lymphoma
• Burkitt lymphoma: morphology
• Follicular lymphoma: morphology
• Causes of splenomegaly

 

4. Hematopathology
Core:
• Hematopoiesis, different stages of RBC and WBC
• Causes of Leukocytosis, leucopenia, eosinophilia, monocities and thrombocytopenia
• Anemia: morphological and etiological classification
• Lab. diagnosis of nutritional anemia, iron deficiency anemia, megaloblastic anemia, pernicious anemia • Hemolytic anemia: classification
• Thalassemia and sickle cell anemia: lab diagnosis
• Aplastic anemia: etiology and lab diagnosis
• PNH, AIHA, Coombs test
• Classification of bleeding disorder
• ITP: causes and lab diagnosis
• Hemophilia: causes and lab. investigation
• Leukemia: classification and lab diagnosis
• CGL
• Multiple myeloma: lab. Diagnosis

 

Additional:
• Constituents of blood and bone marrow Polycythemia Blood Group and blood transfusion

 

Core:
• Blood transfusion: grouping and cross matching, transfusion reaction, blood transmissible disease, Rh incompatibility, Blood transfusion products

 

Term-2A – Systemic Pathology (Term-2A)
1. Blood vessels
Core:
• Name of different vasculitis, and vascular tumor,

 

Core:
• Define arteriosclerosis and atherosclerosis, aneurysm and dissection,
• Risk factors of atherosclerosis, site of involvement and complications
• Lipid profile

 

Additional: Pathogenesis of atherosclerosis

 

2. Heart
Must know
• Ischemic heart disease and myocardial infarction : pathogenesis, morphological features and biochemical indicators, complications
• Rheumatic fever: pathogenesis, morphology and complications
• Infective endocarditis: pathogenesis, morphology and complications
• Causes of myocarditis, pericarditis

 

Additional:
Names of congenital heart disease.

 

5. Respiratory System
Core:
• Cause of Pulmonary oedema
• Define: ARDS, obstructive pulmonary disease and pneumoconiosis
• Morphology of obstructive airway disease
• Pathogenesis and morphology of Pneumonia
• Lung abscess: pathogenesis and morphology
• Pulmonary tuberculosis: pathogenesis, morphology, fate
• Cause of pleural effusion
• Classification of lung tumor

 

Additional:
• Congenital anomalies
• Pathogenesis of obstructive airway disease, name of the granulomatous lesion of lung
• Defense mechanism of lung
• Definition of restrictive disease
• Morphology and clinical effect of lung tumor

 

6. GIT
Core:
• Leukoplakia, , name of the carcinoma of oral cavity
• Salivary gland tumor, morphology of pleomorphic adenoma
• Oesophagus:causes of oesophagitis, Barretts oesophagus
• Congenital anomalies of GIT – morphology of Hirschprung disease and hypertrophic pyloric stenosis
• PU: pathogenesis, morphology, complications
• Inflammatory bowel syndrome, difference between crohns and ulcerative colitis
• Tumors of stomach
• Gastric cancer: morphology and etiopathogenesis
• Acute appendicitis Morphology
• Ca colon: morphology and etiopathogenesis
• Name of the different polyp of GIT

 

Additional:
• Pathogenesis of IBD
• Diverticulosis
• Infarction
• Necrotizing enterocolitis
• Ulcerative lesion of GIT
7. Hepato biliary system

 

Core:
• Liver function tests & their interpretation
• Jaundice: types, differences
• Hepatitis: cause, morphology
• Cirrhosis: etiology, pathogenesis, morphology and complication
• Portal hypertension and hepatic failure: feature
• Liver abscess: morphological features
• Tumor of liver: types
• Cholecystitis and cholelithiasis: etiology, pathogenesis,

 

Additional:
• Neonatal jaundice
• Diseases of exocrine pancreas
• Hepatic Cysts

 

Term-2B – Systemic Pathology (Term-2B)
8. Renal system
Core:
• Classification of renal disease and their clinical manifestation
• Renal function test including examination of urine
• Immune basis of glomerulonephritis
• Classification of glomerulonephritis
• Acute post streptococcal glomerulonephritis: etiopathogenesis, morphology, complications
• Nephrotic syndrome: definition, causes
• Pyelonephritis: etiopathogenesis, morphology and complications
• Renal tumor: different types
• Renal cell carcinoma
• Urinary bladder tumor: different types

 

Additional:
• Congenital disease of kidney
• Polycystic kidney disease
• Urolithiasis: Types
• Morphology of renal cell carcinoma
• Morphology of different types of cystitis

 

9. Male genital system
Core:
• Prostate: causes of prostatitis
• A etiopathogenesis and morphology of nodular hyperplasia
• Role of PSA in prostatic carcinoma
• Testis
• Undescended testis: importance
• Inflammatory diseases of testis
• Testicular tumor: classification and clinical outcome
• Morphology of seminoma, yolk sac tumor and embryonal carcinoma
• Tumor markers for testicular tumors
• Semen analysis

 

10. Female genital system
Core:
• Causes of cervicitis, salpingitis
• Risk factors of cervical cancer
• Role of human papilloma virus –screening for cervical cancer
• Different histological types of cervical cancer
• Endometriosis: possible mechanism, sites and effect of endometriosis
• Common tumor of the corpus of uterus: morphology of leiomyoma,
• Endometrial hyperplasia: different types, their morphology and importance
• Classification of ovarian tumor and role of tumor marker
• Morphology of teratoma, dysgerminoma, choriocarcinoma and the different surface epithelial tumor, Kroonenberg tumor
• Hydatidiform mole and choriocarcinoma predisposing factors, morphology and diagnosis
• Pregnancy test

 

11. Breast
Core:
• Name of the different inflammatory diseases of breast, cause of lump of breast
• Fibrocystic disease: different types and their importance
• Classification of breast tumor
• Breast carcinoma: risk factors and the prognostic factors
• Screening of breast carcinoma

 

12. Endocrine system—thyroid and endocrine pancreas diabetes mellitus
Core:
• Causes of goiter, name of the different auto immune disease of thyroid
• Thyroiditis: types and morphology
• Different types of thyroid tumor, their morphology and prognosis
• Diabetes mellitus: different types, pathogenesis, and complications
• Estimation of blood sugar
• Glucose tolerance test and its interpretation
Additional: Mechanism of ketoacidosis

 

13. Skin
Core:
• Terms used in dermatology
• Cause of bullous lesions
• Name of premalignant and malignant lesions of skin
• Basal cell carcinoma, malignant melanoma and squamous cell carcinoma: morphology

 

14. CNS
Core:
• Indications of Examination of CSF and the findings in different types of meningitis
• Name of the CNS tumor

 

Additional:
• Changes in cerebral infarction
15. Bone, soft tissue, eye and ENT

 

Core:
• Soft tissue tumor: names
• Bone tumor: names and their histogenesis
• Osteomyelitis: a etiopathogenesis, morphology
• Name of the tumors of eye and nasal cavity

 

Additional:
• Morphology of retinoblastoma, giant cell tumor of bone, Ewings sarcoma,

 

Lecture on specimen and morphology based on different systems.