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Lecture 11

HLSC 1F90 Lecture 11: Pathology

5 Pages
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Department
Health Sciences
Course Code
HLSC 1F90
Professor
Kelli-an Lawrance

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Week 11 November 24, 2016 Pathology  Apoptosis and staging of breast cancer video Pathology: The Study of Development and Disease:  Diagnostic toolkit o Clinical findings: examination and family history, supported by Lab findings o Radiological (imaging) results o Pathological findings: examination of tissue removed from the body  Science of disease diagnosis through examination of organs, tissues, cells and body fluids o Kidney picture: acute renal failure: intact glomeruli, tubular atrophy, interstitial lymphocytes  To know pathology, we need to know normal  Morphological databases are the place for normal  When kidney receives blood from the rest of the body, it dumps everything out into the urine  Autoimmune disease Case Study in Pathology:  16-year-old girl stung by a bee presents in ER  Initial complaint: localized pain, welling  After 15 minutes: shortness of breath, wheezing, weakness, dizziness  Vital signs in hospital: Respirations = 39 (should be 15-20); BP=69/45 (should be 120/80, therefore she’s hypotensive), tachycardia (fast heart rate)  Generalized urticarial  Conjunctival edema (edema around eyes)  Swollen lips  Affect: Drowsy, pale, responsive Clinical Management of Anaphylaxis:  Epinephrine  H1 antihistamines Pathways to Disease: 1. Etiology – what caused it? 2. Pathogenesis – birth of disease 3. Biochemical changes or Morphological changes 4. Functional changes 5. Natural history Example of Hepatitis C Disease: Etiology:  Cause = infection with Hep C virus (HCV)  Transmission = blood/body fluid exchange  HCV – as soon as liver transplant, it gets infected with HepC o Healthy liver, fatty, and cirrhosis (not functioning) Branches of Pathology: Week 11 November 24, 2016  Diagnostic pathology – study of deviation of cell and tissue morphology and biochemistry from normal  General pathology – study of any abnormality manifesting in altered structure and/or function of organs, tissues and/or cells  Anatomical pathology – analysis of surgical samples  Clinical pathology – analysis of body fluid and tissue samples Diagnostic of Pathology – Cell Tissue Morphology and Biochemistry  Diagnosis – identification of the disease  Grade – degree of deviation from normal  Stage – extent of disease Staging of Cancer:  Size of cancer = tumor size = T  Invasive vs, non-invasive nature of the cancer  Lymph node vs. no lymph node involvement = N  Whether or not the cancer has spread to other parts of the body beyond the primary site =metastases = M o Lymph node tries to hold the antigen, and it keeps growing in the lymph node Grading of Cancer – A measure of Deviation from Normal: Total Feature Score Tumor Grade Appearance of Cells 3-5 Grade 1 Tumor Well-differentiated (appear normal, growing slowly, not aggressive) 6-7 Grade 2 Tumor Moderately-differentiated (semi-normal, growing moderately fast) 8-9 Grade 3 Tumor Poorly-differentiated (abnormal, growing quickly, aggressive)  Differentiated cells are mature, functional components of a tissue. Benchmark of normal  De-differentiated cells are immature, non-functional, usually highly proliferating cells that do not support normal tissue function Histologic Grading of Colonic Neoplasia:  Colon cancer 95% treatable if caught early  Late – zippering, as cells proliferate (divide) out of control, architecture of colon is changed, and can no longer perform its function Ductal Carcinoma in situ:  Histological grade – the degree that tumor resembles normal Liver Function Tests:  Clinical pathology platform: begin by comparing normal LFT Components Hepatitis Pattern Cirrhosis Pattern GGT/(SGGT) Increased with alcohol Hepatitis Increased with alcohol Cirrhosis 9 to 48 U/L or biliary stasis or biliary Cirrhosis Week 11
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