Pathology syllabus for MBBS(MCI)

2nd Year MBBS Student

The word ‘Pathology’ is derived from two Greek words—pathos meaning suffering, and logos meaning study. Pathology is, thus,scientific study of structure and function of the body in disease; or in other words, pathology consists of the abnormalities that occur in normal anatomy (including histology) and physiology owing to disease. Another commonly used term with reference to study of diseases is ‘pathophysiology’ comprised by two words:
patho=suffering; physiology=study of normal function. Pathophysiology, thus, includes study of disordered function or breakdown of homeostasis in diseases. Pathologists are the diagnosticians of disease. Therefore, knowledge and understanding of pathology is essential for all would-be doctors, general medical practitioners and specialists since unless they know the causes, mechanisms, nature and type of disease, and understand the language spoken by the pathologist in the form of laboratory reports, they would not be able to institute appropriate treatment or suggest preventive measures to the patient. For the student of any system of medicineMedicine Refers to the practices and procedures used for the prevention, treatment, or relief of symptoms of diseases or abnormal conditions. This term may also refer to a legal drug used for the same purpose., the discipline of pathology forms a vital bridge between initial learning phase of preclinical sciences and the final phase of clinical subjects. Remember the propheticProphet Προφητεύω (Prophesy) - He who tells in advance. A prophet may not be a Messenger from God. He may simply predict something may happen in the future. Hebrew prophets claimed to have the capacity to see the future or interpret the present situation for future circumstances. Narada in Indian Puranas was the Messenger from Devatas (Vishnu). Vyasa gave power to Sanjaya to see from a distance and not the future. Whether 'future' exists or not is the investigative subject of Physics. If the future is fixed from the past, why should people move (Karma) for anything? Elohim never created any future for Adam in Genesis (1.1) words of one of the eminent founders of modern medicine in late 19th and early 20th century, Sir William Osler, “Your practice of medicine will be as good as your understanding of pathology.”[ Harsh Mohan]

HEALTH AND DISEASE

Before there were humans on earth, there was disease, albeit in early animals. Since pathology is the study of disease, then what is disease? In simple language, disease is opposite of health i.e. what is not healthy is disease. Health may be defined as a condition when the individual is in complete accord with the surroundings, while disease is loss of ease (or comfort) to the body (i.e. dis-ease). However, it must be borne in mind that in health there is a wide range of ‘normality’ e.g. in height, weight, blood and tissue chemical composition etc. It also needs to be appreciated that at cellular level, the cells display wide range of activities within the broad area of health similar to what is seen in diseased cells. Thus, health and disease are not absolute but are considered as relative states. A term commonly confused with disease is illness. While disease suggests an entity with a cause, illness is the reaction of the individual to disease in the form of symptoms (complaints of the patient) and physical signs (elicited by the clinician). Though disease and illness are not separable, the study of diseases is done in pathology while the learning and management of illnesses is done in wards and clinics. In addition to disease and illness, there are syndromes (meaning running together) characterised by combination of symptoms caused by altered physiologic processes

Medical Council of IndiaIndia Bharat Varsha (Jambu Dvipa) is the name of this land mass. The people of this land are Sanatan Dharmin and they always defeated invaders. Indra (10000 yrs) was the oldest deified King of this land. Manu's jurisprudence enlitened this land. Vedas have been the civilizational literature of this land. Guiding principles of this land are : सत्यं वद । धर्मं चर । स्वाध्यायान्मा प्रमदः । Read more

COURSE CONTENTS

(A) General Pathology

Introduction to Pathology
CellCell The smallest unit that can live on its own and that makes up all living organisms and the tissues of the body. A cell has three main parts: the cell membrane, the nucleus, and the cytoplasm. The cell membrane surrounds the cell and controls the substances that go into and out of the cell. The nucleus is a structure inside the cell that contains the nucleolus and most of the cell’s DNA. It is also where most RNA is made. The cytoplasm is the fluid inside the cell. It contains other tiny cell parts that have specific functions, including the Golgi complex, the mitochondria, and the endoplasmic reticulum. The cytoplasm is where most chemical reactions take place and where most proteins are made. The human body has more than 30 trillion cells. Injury
a) Cell injury: Causes and Mechanism: Ischemic, Toxic.
b) Reversible cell injury : Types, morphology: Swelling, vacuolation, hyaline, fatty change.
c) Irreversible cell injury : Types of Ne
e) Auto-immune disorders like systemic lupus erythematosis; organ specific and non-organ specific
such as polyarteritis nodosa, Hashimoto’s disease.
f) Tumor Immunity
g) Organ transplantation : Immunologic basis of Rejection and Graft versus host reaction

3. Amyloidosis and Calcification

a) Calcification : Dystrophic and Metastatic
b) Amyloidosis : classification, Pathogenesis, Morphology

4. Inflammation and Repair

a) Acute inflammation : Features, causes, vascular and cellular events.
b) Morphologic variants of acute inflammation
c) Inflammatory cells and Mediators
d) Chronic inflammation : Causes, types, nonspecific and Granulomatous with examples
e) Wound healing by primary and secondary union, factors promoting and delaying the process
f) Healing at specific sites including bone healing

5. Circulatory Disturbances

a) Edema : Pathogenesis and types
b) Chronic venous congestion : Pathogenesis and changes in Lung, Liver, Spleen
c) Thrombosis and Embolism : Formation, Fate and Effects
d) Infarction : Types, common sites, Gangrene
e) Shock : Pathogenesis, Types, Morphologic changes
f) Derangements of Fluid and electrolyte imbalance

6. Growth Disturbances and Neoplasia

a) Atrophy, Hypertrophy, Hyperplasia, Hypoplasia, Metaplasia, Malformation, Agenesis, Dysplasia
b) Neoplasia : Classification, Histogenesis, Biologic Behaviour : Benign and Malignant; Carcinoma and Sarcoma
c) Malignant Neoplasia : Grades and Stages, Local and distant spread
d) Carcinogenesis : Environmental carcinogens, chemical, viral, occupational, Heredity and cellular oncogenes
e) Tumour and Host Interactions : Systemic effects including paraneoplastic syndromes, Tumor immunology
f) Laboratory diagnosis : Cytology, Biopsy, Tumor markers

7. Immunopathology

a) Immune systemImmune system A complex network of cells, tissues, organs, and the substances they make that helps the body fight infections and other diseases. The immune system includes white blood cells and organs and tissues of the lymph system, such as the thymus, spleen, tonsils, lymph nodes, lymph vessels, and bone marrow. : organisation, cells, antibodies and regulation of immune responses.
b) Hypersensitivity : types and examples, Antibody and cell mediated tissue injury with examples.
c) Primary immunodeficiency
d) Secondary Immunodeficiency including HIV Infection
e) Auto-immune disorders like systemic lupus erythematosis; organ specific and non-organ specific
such as polyarteritis nodosa, Hashimoto’s disease.
f) Tumor Immunity
g) Organ transplantation : Immunologic basis of Rejection and Graft versus host reaction

8. Infectious Diseases

a) Mycobacterial Diseases : Tuberculosis and Leprosy
b) Bacterial diseases : Pyogenic, Typhoid, Diphtheria, Gram negative infection, Bacillary dysentery, Syphilis
c) Viral : Polio, Herpes, Rabies, Measles; Rickettsial, Chlamydial infection
d) Fungal diseases and opportunistic infections
e) Parasitic Diseases : Malaria, Filaria, Amebiasis, Kala-azar, Cysticercosis, Hydatid
f) AIDS : Aetiology, modes of transmission, diagnostic procedures and handling of infected material and health education.

9. Miscellaneous Disorders

a) Autosomal and sex-linked disorders with examples
b) Metabolic disorders
c) Protein energy malnutrition and vitamin deficiency disorders
d) Radiation Injury
e) Disorders of Pigment and Mineral metabolism such as bilirubin, melanin, hemosiderin

(B) Systemic Pathology

1. Cardiovascular Pathology

a) Rheumatic fever and Rheumatic Heart Disease : Pathogenesis, Morphology and effects
b) Infective Endocarditis : Causes, Pathogenesis and Morphology
c) Atherosclerosis and Ischemic Heart Disease; Myocardial Infarction
d) Diseases of blood vessels other than atherosclerosis
e) Hypertension and Hypertensive Heart Disease
f) Congenital Heart Disease : ASD, VSD, Fallot’s Bicuspid aortic valve, PDA
g) Pericarditis and other pericardial diseases
h) Cardiomyopathy

2. Respiratory Pathology

a) Structure of Bronchial tree and alveolar walls, normal and altered lung function; concept of
obstructive and restrictive lung disorders
b) Inflammatory diseases of bronchi : chronic bronchitis, bronchial asthma, bronchiectasis, chronic
obstructive lung disease
c) Pneumonias : Lobar, Broncho, Interstitial
d) Pulmonary suppuration including lung abscess : Etiopathogenesis and Morphology
e) Pulmonary Tuberculosis : Primary and Secondary, Morphologic types including pleuritis
f) Emphysema : Types, pathogenesis
g) Atelectasis and Hyaline Membrane Disease
h) Tumors : Benign; Carcinoid, Malignant; Squamous cell, Oat cell, Adeno, etiopathogenesis.
i) Occupational lung disorders : anthracosis, silicosis, asbestosis, mesothelioma

3. Urinary Tract Pathology

a) Renal structure, basis of impaired function, urine analysis
b) Glomerulonephritis : Classification, Primary Proliferative and Non Proliferative
c) Secondary Glomerulonephritis : SLE, Purpura, Polyarteritis, Amyloidosis, Diabetes
d) Nephrotic Syndrome
e) Acute Renal Failure : Acute tubular and cortical necrosis
f) Progressive renal failure and end stage renal disease
g) Pyelonephritis, Reflux Nephropathy, Interstitial Nephritis
h) Renal tumors : Renal cell carcinoma, Nephroblastoma
i) Renal vascular disorders, kidney changes in Hypertension
j) Urinary bladder : cystitis, carcinoma
k) Urinary Tract Tuberculosis
l) Urolithiasis and Obstructive Uropathy
m) Renal Malformations : Polycystic kidneys

4. Pathology of the Gastro-Intestinal Tract

a) Oral Pathology : Leukoplakia; Carcinoma oral Cavity and Esophagus
b) Salivary gland tumors : Mixed, Ad
c) Nutritional anaemias : Iron deficiency anaemia, Folic AcidAcid A chemical that gives off hydrogen ions in water and forms salts by combining with certain metals. Acids have a sour taste and turn certain dyes red. Some acids made by the body, such as gastric acid, can help organs work the way they should. An example of an acid is hydrochloric acid. Acidity is measured on a scale called the pH scale. On this scale, a value of 7 is neutral, and a pH value of less than 7 to 0 shows increasing acidity./Vit B 12 deficiency anaemia including pernicious anaemia
d) Hemolytic Anaemias : Classification and invesgiation
e) Hereditary hemolytic anaemias : Thalassemia, sickle cell anaemia
f) Hereditary hemolytic anaemias : hereditary spherocytosis, G-6-PD deficiency
g) Acquired hemolytic anaemias

h) Hemolytic Anaemias : Autoimmune, Alloimmune, DrugDrug Any substance (other than food) that is used to prevent, diagnose, treat, or relieve symptoms of a disease or abnormal condition. Drugs can also affect how the brain and the rest of the bodywork and cause changes in mood, awareness, thoughts, feelings, or behavior. Some types of drugs, such as opioids, may be abused or lead to addiction. Apart from management Allopathic drugs never cure any disease. induced Microangiopathic and Malaria
i) Aplastic Anaemia, PNH and Myelodysplastic syndrome
j) Hemostatic disorders : Platelet deficiency; ITP, Drug induced, secondary
k) Coagulopathies : Coagulation factor deficiency; hemophilia, DIC and anticoagulant control
l) Leukocytic disorders : Leukocytosis, leukopenia, leukemoid reaction
m) Acute and chronic Leukemia : Classification, Diagnosis
n) Myeloproliferative disorders : Polycythemia, Myelofibrosis
o) Multiple myeloma and dysproteinemias
p) Blood transfusion : grouping and cross matching, untoward reactions, transmissible infections including HIV and hepatitis

6. Liver and Biliary Tract Pathology

a) Jaundice : Types, Pathogenesis and Differentiation
b) Hepatitis : Acute and Chronic, Etiology, Pathogenesis and Pathology
c) Cirrhosis: Etiology, Postnecrotic, Alcoholic, Metabolic, Pathology, Morphology (Macronodular, Micronodular, Mixed), complications
d) Portal Hypertension : Types including non-cirrhotic portal fibrosis and Manifestations
e) Tumors of Liver : hepatocellular and metastatic carcinoma, tumor markers
f) Concept of hepatocellular failure
g) Diseases of the gall bladder : Cholecystitis, Cholelithiasis, Carcinoma

7. Lymphoreticular System

a) Lymphadenitis : nonspecific, Granulomatous
b) Hodgkin’s and Non-Hodgkin’s Lymphomas : Classification, Morphology
c) Diseases of the spleen : Splenomegaly causes and effects
d) Thymus : Dysgenesis, Atrophy, Hyperplasia, Neoplasia
8. Reproductive System
a) Diseases of cervix : cervicitis, cervical carcinoma, etiology, types and cytologic diagnosis
b) Hormonal influences and histological appearances of different phases of menstrual cycle and the abnormalities associated with it
c) Diseases of uterus : endometritis, endometrial hyperplasia and carcinoma, adenomyosis, smooth muscle tumors
d) Trophoblastic disease : Hydatidiform mole, Choriocarcinoma
e) Diseases of the breast : Mastitis, abscess, Fibrocystic disease, Neoplastic lesions : Fibroadenoma, Carcinoma, Phyllodes tumor
f) Prostate : Nodular Hyperplasia and Carcinoma
g) Ovarian and testicular tumors
h) Carcinoma of penis
i) Pelvic inflammatory diseases including salpingitis
j) Genital Tuberculosis

9. Osteopathology

a) Bone – general considerations, reactions to injury and healing of fractures
b) Osteomyelitis : Acute, Chronic, Tuberculous, Mycetoma
c) Metabolic diseases : Rickets/Osteomalacia, Osteoporosis, Hyperparathyroidisism
d) Tumors : Primary, Osteosarcoma, Osteoclastoma, Ewing’s Sarcoma, Chondrosarcoma;
Metastatic
e) Arthritis : Rheumatoid, Osteo and tuberculous

10. Endocrine Pathology

a) Scope of endocrine control and investigations
b) Diabetes Mellitus : Types, Pathogenesis, pathology
c) Nonneoplastic lesions of thyroid : Iodine deficiency goiter, autoimmune thyroiditis, thyrotoxicosis, myxedema
d) Tumors of thyroid – adenoma, carcinoma : Papillary, Follicular, Medullary, Anaplastic
e) Adrenal diseases : Cortical hyperplasia, atrophy, tuberculosis, tumors of cortex and medulla
f) Parathyroid hyperplasia and tumors and Hyperparathyroidism
g) Pituitary tumors
h) Multiple endocrine neoplasia

11. Neuropathology

a) Structural Organization, specific cell types, and reaction patterns
b) Inflammatory disorders : Pyogenic and tuberculous meningitis, brain abscess, tuberculoma
c) CNS tumors – primary : glioma and meningioma (excluding histopathology) and metastatic
d) CSF and its disturbances : cerebral edema, raised intracranial pressure
e) Cerebrovascular diseases : Atherosclerosis, thrombosis, embolism, aneurysm, Hypoxia, Infarction
and Hemorrhage
f) Peripheral neuropathies and demyelnating disorders
g) Diseases of muscles
h) Traumatic lesions of CNS

b) Perform with accuracy and reliability basic haematological procedures such as haemoglobin estimation, total and differential WBC count and peripheral blood smear staining, examination and report.
c) Calculate the indices and interpret the relevant significance.
d) Perform the basic laboratory haematological tests like bleeding timeTime Where any expression of it occurs in any Rules, or any judgment, order or direction, and whenever the doing or not doing of anything at a certain time of the day or night or during a certain part of the day or night has an effect in law, that time is, unless it is otherwise specifically stated, held to be standard time as used in a particular country or state. (In Physics, time and Space never exist actually-“quantum entanglement”) and clotting time
e) Perform a complete examination of the urine and detect any abnormalities
f) Grouping and cross matching of blood
g) Collect and dispatch clinical samples from patients in a proper manner
h) Interpret abnormalAbnormal Not normal. Describes a state, condition, or behavior that is unusual or different from what is considered normal. biochemical laboratory values of common diseases.

TEACHING AND LEARNING METHODOLOGY

Department stresses on teaching basic fundamentals of the disease process and the applied aspects relevant to the clinical subjects.

General Pathology

Taught with the help of Didactic lectures on specific topics, followed by Practicals pertaining to that
topic. Besides microscopic examination, fresh specimens obtained at autopsy or surgical operations are shown.

Systemic Pathology

The following tools are employed:
i) Didactic lectures: discussing a particular topic at length in an one hour lecture
ii) Paraclinical seminars: are conducted by a combined team of pathologist and a clinician who discuss
the pathophysiology and clinical aspects of the particular disease entity.
iii) Case studies: The significant and common diseases are discussed in the form of a representative
clinical case in which the clinical features, the course of the disease in that particular patient and
relevant laboratory investigations are discussed by a clinical faculty in an interactive manner in small
groups. This is followed by demonstration of the gross and microscopic features of the disease in
that case by the pathologist. This is followed by clinico-pathologic correlation.

iv) Practicals
Deals with demonstration of gross, and/or microscopic features of the disease entities.

v) Clinical case demonstration

Patients of a particular disease are demonstrated to the students by a clinical faculty in the ward, discussing the clinical features in the patient which provides them a real-life experience of studying a disease as it presents in a patient.
By a combination of above modalities/tools, student learns applied aspects of the disease process.

TEXT-BOOKS RECOMMENDED

Robbin’s Pathologic Basis of Diseases
Text-Book of Pathology by Harsh Mohan
Roitt’s Essential Immunology
Walter and Israel’s General Pathology

Text-Book of Pathology by Harsh Mohan

Table of content

Chapter 1: Introduction to Pathology
Chapter 2: Cell Injury, Cellular Adaptations and Cellular Ageing
Chapter 3: Immunopathology Including Amyloidosis
Chapter 4: Derangements of Homeostasis and Haemodynamics
Chapter 5: Inflammation and Healing
Chapter 6: Infectious and Parasitic Diseases
Chapter 7: Neoplasia
Chapter 8: Environmental and Nutritional Diseases
Chapter 9: Genetic and Paediatric Diseases Section II: Haematology and Lymphoreticular Tissues
Chapter 10: Introduction to Haematopoietic System and Disorders of Erythroid Series
Chapter 11: Disorders of Platelets, Bleeding Disorders and Basic Transfusion Medicine
Chapter 12: Disorders of Leucocytes and Lymphoreticular Tissues Section III: Systemic Pathology Chapter 13: The Blood Vessels and Lymphatics
Chapter 14: The Heart
Chapter 15: The Respiratory System
Chapter 16: The Eye, ENT and Neck
Chapter 17: The Oral Cavity and Salivary Glands
Chapter 18: The Gastrointestinal Tract
Chapter 19: The Liver, Biliary Tract and Exocrine Pancreas
Chapter 20: The Kidney and Lower Urinary Tract
Chapter 21: The Male Reproductive System and Prostate
Chapter 22: The Female Genital Tract
Chapter 23: The Breast
Chapter 24: The Skin
Chapter 25: The Endocrine System
Chapter 26: The Musculoskeletal System
Chapter 27: Soft Tissue Tumours
Chapter 28: The Nervous System

Robbins and Cotran Pathologic Basis of Disease

Table of Contents

Chapter 1. The Cell as a Unit of Health and Disease
Chapter 2. Cell Injury, Cell Death, and Adaptations
Chapter 3. Inflammation and Repair
Chapter 4. Hemodynamic Disorders, Thromboembolism, and Shock
Chapter 5. Diseases of the Immune System
Chapter 6. Neoplasia
Chapter 7. Genetic and Pediatric Diseases
Chapter 8. Environmental and Nutritional Diseases
Chapter 9. General Pathology of Infectious Diseases
Chapter 10. Blood Vessels
Chapter 11. Heart
Chapter 12. Hematopoietic and Lymphoid Systems
Chapter 13. Lung
Chapter 14. Kidney and Its Collecting System
Chapter 15. Oral Cavities and Gastrointestinal Tract
Chapter 16. Liver and Gallbladder
Chapter 17. Pancreas
Chapter 18. Male Genital System and Lower Urinary Tract
Chapter 19. Female Genital System and Breast
Chapter 20. Endocrine System
Chapter 21. Bones, Joints, and Soft Tissue Tumors
Chapter 22. Peripheral Nerves and Muscles
Chapter 23. Central Nervous System
Chapter 24. Skin

Goljan Rapid Review Pathology 4th Edition

Table of Contents

Diagnostic testing
Cell injury
Inflammation and repair
Immunopathology
Water, electrolyte, acid-base, and hemodynamic disorders
Genetic and developmental disorders
Environmental pathology
Nutritional disorders
Neoplasia
Vascular disorders
Heart disorders
Red blood cell disorders
White blood cell disorders
Lymphoid tissue disorders
Hemostasis disorders
Immunohematology disorders
Upper and lower respiratory disorders
Gastrointestinal disorders
Hepatobiliary and pancreatic disorders
Kidney disorders
Lower urinary tract and male reproductive disorders
Female reproductive disorders and breast disorders
Endocrine disorders
Musculoskeletal and soft tissue disorders
Skin disorders
Nervous system and special sensory disorders.