BI 240 - Pathophysiology

2. Explain the role of normal defense mechanisms, inflammation, and healing in response to injury or disease.

3. Explain various disease processes that result as an alteration of the normal immune response and describe factors that play a role in the development of disease.

4. Describe the principles of disease development, morphology (molecular and structural alterations), clinical features (clinical manifestations, diagnostic tests, and treatment) and apply these principles to various diseases.

5. Explain the role of genetics and environmental factors related to the development of various disorders.

6. Describe common types of neoplasia, including their etiology, pathogenesis, clinical features, and preventative measures.

7. Analyze arterial blood gas values to determine the presence of an acid-base disorder and explain physiologic compensation mechanisms.

8. Explain the etiology, pathogenesis, and clinical features of select disorders of the cardiovascular, hematological and lymphatic, pulmonary, gastrointestinal, urinary, neurological, endocrine, and musculoskeletal systems.

I. Cellular Responses to Stress and Toxic Insult

A. Introduction to pathophysiology

B. Homeostasis

C. Stress response

1. Role of the stress response in disease progression

2. Effects of stress

3. Complications of stress

D. Cellular adaptation

1. Hypertrophy

2. Hyperplasia

3. Atrophy

4. Metaplasia

E. Cellular injury and toxic insult

1. Mechanisms of injury/insult

2. Manifestations of injury/insult

F. Cell death

1. Necrosis

a. Coagulative necrosis

b. Liquefactive necrosis

c. Gangrenous necrosis

d. Caseous necrosis

e. Fat necrosis

2. Ischemic and hypoxic injury

3. Apoptosis

4. Intracellular accumulations

5. Pathologic calcification

II. Inflammation and Healing in Response to Injury or Disease

A. Acute inflammation

1. Development of the inflammatory response

2. Leukocytes

3. Reactions of the blood vessels

a. Vasospasm

b. Vascular permeability

4. Mediators of inflammation

5. Outcomes of acute inflammation

B. Chronic inflammation

1. Causes of chronic inflammation

2. Morphologic changes

3. Granulomatous inflammation

C. Systemic effects of inflammation

D. The healing process

1. Steps in the healing process

a. Cell proliferation

b. Angiogenesis

c. Collagen synthesis

d. Deposition

2. Scar tissue formation & fibrosis

3. Complications

III. Fluids, Electrolytes, Acids and Bases

A. Fluid alterations in disease processes

1. Etiology

2. Pathophysiology

3. Clinical manifestations

B. Electrolyte imbalances

1. Etiology

2. Pathophysiology

3. Clinical manifestations

C. Maintenance of homeostatic pH

1. Buffering mechanisms

2. Respiratory compensation

3. Renal (metabolic) compensation

D. Acid-base disorders

1. Etiology

2. Pathophysiology

3. Compensatory mechanisms

4. Clinical manifestations

5. Arterial blood gas values

IV. Hemodynamic Disorders, Thromboembolic Disease, and Shock

A. Edema

1. Categories of edema

2. Morphology

3. Clinical consequences

B. Hyperemia & Congestion

C. Hemorrhage

1. Causes

2. Morphologic patterns in tissue hemorrhage

D. Hemostasis & Thrombosis

1. Normal hemostasis

a. Role of the endothelium

b. Platelets

c. Coagulation cascade

2. Thrombosis

a. Endothelial injury

b. Alterations in blood flow

c. Hypercoagulability

E. Embolism

1. Pulmonary embolism

2. Systemic thromboembolism

3. Fat & marrow embolism

4. Air embolism

F. Infarction

1. Morphology

2. Factors that influence development of an infarct

G. Shock

1. Cardiogenic shock

2. Hypovolemic shock

3. Septic shock

a. Disseminated intravascular coagulation

4. Vasogenic shock

5. Anaphylactic shock

V. The Immune Response

A. The Immune Response

1. Roles of Leukocytes

2. Innate (natural) immunity

a. Epithelial barriers & chemical barriers

b. Inflammation

c. Phagocytic cells

d. Interferon

e. Complement system

3. Adaptive (acquired) immunity

a. Antibody-mediated (humoral) immunity

1. Primary immune response

2. Secondary immune response

b. Cell-mediated immunity

B. Etiology, pathogenesis, clinical manifestations, and treatment of:

1. Hypersensitivity reactions

a. Type I hypersensitivity reactions

b. Type II hypersensitivity reactions

c. Type III hypersensitivity reactions

d. Type IV hypersensitivity reactions

2. Autoimmune disorders

3. Immunodeficiencies

a. Primary immunodeficiencies

b. Secondary immunodeficiencies

VI. Neoplasia

A. Genetic mutation & disease processes

B. Characteristics of neoplasms

1. Benign neoplasms

2. Malignant neoplasms

3. Local invasion

4. Metastasis

C. Carcinogenesis

D. Epidemiology

1. Incidence

2. Geographic factors

3. Environmental factors

4. Age

5. Genetic predisposition

6. Nonhereditary predisposing conditions or factors

E. Clinical aspects

1. Clinical manifestations

2. Diagnostic tests

3. Current treatment options

4. Preventative measures

VII. Genetic Disorders

A. Disorders caused by autosomal dominant or recessive genes

1. Inheritance patterns

2. Disease manifestations

B. X-linked recessive genes and their prevalence in males

C. Common causes of developmental disorders

VIII. Infectious Disease

A. Pathogenic microbes

1. Modes of entry into the host

2. Dissemination in the host

B. Review of Host defenses

1. Leukocytes: Adherence, margination, diapedesis, and adherence

2. Innate (natural) immunity

3. Acquired immunity

C. Infectious disease

1. Transmission of disease

2. Pathogenesis

3. Stages of infectious disease

4. Localized vs. systemic effects

5. Diagnostic tests

6. Antimicrobial therapy

7. Vaccination

SYSTEMIC PATHOLOGY: DISEASES OF ORGAN SYSTEMS

IX. Cardiovascular Disorders

A. Etiology, pathogenesis, morphology, and clinical features of the following:

1. Vascular disorders

a. Hypertensive vascular disease

1. Types and causes of hypertension

2. Mechanisms of essential hypertension

3. Vascular pathology in hypertension

4. Risk factors

b. Atherosclerosis

1. Atheromas

2. Risk factors

c. Aneurysms

1. Aortic aneurysms

2. Berry aneurysms

d. Vasculitis

e. Thrombophlebitis

2. Cardiac disorders

a. Heart failure

1. Right-sided heart failure

2. Left-sided heart failure

b. Ischemic heart disease

1. Angina

2. Myocardial infarction

3. Valvular heart disease

4. Cardiomyopathies

X. Hematological & Lymphatic System Disorders

A. Etiology, pathogenesis, morphology, and clinical features of the following:

1. Erythrocyte disorders

a. Anemias

1. Iron-deficiency

2. Pernicious

3. Aplastic

4. Sickle cell

b. Thalassemia

c. Polycythemia

2. Platelet disorders

a. Thrombocytopenia

3. Leukocyte disorders

a. Leukocytosis

b. Leukopenia

4. Lymphatic system disorders

a. Acute vs. chronic leukemia

b. Hodgkin’s disease vs. non-Hodgkin’s lymphoma

c. Multiple myeloma

XI. Respiratory Disorders

A. Etiology, pathogenesis, morphology, and clinical features of the following:

1. Pulmonary edema

2. Obstructive pulmonary diseases

a. Asthma

b. Chronic bronchitis

c. Emphysema

3. Chronic diffuse interstitial (restrictive) pulmonary disease

a. Fibrosing

b. Smoking-related

4. Pulmonary infections

a. Pneumonias

b. Tuberculosis

XII. Gastrointestinal (GI) Disorders

A. Etiology, pathogenesis, morphology, and clinical features the following:

1. Gastrointestinal bleeds

a. Upper GI bleed

b. Lower GI bleed

2. Esophageal disorders

a. Obstruction

b. Achalasia

c. Barrett esophagus

3. Gastric disorders

a. Acute gastritis

b. Peptic ulcer disease

4. Intestinal disorders

a. Irritable bowel syndrome

b. Crohn’s disease

c. Ulcerative colitis

d. Diverticulitis

e. Ischemic bowel disease

5. Liver disorders

a. General features of hepatic disorders

1. Hepatic injury

2. Hepatic failure

3. Cirrhosis

b. Viral hepatitis

c. Chronic hepatitis

d. Drug-induced (toxin-induced) liver disease

6. Gallbladder disorders

a. Cholelithiasis

b. Cholecystitis

7. Pancreatic disorders

a. Acute pancreatitis

b. Chronic pancreatitis

XIII. Urinary Disorders

A. Clinical manifestations of renal disease

1. Acute renal disease

2. Chronic renal disease

3. Renal failure

B. Etiology, pathogenesis, morphology, and clinical features of the following:

1. Glomerular diseases

2. Tubular and interstitial diseases

a. Acute kidney injury

b. Tubulointerstitial nephritis

c. Pyelonephritis

3. Vascular disorders

a. Malignant hypertension

b. Nephrosclerosis

4. Polycystic kidney disease

5. Urolithiasis

6. Bladder disorders

a. Urinary tract infection

b. Urine retention

c. Urinary incontinence

7. Neoplasias

XIV. Neurologic Disorders

A. Pathogenesis, morphology, and clinical features of the following:

1. Acute disorders

a. Traumatic injuries

1. Concussion

2. Contusion

3. Coup-contracoup injuries

4. Skull fractures

5. Shaken baby syndrome

b. Epidural hematoma

c. Subdural hematoma

d. Hypoxia, ischemia and infarction

e. Spinal cord injury & spinal shock

2. Chronic neurologic disorders

a. Seizure disorders

b. Alzheimer’s disease

c. Parkinson’s disease

d. Amyotrophic lateral sclerosis

e. Multiple sclerosis

XV. Endocrine Disorders

A. Pathogenesis, morphology, and clinical features of the following:

1. Hypothalamic-pituitary disorders

a. Posterior pituitary disorders

b. Anterior pituitary disorders

c. Hypothalamic tumors

2. Thyroid gland disorders

a. Hyperthyroidism

b. Hypothyroidism

3. Parathyroid gland disorders

a. Hyperparathyroidism

b. Hypoparathyroidism

4. Adrenal gland disorders

a. Addison’s disease

b. Cushing’s disease vs. Cushing’s syndrome

c. Pheochromocytoma

5. Endocrine pancreas disorders

a. Diabetes mellitus type I

b. Diabetes mellitus type II

XVI. Musculoskeletal Disorders

A. Pathogenesis, morphology, and clinical features of the following:

1. Traumatic injuries

a. Sprains and strains

b. Dislocations

c. Fractures

2. Musculoskeletal disorders

a. Muscular dystrophy

b. Fibromyalgia

c. Osteoporosis

3. Joint disorders

a. Osteoarthritis

b. Rheumatoid arthritis

c. Infectious arthritis

d. Gout

e. Ankylosing spondylitis

Common Final Comprehensive Exam: 20%

Facilitated Discussion: 10-40%

Mediated Instruction: 0-20%

Group Work: 0-30%

Other: 0-10%

Bonus/extra credit shall not exceed 2% of the total possible points in the course

Unit and final exams in a lecture, online or laboratory course may not be administered in a take-home or online format but shall be administered in the classroom, in a supervised assessment facility (e.g., GRCC Assessment/Testing Center), or utilizing an exam monitoring program/resource that incorporates a lockdown browser and the use of a video monitoring system (e.g., Respondus Lockdown Browser with Monitor) that verifies student identification.