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Lecture Notes Pathology Exam 1
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PATHOLOGY SUMMARYCLAIRE SNEL
GEZONDHEID EN LEVEN
VRIJE UNIVERSITEIT VAN AMSTERDAM
,Inhoudsopgave
HC 1 – Ch 2 cell injury, cell death and adaptations ........................................................................................... 2
HC 2 – Ch 3 inflammation and repair .............................................................................................................. 17
HC 3 – Ch 4 Hemodynamic Disorders, Thromboembolism, and Shock ............................................................ 27
HC 4 – Ch 5 Disease of the immune system .................................................................................................... 41
Immunopathology part 1: Immune-mediated tissue damage and – dysfunction (‘hypersensitivity’) .............. 41
1. Hypersensitivity type I: allergy ................................................................................................................ 45
2. Antibody mediated (type 2) hypersensitivity .......................................................................................... 47
3. Immune complex mediated (type 3) hypersensitivity ............................................................................. 49
4. (T-) cell mediated (type 4) hypersensitivity ............................................................................................. 51
Immunopathology part 2: Autoimmunity ........................................................................................................ 52
Immunopathology, part 3: Immunodeficiencies............................................................................................... 56
HC 5 – Ch 5 Transplant rejection and Ch 6 Tumor immunology ...................................................................... 60
1. Basic principles of the immune system ........................................................................................................ 60
2. The immune system and organ transplantations (chapter 5) ...................................................................... 62
3. The immune system and cancer (chapter 6: tumor immunology) ................................................................ 65
HC 6 – Ch 6 Neoplasia ..................................................................................................................................... 69
What is cancer: incidence and histopathological characteristics ..................................................................... 69
Cancer causing factors ..................................................................................................................................... 71
Cancer is a DNA disease ................................................................................................................................... 72
Oncogenes ........................................................................................................................................................ 73
Tumor suppressor genes................................................................................................................................... 76
Hallmarks of cancer .......................................................................................................................................... 80
1
,HC 1 – Ch 2 cell injury, cell death and adaptations
What is disease?
- Dysfunction of an organ or tissue because of damage to the cells
- The damage can be of many causes, chemical, thermal, radiation, DNA damage,
microbacterial
- The damaging agent (bacteria, viruses, genetics, radiation) is the etiology, the influence
on and the changes in cellular processes reflect the pathogenesis
Example 1:
– Radiation causes a nucleotide (C) to change into another nucleotide (G)
o Radiation = etiology
– Therefore, a different amino acid will be read which causes a different protein
o The different amino acid and protein = pathogenesis
– Sickle cell disease is caused by a change of one nucleotide which causes a
malfunctioning protein
Example 2:
- Cholera bacteria = not harmful (innocuous)
o Cholera bacteria = etiology
- Produce a toxin which causes diarrhea
- Liters per hour of fluid will be lost
o Toxin = causes pathogenesis of disease
2
, The roll of DNA in pathology
- DNA organized in chromosomes, complex structure that is strictly organized in small
units > when you need it these units can be opened (DNA > RNA > Protein)
- All your cells have all your DNA > not every part of your DNA is approachable and can be
read
- The reading of DNA is the largest part that can go wrong in
your cells
– Everything that is wrong in people, you can track it
back to something that goes wrong in cells
– Lots of cells working together = a community
Amoebe (dictyostelium discoideum) work together when they have little food around >>
multicellular by choice
Multicellular individuals: pros and cons
¤ Internal environment (milieu) is optimised, and thus also attractive for intruders
(indringers) – effective defence is required (immune system)→ INFECTIOUS DISEASES
¤ Organisation & clear division of tasks is mandatory, cell proliferation is needed
because during life you lose a lot of cells >> proliferation must be kept under close
control (you don’t want cells to proliferate when they don’t need to) → CANCER
Cell damage, stress & stressors
1. Disease is caused by damage to (part of) a cell or group of cells (etiology)
2. The initial damage can cause further damage (pathogenesis)
3. The cell/organ reacts to minimize impact of damage (adaptation)
4. Damage can be reversible, lead to adaptation or, ultimately to death of the cell
Adaptation (A) versus cell death (B)
– Heart cell/ muscle cell
– Workload increases for a heart – can increase by high blood pressure
o Heart has to pump against a higher resistance > workload of heart cells
increases
– To counteract (tegengaan) that: the cell can
increase in size: hypertrophy
o All cells will get bigger - organ gets bigger
– When and if the stress is permanent and too
much for the cell to bear > it will die > cell death
o Myocardinfarction: insufficient oxygen in
heartmuscles
3
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