Download Modul 4.3 Almen patologi Almen patologi, Fadls forlag Cellular

Modul 4.3
Almen patologi
Basic Reading: Principles of Cancer biology, Kleinsmith LJ, Pearson International
Almen patologi, Fadls forlag
Cellular pathology
 Discuss the ways diseases can be classified, and distinguish between those which are
congenital or inherited and those which are acquired.
 Distinguish the aetiology, pathogenesis and manifestations of disease.
 Explain the terminology commonly used to describe disease – eg: common prefixes and
suffixes, the terms acute/chronic, primary/secondary, benign/malignant
 Give examples of how a disease condition causes changes in the appearance of cells and
tissues which can be investigated by a cell pathologist.
 Distinguish the terms hyperplasia and hypertrophy; and metaplasia and dysplasia.
Cell injury and death
 Explain the terms necrosis and apoptosis, and describe the range of cellular appearances
typical of each.
 Describe the typical processes of repair and regeneration following injury, and give of the
way these vary according to the tissue involved and other influences.
Haemodynamic disorders
 Explain the terms thrombosis, embolism and infarction.
 Describe the different pathological changes that can alter vascular flow.
 Explain the terms hypoxia, ischaemia and shock in describing the consequences of
haemodynamic disorders.
 Describe the main sites and stages of atheroma.
 Explain the term aneurysm and list the different types.
Biology of skin
 Draw a simple sketch of the structure of skin as a series of layers, and describe the process
of division and differentiation of cells in the epidermis.
 Explain where in the structure are the components responsible for the following functions:
barrier to physical insult; barrier to water movement; barrier to entry of infectious
microorganisms; temperature regulation; nervous sensations; vitamin D synthesis;
protection against UV radiation damage; immunological/inflammatory/wound repair
functions.
 Describe the morphological differences between thin and thick skin and list sites in the
human body where each is found.
 List the types of tissues and glands which are found in the dermis of the skin.
 Draw a cross-section diagram of a hair, including the follicle and sebaceous gland.
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Interpret and use the terminology used in describing common skin conditions
Outline the appearance and pathology of atopic eczema
Introduction to clinical dermatology
 List the information that should routinely be obtained when taking a dermatological
history.
 Understand and use the following terminology for describing skin pathology: urticaria,
angioedema, purpura, ecchymosis, erythema, macule, papule, nodule, naevus.
 Give common examples of the following types of skin disease: bacterial infection, viral
 infection, fungal infection, inflammatory rashes.
 Give examples of common systemic diseases that often have dermatological
manifestations.
 Describe the main tumours of skin, indicating which are benign, which malignant. For the
malignant tumours, indicate the relative degrees of invasiveness.
Biology of cancer
General pathology of cancer
 Explain what is meant by tumour, and the nomenclature used to describe tumours.
 Describe the features that allow distinction of tumours as benign or malignant
 Explain what is meant by tumour progression and define metastasis
 Describe the cellular changes associated with the development of malignancy
 Explain the terms type, grade and stage as used in the pathological description of tumours.
 Describe the range of ways in which tumours affect their hosts, including local invasion,
dissemination (via blood, lymph or trans-coelomic)
 Define the words metaplasia, dysplasia, neoplasia, malignancy, hamartoma, carcinoma,
sarcoma ,teratoma, lymphoma, leukaemia, carcinogen, metastasis.
 Outline the pathology of skin cancer
 Describe the processes and routes of distant spread of cancer
 Determine the risk factors for melanoma
 Outline the pathogenesis of cervical cancer
 Explain the terminology chronic versus acute, myeloid versus lymphoid, in relation to
leukaemias.
 Summarise in outline the approaches for analysing cancer changes at the chromosomal or
DNA level.
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Cell and molecular biology of cancer
 Describe the cell cycle and how it allows decision making about whether a cell divides,
differentiates or undergoes programmed cell death. The phases of the cell cycle being
composed of G1,S , G2 and M phases. Progression through the cell cycle is driven by cyclin
dependant kinases.
 Explain the importance of checkpoints in controlling the cell cycle. Growth factor signaling
pathways act on the restriction points by stimulating the phosphorylation of the Rb
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protein. Check point pathways monitor for DNA replication, chromosome to spindle
attachment and DNA damage. Describe the different factors that act at the control points.
Cell cycle control mechanisms are often defective in cancer: Explain why these are targets
for cancer causing mutations.
Give examples of the different rates of cell division found for cells in different tissues and
under different physiological and pathological conditions.
Explain in molecular terms the concepts of proto-oncogenes: cellular oncogenes arise from
proto-oncogenes,through mutations such as point mutations, gene amplification,
chromosome translocation, local DNA rearrangements, insertional mutagenesis. Examples
of oncogenes
Explain in molecular terms tumour suppressor genes:their roles in cell proliferation and
cell death, examples including Rb, p53, APC, PTEN, BRAC1……
The role of tumor repressor genes in DNA repair and genetic stability.
Give examples of the mutations in genes which can lead to cancer, and explain why many
of these genes are related to signal transduction pathways.
Outline in general terms the role of p53 in the detection of and response to DNA damage
as part of decision making during the cell cycle.
Carcinogenesis
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The main causes of human cancer, environmental and life style factors, tobacco smoke,
alcohol, carcinogenic food stuffs, diet, radiation and sunlight. The main chemical agents
that are known to cause cancer: examples such as aniline dyes, asbestos, pollution, and
chemical carcinogens . Chemical carcinogenesis is a multistep process based on DNA
mutations.
Mechanisms of chemical carcinogenesis: Describe the ways in which DNA can bedamaged
by exposure to radiation or chemicals.
Summarise the natural repair mechanisms for damaged DNA.
Distinguish somatic and germline mutations, and explain why germline mutations can
predispose an individual to cancer using as examples retinoblastoma, familial colon cancer.
Describe how somatic mutation and clonal expansion are involved in the development of
cancer.
Using colon cancer as an example, describe the way in which successive gene mutations
are thought to lead to clinical cancer.
Epidemiology of cancer
 Define incidence and mortality rates of the major adult tumours, as well as their spatial
distribution and temporal trends in DK.
 List the sites of the most common cancers occurring in children.
 Discuss the epidemiological evidence for cancer causation.
 Discuss the role of legal and lifestyle changes in reducing the incidence of, and mortality
from, cancer.
Treatment of cancer
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Describe the main chemotherapeutic and radiotherapeutic approaches to treating cancer.
The use of radiation therapy with examples; radiation therapy kills cells by triggering
apoptosis.
Chemotherapy in the form of drugs that circulate in the bloodstream. Antimetabolites that
disrupt DNA synthesis by substituting molecules involved in normal metabolic pathways.
Alkylating agents and platinating drugs that cross link DNA. Hormones and differentiating
agents, combination chemotherapy and stem cell transplants, strategies for improving the
effectiveness of chemotherapy.
Toxic side effects of chemotherapy: Explain why many cancer treatments cause side effects
such as nausea, hair loss, anaemia and immunosuppression, and indicate the approaches
which have been tried to minimise these.
Explain how cancers can evolve resistance to therapies using CML as an example
Discuss the prospects for new therapies based on the biology of cancer development.
The importance to patients of body image
 Explain the different ways of describing body image.
 Describe the relationship between body image and self-esteem.
 Describe how body image influences behaviour.
 Give examples of diseases and their symptoms, and treatments and their side effects,
which affect body image.
Making sense of the clinical record
 Describe the basic structure of the clinical record.
 Identify some of the differences in hospital and general practice records, and the reasons
for these.
 Identify the strengths and weaknesses of paper and electronic records.
 Recognise the contribution that different professional groups make to the record.
 Identify the strengths and weaknesses of the record as an audit, management and research
tool.
Cancer care policy
 Appreciate the nature of the cancer patient’s “journey
Ressourcemanagement, organisation og sundhedsøkonomi
 Gøre rede for omfang og organisation af palliativ behandling i Danmark
 Beskrive hvordan politiske beslutninger influerer på kræftbehandling.
 Value of screening programmes with reference to cervical screeing done in DK
 Explain the use of cancer networks, which extend from primary care to specialist cancer
units, to plan for regional cancer services (including prevention, screening, diagnosis,
treatment, supportive care, palliative care.Describe the emphasis on multidisciplinary
teams which work together to improve the quality and speed of cancer diagnosis and
treatment