Download Pathology

Forensics
Pathology is the study and diagnosis of disease through
examination of organs, tissues, bodily fluids and whole bodies.
What is a Pathologist?
Types of death
Determining the cause of death
Autopsy.
What is a Pathologist?
The following information is adapted from www.rcpath.org (The Royal College
of Pathologists)
Discovering disease
Pathologists study the causes of disease and the ways in which
disease processes affect our bodies, or those of the animals and
plants on which we all depend. Recognising the patterns that
disease takes allows us to understand what’s at the root of a
problem, enabling accurate diagnosis. And following up this
understanding of what has gone wrong helps us devise treatments
and put preventative measures in place.
At the core of all medicine
The science of pathology permeates all branches of medicine. The
doctors who you meet in a surgery or clinic all depend on the
knowledge, diagnostic skills and advice of some of the 4000
pathologists working in the UK. Whether it’s your GP arranging a
pregnancy test or your surgeon wanting to know the nature of the
lump removed at operation, the definitive answer is usually
provided by a pathologist.
Pathology is a relatively young science. Although the foundations
were laid in the 19th century, it was only in the 1930s that it began
to develop as a clinical discipline in its own right.
The first pathologists dealt with all areas of the subject, but rapid
advances quickly meant that pathologists too became specialists.
At the forefront of research
The achievements of modern pathology are impressive. Here are
just a few:
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developing vaccines against major infectious diseases such as
smallpox, diphtheria, polio, influenza and meningitis; enabling
safe blood transfusions - vital for the success of complicated
modern operations;
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managing the immune system for successful organ
transplants;
monitoring drug treatment;
establishing a tissue diagnosis and a prognosis in tumours and
inflammatory diseases;
pinpointing the genetic causes of disease. Every day, these
activities, along with countless more routine tests and
investigations, underpin doctors’ ability to deal with illness.
The fact that much pathology is done behind the scenes may
account for the fact that many people are almost unaware of its
vital, ongoing contributions to modern medicine. Without the
detective work of pathologists investigating disease there could be
no firm answers, and improving or even maintaining the quality of
medical care would be impossible. The following pages highlight the
crucial work carried out in some of the main areas of modern
pathology.
Understanding living tissue
Histopathologists are doctors who
specialise in studying the changes caused
by disease in human tissues.
Using sophisticated microscopes and a trained eye, they examine
tissues and cells removed from patients in the clinic or at operation.
By examining tissue sections which have been stained to reveal the
microscopic structure, a histopathologist decides whether disease is
present and, if so, what effect the disease will have on the patient.
Many different stains are used to identify different tissue
components and additional investigations involving electron
microscopy or molecular biology are often helpful in selected cases.
Although some histopathologists specialise, like surgeons, in
diseases of a particular part of the body, they all need a broadbased understanding of the clinical and pathological aspects of
disease. Histopathologists are also the doctors who carry out
autopsy examinations to establish the cause of death. Some of
them specialise in forensic pathology, dealing with suspicious or
criminal deaths.
Forensics
Haematology
Early scientists were amazed when they looked at blood under the
microscope and found that it contained cells as well as fluid. There
are red cells for carrying oxygen, several types of white cells for
fighting infection, and platelets for helping blood to clot.
Haematologists are experts in blood cells, including those already in
the blood and those being made in the cell factories of the bone
marrow.
Many diseases involve blood cells. They
include anaemias (where there are not
enough red cells), leukaemias (where there
are too many white cells), haemophilia
(where the blood does not clot properly)
and bone marrow diseases (where the cell
factories go wrong).
Haematologists also supervise blood transfusion, which provides
replacement blood for patients who have lost or cannot make their
own. Haematologists have both clinical and laboratory
responsibilities, so in this specialty the doctor who looks after you in
the clinic or on the ward will be the same person who has examined
your blood or bone marrow under the microscope.
Microbiology
The role of pathologists who specialise in microbiology is to
examine, diagnose, treat and prevent the spread of infection. This
applies equally to infections in the hospital and in the community.
So if there's an outbreak of food poisoning, meningitis or a nasty
type of flu in your area, you can be sure that it is being investigated
by a microbiology laboratory.
Many organisms can cause infections, including bacteria, viruses
and fungi. The Microbiologist uses the laboratory to identify
invading organisms and test different medicines to find the most
effective treatment. Advising on the appropriate use of antibiotics is
particularly important at a time when many bacteria are developing
resistance to their effects.
By studying how a patient became infected, microbiologists also
take action to prevent the spread of infection. So you will often see
a microbiologist on ward rounds or in the clinic, helping to stop
infections before they can spread to other people.
Forensics
Immunology
Immunology developed a firm clinical base
following the second world war, when skin
grafts given to injured soldiers failed to
take properly.
Immunologists discovered that the immune
system was treating the transplanted skin
as an enemy and attacking it. Study of the
immune system enabled them to interfere
with the process, so that skin and other
organ transplants now have a much better
chance of success. Immunology remains an area of rapid scientific
progress to this day, with many of its practitioners being actively
involved in research and teaching.
Modern immunologists deal with a wide range of clinical problems,
including common allergies, genetic and acquired immune
deficiencies, and autoimmune disease, where the immune system
goes wrong and starts damaging normal body tissues. They carry
out specialised laboratory tests, advise other doctors on
immunological complexities and also run their own clinics for
patients where the main disease is in the immune system.
Chemical Pathology
Many illnesses are the direct result of a disturbance in the body's
chemistry. The job of the chemical pathologist is to read the state of
your body chemistry. Hospital doctors and GPs send samples of
blood, urine or other body fluids (such as saliva or spinal fluid) to
the chemical pathology laboratory where the concentrations of
various constituents are measured. The results help the doctors to
make a diagnosis and decide on the best treatment. The chemical
pathologist manages the laboratory and is responsible for making
sure that the results are reliable. Doctors using the laboratory may
seek guidance from the chemical pathologist on selection of
appropriate tests and interpretation of results. For diseases where
the main problem is chemical in nature (for example, abnormalities
of blood fats, nutritional disorders and some diseases of bone), the
chemical pathologist may take direct clinical responsibility for
patients in out-patient clinics or on the wards.
Forensics
Determining cause of death is the most important task a
pathologist can perform during the course of an autopsy. In terms
of legality it is a necessity for law enforcement to be able to prove
beyond any doubt that the deceased has died of means other than
natural causes. The murder rate in parts of the world is so high that
it is a basic requirement for any individual who has died
unexpectedly to have an autopsy performed on them in order to
prove definitely the cause of death and rule out the chance of foul
play.
Factors to Consider
Determining the cause of death is done by taking a number of
factors into consideration.
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Deciding on a Cause
Medical records, psychiatric reports and statements from the next of
kin are all required when death occurs without any warning. This is
so that a detailed picture of the individual's life can be built up along
the way. This is useful if - for example - the deceased suffered from
high levels of stress and where heart failure might have been a
possibility.
The main way in which the cause of death can be determined is by
carrying out an autopsy; an autopsy offers definite proof as to the
cause of death and also can shed light on how the death occurred.
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Forensics
Heart - Cross section (diagram)
Kidney-Cross Section (diagram)
Forensics
Course Outline
Monday 22nd September
Monday 17th November
Introduction
Graphology
Chromatography
Questioned document analysis
The crime scene
Fingerprints
Forensic Photography
Forensic Reconstructions
Monday 29th September
Monday 24th November
Pathology 1
What is a Pathologist?
Types of death
Determining the cause of death
Autopsy.
Pathology 5
Exhuming a corpse
Skeletal remains
Facial reconstruction
Monday 1st December
Monday 6th October
The scientific method
Carrying out a scientific investigation
Taking measurements and readings
Recording your findings
Precision and Accuracy
Monday 13th October
Pathology 2
External examination
Identifying the victim
Scars Birthmarks and tattoos
Determining sex
Using eyes to determine age
Monday 20th October
The crime scene
Preserving the scene
Types of evidence
Polluting the scene
Recording and preserving evidence
Monday
Half Term
27th October 2008
Monday 3rd November
Pathology 3
Bodily fluids
Blood types
DNA fingerprinting
Monday 10th November
Pathology 4
Estimating time of death
Entemology
Stomach contents
Pathology 6
Injuries
Monday 8th December
Ballistics
Monday 15th December
Other types of Forensics
Forensic Psychology
Forensic Toxicology
Forensic Medicine
Forensic Dentistry
Forensic IT
Monday 22nd December
Monday 29th December
Christmas Break
Monday 5th January 2009
Portfolio
A chance to catch up on missed work
and finalise portfolios for OCN
accreditation
Monday 12th January
Mock crime scene
Monday 19th January
Presenting Evidence to a Jury