BIOLOGY 2290 Pathophysiology I (Health Sciences III ) Sept 2010 Instructor : Dr. Paul S. Sunga, Rm A359a, , Introduction

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1 BIOLOGY 2290 Pathophysiology I (Health Sciences III ) Sept 2010 Instructor : Dr. Paul S. Sunga, Rm A359a, , psunga@langara.bc.ca Introduction This course is designed to provide students with insights into the processes of human disease. The prerequisites are Human Anatomy and Physiology I and II (Biology 1190 and 1191). Pathophysiology I is focused on the principles of pathophysiology beginning with the concepts of tolerance, stress and compensation. This is followed by cellular foundations of disease and therapeutics, including principles of pharmacology, neoplasia, inflammation and immunity and inherited conditions. The systems approach commences with diseases of the cardiovascular system and blood. (The remaining systems are covered in the sequel course, Biology 2291.) Infectious Diseases is also surveyed through assigned readings, tutorials and student led seminars. In total the course is six hours per week, four of which are devoted to lecture and two of which are tutorials and seminars. Objectives The overall objectives of the course are for students to be able to - analyze the principles underlying biological theories of disease, including laboratory, epidemiological and clinical observations - communicate the principle concepts that constitute the biological understanding of disease cause and manifestations - distinguish physiological adaptations and homeostatic processes from the alterations associated with disease processes - understand and participate in scientific approaches to understanding disease and therapy - acquire an attitude of inquiry concerning the scientific bases of disease and treatments - communicate the links between concepts of disease causation, prevention and treatment - identify most major human disorders and their causes - communicate the major principles of infectious disease principles, treatment and prevention Textbook Porth C., Matfin G., Pathophysiology: Concepts of the Altered Health States, 8 th Ed., 2008 Marking and Grading Scheme Test 1 20 Test 2 25 Test 3 25 Inf. Disease Tutorial/Seminar 30 [Seminar (15%) + Test 4 (15% )] 1

2 COURSE OUTLINE Biology 2290 Week Lecture Topics Lect Hrs 1.Sept 6-10 Lbr Day Sept 6 2.Sept Sept Sept 27- Oct 1 Introduction, Concepts and Definitions Basic concepts and definitions Intro to epidemiological concepts Understanding rational therapy Basic Principles of Drug Therapy: Intro Basic Principles of Drug Therapy: Pharmacokinetics and pharmacodynamics Cellular Pathophysiology : Basic cellular mechanisms Cellular Adaptation, Cell Injury and Cell Death TEST 1 5. Oct 4-8 Abnormalities of Growth and Differentiation Neoplasia 6. Oct Thnksgvng Oct Oct Neoplasia - con t d Genetic and Inherited Disorders 8. Oct Genetic and Inherited Disorders TEST 2 9. Nov 1-5 Systems of Defence: Inflammation and repair Immune response review 2 Seminar/tutorial 4 Intro to Infectious Diseases 4 Bacteria 4 Survey of bacterial infections 4 Survey of bacterial infections 2 Viruses Survey of viral diseases Abnormalities of the Immune Response 4 2

3 Week Lecture Topics Lect Hrs 10. Nov Nov Cardiovascular Abnormalities: The Heart 12. Nov Disorders of Systemic Circulation Blood Disorders 13. Nov 29 Dec 3 Review TEST 3 Seminar/tutorial 4 4 TEST 4 4 3

4 BIOLOGY 2290 General Pathophysiology Course Outline in Detail PART I INTRODUCTION Brief history of the study of health and disease. Scientific medicine in perspective Definitions in Pathology and epidemiology Pathology, pathophysiology, epidemiology, prevalence, incidence and more Stress, Tolerance and Disease Homeostasis and Adaptation Physiological Tolerance Understanding therapeutics The Era of Pharmaceuticals PART II PRINCIPLES OF PHARMACOLOGY Phases of Drug Action Pharmacokinetics Absorption Distribution Metabolism Excretion Pharmacodynamics Concentration - Response Relationship Cellular Signalling and Receptors Factors influencing Drug Responses PART III CELLULAR PATHOPHYSIOLOGY a) Cellular Physiology Cells Functions and Disease Processes ( Pathophysiologist s tour through the cell) Cell Cycle Cellular Differentiation b) Cellular Adaptations Atrophy Hypertrophy Metaplasia Hyperplasia c) Cellular Injury Mechanisms of Cellular Injury Accumulations Intoxication Role of Free Radicals Hypoxia Ischemia Thrombosis Embolism Infarction 4

5 Classes of Injury Cellular Swelling Fatty accumulations Non-fatty accumulations Glycogen Deposition Pigments Calcification Hyaline Necrosis Coagulative Necrosis Colliquative Necrosis Other Types of Necrosis Wet gangrene Dry gangrene Gas gangrene d) Abnormalities of Cell Growth and Differentiation Dysplasia Neoplasia Classes of Neoplasms Benign Neoplasms Malignant Neoplasms Mechanisms of Carcinogenesis Genetic Factors Genetic Instability Oncogenes Environmental Carcinogens Tumour Growth Staging of Neoplasms Metastasis Approaches to Cancer Therapy e) Developmental and Inherited Disorders Developmental Anomalies Teratology Morphogenetic Errors Genetic Disorders Single gene disorders Autosomal Dominant patterns of transmission AutosomalRrecessive patterns X-linked Inheritance Biochemical Significance of Single Gene Disorders Metabolic Cell membrane components Circulating proteins Collagen disorders Polygenic disorders Chromosomal Anomalies Classes Numerical 5

6 Structural Sex Chromosome PART IV - SYSTEMS OF DEFENCE Inflammation and Repair Inflammatory Response Acute Inflammation Vascular Phase Cellular Phase Mediators of Inflammation Chronic Inflammation Local and Systemic Effects Resolution and Repair Simple Resolution Regeneration Repair by Scar Healing by First Intention Healing by Second Intention Abnormal Healing Immune System Review of the Immune System Components of the Immune System Lymph Nodes Thymus Spleen Other Lymphoid Tissue Immune Cells B cells T cells MHC Killer Cells Helper Cells Suppressor Cells Granulocytes The Immune Response Cell-mediated Humoral Primary and Secondary Response Complement Activation Active and Passive Immunity 6

7 Hypersensitivy and Autoimmune Reactions Hypersensitivity Type I: Immediate Hypersensitivity Anaphylaxis Asthma Eczema Type II: Cytotoxic Hypersensitivity Hemolytic Reactions Other Cell Destruction Type III: Immune Complex Disease Serum Sickness Arthus Reaction Type IV: Cell Mediated Hypersensitivity Delayed Hypersensitivity Granulomatous Hypersensitivity Response Contact Dermatitis Immune Deficiency Primary (Congenital) Immune Deficiency Stem Cell Deficiency Antibody Deficiency Cell-mediated Immune Deficiency Secondary (Acquired) Immune Deficiency Multifactorial Secondary Immune Deficiency HIV/AIDS Pathogenesis Epidemiology Current Interventions PART V CIRCULATORY SYSTEM a) Cardiac Disorders Abnormalities of Conduction Electrocardiogram Normal Conduction Dysrhythmias Impaired Pumping Ability Congestive Heart Failure Pathophysiology Classification Left Heart Failure Right Heart Failure Cardiogenic Shock Cardiomyopathy Dilated Cardiomyopathy Restrictive Cardiomyopathy Cardiac Hypertrophy Myocarditis Coronary Artery Disease (CAD), Cardiac Ischemia and Myocardial Infarction Risk Factors Pathogenesis of CAD Myocardial Ischemia and Angina Pectoris 7

8 Myocardial Infarction Pathophysiology Manifestations Complications Valvular Disease Rheumatic Fever Mitral Stenosis Mitral Regurgitation Mitral Valve Prolapse Aortic Stenosis Aortic Regurgitation Infective Endocarditis Pericarditis Acute Pericarditis Chronic Pericarditis Congenital Heart Disease Patent Ductus Arteriosus Atrial Septal Defects Ventricular Septal Defects Tetralogy of Fallot b) Disorders of the Systemic Circulation Alteration in Arterial Flow Arteriosclerosis Atherosclerosis Aneurysms Alteration in Venous Flow Obstructive Disease of Veins Thrombophlebitis Venous Insufficiency and Stasis Varicose Veins c) Blood Pressure Abnormalities Hypertension Etiology and Classifications Essential Hhypertension Hypertension in Pregnancy Secondary Hypertension Malignant Hypertension 8

9 a) Erythrocyte Disorders Red Blood Cell Cycle Anemias Thalassemias Polycythemia b) Leukocyte and Lymphoid Tissue Disorders Leukocyte Generation and Differentiation Leukocyte Classes and Characteristics Non-malignant Disorders Alterations of Quantities of Leukocytes Monocyte Abnormalities Lymphocyte Abnormalities Malignancies Malignant Lymphomas Classes Leukemia Classes Manifestations Progression c) Disorders of Coagulation Hemostasis Mechanism of Blood Coagulation Clot Lysis Deficiencies in Blood Coagulation Hemophilia Vitamin K Deficiency Liver Disease Platelet Disorders Thrombocytopenia Thrombocytosis Hypercoagulation PART VI HEMATOLOGIC SYSTEM 9

10 Host/Parasite Relationships Epidemiology of infectious diseases Bacteria Prokaryote biology Infectious cocci Infectious gram positive bacilli Infectious gram negative bacilli Other medically important bacteria Viruses Virus biology DNA viruses RNA viruses Infectious Disease Control and Therapeutics Infection control Antibacterial drugs Antiviral drugs - SEMINARS / TUTORIALS - INFECTIOUS DISEASES 10