GENERAL

PATHOLOGY
Ashebir Alemu (MD)

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Course outline
Chapters Title
1. Chapter one Introduction to Pathology
2. Chapter two Cellular Reactions to
Injury
3. Chapter Inflammation
three
4. Chapter four Healing
5. Chapter five Hemodynamic Disorders
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 Cont…
Chapters Title
6. Chapter six Genetic Diseases
7. Chapter seven Immunopathology
8. Chapter eight Selected Tropical
Diseases
9. Chapter nine Neoplasia
10. Chapter ten Metabolic Diseases
11. Chapter eleven Environmental Diseases
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 Course Objectives
Upon completing the course,
students should be able to have
knowledge and proper
understanding about:
1. General pathology
• Definition of pathology
• Historical progress
• Scope of pathology
• Classification of pathology
• Techniques used in pathology
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Cont…
2.The role of cells in healthy and
diseased condition:
• How cellular changes can influence
the normal function of healthy body
and can be the result of changes in a
diseased body?

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 Cont…
3.The scientific process of inflammation,
healing and repair.
4.Disorders in different body system
functions:
• Hemodynamic
• Genetic
• Immune
• Metabolic
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Cont…

5.General introduction about neoplasia.

6.Infectious disease in general and

Selected tropical diseases.

7.Environmental diseases.
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 INTRODUCTION TO
GENERAL
PATHOLOGY

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 Learning Objectives
Upon completing this chapter students
should be able to:
1.Define pathology. ↔ What is pathology?
2.Discuss the core aspects of disease in
pathology ↔ Apply all the
understandings
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of disease to study
9
Cont…

4. Know the diagnostic techniques used in

pathology ↔ The objective after studying
pathology is reaching on the final diagnosis
by using different laboratory techniques.
5. Know the various categories of the causes of
diseases ↔ Etiologies of disease.
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Cont…

6. Know the course, outcome,

consequences of diseases ↔ The
mechanism how the causative agent
result in a disease and changes due to
that disease with the final result.
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 Definition
Literally translated, Pathology is the
science(study) of suffering,
i.e., (Pathos (Latin) = suffering) (Logos = science),.
Pathology is the study of disease by
scientific methods
Diseases is an abnormal variation in
structure or function of any part of the
body.
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 Cont…
• Pathology in general is about scientific
explanation of disease and applying that
explanation to diagnose the disease.
• To study pathologic changes having good
knowledge of basic medical science is
important.
• Pathology bridges the clinical practice and
basic science
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 Cont..
• Pathology gives explanations of a
disease by studying the following five
aspects:
1. Etiology,
2. Pathogenesis,
3. Morphological changes,
4. Functional alteration,
5. Clinical signs and symptoms.
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 Etiology
• Etiology of a disease means the cause of the
disease.

• If the cause of a disease is known it is called

primary etiology.

• If the cause of the disease is unknown it is

called idiopathic (cryptogenic).
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 Cont…
• Another categories of etiology,
• Congenital a condition existing at birth
or before birth, or that develops during
the first month of life
1. Genetic – due to genetic mutations in
chromosomes
2. Non-genetic - abnormal defect or
deformity a child is born with, associated
with embryogenesis
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 Cont…
• Acquired etiology
• Infectious,
• Nutritional (deficiency and excess)
• Chemical (Drug induced - therapeutic
and recreational Drugs),
• Physical (Mechanical),
• Radiation,
• Metabolic, etc...
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 Pathogenesis
• Pathogenesis means the mechanism

through which the cause operates to

produce the pathological and clinical
manifestations. (Normal cells into
Abnormal cells)
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 Cont…
• Four basic pathogenic mechanisms in a
disease
• Inflammatory process
• Immunological process
• Degenerative process
• Carcinogenesis (the transformation of
normal cells to malignant)

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Morphologic changes
• The morphological changes refer to the
structural changes at the level of cells,
tissues, and organs. (appearance of
illness)
• Gross change; seen by the naked eye and
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 Functional
derangements and
Clinical significance
• The morphologic changes in the organ
influence the normal function of the organ.
(structure determines function)
• By doing so, they determine the clinical
features (symptoms and signs), course, and
prognosis of the disease.
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 In summery;
• In medicine, diseases are studied under the
following headings (How you study Pathology):
• Definition

• Epidemiology of disease
• Etiology
• Pathogenesis and pathophysiology
• Morphology:
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Cont…
• Clinical features/presentation: signs and
symptoms
• Differential diagnosis: is there any other
alternative diagnoses with similar findings?
• Treatment and management
• Prognosis
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 History of Pathology
• Autopsy → examination of the dead body
to identify the cause of death. Organ
pathology (1761)

• Light microscope → Cellular pathology

(1854)
• Electro
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microscope → Ultra-structural
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Cont…

• Immunopathology,

• Molecular pathology,

• Genetic pathology,

• Quantitative pathology
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 Classification of pathology
• Human pathology is conventionally divided
into
• General Pathology focuses on cellular and
tissue responses to pathologic stimuli, and
• Systemic Pathology study of diseases parting
to the specific organs and body systems.
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Diagnostic techniques in
pathology
• Pathologists uses different techniques to
diagnose diseases:
1.Histopathology
2.Cytopathology
3.Hematopathology
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Cont…

4. Immunohistochemistry

5. Microbiological examination

6. Biochemical examination

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Cont…

7. Cytogenetic

8. Molecular techniques

9. Autopsy

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 Histopathology
• The study of tissue biopsied/exfoliated from
body.
• Includes;
• Structural changes observed by naked eye
(gross or macroscopic changes), and
• The changes detected by LM and EM
• Special staining methods including
histochemical and immunological techniques
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 Cont…
• Biopsy is a tissue sample from a living
person to identify the disease. (incisional or
excisional)
• After the tissue sample (biopsy) is
removed, it has to be immediately
preserved (fixed) by putting it in a
container of formalin (10% formaldehyde).
• The purpose of fixation is to prevent
autolysis and decomposition of the tissue.
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 Cont…
• Tissue is then processed in a special
multistep way and the end result is very
thin slices of stained tissue (4-6 microns)
glued on a slide.
• The most commonly used routine stain is
Hematoxylin& Eosinstain.
• It gives the nucleus a blue/violet color & the
cytoplasm a pink color.
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 Cytopathology
• Study of cell INDIVIDUAL morphology,
exfoliated or aspirated from body.
• Exfloitive cytology - cells shed off from the lesions and

• Fine-needle aspiration cytology (FNAC)-

superficial and deep-seated lesions for
diagnosis
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 Cont…
3.Hematology: Study of blood, blood cells &
bone marrow, used in the diagnosis of anemia
& leukemia (blood disorders).

4.Chemical pathology / clinical

biochemistry: Analysis of biochemical
constituents of body fluids like blood, urine,
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 Cont…
5.Immunology: Is the analysis of the
immune system of the body to detect
abnormalities in the immune system.
6.Immunohistochemistry: A Special staining
procedure is used to detect antigens in
the tissue
7.Microbiology: Is the study of
microorganisms
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 Cont…
8. Toxicology: Study of various poisonous and toxic
substances.
9. Cytogenetics: Is a study of chromosomal
abnormalities.
10.Molecular pathology: molecular and genetic
approach to diagnose and classification of disease.
e.g. PCR, fluorescent in situ hybridization, antibody
based immunofluorescence.
11.Autopsy: It is a sub-specialty of pathology which
involves examining a dead body
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Causes of disease
Diseases can be caused by either
Environmental factors,
Genetic factors or
A combination of the two

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 Cont…
Environmental causes of disease are many and are
classified into:
1. Physical agents
2. Chemicals
3. Nutritional deficiencies & excesses
4. Infections & infestations
5. Immunological factors
6. Psychogenic factors

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Course of disease
Exposure

Biological onset

Clinical onset

Permanent damage
•
Death
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 Cont…
Exposure – exposure to various risk factors (causative
agents)

Latency / Incubation period - Is the time period from

the exposure to the development of signs and symptoms
 Biological onset of disease - this marks the initiation of the
disease process without any sign or symptom

Clinical onset - The begging of signs and symptoms

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Outcome and consequences of
disease
1. Resolution can occur leaving no
sequel (no damage),
2. The disease can settle down, but
sequel are left (living damage) –
Resolution with sequel, or
3. Complications
4. It may result in death.
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 Clinical & biologic death
Clinical death; is the period of respiratory,
circulatory or brain arrest during which
initiation of resuscitation can lead to recovery.
Biological death; (sure sign of death),
which sets in after clinical death, is an
irreversible state of cellular destruction.
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 Class activity
• T/F Qs:
1. Idiopathic means a known cause.
2. The beginning of signs and symptoms is the outcome of the disease.
3. Formalin is the mostly used staining agent.
• MCQs:
1. Signs:
A. features of illness that the patient notice.
B. are findings discovered by the physician during examination.
C. complications and sequences of disease
D. stages of pathogenesis
2. Atherosclerosis/myocardial infarction:
A. Inflammatory
B. congenital inherited
C. Vascular disease
D. Drug induced
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Cont…
• SAQs:
1.How do Etiology & Pathogenesis
differ?
2.Define Autopsy?

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 Thanks for today!
END
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