PATHOLOGY & MICORBIOLOGY-I

Resource Person: Dr. Izza Waheed

Course Code: SHS.301
Credit Hours: 3
LECTURE OUTLINE

• Introduction of Pathology
• Basic terms in Pathology
• Cell Injury
• Causes of Cell Injury
 INTRODUCTION TO PATHOLOGY

• Pathology is the branch of biology devoted to understand the

cause of disease, the changes at cellular or tissue level & the
clinical manifestations of the disease.
• For example, Diabetes mellitus is a disease in which blood
sugar (glucose) levels are abnormally high as the body is
unable to produce sufficient insulin (Type 1) or respond to
insulin (Type 2). The pathology behind Type 1 diabetes
mellitus is the destruction of beta cells on islets of langerhans
of pancreas thereby, less insulin is secreted & glucose levels
remain high in blood.
 UNDERSTANDING PATHOLOGY OF DIABETES
MELLITUS

Diabetes Mellitus
E (Type 1) MA CLI
U S N I NI
F E CA
CA ST
AT L
IO
CHANGES NS
Elevated blood AT CELL
Polyuria
glucose levels LEVEL
Polydipsia
Weight loss
Destruction of beta-cells on islets of Langerhans of Pancreas
BASIC TERMS IN PATHOLOGY

1. Etiology: This terms refers to the underlying 'cause' or 'factors'

that are responsible for the inititation & progression of disease.
Sometimes, diseases result from multiple etiologies including
environmental & genetic factors e.g, diabetes mellitus,
hypertension. This refers to 'WHY' a disease arises.
2. Pathogenesis: This terms refers to the 'mechanisms' of
development & progression of disease. Pathognesis accounts for
the abnormal changes occuring at cellular/molecular level that
give rise to structural malformations or functional deviations.
This refers to 'HOW' a disease develops.
IMPORTANCE OF ETIOLOGY & PATHOGENESIS

• Always define the pathogenesis & etiology of disease because

they will help you:
1. Better understand the disease
2. Basis for developing rationale treatment regimens
3. Basis for developing effective preventive measures

PATHOLOGY is the BASIS of MEDICINE.

 APPLICATION OF KNOWLEDGE- DIABETES
MELLITUS (TYPE 1)
Pathogenesis Etiology
Destruction of beta-cells on Elevated blood glucose
islets of Langerhans levels/genetic +
environmental factors

Preventive Treatment
measures
Nutritious diet, Insulin medications
Physical activity
CELL INJURY

Cells actively interact with their environment, constantly adjusting

their structure and function to accommodate changing demands and
extracellular stresses. The intracellular milieu of cells is normally
tightly regulated such that it remains fairly constant, a state referred
to as homeostasis. As cells encounter physiologic stresses (such as
increased workload in the heart) or potentially injurious conditions
(such as nutrient deprivation), they can undergo adaptation,
achieving a new steady state and preserving viability and function.
If the adaptive capability is exceeded or if the external stress is
inherently harmful or excessive, cell injury develops
• Within certain limits, injury is reversible, and cells return to their
stable baseline; however, if the stress is severe, persistent, or rapid in
onset, it results in irreversible injury and death of the affected cells.
Cell death is one of the most crucial events in the evolution of
disease in any tissue or organ. It results from diverse causes such as:
• ischemia (lack of blood flow)
• infections
• toxins
• immune reactions.
CAUSES OF CELL INJURY

The causes of cell injury span a range from gross physical trauma, such as after a
motor vehicle accident, to a single gene defect that results in a nonfunctional
enzyme in a specific metabolic disease. Most injurious stimuli can be grouped into
the following categories.
• Hypoxia and ischemia
• Toxins
• Infectious agents
• Immunologic reactions
• Genetic abnormalities
• Nutritional imbalances
• Ageing
HYPOXIA & ISCHEMIA

Hypoxia, which refers to oxygen deficiency, and ischemia, which means

reduced blood supply, are among the most common causes of cell injury.
Both deprive tissues of oxygen, and ischemia, in addition, results in a
deficiency of essential nutrients and a build up of toxic metabolites.
The most common cause of hypoxia is ischemia resulting from an
arterial obstruction, but oxygen deficiency also can result from
inadequate oxygenation of the blood, as in a variety of diseases affecting
the lung, or from reduction in the oxygen-carrying capacity of the blood,
as with anemia of any cause, and carbon monoxide (CO) poisoning.
TOXINS

• Potentially toxic agents are encountered daily in the

environment; these include air pollutants, insecticides, CO,
asbestos, cigarette smoke, ethanol, and drugs. Many drugs in
therapeutic doses can cause cell or tissue injury in a susceptible
patient or in many individuals if used excessively or
inappropriately. Even innocuous substances, such as glucose,
salt, water and oxygen, can be toxic.
INFECTIOUS AGENTS

• All types of disease-causing pathogens, including viruses,

bacteria, fungi, and protozoans injure cells.
IMMUNOLOGIC REACTIONS

• Although the immune system defends the body against

pathogenic microbes, immune reactions also can result in cell
and tissue injury. Examples are autoimmune reactions against
one’s own tissues, allergic reactions against environmental
substances, and excessive or chronic immune responses to
microbes. In all of these situations, immune responses elicit
inflammatory reactions, which are often the cause of damage to
cells and tissues.
GENETIC ABNORMALITIES

• Genetic aberrations can result in pathologic changes as

conspicuous as the congenital malformations associated with
Down syndrome or as subtle as the single amino acid
substitution in hemoglobin giving rise to sickle cell anemia.
Genetic defects may cause cell injury as a consequence of
deficiency of functional proteins, such as enzymes in inborn
errors of metabolism, or accumulation of damaged DNA or
misfolded proteins, both of which trigger cell death when they
are beyond repair.
NUTRITIONAL IMBALANCES

• Protein–calorie insufficiency among impoverished populations

remains a major cause of cell injury, and specific vitamin
deficiencies are not uncommon even in developed countries
with high standards of living . Ironically, excessive dietary
intake may result in obesity and also is an important underlying
factor in many diseases, such as type 2 diabetes mellitus and
atherosclerosis.
PHYSICAL AGENTS

• Trauma, extremes of temperature, radiation, electric shock, and

sudden changes in atmospheric pressure all have wide-ranging
effects on cells.
AGEING

• Cellular senescence results in a diminished ability of cells to

respond to stress and, eventually, the death of cells and of the
organism.
Recommended Book

• Pathology by Robbins (10th Edition).

THANK YOU FOR
LISTENING!