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Summary Human Physiology And Pathology lectures

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Human Physiology And Pathology

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  • 26 oktober 2021
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  • 2019/2020
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Pathology
Adaptation and cell death
03-03-2020
Pathos = suffering, -logos = study of
Etiology (causes of disease) > pathogenesis (mechanisms of disease) > molecular, functional and
morphologic abnormalities in cells and tissues > clinical manifestations (signs and symptoms of
disease)

Microscopic > light microscopy:
- Dyes (histochemistry): HE (hematoxylin-eosin) staining > H: basophilic structures, E:
eosinophilic structures > nuclei blue/purple, cytoplasm pink. But also Masson’s trichrome,
PAS and Sirius red.
- Antibodies (immunohistochemistry): localisation of specific structures (antigens) in biological
tissues with antibodies > binding of antibody to antigen > reaction > strains.
- Substrates (enzyme histochemistry)

Pharmacist:
- Understanding terminology MD
- Understanding therapeutic activities of drugs and its implications
- Co-determine choice of medication

Pathology:
- Terminology
- Characteristics of diseases and its progression
- Understanding drug activities

Etiology: causes of disease
- Various injurious stimuli (e.g. toxins, nutritional imbalances or aging)
- Limited number of cellular responses

Oxygen deficit
- Most common cause of cell injury
- Hypoxia = not enough oxygen due to low O2 concentrations in the blood > oxygen
deprivation. E.g. due to CO poisoning, anaemia, respiratory problems or altitude sickness.
- Ischemia = not enough oxygen due to reduced blood supply > oxygen deprivation +
deficiency of essential nutrients + build up of toxic metabolites. E.g. occlusion of artery.
- Anoxia = no oxygen at all.

Aging:
- Results from combination of multiple, progressive cellular alterations
- Inflammaging
- Progressive decline in life span and functional activity of cells
- Due to: environmental/metabolic insults, telomere shortening and abnormal protein
homeostasis, but also stress and chronic diseases > accumulation of mutations in DNA,
decreased cellular replication and decreased proteins > decreased cell functions or cell loss.
- Diminished ability of cells to respond to stress = cellular senescence

Cellular adaptation: depending on the damaging stimulus different disease outcomes are possible.
- Reversible processes!
- Changes in number, size, phenotype, metabolic activity or function of cells

, - Physiological adaptations: normal stimulations by hormones or endogenous chemical
mediators
- Pathological adaptations: responses to stress that allow cells to modulate their structure and
functions and thus escape injury, but at the expense of normal functions.

Forms of adaptation:
1. Hypertrophy = increase in cell size > increased organ size
- Occurs in cells with a limited dividing capacity (e.g. heart and muscle cells)
- Reversible process, but if stress is too much or not relieved > organ cannot enlarge further >
progression towards more degenerative organ changes
- E.g. phy: muscle growth
- E.g. path: cardiac enlargement from hypertension
2. Hyperplasia = increase in number of cells = proliferation
- Cells capable of replication
- Stimulated by growth factors or hormones
- Reversible, but if it persist it is a fertile soil for cancer
- Hyperplasia and hypertrophy can occur together > uterus enlargement
- E.g. phy: proliferation of the female breast / residual tissue growth
3. Atrophy = decrease in cell size
- Diminished cell function but not cell death
- Associated with decreased protein synthesis and increased protein/organelle degradation >
lysosomes and proteasomes (intracellular proteins) > autophagy / ubiquitin pathway
- Atrophy often associate with autophagy > adaptation to nutrient deprivation > self-eating in
order to provide energy and nutrients > organelles auto phage and fuse with a lysosome >
digested > used as source of nutrients (stress too severe > apoptosis)
- Common causes include: less work load, diminished blood supply, aging
- E.g. phy: decreased work load
- E.g. path: aging and reduced blood supply > brain atrophy
4. Metaplasia = change in phenotype of differentiated cells
- Reversible
- Chronic irritation
- Better able to withstand the adverse environment
- Epithelial or mesenchymal cells
- E.g. change in lung epithelium due to smoking
- Reduced functions or increased chance for bad transformation

Hyperplasia > metaplasia > dysplasia  neoplasia (increase in the variation in cell and nuclear sizes +
disordered cellular arrangements)

Reversible injury:
- Cellular swelling: due to over uptake of water > failure of energy dependent ion pumps in
plasma membrane
- Fatty change: principally in organs involved in lipid metabolism (fatty liver!)
- Plasma membrane alterations, swelling mitochondria, dilation ER and detachment of
ribosomes, nuclear alterations, myelin figure formation.

Pathology
Immunology part I
04-03-2020
Immune system:

, - Defence against invaders, such as bacteria/viruses/parasites/fungi
- Removal of dead cells, tumors, artificial objects, damaged molecules

Experience immunology (1600-1900) > experimental immunology (1900-1950) > modern
immunology (1950-now)

Scarlet fever: streptococcus
- No vaccine
- Antibiotics
- Complication when spreads
- Induces autoimmune response (rheumatic fever)
- Rash is caused by pyrogenic exotoxin
Diphtheria: Corynebacterium diphtheriae
- 5-10% fatal
- Diphtheria toxin kills body cells > taken up via endocytosis > acidification of endosome >
release unit A > inhibition protein synthesis > cell dies
Cholera: vibrio cholera
- Diarrhea and vomiting
- Blue death: bluish grey skin due to dehydration
- Intestine bacterium produces cholera toxin > efflux of water and ions into intestinal lumen
Measles: measles morbillivirus
- Highly contagious
- Pneumonia and diarrhoea
Pertussis: whooping cough
- Bordetella pertussis
- Vaccine
Smallpox:
- Virus infection: variola (minor, major)
- Fever, vomiting, sores
- Vaccine  first vaccine ever > variolation > lady Montague

Immune system:
- Innate immunity = immunity you are born with (myeloid cells, only takes hours)
- Adaptive immunity = immunity you have to develop (lymphoid cells, takes days)

Severity of epidemic also depend on infectiousness
R0 = Rnaught = virus reproduction number = number of people an individual infects
Higher fatality rate > lower R0, since infected people barely infect others.

R0 depends on virulence of virus, population and vaccination:
- Virulence = how much does the pathogen affects the host > infected people infect others?
- Herd immunity (paraplu effect) because of vaccination/immunization




A new invader! What happens?
- Epithelial barriers: block income as good as possible
- Cellular alarm system
- Tissue-resident immune cells > immediate response and signalling
- Bone marrow: helps signalling cells > specialised help from lymphocytes

, Lymphocytes:
- Tellers: t-helper cells
- Killers: cytotoxic t-cells
- B-cells: produce antibodies

All leukocytes (white blood cells) develop from stem cells in bone marrow or in the yolk sac/fetal
liver. The stem cell develops into a progenitor cell that can differentiate into many types of cells.

White blood cells:
- Monocyte: heart form
- Lymphocytes: round nucleus, less cytoplasm, smaller
- Eosinophil: headphone nucleus
- Basophil
- Neutrophil: 3 ball nucleus




T-cells develop/mature in the thymus, but are generated in the bone marrow.
B-cells develop in the bone marrow.
Nk-cells develop from lymphocytes.
T-/NK-/B-cells are lymphoid cells, the rest are myeloid cells.

Macrophages = eating / clean up of parts.

The mass of all immune cells in the body = mass of brain.

Lymphoid tissue:
- Primary: thymus gland, bone marrow  development and maturation
- Secondary: spleen + lymph nodes  meeting place for immune cells and antigen
Immune cells in the lymph node sense and intercept pathogens preventing their spread throughout
the body by initiating an immune response.
Spleen: highly vascularized > monitors and filters the blood for ‘rubbish’.

T cells can react to antigens presented by dendritic cells, B cells can react directly themselves.
Lymph nodes get bigger during antibody producement. BALT/GALT/MALT.




Pathology

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