ABOUT THE SUBJECT
Pathological physiology is a science that studies causes - aetiology, and mechanisms - pathogenesis of disease.
The aims of physiology as a bridge between preclinical and clinical subjects are:
- Study of specific aetiological factors, their properties that lead to the initiation of pathological processes, and the ways they interact with the structures of the body.
- Understanding of the genesis of pathological processes at the molecular level, and their evolution from subcellular, biochemical and cellular damage, through humoral and tissue functional disorders, to the system organ dysfunction, which ultimately leads to the manifestations of the disease.
- Study of the ways a diseased organism adapts and reacts to the external environment.
Practical exercises in pathological physiology are designed to provide students with basic knowledge of the principles of laboratory work in vitro, the practices of acute in vivo experiments, and finally enable them to interpret certain laboratory tests in clinical context.
Members of the teaching staff
Professors
Prof. Tatjana Radosavljević, MD, PhD
Prof. Snežana Žunić, MD, PhD
Prof. Danijela Vučević, MD, PhD
Prof. Silvio De Luka, MD, PhD
Prof. Srđan Lopičić, MD, PhD
Prof. Jelena Nešović Ostojić, MD, PhD
Prof. Jasna Todorović, MD, PhD
Assoc. Prof. Dušan Mladenović, MD, PhD
Assoc. Prof. Marija Stanković Stanojević, MD, PhD
Assoc. Prof. Marija Stanojević, MD, PhD
Asst. Prof. Bojan Jorgačević, MD, PhD
Asst. Prof. Milena Vesković, MD, PhD
Asst. Prof. Svetolik Spasić, MD, PhD
Asst. Prof. Sanjin Kovačević, MD, PhD
Asst. Prof. Jovana Paunović Pantić, MD, PhD
Asst. Prof. Marko Dinčić, MD, PhD
Teaching assistants and associates
Teaching Asst. Vedrana Makević, MD, PhD
Teaching Asst. Mirjana Jovanović, MD, PhD
Teaching Asst. Andrija Vuković, MD
Teaching Assoc. Nikola Mitović, MD
Teaching Assoc. Aleksandra Nenadović, MD
Course director
Prof. Snežana Žunić, MD, PhD
snezana.zunic@med.bg.ac.rs
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PATHOPHYSIOLOGY CURRICULUM 2024/2025. academic year, V semester |
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WEEK I starting on 01/10/2024. |
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Lectures Introduction to pathophysiology. Aetiology. Pathogenesis. Genetic and congenital disorders. Systemic and local effects of high and low environmental temperature. Seminar Pathophysiology of cellular adaptation and damage Lab Methods in pathophysiology, Physical aetiological factors I (hypothermia) |
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WEEK II starting on 07/10/2024. |
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Lectures Mechanical factors. Electricity. Sound and ultrasound. Disorders due to chemical factors. Seminar Cellular and systemic hypoxia Lab Physical aetiological factors II (asphyxia and altered barometric pressure) |
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WEEK III starting on 14/10/2024. |
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Lectures Disorders due to biologic agents. Fever. Inflammation. Seminar Pathophysiologic aspects of radiation Lab Effects of electric current, Chemical aetiological factors |
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WEEK IV starting on 21/10/2024. |
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Lectures Specific defence. Immunodeficiency. Autoimmune diseases. Alterations of immunologic reactions Seminar Implication of alterations of vitamins and trace elements Lab Alterations of local circulation |
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WEEK V starting on 28/10/2024. |
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Lectures Non-specific defence, The stress response, Disorders of carbohydrate metabolism. Seminar Pathophysiology of acute and chronic stress Lab Inflammatory process I |
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WEEK VI starting on 04/11/2024. |
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Lectures Metabolism alterations of proteins, Pathophysiologic aspects of enzymopathies, Metabolism alterations of lipids. Seminar Metabolic and systemic alterations in diabetes mellitus Lab Inflammatory process II |
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WEEK VII starting on 11/11/2024. |
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Lectures Aetiopathogenesis of hypercholesterolemia. Extracellular and intracellular dehydration. Water excess and generalised oedema. Seminar Dynamic of atherogenesis Lab Reactions of hypersensitivity |
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WEEK VIII starting on 18/11/2024. |
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Lectures Alterations in sodium, potassium and chloride balance, Mechanisms of calcium, phosphate, and magnesium imbalances, Malignant tumours. Seminar Obesity and under nutrition Lab Autoimmune diseases |
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WEEK IX starting on 25/11/2024. |
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Lectures Shock, aetiopathogenesis, Reversible and irreversible shock. Seminar Systemic changes in organism with malignant tumour Lab Alterations of protein metabolism |
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WEEK X starting on 02/12/2024. |
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Lectures Acid-base imbalances, Metabolic and respiratory acidosis, Metabolic and respiratory alkalosis. Seminar Implications and evaluation of water and electrolytes alteration Lab Disorders of lipid metabolism |
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WEEK XI starting on 09/12/2024 |
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Lectures Valvular heart disease, Ischaemic heart disease, Heart failure, Cardiac oedema. Seminar Implication and evaluation of acid-base imbalance. Lab Fluid and electrolyte alterations |
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WEEK XII starting on 16/12/2024. |
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Lectures Disorders of the heart’s impulse formation and conduction. Arterial hypertension and hypotension. Seminar Molecular mechanisms of shock Lab Acid – base imbalances |
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WEEK XIII starting on 23/12/2024. |
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Lectures Obstructive pulmonary disease. Restrictive respiratory syndrome. Alterations in pulmonary circulation. Alterations in control of ventilation. Respiratory arrythmia. Seminar Heart failure and evaluation of CVS functions Lab Pathophysiology of shock |
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LAST WEEK – exact dates will be announced later |
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Lectures NO LECTURES Seminar Pathophysiology of cardiac arrhythmias Lab Pathological ECG |
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Textbooks
Pathophysiology: The Biologic Basis for Disease in Adults and Children, 9th Edition, Kathryn L. McCance RN PhD, Sue E. Huether RN PhD, Elsevier Science, 2024.
Study Guide for Pathophysiology, 9th Edition, Kathryn L. McCance, RN, PhD and Sue E. Huether, RN, PhD, Elsevier Science, 2024.
The pathophysiology workbook. Editors: Vucevic D. and Pesic B. Libri Medicorum, Belgrade
Online study platform
Materials for lectures, seminars and labs provided on the online study platform
Medical Pathophysiology Grading Policy for academic 2024/2025.
The final mark in pathophysiology is the sum of points gained through pre-exam activities, the practical exam and the final test. The pre-exam activities include colloquia, attendance and activity. All of these taken together comprise 30% of the final mark. The practical exam comprises 20% and the final test 50% of the final mark. Details about each of these are given below.
1. Colloquia – up to 20 points
The pathophysiology course includes three colloquia, one in the fifth (winter) and two in the sixth (spring) semester. Colloquia include the material covered in lectures, seminars and labs held between the previous colloquium and the one being taken. Each colloquium consists of 20 questions. The questions are of the single best answer type, meaning the student is given 4 possible answers for each question, and only one of those answers is the correct one. The colloquium may also include a case study (vignette).
If the student does not take a colloquium for a valid reason, she or he can take a make-up colloquium which will be organised within 10 days. The colloquium is not eliminatory. This means that a student does not have to have any specific number of points in any of the colloquia in order to be given the semester signature or to take the exam.
The number of pre-exam points you get for colloquia is calcualted as the average of the total number of correct answers that you get on all three colloquia. In other words, you cannot fail the colloquium – if you have only one correct answer you get points.
2. Attendance and activity – up to 10 points
The students will be awarded points for regular attendance during the course and active involvement in seminars and labs. There are 6 attendance points and 4 activity points per year.
Lecture attendance points (1 per semester) are awarded for attending at least 50% of lectures per semester.
Seminar attendance points (1 per semester) are awarded for not being late or absent on seminars more than two times per semester.
Labs attendance points (1 per semester) are awarded for not being late or absent on labs more than two times per semester.
Activity points (1 for seminars and 1 for labs per semester) are awarded by the members of the teaching staff during a seminar or a lab if a student takes an active part in that seminar/lab.
3. Practical exam – up to 20 points
Practical exam in pathological physiology is compulsory and eliminatory, meaning that a student has to take and pass the practical exam in order to take the final test.
The practical exam is taken orally with a member of the teaching staff. The student randomly picks two questions – one from general pathophysiology and one from special (systems and organs) pathophysiology. All of the questions in the practical exam are from the material covered on labs during the academic year, and are listed in the appropriate section of Medical Pathophysiology web site. The student is expected to explain the experimental procedure, analyse the results and explain the significance or practical application of the exercise.
The marks and points from the practical exam are as follows:
| MARK ON THE PRACTICAL EXAM | NUMEBER OF POINTS FOR THE PRACTICAL EXAM |
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| Fail (5) | 0 |
| 6 | 12 |
| 7 | 14 |
| 8 | 16 |
| 9 | 18 |
| 10 | 20 |
The practical exam is valid for one academic year.
4. Final test – up to 50 points
The final test in pathophysiology consists of 60 questions. The questions are single best answer, matching or case study (vignette). The minimum number of correct answers required to pass the final test is 31.
The final test points are awarded according to number of correct answers as shown in the table below.
| NUMBER OF CORRECT ANSWERS ON THE FINAL TEST | NUMBER OF POINTS FOR THE FINAL TEST |
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| Fail (30 or less) | 0 |
| 31-36 | 30 |
| 37-42 | 35 |
| 43-48 | 40 |
| 49-54 | 45 |
| 55-60 | 50 |
5. Final mark
The points that the student has collected on pre-exam activities, on the practical exam and on the final test are added together to get the final sum of points.
The final mark is formulated based on the final sum of points as shown in the table below.
| FINAL SUM OF POINTS | FINAL MARK |
|---|---|
| 50 or less | 5 |
| 51-60 | 6 |
| 61-70 | 7 |
| 71-80 | 8 |
| 81-90 | 9 |
| 91-100 | 10 |
Questions for the practical exam for academic 2024/2025.
GENERAL PATHOPHYSIOLOGY
- Experimental hypothermia
- Effects of altered atmospheric pressure on the organism
- Effects of asphyxia on the organism
- Significance of the electrical current path through the organism
- Significance of chemical substance's port of entry into the organism
- Enzymatic inhibition as mechanism of intoxication
- Toxic effects of ethanol
- Experimental arterial (active) hyperaemia
- Experimental venous (passive) hyperaemia
- Experimental thrombosis
- Experimental embolism
- External signs of inflammation
- Experimental phagocytosis
- Analysis of exudate nad transudate (Rivalta test)
- Determination of pH of pus and serum
- Determination of biochemical parameters of inflammation (CRP nad fibrinogen)
- Acute and chronic infeammation (vignettes)
- Anaphylactic shock
- Schultz-Dale experiment
- Determination of immune complexes in a patient's serum
- Determination of rheumatoid factor in a patient's serum
- Determination of antinuclear antibodies in a patient's serum
- L.E. cells
- Determination of the crystals in synovial fluid
- Analysis of the cells from the synovial fluid
- Determination of protein fractions in different pathophysiological disorders (vignettes)
- Photometric determination of lipid frections in patient's serum (HDL, LDL, apoB, triglycerides and cholesterol)
- Alteration of lipid metabolim (vignettes)
- Experimental dehydration
- Alteration of water and electrolyte metabolism (vignettes)
- Experimental hypocalcaemia
- Analysis of acid-base disorders (vignettes)
SPECIAL (SYSTEMS AND ORGANS) PATHOPHYSIOLOGY
- Analysis of ECG in hyperkalaemia, rhythm and conduction disorders
- Analysis of ECG in rhythm disorders (tachycardia, bradycardia, extrasystole, flutter and fibrillation of atria and ventricles)
- Analysis of ECG in conduction disorders (heart blocks)
- Determination of cardiac enzymes and analysis of altered cardiac electrical activity in ischaemic heart disease
- Ischaemic heart disease (vignettes)
- Pathophysiology of shock (vignettes)
- Alterations of respiratory system (obstructive and restrictive disorders)
- Hypochromic anaemia
- Megaloblastic (pernicious) anaemia
- Haemolytic anaemia
- Toxic anaemia
- Reticulocytosis
- Analysis of haematologic parameteres in anaemic patients (vignettes)
- Quantitative alterations of white blood cells
- Acute leukaemia
- Chronic lymphocytic leukaemia
- Chronic myelogenous leukaemia
- Prothrombin time
- Activated partial thromboplastim time
- Analysis of INR (International Normalised Ratio)
- Determining D-dimer value
- Clot retraction
- Determination of inhibitors of coagulation
- Determination of gastric juice acidity by titration
- Interpretation of gastric juice acidity curves
- Determination of presence of lactic acid in gastric juice
- Determination of amylase activity in urine
- Determination of bilirubin, urobilinogen and urobilin in urine in obstructive jaundice
- Determination of bilirubin (Van den Bergh)
- Detection of aminotransferase activity in patient's serum
- Detection of alkaline phosphatase activity in serum in obstructive jaundice
- Glycosuria
- Proteinuria - qualitative and quantitative determination of proteins in urine
- Haemoglobinuria
- Urine sediment
- Disorders of physical characteristics of urine
- Pathophysiology of diuresis
- Determination of urea and creatinine concentration
- Acute kideny injury and chronic kideny disease (vignettes)
- Analysis of the results of standard thyroid gland and suprarenal gland function tests
- Lesion of the lower motor neuron
- Lesion of the upper motor neuron
- Effects of hyperkaliaemia on muscle contraction
- Conduction disorders in the neuromuscular junction
- Analysis of EEG in experimental epilepsy
- Functional evaluation of the autonomic nervous system
Research topics