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Medical Pathophysiology

Medical Pathophysiology

About our subject

Pathological physiology is a science devoted to the systematic study of cause - aetiology and the underlying mechanisms - pathogenesis of disease.

As a pivotal connection between preclinical and clinical subjects pathological physiology pursues several core aims:

  • Analysis of aetiological factors
    • Study of specific aetiological factors, their properties, and the ways they interact with the structures of the body - a complex interplay that leads to the initiation of pathological processes as well as their progression
  • Mechanistic understanding of disease genesis and evolution
    • Understanding of the genesis of pathological processes at the molecular level and their evolution starting from the 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.
  • Response of the diseased organism
    • Study of the ways a diseased organism responds, adapts, and reacts to the external environmental challenges.

Practical instruction (exercises) in pathological physiology is designed to equip students with the basic knowledge and fundamental skills of laboratory work in vitro, the practices of acute in vivo experiments and enable them to interpret certain laboratory tests and findings within a clinical framework.

Members of the teaching staff

 

Professors

Prof. Snežana Žunić, MD, PhD

Prof. Tatjana Radosavljević, 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

Assoc. Prof. Bojan Jorgačević, MD, PhD

Assoc. 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

Asst. Prof. Vedrana Makević, MD, PhD

 

Teaching assistants and associates

Teaching Asst. Mirjana Jovanović, MD, PhD

Teaching Asst. Andrija Vuković, MD

Teaching Asst. Nikola Mitović, MD

Teaching Asst. Aleksandra Nenadović, MD

Teaching Assoc. Mina Bogetić, MD

Teaching Assoc. Marko Biorac, MD

 

Course director

Asst. Prof. Svetolik Spasić, MD, PhD

patoloska.fiziologija.mfub@gmail.com

UNIVERSITY OF BELGRADE FACULTY OF MEDICINE

MEDICAL PATHOPHYSIOLOGY

ACADEMIC YEAR 2026/2027.

WINTER (FIFTH) SEMESTER ORGANIZATION OF CLASSES

 

LECTURES

All students – Wednesdays,10.30 – 13.15 h in Classroom 1, Head Building, dr Subotića 8, 2nd floor

 

SEMINAR COURSE

Group 1 – Tuesdays, 14.30 – 16.00 h in the Lecture Hall, Pathophysiology building, dr Subotića 9, ground floor

Group 2 – Tuesdays, 14.30 – 16.00 h in Classroom 2, Head Building, dr Subotića 8, 2nd floor

Group 3 – Mondays, 14.30 – 16.00 h in the Classroom 2, Head Building, dr Subotića 8, 2nd floor

 

LABORATORY COURSE

Group 1 – Mondays, 14.30 – 16.00 h in Lab Classroom A, Pathology building, dr Subotića 1, 2nd floor

Group 2 – Mondays, 14.30 – 16.00 h in Lab Classroom B, Pathology building, dr Subotića 1, 2nd floor

Group 3 – Tuesdays, 14.30 – 16.00 h in Lab Classroom B, Pathology building, dr Subotića 1, 2nd floor

 

 

WINTER (FIFTH) SEMESTER CURRICULUM

WEEK I

Lecture

Introduction to the Medical Pathophysiology course

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)

WEEK II

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)

WEEK III

Lectures

Disorders due to biologic agents. Fever. Inflammation.

Seminar

Pathophysiologic aspects of radiation

Lab

Effects of electric current. Chemical etiological factors

WEEK IV

Lectures

Specific defense. Immunodeficiency. Autoimmune diseases. Alterations of immunologic reactions

Seminar

Pathophysiology of acute and chronic stress

Lab

Alterations of local circulation

WEEK V

Lectures

Non-specific defense. The stress response. Disorders of carbohydrate metabolism.

Seminar

Implication of alterations of vitamins and trace elements

Lab

Inflammatory process I

WEEK VI

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

WEEK VII

Lectures

Aetiopathogenesis of hypercholesterolemia. Extracellular and intracellular dehydration. Water excess and generalized oedema.

Seminar

Obesity and undernutrition

Lab

Reactions of hypersensitivity

WEEK VIII

Lectures

Alterations in sodium, potassium, and chloride balance. Mechanisms of calcium, phosphate, and magnesium imbalances. Malignant tumors.

Seminar

Dynamic of atherogenesis

Lab

Autoimmune diseases

WEEK IX

Lectures

Shock, aetiopathogenesis. Reversible and irreversible shock.

Seminar

Systemic changes in an organism with a malignant tumor

Lab

Alterations of protein metabolism

WEEK X

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

WEEK XI

Lectures

Valvular heart disease. Ischaemic heart disease. Heart failure. Cardiac oedema.

Seminar

Implication and evaluation of acid-base imbalance

Lab

Fluid and electrolyte alterations

First colloquium 

WEEK XII

Lectures

Disorders of the heart’s impulse formation and conduction. Arterial hypertension and hypotension.

Seminar

Molecular mechanisms of shock

Lab

Acid-base imbalances

WEEK XIII

LAB MAKE-UPs

 

Seminar

Pathophysiology of cardiac arrhythmias

Lab

Pathophysiology of shock

WEEK XIV

Lectures

SObstructive pulmonary disease. Restrictive respiratory syndrome. Alterations in pulmonary circulation. Alterations in control of ventilation. Respiratory arrhythmia.

Seminar

Heart failure and evaluation of CVS functions

Lab

Pathological ECG

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 

 

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.

Final number of points (up to 100) comprises:

  • Colloquia (3 colloquia, in total up to 20)
  • Lecture attendance (up to 2)
  • Seminar regular attendance (up to 2) and activity (up to 2)
  • Lab regular attendance (up to 2) and activity (up to 2)
  • Practical exam (up to 20)
  • Final test (up to 50)

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 (summer) semester. Colloquia include the curriculum covered in lectures, seminars and labs held between the previous colloquium and the one being taken (one week before the coloqium week). 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) and/or matching questions.

If the student is prevented from taking the regular colloquium for a valid reason, they can take a make-up colloquium, which will be organized within 10 days. A student must submit written proof of the justified absence from the regular colloquium term in order to be eligible to take the repeat colloquium. 

The colloquium is not eliminatory. This means that a student does not have to have any specific number of correct answers in any of the colloquia in order to be given the semester signature or to take the exam. In other words, you cannot fail the colloquium – if you have only one correct answer you get points.

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. 

 

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 from seminars (held at a specificic date/ time provided for the student group the student is assigned to) more than two times per semester.

Labs attendance points (1 per semester) are awarded for not being late or absent from labs (held at a specificic date/ time provided for the student group the student is assigned to) 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         

The practical exam in Medical Pathophysiology 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 in front of 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 in labs during the academic year and are listed in the appropriate section of the Medical Pathophysiology website. The student is expected to explain the experimental procedure, analyze the results, and explain the significance or practical application of the exercise.

The practical exam is valid for one academic year.

The marks and points from the practical exam are as follows:

Mark on the practical exam  Number of points for the practical exam 
Fail (5) 0
6 12
7 14
8 16
9 18
10 20

 

4. Final test – up to 50 points     

The final test in Medical Pathophysiology consists of 60 questions. The questions are single-best-answer multiple-choice questions, matching questions, and/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 the number of correct answers as shown in the table below.

Number of correct answers on the final test Number of point for the final test
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

 

 

 

Medical Pathophysiology

Questions for the practical exam

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 below. The student is expected to explain or perform the experimental procedure, analyse the results and explain the significance or practical application of the exercise.

GENERAL PATHOPHYSIOLOGY

  1. Experimental hypothermia
  2. Effects of altered atmospheric pressure on the organism
  3. Effects of asphyxia on the organism
  4. Significance of the electrical current path through the organism
  5. Significance of chemical substance's port of entry into the organism
  6. Enzymatic inhibition as mechanism of intoxication
  7. Toxic effects of ethanol
  8. Experimental arterial (active) hyperaemia
  9. Experimental venous (passive) hyperaemia
  10. Experimental thrombosis
  11. Experimental embolism
  12. External signs of inflammation
  13. Experimental phagocytosis
  14. Analysis of exudate nad transudate (Rivalta test)
  15. Determination of pH of pus and serum
  16. Determination of biochemical parameters of inflammation (CRP nad fibrinogen)
  17. Acute and chronic infeammation (vignettes)
  18. Anaphylactic shock
  19. Schultz-Dale experiment
  20. Determination of immune complexes in a patient's serum
  21. Determination of rheumatoid factor in a patient's serum
  22. Determination of antinuclear antibodies in a patient's serum
  23. L.E. cells
  24. Determination of the crystals in synovial fluid
  25. Analysis of the cells from the synovial fluid
  26. Determination of protein fractions in different pathophysiological disorders (vignettes)
  27. Photometric determination of lipid frections in patient's serum (HDL, LDL, apoB, triglycerides and cholesterol)
  28. Alteration of lipid metabolim (vignettes)
  29. Experimental dehydration
  30. Alteration of water and electrolyte metabolism (vignettes)
  31. Experimental hypocalcaemia
  32. Analysis of acid-base disorders (vignettes)

 

SPECIAL (SYSTEMS AND ORGANS) PATHOPHYSIOLOGY

  1. Analysis of ECG in hyperkalaemia, rhythm and conduction disorders
  2. Analysis of ECG in rhythm disorders (tachycardia, bradycardia, extrasystole, flutter and fibrillation of atria and ventricles)
  3. Analysis of ECG in conduction disorders (heart blocks)
  4. Determination of cardiac enzymes and analysis of altered cardiac electrical activity in ischaemic heart disease
  5. Ischaemic heart disease (vignettes)
  6. Pathophysiology of shock (vignettes) 
  7. Alterations of respiratory system (obstructive and restrictive disorders)
  8. Hypochromic anaemia
  9. Megaloblastic (pernicious) anaemia
  10. Haemolytic anaemia
  11. Toxic anaemia
  12. Reticulocytosis
  13. Analysis of haematologic parameteres in anaemic patients (vignettes)
  14. Quantitative alterations of white blood cells
  15. Acute leukaemia
  16. Chronic lymphocytic leukaemia
  17. Chronic myelogenous leukaemia
  18. Prothrombin time
  19. Activated partial thromboplastim time
  20. Analysis of INR (International Normalised Ratio)
  21. Determining D-dimer value
  22. Clot retraction
  23. Determination of inhibitors of coagulation
  24. Determination of gastric juice acidity by titration
  25. Interpretation of gastric juice acidity curves
  26. Determination of presence of lactic acid in gastric juice
  27. Determination of amylase activity in urine
  28. Determination of bilirubin, urobilinogen and urobilin in urine in obstructive jaundice
  29. Determination of bilirubin (Van den Bergh)
  30. Detection of aminotransferase activity in patient's serum
  31. Detection of alkaline phosphatase activity in serum in obstructive jaundice
  32. Glycosuria
  33. Proteinuria - qualitative and quantitative determination of proteins in urine
  34. Haemoglobinuria
  35. Urine sediment
  36. Disorders of physical characteristics of urine
  37. Pathophysiology of diuresis
  38. Determination of urea and creatinine concentration
  39. Acute kideny injury and chronic kideny disease (vignettes)
  40. Analysis of the results of standard thyroid gland and suprarenal gland function tests
  41. Lesion of the lower motor neuron
  42. Lesion of the upper motor neuron
  43. Effects of hyperkaliaemia on muscle contraction
  44. Conduction disorders in the neuromuscular junction
  45. Analysis of EEG in experimental epilepsy
  46. Functional evaluation of the autonomic nervous system

Research topics

Medical Pathophysiology

Course Director

Asst. Prof. Svetolik Spasić, MD, PhD

patoloska.fiziologija.mfub@gmail.com

Institute for Pathological Physiology "Ljubodrag Buba MIhailović"

Room 16, 1st floor, dr Subotića 9

tel. 2685-340