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Systemic Pathology

Cardiovascular System

Cardiac failure: definition and common causes in adults.
Pathophysiology and clinicopathological features.

Ischaemic heart disease: coronary artery atherosclerosis.
Angina pectoris. Myocardial infarction, pathogenesis, detailed gross and microscopic appearances including sequence of changes with time. Complications of myocardial infarction. Clinical features and possible outcomes. Laboratory evaluation.

Chronic ischaemic heart disease: morphology and clinical features.
Causes and morphology of sudden cardiac death.

Hypertension: definition, classification and causes.
Pathogenesis of essential hypertension. Effects of hypertension on the heart and blood vessels and the systemic effects.

Valvular disease: causes and clinicopathological features of mitral stenosis, mitral incompetence, aortic stenosis, aortic incompetence and tricuspid and pulmonary valve disease. Rheumatic fever and rheumatic heart disease.

Calcific aortic sterosis. Mitral valve prolapse ("floppy" valve).

Infective endocarditis: aetiology, morphology and complications. Clinical features, investigations and principles of treatment and prevention.

Non-infective endocarditis. Prosthetic valves and complications arising therefrom.

Primary myocardial disease: myocarditis and the cardiomyopathies.

Pericardial disease: pericarditis and effusions.

Tumours of the heart.

Congenital heart disease: atrial septal defect, ventricular septal defect, patent ductus arteriosus, coarctation of the aorta, tetralogy of Fallot, transposition of great vessels, congenital anomalies of valves and coronary arteries.

Vascular diseases (other than atherosclerosis): aneurysms, definition, types and causes, complications and clinical effects.
Dissection of the aorta and main branches. Vasculitis. Miscellaneous disorders (Monckeberg's sclerosis, fibromuscular dysplasia, Raynaud's disease).
Thrombophlelibitis, phlebothrombosis and varicose veins.
Superior and inferior vena caval obstruction syndromes.
Lymphangitis and lymphoedema.
Tumours and tumour-like lesions of vessels.

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Respiratory System

Pulmonary infections: community acquired acute pneumonia, community-acquired atypical pneumonia, nosocomial (hospital-acquired) pneumonia, aspiration pneumonia. Infections in the immunocompromised host. Lung abscess and its complications. Pulmonary tuberculosis.

Restrictive lung diseases and acute interstitial lung disease (adult respiratory distress syndrome, drug, toxin and radiation-induced injury) and chronic interstitial lung disease (pneumoconiosis, sarcoidosis, fibrosing alveolitis).

Obstructive pulmonary disease: chronic bronchitis, definition, aetiology and morphology.
Emphysema: definition, classification and morphology and aetiology of the different types.
Clinical effects of chronic obstructive pulmonary diseases (COPD).
Respiratory failure: definition, types and causes. Bronchial asthma: characteristics, types, pathogenesis, morphology and clinical course.

Bronchiectasis: definition, causes, pathogenesis, morphology, clinical features and complications.
Collapse of the lung tissue (atelectasis): resorption, compression, contraction and microatelectasis.

Vascular disorders of the lung: thromboembolism and infarction, importance, pre-disposing conditions, pathophysiology, morphology and clinical course, Non-thrombotic emboli.
Pulmonary haemorrhage. Pulmonary hypertension, causes, morphological changes, cor pulmonale.

Neoplasms of the lung: bronchiogenic carcinoma, importance, aetiology, morphology, histological classification, spread, clinical features, paraneoplastic phenomena, role of the laboratory in diagnosis, grading and staging, prognosis and treatment.
Other primary neoplasms, benign and malignant.
Metastatic lung tumours. Lymphangitis carcinomatosum.

Diseases of the pleura: pleurisy, effusions, fibrosis, pleural plaques, neoplasms.

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Head and Neck Pathology

Common diseases of the nasal passages, sinuses, middle ear and larynx.
Cysts in the neck.
Common diseases of the mouth, pharynx and salivary glands.

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Alimentary System

Oesophagus.

Congenital and mechanical disorders: atresia/fistula, achalasia, webs and benign strictures, diverticula, hiatus hernia, oesophageal varices, Mallory-Weiss syndrome.
Oesophagitis: infective causes, reflux oesophagitis. Barrett's mucosa, metaplasia, dysplasia, carcinoma sequence.
Carcinoma: geographic variation, aetiology and pathogenesis, morphology including histological types. Spread. Clinical features. Other tumours.

Stomach.

Congenital anomalies, pyloric stenosis. Acute gastritis, erosions and ulceration: causes, morphology and clinical features. Chronic gastritis - Helicobacter - associated gastritis, autoimmune gastritis, chemical and drug induced gastritis and other forms. Pathogenesis and morphology. Chronic peptic ulcer - sites, aetiology and pathogenesis, morphology and complications. Clinical features of gastritis and peptic ulceration. Carcinoma - geographic variation, aetiology, pre-malignant conditions, dysplasia-carcinoma sequence, morphology, including histological types. Spread. Clinical features. Lymphoma - mucosa - associated lymphoma (MALT). Other tumours - carcinoid tumour, gastric stromal tumours.

Intestines.

Congenital anomalies: atresia/stenosis, malrotation, duplication, Meckels' diverticulum, meconium ileus, Hirschprung's disease.
Malabsorption: causes of small intestinal malabsorption. Coeliac disease - aetiology, pathogenesis, morphology, complications and clinical features.
Diarrhoea: categorisation of causes - secretory, osmotic, exudative, malabsorptive and deranged motility. Infectious enterocolitis: global importance.
Bacterial infections: general morphological changes, features seen in Escherichia coli, Salmonella, Shigella, cholera, Clostridium difficile (antibiotic, associated colitis) and tuberculosis. Neonatal necrotizing enterocolitis. Viral infections. Parasitic infestations, giardiasis, amoebiasis, cryptosporidiosis.

Chronic inflammatory bowel disease: Crohn's disease and ulcerative colitis.
Crohn's disease: morphology, gross and microscopic, complications, aetiology and pathogenesis, clinical features.
Ulcerative colitis: morphology, gross and microscopic, complications, local and systemic, aetiology and pathogenesis, clinical features.

Vascular disorders: ischaemic bowel disease, arterial occlusive and non-occlusive forms, venous occlusion. Morphology, complications and clinical features.
Angiodysplasia.

Diverticulosis: colonic diverticulosis, morphology, complications, aetiological factors and clinical features.
Intestinal obstruction: pathophysiology of small and large intestinal obstruction. Hernias, adhesions, intussusception, volvulus, tumours, strictures and pseudo-obstruction (paralytic ileus, bowel infarction, myopathies/neuropathies).

Intestinal polyps: definition of a polyp, benign epithelial types (adenoma, hyperplastic, inflammatory, hamatomatous) and malignant. Familial polyposis syndromes.

Colonic adenomas: morphology, gross and microscopic appearances, cancer risk related to size, grade of dysplasia, histological type. Clinical features.

Colorectal carcinoma: importance, epidemiology, aetiological factors and the adenoma - carcinoma sequence. Molecular pathology of the adenoma - carcinoma sequence. Morphology - gross appearances, differences between right and left sides of the colon. Microscopic appearances. Spread. Clinical features.
Importance of grading and staging in prognosis (Duke's staging and TNM staging).

Other tumours of small and large intestine including carcinoid tumour and lymphoma.

Appendix. Acute appendicitis, aetiology, pathogenesis, morphology, complications.
Tumours - carcinoid, mucinous tumours.

Anus and anal canal Haemorrhoids, warts (condyloma acuminata and human papilloma virus), carcinomas and melanoma.

Peritoneum: peritonitis, effusions, adhesions, neoplasms (primary, secondary and pseudo, myxomatous peritonei).

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Liver, biliary tract and exocrine pancreas

Liver.

Investigation of liver disease: biochemical (bilirubin, enzymes, albumin), haematological (clotting factors), immunological (viral antibodies/antigens, autoantibodies, immunoglobulins), liver biopsy (uses and limitations), imaging techniques.
Jaundice and cholestasis - definition, classification and mechanisms.

Liver failure: acute and chronic failure, causes, morphology, pathophysiology of hepatic encephalopathy and other features of liver failure. Laboratory investigations. Precipitating factors.

Cirrhosis: definition, morphology, pathogenesis, classification. Complications of cirrhosis including portal hypertension and its effects, liver failure and hepatocellular carcinoma.

Acute hepatitis. Causes. Acute viral hepatitis, clinical and laboratory features, histological appearances, possible outcomes. Pathogenesis, epidemiology and course of the different hepatotropic viruses.

Chronic hepatitis. Definition and classification according to aetiology. Clinical and laboratory features, histological appearances, grading of activity and staging of fibrosis of liver biopsy. Characteristics of chronic hepatitis due to the different hepatotropic viruses.

The liver in infectious diseases (non-hepatotropic viruses, bacteria, fungi, parasites). Neonatal hepatitis.

Autoimmune hepatitis: clinical, immunological and morphological features. Outcomes.

Drugs, toxins and the liver: outline of the numerous manifestations of drug and toxin induced liver injury. Particular attention to acute cholestasis, cholestatic hepatitis , chronic hepatitis and cirrhosis. Alcoholic liver disease: importance, metabolic disturbances, fatty liver, alcoholic hepatitis and cirrhosis. Pathogenesis of and factors influencing alcoholic liver disease.

Iron overload. Classification. Genetic haemochromatosis: importance, genetics, pathogenesis, laboratory diagnosis, morphology and complications.

Metabolic disorders. Wilson's disease, alpha-1-antitrypsin deficiency, and other inborn errors of metabolism.

Biliary obstruction. Extrahepatic obstruction - causes, effects on the liver, complications.

Intrahepatic obstruction: primary biliary cirrhosis, primary sclerosing cholangitis. Other causes of acquired and congenital bile duct injury.

Circulatory disorders.
Occlusion of portal veins, hepatic veins and arteries. The liver in heart failure and shock. Classification and causes of portal hypertension.

Tumours and tumour-like lesions.
Benign, malignant and metastatic neoplasms.
Primary hepatocellular carcinoma - importance, geographic incidence, risk factors, environmental carcinogens, morphology, spread, diagnosis and prognosis.
Cholangiocarcinoma - geographical incidence, risk factors, morphology, spread, prognosis. Tumour like lesions and cysts.

The liver in systemic diseases. Liver transplantation and graft versus host disease.

Diseases of the gall-bladder and extrahepatic bile ducts.
Gall stones: types, aetiology and pathogenesis and risk factors. Clinical features and complications.
Acute cholecystitis: causes, morphology and complications.
Chronic cholecystitis: causes and morphology.
Cholesterolosis. Benign strictures of bile ducts.
Neoplasms of the gall-bladder and bile ducts.
Neoplasms of the peri-ampullary region. Congenital biliary tract anomalies.

Diseases of the exocrine pancreas.
Acute pancreatitis: aetiology and pathogenesis, morphology and complications. Clinical features and laboratory diagnosis. Chronic pancreatitis: aetiology and pathogenesis, morphology. Clinical features.
Carcinoma of the pancreas: importance, aetiology and pathogenesis, morphology and spread. Clinical features and prognosis. Cysts and cystic neoplasms. Congenital anomalies; cystic fibrosis.

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Kidneys and Urinary Tract

Kidneys.

Clinical manifestations of renal disease. The pathology of renal failure. Glomerular diseases - classification, aetiology, pathogenesis, morphology and clinical cause of the various forms of primary glomerular disease. Chronic glomerulonephritis.
The glomeruli in systemic disorders, vascular disorders and hypertension. Renal infarction. Acute cortical necrosis. Renal transplantation. Tubulo-interstitial diseases. Acute pyelonephritis - aetiology, pathogenesis, morphology, complications and clinical course.
Chronic pyelonephritis: aetiology, pathogenesis, morphology and clinical course. Renal tuberculosis. Acute tubular necrosis. Interstitial nephritis. Analgesic nephropathy. Congenital and cystic disease of the kidney.

Urinary outflow obstruction.

Renal stones: pathogenesis, morphology and clinical course. Hydronephrosis - causes, morphology and clinical course.

Bladder & ureters.

Inflammation, obstruction, calculi and congenital lesions.

Neoplasms of the kidney and urinary tract.

Renal cell carcinoma: aetiology, types, morphology, spread, paraneoplastic syndromes, clinical features. Wilm's tumour. Transitional cell carcinoma of bladder and collecting system. Aetiology, morphology, spread, grading and staging and clinical course of bladder carcinoma.

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Male Genital Tract

Prostate Gland.

Prostatitis: acute and chronic.
Benign nodular hyperplasia: incidence, aetiology, morphology, complications and clinical features.
Prostate carcinoma: incidence, aetiology, symptomatic & latent forms, morphology, spread, grading and staging.
Clinical features, diagnosis and principles of therapy.
Screening for prostatic carcinoma.

Testis.

Cryptorchidisim, hydrocoele, haematocoele, torsion and orchitis.
Neoplasms of the testis. Aetiology, classification and histogenesis. Morphology and spread.
Clinical features, staging, assay of tumour markers and principles of therapy.

Epididymis.

Cysts, spermatocoele, epididymo - orchitis.

Penis and Scrotum.

Congenital anomalies, inflammations including sexually transmitted diseases, venereal warts, carcinoma of the penis and scrotum.
Causes of male infertility.

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Female Genital Tract

Vulva.

Sexually transmitted and other infections. Condyloma. Cysts. Non-neoplastic epithelial lesions. Neoplastic epithelial lesions. Paget's disease.

Vagina.

Vaginitis and neoplasms.

Uterine Cervix.

Cervicitis. Polyps.
Cervical squamous carcinoma - importance, changing incidence, epidemiology, aetiology and pathogenesis.
Cervical intra-epithelial neoplasia - morphology.
Invasive carcinoma - morphology, spread and staging.
Cytology screening programmes. Clinical course. Glandular neoplasia of the cervix.

Uterine corpus.

The normal endometrium and menstrual cycle. Endometritis, endometriosis, adenomyosis and endometrial hyperplasia. Iatrogenic changes in the endometrium. Causes of dysfunctional uterine bleeding. Endometrial polyps. Endometrial carcinoma - importance, epidemiology and pathogenesis, morphology and spread. Clinical course. Endometrial stromal sarcoma and mixed Mullerian tumour. Leiomyomas of the myometrium - importance, morphology and clinical features. Leiomyosarcoma. Diseases of the Fallopian tubes. Pelvic inflammatory disease.

Ovaries.

Follicle development. Follicular, luteal and other non-neoplastic cysts. Polycystic ovary syndrome. Stromal hyperplasia and luteinization.
Neoplasms: importance and classification.
Epithelial neoplasms: sub-classification, benign, borderline and malignant forms.
Morphology, spread and complications. Pathogenesis including genetic susceptibility. Germ cell tumours, sex cord stromal tumours and metastatic tumours. Clinical features, tumour markers and therapy of ovarian neoplasms.

Female Infertility.

Pathology of Pregnancy
Placental inflammations and infections. Pre-eclampsia and eclampsia - placental changes and multi-organ changes. Post partum haemorrhage. Pathology of the full term placenta. Gestational trophoblastic disease - hydatidiform mole, complete and partial, invasive mole, choriocarcinoma.
Epidemiology, morphology and clinical outcomes.
Tumour markers.
Pathology of umbilical cord and membranes.
Ectopic pregnancy.
Maternal death.

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Diseases of the Breast

Development and developmental abnormalities. Structure, cyclical changes, pregnancy and lactation, involution.
Inflammatory conditions: infections, duct ectasia, fat necrosis.
Proliferative conditions: fibrocystic change, terms, incidence, aetiology and pathogenesis, morphology, including histological types.
Significance of proliferative lesions, especially atypical hyperplasia.
Benign neoplasms: fibroadenoma, duct papilloma, adenoma.
Malignant neoplasms: Breast carcinoma - importance, risk factors, pathogenesis - genetic, hormonal and environmental factors. Morphology, macroscopic and microscopic types and appearances.
In-situ and invasive carcinoma.
Paget's disease of the nipple. Spread of breast carcinoma. Prognostic factors - type, histological grade, stage, hormone receptors, growth kinetics.
The clinical features of breast diseases and their pathological basis.
Diagnostic methods - fine needle aspiration cytology, core biopsy, frozen section, mammography and ultrasound. Screening for breast cancer.
Diseases of the male breast - gynaecomastia and carcinoma.

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Endocrine System

General principles of disease of the endocrine system - hyperfunction, hypofunction, benign and malignant tumours, interdependence of the glands, multiple involvement by tumours and autoimmune diseases.

Pituitary.

Adenohypophysis - hyperfunction and adenomas. Types of adenomas. Effects of excess hormone secretion. Pressure effects of adenomas. Hypopituitarism - pituitary dwarfism, ischaemic necrosis (including Sheehan/Simmond post-partum necrosis), iatrogenic causes, neoplasms. Posterior hypophysis - diabetes insipidus and inappropriate ADH secretion.

Pineal Gland.

Thyroid

Hyperthyroidism. Systemic effects of thyrotoxicosis.
Grave's disease: pathogenesis and morphology. Other causes thyrotoxicosis - functioning adenoma and toxic nodular goitre. Hypothryoidism. Myxoedema and cretinism. Hashimotos's thyroiditis - pathogenesis, morphology and risk of lymphoma. Other forms of thyroiditis. Iatrogenic causes of hypothyroidism. Goitre - definition, classification, morphology and causes. Solitary nodules - investigation including diagnostic imaging and fine-needle aspiration cytology. Neoplasms. Adenoma. Carcinomas - classification, pathogenesis including genetic and environmental factors and pre-existing thyroid disease. Morphology of the different types, spread, and clinical features including differences in prognosis. Lymphoma of the thyroid.

Parathyroids.

Primary hyperparathyroidism: causes (especially adenoma), morphology of the parathyroids and other organs, molecular pathology and clinical features.
Secondary hyperparathyroidism: causes, morphology, clinical features and tertiary hyperparathyroidism. Hypoparathyroidism: causes and clinical effects.

Adrenals

Hypercorticolism (Cushing's syndrome): causes, morphology, clinical effects and diagnosis.
Hyperaldosteronism (Conn's syndrome): causes, morphology, clinical effects and diagnosis.
Adrenogenital syndromes.
Adrenal cortical insufficiency (Addison's disease and Waterhouse - Friderichsen syndrome) - causes, morphology and clinical effects.
Neoplasms of the adrenal cortex.
Neoplasms of the adrenal medulla.
Multiple Endocrine Neoplasia Syndromes.

The Endocrine Pancreas.

Diabetes mellitus: importance, classification, pathogenesis, morphology and pathogenesis of complications, clinical features.
Islet cell tumours.

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The Lymphoid System

Lymph Nodes

The functional anatomy of lymph nodes. Non-specific reactive hyperplasia. Morphology and causes of follicular hyperplasia, paracortical hyperplasia and sinus histiocytosis. Lymphadenitis, non-specific and specific forms.
Lymphomas. Hodgkin's disease - classification and morphology. Clinical features, staging and survival. Non-Hodgkin's lymphomas, including extranodal lymphomas - classification, morphology, molecular pathology and prognostic factors.

Spleen

Causes of splenomegaly. Hypersplenism. Splenic atrophy. Splenic infarction. Splenic rupture. Congenital anomalies.

Thymus

Hyperplasia and thymomas.
Muskuloskeletal System

Bones

Osteoporosis: definition, importance, classification, pathogenesis, morphology, clinical features, complications and prevention and treatment.
Rickets and osteomalacia: definition, pathogenesis, morphology and diagnosis, prevention and treatment. Bone disease in hyperparathyroidism and renal disease.
Osteomyelitis: aetiology, morphology, clinical features and complications.
Paget's disease of bone: incidence, epidemiology, pathogenesis, morphology and complications. Congenital and hereditary conditions.
Bone neoplasms and tumour-like lesions: classification, morphology and principles of diagnosis.

Joints

Osteoarthritis: importance, pathogenesis, morphology and clinical features.
Rheumatoid arthritis - aetiology, pathogenesis, morphology and clinical features including extra-articular manifestations.
Gout and "pseudogout". Ankylosing spondylitis.
Arthropathies occurring in other diseases.
Degenerative disease of intervertebral discs.
Infective arthritis.

Skeletal muscle.

Muscle atrophy, myasthenia gravis, myositis and muscular dystrophies.

Soft tissue.

Tumours and tumour-like lesions of soft tissue.

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Skin

The vocabulary of skin diseases: clinical and histological terms. Principles of skin biopsy.
Acute inflammatory dermatoses: urticaria, dermatititis and erythema multiforme.
Chronic inflammatory dermatoses: psoriasis and lichen planus.
Bullous diseases: pemphigus, bullous pemphigoid and dermatitis herpetiformis.
Common benign epithelial tumours. Squamous and basal cell carcinoma - aetiology, clinical features and morphology.
Naevi and dysplastic naevi. Malignant melanoma - environmental and genetic aetiological factors, morphology, staging, spread and clinical features.

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Central and Peripheral Nervous System.

Intracranial space-occupying lesions - causes of diffuse and focal brain swelling. Consequences of raised intracranial pressure.

Central nervous system trauma: missile and non-missile head injury - mechanisms, morphological appearances, clinical features and outcomes. Spinal cord injury.
Cerebrovascular disease: hypoxic/ischaemic damage.
Strokes: infarction, pathogenesis and morphology.
- intra-cranial and subarachnoid haemorrhage - pathogenesis and morphology.
Effects of hypertension.

Infections. Bacterial: meningitis and brain abscess. Tuberculosis and syphilis. Viral - meningitis and encephalitis. Latent and persistent viral infections. Human immunodeficiency virus. Prior diseases - spongiform encephalopathies. Fungal and parasitic diseases.
Infections in immunosuppressed patients.

Demyelinating conditions. Multiple sclerosis - epidemiology, pathogenesis, clinical features and morphology. Miscellaneous demyelinating conditions. Toxic, metabolic and nutritional deficiency states. Congenital malformations and peri-natal brain injury.
Age-related changes in the CNS.
Degenerations: Alzheimer's disease and related disorders, causing dementia.
Parkinson's disease. Huntington's disease. Motor neurone disease.

Neoplasms: classification. Clinicopathological features. Characteristics of the various types of intrinsic and extrinsic tumours. Metastatic tumours.
Peripheral nervous system: reaction to injuries, neuropathies and neoplasms.

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Last updated 7 May 2010 Paul Smyth (Email).