FIVE CARDINAL SIGNS OF INFLAMMATION

 “redness”; due to arteriolar and capillary dilatation with increased rate of

blood flow towards the site of injury
 “swelling”; due to increased capillary permeability causing extravasation of
blood fluid
 “heat”; due to transfer of internal heat to the surface or site of injury,
brought about by increased blood content
 “pain”; due to pressure upon the sensory nerve by the exudate/tumor
 “diminished/loss of function”; destruction of the functioning units of the
tissue

CHANGES IN CELLULAR GROWTH PATTERNS

Retrogressive changes – organ/tissue smaller than normal

 Incomplete/defective development of tissue/organ; most commonly seen in
one of paired structures; this is most commonly seen in one of paired
structures such as kidneys, gonads and adrenals
 Non-appearance of an organ
 Failure of an organ to reach its full, mature size
 Failure of an organ to form an opening
 Decrease in size of a normally mature tissue/organ resulting from the
reduction in cell size or decrease in the total number of cells
Progressive changes-organ/tissue larger than normal
 Tissue size increases because of size increase of individual cells
 Tissue size increases because of increase in the number of cells making up the
tissue
Degenerative changes-tissue have abnormalities
 Reversible change involving the transformation in one type of adult cell to
another
 The regressive alteration in adults cells manifested by variation in size, shape
and orientation, associated with chronic inflammation and protracted
irritation; usually applied to epithelial cells
 Otherwise known as dedifferentiation; marked regressive change in adult cells
towards more primitive or embryonic cell types, usually utilized as a criterion
towards malignancy
 Otherwise known as Tumor; the continuous abnormal proliferation of cells
without control, serving no useful purpose or function, usually accompanied
by increase in size and pigmentation, mitosis, number, metaplastic and
anaplastic changes of the cells; this represents a pathologic overgrowth of the
tissue

COMMON BENIGN AND MALIGNANT TUMORS

Malignant Benign
Hematopoietic
 Leukocyte Leukemia -
 Lymphoid Tissue Lymphosarcoma/lymphoma Infectious mononucleosis
 Plasma cells Multiple myeloma -
Epithelial Tissues
 Glandular epithelium Adenocarcinoma Adenoma
 Squamous epithelium Squamous carcinoma Papilloma
 Renal epithelium Renal cell carcinoma Renal tubular adenoma
 Testicular epithelium Seminoma -
Connective tissue
 Smooth muscle Leiyomyosarcoma Leiyomyoma
 Striated muscle Rhabdomyosarcoma Rhabdomyoma
 Blood vessels Hemangiosarcoma Hemangioma
 Fibrous Fibrosarcoma Fibroma
 Cartilage Chondrosarcoma Chrondroma
 Bone Osteosarcoma Osteoma
  Far Liposarcoma Lipoma
Nerve tissue
 Glial tissue Glioma -
 Retina Retinoblastoma -
 Nerve cells - Neuroma
 Nerve sheath Neurogenic sarcoma -

DEATH

Cell death
 Programmed cell death
 Physiologic death of cell
 Pathologic death of cell
Types of Necrosis
 Most common type; “tombstone formation”
 Otherwise known as Colliquative Necrosis; “pus formation”
 “yellow cheezy crumby masses”
 Production of sulfide gas
 “chalky white precipitate
Somatic death – death or complete cessation of metabolic and functional activities of the entire body or organism
 First demonstrable change observed; cooling of the body
 Rigidity or stiffening of the muscles, 2-3 hours after death
 Post-mortem lividity/post-mortem suggillations; purplish
discoloration/ lividity of skin
 Differentiation between post-mortem clot and antemortem clot
 Drying and wringkling of the anterior chamber of the eye
 Invasion of the intestinal microorganism
 Self-digestion of cells

AUTOPSY

 The process of taking pieces of tissue from a dead person for the
purpose of examination or investigation, in order to determine the
cause of death or extent of injury leading to the death of the
person
 To determine or ascertain the cause of death of a death
 To determine the final diagnosis
 To investigate the cause of death or extent of injury leading to the
death of the person
 To preserve the tissue of the dead body for further examination,
investigation and future study as in research or scientific study

PRINCIPAL TECHNIQUES IN AUTOPSY

 Organs re removed one by one. This method has been used most
widely, often with some modifications. Originally, the first step was
to expose the cranial cavity and from the back, the spinal cord,
followed by the thoracic cavity, cervical cavity and abdominal
organs
 This technique is characterized by in situ dissection, in part
combined with en bloc removal
 Thoracic and cervical organs, abdominal organs and the urogenital
system are removed as organ blocks. Modification of Ghon’s “en
bloc” removal technique is now widely used
 Thoracic, cervical, abdominal and pelvic organs are removed en
masses and subsequently dissected into organ blocks
IMMUNOHISTOCHEMICL TECHNIQUES

 The use of antibodies as histological tools for identifying patterns of

antigen distribution within a tissue or organism
 Most commonly used antibody for immunocytochemistry
 Produced by immunizing an animal with an immunogen that
contains the antigen of interest
 Most frequently used animal: RABBIT, goat, pig, sheep, horse,
guinea pigs and others
 Products of an individual clone of plasma cells
 Animal used: mice

TUMOR MARKERS

EPITHELICAL Tumor Markers Intermediate Filament Markers Neuroendocrine Markers

 Keratin  Actin  NSE (Neuron-specific enolas)
 EMA (Epithelial Membrane  Vimentin  Chromogranin
Antigen)  Desmin  Synaptophysin
 CEA (Carcinoembryonic  GFAP (Glial Fibrillary Acidic
Antigen) Protein)
 TTF-1 (Thyroid Transcription  NF (Neurofilament)
Factor-1)  S100 Protein
 PSA (Prostate Specific
Antigen)

Germ cell tumor Markers
 HCG (Human Chorionic
Gonadotropin)
 AFP (Alphafetoprotein)
 PLAP ( Placentalike ALP)
Mesenchymal Tumor Markers Infectious Agent Markers
 Myogenic Tumors – use actin  Hepa A virus
and desmin and/or other  Hepa B surface and core
muscle markers such as myo- antigens
D1, myoglobin and myogenin  Heap C virus
 Fibrohistiocytic Tumors-  Human papillomavirus
CD68 or FAM 56, combined  CMV
with nonspecific proteolytic  EBV
enzymes such as alpha-1-  Toxoplasma
antitrypsin and alpha-1-  Pneumocystis carinii
antichymotrypsin  H. pylori
 Vascular Tumors- factor VII  Cryptosporidium
related antigen, CD31 and  C. neoformans
Ulex europaeus I (UEA)  Histoplasma
 Melanomas- S100, HMB-45,  E. histolytica
Melan-A (MART-1), HMB-45
 Mycobacteria
 Lymphomas-LCA (Leukocyte
common antigen/CD45

MEDICAL TECHNOLOGY LAWS AND BIOETHICS

RA. 5527: THE PHILIPPINE MEDICAL TECHNOLOGY ACT OF 1969 (JUNE 21,1969)

Section 1  Title
Section 2  Definition of terms
Section 3  Composition of the council of medical technology
Section 4  Compensation and traveling expenses of council members
Section 5  Functions of the council of medical technology
Section 6  Minimum required course
Section 7  Medical technology board
Section 8  Qualification of board examiner
Section 9  Executive officer of the board
Section 10  Compensation of the members of the board
 Section 11  Functions and duties of the board
Section 12  Removal of the board examiner
Section 13  Accreditation of schools of medical technology and training laboratories
Section 14  Inhibition against the practice of medical technology
Section 15  Examination
Section 16  Qualification for examination
Section 17  Scope of examination
Section 18  Report of rating
Section 19  Rating in the examination
Section 20  Oath taking
Section 21  Issuance of certification of registration
Section 22  Fees
Section 23  Refusal to issue certification
Section 24  Administration investigation
Section 25  Appeal
Section 26  Reinstatement, reissue or replacement of certification
Section 27  Foreign reciprocity
Section 28  Roster of medical technology
Section 29  Penal provisions
Section 30  Separability clause
Section 31  Repealing clause
Section 32  effectivity

OTHER RELATED LAWS

RA 5527  June 21, 1969

RA 8981  December 5, 2000
RA 1517  June 16, 1954
RA 7719  May 5, 1994
RA 8504  February 13, 1998
RA 4688  June 18, 1966
RA 6425  March 30, 1972
RA 9288  April 7, 2004
RA 9165  June 7, 2002
RA 9482  May 25, 2007

RA 9288; NEWBORN SCREENING ACT OF 2004

Disorder Screened Effects Screened Effect if Screened and Treated

 Severe mental retardation  normal
 death  alive normal
 death, cataracts  alive and normal
 severe mental retardation  normal
 severe anemia, kernicterus  normal