GPAT Pathophysiology Syllabus

Pathophysiology syllabus — full chapter and topic list

Expand any chapter to see its topics and sub-topics. This is the whole examinable outline for Pathophysiology in GPAT, not a summary of it.

1. 1

   Basic principles of cell injury and adaptation

   1 topic

   • Cell Injury
     • Causes of Cell Injury
     • Cellular Adaptation
2. 2

   Neoplastic diseases

   1 topic

   • Introduction to Neoplasia
     • Benign vs Malignant Tumors
     • Carcinogenesis
3. 3

   Pathophysiology of common diseases

   2 topics

   • Cardiovascular Diseases
     • Hypertension
     • Coronary Artery Disease
   • Respiratory Diseases
     • Asthma
     • Chronic Obstructive Pulmonary Disease (COPD)
4. 4

   Laboratory tests for Liver function tests and kidney function tests

   2 topics

   • Liver Function Tests
     • AST and ALT
     • Bilirubin Levels
   • Kidney Function Tests
     • Creatinine Clearance Test
     • Blood Urea Nitrogen (BUN)
5. 5

   Immunopathology including amyloidosis

   2 topics

   • Immunopathology
     • Autoimmune Diseases
     • Hypersensitivity Reactions
   • Amyloidosis
     • Types of Amyloidosis
     • Pathogenesis
6. 6

   Infectious diseases

   2 topics

   • Bacterial Infections
     • Gram-positive Bacteria
     • Gram-negative Bacteria
   • Viral Infections
     • RNA Viruses
     • DNA Viruses
7. 7

   Basic mechanisms of inflammation and repair

   2 topics

   • Inflammatory Response
     • Vascular Changes
     • Cellular Events
   • Tissue Repair
     • Regeneration
     • Fibrosis
8. 8

   Disorders of fluid, electrolyte and acid-base balance

   3 topics

   • Fluid Imbalance
     • Dehydration
     • Edema
   • Electrolyte Imbalance
     • Sodium Imbalance
     • Potassium Imbalance
   • Acid-Base Balance
     • Respiratory Acidosis
     • Metabolic Alkalosis
9. 9

   Disorders of homeostasis: white blood cells, lymphoid tissues, and red blood cells related diseases

   3 topics

   • White Blood Cell Disorders
     • Leukocytosis
     • Leukopenia
   • Lymphoid Tissue Disorders
     • Lymphadenopathy
     • Lymphoma
   • Red Blood Cell Disorders
     • Anemia
     • Polycythemia

Pathophysiology flashcards for GPAT

24 of 59 cards from the Pathophysiology deck — real questions with worked answers.

1. What is the difference between reversible and irreversible cell injury?

   Reversible injury (cell swelling, fatty change) resolves if the stimulus is removed; irreversible injury involves severe mitochondrial damage, membrane breakdown, and influx of Ca2+, leading to cell death by necrosis or apoptosis.

2. Name the two main morphological patterns of cell death.

   Necrosis (uncontrolled, with inflammation and membrane rupture) and apoptosis (programmed, energy-dependent cell death without inflammation).

3. List the major types of necrosis.

   Coagulative, liquefactive, caseous, fat, gangrenous, and fibrinoid necrosis.

4. Which type of necrosis is characteristic of tuberculosis?

   Caseous necrosis (cheese-like appearance).

5. What is free radical-mediated cell injury and which key enzymes defend against it?

   Injury from reactive oxygen species (e.g., superoxide, hydroxyl radical, H2O2) damaging lipids, proteins, and DNA. Defenses include superoxide dismutase, catalase, and glutathione peroxidase.

6. Define neoplasia.

   An abnormal mass of tissue with uncoordinated, excessive growth that persists after the inciting stimulus is removed (an autonomous new growth).

7. What are the key differences between benign and malignant tumors?

   Benign: well-differentiated, slow growth, encapsulated, no invasion or metastasis. Malignant: poorly differentiated (anaplastic), rapid growth, invasive, and metastasize.

8. Differentiate oncogenes from tumor suppressor genes.

   Oncogenes promote cell growth and are activated/gain-of-function in cancer (e.g., RAS, MYC). Tumor suppressor genes inhibit growth and are inactivated/loss-of-function in cancer (e.g., TP53, RB).

9. What is metastasis and what are its main routes of spread?

   Spread of tumor cells from a primary site to distant sites. Routes: lymphatic (typical of carcinomas), hematogenous (typical of sarcomas), and transcoelomic (across body cavities).

10. What is the morphological hallmark of atherosclerosis?

    The atheromatous (fibrofatty) plaque in the intima of large and medium arteries, with a lipid core and fibrous cap.

11. What distinguishes myocardial infarction from angina pectoris?

    Angina is reversible ischemic chest pain without myocyte death; myocardial infarction is irreversible ischemic necrosis of cardiac muscle due to prolonged coronary occlusion.

12. Which cardiac biomarkers are most specific for myocardial infarction and when do they rise?

    Cardiac troponins I and T are most specific, rising within 3-12 hours, peaking at ~24 hours, and remaining elevated for 7-10 days. CK-MB rises early and normalizes in 2-3 days.

13. Differentiate left-sided from right-sided heart failure.

    Left-sided failure causes pulmonary congestion and edema (dyspnea, orthopnea). Right-sided failure causes systemic venous congestion (peripheral edema, hepatomegaly, JVP elevation).

14. What is the pathological difference between emphysema and chronic bronchitis?

    Emphysema is permanent enlargement of airspaces distal to terminal bronchioles with alveolar wall destruction. Chronic bronchitis is defined clinically as productive cough for 3 months in 2 consecutive years, with mucous gland hyperplasia.

15. What is the underlying pathophysiology of bronchial asthma?

    Reversible airway obstruction from chronic airway inflammation, bronchial smooth muscle hyperreactivity, and excess mucus; often IgE-mediated (Type I hypersensitivity).

16. What characterizes restrictive vs obstructive lung disease on spirometry?

    Obstructive: reduced FEV1/FVC ratio (<0.7), e.g., asthma/COPD. Restrictive: normal/increased FEV1/FVC but reduced FVC and total lung capacity, e.g., pulmonary fibrosis.

17. Name the main liver function tests grouped by what they assess.

    Hepatocellular injury: ALT, AST. Cholestasis: ALP, GGT, bilirubin. Synthetic function: serum albumin, prothrombin time (PT/INR).

18. What does an AST:ALT (De Ritis) ratio greater than 2 typically suggest?

    Alcoholic liver disease (AST > ALT). In most other hepatocellular injury, such as viral hepatitis, ALT > AST.

19. Differentiate conjugated (direct) from unconjugated (indirect) hyperbilirubinemia.

    Unconjugated: water-insoluble, raised in hemolysis and Gilbert syndrome, not in urine. Conjugated: water-soluble, raised in biliary obstruction and hepatocellular disease, appears in urine (dark urine).

20. Which liver test best reflects acute hepatic synthetic function and why?

    Prothrombin time (PT/INR), because clotting factors have short half-lives (especially factor VII); it changes faster than albumin, which has a ~20-day half-life.

21. Which markers are used to assess kidney function and glomerular filtration?

    Serum creatinine, blood urea nitrogen (BUN), and estimated glomerular filtration rate (eGFR); creatinine clearance directly estimates GFR.

22. Give the Cockcroft-Gault formula for creatinine clearance.

    CrCl = [(140 - age) x weight (kg)] / (72 x serum creatinine in mg/dL); multiply by 0.85 for females.

23. What does an elevated BUN:creatinine ratio (>20:1) suggest?

    Prerenal azotemia (e.g., dehydration, hypovolemia, reduced renal perfusion) with enhanced urea reabsorption.

24. What is the difference between nephrotic and nephritic syndrome?

    Nephrotic: heavy proteinuria (>3.5 g/day), hypoalbuminemia, edema, hyperlipidemia. Nephritic: hematuria, RBC casts, hypertension, oliguria, and mild proteinuria.

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