foreign a very good morning to all of you sorry for being late I was a little bit late I'm really sorry for that there was some technical so we were dealing with that that's why I got late I'm really sorry for that so let's start the session a very very good morning a refreshing morning to all of you right so I welcome you all for today's session I am Dr Priyanka sachdev here and today I am here to announce my new course of pathology that is complete pathology by Dr Priyanka am I visible am I audible Kishore Siri Mehran can someone reply me if I'm clearly visible audible there were some audio glitches we were dealing with that's why I got late for the class I'm really sorry for that can you please confirm Siri Kishore anyone Deepak Deepak yes okay okay great great thank you thank you so much for confirming thank you so much so today I want to announce my new course which I am going to launch on an academy the complete pathology it's a structured course by Dr Priyanka so if you are preparing for any of these exams that is just a second if you are preparing for neet PG FNG inict next us Emily any of the medical entrance competitive exam or if you are preparing for your University exams for second prop and if you are struggling with pathology as a subject in these exams then I am here for you this course is just perfect for you right so um if you are targeting for your University exam if you are a second prop student what do you want from pathology you want to secure a distinction or if you are lucky you want to secure a gold medal in pathology right right but if you are targeting for any of the competitive exam need PG and ICT what you expect from pathology you want to secure a single digit rank of course pathology is the big contributor in that right so whatever questions you get in your exam out of 200 or 300 questions I guess 30 or 25 30 questions straight forward from pathology and remaining another 20 by 39 integrated way so pathology is a great contributor for your good rank a single digit rank in your exam isn't it yes or no tell me yes or no so uh I am launching this course for you people that is complete pathology by Dr Priyanka so this course is starting from 24th of March so first let me Orient you just in the five minutes regarding this course then we will start a very important topic I will give you some important topics today right so I will discuss those topics with you just a second so this course uh in the course I will give you live interactive lectures I will give you live interactive lectures uh you can ask your doubts live instantly with me and your doubts will be resolved so you know watching lectures in a recorded version will be sometimes boring for the students so that's why we came up with this module in which I will give you live interactive lectures you can ask your doubt instantly to me right and I will give you first conceptual Theory we will not study retrospectively first I will give you a question then related Theory no first I will teach you that topic in depth just suppose I am teaching you any topic Mi cardiomyopathy or any topic first we will see the crisp conceptual theory of that topic followed by which we will see the heteropathological diagram we will see the latest updates of the robins we will solve all pyq ibq most expected questions clinical questions related to that topic today we will see a topic in demo right not only this on the top of this I will provide you concise notes also I will provide you updated question bank and a high yield mock test after every module so this course is just perfect it's the complete preparation of pathology right now let me tell you approach to pathology whether you join this course or doesn't join this course but it is important to know how to approach pathology many students ask me this question ma'am how to approach pathology we find this subject as very difficult so the funk thing let me clarify you the Bible of pathologies Robbins you have to follow Robins you have to if you want to excel if you want to master in pathology you have to understand Robins now many students tell me ma'am there is a problem in Robbins what is the problem students face in Robin It is incomprehensible big paragraphs are there language is very difficult to understand not able to get an overview in the first reading multiple readings are required likewise you got my point so these are the problems and problems then let me tell you how to complete this book in the shortest man of time possible right so it is a very simple approach I am launching this course right so first thing you watch my videos so videos will be not known it is not the live sessions complete day the eight hour session 10 hour session no we will take two two or three three hour session every weekend Friday Saturday Sunday Friday Saturday Sunday so you can spend two or three hours on the weekend definitely you can and the sessions will be live we can interact with each other right you can ask your doubts to me after that make your own notes I prefer you make your own notes right the notes will be provided by me also you can download the notes anyway but you can make your own notes also if you which it will be better right after that I will provide you if you're a second prop student now I will provide you all the saqs and la queues which are asked in various universities of the India throughout India right I will provide you that list so from that topic what execues that leqs are important have a look on that and if you are preparing for the competitive exam I will provide you the question Bank related to that topic what all pyqs already asked the frequently Asked topics from that particular chapter have a look on that right after watching my videos and after that if you have time now read Robins now Robin's will be a cakewalk for you believe me Robbins will be a cakewalk if you don't have time you can skip also because everything will be covered in the videos only and you have already made your notes from the videos so basically you have already my videos are the simplified version of problems only you got my point so you have already made your notes in the simplified version of the robins you have understood it if you have time you can read it if you are in second Prof but if you are preparing for the competitive exam no need to read Robin's this is just efficient right so when I provide you the videos it will give you a bird's eye view of that topic right it will be better understanding and you can read understand that topic with much higher speed you got my point and if you make your own notes now it will fit in your permanent retention now there is a very good proverb if you read anything there is a probability you can forget but if you write anything you will not forget it in your entire life try it out if you read anything you can forget but if you write now you will never forget so that's why I always in students to make their own note right to make their own notes now there is the Golden Rule exam is not about how much you read exam is all about how much you recall any exam whether it's a University exam whether it is any medical entrance competitive exam how much you recall in the exam that matter the three hours in the exam that matter it doesn't matter how much you have studied since the last four years five years doesn't matter you studied for 10 hours you studied for 12 hours you studied for two hours daily it doesn't matter how you are recalling in the exam and performing in the exam that matters that will decide your rank right and record depends on revision and revision will be fast if you make your notes at the end you cannot reopen all the books and read it you cannot open Robins in the last 10 days of course right you have to make your notes so make a strategy not only in pathology in all subjects you have to make your own notes you gotten a point so uh solve as many as questions from the question bank I will provide you question Bank topic by topic chapter by chapter so just suppose today I'm teaching you apoptosis necrosis so just after watching immediately the lecture you solve all questions from the question Bank after the session only it will hardly take 30 more minutes or one more hour right but the topic will be cover you know so you have watched the video while watching only you make your notes and if you if you miss anything while watching if you cannot write the notes are easily downloadable now you can later on download the note and complete your notes right so why watching it write it and make your notes then solve the question Bank instantly after the session right so in two two or three three hour session I would like to complete one one chapter in every session just suppose I am going to start with CVS so in the three hours I will take all important things of the CVS then we will go on CNS then respiratory system likewise we will cover one one unit or two two small units in that spawn so you have to solve the question Bank complete question bank so I will provide you free I will give you a list of the topics which are trick on which the questions are frequently framed so you know in any competitive exam nearly 50 percent of the questions are repeat 50 60 not exactly the questions are repeat the topics are repeat but the remaining forty fifty percent of the new questions every year yes so you if you want to secure a good rankner you should do py cues also but you should be prepared for the new questions also so how you will be prepared for the new question P by Q you will solve the P by Q of last three year or five year but how you will secure a good rank like how you will excel in new question solving for that I will give you frequently Asked topic list just see the conceptual theory of that topic so any question frame from that topic whether it is an image based question clinical scenario based question or an integrated question you will be able to solve it I can challenge you got my point so after that if in any case if required read Robins so read the Robin but before reading Robins I always advise my student to do this thing I always advise to do the thing you uh stick a sticky note here on the first page of the chapter and first write down the frequently Asked topic from this chapter so this is the chapter we are talking from this chapter adaptation apoptosis necrosis calcification pigments these are the five important topics so while reading now you know that questions are frequently Asked from these topics and you will read these topics with full concentration right so this is the way you should approach you should approach pathology right now the next question students ask me ma'am how many hours we should study in a day so that we can get a good rank or you can get a distinction in your exam or a single digit rank so do you really think it is the quantity of time you give to your study matters right now if a student is studying for 12 hours 14 hours or 16 hours but with full distraction on multiple social media digital platform forms and the other student on the contrary studying only for six to eight hours but with full concentration away from social media platforms now you yourself decide at the end of the day output is more for which student so at the end of the day what matters is the output it doesn't matter for how many hours you study it matters what is your output at the day at the end of the day so while you go to sleep you should ask yourself whatever was the target for today have I completed those targets right that is the point and so basically you have to study all 19 subjects in five years of Spawn and you have one exam that will decide your entire life so whatever MD or Ms you want to do any of the 19 subject that will depend on this exam the rank you get in this exam and now we know we are approaching towards next now next from next year the next will replace all other exams and in the next 70 percent of the questions are going to be clinical integrated it is very important tend to integrate the pathology with all other subjects you got my point so I will teach you the basics of pathology not only this I will teach you how pathology is integrated with all these other subjects so I will teach you pathology in a integrated manner right do you have any doubt are you people there can you write something in the chat box do you have any doubt please tell me if you have any doubt so basically you want to achieve your dream Branch what you want to get you want to a dermatologist you want to become a pathologist surgeon obstetrician gynecologist what you want to become whatever your dream Branch you want to achieve it from your Apex Institute you know one of the Apex Institute you should do your mdms that should be a dream that should be a Target and if you get a good rank rank one or good rank so you will have a choice you can take any of the 19 Branch but if you get not a good rank a compromise rank you have to do the compromise now you want a choice or you want compromise it's your it's in your hands you got my point so anyways after this let me tell you my plan so in this course which I am launching uh for pathology so ayats you are asking when it is going to finish it is starting from 24th March I guess it is the end of the March and it will last for March April May till end may end I will end this course so classes will be on Fridays Saturdays Sunday two to three hour classes so basically we can say we can say 6 to 10 hour classes every weekend every weekend we will we cannot just fix the number of hours but depending on topic to topic 2 to 3 hours classes on every Friday Saturday Sunday we will take right so this is how we are going to finish the entire syllabus right theories pyq ibq clinical question the new expected question we are going to cover everything in pathology after this course you will have a strong foundation and pathology that I can challenge so just a spawn of two months or two and half months and you will excel in pathology I can challenge that so I have the divided the complete pathology in three segments the general pathology hematology and systemic pathology right so I will start with systemic pathology right because most of the students found this portion to be most difficult so you know at the start of the course we are very enthusiastic and as we go um far ahead sometimes we have other commitments and sometimes we get you know so at the start only I will start with systemic pathology the most difficult portion you feel I don't feel it's difficult right I will make this fun for you believe me you don't have to learn even a single word I will explain everything in a conceptual crisconceptual manner right so we will start with systemic pathology followed by we will come on General pathology in the end we will we will go on hematology right so in this manner we are going to cover entire pathology in general pathology I am going to cover these nine chapters I will not skip any anything I will cover all these you can see the topics are in front of you the chapters are in front of you in each chapter whatever relevant for your exam Point your competitive exams also like I will cover all clinical questions also number one I will cover maximum ibqs also so I will give you few prototype questions to solve within the class only in the form of the polls and whatever extra questions will be there I will provide you in the question bank and immediately after the lecture I will ask you to solve the question bank so you will master in that topic topic by topic you will master so this is the general pathology hematology everyone knows we have only four topics it's a small portion so in the end last two weeks or last one week we will take entire hematology all anemia's all leukemias all thrombocytopenias along with blood transfusion right right and in the systemic pathology I will teach you these 12 systems one by one we will not keep even a single system we will cover everything each and everything in pathology so we will uncover pathology in a beautiful manner the pink and purple will become fun for you you got my point believe me try it out try it out at least so today I am taking a topic from General pathology for demo tomorrow also we are having a free class a demo class and after that if you like the demo if you like the plan if you like the strategy schedule and if you are confident you can go ahead with the plan and we will start from Friday I guess this Friday the coming Friday or from 24th of March today I selected a topic inflammation from General pathology so we are going to cover inflammation in the next one hour are you people with me are you people with me am I audible everyone give me a thumbs up everyone are you people there can I start inflammation and tomorrow you can tell me topic of your choice either from hematology or systemic pathology or one-man topic from both so tomorrow Monday we are having a class at 9 00 PM in the night so 9 to 11 I will take the class so you can take any system of your choice I can take CVS also long also glomerulonephritis whatever you say we will take that as a demo anyways I have to teach you entire pathology whatever you say I can put for the demo the free class right so we will study I mean I will give you uh this tomorrow right the systemic pathology demo tomorrow so today we are studying a topic from General pathology that is acute inflammation so let's start acute inflammation believe me just give me 40 minutes 40 minutes for this topic 30 to 40 minutes and you yourself realize how interesting and easy going topic is this and after that if you wish I will provide you question Bank also notes also and you just flip the pages of robins it will become a cake box for you believe me try it out now give 40 minutes then we will talk again okay so let's start inflammation first acute then chronic of course so acute inflammation you have to understand the difference between inflammation inflammation and infection inflammation and impaction you have to understand the difference listen let me tell you something okay just a second so whenever any organism microorganism it can be a bacteria it can be a virus it can be a fungus or it can be a parasite out of the poor microorganism enters human body they causes infection the harmful effects caused by the microorganism is known as infection the human body opposes it the human body do the defense the human body opposes do the defense in a protective mechanism that is known as inflammation so you only tell me inflammation is protective for us or harmful for us I am asking you inflammation is protective or harmful what is it so of course inflammation is protective for us it is a defense mechanism so inflammation is the body defense reaction you know so in a country we live in India so whatever country we are residing we have a army the Army is for the defense so whenever any foreign particle that is the terrorist enters in in the country in the territory of the country the Army get activated and there is a fight between the terrorist and the Army the terrorists is the bacteria or microorganism you can say it's a foreign particle basically right which is entering in the territories the territory is human body right and the army of human body is the WBC so there is a fight between the microorganism and the WBC in that fight if microorganism is winning there is infection and in that fight if WBC is winning there is inflammation so whether in the fight who is more strong your immunity is more strong or the microorganism virulence is more strong depends on that you will have infection or inflammation in your body we all want we don't have infection so that you should have a strong immunity but strong immunity means you should have a adequate number of functional WBC the defense the army so that you will have inflammation in your body you got my point so this is the basic you must understand what is inflammation first Define it it is the defense mechanism of in in human body in order to eliminate or limit the spread of the injurious agent the injurious agent can be bacteria virus fungus or parasite right and who does so who does so so it is the wbcs wbc's is the defense mechanism now let me classify inflammation we classify inflammation into two segments the acute and The Chronic there are two types of inflammation acute or chronic acute electronic so let's take example of one by one acute inflammation the best example which come in my mind is tonsillitis do you have tonsillitis sometime in your life I have multiple episodes right so we are aware what is tonsillitis it's a very common disease and I guess everyone is exposed to this this disease sometime in the in your life right so it is the type of acute inflammation you can see the tonsils right and this is tuberculosis it is an example of chronic inflammation right so it is rare not as common as the tonsillitis but it is an example of chronic inflammation now this is also caused by a bacteria known as trapped pneumonia this is also caused by a bacteria known as mycobacterium tuberculosis now listen carefully as soon as in acute inflammation the bacteria until the body the onset of the disease is very fast after the entry of the bacteria within few hours we have pain in tonsil we have fever pain in tonsil and all the symptoms and it will maximum last for seven days whether you take treatment or do not take treatment it will last for a week nearly so onset is passed duration is duration is um less so duration of the disease is very less onset is very fast see in TB the mycobacterium tuberculosis enters human body and remain dormant remain latent for several months or several years and after that when the immunity drops at that time patients have coughline symptoms so onset is very slow it is after months or years come on and once someone have TB so the treatment is dots we know the treatment is dots If the percentage takes dot the minimum dots duration is six months maximum it is 1.5 year also right so in mdrtb here minimum sixth month and if the patient don't take treatment the duration is still longer so basically I'm I mean to say that in acute inflammation onset is rapid in chronic the onset is late in acute inflammation the duration is short so the tonsillitis lost only for one week but the TB lasts for one year half year Pride the Hallmark feature of acute inflammation is edema the Hallmark feature of chronic inflammation is granuloma granuloma never occur in acute edema never academic these are the pathognomatic feature in these and here the main cells are neutrophil in acute in chronic the male main cells are macrophages we know that so after that let's start acute inflammation followed by chronic are you people with me can I go ahead acute inflammation now acute inflammation can occur from head to toe in any part of the body if it occurs and managers it is meningitis if it occurs in parenchyme of the brain encephalitis it can be tonsillitis pharyngitis rhinitis ophthalmitis it can be any organ from head to toe it can occur technically in any organ right in whatever organ the acute inflammation is occurring that organ show five features that particular organ will show the five Cardinal features so what are the five Cardinal features if these are the Cardinal features only of acute inflammation none of them occurs in chronic these occurs only in acute inflammation not intronic you got no point so imagine again tonsillitis for acute inflammation you have to imagine again tonsils can you see the tonsils become red that organ becomes red number one the tonsil temperature is more as compared to surrounding temperature as compared to surrounding temperature the tonsil temperature will be more right the tonsil swelts up you can see how swelled they are come on right the tonsils have pain the tonsils have that that particular organ will have pain and loss of function temporarily right now you have to say these functions you have to say these um cardinal signs not in English language you have to say them in Latin I don't know the examiner likes Latin and they will ask you these cardinal signs in Latin language do you know Latin I don't know Latin unfortunately but if you know Latin it will be easy for you if you don't know just learn it so redness in Latin is known as rubor in Latin language it's the language okay the increased temperature in Latin is known as calor you know have you heard about calorimeter calorimeter is an instrument to measure the heat from from here this word is derived color right swelling swelling in Latin is known as tumor now don't get confused tumor in English tumor in English is malignancy you know it can be benign malignant but we are not saying English language in Latin tumor means dwelling it's not malignant pain in Latin is known as dolor and loss of function is known as function so it's rubor kelot tumor dolor and punctiolesia these are the five cardinal signs of acute inflammation learn it learn it say yes you got it you got it right so these are the five cardinal signs and out of these five the first four are described by a person's Celsius and the last one is described by another person with you you have pyq on these also so learn the five cardinal signs you have P by cues like which of the following is Cardinal sign or which of the following is not a cardinal sign of acute inflammation you may be knowing all five in in Latin language number one and number two who who described them the name of the person now let's Describe acute inflammation there are vascular events and cellular events the five vascular and thick cellular the total 11 events in the next 15-20 minutes we are going to cover all 11 events of acute inflammation you got no point so all 11 events of acute inflammation okay the board is uh you have to give me a minute to fix it I'm sorry you have to give me a minute just a second let me fix it let me fix it foreign audible is the screen visible to you are you people there can someone tell me ah can please can you please reply if I am visible audible I am waiting there is a little bit lag I'm really sorry for the technical glitches I guess the things are sorted now uh I'm waiting for someone to reply please yes thank you thank you thank you so much so let me continue I was teaching you the events in acute inflammation so I will be teaching you I will be teaching you the five vascular events and six cellular events so total 11 events in the next 15 minutes so you may be thinking then what are these events and why actually they are required what is the purpose of these events and what are these events actually right so there are five vascular events I'm not reading I will directly explain you one by one these are the five vascular events in front of you you can see these are the six cellular events in front of you I will be teaching you one by one I'm not reading I will directly teach you right so to understand all these 11 events I'm having a master diagram for you this is the master diagram if you understand this diagram now you will understand all 11 events in this diagram only so please let me explain you this diagram this is any part of human body the yellow color can you see the yellow color here this yellow color is the skin can you see the theolog color just suppose this is skin of this portion of my body can you see this is the skin this is the skin just below the skin just below the skin we are having a blood vessel so we have blood vessel everywhere you can see the blood vessel lined by the endothelial cells these are the endothelial plus lining the blood vessel right in the blood we have RBC WBC platelet but currently I am interested only in WBC that is my defense you can see these are the WBC green color cells I have drawn this is my Army the defense the Army and in my body just suppose any foreign particle enters it can be bacteria virus fungus parasite any dust particle inert material any chemical any physical injury anything so that is known as injurious agent this is the injurious agent right and we will call it as terrorist we will call because it is foreign just below the skin now I want the terrorist and army should fight with each other as I told you if the Army wins patients have the person will have inflammation the arm is defensing now it will do inflammation but in that fight if the terrorist is winning it will lead to infection so whether the end result is impaction or inflammation that will be decided after fighting you will remember what is the big deal Let Them Fight let's see who is winning right but there is a problem what is the problem you can see the Army is intravascular you can see the wbcs are intra vascular now they are present inside the blood vessel but the injurious agent that is terrorist is extravascular how they will fight with each other unless until they will not meet with each other how they will fight with each other so we have to make them fight we have to make them meet now there are two possibilities you will say ma'am you can take the terrorist inside no no no no no it's a very bad idea if you take the bacteria inside your blood vessel the person will have sapthill come on it will spread in all organs via blood and the treatment will be difficult we cannot afford sepsis right the other way around take WBC out yes that looks to be a nice idea yes that looked to be a nice idea so take the WPC out and after that we will make them fight you got no point after that we will make them fight so we will take the WBC out you will see them then what is the problem take WBC out and let them fight fight means phagocytosis so let let the WBC do the phagocytosis of the injurious agent what is the problem so it is not as simple as that for that we require 11 events for that for taking the WBC out and making them fight we require 11 events in front of you one by one I will be telling you you got what is the ultimate purpose we are having right what is the ultimate purpose so Praveen Abdullah aarti simran Akash have you all got the ultimate purposes to take WBC out for that we will perform 11 events one by one so let let me start with the vascular events I am starting first with five vascular events let me start the first out of 11 the first is transient vessel constriction what is the first one it's transient about the constriction can you see instead of learning instead of reading see it in the diagram can you see this is the injurious agent I will call it a bacteria now please understand it is not always bacteria it can be virus fungus parasite physical chemical any injury right but for the sake of understanding I will call it a bacteria or a terrorist and this is our army so the the segment in which that bacteria is present that segment of blood vessel undergo vasoconstriction you can see but it is only for few seconds it is not permanent for few seconds that's why it is known as strong variant why it is there as soon as the bacteria is entering now there is stimulation of sympathetic system and the adrenaline is causing this vasoconstriction which is very transient you know expensive it is of the fear suddenly it is so sudden so as soon as the injurious agent is entering human body the first thing happens is transient vasoconstriction and and this transient pressure constriction is only for few seconds that's it that is Step number one step number two is best of dilatation now now after vasoconstriction there will be vasodilation and this time it will be perfect tent can you see the same segment in front of you see the same segment so again we are having the bacteria or injurious agent or terrorist here the same segment instead of vasoconstriction now undergo vestro dilatation right and this vasodilation is persistent it's it's persistent it's um it's ah not transient like vasoconstriction it is persistent now just suppose this is the area I told you know for example this is the skin of this area of my hand can you see this my hand just below it the blood vessel undergo vasodilated so if I look from above with my eyes I will see this area will be red in color because having more blood now this area have more blood so particularly this area if I see from the skin from the entire this area is red in color number one and if I touch this area as compared to surrounding area it will be more more warm as compared to surrounding area because it is having more blood the reason for both of this is more blood in this segment so out of the five Cardinals fine the two are explained here real bar and Keller I explained you what a group or I explained you what a scalar and why I mean why they happened so out of five two are explained here give me a thumbs up you got it you got it do you have any doubt so reborn and calor is due to step number two that is persistent to visit dilatation moving on step number three moving on step number three have you heard about star length hypothesis what is starlings hypothesis have you heard about it now there are two types of pressure operating at a capillary level in the blood level of human beings at the capillary level in the blood level of human beings two pressures are operating one is one is outward pressure known as hydrostatic Hydro means water it is the pressure due to water I guess everyone knows it yes and the second is the inward pressure can you see this one this one is the inward see the arrow it is oncotic pressure it is due to protein it is due to protein now you tell me in the last step step number two what happened you will see now I'm step number two vasodilation vasodilation means increase blood in this area say yes or no say yes or no vasodilation means this segment is well so dilated can you see it is vasodilated so it is having more blood more blood means more water and more water means which pressure will increase you yourself decide is it hydrostatic pressure which will increase or is it oncotic pressure which will increase which normally they are equal and opposite the outward is equal to invert that's why there is no edema now which pressure will increase I am waiting for your answer who is others I can't see all names yashi Abdullah can anyone tell me come on simple question vasodilation leads to increased blood in this segment increased blood means increased water so water is leading which type of pressure it's hydrostatic pressure yes so the hydrostatic pressure will increase right hydrostatic pressure will increase oncotic pressure will not increase yes they per absolutely right so hydrostatic pressure will hydrostatic pressure is outward pressure normally outward is equal to inward right normally but now I am saying outward is much more than inward because of more blood more water in the segment so outward is more inward is less the fluid will come out it will lead to edema come on oh my God there is edema so the third third step of the vascular event is increased hydrostatic pressure it's increased hydrostatic pressure can you see so the fluid is coming out can you see the fluid hydrostatic so see the arrows outward pressure is more so fluid is coming out let me draw the fluid for you okay I will try to draw the fluid for you so this fluid is deposited in the background and it will lead to edema the fluid is coming out because the hydrostatic pressure is more see I have drawn the fluid it is simple water or the fluid which is coming out from the inter muscular compartment to extra vascular compartment because there is increased hydrostatic pressure the outward pressure is more the invert is less so there is the imbalance the fluid is coming out so it will lead to edema you got it it will lead to edema but you are an ambient student you are a medical student at your level saying only edema doesn't look nice you know edemas of two type translate so whenever you say edema you should add mam is it translated or accident at your level saying only edema is not justifiable at all right now you must understand the difference between translate and absolute type of Edema translate edema is the edema which contain only water which contain only fluid I mean only fluid but accurate is the edema in which along with the fluid along with the fluid protein and cells are also present it is protein Rich cell Rich edema the exudate the other name of the accident is the thick pus the yellow white color pus and translate it is a thin fluid coming out it's only water protein poor self poor right now you yourself decide here what is coming out is it only water which is coming out or along with water proteins and cells are also coming out you will see them how protein and cell will come there is no whole num for for protein and cell to come out holes are required but for water it can leak out anyway so here only water is coming out so basically edema is transduced is it clear everything in pathology you have to understand you don't have to mug up even a single word in pathology you got my point see how interesting and easy it is so here edema is translated you got my point edemas translated so that is the here translated edema is there so that is explaining the third Cardinal sign that is tumor tumor means swelling now it will lead swelling just a second if I see from above so this area is red this area is hot it attached from the surrounding temperature and this area is swelled out as compared to surrounding temperature so reborn calor and tumor the three things are proven the third thing is due to this step you got my point so you can see beautiful diagram can you see this diagram everyone here so in this diagram let me explain you this is normal see author the beautiful diagram have drawn uh this is the lining of the blood vessel these are the endothelial cells you can see these are the endothelial cells you can see in the lining of the blood vessel right inside which this is the protein is present this is outward pressure and this is inward pressure see the size of the two arrows is normal so inward is equal to outward so there is no edema it's normal it's normal there is no edema in you me everyone it's like this but C in acute inflammation what is happening in acute inflammation this area because of nasodilated C hydrostatic pressure is more and osmotic pressure is less see the thickness of the arrows so outward is more inward is left so can you see fluid is leaking out the fluid is leaking out and after leaking it is accumulating in the background so can you appreciate the fluid here that accumulated in the background only fluid have came out that's why it's translated that's why it's translated in the next step I will teach you it will convert into accelerate in The Next Step so coming on the most important and the fourth vascular event till now three we have completed what are the three we have completed the first was with the constriction which was transient the second was vasodilation which is persistent and third is increased hydrostatic pressure what is the relevance of each one of them the first one is transient no other elements the second one leads to rebar and calor and the third one leads to tumor tumor means edema that is exudate type of video I'm sorry translated type of Edema not exudate translated do you have any problem you can write to your doubt I can see your chat if you have any problem kindly let me know if you don't have any problem kindly let me know that also give me a thumbs up in the chat box can I proceed so the fourth step is increase vascular permeability one two three fourth fourth step is increase vascular permeability what do you mean by vascular permeability vascular permeability means creating creating defects in the wall of the blood vessel creating defects normally the ball of the blood vessel is continuous it's like this this is the wall of the blood vessel and these are the endothelial lining which is continuous I can't see even a single defect no I can't see even a single defect but if I create the defects here defects means whole you will see them why at all you want to create the whole because my ultimate purpose you forget I guess my ultimate purpose is to take the wbts out these are the wvcs now we want to take them out you will ask me ma'am how you will take the WBC out without a defect if it is continuous how you will take the cell out you cannot take a cell out in the continuous lining now you have to create the defects but defects I mean whole you have to create holes in the wall of the blood vessel and creating holes in the wall of the blood vessel is known as increasing vascular permeability that is the most important step the Hallmark step of acute inflammation so just create this is the Hallmark step you you can see right now see here we have created the holes how we have created the hose there are five mechanism I will explain you all five don't worry so firstly just suppose the holes are created how they are created I will explain you but see can you see there is a hole there is a hole there is a hole you can see multiple holes are there in the entire wall of the blood vessel I can see multiple holes now from these holes the protein will also leak out and later on the cells will also leak out so the edema which was initially translated now get converted into axle rate am I right yes now the edema converted into accident type of Edema so translate type of Edema is due to the third vascular event that is increased hydrostatic pressure but exudate type of edemas due to increased vascular permeability see the concepts are very small but yet very important you will get simple simple question auxiliary type of edemas due to which of the step translated type of edemas which due to which which of the following step ribose or caloris due to which of the step so actually which of the step is leading to which of the event you should be knowing that so here the edema you can see you can see ah here the edema is like exudate because along with the fluid the protein and the cells also leak out from the defects now the question arises that the next question arises that how these holes are created so there are five mechanism okay I will be explaining you the five mechanism before that have a look on this the first diagram I explained you the wall is continuous the ball is continuous there is no defect and outward pressure is the inward pressure so there is no edema and it's normal the second also I have explained you here also the ball is continual see the ball is continuous but outward pressure is more than inward pressure that's my only fluid leaks out you can see here the fluid is leaking out collecting in the background it is leading to translated type of Edema see the third diagram in the third diagram you can see the holes appreciated appreciate it these are the holes or the defects created in the wall of the blood vessel from which along with the fluid the protein can you see this dot like structure these dot like structures are protein they also leak out so now the edema converted into exudate because along with the fluid we have protein and cells also you got my point now uh so I told you translated type of edemas due to increased hydrostatic pressure step number three and accident step number four anyone having any doubt in that so coming on the steps how the holes are created so how holes are created there are five mechanism for that let me revise you so we are studying vascular events vascular events of acute inflammation there are five vascular events So currently I am teaching you the fourth one I explained you the first first one is vessel construction can you tell me that's a construction vasoconstriction what is the first one the vasoconstriction it is transient the second one is Vector dilatation it's persistent or permanent the third one is increased hydrostatic pressure and the fourth one is increased vascular permeability the fifth one is the stresses that I will come later on the fifth one currently I am teaching you the fourth one the relevance of each of them you have to tell me the first one is the transient that is the only relevance no important point in vasodilation will lead to reborn and calor increase hydrostatic pressure leads to edema which is translated in nature increase vascular permeability again exaggerate that edema but convert the edema from translated to accelerate does anyone have any problem in understanding these points and coming on your doubts wait a while but first tell me uh any one having any doubt here now you may be asking that what is the mechanism of creating holes of course I will explain you five mechanisms here and after that I will move on the fifth step the last step then we will move on the cellular events people there what is their doubt what saint is asking uh foreign as compared to the surrounding segment vasodilation means more blood in this segment more blood means more water more water means increase hydrostatic pressure this is the reason I guess you have missed the initial portion of the lecture right so this is the reason can we go ahead are you people there so let's move ahead so these are the five mechanisms I am going to teach you how to create holes the most important mechanism is the first one endothelial cell contraction the five mechanisms are in front of you you may be thinking ma'am all five diagrams are same no no no no it requires expertise in your eyes to see the difference between the five diagrams so give me two minutes you will you will yourself uh appreciate the difference between the five let me come on the first mechanism I am teaching you the five mechanism of increased vascular permeability that is creating defects in the wall of the blood vessel okay so the first is formation or endothelial cell contraction can you see this diagram can you see a hole you will say no ma'am I can't see a hole it's continuous it's continuous right this is the first cell this is the second cell this is the third all endothelial cells are continuous imagine this contract imagine this also contract this also this also this also what will be the end result it's like this so all the endothelial cells are Contracting since they are Contracting at the junction we are having hole so the defects are at specifically only at Junction the specific the defects are only at Junction not anywhere it they are adjunction you got no point so the defects basically are at the junction you can see the same diagram here also see the first diagram endothelium is continuous can you see see the second diagram the lower one this is the first cell this is the second cell this is the third cell at the junction I can see the whole give me a thumbs up so who is causing the contraction of the endothelial cell there is the chemical mediator known as these all are pyqs there is a chemical mediator histamine yes yes it is for FNG also someone is asking is the classes for fmg so I'm going to cover all pyqs of fmg need PG ionic and clinical questions for the next so everything will be covered okay so histamine is the chemical mediator which is causing the contraction here you're going partner point and you know we have our trees arterioles veins vanules and capillaries so basically the five type of blood vessels so this mechanism takes place in which blood vessel is it takes place in all five it basically takes place in vanilla not vein not artery not capillary not arteriole it takes place in manuals so these are the important points regarding the first one number one out of the five mechanism this one is most common right the first one it is the most common it is due to the contraction of the endothelial cells so gaps are at the junction and it is due to histamine release histamine release and it is in the manual see if I cut this artery from ear this blood vessel from here and see from the side so this is the cross section so in this can you see true yellow cell this is the first yellow color cell you can see this is the second yellow color cell you can see and at the junction of the two cell you can see the Gap so you can see the gaps are at Junction you got my point you got my point so this is the transverse diagram this is the cross sectional diagram of the first mechanism we are done the second mechanism is direct endothelial injury see now now we are having the blood vessels and endothelial cells are not Contracting the endothelial cells are not at all Contracting no still we want to create the Gap now what is the mechanism how we can create the Gap the second and the third mechanism so let me explain you two more more mechanisms here so how I will create the Gap endothelial cells are not Contracting the most common mechanism was that only but now it is not Contracting still I want to create the Gap so the terrorist is very strong very strong terrorist he will come and create the gaps here at the junction also at non-junction the terrorist will cause the necrosis of the endothelial lining right so it is not necessarily at the junction only it can be at the junction it can be at non-junction so this type of mechanism is known as direct injury by the injurious agent direct injury by the injurious agent you got my point the second mechanism and the third mechanism if endothelial cells are not Contracting if the injurious agent is of low virulence it is not causing the necrosis it is also not creating rap nor who will create the Gap now who will create the Gap the third mechanism is WBC the army army this time Army is very strong Army will cause the necrosis of endothelial cell and create the Gap they want to fight with each other either the tariffs will create the gap or the army so the second mechanism in which the terrorist is creating the Gap is direct endothelial injury by the injurious agent it will cause the necrosis of the endothelium you got my point and it do not occur only at manuals it occurs at all five blood vessels are three arterioles weight vanules and capillaries you got it you got it can I go ahead right okay so can I go ahead so let's move to the so this is the diagram can you see who is causing the Gap here you can see this is the injurious agent which is causing the necros will see it can be a junction it can be at non-junction right it can be a junction see the same diagram it can be a junction it can be at non-junction if I cut it see the transverse view this is the transverse view so only difference it can be a junction it can be at non Junction again and again I'm repeating the same thing the first mechanism was always at Junction this one can be a junction can be at non-junction also the third mechanism I already told you it is the WBC will create the Gap leukocyte means WBC the Army WBC means Army this time the Army will create the Gap can you see the diagram see beautiful diagram who is creating the Gap I can clearly see the wbcs are creating the Gap again either at the junction or at the non-junction the wbcs are creating the Gap can you see so can you tell me the first three mechanism which I taught you the first three mechanism which I taught you okay okay what is the first mechanism it's endothelial cell contraction please help me for writing this any one the first I told you endothelial contraction the second I told you direct injury by the injurious agent that is the terrorist and third I told you WBC that is leukocyte mediated injury the third one now here I told you uh the Gap is created by the histamine the histamine will cause the contraction of endothelial cells and gaps will always be at the junction here it is caused by injurious agent and here it is caused by WBC right and here in both of them the Gap can be at Junction also at non-junction also one more difference you have to understand between the three one more difference the first one is immediate transient the second one is delayed transient and the third one is delayed too long what do you mean by immediate transient delay transient and delayed prolonged so in the the first what is indicating let me explain you this very clearly the first word is indicating the onset and the second word is indicating the duration what do you mean by onset and duration I have to draw three diagrams you get many complicated mcqs based on this mechanism please understand so the first mechanism is the endothelial cell contraction you got my point here I am drawing the endothelial cells are Contracting the second mechanism the gaps are created the gaps are created by the injurious agent okay okay so here is the injurious agent who is creating the gaps and the third mechanism the gaps are created by the WBC so these are the WBC who is creating the gaps what I mean to say now here it is immediate so as soon as the injurious agent come here as soon as the injurious agent is coming here it is coming and here it is coming so the first one is immediate and it is transient also so as soon as injurious agent will come the onset is very fast but it will last only for few seconds so the duration the onset is passed the duration is less both are less onset is also fast duration of blood the second one is delay transient mean after coming injurious agent it will cause the necrosis after few hours it will take time to do the necrosis it is not very immediate it will take time to do the neck process so it is delayed it is delayed right it is delayed right and it is transient also and the third one is delayed and prolonged right so the third one is delayed and it will be permanent prolonged there you got my point so you can understand like this so coming to the fourth mechanism now you got this coming to the fourth mechanism yes WBC is causing injury to the endothelium yes very good the three mechanism absolutely right you have written very good the fourth mechanism without Gap the WBC will come out you will say ma'am are you joking how without Gap WBC can come out we will not create any Gap come on still WBC can come out how can you see this mechanism this mechanism is known as strong fight also the fourth mechanism here the WBC can you see the WBC it will enter inside the endothelial cell from this side and after entering it will exit the endothelial cell from that side it is known as cell within cell what I am saying cell within cell so it is the cell within cell movement okay it is known as trans cytosis cytosis means cell trans means inside another cell so cell within cell you got my point and these are through the cycles the Cycles are present inside the endothelial cell that will carry the duplicate from this side to that side so this is known as trans you can see can you see the Cycles appreciated there is no Gap but WBC will travel from this side to that side via the cycle transcytosis and the last one is formation of new blood vessel that is angiogenesis not the rule wherever inflammation takes place at that reason particularly at that portion at that segment inflammation take place um of course inflammation I mean in inflammation new blood vessel formation take place the angiogenesis and new blood vessels are very leaky they are very leaky they are already leaky you don't have to create the Gap they are already leaky right can you see this is the new blood vessel can anyone among the students among the audience can tell me why it is a new blood vessel how this diagram is indicating you that it is a new blood vessel not a material your one it is a new blood vessel why can you see the cells endothelial cells this is one this one is two this one is three and this one is four I can see four endothelial cell can you see the nucleus of all of them can you see the nucleus it's spindle formation it's dividing it's still dividing that's why it is a new blood vessel new blood vessel is already leaky it's already leaky there is no need to create Gap in them they are already leaking so very easy job that is angiogenesis you got my point so these are the five mechanism first we will revise and then we will see the five diagrams can you help me with the fight mechanism of increased vascular permeability okay forget it first tell me the vascular event how many vascular events I taught you currently I am teaching you the fourth one so we will revise the pore the first one is that's the constriction which is transient then Vaso dilatation which is persistent then increased hydrostatic pressure then increased vascular permeability I am teaching you the fourth one currently I am teaching you the fourth one increased vascular permeability have five mechanisms can you tell me the names of these five mechanism yes very good cushy very good what about others everyone can you tell me please so the first mechanism is endothelial cell contraction most common the second is what is the second mechanism second mechanism is injury caused by the terrorist that is injury caused by the injurious agent the injurious agent will create the holes injury by injurious agent the third the holes will be created by leukocyte by wbcs WBC will create the whole the Army will create the whole the fourth one is strong cytosis transcytosis that is cell within cell and the last one is angiogenesis that is new blood vessel formation say yes the first three I'm sorry for so you can see the 5 diagrams in front of you can you see the first one the gaps are only at Junction appreciate the gaps are only at Junction so this one is endothelial cell contraction the first one the second one the gaps at Junction also at non-junction also so this one is the injury caused by injurious agent the necrosis of the endothelial cell the third one again the gaps at Junction as well as non-junction but I can see WBC is causing the Gap so this is leukocyte mediated injury of the endothelial cell in the fourth diagram I can't see a gap I can see the Cycles from these were Cycles the cycles and inside the endothelial cell the WBC will move out this one is known as transitosis and the last one see the nucleus of the first four diagram of the endothelial cell see this nucleus here appreciate the nucleus here appreciate nucleus everywhere and see the nucleus here you yourself will realize what I mean to say see the nucleus here the nucleus is leaky this one is known as leaky that is leaky angiogenesis new blood vessels are already new um a leaky in nature so no need to create the Gap so have you got the difference between the five diagrams give me a thumbs up if you got it do you like this concept so this is the ultimate table we have to make the five mechanisms in front of you very good very good very good so you all are right can you help me in filling this table the fight mechanism names are in front of you you can see the first five mechanism five mechanism of increased vascular permeability so the first one takes place especially in venules but the second one takes place in all blood vessel the third one again manual the fourth one again Daniel and the fifth one there is no specific thing the Leaky blood vessels formed everywhere so maximum they are formed in Bengals so maximum gaps are in venials maximum edema will be vanules only you got my point so response I told you this is immediate transient this is immediate prolonged this is delayed prolonged by mistake I told you I guess this is delayed uh transient it is the immediate prolong I guess you can understand this one is the onset this one is the duration immediate transient you can learn it ipdp immediate transient immediate prolong delayed prolong here it is not relevant and pathogenesis who is creating the Gap I already told you here the histamine is creating causing the contraction here the injurious agent here the wbc's here histamine and Vega and the Leaky blood vessels are formed due to vegf so this is the ultimate master table right right so can we go ahead can we go ahead so finally the last the fifth step is the stasis of the blood in the stasis of the blood all the fluid came out all the protein came out and the cells accumulate cells accumulate this is known as blood status we are done with five vascular events now it's time to solve some mcqs I want each and every one of you to participate you already know the five mechanism right so vasoconstriction vasodilation increase hydrostatic pressure increase permeability vascular permeability which is having five mechanism inside it and the fifth one is the stasis now you will solve these mcqs and tell me the correct answer based on the vascular events can you tell me let me read the question I want to see who is first to answer it accurately the question is in front of you can you tell me the sequence of events in acute inflammation the vascular events what is the correct sequence you can read the option you know the five steps arrange them from first to last can you arrange it let me see who is first to answer come on SO Kushi is saying d as the correct answer what about others a b c d are your options yes so I guess everyone is saying D I want everyone to participate at Max you will be wrong it's okay come on try it out now yes yes everyone is right so everyone is saying d as the correct answer do you agree so the first step is well so construction yes the second is vasodilation yes the third is not given increase hydrostatic pressure it is myth tier the fourth one is increased permeability and the last one is status if you read other options they all are incorrect the correct one is only one the last one okay yes so D is the correct answer the next question is in front of you can you tell me the correct answer in acute inflammation due to contraction of endothelial cell the contraction of the endothelial cells which of the following groupers so contraction of the endothelial cell is the first mechanism of increased vascular productivity I told you five so among them is the delay transient is it early transient delayed permanent or early permanent I told you the onset and the duration now so I told you it is it is for first three mechanism that is endothelial cell contraction the injurious agent and WBC these are the first three mechanism write down like this everyone the onset and duration so first one is immediate transient so both are less immediate transient Downs that is less the duration is left the second one is immediate prolong onset is still less but duration is long and third one is delayed too long so that is the answer duration both so they are asking for what they are asking for the first mechanism and to kill yourself contraction so I will go with early transient so it is transient as well as early is it transient as well as early if I ask the same question for injurious agent but not for endothelial cell contraction if I ask the same question for injurious agent injury the necross is caused by the injurious agent it is it should be onset should be late uh on the onset should be less but duration should be more so it will be delayed transient you got the point so this is how we can change the answer we can change the answer you got my point so can we go to the next question the correct answer here is B can you tell me the next question increase vascular permeabilities due to which chemical the four options are this is the ABCD histamine interleukin to TGF beta this one is beta and fgf so increase vascular permeability they have not mentioned which they are asking out of the pipe mechanism out of the pipe mechanism the most common mechanism is the endothelial cell contraction and endothelial cell contraction is caused by histamine you all are right and super smart students very good the correct answer here is histamine very good histamine the next question in front of you can you tell me what is path to appear tell me the first step of acute inflammation the four options are in front of you the first step what is the first step is it vasodilation is it passive constriction is it increased vascular permeability is it decreased vascular permeability so what is the first step yes absolutely right it is a simple question I guess everyone should answer it the first step is always was a construction although it's transient although it's transient no Akash it's not a the answer is B someone is wrong but it's okay to do the mistakes here all that's transient but you cannot neglect it it's transient but first so they are asking First Step so correct answer here is B you got it you got it the correct answer here is B so the next question in front of you riobor in inflammation is due to withstep can you tell me what is the reason for real bar what do you mean by rueboar reborn is the Latin word the meaning of the reward is redness in English it's known as redness the meaning of the Rio bar is Readiness so redness is due to dilatation of arterioles or increased muscular permeability or increase viscosity or edema so yes it is due to vascular dilatation I told you the five steps now vasoconstriction is transient but vasude dilatation leads to rubor and calor instead of Rio bar if I change the question and ask you Keller what is your answer now what is your answer now still your answer is key so reborn and calor both are due to vasodilation you got my point you got no point so you should know the relevance of all steps the correct answer here is a these all are p y Q's of either need PG fmg inict you know so all the pyqs the last five year pyqs from this topic I have covered here in this way we are going to cover entire pathology read a topic understand it completely then solve the py cues and remaining most expected question I will give you for practice you can solve everyone everything and if you still have doubt you can connect with me anytime you got my point so the next question in front of you all of the following vascular changes are observed in inflammation except the question contains accept can you tell me which of the following vascular change do not takes place do not takes place which are the following uh change do not takes place in acute information vasodilation do it take place here yes or no it occurs right I guess it is the Second Step stasis yes it is the fifth step increased vascular permeability it is the Hallmark step the fourth step decrease hydrostatic pressure I think this is wrong it is not decreased it should be increased increased hydrostatic pressure is the step but decrease doesn't occur so that's why we all will go will go with the yes absolutely right so what is the primary of vascular events we have learned we have learned five muscular events so these are the five vascular events in front of you and you know the diagram for all of them this is the master diagram you will tell me one by one what's the summary so first is vessel constriction see this segment is west of construct cage and it is transient the first one the second one this segment is worth so dilated and it is persistent right the third one increased hydrostatic pressure the outward pressure so only fluid will come out not cell not protein so edema is translated increase hydrostatic pressure this segment is vasodilated so more blood more water increase hydrostatic pressure the fourth step is increase vascular permeability that is the Hallmark step pathogmatic step in which the defects are created inside the wall of the blood vessel that is permeability is increased there are five mechanism of creating these defects the pipe mechanism what are the five mechanisms these are the five mechanisms we have already seen water yes here it will lead to oxidate absolutely right and these are the pipe mechanism I am not saying their names you already know most common is this one endothelial cell contraction and it is due to histamine you should learn the first one is immediate transient the second one is immediate prolong and the third one is delay true Long on which many confusing videos come in your exam your concept should be Crystal and clear and the last one is the status of the blood on which hardly any mcqs come we are done with the five vascular events it's time to start the six cellular events so total uh 11 events will be done till now what's the summary this is the summary of muscular events we will ask them why at all we require cellular events in vascular events in vascular events I'm sorry we have created a whole we have created a defect in the wall of the blood vessel by one of the pipe mechanism I don't know the name but by one of the five mechanism I have created a gap now it's time to take WBC out of that Gap the WBC will go out of that gap for this we require six steps you will see ma'am six steps why don't in one step you take it out no it is not an easy job it is not that much easy job you got my point we have to take WBC out of this defect and there are six steps for it so what are the six cellular events please understand now have you heard about uh Bernoulli theorem in physics have you had read physics in year six seven eight nine standard when you were a kid yes I guess everyone have read it right so in physics you may have read or in 11 12 when you took biology right physics may be a subject now so Bernoulli's Theorem states that in a pipe in a hollow luminated structure whenever any fluid goes through it so the heavy portion of the fluid will be at the center and the light portion of the fluid will be at the periphery right the light will be at the periphery the heavier the center everyone knows the serum right he will say ma'am why you are teaching physics to us we know this theorem now let's apply Bernoulli serum in blood vessels blood vessel is also a pipe now right in the blood vessel we have RBC WBC platelet and plasma the four things who is heaviest the heaviest of the WBC unfortunately the heaviest is the WBC it will travel at the center RBC and platelet are surrounding here so arbitis and platelet are at the periphery and most peripari will be the plasma the lightest one is the plasma you got my point now in inflammation I want to take WBC out this blood flow is known as axial blood what is axial blood flow in me in you normally our blood flow is axial in axial blood flow the WC is at the center it is surrounded by RBC platelet and plasma the WBC at the center this is normal but I want to take WBC out from the hole from the defect so how from the center it will jump out it cannot jump out from the center now first you have to take WBC from the center to the periphery and then you will take out so taking the WBC from the center to the periphery is known as reverse axial blood flow so first do the reverse axial then only things will happen you got no point so can you see the six cellular events let me explain you all of you here see on the board everyone here please so can you see the WBC at the center see it's Center so this is that real blood flow because WBC is at the center you all can see the blood flow is axial yes now the WBC is leaving the center and coming to the periphery so first step is margination this is known as margin margin WBC leaving the center coming at the margin that is doing reverse axial blood flow this is known as margination you got like margination after margination now WBC is that the peripheralism and problem is solved let's take out but the hole is not immediately here only the hole is here the defect is here so WBC have to travel this distance the WBC have to travel this much of distance for coming out right so WBC Will Roll can you see wvc is rolling rolling rolling so it's rolling on the road like a tire who is the road the road is the endothelial lining and who's the tire who's the tire the tire is the circular WBC so this is known as rolling rolling rolling right just before the Gap just before the Gap it stopped it stopped now it's time to come out it is known as adhesion so first margination then rolling rolling rolling then addition addition after that WBC come from intravascular compartment to extra vascular compartment after that WBC comes from intervascular to extra vascular compartment it is known as trunk migration or it is also known as GI PDF one and the same thing many mcqs come what is the meaning of diabetes WBC leave intracellular compartment intra vascular compartment income extravascular the most important step now you will remember the problem is solve WBC is already out we were doing all these things to take the WBC out WC is already output wvc don't have eyes they don't have eyes here is the bacteria see here is the bacteria now WBC is in three dimensional space after coming out it's three diamonds now double obviously have to go there there there there how WBC will come to know WBC will don't see over have this is the bacteria this is not bacteria I have to move they are not there so bacteria will secrete certain chemical that will attract WBC towards it and WBC will move towards the chemicals it is known as chemotaxis you know taxi taxi means moving moving from one place to another taxi and chemo means chemical oriented it's chemical oriented movement that is known as chemotaxis the fifth step and lastly it will engulf there is a file between the two and the wbc's engulfing the bacteria that is the sixth step say yes everyone say yes you got the six steps so what are the six steps can you help me in revision once again please so the first step is margination in which WBC leave the center and come to the periphery second step is rolling in which wvc is rolling on the surface of the endothelial cell the second is the third is the addition just before the Gap is stopped the fourth step is transmigration in which WBC coming out or diabetes the fifth step is chemotaxis it is moving chemically towards the bacteria chemical oriented movement and last step is phagocytosis in which WBC will Ingle the bacteria say yes now we have to see the details of all all six steps one by one in the space cellular events are also done so we are done with five vascular and in this way yes absolutely right the six cellular events will be done so out of the six let me explain you the most important margination is done I am not explaining you any more you got a WBT will leave the center and come at the periphery that is from axial blood flow it will convert into reverse axial we are done how rolling and addition take place tell me the mechanism of rolling and irrigation so can you see the same diagram from a book can you see the same diagram from a book let me explain you this also so can you see the WBC is at the center it will leave the center and come to the periphery this is margination after that it's rolling it's rolling it's rolling this is rolling and just before the Gap it stops so this is adhesion so you can see the first margination then rolling and then adhesion after that it's coming out that is diabetes after that it is moving towards the microbe towards the microbeads moving that is chemotaxis chemo taxes and finally it is engulfing the bacteria that is phagocytosis do you have any doubt in that yes absolutely right right so no need to learn it Muhammad it's very simple if you close your eyes and imagine WBC is leaving the center then rolling then adhesion then coming out you can easily make out the six steps okay now my point is that my question to all of you is that margination is done so here margination axial blood flow convert into reverse axial reverse acne it is as simple as that but the difficult have to understand is the rolling and adhesion you will say ma'am who is the road and who is the tire I told you the road is the endothelial lining and the tire is the WBC so how WBC is rolling rolling on the road how does because of the receptors can you see these are the receptors the complementary receptors are present on the WBC and the endothelium the road and the tire have complementary receptors with each other so bond form Bond break so again it will move then bond form then Bond break so again it will move then again bond form Bond break so these are the transient Bond formation between the corresponding molecules I will tell you the name of the corresponding molecules so there is a receptor on the WBC and there is a receptor on the road so a transient bond form between them then break then it will move then again bond form then break then again move so this is the mechanism this is the mechanism you got my point this is the mechanism so you may be asking them tell me the pairs so I will teach you six pairs in six pairs total 12 molecules are there the six are present on the road and the corresponding sticks are present on that tire you cannot interchange these are couples these are couples you can learn on the name of the thick couples in front of you the six couples in front of you are given can you see so this is a beautiful diagram listen the red color Road appreciate it the red color endothelial lining the green color are the WBC the tire the tire is the WBC appreciate the first pair second pair third pair fourth pair fifth pair and last sixth pair I have used 12 different colors if you can see the color coding also I have used all different colors so you can see all of them are different and unique you have to learn the name of the pairs I will tell you the name of the six pairs then I'm sorry we will try to fill it we will try to fill it like this you have to tell me the pairs right so can you see the first pair okay let me tell you in this diagram only okay the first pair that's the lactan p selectin and E selectin these are present on the road you have to understand which one on the road which one on the tire you got my point you got it so the piece the Latin and E selectin are present on the endothelium and the corresponding molecule is stylus that this one is same for both of them so P and L selectin they are forming the bond with Salah Lu is X the P and L selected on endothelium and thyroid Lewis X on the WBC say yes see the first pair see the second pair learn the pair among the pair which one on the road which one on the tire learn like that the third pair that there are three selected p and E are present on the endothelium but the third select in l l for leukocyte leukocyte means WBC it is present on the WBC the third selection and it form a bond with glycam glycam on the endothelium so the first is piece Latin and salil Lewis X the second is X the third is glycam and L selectin that is the third pair now glycanada right glycam I can become so I came and V chem they form bond with integrand beta 2 integral from bond with icam beta 1 with um V cam so these are the five pairs they are responsible for rolling and addition the sixth one is unique the sixth one only pair which is same on the road and tire can you see this one it is present on the road also and this one present on the tire also the name of the sixth one is known as P cam Ultra important pyq repeated many times and this one is not responsible for rolling this one is not responsible for addition this one is responsible for diaper this one is responsible for that pediatrical so can you tell me the name of the six pairs can you tell me the first pair P selecting with the Ally Lewis act say yes are you people there the second is easy Latin with the Ally Lewis X the third is L selected on the WBC with glycam then icam and vcam with the integrands last PCM with PKM PCM is also known as cd31 you have to learn them in a sequence right the first is responsible and third is responsible for Rolling first and third the second I'm sorry the fourth and fifth responsible for addition right and the second is unique responsible for both learn the second pair responsible for both it's a pyq difficult level pyq and the last one is responsible for diabetes can you try it out with me who will help me in filling it please anyone from the audience tell me the molecules present on the endothelium tell me the molecules present on WBC and tell me their function function we will see in the end who will tell me the first pair promo muhammadu anyone will tell me the first first pair on endothelium what we have on endothelium we have p selectin and E selectin and both of them form pair with silai Lewis acts thylai Lewis X on WBC we have L selectin it will form a bond with the glycam glycan and V Camp they form bond with integral beta to integrand beta1 integral right and last one is unique cd31 CD 31 so tell me their function the first and the third is responsible for rolling right first and third responsible the fourth and fifth is for addition lasted but the second is rolling plus addition the second pair is rolling plus addition that is easy Latin plus tax that is unique yes everyone is right if you have done this now any even a difficult level McQ you can solve it I can challenge right it is not an easy level McQ uh based on this so I'm not filling it again fill in the blankets for you you have to fill it right this is your homework right the six pairs this is how the rolling and adhesion is completed then diabetes is there it will come out and finally chemo taxes so I told you the bacteria secreting certain chemicals that will attract the WBC towards it so name those chemicals name core chemicals four chemicals name of four chemicals so the first one there are four chemicals you have to learn so first one is leucotrin B4 leucotrin B4 the second is interleukinate let me write leucotrin D4 interleukin eight and two are complement one is complement c3a and one is c5a T3 is c5a let me write again one is leucotrin one is interlooking don't get confused leucotran interleukin crystal clear and two are complement give their numbers numbers are confusing leukotron is B4 interleukin is eight complement is c3a and C pi b the strongest is this one last one is the most potent C pi a it's a pyq right that is chemotaxis there I'm not going in the details of Phagocytosis right now so in this was a demo lecture I will give you in the main lecture let's solve some mcqs based on cellular events we are done with vascular events and cellular events five vascular thick cellular total 11 events we are done you got my point let's solve some mcqs the first question in front of you who will tell me the correct answer correct sequence in extroversation of WBC what's the correct sequence of cellular events I told you six cellular events now arrange them in a sequence can you tell me the correct answer please you can read the options are in front of you you can read the options in front of you Pomo if you have any doubt you can write down in the chat box only I can read right I can read it and in the main app if you take the subscription on an academy we have a separate forum for the doubt solving you can ask your doubt and we can keep a separate session on the doubt solving also if you wish anyways let me if there is necrosis caused by the bacteria will it lead to sepsis no fomo it will not lead to sepsis Amenia the bacteria can also enter inside and WBC so main purpose here is to WBC come out and it will not lead to sex success actually it will not lead to substance so yeah technically you are right there is a hole so why not uh after causing necrosis it will enter it will cause an acrosis and maybe to some extent it will go in the blood but it is not necessarily it will always lead to substance right it is a part of event but rarely it happens most common 95 percent it is due to endothelial cell contraction only and rarely the other four mechanisms hold good so coming on this point okay yeah what is the correct answer you all are right here a is the correct sequence first margination then rolling then addition and then diabetesus so out of the six the four are given can you tell me most important mediator for diabetes diet pediasis that is transmigration is that P cam is it one of the selectin p selectin e selectin l selectin or integrin or is it integrin or is it mucine like glycoprotein you have learned the six pairs now from that sixth pair last pair was unique that leads to diabetes what was that pair yes pecam cd31 very good RP cushy pratik everyone Deepak everyone yes the correct answer is PM and you are absolutely right yes the next question in front of you all of the following belongs to the family of selectin accept there are three select enough but you have given four option so which is not a selecting there are only three selection so p selectin l selectin a selectin and among them which is not a selective in the family of selectin there are only three selectance now yes the correct answer is c a selecting is not a selection not at all L is present on WBC and the remaining two are present on endothelium but a selected there is no selection at all you've got my point by this name a selectin is not a selection there is no existence itself the next question in front of you can you define what is chemotherapy what is chemotaxial is it random multi-directional movement is it unidirectional moment is it Adoration of WBC to the endothelium or is it augmented oxygen dependent bacterocidal killing what is chemotaxial can you define it what is chemotaxis yes so chemotaxis I told you the bacteria secrete the chemical which attract the WBC towards it in a unidirectional movement yes it's not multi-directional the typical unidirectional movement towards the chemical only chemical oriented movement it's chemotaxis and the strongest chemical is c5a right the next question can you tell me the name of the chemicals which mediate chemotaxis I told you poor leucotril interleukin and two complement can you tell me the numbers please leucotrin was B4 interleukin was eight complement was T3 a and C5 and now match the option no match the option in the options can you see histamine is not there bradycardin is not there see the remaining two options so the options are confusing you got my point the correct answer here is b c is partially correct this portion is correct but this portion is wrong so I will not go with C so correct answer is B you got it not C many of you are saying C Sharia correct answer is not C it's D you got a tria vital so yes can we go ahead the last question can you tell me wbsp leukocyte means WBC WBC migrating through the capillary wall is called as what it is called as what is it rolling diaper DSS migration or fermentation WBC coming out of the capillary WC coming out of the W capillary that step is known as what yes that step is known as diaperiasis that step is known as diabetes the movement of uh WBC uh from intravascular to extravascular space it is right you got it so this is the thing to summary we have learned the five vascular events we have learned the five vascular events what are they would you like to revise the all 11 events all 11 with me everyone will say so first say the five vascular events this is the master diagram in which we will draw all 11. the first one is the vasoconstriction transient vasoconstriction then vasodilation which is persistent then increase hydrostatic pressure increase vascular permeability and state you know how to draw it the five vascular events the six cellular events are in front of you so first there is margination then rolling then adhesion then diabetes then chemotaxes and then phagocytosis we are done with this topic now if you are preparing for any of the competitive exam need PG fmg ionicity next USMLE or any medical entrance exam I had given you the Prototype questions which belongs to this um topic and extra questions I will provide you in the notes you have to do the question practiced by yourself the extra expected question pyqs ibqs we have already done here and if you're belonging to Second prop and preparing for your University exam these are the long question from this topic come in your exam these are the short questions which come in your exam now try any long any short you can write it out so whether you are preparing for any of the competitive exam or whether you are preparing for University exams they can drop my course will be useful for you because I will provide you mcqs also at University exam long question short questions also so in this course which I am launching from 24th of March I am going to take entire live interactive classes these are not recorded one the recording will be provided to you for the next six months but try to attend it live so we can interact you can ask your doubts instantly and and the session will be interesting it's not boring unilateral it is the bilateral right I will give you cross-conceptual Theory like I have given for this topic followed by we will solve pyq ypq meq clinical question relevant that topic I will give you Robin's latest update I will give you note question Bank mock test everything it's a complete course complete General pathology hematology system pathology everything will be covered the duration of the course will be 40 to 50 hours weekend Friday Saturday Sunday Friday Saturday evening and Sunday morning we will take two to three hour Clockwork every weekend not every weekend but I guess two or three weekends in a month so we can have a coverage of 40 to 50 hours 24th March till May end the course will last right the course will be there total and the details of the course are there the pricing is there you can get offers also if you apply the code the code you may be having the code or you can apply my code it's such Dev 10 s a c h d e b that's my surname Dr sachdevsdv such Dev 10 without any space apply this code to get maximum discount on the course thank you so much and the second demo the free lecture tomorrow on an Academy app an academy Learners app it's app it's free it's not paid it's free the only thing you have to install an academy Learners app from the Play Store after installing the course will be live you can use the same code which I have said now such they've done for watching it so tomorrow night 9 pm tomorrow night be with me can you suggest a topic what should I take tomorrow if you have some topic in your mind you can tell me I will take that otherwise I will take it from my choice it is a demo session the complete course will be from Friday tomorrow Monday the second demo part two today was demo part one right okay so that's all about it before ending let me tell you something dreams are not those which we see in sleep dreams is something that don't let you sleep right so dream is something you are dreaming of rank one in your exam or if you are in second prop or University exam you are dreaming of gold medal that should be a dream and that should not let you sleep the sleepless night you are doing hard work you are doing your studies and that dream will come to that will convert into reality that is the definition of dream right so wishing you all the best for your exams bye bye hope to see you all of you tomorrow also in the demo class I want each and every one of you it's a free class now it's okay if you don't want to take subscription it's okay but at least one or two topics will be covered now tomorrow so come on an academy Learners app come tomorrow 9 pm and if you like the way of teaching if you think this course will be beneficial for you don't overthink and just find it out I can guarantee this course will be beneficial for you at whatever stage of preparation you are thank you so much if you have any doubt uh if you have any doubt you can ask here okay so you are telling me respiratory system or renal systems TVs I will take multiple topics from the systemic pathology tomorrow 9 pm ask your friends colleagues seniors Juniors all medical throughout the globe whosoever interested in studying pathology try tomorrow's demo okay see you bye bye wishing you all the best and I know you build Rock