08/29/19

Chapter 1: Intro

 Pathology- study and diagnosis of disease through examination of organs, tissues, cells and
bodily fluids.
 Physiology - study of the mechanical, physical, and biochemical functions of living organisms.
 Pathophysiology -study of abnormalities in physiologic functioning of living beings.

“Normal” values occur within a range of values and may vary depending on technology used for
measurement.

 Adjustments caused by the following:

 Age

 Gender

 Genetics

 Environment:

 Activity level: : athletes have slower heart rate and pulse rate

Disease prevention has become a primary focus in health care

Concepts of Epidemiology (Cont.)

Levels of prevention

 Primary: reducing exposure for susceptible persons (healthy)

o Ex- education, regular examinations, and immunizations
 Secondary: goal is to halt the progress of disease condition and limit disability (it started)
o detection, screening, and management of disease by medications
o clinics
 Tertiary: reducing disability and restoring function following disease (how to manage)
o Ex rehab, supportive care (stroke rehab program)(appropriate in the stage of
advanced disease or disability)

Medical history

 Current and prior illnesses Hospitalizations

 Allergies Treatment

 Any type of therapy or drugs

o Prescription/ Nonprescription

o Herbal items, including food supplements

 Terminology of Pathophysiology

 Gross level

o Organ or system level (Kidney)

 Microscopic level

o Cellular level (Nephrons)

 Biopsy

o Excision of small amounts of living tissue

 Autopsy

o Examination of the body and organs after death

 Diagnosis

o Identification of a specific disease through evaluation of signs and symptoms and lab
tests

 Etiology

o Study of causes/reasons for phenomena

o Identifies causal factors acting in concert that provoke a particular disease or injury

o Ex- skin cancer- etiology Is sun uva rays

 Idiopathic

o Cause is unknown

 Iatrogenic

o Cause results from unintended or unwanted medical treatment

There is an etiology and try to determine why its happening. It its unknown it is idiopathic if its due to
medical treatment its iatrogenic

Most disorders are multifactorial, having several different etiologic factors that contribute to their
development.

Ex: coronary heart disease is a result of the interaction of genetic predisposition, diet, exposure
to cigarette smoke, elevated blood pressure, and perhaps numerous other lifestyle and hormone factors
acting in concert.

 Predisposing factors

o Tendencies that promote development of a disease

 Ex: Being exposed to second hand smoke

  Risk Factor

o A factor that when present increases the likelihood of disease

 Prophylaxis

o Measures designed to preserve the health

o Ex- vaccines

 Pathogenesis

o Development or evolution of disease, from initial stimulus to ultimate expression of

manifestations of disease

 Gensis= is beginning patho= is disease

 How did the disease start

Characteristics of Disease

 Acute disease (Appendicities)

o Develops quickly, marked signs, short term

 Chronic disease (arthritis)

o Often milder, develops gradually, persists for a long time

 Subclinical state (Renal damage)

o Pathologic changes, no obvious manifestations

 Cant see the damages in you but its affecting you

 Latent state

o time between exposure of tissue to injurious agent and first appearance of signs and/or
symptoms

 Incubation period

o Time of exposure to a microorganism and onset of signs and symptoms

 Prodromal period

o Time during early development of a disease

o Signs nonspecific or absent

 Manifestations

o Signs and symptoms of disease (local & systemic)

 Syndrome
 o Collection of sign and symptoms

o Often affects more than one organ (AIDS)

 Remissions

o Manifestations of the disease subside or are absent.

 recovery

 Exacerbation:

o increase in severity, signs, or symptoms

 it gets worse

 Precipitating factor

o Condition that triggers an acute episode

 Something that is triggering the problem

 Complications

o New secondary or additional problems

 Therapy

o Treatment measures to promote recovery or slow the progress of a disease

 Sequelae (Scarring fro inflammatory disease)

o Unwanted outcomes resulting from primary condition

 Convalescence

o stage of recovery after a disease, injury, or surgical procedure

 Prognosis

o Probability for recovery or for other outcome

 Rehabilitation

o Maximizing function of diseased tissues

Disease Prognosis

 Epidemiology

o Science of identifying the causative factors and tracking the pattern or occurrence of
disease

 Pattern of disease
  How/who is effected, in which area?

 Morbidity

o Indicates the number of people with a disease within a group

 Disease case

 Mortality

o Indicates the number of deaths resulting from a particular disease within a group

 Death of ppl from disease

 Epidemics

o Occur when a higher than expected number of cases of an infectious disease occur
within a given area

 A large outbreak

 Endemic:

o Infectious disease occur within a local area or region

 Outbreak in a small area

 Pandemics

o Involve a higher number of cases in many regions of the globe Eg Zika virus

 Worldwide

 Occurrence of disease

o Tracked by incidence and prevalence

 Incidence

o Number of new cases in a given population within a specified time period

 New cases

 Prevalence

o Number of new and old or existing cases in a specific population within a specified time
period

 New and old cases

 Communicable diseases

o Infections that can spread from one person to another

 Notifiable or reportable diseases

 o Diseases that must be reported by the physician to certain designated authorities

 Autopsy or postmortem examination

o Performed after death to determine the exact cause of death

Cellular adaptation

 Atrophy

o Decrease in the size of cells

 Results in reduced tissue mass like limb immobilization

 Hypertrophy

o Increase in cell size

 Results in enlarged tissue mass like high cardiac demand

 Hyperplasia

o Increased number of cells

 Results in enlarged tissue mass

 Metaplasia

o Mature cell type is replaced by a different mature cell type.

 New cells are replacing the old ones

 Dysplasia

o Cells vary in size and shape within a tissue.

 Anaplasia

o Undifferentiated cells, with variable nuclear and cell structures

 Cells Completely loses its shape or structure

 Neoplasia

o “New growth”―commonly called tumor

Cell damage

 Apoptosis

o Refers to programmed cell death

  Normal occurrence in the body

 Normal death in cells

 Ischemia

o Deficit of oxygen in the cells

 Hypoxia

o Reduced oxygen in tissues

 Physical damage

o Excessive heat or cold

o Radiation exposure

 Mechanical damage

o Pressure or tearing of tissue

 injury

 Chemical toxins

o Exogenous: from environment

o Endogenous: from inside the body

 Microorganisms

o Bacteria and viruses, for example

 Abnormal metabolites

o Genetic disorders

o Inborn errors of metabolism

o Altered metabolism

 Nutritional deficits

 Imbalance of fluids or electrolytes

Irreversible cell injury

Necrosis

 Usually occurs as a consequence of ischemia(cells aren’t getting oxygen) or toxic injury

 Characterized by cell rupture, spilling of contents into extracellular fluid, and inflammation

o Four different types of tissue necrosis:

  (1) coagulative, (2) liquefactive, (3) fat, and (4) caseous

 Liquefaction necrosis (Infection)

o Dead cells liquefy because of release of cell enzymes

 Pus comes out

 Coagulative necrosis (MI)

o Cell proteins are altered or denatured― coagulation

 Fat necrosis (Infection)

o Fatty tissue broken down into fatty acids

 Caseous necrosis (TB)

o Form of coagulation necrosis

o Thick, yellowish, “cheesy” substance forms

 Infarction

o Area of dead cells as a result of oxygen deprivation

 Gangrene

o Area of necrotic tissue that has been invaded by bacteria

Fluid imbalance

• Body’s equilibrium is maintained when all fluids osmolarity is close to 270-300 mOsm/L. The
fluids are isotonic to each other.

• Less than 270= hypotonic

• Higher than 270= hypertonic

• 30/mL per hour for urine output