 Pathophysiology is the study of disease.

It involves the investigation of the

causes of disease (etiology) and the associated changes at the levels of cells,
tissues, and organs (pathogenesis), which in turn give rise to the presenting
signs and symptoms of the patient.
Note: Defining the etiology and pathogenesis of disease not only is essential for
understanding a disease but is also the basis for developing rational treatments.
 To render diagnoses and guide therapy in clinical practice, pathologists
identify changes in the gross or microscopic appearance (morphology) of
cells and tissues, and biochemical alterations in body fluids (such as blood
and urine) using a variety of morphologic, molecular, microbiologic, and
immunologic techniques.
 In this course, we will first cover the broad principles of general pathology
and then will progress to specific disease processes in individual organ
systems and organs.

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Language of Pathophysiology

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 Language of Pathophysiology
• Etiology • Diagnosis • Prognosis
• Subclinical State
• Idiopathic • Diagnostic tests • Morbidity
• Latent Stage
• Risk factors • Biopsy • Mortality
• Incubation period
• Iatrogenic • Autopsy • Epidemiology
• Prodromal Period
• Predisposing • Remission • Epidemics
• Manifestations
factors • Exacerbation • Pandemics
(local or systemic)
• Precipitating • Complications • Incidence
• Signs
factors • Therapy • Prevalence
• Symptoms
• Pathogenesis • Sequelea • Communicable
• Lesions
• Onset (Acute or • Convalescence disease
• Syndrome
insidious) • Rehabilitation • Notifiable &
• Acute or Chronic reportable
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A disease or abnormal condition usually involves changes at the
organ or system (gross) level as well as at the cellular, or
microscopic, level.

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 Causes
 Etiology = the causative factors (one or several) in a particular
disease
(e.g., congenital defects, inherited or genetic disorders, microorganisms such as viruses or
bacteria, immunologic dysfunction, metabolic derangements, degenerative changes,
malignancy, burns and other trauma, environmental factors, and nutritional deficiencies).

 Idiopathic = When the cause of a disease is unknown.

 Risk factors = Factors that increases a person's chances of
developing a disease.
 Iatrogenic = when a treatment, a procedure, or an error may
cause a disease
(examples of an iatrogenic disease = a bladder infection following catheterization, or bone
marrow damage caused by a prescribed drug).

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 Causes

 Predisposing factors = the tendencies that promote

development of a disease in an individual (e.g., age, gender,
inherited factors, certain dietary practices, diet rich in fat that
predispose to heart attack)
Note: A predisposing factor indicates a high risk for the disease but
not certain development.
 Precipitating factor = a condition that triggers an acute episode
Note: a precipitating factor differs from a predisposing factor. For
example: a patient may be predisposed to coronary artery disease and angina because of
a high-cholesterol diet. An angina attack can be precipitated by shoveling snow on a very
cold day.

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 Prevention of a disease is closely linked to etiology and the
predisposing factors.
Preventive measures include vaccinations, dietary or lifestyle
modifications, removal of harmful materials in the environment,
cessation of potentially harmful activities such as smoking, etc.

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 Acute & Chronic Diseases

 An acute disease = a short-term illness that develops very

quickly with marked signs such as high fever or severe pain, for
example, acute appendicitis.
 A chronic disease = often a milder condition developing
gradually, such as rheumatoid arthritis, but it persists for a long
time and usually causes more permanent tissue damage. Often a
chronic disease is marked by intermittent acute episodes.

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 Pathogenesis

 Pathogenesis = the development of the disease or the sequence

of events involved in the tissue changes related to the specific
disease process.

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 Manifestations
 The manifestations of a disease are the clinical evidence or
effects, the signs and symptoms, of disease. They may be:
• local, or found at the site of the problem.
• or systemic, meaning general indicators, such as fever.
 Signs are objective indicators of disease that are obvious to
someone other than the affected individual. Examples: skin rash.
 Symptoms are subjective feelings, such as pain or nausea.
 Lesion = a specific local change (microscopic or highly visible).
 Syndrome = a collection of signs and symptoms, often affecting
more than one organ, that usually occur together.
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 Onset & Stages

The onset of a disease may be:

• Sudden and obvious or acute: for example, gastroenteritis with
vomiting, cramps, and diarrhea.
• Insidious: best described as a gradual progression with only
vague or very mild signs.

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 Onset & Stages

 An initial latent or “silent” stage in which no clinical signs are

evident. Example: the incubation period in infectious diseases, or the time
between exposure to the microorganism and the onset of signs or symptoms.
 A subclinical state in which pathologic changes occur, but no
obvious manifestations are exhibited by the patient, perhaps
because of the great reserve capacity of some organs. For example,
kidney damage may progress to an advanced stage of renal failure before symptoms
are manifested.
 The prodromal period comprises the time in the early
development of a disease when one is aware of a change in the
body, but the signs are nonspecific. For example, chronic fatigue, loss of
appetite, or headache
(Note: Laboratory tests are negative during the prodromal period).

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 Disease Course
 Remissions and exacerbations: mark the course or progress of a
disease. During a remission, the manifestations of the disease
subside, whereas during an exacerbation the signs increase.
Example: Rheumatoid arthritis typically has periods of remission when pain and swelling are
minimal, alternating with acute periods when swelling and pain are severe.

 Complications are new secondary or additional problems that

arise after the original disease begins.
For example, following a heart attack, a person may develop congestive heart failure, a
complication.

 Sequelae describe the potential unwanted outcomes of the

primary condition, such as paralysis following recovery from a
stroke. Sequelae is a chronic condition.
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 Diagnosis

 Diagnosis = the identification of a specific disease through

evaluation of signs and symptoms, laboratory tests or other
tools.
Examples of diagnostic tests: chemical analysis of body fluids such as blood,
Pathology laboratory studies, radiologic examination of the body, etc.

 Pathology laboratory studies are tests that examine tissue and

cells specimens from biopsy procedures (excision of very small
amounts of living tissue), surgical specimens, or examination
after death (Postmortem examination or autopsy).

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 Therapies

 Therapy or therapeutic interventions = the treatment measures

used to promote recovery or slow the progress of a disease.
Examples: These measures may include surgery, drugs, physiotherapy, alternative
practices, or behavior modification.

 Convalescence or rehabilitation = the period of recovery and

return to the normal healthy state (It may last for several days or
months).

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 Prognosis, Morbidity, Mortality

 Prognosis = The probability for recovery.

 Morbidity = the disease rates within a group; or the
functional impairment that certain conditions cause within a
population.
 Mortality = the relative number of deaths resulting from a
particular disease.

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 Epidemiologic data of a disease
 Epidemiology is the science of tracking the pattern or
occurrence of disease.
 Epidemics = when there are a higher than expected number of
cases of an infectious disease within a given area
 Pandemics = higher numbers of cases in many regions of the
globe.
 The occurrence of a disease is tracked by recording two factors:
the incidence and the prevalence.
• The incidence of a disease indicates the number of new
cases in a given population noted within a stated time
period.
• Prevalence refers to the number of new and old or existing
cases within a specific population and time period.
Note that prevalence is always a larger figure than incidence.

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 Communicable & Notifiable Diseases

 Communicable diseases are infections that can be spread

from one person to another.
 Notifiable or reportable diseases must be reported by the
physician to certain designated authorities (to prevent
further spread of the disease and maintain public health).
Examples of notifiable or reportable disease: infections as measles, Severe Acute
Respiratory Syndrome (SARS) and human immunodeficiency virus (HIV) or acquired
immunodeficiency syndrome (AIDS).

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