Chapter 1: Mechanisms of Disease, Diagnosis and Treatment

pathology

study of disease

What makes something a pathologic condition?

it causes measurable change that threaten homeostasis

symptom

negative characteristics described by patient

sign

evidence of disease found by examination or testing

asymptomatic

there are no symptoms

syndrome

defined collection of signs and symptoms that characterize a disorder

pathogenesis

the development of diseases in stages

example of pathogenesis for infection

incubation period, full blown symptoms and remission

acute disease

is abrupt, often less severe symptoms and last less than 6 months

chronic disease

develops slowly, is intermittent, or lasts for longer than 6 months

equilibrium

is preserved by organs and structures in the body in order to meet celluar needs

what causes signs and symptoms?

the disruption of equilibrium

what all may affect pathogenesis

access to health care, genetics, current diseases, physical truama, predisposed factors, age, etc

predisposing factors

risk factors

examples of predisposing factors

age, gender, lifestyle, environment, hereditary, immunodefiency

Is it possible to alter risk factors assoviated with lifestyle? Can you give an example?

Yes - ex, smoking, drinking, engaging in risky sex, exercise, nutrition, certain stressors

examples of environmental factors that affect risk factors

air/water pollution, poor living conditions, geographic location, excessive noise, stressors

hereditary diseases often develop as a result of the combined effects of:

inheritance and environmental factors

immunodeficiency

inadequate or absent immune system, making the individual septible to infections

autoimmune disorder

immune response targets one’s own body

acute inflamtion symptoms

redness, swelling, heat, loss of function, fever, malaise, loss of appitite

how to detect an inflamitory disorder

blood testing

causes of inflimation

infection, toxins, physical truama, ischemia, necrosis

inflammation is a ______ response

exudative

What happens during inflammation?

the body attempts to wall off a certain area to destroy bacteria, dead and foriegn materials. liquid leaks into the site to introduce phagocytic activity. After the clwan up, repair of the issue begins

infectious diseasses are caused by

pathogens

signs of local infection

redness, swelling, heat, fever, enlarged lymph nodes, red streaks

signs of widespread infection

fever, headache, body aches, weakness, fatigue, appitite loss, deliruim

when desieases grow in the body, they either

invade and destruct tissue, or they produce posionous substances in the body

what does it mean when an infection is endogenous?

originates within the body

what does it mean when an infection is exogenous

origniates out of the body

how are pathogens transmitted?

direct or indirect phydical contact, inhalation, injestion

types of pathogentic agents

bacteria, fungi, viruses, protozoa

contagious diseases

tramitted from person to person. the carrier is asymptomatic

The bodys three defenses

1. natural/chemical barriers

2. inflattory response

3. immune response

natural/chemical barriers

the skin, natural body flora, chemicals in the body

steps in medical intervention

identify organzism in lab testing, give correct antimicrobial, give other meds, such as pain meds if needed for comfort, ensure patient gets plenty of water and rest

How to prevent spread of certain infections

-isolate patient

-immunization

-educate the public

superbug or super strain

a strain of bacteria resistant to antibiotics

examples of super strains

MRSA, VRE, CRE, acinetobacteribaummanii

genetics

study of genes and their hereditary

genetic information is coded onto

23 pairs of chromosomes

sex chromosone

x or y ; determines sex of person

autosomones

the 22 pairs of chromosones that are not sex chromosones

genotype

genetic information stored in a cell

karyotype

photographed arrangement of chromosones

genetic disease causes

1. abnormal single gene

2. polygenic diseases

3. abnormal presence or abscene of chromosone

4. altered chromosone

polygenetic diseases

caused by several sbnormal genes

mutations

harmful changes in the genetic code

mutagens

mutant agents

examples of mutagents

chemicals, radiation, viruses

modes of inheriting genetic diseases

1. autosomal dominant

2. autosomal recessive

3. X-linked recessive

1. autosomal dominant

dominant over the gene of the other chromosone. You need only one to have it

autosomal recessive

both chromosones need to have it for it to appear

1. X-linked recessive

attached to the X chromosone. Women need it on both, but since men only have one, they are more prone to it

genetic councilling

a communication centered on the occurance and risk in a family in which one or more members have a genetic disease. Also provides emotional support

cancer

a group of diseases characterized by uncontrolled cell proliferation

examples of cancers

carinoma - epithilal cells

sarcoma - supportive tissue

lymphoma - lymph

melanoma - malanin-producing cells

bengin tumor

slow growing, doesnt infiltrate surronding tissue

malignant tumor

looks disorderly and will invade surronding tissue. Often does so by invading the blood or lymph stream and creating new tumors elsewhere, making it hard to eradicate

metastases

secondary tumors that developed from the original. Moved to a differeent part of the body by blood or lymph

carcinogens

chemicals, radiation or viruses that cause cancer

internal risk factors of cancer

hormones, immune conditions, inherited mutations

Hoe to decrease risk of cancer

early detection of cancer, diet with lots of fruits, veggies and whole grains, limit smoking and alchol, reduce skin exposure to sunlight, limit radiation and chemicals, increase physical activity, maintain healthy weight, avoid STDs

tumor markers

substance some tumor cells produce which can be found in testing

What happens when cancer is suspected?

high tech imaging is used to help further dignose it. A bioposy of the lesion is likely performed

stage of neoplasm

the tumor size and spread is organized in stages so hospitals can communicate and determine best treatment

tumor-node-metastasis

thee most common staging sysytem for cancer. it assesses

1. the primary tumor (T)

2. the extent of regional lymph involvement (N)

3. number of distant metastases (M)

cancer stage names

1, 2, 3, 4

earliest cancer stage

1

latest and most serious cancer stage

4

prognosis

reflects the estimation of cacer reoccurance and death. Often reported as a percent of patients still alive after a certain amount of time

what affects prognosis

stage, age of patient, serum concentration of tumor markers, time waited until treatment, grade of tumor

grade of tumor

assigned based on the differention of cells in the tumor

low grade tumor looks like

well-differenated cells that still resemble the tissur they are dervived from

high grade tumor looks like

poorly differentiated are more abmormal in appearance and do not resemble tissue they came from

glenson grade

a grade given to prostate cancer. There are two distinct patterns, each given a score of 1-5. 1 is well differinciated. The two scores are combined to recieve a score between 2-10

cancer treatments

surgery, chemotherapy, hormone therapy, readiation, palitative surgery

pallitative surgery

relieves troublesome symptoms

How does chemotherapy work?

it affects cell replication, especially for fast producing cells. This not only includes cancer cells, but hair xells, GI tract, hemopetic cells, reproductive cells

How does hormone therapy work?

inhinbits horomone synthesis. effective in horomone dependent cancers, like breast and prostate

how does immunotherapy work?

uses cancer vaccines, T cells, or NK cells

long term conesquences of cancer treatment

treatments are toxic to the body. patients are predisposed to other illnesses. Children see delayed growth and cognitive impairments

Cachexia

a metabolic syndrome that causes muscle loss and can also lead to fat loss. It's also known as wasting syndrome or anorexia cachexia syndrome. One long term effect of cancer

oncogene

broken gene that may cause cancer

three types of immune disorders

Hypersensitivity reaction (allergy)
 Autoimmune disease
 Immunodeficiency disorders

allergen

harmless substance

antigen

substance that causes allergies

How are allergies dignosed and trated?

blood and skin tests. The antigen is eliminated from the person’s enviroment. Injections may be given to desentize the person. Antihistimines are given for treatment.

anaphylaxis

a severe allergic reaction requiring emergency care

What happens in an autoimmune disorder?

self-antigens are wrongly idenefied as forigen antigens and wrongly attacked

what causes immunodifficency?

Primary: lack of T and B cells

Secondary: caused by disease, or treatment (drugs, surgery, radiation)

Emergency management begins with

triage
 Determines priority of care

malnutrition and irs causes

does not allow the body to get enough nutrients, can be caused by diet or conditions such as eating disorders, iron difcency, obesity, etc

immunosenescence

gradual deterioation of the immune system that comes with age

probiotics

promote gut health

Changes in aging adults include

melobotic changes (dcreased body water), cognitive impairment, incontience, sensory isolation due to vision/hearing loss

phycological evaluation includes

observation of
behavior, appearance, mood, communication,
judgment, and thought processes

mental disorders

Behavioral or psychological syndromes associated
with psychic pain or impairment of function

How to establish dignosis

process of data collection from medical history, physical exam and dignostic testing