Exam 1 - Patho

define health

a state of complete mental, physical, and social wellbeing and not just the absence of a disease

define pathophysiology

study of a body’s response to dysfunction or disease. A mechanistic study of a disease

define disease

an interruption, cessation, or disorder of a body system

define diagnosis

a designation as to the nature or cause of a disease, i.e. COPD

Define Sensitivity

proportion of people with a disease that result positive with that disease in a given test (true positive)

Define Specificity

proportion of people without a disease that result negative of that disease in a given test (TRUE NEGATIVE)

define etiology.

• give example

cause of disease

• could be viral, bacterial

when the etiology cause is idiopathic, what does it mean?

that the cause is unknown

define pathogenesis

describes how diseases process evolves

Define/describe sign

Define/describe Symptom

Sign

• OBJECTIVE → What you observe

• Ex: nurse takes BP and its 120/80

Symptom

• SUBJECTIVE- what patient tells you

• Ex: patients says “I feel warm”

define syndrome

a compilation of signs and symptoms.

(Ex: Chronic Fatigue Syndrome)

Clinical Course describes the

can be what?

Clinical course describes the evolution of a disease

can be acute or chronic

Acute disorder vs Chronic disease

Provide examples

Acute disorder:

• Severe, sudden onset, and self-limiting

• Ex: UTI, Pneumonia

Chronic Disease:

• a continuous long-term process

  • maybe presented as exacerbation (aggravation of symptom) or

  • remission (period of decrease in severity and symptoms)

• 6 months or longer

• Ex: Cancer, multiple sclerosis (MS)

What is a risk factor

What are the types of risk factors. Provide examples

Risk factor- exposure of an individual that increase the chance of someone getting a disease or injury

modifiable and non-modifiable

• Non-modifiable

  • Age, race, sex, gender

  • Genetics - i.e. family history of high BP, diabetes

• Modifiable

  • Environmental: lifestyle, alcohol and smoking consumption, lack of activity/exercise, diet,

  • hypertension

Describe epidemiology

study of disease occurrence in human populations.

A science to study risk factors for multifactorial diseases, i.e., heart disease and cancer

Concerns how disease is spread, how to control it, prevent it, and eliminate it

define incidence

number of NEW CASES in a population at risk during the specified time

define prevalence

measure of existing disease in a population at a given point in time

Morbidity

vs

Mortality

Morbidity: describes the effect an illness has on a person’s life

Mortality: causes of deaths in a given population

define natural history

Give an example

the progression and projected outcome of a disease without medical intervention

Ex: hepatitis C- 75% - 85% of ppl who become infected fail to clear the virus and progress to chronic infection

Define prognosis

probable outcome of a disease

What is a good response when handling difficult conversations?

For example, what would you say if the patient ask “how long do I have left to live”

“let me get the doctor for you”

describe and give examples of:

• primary prevention

• secondary prevention

• tertiary prevention

Primary prevention

• removing risk factors, so disease does not occur

  • Ex: immunizations, environmental factors, diet, exercise, seat belts

Secondary prevention

• detecting a disease when it is still curable

  • Ex: Screenings (Pap smears to detect cervical cancer, BP, mammograms), Self-examination (skin, breast, testicles)

Tertiary prevention

• preventing disease from getting worse

  • ex: rehab therapy

describe laboratory tests

define validity

define reliability

laboratory tests - therapeutic level or EXPECTED RESULTS

validity- extent to which a measurement tool measure what it is intended to measure

• Ex: validity of a BP measurements

reliability- extent to which an observation, if repeated gives the same results

Cells adapt to changes in the internal environment.

• what are the two types of cellular adaptations?

  • what could these adaptations result in?

cellular adaptation:

• Physiological (adaptive) or Pathogenic (disease)

Could result change in:

• cellular size

• number of cells

• manner of cell growth

• change in cellular form

What is Atrophy?

decrease in cell size

what is hypertrophy?

INCREASE in cell size

what is hyperplasia?

increase in number of cells

What is Metaplasia?

replacement of adult cells

Dysplasia

deranged cell growth of a specific tissue

Ex: Cancer

What is Metastasis

cells with the ability to break loose

Describe hypoxic cell injury.

• results in?

• the longer the tissue is hypoxic,….

• Causes of hypoxia

  • Out of all of them, which one is the most common cause?

-deprives cell of oxygen and interrupts oxidative metabolism and generation of ATP (low oxygen level to tissue)

-Acute cellular swelling (edema)

-the longer the tissue is hypoxic, the greater the chance of irreversible cellular injury

Causes:

• inadequate amount of O2 in the air

• Respiratory disease (COPD)

• Inability of the cells to use O2

• Edema

• Ischemia (reduced blood flow) → most common cause of hypoxia

Anoxia is

absence of oxygen

Necrosis refers to what?

• Necrosis often interferes with

• What occurs when a considerable mass of tissue undergoes necrosis

Necrosis refers to the cell death in an organ or tissues that is still part of a living person

• often interferes with cell replacement and tissue regeneration

• GANGRENE occurs when a considerable mass of tissue undergoes necrosis

Gangrene:

• is an example of what?

• Caused by?

• What are the types of gangrene

  • describe the characteristics of each (texture, color)

  • How is the pace of each type in regard to spreading

an example of necrosis

caused by loss of blood supply due to an underlying illness, injury, and/or infection

Dry and Wet gangrene

Dry:

• affected tissue becomes dry, shrinks. Skin is wrinkled and becomes black/brown color

• spread of dry gangrene is slow

Wet gangrene:

• Area is cold, swollen, and pulseless. Skin is moist, black. Blebs form on the surface, liquefaction occurs and FOUL ORDOR caused by bacterial action

• spread is fast

What type of gangrene is it when the spread of tissue damage is fast, area is cold, swollen, moist, PULSELESS, and black and has a foul odor

What type of gangrene is it when the spread of tissue damage is slow. Area becomes dry, skin shrinks and becomes wrinkly, and color is dark brown or black.

wet

dry

Difference between normal cells and cancer cells in:

• Growth

• Communication

• Cell repair and death

• stickiness

• metastasis

• appearance

• maturation

• angiogenesis

Normal cell:

• Growth: stop growing when enough cells are present

• Communication: responds to signal when boundary is reached

• Cell repair and death: apoptosis

• stickiness: secretes substance to stick together

• metastasis: none, stay where they belong

• appearance: stable

• maturation: reach maturity

• angiogenesis: development of new blood cells as part of normal growth

• Other important :

  • Renewal and repair involves: cell

  • proliferation and differentiation

Cancer cell:

• Growth: never stop growing; continues to grow

• Communication: no communication/interaction

• Cell repair and death: not repaired; damaged cells allowed to reproduce

• No stickiness: none- they float away; lack adhesion molecules

• Metastasis: spreads towards other organs

• appearance: abnormal shape, smaller, larger

• maturation: immature, divides rapidly before reaching maturity

• angiogenesis: Yes angiogenesis even when growth not needed

What is angiogenesis?

(T/F): Angiogenesis is not a factor leading to cancer

Angiogenesis is the production (growth) of blood vessels from existing ones

False→ IT IS A FACTOR LEADING TO CANCER

What are the 3 categories of the etiology of cancer?

1.) Genetics → damage or mutation; cancer-associated cells

2.) Epigenetic mechanisms → changes in gene expression but no change in DNA

3.) Host and Environmental factors → exposure to carcinogens

What are etiology of cancer, in terms of genetics?

• protooncogenes if mutated

• less active tumor suppressor genes

• loss of retinoblastoma gene (gene that prevents cell division)

• inactivity of TP53 gene (activated to initiates apoptosis)

• activation of ras oncogenes triggers cell proliferation (cell multiplying)

The process by which normal cells become cancer cells is called

transformation

list examples of carcinogens

• Cigarette smoking

• Soot (impure carbon particles)

• Asbestos, arsenic compounds, benzene

• Insecticides, fungicides

• Nickel and chromium compounds

• Smoked Foods

• Nitrosamines

• Anticancer drugs like chlorambucil, cyclosphamide

• Radiation

• Oncogenic viruses like HPV, human herpes virus, hepatitis B

What are epigenetic factors for cancer

METHYLATION

changes in gene expression but no change in DNA

Identify whether each tumor is either Benign or Malignant:

• Adenoma

• Fibrosarcoma

• Osteoma

• Neuroblastoma

• Hemangiosarcoma

• Neuroma

• Rhabdoyoma

How do you know?

Bengin:

• Adenoma (epithelial-)

• Osteoma (bone-)

• Neuroma (nerve cells-)

• Rhadomyoma (striated muscles-)

all end in -OMA.

Malignant:

• Fibrosarcoma (connective tissue-)

• Neuroblastoma (nerve cells-)

• Hemangiosarcoma (blood vessels- )

all end in -SARCOMA or -CARCINOMA

EXCEPTION: Neuroblastoma

Name the medical term for malignancies of blood-forming cells (hematologic-)

leukemia

What are cancer biomarkers?

Give examples.

cancer biomarkers refer to a substance or process that is indicative of the presence of cancer in the body. (“marks” in the body that show that there is cancer)

Ex:

• BRCA 1 or 2 → Breast cancer gene

• PSA → Prostate cancer (Prostate specific antigen)

• AFP → Liver, ovaries, testicles (alpha fetoprotein)

• CA 125 → Ovarian cancer (Cancer antigen)

• CA 19.9 → Prostate; pancreas

• HER2 → breast; esophagus and stomach (human epidermal growth receptor 2 )

• EGFR → for non-small-cell lung carcinoma (epithelia growth factor receptor)

• Calcitonin → thyroid cancer

Steps for transformation (normal cell → cancer cell)

describe each step.

1.) Initiation - cell exposed to carcinogenic agent

2.)Promotion - unregulated accelerated growth in cell

3.)Progression - tumor cell takes on malignant characteristics (autonomous growth tendencies, and increased karyotypic instability)

Cardinal signs of Cancer

C: Changes in bowel or bladder habits

A: A sore that never heals

U: Unusal bleeding or discharge

T: Thickening or lumps of the breast

I: Indigestion or difficulty swallowing

O: Obvious change in wart or mole

N: nagging cough or hoarsenesses

Other symptoms of cancer:

• weight loss, anorexia, fatigue/weakness, nausea, pain (occurs at late stage)

Examples of cancer treatment. Describe it

• Chemotherapy

  • Can cause bone marrow depression

  • side effects:

    • elevated uric acid, rate stone formation

    • chemo brain - reduced ability to concentrate, recall info

• Radiation therapy

  • cells damaged by radiation either die or unable to divide; used gamma rays to penetrate tissues

  • Teletherapy - distant treatment, source external to client

  • Brachytherapy - short or close therapy, radiation comes into direct cont. contact with tumor tissues - high dose of radiation

Difference between mutation and methylation 

mutation → DNA damage to a cell/gene

methylation → changes in gene expression but not DNA

Nonpharmacologic methods of stress reduction

-rela