INTRODUCTION OF PATHOPHYSIOLOGY

WHAT IS PATHOPHYSIOLOGY?

•Pathophysiology involves the study of

anatomy or physiologic changes in the body

that result from disease processes.

•As a disease develops, the changes in the normal

anatomy and/or physiology of the body

may be obvious or maybe hidden, occurring at the

cellular level.

What is Homeostasis?

:

•The maintenance of a relatively stable

internal environment regardless of external

changes.

Explain a negative feedback loop

What impacts “normal” limits?

body temp, blood pressure…

Normal limits are represented by____

BP:

HR:

RR:

TEMP:

RANGE

120/80

60-100bpm

12-20

97.8-99

What are the locations for checking temps?

Oral, rectal, axillary, temporal and frontal

____ is the primary focus in health care

Prevention

What is used to develop more effective preventive programs?

Know causes of conditions and disease along with predisposing.

What are some examples of prevention in healthcare?

• Routine vaccination programs

• Screening programs

• community health programs

Health research had lead to new____

therapies

What are the 3 stages of health research?

1. Basic science

2. Small number of human subjects

3. Large number of patients

Further explain:

1. Basic science

2. Small number of human subjects

3. Large number of patients

1. RESEARCHERS WORK TO

   IDENTIFY A TECHNOLOGY THAT WILL WORK TO

   LIMIT OR PREVENT THE DISEASE PROCESS

   •CARRIED OUT IN A LAB – REQUIRES CELL cultures

   AND/OR ANIMALS

2. TO DETERMINE IF THERAPY IS SAFE FOR HUMANS

3. LARGE NUMBER OF PATIENTS WITH THE DISEASE OR

   at risk ARE ENROLLED IN A CLINICAL TRIAL

What is a double blind study?

•RESEARCH SUBJECT AND THE PERSON ADMINISTERING THE

TREATMENT DO NOT KNOW IF THE SUBJECT IS RECEIVING A PROVEN TREATMENT OR PLACEBO

IF IT MAKES IT TO THE 3 RD STAGE AND

RESULTS ARE POSITIVE (PATIENTS

ARE REACTING THE WAY THEY

SHOULD), THEN WHAT IS THE NEXT

STEP?

“EVIDENCE-BASED RESEARCH FINDINGS”

what is a “EVIDENCE-BASED RESEARCH FINDINGS” ?

ALL DATA/RESEARCH IS COLLECTED AND PASSED ON

TO A regulatory body SUCH AS FOOD AND

DRUG ADMINISTRATION

•THEY THEN DECIDE THE WHAT HAPPENS WITH THIS

THERAPY

What is the ANTIRETROVIRAL?

• the first ANTIRETROVIRAL agent

• working against or targeted against

  retroviruses , especially HIV

What is a retrovirus?

A virus that is composed not of DNA but of RNA. Retroviruses have an enzyme, called reverse transcriptase , that gives them the unique property of transcribing their RNA into DNA after entering a cell. The retroviral DNA can then integrate into the chromosomal DNA of the host cell, to be expressed there. HIV is a retrovirus

How many stages did AZT under go?

3 stages.

When AZT was being tested, why did they use the drug?

THOSE IN THE TRIAL THAT WERE TAKING AZT WERE

outliving THE GROUP THAT WAS NOT TAKING THE

DRUG

THEY THEN OFFERED THE DRUG TO BOTH GROUPS

what is gross anatomy (and cellular and microscopic level)?

A DISEASE OR ABNORMAL CONDITION USUALLY

INVOLVES CHANGES AT THE ORGAN OR SYSTEM ….

What is a Biopsy?

EXCISION OF VERY SMALL AMOUNTS OF living TISSUE

What is a autopsy?

surgical SPECIMENS OR

EXAMINATION AFTER DEATH

What are some medical history question to ask a patient?

What is PROPHYLACTIC MEDICATION?

USED TO PREVENT

INFECTION OR EXCESSIVE BLEEDING

What is a symptom?

SUBJECTIVE EVIDENCE OF A DISEASE/

CONDITION

•only the patient can perceive them.

What is a sign?

OBJECTIVE EVIDENCE OF DISEASE/ CONDITION

•apparent to the patient, physical and others

What is a diagnosis?

THE IDENTIFICATION OF A SPECIFIC DISEASE

THROUGH EVALUATION OF signs AND

SYMPTOMS, laboratory tests

•USUALLY NEED MORE THAN 1 TO VERIFY A

DIAGNOSIS

What is etiology?

CONCERNS THE CAUSATIVE FACTORS IN A PARTICULAR DISEASE (what caused the disease?)

What are some etiology factors?

• congential DEFECTS

• INHERITED/GENETIC DISORDERS

• MICROORGANISMS (VIRUSES/BACTERIA)

• IMMUNOLOGICAL DYSFUNCTION

• degenerative CHANGES

• MALIGNANCY

• BURNS

What does idiopathic mean?

•WHEN THE CAUSE OF A DISEASE IS UNKNOWN

What does iatrogenic mean?

•THE TERM USED WHEN A treatment, A PROCEDURE, OR

AN error MAY CAUSE A DISEASE

What are PREDISPOSING FACTORS?

•TENDENCIES THAT PROMOTE DEVELOPMENT OF A

DISEASE IN AN INDIVIDUAL

•INDICATES A HIGH RISK FOR A DISEASE

•SPECIFIC PREDISPOSING FACTORS:

EX: asbestos( causes lung cancer)

What is pathogenesis?

DEVELOPMENT OF A DISEASE OR THE SEQUENCE OF

EVENTS INVOLVED IN THE TISSUE CHANGES RELATED

TO THE SPECIFIC DISEASE PROCESS

What does onset mean?

•first appearance of the sign and symptoms an

illness appear quick

What does acute mean?

SHORT-TERM ILLNESS THAT DEVELOPS QUICKLY

• MARKED SIGNS – MAYBE HIGH FEVER OR SEVERE PAIN

What does chronic mean?

•A MILDER DISEASE CONDITION DEVELOPING

gradually

PERSISTS A LONG TIME

•CAUSES MORE permanent TISSUE

DAMAGE

What is a lesion?

A SPECIFIC LOCAL CHANGE IN THE TISSUE

•EXAMPLES:

• LIVER CELLS CHANGE WHEN VIEWED FOR PATHOLOGIC CHANGES

• A blister/pimple IS OBSERVED ON THE SKIN

What is a syndrome?

A COLLECTION OF SIGNS AND SYMPTOMS, OFTEN

Affecting MORE THAN 1 organ

DOWN’S SYNDROME

• congenital heart defects

• Respiratory problems

• hearing problems

• Alzheimer's disease

• childhood leukemia

• Epilepsy

• thyroid conditions

DIAGNOSTIC TEST

What is the purpose of laboratory tests?

THAT ASSIST IN THE

diagnosis AND/OR MONITORING OF A SPECIFIC

DISEASE

What is remission?

THE MANIFESTATIONS OF THE DISEASE subside

What is Exacerbation

signs increase

What is a PRECIPITATING FACTOR?

A CONDITION THAT TRIGGERS AN acute episode

What is a complications?

NEW secondary OR ADDITIONAL PROBLEMS THAT

ARISE AFTER THE ORIGINAL DISEASE BEGINS

•EXAMPLE – AFTER DEALING WITH CHRONIC

CONSTIPATION/IMPACTED COLON THE PATIENT

DEVELOPS A colonic perforation

What are the purpose of therapy or therapeutic interventions?

TREATMENT MEASURES (SURGERY, DRUGS,

PHYSIOTHERAPY, ETC...) USED TO PROMOTE

recovery OR SLOW PROGRESS OF A DISEASE

What is a PROGNOSIS?

THE probability FOR RECOVERY OR OTHER OUTCOMES

BASED ON

• AVERAGE OUTCOMES

• SIZE OF CLINICAL GROUP

What is MORBIDITY?

Disease RATES WITHIN A GROUP

•THE INCIDENCE OF A DISEASE – SUCH AS THE

NUMBER OF STROKE PATIENTS HAVE BEEN

DECLINING OVER THE PAST 5 YEARS

What dose mortality mean?

RELATIVE NUMBER OF DEATHS RESULTING FROM A

PARTICULAR DISEASE

What is EPIDEMIOLOGY?

THE SCIENCE OF tracking THE PATTERN

OR OCCURRENCE OF DISEASE

INCLUDES:

•DATA ON transmission

•Distribution OF DISEASE

•ENVIRONMENTALLY RELATED DISEASES

What is a Epidemic?

A HIGHER THAN EXPECTED NUMBER OF CASES OF AN

infectious DISEASE WITHIN A GIVEN AREA

What is pandemic>

INVOLVES A HIGHER NUMBER OF CASES IN MANY REGIONS OF THE GLOBE

What is INCIDENCE?

•INDICATES THE NUMBER OF NEW CASES IN A GIVEN

population NOTED WITHIN A STATED TIME PERIOD

What is PREVALENCE?

THE NUBMER OF NEW AND OLD OR EXISTING CASES WITHIN

A SPECIFIC POPULATION AND TIME PERIOD

Communicable diseases are…..

•infections THAT CAN BE SPREAD FROM 1

PERSON TO ANOTHER

•NEEDS TO BE REPORTED TO HEALTH AUTHORITIES

What is atrophy?

Shrinkage in the size of the cell by the loss of

cell substance. When a sufficient number of

cells is involved, the entire tissue or organ

diminshies in size. Cells are not

dead.

What is atrophy?

1- Decreased workload (e.g., immobilization of a

fractured limb to permit healing)

2- Loss of innervation

3- Diminished blood supply

4- Inadequate nutrition

5- Loss of endocrine stimulation

stimulation

6- Aging.

What is hypertrophy?

Hypertrophy is an increase in the size of cells

and consequently an increase in the size of the

organ.

•Hypertrophy can be caused by additional tissue in the tissue

• Hypertrophy and hyperplasia (increased

number of cells) can also occur together, and obviously

both result in an enlarged (hypertrophic) organ

what is hyperplasia?

Hyperplasia constitutes an increase in the

number of cells in an organ or tissue.

•Hyperplasia could be pre-canancerus.

What is a metaplasia?

When 1 mature cell type is replaced by a

different mature cell type

It might be protective adaptive mechanism e.g.

cigarette smoking but it involves

loss in function.

What happens in smokers lungs?

In smokers the stratified

squamous epithelium

replaces the ciliated

columnar epithelium.

It is now a stronger

barrier, it now has

decreased defenses

because cilia is no

longer present.

What is the purpose of

the cilia?

What are ways of cell damaged and necrosis?

• ischemia, or deficit of oxygen in the cells, due

to respiratory problems or circulatory obstruction;

• physical agents, excessive heat or cold

radiation exposure;

• mechanical damage such as pressure or tearing of

tissue

• chemical toxins or foreign substances;

• microorganisms such as bacteria, viruses, and

parasites;

• nutritional deficits;

• and imbalance of fluids or electrolyte

What is ischemia?

or deficit of oxygen in the cells, due

to respiratory problems or circulatory obstruction

What is the most common cause of injury is cell damage and necrosis?

ischemia where sensitive cells suffer

hypoxia (reduced oxygen in the

tissue)

What is hypoxia?

reduced oxygen in the

tissue

In ischemia, how does it effect your cells?

interferes with energy (ATP) production

•loss of the sodium pump

•increase in sodium ions inside the cell

•cell swelling & rupture

What is cell lysis?

releases destructive lysosomal

enzymes into the tissue, which cause

inflammation (swelling, redness and pain) as well

as damage to nearby cells.

During cell lysis what does it do to your body?

The enzymes released from the dead cells can

diffuse into the blood, providing helpful

clues in blood tests that indicate the type of cells

damaged.(e.g. diagnostic test of myocardial

infarction)

Irreversible cell injury 1: NECROSIS

What is necrosis?

denotes death a group of cells. It

is characterized by cell swelling,

denaturation of cytoplasmic proteins, and enzymatic

digestion of the cell.

What is Coagulative necrosis?

When the cells protein are altered or denatured

(similar to the coagulation that occurs when cooking

eggs)

•Cells retain some form for a time after death

•Example

•Tissue of the heart goes through this after a heart attack

due to the lack of oxygen

What is Liquefactive necrosis?

• the process by which dead cell liquefy under

the influence of certain cell enzymes

•the central nervous system – brain – when

brain tissue dies.

What is Gangrenous necrosis?

An area of necrotic tissue that has

been invaded by bacteria

Gangrenous necrosis provides a _____ for infection.

medium

-Gangrenous necrosis causes what to buildup, and then reduces…

Can cause gases to buildup within tissue

and further reduce blood supply

-Gangrene tissue must be frequently

removed surgically to prevent the

spread of infection to other parts of the

body

What is caseous necrosis?

form of coagulation necrosis

•Thick, yellowish,

“cheesy” substance forms

What diseases is example of Caseous necrosis?

Tuberculosis

What can happen if tuberculosis is not treated?

If TB is not treated and the

infection continues to spread,

the area may undergo

liquefaction necrosis – forming

a cavity.

What is fat NECROSIS?

When fatty tissue is broken down info

fatty acid in the presence of infection or

certain enzymes

•The released fatty acids combine with calcium

to produce grossly visible chalky white areas

•The compounds may increase

inflammation