intro to patho : basics and terms

how is health defined today

it is multifactorial

pt must be considered holistically- all aspects of health must be considered in their management plans

what are social determinants of health

income and education

access to decent work, living wage, job security and safe working conditions

access to community and social support systems including medical care

access to adequate and affordable housing

access to public spaces

living conditions free from discrimination and violence

what are structural determinants of health

federal provincial indigenous and local governments

educational health immigration and financial

labour markets

international relations and agreements on subjects like trade and human rights

daily living conditions

access to opportunities

how social and material resources are distributed

how is disease defined

an acute or chronic illness that one acquires or is born with that causes physiological dysfunction in one or more body system

• generally

  • caused by an etiological agent-

  • identified by group of signs and symptoms

  • identified by consistent anatomic alterations - birthmark type thing that can be found

what are the aspects of disease process

etiology

pathogenesis

morphological changes

clinical manifestations

diagnosis

clinical course

what is etiology

the cause of a disease —> by a pathogen/ etiologic agent

• biological agent ( bacteria virus fungi)

• physical forces ( trauma burns radiation footwear)

• chemical agents ( arsenic poisoning alcohol)

• genetic factors ( rheumatoid arthritis psoriasis)

• nutritional excess or deficits (rickets, pernicious anemia)

multifactorial

• do not have a single cause and in fact have multiple factors involved

types of etiology classification

nosocomial- originating/ acquired from a hospital ( mrsa, vre)

iatrogenic- caused by a treatment( blisters from cryotherapy for wart ( verrucae pedis)

idiopathic- unknown cause or origin

etiology and risk factors

factors predisposing an individual to a disease

one way to view the factors that cause disease is to group them into categories according to whether they were present at birth or acquired later

congenital- defects from birth- intrauterine crowding—> clubfoot

acquired defects - events after birth, smoking —> peripheral heart disease—> gangrene

what is pathogenesis

sequence of cellular and tissue events that take place from initial contact with etiologic agents until the expression of disease

explains how the disease process evolves

eg. rhumatoid arthritis

• etiology- genetic predisposition autoimmune response

• pathogenesis- auto antibody antigen complex attaches to joints —> inflammatory process—> joint destruction

what is morphology

refers to the fundamental structure or form of cells or tissue

morphological changes

• anatomic or microscopic changes that are characteristics of disease

  • histology- the study of cells and extracellular matrix- microscopic changes ie, cellular changes in malignant melanoma, biopsies are helpful for diagnosis of disease

  • lesions- pathogenic trauma discontinuity of a body organ or tissue

    • can be visualized by imaging modalities biopsies and samples for joint changes

what are clinical manifestations

how the disease manifests

signs and symptoms are terms used to describe the structural and functional changes that accompany a disease

signs

• objective findings from an observer

  • redness swelling elevated temperature

• symptoms

  • subjective descriptions, from the pt like pain heaviness and numbness

signs and symptoms

• objective findings from an observer

  • redness swelling elevated temperature

• symptoms

  • subjective descriptions, from the pt like pain heaviness and numbness

• s and s can be manifestation of disease process ( fever)

or

• body’s ability to compensate for the disease [process ( tachycardia due to blood loss

can be

• local or systemic

when observing signs and symptoms what acrynm/ steps must be considered ( for charting notes)

soap

subjective

• statements about relevant pt needs, behaviours and status

• what the pt tells us

objective

• measurable quantifiable and observable data

• what we see ( assessments findings)

assessment

• interpret the meaning of s and o, always involve the pt

• give a name/ diagnosis

plan

• anticipated frequency and duration, course of treatment for next session, recommendation and any changes

• rx, folllowups

whats a syndrome

compilation of s and s that are characteristics of a specific disease state

• etiology is unknown

• on the way to disease

• ie metabolic syndrome

  • high blood glucose

  • high bp

  • high lipid profile

  • large wasie size

what is a diagnosis

designation as the nature or cause of a health problem

• ie

  • bacterial skin infections fungal or nail infections

• must consider the following factors

  • history taking

  • physical examinations

  • diagnosis tests

    • imaging or lab

  • other factors like age sex race and lifestyle

differential diagnosis

other diseases/ conditions with similar signs and symptoms

what is clinical course

the evolution of the disease

acute- relatively severe but self limiting

subacute - intermediate severity between acute and chronic, not as severe as acure and not as prolonged as chronic

chronic- can be continuous, chronic tophaceous gout, or can be intermittent with remission and exacerbations like systemic lupus erythematosus

the spectrum of disease severity for infecsious diseases

pre clinical

• disease not clinically evident but is destined to progress ie incubation period for infection

subclinical

• disease not clinically apparent and not destined to become clinically apparent

• diagnosed with antibody or culture tests ( some tb cant be seen only from skin test)

clinical

• disease manifested by signs and symptoms ie pt testing positive for tb with a bad cough

carrier

• individual who harbour an organism but are not infected s evidence y antibody response or clinical manifestations- asymptomatic covid carriers

what is epidemiology

study of disease occurrence in human populations

the science to study risk factors of diseases specialty multifactorial diseases and cancer

looks for the patterns in the people affected

• gender,ethnicity, age, lifestyle

prevalence vs incidence

prevalence- number of existing cases at a given point in time

incidence- the number of new cases arising in population risk during a specified amount of time

what terms refer to population health

endemic- regularly occurring in a small area

epidemic- large scale or widespread (west nile)

pandemic- spread of disease worldwide

morbidity vs mortality

morbidity

• functional defect aused by disease

• describes the effects an illness has on a persons life ( long term consequences of disease

mortality

• death caused by disease

• influenced by risk factors usually

natural history and prognosis

progression and predicted outcome of a disease without any medical intervention

helps establish severity nd priorities in health care services

helps determine impacts of early screening and detection

prognosis

• probable outcome and prospect f recovery from a disease

what are the 3 levels of prevention

primary

• removing risk factors to prevent disease form occuring

• typically happens outside the clinic in community settings

  • immunizations, habits, education

secondary

• early detection of disease and treatments

• detected during asymptomatic and treatment can affect a cure or stop disease from progressing

• often accomplished in a clinical setting

tertiary

• clinical intervention to prevent further deterioration or reduce complication of a disease once it has been diagnosed

• mostly occurs within the health care system

• anti diabetid drugs, on going foot care