Patho/Pharm Exam 1 CH 1,4

Pathophysiology definition and what is consists of (4)

Study of functional changes due to disease

1. etiology

2. pathogenesis

3. clinical manifestations

4. treatment

Etiology

the cause of the disease

Idiopathic

Cause of the disease is unknown.

Iatrogenic

Cause of disease is from unintended or unwanted medical treatment, procedure, or error

ex. allergy to medication, tissue scarring, nerve damage

Pathogenesis

development/evolution of a disease

clinical manifestations

signs and symptoms

What are the stages of a clinical manifestation?

1. Latent period (silent)

2. Prodromal period

3. Exacerbation

4. Remission

5. Convalescence

6. Sequela

7. Complication

8. Clinical course of disease

latent period

silent/incubation period - mild signs and symptoms

prodromal period

first signs and symptoms appear - vague symptoms

acute phase

disease reaches its full intensity but last a short period

Exacerbation

sudden increase in severity or signs and symptoms

Remission

decrease in severity or signs and symptoms

Remission for longer than five years - person is said to be cured

Convalescence

Recovery stage

Sequela

results from a previous disease or injury - ex. permanent weakness after a stroke

Complication

new or secondary problems caused by the disease or treatment - ex. infection from surgery

Clinical course of disease

classified as acute (short lived) or chronic (long term)

Epidemiology (5)

The science of identifying and studying pattern and occurrence of diseases involving populations

occurrence

incidence

prevalence

transmission

distribution

occurrence

incidence

prevalence

transmission

distribution

Occurrence - frequency and distribution of disease

Incidence - number of new cases in a time period

Prevalence - total number of people who have a disease (existing and new)

Transmission - how disease spreads

Distribution - who gets the disease, where it occurs, and when it happens

endemic disease

local disease

epidemic disease

many people in a local area

pandemic

global

primary prevention level

Altering susceptibility or reducing exposure for susceptible persons

secondary prevention level

Early detection, screening, and management of disease

tertiary prevention level

Rehabilitation, supportive race, reducing disability, restoring effective function

Role of the Nurse

Assess - individuals and communities

case findings - identify infected or at risk individuals

contact tracing - determine exposure sources and prevent further spread

health teaching - educate communities about prevention and control

causes of cell injury

Hypoxia

Physical agents

Chemical agents

Infectious agents

Nutritional imbalances

adaptation

persistent sublethal injury

necrosis

cell death via external injury - inflammatory

apoptosis

regulated by intracellular signaling cascades - not inflammatory

reversible cell injury - hydropic swelling

- cellular swelling attributable to accumulation of water

- Failure of sodium-potassium pumps leads to accumulation of sodium ions in the cell - osmotic gradient -> water entry -> swelling

reversible cell injury - intracellular accumulations

- excess accumulations of substances in cells

- Excessive amounts of normal intracellular substances such as fat

- Accumulation of abnormal substances produced by the cell because of faulty metabolism or synthesis

- Take up space that's needed for cellular functions

Cellular Adaptations - reversible

atrophy

hypertrophy

hyperplasia

metaplasia

dysplasai

atrophy

Cells shrink and reduce their differentiated functions in response to a variety of normal and injurious factors

hypertrophy

Increase in cell size with enhanced function

hyperplasia

increased number of cells with enhanced function

Metaplasia

Replacement of one differentiated cell type with another - adaption to persistent injury with replacement of a cell type that is better suited to tolerate injurious stimulation - reversible when injurious stimulus is removed

Dysplasia

Disorganized appearance of cells because of abnormal variations in size, shape, and arrangement - potential to transform to cancerous cells

-plasia

formation, growth, or development of cells and tissues

irreversible cell injury - necrosis

Cell rupture, Spilling of contents into the extracellular fluid

irreversible cell injury - apoptosis

Responds to injury that does not directly kill the cell -> triggers a cascade

- self-destructs and nearby immune cells clean up the debris

- no inflammation

- internal injury

Coagulative necrosis

lack of blood flow denatures structural proteins, allowing dead tissue to keep its basic shape and firm structure for several days

liquefactive necrosis

Occurs with the dissolution of dead cells, Body tries to absorb dead cells -> Liquification of lysosomal enzymes

Formation of abscess or cyst form dissolved dead tissue

fat necrosis

Death of adipose tissue

Result of trauma or pancreatitis

Appears as a chalky white area of tissue

caseous necrosis

lung damage specifically secondary to tuberculosis

Resembles chumpy cheese

Ischemia and hypoxic cell injury

tissue hypoxia

ischemia (interruption of blood flow to area)

ischemia-perfusion (calcium overload -> free radicals formed -> inflammation

somatic death

death of entire organism