Pathophysiology - Unit 2

Eustress

Beneficial stress, mild/brief/controllable, comes from good sources. ex) watching a horror movie

Distress

Bad stress, non beneficial, comes from sorrow or pain, can negatively affect health

Sensor

detects change

Integrator

compares incoming data as “normal”

Effectors

try to reverse the change, ex) increased HR + respiratory rate

Alarm Stage

immediate reaction to stress, release of catecholamines + cortisol (fight/fight response)

Resistance Stage

adaptation, normalization, “its gonna be okay”

Exhaustion Stage

resources are depleted, leads to disease + chronic illness ex) can lead to diabetes, poor sleep, GI issues

Stress Response

Sympathetic NS, Hypothalamus-Pituitary-Adrenal axis (HPA axis), hormone suppression

Physiologic Reserve

excess capacity in organs and biological systems, depleted during stress

Anatomic Reserve

in PAIRED organs, where only one is needed to survive. ex) kidneys, adrenals, lungs

Hardiness

associated with greater physiological well-being and lower leveles of stress, easy to overcome stress

Hypofunction

underproduction of hormone, caused by congenital defects, disruption in blood flow, infection, inflammation + autoimmune responses

Hyperfunction

excessive hormone production, caused by excessive stimulation and hyperplasia of the endocrine gland

Primary disorders

originate in the TARGET GLAND responsible for producing hormones

Secondary disorders

caused by PITUITARY dysfunction from defective levels of stimulating hormones

Tertiary disorders

result from HYPOTHALAMIC dysfunction, both pituatary and target organ are understimulated

Hypopituitarism

abscence or failure of anterior pituitary hormones. caused by pituitary infarction or space-occupying lesions. Hormones affected: GH, Prolactin, FSH, LH, ACTH, TSH

GH deficiency

interferes with linear bone growth, results in short stature or dwarfism

GH excess

increase in linear bone growth, gigantism

Acromegaly

overgrowth of the cartilaginous parts of the skeleton, enlargement of the heart and other organs in the body

Thyroid gland

Hormones: T3 + T4, regulate metabolic rate, weight loss/gain, heart rate, influence the rate of GI tract digesting food, controls muscle contraction, controls body temp, essential for normal brain development=[]’

Hypothyroidism

“LOW AND SLOW”, can result from Hashimoto’s disease, impairedpituitary function, hypothalamic dysfunction, causes decreased metabolic rate. LOW: energy, metabolism, digestion, mood, mental status, body hair, oils, libido, menstrual cycles(irregular), cold tolerance

Hyperthyroidism

“HIGH AND HOT”, Thyrotoxicosis: caused by Graves disease, toxic multinodular goiter, follicular adenoma, excessive amounts of TH medication. causes: increased, metabolic rate, O2 consumption, use of metabolic fuels, SNS responsiveness. HIGH: energy, HR, BP, temp, intolerance to heat, GI mobility, weight loss. causes exophthalamos (grape eye), goiter

Adrenal Insufficiency (hypocortisolism)

Addison’s disease, “SMALL, WEAK, TANNED”, LOW: sodium, blood volume from water loss, dehydration, BP, glucose

Hypercortisolism

Cushing’s Syndrome, BIG: glucose, face (moon face), belly , buffalo hump, BP, sodium, water retention, hair (hirsutism), stretch marks, infections, risk for bone fractures

Normal blood glucose level

<100 mg/dL

Prediabetes

100-125 mg/dL, most experience no symptoms, without intervention most likely to be type 2 DM. risk factors: overweight, large waist size, diet high in red meat, processed foods + sugar sweetened drinks, inactivity, age over 45, family history, race/ethnicity, smoking, sleep apnea

Type 1 Diabetes Mellitus

caused by autoimmune destruction of pancreatic beta cells, characterized by lack of insulin, increased blood glucose, breakdown of fats and proteins. requires life-long insulin therapy, cannot be prevented

Polyuria

excessive urination

Polydipsia

excessive thirst

Polyphagia

excessive hunger

Type 2 DM

caused by INSULIN RESISTANCE + increased hepatic glucose output. risk factors: obesity, fam history, age, hypertension, poor diet, physical inactivity. may be improved with a healthy lifestyle

Diabetic Ketacidosis

mostly occurs with type 1 DM, hyperglycemia, acidosis(low pH), ketonuria. clinical manifestations: KUSSMAUL respirations, fruity or acetone breath, vomiting + abdominal pain, mental status changes, CAN PROGRESS: cerebral edema, coma or DEATH

Hyperosmolar Hyperglycemic State

most often associated with TYPE 2 DM. characterized by: severe hyperglycemia, extreme dehydration, hyperosmolarity, altered consciousness

Hypoglycemia

too much insulin in the body, iatrogenic. caused by: decrease in calorie intake, exercise with inappropriate modification of insulin dosing. causes altered brain function, activiation of the ANS

Microvascular Disease

occlusion of the capillaries and tissue ischemia. retinopathy(eyes), nephropathy(kidneys), neuropathies(aneurysm)

Macrovascular Disease

lesions in large and medium sized arteries (can lead to transient ischemic strokes), cardiovascular disease, cerebrovascular disease and stroke, peripheral vascular disease

Dysphagia

difficulty swallowing, resulting from neuromuscular or structural causes. causes narrowing of esophagus, lack of salivary secretion, weakness of musc. structures propelling food toward the stomach, disruption of the neural networks coordinating the swallowing mechanism

Hiatal Hernia

a herniation of the stomach through the esophageal hiatus of the diaphragm, symptoms often associated with GERD

GERD

symptoms/mucosal damage produced by the backward movement of gastric contents into the esophagus. cause: relaxation of a weak/incompetent lower esophageal sphincter. manifestations: heartburn, esp at night, dysphagia, regurgitation of stomach contents, belching, chest pain, Barrett’s Esophagus (esophagus damaged by acid reflux)

Acute Gastritis

inflammation of gastric mucosa. caused by use of NSAIDS, alcohol+smoking, bacteria, stress. manifestations: dyspepsia(indigestion), bloating and belching, loss of appetite/feeling full after eating, nauseaa/vomiting

Chronic Gastritis

erosions and inflammatory changes, mucosal atrophy and epithelial metaplasia. caused by H.PYLORI INFECTION, NSAIDS, same as acute gastritis. complications: ulcers, stomach cancer

Peptic Ulcer Disease

OPEN SORES/ULCERS, form in the stomach (gastric ulcer) or in the first part of the small intestine (duodenal cancer) most common causes (same as chronic gastritis). manifestations: pain, burning, gnawing,cramplike sensation. duodenal: RELIEVED by food/antacids, gastric: INTENSIFIES after eating

Irritable Bowel Syndrome (IBS)

neurogastrointestinal disorder affecting the large intestine. manifestations, persistent or recurrent: abdominal pain, altered bowel function, bloating/gas/nausea, constipation/diarrhea, feeling of incomplete BM’s, anxiety or depression. symptoms usuallu relieved with defaction, do not interfere with sleep

Ulcerative Colitis

idiopathic chronic inflammatory disease that causes ulceration of the colonic mucosa. patho: inflammation begins in the rectum, spreads proximally, may extend to the entire colon. causing ulcers, edema, + thickening of the bowel wall. THICK LESIONS. mani: freq. diarrhea, urgency, stools containing blood+mucous, cramping.

Crohn’s DIsease

idiopathic chronic granulomatous inflammatory disease, affecting any area of digestive tract. spreads w/ SKIP LESIONS, ulcers can produce fissures that extend thru bowel wall

Diverticular Disease

combo of DIverticulosis(small bulging pouches in colon) + Diverticulitis(inflammation + infection of the diverticula). mani: fever, nause/vomiting, lower left abdominal pain, increased WBC’s.

Appendictis

inflammation of the appendix, obstruction of the lumen w/ stool, tumors, gallstones, parasites, lymphatic tissue. mani: vague epigastic +periumbilical pain, increased intensity over a few hours (migrating to the right lower quadrant), nausea/vomiting, low grade fever, rebound tenderness

Jaundice

yellow/greenish pigment of the skin caused by hyperbilirubinemia. causes: liver disease, excessive destruction of RBC’s, obstruction of bile flow (occlusion of common bile duct). mani: yellow skin + sclera(eyes), pruritis(itchy skin), dark-coloured urine, clay-coloured stools.

Hepatitis A

transmitted thru fecal-oral route (VOWEL-BOWEL), flu-like symptoms, jaundice, hepatomegaly, dark urine, clay stool, pruritis, elevated liver enzymes

Hepatitis B

transmitted thru BLOOD SEMEN, VAGINAL fuid (B-ody fluid), flu-like symptoms, jaundice, hepatomegaly, dark urine, clay stool, pruritis, elevated liver enzymes

Hepatitis C

transmitted thru blood (C-irculation), usually asymptomatic

Alcohol-induced Liver Disease

Alcoholic fatty liver(steatosis): Acetaldehyde(toxic byproduct of alcohol metab.): damages hepatocytes, impairs oxidation of fatty acids, result: fat accumulates in + around hepatocytes, usually asymptomatic. alcoholic hepatitis: inflammation + necrosis of liver cells, outcome depends on the severity of the damage. mani: anorexia, nausea+vomiting, abdominal tenderness, low grade fever, fatigue +weakness.

Nonalcoholic Fatty Liver Disease

the buildup of extra fat in liver cells that is not caused by alcohol consumption. prog: steatosis(abnormal buildup of fat inside cells), steatohepatitis(fat buildup causing inflammation/cell damage), fibrosis+cirrosis(generally irreversable)

Cirrhosis

END STAGE LIVER DAMAGE. leading to scarring (fibrotic tissue) and liver failure. caused by by chronic alcohol abuse, nonalcoholic fatty liver disease, bile duct obstruction, toxic effects of drugs/chemicals

Portal Hypertension

abnormally high BP in the portal vein. most common cause: CIRRHOSIS. mani: hepatic encephalopathy, splenomegaly, ascites, caput medusa, hemorrhoids, esophageal varices.

Ascites

accumulation of fluid in the peritoneal cavity (preggo looking). caused by liver disease(cirrhosis, portal HTN). mani: abdominal distention, weight gain, difficulty breathing, loss of appetite.

Cholelithiasis

formation of GALLSTONES. caused by precipitation of substances in bile > too much cholesterol+bilirubin, not enough bile acids. risk factors: female, obesity, middle age (>40), pregnancy, oral contraceptive use, high-fat, high cholesterol, low-fibre diet, rapid weight loss

Cholecystitis

inflammation of GALLBLADDER or CYSTIC DUCT. almost always caused by: gallstone lodged in cystic duct. mani: severe pain in upper right/centre abdomen, may spread to right shoulder or back, abdominal tenderness, mild fever, anorexia, nausea+vomiting

Pancreatitis

Acute/chronic inflammation of the pancreas. Prematurely activated pancreatic enzymes cause injury and an intense inflammatory response which leads to AUTODIGESTION OF PANCREATIC TISSUE. causes: gallstones, alcohol abuse.