Patho 1 exam 1

Pathophysiology

The study of abnormalities in physiologic functioning of living beings. It is about revealing the body’s responses to disruptions in its internal/external environment

What are the 4 interrelated topics corresponding to pathophysiology?

• Etiology

• Pathogenesis

• Clinical manifestations

• Treatment implications

True or False: Most diseases are multifactorial.

True

• Many different etiologic factors contribute to disease development

A patient presents with hair loss due to undergoing chemotherapy. This is an example of?

Iatrogenic cause

Coronary heart disease is a multifactorial disease. What are some reasons that classify a multifactorial disease?

• genetic predisposition

• diet

• smoking

• high blood pressure (hypertension)

• hight mental stress

• lifestyle factors

True or false: Every individual exposed in a population will contract the disease.

False

• only a portion of the population may develop the disease

Pathogenesis

The evolution of development of disease, starting from the initial stimulus to the final result of manifestation of the disease.

Etiology

The causes or reasons of disease

What are the classifications of etiology?

Idiopathic and iatrogenic cause

Idiopathic

Cause is unknown

Iatrogenic

Cause from unintended/unwanted medical treatment

Pathogenesis

Development of disease

Clinical manifestation

Signs, symptoms, stages, course

Treatment implications

General treatment strategies

True or false: Sign can be defined as a subjective clinical manifestation.

False

• They are objective/observed manifestation of disease

True or false: Symptoms can be defined as objective clinical manifestations.

False

• They are subjective feelings of abnormality in the body

Which of the following is an example of the clinical manifestation known as a symtom?

Headache

Syndrome

The etiology of signs and symptoms that have not been determined

Latent period

Time between exposure of tissue to injurious agent and first appearance of signs and/or symptoms

Prodromal period

Time during which first sign and/or symptoms appear showing onset of disease. Often nonspecific.

Acute phase

When the disease/illness has reached its full intensity

Which is a phase that also refers to a period during an illness when signs/symptoms temporarily become mild, silent, or disappear?

Latent period

Exacerbation

Sudden increase in severity of disease or sign/symptoms

Remission

Decrease in severity, signs, or symptoms; may indicate disease is cured

Convalescence

Stage of revcovery after a disease, injury, or surgical procedure

Sequela

Subsequent pathologic conditions resulting from an illness

To determine whether a certain finding is indicative of a disease or “abnormal”, it must be compared to what?

Must be compared to what is normal

Positive value

Probability that the disease is present if the test is positive

Negative value

Probability that the disease is absent if the test is negative

Sensitivity

Probability that a test will be positive when applied to a person with a particular condition

Specificity

Probability that a test will be negative when applied to a person without a particular condition

Strep throat swab with a sensitivity of 80% means that 20% of people with the condition will test negative making this a?

false negative

Endemic disease

Native to local region

• relatively low and predictable

Epidemic disease

Spread to many at the same time; occurs in a community/region

• cases exceed normal expectancy

Pandemic disease

Spread to large geographic area, potentially across countries/contients

• affects large number of people

Which of the following is an example of a secondary prevention?

Performing monthly breast examinations and screenings for cancer

Levels of prevention

Primary, secondary, and tertiary

Primary prevention

Altering susceptibility or reducing exposure for susceptible persons

Secondary prevention

Early detection, screening, and management of disease

Tertiary prevention

Rehabilitation, supportive care, reducing disability, and restoring effective functioning

What are the three ways cells respond to environmental changes and injury?

• Withstanding

• Adapting

• Cell death

Out of the 3 ways cells respond to environmental changes and injury, which one(s) is reversible?

Withstand & adapt

Out of the 3 ways cells respond to environmental changes and injury, which one(s) is irreversible?

Cell death

What does reversible cell injury cause?

Cell swelling and intracellular accumulation

What is another word for oncosis?

Hydropic swelling

Hydropic swelling (oncosis)

Cellular swelling due to accumulation of water

• caused by malfunction of sodium-potassium pump with accumulation of sodium ions within cell

• can cause organ enlargement (megaly)

Intracellular accumulation is characterized by?

Excessive amounts of normal intracellular substances

What are examples of normal intracellular substance?

• Lipids → fatty liver disease, atherosclerosis

• Carbohydrates → glycogen

• Proteins → in kidney tubular cells

• Inorganic pigments → bilirubin, hemosiderin

What are common adaptive responses

• atrophy

• hypertrophy

• hyperplasia

• metaplasia

• dysplasia

Atrophy

decreased cell size

Hypertrophy

Increased cell size

Hyperplasia

Increased cell number

Metaplasia

Conversion of one cell type to another

Dysplasia

Disorderly growth

Increase in skeletal muscle size in response to exercise is an example of?

Physiologic hypertrophy

Heart muscle enlargement in response to high blood pressure is an example of?

Pathologic hypertrophy

Two categories of irreversible cell injury are?

Necrosis and Apoptosis

Necrosis

Caused by ischemia or toxic injury

• cell rupture

• spilling of contents into extracellular fluid

• inflammation

Apoptosis

Occurs from injury that does not directly kill the cell but triggers “suicide”

• No rupture or inflammation

What is the most common form of necrosis?

Coagulative

Coagulative

• Process that begins with ischemia

• Loss of plasma membrane’s ability to maintain electrochemical gradient

• Influx of calcium and mitochondrial dysfunction

• Degradation of plasma membrane and nuclear structures

• affected area is composed of degenerated proteins and is relative solid

Gangrene

Cellular death in a large area of tissue and results from interruption of blood supply to a particular part of the body

What are the three types of gangrene?

Dry, wet, and gas

Dry gangrene

Form of coagulative necrosis characterized by blackened, dry, wrinkled tissue separated by a line of demarcation from healthy tissue

Wet gangrene

• Form of liquefactive necrosis

• Typically found in internal organs

• Can be fatal

Gas gangrene

Results from infection of necrotic tissue by anaerobic bacteria (clostridium)

• Formation of gas bubbles in damaged muscle tissue

• Can be fatal

Does apoptosis cause an inflammatory response?

No; it is tidy

Ischemia injury

Lack of blood supply

Hypoxic injury

Lack of oxygen

What is the relationship between ischemia and hypoxia?

Tissue hypoxia is most often caused by ischemia which causes power failure within the cell

True/False: Restoration of oxygen can worsen cell injury rather than reversing it.

True

Nutritional deficiencies may result from?

• Poor intake

• Altered absorption

• Impaired distribution by circulatory system

• Inefficient cellular uptake

What are the five causes of cellular injury?

1. Ischemia/Hypoxic injury

2. Nutritional injury

3. Infectious/immunologic injury

4. Chemical injury

5. Physical/mechanical injury

Radiation is an example of what cellular injury?

Physical and mechanical injury

What are the primary effects radiation may have on a cell?

• Genetic damage

• Acute cell destruction

  • hematopoetic

  • gondal

  • mucosal

  • fetal

True/False: The aging process and disease processes are different.

True

What is the cellular basis of aging?

The cumulative result from two factors that cause cellular and molecular damage

• progressive decline in proliferation and reparative capacity of cells

• exposure to environmental factors

What is programmed senescence theory?

Aging is the result of intrinsic genetic program

What is the free radical theory?

Aging results from cumulative and progressive damage to cell structure

Arteriosclerosis and atherosclerosis can lead to?

High blood pressure

The human DNA is organized into how many chromosomes and composed of how many pairs?

46 chromosomes; 23 pairs

How many pairs of chromosomes are autosomal for humans?

22 pairs

Which pair of chromosome is defined as the sex chromosome?

The last pair; XX = female & XY = male

What are the four groups of genetic disorders?

• Chromosomal abnormalities

• Mendelian single-gene disorder

• Non-medelian single-gene disorder

• Polygenic/multifactorial disorders

Chromosomal abnormalities generally result from?

• Abnormal number of chromosomes

• Alternations to the structure of one or more chromosomes

Aneuploidy

Abnormal number of chromosomes either less than or greater than 46 chromosomes (in humans)

• Usually caused by nondisjunction

What is Down syndrome also called and why is it considered an autosomal aneuploidy?

Trisomy 21

• Extra copy of chromosome 21

• Caused by disjunction, which is the failure of pairs to separate properly during 1st/2nd division

Trisomy 13, Trisomy 18, and Trisomy 21 are all examples of what?

Autosomal aneuploidy

Trisomy 18 is another name for?

Edwards syndrome

Trisomy 13 is another name for?

Patau syndrome

Klinefelter syndrome and Turner syndrome are examples of?

Sex chromosome aneuploidy

What are the differences in abnormal chromosome structure between meiosis and mitosis?

Meiosis → crossing over errors

• Chromosome portions lost, attached upside down or attached to wrong chromosome

Mitosis → Chromosomal breakage and rearrangement

What causes abnormal chromosome structure?

Results from breakage and loss or rearrangement of chromosome pieces during meiosis or mitosis

What are the common types of chromosomal rearrangement?

1. Translocation

2. Inversions

3. Deletions

4. Duplications

The long arm on a chromosome is labeled as?

The q arm

The short arm on a chromosome is labeled as?

The p arm

Cri du Chat Syndrome

Deletion of part of the short arm (p arm) of chromosome 5

Location of the defective gene is found where?

Autosomal or sex chromosome

The mode of transmission is defined as?

Dominant or recessive

Marfan syndrome and Huntington disease are examples of what disorder?

Autosomal dominant disorder