CH. 1 Mechanisms of Disease, Diagnosis, and Treatment

pathology

study of traits, causes and effects of abnormal conditions that lead to measurable changes in structure and function

homeostasis

state of internal stability within the body

symptoms

subjective negative characteristics or departures from normal status experienced by the patient

signs

objective abnormal findings that can be observed or measured by a healthcare professional

syndrome

a defined collection of signs and symptoms that characterize a specific disorder or condition

pathogenesis

stages of development of a disease

acute illness

an illness with an abrupt onset of symptoms that run a brief coursec

chronic illness

an illness that develops slowly, can be intermittent, and lasts longer than 6 months

systemic health

also known as internal equilibrium, maintained by various body organs and structures working together to meet cellular needs

major disruption to systemic health

fluid and electrolyte imbalance

major disruption to systemic health

accidosis

major disruption to systemic health

alkalosis

predisposing factors

factors that increase an individual’s susceptibility to disease

nonchangeable predisposing factors

age, gender, heredity, immunodeficiency

changeable predisposing facors

lifestyle, environment

acute inflammation

normal protective physiological response to tissue injury and disease

infection

caused by pathogens

signs: redness, swelling, heat, pain, fever, pus, enlarged lymph glands

symptoms: fever, headache, body aches, weakness, fatigue, loss of appetite

endogenous

source of infection originating INSIDE the body

exogenous

source of infection originating OUTSIDE the body

natural mechanical and chemical barriers

way of preventing infection

skin, mucous membranes, cilia, gastric acid

iinflammatory response

way of preventing infection

walls off and destroys pathogens

immune response

way of preventing infection

specific defense against pathogens

isolate and identify organism

way of preventing infection

identify the pathogen and initiate appropriate treatment

isolate the individual

way of preventing infection

isolate infected individuals to prevent further spread

immunization programs

way of preventing infection

implement vaccination programs to prevent disease

report infectious diseases

way of preventing infection

reporting infectious diseases to the health department

superbugs

virulent antibiotic-resistant strains of bacteria

methicillin-resistant staphylococcus aureus (MRSA)

Type of Superbug

leading cause of skin and tissue infections, including surgical wound infections

-began showing up in hospitals, jails, crowded living quarters, and other community environments

vanocomycin-resistant enterococcus (VRE)

Type of Superbug

a problem in chronic care facilities

carbapenem-resistant enterobacteriaceae (CRE)

Type of Superbug

a cause for concern among patients receiving treatment for other infections

-has high levels of resistance to antibiotics

bacteria

single-celled organisms that can cause disease

-pathogen

viruses

non-living entities that require a host cell to replicate

-pathogen

fungi

eukaryotic organisms that can cause infections

-pathogen

protozoa

single-celled eukaryotic organisms that can cause disease

-pathogen

benign neoplasms

-grows slowly

-arise from any tissue

-resemble the tissue of origin

-rarely recur after surgical removal

malignant neoplasms

-cells variable in appearance and disorderly

-have ability to invade other tissues

-can metastasize, making them more difficult to eradicate

chromosomes

every cell has 23 pairs… (X Y sex ___)

genotype

genetic code within each cell

karyotype

ordered arrangement of photographs of a full chromosome set

genes

small stretches of DNA molecule located at a specific site on a chromosome

single gene abnormality

mutation in a single gene

polygenic diseases

multiple abnormal genes

chromosome abnormality

abnormal presence or absence of an entire chromosome

chromosome structural alteration

changes to structure of chromosomes

mutations

changes in genetic code

autosomal dominant

Mode of Inheritance

mutant phenotype is expressed even if a normal gene is present on the other chromosome

autosomal recessive

Mode of Inheritance

the mutant phenotype is only expressed if both copies of the gene are abnormal

x-linked (sex-linked) recessive

Mode of Inheritance

the gene is located only on the X chromosome

genetic counseling

communication process focused on the occurrence or risk of genetic disorders in a family

cancer

a group of diseases characterized by uncontrolled cell proliferation, leading to the development of neoplasms

neoplasms

growing masses of abnormal cells that proliferate at the expense of the healthy organism

cancer prevention

• Dietary Recommendations

• Tobacco Smoke Avoidance

• Sun Exposure Limitation

• Alcohol Limitation

• Radiation and Radon Avoidance

• Carcinogen Avoidance

• Physical Activity

• Weight Management

• HPV Vaccinations

tumor markers

elevation of blood serum in _______ can help

-Determine diagnosis of cancer

-Evaluates response to therapy

-Screens for disease recurrence

T

TNM Stagging System

size and extent of primary tumor

N

TNM Stagging System

extent of regional lymph node involvement by the tumor

M

TNM Stagging System

number of distant metastases (whether cancer has spread to other parts of the body)

stage I cancer

best prognosis

stage 4 (IV) cancer

most advanced stage

palliative surgery

surgery to relieve symptoms or improve quality of life

chemotherapy

use drugs to kill cancer cells

immunotherapy

stimulate the body’s immune system to fight cancer

consequences of cancer therapy

-toxicity: chemo/radiation toxic to body

-secondary malignancies: pts. predisposed to other malignancies

-effects on children: growth delay and cognitive impairment

-evolving therapies

research focus

current research aims to develop vaccines that can treat cancer in pts who already have the disease

immune response triggering

isolate proteins from cancer cells that can trigger an immune response in the pt to attack and destroy the cancer cells

generalized immune response

inject a substance that will cause generalized immune response to destroy tumor tissue

hospice care

• Compassionate Care

• Family Support

• Death Management

• Mental and Spiritual Prep

• Variety of Settings

hypersensitivity reaction (allergy)

Immune Disorder

an exaggerated immune response to a normally harmless substance

autoimmune disease

Immune Disorder

the immune system attacks the body’s own tissues

immunodeficiency disorder

Immune Disorder

a weakended or absent immune response

allergen exposure

exposure to an allergen, which acts as an antigen

self-antigen misidentification

antibodies formed against self-antigens mistakenly identified as foreign

immunodeficiency

depressed or absent immune response

immunosenescence

decline of the immune system with age

holistic medicine

-whole person focus

-multidimensional approach

-patient uniqueness

-conscious pursuit

experimental intervention

repairs or blocks the expression of specific genes to treat disease

vector delivery

gene therapy involving therapeutic gene delivered using a vector

ex vivo

gene therapy protocol

• modified cells returned to the pt

in vivo

gene therapy protocol

• gene delivery vehicle targets desired cells for modification within the pt

gene therapy goal

aim to treat autosomal or X-linked recessive diseases by adding a functional copy of the defective gene

stem cell

an unspecialized cell that has the potential to give rise to cells specialized for any tissue in the body

(studied in regenerative medicine.. daughter cell has potential to become another stem cell or to differentiate)

• has resulted in bone marrow transplantation for cancer, skin/bone grafts, and corneal transplants

pain

• Stimulation of specialized nerve endings called nociceptors

• Receptors that respond to:

  -Temperature extremes

  -Mechanical damage

  -Dissolved chemicals

acute pain

characterized by increased blood pressure and pulse

chronic pain

pts often exhibit weight loss or gain, insomnia, anorexia, or inability to continue normal activities

intractable pain

debilitating pain that can cause depression

acute pain relief

• Narcotics or opioid-related drugs

• Analgesics

chronic pain relief

• NSAIDs

• Antidepressants

• Anticonvulsants

referred pain

phenomenon where pain is perceived in a location different from its actual source.

• occurs due to Convergence of nerve pathways from different body areas

• Example: Pain in the left arm during a heart attack

chiropractic medicine

based on the concept that the body’s nervous system is the foundation of health and that undue pressure on or an insult to the nervous system may result in pain and diseases

reflexology

form of massage, directs its efforts primarily toward massafe of the feet and sometimes the hands

aromatherapy

uses essential oils to promote wellness and healing and to relieve stress

acupuncture

attempts to adjust the body’s energy flow by inserting needles into acupuncture points

integrative medicine

COMBINED APPROACH

integrates mainstream medicine with complementary and alternative mendicine (CAM)

goals of patient teaching

• Compliance

• Support and Guidance

• Therapeutic relationship

• Healthy Lifestyle Choices

reasons for patient teaching

• anxiety reduction

• question answering

• confidence instillation

• coping improvement

• skill practice

• reduced visits and hospitalizations

addressing patient concerns

• test prep

• procedure explanation

• complication warning signs

• result timeline

• cost discussion

preoperative care

• reassurance

• physician instructions review

• understanding confirmation

• preoperative testing

postoperative care

• pain control reassurance

• complication warning signs

• written instructions

• support group referrals

positive health behavior

• healthy lifestyle choices

• stress management