updated patho1

Pathophysiology

Study of abnormalities in physiological functioning of living being, physiology of altered health (structure and functional changes in cells tissues and organs of the body that are caused or cause disease)

Static

same

Dynamic

constantly changing

Etiology

proposed cause/reason for diseases

Pathogenesis

proposed mechanism by which disease leads to clinical manifestation, before symptoms (growing of disease)

Clinical Manifestations

describe signs and symptoms

Treatment indications

implied thorough understanding of above

Sign

can see

Symptom

patient reports

Syndrome

signs and symptoms that occur together, not labeled as disease

Congenital

born with it but not inherited

Metabolic

abnormalities in body chemistry (diabetes)

Degenerative

breakdown

Iatrogenic

medical problems due to treatment

Idiopathic

no identifiable cause

Nosocomial

acquired as consequence of being in the hospital (MRSA)

Risk factor

increases likelihood of disease (smoking, air pollution)

Pathogenesis

how disease evolves, development of a disease from the initial stimulus to manifestation of disease

Latent period (two definitions)

period of remission, time between exposure and symptoms

Prodromal

first sign/symptom or onset of disease with vague sign/symptom

Subclinical

has disease but functions normally

Convalescence

stage of recovery

Acute

short (under 6 months)

Chronic

months to years (over 6 months)

Exacerbation

increase in severity of s/s

. Remission

decrease in severity of s/s

sequelae

subsequent pathologic condition resulting from an acute illness

Statistical normality

estimate of diseases in a normal population

Sensitivity

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

Specificity

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

Reliability

tests ability to give the same results in repeated measurements

Validity

degree to which a measurement reflects the true value of what it intends to measure

Predictive value

extent to which a test can differentiate between presence or absence of a person's condition

Endemic

native to a local region

Epidemic

spreads to many individuals at the same time

Pandemic

worldwide epidemic

Incidence

number of new cases occurring in a specific time period

Prevalence

number of existing cases within a population during a specific period of time

Factors affecting patterns of disease

age, ethnic group, gender, socioeconomic factors/lifestyle considerations, geographic location

Primary

prevention of disease by altering susceptibility, reduce exposure

Secondary

early detection, screening, and management of disease

Tertiary

treatment, rehabilitation, supportive care, reducinging disability

Homeostasis

state of equilibrium maintained by process of feedback and regulation

Allostasis

ability to successfully adapt and maintain/reestablish homeostasis

negative feedback

causes the controller to respond in a manner that opposes deviation from normal (most)

positive feedback

an increase in function in response to a stimulus (pregnancy)

Alarm

SNS arousal of body defenses (fight or flight)

Resistance

adaptation

Exhaustion

unable to return to homeostasis

Concept of stress

state of tension, real or perceived threat, tolerance is based on adaptive capacity, fight or flight reaction

Hypothalamus senses

stressful stimulus, secretes hormone

Stress Risk factors

lifestyle, age, gender

Norepinephrine

constricts blood vessels, raises BP, reduces gastric secretions, increases night and far vision

Epinephrine

enhances myocardial contractility, increases HR and CO, causes bronchodilation, increased glycogenolysis and elevates blood glucose levels

Endorphins and Enkephalins

body's natural pain relievers

Immune Cytokines

mediators of immune responses

Sex Hormones

testosterone, estergon

Cortisol

glucocorticoid, stimulates gluconeogenesis, promotes catabolism of protein, hormones appetite, anti inflammatory effect, immunosuppressive

Aldosterone

mineralocorticoid, promotes reabsorption of sodium and water, increases blood pressure

. Adaptation

how body adapts to change

Coping

behavioral adapt to stressor

illness

both physiological and psychological is a stimulus for the stress response

Distress

perceived inability to cope with a stressor

Physical indicators of stress

increased BP, increased muscle tension, tarchadia, diaphoresis, fatuife, tension headache, nausea, vomiting, diarrhea, change in weight, change in appetite, restlessness, insonmoe

Behavioral indicators of stress

anxiety, depression, alcohol abuse, change in activity patterns, exhaustion, loss of self esteem, increased irritability, loss of motivation, decreased productivity, inability to concentrate, increased illness

Cellular Adaptation

cells adapt by changing (size, number, type)

Atrophy

decreased cell size and reduced function (normal or injury/illness)

Atrophy reduces

O2 consumption

Atrophy S/S/causes

decreased muscle size, lipofuscin (yellowish color), disuse, disease, denervation (lack of nerve supply: paralysis), ischemia, nutrient starvation, interruption of endocrine signals, injury, aging

Ischemia

not enough oxygenated blood to an area

Hypertrophy

increased cell size and mass

Hypertrophy results from

increased workload, increase in functional components of the cell

Hypertrophy causes

repeated exercise, hormones (development of breasts), stress, high BP

Hyperplasia

increased cell number, increase in functional capacity

Hyperplasia often occurs with

hypertrophy

Hyperplasia results

from increased physiologic demand, hormonal stimulation (period), persistent cell injury (skin gets thicker, calluses) or high altitude

Metaplasia

conversion of one adult cell to another cell

Metaplasia occurs

in response to chronic irritation and inflammation or persistent injury

Metaplasia fully reversible when

injury stimulation is removed

In metaplasia

Conversion NEVER oversteps boundaries (same cell family)

**metaplasia example, chronic insult of drinking or smoking

Barrett's esophagus

Metaplasia not cancerous but

can turn into cancer

Dysplasia

disorderly growth (CANCER), disorganized appearance of cells

Dysplasia factors

Abnormal changes in size, shape and organization of mature cells, not truly adaptive (just happens)

Cancer in situ

severe dysplasia that invades the entire thickness of the epithelium

Irreversible Cell Injury

not able to adapt any more is going to die

Necrosis

cell death (unable to adapt)

Necrosis result of

ischemia or toxic injury (generalized inflammatory response, degradation of plasma membrane of cell:no membrane, cell leaks out into blood)

Local and systemic indicators of cell death

pain, elevated serum enzyme levels (looking to see if cardiac cells have died), inflammation, loss of function

Gangrene

large area of cell death (lot of necrosis)

Gangrene is

interruption of blood supply to particular part of body

Apoptosis

programmed cell death (something wrong with the cell, it recognizes it, then kills itself, happens all the time) good thing

Apoptosis occurs in response to

injury that does not directly kill the cell (triggers intracellular cascades, activates a cellular suicide response)

Apoptosis

not always a pathologic process, does not cause inflammation

Etiologies of Cell injury

unable to maintain homeostasis

degree of injury related to

intensity and duration of injury, type of cell, *blood supply of cells (need oxygenated blood), nutritional status, previous state of functioning

Hypoxic

not getting oxygen

Hypoxia causes

interrupts generation of ATP, leakage of enzymes, combo of disruption of oxygen supply with accumulation of metabolic waste (acidic), cellular events lead to lactic acidosis

Ischemic

not getting enough oxygenated blood to an area, most common cause of killing cells

Nutritional excess

BMI over 27 \= health risk, BMI over 30 \= obesity