EXAM 1: Pathophysiology

what is pathophysiology?

• the study of abnormalities in physiologic functioning of living beings

• the physiology of altered health

• structural and functional changes in cells, tissues, and organs of the body cause or are caused by disease

Describe a disease

• a disruption of homeostasis

• dynamic rather than static, represents the sum of the deviations from normal

what is etiology?

a proposed cause or reason for a disease/ phenomenon

what are the classifications for etiology?

• inherited

• congenital

• metabolic

• degenerative

• neoplastic

• immunologic

• infectious

• induced by physical agents

• nutritional deficiency

• iatrogenic

• psychogenic

• idiopathic

• nosocomial

what is pathogenesis?

proposed mechanism by which disease leads to clinical manifestations

• describes how etiologic factors are thought to alter physiologic functions and lead to the development of clinical manifestations

• factors affecting pathogenesis: time, quantity, location, morphologic changes

clinical manifestations

describes signs and symptoms that typically accompany a particular pathophysiologic process - signs, symptoms, syndrome

treatment implications

understanding the etiology, pathogenesis and clinical consequences of a disease/illness may determine which treatments may be helpful

what is the latent period?

period of remission and time between exposure/symptoms

what is prodromal?

first signs and symptoms or onset of disease with vague signs or symptoms

what is subclinical?

a person has a disease, but functions normally

what is convalescence?

stage of recovery

what does acute and chronic mean?

• Acute is some pain or disease that is short lived

• Chronic is when a clinical course may last months to years

what is exacerbation?

increase in severity, signs or symptoms

what is remission?

decrease in severity of signs and or symptoms

what is sequela?

subsequent pathologic conditions resulting from an acute illness

what is statistical normality?

estimate of diseases in a normal population

what is sensitivity?

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

what is specificity?

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

what is reliability?

test’s ability to give the same results in repeated measurements

what is validity?

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

what is predictive value?

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

what is an endemic?

something that is native to a local region

what is a epidemic?

spreads to many individuals at the same time or at a particular time

what is a pandemic?

worldwide epidemic (AIDS, COVID - 19)

what is an incidence?

number of new cases occurring in a specific time period

what is prevalence?

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

what is evidence- based practice?

the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients

what are the epidemiologic variables?

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

levels of prevention - what is primary prevention?

prevention of disease by altering susceptibility - reduce exposure

levels of prevention - what is secondary prevention?

early detection, screening and management of disease

levels of prevention - what is tertiary prevention?

TX, rehabilitation, supportive care, reducing disability

what is homeostasis?

state of equilibrium maintained by a process of feedback and regulation

what is allostasis?

ability to successfully adapt and maintain or re-establish homeostasis

homeostatic control mechanisms - what is negative feedback?

this causes the controller to respond in a manner that opposes deviation from normal

homeostatic control mechanisms - what is positive feedback?

an increase in function in response to a stimulus

General Adaptation Syndrome - What is the alarm stage?

SNS arousal of body defenses

General Adaptation Syndrome - what is the resistance stage?

adaptation stage

General Adaptation Syndrome - what is the exhaustion stage?

the body is unable to return to homeostasis

what is stress?

state of tension that can threaten homeostasis

what is the concept of stress?

• the hypothalamus senses a stressful stimulus in the internal or external environment

• the hypothalamus secretes corticotropin - releasing hormone

• the sympathetic nervous system and adrenal medulla secrete catecholamines (epinephrine and norepinephrine) OR the anterior pituitary secretes adrenocorticotropic hormones

• adrenal cortex secretes glucocorticoids (cortisol and aldosterone)

neurohormonal mediators of stress - what are Catecholamines?

Norepinephrine, epinephrine

what are the effects of norepinephrine?

constricts blood vessels, raises blood pressure, reduces gastric secretions, increase night and fat visions

what are the effects of epinephrine?

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

what are endorphins and enkephalins?

the body’s natural pain relievers

what are immune cytokines?

mediators of immune responses

what are important hormones?

• sex hormones : testosterone and estrogen

• Oxytocin

Adrenocortical steroids - What is cortisol?

glucocorticoids, stimulates gluconeogenesis, promotes catabolism and protein, promotes appetite, anti-inflammatory effect, immunosuppressive

Adrenocortical Steroids - what is aldosterone?

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

what is the stress response?

initiated when stress is present, involves the nervous, endocrine, and immune systems

what is adaptation?

bio psychological process of change in response to new or altered circumstances, internal or external in origin

what is coping?

behavioral adaptive response to a stressor using culturally based coping mechanisms

what is Illness?

Both physiological and psychological; is a stimulus for the stress response

What are physical indicators of high stress?

increased blood pressure and respirations, increased muscle tension, tachycardia, diaphoresis, fatigue, tension headaches, nausea, vomiting, diarrhea, change in weight/appetite, restlessness, insomnia

what are behavioral indicators of high stress?

anxiety and depression, substance abuse, change in activity patterns, exhaustion, loss of self-esteem, increased irritability, loss of motivation, decreased productivity, inability to concentrate, increased illnesses

what are the effects of stress with age?

• stress response is brisk and timely in healthy infants and children

• elderly persons are not only at risk for stress related disorders, but they have diminished immune functions making it harder to protect themselves