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83 Cards in this Set
- Front
- Back
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Epidemiology |
*Study of disease occurrence in human populations *Analysis of patterns of people affected by a certain condition *Determination of how disease is spread, how to control it, prevent it, and eliminate it |
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Incidence (Epidemiology) |
Number of new cases within a population at risk during a specific time (Example: number of new cases of Hep. C in heroin addicts) |
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Prevalence (Epidemiology) |
Measure of existing disease in a population at a given point in time |
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Morbidity (Epidemiology) |
*Describes the effects an illness has on a person's life *Persistence and long term consequences of a disease |
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Mortality (Epidemiology) |
Causes of death in a given population (Example: infant mortality rates) |
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Natural History |
Progression and outcome of a disease without medical intervention |
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Prognosis |
probable outcome and prospect of recovery from a disease; chances of survival |
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Purpose and Components of the Diagnostic Process |
Purpose: *accumulate info *assess and evaluate the info collected *integrate the info Components: *Interview *Physical examination *Other examinations (labs, imaging studies) |
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Signs |
objective; seen, heard, or felt by another |
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Symptoms |
subjective; only felt by the sick person |
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Does the interview look for signs or symptoms of the disease? What other information should be collected during the interview? |
Symptoms family history, lifestyle, social history (smoking, sex, occupation), past medical history, medications (esp. elders), demographics (age, gender) |
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Physical examination |
*Measurement of vital signs (BP, temp, pulse) *Inspection: visualizing structure; swelling, redness, hair, weight, height *Palpation: fingertips to feel size, location, etc. *Percussion: using fingertips to tap over different parts of body *Auscultation: listening to sounds of body (chest & abdomen with stethoscope) |
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Medical imaging studies (3) |
*MRI: look at soft tissue *CT scan: 360 degree manner *X-ray: shadow/silhouette of bones |
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Etiology |
study of the cause (of disease) |
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Hypoxic injury |
*lack of oxygen; cannot undergo oxidative phosphorylation for ATP Causes: *Ischemia - insufficient blood supply (most common) *heart disease, lung disease, RBC disorders |
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Anemic Hypoxia |
*poor oxygen delivery *iron deficiency, reduced RBCs, shitty hemoglobin |
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Ischemic Hypoxia |
*impaired blood circulation *inclusion of the artery |
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Histotoxic Hypoxia |
*impaired utilization of oxygen *tissue poisoning, blocks enzyme systems that work with oxygen |
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Hypoxemia Hypoxia |
*reduced arterial oxygen levels *lung disease |
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Effects of Hypoxia |
*Hydropic swelling *Glycolytic pathway *Cell death *Reperfusion injury |
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Hydropic swelling (Effects of Hypoxia) |
*Failure of the injured cells to maintain electrolyte balance through the Na+ / K+ - ATPase pump (needs ATP, lack of oxygen = lack of ATP) *Decreased functioning of Ca2+ / Mg2+ - ATPase pump; activates enymes which damage the cell |
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Reperfusion injury (Effects of Hypoxia) |
*Blood supply is suddenly restored to tissue *Oxygen acts as a free-radical = cell injury |
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Glycolytic pathway (Effects of Hypoxia) |
*Anaerobic metabolism (lactic acid builds up) |
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Nutritional deficiencies (Effects of Hypoxia) |
*poor intake (low intake of calories) *excessive output (not absorbing nutrients) *altered absorption (not enoughintrinsic factor for absorption of vitamin B12) *impaired distribution (trans fat > plaques > obesity; excess glucose > diabetes mellitus) *inefficient cellular uptake (lack of insulin) |
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Gangrene |
*Mass of tissue undergoes cell death *Caused by a loss of blood supply followed by bacterial growth (infection) *wet - spreads rapidly & can be fatal; caused by blockage of venous blood flow *dry - limited to the extremities and spreads slowly; caused by interfering with arterial blood supply to the tissue; |
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Chemical Injury (2) |
Drugs: alcohol, Rx drugs (too much acetaminophen > liver problems), street drugs, OTC Heavy Metals (Pb): in paint, contaminated soil, makeup; stored in bone, eliminated by kidneys; causes inactivation of enzymes, interference of nerve transmission, brain development |
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Hypothermia (physical injury) |
*vasoconstriction (to prevent heat loss, protecting internal organs); ischemia *freezing, ice crystals form, rupture cell |
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Hyperthermia (physical injury) |
*microvascular coagulation *speed up of cellular metabolic processes *protein degradation |
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Electromagnetic radiation (physical injury) |
*direct breakage of chemical bonds *ionization *heat production *disruption of neural, cardiac impulses *hyperthermia |
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Mechanical deformation (physical injury) |
*Non-penetrating or penetrating *blood loos or obstruction of blood flow *hypoxia *inflammation |
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Patho |
disease |
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physiology |
bodily function |
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health |
a state of complete physical, mental, and social wellness |
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disease |
pathologic condition; clinical signs, symptoms, and laboratory findings |
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Normal white cell count |
4.0 - 11.0 x 10^9 / L |
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Reference Intervals |
*usual values for all parameters within a healthy population |
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Pathogenesis |
*the evolution, effect, & duration of a disease *Onset: acute (sudden) vs. insidious (subtle) *Duration: acute (one time) vs. chronic (reoccurring) |
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Syndrome |
collection of signs and symptoms that usually occur together in response to a given condition |
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Signs and Symptoms can be localized or system |
localized: one place; example: strep throat, swelling system: multiple organ systems; example: fever, fatigue |
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Subclinical stage |
no signs or symptoms but abnormal physiology and lab values |
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Prodromal Stage |
Appearance of the first signs of symptoms |
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Acute Stage |
Disease reaches its fullest intesity |
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sequela (pl. sequelae) (Outcomes of Disease) |
a condition that is the consequence of a disease (example: neck pain from whiplash) |
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complications (Outcomes of Disease) |
new or separate process that arises secondarily to the original disease |
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resolution (Outcomes of Disease) |
return to normal function |
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Classification of Disease (7): (the etiology) |
*Inherited (from parents / genetic) *Congenital (occur in utero) *Toxic (Pb or alcohol poisoning) *Infectious (caused by microorganisms) *Neoplastic (new growth; cancer) *Iatrogenic (caused by medical intervention) *Idiopathic (unknown cause) |
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Cells have three responses to challenges: |
*Reversible *Adaptation *Cell death |
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Hydropic swelling (definition & cause) |
water & sodium accumulation; Na+/K+ - ATPase pump not working properly; lack of ATP caused by viruses, alcoholism, etc |
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Characteristics of hydropic swelling |
*large, pale cytoplasm *dilated endoplasmic reticulum *swollen mitochondria |
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Cellular Accumulations (Reversible Cellular Injury) |
*Buildup of toxic substances that cells cannot immediately use or eliminate *Categorized according to type of substance accumulated *Example- fatty liver; delivery of free fatty acids is increased and disturbs metabolism *Causes: diet high in fats, alcoholism, low glucose |
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Hemosiderosis (in the liver) |
*iron overload disorder *brown deposits *caused by intravascular hemolysis (mechanical injury, sickle cell anemia, thalassemia, frequent blood transfusions |
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Bilirubin Deposition |
*Increased bilirubin production *obstruction of bile duct into intestine *diseases that affect liver's ability to remove bilirubin from the blood (jaundice) |
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Asbestosis |
*Inhalation of asbestos fibers *deposits in lung tissue *scar tissues formation *causes mesothelioma and lung cancer |
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Cellular Adaptation |
*Atropy *Hypertrophy *Hyperplasia *Metaplasia *Dysplasia *Anaplasia |
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Atrophy |
*cellular shrinkage; decreased functional capacity Causes: *disuse *chronic nutrient starvation *neurological disorder / central nervous system *denervation (injury to nerve) *alchemia (cutting off blood supply) |
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Hypertrophy |
*larger in size; increase in functional capactiy *seen in skeletal and cardiac muscle Causes: *increased function (body builders) *high blood pressure (hypertension) |
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Hyperplasia |
*increase of cell number *increase in functional capacity Caused by: Physiological *hormonal stimulation (pregnancy) *chronic irritation *regeneration (wounds; tumors) Non-physiological *hormonal (endometriosis; enlarged lining) *growth factors (produced by viruses; HPV) |
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Metaplasia |
*persistent injury; chronic irritation & inflammation *reversible conversion of 1 type to another *replacement of glandular epithelium with squamous epithelium |
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Dysplasia |
*disorganized appearance of cells *loss of adaptive effect *potentially reversible after the stimulus is removed Causes: *chronic irritation or infection *implicated as a precursor to cancer |
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Papanicolaou (Pap) smear |
checks for HPV which leads to cervical cancer; 1:4 to 1:1 |
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Anisocytosis |
unequal or different size |
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Poikilocytosis |
abnormal shape |
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Hyperchromatism |
excessive pigmentation |
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Mitotic figures |
abnormal cell division |
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Anaplasia |
*differentiated body cells return to an undifferentiated (irreversible) state *associated with malignancy Features: *loss of polarity *loss of specialized functions *vary in shape (pleomorphism) *altered nucleus *hyperchromatism |
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Neoplasia |
New growth (cancer) |
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Neoplasm |
Abnormal mass of proliferating cells Benign - grow slowly; stays confined in the tissue it originated in Malignant - fast growth rate; poorly differentiated; spreads |
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Cell death (two types) |
*Occurs when an injury is too severe or prolonged to allow cellular adaptation or repair *Apoptosis - normal cell death (beneficial) *Necrosis - abnormal cell death |
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Apoptosis |
*Elimination of injured or aged cells *"Programmed cell death" *Responsible for localized deletion of cell during normal cell development |
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Characteristics of Apoptosis |
*Shrinkage and condensation of nucleus and cytoplasm *Chromatin aggregation at the nuclear envelope *Nuclear fragmentation *Apoptotic bodies |
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Nuclear changes during apoptosis |
*Pyknosis - irreversible condensation of chromatin in the nucleus *Karyorrhexis - fragmentation of the pyknotic nucleus *Karyolysis - complete dissolution of chromatin |
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Normal physiologic processes of Apoptosis |
*Embryonic development (fingers and toes) *Maintenance of homeostasis *Immune system (rids of B & T cells that produce autoimmune response) |
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Two basic pathways of Apoptosis |
Extrinsic (death receptor) *Extracellular signaling proteins bind to the cell surface molecules and trigger apoptosis Intrinsic (mitochondrial) *Cytochrome c (from mitocondria moves to cytoplasm) *Activated by conditions such as DNA damage, hypoxia, decreased ATP levels |
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Necrosis |
*Pathologic cell death *Unregulated enzymatic digestion of cellular components *Loss of plasma membrane integrity (intracellular > extracellular; provokes immune response) *Interferes with cell replacement and tissue regeneration |
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Nuclear changes during necrosis |
*Pyknosis - irreversible condensation of chromatin in the nucleus *Karyorrhexis - fragmentation of the pyknotic nucleus *Karyolysis - complete dissolution of chromatin |
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Other cell changes during necrosis (that don't occur during apoptosis) |
*swollen cell volume *dispersed ribosomes *disrupted plasma membrane *disrupted organelle membranes |
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Types of Necrosis |
*Coagulative *Liquefactive *Fat *Caseous |
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Coagulative Necrosis |
*Most common *Retention of architectural pattern (you can tell what it looked like) *Dense in comparison to surrounding tissue *acidic pH, breaks down enzymes *Mechanism = hypoxic injury |
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*Appearance of Coagulative Necrosis |
*Composed of denatured proteins that are dissolved by proteolytic enzymes and replaced by scar tissue *Example: Gangrene |
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Liquefactive Necrosis |
*Cells die, enzymes are not destroyed *transformation of tissue into viscous liquid mass *formation of cyst (fluid, puss, air) *associated with injury in brain and following infections *seen when dissolution of dead cells occurs quickly *liquefied area of dissolved tissue *Example: lung |
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Fat Necrosis (from Acute pancreatitis) |
*leakage of enzymes (lipase) *break down adipose cells and split triglycerides within the cells *release of fatty acids *Fatty acids combine with Ca2+ to form chalky white areas called soaps |
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Fat Necrosis (from Trauma / Mechanical injury) |
*Physical injury of adipocytes releases triglycerides *Triglycerides are hydrolyzed by serum lipases to free fatty acids *Free fatty acids combine with Ca2+ |
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Caseous Necrosis |
*Characteristic of injury to lung tissue by mycobacteria *No histologic architecture is preserved *dead cells remain indefinitely as a soft, clumpy debris (clumpy cheese) *Example: mycobacterium tuberculosis |
