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Pathophysiology

Pathophysiology. Pathophysiology / Agenda What is pathophysiology ? Why do we study pathophysiology ? Concepts of Health and Disease Concepts of Health

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Page 1: Pathophysiology. Pathophysiology / Agenda What is pathophysiology ? Why do we study pathophysiology ? Concepts of Health and Disease Concepts of Health

Pathophysiology

Page 2: Pathophysiology. Pathophysiology / Agenda What is pathophysiology ? Why do we study pathophysiology ? Concepts of Health and Disease Concepts of Health

Pathophysiology / Agenda

What is pathophysiology ? Why do we study pathophysiology ? Concepts of Health and DiseaseConcepts of Health and Disease What is the Disease ? Etiology of DiseaseEtiology of Disease PathogenesisPathogenesis of Disase of Disase Outcome of DiseaseOutcome of Disease

Page 3: Pathophysiology. Pathophysiology / Agenda What is pathophysiology ? Why do we study pathophysiology ? Concepts of Health and Disease Concepts of Health

What is pathophysiology?What is pathophysiology? X X

Pathophysiology may be defined as the Pathophysiology may be defined as the

physiology of disease, of disordered function, physiology of disease, of disordered function,

or derangement of function seen in disease or derangement of function seen in disease

that is produced by the action of etiologic that is produced by the action of etiologic

agents on susceptible tissues or organsagents on susceptible tissues or organs . .

Pathophysiology includes also the study of the Pathophysiology includes also the study of the

mechanisms underlying disease.mechanisms underlying disease.

study of the effect of disease on cell, tissue, organ and

system.

Page 4: Pathophysiology. Pathophysiology / Agenda What is pathophysiology ? Why do we study pathophysiology ? Concepts of Health and Disease Concepts of Health

What is pathophysiology? X

A subject to explore the rule of origin and

evolution of disease processes and the

fundamental mechanisms.

Pathophysiology can also mean the

functional changes associated with or

resulting from disease or injury

Page 5: Pathophysiology. Pathophysiology / Agenda What is pathophysiology ? Why do we study pathophysiology ? Concepts of Health and Disease Concepts of Health

001Heart Attack / Myocardial Infarctionhttp://www.youtube.com/watch?v=gGY2CsFsiAk

Page 6: Pathophysiology. Pathophysiology / Agenda What is pathophysiology ? Why do we study pathophysiology ? Concepts of Health and Disease Concepts of Health

Why do we study pathophysiologyWhy do we study pathophysiology ??

bridge subjectbridge subject

basicbasic

sciencessciences

clinical clinical

medicinemedicine

pathophysiologypathophysiology

Pathophysiology is an important subject bridging

Basic sciences and clinical medicine.

Page 7: Pathophysiology. Pathophysiology / Agenda What is pathophysiology ? Why do we study pathophysiology ? Concepts of Health and Disease Concepts of Health

Why do we study pathophysiology X

Enabling the students, clinicians and other practitioners to understand why and how diseases develop and various clinical manifestations appear,

and what are the fundamental

mechanisms.

Page 8: Pathophysiology. Pathophysiology / Agenda What is pathophysiology ? Why do we study pathophysiology ? Concepts of Health and Disease Concepts of Health

Other names

Also named:

Physiopathology

Physiology of Disease

Physiology of Disordered Function

Page 9: Pathophysiology. Pathophysiology / Agenda What is pathophysiology ? Why do we study pathophysiology ? Concepts of Health and Disease Concepts of Health

Difference from Physiology X

Pathophysiology or Physiopathology is a convergence pathology with physiology. Pathology is the medical discipline that describes conditions typically observed during a disease state, whereas physiology is the biological discipline that describes processes or mechanisms operating within an organism.

Page 10: Pathophysiology. Pathophysiology / Agenda What is pathophysiology ? Why do we study pathophysiology ? Concepts of Health and Disease Concepts of Health

Difference from Pathology X

Pathology emphasizes the structural changes

Pathophysiology focuses on the functional

and metabolic alterations and

the mechanisms

Page 11: Pathophysiology. Pathophysiology / Agenda What is pathophysiology ? Why do we study pathophysiology ? Concepts of Health and Disease Concepts of Health

Difference from Pathology X

Pathology describes the abnormal or undesired condition, whereupon pathophysiology seeks to explain the physiological processes or mechanisms whereby such condition develops and progresses

Page 12: Pathophysiology. Pathophysiology / Agenda What is pathophysiology ? Why do we study pathophysiology ? Concepts of Health and Disease Concepts of Health

■■Health

Concepts of Health and DiseaseConcepts of Health and Disease X X

The World Health Organization affirms that health is “more The World Health Organization affirms that health is “more

than the absence of disease,” but rather than the absence of disease,” but rather a state of a state of

“complete physical, mental, and social well-being“complete physical, mental, and social well-being,” This ,” This

definition sets a lofty goal for patients seeking health as definition sets a lofty goal for patients seeking health as

well as for health care professionals.well as for health care professionals.

●Factor in healthhealth

▲▲ physical well-being

▲▲ mental well-being

▲▲ social well-being

Page 13: Pathophysiology. Pathophysiology / Agenda What is pathophysiology ? Why do we study pathophysiology ? Concepts of Health and Disease Concepts of Health

HomeostasisHomeostasis

Neural regulatedNeural regulated

Humoral regulatedHumoral regulated

Signal regulated in cellSignal regulated in cell

▲▲disease is caused by the

etiological factors.

▲▲base of disease is

deregulated homeostasis.

●Factor in diseaseFactor in disease

■■Disease X

Disease is referred as aberrant manifestation of Disease is referred as aberrant manifestation of

deregulated homeostasis caused by harmful agents. deregulated homeostasis caused by harmful agents.

Disease is defined as an abnormal life process which Disease is defined as an abnormal life process which is induced by disorders of homeostasis under the is induced by disorders of homeostasis under the action of certain cause(s).action of certain cause(s).

deregulatedderegulated

Page 14: Pathophysiology. Pathophysiology / Agenda What is pathophysiology ? Why do we study pathophysiology ? Concepts of Health and Disease Concepts of Health

What is the Disease? X

It is the “State in which an individual

exhibits an anatomical, physiological, or

biochemical deviation from the normal”

•Disease may be defined as :Disease may be defined as :

an abnormal alteration of structure or function in any part of the body.

Page 15: Pathophysiology. Pathophysiology / Agenda What is pathophysiology ? Why do we study pathophysiology ? Concepts of Health and Disease Concepts of Health

Various Classification of Disease 1 Developmental – genetic, congenital.

Acquired:

*Inflammatory – Trauma, infections, immune, etc.

*Neoplastic – tumors cancers

*Degenerative – ageing.

*Metabolic.

*Iatrogenic: Drug induced.

Page 16: Pathophysiology. Pathophysiology / Agenda What is pathophysiology ? Why do we study pathophysiology ? Concepts of Health and Disease Concepts of Health

Various Classification of Disease 2

Anatomical Organ System

Developmental (age) Neonatology Pediatrics Adolescent Adult Geriatrics

Etiological

Page 17: Pathophysiology. Pathophysiology / Agenda What is pathophysiology ? Why do we study pathophysiology ? Concepts of Health and Disease Concepts of Health

HomeostasisHomeostasis internal constancy or a stable internal environment A “body

in balance” is in homeostasis Homeostatic regulation ---- works by using feedback loops

• Feedback loopsFeedback loops utilize 3 components (1) receptor (2) control center (3) effector– 2 types of feedback loops

(1) negative feedback– Restores any change back to normal– Resembles “teeter-totter”– Stabilizing– Most common

(2) positive feedback– Exaggerates the change– Resembles “domino effect”– Stimulating– Least common

Page 18: Pathophysiology. Pathophysiology / Agenda What is pathophysiology ? Why do we study pathophysiology ? Concepts of Health and Disease Concepts of Health

Disease Process 5 Components

Epidemiology Etiology Pathophysiology Clinical Manifestations Outcome

“COPE”

Page 19: Pathophysiology. Pathophysiology / Agenda What is pathophysiology ? Why do we study pathophysiology ? Concepts of Health and Disease Concepts of Health

Epidemiology

Epidemiology Define Factors: Predisposing, Precipitating

Herpes D Virus

Page 20: Pathophysiology. Pathophysiology / Agenda What is pathophysiology ? Why do we study pathophysiology ? Concepts of Health and Disease Concepts of Health

Epidemiology X

 is the study of the patterns, causes, and effects of health and disease conditions in defined populations. It is the cornerstone of public health, and informs policy decisions and evidence-base medicine by identifying risk factors for disease and targets for preventive medicine.

Page 21: Pathophysiology. Pathophysiology / Agenda What is pathophysiology ? Why do we study pathophysiology ? Concepts of Health and Disease Concepts of Health

EtiologyEtiology X X

■■Concept of Etiological Factors & PredisposingConcept of Etiological Factors & Predisposing

Etiologic factors involved in diseases include causative, predisposing and precipitating factors, which contributes to the onset of diseases.

●Etiological factorsEtiological factors

▲▲The factor that causes the disease and determine the clinical features of the disease

▲▲Among the etiological factors, a wide range of extrinsic factors in the environment and intrinsic factors in the body must be considered.

Page 22: Pathophysiology. Pathophysiology / Agenda What is pathophysiology ? Why do we study pathophysiology ? Concepts of Health and Disease Concepts of Health

Environmental agents:• Physical• Chemical• Nutritional• Infections• Immunological• Psychological

Genetic Factors:• Age• Genes

Multifactorial As Diabetes, As Diabetes,

HypertensionHypertension CancerCancer

Etiology: What is the cause? X

Page 23: Pathophysiology. Pathophysiology / Agenda What is pathophysiology ? Why do we study pathophysiology ? Concepts of Health and Disease Concepts of Health

•One etiologic One etiologic agent agent several diseases, several diseases, as smoking.as smoking.

Disease

• Several etiologic Several etiologic agents one agents one disease, as diabetes disease, as diabetes ..

Disease Disease

DiseaseDisease

One etiologic agent One etiologic agent - one disease, - one disease, as Malaria.as Malaria.

Etiology

Page 24: Pathophysiology. Pathophysiology / Agenda What is pathophysiology ? Why do we study pathophysiology ? Concepts of Health and Disease Concepts of Health

Etiological factors

Biological agents Chemical agents Physical agents Nutritional imbalance

Extrinsic Factors

Page 25: Pathophysiology. Pathophysiology / Agenda What is pathophysiology ? Why do we study pathophysiology ? Concepts of Health and Disease Concepts of Health

Etiological factors

Genetic factors

Congenital factors

Immunological factors

Psychological factors

Intrinsic Factors

Page 26: Pathophysiology. Pathophysiology / Agenda What is pathophysiology ? Why do we study pathophysiology ? Concepts of Health and Disease Concepts of Health

■■Classification of etiological factorsClassification of etiological factors

▲▲biological agentsbiological agents

●Factors of environmentFactors of environment

▲▲physical agents physical agents

▲▲chemical agentschemical agents

●Inherited factors Inherited factors

▲▲gene mutationgene mutation

【【 genetic predispositiongenetic predisposition 】】

The genetic mutations cause problems only when a The genetic mutations cause problems only when a person is eposed to certain environmental agents.person is eposed to certain environmental agents.

▲▲chromosomal aberrationchromosomal aberration

Page 27: Pathophysiology. Pathophysiology / Agenda What is pathophysiology ? Why do we study pathophysiology ? Concepts of Health and Disease Concepts of Health

●Congenital factorsCongenital factors

The disorders are of a developmental nature and most The disorders are of a developmental nature and most of them are nongenetic.of them are nongenetic.

●Nutritional imbalanceNutritional imbalance

Either excesses or deficiencies of nutrients Either excesses or deficiencies of nutrients predispose cells to injury.predispose cells to injury.

Page 28: Pathophysiology. Pathophysiology / Agenda What is pathophysiology ? Why do we study pathophysiology ? Concepts of Health and Disease Concepts of Health

●Immunological factorsImmunological factors

▲▲immunodeficiency diseaseimmunodeficiency disease

▲▲autoimmune diseaseautoimmune disease

▲▲anaphylactic reactionanaphylactic reaction

●Psychological and social factorsPsychological and social factors

Anxiety, strong or persistent psychological Anxiety, strong or persistent psychological stimulation or stress may lead to mental stimulation or stress may lead to mental illness and may be related to some illness and may be related to some diseases, such as hypertension, peptic diseases, such as hypertension, peptic ulcer, coronary heart disease, and ulcer, coronary heart disease, and depression.depression.

Page 29: Pathophysiology. Pathophysiology / Agenda What is pathophysiology ? Why do we study pathophysiology ? Concepts of Health and Disease Concepts of Health

Predisposing factors

The function of these factors is to intensify the effects of causative factors and promote the onset and development of diseases.

Page 30: Pathophysiology. Pathophysiology / Agenda What is pathophysiology ? Why do we study pathophysiology ? Concepts of Health and Disease Concepts of Health

Predisposing FactorsPredisposing Factors X X

Age Young are prone to accidents Getting diseases such as diabetes, heart disease,

and certain cancers increase with age Very old are prone to drug interactions

Sex More frequent in woman: MS, osteoporosis More frequent in men: gout, Parkinson’s disease

Lifestyle Examples of harmful lifestyle:

Perilous occupation Smoking Excess alcohol Poor nutrition Sedentary activity

Page 31: Pathophysiology. Pathophysiology / Agenda What is pathophysiology ? Why do we study pathophysiology ? Concepts of Health and Disease Concepts of Health

Environment Air pollution Water pollution Poor living conditions Excessive noise Chronic psychological stress

Heredity Deals with genetic predisposition (inheritance)

Genetic predisposition + certain type of environment =

mental retardation , lung cancer, etc.

Preventive health care The best treatment of a disease is prevention !! Deals with altering risk factors that can be changed

Predisposing FactorsPredisposing Factors X X

Page 32: Pathophysiology. Pathophysiology / Agenda What is pathophysiology ? Why do we study pathophysiology ? Concepts of Health and Disease Concepts of Health

Predisposing factors for colorectal Cancer Poor diet (more fresh food, increase fiber) Sedantary life style Decreased regular physical activity Heredity (regular screening) Age (digestion slows)

COLONOSCOPY after 50

Page 33: Pathophysiology. Pathophysiology / Agenda What is pathophysiology ? Why do we study pathophysiology ? Concepts of Health and Disease Concepts of Health

Precipitating Factors

Natural conditions

Physical condition

Social condition

aftershave-asthma

The factors The factors that that promote the promote the development of disease and development of disease and influences the timing of illness onsetinfluences the timing of illness onset

The factors that start to outset of The factors that start to outset of diseasedisease. .

Page 34: Pathophysiology. Pathophysiology / Agenda What is pathophysiology ? Why do we study pathophysiology ? Concepts of Health and Disease Concepts of Health

Pathogenesis X

The sequence events in the response of the cells or

tissues to the etiologic agent, from the initial stimulus to

the ultimate expression of the disease,”from the time it

is initiated to its final conclusion in recovery or death” 

The pathogenesis of a disease is the mechanism that causes the disease. For example bacterial pathogenesis is the mechanism by which bacteria cause infectious illness.

Page 35: Pathophysiology. Pathophysiology / Agenda What is pathophysiology ? Why do we study pathophysiology ? Concepts of Health and Disease Concepts of Health

PathogenesisPathogenesis X X

Pathogenesis of disease refers to the rules and Pathogenesis of disease refers to the rules and

mechanisms underlying the development or evolutimechanisms underlying the development or evolutioon of n of

diseases. It studiesdiseases. It studies::

how the primary pathological agents cause disease in how the primary pathological agents cause disease in

organism and how the disease develops.organism and how the disease develops.■■Basic MechanismBasic Mechanismss of Disease of Disease

•Neural mechanism

•Humoral mechanism

•Cellular mechanism

•Molecular mechanism

Page 36: Pathophysiology. Pathophysiology / Agenda What is pathophysiology ? Why do we study pathophysiology ? Concepts of Health and Disease Concepts of Health

Neural mechanism •Neural system plays a central role in regulating entire life activities; the disturbance occurred in neural system and in periphery organs are mutually affected. •Encephalitis B virus can damage neural system directly; •some poisons may interrupt the metabolism of neural cells and the production and release of neurotransmitters.

Page 37: Pathophysiology. Pathophysiology / Agenda What is pathophysiology ? Why do we study pathophysiology ? Concepts of Health and Disease Concepts of Health

Humoral mechanism (humoral factors, cytokines) Humoral regulation is crucial in maintaining internal homeostasis. Humoral dysfunction generally indicates the alterations in number and in activities of some humoral factors( hormones, chemical mediators, cytokines). They function through endocrine, paracrine, and autocrine to regulate the metabolism and activities of the cells .

Page 38: Pathophysiology. Pathophysiology / Agenda What is pathophysiology ? Why do we study pathophysiology ? Concepts of Health and Disease Concepts of Health

During the development of diseases, the regulations in humoral and neural system are usually simultaneous e.g. disturbance of neural-humoral regulation in hypertension: constant stress--- dysfunction of neural system (cerebral cortex and hypothalamus)---sympathetic-adrenal medulla system----increased secretion of norepinephrine and epinephrine--- constriction of arteries/ constriction of renal afferent arterioles will activate renin----- angiotensin-aldosterone system, and finally causes hypertension.

Page 39: Pathophysiology. Pathophysiology / Agenda What is pathophysiology ? Why do we study pathophysiology ? Concepts of Health and Disease Concepts of Health

Cellular and molecular mechanism Cellular and molecular damages or alterations are fundamental in the development of disease. Strong acid and alkali destroy the cells with no selection; hepatitis virus damages specifically the hepatocytes.

•Disease genomics: Disease proteomics

Page 40: Pathophysiology. Pathophysiology / Agenda What is pathophysiology ? Why do we study pathophysiology ? Concepts of Health and Disease Concepts of Health

Pathophysiology Focus Disease Mechanisms

Genetic Internal External

Pathogenesis Morphology

Gross Histological

Page 41: Pathophysiology. Pathophysiology / Agenda What is pathophysiology ? Why do we study pathophysiology ? Concepts of Health and Disease Concepts of Health

Morphology: X

Structural changes in disease.Tumor in a cancer.Ulcer in an infection.Atrophy in dementia.

Gross & Microscopic.

Page 42: Pathophysiology. Pathophysiology / Agenda What is pathophysiology ? Why do we study pathophysiology ? Concepts of Health and Disease Concepts of Health

■■General Rules for Pathogenesis of DiseasesGeneral Rules for Pathogenesis of Diseases

●Damage and anti-damage responsesDamage and anti-damage responses

Damages are usually made when a variety of harmful Damages are usually made when a variety of harmful insults attack the body. insults attack the body.

During this process, anti-damage responses are During this process, anti-damage responses are also induced in the body to restore the normal also induced in the body to restore the normal situation. situation.

pain pain Infection (fever) plasma lossInfection (fever) plasma loss

shock ischemia & injury of Cells shock ischemia & injury of Cells BpBp↓, blood volume↓, blood volume↓↓

Severe burnSevere burn

DamageDamage

Anti-damageAnti-damage

Stress WBC↑, Blood coagulation↑ SAMS excitation(+)Stress WBC↑, Blood coagulation↑ SAMS excitation(+)

C.O↑, Blood redistributionC.O↑, Blood redistribution

Rehabilitation blood flow heart & brain↑Rehabilitation blood flow heart & brain↑

Anti-infection↑, plasma lossAnti-infection↑, plasma loss↓↓

SAMS: Sympathetico-adrenal-medullay system; c.o: cardiac outputSAMS: Sympathetico-adrenal-medullay system; c.o: cardiac output

Page 43: Pathophysiology. Pathophysiology / Agenda What is pathophysiology ? Why do we study pathophysiology ? Concepts of Health and Disease Concepts of Health

Clinical Manifestations X Symptoms /Syndrome

Patient Report Subjective Related Terms: Prodromal,

Insidious, Latent Signs

Health care exam Observable phenomena Objective

Diagnostic Criteria Laboratory results Imaging Biopsy

Digital Thermal Imaging

Page 44: Pathophysiology. Pathophysiology / Agenda What is pathophysiology ? Why do we study pathophysiology ? Concepts of Health and Disease Concepts of Health

Clinical Manifestations

Displaying clues and symptoms of an illness

  Clinical manifestations are the observable symptoms by which a disease may be diagnosed by a physician.

It is how a disorder 'manifests' itself to an observer.

Page 45: Pathophysiology. Pathophysiology / Agenda What is pathophysiology ? Why do we study pathophysiology ? Concepts of Health and Disease Concepts of Health

What is Osteoarthritis: Signs & Symptomshttp://www.youtube.com/watch?v=YLB11LJF5Vk

Page 46: Pathophysiology. Pathophysiology / Agenda What is pathophysiology ? Why do we study pathophysiology ? Concepts of Health and Disease Concepts of Health

Signs & Symptoms

Relating to disease, noticable or preceptible interpretation of modified health condition

A signal that is expressed by an ill individual and is often considered a personal meaning

Page 47: Pathophysiology. Pathophysiology / Agenda What is pathophysiology ? Why do we study pathophysiology ? Concepts of Health and Disease Concepts of Health

Signs vs symptoms X

Signs are the physical manifestation of injury, illness or disease.

A high temperature

a rapid pulse,

low blood pressure, bruising can be called as signs

symptoms are what a patient experiences about the injury, illness or disease

Chills, shivering, fever, nausea, shaking and vertigo are the symptoms.

Page 48: Pathophysiology. Pathophysiology / Agenda What is pathophysiology ? Why do we study pathophysiology ? Concepts of Health and Disease Concepts of Health

Pneumonia signs & Symptoms

Flu like Persistent cough Fever Shortness of

breath Chest pain Chills sweath

Cough, with thick, sticky fluid

Fatigue and muscle aches

Nausea, vomiting or diarrhea

Headache

Page 49: Pathophysiology. Pathophysiology / Agenda What is pathophysiology ? Why do we study pathophysiology ? Concepts of Health and Disease Concepts of Health

Common symptoms (Diabetes) Frequent urination Excessive thirst Unexplained weight loss Extreme hunger Sudden vision changes Tingling or numbness in the hands or feet Feeling very tired much of the time Very dry skin Sores that are slow to heal More infections than usual

Page 50: Pathophysiology. Pathophysiology / Agenda What is pathophysiology ? Why do we study pathophysiology ? Concepts of Health and Disease Concepts of Health

• Latent symptoms: Existing or present

but concealed or inactive. X Prodromal symptoms: An early symptom

indicating the onset of an attack or a disease. Insidious/Vague symptoms: There are a

number of diseases, some of them very serious, which only cause mild or vague symptoms. People may not even really feel sick, but just have a feeling that things are not quite right.

Page 51: Pathophysiology. Pathophysiology / Agenda What is pathophysiology ? Why do we study pathophysiology ? Concepts of Health and Disease Concepts of Health

Asymptomatic X

Absence of any observable symptoms even though lab tests announce a disease is present

Page 52: Pathophysiology. Pathophysiology / Agenda What is pathophysiology ? Why do we study pathophysiology ? Concepts of Health and Disease Concepts of Health

The course of a diseaseThe course of a disease X X

An An acuteacute disease has relatively sudden disease has relatively sudden onset and lasts for a short term,onset and lasts for a short term,

a a chronicchronic disease, sometimes begins with disease, sometimes begins with an acute phase, usually lasts for a long an acute phase, usually lasts for a long period of time.period of time.

subacutesubacute

Page 53: Pathophysiology. Pathophysiology / Agenda What is pathophysiology ? Why do we study pathophysiology ? Concepts of Health and Disease Concepts of Health

Eczema-Dermatological Definition

An acute, subacute but usually chronic pruritic inflammation of the epidermis and the dermis, often occurring in association with a personal family history of hay fever, asthma, allergic rhinitis or atopic dermatitis.

Page 54: Pathophysiology. Pathophysiology / Agenda What is pathophysiology ? Why do we study pathophysiology ? Concepts of Health and Disease Concepts of Health

Characteristics of Acute Eczema

Well demarcated plaques of erythema and edema on which are superimposed and closely spaced small vesicles filled with clear fluid with punctate erosions and crusting

Distribution may be isolated and localized or general

Page 55: Pathophysiology. Pathophysiology / Agenda What is pathophysiology ? Why do we study pathophysiology ? Concepts of Health and Disease Concepts of Health

Acute Eczema

Note the erythema, vesicles and swelling

Page 56: Pathophysiology. Pathophysiology / Agenda What is pathophysiology ? Why do we study pathophysiology ? Concepts of Health and Disease Concepts of Health

Characteristics of Subacute Eczema Plaques of mild erythema with small dry

scales and or superficial desquamation, sometimes associated with small red, pointed or round papules

Distribution may be isolated and localized or general

Page 57: Pathophysiology. Pathophysiology / Agenda What is pathophysiology ? Why do we study pathophysiology ? Concepts of Health and Disease Concepts of Health

Subacute Eczema

Note erythema, swelling and desquamation

Page 58: Pathophysiology. Pathophysiology / Agenda What is pathophysiology ? Why do we study pathophysiology ? Concepts of Health and Disease Concepts of Health

Characteristics of Chronic Eczema

Plaques with deepening of the skin lines with satellite, small, firm flat or round top papules, excoriations and pigmentations or mild erythema

lichenification

Page 59: Pathophysiology. Pathophysiology / Agenda What is pathophysiology ? Why do we study pathophysiology ? Concepts of Health and Disease Concepts of Health

Chronic Eczema

Note lichenification, scaling and fissuring

Page 60: Pathophysiology. Pathophysiology / Agenda What is pathophysiology ? Why do we study pathophysiology ? Concepts of Health and Disease Concepts of Health

Acute - Subacute - Chronic

Swelling and erythema

Punctate erythema,

desquamation Lichenification

Page 61: Pathophysiology. Pathophysiology / Agenda What is pathophysiology ? Why do we study pathophysiology ? Concepts of Health and Disease Concepts of Health

Outcome

Expected Prognosis

Actual Cure Remission Exacerbation Complication Palliative Death

Page 62: Pathophysiology. Pathophysiology / Agenda What is pathophysiology ? Why do we study pathophysiology ? Concepts of Health and Disease Concepts of Health

Prognosis X

Expected outcome of the disease, It is the clinician's

estimate of the severity and possible result of a

disease. 

Page 63: Pathophysiology. Pathophysiology / Agenda What is pathophysiology ? Why do we study pathophysiology ? Concepts of Health and Disease Concepts of Health

Outcome of disease X

Complete recovery

Incomplete recovery

Death

Page 64: Pathophysiology. Pathophysiology / Agenda What is pathophysiology ? Why do we study pathophysiology ? Concepts of Health and Disease Concepts of Health

Outcome X Cure: Restoration of health; recovery from

disease Remission: A period during which

symptoms of disease are reduced (partial) or disappear (complete remission)

Exacerbation: An increase in the severity of a disease or in any of its signs or

Page 65: Pathophysiology. Pathophysiology / Agenda What is pathophysiology ? Why do we study pathophysiology ? Concepts of Health and Disease Concepts of Health

Outcome X Complication;  secondary disease or

condition that develops in the course of a primary disease or condition and arises either as a result of it or from independent causes.

Palliative: Medications and treatments are said to have a palliative effect if they relieve symptoms without having a curative effect on the underlying  disease  or cause

Page 66: Pathophysiology. Pathophysiology / Agenda What is pathophysiology ? Why do we study pathophysiology ? Concepts of Health and Disease Concepts of Health

Complete recovery

The best outcome of a disease:•the etiological factors disappear•the pathologically altered metabolism, structure and function are perfectly restored•the symptoms and signs of the disease disappear entirely• homeostasis is recovered

Page 67: Pathophysiology. Pathophysiology / Agenda What is pathophysiology ? Why do we study pathophysiology ? Concepts of Health and Disease Concepts of Health

Incomplete recovery

The main symptoms and signs disappear but some pathological changes are left behind, namely sequela. Sequela is generally brought about by the compensatory response to maintain a relatively normal activity. For example, the permanent damage to the heart valve after rheumatic fever.

Page 68: Pathophysiology. Pathophysiology / Agenda What is pathophysiology ? Why do we study pathophysiology ? Concepts of Health and Disease Concepts of Health

■■DeathDeath

The cessation of heart-beats and breath is used as the The cessation of heart-beats and breath is used as the

criterion of death of a body.criterion of death of a body.

●Brain deathBrain death

The functions of cerebrum and brain stem stop forever.The functions of cerebrum and brain stem stop forever.

Page 69: Pathophysiology. Pathophysiology / Agenda What is pathophysiology ? Why do we study pathophysiology ? Concepts of Health and Disease Concepts of Health

Brain Death (WHO criteria ) X

Cessation of spontaneous respiration Irreversible coma Absence of cephalic reflexes and dilated

pupils Absence of any electrical activity of the brain Absence of brain blood flow

Page 70: Pathophysiology. Pathophysiology / Agenda What is pathophysiology ? Why do we study pathophysiology ? Concepts of Health and Disease Concepts of Health

Terms Used In PathophysiologyTerms Used In Pathophysiology X X Pathology = study of disease Pathogenesis = the development of a disease Diseases develops in stages

Infectious disease example:(A)incubation (b)disease

(c)convalescence Pathophysiology = the study of the functional changes

associated with a specific disease How the disease affects specific functions of the

body Subjective findings

The patient’s symptoms Described by the patient----(the patient’s history)

Objective findings Health provider’s findings---( the physical exam)

Occurrence of disease defined by 2 factors Incidence = # new cases per unit of time Prevalence = # new & old cases per unit of time

Page 71: Pathophysiology. Pathophysiology / Agenda What is pathophysiology ? Why do we study pathophysiology ? Concepts of Health and Disease Concepts of Health

Disease terminology X Etiology = cause of the disease Idiopathic = disease with unknown cause Iatrogenic = disease caused by human intervention Congenital diseases = diseases occurring at birth Syndrome = common cause of different signs & symptoms Remission = period when symptoms & signs of disease abates Exacerbation = period when symptoms & signs increase Endemic disease = disease native to local area Epidemic = many people affected in a given area Pandemic = many people affected in large areas Incubation = latent period of the disease before develop signs

& symptoms Prognosis = probability for recovery Morbidity = disease rates within a group Mortality = death rates within a group Epidemiology = how the disease occurs & spreads through an

area

Page 72: Pathophysiology. Pathophysiology / Agenda What is pathophysiology ? Why do we study pathophysiology ? Concepts of Health and Disease Concepts of Health

I hear, I forgetI hear, I forget

I see, I rememberI see, I remember

I do, I understandI do, I understandChinese Proverb..Chinese Proverb..

Page 73: Pathophysiology. Pathophysiology / Agenda What is pathophysiology ? Why do we study pathophysiology ? Concepts of Health and Disease Concepts of Health