Pathophysiology Primer

Johis Ortega, PhD, ARNP-BC

Carmen Presti, ACNP-BC

What is Pathophysiology?

Pathophysiology deals not only with the cellular  and organ changes that occur with disease, but with the effects that these changes have on total body function.

Pathophysiology  also focuses on the mechanisms of the underlying disease process and provides the background for preventive as well as therapeutic heath care measures and practices

Breaking it down further…

Physiology of altered health Pathology (from the Greek pathos, meaning

“disease”) deals with the study of the structural and functional changes in cells, tissues and organs of the body that cause or are caused by disease

Physiology deals with the function of the human body

Physiologic changes that occur as a result of disease

Etiology Factors(Causes of the Disease)

Biologic Agents Bacteria, viruses

Physical Forces Trauma, burns, radiation

Chemical Agents Poisons, alcohol

Nutritional Excesses or Deficits Risk Factors

Factors that predispose to a particular disease Congenital (born with) vs. Acquired (obtained by other

mechanism)

Some Definitions

Pathogenesis Sequence of cellular and tissue events that take

place from the time of initial contact with an etiologic (causative) agent until the ultimate expression of a disease

Morphology Refers to the fundamental structure or form of

cells or tissues

Definitions How do we know a person is sick? How do they look, what are their

complaints? Do they have a fever? Sore throat? If we drew blood work, what would their laboratory results tell us? If we did x-rays, what would they show?

Clinical Manifestations is the way a disease manifests, or appears in a person.

These Clinical Manifestations appear as Signs and Symptoms: Sign and Symptoms

Sign-Manifestation that is noted by an observer Example: Reddened throat, Fever

Symptoms-Subjective complaint that is noted by the person with a disorder Example: Patient states: “My throat hurts”, “My body aches all

over”

Sign or Symptom?

Correct Answer: Sign!

Clinical Manifestations-continued Syndrome

Compilation of signs and symptoms that characterize a disease-Certain disorders present with various signs and symptoms, that when clumped together, meet the disease criteria

Complications-possible adverse consequence of disease or treatment Example: drug reaction: itchy skin and hives after

new antibiotic Sequelae-impairment following disease or caused by

disease Example: diabetes mellitus is #1 cause of blindness

Down Syndrome

Complication VS Sequelea

Drug Reaction after penicillin use

Complications of diabetes mellitusSequelea would be if Right Foot would need to be amputated

Clinical Course

The way a disease evolves in a person This can occur as an acute, subacute, or chronic course

Acute disorder can be severe but is self-limiting (will not continue to progress)

Example: fractures after motorcycle accident Chronic disease can run a continuous course or have

periods of exacerbations (heightened symptoms) and remissions (decrease in symptoms)

Subacute disease is not as severe as acute or as long lasting as chronic…is intermediate in duration and severity

Levels of Prevention of Disease Though we are concerned with disease identification and

treatment, nurses and healthcare providers are involved in prevention of disease as well. This can happen in the community at health fairs, doctor’s offices, hospitals, schools, on the job, etc.

If a disease has not occurred and our aim is prevention, we are involved in Primary Prevention.

If a person is at risk for certain diseases and we are screening them so they can have early treatment, we are involved in Secondary Prevention.

If the person is now diagnosed with a disease or disorder, then we want to help the client manage their disease as effectively as possible. This is Tertiary Prevention.

Levels of Prevention of Disease Primary Prevention

Happens at level of community, outside of hospital setting. Aim is to remove risk factors for disease. Folic acid to pregnant women to prevent certain diseases in fetuses Immunizations to children to prevent communicable diseases Promotion of seat belt use, healthy lifestyles

Secondary Prevention Detects disease early when patient has no symptoms of disease so that treatment

can cure or stop progression of disease. Occurs in clinical setting, so nurses are involved heavily Papanicolau (Pap) smear to detect cervical cancer Colonoscopy to detect colon cancer, abnormal growths in intestine Lab tests to check for high cholesterol

Tertiary Prevention Clinical interventions to prevent further deterioration after diagnosis of disease

Blood pressure management after a heart attack Skin protection after skin cancer diagnosis

Studying Tips for Pathophysiology

This course is designed differently from other nursing courses. Your other courses have a focus heavily on your role as a nurse. This course provides a foundation of knowledge that will aid you in how to assess and treat your client. In order to know what to do as a nurse, you need to know what is happening with the client. Therefore, nursing actions will not be emphasized as much as the pathophysiology, clinical manifestations, and treatments of the different disease processes you will be studying.

Studying Tips for Pathophysiology

In your prerequisite Anatomy and Physiology courses, you learned the “normals”. You will not receive an in-depth review of this information, since the focus will be on the “abnormals”. If you need to refresh A & P, please take time to do this now.

Get familiar with the textbook. If you think the text is overwhelming, consider a Review book that may be easier to read-though you may have to refer to the text for information that may not be provided in a Review book.

Studying Tips for Pathophysiology

Study smarter, not harder. You will be learning about many diseases over the course of the semester…there is no way to memorize this information. You need to understand and conceptualize the differences between the diseases, and sometimes they are very similar. Draw pictures, charts, use flashcards, techniques to help differentiate, compare and contrast the concepts.

Don’t sweat the small stuff. What’s common is common in medicine-don’t waste time fretting over rare complications or findings…stick to what is emphasized in lecture, syllabus.