Spring 2012

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PathologyPathogenesis

DiseaseSigns vs. SymptomsDiagnosisPrognosis

Syndrome

Acute vs. Chronic diseaseSequelae

Etiology

Epidemiology

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Causes of DiseaseNormal agents

Bacteria, viruses, trauma, and heat

Poor infection controlNosocomial

Adverse reactions to medical treatmentIatrogenic

No known causeIdiopathic

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Technique Adjustments

Subtractive

Lytic

Destructive

Additive

Sclerotic

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Disease TrackingCDPH

NCHS

CDC

Monitoring

Trends

Epidemics

Intervention

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Life Expectancy

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Health Care Costs and Changes

Delivery MethodsAmbulatory careInpatient services

Health care costsIncreasing costsSources of funding

Medicare Medicaid Private insurance Cash

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Disease Classifications Hereditary

CongenitalInflammatoryMetabolicDegenerativeTraumaticNeoplastic

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What is the difference between Congenital and Hereditary?

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CongenitalIn utero

Maternal infections, radiation, trauma or drugs

Usually cannot be recognized before birth

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Hereditary Genetically transmitted from either parent to

childGenetic testing can detect these before birth

InterventionTerminate pregnancyMake decisions

46 chromosomes44 automsomal 2 are X and Y XY XX

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Hereditary Terms

Homozygous

Heterozygous

Dominant Genes

Recessive Genes

Codominant Genes

Mutations

Autosomal Dominant

Autosomal Recessive

Sex linked disorders

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Homozygous- genes are same for a traitBlue and blue

Heterozygous- genes differ from each parentBlue (recessive) and Brown (dominant)

Dominant Genes-always produce effect

Recessive Genes- traits manifest only if person is homozygous

Codominant Genes- both traits are expressed

AB blood types13

Autosomal Dominant -

Autosomal Recessive Transmitted from one generation to next.Affects males and femalesEither can transmit

Affected father + Unaffected Mother= ½ children will have

disease Not all will demonstrate

the traitSome may demonstrate

differentlyEX:

PolydactylyMarfan’s syndrome

Disorders when a person in homozygousParents may not show

disease but siblings may

EX: cystic fibrosis Tay-sachs Sickle cell anemia

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Sex Linked DisordersMutations- alterations in

DNA that become permanent hereditary change if they affect gonadal cells

Generally as a result of a defective X chromosomeY chromosomes are small

and carry few genesVirtually all are recessive

Most transmitted through heterozygous femaleTo sons1-2 chance of receiving

mutant gene

Affected fathers transmit to ALL daughters

EX:Color blindnessHemophiliaMuscular Dystrophy

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Inflammatory DiseasesWhat is inflammatory disease?

Body’s reaction to a injurious agent

Primary causes Invasion by microorganisms

Infective diseases Poisoning by biologic substances

Toxic diseases

Overreaction of body’s own defenses Toxic diseases

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4 Stages of Inflammation1) Alterations of blood flow and vascular

permeaabilityDilation of arterioles, capillaries and venulesProduces increased blood flow around injury siteCauses heat, redness and pain

2) Migration of WBC to injured tissueLeukocytosis occursMainly leuckocytes such as neutrophils and

macrophages

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4 Stages of Inflammation3) Phagocytosis

WBC engulf and digest infecting organisms

4) Repair of injuryRegeneration of normal cellsGranuation tissue

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InflammationChronic inflammation:

Damage caused by an injurious agent may not result in necrosis

Longer duration of inflammation periods

Acute inflammation:HeatRedness of skinSwellingPainLoss of functionElevated body temperature

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Redness

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Heat And Fever

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Swelling

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Pain

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Loss of Function

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Localized EdemaInflammatory Process Lymph obstruction

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Generalized

Edema•Usually occurs form CHF, cirrhosis and many renal diseases

•Gravity causes it to be more prominent in lower body•Sedentary persons

•Lower back•Lungs •Sacral area

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Traumatic

Disease that may result from mechanical forces such as crushing or twisting of a body part or from the effects of ionizing radiation on the body

FractureWoundBruise/contusion

NeoplasticDefined as: new abnormal tissue growth

Come from latin word “neoplasia” meaning new growth

Abnormal proliferation that are not governed by laws of normal cellsCell act as parasites competing with normal cells

for their metabolic needs

Onocology- study of neoplasmsDerived from greek word “oncos” which means

tumor28

All tumors have 2 basic components

1) The organ tissue is made up of proliferating neoplastic cells

2) The supporting tissue is made up of connective tissue, blood vessels and possibly lymphatic cells.

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Grading (Differentiation)Used to assess biologic behavior and choice

of treatment

Differentiated tumorsTend to grow slowResemble cells of origin

Poorly differentiated or undifferentiatedRapid growthExhibits atypical characteristics and does not

resemble cells of origin30

TNM SystemStaging of cancer

TNM system emerged in 1950s and endorsed by AJCCT—TumorN—Node (lymph node involvement)M—Metastases

Addition of numbers indicates the extent of malignancy and progressive increase in size or involvement of tumor

Tumor Word Roots

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Benign NeoplasmsClosely resemble their cells of origin in structure

and functionRemain localizedCan be surgically removed

Can still have severe consequencesEX:

Pituitay tumore can cause pressure and destruction of gland

Pancreas- excessive insulin can be fatalBrain and spinal cord- impair or alter CNS functionTrachea / esophagus- occlude air supply or

swallowing 33

Benign TumorsConsist of differentiated cells

Add suffix OMA to root word

Examples:FibromasChondromasAdenomaLipomasMyomasAngiomas

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Malignant NeoplasmsInvade and destroy adjacent structures

MetastasizePoorly or undifferentiated so it may be

impossible to determine origin

Cancer comes from the latin word crab, because it has fingerlike projections that resemble crablike claws

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Malignant Neoplasms

Carcinomas- epithelial originAffects epithelial cells, skin and mucus

membranesComes from greek word “karkinos” which means

crab

Adenocarcinoma- malignancies from glandular tissuebreast, liver, pancreas, and cells lining the GI

tract36

Malignant Neoplasms Cont.Squamous cell carcinoma- tumors of

connective tissueResemble stratified squamous epitheliaLungs, head and neck regions

Sarcomas- connective tissueHighly malignant and spread rapidlyBone, muscle, and cartilageLess common than carcinomas

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Metastatic Methods 41) Seeding- travels to distant sites and organs

2) Lymphatic-Spreads through lymphatic system 1) Especially lung and breast2) major metastatic route of carcinomas

3) Invasion1. Spreads to other areas in close proximity

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Metastatic Methods cont.4) Hematogenous- spreads through circulatory system

Tumor cells invade and penetrate blood vesselsTravel as emboli until they get stuckInvade wall in the vessel they are stuck Infiltrate to surrounding tissue

ExamplesAbdominal carcinomas metastasize to liver

Because of flow of the portal vein blood to that organ

Midline organs spread to vertebrae

Neoplasms in organs that drain into inferior & superior vena cava, such as kidneys spread to lung

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CarcinogensChemicals that alter DNA

Air and water pollutionCigarette smokeAsbestos

Sun, bombs, and radiation

Viruses that alter genetic material

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Treatment OptionsSurgical removal

Well localized tumors with no metastases

Radiation TherapyFast growing Poorly or undifferentiated tumors

ChemotherapyCytotoxic substances used to kill neoplastic cellsKills good cells to causing significant

complications

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DegenerativeDegenerative—Disease caused by a

deterioration of the body May occur following traumatic injury,

regardless of age

May occur as a hereditary illnessProcess of aging

Factors affecting the rate of agingHereditaryDietEnviromental factorsSedentary lifestyle

Degenerative Diseases

Atherosclerosis

Osteoporosis

Osteoarthritis

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Metabolic Disease

Disease caused by the disturbance of the normal physiologic function of the body

Metabolism is the sum of all physical & chemical processes in the bodyTo functionMaintain homeostasis

Metabolic DiseaseEndocrine disorders

Hypersecretion Insufficient secretion

Fluid and Electrolyte imbalances

Dehydration Insufficient water Loss of too much water

Can occur from: Vomiting Diarrhea Diuretics Athletic (very hard training)

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