Pathophysiology Exam 1 Questions & Answers Correct 100%

What is pathophysiology? - Answer "...the study of functional or physiologic changes in the body that result from disease processes." (Gould, 2006) "... the study of the disorder or breakdown of the human body's function." (Copstead & Banasik, 2005) Explain the differences between pathology and pathophysiology. - Answer Pathology = "... the laboratory study of cell and tissue changes associated with disease" (Gould, 2006) Cellular changes may cause functional disturbance, so pathology = a component of pathophysiology Homeostasis - Answer Humans are continually in an internal state of self-regulation and self-adjustment Results in a relatively stable internal environment = dynamic steady state Most homeostatic control mechanisms operate based on negative feedback Homeostasis - Negative Feedback - Answer Control mechanism for particular body function senses a deviation from normal Controller opposes/negates the deviation and brings back to normal level If disease present: the "sensor" or "controller" may not operate effectively Disease and Illness Involves __________ Is a dynamic process due to: 1) 2) - Answer Involves a disruption of homeostasis Is a dynamic process due to: 1) Interaction between injury and reaction to injury 2) Signs and symptoms may change daily based on compensatory mechanisms and shift in biological equilibrium Characteristics of Disease - Answer Changes occur at cellular level (pathology) which... Result in changes at the organ level (pathophysiology) Disease is the sum of deviations from normal, not the abnormal state in and of itself (Copstead and Banasik, 2005) Process of Disease Manifestation - Answer Presence of an infectious agent is detected Infectious agent causes changes at cellular and organ level = alters homeostasis These changes present as signs and symptoms, which are also impacted by external factors All of these deviations from normal together = DISEASE Framework for Pathophysiology To understand a disease, need to consider three aspects of the disease process: 1) 2) 3) - Answer 1) Etiology: cause 2) Pathogenesis: how the disease develops 3) Clinical manifestations: functional consequences of altered homeostasis Etiology - Answer The causative factors of a disease, illness, or injury Idiopathic - Answer The cause of a condition is unknown Iatrogenic - Answer The cause of a condition is due to medical treatment or error (Ex: bladder infection after catheterization) There are many types of causative factors; one or more than one may be present depending on the condition - Answer Genetics Viruses Bacteria Degenerative changes Classification of Disease - Answer Intrinsic or Extrinsic (Physical Agents or Infectious) Classification of Disease - Intrinsic - Answer Inherited Congenital Metabolic Degenerative Neoplastic Immunologic Nutritional Deficiency Psychogenic Classification of Disease - Extrinsic (Physical Agents) - Answer Force Temperature Humidity Radiation Electricity Chemicals Iatrogenic Classification of Disease - Extrinsic (Infectious) - Answer Pathogenic organisms Viruses Bacteria Fungi Protozoa Pathogenic animals Insects Worms Pathogenesis - Answer How a disease develops or evolves = sequence of the disease Pathogenesis Will vary based on: 1) 2) - Answer 1) Causal agent 2) Type of cell, tissue, and organ affected Pathogenesis Immediate response to altered homeostasis is usually: 1) 2) - Answer 1) Depression of cells (fewer, hypo-responsivity) 2) Stimulation of cells (more, hyper-responsivity) Factors Affecting Pathogenesis - Answer Time Quantity Location Morphologic Changes Factors Affecting Pathogenesis - Time - Answer Disease staging Acute vs. chronic Factors Affecting Pathogenesis - Quantity - Answer How much of the pathogen is present How strong the bodily response Factors Affecting Pathogenesis - Location - Answer Varied cell responsivity based on location in body Factors Affecting Pathogenesis - Morphologic Changes - Answer The structural and associated functional changes associated with the disease Clinical Manifestations - Answer functional consequences of altered homeostasis Clinical Manifestations - Signs - Answer Objective and observable indicators Fever Reddening of the skin Palpable mass Clinical Manifestations - Symptoms - Answer Subjective feelings Nausea Pain Malaise Clinical Manifestations - Syndrome - Answer Syndrome: a collection of signs and symptoms that occur together Stages of a Disease - Answer Latent or incubation period Prodromal period Acute phase Convalescence Stages of a Disease - Latent or Incubation Period - Answer Time between exposure to an injurious or infectious agent and the appearance of signs and symptoms Stages of a Disease - Prodromal Period - Answer The appearance of the first S/S, indicating onset of disease (often non-specific) Stages of a Disease - Acute Phase - Answer S/S reach their full severity Stages of a Disease - Convalescence - Answer recovery stage of a disease Course of Disease - Answer Exacerbation: S/S are increased Remission: S/S subside Example: RA Exacerbation = increased joint pain and swelling Remission = decreased joint pain and swelling Example: MS Types of Disease - Answer Acute Chronic Types of Disease - Acute - Answer Relatively severe manifestation Runs a short course Types of Disease - Chronic - Answer May have intermittent acute episodes Generally more mild manifestation S/S develop gradually Tissue damage usually more permanent and long term Epidemiology of Disease - Answer The study of patterns of disease Used largely for the control of infectious diseases Epidemic: When a disease spreads to a large number of people at the same time in a given area Pandemic: Worldwide spread of a disease Factors Which Influence Patterns of Disease - Answer Age Ethnic group Gender Socioeconomic factors Lifestyle Geographic location Prevention of Disease - Primary Prevention - Answer prevention of disease by reducing susceptibility or exposure Improved nutrition Improved living conditions Improved sanitation Improved and accessible immunizations Health education and promotion Improved adherence to safety precautions Prevention of Disease - Secondary Prevention - Answer early detection, screening, and management of a disease Yearly physical exams Routine Pap smears and breast exams Prenatal testing Prevention of Disease - Tertiary Prevention - Answer once a disease is established Medical intervention Physical rehabilitation Psychological rehabilitation Surgical management As a physical therapist, why is studying pathophysiology important? - Answer Approach clients with better understanding of their disease or disability Make sound clinical judgments Establish appropriate goals & intervention plans HIV - Human Immunodeficiency Virus - Answer Attacks CD4 cells (T cells) which are part of the immune system and help fight off infection Over time, fewer CD4 cells → increase risk of infections and cancer (Average loss of 50-90 CD4 cells / ml of blood per year) Unlike some viruses, HIV never leaves the body No cure exists, but progression can be controlled with antiretroviral therapy (ART) If treated early and continuously, some people with HIV may have close to a normal life expectancy AIDS - Acquired Immune Deficiency Syndrome - Answer Final stage of HIV infection Diagnosed when CD4 level is less than 200 cells/ml of blood Not everyone with HIV reaches this stage (early treatment important!) Without treatment, people diagnosed with AIDS live only about 3 years HIV Origins - Answer Chimpanzees in Africa - Simian Immunodeficiency Virus (SIV) Chimpanzees hunted for meat - Humans came into contact with infected blood Some studies suggest that the virus jumped from apes to humans in late 1800s Slowly spread across Africa and then to other parts of the world First U.S. case recognized in 1981, but scientists now believe the virus has been in the U.S. since the mid to late 1970s How do you get HIV/AIDS? - Answer Transmitted primarily through sexual behaviors and needle / syringe use Anal sex - highest risk of transmission Vaginal sex - particularly if multiple partners Needle / syringe use Sharing needles / syringes / supplies HIV can live in a used needle for 42 days Mother to child Pregnancy, childbirth, or breastfeeding Body fluids that contain HIV Blood Semen & pre-seminal fluid Rectal fluids Vaginal fluids Breast milk What is HIV? - Answer HIV is a retrovirus - Uses RNA as its genetic material - Infects a cell, then inserts a DNA copy of its genome into the host cell in order to replicate = Reverse transcription Infects CD4 T-helper cells HIV is a lentivirus - Infection develops slowly Two types - Type 1 - More common in U.S. and Europe - Type 2 - More common in Africa Retrovirus - Answer Any of a group of RNA viruses that insert a DNA copy of their genome into the host cell in order to replicate (i.e. HIV) Lentivirus - Answer Any of a group of retroviruses producing illnesses characterized by a delay in the onset of symptoms after infection RNA vs. DNA - Answer DNA - Deoxyribonucleic Acid - "Like a blueprint of biological guidelines that a living organism must follow to exist and remain functional" - Self-replicating RNA - Ribonucleic Acid - "Helps carry out the blueprint's guidelines" - Synthesized from DNA when needed CD4 - T-Helper Cells - Answer Type of white blood cell (lymphocyte) Protects body from infection Activates immune response by sending signals when intruders like viruses or bacteria are detected What goes wrong? - Answer Normal Flow DNA makes RNA, then RNA makes protein Reverse Transcription HIV RNA → Reverse Transcriptase → HIV DNA Course of HIV / AIDS - Answer Phase 1 - Initial Infection Phase 2 - Clinical latency (chronic HIV infection)