Pathophysiology NSG 533 study guide graded A

What are the five essential components of pathophysiology? - 1. Etiology (Causative mechanisms) 2. Epidemiology (risk factors and distribution in populations) 3. Pathogenesis (disease mechanism) 4. clinical manifestations (signs, symptoms and diagnostic criteria) 5. Outcomes (cure, remission, chronicity, or death) The "why" of disease- what is the reason for it- what caused it to happen? May be simple/complex. - etiology Looks at the pattern of disease among groups or aggregates or populations. This component of disease represents the relationship between numerous population characteristics (e.g. age, ethnicity, socioeconomic status, geographic location) and the incidence and prevalence of disease. - Epidemiology Involves the sequence of events that occurs between the stimulus event(s) and the manifestations of the disease. - pathogenesis Tell an individual and their health care provider that something is wrong. e.g. Signs and symptoms - Clinical manifestations Are relatively easy to understand if you review their definitions (cure, remission, chronicity, or death) - Outcomes What are the 4 common mechanisms that characterize all cell injury and death? Give 2 examples of each. - 1. ATP depletion- Ischemia and Anemia 2. Oxygen and oxygen-derived free radicals- Chemical and radiation injury, ischemia reperfusion injury, microbial killing by phagocytes, and cellular aging 3. intracellular calcium and loss of calcium steady state- Ischemia and certain chemicals 4. Defects in membrane permeability- Certain medications that can lead to liver or kidney damage The disease mechanism that is the basis of much of the disease today- and most of the cases involve hypoxia. Refers to the inability of the cell to produce adequate energy to fuel normal activities of that particular cell type (cell membrane pumps and protein synthesis) and function. - ATP depletion A very inefficient method of ATP production (yields 2 ATP) - glycolysis Is a very efficient method of ATP production (yields 36 ATP) - Oxidative Phosphorylation What is the most common method of impairing oxygen and ATP production? - hypoxia Can lead to irreversible cell injury directly through impairment of energy production in the cell. - Ischemia What are the cellular events that occur with ischemia-induced- hypoxic injury? - 1. The amount of ATP production within the mitochondria declines 2. The drop in ATP causes NA-K- ATPase pump on CM to fail. Which then leads to increase in NA+,H2O, and Ca+ in cell and decrease in K+ in cell. 3. Increase in water in cell causes cell and it's organelles to swell. 4. When RER swell it's ribosomes fall off and protein synthesis stops. 5. ATP production through phosphorylation declines and glycolysis (anaerobic metabolism) increases. When glycolysis increases in the cell glycogen stores are depleted. 6. Glycolysis also produces lactic acid as by-product. Glycolysis also = intracellular pH decline ( the cell functions within narrow range of pH and even slight drop can incapacitate the cell). 7. Drop in pH causes clumping of nuclear material called pyknosis. Leads to fragmentation of the nuclear material (karyorrhexis) and then to dissolution of nuclear membrane (karyolysis). Decline in pH= rupture of already swollen lysosomes and release of proteolytic enzymes= autodigestion of cell contents and cell membrane. 8. Disruption of CM also increases Ca+ influx into the cell and organelles= activate proteases, endonucleases, and phospholipases that proceed to destroy the cell.