Last-Time Revision Notes: Pathophysiology with Definitions
Congestive Cardiac Failure (CCF)
Definition:
CCF is a clinical syndrome in which the heart is unable to pump sufficient blood to meet the
metabolic needs of the body.
Pathophysiology:
In CCF, impaired cardiac function leads to decreased cardiac output. This triggers compensatory
mechanisms such as activation of the sympathetic nervous system, renin-angiotensin-aldosterone
system (RAAS), and increased antidiuretic hormone (ADH) secretion. These result in
vasoconstriction, sodium and water retention, and increased preload and afterload, further
worsening cardiac performance. Fluid accumulates in lungs (left-sided failure) and peripheral tissues
(right-sided failure).
Thrombosis
Definition:
Thrombosis is the formation of a blood clot inside a blood vessel, obstructing blood flow.
Pathophysiology:
Thrombosis occurs due to Virchow's triad: endothelial injury, stasis or turbulent blood flow, and
hypercoagulability. These conditions promote platelet adhesion, activation, and aggregation, leading
to fibrin deposition and clot formation. This can cause ischemia or infarction in affected tissues.
Peptic Ulcer
Definition:
Peptic ulcer is a mucosal erosion in the stomach or duodenum due to acid and pepsin activity.
Pathophysiology:
It results from an imbalance between aggressive factors (acid, pepsin, H. pylori, NSAIDs) and
protective mechanisms (mucus, bicarbonate, mucosal blood flow). H. pylori and NSAIDs disrupt
mucosal integrity, increase acid secretion, and impair healing, leading to ulceration.
Hypertension (HTN)
Definition:
HTN is a condition in which blood pressure is persistently elevated above 140/90 mmHg.
Pathophysiology:
Hypertension involves increased systemic vascular resistance and/or cardiac output. Mechanisms
include increased sympathetic activity, RAAS activation, endothelial dysfunction, and sodium
retention. Chronic HTN leads to vascular remodeling, left ventricular hypertrophy, and end-organ
damage.
Ulcerative Colitis
Definition:
Ulcerative colitis is a chronic inflammatory bowel disease affecting the colon and rectum.
Pathophysiology:
It involves continuous mucosal inflammation starting from the rectum and extending proximally.
Immune dysregulation and genetic susceptibility contribute. Inflammation leads to ulceration, crypt
abscesses, and mucosal damage, causing diarrhea, bleeding, and abdominal pain.
Parkinsonism
Definition:
Parkinsonism refers to a group of movement disorders with symptoms like tremor, rigidity, and
bradykinesia.
Pathophysiology:
It is mainly due to degeneration of dopaminergic neurons in the substantia nigra pars compacta.
This reduces dopamine levels in the striatum, disrupting basal ganglia circuitry, and leading to
impaired motor control.
Diabetes Mellitus (DM)
Definition:
DM is a metabolic disorder characterized by hyperglycemia due to defects in insulin secretion or
action.
Pathophysiology:
Type 1 DM involves autoimmune destruction of pancreatic beta-cells, leading to absolute insulin
deficiency. Type 2 DM involves insulin resistance and relative insulin deficiency. Chronic
hyperglycemia causes microvascular and macrovascular complications.
Asthma
Definition:
Asthma is a chronic inflammatory airway disease with reversible airflow obstruction and bronchial
hyperresponsiveness.
Pathophysiology:
Allergens or irritants trigger inflammation, causing mast cell degranulation and cytokine release. This
leads to bronchoconstriction, mucosal edema, and mucus hypersecretion, resulting in airway
narrowing and symptoms like wheezing and dyspnea.
Inflammatory Bowel Disease (IBD)
Definition:
IBD is a group of disorders including Crohn's disease and ulcerative colitis that cause chronic
gastrointestinal inflammation.
Pathophysiology:
IBD involves immune system dysregulation, genetic predisposition, and environmental triggers.
Inflammation leads to mucosal damage, ulceration, and fibrosis, resulting in abdominal pain,
diarrhea, and malabsorption.
Chronic Obstructive Pulmonary Disease (COPD)
Definition:
COPD is a progressive lung disease characterized by airflow limitation that is not fully reversible.
Pathophysiology:
Chronic exposure to noxious particles (e.g., smoking) causes inflammation, fibrosis, and narrowing
of airways. Emphysema leads to alveolar wall destruction. These changes impair gas exchange and
lead to chronic hypoxia and respiratory symptoms.
Depression and Mania
Definition:
Depression is a mood disorder with persistent sadness; mania is an elevated mood state with
hyperactivity.
Pathophysiology:
Depression is linked to reduced monoamines (serotonin, dopamine, norepinephrine) in the brain,
HPA axis dysregulation, and neuroplasticity changes. Mania involves increased dopaminergic and
noradrenergic activity, with altered circadian rhythms and neuroinflammation.
Alcoholic Liver Disease
Definition:
It is liver damage due to chronic alcohol consumption, ranging from fatty liver to cirrhosis.
Pathophysiology:
Alcohol metabolism produces acetaldehyde and ROS, causing hepatocyte injury, inflammation, and
fibrosis. Repeated injury leads to steatosis, alcoholic hepatitis, and cirrhosis.
Pneumonia
Definition:
Pneumonia is an infection of the lung parenchyma causing inflammation and consolidation.
Pathophysiology:
Pathogens (bacteria, viruses, fungi) enter alveoli, triggering immune responses. Neutrophil
infiltration and cytokine release cause alveolar filling with exudate, impairing gas exchange.
Symptoms include fever, cough, and dyspnea.