Introduction to pathophysiology

E. ANOKYE KUMI
 What is Pathophysiology
• The physiology of altered health.
• Pathology (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 diseases
• Physiology deals with the functions of the human body.
• Science that provides understanding of the mechanisms of
disease (impaired physiology).
• Functional changes in cells, tissues and organs by disease and/or
injury that lead to the signs and symptoms of the disease
• Pathophysiology deals not only with the cellular and organ
changes that occur with disease, but also with the effects that
these changes have on total body function.
• Homeostasis
• The human body strives to maintain
internal stability.
• The process of maintaining normal
balance within the body is called
homeostasis.
• Negative feedback
• Positive feedback
• The essential variables of the internal
environment that are maintained within
limits acceptable are
• Concentration of oxygen and carbon dioxide
• pH of the internal environment
• Concentration of nutrients and waste
products
• Concentration of salt and other electrolytes
• Volume and pressure of extracellular fluid
• temperature
•Successful
compensation
•Homeostasis
reestablished
•Failure to compensate
•Pathophysiology
•Illness
•Death

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 Disease
• Change from normal
• A disease is a particular
abnormal condition that
negatively affects the structure or
function of all or part of an
organism and is not immediately
due to any external injury
• An interruption, cessation or
disorder of a body system or
organ structure that is
characterized usually by a
recognized etiologic agent or
agents, an identifiable group of
signs and symptoms, or
consistent anatomic alterations
Clinical course
• This describes the evolution of a disease.

• A disease can have an acute, subacute or chronic course

• An acute disorder is one that is relatively severe, short term

and with a sudden onset.

• Chronic disease implies a continuous, long-term process.

• It can a run a continuous course or can present with

exacerbations (aggravation of symptoms and severity of the
disease) and remissions ( a period during which there is a
decrease in severity and symptoms)

• Subacute disease is intermediate or between acute and chronic:

it is not as severe as an acute disease and not as prolonged as a
chronic disease.
 CLINICAL MANIFESTATIONS
• A clinical manifestation is the
physical result of some type of
illness or infection.
• Diseases can manifest in a
number of ways. Sometimes
the condition produces
manifestations, such as fever,
that make it evident that the
person is sick.
• In other cases, the condition is
silent at the onset and is
detected during examination
for other purposes or after the
disease is far advanced
• Signs and symptoms are terms used
to describe the structural and
functional changes that accompany a
disease
• A symptom is a subjective complaint
that is noted by a person with a
disorder. For example pain, difficulty
in breathing, and dizziness are
symptoms of a disease
• A sign is a manifestation that is noted
by an observer. An elevated
temperature, a swollen extremity, and
changes in pupil size are objective
signs that can be observed by
someone.
• Signs and symptoms may be related
to the primary disorder or they may
represent the body’s attempt to
compensate for the altered function
caused by the pathologic condition.
 Diagnosis
• A diagnosis is the designation or
identification as to the nature or
cause of a health problem
• The diagnostic process usually
requires a careful history and
physical examination
• The history is used to obtain a
person’s account of his or her
symptoms and their progression,
and the factors that contribute to a
diagnosis
• The physical examination is done to
observe for signs of altered body
structure and function.
• The development of a diagnosis
involves weighing competing
possibilities and selecting the
most likely one from among the
conditions that might be
responsible for the person’s
clinical presentation
• The clinical probability of a
given disease in a person of a
given age, gender, race, lifestyle,
and locality often is influential in
arriving at a presumptive
diagnosis
• Laboratory tests, radiologic
studies, computed tomography
scans, and other tests often are
used to confirm diagnosis
Disorder
• Abnormality, Irregularity, disturbance, or interruption of
normal functions. . Eg. Nutritional disorder

Syndrome
• A compilation of signs and symptoms that are
characteristic of a specific disease state. A number of
symptoms occurring together and characterizing a specific
disease.
Pathogens
•A pathogen is defined as an organism causing disease
to its host

Pathologic
•Indicative of or caused by disease
Pathogenesis
• Pattern of changes associated with the development of
diseases (natural course of the disease from exposure to
recovery). Description of how a particular disease
progresses.
Exacerbation
• Periods when symptoms become worse and more severe
Latent state
• No apparent clinical symptoms or signs.
Precipitating Factors
• Elements that trigger actual development of a disease.
Example: Poor diet and exercise can precipitate diabetes
Biopsy
• Excision of a part of the living tissue.
Eg. taking a piece of a tumor to examine.
Autopsy
• Examination of the body/organs after death. Performed to
determine the exact cause of death.
Predisposing factors
• Tendencies that promote a disease. Example: Genetic factor
leading to diabetes.
Remissions
• Manifestations of the disease subsiding or are absent.
Example: Leukemia following successful chemotherapy.
Sequelae
• Lessions or impairments that follow or are caused by a
disease.
• Residual outcomes of primary condition. Example: a scar
following a burn.
Complications
• Are possible adverse extensions of a disease or outcome
from a treatment
• New, secondary or additional problems.
Prognosis
• The expected outcome of
the disease, such as
recovery, chronic state,
survival rate.

• Prognosis affects
treatment decisions for
patients and health
practitioners.
• Etiology
The cause, set of causes, or manner of causation of a
disease or condition.
• Idiopathic
Relating to or denoting any disease or condition
which arises spontaneously or for which the cause is
unknown
• Iatrogenic
Iatrogenic disease is defined as a disease induced by a drug
prescribed by a physician; or after a medical or surgical
procedure.
• Nosocomial
infection(s) acquired during the process of receiving health
care that was not present during the time of admission.
 Etiologic Agents
• Biological
• Chemical
• Physical
• Nutritional (Excesses or
deficit)
Predisposing factors are
the risk factors that make a
person more susceptible to
developing a disease

• Age
• Sex
• Environment
• Lifestyle
• Heridity
1. Age (Newborn babies)
•immature immune system
•liver enzymes necessary for detoxification of some
substances are often lacking
•fewer nutritional reserves
•less body fat to insulate against cold

Elderly
•decrease in immune function
•decline in homeostatic mechanisms
•depression; isolation; malnutrition
2. Sex - some diseases are more prone to one gender
than the other
• men more likely to develop gout
• women more likely to develop osteoporosis
3. Genetic makeup (familial tendencies for: diabetes,
asthma, migraines, etc.)
4. Stress - increases body’s production of corticosteroids,
which decreases immune system function.
5. Lifestyle - personal habits in regard to diet, exercise,
weight control, smoking, alcohol consumption, sexual
practice
6. Occupation - exposure to loud noises, pollutants,
repetitive movements, heavy equipment, high places, etc.
7. Preexisting illness
illnesses can lower body’s resistance and make individuals
more susceptible to other disease
chronic illness interferes with proper function of some
body systems, therefore complicating disease
8. Environmental exposure
prolonged exposure to cold or heat can lower the body’s
resistance
exposure to allergens
long-term exposure to sunlight
long-term exposure to occupational chemicals
Precipitating factors are
factors that initiate or
promote the onset of any
illness, disease, accident,
or behavioral response
• Treatment is a medical intervention intended to remediate
a health problem, such as a disease or disorder
• Interventions
• Medication
• Surgery
• Exercise
• Nutrition
• Physical therapy
• Education
• Preventive
• Care given to prevent a disease
• Palliative
• Care given to prevent discomfort but not cure a disease.
 Epidemiology
• This is the study of the patterns of disease involving
population, examining the occurrence, incidence, prevalence,
transmission, and distribution of diseases in large groups of
populations/people
• Types
• Endemic disease: a disease that appears to be indigenous
to a particular area or region
• Epidemic: a disease that affects many people in a given region
at the same time
• Pandemic: spread to large geographic areas.

• Mortality: a measure of the number of deaths in a particular

population
• Morbidity: Morbidity is the state of being symptomatic or
unhealthy for a disease or condition
 Levels of Prevention
• Leading a healthy life contributes to the prevention of
disease. There are three types of prevention:
• Primary prevention is directed at keeping disease from
occurring by removing all risk factors. Eg. Immunization,
vaccination, counselling
• Secondary prevention detects the disease early when it is
still asymptomatic and treatment measures can affect a cure
or stop the disease from progressing.
• Tertiary prevention is directed at clinical intervention that
prevents further deterioration or reduce the complications
of a disease once it has been diagnosed.
 Additional Terminology
• Communicable disease – a disease that can be transmitted
from one person to another
• Localized disease – disease is confined to one area of body.
• Systemic (generalized) disease – disease that spreads
throughout the body or to many systems
• Asymptomatic (Sub-clinical) disease– a disease in which
symptoms are not noticeable to the patient; presence of
disease (signs) is detected by routine physical or tests
• Self-limiting disease – a disease that does not require
treatment to be cured; it will resolve on its own.