Introduction to Pathophysiology PDF

Introduction to Pathophysiology Department of Clinical Pharmacy College of Pharmacy Jouf University Email: [email protected] https://www.keithrn.com/2015/08/three-simple- strategies-to-situate-pathophysiology-...

Introduction to Pathophysiology Department of Clinical Pharmacy College of Pharmacy Jouf University Email: [email protected] https://www.keithrn.com/2015/08/three-simple- strategies-to-situate-pathophysiology- throughout-nursing-education/ 1  Learning outcomes After completing this session, students should be able to: 1. Differentiate the terms – pathology, physiology and pathophysiology 2. Explain the importance of pathophysiology 3. Use related terms in etiology, pathogenesis, clinical manifestations, diagnosis http://www.amazon.com/ and treatment, and homeostasis 2  Outline 1. Overview of pathophysiology 2. Components of pathophysiology 3. Topics of pathophysiology http://www.amazon.com/ 3 1. Overview of Pathophysiology Physiological changes, diseases and healthcare services  Pathophysiology is involved in physiological changes and disease management and partly in pharmacotherapy and healthcare services.  A human body has naturally undergo physiological https://www.wikihow.com/Study- changes even with or without the-Pathophysiology-of-Diabetes- any diseases. Mellitus 4  All patient’s diseases or disorders occur due to a ‘cause’ or ‘risk factors’ and they need some time to manifest its signs and symptoms, which called an ‘incubation or latent’ period.  Patients will eventually experience a certain health outcome that can be recovery, death, disability, relapse or recurrence, etc.  Therefore, appropriate healthcare services should be provided for them at various stages to improve the health outcomes. 5 Physiological changes, diseases and healthcare services Clinical course Nature of disease (natural history of disease) Symptom Outcome Cause Incubation & sign Risk factor or latent period Time Good Good Physiological changes birth death Prognosis Monitoring 1 prevention Early diagnosis Diagnosis Management 2 prevention Health promotion Risk factor mod. Rehabilitation Screening Patient health education Case finding Acute care Healthcare services Intermediate care Nursing home care Residential care Home care Palliative/hospice care 6 Definition  Pathophysiology or physiopathology is the combined word of pathology and physiology – pathos + physiology.  Pathology is a medical study to describe abnormal or undesired conditions, esp. STRUCTURAL changes in cells or tissues, due to an injury or disease. Pathos = feeling, suffering, disease -ology = study of 7  Physiology is a biological study to describe processes or mechanisms operating within an organism or body, i.e. body functioning.  Physis = nature, origin, function  Pathophysiology is the study of FUNCTIONAL changes, esp. in cells or tissues, that occur in the body as a result of an injury or disease, or simply “the study of disease mechanisms”.1 1 Copstead LC, Banasik JL, editors. Pathophysiology. 5 ed. Philadelphia, PA: Saunders; 2012. th 8 Pathophysiology is a must-learn for pharmacy and other health profession students. Why? 9 Why is pathophysiology important? Pathophysiology helps you to find answers to important questions about disease processes. 1) What is the cause of the disease and why is the disease developing?..........Etiology 2) What are the mechanisms for disease onset and progression?........Pathogenesis 3) What are the signs and symptoms of a disease?.........Clinical manifestations https://www.uv.es/freshage/ pathophysiology-of-alzheimer.htm 10 Why is pathophysiology important? 11 2. Components of Pathophysiology  To understand pathophysiology, you should acquire knowledge of the following topics: 1) Etiology 2) Pathogenesis 3) Clinical manifestations 4) Diagnosis and treatment https://www.wikihow.com/Study- 5) Homeostasis the-Pathophysiology-of-Diabetes- Mellitus 12 Etiology  Etiology is the study of cause of a disease.  Etiologic agents can be biologic agents (bacteria), physical forces (burns), chemical agents (poison) or nutritional excess or deficit.  Pathogen – an agent of disease, which is mainly a biologic agent, i.e. bacteria, virus, fungi, etc.  Multifactorial – many ‘risk’ factors  Idiopathic – no known cause or the etiology is unknown  Iatrogenic – caused by treatment or healthcare professionals 13 Pathogenesis  Pathogenesis is the sequence of cellular and tissue events that occur from the time of initial contact with an etiologic agent until the ultimate expression of the disease or origination and development of a disease  Onset – a starting point or time  Duration – a period of time  Latent period – the time from exposure to a pathogen, chemical or radiation until signs and symptoms appear  Incubation period – a latent period only for a pathogen or infectious agent, e.g. 3 – 5 days for bacterial pharyngitis 14 Example: Pathogenesis of diabetes mellitus In Diabetes Mellitus (DM) Pancreatic beta-cells destruction Years pass by Progression of beta-cell destruction Development of signs and symptoms 15  Disease – functional impairment of cells, tissues, organs or organ systems, e.g. hypertension The term ‘disease’ is used to include an injury, disorder, illness and syndrome.  Syndrome – A collection or set of signs and symptoms that characterise or suggest a particular disease, e.g. Down syndrome 16 Clinical manifestations  Clinical manifestations are the presenting signs and symptoms that describe the structural and functional changes of a disease.  Sign – an objective manifestation directly observed or measured by an examiner Ex. High temperature, high blood pressure, etc.  Symptom – a subjective manifestation, i.e. complaint or feeling, reported by a patient or someone else on behalf of the patient and difficult to observe or measure Ex. pain, dizziness, fever, etc.  Asymptomatic – no noticeable symptoms 17  Signs and Symptoms Local or systemic Acute, subacute or chronic  Local – a manifestation found at the site of disease, e.g. local swelling or redness, pain, etc.  Systemic – a manifestation presents throughout the body, e.g. fever, lethargy, high BP, etc. http:// www.differencebetween.info/ difference-between-signs-and- symptoms 18  Acute – begins abruptly and lasts a few days to weeks, e.g. common cold  Subacute – between acute and chronic manifestations  Chronic – happens gradually (or insidious, gradual onset) and lasts more than 6 months, e.g. stress ulcer, dyslipidemia, etc.  With chronic diseases, patients can have a remission (symptom-free period), e.g. rheumatoid arthritis, or an exacerbation (increasing symptoms or flaring of symptoms), e.g. asthma, etc. 19 Diagnosis and treatment  Diagnosis aims to identify a label for a disease (or formulate a hypothesis) based on patient’s manifestations, clinical investigations and laboratory tests.  Differential diagnosis – determination of which one of several diseases (or many hypotheses) may result in the manifestations  Prognosis is to forecast or predict how the patient will proceed through the disease process or a health outcome, i.e. recovery, death, disability, etc. 20  Excellent prognosis complete recovery Poor Prognosis increasing risk of morbidity and mortality  Morbidity – a diseased state, e.g. the morbidity rate (disease rate) of diabetes mellitus in a country being 60%  Mortality – death, e.g. the mortality rate (death rate) of breast cancer being 40%  Epidemiology – the study of factors determining and influencing the frequency and distribution of disease, injury and other health-related events in a population in order to prevent and control the health problems 21 Homeostasis Homeostasis is a dynamic balance in the body marked by the appropriate and effective response to stimuli, thereby keeping the body in balance with the steady state. Homeostasis is the crucial body goal!!! (confusing words: homeostasis vs. hemostasis) http:// www.assignmentpoint.com/ science/biology/ homeostasis.html 22  3. Topics of Pathophysiology  Pathophysiology can be divided into many topics based on body systems or disease groups.  Pathophysiology-I covers the following topics: 1) Altered cells and tissues 2) Cardiovascular diseases  Atherosclerosis  Hypertension  Coronary artery disease  Heart failure  Cardiac arrhythmia  Hyperlipidemia (dyslipidemia)  Venous thromboembolism 23  3) Neuropsychiatric disorders  Stroke & epilepsy 4) Hepatobiliary diseases  Hepatitis & liver cirrhosis  Pathophysiology-II covers the topics: 5) Gastrointestinal (GI) diseases  Nausea and vomiting  Peptic ulcer diseases  Gastro-esophageal reflex disease (GERD)  Diarrhea  Constipation 6) Respiratory diseases  Asthma  Chronic obstructive pulmonary disease (COPD)  Allergic Rhinitis  Pneumonia 24 7) Hematological disorders  Anemia 8) Endocrine diseases  Diabetes mellitus  Hypothyroidism  Hyperthyroidism Topics that do not include in the two courses are: Oncological disorders Musculoskeletal diseases Genitourinary diseases Infectious diseases Nutritional, fluid and electrolyte disorders 25 https://www.livescience.com/37009-human-body.html 26 Further Reading 1. Zdanowicz MM, McCorry LK. Essentials of human physiology and pathophysiology for pharmacy and allied health. Boca Raton, FL: CRC Press; 2018. 2. Huether SE, McCance KL, Brashers VL, Rote NS. Understanding pathophysiology. Amsterdam: Elsevier; 2017. 27 Post-test 1. From your study, what is the difference between pathology and pathophysiology’? Pathology ……………… Pathophysiology ……….. 2. If a patient wants to know the cause of his illness (or disease), this should be regarded as which part of pathophysiology? A. Etiology B. Pathogenesis C. Diagnosis D. Prognosis E. Disease identification 28 3. Which of the following terms indicates the dynamic state that the body tries to keep in balance every day? A. Morbidity B. Mortality C. Steady state D. Homeostasis E. Idiopathy 4. Mr. Amma has difficulty in breathing and some rashes throughout her body when he takes seafood this morning. What is called for the symptoms? Select TWO answers. F. Chronic G. Subacute H. Acute I. Local J. Systemic 29