Pathophysiology: Concepts of Human Disease PDF

Pathophysiology: Concepts of Human Disease First Edition Chapter 1 Introduction to the Basics of Pathophysiology Copyright © 2019 Pearson Education, Inc. All Rights Reserved L...

Pathophysiology: Concepts of Human Disease First Edition Chapter 1 Introduction to the Basics of Pathophysiology Copyright © 2019 Pearson Education, Inc. All Rights Reserved Learning Outcomes 1.1 Define the conceptual basis for and the language used in the study of pathophysiology. 1.2 Describe characteristics of risk factors associated with health and illness. 1.3 Outline the structure of this book/eText, including the pathogenesis and etiology of disease; the clinical manifestations of disorders; how pathophysiology is linked to diagnosis and treatment; and the impact of genetics, nutrition, and lifespan on health and illness. Copyright © 2019 Pearson Education, Inc. All Rights Reserved Learning Outcomes 1.4 Describe the study of epidemiology, and outline the leading indicators of morbidity and mortality in the United States. 1.5 Explain the importance of evidence-based practice. Copyright © 2019 Pearson Education, Inc. All Rights Reserved The Language of Pathophysiology Pathophysiology The study of functional alterations at the molecular, cellular, tissue, and organ system levels that are involved in disease states. Copyright © 2019 Pearson Education, Inc. All Rights Reserved The Language of Pathophysiology Pathology – Medical discipline – Structural alterations in tissues and organs – Closely related to pathophysiology – Involves specimen analysis ▪E.g., tissue, blood, urine, sputum Copyright © 2019 Pearson Education, Inc. All Rights Reserved The Language of Pathophysiology Histology – Subdivision of pathology – Study of microscopic anatomy of cells and tissues ▪Patient samples or tissue culture – Specialized stains ▪Identify various cell types ▪Study cellular organization ▪Analyze intracellular contents Copyright © 2019 Pearson Education, Inc. All Rights Reserved The Conceptual Basis of Pathophysiology Primary concepts – Fundamental principles of physiologic mechanisms ▪E.g., oxygenation, perfusion, tissue integrity Subconcepts – Biophysiologic processes related to primary concepts ▪E.g., myocardial infarction, pressure ulcers Copyright © 2019 Pearson Education, Inc. All Rights Reserved Figure 1.1 Concepts related to the pathogenesis of myocardial infarction in an individual with diabetes. Copyright © 2019 Pearson Education, Inc. All Rights Reserved Overview of Health and Illness Health – Absence of disease – Absence of disease-related functional changes Health and illness – Best viewed as points along a continuum Copyright © 2019 Pearson Education, Inc. All Rights Reserved Figure 1.3 An illness-wellness continuum. Copyright © 2019 Pearson Education, Inc. All Rights Reserved Overview of Health and Illness Disease – Situation that impairs functional ability ▪E.g., hypertension Illness – Individual’s subjective experience with disease – Influenced by personal factors ▪Beliefs, knowledge, cultural factors, overall health Copyright © 2019 Pearson Education, Inc. All Rights Reserved Overview of Health and Illness Disorder – Disruption of physiologic or psychologic function ▪E.g., cellular dysregulation due to leukemia Syndrome – Group of signs and symptoms – Signs and symptoms emerge from a disease state ▪E.g., acute coronary syndrome Copyright © 2019 Pearson Education, Inc. All Rights Reserved Risk Factors Risk factor – Anything that increases the risk for disease Sources of risk factors – Genetics – Lifestyle factors – Social determinants of health Copyright © 2019 Pearson Education, Inc. All Rights Reserved Risk Factors Modifiable risk factors – Can be changed ▪E.g., diet, smoking Nonmodifiable risk factors – Cannot be changed ▪E.g., age, race, genetic characteristics Copyright © 2019 Pearson Education, Inc. All Rights Reserved The Structure of Pathophysiology: Concepts of Human Disease Presentation of disorders and conditions – Etiology and Pathogenesis – Clinical Manifestations – Linking Pathophysiology to Diagnosis and Treatment Copyright © 2019 Pearson Education, Inc. All Rights Reserved Etiology and Pathogenesis Etiology The cause of a disease or injury. Copyright © 2019 Pearson Education, Inc. All Rights Reserved Etiology and Pathogenesis Etiologic agents – Exogenous: From external environment – Endogenous: From within the body Idiopathic: Cause undetermined Iatrogenic: Caused unintentionally – E.g., by treatment, diagnostic procedure, or error Copyright © 2019 Pearson Education, Inc. All Rights Reserved Etiology and Pathogenesis Pathogenesis The origin of the sequence of events to structural and/or functional alterations in cells, tissues, or organs resulting in disease; the underlying mechanisms responsible for the clinical manifestations of a disease. Copyright © 2019 Pearson Education, Inc. All Rights Reserved Clinical Manifestations Clinical manifestations include: – Signs and symptoms associated with a disease – Related alterations in diagnostic tests Copyright © 2019 Pearson Education, Inc. All Rights Reserved Clinical Manifestations Sign: Objective indication of disease – E.g., abnormal heart or lung sounds, rash, fever Symptom: Subjective indication of disease – E.g., pain, nausea, dyspnea, numbness Syndrome: Combination of signs and symptoms – Characteristic of a particular disease – E.g., acquired immunodeficiency syndrome Copyright © 2019 Pearson Education, Inc. All Rights Reserved Clinical Manifestations Acute disease: Appears quickly Chronic disease: Enduring with lasting implications Exacerbation: Increase in disease severity Remission: Decrease in disease severity Copyright © 2019 Pearson Education, Inc. All Rights Reserved Leading Indicators of Morbidity and Mortality Term Definition Epidemiology Study of how disease is distributed in populations and identification of the factors influencing the distribution Incidence Number of new cases of a disease or condition within a defined period and for a defined population Prevalence Number of individuals of a defined population who already have a disease or condition Copyright © 2019 Pearson Education, Inc. All Rights Reserved Leading Indicators of Morbidity and Mortality Public Health The science of protecting and improving the health of families and communities through promotion of healthy lifestyles, research for disease and injury prevention, and detection and control of infectious diseases Copyright © 2019 Pearson Education, Inc. All Rights Reserved Leading Indicators of Morbidity and Mortality Term Definition Mortality Number of deaths in a given population Morbidity Departure from physiologic or psychologic well-being and encompasses disease, injury, and disability Copyright © 2019 Pearson Education, Inc. All Rights Reserved Table 1.2 Leading Causes of Death in the United States in 2015 Cause Number of Deaths Heart disease 614,348 Cancer (all forms) 591,699 Chronic lower respiratory diseases 147,101 Accidents (unintentional injuries) 136,053 Stroke (cerebrovascular diseases) 133,103 Alzheimer disease 93,541 Diabetes 76,488 Influenza and pneumonia 55,227 Nephritis, nephrotic syndrome, and nephrosis 48,146 Intentional self-harm (suicide) 42,773 Copyright © 2019 Pearson Education, Inc. All Rights Reserved Leading Indicators of Morbidity and Mortality Healthy People 2020 - Leading Health Indicators Access to Health Services Clinical Preventive Services Environmental Quality Injury and Violence Maternal, Infant, and Child Mental Health Health Nutrition, Physical Activity, Oral Health and Obesity Reproductive and Sexual Social Determinants Health Substance Abuse Tobacco Source: HealthyPeople. (2017). Leading health indicators. Available at https://www.healthypeople.gov/2020/Leading-Health-Indicators Copyright © 2019 Pearson Education, Inc. All Rights Reserved Evidence-Based Practice Evidence-Based Practice “The conscientious, explicit and judicious use of current best evidence in making decisions about the care of the individual patient. It means integrating individual clinical expertise with the best available external clinical evidence from systematic research.” - Dr. David Sackett (1996) Source: Sackett, D., Rosenburg, W. M.C., Gray, A. M., Haynes, R. B., & Richardson, W. S. (1996). Evidence based medicine: What it is and what it isn’t. BMJ, 312, 71. Available at http://www.bmj.com/content/312/7023/71 Copyright © 2019 Pearson Education, Inc. All Rights Reserved Evidence-Based Practice Underlying Principle of Evidence-based Practice Practice decisions should be based on research studies that have been evaluated by using a set of consistent criteria. Copyright © 2019 Pearson Education, Inc. All Rights Reserved Evidence-Based Practice From Evidence-Based Guidelines to Evidence-Based Practice Evidence-based findings compiled into practice guidelines Practice guidelines form basis for identifying healthcare procedures and techniques supported by clinical evidence Guidelines and recommendations integrated into clinical practice by melding clinical expertise with research evidence Delivered care respects patient values and preferences Ignoring patient preferences and experience may lead to patient non-adherence due to conflicting goals or values Copyright © 2019 Pearson Education, Inc. All Rights Reserved Copyright Copyright © 2019 Pearson Education, Inc. All Rights Reserved