Introduction to Introduction to PathologyPathology

Fall 2009Fall 2009

FINALFINAL

TermsTerms

1.1. __________________________ is the study of disease. is the study of disease.

2.2. __________________ is any abnormal disturbance of is any abnormal disturbance of function or structure as a result of injuryfunction or structure as a result of injury

3.3. ____________________occurs after disease. This is the occurs after disease. This is the sequence of events producing cellular sequence of events producing cellular changes which produce manifestations.changes which produce manifestations.

4.4. ______________________________ are observable changes are observable changes

Types of Types of ManifestationsManifestations1.1. _________________________________:_________________________________:

– Complaints offered by the patients.Complaints offered by the patients. Headaches, nausea, aches and painsHeadaches, nausea, aches and pains

2.2. ________________________________:________________________________:

– Abnormal changes as observed by a physicianAbnormal changes as observed by a physician Can be acquired by touch, smell, tests or visual Can be acquired by touch, smell, tests or visual

inspectioninspection Includes fever, swelling, discoloration and rash.Includes fever, swelling, discoloration and rash.

EtiologyEtiology

Is the study of the cause of a disease.Is the study of the cause of a disease.

Common agents:Common agents:– VirusesViruses– BacteriaBacteria– TraumaTrauma– Heat, Heat, – Poor infection controlPoor infection control

Poor Infection ControlPoor Infection Control

__________ Infections- are those __________ Infections- are those that occur in a hospital or hospital that occur in a hospital or hospital like settinglike setting

– Are a result of 3 factors:Are a result of 3 factors: High prevalence of pathogens High prevalence of pathogens High prevalence of compromised hosts High prevalence of compromised hosts Efficient mechanisms of transmission Efficient mechanisms of transmission

from patient to patient from patient to patient

Iatrogenic DiseaseIatrogenic Disease

Adverse responses induced in a patient Adverse responses induced in a patient by a physicians manner, activity or by a physicians manner, activity or

therapy.therapy.

Ex: A collapsed lobe of the lung Ex: A collapsed lobe of the lung that that

occurred due a complication occurred due a complication during an arterial line placement.during an arterial line placement.

Acute vs. ChronicAcute vs. Chronic

1.1. _____________ disease_____________ disease– Quick onsetQuick onset– Lasts a short period of timeLasts a short period of time

Ex. PneumoniaEx. Pneumonia

1.1. __________________________– Presents more slowlyPresents more slowly– Lasts a long timeLasts a long time

Ex. Multiple SclerosisEx. Multiple Sclerosis

Identification and Identification and OutcomeOutcome

1.1. DiagnosisDiagnosis

2.2. PrognosisPrognosis

Technique Technique ConsiderationsConsiderations

1.1. Decrease techniqueDecrease technique– In diseases that are destructiveIn diseases that are destructive– Decreasing tissue densityDecreasing tissue density– Subtractive or lytic changesSubtractive or lytic changes

1.1. Increase techniqueIncrease technique– In diseases that increase tissue densityIn diseases that increase tissue density– Additive or sclerotic changesAdditive or sclerotic changes

EpidemiologyEpidemiologyIs the investigation of diseases in large groups.Is the investigation of diseases in large groups.

1.1. ______________________ is the number of cases in a given is the number of cases in a given populationpopulation

2.2. ______________________ is the number of new cases in a given is the number of new cases in a given time periodtime period

3.3. ______________________ are diseases in high prevalence in a are diseases in high prevalence in a certain areacertain area

4.4. ______________________ - substantially exceeds what is - substantially exceeds what is "expected," based on recent experience "expected," based on recent experience

Disease ClassificationsDisease Classifications

1.1. Congenital and HereditaryCongenital and Hereditary

2.2. InflammatoryInflammatory

3.3. DegenerativeDegenerative

4.4. MetabolicMetabolic

5.5. TraumaticTraumatic

6.6. NeoplasticNeoplastic

Congenital and Congenital and HereditaryHereditary

1.1. _______________ are present at birth _______________ are present at birth and result from genetic or and result from genetic or environmental factorsenvironmental factors

– 2-3% of all live births have one or more 2-3% of all live births have one or more congenital diseasecongenital disease

2.2. _______________ are developmental _______________ are developmental disorders genetically transmitted disorders genetically transmitted from either parentfrom either parent

Inflammatory DiseaseInflammatory Disease

Results from the body’s reaction to Results from the body’s reaction to a localized injurious agent.a localized injurious agent.

Types of inflammatory disease:Types of inflammatory disease:– ToxicToxic– InfectiveInfective– AllergicAllergic– AutoimmuneAutoimmune

Acute Local Acute Local Inflammatory DiseaseInflammatory Disease Characteristics:Characteristics:

– HeatHeat– RednessRedness– SwellingSwelling– PainPain– Loss of functionLoss of function

Capillary dilatationCapillary dilatation

Cellular necrosisCellular necrosis

Chronic Inflammatory Chronic Inflammatory DiseaseDisease

May not result in cell deathMay not result in cell death

More commonly it does not result More commonly it does not result in cell deathin cell death

Lasts for extensive periods of timeLasts for extensive periods of time

Repair from Repair from Inflammatory DiseaseInflammatory Disease

The repair of tissues is the body’s The repair of tissues is the body’s attempt to return the body to attempt to return the body to

normal.normal.

Tissue regenerationTissue regeneration Fibrous connective tissue repairFibrous connective tissue repair DebridementDebridement RemodelingRemodeling

InfectionInfection

Is an inflammatory process caused by a Is an inflammatory process caused by a disease causing organism.disease causing organism.

It invades, multiplies and causes injury.It invades, multiplies and causes injury. Generally localized infections causes Generally localized infections causes

inflammationinflammation VirulenceVirulence

– High virulence High virulence – Low virulenceLow virulence

Degenerative DiseaseDegenerative Disease

Are caused by a deterioration of Are caused by a deterioration of the body usually associated with the body usually associated with aging.aging.

Although some degenerative Although some degenerative diseases affect younger patientsdiseases affect younger patients

Metabolic DiseaseMetabolic Disease

Diseases caused by a disturbance of the Diseases caused by a disturbance of the normal physiologic function of the body.normal physiologic function of the body.

Metabolism is the sum of all physical Metabolism is the sum of all physical and chemical processes of the body.and chemical processes of the body.

Includes endocrine disorders and Includes endocrine disorders and imbalance of fluid and electrolytes.imbalance of fluid and electrolytes.

Endocrine SystemEndocrine System

The major glands are: pituitary, The major glands are: pituitary, thyroid, parathyroids, adrenal thyroid, parathyroids, adrenal glands, pancreatic islets, ovaries glands, pancreatic islets, ovaries and testes.and testes.

A disorder can be caused fromA disorder can be caused from– HypersecretionHypersecretion– Insufficient secretionInsufficient secretion

Fluid and Electrolyte Fluid and Electrolyte ImbalanceImbalance _______________ is the most common _______________ is the most common

fluid imbalancefluid imbalance– Caused by lack of water Caused by lack of water – Excessive loss of waterExcessive loss of water

_______________ mineral salts_______________ mineral salts– Potassium and sodiumPotassium and sodium

Depletion of electrolytes is caused by:Depletion of electrolytes is caused by:– Vomiting, diarrhea, and diureticsVomiting, diarrhea, and diuretics

Traumatic DiseaseTraumatic Disease

Diseases as a result of a mechanical forceDiseases as a result of a mechanical force– CrushingCrushing– TwistingTwisting– RadiationRadiation– Extreme temperaturesExtreme temperatures

Can involveCan involve– BoneBone– Soft tissueSoft tissue– SkinSkin– CapillariesCapillaries

Neoplastic DiseaseNeoplastic Disease

New or abnormal growth.New or abnormal growth.

Uncontrollable growthUncontrollable growth

NeoplasmNeoplasm– ___________: remain localized and non-___________: remain localized and non-

invasiveinvasive– ___________: continue to grow, spread and ___________: continue to grow, spread and

invade other tissuesinvade other tissues

MetastasisMetastasis

Spread of malignant cancer.Spread of malignant cancer.

Cancer is the general term to denote Cancer is the general term to denote malignant neoplasms.malignant neoplasms.

Ways of metastasisWays of metastasis– HematogenousHematogenous– LymphaticLymphatic– InvasionInvasion– SeedingSeeding

Staging of CancerStaging of Cancer

TNM system adopted in 1950’s is the standardTNM system adopted in 1950’s is the standard– American Joint Committee on CancerAmerican Joint Committee on Cancer– American Cancer SocietyAmerican Cancer Society– American College of RadiologyAmerican College of Radiology

Staging is the evaluation of the extent of Staging is the evaluation of the extent of cancer based on clinical findingscancer based on clinical findings

Treatment protocol is based on these findingsTreatment protocol is based on these findings

Provides indication of prognosisProvides indication of prognosis

TNM StagingTNM Staging

T: size of the tumorT: size of the tumor– Untreated primary cancer or tumorUntreated primary cancer or tumor

N: Regional lymph node involvementN: Regional lymph node involvement

M: Presence or absence of distant metastasisM: Presence or absence of distant metastasis

Numerical staging is usually designated Numerical staging is usually designated – T1 - T4T1 - T4– N1 - N4N1 - N4– M1 – M4M1 – M4

Cell DifferentiationCell Differentiation

Is a process in which cells mature into a Is a process in which cells mature into a functional and structurally specialized functional and structurally specialized

cell.cell.

__________________ tumor cells__________________ tumor cells– Resemble normal cellsResemble normal cells– Grow and spread a slow rateGrow and spread a slow rate

___________ or __________ differentiated___________ or __________ differentiated– Lack structure and function of normal cellsLack structure and function of normal cells– Grow uncontrollablyGrow uncontrollably

Grading of CancerGrading of Cancer

Is an attempt to estimate the degree Is an attempt to estimate the degree of malignancy of a neoplasm.of malignancy of a neoplasm.

Classified into 4 gradesClassified into 4 grades– Grade IGrade I– Grade IIGrade II– Grade IIIGrade III– Grade IVGrade IV