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Mechanism of Disease Diagnosis
Treatment NOTES Dr. Jay Shahed
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Pathophysiology

• The study of the physiological mechanism of a
  disease.
• Including
• The abnormal cellular activity
• The description of the causes of the disease
• The traits and effects of abnormal conditions.

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Pathogenesis

• The source or cause of the illness including its
  course of development.
• Stages
• Incubation period
• Symptomatic period
• Remission period

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TYPES OF DISEASES

• Acute
• Sudden onset
• Brief course
• Resolves or kills individuals.
• Chronic
• Slow development or intermittent.
• Last longer than 6 months
• Irreversible.

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PREDISPOSING FACTORS (RISK FACTORS)

• The factors that make individuals more vulnerable
  to disease
• AGE
• Young Vs. Old
• SEX
• Male Vs. Female
• LIFESTYLE
• Habits, occupations
• ENVIRONMENT
• Pollution, living areas
• HEREDITY
• Genetic inheritance

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GENETIC DISEASES

• Diseases that are caused by changes in the
  genetic code or Mutations
• CHROMOSOMES
• Inside the nucleus
• DNA
• Double Helix
• Inside the Chromosomes
• GENES
• Inside the DNA
• Sources
• Chemicals
• Radiation
• Viruses

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INFECTION

• Causative pathogenic agents
• Bacteria
• Viruses
• Fungi
• Protozoa

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Local infection

• Cardinal Signs
• REDNESS
• HEAT/FEVER
• PUS
• SWELLING
• PAIN
• ENLARGED LYMPH NODES

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Widespread infection ( Sepsis )

• Signs and Symptoms
• HEADACHES
• BODY ACHES
• FATIGUE
• LOSS OF APPETITE
• DELIRIUM

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Result of pathogenesis

• Direct invasion and destruction of tissue
• Intoxication or poisoning of part of body

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SOURCES OF INFECTION

• Endogenous
• Originating within the body
• Exogenous
• originating outside the body

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MODES OF TRANSMISSION

• Direct contact
• Indirect contact
• Inhalation
• Ingestion

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COMMUNICABLE

• Contagious
• Disease transmitted directly from one person to
  another
• Example
• Tuberculosis (TB)

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CARRIERS

• Asymtomatic persons or animals that harbor
  pathogens inside their bodies that can be
  transferred to others.

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NATURAL DEFENSE MECHANISM

• Natural Mechanical Chemical barriers
• Stomach acidity, Skin, Cilia, normal flora
• Inflammatory response
• Immune response

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EXTERNAL TREATMENTS TO AID IMMUNE SYSTEM

• Antimicrobial therapy
• Antibiotics, Antifungal, Antiviral, Antiparasitic
• Analgesics
• Antipyretic
• Adequate fluid intake
• Rest
• Isolation of patient
• Sterilization and hand washing

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INFLAMMATION AND REPAIR

• Inflammation
• The normal protective response of the body to an
  injury or disease.

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Acute (Local) inflammatory reactions

• Cardinal signs and symptoms
• REDNESS
• O2
• HEAT
• Blood
• PAIN
• Pain from swelling
• SWELLING
• Fluid escape from tissue and cells

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Widespread systemic inflammation

• Cardinal signs and symptoms
• FEVER
• MALISE
• LOSS OF APPETITE
• ELEVATED WHITE BLOOD COUNT

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Mechanism of Inflammation

• Exudative response
• Destroy pathogens, dead tissue and digest
  bacteria.
• Vascular changes
• Dilation of blood vessels allow fluid leakage
  where chemicals are released.
• Phagocytosis.
• The response is to prevent the spread of
  infection with the help of antibodies.

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HEALING AND REPAIR

• Mitosis
• The formation of new tissues
• Collagen
• Scaring is usually the result
• Must meet the requirements for a healing
  environment

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NEOPLASMS
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BENIGN

• Local
• Does not infiltrate
• Well differentiated
• Resembles original tissue
• Encapsulated
• Slow growing
• Arises from connective tissue
• Good prognosis
• Not life threatening

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MALIGNANT

• Metastasizes
• Spread throughout blood and lymph
• Serious
• Life threatening
• Bleed, ulcerate and become infected.
• Poorly differentiated
• Does not resemble the original tissue
• Can lead to Cachexia
• Death stages

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Diagnosis

• Medical history
• Lab screening
• Radiology
• Biopsy

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AFTER DIAGNOSIS

• Staging
• Degree of change in appearances
• Grading
• The extent to which the cancer has spread

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TREATMENT

• Surgery
• Radiation
• Chemotherapy
• Immunotherapy

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PROGNOSIS

• 5 year prognosis
• 4 out of 10 are still alive five years after
  diagnosis.

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The most frequent Cancer incidence in males

• Prostate
• Lung ( Most Death )
• Colon Rectum
• Bladder
• Lymphoma
• Oral
• Skin (Melanoma)
• Kidney
• Leukemia
• Stomach

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The most frequent Cancer incidence in females

• Breast
• Colon Rectum
• Lung ( Most Death )
• Uterus
• Ovarian
• Lymphoma
• Skin (Melanoma)
• Pancreas
• Bladder
• Leukemia

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MALNUTRITION

• Diet deficiency
• Disease that blocks body from breaking down
  essential nutrients
• (E.G. Anemia, obesity)

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IMMUNE DISORDERS

• Breakdown of bodily defenses
• Types
• Hypersensitivity
• Allergic reactions
• Autoimmune disease
• Self defense destruction
• Immunodeficiency disease
• Reduction of the production of lymphocytes
• Increase in the destruction of lymphocytes

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Mechanism of Hypersensitivity Reaction

• Antigens (Ag)
• Dust, mold, food, drugs, heat, cold, Radiation.
• Antibodies (Ab) Immunoglobulins (Img)
• Produced by the plasma cells
• Img E
• Ag-Img E complex will cause the release of
  Histamine
• Histamine
• Neurotransmitter that produces signs and symptoms
• Rhinites, sneezing, itching, swelling, couching,
  diarrhea, etc.

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Anaphylaxis

• SEVERE SYSTEMIC allergic reaction
• Glomerulonephritis
• Hashimotos disease
• Serum sickness
• Arthralgia
• Asthma

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Natural Risk factors

• AGING
• Leads to diminished bodily functions
• Screening examination should include
• blood cholesterol
• EKG
• Prostate ( PSA)
• Pap smear
• Mammogram
• UA ( Diabetes, Kidney)
• Other concerns
• Substance abuse, overmedication
• Loss of mental acuity
• Depression
• Nutritional problems

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• PSYCHOSOCIAL FACTORS
• Psychosocial disorder can alter the reaction of
  the individual to a disease
• Psychological Evaluation
• Cognitive
• mood
• Chronic diseases can alter the attitude and self
  esteem of the patient
• Anxiety, shock, denial, anger withdrawal,
  depression, acceptance.
• MENTAL DISORDERS
• Somatoform disorders

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DIAGNOSIS

• This involves a series of steps to assess and
  investigate the cause of disease.
• Medical history
• Integrate or interpret
• Physical examination
• Compare with normal findings
• Diagnostic tests and labs
• Compare with normal findings
• Integrate or interpret
• Formulate diagnosis, Plan treatment then Prognosis