Pathophysiology is
distruption of normal body function due to disease or physiology
pathology
structutal or morphological abnormalities expressed as disease in cell, tissue, organ, whole
Disease is
impairment of cells, tissues, organ, whole to altered function that does not allow homeostasis
homeostasis is
dynamic steady state marked by regulation responces
Various types of Etiologies of pathology
Idiopathic, iatropic, congenital, nosocomial, genetic,
acute disease
severe disorder quick onset, usually self limiting
Chronic disease
long-term process exacerbation & remission, usually not curable
Subacute disease
between acute and chronic
Carrier state
no signs or symptoms, can transmit disease (typhoid mary)
Disease vs Syndrome
Disease: impairment due to altered body func, challenge to maintain homeostasis.
Syndrome: group of clinical symptoms & physical features that characterize a disorder
Examples of Syndromes
Down syndrome (trisomy 21) Cushing (increased ACTH) Fetal alcohol (ethanol preg) Turners (XO) Klinefelter's XXY Toxic Shock (S. aureus)
Down’s Syndrome Characteristics
Mental retardation, cloverleave face, epicathal fold, white spots in eyes, slanted eyes, Large tongue, congenital heart disease, Simian creasem shorter 5th finger, wide gap btw 1 & 2 toes
Cushing’s Syndrome
Female balding, Irreg Menses, Hirsutism
Fetal alcohol syndrome
epicanthal folds, flat nose, railroad track ears, thin upper lip, uptured nose
Turner’s syndrome
short, Webbed neck, Heart shapped face, coartation of aorta, broad chest
Klinefelter syndrome
Gynecomastia, female-like hips, no facial hair, testicular atrophy
Toxic shock syndrome
tampon use, IV drug use
Cell Adaptation definition
Prolonged exposure to exaggerated stim evokes cell, tissue, organ change. If stim stops, cells may revert
what are the 6 cell adaptations
Atrophy, Hypertrophy, Hyperplasia, Metaplasia, Dysplasia, Anaplasia
Atrophy Physiologic vs Pathologic examples
Decrease cell, tissue, organ size. Physiologic: Thymus, Ovaries, uterus, breasts after menopause, bones. Pathologic Ischemic organs kidneys due to atherosclerosis, testicular size, Alzheimers
Hypertrophy. Physiological & Pathological example
increase in tissue size from individual cell enlargement.
Physiological: Skeletal muscle enlargement.
Pathological: Heart (LV: afterload compensate) HTN
Hyperplasia definition and examples
Adaptive increase in number of cells to enlarge tissue. endometrial hyperplasia from E2. Hyperplastic polyps of the colon or stomach
Hypertrophy & Hyperplasia example
Uterine muscles during pregnancy.
HPB (hyperplastic prostate benign)
Metaplasia definition and example
Squamous metaplasia of bronchial epithelium from smoking. Gastric metaplasia of GE junction in Barrett Esophagus. Reversible but can progress to dysplasia.
1 bronchogenic cancer.
squamous cell carcinoma
Barrett’s Esophagus definition, risk factors.
Gastric acids change stratified squamous cells to hardy epithelium of stomach. Smoking, drinking, spicy foods.
Dysplasia definition & example
Disordered growth of tissues = chronic irritation or infection. Precancer. Cervical dysplasia (cervical intraepithelial neoplasia CIN) from PAP smear
CIN levels
CIN 1 = mild dysplasia
CIN 2 = moderate dysplasia; get tissue biopsy.
CIN 3 = Severe dysplasia: Biopsy
Anaplasia, names, example
Undifferentiated & uncontrolled growths. HALLMARK OF CANCER. Neoplasm, carcinoma, cancer, Malignancy.
Squamous Cell Carcinoma from cervix or lungs. Malignant Melanoma. Renal Cell Cancinoma.
What are the microscopic hallmarks of Anaplasia
1) cell and nucli have different pleomorphism (size and shape).
2) Nucli are irregular and hyperchromatic (Purple).
3) Extremely high nuclear: cytoplasm ratio (N/C ratio) = 1:1 vs 1:6 (normal)
4) Larger nucleoli within nucleus
5) Alot of mitotic figures (proteins present).
Pleomorphism is of Hallmark of
Cancer
Cellular necrosis definition . Difference between necrosis and autolysis?
Death of cells in living organism.
Necrosis is seen in living tissue (inflammation).
Autolysis seen after death.
4 types of necrosis
1) Coagulative: solid organs
2) Liquification: Brain.
3) Caseous: TB
4) Fat: Pancreatic, soaponification
Coagulative necrosis and exampls
most common forms (firm). Only solid organs, Heart, Kidney, Spleen, Liver due to anoxia (MI)
Neutrophils
Hall mark of acute inflammation.
Liquefactive Necrosis and examples
dead cells liquify into gel-like. Brain infarcts lead to fluid filled cavity = stroke. See Neutrophils
Caseous Necrosis and example
Coagulative cheese, TM in lungs, brain. Histoplasmosis and fungal infections.
Fat necrosis and example
lipolytic enzymes cause liquefication. Only fat tissue like pancrease.
Fat necrosis mechanism
degrade fat to glycerol and FFA. FFA bind with calcium to make soaps
Gangrene wet and dry
Bacteria infect necrotic tissue leads to coagulation and liquefied inflammation (adv decubitous ulcers). Dry = if necrosis dries out and becomes Mummy Black.
Conditions that lead to Gangrene
Infections after infartion in intestines or limbs due to atherosclerosis or diabetes.
Dystrophic Calcifications
Necrotic tissue attracts Calcium = calcification.
Macroscopic calcium deposits in dead tissue.
Dystrophic calcification
1) calcification atherosclerotic coronary arteries
2) calcification of Mitral or Aortic valves (Stenosis)
3) calcification breast cancers - mammography
4) Infant periventricular (brain) calcification seen in Toxoplamosis
Metastatic Calcifications and examples
Reflects deranged calcium metabolism (Not Cell Injury) - Increased Serum Calcium.
Hyperparathyroidism (PTH), Vit D toxicity, Chronic Renal failure, Calcium stones in gallbladder, kidney, bladder.
calcium stones are called
calcium oxalate