1. Pathology
    study of disease
  2. pathophysiology
    study of physiological processes leading up to disease
  3. etiology
    study of CAUSE of disease
  4. idiopathic
    no identifiable cause
  5. syndrome
    concurrent sets of s/sx
  6. prognosis
    predicted course and outcome
  7. remission
    symptoms subside or diminish
  8. exacerbation
    worsening of symptoms
  9. relapse
    returns wks/mths after cessation
  10. complication
    onset of another disease or abnormal state
  11. sequelae
  12. epidemiology
  13. Anabolism
    cellular functions which require energy
  14. Catabolism
    • energy-releasing process (transferred to ATP in the mitochondria)
    • -proteins to amino acids
    • -lipids to fatty acids (ketoacids) and glycerol
    • -carbs to monosaccharides (glucose)
  15. passive transport
    • no energy expenditure
    • -diffusion....blood vessels
    • -filtration...glomerulus (kidneys)
    • -osmosis....cell membrane (depends on solution tonicity)
  16. isotonic
    similar osmolarity as serum
  17. hypotonic
    • decrease in osmolarity
    • -shift of fluid from solution into cells, from vessels into tissues
  18. hypertonic
    • increase osmolarity
    • -shift of fluid out of cells, from tissues into vessels
  19. mediated transport
    • can be passive or active
    • -passive-(facilitated diffusion) involves transport proteins
    • -active
    • *energy expenditure
    • *lg. molecules or movement against a concentration gradient
    • *endocytosis-(pinocytosis, phagocytosis)
    • *exocytosis- secretion (hormones)
    • *membrane potential (depolar/repolarization)
  20. hormonal signaling
    hormones secreted by endocrine cells travel via bloodstream to target cells
  21. paracrine signaling
    • localized
    • -neurotransmitters at synapses
    • -coagulation factors
    • -hypothalmic releasing factors...pituitary
  22. autocrine signaling
    self stimulation (interleukins)
  23. 4 types of tissues
    • -epithelial
    • -muscle
    • -connective
    • -nervous
  24. epithelial tissue
    • -forms sheets that cover the body's outer surface, lines internal surfaces and forms glandular tissue
    • -regenerative
    • -malignant tumors-carcinomas
  25. connective tissue
    • -most abundant tissue; binds organs and tissues together, support, storage site
    • -regenerative
    • -malignant tumors-sarcomas
  26. muscle tissue
    • -contractile tissue
    • -important source of body heat
    • -skeletal muscle(striated; voluntary)- non-regenerative
    • -cardiac muscle(striatved;involuntary)-non-regenerative
    • -smooth muscle(non-striated;involuntary)-regenerative
  27. nervous tissue
    • -highly specialized cells (neurons) and supporting cells (neuroglia) that receive and transmit electrical impulses very rapidly across junctions called synapses;designed for communication purposes
    • -non-regenerative
  28. hypoxia
    • -lack of oxygen
    • -single most common cause of cellular injury
    • *systemic injury
    • •Decreased amt oxygen in the air
    • •Loss or interference with hemoglobin function
    • •Decreased rbc production
    • •Diseases of respiratory & cardiovascular systems
    • •Poisoning
  29. ischemia
    • -cellular injury
    • -reduces blood supply (decrease oxygen, decrease waste removal)
    • -localized injury
    • -ex. occluded blood vessel
  30. Toxic injury (cellular injury)
    • Free radicals – injurious chemical bond formation generates unpaired, unstable electrons that disrupt cellular function. Most susceptible to damage: cell membranes ≠ transport, signaling
    • DNA in mitochondria = decreased energy = aging
    • •smoking, pollution, herbicides, radiation
    • •antioxidants (Vit A,C,E) – to protect against damage

    • •Chemicals agents – alcohol, lead, arsenic, CO, drugs
    • •toxic substances damages cell membrane ® increased permeability
  31. physical injury (cellular injury)
    • •Mechanical – trauma, surgery
    • •Thermal - electrical injuries, ionizing radiation, extremes of temperature
    • •Extremes of temperature
  32. infectious injury (cellular injury)
    •Biological – pathogens multiply, trigger immune/inflammatory
  33. Deficit injury (cellular injury)
    •Oxygen, water, nutrients, decreased waste removal
  34. atrophy (cellular adaptation)
    • -lack of use (broken limb-muscle)
    • -muscles shrink-decrease hormone/growth..poor nutrition
    • -ex. skin changes (ischemia) that occur on the legs and feet of an individuals with poorly controlled diabetes mellitus
  35. hypertrophy (cellular adaptation)
    • -impt in NON-REGENERATIVE tissues (cardiac and skeletal)
    • -ex. myocardium in response to prolonged elevated BP
  36. hyperplasia (cellular adaptation)
    • -increase demand on REGENERATIVE tissue
    • -ex. development of a callus on the hands of an individual involved in heavy physical labor
    • -ex. breast enlargement at puberty
    • -ex. enlargement of the prostate gland w/age
    • -ex. Thyroid gland’s response to hypersecretion of TSH
    • -ex. Liver’s response to chronic alcohol abuse
  37. metaplasia (cellular adaptation)
    • -change-adaptative strategy from chronic irritation (acid reflux)
    • -if continued on...=dysplasia
    • -ex. Changes that occur over the years in the respiratory tract of a smoker
  38. dysplasia (cellular adaptation)
    • -disorderly-tissue dysfunction
    • -ex. Changes responsible for an abnormal Pap smear
  39. anaplasia (cellular adaptation)
    total dysfunction
  40. passive transport
    • -(Facilitated diffusion)
    • -Involves transport proteins
    • -no energy expenditure
    • -water and solutes through semipermeable barrier
    • •Diffusion
    • •Filtration
    • •Osmosis
    • *depends on solution tonicity
  41. active transport
    • •Energy expenditure
    • •Large molecules or movement against a concentration gradient
    • •Endocytosis - (pinocytosis, phagocytosis)
    • •Exocytosis - secretion
    • •Membrane potential (depolar/repolarization)
  42. congenital (perinatally acquired disease)
    • –appear at birth or shortly after, may be multifactorial in combination with an inherited disorder but typically not caused by genetic or chromosomal abnormalities
    • •usually result from some failure in development during the embryonic stage/first 2 months of pregnancy
    • Can not be transmitted to offspring
    • •Inadequate oxygen
    • •Maternal infection - rubella
    • •Drugs - thalidomide
    • •Alcohol – fetal alcohol syndrome
    • •Malnutrition
    • •Radiation
  43. Hereditary (familial)
    • -result of metabolic breakdown cause by a lack of direction from a missing or compromised gene or chromosomal segment
    • Chromosomal disorders
    • -additions, deletions, translocations
    • Genetic disorders
    • -gene responsible for the production of a protein (enzyme or structural type) is missing or defective results in the accumulation of toxic metabolites®cellular dysfunction and alternations leasing to disease or death
  44. gene therapy
  45. Use of genes to treat or prevent disease.
    • •Replacing a mutated gene that causes disease with a copy of the gene from a healthy donor.
    • •Inactivating, or “knocking out,” a mutated gene that is functioning improperly.
    • •Introducing a new gene into the body to help fight a disease oftentimes via viruses
  46. genetic disorder transmission
    • Autosomal dominant: presence of disorder/trait (phenotype) ID’s individuals with the dominant gene
    • •phenotype will be the same (always be expressed) whether homozygous (DD) or heterozygous (Dd); only 1 copy of gene needed for expression
    • •diseased person will always have at least one affected parent
    • •if both parents are homozygous, all offspring will be affected
    • •if diseased parent is heterozygous, varies 50-75%
    • •no carriers
    • •male & female offspring affected equally
    • *Hunginton disease
    • *Marfan syndrome
    • *Familial hypercholesterolemia
    • *Polydactyly
    • *Achondroplasia
    • -Autosomal Recessive
    • Both parents must pass on recessive gene ® homozygous child with the expressed trait/disease
    • •carriers result when offspring receives 1 gene
    • •Offspring have 25% chance of being affected if have 2 carrier parents
    • •male & female offspring affected equally;
    • •consanguinity a factor (families, ethnic groups)
    • *Sickle cell disease
    • *Cystic fibrosis
    • *PKU
    • *Tay-Sachs
    • *Albinism
  47. Benign Tumors
    • -Above-normal growth rate
    • -Encapsulated(non-invasive)
    • -Differentiated cells of normal size, shape
    • -Orderly tissue structure
  48. Malignant Tumors (cancer)
    • •Rapid, unceasing growth
    • •Infiltrative, invasive
    • •Loss of differentiation; anaplasia
    • •Disordered,irregular
    • •metastatic*
  49. Cancer risk factors (controllable)
    • All cancers caused by cigarette smoking and heavy use of alcohol could be prevented completely
    • •ACS est. 169,000 deaths caused by tobacco use
    • •1/3 will be related to overweight or obesity, physical inactivity and poor nutrition and could be prevented
    • •Cancers related to infectious agent (HBV, HPV, HIV, H. pylori) could be prevented through behavioral changes, vaccines or antibiotics
    • •Many of the >1 million skin cancers could be prevented by protection from sun’s rays and avoiding indoor tanning
  50. Cancer risk factors (cont.)
    • -----Heredity (inheritance of CA susceptibility genes)
    • •BRCA1, BRCA2, HER2, NF-1, WT-1, p53

    • ---Environmental factors
    • •chemical agents (benzene, asbestos, dyes)
    • •pesticides/herbicides (agent orange)
    • •meds (diethylstilbestrol-DES)
    • •air pollutants
    • •radiation (UV, Xrays, sunlight)
    • •Microorganisms (chronic infections-HBV, HCV, HIV, HTLV-1, EBV, HPV, HHV8, H. pylori, Schistosoma mansoni)
  51. tumor cell markers
    "altered tissue antigens"(BRCA1, BRCA2, HER2, AFP, CEA, CA125)
  52. cancer grading
    • -Determines the degree of abnormality of the neoplasm. Microscopic exam of the tumor to determine degree of differentiation. Grades I to IV.
    • •Grade I – (well-differentiated) less aggressive and serious
    • •Grade IV (anaplastic)–
    • most aggressive and serious

    -Grading and staging are used to plan treatment and to help determine prognosis
  53. cancer staging
    • -Process of finding out the extent and spread of the disease.
    • -TNM system of the American Joint Committee on Cancer (AJCC) most commonly used
    • •T (tumor) – size of primary tumor & local spread
    • •N (nodes) –involvement of regional lymph nodes
    • •M (metastasis) - extent of metastatic involvement
    • -The stage of a cancer does not change over time, even if the cancer progresses
    • -Survival statistics and treatment by stage info of specific cancer types refer to the stage when the cancer was first diagnosed
  54. cancer treatment
    • -Goals of cancer treatment methods fall into three categories: curative, control, palliative
    • Surgery -debulking, majority of tumor removed
    • Radiation therapy -idea is that the rapidly proliferating and poorly differentiated cells are more likely to be injured by ionizing radiation than normal cells. Injurious to rapidly ¸norm cells (bone marrow, GI tract lining)
    • Chemotherapy -systemic treatment that allows drugs to reach the primary tumor as well as distant tumor sites. Most effective when used in combination (cocktail)-individually effective against the tumor and synergistic w/ea other
    • Immunotherapy -anti-tumor immune response
    • Anti-angiogenesis -stop tumors from making new blood vessels

    --Side effects: GI, bone marrow, hair, skin, reproductive tract
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