Patho

study of disease

study of physiological processes leading up to disease

study of CAUSE of disease

no identifiable cause

concurrent sets of s/sx

predicted course and outcome

symptoms subside or diminish

worsening of symptoms

returns wks/mths after cessation

onset of another disease or abnormal state

cellular functions which require energy

• energy-releasing process (transferred to ATP in the mitochondria)
• -proteins to amino acids
• -lipids to fatty acids (ketoacids) and glycerol
• -carbs to monosaccharides (glucose)

• no energy expenditure
• -diffusion....blood vessels
• -filtration...glomerulus (kidneys)
• -osmosis....cell membrane (depends on solution tonicity)

similar osmolarity as serum

• decrease in osmolarity
• -shift of fluid from solution into cells, from vessels into tissues

• increase osmolarity
• -shift of fluid out of cells, from tissues into vessels

• 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)

hormones secreted by endocrine cells travel via bloodstream to target cells

• localized
• -neurotransmitters at synapses
• -coagulation factors
• -hypothalmic releasing factors...pituitary

self stimulation (interleukins)

• -epithelial
• -muscle
• -connective
• -nervous

• -forms sheets that cover the body's outer surface, lines internal surfaces and forms glandular tissue
• -regenerative
• -malignant tumors-carcinomas

• -most abundant tissue; binds organs and tissues together, support, storage site
• -regenerative
• -malignant tumors-sarcomas

• -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

• -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

• -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

• -cellular injury
• -reduces blood supply (decrease oxygen, decrease waste removal)
• -localized injury
• -ex. occluded blood vessel

• •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

• •Mechanical – trauma, surgery
• •Thermal - electrical injuries, ionizing radiation, extremes of temperature
• •Extremes of temperature

•Biological – pathogens multiply, trigger immune/inflammatory

•Oxygen, water, nutrients, decreased waste removal

• -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

• -impt in NON-REGENERATIVE tissues (cardiac and skeletal)
• -ex. myocardium in response to prolonged elevated BP

• -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

• -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

• -disorderly-tissue dysfunction
• -ex. Changes responsible for an abnormal Pap smear

total dysfunction

• -(Facilitated diffusion)
• -Involves transport proteins
• -no energy expenditure
• -water and solutes through semipermeable barrier
• •Diffusion
• •Filtration
• •Osmosis
• *depends on solution tonicity

• •Energy expenditure
• •Large molecules or movement against a concentration gradient
• •Endocytosis - (pinocytosis, phagocytosis)
• •Exocytosis - secretion
• •Membrane potential (depolar/repolarization)

• –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

• -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

• •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

• 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

• -Above-normal growth rate
• -Encapsulated(non-invasive)
• -Differentiated cells of normal size, shape
• -Orderly tissue structure

• •Rapid, unceasing growth
• •Infiltrative, invasive
• •Loss of differentiation; anaplasia
• •Disordered,irregular
• •metastatic*

• 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

• -----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)

"altered tissue antigens"(BRCA1, BRCA2, HER2, AFP, CEA, CA125)

• -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

• -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

• -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