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Unit 1
Basic Concepts of
Health & Disease
Paul Anderson
2011
Learning Objectives
Describe health and disease in terms of the homeostatic model of the human
body.
Explain how disease of cells, tissues or organs affects homeostasis and relate
selected disequilibria to their diseases of origin.
Explain how homeostatic responses may cause clinical manifestations of
disease.
Define the terms etiology, physiology, pathology, pathophysiology.
Define etiological factors and distinguish between genetic and environmental
factors.
Define multifactorial, congenital and acquired, infectious, contagious
(communicable) diseases.
Define clinical manifestations, signs, symptoms, syndrome.
Describe the process of diagnosing diseases and requirements of good lab tests.
Describe the clinical course & appearance of disease, defining the terms acute
and chronic diseases, preclinical, clinical, subclinical and carrier.
Compare how a disease is studied by means of epidemiology and by the study of
its pathogenesis.
Define mortality, morbidity, incidence and prevalence of diseases.
References: Porth, Pathophysiology, Ch. 1 pp. 2 - 9, Ch. 9 (Homeostasis)
Porth, Essentials, Introduction, pp. xxxi-xxxv, Ch. 7 (Homeostasis).
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What is Disease?
Disease can be defined as a recognisable
deviation from the normal structure and
functioning of a body system or its
components.
Diseases may also be called Disorders.
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damages
Glomerulonephritis
cells
epithelial cells
tissues
organs
Glomerular Epithelium
Kidney
Loss of
Filtration of blood
homeostatic
Urine formation:
function
Disequilibrium
Hypertension
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Hypotension
Ventricular
muscle
weakened
Hearts pumping
ability declines
(cardiogenic shock a dangerous
complication of
CHD)
Reduced
cardiac output
Examples of Disequilibria
DISEQUILIBRIUM
Fever
Edema
Hypertension
Hypotension
FACTOR AFFECTED
POSSIBLE CAUSES
Hyperglycemia
- elevated plasma
[glucose] -"blood sugar
Hypoxia
kidney disease
(causing fluid retention)
CV or kidney disease
hemorrhage or heart disease
Diabetes mellitus
Respiratory or CV disease
Disequilibrium remains
Further disequilibria may occur
Secondary disease may occur
Health
Disease
normal
abnormal
Normal Hypertrophy
increases cardiac
output & reduces
stress on heart
muscle
Health
Increased
Workload on
Heart
Local (Cellular)
Adaptation
Chronic hypertension
means heart must
generate higher
pressure to eject
blood
Abnormal Hypertrophy
may cause decline in
cardiac output
Disease
Porth fig 5-2
Hyperglycemia
Systemic Adaptation
Health
Normal blood sugar
level restored
Disease
Hyperglycemia remains
Further disequilibria may
occur (e.g. ketoacidosis,
dehydration)
Secondary disease may
occur (in skin, eyes,
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kidneys, nerves, arteries)
Increased
workload on
left ventricle
Left ventricle
hypertrophies
Decreased
cardiac output
Cardiac
Arrythmia
Overcompensation
may eventually cause
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Disequilibrium
Stimulus
activates
Negative
feedback
normally
turns off
stimulus
Clinical
Manifestation
of Disease
may
cause
Compensatory
Homeostatic
Response
Receptor
Sends
message
to
Integrating Center
Sends
message
to
causes
Effector
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Compensatory Responses may Persist in Disease State giving Clinical Manifestations
Disease
or Injury
Causes acute
hemorrhage
Blood Volume
Hypotension
Negative
feedback
Tachycardia
Clinical Manifestation
(Sign) of Disease
Arterial
Baroreceptors
Cardiac Accelerator
Center of hind brain
Compensatory
Homeostatic Response
Increased heart activity
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Definition of Pathophysiology - 1
Pathophysiology is the Physiology of Disease
Pathophysiology is a combination of
Pathology and Physiology
Definition of Pathophysiology - 2
Disturbance to Homeostasis
Local (Cellular)
normal
Health
studies
Physiology
Systemic
Adaptation
(Homeostatic
Control System)
abnormal
Disease
Pathology Studies
diseased
organs &
tissues
Pathophysiology
combination of pathology & physiology
Studies the
physiology of
disease
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Etiology
Etiology is the the study of the causes of disease
Etiological factors are factors that cause disease
Etiological factors may be Environmental or Genetic
Environmental Factors
Genetic Factors
Inherited gene or chromosomal mutations (alterations to DNA)
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Infectious Diseases
Infection is the presence and multiplication of a living
organism, virus or protein in or on a host organism.
Note - not all microorganisms are detrimental to health
(a normal microflora in the body is important for
health).
Agents of infectious disease (pathogens) include
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Clinical: shows signs and symptoms & positive test for antibodies.
Sub-clinical: If a disease is inactive (dormant). Most cases of
Tuberculosis- TB are latent TB: immune system is activated so person
gives a positive immune response test result.
Clinical Manifestation
of Disease
Clinical
becomes
Preclinical
No Clinical
Manifestation of Disease
may act as
carrier
SubClinical
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Disease
causes
Clinical Manifestations
of Disease
Symptoms
Homeostatic
Responses
Signs
Syndrome
Diagnosis
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Diagnosis of Disease - 1
Diagnosis is the designation of the nature of
the disease.
- Involves careful consideration of history
(symptoms) and physical examination (signs) .
- Requires determination of individual
normality by taking into account age, sex,
race, lifestyle, family history, etc.
- Often relies on information from
epidemiology and pathogenesis.
Diagnosis usually requires several pieces of
information such as laboratory tests.
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Diagnosis
Reliable: test can be repeated with same result
Valid: test is a true measure of the disease
Sensitive: test gives no false -ves - delays treatment
Specific: test gives no false +ves - creates stress
DISEASE
Present
Absent
Positive
TEST
RESULT
Negative
True
Positive
False
Positive
False
Negative
True
Negative
Epidemiology
Epidemiology measures disease frequency,
through the Incidence and Prevalence of disease in
populations using statistics
Mortality (death) rates
Morbidity (presence of disease & how disease affects
persons life over long term).
Morbidity Rates include
Incidence: % of new cases in a population at risk
in a specific time
Prevalence: % of people in population who have
the disease at a given time
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