1. 1 Welcome to Biology 274 - Pathophysiology Please be sure you initialed the attendance sheet! You should do this each time you come to lecture.

2. 2 General Information Who am I? –Greg Erianne, Ph.D. –Office SH 205 –Office Hours Wednesdays 9:30 am – 10:30 am Fridays 9:30 am – 10:30 am I will be available Wednesday 3:30-4:30 pm –E-mail - CCM: gerianne@ccm.edu –Telephone; 973-328-5377 (voice mail)

3. 3 Emergency Evacuation Procedures Emergency evacuation may be required when there is an actual or potential danger to the occupants of any building as a result of fire or other emergency situation. When a fire alarm is sounded, all occupants must leave the building(s) via the nearest exit and proceed immediately to the designated staging area and remain 50 feet from any building. Fire Marshals will direct the evacuation. All walkways and roads must remain clear for emergency vehicles. Take all belongings with you. You will remain there until the all clear is sounded, or a Fire Marshal directs you to a remote staging area. Evacuation of physically disabled individuals will be assisted or coordinated by the faculty at the site. DO NOT USE ELEVATORS DURING THE EVACUATION PROCESS. The evacuation staging area for this classroom or laboratory is: DH 100-level Classrooms Rear exit to walkway; move at least 50’ from building

4. 4 Overview of Today’s Lecture Course Intro, Web sites and Publisher Web site Course Description/Textbook Course Objectives and Syllabus Review Blueprint for success Ch. 1 –Health and Disease Ch. 2 –Cellular Pathology

5. 5 Course Web Sites Our Web site can be found on Blackboard in the list of courses in which you are enrolled: You will need your student ID and password for the Blackboard (BB) site Announcements (VERY IMPORTANT TO LOOK AT FREQUENTLY!) Syllabus, Policies, lecture and exam schedules Lecture slides used in class (in both ppt and pdf formats) Supplementary online materials for Lecture (added as needed) Lecture Exam Study Guides, Suggested Study Method Links to some other sites Your grades for the course Wolters Kluwer’s Web site associated with your course textbook –http://thepoint.lww.com/http://thepoint.lww.com/ Supplemental: http://gserianne.com/science/GerianneBio274 –Printing slides and other materials (see email I sent)

6. 6 Textbook & Study Guide Course Description –Lecture / discussion format Lectures will generally follow McConnell’s The Nature of Disease, 2nd edition closely Use your topic outline as a guide –Figures used for class –Reading assignments must be done BEFORE you come to class. Remember this is an upper level course and you are expected to already know the basics.

7. 7 Major objectives of this course In general, you will… –Master the objectives listed in the TNOD Study Guide –Develop a further mastery of scientific/biomedical terminology –Develop an appreciation for the way in which a disturbance of homeostasis causes disease –Further develop your ability to think logically and critically Let’s review the syllabus, policies, and handouts…

8. 8 Grading Summary for BIO 274 Lecture Exams Lecture Exam 1 22.5 pts Lecture Exam 2 22.5 pts Lecture Exam 3 22.5 pts Lecture Exam 4 22.5 pts TOTAL 90 pts Attendance/Participation 10 pts TOTAL 100 pts Letter Grade Numerical Average GPA Quality Points A93.0 – 100.04.00 A-90.0 – 92.93.67 B+87.0 – 89.93.33 B83.0 – 86.93.00 B-80.0 – 82.92.67 C+77.0 – 79.92.33 C70.0 – 76.92.00 D60.0 – 69.91.00 F< 59.90.00

9. 9 Suggestions for Studying Most importantly…keep up! –Make a schedule (plan your work, and work your plan!) –ALWAYS read what we’re going to do in lecture BEFORE coming to lecture –Use SQ3R method for better reading retention –When making notes, use your own words –Be sure to do Case Notes, Pop Quizzes, and Chapter Challenges at end of each Chapter (exam questions!) –Use your Study Guide (Paulson and Valasek) – exam questions will be taken from the material there. –Might want to write your Study Guide answers on a separate piece of paper so your Study Guide will still be blank when preparing for exams. –Only AFTER you’ve attempted to answer the Study Guide questions, check your answers.

10. 10 Notes on Material We Will NOT Cover We are not going to cover in class: –Chapters 16 & 17; Male/Female Reproductive Disorders –Chapter 20; Disorders of the Senses –Normal Anatomy & Physiology – we will review this very briefly, but you should read this in advance of coming to lecture –Any sections omitted from Textbook Reading pages in the Course Schedule –Any sections I decide we will not cover in class as the semester progresses

11. 11 Chapter 1 Health and Disease The Nature of Disease Pathology for the Health Professions Thomas H. McConnell

12. 12 Your Textbook’s Approach to Pathophysiology Part I: Mechanisms of Health and Disease (Exam 1) –Also called General Pathology –General mechanisms of disease Part II: Disorders of Organ Systems (Exams 2 & 3) –Also called Special Pathology –Diseases of Specific Organ Systems Part II: Disorders of the Stages and States of Life (Exam 4) –Application of general and special pathology to stages of life

13. 13 Pathophysiology – the study of the underlying changes in body physiology that result from disturbance(s) in homeostasis, i.e., disease or injury. It seeks to: - Understand mechanisms of disease - Examine how/why alterations occur during disease - Understand how these alterations produce signs and symptoms of disease Pathogenesis – Pattern of changes, or stages, occurring during the development of the disease Anatomic Pathology – examines structural alterations (lesions) in cells tissues and organs. May be gross or microscopic Clinical Pathology – Studies functional aspects of disease by laboratory analysis of tissue, blood, urine, other body fluids Introduction to Pathophysiology

14. 14 Disease and Structure/Function WHAT IS DISEASE? Failed homeostasis Anatomy and physiology gone wrong –Abnormal form, abnormal function –Structural disorder >> functional disorder –Functional disorder >> structural disorder

15. 15 Some Introductory Terminology Etiology – cause of a disease (pathogens, environment, genetics, etc.) –Idiopathic: cause unknown –Iatrogenic: result of medical treatment –Nosocomial: result of being in a hospital environmenthospital environment Disease terminology –Acute: rapid onset, short-lived, distinct manifestations –Chronic: slow onset, long duration, indistinct manifestations –Remission: periods when signs/symptoms diminish –Exacerbation: periods when signs/symptoms worsen –Complication: onset of additional disease –Sequellae: events that result from disease or trauma

16. 16 More Introductory Terminology… Clinical manifestations – evidence of disease –Signs: objective, measurable evidence of disease –Symptoms: patient-reported, subjective experiences –Prodrome: vague symptoms (insidious), prior to full-blown disease Latent period (incubation): disease present, but no symptoms (subclinical since no evidence of disease yet) Syndrome, e.g., AIDS, SIDS, ARDS: –Group (constellation) of symptoms that occur together – May be caused by several interrelated problems See your textbook on pp. 4-5 for terms on last three slides

17. 17 How Do Scientists Study Disease? Pathology is the study of disease in individuals –Lesion, etiology, pathogenesis, pathophysiology Epidemiology is the study of disease in populations –Incidence: # new cases per year –Prevalence: # people with the condition at any moment –Morbidity: # of people with an illness or complications of an illness (can refer to incidence or prevalence) –Mortality: # of people dying from disease in a given amount of time

18. 18 What Causes and Influences Disease? All disease is due to one of two factors: –environmental injuries (factors, influences) –genetic defects (factors, influences) Determinants of health can indirectly influence disease –Personal habits, social and economic factors, environmental influences

19. 19 How Are Medical Tests Interpreted? Healthy and sick refer to whether or not the patient actually has a disease Normal and abnormal describe observations and measurements.

20. 20 Combining Healthy/Sick and Normal/Abnormal

21. 21 Sensitivity and Specificity Sensitivity –The ability of a test to be positive when disease is present –Mathematically: TP / (TP + FN) –*Sensitivity rules OUT Specificity –The ability of a test to be negative when the disease is absent –Mathematically: TN / (TN + FP) –*Specificity rules IN See Study Guide: Sp-IN SN-Out

22. 22 Application of Sensitivity/Specificity Positive Test Negative Test Total Sick (diseased) Well (not diseased) Total Population: 100,000 Actual Disease Prevalence: 1% (1,000 per 100,000) Sensitivity: 98% Specificity: 85% Test Results

23. 23 Application of Sensitivity/Specificity Positive Test Negative Test Total Sick (diseased) 980201,000 Well (not diseased) 14,85084,15099,000 Total15,83084,170100,000 Population: 100,000 Actual Disease Prevalence: 1% (1,000 per 100,000) Sensitivity: 98% Specificity: 85% Test Results

24. 24 Sensitivity First; Specificity Second