1. Mechanisms of Disease By: Mary Beth Vogel, BSN, RN-C

2. Not So Useless Facts! 50 million in US have HTN; @ 50% don’t know it bc it’s asymptomatic Cardiovascular disease is the #1 killer in the US CVA is the #1 cause of adult disability MVA is the #1 cause of death for teens In 2009, 104 million MVA were caused by drivers using cell phones; 200,000 of these were caused by drivers texting

3. Studying Disease Disease terminology Health—physical, mental, and social well-being—not merely the absence of disease Disease—an abnormality in body function that threatens health Etiology—the study of the factors that cause a disease

4. Studying Disease Disease terminology Idiopathic—refers to a disease with an unknown cause Signs and symptoms—the objective and subjective abnormalities associated with a disease Pathogenesis—the pattern of a disease’s development

5. Studying Disease Patterns of disease Epidemiology is the study of occurrence, distribution, and transmission of diseases in human populations Endemic diseases are native to a local region Epidemics occur when a disease affects many people at the same time

6. Studying Disease Patterns of disease Pandemics are widespread, perhaps global, epidemics Discovering the cause of a disease is difficult because many factors affect disease transmission Disease can be fought through prevention and therapy (treatment)

7. Pathophysiology Mechanisms of disease Pathophysiology—the study of underlying physiological aspects of disease 7 Categories of Mechanisms of Disease: 1. Genetic mechanisms 2. Pathogenic organisms and particles 3. Tumors and cancer Neoplasms

8. Pathophysiology Categories of Mechanisms of disease (Cont.) 4. Traumatic mechanism - Physical and chemical agents 5. Metabolic mechanism 6. Inflammation a. Autoimmune b. Inflammation 7. Degeneration

9. Categories of Disease Mechanisms

10. 1.Genetic Mutations Direct cause or an associated risk factor Ex: Hemophelia, Down syndrome, oncogene

11. 2. Infectious Mechanism Pathogenic organisms or particles Disease causing microorganisms Bacteria, fungus, virus, parasite, etc

12. Spread of Pathogens: Person to person Environmental Opportunistic invasion Transmission by vector

13. 3. Neoplastic Mechanism Cancers or neoplasms Abnormal cell growth/division Neoplasm Hyperplasia Anaplasia

14. 4. Traumatic Mechanism Physical or chemical causative factors Ex: lacerations, burn, contusion, fx, poisoning

15. 5. Metabolic Mechanisms Malnutrition Endocrine imbalance Ex: night blindness, ricketts, anemia, impaired post op wound healing, DM, hypothyroid

16. 6. Inflammatory Mechanisms A. Autoimmune B. Inflammation Ex: Lupus, asthma, crohn’s disease, RA Inappropriate or abnormally prolonged inflammation

17. 7. Degeneration Usually d/t aging Ex: DJD, osteoporosis, Dementia

18. Risk Factors Predisposing conditions Contribute to likelihood of dev illness May be minimized, controlled, eliminated Common risk factors and associated diseases?

19. Risk Factors Genetics Age Lifestyle Sleep Stress Environment Preexisting conditions Abuse: substance, physical, emotional Race Gender Socioeconomics Medical hx Nutrition Travel Trauma Obesity Immunocompromise

20. Prevention/Control Prevent spread of pathogens/control transmission Manage risk factors Aseptic techniques: sterilization, disinfection, antisepsis, isolation Vaccination: attenuated/weakened or inactive/killed Antibiotics Antivirals

21. Types of Pathogenic Organisms 1.Viruses 2.Prions 3.Bacteria 4.Fungi 5.Protozoa 6.Pathogenic Animals

22. Cancer Neoplasm – “new matter” – aka “tumors” Malignant or benign Metastasis Can be distinct lump or diffusely spread Most common: skin, prostate Most # CA related deaths are d/t lung CA Least common: pancreatic

23. http://www.cancer.gov/cancertopics/types/c ommoncancers http://www.cancer.gov/cancertopics/types/c ommoncancers http://apps.nccd.cdc.gov/uscs/toptencancers.aspx http://apps.nccd.cdc.gov/uscs/toptencancers.aspx

24. 1. Benign: Localized Encapsulated Grows slowly No metastasis Usually not life threatening Differentiated cells A.Benign Epithelial Tumors: Papilloma, Adenoma, Nevus B. Benign Conn Tiss Tumors: Lipoma, Osteoma, Chondroma

25. 2. Malignant: Not encapsulated Can metastasize by blood or lymph Rapid growth Undifferentiated cells Life threatening

26. A. Malignant Epithelial Tumors (carcinomas): Melanoma, Adenocarcinoma B. Malignant Conn Tiss Tumors (sarcomas): Lymphoma, Osteosarcoma, Myeloma, Fibrosarcoma Other Cancers: Neuroblastoma Cancers labeled acc to general organ location

27. What causes CA? Genetics Env Virus Lifestyle Aging cells Hyperplasia Anaplasia Diagnosing CA: Self exam Imaging Biopsy Blood testing

28. Major Forms of Cancer… Lung CA Colorectal CA Breast CA Prostate CA Uterine (including cervical) CA Urinary CA (bladder and kidney) Oral CA (lip, mouth, throat) Pancreatic CA Leukemia (cancer of blood tissue) Lymphoma (cancer of lymphoid tissue) Ovarian CA Skin CA

29. CA Warning Signs: Unusual bleeding/bruising Sore that doesn’t heal Change in wart/mole Lump/thickening Cough/hoarseness Chronic indigestion Change in bowel/bladder habits Bone pain Extreme fatigue Unexplained wt loss

30. CA Prognosis: Staging: (I-IV) size/extent of spread Grading: (A-D) degree of cell abnormality Also extent of lymph node and other organs involved

31. CA Imaging & Diagnosis Xray, CT, MRI, US, PET Biopsy & Blood tests CA Tx: Surgery Radiation Chemotherapy Laser therapy Immunotherapy CA Tx complications: Cachexia Death: tx complication or secondary infection

32. Inflammation

33. Inflammatory response Protective response, combo of body processes with goal of minimizing tissue injury and maintaining homeostasis Regeneration & replacement of tissues Signs of Inflammation: Redness Swelling/Edema Heat Pain

34. Types of Inflammation: Acute Chronic Localized Systemic Inflammatory response Inflammation Mediators: Kinins, prostaglandins, histamines Cause a series of events…

35. Irritant: Cell damage (intro of bac) causing the rel of inflamm med Inc bld vess permeability Chemotaxis Bld vess Dilation Inc bld vol and WBCs to area Inc WBCs, inc H2O to dilute and bld prot that encapsulate irritant WBC attraction and phagocytosis Redness Heat Edema Pain

36. Irritant = cell damage/release of inflamm med; causes 3 events: 1. Bld vessel dilation= redness/heat 2. Increase Bld vessel permeability: = edema/pain 3. Chemotaxis: WBC to site Inflammatory exudate = Pus (tiss fl w/ WBCs, pathogens, debris)

37. Irritant: Cell damage (intro of bac) causing the rel of inflamm med. Names of these? Redness Heat Edema Pain

38. Fever – purpose?? Pyrexia/febrile Systemic inflammatory response Pediatrics/geriatrics: altered fever response Increased temp kills/inhibits pathogens TX: ASA, Acetominophen, Ibuprofen, etc.

39. Meds to tx inflamm: Acetaminophen Antihistamines NSAIDs Steroids Is acetominophen an NSAID? Inflammatory Diseases: RA, Allergies, Lupus, Crohns Eczema, Chronic bronchitis, Asthma

40. Tissue Repair Regeneration Replacement = scar Keloid – abnormal scarring beyond original inj site Adhesion - internal

41. Review! The pt states they feel nauseous. Is this a sign or symptom? Name the 5 vital signs. Why are they signs? What is an ex of an acute illness? What is an ex of a chronic illness? What is an illness endemic to the northeast US? Name 2 current pandemics.

42. Disease Terminology 1.Health 2. Pathology 3. Pathophysiology 4. Disease 5. Sign 6. Symptom 7. Syndrome

43. 8. Acute 9. Chronic 10. Etiology 11. Idiopathic 12. Pathogenesis

44. 13. Communicable/infectious 14. Epidemiology 15. Morbidity 16. Mortality 17. Remission 18. Incubation 19. Convalescence

45. 20. Endemic 21. Epidemic 22. Pandemic