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Conspectus of disease

Concept, Etiology, Pathogenesis and Outcome of a disease

What is Health?
A state of complete physical, mental and social well-being, and not
merely the absence of disease or infirmity.
Factors affecting health:
Inherent factors:
Age elderly and young ones because of reduced immunity
Ethnic origin genetic make up, rituals or living environment
Genetic makeup
Outside factors:
To be healthy is to be in a state of homeostasis (balance) with ones
1) Taking regular exercises and adequate rest.
2) Adopting a high level of personal hygiene.
3) Eating a nutritionally balanced diet.
4) Abstaining from the abuse of drugs and alcohol.
5) Taking care of ones mental well-being.
6) Developing social skills to interact in a positive manner within
Sub-health: A situation in which the person does not show specific
symptoms and signs of illness, but lives a low-quality of life both
physically and mentally.
Causes of sub-health:
1) Psychological stimulation or stress.
2) Environmental pollutions.
3) Unhealthy life style.
4) Great pressure of work.
What is a disease?
A disease is defined as any deviation from or interruption of
the normal structure or function of a part, organ, or a system of the
body that is manifested by a characteristic set of symptoms or
signs; the etiology, pathology, pathogenesis and prognosis may be
known or unknown.

Causes of diseases
Biological agents- microorganisms, parasites
Chemical agents corrosive chemicals
Physical agents high temperatures, radiation,
Intrinsic factors:
Genetic factors
Congenital factors
Immunological factors immunodeficiency, autoimmune,
Psychological factors
Predisposing factors influence susceptibility or resistance to certain
diseases. They include genetic make-up, physiological and
psychological make up.
Precipitating factors intensify the effects of the causative agents and
promote the onset and development of diseases.
Natural conditions
Physical conditions
Social conditions
Factors that contributed in decline of infectious diseases:
1) The success of Immunization Programmes.
2) Availability of antibiotics.
3) Rising standards of living (especially dietary).
4) Improvements in hygiene.
5) Control of physical environment.
6) Limitation of population growth.
7) Improvement in preventive and treatment measures
In adults, cancer and heart diseases are now the major causes of
death in the developed world.
The rise in: tobacco consumption, poor eating habits (high fat
low fiber) and a sedentary lifestyle contribute to a large proportion
of current morbidity and mortality.
Etiology: it is used to study the contributing factors that cause
diseases including microorganisms, environmental, social factors
and personal habits.
Diseases can be classified into :
Infectious or non-infectious
Congenital or acquired
Primary or secondary

Infectious diseases transmitted from human to human (rarely from

other sources e.g. Birdflu); caused by
1) Viruses Rubella (abnormalities in unborn if occurred early in
pregnancycombined MMR vaccine for children (Measles,
Mumps and Rubella)
2) Bacteria - Staphylococcus aureus
3) Fungi Tinea (ringworm)
4) Parasites Plasmodium spp
1) Cancer
2) Degenerative
3) Dietary
4) Allergy
5) Psychological
6) Metabolic
7) Inherited
Pathogenesis: It refers to the rules and mechanisms underlying the
development or evolution of the disease.
It studies how the primary pathological agents cause diseases in
organisms and how the disease develops.
Rules for Pathogenesis of disease
1) Disruption of homeostasis by pathological insults
2) Bodys response to damages and anti-damages
3) Reversal role of cause and effect
4) Comprehensive mutual interaction between systemic and
local regulation
Homeostasis: process whereby internal environment of organism
remains balanced and stable required for optimum functioning.
In case of damage, the body reacts (anti-damage) but overdoing
anti-damage can cause new injuries and more harm.
E.g. burn leads to vasoconstriction-hypoxiamassive
cellular necrosis and dysfunction
Alternation of cause and effect
In case of hypoxia, Red Bone Marrow increase the production
of RBCs but overproduction of RBCs(consequence of hypoxia)
becomes the cause of polycythemia in which blood viscosity is high
thus thrombus may be formed in vessels.
Local alterations can affect the whole body through neural and
humoral regulation and the systemic functional states can in turn
affet the development of local damages via the same regulatory
Fundamental Mechanisms for diseases:

Neural, humoral, cellular and molecular mechanisms

Morphology: The fundamental structure or form of cells or tissues.
Morphologic changes are concerned with both the gross
anatomic and microscopic changes that are characteristic of a
Lesion: A pathologic or traumatic discontinuity of a body organ
or tissue.
Clinical manifestations
Signs and symptoms describe the structural and functional
changes that accompany a disease.
Symptom: a subjective complaint that is noted by the person with a
Sign: a manifestation that is noted by an observer.
A single sign or symptom may be associated with a number of
different disease states.
Syndrome: A complication of signs and symptoms that are
characteristic of a specific disease state.
Complications are possible adverse extensions of a disease or
outcomes from treatment.
Sequelae are lesions or impairment that follow or caused by a
disease -Polio.
The designation as to the nature or cause of a health problem.
The diagnosis process usually requires a careful history and
physical examination.
Laboratory tests, radiologic studies, CT scans, and other tests
are often used to confirm a diagnosis.
Clinical course
It describes the evolution of a disease.
A disease can have an acute, subacute, or chronic course.
Acute--- Relatively severe, but self-limiting.
Chronic--- Run a continuous course.
Subacute ---Intermediate or between acute and chronic.
Preclinical stage--- not clinically evident but is destined to progress
to clinical disease. Hepatitis B.
Subclinical disease--- not clinically evident and is not destined
to become clinically apparent.

Clinical disease is manifested by signs and symptoms.

Carrier status refers to an individual who harbors an organism
but is not affected.
A prediction of the probable outcome of a disease based on a
individual's condition and the usual course of the disease as seen in
similar situations.

Outcome of diseases
- Complete recovery : pathologically altered metabolism, structure
and function are perfectly restored . symptoms and signs disappear
Incomplete recovery: Sequela. Symptoms disappear but some
pathological changes are left behind.
Brain Death
It is a state of prolonged irreversible cessation of all brain activity
with the complete absence of conscious and voluntary movements,
responses to stimuli, brain stem reflexes, and spontaneous
The criteria of brain death released from WHO
1. Cessation of spontaneous respiration
2. Irreversible coma
3. Absence of cephalic reflexes and dilated pupils
4. Absence of any electrical activity of brain
5. Absence of brain flow

Unit 2
Cell communication autocrine, endocrine and paracrine
Cell signal transduction refers to the process in which cells
sense the extracellular stimuli through membrane or
intracellular receptors, then transduce the signals through
intracellular molecules, and thus regulate the biological
function of cells.
Signal transduction systems include:
receptors, transducers, effectors
A Cell signal
(1) Physical signal--Optical, electrical and aural signals
(2) Chemical signal (ligand)
Body fluid factor
Hormone, neurotransmitter
Odor molecule
Cell metabolic production
ATP, activated oxygen species.
Medicine and poison
Biological effect
(1) Induce cell proliferation
Platelet-derived growth factor(PDGF),
epidermal growth factor(EGF)
(2) Induce cell differentiation
Fibroblast growth factor(FGF),
transforming growth factor(TGF- ),
insulin-like factor-1(IGF-1)
(3) Induce cell apoptosis

Tumor necrosis factor(TNF )

(4) Neurotransmitter, stressor.
Transmembrane signal transduction mediated by membrane
(1) Ion-channel-linked receptors
(2) G-protein-linked receptors
G protein: The protein family that can combine with
GTP and GDP reversibly

Trimer G protein
Gs, Gi, Gq, G12
Small molecular G protein

Regulation of activity
Activation : GTP-G
Inactivation: GDP-G
1) Activate adenyl cyclase (AC) signal transduction pathway
mediated by Gs
2) Inactivate adenyl cyclase (AC) signal transduction
mediated by Gi