Etiology is the study of causes and origin of disease or abnormal condition.

A branch of
medical science concerned with the causes and origins of diseases. A pathogen can be
living or non-living, but usually refers to a live agent. A pathogen is an organism which
causes a disease. Pathological is a condition of being diseased. A disease is not static; it is a
series of changes in the plant or animal. When a doctor tries to figure out the cause of
a disease, they are actually trying to figure out the etiology of the disease. Etiology is
the cause of a disease or the science that deals with such causes.

Pathophysiology is the study of the physical and biological abnormalities occurring within the
body as a result of disease. Nurses who are able to recognize the pathophysiological signs
and symptoms of the conditions of their patients will be able to provide a higher quality of
advanced care. Deranged function in an individual or an organ due to a disease.
For example, a pathophysiologic alteration is a change in function as distinguished from a
structural defect.

How Etiology of disease link to its Pathophysiology

1. Etiology of Chronic Fatigue Syndrome (CFS) and Myalgia Encephalomyelitis (ME) can be an
Infection, which may lead to pathophysiology change in the immune system that contribute to
the development of ME/CFS following an acute viral-like illness.– some, but not all, patients
develop ME/CFS following an acute viral-like illness. It is possible that in some people an
infection may lead to changes in the immune system that contribute to the development of
ME/CFS. Post-infectious fatigue is recognized to occur in about one in ten people infected
with Epstein-Barr virus, Ross River virus, or Coxiella burnetti (the causative agent of Q
fever). People with these infections who had severe symptoms during the acute illness were
more likely than those with mild symptoms to later develop an ME/CFS-like illness.

2. Etiology of CFS/ME can be Physical or emotional trauma – some patients report

experiencing an accident, trauma, immobilization, surgery, or significant emotional stress
prior to onset of symptoms.
3. Etiology of CFS/ME can be Genetics – ME/CFS has been observed within some families.
This suggests either a possible genetic link or a common environmental exposure (infectious
or toxic). Twin studies show higher rates of ME/CFS in identical than fraternal twins.
However, specific genetic associations have not been established.

4. Etiology of CFS/ME can be Environmental factors – exposure to mold or toxins has been
suspected as a trigger for ME/CFS. However, associations of specific environmental factors
with ME/CFS have not been established.
5. Patients with CFS/ME, with its etiology as infection, environmental, physical, and
genetic factors may develop pathophysiological change like Immune system
abnormalities – some people with ME/CFS have impaired natural killer cell function and/or
T cell function, chronic higher production of inflammatory cytokines, and in some cases slight
increase in some autoantibodies (rheumatic factor, anti-thyroid antibodies, anti-gliadin, anti-
smooth muscle antibodies, and cold agglutinins).

6. Patients with CFS/ME, with its etiology as infection, environmental, physical, and
genetic may develop pathophysiological change like Cellular metabolism
abnormalities – some people with ME/CFS also appear to have impaired ability to produce
energy from the usual “fuel” that cells use to produce energy: oxygen, glucose, fatty acids,
 and amino acids. Exercise studies in adults have revealed impaired oxygen consumption
and activation of anaerobic metabolic pathways in the early stages of exercise.

7. Patients with CFS/ME, with its etiology as infection, environmental, physical, and
genetic may develop pathophysiological change like Neuroendocrine disturbances –
some people with ME/CFS report physical or emotional stress before they become ill, which
can lead to dysregulation of the hypothalamic-pituitary-adrenal axis (HPA axis). Some
patients with ME/CFS have flattened diurnal cortisol profiles compared to healthy people, but
their cortisol levels are still within the normal range.

8. Patients with CFS/ME, with its etiology as infection, environmental, physical, and
genetic may develop pathophysiological change like Blood pressure or heart rate
regulation abnormalities – some people with ME/CFS, particularly adolescents, experience
symptoms of orthostatic intolerance. Patients with orthostatic intolerance develop a
worsening of symptoms with quiet upright posture and improvement (though not necessarily
full resolution) of symptoms with recumbency. Two common forms of orthostatic intolerance
experienced by patients with ME/CFS are:
o Neurally-mediated hypotension (NMH): an abnormality in the regulation of blood pressure
during upright posture. NMH is sometimes also referred to as neurocardiogenic syncope,
vasodepressor syncope, vaso-vagal syncope, “the fainting reflex”, and delayed orthostatic
hypotension.
o Postural orthostatic tachycardia syndrome (POTS): an abnormality in the regulation of heart
rate in which a change from lying to standing causes an abnormal increase in heart rate; the
heart is usually structurally normal..

How different etiology produces different pathophysiology

change in the body.
1. Obesity is normal adiposity and is a central player in the pathophysiology of diabetes
mellitus, insulin resistance, dyslipidemia, hypertension, and atherosclerosis, largely because
of its secretion of excessive adipokines. Obesity is a major contributor to the metabolic
dysfunction involving lipid and glucose, but on a broader scale, it influences organ
dysfunction involving cardiac, liver, pulmonary, endocrine, and reproductive functions.
Obesity contributes to immune dysfunction from the effects of its secretion of inflammatory
adipokines and is a major risk factor for many cancers. Because of the accelerating effects it
has on the worsening of metabolic syndrome and cancer, obesity has the potential to be
profoundly detrimental to our species if major methods of prevention and/or effective
treatment are not realized. It is essential then to institute major educational efforts aimed at
promoting better habits of eating and physical exercise. These lifestyle changes may be
complemented by pharmacologic therapy.

2. The etiology of heart disease, type 2 diabetes, stroke, hypertension, dyslipidemia, and
certain cancers is obesity which its pathophysiological changes like significant metabolic,
organ and immune system dysfunction lead to many serious and fatal conditions like heart
disease, type 2 diabetes, stroke, hypertension, dyslipidemia, and certain cancers. Nurses
can play a significant role in reducing obesity in child and adult patients by recognizing early
signs and symptoms. By promoting awareness and teaching patients about diet, exercise,
and other aspects of a healthy lifestyle, nurses can lessen instances of the dangerous
 conditions obese patients may develop. In extreme cases, nurses may help patients manage
weight loss with prescription medication or bariatric surgery.
3. The etiologies of heart failure are hypertension, myocardial infarction, diabetes, and heart
disease, which its pathophysiological changes may result from the significant metabolic,
organ and immune system dysfunction. Some etiology of high blood pressure are smoking,
lack of excises, stress, a diet high in salt and fat

4. The etiology of Alzheimer’s disease is not entirely understood just yet, but the research over
the years has provided us with some clues to its origins. It is believed to be activated by a
mix of genetic and environmental factors. Lifestyle choices are also speculated to play a role
in its onset which result to the pathophysiology of Alzheimer involve plaques in the brain
caused by the accumulation of the protein beta-amyloid, along the neurofibrillary tangles.

5. Etiology of Parkinson’s disease is reduction in dopamine (a neurotransmitter which has

several role in the body like motor control) leading to pathophysiology involve cell death
connected with the build-up of proteins in the brain, known as lewy bodies, which tend to
gather in the basal ganglia, the subtantia nigra, as well as the thalamus and the cortex,
Parkinson's is the second most common condition that results in dementia, usually when it
becomes more advanced. Parkinson's is mostly known for its motor symptoms which
include:

 rigidness
 shaking
 movement difficulties

6. The etiology of stroke is the inadequate blood flow to the brain, which causes cell death and
the lack of this supply is precisely the pathophysiology of vascular dementia. Dementia in
stroke patients is created by the reduced blood supply from blocked vessels, which leads to
progressive cognitive impairment. This event can also happen in minor strokes. The brain
has an intricate system of vessels to provide blood and oxygen to it; however, it is also
fragile.

Source: pixabay.com

Chronic Traumatic Encephalopathy

7. The etiology of multiple diseases can bring about the onset of dementia, a degradation of
cells in the brain, through biological or external means. The etiology of dementia is
infections, like Crutzfeldt-Jakob disease, which narrow and damage blood vessels in the
brain and the narrowing and damaging of blood vessels in the brain is the pathophysiology of
vascular dementia.

8. Genetic factor is also an etiology of Huntington’s disease, which possibly lead to Alzheimer.
 9. External factors such as repeated head injuries and concussions and non-biological source
like alcohol abuse are etiology of chronic traumatic encephalopathy (CTE) and dementia
pugilistica, that is, narrowing and damaging of blood vessels in the brain lead to brain
degradation and it is the pathophysiology of dementia.

10. The dementia associated with CTE is known as dementia pugilistica and the etiology of it is
from repeated head injury by boxers and the pathophysiology in dementia pugilistica involves
Tau proteins which clump in the brain, make tangles and often around the sulcal depths.
Chronic traumatic encephalopathy can potentially appear very early in one's life, or it can
happen many years later. This contrasts with other conditions where dementia usually does
not start showing signs until old age. Also, unlike other diseases, CTE cannot be formally
diagnosed until a patient is deceased.

11. The etiology of Wernicke-Korsakoff Syndrome (WKS) is thiamine (vitamin B-1) deficiency,
which can arise from malnutrition and alcoholism. The pathophysiology of this condition
involves sugar and energy. If there is not enough thiamine, the brain cells do not have
adequate fuel to perform tasks.

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