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W 1 - PATH 1016: Pathology and Therapeutics –
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Why study pathology and therapeutics?
Nursing actions require a knowledge base to make informed decisions.
Why study pathology and therapeutics?
Nurses require a solid foundation in anatomy, physiology, pathology and pathophysiology to care for clients
Why study pathology and therapeutics?
Therapeutic interventions are based on professional assessments of clients...one cannot accurately assess if one doesn't know what to assess for
Pathophysiology
Defined as the physiology of altered health and the Study of structural and functional changes in cells, tissues and organs of the body are caused by disease
Pathophysiology Framework: Etiology
Etiologic factors and Risk factors
Pathophysiology Framework: Pathological Process
Disease/Illness ,Manifestations and complications, Signs & symptoms, body responses and Clinical course
Pathophysiology Framework: Interventions
Diagnostic and Therapeutic
Etiology
cause of disease
Manifestations
Signs and Symptoms
Complications
problems that arise as characters struggle to reach their goals
Prognosis
a prediction of the course of a disease
Morbidity
Chemical agents
substances that can interact with the body
Autoimmunity
reaction of immune response to one's own tissues
Malnutrition
a state of poor nutrition
Inflammation
a localized response to an injury or to the destruction of tissues
Necrosis
tissue death
Contributing Factors of Disease
- Age, Gender, Lifestyle, Stress and Environment
Infection
An invasion of the body by a pathogen (any microorganism that causes disease) and Resulting signs & symptoms develop in response to the invasion
Infection
Infection can localized (limited to small area) or systemic (widespread throughout body, often spread via the blood)
Infectious agents
A pathogen that has the potential to cause infection.
Infectious agents
Examples of pathogens:
- Bacteria
- Virus
- Fungus
- Parasite
Pathogen: agent that causes a disease
- Bacteria
- Viruses
Prions:Example:
bovine spongiform encephalopathy (BSE) or Mad cow disease.
Prions:Symptoms:
transmissible neurodegenerative diseases.
Prions
Ataxia, dementia and death over months to years and Unable to treat because metabolism and replication not clearly understood
Viruses
are not generally considered alive because they are not cellular and cannot reproduce on their own and A virus is essentially ggenes in a box,g an
infectious particle consisting of a bit of nucleic acid
Viruses
wrapped in a protein coat called a capsid, and in some cases, a membrane envelope.
Ex's of viruses
- Latent viruses
- Herpes viruses (ie. shingles).
- Influenza viruses • H1N1 in 2009.
- SARS in 2003
- HIV in early 1980s causing AIDS.
- HIV is a retrovirus that has a viral enzyme, reverse transcriptase, to translate viral RNA into host's DNA.
Bacteria
Are unlike viruses - they are not just a ggene in a boxg and Bacteria have all the cellular mechanisms to self replicate without a host
Bacteria
Prokaryotes and Some bacteria are pathogens, causing disease. But most bacteria on our bodies are benign or beneficial.
Bacteria
Bacteria are very adaptable, but each species has a defined set of growth parameters different Temperature , Atmosphere and Environment
Example: Aerobes and anaerobes
Cocciare spherical prokaryotic cells:
They sometimes occur in chains that are called streptococci.
simpler cell with thick walls containing peptidoglycan,
Bacteria Gram Negative
less peptidoglycan, and more complex with thin walls and more likely to cause disease
Fungi
are absorptive heterotrophic eukaryotes, they secrete powerful enzymes to digest their food externally, and acquire their nutrients by absorption.
Molds
are any rapidly growing fungus that reproduces asexually by producing spores.
Yeast
are single-celled fungi that reproduce asexually by cell division or budding. (Cause of Thrush)
Fungi
Colonies of yeast are smooth with a waxy or creamy texture, Yeast infections and groin areas.
Fungi
Molds produce cottony or powdery colonies. and Unique rigid cell wall not susceptible to effects of penicillin-like antibiotics.
Fungi
Only about 50 species of fungi are parasitic on animals, The general term for a fungal infection is mycosis, Skin mycoses include
- ringworm, named because it appears as circular red areas on the skin,
- athlete's foot, also caused by the ringworm fungus,
- vaginal yeast infections, and
- deadly lung diseases.
- Some fungi provide antibiotics that are used to treat bacterial disease - penicillin
Protozoa:
are unicellular eukaryotes, can cause Malaria, dysentery.
Helminths:
are worm-like parasites, can cause Tapeworm, trichinosis, and mostly limited to developing countries
Arthropods:
are vectors of infection, ticks and mosquitoes
help organisms stick to the body, pathogen must be able to attach to and colonize host, Receptors (site to which microorganisms adhere) and ligands
(molecule or substance that binds to the receptor). and Form slime or mucus layer which anchors and protects the bacteria.
Evasive
prevent host from destroying bacteria.
Virulence Factors:
are products (mostly enzymes) produced by infectious agents that facilitate penetration and invasion of host tissue.
Host
humans
Infection
Infection means presence and multiplication
Colonization
means establishing a presence e.g. tracheostomies
Microflora and commensalism
Example: Candida in mouth and GI tract
Commensalism - benefits the microorganism, no
harm to the human)
Mutualism
Example: vitamin K in human GI tract
itis
means inflammation, May or may not be due to infection
emia
means in the blood
Sepsis or septicemia
means bloodstream infection
Parasitic relationship
A relationship that is one-way and detrimental to one of the organisms over time.
Systematic
Affecting the entire body e.g. fever, anorexia, malaise
Acute
The clinical signs appear suddenly with severe manifestations. Limited duration depending on the virulence of the pathogen and the host's resistance.
Nosocomial
are hospital acquired infections.
Community acquired
are outside the hospital, May influence treatment
Symptoms of Infection:Specific:
Respiratory distress in children.
Symptoms of Infection:Nonspecific:
Fever, malaise, fatigue, weakness, anorexia
Incubation Period:
Pathogen begins active replication without producing recognizing symptoms in host and Incubation may be short or long ie. salmonella, HIV, Influenced by factors such as health of host, portal of entry, infectious dose of the pathogen.
Prodrosomal Stage(onset and symptoms):
Initial appearance of symptoms in the host • Mild fever, headache, myalgia, fatigue
Acute:
Host experiences maximum impact of infection due to rapid proliferation and spread of pathogen and Symptoms more specific.
Convalescent Period:
Containment of infection, progressive elimination of pathogen, repair of damaged tissue and resolution of associated symptoms
Resolution:
Total elimination of pathogen without residual signs or symptoms.
Chronic infections
irregular course and no convalescent phase.
Diagnostic Tests
- Culture • Serology
- DNA and RNA sequencing
- Blood panels
- Diagnostic Imaging
Diagnostics Tests - Culture
Any body fluid can be cultured, Propagation of microorganism outside the body on an artificial medium and Placed in a controlled environment until growth of microorganism becomes detectable.
Diagnostics Tests - Culture
Organism is identified under microscope andthrough biochemical reactions (including gramstain), Takes days to get a result 24 to 48 hours minimum and Sensitivity is typically done to determine which drugs are capable of killing the organism or theorganism is resistant to
Diagnostics Tests:Serology:
study of serum;Indirect means of identifying infections by measuring serum antibodies in host (i.e. antibody titer)
Diagnostics Tests:Direct Antigen Detection:
Newer technology that reduces detection time and Uses florescent dye and microscope to detect antigens on specific pathogens that will glow against a black background
Diagnostics Tests:Polymerase chain reaction(PCR):
Used to detect DNA or RNA sequences unique to a single virus or bacterium, Most rapid test and Extremely sensitive and specific
Cellular Response to Infection
Bacterial infections cause increase in neutrophils, Parasitic or allergic reactions cause increase in eosinophils and Viral infections decrease neutrophils and increase in lymphocytes.
Leukocytosis:
An increase in WBCs especially with bacterial infections and Normal value 4000-10000 cells/microlitre.
Cellular Response to Infection
More immature neutrophils produced with more severe infections. This is called 'shift to the left' or LEFT SHIFT
Leukopenia:
A decrease in WBCs and may occur with overwhelming infection or impairment of WBC production
Mechanisms of Antibiotic Action:
- Interference with cell wall synthesis.
