Chapter 1 

Introduction of Pathophysiology and Conspectus of Disease

COURSE CONTENT

Ⅰ. Introduction of Pathophysiology

1. The roles of pathophysiology

Pathophysiology is the study of abnormalities or alterations in the body function and metabolism. It is the study of the basic mechanism by which disease development, evolution, and outcome. The roles of pathophysiology contain etiology, mechanisms and pathogenesis.

2. Position of pathophysiology

Pathophysiology is considered as a bridge subject to connect the basic medicine and clinical medicine. It is regarded as a required subject in the whole medical curriculum.

3. Main contents of pathophysiology

⑴ Conspectus of disease.

⑵ Fundamental pathological processes of diseases: the common changes of structure, function, and metabolism occurred in the different diseases.

⑶ Pathophysiology of the critical organs and systems in diseased body.

4. The methods for studying pathophysiology

Ⅱ. Conspectus of disease

1. Health and disease

World Health Organization defined health as a state of complete well-being in physical, mental and social and not merely the absence of disease or infirmity.

Disease is the opposite of health. It is defined as an abnormal life process under the actions of certain cause and condition, with disturbances of function, metabolism and structure in the body which are manifested by a series symptoms and signs.

Signs— objective evidence observed on physical examination.

Symptoms—subjective manifestation perceived by the patient.

Syndrome—is a set of signs and symptoms that occur together and are characteristics of a specific disease state.

2. Etiology

It is the study of the factors that cause diseases. The causative agents act on body, lead to disease, decide characteristics of disease. So they are the absolutely necessary factors for development of disease.

⑴ Extrinsic factors: ①biological agents; ②chemical agents;③physical agents;④nutritional imbalance.

⑵ Intrinsic factors: ①genetic factors;②immunological factors; ③congenital factors;④psychological factors.

⑶ Condition of disease: includes internal condition and external condition.

⑷ A predisposing factor refers to the factor that influences the susceptibility or resistance to certain disease of the body. It includes the body’s genetic constitution, physiological make up, as well as various psychological characteristics.

⑸ A precipitating factor refers to the factors that intensify the roles of etiological factors through a change in condition that promotes the development of disease and influences the timing of illness onset, such as nature condition, body condition and social condition.

3. Body barriers and spread routs of disease 

⑴ Body barriers: ①external barrier; ② internal barrier.

⑵ Spread route of disease: ①tissue spread;② humoral spread: such as blood, lymph and urine; ③nerve spread.

4. Pathogenesis

It refers to the mechanisms of development or evolution of the disease.

⑴ General aspects of pathogenesis: ①disruption of homeostasis; ②damage and anti-damage responses; ③Alternation of cause and effect in pathological process (vicious circle)

⑵ Basic mechanisms: ①neural mechanism; ②humoral mechanism; ③cellular mechanism; ④molecular mechanism.

5. Course of disease

⑴ Latent period

⑵ Prodromal period

⑶ Manifest illness period

⑷ Resultant period

6. Outcome of disease

⑴Complete recovery

⑵ Incomplete recovery

⑶ Death: ①physiological death and pathological death; ②the causes of pathological death; ③ the course of death undergoes three stages: agonal stage, stage of clinical death and stage of biological death; ④ brain death is a state of prolonged irreversible cessation of all brain activity. The critical of brain death released from WHO. The significance for judging brain death.

EXERCISES

Ⅰ. True or false questions (mark √ for true question, mark ´ for false question. If it is false, correct it. )

1. The investigation of pathophysiology is mainly based on animal experiment.

2. Health defined as the state of the organism when it functions optimally without evidence of disease.

3. Condition of disease is the absolutely necessary factors for development of disease.

4. Congenital factors refer to chromosomal genetic disorders.

5. Affected by the general rule of alternation of cause-consequence, the development of disease can be either vicious circle or beneficial circle.

Ⅱ. Fill in blanks

1. Main content of pathophysiology includes ________, ________, ________.

2. The causative agents are classified into external and internal factors, external factors of disease are ________, ________, ________, ________.

3. Internal factors of disease are as followings ________, ________, ________.

4. Conditions of disease include: ________, ________.

5. Body barrier includes ________, ________.

6. Once the barrier is destroyed, the causative agents will along a certain route to spread. The spread routes of disease includes________, ________, ________.

7. Humoral spread include________, ________, ________.

8. General rules for pathogenesis of diseases are ________, ________, ________.

9. The fundamental mechanisms for diseases are________, ________, ________, ________.

10. The course of disease is divided into four stage ________, ________, ________, ________.

11. There are three types of outcomes for a disease, they are________, ________, ________.

12. Death is the end of life activity. It is generally classified into ________, ________.

13. The causes of pathological death include________, ________, ________.

14. The course of death can be divided into three stages, they are ________, ________, ________

15. The significance for judging brain death is ________, ________, ________.

Ⅲ. Multiple choice questions of type A

1. Pathophysiology is the study of

A. Causative factors of disease

B. The condition of disease

C. Mechanism and general rules of disease development, evolution, and outcome

D. The outcome of disease

E. The alterations in the diseased body

2. Which one of following subjects is study of abnormalities or alterations in the body function and metabolism?

  A. Clinical pathophysiology           B. Systemic pathology

C. Pathophysiology                  D. Human physiology

E. Anthropotomy

3. Which one of follows is not external barrier?

A. Skin                            B. Respiratory tract

C. GI tract                         D. Eye conjunctiva

E. Lymph node

4. The spread rout of disease doesn’t include

A. Blood spread                     B. Urine spread

C. Nerve spread                     D. Hospital- acquired spread

E. Tissue spread

5. Correct explanation of complete recovery should be

A. Conspectus of disease              

B. Ability to work

C. Pathophysiology of the critical systems and organs in diseased body

D. Without any uncomfortable

E. The manifestations are absent but pathological changes are still occurring in the body

6. Brain death refers to

A. Cessation of respiratory and heartbeat, absence of reflexes

B. All the activities of central nervous system have stopped irreversible

C. The activities of cerebra have stopped

D. The activities of pallium have stopped

E. Irreversible coma

7. Which of the following is not a basic process of disease?

A. Pneumoniae                      B. Shock               

C. Hypoxia                         D. Fever

E. Edema

Ⅳ. Multiple choice questions of type X

1. Main content of pathophysiology include

A. Conspectus of disease

B. Basic pathologic processes

C. Pathophysiology of the critical systems and organs in diseased body

D. Prevention and treatment of disease

E. Manifestations of disease

2. The critical of brain death are as follows

A. Cessation of spontaneous respiratory and heartbeat

B. Irreversible coma

C. Absence of cephalic reflexes and dilated pupils

D. Relieve oneself Incontinence (irretention)

E. Absence of any electric activity of brain  

3. The General rules for pathogenesis of diseases are

A. Disruption of homeostasis

B. Damage and anti-damage responses

C. Alternation of cause and effect

D. Reaction of antigen and antibody

E. Main steps of pathogenesis

4. The fundamental mechanisms for development of diseases are

A. Neural mechanism                 B. Humoral mechanism

C. Cellular mechanism                D. Molecular mechanism

E. Biological mechanism

5. Which of the following is biological agent?

A. Virus                                                 B. Bacteria

C. CO                                                    D. Mildew

E. Epiphyte                                                                                       

6. Which one of the followings is the symptom?

A. Fever                            B. Tinnitus              

C. Increased WBC                    D. Vomiting         

E. Hepatomegaly

7. Which one of the followings is the sign?

A. Fever                            B. Tinnitus              

C. Increased WBC                    D. Bubble sound of lung     

E. Hepatomegaly

8. External barrier includes

A. Skin                             B. GI tract          

C. Respiratory tract                   D. Liver            

E. Urinary-procreative tract

9. Internal barrier includes

A. Lymph node                     B. Macrophage           

C. Blood-brain barrier                D. Histiocyte               

E. Respiratory tract

10. Which one of the followings is internal factor of disease?

A. Genetic factors                  B. Immunological factors

C. Congenital factors                D. Psychological factors

E. Chemical agents

11. Which one of the followings is external factor of disease？

A. Biological agents                B. Chemical agents

C. Physical agents                  D. Nutritional factors

E. Psychic, psychological and social factors

Ⅴ. Term explanations

1. disease                                                 2. signs

3. symptoms                                            4. syndrome

5. etiology                                               6. pathogenesis

7. pathologic processes                              8. brain death

9. precipitating factor

Ⅵ. Questions to be answered briefly

1. What is the role of pathophysiology?

2. What is the main content of pathophysiology?

3. What are the causes of pathological death?

4. What are the spread routes of disease?

5. What are the General rules for pathogenesis of diseases?

6. What is the outcome of disease?

7. Explain the course of death.

8. What is the significance for judging brain death?

Ⅶ. Questions to be answered in detail

1. What are the fundamental mechanisms for diseases?

2. What are the causative agents that can cause the diseases?