UNIT-01

INTRODUCTION TO PATHOPHYSIOLOGY

SHAHZADO BHATTI
POST RN BSN, RN, DIP-PAEDS
BLESSING COLLEGE OF NURSING SUKKUR

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 OBJECTIVES
At the end of this unit each learners will be able to:
1. Define Pathology and Pathophysiology.
2. Differentiate among pathophysiology and other biomedical
sciences.
3. Discuss the basic concepts of disease and its development.
4. Briefly discuss each of the five component the disease
process:
 Prevalence,

 Etiology,

 Pathogenesis,

 Clinical manifestation,

 Outcomes
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 PATHOLOGY
• The pathology is Greek ,pathos, means "feeling, or
suffering"; and logia, means "the study of".
• Pathology refers to the study of essential nature of diseases.
• Pathology is a branch of medical science primarily
concerning the cause, origin and nature of disease.
• It is a medical discipline used in the diagnosis of a disease
through the physical examination of surgically-removed
tissues (biopsy samples), organs, body fluids, or the whole
body (autopsy).

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 CLINICAL PATHOLOGY
Clinical pathology is a medical specialty that is concerned with
the diagnosis of disease based on the laboratory analysis of
bodily fluids such as blood and urine, as well as tissues, using the
tools of biochemistry, clinical microbiology, hematology,
immunology and molecular pathology e.g. PCR (polymerase
chain reaction).

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 Clinical biochemistry
Clinical biochemistry (chemical pathology, clinical chemistry) is
the area of chemistry that is generally concerned with analysis of
bodily fluids for diagnostic purposes.

Blood, urine or bodily fluid for various tests e.g. RFTs, LFTs,
RBS, FBS, Serum Albumin, Serum Electrolytes etc.

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 Clinical Microbiology
• Clinical Microbiology deals with isolation and identification
of infectious agents such as bacteria, viruses, fungi and
parasites that cause disease.

• Specimens such as urines, faeces and swabs to identify

pathogens to select the appropriate treatment.

e.g. Blood C/S, Urine C/S, Sputum C/S

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 Hematology
• Is the study of diseases which affect blood. Investigations
that take place the Hematology laboratory include:
• Routine hematological testing
Specimens of whole blood are analyzed by a specialized
instrument called a Coulter Counter which measures the
number of the various blood cells such as red cells, white cells
and platelets
• E.g. Complete blood count, ESR etc

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 CLINICAL IMMUNOLOGY

• Clinical Immunology is concerned with the diagnosis and

management of diseases arising from abnormal immune
responses.

• In broad terms, these abnormalities may be the result of

either under activity (immunodeficiency) or over activity
(autoimmunity and allergy) of the immune system.

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 MOLECULAR PATHOLOGY
• Molecular pathology is an emerging discipline within
pathology which is focused in the study and diagnosis of
disease through the examination of molecules within organs,
tissues or bodily fluids.

• Molecular pathology is commonly used in diagnosis of cancer

and infectious diseases.

• E.g. polymerase chain reaction (PCR), genes analysis

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 PATHOPHYSIOLOGY
Physiology: deals with the function of the human body.

• The term combines the words pathology and physiology.

• Thus ,Pathophysiology deals not only with the cellular and
organ changes that occur with disease , but with the effect that
these changes have on total body function.

• Pathophysiology also focus on the mechanism of the

underlying disease and provides the background for preventive
as well as therapeutic health care measure and practices.

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IMPORTANCE OF PATHOPHYSIOLOGY FOR NURSES
It helps them to find answers to important questions related to
disease processes:

1. What is the cause/causes of the disease, and why the disease is

developing?
2. What are the mechanisms responsible for disease onset ,
progression, and recovery
3. What are the mechanisms responsible for development of signs
and symptoms of disease.

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DIFFERENTIATE AMONG PATHOPHYSIOLOGY AND OTHER BIOMEDICAL
SCIENCES
other biomedical sciences pathophysiology
1.Physiology: Studies normal body Pathophysiology focuses on abnormal changes
functions and processes in these processes
2.Anatomy: Examines the structure and Pathophysiology explores how disease affects
organization of body parts these structures
3.Biochemistry: Investigates chemical Pathophysiology applies biochemical
processes within living organisms knowledge to understand disease mechanisms.
4.Pharmacology: Deals with drug Pathophysiology helps understand how drugs
actions and effects interact with diseased tissues and cells.
5.Epidemiology: Studies disease patterns Pathophysiology provides insights into disease
and risk factors in populations mechanisms, complementing epidemiological
findings
6.Molecular Biology: Examines Pathophysiology applies molecular biology
molecular structures and processes principles to understand disease at the
molecular level
7.Clinical Medicine: Focuses on Pathophysiology informs clinical decision-
diagnosis, treatment, and management of making by providing a deeper understanding of
diseases disease mechanisms.
 BASIC CONCEPT OF DISEASE AND ITS DEVELOPMENT
In infection by pathogen is influenced by several factors:
1. Mechanism of action: pathogens directly damage cells,
interfere with cellular metabolism, and render the cell
dysfunctional and damage cell because of the accumulation of
pathogenic substances and toxin production.
2. Infectivity: ability of the pathogen to invade and multiply in
the host.
3. Pathogenicity: the ability of an agent to produce
disease depend on its speed of production, extent of
tissue damage, and production of toxin.
4. Virulence: the potency of a pathogen measured in
terms of the number of microorganisms of toxin
required to kill a host.

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 CONT…
5. Immunogenicity: the ability of pathogens to induce an
immune response.
6. Toxigenicity: a factor important in determining a pathogen's
virulence, such hemolysin , leucocidin and other exotoxins,
and endotoxin. Hemolysin destroy erythrocytes, and
leucocidin destroys leukocytes, both are product of
streptococci and staphylococci.
7. Portal of entry: the route by which a pathogenic organism
infect the host: direct contact, inhalation, ingestion, or bite of
an animal or insect.
Spread of infection is facilitated by the ability of pathogens to
spread through lymph and blood and into tissue and organs,
where they multiply and cause disease.

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 NATURAL HISTORY OF DISEASE
• Thenatural history of disease is the course a disease takes place in an
individual from its pathological onset to its eventual resolution through
complete recovery, disability or death in the absence of intervention.

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1.Stage of susceptibility In this stage, disease has not yet developed, but the groundwork has
been laid by the presence of factors that favor its occurrence.
Example: unvaccinated child is susceptible to measles.
2. Stage of Pre-symptomatic (sub-clinical) disease: In this stage there are no manifestations
of the disease but pathologic changes (damages) have started to occur in the body.The disease
can only be detected through special tests since the signs and symptoms of the disease are not
present.
Examples: • Detection of antibodies against HIV in an apparently healthy person. • Ova of intestinal
parasite in the stool of apparently healthy children. The pre-symptomatic (sub-clinical) stage may lead to
the clinical stage, or may sometimes end in recovery without development of any signs or symptoms
3. The Clinical stage :At this stage the person has developed signs and symptoms of the disease. The
clinical stage of different diseases differs in duration, severity and outcome. The outcomes of this stage
may be recovery, disability or death.
Examples: Common cold has a short and mild clinical stage and almost everyone recovers quickly.
Polio has a severe clinical stage and many patients develop paralysis becoming disabled for the rest of
their lives. Rabies has a relatively short but severe clinical stage and almost always results in death.
Diabetes Mellitus has a relatively longer clinical stage and eventually results in death if the patient is not
properly treated.
4. Stage of recovery, disability or death :Some diseases run their course and then resolve completely
either spontaneously or by treatment. In others the disease may result in a residual defect, leaving the
person disabled for a short or longer duration. Still, other diseases will end in death.
Examples: • Trachoma may cause blindness • Meningitis may result in blindness or deafness.
Meningitis may also result in death.
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 BRIEFLY DISCUSS EACH OF THE FIVE COMPONENT THE DISEASE PROCESS:
ETIOLOGY
• Etiology, is the study of causation or origination. The word is
derived from the Greek, aitiologia, "giving a reason for“
• Used in medical and philosophical theories, where it is used to
refer to the study of why things occur, or even the reasons
behind the way that things act.
TYPES OF ETIOLOGY
1. Intrinsic: diseases caused by an internal source within the
person. i.e. genetic disorders, cancer and endocrine disorders
etc.
2. Extrinsic: causes of disease which are originally found outside
of the body of a human. i.e. infectious illnesses , exposure to
radiation/chemicals/electricity
3. Idiopathic: Any disease that is of uncertain or unknown origin
may be termed idiopathic. i.e. idiopathic scoliosis, idiopathic
pulmonary fibrosis etc.
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 DISEASE
• The term disease literally means “without ease” (uneasiness),
when something is wrong with bodily function.
• The term disease broadly refers to any condition that impairs the
normal functioning of the body.
• Diseases are associated with dysfunctioning of the body's
normal homeostatic processes.

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 PATHOGENESIS
• The word Pathogenesis comes from the Greek
pathos ("disease") and genesis ("creation").
• The pathogenesis of a disease is the biological mechanism that
leads to the diseased state.
• The term can also describe the origin and development of the
disease, and whether it is acute, chronic, or recurrent.

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 CLINICAL MANIFESTATION
• Means the features of disease or the physical result of some
type of illness or infection.
• Symptoms: Subjective experience----chest pain, thirst, loss of
taste or smell and fatigue etc.

• Sign: Objective/detected by the observer, Increase body temp

or an irregular pulse, jaundice etc. Sign usually emerge in
physical examination.

• Syndrome: Characteristic combination of signs and

symptoms. Cushing’s Syndrome, metabolic syndrome.

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 OUTCOME
The consequence of disease or end of the disease is known as
outcome which may any of the following form
– Complete recovery

– Recovery with disability

– Death

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 METHOD OF PATHOLOGICAL OBSERVATION
Pathological observation involves the examination of tissues, cells, and
bodily fluids to diagnose diseases. The methods used in pathological
observation can be broadly categorized into several types, each with
specific techniques and applications. Here are some common methods:
1. Histopathology
Definition: Study of tissues under a microscope after being processed
and stained. E.g biopsy, Staining, microscopy

2. Cytopathology
Definition: Examination of individual cells or clusters of cells.
e.g. Pap Smear: Screening test for cervical cancer.
Fine Needle Aspiration (FNA): Collecting cells using a thin needle.
Fluid Cytology: Examining body fluids (e.g., pleural, peritoneal).
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 CONT…
3. Immunohistochemistry (IHC)
Definition: Using antibodies to detect specific antigens in
tissues.

4. Molecular Pathology
Definition: Analysis of genetic material within tissues and cells.
E.g PCR

5. Electron Microscopy
Definition: Using electron beams to achieve higher resolution
imaging.

6. Autopsy Pathology
Definition: Examination of a body after death to determine the
cause of death.
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 ROLE OF PATHOLOGY IN CLINICAL MEDICINE
Diagnosis of Disease:
• Accurate Diagnosis: Pathologists analyze tissue samples, cells,
and body fluids to diagnose diseases accurately. This includes
identifying the type and stage of cancer, infections, autoimmune
diseases, and other conditions.
1.Histopathology: Examination of tissue biopsies to diagnose
diseases such as cancer, inflammatory diseases, and infections.
2.Cytopathology: Examination of individual cells to diagnose
conditions like cervical dysplasia through Pap smears or cancer
through fine needle aspirations.

© Shahzado Bhatti; Faculty BCON SKR