Pathophysiology: Understanding Disease Mechanisms and Clinical Manifestations

1. Welcome to Pathophysiology

2. 1 2 Introduction Conspectus of Disease Contents of the lecture

3. What is Pathophysiology? A subject to explore the rule of origin and evolution of diseases and the underlying mechanisms.

4. Subjects involved in Pathophysiology • All diseases seen in all clinical • departments • All diseases reproduced in animal • models

5. Differences from Physiology • Physiopathology • Physiology of Disease • Clinical Physiology • Medical Physiology • Physiology of Disordered Function • Physiology under diseased situation

6. Differences from Pathology • “Pathology” emphasizes the structural • changes • pathophysiology deals with functional • and metabolic alterations and the • mechanisms.

7. The Methodologies Used in Pathophysiology • As a subject, the experiments are assigned in systemic or organic levels. • Animal study • Clinical observation • Epidemiological study • For scientific research, studies in cellular and molecular levels are required.

8. Why Is Pathophysiology Important? • An essential introduction to clinical medicine. • A bridge: basic medicine and diseases. • Enables us to understand why and how • diseases develop and various clinical • manifestations appear. • What are the underlying mechanisms, and in • so doing devise rational therapeutics.

9. How Pathophysiology is Arranged? • Introduction: what pathophysiology is • and what disease is. • Fundamental pathological processes: • fluids and electrolytes imbalance, acid • and base disturbances, stress, fever, • edema, ischemia and reperfusion, shock, • multiorganic dysfunction, and hypoxia.

10. Fundamental pathological processes Some common and whole set alterations in metabolism, function and structure, which may appear in different disorders

11. How Pathophysiology is Arranged? (cont.) • Organic pathophysiology: heart, lung, • liver, kidney and brain • Cellular and molecular pathophysiology: • signal transduction and diseases and • cell apoptosis in diseases

12. Major Points in Learning Pathophysiology • The general concepts • The etiology and pathogenesis • The alterations of metabolism and function • The principles for prevention and therapies

13. How to Learn Pathophysiology • Grasp the major points: causes, pathogenesis, alterations in metabolism and functions • Use dialectical thinking and methods, such as views of contradictory and unification, transformation, etc. • Selectively review related knowledge learned previously, such as physiology, biochemistry, molecular biology, immunology, pathology, and so on.

14. How to Learn Pathophysiology • Pay attention to experimental courses • Pay attention to clinical practices

15. Disease

16. Concept of Disease • Aberrant manifestation of deregulated • homeostasis caused by harmful agents. • The development of a disease is a • pathologic process with a characteristic • set of signs and symptoms involved in the • whole body or any of its parts.

17. Concept of Health • The state of the organism when it functions • optimally without any evidence of disease. • The definition of health from WHO: • Without any evidence of disease, and a state • of complete well-being physically, socially • and psychologically.

18. Etiology of Disease • Etiology is to study the causative agents, • microorganisms, environmental, social • factors and personal habits as contributing • factors that cause diseases. • Answer the question why disease happens.

19. Etiology Dis-beneficial （Inducer） （+） Diseased body Pathogen Healthy body （ ） Beneficial • Pathogeny: causes disease and endue the characteristics of the diseases

20. Etiological Factors • Extrinsic Factors • Biological agents: microorganisms and parasites: Roup virus • Chemical agents: non-specific and specific • Physical agents: mechanical injuries, extremes of temperature, electricity, and radiation • Nutritional imbalance: excesses or deficiencies

21. 2. Intrinsic Factors • Genetic factors: gene mutation, sickle cell anemia, colorblindness • Congenital factors: abnormal embryonic developmental error • Immunological factors: the immune response is deficient or inappropriately strong or misdirected. • Psychological factors: Anxiety, strong or persistent psychological stress, such as hypertension, peptic ulcer, coronary heart disease, and depression.

22. Predisposing factors • Genetic constitution • Physiological diathesis • Psychological characteristics • Psychological characteristics

23. Basic Mechanisms for Disease • Neural regulations • Hormonal regulations • Organic regulations • Cellular regulations • Molecular regulations

24. General rules for the onset and development of diseases • Disruption of homeostasis • Process of damage and anti-damage • Reversal role of cause and result • Correlation between systemic and local regulations

25. Radiation Trauma Microbe Monocyte Detoxification Physic barrier Carcinoma Coagulation Eyewinker Stress Teratologic Inflammation Immunoreaction Stressor Pyrogen Process of damage and anti-damage

26. Reversal rule of cause and result Primary causes (-) (+) Further alterations Responses Secondary alterations (cause)

27. Systemic and local regulations • Interact and restrict each other • Learn to grasp the key

28. Outcome of Disease Complete recovery Recovery Incomplete recovery Outcome of a disease Death

29. Phases of Diseases 高潮 前奏 尾声 序曲 Clinic symptoms Prodrome Disease Recovery Latency

30. Death • The body as a whole stop working forever • Brain dearth is the marker for the diagnosis

31. Brain Death (WHO criteria) • Cessation of spontaneous respiration • Irreversible coma • Absence of cephalic reflexes • Dilated or fixed pupils • Absence of any electrical activity of the brain • Absence of brain blood flow

32. Significance for diagnosis of brain death • In favor of recording the time of death • Define the time to terminate for the rescue • In favor of organ transplantation