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Concept Disease Ch1

Principles of Diagnosis

lesions well-defined, characteristic structural changes present in various organs/tissues
disease is often associated with lesions
gross examination examining with naked eye
histological examination exam with aid of microscope
lesions can be recognized by what type of exam? gross or histological
specialized studies supplement to histological exam, which evaluates properties of cell membranes & proteins within cell
organic disease associate with structural changes
functional disease no morphological abnormalities even though body functions may be profoundly disturbed
pathology study of disease
pathologist physician specializing in diagnosing & classifying diseases
pathologists diagnose & classify diseases by examining the ___ of cells & tissues. morphology
symptoms of a disease subjective manifestations in an affected individual
signs of a disease objective manifestations, detectable by clinician; physical findings
abnormal lab test results changes in quantity of circulating blood, or to biochemical constituents in blood fluids
asymptomatic disease/illness disease causing no discomfort/disability to affected individual
in its early stages a disease is often asymptomatic
distinction between asymptomatic/symptomatic disease is one of degree depending primarily on extent of disease
etiology cause, especially the cause of a disease
disease of unknown etiology is one for which the cause is not yet known
etiological agent agent responsible for cause of disease
pathogenesis manner by which disease develops
pathogen any microorganism that causes development of a disease
lesions produced by various disease in a category are morphologically similar or have similar pathogenesis
congenital & hereditary diseases result of a range of developmental disturbances
inflammatory diseases body reacts to injurious agent by means of inflammation
sore throat or pneumonia, as an inflammatory disease, are caused by bacteria or other microbiological agents
as an inflammatory disease "hay fever" is a manifestation of an allergic reaction or hypersensitivity state in the patient
caused by antibodies formed against the patient's own tissues inflammatory autoimmune diseases
primary abnormality is degeneration of various parts of the body degenerative diseases
these are more advance/occur sooner that normal if age related & distinctly abnormal degenerative lesions
certain types of arthritis & arteriosclerosis are common examples of degenerative diseases
chief disturbance in some important metabolic process in the body metabolic diseases
common examples of metabolic diseases are diabetes, disturbances of endocrine glands & electrolyte balances
characterized by abnormal cell growth leading to formation of various benign/malignant tumors neoplastic diseases
goal of traditional medicine cure or ameliorate disease
health condition in which mind/body function efficiently & harmoniously as integrated unit
diagnosis determination of nature & cause of patient's illness
the diagnosis is based on practitioner's evaluation, patient's subjective symptoms, physical findings & results of various lab tests
prognosis opinion concerning eventual outcome of disease/disorder; outlook for recovery
history of present illness elicits details concerning severity, time of onset & character of patient's symptoms
past medical history provides details of patient's general health & previous illnesses
family history provides information about health of parents & other family members
social history deals with patient's occupation, habits, alcohol & tobacco consumption & similar data
review of symptoms inquires as to presence of symptoms other than those disclosed in history of present illness
possible dysfunctions of other organ systems are evaluated by systematic inquiry
physical examination systemic evaluation of patient
differential diagnosis the practitioner considers number of diseases characterized by patient's symptoms
practitioner can narrow list of diagnostic possibilities to arrive at correct diagnosis by using selected lab test or other specialized diagnostic procedures
medical consultant physician with specialized training & experience in type of medical problems presented by patient
disease-management team composed of group of persons with special skills useful to care/treatment of patients with the diseases
specific treatment exerts highly specific & favorable effect on basic cause of disease
symptomatic treatment alleviates symptoms but doesn't influence course of underlying disease
screening tests for disease are important because many diseases respond to treatment are asymptomatic initially
when left untreated the disease often progresses slowly causing gradual but progressive organ damage until person is seriously ill with far advanced organ damage from the disease
treatment of late-stage disease is often much less effective and may not be able to restore function of organs that have been damaged
disease-related organ damage can be prevented or minimized if identified & treated in its asymptomatic stage
a successful screening program should include significant # of persons in group being screened are at risk for the disease
a successful screening program should be relatively inexpensive test not yielding excessive # false-positive/false-negative results in screening for the disease
a successful screening program should provide for early identification & treatment of disease with favorable influence on health/welfare of persons with the disease
screening tests should target group of persons with relatively high frequency of disease & age group disease likely to be present
screening groups of persons for a disease in early asymptomatic stage requires type of test that can identify characteristic manifestation of the disease
false-positive test is positive when no disease is present
less sensitive screening tests can yield an excess of false-negative results
false-negative test is negative when disease is present
screening test results should provide some benefit to the person being screened
there is no point in screening for a disease if there is no treatment available to arrest progression of disease
cost-effective screening test for diabetes urine test to detect glucose in urine
cost-effective screening test for colon tumors tests to detect blood in stools
cost-effective screening test for abnormalities in epithelium of uterine cervix that is predisposed to cancer Papanicolaou smear (Pap tests)
cost-effective screening test for very early breast cancer at stage when can be treated most effectively mammograms - breast x-ray examinations
can also be used to screen for carriers of some genetic diseases screening tests
screening tests to identify genetic disease trait carriers allows for persons to make decisions about future childbearing or management of future pregnancy
invasive procedures patient's body is actually "invaded" in some way in order to obtain diagnostic information
noninvasive procedures entail minimal/no risk/discomfort to patient in order to obtain diagnostic information
with any diagnostic procedure the practitioner must possible disadvantages to patient vs. benefits derived from info obtained during procedure
it would be unwise to perform a potentially risky diagnostic procedure if info gained would not significantly contribute to diagnosis or influence course of treatment
can be used to determine the concentration of various constituents in the blood/urine frequently altered by disease clinical lab tests
using clinical lab tests could determine concentration of urea in blood to diagnose kidney function issues
clinical lab tests can detect concentrations of hemoglobin & quantity of reduced red cells in patients with anemia
clinical lab tests can determine concentration (activity) of enzymes in blood
enzyme levels in blood can be elevated, and detected with clinical lab tests, due to enzymes leaking from diseased/injured organs
when enzyme synthesis is increased as a result of disease enzyme levels in blood can be elevated & detected with clinical lab tests of blood
when there is elevated enzyme levels in clinical lab tests of blood, it can indicate excretion of enzymes impaired due to blockage of normal excretory pathways by disease
clinical lab tests may also be used to evaluate function of organs
clearance tests measure rate at which a substance is removed from blood & excrete in urine
provides a measure of renal function clearance tests
pulmonary function tests measure rate at which air moves in/out of lungs
determination of concentration of O2 & CO2 in blood can also indicate pulmonary function
simple device applies to finger can rapidly calculate the amount of O2 carries by hemoglobin as another measure of pulmonary function
measure of liver function tests that measure uptake & excretion of various substances by the liver
serial analysis of liver uptake substances can be used to monitor response of certain tumors to treatment
microbiological tests detect presence of disease-producing organisms in urine, blood & feces
determine responsiveness of organisms to antibiotics microbiological tests
serologic tests detect & measure presence of antibodies as indication of response to infectious agents
ECG, EEG, & EMG are tests measuring electrical impulses associated with various bodily functions/activities
the most widely used test of electrical activity is the ECG (electrocardiogram)
ECG (electrocardiogram) electrodes measure serial changes in electrical activity of heart during various phases of cardiac cycle
identifies disturbances in heart rate/rhythm & abnormal conduction of impulses through heart ECG (electrocardiogram)
heart muscles injury (i.e. heart attack) can be recognized by means of characteristic abnormalities in cardiogram
EEG (electroencephalogram) measures electrical activity of brain via electrodes attached to various areas on scalp
EEG can detect brain tumors, strokes, & many abnormalities of cerebral structure/function
EMG (electromyogram) measures electrical activity of skeletal muscles at rest & at contraction
EMG detects abnormal electrical activity often encountered in various inflammatory/degenerative diseases involving skeletal muscles
radioisotope (radionuclide) studies evaluates function of various organs by administering radioisotope
radioisotope substance labeled with radioactive material
specially processed albumin labeled with radioisotope is administered intravenously as measure of pulmonary blood flow; used frequently to detect blood clots in lung
phosphorus containing isotopes are concentrated in skeletal system; can detect deposits of tumor in bones
using radioactive material injected intravenously can be used to evaluate blood flow to heart muscle & identify areas of damaged heart muscle
endoscopy exam of interior of body by means of various flexible/rigid tubular instruments
endoscopic tubular instruments are named according to part of body designed to examine
esophagoscope used to examine interior of esophagus
gastroscope used to examine interior of stomach
bronchoscope used to examine interior of trachea & major bronchi
cystoscope used to examine interior of bladder
sigmoidoscope rigid tube used to examine rectum & sigmoid colon
colonoscope flexible tube used to examine entire length of colon
laparoscope used to visualize abdominal & pelvic organs
laparoscopy procedure used to visualize abdominal & pelvic organs
laparoscopy can be used to visualize abdominal & pelvic organs and also perform various surgical procedures to excise tissues/organs formerly removed through much larger incisions
ultrasound technique for mapping echoes produced by high-frequency sound waves transmitted into the body
ultrasound is widely used during pregnancy to study uterus, position of placenta & fetus within uterus, identify fetal abnormalities & detect twins
using ultrasound to study structure/function of heart valves can detect valve abnormalities & identify blood clots in association with infection of the valve
X-ray examination x-rays are passed through the part of the body to be examined & rays leaving body expose an x-ray film
extent to which x-rays are absorbed by tissues as they pass through body depends on density of tissues
during x-ray exams, tissues of low density appear as black
during x-ray exams, tissues of high density appear as white
during x-ray exams, tissues of varying densities appear as varying shades of gray
roentgenogram (radiograph) x-ray image produced on the film
a contrast medium is needed when using x-ray to examine intestinal & urinary tract, bronchi, fallopian tubes & biliary tract
contrast medium dense radiopaque substance that enhances visibility
administered when x-ray examination of linings of internal organs that have little contrast contrast medium
this is necessary in order to x-ray exam interior of gastrointestinal tract suspension of barium sulfate to swallow or administer as an enema
bronchogram visualizing lining of bronchi by instilling radiopaque oil into bronchi
intravenous pyelogram (IVP) radiopaque substance injected into vein & excreted in urine as blood flows through kidney outlining contour of urinary tract
retrograde pyelogram cystoscope introduced into bladder & dye introduced directly into ureters
arteriogram or angiogram dye injected to study blood flow of lrg arteries & identify areas of obstruction
using arteriography is often used to detect narrowing/obstruction of coronary &/or carotid arteries which carry blood to brain
obstruction of pulmonary arteries by blood clots can also be identified by arteriography
cardiac catheterization study flow of blood through heart & can detect abnormal communications between cardiac chambers
CT (computed tomography) scan highly sophisticated x-ray machine produces images of body in cross section by rotating x-ray tube around patient at various levels
in CT scans the amount of radiation absorbed is not read on an x-ray film; instead radiation detectors fed into computer that reconstructs data into images of patient's anatomy
abnormalities of internal organs that cannot be identified by standard x-ray exams can often be identified with CT scans
increases in used of CT scans in recent years has been used in screening asymptomatic persons for lung/colon tumors & screening studies in children
due to increased exposure to radiation in CT scans this is a comparable alternative exam ultrasound exam
magnetic resonance imaging (MRI) produces computer-constructed images of various organs/tissues
MRI scans depend on response of hydrogen protons contained in water molecules when placed in a strong magnetic field
in MRI scans, when a pulse of radiofrequency waves is directed at the protons they are temporarily dislodged from their orientation, then when return to original position emit signal (resonance) measured & used to produce image
MRI is useful in demonstrating areas where myelin sheaths of nerve fibers have been damaged in a neurological disease called multiple sclerosis
positron emission tomography (PET scan) related to radioisotope studies but more complex/sophisticated & one of newest diagnostic imaging tests
positrons unique subatomic particles that have same mass as electrons but carry positive charge
positrons are formed when atoms are bombarded in cyclotron which high-energy particles, which breaks down atomic nuclei & releases positrons along with other subatomic particles
when escaping positrons collide with negatively charged electrons circling nuclei they produce radiation that can be detected & measured by sensitive radiation detectors
PET scan studies provide information on metabolic activities of organ/tissue being studied, site within organ where compound is being metabolized & blood flow to organ being studied
major clinical application for PET scans is to assess biochemical functions within in the brain
PET scans are able to measure changes in brain functions associated with strokes, brain tumors, Alzheimer disease, Parkinson disease, & some degenerative hereditary diseases of nervous system
A disease in which no morphologic abnormalities can be identified, despite a disruption of bodily function, is Functional Disease
physician who specializes in the diagnosis and classification of disease is pathologist
A disease caused by chromosomal damage at birth would be classified as congenital
A young woman has a benign growth of cells on her thymus. This patient's condition would be classified as neoplastic disease
The opinion of a physician concerning the origins of a disease in a patient is called etiology
A physician examines a patient and determines that the origin of the patient's condition was a Giardia infection caused by drinking contaminated water. The physician's evaluation is called an etiology
A diagnostic test that measures an organ or system's uptake and excretion through the use of a radioactive material is radioisotope
Examining diseased tissue with the naked eye is called a ________ examination gross
esophagoscopes, gastroscopes, cystoscopes, and sigmoidoscopes are all tools used for endoscopy
A computed tomographic scan is a type of x-ray machine
The major clinical use of PET scans today is to examine the brain
An MRI scan uses a magnetic field to align hydrogen protons within the water that naturally composes the patient's tissues
Common types of cytologic and histologic examinations include pap smear & biopsy
genetic abnormalities, abnormalities in #/distribution of chromosomes, intrauterine injury resulting of various agents, or interaction of environmental/genetic factors congenital/hereditary diseases