Flashcards in Chronic Illness Deck (15)
What is incidence?
The number of new cases
What is prevalence?
The number of existing cases
What is pathophysiology?
Defines the pathological basis of the underlying disease process. It may include causation where it is known and the pathological course. For instance, in atherosclerosis there is deposition in the sub-intimal layer of the arter- ies of atheroma leading to a narrowing of the blood vessels. This occurs prior to any clinical events and, therefore, will be present in the absence of clinically detectable disease.
What is clinical disease?
Occurs when the pathophysiological process leads to a specific clinical consequence. In atherosclerosis the clinical consequence is dependent upon the site of the atheroma. If this predominantly involves the coronary arteries then occlusion with subsequent thrombus leads to myocardial infarction. On the other hand, if the same process involves intracerebral vessels then a cerebrovascular accident (stroke) occurs whereas in the peripheral circulation of the legs the resulting ischaemia leads to intermittent claudication with pain on walking due to poor blood supply to the leg muscles.
What do we mean by illness episode?
The time between the onset and offset of illness
What do we mean by response?
pattern of decrease in symptoms and/or signs of illness indicative of a decrease in severity of the underlying pathological process.
What do we mean by recovery?
A sustained period of health that follows an episode of illness when signs or symptoms of illness are no longer present or are regarded as insufficient to warrant further investigation or a change in treatment.
What do we mean by remission?
A period following an episode of illness of insufficient duration to warrant the term “recovery” when signs or symptoms of illness have lessened in intensity and remain insufficient to warrant further investigation or a change of treatment.
What do we mean by relapse?
The reinstatement of signs or symptoms following an episode of illness. It is not necessary for an individual to have entered a remission in order to relapse and can relapse during the response period.
What do we mean by recurrence?
The reinstatement of a new episode of illness following an abatement of signs or symptoms of sufficient duration to warrant the term “recovery”.
What do we mean by vulnerability?
An individuals capacity to resist disease, repair damage and restore physiological homeostasis can be deemed vulnerability.
It’s particularly important at the extremes of life, as discussed last year.
Even certain organs can vary – to an extent the liver repairs well, whereas the brain does not.
What is hypothetico-deductive reasoning?
You get into your car, turn the key and it does not start.
There are many possible reasons why.
There are a few probable reasons however.- no petrol, flat battery.
However if there was no petrol, at least the electrics would come on.
It’s probably the battery then.
This is hypothetico-deductive reasoning
What are important things to remember about hypothetico-deductive reasoning?
Some causes are more probable than others. Whilst it is therefore efficient to bear the common causes uppermost in our minds, at the back of our minds we also have to hold the important, although rare, possibilities. Some of these may have to be positively excluded even although they are unlikely.
Some pieces of information are more valuable than others. In fact often a very few pieces of information are crucial, whilst other information adds relatively little to the solution of the problem.
What is inductive reasoning?
What we fall back on.
What if you knew nothing about cars.
You would start systematically thinking about what might be wrong.
This is how you learn medicine