Module 1

Question 1

Define Pathology.

Answer 1

Pathology is the study of disease - “The study of the structural and functional changes in cells, tissues, and organs of the body that cause or are caused by disease”.

Question 2

Define Disease.

Answer 2

The pattern of response of living organisms to injury - When cells fail to adapt to injury, or the adaptive mechanism itself becomes harmful, disease results. Disease is any deviation from, or interruption of, the normal structure or function of a tissue, organ, or system.

Question 3

Define sign(s) and symptom(s) and distinguish between them.

Answer 3

Sign(s): We identify disease by appearance of physical signs - signs that can be objectively observe/measured (i.e. fever, swelling, etc.)

Symptom(s): Subjective complaints described by the patient (i.e. dizziness, nausea, etc.) - These changes appear late in the disease process, long after the disease is present and has been acting at a cellular level.

Question 4

Define morbidity and mortality and distinguish between them.

Answer 4

Morbidity: Illness that impairs the well-being/normal functioning of a patient (i.e. living with a disease).

Morbidity: Illness causing the death of a patient (death from disease).

Question 5

Has life expectancy increased? What is it for males and females from 2012-2014? What is it for both sexes in 2016?

Answer 5

Yes.

• Males: 79.7
• Females: 83.9
• Both: 82

Question 6

Has life expectancy increased? What is it for males and females from 2012-2014? What is it for both sexes in 2016? What caused this increase?

Answer 6

Yes.

• Males: 79.7
• Females: 83.9
• Both: 82
• Improvements in sanitation, medical care, and in-surgical and drug-related treatments

Question 7

What has caused life expectancy to increase? Give examples.

Answer 7

Improvements in sanitation, medical care, and in-surgical and drug-related treatments.

• Better diets
• Public awareness (i.e. dangers of smoking, drinking and driving, vaccines, etc.)
• Better detection, treatment, and management of chronic conditions

Question 8

What is an accidental death? Where do they rank in cause of death in Canada?

Answer 8

Include but are not limited to:

• Transport accidents
• Discharge of firearms
• Drowning
• Exposure to smoke/fire
• Poison (i.e. overdose)

Accidental deaths are the third leading cause of death in Canada (2017).
- Rose from 8,500 to 13,900… Drug overdose represents 94% of these deaths

Question 9

What is the first and second leading causes of death (2017)? Compare the % between cancer and heart disease from 2000 to 2017.

Answer 9

Cancer and heart disease (48%)

• Heart disease: Fell from 54% in 2000 to 19% in 2017
• Cancer: Deaths have remained stable

Question 10

What are the remaining 7/10 leading causes of death in 2017?

Answer 10

4) Stroke
5) Chronic lower respiratory disease
6) Influenza and pneumonia
7) Diabetes
8) Alzheimer’s
9) Suicide
10) Liver disease

Question 11

What are the chances of developing cancer? What was the estimate for 2019 (diagnosed vs. deaths)?

Answer 11

1/2 Canadians are diagnosed and 1/4 are expected to die:

- 220,400 diagnosed and 82,100 deaths

Question 12

What has changed in the past 5 years about cancer patients?

Answer 12

There is an increasing number of survivors 5 years past their diagnosis.

Question 13

What is the most frequently diagnosed cancer (men vs. women)?

Answer 13

Men: Prostate
Women: Breast

Question 14

What types of cancer comprise 50% of cancer deaths?

Answer 14

Lung, colorectal, breast, and prostate.

Question 15

What is the leading cause of cancer death for both genders? Distinguish between men and women’s survival rate.

Answer 15

Lung cancer

• Men: Mortality rate has decline
• Women: Mortality rate has more than doubled

Question 16

Who does cancer affect more? Why do we see an increased rate of cancer?

Answer 16

Elderly: 40% of new cases and 60% of deaths occur in individuals 70y >
- Growing aged population

Question 17

Broadly discuss the cause of disease. What are most diseases? What do majority of diseases result from?

Answer 17

Diseases result from a variables between:

• Host (genetic) - Ex. Abnormalities such as sickle cell
• Environment - Ex. Physical injury or death from a car crash

Most diseases are multifactorial and due to an interplay between both genetic and environmental components.

Majority of diseases result from both genetic and environmental factors.

Question 18

What are genetic diseases? Are they common?

Answer 18

A disease that results from genetic alterations (i.e. DNA mutations, chromosome rearrangements, etc.)
- Not common - Sporadic mutations to DNA that occur throughout life are more common (i.e. cancer)

Question 19

What is a chromosomal disorder? Give an example (number vs. structure of chromosomes).

Answer 19

It is a form of a major genetic disease accounting for a large proportion of congenital malformations, intellectual disability, and early gestational spontaneous abortions.

• Abnormal number of chromosomes (I.e. Down Syndrome)
• Abnormal structure of chromosomes (i.e. deletions, inversions, translocation, exchange)

Question 20

Describe mutations involving single genes.

Answer 20

Three typical patterns:

1) Autosomal dominant
2) Autosomal recessive
3) X-linked

Question 21

Do all inherited genetic diseases manifest at birth? Give an example.

Answer 21

No:

- Huntington’s Disease is not evident until adulthood

Question 22

Are congenital diseases all genetic? Give an example.

Answer 22

No:

- A fetus is subject to infections that can result in malformations/impairment of function in specific systems

Question 23

What is a congenital anomaly? Do they have an underlying genetic cause?

Answer 23

Structural deficits that are present at birth

- They may or may not have an underlying genetic cause

Question 24

What are common causes of congenital anomalies?

Answer 24

1) Malformations: Result from intrinsically abnormal development process that may involve a single organ or body system or multiple organs/tissues.
2) Disruptions: Result from a secondary destruction of an organ or body region that was normal in development (i.e. extrinsic disturbances).
3) Deformations: Result from a secondary destruction of an organ or body region that was normal in development - May result from localized or generalized compression of the growing fetus by bio-mechanical forces leading to a variety of structural abnormalities.

Question 25

What is a teratogen?

Answer 25

Environmental factors that can cause abnormal development or congenital malformations:
- I.e. Infectious agents (ex. drugs, chemicals, etc.)

Question 26

What are two environmental factors that predispose to disease? Give examples.

Answer 26

The environment can predispose to disease depending on exposure and lifestyle
- Ex. Diet, exercise, weight, smoking, alcohol, etc.

Question 27

What are physical and chemical environmental agents?

Answer 27

1) Physical
- Mechanical Trauma: Cuts, accidents, gunshots
- Temperature: Burns, heatstroke, frostbite
- Electrical burns: natural or man made
- Radiation: Cell division
- Atmospheric Pressure: Deep diving (N in blood), decreased pressure (gas in blood)

2) Chemical Agents
- Environmental or industrial
- Posion
- Toxins

Question 28

What are infectious environmental agents? How are they recognized?

Answer 28

A wide variety exists from microscopic bacteria and viruses to large tapeworms
- They are recognized by the signs and symptoms of a patient (product)

Question 29

What are allergenic environmental agents?

Answer 29

Variety of exogenous and endogenous substances that trigger immune responses

Question 30

What is an iatrogenic disease? Why is it important? How common is it in Canada (%)?

Answer 30

An adverse condition in a patient occurring as the result of treatment by a physician, surgeon, and/or other health professional - It is an unintended injury or complication resulting in death, disability or prolonged hospital stay

• It is important to improve patient safety
• 7.5%

Question 31

What is idiopathic cause of disease?

Answer 31

When one cannot define the underlying cause or ethology of disease.

Question 32

What are the 9 classifications of disease based on pathogenesis? Explain.

Answer 32

1) Injury: Physical, biological, or chemical agents
- At the cellular level, injury must be reversible and the cell/tissue survives or adapts OR irreversible leading to degeneration of the cell and death

2) Inflammation: Common to many diseases

3) Infection: Mild to moderate symptoms - Infectious organisms that produce serious illness in those whose immune systems are compromised
- The extent depends on the attacking organism and the host

4) Immunological Reaction: An excessive immune response, causing body to attack itself or be absent or be depressed

5) Neoplasia: Autonomic proliferation of cells usually causing tumors or masses
- Benign: Will not spread
- Malignant: Can spread

6) Metabolic/Endocrine: Disorders of enzymes, hormones, or secretory products
- Some are genetic

7) Nutritional: Deficiency in protein or calories due to insufficient supply, decreased absorption, transport or utilization or specific vitamin/mineral deficiencies
- In excess = obesity and risk of conditions

8) Vascular Disease: Narrowing of blood vessels (heart attacks and strokes)

9) Psychological Factors: Both cause and effect disease processes
- I.e. Stress may lead to mental illness
- I.e. Drug addictions