Intro toPathology

What comes to mind when you hear the term

HEALTH?

HEALTH

What comes to mind when you hear the term disease?

DISEASE

Pathology (Key Terms)

Pathology - the study and diagnosis of disease through the examination of organs, tissues, bodily fluids and whole bodies (autopsy).

Disease – any condition that causes extreme pain, dysfunction, distress, social problems, and/or death

Causes of Disease

Causes of Disease

2 broad groups

(2) Non-infectious diseases – are not communicated from person to person and are not known to involve infectious agents. Some causes include:

» Heredity» Lifestyle (diet, stress, etc.)» Example: Diabetes Type II

As You already knowBody’s Reaction to Disease

When pathogens successfully invade the body, the immune system immediately begins to destroy them

The spleen, lymph nodes, tonsils, thymus, lungs, liver, kidneys and entire lymphatic system gets called into action

Lymphocytes– The specialized white blood cells responsible for

combating infectious agents

Do you ever feel like you always seem to get sick at the worst

times??

Hmm, why do you think that is the

case?

StressStress

STRESSDid you know….

75% to 90% of all visits to primary care physicians are for stress-related complaints up to 80% of on-the-job accidents are stress-related 40% of job turnover is due to stress Stress accounts for $26 billion in medical and disability

payments and $95 billion in lost productivity per year Over 50% of lost work days are stress related which

keeps about 1 million people per day from attending work

75% of employees believe the worker has more on-the-job stress than a generation ago

WHAT IS STRESS? Stress is your mind and body’s response

or reaction to a real or imagined threat, event or change.

The threat, event or change are commonly called stressors. Stressors can be internal (thoughts, beliefs, attitudes) or external (loss, tragedy, change).

Different Types of Stress

Eustress vs. Distress

EUSTRESS

Eustress or positive stress occurs when your level of stress is high enough to motivate you to move into action to get things accomplished.

DISTRESS Distress or negative stress occurs when

your level of stress is either too high or too low and your body and/or mind begin to respond negatively to the stressors.

***In his work, Selye - 'the father of stress research,' developed the theory that stress is a major cause of disease because chronic stress causes long-term chemical changes.

He observed that the body would respond to any external biological source of stress with a predictable biological pattern in an attempt to restore the body’s internal homeostasis.

This initial hormonal reaction is your fight or flight stress response - and its purpose is for handling stress very quickly! The process of the body’s struggle to maintain balance is what Selye termed, the General Adaptation Syndrome.

General Adaptation Syndrome

ALARM STAGE First reaction to stress: recognizes there’s a danger

and prepares to deal with the threat, a.k.a. the fight or flight response.

During this phase the main stress hormones cortisol, adrenaline, and noradrenaline, is released to provide instant energy.

If this energy is repeatedly not used by

physical activity, it can become harmful.

FIGHT or FLIGHT Response

Alarm Stage Continued

The excess production of the cortisol hormone can cause damage to cells and muscle tissues. Stress related disorders and disease from cortisol include cardiovascular conditions, stroke, gastric ulcers, and high blood sugar levels.

At this stage everything is working as it should – you have a stressful event, your body alarms you with a sudden jolt of hormonal changes, and you are now immediately equipped with enough energy to handle it.

Stress Hormones Cortisol stimulates the release of glucose,

fats and amino acids into the bloodstream Cortisol levels lowest at night, highest

when you wake up. Under ideal conditions, your cortisol

levels should be neither consistently high nor low, but fluctuate in a fairly rhythmic pattern.

RESISTANCE STAGE The body shifts into this second phase with

the source of stress being possibly resolved. Homeostasis begins restoring balance and a period of recovery for repair and renewal takes place.

Stress hormone levels may return to normal but you may have reduced defenses and adaptive energy left.

Resistance Stage Con’t…

If a stressful condition persists, your body adapts by a continued effort in resistance and remains in a state of arousal.

Problems begin to manifest when you find yourself repeating this process too often with little or no recovery. Ultimately this moves you into the final stage.

Changes to observe in Resistance stage

Behavior indicators include: lack of enthusiasm for family, school, work or life in general, withdrawal, change in eating habits, insomnia, hypersomnia, anger, fatigue.

Cognitive Indicators include: poor problem solving, confusion, nightmares, hyper-vigilance.

Changes to observe in Resistance Stage

Emotional indicators include: tearfulness fear anxiety panic guilt agitation depression overwhelmed.

EXHAUSTION STAGE Your body’s ability to resist is lost because its

adaptation energy supply is gone. Often referred to as overload, burnout, adrenal fatigue, maladaptation or dysfunction

This stage of the general adaptation syndrome is the most hazardous to your health. Chronic stress can damage nerve cells in tissues and organs.

Elevated levels of stress hormones: Obesity Heart disease Depression/anxiety Alzheimer’s disease Diabetes Osteoporosis Fibromyalgia Chronic fatigue syndrome

STUDENT STRESS RATING SCALEThe following are events that occur in the life of a student. Place a check in the left-hand column for each of those events that has happened to you during the last 12 months.___ Death of a close family member - 100 points

____ Jail term - 80 points

____ Final year in high school or first year in college - 63 points

____ Pregnancy - 60 points

____ Severe personal illness or injury - 53 points

____ Marriage - 50 points

____ Any interpersonal problems - 45 points

____ Financial difficulties - 40 points

____ Death of a close friend - 40 points

____ Arguments with your roommate (more than every other day) - 40 points

____ Major disagreements with your family - 40 points’

____ Major change in personal habits - 30 points

____ Change in living environment - 30 points

____ Beginning or ending a job - 30 points

____Problems with your boss or professor - 25 points

____ Outstanding personal achievement - 25 points

____ Failure in some course - 25 points

____ Final exams - 20 points

____ Increased or decreased dating - 20 points

____ Changes in working conditions - 20 points

____ Change in your sleeping habits - 18 points

____ Several-day vacation - 15 points

____ Change in eating habits - 15 points

____ Family reunion - 15 points

____ Change in recreational activities - 15 points

____ Minor illness or injury - 15 points

____ Minor violations of the law - 11 points

Score: _________________

INTERPRETING YOUR SCORE

Less than 150 points : relatively low stress level in relation to life events 150 - 300 points : borderline range Greater than 300 points : high stress in relation to life events

Note: From Girdano, D.A., Everly, G. S., Jr., & Dusek, D. E. (1990). Controlling stress and tension (3rd edition), ENnglewood Cliffs, NJ: Prentice Hall.

I’M IN CONTROL - DISTRESS RELIEF STRATEGIESFeeling good about yourselves can be an effective buffer against stress. Eliminate unnecessary worries.

Most worries are either passed on to us by another or conjured up in our imagination.GET PHYSICAL

1. Relax neck and shoulders

2. Take a stretch

3. Get a massage

4. Exercise

GET MENTAL

5. Count to 10

6. Control your thoughts

7. Fantasize

8. Congratulate yourself

9. Ignore the problem if appropriate, after evaluation

10. Perform self maintenance

11. Talk to a counselor

GET SPIRITUAL

12. Meditate

13. Pray

14. Remember your purpose

USE YOUR BODY AND MIND TOGETHER

15. Take a break

16. Get hug therapy

17. Try progressive relaxation

18. Try yoga

19. Try aroma therapy

20. Laugh

DEVELOP NEW SKILLS

21. Prioritize daily tasks

22. Learn something

23. Practice a hobby

MORE STRATEGIES

“What is Stress” Web Site. http//www.teachhealth.com How to reduce and relieve stress “Web Site. http//www.family.com “Stress Relievers” Web Site. http//www.residentassistant.com “Massage” Downing, G. (1972). Massage Book. New York: Random

House. “Aromatherapy” Web Site.

http//www/aromaweb.com/articles/wharoma.as “Yoga” Web Site. http//www.kevala.co.uk/yoga/overview.htr

Group work time! Work in groups of 4 and answer the following questions on chart paperBe prepared to share your answers with the class1. List the top 10 causes of teen stress2. Define what nutrition means to you3. Define what exercise means to you4. How can proper nutrition and exercise help manage stress?5. Why is it important to consider proper nutrition and exercise when

studying pathology?6. Consider what you know about Canadian's health care system, do you

think we are headed towards a healthy future? What changes would you like to see, if any, within our health care system here in Ontario?

Steps in Diagnosing an Infection

Steps in Diagnosing an Infection1. Examine the Patient

2. Obtain One or More Specimens

3. Examine the Specimen Directly

4. Culture the Specimen

5. Determine the Culture’s Antibiotic Sensitivity

6. Treat the Patient as Ordered by the Physcician

STEP 1: EXAMINE THE PATIENT

Interviewing a Patient, Taking a History & Documentation

Interviewing Skills Effective listening

Being aware of nonverbal clues and body language

Using a broad knowledge base

Summarizing to form a general picture

Interviewing Successfully 1) Do your research

before the patient interview

2) Plan the interview

3) Approach the patient and request the interview

4) Make the patient feel at ease

5) Deal with sensitive topics with respect

6) Do not diagnose or give a diagnostic opinion

7) Formulate the general picture

8) Conduct the interview in private without interruptions

Methods of Collecting Patient DataEffectiveOpen-ended questionsHypothetical questionsMirroring & VerbalizingFocusing on patientEncouraging patient to take the leadEncouraging patient to provide additional informationEncouraging patient to evaluate his situation

IneffectiveClosed-ended questionsAsking leading questions Challenging patientProbingAgreeing or disagreeing with patient

6 Cs of Charting

Client’s words Clarity Completeness Conciseness Chronological order Confidentiality

Methods of Charting

Most charting methods are based on a series of steps to document information

SOAP Method

1) Subjective data: obtained through conversation with patient. Thoughts, feelings, and perceptions

2) Objective data: apparent and measurable. Vital signs and test results

3) Assessment: the physicians diagnosis or impression of the patient’s problem

4) Plan of action: Options for treatment

Good Interview Technique Start with INTRODUCTION

(age, previous illnesses, surgical history, allergies, medication history and family medical history

PQRST Technique

P = Provoke or Palliative

Q = Quality or Quantity

R = Region or Radiation

S = Severity Scale

T = Timing

Health History Form (1) Personal Data – Name

and D.O.B.

(2) Chief Complaint – Main reason patient came to office

(3) History of present Illness – medications taken, pain scale

(4) Past medical History – any and all past and present illnesses and surgeries

(5) Family History – can help lead practitioner to a diagnosis

(6) Social and occupational history – marital status, occupations

(7) Review of symptoms

CASE STUDIES

S.O.A.P Method of Documentation