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Chapter 1: Pathology:, Vocab:
aberrant: departing from accepted standard…
Chapter 1: Pathology:
A. Pathology's definition:
- DEFINITION:
- anatomical & physiological changes in disease
- FUNCTION: explains 7 things DISEASE'S CHARACTERISTICS DOC
- Pathogenesis
- Characteristics: ↑ Diseases' categorization
- Complications
- Prognosis
- Epidemiology
- Prevention
- Treatment
Aetiology: 4
- a. Unknown causes (Idiopathic):
- Clues via: clinical genetics & molecular biology to study diseases in people with risk factors; eg.:
- Constitutional/genetic traits/abnormalities
- Habitats or geographic regions: most common clue = microbes
- Habits
- Others have permissive effect, developing disease: eg. Malnutrition favors infections
- b. Single Causes (Unifactorial): 2 aetiology + techniques for elucidation
- entirely genetic: inherited or prenatally acquired defects of genes; are increasing
- entirely environmental: most diseases; linked with occupations or geographic regions
- Microbes: most abundant cause
- Chemicals
- Radiation
- Mechanical trauma
- c. Complex causes (Multifactorial):
- combined causes (genetic + environmental)
- d. Cause >1 disease:
- eg. Ionising radiation cause rapid deterioration → death, tissue scarring, or tumours
- Ways of classifying between genetic or environmental causes; Best Way: lab
- Disease's association with host factors:
- Age
- Nutritional status
- Genetic influences/variables
- Pre-existing immunity
- 6 Clues:
Disease's probability:
- relationship between quantity of causal agent & probability that disease will occur ≠ always linear; e.g. infections by sufficient no. of microorganisms + overcome body's defenses = disease
- some agents (e.g. alcohol) are beneficial in small doses; abstention from alcohol confers slightly higher risk of premature death from IHD
*Relationships between amount of causal agent & probability of disease
A. Physical agents: e.g. risk of traumatic injury to pedestrian ↑ in proportion to kinetic energy of motor vehicle
B. Infectious agents: result only if sufficient numbers of microorganism are transmitted; smaller numbers can be eliminated by nonimmune & immune defenses
C. Allergens: in sensitized (i.e. allergic) individuals, minute amounts of allergen provoke severe anaphylactic reaction
D. J-shaped curve: best exemplified by alcohol, of which small doses (c. 1-2 units/day) ↓ risk of premature death from IHD, but larger doses ↑ cirrhosis
5 predisposing factors & precursors of disease:
- predictable diseases: genetic factors have little contribution
- e.g. physical injury: mechanical trauma or radiation injury are dose-related thus directly proportional agent's strength
- probable diseases: won’t always happen
- e.g. infectious diseases from harmful environmental agents, but influenced by host factors
- diseases with congenital predisposition:
- e.g. ankylosing spondylitis (disabling inflammatory disease of spinal joints of unknown aetiology) occurs more commonly in HLA-B27 allele individuals or haplotype
- diseases predispose to risk of other diseases such as increased risk of cancer which are premalignant conditions; e.g. include below; preneoplastic conditions (diseases predisposing to tumors); preneoplastic lesions (lesions from which tumors develop); premalignant lesion (histologically identifiable antecedent lesion from which cancer directly develops)
- hepatic cirrhosis predisposes to hepatocellular carcinoma
- ulcerative colitis predisposes to carcinoma of colon of large intestine
- some diseases predispose to others due to permissive effect, allowing normally nonharmful/nonpathogenic environmental agents to cause disease; exemplified by opportunistic infections in patients with impaired defense mechanisms = infection by normally nonharmful/nonpathogenic organisms to humans
- patients with leukemia or AIDS, organ transplant recipients, or other patients treated with cytotoxic drugs or steroids, are susceptible to infections; e.g.
- pneumonia due to Aspergillus fungi, cytomegalovirus or Pneumocystis jirovecii
Cause vs agent:
- both (cause & agent) should be distinguished; e.g. tuberculosis' underlying cause = adverse socioeconomic factors (eg. poverty, social deprivation & malnutrition), not by tubercle bacillus (Mycobacterium tuberculosis) which is disease's agent
- decline in incidence of many serious infectious diseases is due to improved hygiene, sanitation & general nutrition rather than to immunization programmes or specific antimicrobial therapy -> country's/individual's socioeconomic status influence prevalence of environmental factor or host’s susceptibility to it
Causal associations:
- mark risk of developing disease; ≠ actual cause
- stronger = likely disease's aetiology
- powerful if:
- plausible
- disease's presence linked with prior exposure to putative cause
- disease's risk proportional to level of exposure to putative cause
- removal of putative cause lessens disease's risk
- above criteria's utility is via association between lung cancer & cigarette smoking
- tobacco smoke: has carcinogenic chemicals; ↓ cigarette consumption = ↓ lung cancer's risk
- neither exclusive nor absolute; e.g. because some heavy cigarette smokers never develop lung cancer, smoking alone ≠ cause -> other causative factors
- strongest with infections; e.g. syphilis (venereal disease) is always due to infection by (no other possible cause) & is only disease caused by spirochaete Treponema pallidum
4 Koch's postulates:
- infective cause of disease isn't proven until satisfies criteria enunciated by Robert Koch (German bacteriologist); each postulate have lost their novelty but has undiminished relevance & further comment due to exceptions; organism must be:
- sufficiently abundant in every cause to account for disease
- in some diseases, causative organism is very sparse; e.g. tuberculosis, where destructive lesions contain very few mycobacteria; destruction is caused by immunological reaction triggered by organism's presence
- linked with disease, can be cultivated artificially in pure culture
- some microorganism's cultivation is difficult, yet with undisputed role in disease's aetiology
- cultivated organism produces disease upon inoculation into another member of same species
- ethics prohibit willful transmission of disease between persons, but animals have been used successfully as surrogates for human transmission
- antibodies to organism appear during disease's course
- immunosuppression: lessen antibody response & render host very susceptible to disease; if antibody's detected , it should be further classified to confirm that it's Ig M class antibody, denoting recent infection, rather than IgG antibody, denoting long-lasting immunity due to previous exposure to organism
- combined causes (genetic + environmental)
- combined causes (genetic + environmental)
- combined causes (genetic + environmental)
- Pathogenesis:
- mechanism through which aetiology operates to produce pathological & clinical manifestations, & cause disease by acting through same common pathway of event
- e.gs include:
- inflammation: response to many microorganisms & other harmful agents causing tissue injury
- degeneration: deterioration of cells/tissues in response to, or failure of adaptation to, agents
- carcinogenesis: mechanism by which cancer-causing agents result in tumor development
- immune reactions: undesirable effects of body's immune system
Latent intervals & incubation periods:
- 3 cases:
- immediately (usually, some time elapses) after exposure: signs & symptoms caused by few aetiological agents
- latent interval of 2-3 decades: period in carcinogenesis context
- incubation period in days/weeks: period between exposure & disease development in infectious disorders; each infectious agent's linked with incubation period
- during these periods, pathogenesis of disease enacted culminating in symptomatic pathological & clinical manifestations
- Structural & functional manifestations:
- aetiological agent acts through pathogenic pathway or mechanism to produce manifestations of disease → signs & symptoms of disease (e.g. weight loss, shortness of breath) & abnormal features or lesions (e.g. lung carcinoma) to which clinical signs & symptoms can be attributed
- pathological manifestations are visible to unaided eye or by microscopy or radiologically or biochemical changes in tissues & blood (latter's more important than structural changes, & appear late in course of disease)
- each disease has its own distinctive & diagnostic features; some common structural & functional abnormalities, alone or combined = ill health
Structural abnormalities:
- common causing ill health:
- SOLs (e.g. cysts, tumours) destroying, displacing or compressing adjacent healthy tissues
- deposition of excessive/abnormal material in organ (e.g. fat, amyloid)
- abnormally sited tissue (e.g. tumors, heterotopias) as result of invasion, metastasis or developmental abnormality
- loss of healthy tissue from surface (e.g. ulceration) or within solid organ (e.g. infarction)
- obstruction to normal flow in tube (e.g. asthma, vascular occlusion)
- distension or rupture of hollow structure (e.g. aneurysm, intestinal perforation)
- other structural abnormalities visible only by microscopy don't directly cause clinical signs or symptoms but are diagnostically useful & are specific manifestations of disease, thus, morphological exam of diseased tissues helps for clinical diagnosis & research
- electron microscopy: see alien particles (e.g. viruses) in affected tissue, or abnormalities in no., shape, internal structure/size of tissue components (e.g. intracellular organelles or extracellular material)
- light microscopy: sees abnormalities in cellular morphology or tissue architecture
- Immunohistochemistry: make visible invisible, & alterations in cells & tissues
- naked eye: changes in size, shape or texture of whole organs discerned either by direct inspection or by radiology
Functional abnormalities:
- e.gs include:
- excessive secretion of cell product (e.g. nasal mucus in common cold, hormones having remote effects)
- insufficient secretion of cell product (e.g. insulin lack in type 1 diabetes mellitus)
- impaired n. conduction
- impaired contractility of muscular structure
What makes patients feel ill:
- due to 1 or combination of common symptoms:
- pain
- fever
- nausea
- malaise
- in addition to above, there are other specific expressions of illness that focus diagnostically & therapeutically on organ or body system; e.gs include:
- altered bowel habit (diarrhoea or constipation)
- abnormal swellings
- shortness of breath
- skin rash (may or may not itch)
- symptoms: have identifiable scientific basis, which is important to know because nothing more than symptomatic treatment is required because either disease will remit spontaneously (e.g. common cold) or there's no recovery (e.g. disseminated cancer)
- 11 egs of known symptoms' mediators:
Lesions:
- structural or functional abnormality causing ill health
- thus, in patient with myocardial infarction, infarct (patch of dead heart m.) is lesion, which is consequence of another lesion → occlusion of coronary a. by thrombus (coronary a. thrombosis)
- may be purely biochemical (e.g. defect in haemoglobin synthesis in patient with haemoglobinopathy)
- some diseases have no visible lesions despite profound consequences for patient
- e.g. schizophrenia & depressive illness yield nothing; visibly abnormal in brain if examined using conventional methods
Pathognomonic abnormalities:
- pathognomonic features denote 1 disease or disease category
- without them = impossible or uncertain diagnosis
- e.g. Reed-Sternberg cells are pathognomonic of Hodgkin disease; they're exceptionally rare in any other condition; similarly, presence of M. tuberculosis is pathognomonic of tuberculosis
- but some diseases are characterized only by combination of abnormalities, none of which on its own is absolutely diagnostic; only particular combination is diagnostic
- syndromes
G. Syndromes:
- diseases characterized by multiple abnormalities, thus, aggregate of signs & symptoms or combination of lesions from which disease’s recognized/diagnosed
- have eponymous titles; e.gs include:
- Cushing syndrome: hyperactivity of adrenal cortex → obesity, hirsutism, hypertension, etc
- Cushing disease: is Cushing syndrome resulting specifically from pituitary tumor secreting ACTH
- Nephrotic syndrome: albuminuria, hypoalbuminemia & oedema; result from variety of glomerular & other renal disorders
- Complications & sequelae:
- diseases may have prolonged, secondary or distant effects; e.gs. include:
- spread of infective organism from original infection site, causing inflammatory reaction to another body part where similar reaction occur; similarly, malignant tumors begin in 1 organ as primary tumors, but tumor cells permeate lymphatics & blood vessels, & spread to other organs to produce secondary tumors or metastases
- disease's course may be prolonged & complicated if body's capacity for defence, repair or regeneration’s deficient
- Prognosis:
- forecasts disease's course & patient's fate
- e.g. saying 5-yr survival prospects for pancreas carcinoma are ~5% = prognosis for that condition
- we can be very specific because available info. about patient & disease enable accurate forecast
- e.g. patient with lung carcinoma already spread to liver, bones & brain very probably & unfortunately have 6-month survival prospect of nil
- prognosis for any disease may be influenced by medical or surgical intervention = objective; thus, must distinguish between prognosis for disease that's allowed to follow its natural course & prognosis for same disease in group of patients receiving appropriate therapy
- in assessing long-term prognosis for chronic disease, compare survival of group of patients with actuarial data for comparable populations without disease
- survival data for group with disease can be corrected to allow for deaths that are likely to occur from other diseases
Remission & relapse:
- not all chronic diseases pursue relentless course
- some are led by periods of quiescence when patient enjoys good health
- some diseases oscillate through several cycles of remission & relapse before patient's cured of or succumbs to disease
- 2 diseases characterized by tendency to remit & relapse include:
- chronic inflammatory bowel disease (Crohn's Disease & ulcerative colitis)
- treated acute leukaemia in childhood
Morbidity & mortality:
- morbidity of disease: sum of effects on patient that may or may not result in patient's disability
- e.g. nonfatal myocardial infarct (heart attack) leaves scarring area of myocardium, impairing its contractility & predisposing to heart failure = patient's morbidity
- heart failure manifests itself with breathlessness, restricting patient's activities = patient's disability
- mortality of disease: probability that death will be end result; expressed as % of all those patients presenting with disease
Disability & disease:
- many diseases = only transient disability
- e.g. influenza or bad cold necessitate time off work for employed person
- some diseases are linked with significant risk of permanent disability; in such cases, treatment is to minimize risk of disability
- some investigations & treatments carry small risk of permanent harm & risk of disability must be outweighed by benefit to patient
- earlier disease's diagnosis = smaller risk of disability either from disease or its treatment; this is one of main objectives of screening programmes for conditions (e.g. cervix & breast cancers)
- objective assessment, preferably measurement, of disability is important in evaluating disease's impact or it's treatment's adverse effects
- e.g. there's balance between longevity for survival from disease & quality of life during survival period after diagnosis
- treatment prolonging life & suffering is unacceptable
- treatment that makes patient more comfortable but doesn't prolong life may be more acceptable
- measures that take account of duration & quality of survival are QALYs (quality-adjusted life years) & DALYs (disability-adjusted life years), which both enable scientifically based judgments about impact of diseases, treatments & preventive measures
B. Pathology's History:
- natural explanations (currently obsolete) of symptoms, signs & postmortem findings were due to imbalance ('isonomia') of 4 humours:
- phlegm
- black bile
- choler or yellow bile
- blood
Morbid anatomy:
- body’s internal exam after death
- Landmark: was when 3 scientists who correlate findings of performed & documented autopsies with:
- patient's clinical signs & symptoms
- natural history of numerous diseases
- Gross pathology: no microscopy → ↑ knowledge of morbid anatomy
-
Microscopic & cellular pathology:
- Microscopy: study of diseased tissues
- previously believed that tissue alteration in disease is due to abiogenesis
- knows nothing about viruses, bacteria, ionising radiation, carcinogenic chemicals, etc
- microorganisms in environment contaminate & impair wine's quality
- Rudolf Virchow: recognized cells are smallest viable constituent units of body; his theory of:
- Cellular pathology: light microscope sees diseased tissues at cellular level, extended further by electron microscopy
- is incomplete & mutable but biochemistry understands diseases at molecular level
Cellular & molecular alterations in disease:
- clearly understand how disturbed normal cellular & molecular mechanisms cause disease
Molecular pathology:
- exemplified by knowledge advancement in biochemical basis of congenital disorders & cancer
- techniques + simple principles (hard practice) show 1 nucleotide change in genomic DNA → defective gene product (fundamental lesion in disease) (Ch. 3)
-
C. Scope of Pathology:
- Scientific knowledge is from:
- analogy from experimental studies on animals, cell cultures & computer simulations
- observation on & detailed study of tissue & body fluids from patients
- Pathology: transfer lab investigations knowledge to clinical practice
- experimentation
- clinical trials
Clinical pathology:
- Clinical medicine can't be practised effectively without understanding pathology, & involves longitudinal approach to patient's illness:
- Diagnosis:
- patient's history: document symptoms
- examination: clinical signs
- investigation: guided by diagnosis based on signs & symptoms
- treatment
- follow-up
- Clinical pathology: meaningless if lacks clinical significance & involves cross-sectional analysis at disease's level as 2 complementary & inseparable perspectives
- cause & mechanisms of disease
- disease's effects on organs & systems
- Pathology in clinical practice includes: subdivisions professionally as each requires its own team of trained specialists than educationally at undergraduate level
- histopathology
- cytopathology: investigate & diagnose disease from examining isolated cells & chromosomes
- haematology
- microbiology
- immunology: study body's specific defense mechanisms
- chemical (or biochemical) pathology
- genetics: study abnormal chromosomes & genes
- toxicology: study effects of known/suspected poisons
- forensic pathology: legal use of pathology (e.g. investigate death in suspicious circumstances)
- Pathology: must be taught & learnt in integrated manner, for body & diseases make no distinction between these professional subdivisions → multidisciplinary approach to pathology
- Systemic section (part 3):
- pathological basis for each disease's clinical implications, signs & symptoms
F. Making diagnoses:
- Diagnosis:
- name disease in patient; enables patient to be at least likely effective since its effects has been observed in other patients with same disease
- ~70% of clinical diagnoses rely on pathology investigations, i.e. 90% of objective data in electronic patient records are from pathology labs
- exclude other possibilities & leave 1 diagnosis; found in decision trees or diagnostic algorithms
- decide which organ or organ system is affected by disease
- from signs & symptoms, decide which general category of disease (inflammation, neoplasia, etc)
- via other factors (age, gender, previous medical history, etc), infer diagnosis or small no. of possibilities for investigation
- investigate only if outcome of each one can be expected to resolve diagnosis, influence management if diagnosis is already known
Diagnostic pathology:
- living patients: apply pathological methods (exam of tissue biopsies & body fluids)
- if there are clinical indications to do so, samples are examined to monitor disease's course & response to treatment
Autopsies = see for oneself
- inspect & analyze organs rather than relying on clinical signs & symptoms & results of diagnostic investigations during life
- useful for:
- determine death's causes & mechanisms
- audit of accuracy of clinical diagnosis
- education of undergraduates & postgraduates: correlate clinical signs with underlying pathological basis
-
Disease mechanisms:
- causation, mechanisms & characteristics of major categories of disease: pathology’s foundations to be understood before studying systematic pathology
Systematic (shouldn't be confused with systemic) pathology:
- is our current knowledge of specific diseases as they affect individual organs/systems
- Systemic pathology: characteristic of disease affecting all body systems
- each disease is attributed to operation of 1/more causes & mechanisms
- thus, acute appendicitis is acute inflammation affecting appendix; lung carcinoma is result of carcinogenic agents acting upon lung cells & behavior of formed cancerous cells follows pattern of malignant tumors, & so on
Pathology in problem-oriented integrated medical curriculum:
- there must be integrated understanding of disease in medicine, surgery, pathology & other disciplines
- Pathological basis of common clinical signs
- Generally, a clinicopathological understanding of disease: achieved by 2 approaches
Problem-oriented:
- 1st step in clinical diagnosis of disease
- in many illnesses, symptoms (patient's problem) alone suffice for diagnosis
- in other illnesses, clinical signs (e.g. abnormal heart sounds) are needed to support diagnosis
- in some cases, special investigations (e.g. lab analysis of blood/tissue samples, imaging techniques) determine diagnosis
- links between diseases (pathological basis) & problems they produce are emphasized in systematic chapters (Part 3) & in table below:
*Combinations of clinical problems with pathological basis
- Justifications for encouraging problem-oriented approach include:
- Patients present with ‘problems’ rather than ‘diagnoses’
- Some clinical problems have uncertain pathological basis (true of psychiatric conditions)
- Clinical treatment: aimed at relieving patient's problems rather than curing disease (which may either remit spontaneously or be incurable)
Disease-oriented:
- more relevant since medical practitioners require knowledge of diseases (e.g. pneumonia, cancer, ischaemic heart disease) for correct diagnosis & most appropriate treatment
- present pathological knowledge
- unclear understanding of disease if problems such as 'cough, weight loss, headaches & pain' are as separate chapters in a textbook, since 1 disease cause variety of problems
Building knowledge & understanding:
- operating theatre & outpatient clinic: provide ample opportunities for further experience of pathology
- e.g. hearing diastolic cardiac murmur through stethoscope prompt student to consider pathological features of narrowed mitral valve orifice (mitral stenosis) causing murmur, & effects of this stenosis on lungs & rest of cardiovascular system
G. Pathology, patients & populations:
- as pathology is focused on individual patients, knowledge of causes of death, disability & death has wide implications about society
Causes & agents of disease:
- what constitutes cause of disease can be controversial
- There's argument that pathology ID agents of diseases rather than underlying causes
- e.g. Mycobacterium tuberculosis: bacterium is agent that cause tuberculosis, but people exposed to it alone don't develop disease → social deprivation & malnutrition (both of which are linked with increased risk of tuberculosis) are causes
- fall of may serious infectious diseases was via improvements in following as by specific immunization & antibiotic treatment:
- housing
- hygiene
- nutrition
- sewage treatment
Nation's health:
- enables diagnoses during life by biopsy + after death by autopsy = accurately documents incidence of disease in population
- cancer registration data: most reliable when based on histologically proven diagnoses
- Epidemiological data derived from death certificates: unreliable unless verified by autopsy
Preventing disability & premature death:
- lab methods: detect early disease by population screening
- earlier detection of disease = better cure's prospects:
- e.g. risk of death from cervical cancer: reduced by screening programmes; in combination with testing for HPV, women's cervix scraped at regular intervals & exfoliated cells examined microscopically to detect earliest changes of development of cancer
- screening for breast cancer: via mammography (radiographic imaging of breast)
- any abnormalities: investigated by microscopically examining either cells/tissue from suspicious area
Pathology & personalized medicine:
- for cancer: type of disease (e.g. invasive adenocarcinoma), its grade (aggressiveness/degree of malignancy) & stage (extent of spread) helps choose most effective treatment
- better understanding of molecular pathology of cancer & development of therapies targeting molecular abnormalities in disease → personalized medicine
- based on molecular profile of patient's tumor, treatment is selected to achieve best prospect of survival
Vocab:
- aberrant: departing from accepted standard
- abiogenesis: old word for spontaneous generation; original evolution of life or metamorphosis of organisms from inorganic/inanimate substances independent of external cause/influence
- advocate: public recommend
- aetiology: cause
- algorithm: rule
- ample: enough
- analogy: comparison between 2 things
- Animism: diseases = adverse effects of immaterial or supernatural forces as punishment for wrongdoing, & where treatments are brutal & ineffective
- Antecedent: preceding in time or order; previous or pre-existing
- ardent: enthusiastic; passionate
- assay: test
- audit: official inspection of organization's accounts, typically by independent body
- autopsy/necropsy or postmortem exams or morbid anatomy: confined to gross examination of organs or detailed dissection of deceased person to determine reason of death
- biopsy: take tissue sample for lab. analysis to discover presence, cause or extent of disease
- Bradykinin: compound released in blood in some circumstances which causes contraction of smooth muscle & dilation of blood vessels; peptide with 9 amino-acid residues
- causal: relating to or acting as a cause
- choler: digestive fluid secreted by liver & stored in gallbladder
- Clinical: observation & treatment of actual patients rather than theoretical or laboratory studies; causing observable & recognizable symptoms
- clinicopathological: combined study of diseases & pathology
- coagulable: change to solid or semi-solid
- constituent: part of whole
- controversial: public disagreement
- conventional: according to what's done/believed
- correlated: mutual; more related; commentary
- cytogenetics: study of inheritance in relation to structure & function of chromosomes
- elucidation: clarification; investigation
- entity: thing with distinct & independent existence
- folk medicine: medicine using herbal & other remedies based on traditional beliefs
- Haemoptysis: coughing up blood from respiratory tract indicating severe infection of bronchi or lungs
- humane; have civilizing effect on people
- humoral theory:
- ancient system of medicine that explains human body & personality in terms of four fluids/humors: blood, choler, phlegm, & black bile; based on Galen's work, a Greek physician & philosopher; according to humoral theory, good health depends on balance of humors, & imbalances → diseases + disorders
- hypothetic: imagined/suggested
- immunoglobulin: m and cells of the immune system, which function as antibodies
- inorganic: not consisting of or deriving from living matter
- in situ: in original place
- integrated: linked/coordinated various parts
- isonomia: balance or equality of those opposite pairs of hot/cold, wet/dry & bitterness/sweetness that maintained body's health
- longitudinal approach to patient's illness:
- holistic, dynamic, & integrated plan that documents important disease prevention & treatment goals & plans & involves patient-centeredness (reflecting patient's values & preferences & is dependent upon bidirectional communications)
- Mechanism: nature
- metamorphosis: change of form/nature of thing/person into completely different one
- meticulously: detailed; very thoroughly
- morbid anatomy: anatomy of diseased organs & tissues
- notoriously: quality or fact, typically a bad one, is well known
- objective: quantitative; undebatable
- obsolete: out of date
- opaque: not able to be seen through; not transparent
- pathogenesis: disease's origination (cause) & development (mechanism) via Science & Technology ↑ → Medicine ↑
- phlegm: thick viscous substance secreted by mucous membranes of respiratory passages, esp. when produced excessively during cold
- prognosis: likely course of medical condition
- prospect: possibility/likelihood of some future event occurring
- prevailing: existing at a particular time; current
- remit: cancel/refrain from exacting or inflicting (a debt or punishment)
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Used sources:
Vocab:
- Commensurate: corresponding to size/degree; in proportion
- Constitutional trait: combined value of person's inborn traits (eg. physical, mental, & emotional characteristics)
- Deposition: place sth in specific place
- Diminution: reduction in size, extent, or importance of sth
- Distention: act/state of being stretched/inflated beyond normal dimensions
- Exclusive: excluding or not admitting other things
- Haemoglobinopathy: group of disorders in which there’s abnormal production or structure of hemoglobin molecule
- Histamine: compound which is released by cells in response to injury & in allergic & inflammatory reactions, causing contraction of smooth muscle & dilation of capillaries
- Malaise: general feeling of discomfort, illness or unease whose exact cause is difficult to identify
- Pathognomic: (of sign or symptom) specifically characteristic/indicative of disease/condition
- Plausible: reasonable/probable
- Postulate: basis for reasoning, discussion or belief
- Prenatal: before birth
- Prostaglandin: any of group of compounds with varying hormone-like effects, notably promotion of uterine contractions; cyclic fatty acids
- Putative: generally considered or reputed to be
- Quiescence: inactivity/dormancy
- Relapse: later, signs & symptoms reappear
- Remission: temporary diminution of severity of disease or pain; conversion from active disease to quiescence
- remote: distant
- scientific medicine: inhuman truth of human body
- sequelae: pathological condition resulting from disease
- socioeconomic status (SES): social standing or class of individual/group; combination of education, income & occupation
- synonymous: having same meaning as another word or phrase in same language
- Therapeutic: treatment, therapy (caring for someone (as by medication or remedial training etc)) or drug
- Treatment: humane therapy or medicine
- viable: able of working
- viscous: having a thick, sticky consistency between solid and liquid; having a high viscosity
- viscosity: state of being thick, sticky, and semi-fluid in consistency, due to internal friction
Abbreviations:
- 5-HT receptors, 5-hydroxytryptamine receptors, or serotonin receptors: group of G protein-coupled receptor & ligand-gated ion channels found in central & peripheral nervous systems; they mediate both excitatory & inhibitory neurotransmission; serotonin receptors are activated by neurotransmitter serotonin, which acts as their natural ligand
- ACTH: Adrenocorticotropic hormone; tropic hormone produced by anterior pituitary; hypothalamic-pituitary axis controls it; ACTH regulates cortisol & androgen production; diseases associated with ACTH include Addison disease, Cushing syndrome, & Cushing disease
- IL-1: Interleukin-1 family; group of 11 cytokines that plays central role in regulation of immune & inflammatory responses to infections or sterile insults
- SOL: Space Occupying Lesion
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