Week 3 - Unit 3: Managing ill health and disease Flashcards
Outline the main categories of causes of death from diseases
Traumas
Burns, car accidents, severe injury
More tissue is damaged than can be replaced
Infections
Microorganisms (bacteria, viruses, fungi, parasites)
Pathogenic destruction of normal tissue caused directly by toxins or indirectly by the growth of foreign cells in the body.
Degenerative diseases
Aging
Lack of vital nutrients (malnutrition).
More cells are lost, or more energy expended than can be replaced or repaired.
Cancerous growths
More cells are made than are needed which replaces and impairs normal tissue.
There are two contrasting approaches to medical models of health and disease, Reductionism and Holism . Describe Reductionism.
- Follows a medical model of health which is Pathogenic – suggesting diseases have a single cause and that this is what needs to be treated in order to cure a disease. - Seeks to explain the experience of ill health in terms of the material functioning of the body (anatomy and physiology). - Is the founding principle of epidemiology.
Single cause of disease
Biological / Environmental
Modern approach
Scientific research approach
Can be used for epidemiology
Can be used for development of curative treatments
There are two contrasting approaches to medical models of health and disease, Reductionism and Holism. Describe Holism.
- Diseases are said to be caused by many factors (multifactorial), which are interrelated.
- The ill individual must be treated as a whole person with a specific identity (personalised medicine approach). - This considers an individual’s lifestyle, beliefs, socioeconomic status, history and personality as causes for a disease.
Multiple causes of disease (multifactorial)
Holistic
Historic approach
Personalised medicine approach
Can be used for social studies
Can be used for development of prevention strategies (health campaigns and promotions)
What does Reductionism suggest about disease aetiology (cause) ?
Single cause for a disease
What does Holism suggest about disease aetiology (cause)?
Many causes for a disease
What are the advantages / strengths / good points about a Reductionist approach to disease?
Can be used to research how a disease develops so that we can better understand it’s pathology and why symptoms develop in the way they do.
Allows for better (more effective) treatment.
Allows for better (more accurate) diagnosis and prognosis.
Can be used to inform epidemiological studies and public health policies (i.e. microorganisms and disease – HIV and Sex / Cholera and contaminated water).
What are the disadvantages / weaknesses / bad points about a Reductionist approach to disease?
Fails to account for personal circumstances.
Difficult to attribute a single cause to many diseases (i.e. obesity and cancer)
What are the advantages / strengths / good points about a Holistic approach to disease?
Takes into account personal circumstances.
What are the disadvantages / weaknesses / bad points about a Holistic approach to disease?
Extremely varied means that the research effort needed is very extensive and complex.
Which approach to disease do you think is the best – Reductionism or Holism?
Perhaps a combination of both!
Reducing a disease to its root cause can allow science to develop targeted treatments, which are aimed specifically at this causal factor.
This may lead to more effective and curative treatments, rather than therapies which only help with reducing symptoms.
However, an illness has wider socioeconomic and environmental determinants.
Reductionism alone may not address the other factors or behaviours that led to the illness developing in the first place.
Eg: Although AIDS is caused by infection with the HIV virus (reductionism), there are many factors and events which will have led to someone becoming initially exposed to and then infected with the HIV virus (holism).
Therefore, all diseases are the result of holistic and reductionist factors.
Reductionism will enable the development of effective treatment.
Holism will enable the development of effective prevention
What are the two types of reductionism?
- Biological reductionist
- Seeks the proximal (close proximity) for what is the ultimate biological cause of a disease.
- Environmental reductionist
- Seeks the distal (at a distance) by looking at the environment (physical, economic, or social) to find the ultimate social cause of ill health.
History of Reductionism vs. Holism
Historically (prior to scientific research into specific disease aetiologies) many diseases were thought to be caused by several factors (particularly lifestyle choices) – i.e. a Holism model.
Eg: People in medieval England thought that cholera was caused by generic poor living conditions.
Eg: People in the 1980’s thought that various AIDS-related diseases (like Kaposi’s Sarcoma) were due to lifestyle choices (including promiscuity, drug use and homosexuality).
Modern advances (in scientific research for specific disease aetiologies) led the conclusion that diseases often have a single cause – i.e. a Reductionism model.
Eg: John Snow discovered that Cholera was caused by drinking dirty water (NOTE JAMES THIS IS THE WATER PUMP OUTSIDE TIMS FLAT HENCE THE JOHN SNOW PUB NEXT DOOR)
Later Louis Pasteur developed the ‘germ theory’ and was able to show that microorganisms like bacteria can cause diseases. (i.e. the dirtiness of the water was due to bacterial contamination).
Eg: By 1985, research had shown that AIDS was caused by a blood borne virus – HIV.
List two examples of single gene mutations causing disease.
Cystic Fibrosis, Huntington’s disease
List two examples of multi gene causes of disease.
Cancer, Fertility problems (ectopic pregnancy)
List one example of a chromosomal problem causing a disease.
Trisomy from non-disjunction (21 = Downs Syndrome)
Disease category: Infectious
Disease cause:Bacteria
Give examples of disease
Epithelial tissue (MRSA), Gastrointestinal tissue (E.coli), Respiratory system (TB), Sexual (Gonorrhoea)
Disease category: Infectious
Disease cause: Fungi
Give examples of disease
Epithelial (athletes foot)
Disease category: Infectious
Disease cause: Viral
Give examples of disease
Respiratory system (influenza), Immune system (HIV), Nervous system (Chicken pox), Epithelial tissue (herpes)
Disease category: Infectious
Disease cause: Parasite
Give examples of disease
Red blood cells (malaria)
Disease category: Immunological
Disease cause: Immunocompromised
Give examples of disease
AIDS (from HIV)
Disease category: Immunological
Disease cause: Allergy
Give examples of disease
Asthma
Disease category: Immunological
Disease cause: Autoimmunity
Give examples of disease
Rheumatoid arthritis, Type 1 Diabetes Mellitus, Graves disease
Disease category: Degenerative
Disease cause: Mental
Give examples of disease
Alzheimer’s disease
Disease category: Degenerative
Disease cause: Muscle
Give examples of disease
Atrophy
Disease category: Degenerative
Disease cause: Bone
Give examples of disease
Osteoporosis
Disease category: Degenerative
Disease cause: Eyes and ears
Give examples of disease
Blindness and Deafness
Disease category: Lifestyle
Disease cause: Diet
Give examples of disease
Malnutrition rickets (lack of Vitamin D and Calcium) , scurvy (lack of vitamin C), Anaemia (lack of Iron) Excess calories (especially fat and sugar) Metabolic Syndrome (Obesity, Diabetes Mellitus and Coronary heart disease)
Disease category: Lifestyle
Disease cause: Exercise
Give examples of disease
Short term Injury bone fracture, muscle tearLong term damage arthritis
Disease category: Lifestyle
Disease cause: Alcohol
Give examples of disease
Kidney disease (renal failure) Liver disease (hepatic cirrhosis)
Disease category: Lifestyle
Disease cause: Smoking
Give examples of disease
Lung disease (COPD, emphysema)
Disease category: Mental
Disease cause: Cognitive
Give examples of disease
Alzheimer’s disease, Parkinson’s disease
Disease category: Mental
Disease cause: Psychosis
Give examples of disease
Schizophrenia, Bipolar disorder
Disease category: Mental
Disease cause: stress
Give examples of disease
Depression, Anxiety
Disease category: Endocrinology
Disease cause: Excess hormone levels
Give examples of disease
Cushing’s syndrome, Hyperthyroidism, PCOS / Endometriosis
Disease category: Endocrinology
Disease cause: Lack / resistance to hormone levels
Give examples of disease
Diabetes Mellitus, Addison’s disease, Hypothyroidism, Post-natal depression
How are genetic diseases initially diagnosed (i.e. signs and symptoms?
Disease specific and well documentedAnatomical and / or Physiological impacts on the bodyLocalised (to one body part or organ system) or widespread (to several body parts and organ systems)
How are infectious diseases initially diagnosed (i.e. signs and symptoms?
Inflammation, fever, coughing, sneezing, restlessness, soreness, diarrhoea, vomiting, dizziness, nausea, seizures, pains (dull or sharp) migraines and headaches
How are immunological diseases initially diagnosed (i.e. signs and symptoms?
Disease specific and well documentedInflammation, rashes on the skin or mucus membranes Hypersensitivity
How are Degenerative diseases initially diagnosed (i.e. signs and symptoms?
Social aspects (often reported by friends and family) – forgetfulness and changes in behaviour / personalityLoss of fitness / functional reserve to maintain homeostasis is impaired
How are lifestyle diseases initially diagnosed (i.e. signs and symptoms?
Disease specific and well documented
How are mental diseases initially diagnosed (i.e. signs and symptoms?
Social aspects (often reported by friends and family) – forgetfulness and changes in behaviour / personality
How are endocrinological diseases initially diagnosed (i.e. signs and symptoms?
Disease specific and well documented
How are genetic diseases firmly diagnosed?
Genetic screening and DNA testing to analyse genes Karyotyping to observe chromosomes Biochemistry and Haematology tests on different aspects of the blood
How are infectious diseases firmly diagnosed?
How would they be treated?
Microbiology tests of skin, blood, sputum / mucus, urine, faeces, semen and vaginal fluids
Antibiotics, Antivirals, antifungals, antiparasites and Rehydration therapy.
How are Immunological diseases firmly diagnosed?
Antibody tests (ELISA tests) from a blood sample Haematology tests - White blood cell counts from a blood sample
How are degenerative diseases firmly diagnosed?
Biochemistry tests on the bloodClinical tests to monitor and assess the function of specific body parts (eye test / hearing test)CT scan, X-rays, MRI scans, Ultrasound
How are lifestyle diseases firmly diagnosed?
Biochemistry tests on the bloodCT scan, X-rays, MRI scans, UltrasoundEndoscopy of the G.I.Tract, ECG on the heart, Angiogram of blood vessels
How are mental diseases firmly diagnosed?
Social, Psychiatric and Cognitive tests with Consultations
How are Endocrinological diseases firmly diagnosed?
Biochemistry and Haematology tests on different aspects of the blood
How would you treat a disease caused by a single gene?
Gene therapy- Adding a healthy version (allele) of a gene to treat recessive diseases- Silencing a diseased version (allele) of a gene to treat dominant diseases
How (in theory) would you treat genetic disorders caused by mutations other than in a single gene (e.g. chromosome disorders)
Personalised medicine (a future prospect)
How are allergies treated?
Immuno-suppressants
Anti-histamines
Adrenergic stimulants
Cytokine therapy
How are autoimmune diseases treated?
Immuno-suppressants
Steroids
Bone marrow transplant
Cytokine therapy
How are degenerative hearing and eye disorders treated?
Diet controlSight and hearing aidsStem cells and regenerative medicine
How are degenerative bone disorders treated?
Diet control
HRT (Hormone replacement therapy)
Physiotherapy
Stem cells and regenerative medicine
How are degenerative muscle disorders treated?
Steroids
HRT (Hormone replacement therapy)
Physiotherapy
Stem cells and regenerative medicine
How is stress treated?
Social therapy and counsellingAnti-depressants
How is psychosis treated?
Anti-psychotics
What is the prognosis of genetic diseases?
Lifelong Often terminal (morbidity eventually leads to mortality) Depending on the severity life expectancy can be drastically shortened
What is the prognosis of infectious diseases?
Usually short term – bacterial and fungal Some life long – viral and parasitic
What is the prognosis of immunological disease?
Often lifelong Become progressive worse overtime and start to develop more symptoms and over diseases as time goes on (especially for autoimmune disease). May have a pattern of 7-year cycles (especially for Asthma).
What is the prognosis of degenerative diseases?
Become progressive worse overtime and start to develop more symptoms and over diseases as time goes on (the result of aging and the loss of functional reserve to maintain homeostasis).
What is the prognosis of lifestyle disease?
Depends on whether the person is willing and able to change their lifestyle!
What is the prognosis of mental disorders?
Depends on how well the person responds to treatments and lifestyle adjustments.
What is the prognosis of Endocrinology disease?
Often very promising.Depends on how well the person responds to treatments and lifestyle adjustments.
Think back to week two. Prevention strategies – including health promotion campaigns for genetic disease.
Genetic screening
Genetic counselling
Family planning
Think back to week two. Prevention strategies – including health promotion campaigns for infectious diseases.
Hygiene awareness and practicesPublic health policyVaccines
Think back to week two. Prevention strategies – including health promotion campaigns for immunological diseases.
DietInfant / childhood exposure to the environment
Think back to week two. Prevention strategies – including health promotion campaigns for degenerative, lifestyle, mental and endocrinological disease.
Lifestyle choices! – Diet, Exercise, Drug and Alcohol awareness
Public health policy for managing stress in the workplace and providing support for employees
