Characterization,

Classification of Disease
Prof. Dr. Siti Balkis Budin
MD (UKM) MSc (Ulster UK) PhD (UKM)
 Concept of Health

• Health is the state of the body

when it functions optimally without
evidence of disease.
• The definition of health from WHO:
• Health indicates not only
without any evidence of disease,
but also a state of complete
well-being physically,
psychologically and socially.
 What is Pathology
• Pathology is a branch of medical science primarily concerning the
cause, origin, and nature of disease.
• It involves the examination of tissues, organs, bodily fluids, and
autopsies in order to study and diagnose disease.
 What is Basic Pathology
• Describes a complex and broad field that involves the study of the
mechanisms behind cell and tissue injury and understanding how the
body responds to and repairs injury.
• Examples of areas that may be studied include necrosis, neoplasia,
wound healing, inflammation and how cells adapt to injury.
• Thorough understanding in these areas is applied in the diagnosis of
disease.
 Concept of Disease
• Disease is referred as aberrant manifestation of
deregulated homeostasis caused by harmful
agents.
• The development of a disease is definitely a
pathologic process.
• With a characteristic set of signs and symptoms
(clinical manifestation) involves in the whole
body or any of its parts.
• A disease is a particular abnormal condition that
negatively affects the structure or function of all
or part of an organism,
 Homeostasis &
Disease
• A state of balance among all the
body systems needed (internal
chemical or physical condition) for
the body to survive and function
correctly.
• Homeostasis is to establish the
optimum condition in human body
being kept within certain pre-set
limits (homeostatic range)
• Disease is the failure to
maintain homeostatic
conditions
 CHARACTERISTICS OF
DISEASES
Involves…
1. Etiology
2. Pathogenesis
3. Clinical manifestation (clinical changes)
Symptoms and sign/ Lesion/Morphological and functional
changes
4. Diagnosis
5. Complication
6. Prognosis
 Causes (Etiology ) of Disease
• Commonly sub-classified into 11 categories :
• 1. Infectious Diseases
• caused by invasion and colonization of pathogenic microorganisms
• examples : fungal infection, bacterial infection, and viral infection
• 2. Neoplasms (“new growth”)
• caused by the uncontrolled growth of abnormal cells
• benign or malignant (cancerous)
• 3. Metabolic Diseases
• upset in the biochemical reactions that govern body processes or
metabolism
• Eg: Diabetes mellitus
 Causes (Etiology ) of Disease
4. Immunologic Diseases
Three immunologic categories:
• 1. over reaction by immune system (hypersensitivity)
• 2. under reaction by immune system (immune deficiency disease
such as AIDS).
• 3. autoimmune disease – destruction of one’s own tissues by
antibodies produced by one’s own immune system
5. Nutritional Diseases- diseases created by insufficient resources for
the body
1. protein vitamin or mineral deficiency –may lead to interference
in biochemical reactions of metabolism
2. Obesity
 Causes (Etiology ) of Disease
6. Genetic Diseases
• inherited or hereditary diseases due to transmission of defective gene(s) or chromosome(s)
from one or both parents
• Eg. hemophilia, thalassemia
7. Congenital Disease (also referred to an anomaly or defect)
• a defect in fetal development that may create a functional (physiologic) or structural
(physical) abnormality which presents itself at birth
• these defects may be genetic; they may be exposure to chemicals, drugs, or viruses during
the pregnancy; they may be a spontaneous event
• Eg: Congenital heart disease
8. A nosocomial disease is one that was acquired from a clinical setting (e.g.
hospital; physician’s office; clinic).
• 1. postoperative patient develops staph infection from surgical instrument that
wasn’t properly sterilized
• 2. child develops cold after being exposed to other sick children at the
 Causes (Etiology ) of Disease

9. Physical Agents - diseases that result from physical agents such as

temperature extremes,
electrical shock, radiation, and poisons, physical force
Causes bruises, abrasions, cuts, fractures, burns, etc.

10. Unknown etiology

Classified as Primary, idiopathic, essential, spontaneous
• 11. Iatrogenic disease (-iatro = medicine, physician) means that the
disease arose as a result of a prescribed treatment *examples:i.
Cushing-like Syndrome as a result of steroid therapy
 Pathogenesis

• The development of a disease is referred to as

pathogenesis (-genesis = origin or development).
• The sequence of events that leads from cause of
disease to structural and functional
abnormalities to how the disease manifests itself
and finally to the resolution or recovery of the
disease.
• Mainly involved
Inflammation
Degeneration
Carcinogenesis
Immune reaction
 Clinical Manifestation
(symptoms and signs)

• Clinical manifestation refers to how a disease “presents

or shows itself”.
• Clinical presentation of patients includes both signs and
symptoms.
• Symptoms
• Symptoms are indicating an underlying disease,
not measurable and are based on the patient’s
subjective perception, i.e. pain, nausea,
weakness, fatigue, dizziness
• Symptoms depend on the type of disease.
• Two or more disease can have common
symptoms.
• Therefore, symptoms of diseases cannot indicate
the exact disease.
• For instance, if a person is having a headache,
• may associated with normal stress, fever, migraine,
 Manifestation:

Signs: refer to objective physical observations as

noted by the person who examines the patient.
• The changes in the normal functioning or structure
of the body.
• During the physical examination the health
professional may use techniques.
• examples of signs are: high temperature, alteration
in blood pressure, abnormal respiratory rate/heart
sounds, mass,.
• Physicians search for signs of diseases on the basis
of symptoms.
• However, to pinpoint exact disease
physicians/doctors runs a series of the laboratory
test on the person.
Manifestation:
Morphological, functional changes
Lesion
• A region in an organ or tissue which has suffered damage through injury or disease,
• Structural or functional abnormalities responsible for diseases
• such as a wound, ulcer, abscess, or tumour,
Functional changes
• Alteration in organ function (structural or biochemical) due to disease

• Eg: Alteration in renal/cardiac/liver function due to diseases

• Eg: Alteration in eyes function. Blurring of vision
• Asymptomatic (Sub-clinical) disease– a disease in which symptoms are not noticeable to
the patient, presence of disease (signs) is detected by routine physical or tests
 DIAGNOSIS
• Process of assigning a name to a patient’s medical problems
• Diagnosis is needed to determine the treatment and potential outcome
of a disease.
• The information required for diagnosis is typically collected from patient
history, clinical manifestation and diagnostic or medical test procedure.
• Diagnosis is often challenging, because many signs and symptoms are
nonspecific.
• For example, cough by itself, is a sign of many disorder
• Thus differential diagnosis, in which several possible explanations are
compared and contrasted, must be performed.
• Occasionally the process is made easy by pathognomonic manifestation.
means "characteristic for a particular disease". A pathognomonic sign is a
particular sign whose presence means that a particular disease is present
beyond any doubt.)
 Complication and Sequelae
• Diseases may have prolonged, secondary and distant effects
• Complication
• is an unfavorable result of a disease and may adversely affect the prognosis, or
outcome, of a disease.
• generally involve a worsening in severity of disease or the development of new
signs, symptoms, or pathological changes which may become widespread
throughout the body and affect other organ systems.
• may lead to the development of new diseases resulting from a previously existing
disease.
• may also arise as a result of various treatments.
• the development of complications depends on a number of factors, including the
degree of vulnerability, susceptibility, age, health status, and immune system
condition
 Classification of Diseases
• Primary vs secondary
• Benign vs malignant
• Acute vs chronic
• Congenital vs acquired
• Communicable vs non communicable
• Localized vs systemic
 Classification of disease: Primary vs Secondary

• Primary and secondary

• To describe the causation of disease
• Primary: disease with unknown etiology eg;
primary hypertension
• Secondary: the disease represent a
complication or manifestation of some
underlying lesion eg; secondary
hypertension due to renal artery stenosis
• To distinguish between the initial and
subsequent stage of disease
• Primary and secondary cancer
• Primary and secondary tuberculosis
 Classification of disease: Benign vs Malignant

• Benign and malignant

• The severity/magnitude of
diseases
• According to their likely
outcome
• Benign and malignant
tumor/Benign and
malignant hypertension
• Benign is less severe as
compared to malignant
•
 Classification of disease: Acute vs Chronic
• Describe the onset of the disease
• Acute Diseases
• disorder with sudden onset, relatively severe, and short
duration of symptoms eg. pneumonia
• and recovery in those who survive is usually complete
• Usually confine to one body area
• Chronic Diseases
• develops slowly, lasting over long periods (months or
years), in some cases for the remainder of the person’s
life. (e.g. tuberculosis)
• Recovery is slow and sometimes incomplete and
recurring.
• Usually involve multiple organ/system
• Latent disease- agent remains inactive for a period of time,
but then activates to cause disease (e.g. shingles)
Classification of disease: congenital vs acquired

• Congenital disease is present since birth

• Genetic disorder
• caused by errors in genetic information that produce diseases in the affected
people.
• Non-genetic
• Environmental; rubella associated cardiac malformation
• Acquired disease is developed after birth
Classification of disease: Communicable vs non
communicable
• Communicable disease – a disease that can be transmitted through
pathogens from one person to another.
• Can be spread, directly or indirectly,
• Vector (through bites from insects),
• contamination (ingesting contaminated food or water),
• person to person (through respiratory droplets, sexual activity, contact with blood, or from
mother to child during pregnancy, birth, or breastfeeding.)
• A non-communicable disease (NCD) is a disease that is not transmissible
directly/ physical contact from one person to another.
• Risk factors
• Background, lifestyle and environment
• age, gender, genetics, exposure to air pollution, and behaviors such as smoking, unhealthy
diet and physical inactivity
• Most NCDs are considered preventable because they are caused by modifiable
risk factors.
Classification of disease: Localized vs
systemic
• Localized disease – disease is confined to one area of body.
• Systemic (generalized) disease – disease that spreads throughout the
body or to many systems
 terminology OF DISEASE

• Prefixes
• ana- = absence
• dys = disorder eg; dysplasia
• Hyper = excess over normal eg; hypertension
• hypo = deficiency below normal
• meta = a change from one state to another state eg; metaplasia
• Suffixes
• -itis = inflammatory process eg; appendicitis
• -oma = tumour
• -osis = state or condition eg; osteoporosis
• -penia = lack of eg; osteopenia
• -cytosis = increase no of cell usually in blood eg; leukocytosis
• -ectasis = dilatation eg; bronchiectasis
• -plasia = disorder of growth eg; neoplasia
• -opathy = abnormal state eg; lymphadenopathy