APP Basis of Disease

Question 0

Cellular injury

Answer 0

1 of 3 factors of response You MAY be able to com back from this, but at some point of stress, cell will no longer return to normal

Question 1

Cellular Death

Answer 1

1 of 3 factor of response

Question 2

Atrophy

Answer 2

Cellular adaptation in response to stress, cells DECREASE in size or DECREASE in cell number decsrease functioning of enzymes, less oxygen consumption, decrease in organelles

Question 3

Hypertrophy

Answer 3

ONLY increase in cell size increase amount of functioning tissue mass usually result of increase in workload increase in functioning components of cells, so increase in number of organelles, enzymes, and functioning tissue pathological situation: cardiomegally Physiological: donated kidney, breast tissue, endometrium

Question 4

Hyperplasia

Answer 4

increase in NUMBER OF CELLS it is a very controlled response, when stimulus is removed, should be removed uncontrolled leads to CA pregnancy: breast tissue hyperplasia and uterine hyperplasia

Question 5

Metaplasia

Answer 5

due to chronic irritant change from one cell type to another stay within cell line, ex epithelial cell to another epithelial cell ex: lung tissue and esophagus tissue lung epithelial cells ciliated columnar cells turn to squamous cells in smoking GERD causes esophageal cells change into cells that we see in the stomach

Question 6

Dysplasia

Answer 6

Are reversible Cell types are changed, but derangement in cell growth so different cell sizes and shapes and appearance found in metaplastic squamous epithelium of the respiratory tract and uterine lining

Question 7

Stress

Answer 7

Mechanical forces electrical injuries nutritional imbalances biological agents poisons

Question 8

Hypoxia

Answer 8

ischemia causes irreversible cell damage Check out the chart in ppt

Question 9

Extremes of Temperature

Answer 9

Heat Cold

Question 10

Heat

Answer 10

accelerate cellular metabolism activate and inactivate temp sensitive emzymes cellular membranes disrupted to temp changes coag of blood vessels coag of tissue proteins causes DIRECT cellular injury

Question 11

Cold

Answer 11

increase in blood viscosity ice crystal formation induces vasoconstriction …

Question 12

Chemical Agents

Answer 12

EX: Lead poisoning, HIGH: mental retardation, convulsions, coma LOW levels: reduced IQ and attn span, behavioral efects, crosses the BBB AND damages BBB

Question 13

Effects of Lead - Phsiology

Answer 13

Causes ROS, decrease in antioxidant systems glomerular fibrosis and proximal tubule mitochondrial damage crosses and damages BBB lead looks like calcium, and enters transportors and changes the channels and cells as a result

Question 14

.

Answer 14

depletion of ATP in cell free-radical formation disruption of intracellular calcium hpmeostasis

Question 15

Depletion of ATP

Answer 15

decrease in oxygenation of the cell Na/K pump will fail, and we get membrane depolatization and increase in intracellular Ca and Na –> cellular swelling 2/2 Na influx and water flux that goes with it –> maybe lysing switch to anaerobic metabolism –> increae in lactic acid –> decrease in cellular pH –> lysing of lysosomes (which are full of degratory enzymes, and get released due to decrease in pH and these enzymes ARE unregulated so cause damage)

Question 16

Lysosomal destruction

Answer 16

Enzymes released, so IRREVERSIBLE damage

Question 17

ischemia reperfusion injury

Answer 17

EX: crushing injuries, stroke, MI which causes decrease in blood flow to an area so that we can keep blood flow to keep cells alive kidneys usually tested in the tissues because only 1 artery to worry about inflammatory response damages tissue

Question 18

Free radical injury

Answer 18

Essential to the physiology of our body, seen in our body due to metabolism and inflammatory response is due to CONTROLLED free radical response When uncolntrolled, can cause a lot of damage to our bodies Caused by: due to UV light, polution, excessive sugar production, lead, anything can become a free radical 3 major effects: 1) Lipid peroxidation 2) oxidative modification of our proteins 3) DNA effects unpaired electron will search for extra electron will chase things that are essentially immobile and can easily take an electron

Question 19

ROS and effects on MI

Answer 19

.

Question 20

Cell Death

Answer 20

When we get to irreversible place of cell injury we get apoptosis and necrosis

Question 21

Necrosis

Answer 21

UNPROMGRAMMED cell death When cell needs to die, this is one of two pathways Blebs occur here too, but cell leaks its contents thru lysis and immune response started by cells around which are effected by the lysis of their sister cell

Question 22

Apoptosis

Answer 22

DOES NOT illicit immune response you get blebs which are outpockets (like a star fish) then broken up into small pieces and eaten by macrophages thru phagocytosis CELL NEVER LYSES

Question 23

Pathways of apoptosis

Answer 23

1) intrinsic pathway- ex: stress and viruses, if DNA too damaged beyond repair, etc 2)extrinsic pathway- ex: too many cells in the tissue , like webbed feet! ALL pathways are propagated thru degratory enzymes called CASPASES and ONLY involved in apoptosis response

Question 24

Apoptosis in Physiology

Answer 24

removal of proliferating cell populations (ex: intestinal epithelial cells) death of host cells that have finished use embryogensis control of immune cell numbers hormone-dependent involution of endometrium

Question 25

Apoptosis in Pathophysiology

Answer 25

Growth of CA, viral infections,

Question 26

Necrosis

Answer 26

result of lysis of our lysosomes Cathepsin causes degradation of the cell and when cell lyses the Cathepsin is in the extracellular environment and will break down cells in the area and so much debris formed that it overwhelms the immune system --\>leads to gangrene

Question 27

Gangrene

Answer 27

DRY - associated with arterial supply depletion, you can generally see where oxygen depletion occurs, turns black bc hemoglobin gets acted upon by bacteria production to make hydrogen sulfide WET - enough blood but can't get blood out; usually seen in heels of feet, but sacrum, coccyx where pressure is increased

Question 28

Normal range of SG

Answer 28

High 1.032 Low 1.015 isoosmotic urine would be 1.010 Compared to density of water

Question 29

Bilirubin

Answer 29

indicates Liver problems bc its not going to the GI tract Pathway of breakdown in reticoloendothelial system: membranes of RBCs get weaker, and burst, releasing hemoglobin heme gets oxidized by Heme oxidase to make biliverdin which then gets reduced by biliverdin reductase to make bilirubin bilirubin attaches to albumin to get to liver and goes thru a few more steps to be transported to GI system

Question 30

Immune outcomes from HBV

Answer 30

1) HBsAG totally cleared = immune stage 2) inactive carrier stage = no injury or inflammation of hepatocytes but patient can suffer from acute flares 3) if virus cannot be cleared and replication continues for \> 6 months = chronic hepatitis stress causes virus to flare-up and replicate

Question 31

Inflammation

Answer 31

baseline cause of almost all chronic diseases

Question 32

Acute inflammation

Answer 32

Endothelial injury infection trauma exposure to physical or chemical agents tissue necrosis foreign bodies hypersensitivity rxns

Question 33

Inflammation - vascular rxn

Answer 33

increase in vascular permeability

Question 34

Inflammation - cellular rxn

Answer 34

begins with activation of the endothelium leukocyte margination leukocyte rolling and pavementing leukocyte adhesion leukocyte emigration thru endothelium chemotaxis to site of injury like leukotriences, anaphalaxins,

Question 35

Chronic Inflammation

Answer 35

continuous activation of T cells accumulation and activation of macrophages in the area --\> ROS get produced and released into tissue release TNF-alpha which are proinflammatory molecules and fibroblasts gets activated via TNF-alpha and proliferated fibroblasts lay down fibrous connective tissue in the area and lay down basement membrane --\> THIS CAUSES FIBROSIS So fibrosis causes change in structure and therefore FUNCTION of the tissue

Question 36

TNF=alpha

Answer 36

increase inflammatory cell recruitment and exacerbate IR increase in expression of MHC II tissue wasting ...

Question 37

HBsAG

Answer 37

Hepatitis B surface Antigen

Question 38

Hepatitis B

Answer 38

DNA hepadenovirus transmitted via infected blood or by sexual contact present in saliva, semen, and vaginal secretions Most ppl with Hep B have been incarcerated

Question 39

Pathophysiological Mechanisms

Answer 39

1) immune tolerance phase - no immune repsonse HBsAG is bound by hepatocyte surface receptors

Question 40

Symptoms of Liver failiure

Answer 40

Fatigue bc of limited amount of energy in the body, and immune system uses most of that limited energy Hepatomegaly bc of swelling Arthralgias - Polyarthritis nodosa - effect on blood vessels due to hormonal changes Membranoproliferative glomerulonephritis Jaundice

Question 41

Pathophysiology

Answer 41

structural and functional changes in disease states