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Pathology > Chapters Three & Four > Flashcards

Chapters Three & Four Flashcards

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1
Q

Explain the destructive mechanisms in autoimmune diseases.

A

Autoimmune diseases can occur in many body systems when lymphocytes are sensitized to develop against the body’s own organs or tissues.

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2
Q

Describe Autoimmune Hemolytic anemia.

A

Condition in which red blood cells are destroyed by antibodies.

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3
Q

Etiology and S&S of Autoimmune Hemolytic anemia.

A

Etiology- B cell-produced antibodies do not identify RBCs as self, resulting in agglutination of RBCs and an attack on and destruction of the red corpuscles.

S&S- Sore tongue, tingling and numbness in extremities, jaundice in skin, mouth extremities appear pale, disturbances in digestion, peripheral weakness, light headedness, altered vision, tinnitus, headaches, irritability, depression, tachycardia, and congestive heart failure.

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4
Q

Describe the signs and symptoms of pernicious anemia.

A

Signs and symptoms are fatigue, pale skin tone, dyspnea, tachycardia, pounding of heart

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5
Q

Name the primary treatment of pernicious anemia.

A

Primary treatment is vitamin b12 shots.

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6
Q

Why can’t the patient take the treatment orally with pernicious anemia?

A

The patient cannot take vitamin b12 orally because because it cannot be broken down in the stomach so it needs a direct shot to the blood stream.

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7
Q

What is the importance of the intrinsic factor with pernicious anemia?

A

The importance of the intrinsic factor is to absorb the vitamin b12 in the intestine.

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8
Q

Why would the patient experience gastrointestinal–type symptoms with pernicious anemia?

A

Patients may report either constipation or having several semi-solid bowel movements daily. These symptoms have been attributed to megaloblastic changes of the cells of the intestinal mucosa.

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9
Q

What is Systemic Lupus Erythematosus (SLE) and describe the systemic features?

A

Systemic Lupus Erythematosus (SLE) is a chronic, inflammatory autoimmune disease characterized by unusual autoantibodies in the blood that target tissues of the body

The features are a characteristic butterfly rash, or erythema, may present on the face, spreading from one cheek across the nose, to the other cheek

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10
Q

What parts/systems of the body does SLE affect?

A

SLE most commonly produces inflammation of the skin, joints, nervous system, kidneys, lungs, and other organs

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11
Q

Recall the diagnostic criteria of SLE.

A

To diagnose SLE the patient has to have at least four of the following symptoms including butterfly rash on the face, a discoid skin lesion, photosensitivity, and nasopharyngeal ulceration and that is only some of them, or they have to have a positive laboratory test, they can also go through a anti-dna test.

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12
Q

Define MS

A

Inflammation of the CNS, specifically the attack of myelin sheath causing debilitation of the nerves

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13
Q

What is the cause of MS?

A

Mainly unknown, theory is that unknown virus triggers immune system to turn against the body

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14
Q

S&S of MS

A

Weakness in limbs, loss of vision in one eye, unsteady gait, difficulty urination leading to UTIs, dysphagia, hearing loss, fatigue, and more

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15
Q

What is the treatment of MS?

A

Acute treatment- corticosteroids

Relapsing-remitting disease so patients are started on long term medications and immunosuppressive therapies

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16
Q

Define Myastenia Gravis and what is its causes

A

A chronic, progressive neuromuscular disease that is caused by autoantibodies to the acetylchline receptor at nerve synapses

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17
Q

What are the S&S of Myasthenia Gravis?

A

Muscular weakness, progressive fatigue, drooping eyelids, diplopia, dysphagia, severe cases have inability to breath and swallow

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18
Q

What is the treatment of Myasthenia Gravis?

A

Symptomatic and supportive treatment. Change of diet to soft/liquid. Anticholinesterase drugs are effective initially for fatigue and weakness but become less effective as condition progresses.

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19
Q

What is Rheumatoid Arthritis?

A

Inflammation and edema of the synovial membranes surrounding a joint. RA has the capacity to destroy cartilage, deform joints, and destroy adjacent bone.

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20
Q

What are the S&S of RA?

A

Signs and Symptoms of RA include weight loss, fatigue, fever, and edema pain in the joints.

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21
Q

What are the treatments (and their side effects) of RA?

A

Nonsteroidal Antiinflammatory Drugs (NSAIDS)- stomach pain and ulcers, increased bleeding

Aspirin- Asthma Attacks, Allergic reaction

Corticosteroids- High Blood Pressure, slower wound healing, fluid retention

Disease-modifying antirheumatic drugs (DMARDs)- stomach upset, liver problems, blood issues

Hydroxychloroquine- Stomach pain, skin rash, spinning sensation, unusual bleed/Bruising

Sulfasalazine- Bleeding Gums, black tarry stool, chest pain, painful urination, irregular heartbeat

Immunosuppressive agents- Stomachache, diarrhea, vomiting

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22
Q

What is the status of HIV in the US and what are new advancements in treatment that have been done over the last 5 years?

A

AIDS was first found in the United States in 1981 since then it has become a top killer of young men and a worldwide threat.

Approximately 35 million people are currently infected with the AIDS virus and more than 36 million have already died from the illness.

Without treatment, time with from infection HIV to death is about 10 years.

The new advancements in treatment that has been done over the last 5 years is HAART (highly active antiretroviral therapy). HAART consists of three drug combinations, two nucleoside reductase inhibitors and either a non-nucleoside reductase inhibitor or a protease inhibitor.

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23
Q

How can HIV be transmitted?

A

Blood, semen, rectal fluids, vaginal fluids and breast milk. Sexual contact is the primary means of transmission.

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24
Q

What precautions should a healthcare worker use when dealing with an HIV infected patient or laboratory specimens?

A

The precautions a healthcare worker should use are:

Practice frequent and thorough hand washing

Report any accidental needle sticks

Wear personal protective equipment and change equipment between patients

Use caution with laboratory specimens

Dispose of contaminated sharps and designated biohazard containers (Caution do not recap or break needles)

Use proper linen disposal containers

Use clean mouth pieces and resuscitation bags

Obtain Hepatitis B vaccination to prevent/protect against occupational exposure to blood

Use proper decontamination techniques

Absorb blood spills with paper towels, clean the area with soap and water followed by disinfection of the area with a 1:10 solution of household bleach

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25
What is vasculitis?
Inflammation of walls of a blood vessel or vessels. The affected vessel becomes necrotic when it is obstructed by a thrombus and an infarct of adjacent tissue results. When blood vessels become inflamed they become weakened, stretch, and either increase in size or become narrow, even to the point of closing entirely.
26
What is small vessel vasculitis?
Small vessel vasculitis affects the venules, arterioles, and capillaries.
27
What are the S&S of small vessel vasculitis?
Palpable purpura (purple, non-blanching papules and plaques), rash, joint pain, abdominal pain, and weakness, pain and burning sensation of lesions, ulcerations and edema ## Footnote The patient needs **prompt** medical evaluation.
28
What is the cause of small vessel vasculitis?
Exposure to certain chemicals, medications, foreign proteins and foods has thought to be a cause.
29
How is the dx of small vessel vasculitis confirmed?
Diagnosis is confirmed by presence of immunoglobulins and complement in the blood vessels.
30
What is the treatment for small vessel vasculitis?
If an underlying cause is found, stop taking the drug (medication) Rest (exercise often induces new lesions) Protect fragile skin Managing the underlying disease Corticosteroid therapy
31
What is systemic necrotizing vasculitis?
An inflammation of the blood vessel walls. It typically affects large and medium arteries. It occurs in a number of cutaneous and systemic conditions. Impaired tissue perfusion causes ischemic pain in the system or tissues involved. Ulceration of skin can result.
32
What are the S&S of systemic necrotizing vasculitis?
Muscle and joint pain, weight loss, angina, dyspnea, headaches, hypertension, and visual disturbances. It is not clear how the inflammation develops.
33
What is the treatment for systemic necrotizing vasculitis?
Corticosteroid or analgesics (to inflammation of arteries), zathioprine and cyclophosphamide (immune suppressors), and plasmapheresis (removes the affected plasma and replaces it with good plasma or a plasma substitute) are all used to lessen the immune activation. Hypertension is treated with antihypertensive drugs such as ACE inhibitors.
34
What is Idiopathic Thrombocytopenic Purpura (ITP)?
A bleeding disorder in which the immune system destroys its own platelets.
35
What are the S&S of idiopathic thrombocytopenia purpura?
Symptoms are related to an inability of the blood to clot; include spontaneous hemorrhages Signs include petechiae, small spider-like hemorrhages under the surface of the skin, and ecchymoses, larger hemorrhagic areas.
36
What does idiopathic mean?
Of unknown cause.
37
What is the treatment for idiopathic thrombocytopenia purpura?
Corticosteroid administration increases capillary integrity IVIG may be administered to increase the platelet count Blood transfusion; vitamin K administration improves the clotting mechanism Splenectomy is generally a last resort
38
What is scleroderma?
Sclerosis and shrinking of the skin and certain internal organs. Involved skin becomes taut, firm, and edematous and is firmly attached to the subcutaneous tissue.
39
Scleroderma can be diffuse or limited. What's the difference?
Diffuse form involves symmetric thickening of the skin of the extremities, face, and trunk Limited form tends to be confined to the skin of the fingers and face
40
Whaat is the cause of scleroderma?
Cause is unknown, but it appears to be an autoimmune disease.
41
What is ankylosing spondylitis?
An inflammatory disease that, over time, can cause some of the vertebrae in your spine to fuse.
42
What are the S&S of ankylosing spondylitis?
The patient may have recurring morning low back pain and stiffness, fatigue, weight loss, fever, diarrhea and limited joint motion due to fusion of the vertabrae.
43
What is the cause of ankylosing spondylitis?
Studies support a genetic basis and an association with several genes, including antigen HLA-B27
44
What is the treatment (and treatment goals) of ankylosing spondylitis?
Relieve pain/swelling with anti-inflammatory medication and analgesics.
45
What is polymyositis?
Connective tissue disease characterised by inflammation of muscles.
46
What are the S&S of polymyositis?
Muscles affected are mostly those closest to trunk/torso. Muscle weakness is the most common symptom; onset can be gradual or rapid. Occasionally, the muscles ache and are tender to the touch.
47
What is the cause of polymyositis?
Cause is unknown; thought to be autoimmune disorder.
48
What are the treatments for polymyositis?
Treatment is directed toward stopping the inflammation and inhibiting the overactive immune system. High doses of steroids suppress inflammation. Immunosuppressive agents are used. Exercise therapy to rebuild strength and prevent atrophy.
49
What is Common Variable Immunodeficiency (CVID)?
An immune disorder characterized by recurrent infections and low antibody levels, specifically in immunoglobulin (Ig) types IgG, IgM and IgA.
50
What are the S&S of Common Variable Immunodeficiency (CVID)?
**Decreased antibody production/function** History of chronic or recurrent infections Gastrointestinal (GI) disease including diarrhea, abdominal pain, and weight loss Chronic lung disease and granulomatous disease are common Susceptibility to opportunistic and viral infections and malignancies escalates
51
What is the cause of Common Variable Immunodeficiency (CVID)?
Exact cause unknown ## Footnote **Genetic defects leading to immune system dysregulation and a failure of B-cell differentiation**
52
What is the treatment of Common Variable Immunodeficency (CVID)?
Regular immunoglobulin replacement decreases the number of infections, antibiotic usage, and hospitalizations.
53
Describe the S&S of thyroid malignancy.
Palpation of the hand Painless lump or nodule on the thyroid gland Vocal cord paralysis Obstructive symptoms Cervical lymphadenopathy Dysphagia hoarseness from compression of the upper aerodigestive tract
54
Discuss the most important prognostic factor of thyroid malignancy.
Age of diagnosis Size of primary tumor Presence of tissue invasion or metastasis
55
S&S of Grave’s Disease
Form of **hyperthyroidism** Anxiety and irritability, excessive appetite and food consumption, and intolerance to hot weather may occur. Other symptoms include muscular weakness, enlargement of thyroid gland, bulging eyes, weight loss, rapid heartbeat and palpitations, profuse perspiration and warm moist skin. General hyperactive behavior and tremor.
56
What is acromegaly?
A chronic metabolic condition of adults caused by hypersecretion of GH by the pituitary gland.
57
When does acromegaly occur?
**After** puberty.
58
What is the cause of acromegaly?
A pituitary tumor or adenoma often is the cause of acromegaly. It affects women and men with equal frequency.
59
What is the treatment of acromegaly?
Reducing level of GH is associated with an improvement in symptoms and signs.
60
What is gigantism?
Describes an abnormal pattern of growth and stature.
61
When does gigantism occur?
**Before** puberty.
62
What is the most likely cause of gigantism?
An anterior pituitary adenoma is often the cause of over secretion of GH that result in gigantism.
63
Signs and symptoms of thyroid hypofunction (hypothyroidism) include what?
Decreased activity, sleepiness, lethargy Dry skin and hair, decreased sweating Cold intolerance Brachycardia Constipation Weight gain Edema, bloated face, puffy eyelids Poor circulation, extremity edema **TSH levels increased, T3 and T4 levels *_decreased_*, I131 uptake decreased**
64
Signs and symptoms of thyroid hyperfunction (hyperthyroidism) include what?
Bulging eyes Restlessness, irritability, nervousness, easily fatigued Tremors Moist skin, increased sweating Heat intolerance Tachycardia Diarrhea Weight loss, increased appetite Loss or thinning of hair **TSH levels decreased, T3 and T4 levels *_increased_*, I131 uptake increased**
65
What are the 3 major types of diabetes mellitus– define each and explain the difference between them.
Type one- Has an early, abrupt onset, usually before 30 years of age, with little or no insulin being secreted by the patient, and can be difficult to control. Type 2- Has a gradual onset in adults older than 30, and more often in people over the age of 55. Gestational Diabetes- condition of damaged ability to process carbohydrate that has its onset during pregnancy.
66
What is the cause of type 1 diabetes?
An infection early in life may trigger an autoimmune process that produces antibodies that destroy the B cells of the pancreas.
67
What are the S&S of type 1 diabetes?
Hyperglycemia, acidosis, polyphagia, pruritus.
68
What is the treatment of type 1 diabetes?
Insulin replacement therapy on a regular schedule.
69
What causes type 2 diabetes?
Obesity, destruction of the pancreas by tumor, trauma to the pituitary gland, or other endocrine disorders.
70
What are the S&S of type 2 diabetes?
Hyperglycemia, acidosis, polyphagia, pruritus
71
What is a metabolic disorder and what is it a precursor for?
A cluster of conditions — increased blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol or triglyceride levels — that occur together, increasing the risk of heart disease, stroke and **diabetes** darkened ring of skin around neck
72
What is the treatment of type 2 diabetes?
hypoglycemic medication (if this is unsuccessful then insulin is used), exercise, healthy diet.
73
What is the cause of gestational diabetes?
Increased destruction of insulin by the placenta plays a role in causing GDM.
74
What are the S&S of gestational diabetes?
polyuria, polydipsia (excessive thirst), and polyphagia (excessive hunger).
75
Treatment of gestational diabetes?
Exercise, oral hypoglycemic agents, and insulin.
76
What is diabetes insipidus?
Disturbance of water metabolism resulting in extreme thirst and excessive secretion of dilute urine.
77
What is Addison’s disease?
An adrenal insufficiency or hypoadrenalism.
78
What are the S&S of Addison's?
Fatigue, weakness, anorexia, agitation, confusion, weight loss, and gastrointestinal disturbances.
79
What are the causes of Addison's?
Possible causes include an autoimmune process, tuberculosis, hemorrhage, fungal infections, neoplasms, or surgical resection of the gland.
80
What is Cushing's?
A condition of chronic hypersecretion of the adrenal cortex which results in excessive circulating cortisol levels.
81
What drug causes Cushing's with lon term usage?
Large doses of glucocorticoids.
82
What is cretinism?
Congenital hypothyroidism developing in infancy or childhood.
83
What causes cretinism?
Fatal error causing thyroid glands to not develop or function.
84
What are the S&S of cretinism?
Thyroid gland absent Retardation Dwarfism Protruding abdomen Short forehead Broad nose Thick protruding tongue Sex organs do not develop
85
What is the treatment of cretinism?
Early treatment promotes normal growth, but may not prevent mental retardation.
86
How do you prevent cretinism?
Iodized salt reduces incidence of cretinism in a population… public education is important.
87
What is myxedema?
Clinical manifestations with a low metabolic rate due to deficient thyroid hormone

Pathology (3 decks)

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