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Flashcards in Misc Deck (27)
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1

TB

Tuberculosis (TB) is a major chronic, progressive communicable disease caused by Mycobacterium tuberculosis. It occurs most commonly in the lungs and usually features a period of latency, sometimes for many years, following initial infection. Extrapulmonary sites (e.g., vertebrae, meninges) may also be infected. TB incites distinctive chronic granulomatous inflammation, which features a central area of semi-solid crumbly, necrotic tissue called caseous necrosis (Latin caseus = cheesy).
Clinical and chest X-ray findings may add up to a very high index of suspicion, but positive diagnosis rests on detection of acid-fast organisms in sputum cultures or smears or by other direct laboratory detection. The purified protein derivative (PPD) test (also known as the Mantoux test) is a skin test for infection. As it is positive in both latent and active cases, it is not diagnostic of active disease. The test is performed by injecting treated TB protein (tuberculin) into the patient’s skin (see The Clinical Side, “The Mantoux Skin Test”).

2

Red marrow

actively produces blood cells

3

Yellow marrow

storehouse for fat, although it can become red marrow if necessary

4

70% of the cross-sectional area of the vessel must be occluded before causing clinical symptoms as a result of impaired flow

Talking atheromas!!!!

5

Etiology:

cause of disease

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pathogenesis

natural history and development of disease process

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pathophysiology

the manner in which the incorrect function is expressed

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idiopathic

etiology is unknown

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Iatrogenic

if disease is byproduct of medical treatment/diagnosis

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nosocomial

if disease originates while hospitalized

11

cell injur

commonly occurs due to inadequate oxygenation. Without O2, cells can’t create energy and die. Anoxia total lack of O2, hypoxia partial. Ischemia causes hypoxia and nutrient delivery

12

physical, thermal, chemical agents

disrupt the structure of organs or tissues.
Physical: force can cause fatal hemorrhage and ischemia
Thermal: frostbite
Chemical: acids, alkalis, or heat causing death to skin etc

13

ionizing radiation

enough to break (ionize) water (H2O) into H+ (hydrogen ion) and OH- (hydroxyl ion)
Acute radiation therapy: OH- attaches to DNA and prevents cell production
Chronic radiation: causes DNA mutations that may result in neoplasia

14

toxins

Depending on chemical, injury may occur in different organs by different mechanisms

15

microbes

can produce toxin that interferes with cell protein synthesis or cell oxygen utilization

16

Inflammation and immune reactions

result from cell injury, but may in turn cause injury themselves. Inflammatory cells release digestive enzymes designed to neutralize foreign agents, but also can digest healthy tissue.

17

Nutritional imbalance

obesity related to CV disease, cancer, DM2

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Genetic and metabolic defects

can cause accumulation of abnormal products, which can damage cells,

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aging

progressive, mild injury that ultimately leads to cell death

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mild injury

atrophy (decreased size and function of cell), hypertrophy (increase size and function of cell), hyperplasia (enlargement of tissue or organ due to more cells), metaplasia (usually reversible - a change from 1 cell type to another due to chronic injury), or dysplasia (disordered growth)

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necrosis

pathological death of cells due to injury

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apoptosis

programed cell death - cell shrivels and ingested/digested by scavenger cells

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Chemical signals to mediate inflammatory process:

injured cells release chemical signals to produce inflammation, reduce consequence of injury, and repair damage
Autocrines: signals that act back on generating cell
Paracrines: molecules released by cells that act on nearby cells
Endocrines (hormones): molecules released into bloodstream to act on distant cells

24

acute inflammation

short term, first phase of wound healing. Occurs before immune response becomes established to eliminate foreign agent. Occurs in 2 overlapping stages (vascular first and cellular second). Vascular: Arterioles and venules dilate promoting congestion and increase in capillary permeability resulting in cardinal signs of inflammation, as fluid leaves, remaining fluid becomes viscous causing clotting. Cellular: initiated by phagocytic WBC - WBCs adhere to vessel wall and through emigration move through inflamed tissue - chemotaxis causes movement through cells - phagocytosis occurs causing increase in disposed foreign particles, lysis of foreign cells causes exudates resulting in signs of inflammation

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chronic inflammation

characterized by abundance of lymphocytes and macrophages, few or no neutrophils, attempted regeneration of destroyed cells, scarring, and rich supply of blood vessels (mix of ongoing inflammation and healing)

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wound types:

incision
laceration
abrasion
contusion
puncture
hematoma
penetration

27

sepsis now mostly caused by...

gram + bacteria