Study guide exam 1 Flashcards

Question

asphyxiation vs strangulation

Answer 1

lack of oxygen from environment OR from blockage of respiratory airway. vs hypoxia from impaired blood flow to brain. Injury/death results from impaired CEREBRAL blood flow

Answer 2

1. Suffocations—lack of oxygen from environment OR from blockage of respiratory airway. Methane or co2 common. 2. Choking—obstruction of airway (by object or compressional if chest trappedpetichiae)

Answer 3

prevent delivery of oxygen to tissues or block o2 use 1. CO!!—odorless, colorless, nonirritating, undetectable. Caused by incomplete combustion of fuels like gas. i. Causes death by indusing CNS depression ii. CO binds with Hgb instead of o2 because affinity 300x more. carboxyhemaglobin iii. Widespread ischemia, but pt only feels sleepy, may appear cherry red (skin and mucous membranes) 1. Symptoms: ha, giddiness, tinnitus, c/p, confusion, nausea, weakness and vomiting 2. Population most affected: fetuses, infants, HF patients, pulmonary patients, anemia iv. Dx by carboxyhemaglobin levels

Answer 4

Dehydration can develop d/t fluid sequestering

Answer 5

hyper-->pulls fluid out of cells and causes dehydration | hypo-->pushes fluid in and can cause cell to burst

Answer 6

pH low=acitic, pH high alkalotic HCO3 low acidotic, HCO3 high alkalotic CO2 low acidotic, CO2 high alkalotic can compensate partially or fully.

Answer 7

a) respiratory system compensates for changes in pH by altering rate/depth of ventilation to inc or dec retained CO2 i) shallow breathing retains co2 (increases acidity potential) ii) rapid breathing blows of co2 (decreases acidity potential) iii) renal compensation (1) if respiratory acidosis the kidneys attempt to compensate by resorbing bicarb and excreting H+ (a) occurs more slowly but very effective (2) respiratory aclokalosis—kidneys decrease rate of H+ in urine and reduce rate of resorption of bicarb iv) respiratory compensation (1) if metabolic acidosis the lungs attempt to compensate by rapid/deep breathing to blow of co2 (potential acid) (a) occurs within minutes (2) if metabolic alkalosis lungs compensate with slow shallow breathing to preserve CO2

Answer 8

pH is WNL but HCO3 and CO2 both high or both low

Answer 9

pH near normal, CO2 and HCO3 both high or low

Answer 10

a) Lactic acidosis d/t poor perfusion or hypoxema (rapid) b) Renal failure, dka or starvation (slow) c) When severe buffers become depleted and can no longer compensate to keep bicarb/carbonic acid 20:1 symptoms: e) Symptoms: HA, lethargy, confusion, coma. Kussmaul respirations (deep and rapid hyperventilation)

Answer 11

used in determining cause of metabolic acidosis i) Elevated anion cap (1) DKA, lactic acidosis, injestion, renal failure ii) Normal anion gap (1) Diarrhea, ureterosigmoidoscopy, early renal failure

Answer 12

a) Hypochloremic metabolic acidosis--if d/t vomiting/diarrhea renal comp not effective d/t loss of HCl and Cl which stim bicarb retention (tX NaCl to replenish chloride so kidneys can excrete bicarb) b) Hyperaldosteronism—sodium bicarb retention and loss of H and K c) Diuretics can cause mild alkalosis d/t excretion of NA, K, Cl more than bicarb d) Symptoms: weakness, muscle cramps, hyperactive reflexes, tetany, confusion, convulsions, a-tach, shallow slow ventilation, s/s low calcium

Answer 13

a) d/t: head injury/drugs, paralysis of resp. muscles, d/o of chest wall, COPD, pna. b) Renal compensation takes 3-4 days to kick in with inc retention of bicarb. Hgb/phosphate system first c) s/s: HA, blurred vision, breathlessness, restless, lethargy, disorientation,muscle twitching, tremors, convusions, coma. Respi rate rapid the depressed and resp center adapts to inc co2 d) treatment: restore alveolar ventilation

Answer 14

alveolar hyperventilation and hypocapnia (low co2), decreases carbonic acid concentration. PaCO2 <35 a) causes: pulm. Disease, hypoxemia, HF, hyigh altitudes, hypermetabolic staes (fever, thyrotoxicosis), aspirin od, cirrhosis, sepsis, improper ventilator settings. Secondary alkalosis can be d/t hyperventilation d/t metabolic acidosis (mixed acid-base) b) s/s: confusion, dizziness, tingling, convulsion, coma, s/s low calcium

Answer 15

HCO3 22-26, PaO2 80-100, PaCO2 35-45, pH 7.35-7.45

Answer 16

innate immunity, physical barriers: skin, cell derived chemicals (sweat, etc)

Answer 17

inlammation 1. Occurs in vascularized tissue, 2. Rapid response (seconds) 3. Cellular and chemical 4. NONSPECIFIC. Same regardless of injury

Answer 18

adaptive immunity

Answer 19

Acute s/s: rubor (red), calor (heat), tumor (swelling), dolor (pain), function laesa (loss of function)

Answer 20

Coagulation—clotting cascade initiatedplateletsslows blood flow, walls off injury, mesh for healing • 2. Vasodilation—increased diameter of blood vessels to deliver more blood—movement of fluids chemicals and cells into tissuesred, heat • 3. Increased vascular permeabilityblood vessels porous s/t contraction of endothelial cellsexudate and edema in area around injury • 4. White blood cell adhesion—adhere to inner walls of vessels, migrate through larger spaces of endothelial cellsmore phagocytes (neutrophils and macrophages)

Answer 21

complement, clotting and kinen

Answer 22

complements the capacity of antibodies and phagocytes to clear pathogens and dead cells and activate inflammation • Consists of complement factors (proteins). Activation of C3 and C5 results in 3 potent molecules being released

Answer 23

opsonins--coat bacteria

Answer 24

chemotactic—like a magnet attracts leukocytes

Answer 25

anaphylatoxins—degranulates mast cells to release histamine which increases vasodilation and capillary permeability

Answer 26

IN COMPLEMENT SYSTEM membrane attack complex • Complements c6-c9. Leads to bacterial destruction and tissue injury by creating pores in outer membranes of cells or bacteria. These cause the infusion of water into the cellscell death

Answer 27

classical: activated by antibodies bind to antigens alternative: doesn’t need antibodies. activated directly by substances on the surfaces of infectious microorganisms (lipopolysaccharides/endotoxins on bacteria or zymosan (carbohydrate on yeast cells). lectin--independent of antibodies. Activated by plasma proteins like mannose-binding lectin (MBL). Binds to bacterial polysacc.

Answer 28

Converge at factor X Activates fibrinfibrin clot activates clotting systemfibrinopeptides which attracts neutrophils (chemotaxis) and increase vascular permeability

Answer 29

activated by tissue factor--TF aka thromboplastin released by damaged endothelial cells of blood vessels. Reacts with activated factor VII

Answer 30

activated when vessel wall damage causes negatively charged subendothelial subst. to come into contact with factor XII

Answer 31

interacts with clotting system. Clotting AND kinin initiated through activation of Hageman factor (XII) which results in formation of factor XIIa activates prekalikreinkallikreinkininogenbradykinin (final product) • Bradykinin causes dilation of blood vessels and induces pain, smooth muscle cell contraction and increases vascular permeability

Answer 32

* Protease inhibitor—inhibits activation of complement * Carboxypeptidase—inactivates toxic activities of C3a and C5a * Kininase—degrates kinins * Histaminase—degrades histamine and kallikrein * Fibrinolytic system—limits size of clot and degrades clot after bleeding stops * Plasminogenplasmin which degrades the fibrin polymers in clots

Answer 33

mast cells, WBCs (neutrophils, monocytes and lymphocytes), macrophages and dendritic cells, erythrocytes, cell receptors and cell mediators, inflammatory cytokines and interleukins

Answer 34

in blood and body secretions- primary secretory immune system antibody, prevents attachment

Answer 35

i) During clonal selection B cell develops into antibody secreting plasma cell. Has option of becoming secretor of IgM or changing to IgG, IgA or IgE

Answer 36

normally at low concentrations, very specialized and mediator of ax responses and against parasitic infection. Causes allergies if produced against environmental antigens. Also attracts eosinophils to parasite.

Answer 37

Largest ab—pentamer—1st antibody produced during initial response to antigens. Best at activating complement

Answer 38

IgM and IgD

Answer 39

i) Protects external surfaces (lacrimal and salivary glands, lymphoid tissue in breasts, bronchi, intestines and GU tract) ii) Plasma cells in above sites secrete antibodies in bodily secretions to prevent infection iii) Includes IgA primarily but also IgG and IgM

Answer 40

5-7 days after exposure to ab production of IgM and IgG | i) Antibody serum sample is called a titer. High titer means more antibodies.

Answer 41

apid production of lg amounts of a from memory cells. IgM produced but will have MORE IgG.

Answer 42

can’t produce all classes of ab. IgM is produced in utero, limited IgA, IgG after birth

Answer 43

 Potent activators of inflammation • Can be activated by tissue damage or complement cascade and IgE (allergies) • Located in connective tissues and close to vessels—skin, GI, respiratory • 2 ways they are helpful • Degranulation—release their contents within seconds of stimulus What’s inside? Histaminesconstriction of smooth muscle and dilation of post capillary venulesincreased blood flow H1—histamine binds to this and causes smooth muscle contraction and bronchoconstriction H2—histamine binds to this and suppresses leukocyte function, H2 blockers reduce gastric acidity • Synthesis of mediators: leukotrienes, prostaglandins and platelet activating factor 1. leukotrienes—induce smooth muscle contraction (bronchoconstriction) and increase vascular permeability, stimulate slow, prolonged inflammatory responses (as apposed to rapid acting histamine) 2. prostaglandins—increase vascular permeability, neutrophil chemotaxis and pain. Produced by COX COX-1 activates platelets and protects stomach lining Cox-02 associated with inflammation 3. platelet activating factor—produced by neutrophils, monocytes, endothelial cells, mast cells and platelets. Cause endothelial cell retractionincreased vascular permeability, adhesion of leukocytes and platelet activation (can also activate mast cells

Answer 44

protective antibodies produced against toxins produced by bacteria (ex. toxins cause symptoms of tentanus or diphtheria).

Answer 45

47,XXY or XXY condition Individuals with at least two X chromosomes and one Y chromosome in each cell (47,XXY karyotype) have a disorder known as Klinefelter syndrome. Characteristics of Klinefelter syndrome: small testes, some development of the breasts, sparse body hair, and long limbs. This syndrome results from the presence of two or more X chromosomes with one Y chromosome (genotypes XXY or XXXY, for example). Moderate degree of mental impairment may be present Usually sterile Sparse body hair, sterile, small testicles 50% are due to nondisjunction of X chromosomes in the mother and frequency rises with increasing maternal age. Can have XXY and XXXY types with the degree of physical and mental impairment increasing with each added X chromosome

Answer 46

Study Guide Content: Fragile X Syndrome Hello Yadhira and Class, Here is Study Guide content excerpted from our textbook, which will not be covered in our weekly discussion: Fragile X Syndrome A number of areas on chromosomes develop distinctive breaks and gaps (observable microscopically) when the cells are cultured. Most of these fragile sites do not appear to be related to disease. However, one fragile site, located on the long arm of the X chromosome, is associated with fragile X syndrome. The most important feature of this syndrome is intellectual disability. With a relatively high population prevalence (affecting approximately 1 in 4000 males and 1 in 8000 females), fragile X syndrome is the second most common genetic cause of intellectual disability (after Down syndrome). In fragile X syndrome, females who inherit the mutation do not necessarily express the disease condition, but they can pass it on to descendants who do express it. Ordinarily, a male who inherits a disease gene on the X chromosome expresses the condition because he has only one X chromosome. An uncommon feature of this disease is that about one-third of carrier females are affected, although less severely than males. More than 20 other genetic diseases, including Huntington disease and myotonic dystrophy, also are caused by this mechanism. Glossary: Chromosomal fragile site: a place where chromosomes are susceptible to gaps or breaks Fragile X syndrome: MedlinePlus Genetics Researchers identify drug target for behavioral symptoms of fragile X syndrome

Answer 47

Cri du chat syndrome Deletions: Broken chromosomes and lost DNA cause deletions. Usually, a gamete with a deletion unites with a normal gamete to form a zygote. The zygote thus has one chromosome with the normal complement of genes and one with some missing genes. Because many genes can be lost in a deletion, serious consequences result, even though one normal chromosome is present. The most often cited example of a disease caused by a chromosomal deletion is the cri du chat syndrome. The term literally means “cry of the cat” and describes the characteristic cry of the affected child. Other symptoms include low birth weight, severe intellectual disability, microcephaly (smaller than normal head size), and heart defects. The disease is caused by a deletion of part of the short arm of chromosome. Duplications: A deficiency of genetic material is more harmful than an excess, so duplications usually have less serious consequences than deletions. For example, a deletion of a region of chromosome 5 causes cri du chat syndrome, but a duplication of the same region causes intellectual disability, but less serious physical defects. Terms: Gamete: sperm & egg cells Zygote: a 23-chromosome female gamete (egg) and 23-chromosome male gamete (sperm) unite to form a 46-chromosome zygote, which is capable of developing into a new individual. A diploid cell formed by the fusion of two haploid gametes (egg and sperm). A zygote is a fertilized ovum (female reproductive cell) Here are images from the CDC, MedlinePlus and Medscape: Details - Public Health Image Library(PHIL) Cri-du-chat Syndrome: Practice Essentials, Pathophysiology, Epidemiology Cri-du-chat Syndrome: Practice Essentials, Pathophysiology, Epidemiology image_80765902131622689238599.jpg (6.54 KB) image_75826298041622689380952.jpg (4.79 KB)

Answer 48

MicroRNA (miRNA) is a type of non-coding RNA (RNA that does not encode a protein) with a length of about 22 base. It binds to a complementary sequence in the 3’UTR of mRNA (coding RNA), and thereby regulates the gene expression. It is said that 30-50% of all genes are regulated in this manner. The regulation mechanisms employed by miRNA include transcript degradation and translational suppression

Answer 49

Single-gene disorders, where a mutation affects one gene. Sickle cell anemia is an example. Chromosomal disorders, where chromosomes (or parts of chromosomes) are missing or changed.

Answer 50

Chromosomes have been gained or lost. Name of affected cell will end in Somy

Answer 51

Single gene disorders are inherited and clearly identifiable patterns. Chromosomal disorders are deviations in the structure or number of chromosomes due to the loss addition rearrangement or exchange of genes.

Answer 52

Maternal age. Non-disjunction can cause chromosomal disorders

Answer 53

DNA polymerase matches base pairs and results in a double-stranded DNA molecule during polymerization (replication) RNA polymerase produces a single-stranded RNA molecule during transcription.

Answer 54

Genomic imprinting is a reversible form of gene inactivation and is not considered a mutation. For instance, Jane inherits two copies of a paternally imprinted gene. The copy she inherited from her father will be imprinted, or inactivated, and the copy she inherited from her mother will be active (not imprinted). example is prader willi sydrome

Answer 55

duchenne muscular dystrophy

Answer 56

a form of base pair substitution, alter amino acids, which produce a change (i.e., the “sense”) in a single amino acid.

Answer 57

muscular dystrophy

Answer 58

Pathologic atrophy is a decrease in cell size due to decreased use. Physiologic atrophy usually occurs early in development; for example, the thymus gland atrophies during childhood. Hypertrophy is an increase in cell size. Hyperplasia is an increase in the number of cells.

Answer 59

interleukins | Interleukins are biochemical messengers produced by macrophages and lymphocytes in response to a pathogen.

Answer 60

viral infections

Answer 61

secreted by macrophages and mast cells Tumor necrosis factor-alpha is secreted by macrophages when Toll-like receptors recognize foreign materials or by mast cells. They are proinflammatory molecules that increase adherence of neutrophils, induce chemokine production, cause fever, increase synthesis of inflammation-related serum proteins by the liver, and cause muscle wasting.

Answer 62

antibodies

Answer 63

Superantigen binding is independent of antigen-recognition and signals Th-cell activation and proliferation and cytokine production, resulting in fever, low blood pressure, and possibly fatal shock.

Answer 64

on Mast cells in tissues

Answer 65

IgD, acts as antigen receptor