Vocab Flashcards
(187 cards)
1
Q
Pathology
A
the study and diagnosis of disease though the examination of organs, tissues, cells, and bodily fluids
2
Q
Physiology
A
study of mechanical, physical, and biochemical functions of living organisms
3
Q
Pathophysiology
A
study of abnormalities in physiologic functioning of living beings
4
Q
Idiopathic Etiology
A
Cause is unknown
5
Q
Iatrogenic Etiology
A
Cause is a result of an unintended or unwanted medical treatment
6
Q
Primary Levels of Prevention
A
Altering susceptibility, reducing exposure for susceptible persons
Ex: Education, immunizations, condoms
7
Q
Secondary Levels of Prevention
A
Early detection and screening; prevent further complications
Ex: Breast cancer screening, PAP smears
8
Q
Tertiary Levels of Prevention
A
Individual has the disease; looking to get them back to better quality of life
Ex: rehabilitation (PT), supportive care, outreach programs
9
Q
Incidence
A
New cases over a time period
10
Q
Prevalence
A
Existing cases over a time period
11
Q
Reliability
A
Same results when repeated
12
Q
Validity
A
Measuring what was intended
13
Q
Sensitivity
A
Correctly identifies a condition
14
Q
Specificity
A
Correctly excludes a condition
15
Q
Predictive Value
A
Ability to predict disease or condition
16
Q
Morbidity
A
Causes disease, illness, consequences
17
Q
Diffusion
A
Passive transport
Movement of area of high concentration to low concentration
18
Q
Osmosis
A
Passive transport
Movement of water via osmotic pressure from high to low concentration
19
Q
Facilitated diffusion
A
Passive transport that requires a protein carrier, such as glucose
20
Q
Ischemia
A
Lack of blood flow
21
Q
Hypoxic
A
Lack of oxygen –> cannot produce ATP
22
Q
What is the first manifestation of most forms of reversible cell injury?
A
Hydropic swelling
23
Q
What is Hydropic Swelling?
A
Cell swelling due to excess water from sodium/potassium pump malfunction (not receiving enough energy/ATP)
Pump malfunction –> sodium ions build up inside the cell –> water always follows salt –> cells swell
24
Q
What is Intracellular Accumulation?
A
Build up of substances due sometimes to faulty metabolisms
- Normal body substance buildup (melanin, lipid)
- Buildup due to metabolic dysfunction (Tay-Sachs disease)
- Exogenous products (black lung filled with coal dust)
25
How does free radical formation (UV/radiation) cause damage?
Lipid preroxidation by attacking fat
| Attacks proteins disrupting transport channels
26
What is Necrosis?
Tissue destruction that occurs as a consequence of ischemia or toxic injury
Characteristics: cell rupture, spilling of contents into ECF, and inflammation
27
Coagulative Necrosis etiology
Ischemia --> loss of energy --> inefficiency of sodium potassium pump --> salt build up inside cell --> swelling --> rupture (triggers inflammatory response)
28
Liquefactive Necrosis etiology
spilled contents --> stimulates inflammatory response --> eaten up by lysosomes --> but healthy tissue gets eaten too --> forms abscesses --> liquid-filled cysts
29
Fat Necrosis
death of adipose tissue as a result of trauma
30
Caseus Necrosis
lung damage secondary to tuberculosis
-clumpy cheese appearance in granulomas
31
What is a gangrene?
Cellular death in a large area of tissue that results in interruption of blood supply to a particular part of the body
32
Describe Dry Gangrene
- Form of coagulative necrosis
- Blackened, dry, wrinkled tissue separated by a line of demarcation from healthy tissue
- Spreads slowly
33
Describe Wet Gangrene
Form of liquefactive necrosis (abscesses) typically found in internal organs but also can be seen outwardly
- No strict demarcation
- Spreads quickly
34
Describe Gas Gangrene
Results from infection of necrotic tissue by Clostridium (anaerobic bacteria)
-Formation of gas bubbles in damaged tissue
35
What does Apoptosis do?
Intracellular cascade that activates cellular suicide response
- Does NOT cause inflammation
- Neat clean matter through cascade signaling
- No further damage
- Removes dead cells, leaving room for new, better functioning cells
36
Component Acquired Capability - leading up to cancer
- Self sufficiency in growth signals (autonomous)
- Insensitivity to antigrowth signals
- Evading apoptosis
- Limitless replicative potential
- Sustained Angiogenesis
- Tissue invasion and metastasis
37
How do Mutator Genes lead to cancer?
Increases the rate of mutation of one or more other genes
38
What are proto-oncogenes and how can they lead to cancer?
Proto-Oncogenes are normal genes for proliferation (cell differentiation)
Thus when they mutate, they turn into oncogenes, enabling cells for autonomy
39
What is an oncogene?
An oncogene is a mutated proto-oncogene, aka CANCER CAUSING GENE
40
What are Tumor-Supressor Genes and how can they lead to cancer?
They are the genes that suppress tumors --> however if they are mutated, they no longer can inhibit the growth of tumors
41
What are other genes that when mutated, can lead to cancer?
Genes that control apoptosis, genes that regulate repair of DNA damage
42
Are mutations that occur in somatic cells passed down to progeny?
No
43
Are mutations that occur in gremlin (stem) cells passed to future generations?
Maybe!
44
GERD can lead to what type of cancer?
Esophageal cancer
45
Chronic Pancreatitis can lead to...
Pancreatic cancer
46
How can viruses cause cancer?
Viruses can insert their own DNA structure/genes --> change the existing genes --> leads to cancer
47
What are the local effects of tumors?
- Pain (which can be absent until late stages --> late diagnosis)
- Tissue Integrity (compressed and eroded blood vessels, ulceration, necrosis, hemorrhage, frank bleeding)
48
What are the systemic effects of (malignant) tumors?
- Weight loss and cachexia (anorexia, fatigue, pain, stress due to the increased demands from tumor cells on the body)
- Anemia (lack of RBC)
- Severe fatigue (due to inflammatory changes, cachexia, anemia, stress of treatment schedule, psychological factors)
- Effusions from the inflammation
- Infections (as a result of immunodeficiency)
- Paraneoplastic syndrome (tumor cells release substances that affect neurologic function and may have hormonal effects)
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Cachexia
Weakness and wasting of body
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Effusions
Fluid buildup in body cavities
51
How does the TNM Classification System work?
```
TX = primary tumor, number is based on size
N = regional lymph nodes and the number of lymph nodes involved
M = distant metastasis; 0 = no metastasis, 1 = metastasis present
```
52
For what type of cells is radiation therapy most effective?
Rapidly dividing cells
53
What are adverse effects of radiation therapy?
Bone marrow depression, epithelial damage, infertility, GI upset
54
What type of drugs does chemotherapy use?
Antineoplastic drugs
55
How can a diagnosis of malignancy be confirmed?
Biopsy
56
Remission of cancer is generally defined as a period in which....
An individual no longer has any detectable signs or symptoms of cancer
57
What is margination?
Margination is the process of neutrophils and macrophages sticking and accumulating to the blood vessel wall in the area of injury
58
How do the marginated WBC stick?
They stick via selections which are released by endothelial cells when trigger by cytokines
59
What is emigration and diapedesis?
The movement of leukocytes out of the circulatory system towards the site of tissue damage or infection
60
What is chemotaxis and how is it created?
Chemical gradient that promotes leukocytes out of the circulatory system towards the site of injury.
The gradient is created by proteins of the complement system + chemokines
61
What are the elements of cellular stage of the inflammatory response?
margination, emigration/diapedesis, chemotaxis, phagocytosis
62
What are the elements of the vascular stage of the inflammatory response?
Bradykinin --> vasodilation --> parin receptors --> mast cells/basophils --> histamine --> (eventually prostaglandins and leukotrienes)
63
How does increased vascular permeability effect osmotic pressure?
Increased vascular permeability --> outpouring of protein-rich exudate into extravascular spaces --> loss of proteins --> reduces capillary osmotic pressure and increases the interstitial osmotic pressure
64
What are inflammatory exudates and what are their functions?
Inflammatory exudates: the fluid that leaks out of blood vessels and into nearby tissues in the inflammatory response
- Transport leukocytes and antibodies
- Dilutes toxins and irritating substances
- Transport nutrients for tissue repair
65
Serous inflammatory exudate =
watery
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Sanguinous inflammatory exudate =
bloody
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Serosanguinous inflammatory exudate
mostly serous (mostly watery)
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Fibrinous
sticky, thick, very high cell content
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Purulent
pus, thick, yellow-green, high in WBC and microorganisms
70
What plasma proteins would show increased levels in diagnostic findings for inflammation?
Fibrinogen and Prothrombin
71
What is C-Reactive Protein and what does it indicate?
It is a protein not normally in the blood but appears with acute inflammation and necrosis within 24-48 hours
-Inflammatory marker
72
What is different about RBC when there is inflammation?
They have an increased ESR (erythrocyte sedimentation rate) due to the elevated plasma protein count
-Inflammatory marker
73
Local effects of inflammation
Redness, swelling, heat, pain, loss of function
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Systemic effects of inflammation
```
Mild fever = pyrexia
Malaise
Fatigue
Headache
Anorexia or weight loss
```
75
Which leukocytes infiltrate more in chronic inflammation than acute inflammation?
Infiltration by macrophages and lymphocytes instead of neutrophils.
Neutrophils are the first responders in acute inflammation.
76
What are there increased presences of in chronic inflammation than acute?
Lymphocytes, macrophages, and fibroblasts
77
What is there less of in chronic inflammation than acute?
There is less swelling and exudate in chronic inflammation than acute.
78
ASA =
Acetylsalicylic Acid
Example: Aspirin
-lowers prostaglandins synthesis at the site --> decreases inflammatory response --> anti-inflammatory
- Analgesic
- Antipyretic
- Anti-Inflammatory
Can increase bleeding, therefore is NOT given to someone with cuts/wounds
79
Acetaminophen
Example: Tylenol
It is an analgesic but has no effects on the inflammatory response
Can also increase bleeding
80
NSAIDs
Non-steroidal anti-inflammatory drugs
Example: Ibuprofen (advil, motrin) or Naproxen Sodium (aleve)
-Anti-Inflammatory, analgesic (relieves pain), and antipyretic
Can increase bleeding
81
What are the side effects of ASAs and NSAIDs?
Increased bleeding
GI stress
Stomach Ulcerations
Delayed blood clotting
82
What are glucocorticoids?
Corticosteroids that decrease capillary permeability, decrease leukocytes and mast cells at site
--> decreased release of histamines and prostaglandins
Anti-finlammatory
83
What are the side effects of Glucocorticoids?
Risk of infection
GI distress
Stomach ulceration
Edema
Increased BP
Atrophy of lymphoid tissue --> decrease in WBC count and hematopoiesis (formation of blood cellular components in bone marrow
Catabolic Effects (tissue breakdown, less protein synthesis ) --> osteoporosis, muscle wasting, thinning of skin
Altered feedback response system --> decrease in release of production of normal hormones --> atrophy of adrenal glands
Delayed healing (and growth in children)
Retention of sodium and water due to aldosterone-like effect in the kidney
84
Resolution Healing
Minimal tissue damage
85
Regenration
Damaged tissues replaced with cells that are capable of mitosis and are still functional
86
Replacement
Functional tissue replaced by scar tissue
87
Primary intention
Approximated wound edges and ALL areas heal simultaneously
88
Secondary intention
Heals from the inside out / bottom up
- Greater risk for infection and scarring
- Examples: Pressure ulcers, fractures
89
What phase of healing occurs 3-4 days after injury?
Proliferative Phase
Foreign material and cell debris removed by phagocytosis and granulation tissue grows into the gap
90
What phase of healing occurs about 2 weeks after injury?
Remodeling phase
| -scar tissue build up
91
What is hypertorphic scar tissue and how does it complicate healing?
Overgrowth of fibrous tissue, leading to hard ridges of scar tissue or keloid formation
92
What is ulceration and how does it complicate healing?
The blood supply may be impaired around the scar, resulting in further tissue breakdown and ulceration at a future time.
93
What is dehiscence?
Previously closed wound reopening
94
What are the 4 basic stages of inflammation and healing?
Hemostasis (blood clotting) --> Inflammation --> Proliferation --> Remodeling
95
Why does Hypovolemia impede healing?
Hypovolemia causes decreased blood flow to the affected area, not allowing adequate oxygen and nutrients to the area that promote healing
96
Briefly describe Autoimmunity
An individual recognizes its own cells as foreign due to a breakdown of self-tolerance, and develops antibodies to their own cells
- it can be polygenic and multifactorial
- can have more than one autoimmune disorder at once
97
Briefly describe Alloimmunity
An immune response to foreign antigens from members of the same species
Examples: Hyperacute graft rejection, Blood transfusion reaction, Graft vs host disease
98
What is a hypersensitivity reaction?
A normal immune response that is either inappropriately triggered, excessive, or produces undesirable effects on the body
99
How does Host Defense Failure happen?
Host Defense Failure is a result from functional decrease in one or more components of the immune system
Ex: AIDS, malnutrition can lead to immune deficiency due to the lack of proteins
100
What are examples of autoimmunity?
Lupus, a chronic inflammatory disease that effects multiple organs
Addison's disease
Celiac disease
Grave's Disease
Hashimoto's Thyroiditis
Multiple Sclerosis
101
What are the first clinical indicators of host defense failure?
Signs and symptoms of infection
102
What is the principle mediating antibody of Type I hypersensitivity reactions and what do they bind to?
IgE binds to sensitized mast cells
103
What is a severe clinical manifestation of Type I Hypersensitivity?
Anaphylaxis (swelling, hives, itchiness)
104
How do you manage Type I Hypersensitivity reactions?
```
Antihistamines
Corticosteroids
IgE therapy
Epinhephrine
Immunotherapy
Pharmacologic desensitization
Stay away from allergen (environmental control)
```
105
What is the principle mediating antibody for Type II Hypersensitivity and what is its pathogenesis?
AKA tissue-specific or cytotoxic hypersensitivity, IgG attack antigens on specific cells or tissues
106
Examples of Type II Hypersensitivity
```
Transfusion reaction
Hyperacute graft rejection (rejection of transplanted donor tissue)
Graves Disease (hyperthyroidism - autoimmune)
Myasthenia Gravis (neuromuscular - autoimmune)
```
107
Describe the etiology and pathogenesis of Type III Hypersensitivity
Immune Complex Reaction
- Antigen combines with the antibody to form a complex that is deposited into tissue, activating the complement system
- Immune and phagocytic systems fail to effectively remove antigen-antibody immune complexes
108
Examples of Type III Hypersensitivity
- Rheumatoid arthritis
- Immune complex glomerulonephritis
- Systemic lupus erythematosus
109
Type IV Hypersensitivity etiology and pathogenesis
Delayed response by sensitized T lymphocytes, resulting in the release of lymphokines and other chemical mediators that cause inflammatory response and destruction of the antigen
110
What is the principle mediating antibody for Type IV?
None!
| There are no antibodies involved, but rather it is regulated by T CELLS
111
Examples of Type IV Hypersensitivity
Contact dermatitis, PPD test (for TB)
112
A patient reports hives associated with eating peanuts has which type of hypersensitivity reaction?
Type I
113
What do HLA do?
The Human Leukocyte Antigen are proteins that label cells of the individual
114
CD8
Cytotoxic T Lymphocytes
115
CD4
Helper T Lymphocytes (Th1 and Th2)
116
Th1
Recruit other T cells to the injured area, activate macrophages, and secrete cytokines and chemokines
117
Th2
Trigger B cells
118
How are MHC molecules involved in immunity?
Major Histocompatibility Complex display HLAs as MHC-presented peptides on the surface of cells to help immune cells discriminate between normal antigens and those that are foreign/dangerous
Prevents immune system from attacking our own cells as well
119
MHC 1
Present on virtually all nucleated cells - triggers cytotoxic T cells
120
MHC 2
Restricted to immune cells, antigen-presenting cells, B cells, and macrophages
The engulfed antigen is then degraded into free-peptide fragments within cytoplasmic vesicles --> complexed with MHC 2 molecules --> present on surface of cell --> T Helper cells recognize them and become activated
121
Cell mediated immunity involves which type of lymphocyte?
T cells
122
B lymphocytes are involved in what type of immunity?
Humoral
123
What is the smallest in size but most common antibody?
IgG
| -can cross placenta
124
Which antibody is best for secondary exposure?
IgG
125
Which antibody is the first responder to antigens at initial response?
IgM
| -supplements IgG on subsequent exposure
126
Which antibody is found in mucous secretions and is critical in mucosal immunity (part of first line of defense)
IgA
127
IgD is co expressed with which antibody?
IgM
128
What does IgD activate?
B cells
129
Which antibody stimulates histamine/allergic response?
IgE
130
Which antibody is transferred from mother to fetus through breast milk?
IgG
131
What is a Titre?
It is a diagnostic test that measures levels of serum immunoglobulins
132
What does an Indirect Coombs test measure?
Detects Rh blood incompatibility
| -affects blood transfusions, mother-child
133
What does an Elisa test detect?
Detects for HIV antibodies
134
Receiving the influenza vaccination provides which type of immunity?
Active artificial
135
What is influenza and how is it transmitted?
Influenza is a viral infection of epithelial cells, leading to infected epithelial cell necrosis of the upper respiratory tract, impairing cilia and mucous production.
Transmitted by respiratory droplet transmission
136
What are the clinical manifestations of influenza?
Cough, sore throat, nasal congestion/drainage, chills, fever, body aches, malaise, anorexia
137
What should you avoid giving children with influenza?
Aspirin --> Reye Syndrome
138
What are the nursing implications when treating influenza?
Droplet precautions!
139
Symptoms of fatigue, low grade fever, and generalized muscle aches would most likely be present in which stage of acute infection?
Prodromal
140
What does leukocytosis, specifically neutrophilic, frequently indicate?
Bacterial infections
141
What would an increase in eosinophils indicate?
Allergic reaction
142
What does a decrease in leukocytes and or neutrophils indicate?
Immunosupression or bone marrow damage
143
Hand washing is an example of an action to break the chain of infection at which link?
Means of transmission
144
Contents of ECF
Sodium, chloride, bicarbonate
145
Contents of Intravascular Fluid:
protein rich fluid (plasma), large amounts of albumin
146
Interstitial Fluid
Fluid between cells and location of most extracellular fluid
- hardly any protein
- rich in electrolytes (sodium, chloride, bicarbonate)
147
Transcellular fluid
contained in specialized body cavities
148
What is Hydrostatic Pressure/Filtration?
Movement of fluid and solutes from an area of higher hydrostatic pressure to lower
The pressure is created by the weight of fluids that forces fluids through the capillary walls into the interstitial spaces.
149
Osmolality
osmotic pull exerted by particles per kg of water
150
What type of pressure influences water movement between vascular and interstitial membranes?
Hydrostatic and osmotic
151
Why is blood pushed out of the capillary into interstitial compartment?
At the arterial end of the capillary, the blood hydrostatic pressure exceeds opposing interstitial hydrostatic pressure and plasma pressure of blood --> blood is pushed out of capillary into interstitial compartment
152
How is blood pulled back into capillary
At venous end of capillary, blood hydrostatic pressure is decreased and osmotic pressure is higher --> therefore blood is pulled back into capillary
153
Describe Hypothalamic Regulation
Osmoreceptors in the hypothalamus regulate the fluid
154
Pituitary Regulation
Posterior Pituitary releases ADH --> water retention in kidneys
155
Adrenal Cortical Regulation
Glucocorticoids and mineralcorticoids secreted by adrenal cortex help regulate both water and electrolytes
156
In Hypotension when there is decreased renal perfusion...
Kidneys release renin --> causes kidneys to release angiotensiongen --> converted to angiotensin I --> then to angiotensin II --> vasoconstrictor to raise BP
Angiotensin II also simulates secretion of aldosterone by adrenal context --> causes tubules of kidneys to increase reabsorption of water and sodium in blood and excrete potassium --> increase in fluid volume
157
What is the primary extracellular electrolyte?
Sodium!
158
What is the primary intracellular electrolyte?
Potassium!
159
Isotonic
Same osmolality as intracellular fluid
160
Hypotonic
Lower osmolality of ICF (more solutes inside the cell than outside)
161
Hypertonic
Higher osmolality of ICF (more solutes outside the cell)
162
What is the most abundant cation in the ECF?
Sodium
163
What is the ECF low in/ the ICF high in?
Potassium, magnesium, and phosphate ions
164
In fluid balance at the capillary level, which force is caused by proteins or other molecules that can pull fluid from the interstitial space into the intravascular space?
Osmotic pressure
165
If cells are in a hypotonic solution...
fluid is pulled IN to the cell, causing the cell to burst
166
If cells are in a hypertonic solution...
fluid is pulled OUT of the cell, causing the cell to shrink
167
Aldosterone release causes _____ retention with _____ excretion
Aldosterone release causes sodium retention with potassium excretion
168
How do Loop Diuretics remove fluid?
They inhibit sodium and chloride reabsorption from the LOOP OF HENLEYS
Example: Lasixs
169
How does Thiazide remove fluid?
Inhibits reabsorption of sodium and chloride from the DISTAL CONVOLUTED TUBULES
Example: HCTZ
170
What are Potassium-Sparing diuretics?
Competitive antagonists for aldosterone - lose lots of fluid but retain or reabsorb potassium --> prevents reabsorption of sodium
171
Clinical manifestations of Hypovolemia
```
Tachycardia (rapid HR)
dry mouth/thirst
skin turgor
Syncope
Low BP
Oliguria (low urine output)
Low RBC and hemoglobin
Nausea
Substantial weight loss
```
172
Treating Hypovolemia
Correct underlying cause and replace both water and electrolytes
173
2% weight loss is a
Mild deficit
174
Moderate deficit is
5% weight loss
175
8% weight loss is considered
Severe dehydration
176
Lab analyses check blood of dehydrated patients for...
Electrolytes, bicarbonate, BUN (blood urea nitrogen) (waste product of digestion of protein), creatinine, and specific gravity
177
Serum electrolytes in Isotonic Dehydration
Stay in normal range
178
Causes of Isotonic Dehydration
fasting, diarrhea, vomiting, burns, hemorrhage
179
In Hypertonic Dehydration...
More fluid loss than electrolytes --> increase in serum electrolytes
180
Causes of Hypertonic Dehydration
Extended fever, diabetes insipidus, DM, reduced fluid intake
181
What type of dehydration does Diabetes Insipidus cause and how?
Diabetes insipidus causes hypertonic dehydration to the reduction in the release of ADH
182
Hypotonic Dehydration
Loss of more electrolytes than fluid --> decrease in serum electrolytes
*HYPONATREMIA
183
What causes Hypotonic Dehydration?
Addison's disease
overuse of diuretics
Not enough electrolyte intake (only H2O)
184
What does an overproduction of ADH lead to?
SIADH = syndrome of inappropriate ADH
- water retention --> decreased urine output
- decrease in plasma osmolality; increase in urine osmolality
185
What is third-spacing?
Fluid shifts out of the blood into a body cavity or tissue and can no longer reenter vascular compartment
186
Which of the following would cause edema?
Increased hydrostatic pressure
Increased interstitial fluid osmotic pressure
Blockage of lymphatic drainage
Decreased capillary osmotic pressure
All!
187
Which of the following terms refers to a combination of decreased circulating blood volume combined with excess fluid in a body cavity?
Dehydration
Hypovolemia
Water Retention
Third Spacing
Third Spacing
