Vol.1-Ch.12 "Pathophysiology" Flashcards
1
Q
Predisposing factors of disease? (5)
A
- age
- gender
- genetics
- lifestyle
- environment
2
Q
Define: Pathogenisis
A
sequence of events that leads to development of disease
3
Q
Define: idiopathic
A
predisposing factors that cannot be identified
4
Q
Define: etiology
A
occurrences, reasons, variables of a disease
5
Q
Define: clinical manifestation
A
manifestation of a disease
6
Q
Define: symptom
A
what patient tells you about disease—subjective complaint
7
Q
Define: sign
A
objective finding you identify through physical examination
8
Q
Define: Syndome
A
specific constellation of signs and symptoms.
9
Q
Define: diagnosis
A
assumption disease will follow prescribed course
10
Q
Define: prognosis
A
expected outcome
11
Q
Define: sequelae
A
complications common or expected
12
Q
Difference btw chronic and acute
A
Chronic is slow onset, acute is fast
13
Q
Difference between cation and anion
A
Cation has positive charge and anion has a negative charge
14
Q
atomic number is _____
A
number of protons in nucleus of atom defines element
15
Q
Isotopes are ?
A
elements have same number of protons; vary in number of neutrons
16
Q
Mass number of an element is _____ + _____?
A
total neutron + total protons
17
Q
covalent bond formed via ____?
A
sharing of electrons
18
Q
ion is formed by _____?
A
atom/molecules that acquire the same electrical charge
19
Q
ionic bond is formed by?
A
opposite charges attracting
20
Q
difference btw organic and inorganic
A
if carbon is present
21
Q
4 major elements of living systems
A
carbon
hydrogen
oxygen
nitrogen
22
Q
define : compound and list major 4
A
chemical union of 2 or more elements
carbohydrates
proteins
nucleic acids
lipids
23
Q
Carbs are divided into different sugars, what are the 3 different classes of sugars?
A
Monosaccharides (glucose, fructose, galactose)
Disaccharides (sucrose, lactose, maltose)
Polysaccharides (starches, cellulose, glycogen)
(Starches:polymers of glucose)
24
Q
What is the most abundant organic molecule in the world, and the structural material of plants?
A
Cellulose
25
Important polysaccharide stored in the liver and skeletal muscle
Glycogen
26
what are the nitrogen based complex compounds that are the basic building blocks of cells?
Proteins - they are also a means of growth and repair of tissue
27
Amino acids are ?
small building blocks of proteins
28
peptide bonds are?
two amino acid molecules join and molecule of water released
29
What is the function of Antibodies and complement protein?
Defense (destruction of diseasecausing agents)
30
What is the function of contractile and motor proteins?
movement
31
What is the function of enzyme proteins?
catalyze chemical reactions
32
What is the function of peptide hormone proteins?
signal and control the activities of cells
33
What is the function of receptor proteins?
Receive chemical signals from outside of the cell and initiate cellular response
34
What is the function of structural proteins?
Support cells and tissues; major factor in various body structures
35
What is the function of transport proteins?
Move substrates across cell membranes and throughout the body
36
peptide vs polypeptide (proteins)?
```
peptide = less than 10 protein chains
polypeptide = more than 10 protein chains
```
37
4 different levels of protein structure from simplest to most complex?
primary
secondary
tertiary
quarternary
38
DNA (deoxyribonucleic acid) (a nucleic acid) is made up of 2 long polymers ( _____ ) bound by paired substances (_____)
nucleotides bound by nucleobases (4 bases)
39
genes are?
code specific amino acid sequence; make up specific protein
40
RNA characteristics (sugars, bases, #of strands)
```
Sugar = Ribose
Bases = Adenine, guanine, cytosine, uracil
#of strands = 1
```
(uracil is only different base from DNA)
41
DNA characteristics (sugars, bases, #of strands)
```
Sugar = Deoxyribose
Bases = Adenine, guanine, cytosine, thymine
#of strands = 2
```
(thymine is only different base from RNA)
42
A nucleic acid called Adenosine triphosphate is aka? and why is is important?
aka ATP (a nucleotide); Principal source of energy for most energy-using activities of cells.
also, its phosphate bond is very unstable and it is a monomer for RNA
43
Lipids are what and function is what?
chemicals that do not dissolve in water (aka nonpolar)
Function in long-term storage of biochemical energy, insulation, structure, control
44
Triglycerides (a lipid) are either ____ or _____
saturated or unsaturated (rich source of energy for the body)
45
Phospholipid (a lipid) function?
form membrane that surround the cell
46
steroid (a lipid) basic unit is _____?
cholesterol
47
anabolism is?
synthesis of steroid compounds by the body
48
water is ____ and its bodily function is to _____?
universal solvent ; polar molecule
it transports substances throughout the body and helps to regulate body temperature
49
what is a dissociation reaction?
compound or molecule breaks apart into separate components
50
in an acid-base reaction, protons are shared...who gains and who looses?
acids give up protons in a reaction while bases gain protons in a reaction
51
what has the ability to act as an acid or base?
water
52
what are the 3 bodily buffer systems (systems that act against pH changes in the body)
carbonic acid-bicarbonate buffer system
protein buffer system
phosphate buffer system
53
Carbonic acid-bicarbonate buffer system regulates what? functions through what? limited by what?
Carbonic acid-bicarbonate buffer system: regulates pH of blood.
Buffer changes in pH caused by organic acids and fixed acids in extracellular fluid (ECF).
Can function only when respiratory system and control centers functioning normally.
Limited by amount of available bicarbonate ions.
54
Protein buffer system depends on what? helps with what?
Protein buffers depend on ability of amino acids in protein chain to react to changes in pH.
Hemoglobin buffer system helps to prevent changes in ECF pH when PaCO2 is rising or falling.
55
phosphate buffer system is limited in _____ and has a major role in stabilizing the pH of _____
Phosphate buffer system limited in ECF; major role in stabilizing pH of urine
56
When pH is out of balance what systems help quick and which help long term?
buffer systems help quickly but repiratory and renal systems help correct the issue long term
57
How do buffer systems help pH and how fast are they at changing it?
they release or absorb H ions and do so immediately
58
Respiratory system can effect pH by doing what? how fast or slow is it at effecting pH?
Retain or remove CO2; it could take minutes to hours
59
Electrolyte shifts can effect pH by doing what? how fast or slow is it at effecting pH?
Exchange Na+ and/or K+ for H+ in ECF ; it could take minutes to hours
60
renal system can effect pH by doing what? how fast or slow is it at effecting pH?
Secretion or absorption of H+ and/or HCO-3, phosphate, and ammonia buffering ; it can take hours to days
61
what is the normal pH range?
7.35-7.45
62
production of organic or fixed acids or conditions that affect levels of bicarbonate in ECF are called?
metabolic acid-base disorders
63
inequality in carbon dioxide generation in peripheral tissues and carbon dioxide elimination in respiratory system
respiratory acid-base disorders
64
Hypercapnia = ? ; what causes it?
elevation in plasma CO2 levels (leads to acidosis) caused by decrease in respiratory rate, tidal volume, or combination of the two
65
hypocapnia = ? ; what causes it?
excessively low plasma CO2 levels (leads to alkalosis) caused by hyperventilation
66
metabolic acidosis is caused by ?
deficiency of bicarbonate (HCO3-) in body
67
metabolic alkalosis is caused by? is this common or rare? what is a common cause of this?
uncommon; due to increase in HCO3- levels or decrease in circulating acids. ingesting too many antacids can cause this
68
prokaryotic cells vs eukaryotic cells?
prokaryotic cells do NOT have a nucleus or organelles while eukaryotic cells HAVE both nucleus and organelles
69
Basic unit of all living organisms = ?
cells
70
plasma membrane consists of _____ while a cell membrane consists of _____?
Plasma membrane: consists of chemicals; phospholipids.
| Cell membrane: lipid bilayer
71
endocytosis is _____?
Materials engulfed by the plasma membrane and drawn into the cell in a vesicle
72
exocytosis is _____?
Membrane-bound vesicle from inside the cell fuses with the plasma membrane and spills contents outside the cell
73
simple diffusion VS facilitated diffusion VS active diffusion
they are all movement of concentration from high to low but ;
facilitated uses the aid of a carrier or channel protein;
and active also does this but with the addition of energy usage (usually from ATP)
74
Plasma membrane functions include _____? (5)
- Cells adhere to each other or stick together; cell adhesion molecules (CAMs).
- Cell-cell recognition; ability of cell to distinguish one type of cell from another.
- Maintains structural integrity of cell
- Role in communications between cells.
- Regulates movement of substances into and out of cell
75
Isotonic vs hypotonic vs hypertonic
isotonic - balanced amounts of solution on each side
hypotonic - low solutes (ex. salt) and high solvents (water)
hypertonic - high solute (ex. salt) and low solvent (water)
76
Free water = ?
water free of solute
77
osmosis generates pressure, i.e. _____
osmotic pressure
78
osmolarity =
concentration of solute particles in solution
79
An example of active transport might include what?
the sodium potassium pump that transports the 2 ions against the concentration gradient
80
phagocytosis = ?
cell engulfs large particles or bacteria
81
Pinocytosis = ?
cell engulfs droplets of fluid carrying dissolved substances.
82
how much of the total body water is found in intracellular fluid?
70% = 29.4L
83
how much of the total body water is found in extracellular fluid?
30% = 12.6L
84
how much of the total body water is found in interstitial fluid?
25% = 10.5L
85
how much of the total body water is found in intravascular fluid?
5% = 2.1L
86
which age groups are at higher risk for dehydration and electrolyte imbalances?
old and young (not adult)
87
infant vs adult TBW percentage (total body water) and what can make TBW vary?
infant's TBW equates to 75-80% of body weight while adult TBW equates to 65%
TBW can vary depending on age and physiologic condition
88
Dehydrated patient vs overhydrated patient symptoms
Dehydrated Pt: dry mucous membranes, poor skin turgor, excessive thirst.
Overhydration Pt: edema; heart failure may be present
89
define: ion? electrolyte: ?
ion: charged particle
electrolyte: substances that dissociate into electrically charged particles when placed into water
90
Types of cations include ? (4)
Sodium (Na+)
Potassium (K+)
Calcium (Ca++)
Magnesium (Mg++)
91
Types of anions include ? (3)
Chloride (Cl-)
Bicarbonate
Phosphate
92
unit of measurement for electrolytes
milliequivalents per liter (mEq/L).
93
Cell membranes are ______ and allow for ____ to pass easily while ______ are restricted; and _____ pass through but less readily than water.
Cell membranes are semipermeable and allow for smaller compounds like water to pass easily while larger ones like proteins are restricted; and electrolytes pass through but less readily than water because of their electrical charge
94
Oncotic force is generated by _____?
Blood Plasma
95
Hydrostatic pressure is _____?
Hydrostatic pressure: blood pressure; force against vessel walls by contractions of heart
96
Filtration occurs via ______?
Filtration: hydrostatic pressure forces water out of plasma across capillary wall into interstitial space
97
what is starling's hypothesis (equation)
Starling's hypothesis: Net filtration = (Forces favoring filtration) - (Forces opposing filtration)
98
what is edema and what are some signs and symptoms related to edema? (4)
Edema: accumulation of water in interstitial space.
(it is usually a sign of another problem but edema itself can be a problem)
- Decrease in plasma oncotic force
- Increase in hydrostatic pressure (BP)
- Increased capillary permeability
- Lymphatic channel obstruction
99
chief regulator of water retention and distribution?
Antidiuretic hormone (ADH) or vasopressin
100
Erythrocytes make up what % of blood cells?
What is an iron based compound that binds with O2?
Thrombocytes are major role in?
Erythrocytes: hemoglobin; transports oxygen; 99 percent of blood cells.
Hemoglobin: iron-based compound that binds with oxygen.
Leukocytes: responsible for immunity and fighting infection.
Thrombocytes: major role in blood clotting.
101
what is the most desirable fluid replacement for blood loss?
whole blood
102
Define: Hematocrit
percentage of blood occupied by erythrocytes
103
What is a (blood) transfusion reaction?
discrepancy between blood type of patient and blood type of blood being transfused
104
Two types of intravenous fluids?
Colloids and crystalloids
105
Colloid type intravenous fluids are? and include?
Colloid: proteins; remain in intravascular space for extended period.
- Plasma protein fraction (Plasmanate)
- Salt-poor albumin
- Dextran
- Hetastarch (Hespan)
106
Crystalloid type intravenous fluids are? and include?
Crystalloids: primary compounds used in prehospital intravenous fluid therapy.
- Isotonic solutions
- Hypertonic solutions
- Hypotonic solutions
107
Intravenous fluid replacement depends on ? (2)
needs of Pt and underlying problem
108
Most commonly used solutions in prehospital care? (3)
Most commonly used solutions in prehospital care:
- Lactated Ringer's solution
- 0.9 percent sodium chloride (normal saline)
- 5 percent dextrose in water (D5W)
(Lactated Ringer's solution and normal saline used for fluid replacement)
109
what controls cell function and protein production?
DNA
110
largest organelle, contains cells genetic information?
nucleus
111
how many chromosomes do humans have?
46 (23 pairs)
112
what is the nuclear envelope?
Nuclear envelope: double membrane encases nucleus.
113
nucleolus is _____?
Nucleolus: region of DNA active in production of ribosomal RNA (rRNA).
114
Ribosome purpose is _____?
Ribosomes: synthesis of polypeptides and proteins.
115
endoplasmic reticulum is _____? its purpose it_____?
Endoplasmic reticulum:
- network of tubules, vesicles, sacs; interconnect with plasma membrane, nuclear envelope, other organelles in cell.
- role in replenishment and maintenance of plasma membrane
116
Rough Endoplasmic Reticulum VS Smooth Endoplasmic Reticulum
Rough : contains ribosomes during protein synthesis.
Smooth : without ribosomes
117
Golgi Aparatus function?
Golgi apparatus (Golgi complex): processes proteins for cell membrane and other cell organelles.
118
Lysosomes function?
Lysosomes: "garbage disposal system" of cells.
- Break down foreign substances and invaders; degrade worn out parts of cell.
- Process macromolecule products
119
Vacuoles function?
Vacuoles: membrane-bound organelles used for temporary storage or transport of substances.
120
Peroxisomes function?
Peroxisomes: generate and degrade hydrogen peroxide (H2O2); highly toxic to cells.
Detoxify harmful substances; regulation of oxygen tension within cell.
121
Mitochandria and cristae function?
Mitochondria: "powerhouses" of cells;
- provide energy needed for all of cell's biochemical processes.
- Cellular respiration.
Cristae: inner membrane folds form shelves within mitochondria.
122
Microtubules?
Microtubules: long, hollow rods made of protein tubulin.
123
Microfilaments?
Microfilaments: made from protein actin.
124
Centrioles?
Centrioles: cylindrical structures composed of groups of microtubules.
125
Cytoskeleton?
Cytoskeleton: three-dimensional structure; serves as skeleton for cell stability.
126
Cilia VS Flagella?
Cilia: hairlike structures that move in back-and-forth motion.
Flagella: much longer than cilia; move in undulating, wavelike manner.
127
Cellular Respiration VS Fermintation?
Cellular respiration: aerobic; requires oxygen.
Fermentation: anaerobic; does not require oxygen
128
Oxidation VS Reduction?
Oxidation: loss of electrons from one atom to another.
Reduction: gain of electrons by one atom from another
129
Three biochemical processes glucose molecule must pass to produce energy through cellular respiration?
glycolysis, citric acid cycle, electron transport.
130
Glycolysis? (1 of 3 chem processes glucose must go through to produce energy through cell respiration)
Glycolysis
Occurs in cytoplasm; breakdown of six-carbon sugar glucose.
Energy-using and energy-yielding phases
131
Citric Acid Cycle? AKA? (2 of 3 chem processes glucose must go through to produce energy through cell respiration)
Citric acid cycle (Kreb's cycle or tricarboxylic acid [TCA] cycle):
Completely oxidizes remainder of glucose molecule
132
Electron Transport Chain? (3 of 3 chem processes glucose must go through to produce energy through cell respiration)
Electron Transport Chain:
- Five types of carriers.
- Electrons transferred from one molecule to next; energy released.
- Passed to oxygen; ultimate electron acceptor.
133
What is the ultimate electron acceptor?
Oxygen
134
Fermentation differs from cellular respiration in ? (5)
Fermentation:
- Breakdown of glucose without oxygen
- Final electron acceptor is pyruvate, not oxygen
- Very inefficient
- Lactic acid fermentation
- Alcohol fermentation
135
Cellular adaption is defined as? what are the 4 types?
Cellular adaptation: physiologic and structural changes to cell, in response to change or stress.
- Hyperplasia
- Hypertrophy
- Atrophy
- Metaplasia
136
Hyperplasia? (type pf cell adaption)
Hyperplasia: increase in number of cells in tissue or organ.
- Hormonal hyperplasia: stimulation by hormones.
- Compensatory hyperplasia: increase in tissue mass following tissue injury or loss.
- Can be pathological.
137
Hypertrophy? (type of cell adaption)
Hypertrophy: increase in size of cells in tissue or organ.
- Due to creation of more structural components within cell
- Physiologic hypertrophy: increased physical demand
- Pathological hypertrophy: abnormal stress
138
Atrophy? (type of cell adaption)
Atrophy: decrease in size of cell.
| - May be physiologic (effect of hormones) or pathological (result of disease or injury).
139
Metaplasia? (type of cell adaption)
Metaplasia: cell can change from one adult cell type to another adult cell type; reversible.
- Protects organism from stress.
140
cells that are too stressed or constantly damaged eventually die; once irreversibly damaged, cells undergo _____ or _____; is this a normal process?
Irreversibly damaged cells undergo necrosis or apoptosis; normal process of keeping body healthy.
141
ischemia VS hypoxia
Ischemia: diminished blood flow.
Hypoxia: decreased availability of oxygen
142
If cellular respiration is impaired, energy production to _____ is limited?
Glycolysis
143
Apoptosis?
Apoptosis: cellular program activated; causes release of enzymes that destroy genetic material within nucleus of cell and selected proteins in cytoplasm.
- Can be physiologic or pathological
144
Dysplasia?
Dysplasia: abnormal or disordered growth in a cell.
| Precursor to development of cancer.
145
Histology VS Histopathology?
Histology: study of tissues.
Histopathology: study of abnormal or diseased tissue
146
what are the 4 types of tissues?
Tissue: group of cells that serve common purpose.
- Epithelial
- connective
- muscle
- nervous
147
what are germ layers and what are the 3 different ones?
Germ layers: all tissues of the body derived from three cell lines in embryonic development.
- endoderm
- mesoderm
- ectoderm
148
Endoderm? (germ layer)
Endoderm: innermost germ cell layer; gives rise to epithelial tissue.
149
Mesoderm? (germ layer)
Mesoderm: middle germ layer; gives rise to numerous body tissues.
150
Ectoderm? (germ layer)
Ectoderm: outermost germ layer; gives rise to all tissues that cover body surfaces as well as nervous system.
151
Epithelium and epithelial tissues?
Epithelium:
- derived from all three germ layers.
- Epithelium forms barrier between organism and environment.
Epithelial tissues:
- cover body surfaces
- Epithelial tissue covers external and internal body surfaces; lines passageways that communicate with outside.
152
Connective tissue purpose?
Connective tissues: framework on which epithelial tissue rests and within which nerve and muscle tissue embedded.
153
Muscle tissue purpose?
Muscle tissues: responsible for movement of substances through organism.
154
Nerve tissue purpose?
Nerve tissues: coordinate activities of the body.
155
4 different epithelial tissue functions?
Epithelial tissue:
- Provides physical protection.
- Controls permeability.
- Provides special senses.
- Produces specialized secretions.
156
Simple VS Stratified epithelium
Simple epithelium: single cell layer thick; provides limited protection.
Stratified epithelium: several layers thick; provides greater degree of protection.
157
General look of squamos VS Cuboidla VS Columnar epithelium
Squamous epithelium: tissues with thin and flat cells.
Cuboidal epithelium: cells cubelike or square shape.
Columnar epithelium: cells tall and more slender.
158
Simple Squamos Epithelium usual locations and functions?
- Linings of heart and blood vessels; air sacs of lungs
| - Allows passage of materials by diffusion
159
Stratified Squamos Epithelium usual locations and functions?
- Linings of mouth, esophagus, vagina; outer layer of skin
| - Protects underlying areas
160
Simple Cuboidal Epithelium usual locations and functions?
- Kidney tubules; secretary portions of glands and ducts
| - Secretion; absorption
161
Stratified Cuboidal Epithelium usual locations and functions?
- Ducts of sweat glands, mammary glands, salivary glands
| - Protects underlying areas
162
Simple columnar epithelium usual locations and functions?
- Most of digestive tract; bronchi; excretory ducts of some glands; uterus
- Absorbs; secretes mucus, enzymes, and other substances
163
Stratified columnar epithelium usual locations and functions?
- Rare: urethra; junction of esophagus and stomach
| - Protects underlying areas; secretes mucus
164
Loose, areolar connective tissue locations and functions?
- Between muscles, surround glands, wrapping small blood vessels and nerves
- Wraps and cushions organs
165
loose, adipose connective tissue location and function?
- Under skin, around kidneys and heart
| - Stores energy, insulates, cushions organs
166
cartilage (semisolid) specialized connective tissue location and function?
- Nose (tip); rings in respiratory air tubules; external ear
| - Provides support and protection (by enclosing) and serves as lever for muscles to act on
167
Dense connecive tissure includes _____ and _____?
| What are their functions and locations?
- Tendons: attach bone to muscle
| - Ligaments: attache bone to bone
168
3 types of fibers in connective tissue?
Collagen fibers
Elastic fibers
Reticular fibers
169
4 types of cells in connective tissue?
Fibroblasts
Macrophages
Adipocytes
Mast cells
170
Skeletal VS Cardiac VS Smooth muscle desciptions (visual)
Skeletal: Long, cylindrical cells; multiple nuclei per cell; obvious striations
Cardiac: Branching, striated cells; one nucleus; specialized junctions between cells
Smooth: Cells taper at each end; single nucleus; arranged in sheets; no striations
171
Neuroglia are?
Neuroglia (glial cells): support, insulate, protect neurons
172
Neoplasia?
Neoplasia :
Abnormal tissue growth; cells grow and multiply in uncontrolled fashion.
173
Dysplastic cells?
Dysplastic (atypical) cells: develop abnormal growth patterns
174
Metastasis
Metastasis: malignant cells shed to other areas of body through bloodstream.
175
Cancers originate what what 2 tissues? Can genetics be involved?
Cancers: epithelial or connective tissue origin.
| Yes genetics can be responsible sometimes
176
Oncogenic Factors VS Oncgenic Viruses?
Oncogenic factors: carcinogens and radiation.
| Oncogenic viruses: produce cancers
177
Environment and hormones role in cancers?
Both can be risk factors/contributers
178
Carcinogenesis?
Carcinogenesis: process of developing a malignant neoplasia.
179
Initiation?
Initiation: event begins transformation from normal tissue to cancer.
180
Promoter? (in cancer terms)
Promoter: carcinogen or any factor associated with cancer development.
- Necessary for continued development of tumor and speeds up process.
181
Progression? (in cancer terms)
Progression: malignancy exists and cells anaplastic in appearance.
- Followed by growth, local tissue invasion, possible metastasis
182
Cancer cells are graded by _____?
Cancer cells graded by degree of cell differentiation present.
183
Once cancer develops, it becomes _____.
| Cancer spreads along _____ _____; attaches to various tissues.
Once cancer develops, it becomes Invasive.
| Cancer spreads along Tissue Planes; attaches to various tissues.
184
Multifactorial disorders are?
Multifactorial disorders: diseases caused by combination of genetic and environmental factors.
185
Hypoperfusion = ?
Shock
186
Preload VS Afterload
Preload: amount of blood delivered to heart during diastole. (Preload affects cardiac contractile force.)
Afterload: resistance against which ventricle must contract.
187
Catecholamines enhance what?
Catecholamines enhance cardiac contractile strength.
| ex. = dopamine, epi and norepinephrine
188
Peripheral vascular resistance?
Peripheral vascular resistance: pressure against which heart must pump.
189
Cardiac output?
Cardiac output: amount of blood pumped by heart in 1 minute.
190
cardiac output equation?
Stroke volume × heart rate = cardiac output.
191
Blood pressure depends on what two things?
Blood pressure: dependent on cardiac output; peripheral vascular resistance.
192
the body keeps BP stable by what 2 things? (general)
Body strives to keep blood pressure constant by compensatory mechanisms and negative feedback loops.
193
Primary energy source for cells =?
Glucose
194
When in shock what is fallout process in order from beginning to organ death? (5 steps)
1) Change from aerobic metabolism to anaerobic metabolism
2) Without oxygen, when glucose breakdown stops after glycolysis, cellular stores of ATP used up much faster than can be replaced
3) Sodium-potassium pumping mechanism fails.
Cell membrane ruptures; cellular death soon follows
4) Same factors that reduce delivery of oxygen to cells
reduce delivery of glucose to cells.
Glucose prevented from entering cells remains in blood (hyperglycemia).
5) Depletion of proteins in gluconeogenesis causes organ failure.
195
Cardiac depression in shock is a sign/factor of?
Cardiac depression: critical factor in downward spiral of decompensation
196
Cardiogenic Shock?
Cardiogenic shock: inability of heart to pump enough blood to supply all body parts.
- Usually result of severe left ventricular failure , acute myocardial infarction or congestive heart failure.
- Presence of pulmonary edema, altered mentation, oliguria
197
Hypovolemic Shock?
Hypovolemic shock: loss of intravascular fluid volume.
198
Neurogenic Shock?
Neurogenic shock: injury to brain or spinal cord.
- Cause of neurogenic shock: central nervous system injury.
- Treatment same as for other types of shock: support of airway, oxygenation, ventilation, maintenance of body temperature, intravenous access.
199
Anaphylactic Shock?
Anaphylactic shock: severe allergic response; occurs very rapidly.
- Death can occur before patient can get to hospital; prompt intervention critical.
- Signs and symptoms can affect: skin, respiratory, cardiovascular, gastrointestinal, nervous systems.
- Treatment is pharmacological
200
Septic Shock?
Septic shock: begins with septicemia (sepsis); infection enters bloodstream and is carried throughout body.
- Dysfunction of more than one organ system (multiple organ dysfunction syndrome).
- Signs and symptoms progressive; most susceptible: lungs and respiratory system.
201
Multiple Organ Dysfunction Syndome? (MODS)
MODS: progressive impairment of two or more organ systems resulting from uncontrolled inflammatory response to severe illness or injury.
- Sepsis and septic shock most common causes.
- Any severe disease or injury that triggers massive systemic inflammatory response.
- Does not occur in one intense crisis; develops over weeks.
- No specific therapy.
- Early recognition; supportive measures
202
Primary VS Secondary MODS?
Primary MODS: organ damage results from specific cause resulting from episode of shock, trauma, surgery.
Secondary MODS: next time there is insult, primed cells activated, producing exaggerated inflammatory response.
203
Bacteria
- Single-cell organisms.
- Can reproduce independently; need host to supply food and other support.
- Can be cultured and identified in hospital laboratories.
- Categorized according to appearance; after staining with dyes (Gram stains).
- Cause many common infections.
- Antibiotics kill or inhibit growth of bacteria.
- Many bacteria release poisonous chemicals (toxins).
204
Endotoxins VS Exotoxins
Endotoxins: trigger inflammatory process and produce fever.
Exotoxins: proteins secreted and released by bacterial cell during growth.
205
Septicemia (sepsis)?
Septicemia (sepsis): systemic spread of toxins through bloodstream.
206
Viruses
- Cause most infections.
- Much smaller than bacteria; only seen with electron microscope.
- Cannot grow without assistance of another organism.
- Incapable of metabolism.
- If does not find host cell, virus will die.
- Do not produce toxins.
- Very difficult to treat.
- Cannot be treated with more than symptomatic care
207
Fungi
- Fungi (yeasts and molds): more like plants than animals.
| - Rarely cause human disease other than minor skin infections
208
Mycoses?
Mycoses: fungus infections.
209
Parasites
Parasites
- Protozoa to large intestinal worms.
- Treatment depends on organism and location
210
Prions
Prions
- Differ from viruses.
- Smaller; made entirely of proteins; do not have protective capsids.
211
What are the bodies 3 lines of defense against disease?
Three Lines of Defense:
- Anatomic barriers
- Inflammatory response
- Immune response
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Is immune and inflammatory fast or slow responding?
Inflammatory response = fast
Immune response = slow
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Immune Response
Detects antigens as foreign.
| Produces antibodies that combine with antigens to control or destroy them.
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Immunity VS Natural immunity VS Acquired immunity VS Active acquired immunity VS Passive Acquired Immunity VS Humoral immunity VS Cell Mediataed immunity
Immunity: long-term protection against specific foreign substances.
Natural immunity: not generated by immune response; inborn; part of genetic makeup of individual or species.
Acquired immunity: develops as outcome of immune response.
Active acquired immunity: generated by host's immune system after exposure to antigen; long-lasting.
Passive acquired immunity: transferred to person from outside source; temporary.
Humoral immunity: long-term immunity to specific antigens. (uses B lymphocytes)
Cell-mediated immunity: recognize presence of foreign antigen; attack it directly. (uses T lymphocytes)
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immunoglobulins = ?
Immunoglobulins = antibodies
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Lymphocytes are responsible for? (3)
Lymphocytes responsible for:
- recognizing foreign antigens
- producing antibodies
- developing memory
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Which lymphocyte does not attack antigens directly?
| Which lymphocyte does not produce antibodies?
B lymphocytes: do not attack antigens directly (humoral immunity)
T lymphocytes: do not produce antibodies. (cell mediated immunity)
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Lymphocytes: circulated through body as part of the _____ system.
Lymphocytes: circulated through body as part of lymphatic system.
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Immunogens?
Immunogens: antigens that trigger immune response.
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What criteria make antigens immunogens?
Sufficient foreignness
Sufficient size
Sufficient complexity
Presence in sufficient amounts
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Major histocompatibility complex (MHC): chromosome 6 is responsible for?
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Major histocompatibility complex (MHC): chromosome 6.
Determines suitability (compatibility) of tissues and organs grafted or transplanted from donor
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HLA antigens purpose is?
HLA antigens: body recognizes as self or foreign. (think of them as a personal barcode, and if other antigens dont have your then they are foreign)
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Lymphocytes are created where?
in yellow bone marrow and thymus
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Process of specialization of B cells includes ? (in humoral response)
Specialization of B cells: processe of clonal diversity and clonal selection.
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Mature B cells produce _____?
All antibodies are _____?
What does the structure of immunoglobulin molecules look like?
(All these are humoral response)
- Mature B cells produce memory cells.
- All antibodies are immunoglobulins.
- Structure of immunoglobulin molecules: Y-shaped chains
(All these are humoral response)
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Anitbody
Antibody: direct or indirect effect on target antigen; inactivation or destruction of antigen.
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Direct(3) and indirect(2) effects of antibodies on antigens?
Direct Effects of Antibodies on Antigens
- Agglutination
- Precipitation
- Neutralization
Indirect Effects of Antibodies on Antigens
- Enhancement of phagocytosis
- Activation of plasma proteins
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What are the 4 main function of antibodies?
Antibodies serve four main functions:
- Neutralization of bacterial toxins.
- Neutralization of viruses.
- Opsonization of bacteria.
- Activation of inflammatory processes
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Secretory Immune System (Humoral Response)
- Secretory immune system (external or mucosal immune system): lymphoid tissues beneath mucosal endothelium.
- Protect body from pathogens inhaled or ingested
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Cell mediated immune resonse properties (t cells) (4)
Cell-Mediated Immune Response
- T cells do not produce antibodies.
- Attack pathogens directly and create temporary immunity.
- Travel through thymus gland.
- T cells become specialized: clonal diversity and clonal selection.
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Sequence of processes necessary before immune response can begin: (3)
Sequence of processes necessary before immune response can begin:
- Antigen processing (by macrophages); ingestion of invading organism; breakdown of its antigens
- Antigen presentation (by macrophages); T cell receptor (TCR): antigen-specific ; CD4 or CD8 receptors: respond no matter what antigen presented.
- Antigen recognition (by T cells or B cells);
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T cells and B cells not differentiated until _____?
T cells and B cells not differentiated until antigens in system react with appropriate receptors on cell surfaces
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Humoral Immune Response:
| Classes of immunoglobulins (antibodies) (5)
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Classes of Immunoglobulins
IgM: largest immunoglobulin. *
IgG: "memory"; recognizes repeated invasions of antigen. *
IgA: present in mucous membranes.
IgE: least-concentrated immunoglobulin.
IgD: very low concentrations.
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Cell-Mediated Immune Response
| Mature T Cells: ? (5)
Cell-Mediated Immune Response
Mature T Cells
Memory cells: secondary immune responses.
Td cells: transfer delayed hypersensitivity.
Tc cells: cytotoxic.
Th cells: helper cells.
Ts cells: suppressor cells.
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As we age, what cell response decreases the most in immune responses? (what cell)
Men and women over age 60 have decreased hypersensitivity responses; decreased T cell response to infections.
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Inflammatory response vs immune response?
(response to what)
(fast or slow)
(specific or not)
(long lasting or temporary)
(responds with what cells)
(how many plasma proteins)
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Inflammation:
- Body's response to cellular injury.
- Immune response develops slowly; inflammation develops swiftly.
- Immune response specific; inflammation nonspecific.
- Immune response long-lasting; inflammation temporary.
- Immune response: one type of white blood cell (lymphocytes); inflammation: platelets and white blood cells.
- Immune response: one type of plasma protein (antibodies); inflammation: several plasma protein systems.
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Immune response and inflammation have what relation?
Immune response and inflammation interdependent.
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4 stages of inflammation?
Phases of inflammation:
Phase 1: Acute inflammation
Phase 2: Chronic inflammation
Phase 3: Granuloma formation (collection of macrophages)
Phase 4: Healing
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4 functions of inflammation
Four Functions of Inflammation
- Destroy and remove unwanted substances
- Wall off infected and inflamed area
- Stimulate immune response
- Promote healing
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What cells activate the inflammatory response and how do they do it?
Mast cells activate inflammatory response through degranulation and synthesis.
Degranulation: mast cells empty granules from their interior into extracellular environment
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Histamine
Histamine: vasoactive amine (organic compound) released during degranulation of mast cells.
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Chemotactic factors?
| Chemotaxis?
Chemotactic factors: chemicals that attract white cells to site of inflammation.
Chemotaxis: attraction of white cells
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When mast cells are stimulated in response to cell damage (to initiate inflammation), the degranulate and synthesize what 2 things? Describe those 2 things?
When stimulated, mast cells synthesize: leukotrienes and prostaglandins.
- Leukotrienes: slow-reacting substances of anaphylaxis (SRS-A); actions similar to histamines.
- Prostaglandins: increased vasodilation, vascular permeability, chemotaxis; cause pain
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Classic pathway VS alternative pathway in immune responses
- Classic pathway: activated by formation of antigen-antibody complex during immune response.
- Alternative pathway: begins without development of antigen-antibody complex.
Much faster than classic pathway; acts as part of first line of inflammatory defense.
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Clots are composed of?
Protein called Fibrin
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Kinin systems chief product is?
Kinin system: chief product, bradykinin.
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Sequence of events in inflammation? (3)
Sequence of events in inflammation
Vascular response
Increased permeability
Exudation of white cells
Exudate: collective term for all helpful substances.
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Lymphocytes (t and b cells) take up what percentage of white blood cells?
25-30%
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Granulocytes include what 3 types of white blood cells?
Neutrophils (55-70% of WBCs)
Basophils
Eosinophils
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AS monocytes (immature) mature what do they become?
Macrophages (mature monocytes)
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What cells are phagocytes? What are phagocytes?
All granulocytes and monocytes are phagocytes; blood cells that ingest other cells and substances.
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What cell is the primary defense against parasite?
Eosinophils: primary defense against parasites
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What is the first phagocyte to reach an inflamed site?
Neutrophils: first phagocytes to reach inflamed site.
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Which WBC releases histamines and chems to control vasoconstriction and dilation?
basophils
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What are lymphokines? why are they important?
| What are monokines?
Lymphokines: cytokines produced by lymphocytes.
Stimulate monocytes to develop into macrophages; critical phase of inflammatory response.
Monokines: cytokines produced by macrophages and monocytes
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Chronic inflammation is defined as? what can cause it?
Chronic inflammation: inflammation that lasts longer than two weeks.
Caused by foreign object or substance that persists in wound.
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what are the 3 functions of exudation?
Exudate has three functions:
- To dilute toxins released by bacteria and toxic products of dying cells
- To bring plasma proteins and leukocytes to site to attack invaders
- To carry away products of inflammation
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Debridement at the end of the healing process is?
Debridement: phagocytosis of dead cells and debris; dissolution of fibrin cells (scabs).
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What stage in healing is clotting or forming a scab? what does it do or allow?
First step of healing: sealing off of wound by clot (scab).
Repair begins with granulation.
Epithelial cells move in under scab, separating it from wound surface.
Provides protective covering for healing wound.
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How many days after healing does contraction begin? (wound edges begin moving inward)
Six to twelve days after injury, contraction begins as wound edges begin to move inward.
