560A: Pathophysiology

Question 1

Etiology:

Answer 1

cause of disease

Question 2

Diagnosis:

Answer 2

determination of the nature and cause of a patient’s illness

Question 3

Cardinal signs of inflammation:

Answer 3

a. dilation (expansion) of blood vessels
b. increased vascular permeability
c. attraction of leukocytes (white blood cells) to site of injury
d. heat, redness, tenderness, swelling, pain
e. systemic response (fever, leukocytosis)

Question 4

Causes of inflammation:

Answer 4

a. chemical agents (mediators) of inflammation that are formed & released when tissue is damaged; some are from cells; others from proteins in blood plasma
b. when antibodies and antigens (toxin or foreign bodies) interact; causes inflammatory response followed by tissue necrosis

Question 5

Acute inflammation:

Answer 5

a. 1st line of defense in response to injury
b. nonspecific
c. may occur in response to any injury in short of one that is lethal
d. short duration
e. exudation of fluid & emigration of leukocytes
f. occurs before immune response
g. goal to remove injurious agents

Question 6

Chronic inflammation:

Answer 6

a. non-degradable pathogens
b. lasts for several months to years
c. failure to rid whatever was causing an acute inflammation

Question 7

Lymphocytes:

Answer 7

a. respond to foreign antigens, macrophages and related cells that process antigen and “present” it to lymphocytes;
b. important cells of immune system that communicate with one another;
c. secrete lymphokines that are chemical messengers

Question 8

Complement system - 2 pathways of activation

Answer 8

1. classical pathway - triggered by antigen-antibody interactions
2. alternative pathway - activated by bacterial cell wall material or products generated during inflammation

Question 9

Antibodies:

Answer 9

globulins produced by plasma cells and are usually called immunoglobulins

Question 10

5 Classes of Antibodies

Answer 10

1. IgM
2. IgG
3. IgA
4. IgD
5. IgE

Question 11

Components of Healing Process: Type 1 - Immediate Hypersensitivity

Answer 11

a. allergy
b. IgE antibodies
c. antigen-antibody interaction
d. antihistamines
e. desensitization w/IgA & IgG (i.e. - food allergy)
f. anaphylaxis (i.e. bee sting)
g. mediator from mast cells & basophils

Question 12

Components of Healing Process: Type 2 - Cytotoxic Hypersensitivity

Answer 12

a. antibody attaches to antigen

b. complement activated followed by cell tissue damage

Question 13

Components of Healing Process: Type 3 - Immune Complex Disease

Answer 13

antigen-antibody complexes form; activate complement and cause inflammatory reaction
i.e. rheumatoid arthritis

Question 14

Components of Healing Process: Type 4 - Delayed (Cell-Mediated) Hypersensitivity

Answer 14

T-lymphocytes secrete cytokines that attract lymphocytes, macrophages, and other inflammatory cells
i.e. tuberculosis, contact dermatitis

Question 15

Control and Complications of Healing: Suppression of the Immune Response

Answer 15

a. unwanted effects of immune response
(autoimmune disease, rejected transplanted organs, Rh hemolytic disease in newborn infants)
b. methods for suppressing - radiation, cytotoxic drugs, adrenal corticosteroids, antibodies
c. tissue grafts and immunity (foreign antigens; lymphocytes reject foreign antigens; immune suppression to prevent rejection)

Question 16

Control and Complications of Healing: Autoimmune Diseases

Answer 16

a. pathogenesis - antibodies formed, cross-reaction, T-lymphocytes fail to control immune response
b. treatment - corticosteroids, cytotoxic drugs
c. connective tissue diseases (autoimmune diseases)
i. e lupus erythematosus, scleroderma

Question 17

Tissue growth disorders (neoplastic diseases)

Answer 17

a. viruses - some animal tumors are caused by viruses; human tumors may be virus induced
b. gene and chromosomal abnormalities
c. failure of immunologic defenses
d. heredity and tumors

Question 18

Tumor:

Answer 18

disturbed cell growth

Question 19

Benign tumors:

Answer 19

mass of cells (tumor) that lacks the ability to invade neighboring tissue or metastasize; non-cancerous

Question 20

Malignant tumors:

Answer 20

a. cancer
b. carcinoma - arising from surface, glandular or parenchymal epithelium
c. sarcoma - solid tumor from other tissue
d. leukemia - neoplasm of blood-forming tissue

Question 21

Benign vs. Malignant

Answer 21

Benign - grow slowly, expands, stays local, cells well differentiated
Malignant - grow rapidly, grow by infiltration, metastasize, cells not well differentiated

Question 22

Hemopoiesis:

Answer 22

production of blood cells & platelets, which occurs in bone marrow

Question 23

Hemostasis:

Answer 23

complex system for causing blood to clot when and where necessary

Question 24

Factors concerned with hemostasis:

Answer 24

a. blood vessels and platelets
b. reflex contraction of blood vessels after injury
c. platelets adhere to injury
d. small breaks in capillaries are sealed by platelets
e. plasma coagulation factors

Question 25

Phases of Hemostasis

Answer 25

Phase I - generation of prothrombin activation (intrinsic & extrinsic system)
Phase II - formation of thrombin
Phase III formation of fibrin

Question 26

4 Major Categories of Bleeding Disorders:

Answer 26

1. Abnormalities of small blood vessels
2. Abnormalities of platelet function
3. Deficiency of 1 or more of plasma coagulation factors
4. Liberation of thromboplastin material into the circulation

Question 27

Erythrocyte Disorders:

Answer 27

anemia - abnormally low oxygen carrying capacity

examples: hemorrhagic anemia, hemolytic anemia, aplastic anemia

Question 28

Leukocyte Disorders:

Answer 28

leukemia - cancerous conditions involving white blood cells

Question 29

Intravascular blood clot (thrombus):

Answer 29

Pathogenesis:

1. slowing or stasis of blood flow
2. damage to blood vessel wall
3. increased coagulability of blood

Question 30

Thrombosis:

Answer 30

blood clot formed withing the vascular system

Question 31

Embolus:

Answer 31

detached clot carried in circulation

Question 32

Infarct:

Answer 32

tissue necrosis caused by interruption of blood supply

Question 33

Formation of blood clots within leg veins - Predisposing factors:

Answer 33

a. stasis of blood
b. varicose veins
c. increased blood coagulability

Question 34

Formation of blood clots within leg veins - Major complication:

Answer 34

a. detachment of clot
b. embolus lodges in pulmonary artery or branches
c. clinical manifestations depend on size and location

Question 35

Large pulmonary emboli:

Answer 35

1. obstruct main pulmonary artery or major brances
2. obstruct blood flow to lungs, causing severe dyspnea, cyanosis, shock, sudden death
3. lung usually not infarcted because adequate collateral blood flow is provided by the bronchial arteries

Question 36

What causes a small pulmonary emboli?

Answer 36

1. impacted in peripheral branches of pulmonary artery

2. lung infarct may develop due to inadequate collateral circulation causing chest pain, cough, bloody sputum

Question 37

What causes a septic pulmonary emboli?

Answer 37

1. thrombi form in pelvic vein following uterine infection
2. bacteria invade thrombi
3. emboli from infected thrombus travel to lungs, causing pulmonary infarct
4. bacteria in clot invade pulmonary infarct, causing lung abscess

Question 38

Arterial Thrombosis:

Answer 38

1. roughening of arterial wall secondary to arteriosclerosis

2. thrombi from on roughened area

Question 39

What can occur as a result of Arterial Thrombosis?

Answer 39

1. blockage of coronary artery: myocardial infarction
2. major artery in leg occluded: gangrene
3. occlusion of artery to brain: stroke

Question 40

What causes intracardiac thrombosis?

Answer 40

a. clot forms (heart failure, valve injury or myocardial infarction)
b. may dislodge into circulation and cause infarction in spleen, kidneys or brain