Class 1 Intro to patho Flashcards
Etiology
Cause of a disease
Pathogensis
its how the disease develops
Clinical Manifestations
clinical effects or evidence of disease ; signs and symptoms.
Atrophy
-it is reversible
Decrease in cellular size because demand decreases.
Causes of Cell atrophy -disuse -ischemia -endocrine dysfunction -persistant cell injury -aging Ex.. when some takes their cast off and their arm looks smaller than the other.
Hypertrophy
Increase in cellular size because the demand increases.
Can be physiologic/normal/weightlifting
or Pathologic/abnormal/enlarged organs.
Hyperplasia
Increase in number of cells
Can be physiologic/ normal/ breast enlargement bc of pregnancy
or pathologic/abnormal/ enlargement of prostate gland.
Metaplasia
Replacement of one cell type with another
ex.. one cell couldnt handle the enviroment so it changed to another cell.
Usually occurs in response to chronic irriration.
It is reversible but if it stays over a long period of time can possibly turn into cancer.
Dysplasia
Deranged cellular growth
- cell mutates with abnormal variations in size, shape and arrangement.
1. abnormal but is potentionally reversible
2. strongly implicated as a precursor to cancer.
Most common cellular injury
Hypoxic Injury
-Hypoxia(decrease in oxygen) means less oxygen in tissues
-Hypoxemia less oxygen in blood.
Results from:
-reduced amount of oxygen in the air.
-Loss of hemoglobin or decreased efficacy of hemoglobin.
-decreased production of red blood cells.
-diseases of the respiratory and cardiovascular systems
-poisoning of the oxidative enzymes within the cells
The most common cause of hypoxic injury
Ischemia (reduced blood flow)
can be progressive or acute
often caused by:
- Arteriosclerosis (gradual narrowing of arteries)
- Thrombosis (complete blockage by blood clots)
All cellular injury causes the cell to..
Swell
What is the best example of an adaptive coping response to stress?
Seeking social support
The stress-age syndrome directly results in depressed function of which system?
Immune
The medical examiner report states that the etiology of the disease is overexposure to radiation. How would the nurse interpret “Etiology”
Cause of disease
A patient experiences a stressor that activates the stress response. What is a pgtsiologic effect seen related to the release of catecholamines into the bloodstream?
Increased heart rate
Which of the following is the most common cause of cellular injury?
Hypoxia
What type of necrosis best describes death of a cell from hypoxia, generally as a result of ischemia in the lower extermites?
Gangrenous
A client has an arm cast removed and the nurse notices that the casted arm is somewhat smaller. What type of cellular adaption has occured?
Atrophy
A 40 year old females pap smear indicates abnormal changes in the shape and organization of cervical cells. Which term would be used to identify this type of change?
Dysplasia
A 75 year old male presents with chest pain on exertion. The chest pain is most likely due to hypoxic injury secondary to..
ischemia
What is the accumulation of sodium and water in an injured cell directly related to?
Decreased ATP production
A 55 year old male has swelling of the feet. Which of the following aided in the development of swelling?
Na+ movement into the cell
While reading a textbook, a student reads the term apoptosis. The student recalls tha tapoptosis is a condition in which cells program themselves into?
die
When a nurse observes muscle stiffening occuring within 6-14 hours after death, the nurse should document this finding as the presence of:
rigor mortis
Which of the following hormones enhances myocardial contractility?
Epinephrine
Stress induces sympathetic stimulation of the adrenal medulla. This causes the secretion of catecholamines, which include…
Epinephrine and norepinephrine
Case Study:
A female student is driving to scool and someone nearly hits her. Her heart starts beating hard and fast as she becomes scared.
Which stage of the general adaptation syndrome is she experiencing?
Alarm stage
Case Study:
A female student is driving to scool and someone nearly hits her. Her heart starts beating hard and fast as she becomes scared
What hormones could her body be releasing during this time? A. epinephrine B.norepinephrine c.Thyroxine D. Cortisol E. Prolactim
A. epinephrine
B.norepinephrine
D. Cortisol
Case Study:
A female student is driving to scool and someone nearly hits her. Her heart starts beating hard and fast as she becomes scared
What clinical manifestations could this student be experiencing during this time? Select all below
A. increased blood pressure B. Increased heart rate C. Increased blood sugar D. Bronchoconstriction E. Water retention
A. increased blood pressure
B. Increased heart rate
C. Increased blood sugar
E. Water retention
Case Study:
A female student is driving to scool and someone nearly hits her. Her heart starts beating hard and fast as she becomes scared
Everytime she gets into the car her heart begins to race, she becomes diaphoretic, her hands shake, and her mouth becomes dry. What type of response is she experiencing?
A. Reactive
B. Anticipatory
B. Antocipatory
Case Study:
A female student is driving to scool and someone nearly hits her. Her heart starts beating hard and fast as she becomes scared
What effective coping mechanisms could the nurse suggest to the student ? Select all that apply
A. therapy B. Meditation C. Avoid Driving D. Biofeedback E. Smoking
A. therapy
B. Meditation
D. Biofeedback
Case Study:
A female student is driving to scool and someone nearly hits her. Her heart starts beating hard and fast as she becomes scared
What complications is this student at risk for developing if the stress continues for a long duration? Select all that apply
A. obesity B. high blood pressure C. diabetes D. atherosclerosis E. elevated lipid levels
A. obesity B. high blood pressure C. diabetes D. atherosclerosis E. elevated lipid levels
All
Nosocomial
Hospital acquired
disease that formed in while in hosptial
Idiopathic
Cause of disease is unknown
Latrogenic
causw results from unintended or unwanted adverse effects of medical treatment.
Risk factor
tendencies that an indivdual at risk for developing certain diseases
Percipitating factor
a condition or event that does cause a pathologic event or disorder
Sequela
unwanted outcome of having a disease
Complications
new problems that arise because of the disease
Local Reaction
localized CM (clinical manifestations) originate in and are confined to one organ system or one general area in the body. ex.. small rash from poisoin ivy
Systemic Reaction
CM affect a number of organs and tissues, or affects the body as a whole.
Remission
occurs when CM subside (become less intense, calm down)
Exacerbation
occurs when the CM increases/gets worse
Iron deficiency Anemia
Intrinsic (belonging naturally)
(nutrional)
Fungal Infection
Animate (alive) Extrinsic (outside)
Degenerative Arthristis
Intrinsic
Fever of unknown orgin
Idiopathic
General Adaptation Syndrome (GAS) 3 stages are
Alarm, resistance, exhaustion
Alarm stage
Fight or flight, Stress triggers hypothalamic-pituitary-adrenal (HPA) axis which activates sympathetic nervous system.
-Epi and Norepi are released.
Resistance stage/Adaptation phase
Attempts homeostasis. (Homeostatis is a dynamic balance between the autonomic branches)
- Actions of adrenal hormones.
- Continued mobilization of the bodys resources to cope an overcome a sustained challenge.
Exhaustion stage/ Allostatic overload
no longer can produce hormones.
- Occurs only if stress continues and adaptation is not successful.
- Bodys physiologic and immune system no longer effectively copes with the stressor and marks the onset of diseases.
- High levels of cortisol which is linked to obesity, sleep deperavtion, elevated lipid levels, hypertension, lose of bone density, etc.
Reactive response
invovles a physiological response from psychological stressor.
ex. . an examination with no physical stressor causes the invididual to get increased heart rate.
- sitting down first exam and your heart starts to beat really fast.
Anticipartory
Already had a bad experience and is anticipating another bad experience. Generated by fear.
ex… have to get blood drawn but last time you had a bad outcome so you think its gonna happen again.
Reactive or anticipatory
-Man develops pounding heart and dry mouth when his boss tells him he is fired from his job.
Reactive
Reactive or anticipatory
-Women develops pounding heart, dry mouth in the car on her way to her chemotherapy appointment
Anticipatory
Reactive or anticipatory
- Student develops pounding heart, dry mouth halfway through an examination
Reactive
Hypothalamus secretes
produce or give off
corticotropin-releasing hormone (CRH)
Pituitary Releases
adrenocorticotropic hormone (ACTH)
Adrenals Secrete
cortisol (increases sugars/glucose in bloodstream and catecholamines (both help body respond to stress or fight or flight
Cortisol
- secreted during stress
- reaches all tissues
- stimulates gluconeogensis
- abnormal elevations linked to:
1. sleep depreivation
2. obesity
3. htn
4. diabetes
5. atherosclerosis
6. elevated lipid levels
What can cortisol do?
- evelates blood glucose during fight or flight.
- affects protein metabolism
- promotes resolution and repair but not long term.
- induce t cell apoptosis
- influences all immune cells
- cognitibe impairments
- used therapeutically as powerful anti-imflammatory/immunisupressive agents.
- to much cortisol can affect wounds and create poor wound care.
Catecholamines
hormone during stress
-epi and norepi
What do catecholamines do
increased blood flow and increased glucose metabolisim in the brain
- increased rate and force contraction of heart.
- peripheral vasoconstriction in cardiovascular system.
- bronchodilation in pulmonary system so we can take in more oxygen.
Stress and role of immune system
- stress directly related to proinflammatory cytokines
- link between stress, immune function, and disease/cancer.
- immune system affected by neruroendocrine factors.
- stress response decreases T-cell cytotoxicity and b-cell function
Coping in stress
Can be adapative or maladaptive
Adaptive- improved outcomes
Maladaptive- adverse health effects
Altered Cellular Function is caused by…
- Cellular adaptation
- Cellular injury
- Cellular Neoplasia
- Aging
- Cellular Death
Etiology of Cell injury
- disease
- poor nutrition
- hypoxia/ischemia
- genetics
- physical/mechanical
- chemical/drugs
- aging process
Blunt force injuries
- contusions
- abrasion
- lacerations
- fractures
Sharp force injuries
puncture wounds
stab wounds
incised wounds
chop wounds
Gunshot wounds
caused by object shot into body
Asphycial Injuries
failure of cells to use oxygen
ex.. hanging, strangling, drowning
Infectious Injury
ability of bacteria and virsus to produce toxins to damage the cell wall and gain entery into cells
Immunologic and Inflammatory Injury
results in swelling and redness.
- Includes phagocytic cells.
- Membrane alterations.
- substances such as histamine,antibodies, lymphokines, complement, and proteases.
Manifestations of cellular Injury
cellular swelling most common change.
Abnormal cellular substances:
-Endogenous: products of abnormal metabolism and synthesis.
-Exogenous: infectious agents or minerals.
*Dead and injured cells initiate inflammation
Cellular Death
-Necrosis
form of cell injury which results in premature death of the cells in living tissue by autolysis
-caused by factors external to the cell or tissue
Cellular Death
-Apoptosis
- process of eliminating unwanted cells, called programmed cell death.
- mechanism of cell death is not limited to developmental causes but may result from enviromental triggers.
ex. .. can be seen in alztimers
Coagulative Necrosis
- usually results from an interuption of blood flow/ishcemia
- often seen in kidneys,heart, and adrenal glands
Liquefactive Necrosis
- usually results from an interuption of blood flow/ishcemia.
- Occurs in the brain
- dead brain cells leak hydrolytic enzyme.
- Bacterial infection
- staph
- strep
- E.coli
Caseous Necrosis
- from TB
- Is a pulmonary infection
- found in lung in Tuberculous
- Combination of coagulative and liquefactive necrosis
Fat Necrosis
- broken down in fatty acids and form soap like looking necorsis.
- Action of lipsases
- Mostly seen in breast, pancreas, and other abdominal organs.
Gangrenous necrosis
- Death of tissue from severe hypoxic injury.
- Mostly in legs or GI
- 3 types: Dry, wet, gas (developing of the presence of clostridium. most serious type and potential to be fatal. Bacteria releases toxins so infections spreads rapidly.
Normal life span
80 to 100 years old.
Women average is 80
Men average is 75
Cellular aging
- atrophy, decreased function, and loss of cells.
- tissue and systemic aging
- progressive stiffness
- sacropenia (loss of muscle mass and strength)
Frailty (commonly see in aging)
Mobility, balance, muscle strength, motor activity , cognition, nutrution, endurance, falls, fractures, and bone density.
Somatic Death
-death of the entire person
Algor Mortis
postmortem reduction of body temperature falls 1-1.5 degrees per hours equalling in temp of enviroment.
- Skin becomes pale
- cheeks and lips remain red
Livor Mortis
purple discoloration in most dependent area (face, chin, nose, etc)
Rigor Mortis
muscle stiffening begans about 6 hours in small muscle and withing 12-14 hours will begin to affect entire body.
-diminshes and body becomes flaccid between 36-62 hours
