everything Flashcards
define hyperplasia
increase in cell numbers
define metaplasia
transformation of a cell
what is the aim of the vascular part of inflammation?
increase blood flow to the region of damage via vasodilation
how does the vascular reaction occur?
liquid moves into the surrounding tissue as artery blood vessel walls become leakier
chemical mediators cause endothelial layers to contract causing holes in the wall
what is the aim of the chemical reaction of inflammation?
get the white blood cells to the damaged soft tissue
how does the chemical reaction of inflammation occur?
margination, adhesions, rolling then transendothelial migration
what are the 3 cells present in the chemical reaction of inflammation?
WBC/ platelets/ erythrocytes
what are the two types of inflammation?
acute and chronic
what are the predominate cells present in the acute response?
neutrophils
what are the aims of the acute response of inflammation?
complete resolution sometimes cannot be achieved which results in fibrosis §
what are the 2 predominate cells in the chronic stage of inflammation?
lymphocytes/ macrophages
when will the chronic stage of inflammation occur?
exposure to persistent infection/ autoimmune (constant) reaction
where does full regeneration occur during healing?
cells with high proliferative capacities
when does healing by fibrosis occur?
when there has been damage to the underlying structure (stoma/parenchyma) because the building blocks are no longer there
what 2 components are deposited during healing by fibrosis?
collagen, ECM components
what are the 5 stages of healing?
inflammation angiogenesis/ neovascularisation migration/proliferation of parenchyma cells scar formation (unsuccessful response) connective tissue remodelling
one complication of healing is deficient scar formation, what does this mean?
wound splits open
explain what excessive granulation tissue means within healing?
microscopic blood vessels form on the surface of the wound
explain a complication of healing that results in a hypertrophic scar?
excessive collagen formation
define the innate immune response
non specific mechanism against bacteria/virus
explain how skin provides an innate immune response?
keratin provides a physical barrier
cells continuously sloughed off
sweat contains antimicrobial materials
name 3 non specific innate immune responses?
macrophages release protein signals (interleukin 1/6)
fever/heat
pain/swelling/redness
explain what the adaptive immune response is?
relies on antigens
what is the role of lymphocytes within the adaptive immune response?
produced in the bones marrow, rest in the lymphatic tissue, rapidly carried around the blood and produce b and t cells
where do t cells mature?
thymus
where do b cells mature?
bone marrow
what is the role of t cells in relation to the histocompatibility complex?
only recognise antigen presented by major histocompatibility complexes, they cannot be activated by the pathogen
how do t cells recognise an invader?
macrophage takes a antigen to a t helper cell for identification if foreign an immune response is launched
what is the immune response?
helper T cells (CD4)–> cytokines –> stimulate B cell division
what are opsonisation?
particles targeted for destruction by the phagocyte
what is the process of agglunation?
antigen is mixed with corresponding antibody
name 2 examples of immunodeficiency?
bone marrow dysfunction/ HIV
what are 6 causes of secondary immunodeficiency?
malnutrition/ burns/ uraemia/ diabetes mellitus/ alcohol/ recreational drugs
name 5 general examples of hyperactive immune system?
anaphylaxis, asthma, rhinitis, systemic inflammatory response syndrome, auto-immunity
name 5 examples of specific diseases where the person has an hyperactive immune system?
diabetes m, coeliac, MS, hashimotos thyroiditis, rheumatoid arthritis
what is an attenuated vaccination?
live weakened pathogen MMP
what is an inactivated vaccination?
part of the pathogen given hep B
what is a toxoid vaccination?
harmless version of the pathogens toxin- diphtheria
what is a conjugated vaccination?
antigen linked to protein carrier
how is plaque formed in a atheroma?
circulating platelets activated by ligands, depositing chemokine on the endothelial cells causing damage
chemokine bind to receptors on circulating macrophages
monocyte fies to the surface of the vessel
circulating LDL’s enter the damaged wall and macrophages ingest them
what do the following symptoms show: chest pain radiating to the arm/jaw, SOB, palpitations, syncope, nausea
angina
what does NSTEMI stand for and what is it?
non ST segment elevation MI, partially blocked coronary arteries
what does STEMIs stand for and what is it?
ST segment elevation MI, complete blockage
what is the treatment of angina?
nitrovasodilators/ beta blockers
what is the treatment for a MI?
oxygen/pain relief
what does PICA stand for in the treatment of MI?
percutaneous transcuminal coronary angioplasty
the use of a balloon to open up the artery
what does CABG stand for and what is it, within the treatment of MI?
coronary artery bypass grafting (new artery)
what does INR stand for?
international normalised ratio
what does INR do?
measure coagulation, higher the number the longer the blood takes to clot
where are the 3 reasons for high INR?
warfarin replacement therapy, vit K deficient, liver disease
what is the definition of thrombus?
inappropriate blood clotting meaning the formation of a solid mass
what is an embolism?
initial clot breaks off and travels to a different point
what are the 4 locations where a thrombus may form?
heart, arteries, capillaries, veins
what is rheumatic endocarditis?
inflammatory condition of the heart and valves, occurs after MI where scar tissue forms which is not as mobile= blood pooling
what conditions comes from blood pooling?
atrial fibrillation
what is an aneurysm?
heart muscle dies and becomes thinner, cant handle the pressure= dilation
what are the causes of abnormalities of clotting?
pregnancy, contraceptive pill, following trauma, damage to the liver, tumours, thickening of the blood (thrombocythaemia)
what is shock?
a medical emergency, decreased blood flow and increased waste products in the body
what are the 3 stages of shock?
compensated, non compensated, irreversible
explain the compensated part of shock?
non progressive, blood volume loss 15-25%
explain the non-compensated part of shock?
progressive, blood loss over 25%, need CPR/ blood transfusion
explain the irreversible part of shock?
failure to restore circulation, critical organ damage
what is hypovolaemic shock?
internal/external haemorrhage (burns)
what is cardiogenic shock?
large acute MI (cardiovascular disease)
what is septic shock?
systemic infection, endotoxins from gram negative/positive
what is neurogenic shock>?
trauma to spinal cord making the body believe that something major has occured
what is obstructive shock?
obstruction of a major organ
what is chronic gastritis?
ongoing inflammation of the stomach mucosa, provides an environment where dysplasia can occur
what do the following symptoms show? upper abdo pain, bloating, N+V, belching, loss of apetite
chronic gastritis
what are the 6 main causes of chronic gastritis?
h pylori, alcohol, tobacco, caffeine, autoimmune
what type of organism is h.pylori?
gram negative
how is h.pylori spread?
faecal-oral route
what are the 3 effects of h.pylori?
chypochlorhydria (production of hydrochloric acid are low), gastric atrophy, intenstinal metaplasia
where is a peptic ulcer normally located?
antrum, duodenum
what do the following symptoms show? pain worse at night and after meals
peptic ulcer
what are the complications of peptic ulcers?
bleeding anaemia, huge haematamesis, perforation leading to peritonitis
what is barretts oesophagus?
stratified squamous epithelium is replaced by columnar epithelium
what do the following symptoms show?dysphagia, weight loss, haemorrhage, sepsis, respiratory fistula with aspiration, more common in female
squamous cell carcinoma
what do the following symptoms show? history of barretts oesophagus, more common in males, dysphagia, weight loss, haetamesis, chest pain, vomitting
adenocarcinoma
name 4 syndromes that could lead to causing cancer?
pernicious anaemia, intestinal metaplasia, neoplastic poly, helicobacter gastritis
what is pernicious anaemia?
deficiency in the production of RBC’s via lack of vit B12
define the transcloemic spread of cancer?
spreads across peritoneal cavity
define the omentum spread of cancer?
spreads across the fold of peritoneum connecting stomach with organs
define the mesentery spread of cancer?
spreads across fold of peritoneum which attaches stomach/ small I, pancreas, spleen to the wall of the abdo
what is coeliacs disease?
allergic disease to gluten
what do the following symptoms show pain/discomfort, chronic constipation, diarhoea, growth stunt in children, anaemia, fatigue
coeliac disease
what are 3 risk factors of small bowel cancer?
chrons, coeliac, radiation
what do the following symptoms show? N+V, reduced appetite, tenderness, guarding, high white cell count…
appendicitis
how does c/diff arise?
abx change balance of bacteria in the gut
what do the following symptoms show? diarrhoea, pain, fever
c.diff
what are the complications of c.diff?
diarrhoea, dehydration, toxic mega colon, bowel perforation, sepsis/death
what are the steps in managing c.diff?
stop causative antibiotics (clindamycin, ciprofloxacin), start new abx (vancomycin, metronidazole)
what are the signs of crohns?
spreads unevenly, at all layers leading to thickened walls and granulomma fissures (cracks)
What do the following symptoms show?abdo pain, weight loss, N+V
crohns disease
what are the 4 complications of crohns disease?
anaemia, malabsorption, bowel obstruction, perforation
what are the factors associated with ulcerative colitis?
affects rectum and colon, spreads continously, only ulceration of the 1st layer
what do the following symptoms show? diarhoea with blood and mucus…
ulcerative colitis
what are the complications of ulcerative colitis?
blood loss, electrolyte disturbances, toxic dilation of the bowel
what is the national bowel screening programme?
targets people 60-75, faecal occult blood test
what do the following symptoms show?blood per rectum, change in bowel habits, iron deficiency, anaemia, weight loss, abdo pain, lump in back passage
bowel cancer
what type of cancer ends in -oma?
benign epithelial tumor