Exam 1 Flashcards
What is pathology
Study and diagnosis of disease through examination of organs, tissues, cells, and bodily fluids
What is pathophysiology
the study of abnormalities of physiologic functioning of living beings
What is etiology
the cause or reason for a phenomena. Identification of causal factors that acting together provoke a disease or injury
What is pathogenesis
development of disease in cells, tissues, and organs. Dynamic interplay of changes in cell, tissue, organ, and systemic function
What is idiopathic
Cause is unknown
What is iatrogenic
Cause is a result of unintended or unwanted medical treatment
What is a risk factor
Probability of development of disease when factor is present
Compare symptom vs. signs
Symptom is subjective that the patient reports (nausea) signs are objective (witnessed vomiting).
Give 8 stages and clinical course of a disease
Latent or incubation period, prodromal period, manifest illness or acute phase, subclinical stage, acute or chronic, exacerbations and remissions, convalescence, sequela
Give four physiologic processes affecting disease
Age, gender, genetic and ethnic background, and geographic area
Give 6 factors affecting disease to think about when treating someone
Cultural considerations, socioeconomic and lifestyle, age differences, gender differences, situational differences, and time variations
Give four types of primary prevention and give its other name
Prevention of disease: improved nutrition, housing, and sanitation. Immunizations. Education. Safety precautions (seat belts, speed limits, chemicals).
Give 3 types of secondary prevention and give its other name
Screening: physical examinations and routing screening. Self breast exams. Amniocentesis.
Give 2 types of tertiary prevention and give its other name
Treatment: Once a disease is established medical and surgical treatment. Rehabilitation.
How are large molecules such as proteins brought through membrane
Ingested via endocytosis (either pino or phago) and secreted via exocytosis.
Describe receptor mediated endocytosis
Chemicals bind to a receptor on the outside of membrane, the membrane with bound chemicals pinches inwards carrying the molecules inside the cell.
What is cellular edema
Excess fluid can enter the cell’s internal environment causing swelling.
Describe the Na-K pump and what happens if it fails
Maintains low Na and high K concentrations in the cell. This maintains cell volume by controlling solute concentration and therefore osmotic forces across the membrane. If Na is continually allowed in the cell it will burst.
What does the Na-K pump exchange every time ATP is bound
3 Na out and 2 K in
Where does aerobic vs anaerobic metabolism take place
Aerobic happens inside the mitochondria and requires oxygen while anaerobic metabolism happens outside of the mitochondria and consists of just glycolysis
Describe mitochondrial DNA
Only organelles with their own DNA. Mitochondrial DNA is subject to mutation by oxygen-derived free radicals.
Describe free radical effect on structures
Free radicals oxidize cell structures and can be called oxidants. They disrupt the integrity of the cell membrane and damage organelles and DNA, causing cell dysfunction. Worst place for this to occur is in muscles, cerebrum, and nerves.
Name some antioxidants
vitamins A, E, C, and beta-carotene counteract free radicals.
Describe lysosomes
contain digestive enzymes. They digest particles brought in by endocytosis, pinocytosis, or phagocytosis. Also digest worn out cell parts. In cell death autolysis occurs and enzymes rupture from lysosome and digest the whole cell.
What types of cells have many lysosomes
White blood cells (macrophages that constantly survey body for antigen)
How do lysosomes play a roll in myocardial infarction
In myocardial infarction cardiac muscle cell death leads to autolysis leading to lysosome enzymes spilling out to digest dead cardiac muscle cells. It is screened for by drawing blood and looking for lysosomal enzymes.
Describe ribosomes
They are the factories of protein synthesis. The nucleus gives directions on what proteins to make.
What is a clinical concept that involves ribosomes
Some antibiotics interfere with the function of bacterial ribosomes, thereby inhibiting bacterial protein synthesis.
What is a chromosome
Chains of genes
Describe cellular adaptations and maladaptive changes
All diseases result in some alteration of cell function because the cell responds to stressors in the environment. In circumstances of overwhelming insult, cell injury or cell death can occur. Cell injury can be reversible but if the injurious agent is persistent or severe enough, cell injury can lead to cell death.
What is histology
The microscopic study of tissues and cells.
What is a biopsy
Cell sample from an organ or mass of tissue to allow for histological examination.
What are pathogonomic changes
Unique histological findings that represent distinct disease processes.
What is atrophy
Decreased cell size
What is hypertrophy
Increased cell size
What is hyperplasia
Increased cell number
What is metaplasia
conversion of one cell type to another
What is dysplasia
disorderly cell growth
Give 6 causes for atrophy
Disuse or diminished workload. Lack of nerve stimulation (paralysis). Loss of hormonal stimulation. Inadequate nutrition. Decreased blood flow (ischemia). Aging.
Describe hypertrophy of cells and the natural effects it brings.
Individual cells become larger which can either be physiologic (lifting weights) or pathologic (disease caused). Hypertrophy necessarily brings a greater metabolic demand and greater energy needs
Give a pathologic hypertrophy example
The heart hypertrophies in response to hypertensions (greater workload because of greater peripheral resistance).
Give a physiologic hypertrophy example
Weight lifters develop hypertrophied muscles because of increased workload and use.
Describe causes of hyperplasia
Can be hormonal such as pregnancy of benign prostatic hyperplasia. Or can be compensatory cellular changes. Excessive cells can be a good adaptive response or they could be detremental.
Give an example of hormonal hyperplasia
Pregnancy increases demand of milk production (lactation) which causes hyperplasia of breast milk glands and tissue mass.
Give some cause for metaplasia
Metaplasia is replacement of one cell type by another cell type. Response to a change in environment. Typically occurs with chronic inflammation. The substitution of cells enables the survival of the tissue.
Give an example of metaplasia
In esophagitis, the cells of the lower esophagus change to be able to cope with the stomach acid that constantly irritates the cells. This leads to a disease called gerd. The flat epithelium of the esophagus change to become more columnar like stomach cells.
Describe dysplasia and what must be watched for
Deranged cellular growth. Cells vary in size, shape, and organization compared to healthy cells. It is a precancerous condition that must be watched carefully becaues very often will develop into neoplasia.
Describe neoplasia
New growth that usually refers to disorganized, uncoordinated, uncontrolled, proliferative cell growth that is cancerous. Tumor and neoplasm are often used interchangeably.
Describe some dysfunctions of the Na-K pump
Insufficient ATP, normal osmotic balance altered. Increased intracellular Na draws water in causing swelling. If an organ is swollen and enlarged it is termed megaly. Increased extracellular K also if calcium pump fails calcium accumulates in the cell leading to cell degradation and calcifications often accumulate in areas of cell injury and death. An example is a mammogram
Describe the effects of loss of plasma membrane integrity
Guardian of organelles is damaged, injurious agents can now affect any organlle. Water can enter causing swelling. The mitochondria can be damaged and halt energy production. Organelles can swell and deteriorate and the nucleus is now vulnerable to injury
Describe the effects of defects in protein synthesis
Cells low in energy, decreased ATP. Protein synthesis begins to fail and the lack of proteins can begin the process of cell degradation and death.
Describe what can happen with genetic damage and give an example
Injury to DNA causes mutations. The cell structure and function is changed. RNA can become damaged which produces abnormal proteins. These changes will often be incompatible with life. An example is exposure to high doses of radiation can trigger cancerous cell changes due to DNA damage.
Describe intracellular accumulations and give a clinical concept that is tied to these
Cells can accumulate excessive amounts of substances through cellular constituents, acquired from the environment, abnormal metabolic function, exposure, and aging. Possibly reversible if brought under control. Jaundice is tied to this.
Give two other examples of abnormal intracellular accumulations
Anthracosis (coal miner’s lung) and fatty liver
What is hypoxic cell injury and give 7 most common causes
Hypoxia is oxygen deprivation most commonly caused by ischemia, anemia, anaerobic metabolism, low concentrations of oxygen in the environment, inadequate oxygen diffusion, suffocation, and airway obstruction.
What is anemia
A condition that happens when your body is producing or has less red blood cells than it should
Describe free radical injury and give a clinical concept
Reactive oxygen molecules are produced as by-products of energy metabolism as well as present in cigarette smoke, pesticides, and other toxins. They disrupt the internal organelles and damage nucleus. Antioxidants can counteract this free radical injury.
Give 3 examples of mechanical trauma
laceration, gsw, falls
Give four examples of temperature causes of injury
Frostbite, radiation, electrical shock, sunburn
Describe 3 types of chemical injury and give examples of each
Endogenous (diabetes), biological (electrolyte imbalance) and exogenous (drugs, pollution, and poison). They injure plasma membrane and gain access to cell’s interior
What is an immunological reaction injury and give two examples
Immune system overreacts and attacks itself such as with allergies and autoimmune diseases like rheumatoid arthritis
What are required for enzymatic reactions
amino acids, glucose, fats, and minerals
What is needed for ALL cellular functions
carbohydrates
What are the basic building blocks of ALL cells
proteins
What is the significance of endothelial cell injury
Endothelial cells line the artery walls. Endothelium are a blanket of cells covering the inside of all arteries. Endothelial injury causes an inflammation reaction an initiates the process of atherosclerosis
Give 3 functions of endothelial cells aside from providing structural integrity of artery walls
Secrete nitric oxide (vasodilator). Secrete endothelin (vasoconstrictor), and secrete thrombogenic substances (help form platelet plugs)
Give four causes of endothelial cell injury
Hypertension, free radicals, high glucose, and hyperlipidemia
Describe hypertension in the context of endothelial cell injury
High shearing force against the wall of the artery damaging the endothelium. Aneurysm becomes more likely due to the weakening of the walls.
Describe free radicals in the context of endothelial cell injury
substances in the environment that attack endothelium and disrupt its integrity such as free radicals from cigarettes
Describe high glucose in the context of endothelial cell injury
in uncontrolled diabetes, glucose attaches to endothelial cells and disrupts their integrity. Development of arteriosclerosis throughout the body.
Describe hyperlipidemia in the context of endothelial cell injury
Low density lipoproteins (LDLs) in the bloodstream combine with WBCs in the endothelial artery wall to initiate the beginnings of atherosclerosis
Describe irreversible cellular injury and give two examples
Injury is too severe or prolonged to allow adaptation or repair and reversal. Apoptosis is genetically programmed cell death over a specific time span and has no adverse effects on the body. One example is ovaries undergo apoptosis in females at age 55. WBCs undergo apoptosis after their participation in an inflammatory reaction.
Describe necrosis and give an example
Tissue and cell death stressors overwhelm the cells ability to survive. Intracellular contents are released into bloodstream such as in myocardial infarction and an elevated troponin level (this is ischemic necrosis)
What happens with a failure of apoptosis and give an example
Cells that fail to undergo apoptosis can give rise to certain cancers, tumors, and detrimental hyperplastic cell changes. An example is prostate cancer is theorized to arise from cells that lose their apoptotic function.
Describe excessive apoptosis and give an example
Some disorders are associated with increased cellular apoptosis, which results in excessive cell death rates. An example is some degenerative neurological diseases such as spinal muscular atrophy are thought to arise from nerve cells that undergo increases apoptotic rates and die prematurely
Describe gangrene and give 3 causes
Necrosis of tissues as cells die. The dead tissue is a medium for certain types of bacteria. Causes are prolonged ischemia, infarction, and typically patients with peripheral arterial disease (PAD)
Describe clinical interventions to reverse cell injury and give 3 clinical examples
Removing the injurious stimuli is the first priority as well as restoring circulation or nerve stimulation. Examples are acid suppression treatment can resolve the metaplasia of barrett’s esophagus. Neoplastic growths can be surgically removed. Intracellular accumulations can usually be eradicated by resolving the etiology of the metabolic derangement
Give four interventions to treat permanent cell injury
Transplantation, restoration with stem cells, reproductive cloning, and therapeutic cloning.
What are embryonic stem cells
Cells taken from an embryo in the blastocyst stage. Cells have potential to become any new organ and since blastocyst cells don’t have surface antigens there are no incompatibility problems.
Give 5 proposed future treatments where stem cells could be used
Sickle cell anemia, diabetes, parkinson disease, tissue repair of skin, and replacement organs
Describe therapeutic cloning
This is another potential use for stem cells. Pluripotent stem cells offer the possibility of a renewable source of replacement cells and tissues to treat a myriad of diseases, conditions, and disabilities including parkinson’s disease, amyotrophic lateral sclerosis, spinal cord injury, burns, heart disease, diabetes, and arthritis.
Compare eustress and distress and name 3 theorists in this realm
Eustress is a stressor that positively motivates a person. Distress is stress that negatively affects a person’s well-being. Theorists are Hans Selye, Walter cannon, and Bruce McEwen
Describe stressor according to the selye stress response theory
A challenging demand on the body that arouses a response from multiple organ systems. Stressors can be positive or negative experiences for the individual and have the potential to cause adverse health effects.
Give 8 conditioning factors for an individual’s reaction to a stressor according to selye stress response theory
Age, gender, genetics, pre-existing health conditions, life experiences, developmental level, educational level, social support
What is adaptive ability according to selye stress response theory
the way in which the individual manages stress and reduces the effect of the stressor on his or her life
Describe the alarm stage of the general adaptation syndrome and give 3 characteristics
Fight or flight, the alarm stage is state of arousal characterized by stimulation of CNS, SNS, and adrenal gland
Describe the resistance stage of stress
The body attempts to stave off the effects of stress through continual hormone and catecholamine secretion. It is a time-limited stage. When stress subsides, then the SNS and adrenal stimulation abate, and the PNS responses resume a state of relaxation
Describe the exhaustion stage of stress
If the stressor does not subside and the stress is prolonged, the high levels of hormone and catecholamine secretion cannot be sustained and the exhaustion ensues. Stress overwhelms the body’s ability to defend itself. Resources are depleted and signs of systemic dysfunction occur. During this stage an individual can feel run-down, unable to cope, depressed, anxious, and can feel physically ill
Describe allostasis according to McEwen’s long term stress theory
a dynamic state of balance that changes according to exposure to stressors
Describe allostatic load according to McEwen’s long term stress theory
The wear and tear on body systems caused by stress reactions. Allostatic load is not only determined by the stressor, but also by how well the individual adapts to the stressor. Elderly individuals have less resiliency to stress because the body requires more time to recover from stressful event
Give four reasons that allostatic load can accumulate
repeated stressful experiences, inability of the individual to adapt to stress, prolonged reaction to a stressor, and inadequate response to a stressor.
According to McEwen what happens when stress exceeds the body’s ability to adapt
allostatic overload ensues and the initiation of pathophysiological disorders happens
Give 5 treatments for stress originating issues
reduce caffeine intake, engage in yoga, increase exercise, ensure sufficient sleep, and achieve proper nutrition
Give four other treatments of stress originating pathologies
Stress management programs, psychotherapy, alternative medicine, and pharmacology
Give 7 interventions to counteract immobility
Active range of motion, passive range of motion, isometric exercise, aerobic exercise, positional changes such as side-lying and to a chair (at least every 2 hours), special mattresses, and antithromboembolic stockings
Describe the four stages of pressure injuries
- Erythema and irritation of skin 2. Loss of skin layer 3. loss of skin and dermal layer with ulceration 4. loss of skin, dermis, muscle, down to the bone
What is erythema
superficial reddening of the skin usually in patches as a result of injury
Name the 6 areas that are most susceptible to pressure injuries
Occiput, shoulders, elbows, sacral region, calf region, and heels
Describe a cancerous neoplasm
Grows in an uncoordinated manner and looks different from normal cells. Doesn’t function like the tissue or origin and competes with normal cells for space, blood supply, oxygen and nutrition. Proliferates independently and FAST. Large numbers of cancers have a genetic link. Can arise from proto-oncogenes and faulty cellular apoptosis
Give the benign tumor suffix with two examples and name 3 exceptions that are all highly malignant
suffix is “Oma” such as lipoma and adenoma. Exceptions are lymphomas, hepatomas, and melanomas
Describe four types of malignant tumors
Adenocarcinoma (glandular tissue), carcinoma (epithelial tissue MOST human cancers are this type), sarcoma (mesenchymal tissue like nerve, bone, and muscle), and leukemia (WBC)
Describe how cancer cells don’t obey the rules
Ignore growth controlling signals and proliferate excessively becoming immortal. Lose their features and contribute poorly or not at all to tissue. Invade local tissue and overrun neighbors. Travel away from origin to invade distant sites. Genetically unstable, and are able to establish new colonies.
Describe benign neoplasia
Resemble healthy cells of tissue of origin (well-differentiated). Don’t metastasize. Stay local and are often encapsulated.
Describe malignant neoplasia
Appear very different from tissue of origin. Secrete inappropriate enzymes, hormones, clotting substances, and tumor angiogenesis factor. Tend to break away and lack normal cell function.
