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Human Pathophysiology > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

Define disease.

A

any distrubance of structure or function of the body

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2
Q

Define acute disease.

A

sudden and rapid onset

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3
Q

(Blank) is the most useful way to assess acute diseases.

A

Prevalence

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4
Q

Frequency of acute illness (increases/decreases) with age.

A

decreases

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5
Q

Define chronic disease.

A

long term

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6
Q

Chronic disease (increases/decreases) with age.

A

increases

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7
Q

What are examples of chronic disease?

A
  • heart disease
  • cancer
  • chronic lung disease
  • stroke
  • Alzheimer’s
  • diabetes
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8
Q

Define idiopathic disease.

A

a disease that occurs spontaneously; no known causes

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9
Q

Define etiology.

A

cause of disease

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10
Q

Define pathogenesis.

A

history and development of illness

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11
Q

Define nosocomial.

A

disease originating within a hospital

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12
Q

Define iatrogenic.

A

disease caused by medical treatment

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13
Q

Define incidence.

A

the # of individuals who develop a specific disease during a particular time period

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14
Q

Define prevalence.

A

total # of individuals in a population who have a disease

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15
Q

Define sensitivity in regards to testing.

A

the probability of a test to be positive in the presence of a disease

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16
Q

Define specificity in regards to testing.

A

the probability of a test to be negative in the absence of a disease

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17
Q

Define a sign.

A

measurable, objective

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18
Q

Give examples of signs.

A
  • fever
  • weight loss
  • blood tests/levels
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19
Q

Define a symptom.

A

reported by the patient, subjective

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20
Q

Give examples of symptoms.

A
  • sore throat
  • feelings of discomfort
  • reported pain/tenderness
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21
Q

What does this phrase mean?

“Structural and functional disorders are intimately related.”

A

alterations of one results in alterations of the other

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22
Q

Define a syndrome.

A

collection of clinical signs and symptoms

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23
Q

Give examples of syndromes.

A
  • Down’s syndrome
  • IBS
  • Turner syndrome
  • Asperger syndrome
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24
Q

T/F: A sick patient can have normal test results.

A

TRUE – normal test results can have crossover with abnormal test results, meaning normal test results ARE NOT a definitive absence of disease

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25
Q

Define sickness.

A

presence of disease

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26
Q

Define healthy.

A

absence of disease

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27
Q

T/F: When talking about sickness and health, signs and symptoms are considered.

A

FALSE – sickness and health DO NOT involve signs/symptoms; absence/presence of disease if the only factor

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28
Q

Define a qualitative test.

A

describes the quality; positive or negative

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29
Q

Define a quantitative test.

A

tests that have numerical results

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30
Q

How is the “normal” established for test results?

A

Normal = Mean (+/-) 2 Standard Deviations

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31
Q

What does this phrase mean?

“The extent of abnormality.”

A

that disease is a continuum; not just a black and white answer

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32
Q

What is the importance of the ‘Degree of Abnormality’ ?

A

greater variance from normal, more likely disease is present

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33
Q

What are 6 characteristics of a good screening test?

A
  • safe
  • low cost
  • easy to administer
  • minimal discomfort
  • valid
  • reliable
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34
Q

Define valid.

A

does the test actually measure what it is supposed to be measuring

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35
Q

What are the 2 components of validity?

A

sensitivity and specificity

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36
Q

Define reliable.

A

results of a test are considerably the same after multiple different tests were ran; consistency

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37
Q

What source of unreliability is natural blood pressure variability?

A
  • biological variability
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38
Q

What source of unreliability is it when there are multiple arm cuffs in a room to read blood pressure?

A
  • instrument variability
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39
Q

What source of unreliability is it when one person gets different results for after doing multiple readings?

A
  • intra-observer variability
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40
Q

What source of unreliability is it when multiple people have different results for one reading?

A
  • inter-observer variability
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41
Q

Define a screening test.

A

a test that detects early disease or risk factors for disease in asymptomatic, or healthy people

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42
Q

What do screening test results mean?

A

indicates probability for disease

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43
Q

T/F: Screening tests are chosen for high sensitivity situations.

A

TRUE – want the results for a disease early, so you’d want the test to be sensitive

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44
Q

Define a diagnostic test.

A

a test that establishes the presence or absence of disease as a basis for treatment

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45
Q

What do diagnostic test results mean?

A

provides a diagnosis

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46
Q

T/F: Diagnostic test are chosen for high specificity situations.

A

TRUE

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47
Q

T/F: Tests can be both specific and sensitive.

A

FALSE – most tests are one or another, but NOT BOTH

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48
Q

Define Positive Predictive Value.

A

among people who truly have the disease, what is the probability that the test will identify them as diseased

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49
Q

Define Negative Predictive Value.

A

among people who don’t have the disease, what is the probability that the test will identify them as being negative

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50
Q

If a screening test is available for a disease, should it always be employed because it might detect disease early?

A

NO, b/c it is a waste of materials if the incidence of a certain disease is low for a specific population

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51
Q

Define palliative care.

A

specialized medical care for people living with serious illness; person can still receive treatment

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52
Q

Define hospice care.

A

comprehensive comfort care; final answer; no attempts to cure illness

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53
Q

Define prognosis.

A

predicted course and outcome of disease

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54
Q

What does prognosis include?

A
  • chances for complete recovery
  • prediction of permanent loss of function
  • probability of survival
  • terminal = diseases that end with death
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55
Q

Define remission.

A

signs and symptoms subside

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56
Q

Define exacerbation.

A

increases the severity of signs/symptoms

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57
Q

Define relapse.

A

disease returns after it’s apparent cessation

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58
Q

Define complication.

A

an abnormal state that develops in a person

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59
Q

Define pathophysiology.

A

functional changes

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60
Q

Define epidemiology.

A

study of disease in populations

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61
Q

Define mortality rate.

A

number of deaths that occur in a population

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62
Q

Define morbidity.

A

degree of disability; heath problems that interfere with the normal physical, mental, or emotional functioning

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63
Q

Define survival rate.

A

% of people who survive within a given time period after diagnosis

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64
Q

Define totipotent stem cells.

A

cells that can differentiate into any cell type, including embryonic & extra embryonic cell types

65
Q

Define pluripotent stem cells.

A

can differentiate into cells of all 3 germ layers
- ectoderm
- mesoderm
- endoderm

66
Q

What does the ectoderm become anatomically?

A

skin, hair, spinal cord

67
Q

What does the mesoderm become anatomically?

A

muscles, organs, glands

68
Q

What does the endoderm become anatomically?

A

inner linings like respiratory and digestive tract

69
Q

Define multipotent stem cells.

A

more specialized compared to the other 2, but they have a limited range of cells they can differentiate into

70
Q

What are characteristics of labile cells?

A
  • constantly dividing and proliferating throughout life
  • high regenerative capacity and ability to quickly replace damaged cells
71
Q

Give examples of labile cells.

A
  • skin
  • mucous membrane in GI tract
  • hematopoietic cells in bone marrow
72
Q

What are characteristics of stable cells?

A
  • normally in a non-dividing state but can re-enter cell cycle and proliferate in response to injury or damage
  • moderate regenerative capacity and can repair tissues when needed
73
Q

Give examples of stable cells.

A
  • liver cells
  • pancreatic cells
  • kidney cells
74
Q

What are characteristics of permanent cells?

A
  • limited or no ability to undergo cell division and proliferation
  • low regenerative capacity and do not regenerate after significant damage
75
Q

Give examples of permanent cells.

A

neurons, cardiac muscle, skeletal muscle

76
Q

What is it called when cells actively control their internal environment within a narrow range of physiological parameters?

A

homeostasis

77
Q

What are the 3 levels of injury that cause disease?

A
  • molecular
  • cellular
  • tissue
78
Q

What are 10 ways cells can become injured?

A
  • inadequate oxygenation
  • physical, thermal, chemical
  • ionizing radiation
  • toxins/poisons
  • microorganisms
  • inflammation/immune reactions
  • nutritional imbalance
  • genetic defects
  • trauma
  • aging
79
Q

What are the targets for cell injury?

A
  • cell membranes (plasma and organelle membranes)
  • DNA
  • proteins (structural and enzymes)
  • mitochondria (oxidative phosphorylation)
80
Q
A
81
Q

T/F: There is a decline in proliferative and reparative capacity of cells with age.

A

TRUE – exposure to environmental factors that cause accumulation of cellular and molecular damage

82
Q

T/F: Telomeres lengthen with age, increasing protection of DNA during replication.

A

FALSE – telomeres shorten after every cell division; they are crucial in protecting ends of DNA during replication

83
Q

T/F: Hypoxia is the most common cause of acute cell injury.

A

TRUE – damage is reversible if O2 is restored, but death if not

84
Q

What is 5 things is hypoxia due to?

A
  • decreased oxygen in air
  • decreased oxygen transport to cells
  • diseases of respiratory or cardiovascular system
  • poisons
  • suffocation/drowning
85
Q

What is the pathophysiology of hypoxia?

A
  • loss of ATP due to failure of Na/K pump and hydropic changes
  • increased anaerobic metabolism which leads to increased lactic acid
86
Q

Mild injuries produce what 2 visible and reversible changes:

A
  • hydropic change (swelling)
  • steatosis (fat buildup in an organ)
87
Q

What are the 2 types of changes with prolonged injury/stress?

A
  • intracellular accumulations
  • altered growth and differentiation
88
Q

What are 6 molecule examples of intracellular accumulations?

A
  • cholesterol
  • mis-folded proteins
  • pigments
  • glycogen
  • fat
  • environmental particles
89
Q

What is the benefit of altered growth and differentiation after chronic cell injury?

A

allows the stressed tissue to survive or maintain function

90
Q

What type of changes occur for altered growth and differentiation?

A
  • change in size
  • change in # of cells
  • change into another type of cell
91
Q

Define atrophy.

A

shrinkage, decrease in cell size

92
Q

Atrophy is due to what physiologically?

A

aging

93
Q

Atrophy is due to what pathologically?

A
  • decreased blood supply
  • decreased nutrition
  • lack of neural or hormone support
94
Q

Define hypertrophy.

A

increase in cell size

95
Q

Hypertrophy is due to….

A
  • hormonal stimulation
  • increased functional demand
96
Q

Hypertrophy results in…

A
  • increased protein synthesis within cell
  • decreased protein breakdown
97
Q

Define hyperplasia.

A

increase in cell number

98
Q

Hyperplasia is due to…

A
  • hormonal stimulation
  • increased functional demand
  • chronic stress
99
Q

Hyperplasia results in…

A

increased cell division (if division can occur)

100
Q

Define metaplasia.

A

replacement of one cell type with another

101
Q

Where is metaplasia most common?
Is it reversible?

A
  • epithelium
  • yes, when stress is removed
102
Q

Define dysplasia.

A

change in cell resulting in abnormal cell size, shape, or organization

103
Q

Is dysplasia reversible?

A

yes, to an extent

104
Q

Define apoptosis.

A

programmed cell death or ‘cell suicide’

105
Q

What are functions of apoptosis?

A
  • removes cells that are ‘worn out’
  • removes unwanted tissue
  • normal process or pathological
106
Q

T/F: Apoptosis involves activation of caspases.

A

TRUE

107
Q

What are causes of apoptosis?

A
  • signaling factor attached to “death domains” of cell surface receptors
  • mitochondrial damage inside the cell
  • DNA damage
108
Q

Define necrosis.

A
  • unregulated cell death in tissue or organ
  • cell swells and ruptures
  • inflammation results
109
Q

What are the 4 types of necrosis?

A
  • Liquefaction
  • Coagulation
  • Fat
  • Caseous
110
Q

Describe coagulative necrosis.

A
  • cells have died, but shape and architecture remain
  • maintains solid consistency
111
Q

When is coagulative necrosis typically seen?

A

infarcts; NOT in the brain

112
Q

T/F: The dead cells from coagulative necrosis may be replaced.

A

TRUE – regeneration from neighboring cells, or by scar (fibrosis).

113
Q

Describe liquefactive necrosis.

A
  • complete dissolution of necrotic tissue
114
Q

When is liquefactive necrosis typically seen?

A
  • with infections (infiltration by neutrophils)
  • brain infarcts
115
Q

Describe caseous necrosis.

A
  • accumulation of amorphous (no structure) debris within an area of necrosis
  • tissue architecture is abolished
  • viable cells are no longer recognizable
116
Q

When is caseous necrosis typically seen?

A
  • associated with tuberculosis
  • some seen with fungal infections
117
Q

Describe fat necrosis.

A
  • fat tissue
  • damaged cells release lipase
  • released fatty acids react with calcium (creates chalky white areas)
118
Q

When is fat necrosis typically seen?

A
  • mechanical trauma
119
Q

Define gangrene.

A

large mass of tissue undergoes necrosis

120
Q

T/F: Gangrene is its own special type of necrosis.

A

FALSE – its a term for necrosis that is advanced and highly visible

121
Q

Define dry gangrene.

A

lack of arterial blood supply, but venous flow can carry fluid out of tissue
- tissue tends to coagulate

122
Q

Define wet gangrene.

A

lack of venous flow lets fluid accumulate in tissue
- tissue tends to liquefy and infection is likely

123
Q

Define gas gangrene.

A

clostridium infection produces toxins and bubbles

124
Q

What are the 4 hallmarks of inflammation after an injury?

A
  • Swelling
  • Redness
  • Pain
  • Heat
125
Q

Inflammation is a response to cell injury that:

A
  • neutralizes harmful agents
  • removes dead tissue
126
Q

What are the 4 stages of Acute Inflammation?

A
  • Vascular Stage
  • Cellular Movement of WBC into tissue
  • Elimination of pathogen
  • Repair
127
Q

Vascular Stage: Injury to a blood vessel triggers…

A

the clotting system

128
Q

Vascular Stage: The clotting system forms fibrinous meshwork at injured/inflamed site to….
(4)

A
  • prevent spread of infection
  • keep microorganisms and foreign bodies at the site of greatest inflammatory cell activity
  • form a clot
  • provide framework for repair/healing
129
Q

Vascular Stage: Main substance involved in clotting system is….

A

fibrin; an insoluble protein

130
Q

Vascular Stage: Explain the purpose of “brief vasoconstriction, followed by vasodilation.”

A

vasoconstriction:
- prevents spread of pathogen/stops blood loss
- hyperemia in injured area

vasodilation:
- increased blood flow (mediated by vasoactive amines)
- capillaries become more permeable to allow WBCs to site of irritation)

131
Q

Vascular Stage: What are the side effects of permeable capillaries?

A
  • edema (swelling)
  • exudate (movement of cells and fluid out of vasculature)
132
Q

Cellular Movement: What is the most involved cell during inflammation?

A
  • neutrophils (also most abundant WBC)
133
Q

Cellular Movement: What is the function of WBCs during inflammation?

A
  • destroying infective organsims
  • removing damaged cells
  • releasing more inflammatory mediators
134
Q

Cellular Movement: What adhesion proteins allow leukocytes to enter an injured area?

A
  • selectins: rolling
  • integrins: complete stop, adhesion
135
Q

What mediates changes seen in inflammation?

A

plasma-derived
- clotting system
- complement system
- kinin system

cell-derived
- vasoactive amines
- membrane factors
- cytokines
- reactive O2 compounds

136
Q

Mediators of Inflammation: What cell releases vasoactive amines, like histamine and serotonin?
What is the function?

A
  • mast cells
  • vasodilation and vascular permeability
137
Q

Mediators of Inflammation: Function of the complement system.

A

activates or collaborates with every other component of the inflammatory response

138
Q

Mediators of Inflammation: Function of the Kinin system.

A
  • activate and assist inflammatory cells
  • primary kinin is bradykinin
  • causes dilation of blood vessel, pain, smooth muscle contraction, vascular permeability and leukocyte chemotaxis
139
Q

Define serous exudate.

A

watery exudate: indicates early inflammation
- low in protein and inflammatory cells

140
Q

Define fibrinous exudate.

A

thick, clotted exudate: indicate more advanced inflammation
- more severe
- high vascular permeability (passage of fibrinogen into tissues
- inflammation of linings

141
Q

Purulent exudate (supperative).

A

pus: indicates a bacterial infection
- severe acute injury
- liquefactive necrosis
- associated with pus (large number of neutrophils

142
Q

Define empyema.

A

collection of pus in body cavity

143
Q

Anatomic characteristics of chronic inflammation

A
  • less intense cardinal signs
  • macrophages accumulate in the damaged area, releasing inflammatory mediators
  • lymphocytes
  • granulomatous inflammation
144
Q

What is granulomatous inflammation?

A
  • macrophages mass together around foreign bodies
  • connective tissue surrounds and isolates the mass
145
Q

Consequences of chronic inflammation

A
  • persistent chronic inflammation
  • fibrosis = resolution to scar
  • fibroblasts and collagen result in fibrous repair
146
Q

Define lymphangitis.

A

red streaks, usually due to infection

147
Q

Define lymphadentis.

A

enlarged tender lymph nodes

148
Q

Define lymphadenopathy.

A

enlarged tender lymph nodes all over the body

149
Q

What are systemic effects of chronic inflammation?

A
  • fever (pyrogens act directly on the hypothalamus)
  • malaise
  • drowsiness
  • liver = acute phase response
150
Q

During acute-phase response, leukocyte cytokines….

A
  • affect thermoregulatory center –> fever
  • affect CNS –> lethargy
151
Q

Liver makes fibrinogen and C-reactive protein…..

A
  • facilitate clotting
  • bind to pathogens
  • moderate inflammatory responses
152
Q

T/F: A higher Erythrocyte Sedimentation Rate (ESR) means higher inflammation and RBC count.

A

TRUE

153
Q

When is inflammation considered to be over?

A

at the beginning of repair

154
Q

Define regenerative.

A

nearly complete restoration

155
Q

Define healing.

A

regeneration and scarring

156
Q

Define fibrous repair.

A

scar formation

157
Q

What are the 3 phases of wound healing?

A
  • inflammation
  • proliferation
  • remodeling and maturation
158
Q

More about the proliferative phase.

A
  • cell migration into wound
  • angiogenesis and in growth of granulation tissue
  • fibroblast migration and deposition of extracellular matrix

Human Pathophysiology (4 decks)

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