exam 1 blueprint Flashcards
tnm staging
a system for classifying the extent of cancer
tnm staging
t = ?
tumor
tnm staging
n = ?
lymph node
tnm staging
m = ?
metastasis
grade 1
well differentiated; tumor cells look like normal tissue cells; low grade
grade 2
moderately differentiated; somewhat abnormal; intermediate grade
grade 3
poorly differentiated; most of the cells look abnormal; high grade
grade 4
undifferentiated; all or most abnormal / anaplastic cells; highest grade
Liquefaction necrosis
necrosis where dead cells liquify; seen in brain tissue
Caseous necrosis
necrosis with a cottage cheese appearance; seen with TB
fat necrosis
necrosis that has a chalky look; seen with breast injury / acute pancreatitis
Coagulative necrosis
necrosis due to interrupted blood flow; affects kidney / heart / adrenal glands
Gangrene
a form of coagulative necrosis due to insufficient blood supply
PKU (Phenylketonuria)
a genetic disorder diagnosed prenatally or at 3-day-old serum screening, caused by a deficiency in phenylalanine hydroxylase.
what is phenylalanine hydroxylase
an enzyme that converts phenylalanine into tyrosine. This reaction is the first step in breaking down phenylalanine, an amino acid that comes from food and artificial sweeteners.
down syndrome
A genetic disorder characterized by three copies of chromosome 21, leading to various physical and developmental issues.
Klinefelter Syndrome
A genetic condition in males characterized by the presence of an extra X chromosome (XXY).
Neurofibromatosis
An incurable genetic disorder that causes tumors to grow on nerves.
Atrophy
A cellular adaptation where cells decrease in size and number due to decreased workload.
Hypertrophy
A cellular adaptation where cells increase in size due to increased workload.
Hyperplasia
An increase in the number of cells in an organ or tissue, often compensatory or hormonal.
Metaplasia
A pathologic replacement of normal cells with the incorrect normal cells.
Dysplasia
A pathologic mutation of normal cells into abnormal cells, often precancerous.
gene
segment of DNA that is a template for protein synthesis (mild to chronic)
Allele
single gene that has many variants
DNA
long chain of nucleotides called chromosomes (23 pairs)
Autosome
22 sets of paired chromosomes
Sex chromosomes
1 pair of sex chromosomes (23rd pair)
Karyotype
person’s unique set of chromosomes
Phenotype
physical expression of karyotype
Homozygous
having two identical alleles for a particular gene
Heterozygous
having two different alleles for a particular gene
Benign tumors
cancers that are slow, progressive, localized, defined and differentiated (specific); causes problems due to location
Malignant tumors
cancers that are rapid, metastatic, undifferentiated (not specific), and fatal
Nociceptive pain
most common type of pain; further classified as somatic or visceral pain
Somatic pain
results from noxious stimuli to the skin, joints, muscles, and tendons; generally easy to pinpoint (‘right here’)
Visceral pain
results from noxious stimuli to internal organs; usually vague and diffuse; hard to pinpoint
Referred pain
sensed on body surfaces at distant locations from the originating organ
Phantom pain
exists after removal of a body part; severed neurons may result in spontaneous firing of spinal cord neurons because normal sensory input has been lost
Intractable pain
chronically progressing pain that is unrelenting and severely debilitating; does not usually respond well to typical pharmacologic pain treatments
Neuropathic pain
results from damage to peripheral nerves by disease or injury; tends to be both chronic and intractable
Acute pain
short-term pain; comes on suddenly; lasts hours to days, less than 6 months
Chronic pain
pain that lasts for more than 6 months, even after original injury has healed
Innate immunity
provides immediate protection and is non-specific (provides protection against all invaders)
Acquired (Adaptive) immunity
can take 7-10 days to provide protection; is specific to the antigen
Infancy
Based on maternal IgG for 3 to 6 months (not fully developed), granting temporary passive immunity, but transferred antibodies bind weakly to antigen.
Breastfeeding
Can transfer IgA; vaccinations grant additional protection (from the mom).
Adolescence
Hormonal changes impact the immune system as B cells (Cytokines) and macrophages have hormone receptors.
Immune dimorphism
The sexes respond differently to infection/vaccination.
Old age
Decreases immune response in immune senescence (not as good).
Comorbidity
Significantly impacts immunity and autoimmune disorders become more likely due to misinterpretation of signals flooding the body; can’t tell self from non-self.
Type 1/I hypersensitivity
IgE mediated; immediate, local or systemic (all over the body).
Type 2/II hypersensitivity
Tissue-specific/cytotoxic; involves destruction of a single cell; IgG or IgM antibodies bind to antigen on individual’s own cells and destroys it.
Type 3/III hypersensitivity
Immune complex-mediated; delayed, local, or systemic; circulating antigen-antibody complexes accumulate in tissue, triggering the complement system’s inflammatory response.
Type 4/IV hypersensitivity
Cell-mediated/delayed-type; delayed, two phases: sensitizing and effector.
Cell-mediated/delayed-type; delayed, two phases: sensitizing and effector.
A model describing the body’s response to stress in three stages: alert, resistance, and exhaustion.
Alert stage
The ‘fight or flight’ response (sympathetic).
Resistance stage
Adapt or NOT.
Exhaustion stage
Exhaustion stage
Exhaustion stage
Vascular reaction from damage or trauma to body tissue; nondiscriminatory: same sequence regardless of cause, local and systemic effects.
Acute phase of inflammation
Hours to days after injury, until threat is eliminated; includes erythema (redness), edema (swelling), heat, vasoconstriction and vasodilation, phagocytosis, and fibrinogen.
Chronic phase of inflammation
Weeks to months; if acute does not resolve issue, lasts until healing is complete; often occurs in presence of resistant organisms.
Granuloma
Mass of tissue that contains macrophages (WBC) and lymphocytes; tries to separate and contain the infection.
Granulation tissue
Mixture of new vasculature and fibroblasts that produces connective fibers and collagen (fills in wound).
IgG
main defense against bacteria
IgM
main defense against bacteria
IgA
important in local immunity
IgE
allergic reaction
IgD
helps anchor cell membranes
Hyperacute tissue rejection
nearly immediate, due to complement system, causes permanent necrosis
Acute tissue rejection
occurs within 3 months, is treatable, and manifests in fever, edema, etc.
Chronic tissue rejection
from 4 months on, antibody-mediated, due to ischemia in vessel walls of transplanted tissue
HIV
a retrovirus infecting CD4 and macrophages
Type 1 HIV
most common strain
Type 2 HIV
more common in West Africa; progressive to disease more slowly
HIV transmission
transmitted via blood and bodily fluids; expecting mothers risk infecting their child
CD4+ cells
cells that HIV invades, converts viral RNA to DNA, and compromises the cell
Immunodeficiency
opportunistic infections
Autoimmunity
pneumonitis/arthritis
Neurologic dysfunction
AIDS dementia/HIV encephalopathy/neuropathies
Symptoms of HIV
weight loss and fever; draw blood to confirm (months to years
Nucleic acid test (NAT)
detects viral load; number of viral particles per ML of blood
Antigen/antibody tests
detect antigen p24 in blood or saliva, often administered with NAT
CD4 cell count Category 1
> 500 cells/mm3
CD4 cell count Category 2
200-499 cells/mm3
CD4 cell count Category 3
< 200 (diagnosis of AIDS)
Normal CD4 count
500-1600 cells/mm3
Category A (clinical presentation)
asymptomatic
Category B (clinical presentation)
some less-serious manifestations of immunodeficiency
Category C (clinical presentation)
AIDS-defining illness present
HAART
combination therapy is best for managing symptoms
Pre-exposure prophylaxis (PrEP)
medications that decrease transmission risk by 90%
Post-exposure (PEP)
medications to prevent HIV after potential exposure
Anemia
common disorder of the erythrocytes that impairs the blood’s oxygen-carrying capacity and creates tissue hypoxia
Iron-deficiency anemia
most common type of anemia where the supply of iron is inadequate to meet the demands of hemoglobin production
Pernicious anemia
Vitamin B12 deficiency (required for DNA synthesis), usually caused by an autoimmune lack of intrinsic factor made by the stomach
Aplastic anemia
bone marrow depression of all blood cells (pancytopenia) often idiopathic, autoimmune, medical, viral, or genetic in origin
Hemolytic anemia
excessive erythrocyte destruction or hemolysis
Sickle cell anemia
inherited codominant disorder in which erythrocytes are crescent/sickle-shaped
Thalassemia
autosomal dominant inheritance with abnormal hemoglobin due to a lack of either alpha or beta globin
Immune thrombocytopenic purpura (ITP)
hypocoagulation due to autoimmune destruction of platelets
Thrombotic thrombocytopenic purpura (TTP)
caused by deficiency in the enzyme that cleaves von Willebrand’s factor, leading to hypercoagulation that depletes platelet levels
Decreased iron intake/absorption
one of the causes of iron-deficiency anemia
Cyanotic sclera
blue-tinted eyes, an additional manifestation of iron-deficiency anemia
Complete blood count
diagnostic test used to identify low hemoglobin, hematocrit, MCV, MCHC in anemia
Supplemental iron intake
treatment for iron-deficiency anemia that includes iron pills
Vitamin B12
required for DNA synthesis, deficiency leads to pernicious anemia
Positive Babinski’s sign
a manifestation of pernicious anemia indicating neurological involvement
Bone marrow biopsy
diagnostic procedure used in aplastic anemia to assess bone marrow function
Sickle cell crises
painful episodes of tissue ischemia and necrosis associated with sickle cell anemia
Hydration
a treatment strategy for sickle cell anemia to avoid sickling triggers
Genetic counseling
part of the treatment for sickle cell anemia to inform about inheritance patterns
Glucocorticoid steroids
a treatment option for immune thrombocytopenic purpura (ITP)
Plasmapheresis
a treatment for thrombotic thrombocytopenic purpura (TTP) that cleans the blood
Oxygen therapy
a treatment for aplastic anemia to manage symptoms
Blood transfusion
a treatment option for aplastic anemia and TTP to manage low blood cell counts
Jaundice
a manifestation of thalassemia indicating liver involvement
Hematocrit
a measure of the proportion of blood volume that is occupied by red blood cells
Thrombocytopenia
low platelet count, a symptom of various types of anemia
Leukocytopenia
low white blood cell count, a symptom of aplastic anemia
Pica
a condition associated with iron-deficiency anemia where the individual craves non-food items
Disseminated intravascular coagulation (DIC)
life-threatening complication of many conditions springing from an inappropriate immune response.
Widespread coagulation
massive bleeding due to the depletion of clotting factors
Causes of DIC
blood transfusion reaction, cancer, sepsis, OB complications, and venomous snake bite.
Manifestations of DIC
tissue ischemia and abnormal bleeding.
Complications of DIC
shock, multisystem organ failure, and death.
Diagnosis of DIC
complete blood count and bleeding studies.
Treatment of DIC
identify and treat underlying cause, replenish clotting components, and prevention of clots and treatment of bleeding.
Hodgkin’s lymphoma
less common; solid tumors contain Reed-Sternberg cells often originating in lymph nodes of the upper body.
Manifestations of Hodgkin’s lymphoma
painless enlarged nodes, night sweats, pruritis, and splenomegaly.
Diagnosis of Hodgkin’s lymphoma
imaging, Reed-Sternberg cells found in biopsy, and complete blood counts.
Non-Hodgkin’s lymphoma
more common, with poor prognosis among the many subtypes
Hemophilia A
a mild to severe X-linked recessive bleeding disorder caused by deficiency or abnormality in clotting factor VIII.
Prevalence of Hemophilia A
1:5,000 male births; rare in females.
Manifestations of Hemophilia A
bleeding or signs of bleeding (bruising, petechia, GI bleed, and hematuria).
Diagnosis of Hemophilia A
genetic testing, clotting studies and serum factor VIII or IX levels.
Leukemia
cancer of the leukocytes (WBC), the second most common blood cancer after lymphomas.
Risk factors for Leukemia
mutagens (chemical, viral, and radiation), smoking, chemotherapies, other diseases, and immunodeficiencies.
Acute lymphoblastic leukemia (ALL)
most common type, affects primarily children, responds well to therapy, and has a good prognosis
Manifestations of Leukemia
Leukopenia, anemia, thrombocytopenia, lymphadenopathy, joint swelling, bone pain, weight loss, and anorexia.
Multiple Myeloma
cancer of the plasma cells characterized by excessive numbers of abnormal plasma in the bone marrow.
Manifestations of Multiple Myeloma
anemia, thrombocytopenia, leukopenia, decreased bone density, persistent bone pain, hypercalcemia, and renal impairment.
Diagnosis of Multiple Myeloma
serum and urine protein, calcium, renal function tests, complete blood count, biopsy, and imaging.
Survival rate for Multiple Myeloma
3 to 5 years.
