Exam 1- Ch 1, 10 and part of 12 Flashcards
What is Pathophysiology?
The study of functional or physiological changes in the body that result from disease processes.
What is a disease?
A deviation from the normal structure or function of any part, organ, system, or state of wellness.
What is homeostasis?
The maintenance of a relatively stable internal environment regardless of external changes.
What are the seven steps to health?
- Be a non-smoker and avoid second hand smoke.
- Eat 5-10 servings of vegetables and fruit a day. Choose high-fiber, lower-fat foods. If you drink alcohol, limit your intake to 1-2 drinks a day.
- Be physically active on a regular basis. This will also help you maintain a healthy body weight.
- Protect yourself and your family from the sun.
- Follow cancer screening guidelines.
- Visit your doctor or dentist if you notice any change in your normal state of health.
- Follow health and safety instructions at home and at work when using, storing, and disposing of hazardous materials.
Define normal.
Average, small range, standard
What varies with normal?
Age, health and gender
What is primary prevention?
Protect healthy people from developing disease or injury.
What is secondary prevention?
Halt or slow disease progression in earliest stages; injury-limiting long term disability or re-injury.
What is tertiary prevention?
Preventing further physical deterioration and maximizing quality of life.
How do we get medicines/treatments?
- Basic science- researchers work to identify a technology that will work to limit or prevent the disease process.
- Involves small number of human subjects to determine IF therapy is safe for humans.
- ONLY takes place if the results from stage 2 are positive.
What is gross?
examination by eye
What is microscopic?
cellular level
What is biopsy?
excision of very small amounts of living tissue
What is autopsy?
examination upon death
What is cell damage and necrosis?
ischemia
physical agents (heat, cold, radiation)
mechanical damage (pressure, tearing of tissue)
chemical toxins
microorganisms (bacteria, viruses, parasites, fungi)
abnormal metabolites accumulating in cells
nutritional deficits
imbalance of fluids or electrolytes
What is necrosis?
death of a group of cells
Cell damage may be what?
reversible or irreversible
Cell damage can lead to what?
loss of function
What has to do with pharmacology?
Integrated medical science involving chemistry, biochemistry, anatomy, physiology, microbiology
What is pharmacology?
The study of drugs, their actions, dosage, therapeutic uses and adverse effects
How does pharmacology link to pathophysiology?
Medications impact patient care
What is Pharmacodynamics?
Drug-induced responses of physiologic and biochemical systems in health and disease
What is pharmacokinetics?
Drug amounts at different sites after administration
What is pharmacotherapeutics?
Choice and drug application for disease prevention, treatment, or diagnosis
What is toxicology?
The study of the body’s response to drugs, their harmful effects, mechanisms of actions, symptoms, treatment, and identification
What is pharmacy?
The preparation, compounding, dispensing and record keeping of therapeutic drugs
What is a dose?
the amount of drug required to produce the specific desired effect in an adult
How is a dose measured?
by weight and time factor
What are the two administration routes?
local and systemic
What is a local administration?
topical, inhalation, eye drops
What is a systemic administration?
transdermal therapeutic systems, orally, sublingual, rectal, inhalation, subcutaneous, intramuscular, intravenous
What are factors that affect blood levels of drugs?
Circulation and cardiovascular function
age
body weight and proportion of fatty tissue
activity level/exercise
ability to absorb, metabolize, and excrete drugs (liver and kidney functions)
food and fluid intake
genetic factors
health status or presence of disease (chronic or acute)
The circulatory system consists of what
the cardiovascular and lymphatic systems
What four things does blood do?
- Transports essential oxygen to all tissues along with nutrients required for cell metabolism
- provides necessary removal of many cell wastes
- plays a critical role in the body’s defenses/immune system
- Maintains body homeostasis
What is pulmonary circulation?
allows the exchange of oxygen and carbon dioxide in the lungs
What is systemic circulation?
Provides for the exchange of nutrients and wastes between the blood and the cells throughout the body
Arteries go to arterioles and do what?
transport blood away from the heart
Veins go to venules and do what?
returns blood back to the heart
What do capillaries do?
microcirculation within the tissues
What is tunica intima?
endothelium (simple squamous epithelium)
What is tunica media?
middle layer, mostly smooth muscles
What is tunica adventitia?
connective tissue with fibrocytes, collagen, and elastic fibers
What is autoregulation?
reflex adjustment in a small area of tissue or an organ, which varies depending on the needs of the cells in the area
What are examples of autoregulation?
decrease in pH
increase of CO2
decrease in O2
Autoregulation leads to what?
Vasodilation
What is plasma?
clear, yellowish fluid remaining after cells are removed
What are plasma proteins?
albumin
globulins
fibrinogen
What does albumin do?
maintains osmotic pressure
What do globulins have to do with?
defenses
What is fibrinogen essential for?
formation of blood clots
When fibrinogen is removed what happens?
yields serum
What are the cellular components of blood?
rbc
wbc
platelets
What is hematocrit?
proportion of cells (mostly rbc) in blood
What does hematocrit indicate?
viscosity of blood
Hematocrit in males
42-52%
hematocrit in women
37-47%
What is blood made of?
plasma
cellular component
hematocrit
What are the characteristics of rbcs?
No nucleus in mature state
biconcave flexible discs
contains hemoglobin
life span of 120 days
Erythropoietin is produced where and stimulates what?
kidneys
rbc production
Two types of wbc?
granulocytes and agranulocytes
types of granulocytes?
neutrophils
basophils
eosinophils
wbc is how much of blood volume?
1%
types of agranulocytes?
lymphocytes
monocytes
what do neutrophils do?
phagocytosis
what do eosinophils do?
allergic response
what do basophils do?
histamine and inflammatory response
what are lymphocytes for?
cell-mediated and humoral immunity
what are monocytes for?
macrophages and phagocytosis
Thrombocytes are for?
platelets
blood clotting
Are thrombocytes cells
no
What are the three steps of blood clotting?
vasoconstriction or vascular spasm after injury
platelet plug
coagulation mechanisms
What are the five steps of the coagulation mechanisms?
damaged tissue and platelets release factors that stimulate a series of clotting factors
prothrombin converted to thrombin
fibrinogen converted to fibrin
fibrin mesh forms to trap cells
clot retracts pulling edges of damaged tissue together and seal site
What will plasmin do?
eventually break down the blood clot
Blood typing is based on what?
antigens on the plasma membrane of the rbcs
What antigens and antibodies are for blood type O
No antigens
Anti A and B antibodies
What antigens and antibody for type A blood types
A antigens
Anti B antibody
What antigens and antibodies for type B blood types
B antigens and Anti A antibody
What antigens and antibodies for type AB blood types?
A and B antigens and no antibodies
Antigen D on plasma membrane means what?
Rh positive
Absence of antigen D means what?
Rh negative
What is a complete blood count (CBC)?
includes the total red blood cells, white blood cells, and platelets
What is leukocytosis?
increased wbc associated with inflammation or infections
What is leukopenia?
decreased wbc associated with some viral infections, radiation and chemotherapy
What does morphology show?
size, shape, uniformity, maturity of cells
different types of anemia
What is a hematocrit
percent by volume of cellular elements in blood
What does hemoglobin indicate?
the oxygen-carrying capacity of blood
What does Prothrombin time (PT) and partial thromboplastin time (PTT) measure?
function of various factors in coagulation process
What does bleeding time measure?
platelet function
What is bleeding time?
the time to plug a small puncture
What does the chemical analysis determine?
serum levels of components (Fe, Vit B, folic acid, Cholesterol, urea and glucose)
What does the chemical analysis indicate?
metabolic disorders and disorders within other body systems
What is reticulocyte count?
immature non-nucleated rbc count
What does reticulocyte assess and how is it done?
assessment of bone marrow function
done with bone marrow aspiration and biopsy
What is epoetin alfa?
artificial form of erythropoietin
When is epoetin alfa used?
before certain surgical procedures
anemia related to cancer
chronic renal failure
What is necessary for bone marrow or stem cell transplantation?
close tissue match
When is a bone marrow or stem cell transplantation used?
treatment of some cancers
severe immunodeficiency
severe blood cell diseases
What does drug treatment aid in?
the clotting process
What is in blood dyscrasias
anemias
Anemia causes what?
a reduction in oxygen transport
what is the basic problem in anemia
hemoglobin deficit
Oxygen deficit leads to what five things?
less energy production in all cells
compensation mechanisms
general signs of anemia
decreased regeneration of epithelial cells
severe anemia may lead to angina or congestive heart failure
Less energy production in all cells has to do with what?
cell metabolism and reproduction diminished
Compensation mechanisms has to do with what?
tachycardia and peripheral vasoconstriction
what are the general signs of anemia?
fatigue
pallor
dyspnea
tachycardia
decreased regeneration of epithelial cells has to do with what four things
digestive tract becomes inflamed and ulcerated, leading to stomatitis
inflamed and cracked lips
dysphasia
hair and skin may show degenerative changes
Insufficient iron impairs what?
hemoglobin synthesis
what results of low hemoglobin concentration in cells?
hypochromic rbcs
Anemia that occurs in all age groups, but more common in women of childbearing age?
iron deficiency
Anemia: Estimated to affect one in five women but increases for pregnant women
iron deficiency
causes of iron deficiency anemia
dietary intake of iron below minimum requirement
chronic blood loss
impaired duodenal absorption of iron
severe liver disease
Normally only what percent of iron absorbed, and increased to what percent when deficit?
5-10
20
What can lead to chronic blood loss
bleeding ulcer hemorrhoids cancer excessive menstrual flow
severe liver disease affects what as well as iron absorption
storage
Signs and symptoms of iron deficiency anemia
pallor of skin and mucous membranes fatigue, lethargy, cold intolerance irritability degenerative changes stomatitis and glossitis menstrual irregularities delayed healing tachycardia, heart palpitations, dyspnea, syncope
Which anemia is a Vit B12 deficiency
Pernicious
What is the basic problem with pernicious anemia?
lack of absorption because of lack of intrinsic factor
The intrinsic factor of pernicious anemia is secreted by what?
gastric mucosa
Pernicious anemia is characterized by what?
very large, immature, nucleated rbcs
The rbc in pernicious anemia have what?
shorter life spans and carry less hemoglobin
Pernicious anemia five reasons
dietary insufficiency is rarely a cause malabsorption most common cause genetic factors have been implicated often accompanies chronic gastritis may also be an outcome of gastric surgery
Vit B12 is needed for the function and maintenance of what
neurons
Significant deficit of the vitamin will cause symptoms in the what
peripheral nerves
Three manifestations in pernicious anemia
tongue is typically enlarged, red, sore, and shiny
digestive discomfort, often with nausea and diarrhea
feeling of pins and needles, tingling in limbs
Diagnostic tests for pernicious anemia
bone marrow examination
Vitamin B12 serum levels below normal
presence of hypochlorhydria or achlorhydria
rbc examination
What does the presence of hypochlorhydria or achlorhydria show the presence of
gastric atrophy
Which anemia has to do with the impairment or failure of bone marrow, leading to loss of stem cells and pancytopenia
aplastic
what is pancytopenia
decrease in rbcs, wbcs, and platelets
This anemia may be temporary or permanent
aplastic
Causes of aplastic anemia include
myelotoxins
viruses
autoimmune disease
genetic abnormalities
rbcs can often appear normal in which anemia
aplastic
a bone marrow biopsy may be required in this anemia
aplastic
is aplastic anemia there are two things required for prompt treatment
removal of any bone marrow suppressants
failure to identify cause and treat effectively is life threatening
This anemia results from excessive destruction of rbcs
hemolytic
cause of hemolytic anemia
genetic defects immune reactions changes in blood chemistry infections toxins in the blood antigen-antibody reactions
examples of hemolytic anemia are
sickle cell anemia
thalassemia
this anemia is a genetic condition that is autosomal and incomplete dominance
sickle cell anemia
this anemia is more common in individuals of African ancestry
sickle cell anemia
cells that are too large to pass through the microcirculation
sickle shaped cells
obstruction in sickle cell anemia leads to
multiple infarctions and areas of necrosis
altered what is unstable and changes shape in hypoxemia
hemoglobin
sickle cell crisis occurs whenever what happens
oxygen levels are lowered
abnormal hemoglobin (HbS)
sickle cell
Multiple infarctions affect what
brain, bones, organs
sickle cell anemia has in addition to basic anemia
hyperbilirubinemia
jaundice
gallstones all caused by a high rate of hemolysis
clinical signs of this anemia do not usually appear until the child is how old
about a year old
Sickle cell anemia signs and symptoms
severe pain pallor, weakness, tachycardia, dyspnea splenomegaly hand-foot syndrome acute chest syndrome delay of growth and development CFH
Treatment of sickle cell anemia
hydroxyurea has reduced the frequency of this crisis
dietary supplementation with folic acid
bone marrow transplantation
immunization in kids
diagnostic tests in sickle cell anemia
prenatal DNA analysis
hemoglobin electrophoresis
Indications of blood clotting disorder
persistent bleeding from gums repeated epistaxis petechiae frequent purpura and ecchymosis more than normal bleeding in trauma bleeding into joint hemoptysis blood in feces anemia feeling faint, low bp, rapid pulse
what is hemoptysis
coughing up blood
what is hemarthroses
swollen, red, painful bleeding into joints
what is petechiae
pinpoint, flat, red spots on skin and mucous membrane
etiologies of blood clotting disorders
thrombocytopenia or autoimmune reactions
chemotherapy, radiation treatments, and cancers
defective platelet function is associated with uremia and ingestion of aspirin
vitamin K deficiency may cause decrease in prothrombin and fibrinogen
liver disease reduced available proteins and vitamin k
inherited defects
hemorrhagic fever
anticoagulant drugs
Hemophilia A is an abnormality of which factor
VIII
this is the most common coagulation factor disorder and is x linked recessive trait manifested in men and carried by women
Hemophilia A
prolonged bleeding after minor tissue trauma, spontaneous bleeding into joints and possible hematuria or blood in feces
Hemophilia A
diagnostic tests of hemophilia A
bleeding time and PT normal
PTT, activated PTT, coagulation time prolonged, serum levels of factor VIII are low
Treatment of hemophilia A
desmopressin and replacement therapy for factor VIII
Most common hereditary clotting disorder
von willebrands disease
von willebrands disease signs and symptoms
skin rashes frequent nosebleeds easy bruising bleeding of gums abnormal menstrual bleeding
Involves both excessive bleeding and clotting
disseminated intravascular coagulation
disseminated intravascular coagulation clotting factors are what, prognosis is what, and this results in what
reduced to a dangerous level
very poor with high fatality rates
widespread uncontrollable hemorrhage
four complications of disseminated intravascular coagulation
carcinomas
major trauma
infections
obstetrical complications
group of inherited or acquired disorders. Mutations in coagulation genes and surgery or injury that allow for increase of clotting factors
thrombophilia
thrombophilia has a risk of abnormal what
clots in veins or arteries
Blood testing for thrombophilia
clotting factor levels and abnormal antibody levels
primary polycthemia
polycythemia vera
increased production of rbcs and other cells in the bone marrow
neoplastic disorder
serum erythropoietin levels are low
primary polycythemia
secondary polycythemia
erthrocytosis
increase in rbcs in response to prolonged hypoxia
increased erythropoietin secretion
compensation mechanism to provide increased oxygen transport
secondary polycthemia
Signs and symptoms of polycythemia
distended blood vessels, sluggish blood flow increased bp hypertrophied heart hepatomegaly splenomegaly dyspnea headaches visual disturbances thrombosis and infarctions
treatment of polycythemia
periodic phlebotomy
drugs or radiation to suppress bone marrow cavity
identify the cause
diagnostic test of polycythemia
increased cell counts
hyperuricemia
hypercellular bone marrow
increased hemoglobin and hematocrit levels
what is state of health?
difficult to define because of genetic differences among individuals as well as variations in life experiences and environmental influences
what does idiopathic mean?
cause of disease is unknown
what is iatrogenic mean?
treatment, procedure or an error may cause a disease
prophylaxis
designed to preserve health and prevent the spread of disease
atrophy
decrease in size of cells and reduced tissue mass
hypertrophy
increase in size of cells and enlarged tissue mass
metaplasia
one mature cell type is replaced by different mature cell type
dysplasia
vary in size and shape of cells, large nuclei are frequently present and rate of mitosis is increased
anaplasia
cells are undifferentiated with variable nuclear and cell structures and numerous mitotic figures
neoplasia
new growth
neoplasm
tumor
malignant neoplasm
cancer
benign
not necessarily life threatening
ischemia
decrease supply of oxygenated blood to a tissue or organ due to circulatory obstruction
hypoxia
decrease oxygen in the tissue
group of neoplastic disorders involving wbc
leukemia
uncontrolled wbc production in bone or lymph nodes
leukemia
leukemia wbcs are what three things
undifferentiated
immature
nonfunctional
leukemia infiltrates what five things
lymph nodes spleen liver brain other organs
malignant b cells cause what types of leukemia
acute lymphocytic leukemia
chronic lymphocytic leukemia
hairy cell leukemia
What leukemia does granulocytic stem cells occur in
acute myelogenous leukemia
chronic myelogenous leukemia
What leukemia does monocytes occur in
acute monocytic leukemia
what age group does acute lymphocytic leukemia
young children
what age group does acute myelogenous leukemia
adults
what age group does chronic lymphocytic leukemia
adults greater than 50 years
what age group does chronic myelogenous leukemia
adults 30-50
what age group does acute monocytic leukemia
adults
what age group does hairy cell leukemia
males greater than 50 years
High proportion of immature nonfunctional cells in bone marrow and peripheral circulation. Onset is abrupt.
acute leukemias
higher proportion of mature cells. Insidious onset, mild signs and better prognosis
chronic leukemias
Signs and symptoms of acute leukemia
frequent or uncontrolled infections petechiae and purpura signs of anemia severe and steady bone pain weight loss, fatigue, possible fever enlarged lymph nodes, spleen, liver headache, visual disturbances, drowsiness, vomiting
Treatment for leukemia
chemotherapy
ALL in young children respond well to drugs
biological therapy
bone marrow transplantation when chemotherapy is ineffective
diagnostic tests for leukemia
bone marrow biopsy
numbers of rbcs and platelets decreased
immature leukocytes and altered numbers of wbcs
complications of leukemia
opportunistic infections sepsis CFH hemorrhage liver failure renal failure CNS depression and coma
neoplastic disease that involved increased production of plasma cells in bone marrow
multiple myeloma
occurs in older adults
unknown cause
production of other blood cells is impaired
poor prognosis with short life expectancy
multiple myeloma
