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Pathophysiology > Exam #1 Infection, Inflammation, & Immunity > Flashcards

Exam #1 Infection, Inflammation, & Immunity Flashcards

1
Q

What are Exotoxins?

A

Gram positive bacteria
Toxins are released from inside the cells
Deadly

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2
Q

What are Endotoxins?

A

Gram negative bacteria
Toxins are released from the cell wall
Need to worry more about these

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3
Q

What are some organisms that are Exotoxins

A

S. aureus
B. cereus
V. cholera

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4
Q

What are some organisms that are Endotoxins?

A

E. coli
Salmonella typhi
Shigella
FEVER!

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5
Q

What is required for viral infections?

A

Invasion of the host cell for replication (Kills host cell)

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6
Q

3 Need to Know things about Fungal Infections

A

Single or Multicellular
Healthy individual = no disease
Compromised Immune System Individual = death

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7
Q

What are Parasitic infections common in developing countries?

A

They do not have water purification

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8
Q

How are parasitic infections ingested most commonly?

A

Pork products

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9
Q

What types of cells increases when infection is present?

A

White Blood Cells (WBC)

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10
Q

What is another name for mature Neutrophils?

A

Segs

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11
Q

What is another name fro immature Neutrophils?

A

Bands

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12
Q

What types of WBCs are most commonly found at a bacterial infection?

A

Neutrophils (Segs & Bands)

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13
Q

What is flank pain?

A

Pain of upper abdomen, back or sides

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14
Q

What types of WBCs are most commonly found at an allergic reaction area?

A

Eosinophils

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15
Q

What types of WBCs are most commonly found at a parasitic infection?

A

Eosinophils

Monocytes

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16
Q

What types of WBCs are most commonly found at a Viral infection?

A

Monocyte

Lymphocyte

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17
Q

What are the 2 types of UTIs?

A

Upper and Lower

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18
Q

What is an exemplar of an Upper UTI?

A

Acute Pyelonephritis

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19
Q

What is an exemplar of a Lower UTI?

A

Cystitis

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20
Q

What are UTIs caused by?

A

Bacteria

Most commonly: E. coli

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21
Q

What are common groups/people at risk for UTI?

A 
Client with indwelling catheter
Urinary Tract Obstructions (kidney stones)
Estrogen deficient women
Women on antibiotics
Prepubertal children
Premature Infants
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22
Q

UtI Prevention

A

Wipe front to back
Pee after sex
Avoid spermicides
Drink lots of water

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23
Q

What is Cystitis?

A

Inflammation of the bladder

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24
Q

Signs and symptoms of Cystitis

A 
Frequency
Dysuria
Urgency
Itching
Burning sensation
CONFUSION! > elderly especially
Discharge
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25
What would the bacterial count be if UTI is present?
>100,000/mL
26
What is Acute Pyelonephritis?
Infection of one/both kidneys
27
What does Acute Pyelonephritis primarily effect?
Interstitial area and renal pelvis
28
Risk Factors for Acute Pyelonephritis
Obstruction - most common cause Pregnancy Incomplete bladder emptying Sexual activity
29
Signs and Symptoms of Acute Pyelonephritis
``` Definite Fever Chills Flank Pain Costonvertebral Tanderness Pus in Urine ```
30
What is Glomeruloneritis?
Inflammation of the glomeruli
31
What is Glomeruloneritis caused by?
``` Streptococcus bacteria (Most Common) Drugs/Toxins ```
32
Clinical Manifestations of Glomeruloneritis.
Hematuria | Proteinuria
33
What is Hematuria?
Blood in the urine
34
What is Proteinuria?
Proteins in the blood
35
What is Oliguria?
Small amounts of urine
36
What does hypertension cause regarding urine output?
Oliguria
37
Uremic Frost
Urea deposits on skin
38
What is Pneumonia?
Lower respiratory tract infection
39
What causes Pneumonia?
Bacteria, viruses, fungi, protozoa, parasites
40
What are the 4 types of acquiring Pneumonia?
``` Healthcare Acquired (HCAP) Community Acquired (CAP) Hospital Acquired (HAP) Ventilator Associated (VAP) ```
41
Atypical Pneumonia is most common in ____
School-aged children (CAP)
42
Symptoms of Atypical Pneumonia
Cough Low grade fever Gradual
43
Bacterial Pneumonia is caused by ____
Streptococcus pneumoniae | bacteria
44
Signs and Symptoms of Bacterial Pneumonia
Fever Alveoli fill with fluid (Atelectasis) Blood stasis Edema
45
What can cause Viral Pneumonia?
Chickenpox & Measles
46
Signs and Symptoms of Viral Pneumonia
Mild fever Chills Cough Malaise
47
What is the most common type of Pneumonia?
Bacterial Pneumonia
48
What is the most lethal type of Pneumonia?
Bacterial Pneumonia
49
Viral is usually ____ & ____
Mild & Self-limiting
50
Pandemics of Viral Pneumonia include:
Swine Flu & Avian Flu
51
Viral Pneumonia is ___
Seasonal
52
What is Cellular Regulation?
All functions carried out within a cell to maintain homeostasis
53
Hormones
Chemical messengers that direct cellular function
54
Cytokines
Chemical messengers that regulate innate & adaptive immune responses Stimulate movement of cells to area of injury
55
Neurotransmitters
Chemical messengers that transmits signals from a nerve cell
56
Uncorrected errors in cellular growth result in ____
Neoplasia
57
Aerobic Metabolism is associated with what cycle?
Krebs Cycle
58
Anaerobic Metabolism is also the process of ___
Glycolysis
59
What does Aerobic metabolism need to occur?
Oxygen
60
How many ATP does Aerobic Metabolism yield?
34
61
How many ATP does Anaerobic Metabolism yield?
2 (+ lactic acid)
62
Etiology
Original cause of a cellular alteration/disease
63
Histology
Microscopic study of tissue & cells
64
Biopsy
Cell sample from an organ/mass of tissues to allow for histological examination
65
Pathogenetic Changes
Unique findings that represent distant disease processes
66
Atrophy
Decrease in cell size
67
Hypertrophy
Increase in cells size
68
Neoplasia
New growth
69
Benign Tumor
Well differentiated (resembles tissue of origin) Slow growth No metastasis
70
Malignant Tumor
Poorly differentiated Erratic growth Invasive to normal tissues Metastasis
71
Signs and Symptoms of Malignant Neoplasia
Fatigue Weight loss Organ failure
72
Risk Factors for Impaired Cellular Regulation
``` Smoking Excess weight Sedentary lifestyle Environmental carcinogens Genetics Infectious agents ```
73
Neoplasia lack ____
Cellular function & adhesiveness to other cells
74
Neoplasia secrete ____
Inappropriate: enzymes, hormones, clotting factors
75
Assessment findings for Neoplasias
Visible lesions Palpable masses Presents of blood in stool
76
Common diagnostic test for Neoplasias
Radiographic tests, colonoscopy, endoscopy, CBC, biopsy
77
Cancer is a disease of ____
Aging
78
Multiple __ are required before cancer can develop
Mutations
79
Cancer cells can do ___
Clonal Proliferation
80
What is Clonal Proliferation?
Selective proliferation of only one type of cell
81
What is the order of the cell cycle?
G0, G1, S, G2, & M
82
What happens at G0?
The cell is at rest & is not actively engaged in the cell cycle
83
What happens at G1?
Cell enters the cell cycle. Prepare for DNA replication Genes that control cell replication are activated
84
What happens at G2?
DNA replication take place
85
What happens at S?
Synthesis of structures occur > move to opposite poles in preparation to separate the 2 cells (46 chromosome reorganize into 2 sets of 23)
86
What happens at M?
Mitosis is complete and 2 daughter cells are created
87
Differentiation
The extent that neoplastic cells resemble normal cells structurally and functionally
88
Anaplasia
Lack of differentiation
89
Grade 1 Malignant Tumor
Indicates the cells are well differentiated
90
Grade 2 Malignant Tumor
Indicates cells are moderately differentiated
91
Grade 3 Malignant Tumor
Indicates poorly differentiated or anaplastic cells
92
What does TNM stand for?
Tumor size Number of Lymph Nodes Metastasis to distant organs
93
If a tumor is a T4 what does that mean?
The tumor is very large
94
If a tumor is a N3 what does that mean?
The tumor has spread to most all lymph nodes
95
If a tumor is a M1 what does that mean?
The tumor has metastasized
96
Why is Cancer a disease of aging?
With age the immune system weakens and make it easier for tumors to develop
97
Chronic ____ can lead to cancer
Inflammation
98
What do Tumor Suppressor Genes do?
Restrain Neoplasia growth
99
What do Oncogenes do?
Stimulate constant cellular proliferation and cell cycling
100
Viruses can inhibit ___
Tumor Suppressor Genes
101
How can viruses cause cancer?
It inserts it's genes into the host cell. The host cell then manufactures the virus. Causing irregular growth in the body.
102
What factor do cancer cells secrete?
Vascular endothelial growth factor
103
What is Vascular Endothelial Growth Factor?
A substance that gives them capability to develop new blood vessels
104
What characterize metastasis to distant organs?
Cancer cells in the blood and lymphatic system
105
Lung Cancer commonly spreads to ___ , ____
Bone | Brain
106
Colon Cancer commonly spreads to ____
Liver
107
Breast Cancer commonly spreads to __, ___, ___, ___
Bone Brain Liver Lung
108
Prostate Cancer commonly spreads to ____
Vertebae
109
Melanoma Cancer commonly spreads to ___
Brain
110
Clinical Manifestations of Malignancy
``` Pain Fatigue Cachexia Anemia Malabsorption Alopecia ```
111
What is Cachexia?
Progressive loss of body fat and lean body mass due to tumor
112
Why is Anemia associated with Malignancy?
May be chronic bleeding resulting on iron deficiency | Malignancy in blood forming organs
113
Tumor invasion of bone marrow can cause ___ & ___
Leukocytopenia & Thrombocytopenia
114
What is another toxic to bone marrow (other than cancer)
Chemotherapy
115
What are tumor markers?
Substances produced by cancer cells that are found on/in tumor cells, blood, urine, CSG, or urine
116
What are Tumor Markers used to do?
Screen Diagnose Observe clinical course of cancer
117
What 2 ways are tumors classified?
Type of tissue in which it originated | Primary site/location in body where it first developed
118
Carcinoma
Epithelial origin
119
Sarcoma
Supportive/Connective tissues
120
Myeloma
Bone Marrow
121
Leukemia
Blood
122
Lymphoma
Glands/Nodes of lymph system
123
Mixed Type
Can be a form of more than one category
124
Inflammation
A protective, coordinated response to an injurious agent
125
Inflammation is part of what type of immunity?
Innate
126
What are the 4 goals of Inflammation?
Wall-off area of injury Prevent spread Bring body defenses to injured area Prepare damage tissue to return to normal function
127
Acute Inflammation
Rapid Enhances healing Rids body of infectious agent
128
Chronic Inflammation
Persist more than 2 weeks Inhibits healing Causes cellular damage and organ dysfunction
129
3 Main Stages of Acute Inflammation
Vascular Permeability Cellular Chemotaxis Systematic Response
130
What is vascular permeability?
Vasodilation of blood vessels
131
What are the 2 main mediators of Vascular Permeability?
Histamine | Bradykinin
132
What blood components are Vascular Permeability trying to get to the site of injury?
Platelets WBCs Fluid
133
What does Vascular permeability cause?
Edema
134
Cardinal signs of Inflammation
``` Pain Redness Swelling Heat Loss of Function ```
135
Macrophages
A protein-rich filtrate that contains WBCs
136
Phagocytosis
Process of WBCs surrounding and consuming foreign material
137
Purulent Exudate
Edema fluid that is rich from proteins from WBCs, microbial organisms & cellular debris Ex. Pus (Bacterial/Protozoan)
138
Transudate
Edema fluid that contains little protein and is mainly a watery filtrate of blood Ex. Blister (No bacteria that give off debris)
139
Chemotaxis
Chemical signals attract platelets and WBCs to the site of injury during inflammation Ex. Secretion of histamine and bradykinin
140
Margination
WBCs arrive at the site of inflammation and line up along the endothelial lining of vessel wall
141
Emigration
Movement of WBCs from vascular space into the the extravascular space at the site of injury
142
What 3 blood component release Histamine?
Basophils, Mast Cells, Platelets
143
What things stimulate the secretion of Histamine?
Injury Immune reactions Cytokines
144
What is rhinorrhea
Runny Nose
145
What are clinical manifestation of the secretion of Histamine?
Rhinorrhea Eye tearing Sinus inflammation
146
Inflammatory mediators
Prostaglandins Leukotrienes Interleukins
147
Cytokines can ___ & ____ the inflammatory response
Build & Deactivate
148
Cytokines stimulate the ___ to release substance called Acute Phase Proteins
Liver
149
What are 3 Acute Phase Proteins?
C-reactive protein (CPR) Fibrinogen Serum amyloid A
150
CBC
Complete blood count | Includes: RBC, WBC, Platelets
151
C-Reactive Proteins (CPR)
Increases in acute inflammation from certain diseases
152
Erythocyte Sedimentation Rate (ESR)
Rate at which RBCs fall to bottom of the tube - quicker with inflammation
153
Antibodies are part of the H___ immune response
Humoral
154
Antibodies come from what kind of cell?
B cell
155
Types of WBCs
``` Neutrophils Monocytes > Macrophages Eosinophils Lymphocytes Basophils ```
156
Signs and Symptoms of Inflammation
``` Fever Pain General Malaise Lymphadenopathy (Swollen Lymph Nodes) Anorexia Lethargy Anemia ```
157
Necrosis
Tissue death
158
Example of Chronic Inflammation
Rheumatoid Arthitis
159
What is unique about Mycobacteria tuberculosis inflammation?
Produces a film so during acute inflammation it is unable to be phagocytize leading to chronic inflammation
160
Consequences of Chronic Inflammation
Tissue damage caused by persistent swelling Hypersensitivity Reactions Systemic Pathology linked diseases
161
Systemic Diseases linked to Chronic Inflammation
Obesity - inflammation of adipose tissue Atherosclerosis- inflammation leading to coronary artery calcification Shock- increased inflammation activity can lead to fibrinolysis which can lead to organ dysfunctions and death
162
Risk Factor for Inflammation
EVERYONE Very young or old Non-immunized Chronic illnesses
163
What does the liver do?
Synthesize: Bile, Albumin, Cholesterol, Thrombopoetin, Insulin, Angiotensinogen, Coagulation factors Conjugation of bilirubin Gluconegenesis Filters antigens out of the blood Detoxification Store Vitamins A, D & B12, Iron and Copper
164
Gluconegenesis
Production of glucose from non-carb substances (increase insulin levels)
165
Cirrhosis
Inflammation of the Liver
166
True/False: Cirrhosis is reversible
False
167
What are 2 main functional problems of Cirrhosis?
Worsens portal hypertension | Leads to toxin accumulation & metabolic alterations
168
What are 3 main structural problems of Cirrhosis?
Infiltration of Leukocytes Release of inflammatory mediators (Cytokine > Histamine) Scarring
169
How is Cirrhosis and Jaundice related?
The obstruction of biliary channel and blood flow leads to jaundice and portal hypertension
170
Clinical Manifestation of Cirrhosis
``` Ascites (Fluid in the abdomen) Jaundice Dark bloody stool Spider-like veins Confusion ```
171
Treatment for Cirrhosis
No cure Lifestyle changes (Low sodium diet) Paracentesis (Remove fluid from abdomen) Immunizations for Hepatitis viruses
172
Risk Factors for Cirrhosis
Hepatitis Drug/Toxin intake Excessive alcohol intake Portal hypertension
173
Rheumatoid Arthritis
Autoimmune disease that cause chronic joint inflammation and deterioration of joint surfaces
174
Rheumatoid Arthritis Pathology:
T cells interact with synovial fibroblasts converting synovium into a thick, abnormal layer of granulation tissue (Pannus)
175
Joint involvement in Rheumatoid Arthritis is ____ or ____
Bilateral or Symmetrical
176
Manifestation of Rheumatoid Arthritis
``` Gradual onset Swelling Pain Worse in the morning time Nodules ```
177
Treatment for Rheumatoid Arthritis
Anti-rheumatic drugs No cure Treat symptoms
178
Innate Immunity
"What your momma gave you" Present at birth Skin, mucus membranes, Normal flora Inflammation
179
Adaptive Immunity
Attained after birth | Active vs. Passive
180
Active Adaptive Immunity
Ex. Vaccines (Hepatitis A vaccine) | Exposure to an antigen to generate an adaptive immune response
181
Passive Adaptive Immunity
Ex. Mother to baby through breast milk OR Tetanus toxoid | Occurs after performed antibodies are introduced
182
Immune System Components
``` Bone Marrow Lymph Nodes Thymus Spleen Tonsils ```
183
Where are B & T cells produced?
Bone marrow
184
Where do B cells mature?
Bone Marrow
185
Where do T cells mature?
Thymus
186
What does the Spleen do for the immune system?
Store macrophages and clears cellular debris
187
What do T cells do?
Attack ALREADY INFECTED cells
188
What do B cells do?
Defend against invading cells (Line backers of immune system)
189
Killer T cells
Destroyers or detectives
190
Helper T cells
Activate B cells to produce antibodies
191
Suppressor T cells
"Bouncers" Keep the immune system from overreacting
192
Memory T cells
On 2nd exposure they transform into Killer T cells to destroy antigens
193
Humoral Immunity
Goal: prevent bacteria/viruses from entering host cells B cells are part of the humoral immunity Involves immunoglobulins
194
5 immunoglobulin classes
``` IgG IgM IgA IgD IgE ```
195
IgG
Most numerous The major antibacterial and antiviral antibody Found in all body fluids Passes through the placenta to the baby during pregnancy (Protects infant for first 6 months)
196
IgM
First immunoglobulin produced during immune response Kills Bacteria Only present in vascular system (too large to pass through membranes)
197
IgA
Found in body secretions | Defend body entrances (especially repiratory and GI tract)
198
IgD
Present in Plasma | On surface of B cells as a antigen receptor (Bind to antigens)
199
IgE
Involved in immediate hypersensitivity reactions (Type I) Defends against parasitic infections Stimulates Mast cells to release Histamine & Heparin
200
Complement System
Part of Humoral immunity | Major mediator of the inflammatory response
201
4 Types of Hypersensitivity Reactions
Type I-IV
202
Type I Hypersensitivity Reaction
IgE mediated Immediate response Ex. Peanut allergy (Anaphalatic reaction)
203
Type II Hypersensitivity Reaction
Tissue specific Immediate response Ex. Blood transfusion
204
Type III Hypersensitivity Reaction
Immune complex reactions Immediate response Ex. Lupus
205
Type IV Hypersensitivity Reaction
Cell-Mediated response Delayed response No antibody involved Ex. Jewelry sensitivity or poison ivy
206
Allergic Reaction Clinical Manifestations
Hives Edema Itching
207
Allergic reaction
Exaggerated response of the immune system
208
Allergic reactions usually do not occur on ___ ____
First exposure
209
Type I reaction sequence
Exposure B cells stimulated Cells mature into IgE IgE bond to antigen receptors
210
What medication do you give for Allergic Reactions?
Benadryl (Anti- histamine) | Zantac (Anti-heparin)

Pathophysiology (12 decks)

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