Exam 1 Material Flashcards
1
Q
What is the definition of health?
A
1)Attain lives free of presentable diseases, disability, injury and premature death
2)Achieve health equity and eliminate disparities
3)Promote good health for all
4)Promote healthy behavior across the lifespan
2
Q
What is disease?
A
An acute or chronic illness that one acquires or is born with that causes physiological disfunction in one or more body structures
3
Q
What is pathophysiology?
A
Physiology of altered health
Study of the structural and functional changes in cells, tissues and organs that cause or are caused by disease
4
Q
What is etiology?
A
The causes of disease
5
Q
What is pathogenesis?
A
How the disease process evolves
6
Q
What are the 5 manifestations?
A
Sign, symptom, syndrome, sequela, complication
7
Q
Manifestions:
What is a sign?
A
a manifestation noted by an observer
8
Q
Manifestions:
What is a symptom?
A
A subjective complaint noted by the person who has the disorder
9
Q
Manifestions:
What is a syndrome?
A
A compilation of symptoms that are characteristic of a specific disease state
10
Q
Manifestions:
What is a sequela?
A
Lesions or impairments that follow or cause disease; a predictable result of disease; result is anticipated
EX: Fatigue from pnemonia
11
Q
Manifestions:
What is a complication?
A
A possible adverse extension of disease or outcome of treatment; an unexpected result that actions are taken to prevent
EX: sepsis from pnemonia from bacteria in lungs spreading to bloodstream
12
Q
Timelines:
What is the difference between acute and chronic?
A
Acute is relatively severe but self limiting while chronic is a continuous long term process
13
Q
Timelines:
What is considered preclinical?
A
A disease that is not clinically evident but will progress to a clinical; patient most likely will not notice
14
Q
Timelines:
What is subacute?
A
Intermediate between acute and chronic
15
Q
What is an incidence?
A
Rate at which a certain event occurs
EX: The number of new cases of a specific disease during a particular point in time in a at risk population
16
Q
What is prevalence?
A
The number of new and old cases of a disease in a population at a given time
17
Q
What is morbidity?
A
The effect an illness has on a persons life
18
Q
What is mortality?
A
The cause of death in a given population
19
Q
What is primary prevention?
A
Keeping disease from occuring by removing risk factors
EX: Folic acid to prevent spinabifida
20
Q
What is secondary prevention?
A
Detects disease early when it is still asymtomatic and treatment measures can still effect or stop a disease from spreading
21
Q
What is tertiary prevention?
A
Directed at clinical interventions that prevent further deterioration or reduce complications
22
Q
What are the main causes of atrophy?
A
Lack of movement, blood supply, hormone or malnutrition
23
Q
What two types of tissue does atrophy appear in?
A
Muscles and fat
24
Q
What is atrophy?
A
A decrease in cell size
25
What is hypertrophy?
An increase in cell size
26
What is an example of a physiological hypertrophy?
Gaining muscles
27
What are the two types of a pathological hypertrophy?
Compensatory and Adaptive
28
What is compensatory hypertrophy?
An organ may grow in size to make up for a missing organ-like a kidney
29
What is adaptive hypertrophy?
We may see hypertrophy appear because an organ is under too much strain, for example in the myocardium
30
What is Hyperplasia?
a increase in the number of cells; not always pathological in nature
31
What is metaplasia?
An area of tissue where cells are not expected type-> most likely a different subtype
32
What is displasia?
The cells are disorganized; they are the wrong size, age, arrangement
-Strong indicator of cancer
33
What is the difference in distrophic tissue calcification and metastatic tissue calcification?
Distrophic is calcification in a set area from injured or dead cells-can see calcification macroscopically
Metastatic is high calcium in the blood which leads to calcium deposits in tissues, no tissue damage, can only see microscopically
34
What two causes might cause metastatic calcification?
Bone cancers or parathyroid disorders
35
What are the types of blunt physical injury?
Contusion (bruise)
hematoma (bleeding beneath skin)
Abrasions (scrape in large area)
Laceration (tear in skin, accidental)
Fracture
36
What are the two types of Heat injury?
low intensity: damage to capillaries and cell membrance
high intensity: Worse damage to blood vessels, coagulations of proteins
37
What occurs during cold injuries?
Blood has a high viscosity and vasoconstriction in blood vessels
38
What are examples of ionizing radiation?
Gamma rays, Xrays,
39
Where does ionizing radiation sit on the UV spectrum?
Higher than the UV spectrum
40
Substances that are not fully phagocytosed end up?
Substances often accumulate in the cytoplasm (frequently in the lysosomes) or in the nucleus
41
How could one become injured from non-ionizing radiation?
Injuries would be caused by heat because non-ionizing radiation's excess vibrations create thermal energy
42
What are two examples of non-ionizing radiation?
ultrasound, microwave
43
What is hypoxia?
deficency of oxygen directly in cells or tissues
44
What is hypoxemia?
deficency of oxygen in the blood
45
What are two causes of systemic hypoxia?
airways issues, lack of hemoglobin to transport O2
46
Localized hypoxia is caused by?
reduced arterial blood flow to tissues
47
Perfusion is the?
steady blood flow through arteries
48
What are the hypoxic injury effects?
Aerobic metabolism is impaired
Lactic acid buildup
Sodium/potassium pump halt
49
What is the result of the Sodium/potassium pump halt during an hypoxic injury?
The sodium and water contents of the cell build up and the cell becomes an acidotic water logged cell. If it continues, the lysosomal membranes and cell membranes will rupture
50
Ischemia is caused by?
Impaired blood supply with the most common cause being localized hypoxia
Athlerosclorosis is normally the reason
51
In an ischemia the tissue is?
impaired but not yet dead-can be reversible if blood supply is returned
52
What is Athlerosclorosis?
Buildup of plaque on walls of arteries
53
What is an Infarction?
Death of tissue caused by studden stoppage of blood supply and complete lack of O2
54
What is necrosis?
Localized cell death due to irreversible damage that is unplanned
55
What can happen to cells undergoing necrosis?
The unregulated cell digestion by enzymes and products being reduced into intracellular spaces can cause inflammation and cells may undergo liquefaction or coagulation
56
What is gangrene?
a large area of necrosis that is visible macroscopically
57
What normally causes gangrene?
an ischemia or infarction
58
Gangrene doesn't just involve necrosis-what other factor deliniates gangrene from regular necrosis?
Saprophytic bacteria grows over the dead tissue feeding on the dead cells
59
What are the 3 types of gangrene?
Dry
Wet
Gas
60
What are the characteristics of dry gangrene?
Tissue has a dry, shriveled, wrinkled appearance that is dark in color and shows a line of demarcation
Normally seen in extremities
61
What causes dry gangrene?
Blockage of arterial blood flow
62
What are the characteristics of wet gangrene?
Tissue is cool, swollen and fluid filled. Presence of fluid filled blisters called bullae
Can occur in extremities or internally
63
What are the characteristics of gas gangrene?
Tissue is discolored with pockets of gas
64
What causes gas gangrene?
Clostridia bacteria in tissue, normally caused by a deep puncture wound.
As the bacteria spread they create gas
65
What are the two levels of immune defense?
1) Natural physical, chemical and mechanical barriers that prevent microorganisms from entering the body
2)Adaptive and Acquired immunity
66
If a tissue is vascular, what should you immediately know about it?
Contains blood vessels
67
What is the purpose of inflammation?
Gets tissue ready for repair
If a pathogen is introduced in an injury, inflammation will limit the pathogen and keep it contained
Helps transition to adaptive immunity
68
When you see the suffix of -itis on a word, what do you know about it?
it indicates an inflammatory condition
69
How long is acute inflammation?
It should be less than two weeks to return to normal
70
How long does it take acute inflammation to start?
minutes to hours
71
Which immune cell mostly responds in acute inflammation?
Neutrophils
72
In chronic inflammation, which immune cell responds after the acute period?
Macrophages
73
What are the 3 components of inflammation?
Vascular phase
Cellular phase
Inflammatory mediators
74
What coordinates the vascular and cellular phases?
Inflammatory mediators
75
What occurs in the vascular phase?
A very brief (a second or two) vasoconstriction or arterioles followed by vasodilation of arterioles and increased capillary permeability and dilation
76
What are the overall results of the vascular phase of inflammation?
-Vasodilation and increase capillary permeability
-Increased blood flow to area
-Macrophages and WBC are able to get access to area
-Aids in clotting
77
The vascular phase timing can change based on the?
Area of injury
78
What occurs during the cellular phase?
-A high concentration of leukocytes arrive near the injury cite because of chemical mediators released during the vascular phase. These leukocytes leak out of capillaries into tissue
79
During the cellular phase, what is the purpose of leukocytes?
Direct result: They conduct phagocytosis
Indirect result: They call more cells to the area
80
When mast cells are damaged they degranulate releasing 3 chemicals. What are they?
Histamine
Neutrophil chemotaxic factor
Eosinophil chemotaxic factor
81
The chemotaxic factors released by the mast cells pull ____________ out of the blood.
neutrophils
82
The main cell of acute inflamation that always circulates in the blood is?
Neutrophils
83
The function of the 1st to arrive neutrophils is to?
immediately start phagocytosis in the blood and release other chemotaxtic factors
84
Macrophages/monocytes are attracted to the injured area by
neutrophils
85
What is the function of Macrophages/Monocytes?
Phagocytosis
86
If a young neutrophil count is up, this would be an indicator of an?
immune response
87
What are the plasma derived mediators?
Kinin (Bradykinin)
Coagulation factors that form clots
Complement System Proteins
88
What are the cell derived mediators?
Histamine, Serotonin
Arachidonic Acid Metabolites
Nitric Oxide
Cytokines
89
What are the cell derived mediators that are made from Achidonic Acid Metabolites?
Leuktrienes, Prostaglandins, Thromboxane
90
What are the meanings of these words:
Rubor
Calor
Tumor
Dolor
Functio Laesa
Rubor-Erthema-Redness
Calor-Heat (increased blood flow)
Tumor-Swelling
Dolor-Pain
Functio Laesa-Loss of function
91
What is exudate?
Fluid accumulated in inflammed tissues usually containing plasma, WBC and proteins
92
What are the 4 different type of exudate?
Serous, Fibrinous, Purulent/suppurative, hemorragic
93
What increases body temp/ causes a fever?
Pyeogens-which are produced by both bacteria and leukocytes
94
The MCV count is the
mean corpuscular volume
The average size of RBC
95
Hematocrit is?
The percentage of RBC in blood
96
Reticulocytes are? What is the Reticulocyte count?
Immature RBC and the reticulocyte count is the number of these in the blood
97
What is a normal WBC count
3.7-11K/uL
98
What are the 3 types of Lymphocytes?
B-cells
T-cells
NK cells
99
What is the average RBC count?
4-6 mill/mm^3
100
What is the average MCV?
81-96 um^3/RBC
101
What is the average hemoglobin concentration?
12-16% for women
40-54% for mean
102
What is the average reticulocyte count?
1-2%
103
What are the 3 important processes for Hemostasis?
Transient vasoconstriction
Platelet activation
Activation of clotting factors
104
What are the phases of hemostasis?
Vasoconstriction
Platelet plug formation
Activation of clotting cascades
Formation of a blood clot
Dissolving of a clot
105
What is the average lifespan and count of platelets?
Lifespan of 10 days
A average of 150,000-400,000/mm^3
106
What is PTT or PT?
Both measure how long a sample takes to clot after chemicals are added
PTT-activated partial thromboplastin time (normal 40s)
PT-Prothrombin time (normal 11-13 sec)
107
The INR is the ratio of?
PT/normal
PT-prothrombin time
108
What is the normal WBC count?
3,700-11,000/mm^3
109
What is the average concentratin of neutrophils in WBC?
55-65%
110
What is the average concentratin of eosinophils?
1-3%
111
What is the average concentratin of basophils?
0.3-0.5%
112
What is the average concentratin of lymphocytes in WBC?
20-30%
113
Neoplasm is a term for?
Malignancy (cancer)
114
Leukopenia/Neutropenia is a?
Decreased WBC count, that most often effects neutrophils
115
A neutrophil count of less than 1000ul would be an indicator of?
Neutropenia
116
Neutropenic precautions are taken if the ANC count is below _______. These precautions are?
below 500ul
Precautions are reducing any risk of possible infection
117
Agranulocytosis is?
A severe lack of neutrophils; the abscense of almost alm
118
If a patient is in agranulocytosis, how might you see an infection present itself in the patient?
The infection may not show any normal manifestations of infection because of the lack of neutrophils
119
Leukocytosis is?
An incresse in WBC, specifically neutrophils that is often a temporary response to infection but ever so occasionally can be chronic
120
Infectious Mononucleosis is?
A self limiting lymphoproliferative disorder usually due to Epstien-Barr virus or CMV (cytomegalovirus)
121
Infectious Mononucleosis is spread via? and is most common in what demographic?
Contaminated saliva and is most common in teenagers and young adults
122
What is the time frame for Infectious Mononucleosis?
4-6 week incubation period, then a prodromal period then overt symptoms
Acute phase lasts 2-3 weeks
Full recovery in 2-3 months
123
What are the symptoms of Infectious Mononucleosis?
Fever, pharyngitis, lmphadenopathy, possible hepatitis, malaise, spenomegaly/inflammation, fatigue, leukocytosis
124
A lymphoma is?
a malignancy of the lymphatic system
125
Where does the initial lymphoma tumor present itself?
in the 2ndary lymphatic organs
126
An adult patient has a solid tumour in the lymph tissue, specifically in the lymphnode. A needle biopsy is done, and there is an abscense of Reed-Stendenburg cells. The patient is not reporting any chest discomfort. Based on this information, what type of lymphoma would it seem to be?
Non-Hodkins lymphoma
127
A teenage patient comes inn complaning of chest discomfort. A tumour is found in the chain of lymphnodes in the diaphram. Upon a biopsy, a large abnormal lymphocute with 2 nuclei was found. What type of lymphoma would this appear to be?
Hodkins Lymphoma
128
What is a leukemia?
A proliferation of malignant hematopoietic stem cells which replace normal bone marrow cells and move out into the blood.
129
Leukemia would be considered what type of cancer?
A blood cancer
130
What is the most common cause of cancer in children?
Leukemia
131
A child comes in with a sudden onset of symptoms including malaise, fever, bleeding, bone pain and tenderness, abdominal discomfort, anemia. A sample of blood and bone marrow is taken. The sample shows a high count of immature lymphoblasts and a low erythrocyte and platelet count. What might be the diagnosis for this patient?
Acute Lymphocytic Leukemia
132
If a high number of immature myeloblasts are found in a bone sample instead of lymphoblasts-what type of leukemia would this be?
Acute Myeloid leukemia
133
An older adult patient comes in with various leukemia manifestations such as lymphadenopathy, anemia and bleeding problems. Upon a sample the WBC count is over 20,000 with lymphocytes being 70-90% of the count. What is the most likely cause?
Chronic Lymphocytic Leukemia
134
A patient comes in with anemia, fatigue and lymphadenopathy. The patient has a high WBC count and a lymphoblast count of over 100,000. The patient has a genetic panel run and it is returned with the presence of a 'philadelphia chromosome'. What is the most likely cause of the symptoms?
Chronic Myelogenous Leukemia
135
A philadelphia chromosome is a?
Translocation of portions of chromosome 9 and 22
136
In older adults Malignant B-cells produce M proteins (or Bence-Jones) protiens that damage bones (especially the skull. What type of leukemia would this be?
Multiple Myeloma
137
Anemia is?
a lowering in number, size or hemologlobin concentration in RBC
138
A polycythemia is>
and increase in the size of RBC
139
The mean corpuscular hemoglobin concentration or MCHC is?
What gives the RBC their color due to the hemoglobin concentration. Not enough results in hypochromic (pale) RBC
140
Macrocytic would be an indicator of what with a RBC?
Large size
141
Normochromic, normocytic RBC but with just a low concentration would indicate what type of anemia?
Acute blood loss anemia, Hemolytic Anemia or Aplastic anemia.
RBC's are normal but due to the bleed there isn't enough to have proper perfusion
142
RBCs that are microcytic, have a low MCV and hypochromic would be an indication of what type of anemia?
Chronic blood loss anemia
143
A hemolytic anemia is an anemia caused by?
Destruction (hemolysis) due to intrinsic or extrinsic problems with RBC
Intrinsic: Defective hb, imparied globulin synthesis, membrane defects, enzyme deficences
Extrinsic: Isoimmune or autoimmune responses, malaria, hyperspeenism
144
A patient comes in with jaundice and a bone marrow sample shows a hyperactive number of reticulocytes. What is the most likely cause?
Hemolytic anemia
The jaundice is caused from high bilirubin levels
145
What is Sickle Cell disease?
An autosomal recessive genetic mutation that changes the structure of Hb to HbS and is the most common form of hemolytic anemia
146
1/600 African Americans have what type of Anemia?
Sickle cell
147
What is a sickle cell crisis?
When a desaturated HbS mol changes shape or 'sickles' which can cause the RBC to clump together causing vascular occlusion especially in the capillaries
148
What are the common manifestations in sickle cell?
Vaso-occlusive pain
Acute chest syndrome
Bone pain, swelling, slowed bone growth
Neurological complications
Infection risk
149
What are the causes for deficent erythrocyte production?
Lack of essential "building blocks" for RBC
Disruption of Bone Marrow Function
Chronic damage of kidneys or liver
150
Iron deficent Anemia is caused by?
low iron intake, impaired absorption of iron, or iron loss
151
RBCs in iron deficent anemia would be classified as?
microcytic, hypochromic
152
What are the two causes for Megaloblastic Anemia?
B12 or Folic Acid deficency
153
A B12 deficency can cause?
A problem with maturation and division of RBC and maintence of myelin sheaths
154
How is B12 absorbed?
In the stomach the B12 molecule links with the parietal cells in stomach and then is absorbed through the small intenstine
155
What are the causes for a Folic acid deficency?
Malnutrition, Poor diet
Alcoholism or malabsorption problems are most likely causes
156
Aplastic Anemia is?
A disorder of the stem cells in the bone marrow. A very high stem cell is the cause.
157
Aplastc Anemia can become life threatening when?
it causes pancytopenia which is a low count of WBC, Platelets or any blood cell
158
How can chronic kidney disease cause anemia?
The kidney secrets erythropoietin which stimulates RBC stem cell production. If the kidney doesnt secret the right amount then you can end up with microcytic hypochromic RBC
159
Primary Absolute Polyscythemia is?
A neoplastic disease of bone marrow and all blood cell counts are high. This contributes to high blood viscosity and clots
160
How is primary Absolute Polyscythemia treated?
Phlebotomy or medication to lower platelet aggregation and WBC count
161
Secondary Absolute Polyscythemia is?
high levels of erythropoietin due to chronic hypoxia
162
What is the treatment of secondary Absolute Polyscythemia?
Supplemental O2, cescation of smoking, better management of COPD
163
What is relative polythemia?
A reduction in the amount of plasma that causes a relative increase in hematocrit. No more RBCs are produced but the decrease of plasma
164
What are the causes of relative polythemia and the treatment?
Dehyrdration, medications, pretty much anything that causes loss of blood volume.
Oral or IV fluids
165
What is Edema?
An accumulation of excess fluid in the ISF
166
The "tissue space" is referred to as the?
ICF
167
The venus space is referred to as the?
IVF
168
A high capillary hydrostatic pressure is the?
pushing pressure from fluid inside the capillaries
169
The low oncotic pressure is the?
same as osmotic pressure
The pressure of fluid compartment based of the concentration of particles in a compartment attract water in the compartment
170
What is an example of oncotic pressure?
Albumin in capillaries are to large to cross the membrane, so if a buildup occurs, it will draw in water if water content is too low
171
Edema can be caused by what 6 Factors?
1) decreased production of plasma proteins
2)decreased capillary oncotic pressure
3)Increased capillary hydrostatic pressure->net movement of fluid into ISF
4)Lymph vessel obstruction->decreased ISF absorption via lymph vessels
5)High tissue oncotic pressure
6)Increased capillary permeability->loss of plasma proteins
172
A pitting edema would be diagnosed how?
If you push thumb or finger into tissuse and an indentation remains due to tissue overload
173
A nonpitting edema is caused by?
Fluid, but it also contains other substances that provide structure
174
What is third spacing?
The movement of a large amount of fluid into one of the transcellular fluid compartments
175
What causes third spacing?
Poor lymphatic drainage that causes the trapping of fluid in transcellular spaces
176
Body Fluid Imbalances:
Volume imbalance
the loss/gain of equal amounts of H2O and electrolytes
Causes change in ECF
Proportionate
177
Body Fluid Imbalances:
Osmolality imbalances
Unequal loss/gain of water and electrolytes that causes change in ICF
178
What is Ascites?
Accumulation of fluid between lining or peritoneal lining
179
What are the mild effects of a ECF volume deficit and what percentage of water loss means mild?
2%
Thirst
180
What are the moderate effects of a ECF volume deficit and what percentage of water loss?
5%
Worsening thirst, dry mucous membranes, poor skin tugor, BP drop, increased HR, orthostatic hypotension, decreased urine volume, high Hgb/Hct/BUN
181
What are the severe effects of a ECF volume deficit and what percentage of water loss?
8%
Pallor, worsening BP drop, tachycardia, weak pulses, severely decreased urine output, change in LOC
182
What are the potientially fatal effects of a ECF volume deficit and what percentage of water loss?
>8%
Anuria and severly decreased BP
183
What are the effects of ECF excess?
Mild weight gain is best indicator
Increased BP
High venus distension
Often edema because distension increases capillary hydrostatic pressure
184
Osmolality imbalances are usually due to?
overall excess of deficency of sodium
Hyperglycemia in diabetes mellitus is less common cause
185
Osmolality imbalances between ECF and ICF cause a shift of water. Which direction?
Plasma shift between tissues into cells
186
Hypoatremia occurs when?
kidneys fail to excret water
excessive hypotonic IV fluids
compulsive water drinking
Think: Na < 135mEq/l
187
What are the symptoms of hypoatremia?
Muscle cramps
decreased reflexes
weakness
188
What is the treatment of hypoatremia?
Water restriction or Na administration
189
What are the causes of Hyperatremia?
Inadequate intake of H2O from waterloss (due to fever/diaphoriesis/burns/diarrhea/renal problems/Diabetes insipitus)
excess hypertonic IV fluids
190
What are the symptoms of hyperatremia?
thirst
lethargy/irritability progressing to seizures/coma
increased body temp
dry mucous membranes
oligura
191
What are the serum Na numbers for someone experiencing hyperatremia?
Serum Na>145mEq/L
192
What are the causes of hypokalemia?
decreased dietary intake of potassium
GI losses
Shift in cells (H+/K+ buffer system)
Increased loss in kidneys (through physiology or diuretics
193
What are the symptoms of hypokalemia?
Fatigue
Weakness/muscle cramps
decrease in deep tendon reflexes
EKG changes-depressed T waves**
194
What are the causes of hyperkalemia?
Inadequate renal excretion
Shift of fluid to ECF*
Excess oral intake
*acidosis, burns, crush injuries
195
What are the symptoms of hyperkalemia?
Muscle weakness
Dyspenea
Dysrythmias
Peaked T waves******
196
Can there be a human error in the diagnosis of hyperkalemia?
Yes-
An incorrect blood drawing technique, a tournquet left on too lonf, a tube of blood being shaken; anything that can cause the RBC to hemolyze releasing the potassium into the IVF
197
PaO2 is?
the amount of free dissolved O2 floating in plasma not attached to hemoglobin
198
What is the standard lab value for PaO2?
80-100mmHg
199
What are the numbers to indicate Acidosis or Alkadosis regarding pH?
<7.35=Acidosis
>7.45=Alkadosis
200
What is the normal PaCO2 range?
35-45mmHg
201
What is the standard HCO3 range?
22-26mEq/l
