exam 2 Flashcards
two major components of immune system
cellular immune system (T lymphocytes)
humoral immune system (B lymphocytes)
autoimmune diseases
too much
immunodeficiency diseases
too little
autoimmune hemolytic anemia
affects red blood cells; anemia, fatigue, weakness, splenomegaly (enlarged spleen). the anemia can be severe and even fatal
Goodpasture’s syndrome
lungs and kidneys; shortness of breath, coughing up blood, fatigue, swelling, and itching; prognosis is good if treatment begins before severe lung or kidney damage occurs
Graves’ disease
thyroid gland; hyperthyroidism (the thyroid gland is stimulated and enlarged, resulting in high levels of thyroid hormones); symptoms may include a rapid heart rate, intolerance of heat, tremor, weight loss, and nervousness; with treatment the prognosis is good
pemphigus
skin; large blisters form on the skin; the disorder can be life-threatening
type 1 diabetes mellitus
beta cells of the pancreas which produce insulin; symptoms may include excessive thirst, urination, and appetite, as well as various long-term complications; lifelong treatment with insulin; the prognosis varies greatly and tends to be worse when the disease is severe and lasts a long time.
rheumatoid arthritis
joints or other tissues, such as lung, nerve, skin and heart tissues; symptoms may include fever, fatigue, joint pain and stiffness, deformed joints, shortness of breath, loss of sensations, weakness, rashes, chest pain, swellings under the skin; the prognosis varies
scleroderma
excessive collage disposition in skin and internal organs such as lung, GI tracts, heart and kidneys; thickened skin, edema, ischemia of fingers, pain…symptoms cry depending on whether disease is progressive or limited
multiple sclerosis
brain and spinal cord; the covering of affected nerve cells is damaged and therefore, cell cannot conduct nerve signals
systemic lupus erythematosus (lupus)
joints, kidneys, skin, lungs, heart, brain and blood cells; symptoms of anemia and those of kidney, lung, or heart disorders may occur; a rash may develop; the prognosis varies widely, but most people can lead an active life despite occasional flare-ups of the disorder
vasculitis
blood vessels; vasculitis can affect blood vessels in one or several parts of the body; symptoms may include rashes, abdominal pain, loss of vision, and symptoms of nerve damage or kidney failure. the prognosis depends on extent of tissue is damage
how autoimmune reactions can be triggered
a substance in the body that is normally hidden from the immune system is released into the bloodstream; a normal body substance is altered, by a virus, drug, sunlight or radiation; the altered substance may appear foreign to the immune system; a foreign body substance that resembles a natural body substance may enter the body; the immune system may inadvertently target the similar body substance as well as the foreign substance; the cells that control antibody production (b lymphocytes) may malfunction and produce abnormal antibodies that attack someone the boyd’s cells
diagnosis of inflammation
erythrocyte sedimentation rate: often increased because proteins that ar produced in response to inflammation interfere with the ability of red blood cells (erythrocytes) to remain suspended in blood; presence of specific antibodies: such as antinuclear antibodies (present in system lupus erythematous), rheumatoid factor (present in rheumatoid arthritis)
treatment of autoimmune disease
suppressing the immune system
malar rash
butterfly rash; lupus
primary/congenital immunodeficiency diseases
antibody ID impaired production
T-cell ID
combined ID; reduced Abs; T-cell defects
antibody ID impaired production
Bruton X-linked; agammaglobulinimeia; selective IgA deficiency; common variable ID
T-cell ID
DiGeorge Syndrome
chronic mucocutaneous candidiasis
combined ID reduced Abs T-cell defects
adenosine deaminase deficiency; wiskott-aldrich syndrome
HIV mechanism
primarily infects CD4+ T-lymphocytes by attaching to cell-surface receptor molecules on the cell membrane; using them to gain entry to the cell
clinical AIDS
when a significant number of CD4 cells have been destroyed and production of new CD4 cannot match destruction, then failure of the immune system leads to the appearance of clinical AIDS. Normal CD4 values: 500-1200 cells/microliter
A decrease in the total CD4 count below 500 cells/microliter
presages the development of clinical AIDS
a drop below 200 cells/microliter for CD4 count
indicates a high probability for the development of AIDS-related opportunistic infections and/or neoplasms
reason for AIDS-related malignancies
could be due to the decreased activity of NK cells which target tumor cells
kaposi’s sarcoma
a cancer of the blood vessels; characterized by purplish lesions on the skin
pneumocystis carinii pneumonia (PCP)
PCP is a life-threatening opportunistic infection; which virtually always affects the lungs, but other organs can be involved, including the lymph nodes, spleen, liver, and bone marrow; symptoms includes fever, a dry cough, chest tightness, and difficulty breathing
herpes simplex virus (HSV)
HSV can cause oral herpes (cold sores) or genital herpes which re relatively common infection but they can be much more frequent and severe in HIV-infected individuals
mycobacterium avid complex (MAC)
bacterial infection with mycobacterium avid can cause recurring fever, painful intestines, weight loss and anemia; almost half o those with late-stage HIV diseases are infected with MAC bacteria
cytomegalovirus (CMV)
a herpes-type virus that can cause eye disease and blindness; usually causes disease when the CD4+ count is very low
most common HIV-related opportunistic infection and can occur even in those with a fairly high CD4+ count
oral/oropharyngeal candidiasis
smoking mechanism
nicotine and carbon monoxide decrease plasma high density lipoprotein levels, increase plasma fibrinogen, increase leukocyte counts, predisposes to MIs and stroke
smokers at higher risk for the following “other” diseases
chronic, bronchitis/empysema, peptic ulcer disease, ocular disease, for women (osteoporosis, thyroid disease, earlier menopause)
environmental tobacco smoke is a risk factor for
lung cancer, respiratory illness and hospitalizations, coronary artery disease, sudden cardiac death
drug abuse deaths
17,000 deaths/yr
oral contraceptive complications
vasculature or reproductive: 1. deep vein thrombosis, 2. no increased risk for MI or ischemic strokes, 3. decreases tumors of female reproductive organs (except benign liver adenomas), 4. breast cancer - still controversial
HRT risk and benefit
reduce myocardial infarction and osteoporosis; increased risk for breast and endometrial cancer
volatile organic solvents and vapors
chloroform, carbon tetrachloride, trichloroethylene, methanol, ethylene glycol, gasoline & kerosine, benzene
number of people who die from pesticide poisoning
30-40 per yr
what can agricultural chemicals cause
acute responses include neuromuscular disorder; chemicals used in agriculture may pose potential long term risks and toxicity
aromatic halogenated hydrocarbons
polychlorinated biphenyls (PCBs), chlorphenols, hexachlorophene, dioxin TCCD
air pollutants
the combustion of fossil fuels, sulfur dioxide, oxides of nitrogen, CO ozone, carbon monoxide
50% Co
coma/ convulsions
60% CO
fatal
lead
1950s exposure a pediatric problem;
“pica” chewing on cribs;
environmental lead contamination; adults occupational exposure
metabolism of lead
absorbed lungs or GI tract; crosses BBB; concentrates brain, liver, kidneys, and bone marrow; interferes with zinc dependent enzymes, those involves with zinc dependent enzymes, those involved in synthesis of cell membranes and steroids
lead encephalopathy
edematous, grain, flattened gyro, compressed ventricles, neural necrosis, vascular lesions
peripheral motor neuropathy
caused by lead; most common manifestation; radial and perineal n. –> wrist drop, foot drop
anemia
caused by lead
mercury
released into the environment; may enter food chain; bacteria convert inorganic mercury compounds from industrial wastes into highly neurotoxic compounds; transferred up food chain to large predatory fish (tuna, pike); nephrotoxicity, neurotoxicity
arsenic
like compounds used in insecticides, weed killers, wood preservatives & pigments; bioaccumulation in food chain; CNA toxicity –> death; multiple symptoms; cancer of skin, respiratory tract and GI tract
nickel
widely used metal; “dermatitis”; exposed workers increase risk for lung cancer, nasal cavity cancer
hypothermia
systemic; decrease in body temp below 35 C; immersion water between 4-10C leads to decrease in core body temp; increase premature ventricular contractions, arrhythmias, fibrillations; w/in 30 min head loss exceeds production, below 35 C respiratory rate, heart rate and BP drop; below 28 –> coma; death caused by cardia arrhythmia or sudden cardiac arrest
hypothermia focal
local decrease in tissue temp –> local vasoconstriction; crystallization of tissue water; denaturation of macromolecules; disruption of cell membrane; sig injury is in endothelial lining of capillaries and venues (alter small vessel permeability, vascular occlusion causes gangrene)
systemic hyperthermia
fever (increase heat production, decrease heat elimination, disturbance of regulatory center); body temp above 108.5 degrees F –> profound functional disturbances
heat stroke hyperthermia
occurs under high temps; impaired cooling response; vigorous exercise; only external cooling and fluid/electrolyte replacement are effective; malignant hyperthermia - thermal alteration, hyper-metabolic state, rhabdomyolysis
local hyperthermia
burns
cutaneous burns
50C - sustains 10+ minutes w/o cells each; 70 C - seconds of exposure = epidermal death
first degree burns
mild sunburn, mild endothelial injury
second degree
epidermal necrosis, spare dermis
third degree
char epidermis and dermis, cell structure lost
healing of cutaneous burns
relative to tissue destruction; first and second heal without scarring; third degree burns: can re-epithelialize, require new epidermis or cultured autologous keratinocytes
inhalation burns
destroy epithelium from oral cavity to alveoli
electrical bruns
death via ventricular fibrillation
mechanical trauma
- force transmitted to the tissue, 2. rate, 3. surface area, 4. area of body
abrasian
tangential force
laceration
splitting/tear; common over bony prominences; usually not produced by sharp objects
wounds
disruption of tissue integrity; incision, deep penetrating wounds
radiation
the transmission of energy by electromagnetic waves; includes charged particles (alpha, beta, neutrons); modes of measurement - rad, gray, sievert; different tissues vary in sensitivity; more proliferative = more sensitive
300 cGy
hematopoietic failure within 2 weeks
10gy
GI system; epithelium destroyed, diarrhea and dehydration
20 Gy
CNS damage, death within hours
genetic effects of whole body irradiation
low risk
radiation pathology
compromised vascular supply, fibrotic repair reaction, small arterioles and arteries
acute clinical features of radiation
pneumonitis, cystitis, dermatitis
chronic clinical features of radiation
interstitial fibrosis; constructive pericarditis
how much did leukemia increase from japan nuclear bomb
10 fold
radon
decaying uranium found in soil/rocks; decay products are chemically active alpha particles; high levels in homes increase risk for lung cancer; may only be in smokers/ex-smokers
