Introduction Flashcards
1
Q
The study of disease–what goes wrong with the body, how it goes wrong, and why the signs and symptoms occur
A
pathophysiology
2
Q
topography of disease–localized to a specific area
A
focal
3
Q
topography of disease–infecting an entire organ
A
diffuse
4
Q
topography of disease–multiple focal areas of infection
A
disseminated
5
Q
topography of disease–involving an entire organ system
A
systemic
6
Q
topography of disease–just everywhere in the body
A
generalized
7
Q
time course of disease–hours to days
A
acute
8
Q
time course of disease–week to a couple months
A
subacute
9
Q
time course of disease–months to years
A
chronic
10
Q
the cause of a disease
A
etiology
11
Q
the sequence of cellular, biochemical, and molecular events that follows exposure to an injurious agent. Mechanism of disease development; includes the cellular/tissue response
A
pathogenesis
12
Q
specifically distinctive or characteristic of a disease; a sign or symptom on which a diagnosis can be made
A
pathognomonic
13
Q
list of possible diagnoses that are applicable to a specific patient or finding
A
differential diagnosis
14
Q
the “normal” steady state of the body
A
homeostasis
15
Q
the reversible new and altered steady state; response to physiologic stresses and some pathologic stimuli
A
adaptation
16
Q
an increase in the number of cells–can be hormonal or compensatory; caused by increased local growth factors-can by pathologic leading to cancer
A
hyperplasia
17
Q
increase in cell size; physiologic or pathologic
A
hypertrophy
18
Q
decrease in number and/or size of cells
A
atrophy
19
Q
when cells change type–sometimes setting up for cancer
A
metaplasia
20
Q
the cell death process that results from abnormal stresses; always pathologic
A
necrosis
21
Q
internally controlled cell suicide; frequently normal
A
apoptosis
22
Q
“new growth” tumor; abnormal mass of tissue with excessive and unregulated proliferation
A
neoplasia
23
Q
cancerous neoplasms are ___
A
malignant
24
Q
noncancerous neoplasms are ___
A
benign
25
a ____ disease/disorder is present from birth
congenital
26
a ___ disease/disorder is obtained from external sources after birth, not genetic (even though there can be a genetic predisposition)
acquired
27
supporting or connective tissue and muscle cells are considered ___ cells
mesenchymal
28
____ cells line or cover body surfaces and serve as interfaces that may be absorptive or secretory
epithelial
29
epithelial cells sit on top of the _____, which acts as a barrier and attachment point; it is not penetrated by lymphatics or blood vessels
basement membrane
30
one layer of epithelial cells is called ___
simple
31
multiple layers of epithelial cells is called ____
stratified
32
epithelial cells are named by ____
the shape of the outermost cell layer
33
single layer of flat cells
simple squamous
34
___ cells are typically protective but also capable of transport
simple squamous
35
single layer of cube-shaped cells
simple cuboidal
36
____ cells are usually seen in small ducts and tubules and are often excretory, secretory, and absorptive properties (glands)
simple cuboidal
37
one layer of tall cells
simple columnar
38
___ tend to be highly absorptive or secretory and are often located in the GI tract
simple columnar
39
in ____ cells there are cilia which are motile and serve a function
columnar ciliated
40
____ are falsely layered cells present in larger airways
pseudostratified ciliated
41
___ operate the mucociliary escalator
cilia
42
___ are multiple layers of flattened cells that are predominantly protective and mature from the basement membrane superficially
stratified squamous
43
____ cells may specialize by forming keratin and are located in the skin and upper aerodigestive tract
stratified squamous
44
___ epithelium lines the urinary tract and is able to expand to large degrees
transitional
45
___ is an adaptive response to combat infection, when the set temperature of the hypothalamus changes
fever
46
____ are molecules that cause fever
pyrogens
47
in ____ the set point of temperature in the hypothalamus does not change
hyperthermia
48
the core body temperature, determined by the hypothalamus, is normally ___C or ___F
37; 98.6
49
____ is when the lowest temperature is in the morning and highest between 4-6pm
diurnal variation
50
With a fever, does diurnal variation remain?
NO
51
In menstruating women, the AM temperature is (higher/lower) for two weeks prior to ovulation and (rises/lowers) about 0.6C with ovulation
lower; rises
52
In what two groups of people is the fever response impaired?
very young and very old
53
The ___ rate of heat production is caused by normal metabolism and bodily functions
basal
54
The __ rate of heat production is caused by muscle activity, hormones, epinephrine from sympathetic stimulation, and increased activity within cells
extra
55
What hormone is most especially associated with extra rate heat production?
thyroxine
56
Heat is lost by what three ways?
radiation, conduction, evaporation
57
A fever is often due to ____ and rarely due to primary ____
foreign invaders; hypothalamic disorders
58
The ceiling of fevers is considered to be at ___F
106
59
____ is a fever greater than 106.7 and is most often due to CNS hemorrhage
hyperpyrexia
60
____ occurs when production of heat is greater than the ability of the body to get rid of it
hyperthermia
61
Do antipyretics help in hyperthermia?
NO
62
What is the most important thing to do in physical exam to differentiate between whether it is probably fever or hyperthermia?
take an accurate history--ask about drug intake and heat exposure
63
What are the two major factors in causing fever?
Change in the set point of the anterior hypothalamus and pyrogens
64
____ pyrogens are commonly organisms that invade the body
exogenous
65
___ pyrogens are things such as cytokines and interleukins
endogenous
66
____ are small proteins which regulate immune, inflammatory, and hematopoietic processes; they are generally produced by white blood cells and macrophages
cytokines
67
____ and ___ stimulate the production of IL-6
IL-1 and TNF
68
____ pyrogens may be stimulated by trauma, inflammation, viruses, or antigen-antibody complexes
endogenous
69
The endogenous pyrogens act on endothelial cells within the hypothalamus to produce ____ which actually produces the change to cause fever
prostaglandin E2 (PGE2)
70
How do antipyretics inhibit fever?
They stop the synthesis of PGE2
71
A fever may induce ____ in patients with organic brain disease
mental status changes
72
Prostaglandins, Prostacyclin, Thromboxane A2, and PGE@ are products of what arachidonic pathway?
Cyclo-oxygenase
73
Lipoxin and Leukotrienes are the products of which arachidonic acid pathway?
Lipoxygenase
74
What are the three criteria to diagnose a Fever of Unknown Origin?
1-fever higher than 38.3 on several measurements
2-duration of at least 3 weeks
3-no diagnosis after 3 days in the hospital or 3 outpt visits
75
What are the 4 major causes of FUO?
- infections
- malignancies
- collagen vascular diseases
- autoimmune diseases
76
What are the 7 infectious causes of FUO? Which one is the most common cause, especially in AIDS patients?
- Tuberculosis (most common)
- Viral
- Fungal
- Pelvic or abdominal abscesses
- Osteomyelitis
- Discitis
- Bacterial endocarditis
77
What are the 4 malignant causes of FUO?
- lymphoma
- leukemia
- renal cell carcinoma
- hepatoma
78
What are the 4 collagen vascular/autoimmune disease that cause FUO?
- RA
- Lupus
- Polyarteritis nodosum
- Giant cell arteritis
79
In children, ____ diseases are the most common cause of FUO
viral
80
In patients over 65, ___ diseases are most common casue of FUO
rheumatic
81
For undiagnosed FUO, about ___ become symptom free and get a diagnosis later
75%
82
What is the most important factor to look at when considering a postoperative fever?
the time of onset of the fever
83
An immediate postoperative fever has an onset ____ and is usually caused by what 5 things?
within the OR or within hours after surgery; the trauma of surgery itself, blood transfusion, infection present prior to surgery, medications, and aspiration
84
An acute postoperative fever has an onset ____ after surgery is caused by what 3 main things?
within the first week; 1-nosocomial infections from pneumonia, UTI especially if catheterized, surgical site. 2-noninfectious-due to pancreatitis, alcohol withdrawal, or a PE. 3-atelectasis, which is arguably the most common reason
85
A subacute postoperative fever has an onset ____ after surgery and has what 3 causes?
one to four weeks after surgery; surgical site infection is most common, drug fever, and blood clots/DVT/PE
86
A delayed postoperative fever occurs ___ after surgery and what are the two main causes?
one month or later, even up to a year; infection transmitted by transfusion OR a surgical site infection especially from indolent organisms on a foreign body
87
this causes cramping of voluntary muscles due to the loss of electrolytes, when heat loss maintains the normal core temperature, treatment with fluid and electrolyte replenishment
heat cramps
88
this is due to vasodilation and/or volume depletion which causes postural hypoperfusion to the brain and results in dizziness or LOC, it is treated with rest, recumbency, and fluid/electrolyte replenishment
heat syncope
89
this is a more severe form of heat syncope where there is sudden onset of prostration and collapse due to failure of the cardiovascular system to compensate for hypovolemia secondary to water depletion; the equilibrium usually quickly and spontaneously re-establishes, but it can go on to get worse
heat exhaustion
90
this is when the core body temperature is greater than 40C/105F and there is CNS dysfunction--altered mental status and seizures, and multiple systems are involved
heat stroke
91
____ heat stroke is when patients have an underlying medical condition that impairs thermoregulation
classic/nonexertional
92
___ heat stroke occurs in young healthy patients with heavy exercise in hot environment usually with high humidity. The acute mortality rate is 20%
exertional
93
At a temperature of __ you start to see uncoupled oxidative phosphorylation, protein denaturation, and enzyme dysfunction
108F
94
The idiosyncratic reaction to antipsychotic/neuroleptic drugs, especially Haldol, not due to an overdose must be treated with what?
Bromocriptine or IV dantrolene
95
A patient presents with muscle rigidity, tremors, profuse sweating, and tachycardia and has recently begun treatment with Haldol. What is happening/what does the patient have?
neuroleptic malignant syndrome
96
A patient presents with clonus and hyperreflexia as well as symptoms that resemble neuroleptic malignant syndrome but the symptoms occurred within hours after taking a drug to increase levels of serotonin. What does the patient have?
serotonin syndrome
97
What disorder is a rare inherited disorder that is a reaction to a general anesthetic, is initially identified by masseter muscle spasm, and must be treated with IV dantrolene?
malignant hyperthermia
