Midterm 3 Flashcards
1
Q
resolution
A
ideal outcome, returns to normal following uncomplicated acute inflammation
2
Q
how can scaring result from acute inflammation?
A
if tissue damage was excessive the lost parenchymal cells will be replaced by new parenchymal cells
3
Q
in chronic inflamation _______ ______ may not occur
A
true resolution
4
Q
what is regeneration?
A
parenchymal cells are lost in which the adjacent surviving cells may undergoe division to replace them
5
Q
what are the requirements for regeneration?
A
- ability of cell to divide
- the numbers of surviving cells
- surviving connective tissue framework to allow normal tissue structure
6
Q
labile cells have a _____ intermitotic ______ phase
A
short, resting
7
Q
labile cells include?
A
skin and mucosal surfaces
8
Q
hematopoietic cells of the bone marrow are ______ cells
A
labile cells
9
Q
a prerequisite for regeneration is ?
A
sufficient number of labile cells have survived the initial injury
10
Q
stable cells are ____ lived and have _____ rate of division
A
short lived, low rate of division
11
Q
stable cells remain in _____ phase but can divide if necessary
A
intermitotic
12
Q
stable cells include
A
parenchymal cells of solid organs such as liver, kidney, and pancreas as well as fibroblasts and endothelial cells
13
Q
Permanant cells _______ divide after fetal life
A
cannot
14
Q
permant cells include?
A
those of the nervous system both central and peripheral along with cardiac muscle
15
Q
injury to permanant cells can only heal by _______
A
scaring, the functional cells cannot be replaced
16
Q
extensive injury of permanant tissue will lead to
A
functional deficit
17
Q
what determines the rate of cell poliferation?
A
proteins called cyclins
18
Q
Cyklins do what?
A
interact with cyklin dependent kinases within the nucleus and control the entry and progression of cells through the cell cycle
19
Q
what is the role of external growth factors and cyklin activity?
A
affect the rate, promote cell replication
20
Q
external growth factors include?
A
epidermal growth factor, platelet derived growth factor, interleukins etc
21
Q
how do external growth factors work with effecting cyclin activity?
A
act through interactions with cell surfaces or nuclear surface antigens to indirectly up regulate cyclin activity
22
Q
cell poliferation can be regulated by _______ signals
A
inhibitory
23
Q
what are the two factors that affect cyclin activity?
A
external growth factors and cell proliferation regulated by inhibitory signals
24
Q
the net rate of cell poliferation depends on what 3 things?
A
- the ability to replicate
- The balance between proliferative and inhibitory signals (cyclin activity)
- the balance between the rate of cell poliferation and cell loss secondary to apoptosis
25
________ are a common cause of diarrhea in a variety of species including humans
rotaviruses
26
epidemic vs epizootic
epizootic in animal populations
27
antifreeze poisoning revolves around
managing ethylene glycol toxicity, inhibiting its metabolism, giving time to allow regeneration of renal tubular epithelium
28
permanent cells ________ regenerate once the organ is mature
do not
29
scaring is the result of healing by _______
fibrosis
30
what is the definition of scarring?
defined as replacement of normal tissue by dense collagenous connective tissue after insult or injury
31
scarring occurs in 2 situations which are?
1. when regeneration isnt possible
| 2. when acute inflammatory process isnt resolved
32
what are the 5 processes involving scarring?
1. inflammation ad debridement
2. granulation tissue formation
3. angiogensis
4. collagenization
5. maturation
33
inflamation and debridement occurs when? and what happens?
immediately following injury, hemostatic plug forms allowing inflammatory cells especially neutrophils to migrate to the area
34
what do neutrophils do during inflammation and debridement?
release lysosomal enzymes which liquefy the debris so it can be removed by lymphatics and macrophages
35
what is the role of macrophages with inflammation and debridement?
remove debris and clean up area, allows scar formation to occur
36
granulation tissue formation is important for _____ formation for what?
scar, fills injured area until more mature scar tissue develops
37
_______ tissue is highly vascular connective tissue
granulation
38
what are the two concurrent processes involved in granulation tissue formation?
angiogenesis and migration and proliferation of fibroblasts
39
angiogenesis
formation of new blood vessels , which are leaky, which contributes to the edema of healing wounds,
40
collagenization
process by which collagen is laid down in the area, synthesized by fibroblasts via production of precursor procollagen
41
collagen gives ____- to scar tissue
strength
42
maturation
process which granulation tissue is gradually replaced by mature connective tissue
43
during maturation the content of ________ increases while the number of _________ and _________ cells decreases
collagen, capillaries and inflammatory cells
44
a mature scar is made up of?
poorly cellular mass of collagen
45
as collagen chages from type III to type I there is ______ cross linking between collagen molecules
increased
46
contraction of scar tissue as it matures does what?
decreases size
47
what causes earlier contraction of collagen and what delays contration?
earlier contraction is due to actomyosin filaments in some fibroblasts such as myofibroblasts while later contraction is due to increased prescence of collagen
48
the glycoprotein ______ has an improtant role in formation of grnaulation tissue
fibronectin
49
is granulation tissue the same as granulomatous inflamation?
NO
50
the superficial epidermis is made up of what?
stratified squamous epithelium
51
abrasion
grase or scrape, epidermal cells if skin are removed, mild injury
52
laceration
tearing of tissues, especially over bony surfaces, affect epidermis and dermis
53
incision/cut
cutting tissue with sharp object, both epidermis and dermis affected
54
contusion
bruise produced by blunt trauma, blood vessel damage and hemorrhage tissue
55
avulsion
tearing away of part due to trauma
56
puncture wound
penetration of object
57
skin healing can be by ?
first intention or second intention
58
scab
composed of clotted blood and some inflammatory cells, bandage to protect wounds from infectious agents, scab will separate when new epidermis matures and shedds superficial keritaized layers
59
describe healing by first intention
important for wound edges to be brought together, usually involves, stiches, or adhesive structures, healing occurs quickly
60
describe healing by second intention
defect healed is much larger, lacerations or cuts not sutured, granulation tissue, keloid formation
61
what is important for both first and second intention healing?
granulation tissue
62
what are the 5 factors that influence effectiveness of wound healing?
1. nutritional factors
2. Drugs
3. Foreign material
4. blood supply
5. age
63
vitamin deficiencies can lead to defective ______ synthesis
collagen
64
corticosteriods can ______ wound healing
delay, slow
65
foreign material can lead to _____ inflamaion
chronic
66
______ supply is a necessity for wound healing
blood supply
67
______ age can slow wound healing
advanced
68
how are viruses classified?
RNA or DNA viruses, based on type of nucleic acid in their genomes
69
bacteria are classified by what 3 things?
shape, gram staining (+,-) , oxygen requirement (aerobic/anaerobic)
70
what are the 3 shapes of bacteria?
cocci, rods, spirochetes
71
fungi can be either ______ or _____
yeasts or molds
72
Dimorphic fungi
have both yeast and mold forms
73
mycelial fungi
are either yeast or mold
74
infectious agents can be consisdered on basis of _____ of multiplication
site
75
viruses are _____ intracellular organisms
obligate
76
obligate means
require host cells to grow and multiply using host metabolic machinery
77
faculative intracellular organisms
can grow both inside and outside of cells
78
myobacteria and some fungi are faculative intracellular organisms but if inside cells they are usually in _____
macrophages
79
where to pathogens generally enter the body?
mucosal or epithelial barriers
80
tissues of internal organs such as heart, bones etc, can only be infected how?
via blood or lymphatics
81
what are the four methods of spread?
1. physical contact
2. airborne
3. Food borne
4. Insect borne
82
what are the 3 results of infection?
1. invader dies due to inflammation or immune response
2. invader survives without giving clinical signs and causes an immune repsonse
3. invader survives multiplies and produces clinical disease
83
what are the 3 primary components to the invader surviving multiplying and producing disease?
1. the pathogen itself
2. the host
3. the environment
84
virulence
ability to affect or damage host
85
the effect of the pathogen depends on _______ and _____
virulence and dose
86
what factors revolve around the hosts response?
status of primary defense and immune status of host
87
infection occurs when....
infectious agent enters and multipied
88
does infection imply disease?
NO
89
sublcinical infection
when infectious agent has led to immune response but disease is not clinically apparent
90
clinically apparent
infectious agent has survived and multiplied in a host producing tissue damage
91
in most infectious the infectious agent is _______to site of entry of pathogen
localized
92
presence of microorganisms in the blood can be termed what 3 things?
viremia (viruses), bacteremia (bacteria), fungemia (fungus), Parasitemia (parasites)
93
emia
blood
94
transient bactereimia
you get from brushing your teeth, body removes small numbers to prevent multiplication
95
toxemia
presence of toxins produced by bacteria within the bloodstream
96
sepsis
disease state that arises from the presence of bacteria or toxic product within the bloodstream, resulting in clinical syndrome of fever, vasodilation and decreased bood pressure
97
virions
free particles of what viruses exist as between cycles of intracellular replication
98
what is the common structure of viruses?
- central core of nucleic acids
- well structured protein coat
- outer lipid envelope (limited viruses)
99
what is the general lifecycle of viruses
1. virus binds to receptors on the cell via viral surface ligands
2. virus penetrates cell, fusion to membrane
3. virus uncoated inside genome separates from structural elements
4. virus initiates cycle of nucleic acid transcription and translation
5. new viral proteins syntheiszed
6. new virions are assembles and released directly
100
why do viruses only infect certain cell types?
- prescence of appropriate receptors for the virus determines the organotropism of the virus
101
what is viral mediated cytopathic injury?
- impairs normal cell function, inhibits host cell RNA or DNA or protein synthesis, damage to cells by direct insertion of viral proteins into membrane
102
inclusion bodies
occurs in some viral infections, formed furing process of viral replication and consist of viral particles or parts of viral nucleic acids, used diagnosticcally to detect viral infection
103
cytopathic viruses
result in cell death
104
ebola virus
outbreaks of disease in africa, death of host, very virulent, causes necrosis of endothelial cells, known with viral hemorrhagic fevers
105
persistant or chronic viral ifnections result in _____ and _____ cell death over time
slow and progressive
106
cirrhosis
loss of lobular architechture of liver as a result of necrosis followed by scarring fibrosis, result of chronic injury to the liver via intoxication or viral injury
107
what happens during virally mediated alteration of apoptosis pathway
host cells may undergoe self directed apoptosis as a mechanism to control viral infection and eliminate infected cells, some viruses can inhibit apoptosis to persist viral infection
108
viruses induce acute immune response characterized by ________, _______ , ________
lymphocytes, plasma cells and macrophages
109
viral infections may express viral proteins on surface of host cell which are recognized by what?
CD8+ cytotoxic cells and T lymphocytes inducing cell mediated immune response and cytolysis
110
the body also responds to viral infections by producing the glycoprotein ______
IFN (cytokine interferon)
111
how is IFN produced
by CD4 T lymphocytes in Th1 response
112
____ has antiviral effects
IFN
113
antiviral effects are due to interference of viral _____
translation
114
viral infections usually show increased _______ and decreased ______
lymphocytes and neutrophils
115
lymphocytosis
increased lymphocytes
116
transformation
infection with some viruses may result in transformation of those cells causing them to become immortal and grow independently of growth regulating signals resulting in cancer
117
Epstein Barr Virus (EBV)
herpes virus and cause of several neoplasms (cancers)
118
latent viral infections result when
viral genes remain in surviving target cells for long periods often for life of host but are not expressed
119
what can induce a response from latent infections?
stress, age, hormone or nutrition inbalance, immune deficiency
120
how is herpes characterized
frequent latent infections, 1 and 2, highly contagious
121
a amjor complication that may occur with viral infection is secondary _________ infection
bacterial
122
rickettsiae and chlamydiae are ______ intracellular bacteria
obligate, reproduce inside cells
123
chlamydia trachomatis
major cause of urethritis
124
trachoma
endemic in tropical countries, leading cause of blindness, severe conjuctivitis leads to scarring and opacification of cornea
125
chlamydophilia psittaci
zoonatic disease which can be passed from birds to man
126
the rickettsiae require ________ for transmition
arthropod vectors, such as lice, ticks, mites
127
R.prowazekii
typhus (spotted fever, transmitted by flea bites, ticks and lice, rat being reservoir of infection
128
myobacteria and fungi can also lead to ________
disease
129
prions are cause of mad cow disease (T/F)
true
130
how do prions differ from viruses?
lack nucleic acid RNA or DNA
131
how do prion associated diseases develop?
when normal prion protein PrPc undergoes conformational change to form n abnormal protein (PrPsC)
132
is there an inflammatory response to prions
no
133
prion diseases are ______
slow, progressive
134
prions are considered _______ transmissible agents consisting of _______ only
subviral, protein
135
bovine spongiform encephalopathy
mad cow disease
136
Dysbiosis
refers to change in composition of the microbiome which can be due to disease processes or diet changes
137
opportunistic bacteria
gain access if host is immunosuppressed
138
how do antibacterial agents work?
exert effect by either denaturing bacterial or interfering with bacterial metabolism
139
bacteriostatic agents
inhibit growth or multiplication of bacteria
140
bactericidal agents
kill bacteria
141
antibiotics were initially prepared from _______
fungi
142
bacteria have enormous capacity to mutate and adapt to change (T/F)
True
143
can genetic materi that codes for resistance, plasmids be transferred between bacteria?
yes
144
what are two important rules before using antibiotics?
1. make sure disease is of bacterial origin
| 2. make sure to determine sensitivity
145
bacterial virulence relies on what 3 things?
1. adhering and colonizing host cells
2. invading the cell to release locally acting as well as remotely acting toxins
3. production of local vasculitis
146
extent of injury from bacteria depends on what?
their ability to attach and enter hose or to produce toxins
147
what is special about gram positive cocci bacteria?
have fibrillar M protein surfaces, preventing phagocytosis from macrophages
148
whats special about mycoplasmas?
hemotrophic and lack a cell wall, they can evade immune system
149
endotoxins
Lipopolysaccharide component of the cell wall of gram negative bacteria and released into the blood stream of the host following death and lysis of bacteria
150
_________activates protective immunity through release of cytokines and chemokines activating T lymphocytes but can also induce excessive levels of cytokines and result in ________
endotoxins, disease
151
bacterial toxins exert effects on _______ ______ ______
small blood vessels
152
whatare some effects bacterial toxins have on blood vessels
vasodilation, shock, massive cytokine release, fever, thrombosis from vasculitis
153
endotoxic shock
accompany severe urinary tract infection, any gram negative bacterial infection
154
bacterial exotoxins
secreted proteins that directl cause cell injury, divided into local acting and remotely acting exotoxins
155
locally acting exotoxins
enzymes such as coagulase and proteases, breaking down food materials, used for bacterial metabolism or tissue invasion
156
staphyloccocus aureus
staphylococci produces enzyme coagulase which converts fibrinogen into fibrin, tend to produce pus in tissues
157
clostridium perfingens
gram +, intestinal tract, causes bloating after death, gangrene in humans, breakdown of sugars in muscles leads to gas
158
Remotely acting exotoxins
secreted by living bacteria, absorbed into the bloodstream and often mediate their effects at distant sites in the body, highly antigenic proteins and will induce the formation of specific antibodies that can be killed through cooking
159
toxic shock syndrome is form what bacteria?
poliferation of staphlococci aureus in the vagina
160
necrotizing facitis
virulent strains of A streptococci which secreted exotoxins
161
Group A streptococci
cause of strep throat, scarlet fever etc
162
tetanus
clostridium tetani is a gram + anaerobe and can survive as spore,usually aquired by contaminated wounds, toxin interferes with neurotransmitters leading to violent muscle spasms
163
botulism
organism does not multiply inside the body – disease is acquired by ingesting the pre- formed toxin, which is one of the most potent known toxins, clostridium botulinium is anaerobic bacillus with highly resistant spores which is primarily found in soil and also found in the intestine of domestic animals
164
Bacterial enterotoxins
exotoxins that exert effect on intestinal mucosal cells , produced by bacteria during multiplication, structural damage of intestine and can cause diahreah, cramping and pain i n the abdomen
165
cholera
asociated with contaminated water supplies, in asia, caused by vibrio cholerae secretes enterotoxin
166
enteroinvasive strains
penetrate intestinal epithelium
167
Haburger disease involves a ____________
verocytotoxin from ecoli
168
verocytotoxin
toxic effect on vascular endothelial cells leading to thrombosis and injury to small vessels primarily in GI tract and kidneys
169
what are the 2 categories of food poisoning?
1. infection type
| 2. toxin type
170
infection type food poisoning occurs when
bacteria in food multiply and produce toxins in bowel, signs appear 12-24hrs following ingestion
171
toxin type food poisoning occurs when
bacteria in food produce toxins which are ingested, signs appear earlier 2-6hrs
172
what is the bodies response to bacterial infections ?
suppurative and acute inflamation, increased vascular permeability
173
the cells reponse to bacterial infections is seen as what?
increased numbers of neutrophils
174
pyogenic bacteria
evoke suppurative inflamation, mostly extracellular gram + cocci and gram negative rods
175
apendicitis is result of
obstruction of lumen of appendix, subsequent superlative inflammation
176
what are two ways of diagnosing bacterial infection?
purulent inflammation, kochs prostulates
177
what are kochs prostulates?
1. causal organism can be found in disease lesions
2. the organism can be grown and isolated in culture
3. secondary inoculation of the purified organism from culture causes the same lesions in experimental animals
4. the organism can be recovered from experimental animal
178
fungal infections are caused by what?
opportunistic invader that can become systemic or spread locally
179
systemic fungal disease
fungal spores come from soil, plant, etc, particular problem in immunosupressed individuals,
180
fungai can exist as what two things?
yeasts single cell forms, or hyphae long filaments
181
what are 3 fungal growth requirements
1. humidity
2. warmth
3. oxygen
182
how do fungi cause tissue injury?
induce DTH hypersenisitivity response to fungi antigens
183
_____________ leasions produced by DTH may suggest fungal disease
garnulomatous
184
what are superficial fungal infections?
athletes foo, ringworm, yeast infections vaginal etc
185
dermatomycoses
highly contagious, poor hygene, favour trnasmission from crowdy areas
186
whats the fungus that causes most diseases?
candidiasis
187
candida is a ________ organism
commensal
188
where is candidiasis found? how does it spread
mucous membranes, immunosupressed individuals, or following antibiotic therapy, can overgrow
189
definitive host of the parasite is ?
host of adult mature reproducing form
190
intermediate host of parasites is?
host of immature form of parasite
191
how are inflammatory reactions in tissues that are associated with parasitic forms characterized?
eosinophils and granulotomatous inflammation
192
protozoa parasites ______ as caused of infectious disease
dominate
193
transmission of protozoan parasites is either _________ or via ________
ingested or via insect vectors
194
protozoa can be __________ or _________
intracellular or extracellular
195
malaria is caused by
protozoal parasite plasmodium
196
toxoplasmosis is caused by
protozoan parasite toxoplasma gondii
197
epitheliotropic
can cross intestinal placenta and blood brai barriers such as toxoplasma gondii
198
how does toxoplasma gondii avoid the adaptive immune system?
uses migrating leukocytes in the intestinal wall to disseminate
199
the helminths include
nematodes, cestodes and trematodes
200
how is the type of disease developed from parasites determined?
life stage of individual parasite and organ affected ex. anemia
201
__________ is often seen with parasitic infections
eosinophilia
202
do parasites behave as opportunistic pathogens ?
no
203
do nematode life cycles require intermediate hosts?
no
204
nematodes include
roundworms
205
cestodes include
tapeworms
206
the cystic stage of tapeworms causes what disease?
Hyatid disease
207
trematodes include
flukes
208
flatworms require an _______ host
intermediate
209
flukes live where?
veins of pelvis and bladder
210
hematuria
blood in urine
211
what parasite leads to hemturia?
flukes
212
Mechanical vector
arthropod picks up infecting agent and either deposits it in exposed foods or passes it on via contamination of biting mouth parts
213
biological vector
arthropod has essential role in life cycle of infecting agent, hypersensitivity response associated
