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Principles of Disease > Midterm 3 > Flashcards

Midterm 3 Flashcards

1
Q

resolution

A

ideal outcome, returns to normal following uncomplicated acute inflammation

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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

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3
Q

in chronic inflamation _______ ______ may not occur

A

true resolution

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4
Q

what is regeneration?

A

parenchymal cells are lost in which the adjacent surviving cells may undergoe division to replace them

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5
Q

what are the requirements for regeneration?

A
  1. ability of cell to divide
  2. the numbers of surviving cells
  3. surviving connective tissue framework to allow normal tissue structure
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6
Q

labile cells have a _____ intermitotic ______ phase

A

short, resting

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7
Q

labile cells include?

A

skin and mucosal surfaces

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8
Q

hematopoietic cells of the bone marrow are ______ cells

A

labile cells

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9
Q

a prerequisite for regeneration is ?

A

sufficient number of labile cells have survived the initial injury

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10
Q

stable cells are ____ lived and have _____ rate of division

A

short lived, low rate of division

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11
Q

stable cells remain in _____ phase but can divide if necessary

A

intermitotic

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12
Q

stable cells include

A

parenchymal cells of solid organs such as liver, kidney, and pancreas as well as fibroblasts and endothelial cells

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13
Q

Permanant cells _______ divide after fetal life

A

cannot

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14
Q

permant cells include?

A

those of the nervous system both central and peripheral along with cardiac muscle

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15
Q

injury to permanant cells can only heal by _______

A

scaring, the functional cells cannot be replaced

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16
Q

extensive injury of permanant tissue will lead to

A

functional deficit

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17
Q

what determines the rate of cell poliferation?

A

proteins called cyclins

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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

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19
Q

what is the role of external growth factors and cyklin activity?

A

affect the rate, promote cell replication

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20
Q

external growth factors include?

A

epidermal growth factor, platelet derived growth factor, interleukins etc

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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

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22
Q

cell poliferation can be regulated by _______ signals

A

inhibitory

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23
Q

what are the two factors that affect cyclin activity?

A

external growth factors and cell proliferation regulated by inhibitory signals

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24
Q

the net rate of cell poliferation depends on what 3 things?

A
  1. the ability to replicate
  2. The balance between proliferative and inhibitory signals (cyclin activity)
  3. the balance between the rate of cell poliferation and cell loss secondary to apoptosis
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25
Q

________ are a common cause of diarrhea in a variety of species including humans

A

rotaviruses

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26
Q

epidemic vs epizootic

A

epizootic in animal populations

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27
Q

antifreeze poisoning revolves around

A

managing ethylene glycol toxicity, inhibiting its metabolism, giving time to allow regeneration of renal tubular epithelium

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28
Q

permanent cells ________ regenerate once the organ is mature

A

do not

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29
Q

scaring is the result of healing by _______

A

fibrosis

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30
Q

what is the definition of scarring?

A

defined as replacement of normal tissue by dense collagenous connective tissue after insult or injury

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31
Q

scarring occurs in 2 situations which are?

A
  1. when regeneration isnt possible

2. when acute inflammatory process isnt resolved

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32
Q

what are the 5 processes involving scarring?

A
  1. inflammation ad debridement
  2. granulation tissue formation
  3. angiogensis
  4. collagenization
  5. maturation
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33
Q

inflamation and debridement occurs when? and what happens?

A

immediately following injury, hemostatic plug forms allowing inflammatory cells especially neutrophils to migrate to the area

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34
Q

what do neutrophils do during inflammation and debridement?

A

release lysosomal enzymes which liquefy the debris so it can be removed by lymphatics and macrophages

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35
Q

what is the role of macrophages with inflammation and debridement?

A

remove debris and clean up area, allows scar formation to occur

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36
Q

granulation tissue formation is important for _____ formation for what?

A

scar, fills injured area until more mature scar tissue develops

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37
Q

_______ tissue is highly vascular connective tissue

A

granulation

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38
Q

what are the two concurrent processes involved in granulation tissue formation?

A

angiogenesis and migration and proliferation of fibroblasts

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39
Q

angiogenesis

A

formation of new blood vessels , which are leaky, which contributes to the edema of healing wounds,

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40
Q

collagenization

A

process by which collagen is laid down in the area, synthesized by fibroblasts via production of precursor procollagen

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41
Q

collagen gives ____- to scar tissue

A

strength

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42
Q

maturation

A

process which granulation tissue is gradually replaced by mature connective tissue

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43
Q

during maturation the content of ________ increases while the number of _________ and _________ cells decreases

A

collagen, capillaries and inflammatory cells

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44
Q

a mature scar is made up of?

A

poorly cellular mass of collagen

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45
Q

as collagen chages from type III to type I there is ______ cross linking between collagen molecules

A

increased

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46
Q

contraction of scar tissue as it matures does what?

A

decreases size

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47
Q

what causes earlier contraction of collagen and what delays contration?

A

earlier contraction is due to actomyosin filaments in some fibroblasts such as myofibroblasts while later contraction is due to increased prescence of collagen

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48
Q

the glycoprotein ______ has an improtant role in formation of grnaulation tissue

A

fibronectin

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49
Q

is granulation tissue the same as granulomatous inflamation?

A

NO

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50
Q

the superficial epidermis is made up of what?

A

stratified squamous epithelium

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51
Q

abrasion

A

grase or scrape, epidermal cells if skin are removed, mild injury

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52
Q

laceration

A

tearing of tissues, especially over bony surfaces, affect epidermis and dermis

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53
Q

incision/cut

A

cutting tissue with sharp object, both epidermis and dermis affected

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54
Q

contusion

A

bruise produced by blunt trauma, blood vessel damage and hemorrhage tissue

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55
Q

avulsion

A

tearing away of part due to trauma

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56
Q

puncture wound

A

penetration of object

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57
Q

skin healing can be by ?

A

first intention or second intention

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58
Q

scab

A

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

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59
Q

describe healing by first intention

A

important for wound edges to be brought together, usually involves, stiches, or adhesive structures, healing occurs quickly

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60
Q

describe healing by second intention

A

defect healed is much larger, lacerations or cuts not sutured, granulation tissue, keloid formation

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61
Q

what is important for both first and second intention healing?

A

granulation tissue

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62
Q

what are the 5 factors that influence effectiveness of wound healing?

A
  1. nutritional factors
  2. Drugs
  3. Foreign material
  4. blood supply
  5. age
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63
Q

vitamin deficiencies can lead to defective ______ synthesis

A

collagen

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64
Q

corticosteriods can ______ wound healing

A

delay, slow

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65
Q

foreign material can lead to _____ inflamaion

A

chronic

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66
Q

______ supply is a necessity for wound healing

A

blood supply

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67
Q

______ age can slow wound healing

A

advanced

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68
Q

how are viruses classified?

A

RNA or DNA viruses, based on type of nucleic acid in their genomes

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69
Q

bacteria are classified by what 3 things?

A

shape, gram staining (+,-) , oxygen requirement (aerobic/anaerobic)

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70
Q

what are the 3 shapes of bacteria?

A

cocci, rods, spirochetes

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71
Q

fungi can be either ______ or _____

A

yeasts or molds

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72
Q

Dimorphic fungi

A

have both yeast and mold forms

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73
Q

mycelial fungi

A

are either yeast or mold

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74
Q

infectious agents can be consisdered on basis of _____ of multiplication

A

site

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75
Q

viruses are _____ intracellular organisms

A

obligate

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76
Q

obligate means

A

require host cells to grow and multiply using host metabolic machinery

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77
Q

faculative intracellular organisms

A

can grow both inside and outside of cells

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78
Q

myobacteria and some fungi are faculative intracellular organisms but if inside cells they are usually in _____

A

macrophages

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79
Q

where to pathogens generally enter the body?

A

mucosal or epithelial barriers

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80
Q

tissues of internal organs such as heart, bones etc, can only be infected how?

A

via blood or lymphatics

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81
Q

what are the four methods of spread?

A
  1. physical contact
  2. airborne
  3. Food borne
  4. Insect borne
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82
Q

what are the 3 results of infection?

A
  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
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83
Q

what are the 3 primary components to the invader surviving multiplying and producing disease?

A
  1. the pathogen itself
  2. the host
  3. the environment
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84
Q

virulence

A

ability to affect or damage host

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85
Q

the effect of the pathogen depends on _______ and _____

A

virulence and dose

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86
Q

what factors revolve around the hosts response?

A

status of primary defense and immune status of host

87
Q

infection occurs when….

A

infectious agent enters and multipied

88
Q

does infection imply disease?

A

NO

89
Q

sublcinical infection

A

when infectious agent has led to immune response but disease is not clinically apparent

90
Q

clinically apparent

A

infectious agent has survived and multiplied in a host producing tissue damage

91
Q

in most infectious the infectious agent is _______to site of entry of pathogen

A

localized

92
Q

presence of microorganisms in the blood can be termed what 3 things?

A

viremia (viruses), bacteremia (bacteria), fungemia (fungus), Parasitemia (parasites)

93
Q

emia

A

blood

94
Q

transient bactereimia

A

you get from brushing your teeth, body removes small numbers to prevent multiplication

95
Q

toxemia

A

presence of toxins produced by bacteria within the bloodstream

96
Q

sepsis

A

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
Q

virions

A

free particles of what viruses exist as between cycles of intracellular replication

98
Q

what is the common structure of viruses?

A
  • central core of nucleic acids
  • well structured protein coat
  • outer lipid envelope (limited viruses)
99
Q

what is the general lifecycle of viruses

A
  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
Q

why do viruses only infect certain cell types?

A
  • prescence of appropriate receptors for the virus determines the organotropism of the virus
101
Q

what is viral mediated cytopathic injury?

A
  • 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
Q

inclusion bodies

A

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
Q

cytopathic viruses

A

result in cell death

104
Q

ebola virus

A

outbreaks of disease in africa, death of host, very virulent, causes necrosis of endothelial cells, known with viral hemorrhagic fevers

105
Q

persistant or chronic viral ifnections result in _____ and _____ cell death over time

A

slow and progressive

106
Q

cirrhosis

A

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
Q

what happens during virally mediated alteration of apoptosis pathway

A

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
Q

viruses induce acute immune response characterized by ________, _______ , ________

A

lymphocytes, plasma cells and macrophages

109
Q

viral infections may express viral proteins on surface of host cell which are recognized by what?

A

CD8+ cytotoxic cells and T lymphocytes inducing cell mediated immune response and cytolysis

110
Q

the body also responds to viral infections by producing the glycoprotein ______

A

IFN (cytokine interferon)

111
Q

how is IFN produced

A

by CD4 T lymphocytes in Th1 response

112
Q

____ has antiviral effects

A

IFN

113
Q

antiviral effects are due to interference of viral _____

A

translation

114
Q

viral infections usually show increased _______ and decreased ______

A

lymphocytes and neutrophils

115
Q

lymphocytosis

A

increased lymphocytes

116
Q

transformation

A

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
Q

Epstein Barr Virus (EBV)

A

herpes virus and cause of several neoplasms (cancers)

118
Q

latent viral infections result when

A

viral genes remain in surviving target cells for long periods often for life of host but are not expressed

119
Q

what can induce a response from latent infections?

A

stress, age, hormone or nutrition inbalance, immune deficiency

120
Q

how is herpes characterized

A

frequent latent infections, 1 and 2, highly contagious

121
Q

a amjor complication that may occur with viral infection is secondary _________ infection

A

bacterial

122
Q

rickettsiae and chlamydiae are ______ intracellular bacteria

A

obligate, reproduce inside cells

123
Q

chlamydia trachomatis

A

major cause of urethritis

124
Q

trachoma

A

endemic in tropical countries, leading cause of blindness, severe conjuctivitis leads to scarring and opacification of cornea

125
Q

chlamydophilia psittaci

A

zoonatic disease which can be passed from birds to man

126
Q

the rickettsiae require ________ for transmition

A

arthropod vectors, such as lice, ticks, mites

127
Q

R.prowazekii

A

typhus (spotted fever, transmitted by flea bites, ticks and lice, rat being reservoir of infection

128
Q

myobacteria and fungi can also lead to ________

A

disease

129
Q

prions are cause of mad cow disease (T/F)

A

true

130
Q

how do prions differ from viruses?

A

lack nucleic acid RNA or DNA

131
Q

how do prion associated diseases develop?

A

when normal prion protein PrPc undergoes conformational change to form n abnormal protein (PrPsC)

132
Q

is there an inflammatory response to prions

A

no

133
Q

prion diseases are ______

A

slow, progressive

134
Q

prions are considered _______ transmissible agents consisting of _______ only

A

subviral, protein

135
Q

bovine spongiform encephalopathy

A

mad cow disease

136
Q

Dysbiosis

A

refers to change in composition of the microbiome which can be due to disease processes or diet changes

137
Q

opportunistic bacteria

A

gain access if host is immunosuppressed

138
Q

how do antibacterial agents work?

A

exert effect by either denaturing bacterial or interfering with bacterial metabolism

139
Q

bacteriostatic agents

A

inhibit growth or multiplication of bacteria

140
Q

bactericidal agents

A

kill bacteria

141
Q

antibiotics were initially prepared from _______

A

fungi

142
Q

bacteria have enormous capacity to mutate and adapt to change (T/F)

A

True

143
Q

can genetic materi that codes for resistance, plasmids be transferred between bacteria?

A

yes

144
Q

what are two important rules before using antibiotics?

A
  1. make sure disease is of bacterial origin

2. make sure to determine sensitivity

145
Q

bacterial virulence relies on what 3 things?

A
  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
Q

extent of injury from bacteria depends on what?

A

their ability to attach and enter hose or to produce toxins

147
Q

what is special about gram positive cocci bacteria?

A

have fibrillar M protein surfaces, preventing phagocytosis from macrophages

148
Q

whats special about mycoplasmas?

A

hemotrophic and lack a cell wall, they can evade immune system

149
Q

endotoxins

A

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
Q

_________activates protective immunity through release of cytokines and chemokines activating T lymphocytes but can also induce excessive levels of cytokines and result in ________

A

endotoxins, disease

151
Q

bacterial toxins exert effects on _______ ______ ______

A

small blood vessels

152
Q

whatare some effects bacterial toxins have on blood vessels

A

vasodilation, shock, massive cytokine release, fever, thrombosis from vasculitis

153
Q

endotoxic shock

A

accompany severe urinary tract infection, any gram negative bacterial infection

154
Q

bacterial exotoxins

A

secreted proteins that directl cause cell injury, divided into local acting and remotely acting exotoxins

155
Q

locally acting exotoxins

A

enzymes such as coagulase and proteases, breaking down food materials, used for bacterial metabolism or tissue invasion

156
Q

staphyloccocus aureus

A

staphylococci produces enzyme coagulase which converts fibrinogen into fibrin, tend to produce pus in tissues

157
Q

clostridium perfingens

A

gram +, intestinal tract, causes bloating after death, gangrene in humans, breakdown of sugars in muscles leads to gas

158
Q

Remotely acting exotoxins

A

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
Q

toxic shock syndrome is form what bacteria?

A

poliferation of staphlococci aureus in the vagina

160
Q

necrotizing facitis

A

virulent strains of A streptococci which secreted exotoxins

161
Q

Group A streptococci

A

cause of strep throat, scarlet fever etc

162
Q

tetanus

A

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
Q

botulism

A

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
Q

Bacterial enterotoxins

A

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
Q

cholera

A

asociated with contaminated water supplies, in asia, caused by vibrio cholerae secretes enterotoxin

166
Q

enteroinvasive strains

A

penetrate intestinal epithelium

167
Q

Haburger disease involves a ____________

A

verocytotoxin from ecoli

168
Q

verocytotoxin

A

toxic effect on vascular endothelial cells leading to thrombosis and injury to small vessels primarily in GI tract and kidneys

169
Q

what are the 2 categories of food poisoning?

A
  1. infection type

2. toxin type

170
Q

infection type food poisoning occurs when

A

bacteria in food multiply and produce toxins in bowel, signs appear 12-24hrs following ingestion

171
Q

toxin type food poisoning occurs when

A

bacteria in food produce toxins which are ingested, signs appear earlier 2-6hrs

172
Q

what is the bodies response to bacterial infections ?

A

suppurative and acute inflamation, increased vascular permeability

173
Q

the cells reponse to bacterial infections is seen as what?

A

increased numbers of neutrophils

174
Q

pyogenic bacteria

A

evoke suppurative inflamation, mostly extracellular gram + cocci and gram negative rods

175
Q

apendicitis is result of

A

obstruction of lumen of appendix, subsequent superlative inflammation

176
Q

what are two ways of diagnosing bacterial infection?

A

purulent inflammation, kochs prostulates

177
Q

what are kochs prostulates?

A
  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
Q

fungal infections are caused by what?

A

opportunistic invader that can become systemic or spread locally

179
Q

systemic fungal disease

A

fungal spores come from soil, plant, etc, particular problem in immunosupressed individuals,

180
Q

fungai can exist as what two things?

A

yeasts single cell forms, or hyphae long filaments

181
Q

what are 3 fungal growth requirements

A
  1. humidity
  2. warmth
  3. oxygen
182
Q

how do fungi cause tissue injury?

A

induce DTH hypersenisitivity response to fungi antigens

183
Q

_____________ leasions produced by DTH may suggest fungal disease

A

garnulomatous

184
Q

what are superficial fungal infections?

A

athletes foo, ringworm, yeast infections vaginal etc

185
Q

dermatomycoses

A

highly contagious, poor hygene, favour trnasmission from crowdy areas

186
Q

whats the fungus that causes most diseases?

A

candidiasis

187
Q

candida is a ________ organism

A

commensal

188
Q

where is candidiasis found? how does it spread

A

mucous membranes, immunosupressed individuals, or following antibiotic therapy, can overgrow

189
Q

definitive host of the parasite is ?

A

host of adult mature reproducing form

190
Q

intermediate host of parasites is?

A

host of immature form of parasite

191
Q

how are inflammatory reactions in tissues that are associated with parasitic forms characterized?

A

eosinophils and granulotomatous inflammation

192
Q

protozoa parasites ______ as caused of infectious disease

A

dominate

193
Q

transmission of protozoan parasites is either _________ or via ________

A

ingested or via insect vectors

194
Q

protozoa can be __________ or _________

A

intracellular or extracellular

195
Q

malaria is caused by

A

protozoal parasite plasmodium

196
Q

toxoplasmosis is caused by

A

protozoan parasite toxoplasma gondii

197
Q

epitheliotropic

A

can cross intestinal placenta and blood brai barriers such as toxoplasma gondii

198
Q

how does toxoplasma gondii avoid the adaptive immune system?

A

uses migrating leukocytes in the intestinal wall to disseminate

199
Q

the helminths include

A

nematodes, cestodes and trematodes

200
Q

how is the type of disease developed from parasites determined?

A

life stage of individual parasite and organ affected ex. anemia

201
Q

__________ is often seen with parasitic infections

A

eosinophilia

202
Q

do parasites behave as opportunistic pathogens ?

A

no

203
Q

do nematode life cycles require intermediate hosts?

A

no

204
Q

nematodes include

A

roundworms

205
Q

cestodes include

A

tapeworms

206
Q

the cystic stage of tapeworms causes what disease?

A

Hyatid disease

207
Q

trematodes include

A

flukes

208
Q

flatworms require an _______ host

A

intermediate

209
Q

flukes live where?

A

veins of pelvis and bladder

210
Q

hematuria

A

blood in urine

211
Q

what parasite leads to hemturia?

A

flukes

212
Q

Mechanical vector

A

arthropod picks up infecting agent and either deposits it in exposed foods or passes it on via contamination of biting mouth parts

213
Q

biological vector

A

arthropod has essential role in life cycle of infecting agent, hypersensitivity response associated

Principles of Disease (8 decks)

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