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PATHOLOGY I > MIDTERM - lectures 4 & 5 > Flashcards

MIDTERM - lectures 4 & 5 Flashcards

1
Q

infectious disease

A

caused by microorganisms invading body

some of these microorganism’s release toxins that invade & damage body tissues that also cause injury

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2
Q

first line of defence

A

mechanical barriers - integrity of epithelial surfaces
-Intact skin and mucous membranes
-Oil & perspiration on skin
-Cilia in respiratory tract
-Gag & coughing reflex
-Peristalsis of GI tract
-Flushing action of tears, saliva & mucous
-Presence of normal flora in gut

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3
Q

second line of defence

A

inflammation

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4
Q

third line of defence

A

acquired immune response (adaptive immunity)

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5
Q

ENDOGENOUS (sources of infection)

A

from source within body, a normally existing microbe (like an already existing yeast)

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6
Q

EXOGENOUS (sources of infection)

A

from source outside body, usually a pathogen from environment (like flu from influenza virus, a toxin in environment or carcinogens)

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7
Q

VIRUSES (sources of infection)

A

pathogen made of nucleic acid inside protein shell

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8
Q

BACTERIA (sources of infection)

A

unicellular organism, no nucleus or organelles

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9
Q

PROTOZOA (sources of infection)

A

unicellular, animal like microorganism, not usually harmful to humans

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10
Q

FUNGI (sources of infection)

A

yeasts or molds

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11
Q

HELMINTHS (sources of infection)

A

worms

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12
Q

MYCOBACTERIA (sources of infection)

A

type of bacteria with fungi like properties

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13
Q

PRIONS (sources of infection)

A

small particle that is made of protein & is infectious

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14
Q

incubation period

A

time between entry of microorganism into body & appearance of clinical signs

there are not enough of organism in body to produce clinical effects

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15
Q

prodromal period

A

nonspecific or generalized symptoms such as fatigue, loss of appetite or headache

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16
Q

acute period

A

typical symptoms of infection begin - usually caused by damaged tissues

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17
Q

virulence

A

number of organisms & time they take to start infection process in a new host

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18
Q

reservoir

A

host or person who has a contagious disease

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19
Q

carrier

A

host or person who has a contagious disease, but does not develop illness

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20
Q

fomite

A

an inanimate object that can transmit an infectious disease
eg/ keyboard, doorknob, phone

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21
Q

routes of transmission

A

Contact: direct/ indirect (through fomite)
Airborne: smaller particles float on air currents for hours
Droplet: larger particles fall within 1 metre of source
Vehicle: common source like food/ water
Vector: carried by something else like insect (mosquito)

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22
Q

opportunistic infection

A

results from impaired immune system that can not defend against pathogens that are normally found in environment

Examples: AIDS / HIV patients, transplant patients, older age, newborns, malnourishment, burn victims, any chronic disease

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23
Q

viral infections/ diseases

A

-viruses are smallest microorganism, always pathogenic * depend on other cells to reproduce
-have protein cover & RNA/ DNA core, must attach to other cells to attack
-once attached, RNA/DNA separates & replicates inside host cell, killing cell & replicating, infecting other nearby cells

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24
Q

viral infections/ diseases - examples

A

flu, common cold, pneumonia, measles, herpes virus, epstein-barr virus, cytomegalovirus, HPV, enteroviruses – polio, meningitis, HIV etc.

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25
Q

fungal infections

A

-also called mycosis
-fungus lives in dirt, plants, on household surfaces & on skin
*EX: fungal pneumonia, candidiasis etc.

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26
Q

bacterial infections - examples

A

EX: lyme disease, syphilis, staph A, streptococcus, meningitis, diptheria, yersinia pestis, Clostridium Botulinum, coliforms, tuberculosis, leprosy, chlamydia, Gonococcus etc.

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27
Q

parasite infection - examples

A

trichomoniasis

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28
Q

natural / innate immunity

A

nonspecific response, defence system you were born with, immunity that is naturally existing & does not require prior sensitization to an antigen

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29
Q

natural / innate immunity - examples

A

-physical barriers like skin, mucosa, & cilia
-fever
-chemical barriers like digestive enzymes, perspiration, vaginal secretions, skin acid
-complement proteins in blood
-phagocytes like neutrophils & macrophages (in both natural & acquired immunity)
-inflammation (in both natural & acquired immunity

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30
Q

acquired immunity

A

-develops when person’s immune system responds to foreign substance/ microorganism, or occurs after person receives antibodies from another source
-specific response using lymphocytes to recognize & attack foreign invaders or pathogens & remember them for next time

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31
Q

2 main types of lymphocytes - acquired immunity

A

B & T cells

both come into contact with pathogen & become activated for that specific pathogen, then they clone themselves

-sometimes they are unable to distinguish body’s own normal, healthy tissues from something that is foreign to body or a pathogen

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32
Q

LYME disease

A

-etiology: Bacteria – gets into body through tick bite
-bulls eye rash = key initial symptom
-initial symptoms flu like, nausea, vomiting, fever & chills
-later can cause neurological & arthritic symptoms & can cause mm weakness, incoordination, paralysis & encephalitis
-only 50% of patients testing positive for bacteria become ill
-treatment = antibiotics

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33
Q

bacterial SYPHYILIS

A

etiology: bacteria
-sexually transmitted / spread through contact with infected fluids, open wounds / trans placental when pregnant
-4 stages – primary, secondary, latent, tertiary
*primary - lesion appears at initial site of infection, called chancre, heals in 1-2 months, infection spreads throughout body
*tertiary is the most severe stage – most don’t get to this stage if they receive treatment
-bacteria invades & causes tissues to fibrose & die causing necrosis, this tissue forms “gummas” which act like tumours, growing & taking resources
-treatment = antibiotics

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34
Q

herpes virus

A

family of DNA viruses that cause infections

virus hides in dorsal root ganglia of spinal cord & appears when body is stressed

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35
Q

5 different herpes viruses

A

Herpes simplex 1 (oral lesions)
Herpes simplex 2 (genital lesions)
Varicella-Zoster virus (shingles)
Epstein-Barr virus
Cytomegalovirus

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36
Q

herpes simplex 1

A

-etiology: herpes virus type 1
-easily transmitted, spread by contact: kissing/ sharing personal items
-affects skin/ mucous membranes
-stored in dorsal root ganglion for lifetime & activates when body is stressed
-often asymptomatic, can causes oral lesions - most common causes “cold sores” or oral lesions (painful blisters)
-no cure but symptoms can be treated with anti viral meds

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37
Q

herpes simplex 2

A

-etiology – herpes virus type 2
-sexually transmitted via genital, oral/ anal contact, or via placenta during birth, easily transmitted via direct/ indirect contact
-causes genital blister-like sores, often painful, blisters heal over & crust within 7-10 days
-may have systemic infection symptoms
-lifelong infection with outbreaks & remissions
-No cure, anti-viral meds can help

38
Q

cytomegalovirus

A

-lifetime infection, spread by sexual & non- sexual contact with body secretions
-produces symptoms only if viral load is high enough/ in immunocompromised
-may affect any organ as it is transmitted via bloodstream
-usually asymptomatic but can cause symptoms similar to mono
-if maternal infection, may cause congenital defects in developing embryo
-if mild usually not treated, can use anti viral drugs

39
Q

HPV genital warts

A

-over 40 types of HPV, some can cause genital warts
-sexually transmitted virus causing skin lesions
-lesions soft & clustered into groups often in genitalia, perineal / perianal regions
-may lead to cervical cancer
-no cure, warts can be removed but often come back
-very common

40
Q

enteroviruses

A

-affects GI tract & may cause respiratory/ nervous system infections
-viruses moderately contagious & spread through direct contact with mucus, saliva or feces from infected person
-enters through mouth via fecal-oral route
-EX: aseptic meningitis, acute paralysis, hand foot & mouth disease, myocarditis, mild respiratory illness, conjunctivitis, poliomyelitis
-mild to moderate flu like symptoms, rash/blisters in hands, mm weakness & paralysis in polio
-no treatment, medications for symptom relief

41
Q

poliomeyelitis (polio)

A

-is an enterovirus
-once ingested travels to anterior horn of spinal cord, multiplies & damages motor neurons causing mm weakness & flaccid paralysis
-flu like symptoms: fatigue, malaise, fever, chills, appetite loss. Rash or blisters occur in hand, foot & mouth disease
-can damage motor neurons causing mm weakness & flaccid paralysis which may lead to paralysis
-no treatment but can prevent with vaccinations

42
Q

influenza virus

A

-“flu”, acute, contagious infection of upper respiratory tract, can also extend into lower respiratory tract
-fever, chills, cough, sneezing, headache, inflamed respiratory mucosa, nasal discharge, malaise, mm aches & fatigue
-usually resolves on its own but elderly & immunocompromised have higher risk for complications
-risk of mortality in high-risk patients due to secondary pneumonia infection
-transmitted by infected droplets / touching fomites then touching mouth or nose
-treatment: vaccine, bed rest, fluids, symptom management, antiviral medications if severe

43
Q

rhinovirus (rhinitis)

A
  • “common cold” or upper respiratory tract infection causing inflammation especially in mucosa of nose & throat
    -has over 200 strains that are spread through airborne droplets / fomites
    -highly contagious, often leads to ear, sinus or lung infections
    -upper respiratory tract symptoms-runny nose, cough & sore throat, coughing, sneezing, watery eyes, nasal congestion, thick yellow discharge, headache, sore throat, hoarseness
    -treatment - bed rest, fluids, medications for symptoms
44
Q

fungal pneumonia (pneumocystis carinii)

A

-fungus causes diffuse type of pneumonia
-occurs in immunocompromised
*opportunistic infection
-commonly found in lungs of healthy people with no symptoms
-fever, cough, shortness of breath, weight loss, night sweats
-fungus attaches to alveolar walls & replicates causing inflammation, an immune response, dysfunction & destruction of alveoli for oxygenation
-treatment - Anti pneumocystic medication with steroids for inflammation

45
Q

yeast infection (candidiasis)

A

-normal in GI tract, mouth, genital areas & on skin, overgrowth of candida that causes symptoms
-often caused by use of antibiotics
-many types depending on location
-mouth symptoms: yellow/ white patches on tongue & roof of mouth, redness & pain around mouth & throat, cracking in corners
-genital: itchiness in vagina, redness, swelling, pain & burning upon urination, painful intercourse & thick white discharge
-urinary system: mild itching, dysuria, watery discharge, skin & mucous membranes: red, itchy rash in moist folds of skin.
Treatment – antifungal agent

46
Q

staphylococcus aureus (staph A)

A

-common, resides on skin, over 30 subtypes
-leading cause of nosocomial & community acquired infections, extremely virulent
-overgrowth of bacteria, lives on skin & in mucosal tissues normally
-affected area red, swollen & painful with drainage of pus
-may affect blood, skin, lungs, soft tissues, joints & bones, respiratory infections, endocarditis, toxic shock syndrome, food poisoning, skin infections
-treatment - antibiotics

47
Q

streptococcus

A

-bacterial infection
-divided into 2 groups: Group A & Group B
-group A = most common: cause of strep throat, localized skin infections, rheumatic fever, necrotizing fasciitis
-transmission via contact, droplets or food borne
-treatment - penicillin

48
Q

pharyngitis - strep throat

A

-caused by Group A streptococcus
-upper respiratory infection
-highly contagious infection in throat & tonsils, common cause of sore throat in children & teens
-fever, sore throat, painful swallowing, white (or red) patches on throat & tonsils, enlarged lymph nodes, headache, rash, nausea & vomiting
-treatment – antibiotics
*if left untreated may lead to other severe pathologies like glomerulonephritis - kidney inflammation, heart damage or rheumatoid fever, arthritis

49
Q

rheumatic fever

A

-untreated infection of Group A streptococcal pyogenes bacteria that may stimulate immune response – autoimmune reaction
-most often affects children between 5-15 yrs
-affects multiple organ systems
-affects the heart & its valves, vegetations form on valves
-fever, affects cardiovascular, musculoskeletal, skin (nodules and rash), CNS, painful tender joints, chest pain, shortness of breath, fatigue, chorea type movements.
-treatment – anti-inflammatories & antibiotics

50
Q

necrotizing fasciitis

A

-caused by Group A streptococcus
-bacterial infection that attacks & destroys skin, fat, CT over mm, also called flesh eating disease
-may be serious & potentially fatal
-spreads quickly along fascial planes, more common in extremities
-bacteria enters wound or crosses skin barrier causing immune response
-damaged tissue may develop gangrene
-more common in immunocompromised
-treatment - surgery to remove infected tissues, antibiotics, hyperbaric oxygen therapy

51
Q

streptococcus pneumoniae

A

-bacteria occurs normally in upper respiratory tract flora but in susceptible people may cause pneumonia, most common cause of community acquired pneumonia
-spreads by direct person to person contact with respiratory droplets
-very young & very old are most susceptible & seriously affected but also seen in uncompromised (diff then fungal pneumonia)
-often follows influenza/ viral respiratory infection
-cough with sputum production, fever & sharp chest pain on inspiration
-can cause middle ear infection, sinusitis, meningitis
-treatment – vaccine, antibiotics

52
Q

gonococcus (gonorrhea)

A

-STI of urogenital tract
-nicknamed ‘The Clap’
-untreated may lead to pelvic inflammatory disease which can lead to fertility issues
-men more frequent symptoms
-symptoms: can cause systemic symptoms, discharge, burning, itching, swollen testicles, painful urination etc.
-treatment – antibiotics

53
Q

bacterial meningococcal infections

A

-inflammation of fluid & membranes of meninges
-bacteria enters bloodstream & travels to brain & spinal cord
-viral meningitis is less severe than bacterial
-severe headache, hyperextended stiff neck, nausea, vomiting, photophobia, lethargy, rash, multiple organ failure, shock, chills, fever
-skin may become hypersensitive with red spotty rash
-treatment - antibiotics & anticonvulsive medication (if present), Corticosteroids to reduce inflammation & swelling

54
Q

corynebacterium diphtheria

A

-acute bacterial infection, affects mucous membranes, respiratory tract, tissues lining ears, eyes & genital areas & skin
-untreated may damage heart, kidneys, nervous system
-spreads by contact & secretions or airborne droplets of nose, mouth & skin
-skin infections with inflammation & necrosis of local tissues, fever, malaise, sore throat, hoarseness, lymphedema, difficulty breathing, difficulty swallowing
-grey, thick pseudomembrane forms over throat & tonsils
-treatment - antibiotics, diphtheria antitoxin, vaccinations

55
Q

yersinia pestis

A

-plague
-bacterial infection of lungs
-transmitted by fleas on rats
-50% mortality rate
-severe pneumonia, enlarged lymph nodes, high fever, progresses to septicemia (may be life threatening), fever, headache, weakness, cough productive of bloody or watery sputum
-treatment - antibiotics, no vaccine

56
Q

clostridium botulinum (botulism)

A

-bacteria found to cause severe food poisoning with paralyzing effects
-most cases caused by home canned foods low in acid
-when in bloodstream, bacteria produces dangerous toxins that block nerve functions & lead to respiratory / mm paralysis
-nausea, vomiting, abdominal cramps, diarrhea, weakness and paralysis, mm weakness starts in mm supplied by cranial nerves
-treatment - antitoxin

57
Q

coliforms

A

-fecal coliforms are bacteria normally found in digestive tract
-also found in water, soil, vegetation & feces
-E-coli is virulent strain & causes GI & urinary tract infections
-fecal – oral transmission
-range of symptoms: mild to bloody diarrhea, nausea, fever, vomiting, stomach cramping
-dehydration being main cause of death
*opportunistic infection
-treatment - hydration, oral, IV

58
Q

coliforms - cholera

A

-infection causing watery diarrhea leading to severe & rapid dehydration, may be fatal within hours
-rare in North America
-transmitted in contaminated water/ raw shellfish
-leads to dehydration, oliguria, & shock, rapid onset of smelly diarrhea called “rice water stool”, vomiting, wrinkled skin, low BP, dry mouth & rapid heart rate
treatment - rehydration, electrolytes, antibiotics

59
Q

tuberculosis

A

-contagious, bacterial lung infection, mostly affects lungs, may affect lymph nodes & other organs
-spread by airborne droplets, leading cause of infection in world
-latent TB (bacteria remain inactive in body, not contagious, no symptoms)
-active TB (contagious & symptomatic)
-TB on rise due to HIV on rise & drug resistant strains for treating TB
-causes pneumonia, meningitis, pericarditis, urogenital infections, may become widespread throughoutbody, fever, night sweats, chest pain, fatigue, weight loss, persistent cough (with blood), tiredness, loss of appetite
-diagnosed with culture sputum or skin test
-treatment: antibiotic cocktail for at least 6-9 months, vaccination

60
Q

leprosy

A

-spread with close & repeated contact with nose & mouth droplets of someone infected
-common in children & mostly in Africa/ Asia
-takes 3-5 years for symptoms to show
-affects skin & peripheral nerves causing disfiguring skin sores & growths, thick, stiff dry skin, painless ulcers on soles of feet, loss of eyebrows/ eyelashes, numbness & tingling of arms & legs, mm weakness or paralysis especially in hands & feet
-treatment - antibiotics for at 1-2 years, does not reverse already present nerve damage

61
Q

chlamydia

A

-most common STI, in last decade increased by 143% in Canada
-infection in urogenital tract
- “silent STD” , often no symptoms
-most common cause of pelvic inflammatory disease (PID) & ectopic pregnancy
-often accompanied by gonorrhea/ syphilis infection
-symptoms: burning, itching, discharge, painful urination etc.
treatment - antibiotics

62
Q

trichomoniasis

A

-sexually transmitted protozoal (parasite) infection, affects lower urogenital tract
-often co infected with gonorrhea
-parasite can be transmitted from infected mother newborn during birth
-frothy, pale yellow to green, odorous vaginal discharge, local itching & redness, painful urination
-men usually asymptomatic, may have penile discharge, slight itching & painful urination
-treatment - antibiotic & antiprotozoal medication

63
Q

hypersensitivity reactions: allergic disorders

A

exaggerated/ inappropriate abnormal immune response to an exogenous antigen (from outside world) OR

reaction to an endogenous (inside body) auto-antigen

basically “over reactions” to something that is normal

64
Q

have four types of hypersensitivity reactions depending on mechanism

A

Type I - Immediate Hypersensitivity: anaphylactic or atopic reactions
Type II - Cytotoxic antibody mediated reaction
Type III - Immune complex mediated reaction
Type IV - Cell mediated or delayed type reaction

65
Q

TYPE I - hypersensitivity reactions (anaphylactic or atopic reactions)

A

-mediated by: IgE, mast cells, basophils
-IgE sensitized to foreign antigen like pollen, 2nd time exposed to foreign substance leads to formation of antibody/antigen complexes
-triggers immediate release of histamine & other mediators
-systemic vasodilation, bronchospasm, increased mucus secretions & edema all referred to as anaphylaxis
-bee stings = most common, also common in asthma, other triggers: penicillin, foods, animal dander, children, semen, latex
-common symptoms: wheezing, hypotension, swelling, urticaria (welts), rhinorrhea, sneezing, may be life threatening, need injection of epinephrine to restore BP
-EX: hay fever, allergic rhinitis, atopic dermatitis, bronchial asthma, anaphylactic shock

66
Q

hay fever - TYPE I hypersensitivity reactions

A

-allergic rhinitis, seasonal allergy to foreign substances not normally pathological
-cause: inhaled pollens, plant substances, cat dander/ house dust trigger abnormal response from immune system
-inhaled pollens trigger release of histamine that causes swelling & inflammation of nasal passages & conjunctiva
-itchy, runny nose, itchy watery eyes, sneezing, swollen skin under eyes, coughing (similar to common cold)
-treatment: desensitization to allergens & antihistamines

67
Q

atopic dermatitis – eczema - TYPE I hypersensitivity reactions

A

-chronic skin irritation, usually in childhood only, effects 10% of children, family history common
-abnormal response to environmental allergens that come into direct skin contact
-hyperproduction of IgE in response to environmental allergens
-usually improves with age
-treatment: moisturizers, anti itch cream, corticosteroid cream, phototherapy

68
Q

asthma - TYPE I hypersensitivity reactions

A

-affects bronchi, chronic, inflammatory disorder of airways characterized by bronchial obstruction
-abnormal response to inhaled allergens
-asthmatic attack happens when bronchiole mm walls are in spasm
-leukotrienes & prostaglandins released constrict bronchioles & cause overproduction of mucus
-coughing, wheezing, excess mucus, SOB
-treatment: inhaled corticosteroids (to open airways & reduce swelling of bronchioles), prevention (recognizing triggers), allergy shots

69
Q

anaphylactic shock - TYPE I hypersensitivity reactions

A

-severe, life-threatening systemic response to allergen
-abnormal response/ reaction to normal substance
-causes massive release of histamine & other vasoactive substances into bloodstream, results in edema in cutaneous tissues (hives) & respiratory tissues, bronchoconstriction occurs, causes acute respiratory failure, generalized vasodilation causes shock
-clinical features: stridor (high pitched sound during breathing caused by vocal cord spasm), choking, wheezing, shortness of breath, fainting
-treatment: epinephrine injected immediately, oxygen, intravenous antihistamines, cortisone, beta agonist

70
Q

hypersensitivity reactionsType II - Cytotoxic antibody mediated reaction

A

-mediated by: IgG & IgM
-form antigen-antibody complexes on usually normal cell membranes which activates complement system
-complexes react with antigens & our body attacks normal substances for unknown reason (autoimmune diseases).
-symptoms depend on tissue reacting
-EX: hemolytic anemia, Goodpasture’s syndrome, Graves Disease, Myasthenia Gravis

71
Q

hemolytic anemiahypersensitivity reaction type 2

A

-RBCs destroyed faster than can be produced in bone marrow & also defective
-destroyed by auto antibodies
-less oxygen to tissues & organs
-may be caused by mismatched blood transfusion, genetic defects, toxins, or infections
-clinical features: fewer RBC’s, reduced life span, fatigue, headache, chest pain, irregular heartbeat, cold intolerance, shortness of breath, pallor, dizziness, brittle hair, spoon shaped nails, delayed wound healing, swollen ankles, beefy red tongue, cracked lips, intermittent calf pain
-treatment: RBC transfusions, immunosuppressants, steroids

72
Q

goodpastures syndromehypersensitivity reaction type 2

A

-autoimmune disease affecting kidneys & lungs
-antibodies produced attack component of collagen (Type IV) that affects alveoli of lungs & glomerulus of kidneys
-etiology: autoimmune, exposure to chemicals and cigarette smoke, cocaine, virus
-clinical features: lungs: fatigue, nausea, vomiting, difficulty breathing or shortness of breath, cough & pale skin
kidney: blood in urine, painful urination, foamy urine, hands and feet swelling, hypertension & flank pain
-treatment: immunosuppressants, corticosteroids & plasmapheresis: removing antibodies from blood

73
Q

hyperthroidism – graveshypersensitivity reaction type 2

A

-autoimmune disorder causing hyperactivity of thyroid gland or hyperthyroidism with resultant goiter (enlargement of thyroid gland)
-etiology: autoimmune disorder, genetics
-antibodies produced in reaction to thyroid hormones a&nd attack regulatory thyroid hormones causing overproduction
-anxiety, hand tremors, weight loss, diarrhea, fatigue, insomnia, tachycardia, flushed & warm skin with profuse sweating, heat intolerance, erectile dysfunction, brittle/ loss of hair, goiter, joints often hypermobile, protrusion of eyeballs & Graves dermopathy - reddening & swelling seen on shins & tops of feet
-treatment: decrease thyroid hormone production & control symptoms, especially tachycardia
-medications include beta-blockers & anti-thyroidal drugs. Surgery (thyroidectomy) or irradiated to kill some of it

74
Q

myasthenia gravis - hypersensitivity reaction type 2

A

-impaired impulse transmission of motor neurons caused by antibodies that attack & destroy acetylcholine receptors at neuromuscular junction
-excess of acetylcholine in synaptic cleft & less nerve signals going to the muscles, this causes mm weakness, progressive & eventually leads to paralysis
-autoimmune disease, also 75% sufferers thymus disorder
-facial weakness & loss of expression, mm of eyes, mouth, throat & neck all affected
-Ptosis: eyelids droop, impaired vision, difficulty chewing & swallowing, impaired speech, head droops forward as result of weak neck mm & fatigue is frequent complaint
-if respiratory mm involved, there are recurrent respiratory infections & risk of breathing dysfunction
-no cure, manage symptoms with medications: cholinesterase inhibitors, corticosteroids, immunosuppressants, surgery if tumour in thymus

75
Q

hypersensitivity reactionsType III - immune complex mediated reaction

A

-mediated by: immune complexes formed between antigens & antibodies & deposited into tissues which activates complement system
-causes inflammation & local tissue injury
-when complexes circulating, they affect whole body & are systemic
-if complexes stay local, they affect specific tissues only
-symptoms: variable depending on systems effected
-EX: systemic lupus erythematosus (SLE), poststreptococcal glomerulonephritis, polyarteritis nodosa

76
Q

systemic lupus erythematosus (SLE) – hypersensitivity reaction type 3

A

-autoimmune disease, unknown cause, maybe a virus
-effects multiple systems in body, 10 x more common in women
-malfunctioning T cells activate B cells that secrete auto antibodies
-variable symptoms, fever, malaise, headache, loss of appetite, often affects skin, kidneys, joints & blood
-skin: causes SLE Butterfly rash
-kidney: 75% of time are involved
-joints: arthralgia
-blood: circulating antibodies damage RBC’s & cause anemia
-treatment: immunosuppressant drugs, hydroxychloroquine (anti malaria drug), corticosteroids & NSAIDS

77
Q

post-streptococcal glomerulonephritis – hypersensitivity reaction type 3

A

-renal disease after upper respiratory tract infection with streptococcal producing antigen/antibody complexes in glomerulus
-caused by group A streptococcus infection or unknown
-antigen/antibody complexes stick to glomerular basement membrane & invoke inflammatory response, kidneys less efficient at filtering
-after pharyngitis or skin infection, loss of glomerular function, dark urine, proteinuria, high BP, facial swelling, swelling in hands & feet, malaise & lethargy
-treatment: BP medication, decrease swelling, diuretics (increases urine output)

78
Q

polyarteritis nodosa - hypersensitivity reaction type 3

A

-blood vessel disease, antibody/antigen complexes of small to medium sized arteries clump up & cause inflammation, slowing down ability to transport blood & its oxygen & nutrients to tissues of body
-cause unknown, possibly Hepatitis B or other infections
-affected vessels show necrosis & acute inflammation which eventually destroys vessel walls
-causes thrombosis & arteries may become occluded causing infarct & ischemia
-flu like symptoms with skin abnormalities & kidney dysfunction
-may affect nerves, causing neuropathy & GI tract, causing pain, bleeding, blockage or perforation
-treatment: corticosteroids, immunosuppressants

79
Q

hypersensitivity reactionstype IV - cell mediated or delayed type reaction

A

-mediated by: T lymphocytes & macrophages, which aggregate at site of injury &forms granuloma
-small molecules attach to normal cell membranes & make them look “foreign”, our immune system is activated, & macrophages activate T lymphocytes & attack these cells
-symptoms variable
-EX: contact dermatitis, transplant rejection, tuberculosis, fungi, syphilis, Crohn’s, sarcoidosis, leprosy

80
Q

contact dermatitis - hypersensitivity reaction type 4

A

-skin irritation, most common Type IV hypersensitivity reaction, no granulation tissue formed, not contagious
-unknown cause, triggers: soaps, cosmetics, fragrances, jewelry, plants
-skin irritation caused by T lymphocytes & macrophages being activated & producing inflammatory response
-causes red itchy rash, dry cracked scaly skin, blisters, swelling, burning
-treatment: avoidance of trigger, anti-itch cream, moisturizers

81
Q

transplant rejection- hypersensitivity reaction type 4

A

-immune system attacks newly transplanted organ as if it was foreign invader like bacteria/ virus.
-all transplants invoke response, mediated by antibodies/ cells & may cause inflammation, may be acute/ chronic
-antibodies bind to cells & cause fibrinoid necrosis & thrombosis
-systemic symptoms: fever, chills, other symptoms depend on organ affected
-treatment: immunosuppressants, corticosteroids

82
Q

Human ImmunodeficiencyVirus (HIV)

A

-sexually transmitted virus spread through sexual contact, with infected blood from mother to child or by sharing needles
-virus infects & destroys CD4 & T cells
-flu like symptoms, fever, headache, aches & pains, rash, sore throat, painful mouth sores, swollen lymph glands, diarrhea, weight loss, cough, night sweats
-treatment: no cure, preventive measures, medications dramatically slow progression
-if untreated HIV infection develops into acquired immunodeficiency syndrome (AIDS)

83
Q

Acquired Immunodeficiency Syndrome(AIDS)

A

-chronic condition caused by damage of the human immunodeficiency virus (HIV).
-may be life threatening.
-virus infects & destroys CD4 & T cells causing immunodeficiency
-flu like symptoms, fever, headache, aches & pains, rash, sore throat, painful mouth sores, swollen lymph glands, diarrhea, weight loss, cough, night sweats
-treatment: no cure, preventive measures, medications dramatically slow progression
-if untreated HIV infection develops into acquired immunodeficiency syndrome (AIDS)

84
Q

amyloidosis

A

-abnormal protein = amyloid builds up in organs & interferes with normal function
-protein not normally found in body but formed from several different proteins
-may affect heart, kidneys, liver, spleen, nervous system & digestive tract
-etiology: genetics, other inflammatory diseases, dialysis
-clinical Features: may not appear until condition is advanced, ankle & leg swelling, severe fatigue & weakness, shortness of breath, numbness & tingling, pain in hands/ feet, diarrhea/ constipation, weight loss, enlarged tongue, skin changes like thickening, bruising, purplish patches around eyes, irregular heartbeat & difficulty swallowing
-treatment: no cure, manage symptoms, chemotherapy (stops the growth of abnormal cells)

85
Q

lymphangitis

A

-infection & inflammation of lymphatic vessels
-most often complication of bacterial infection, acute streptococcal/staphylococcal bacterial skin infection that enters break in skin & migrates to local lymphatics
-bacterial infection causes inflammatory response in lymphatic vessels
-enlargement of local lymph & red streaks extending from infected area, chills, fever, fatigue, loss of appetite, headaches, & cellulitis
-treatment: aggressive antibiotic therapy

86
Q

edema

A

-local accumulation of fluid in interstitial space
-ay be caused by venous stasis (sitting too long) or high salt intake
-often pregnant women in 3rd trimester experience edema, some medications, heart, liver, & kidney disease, bodily injuries etc.
-fluid distribution sluggish or overloaded & can not drain so accumulates
-symptoms depends on cause: feeling of heaviness, tightness, aching, redness & discomfort, pain, weight gain from fluid retention
-treatment: elevate body part above level of heart, compressive bandages/stockings, gentle active movements to encourage draining, salt intake restriction, diuretics to reduce fluid volume in edema, avoid prolonged standing, surgical intervention, antibiotics & anti-inflammatories for infection, -massage therapists trained in advanced techniques of MLD

87
Q

lymphedema

A

-abnormal chronic accumulation of fluids in interstitial space, dysfunction of lymphatic system
-obstruction of lymph vessel, associated with infections, chronic inflammation & tumors, surgical damage from repair/ removal
-fluid distribution sluggish/ overloaded & can not drain so accumulates
-swelling may be local/ systemic, tissue is pitting: boggy, tissue retains indentation after pressure is applied
-non pitting: hard & firm edema, feeling of fullness & discomfort, sometimes painful, ROM may be decreased
-treatment: diuretics, surgery, mechanical compression sleeves, cold hydrotherapy, diaphragmatic breathing, specialized massage technique for (MLD)

88
Q

lymphoma

A

-cancer of lymph node, spreads throughout other lymphatic tissues
-two main types of lymphoma: Hodgkin’s & non Hodgkin’s
-cause unknown, associated with previous infection with Epstein-Barr virus, immunosuppression & HIV infection
B & T lymphocytes grow uncontrollably due to genetic mutations
-hodgkin’s: enlarged painless lymph node usually in neck region appears first then other nodes appear enlarged - recurrent infections & pruritis (itching), low grade fever, night sweats, weight loss, fatigue and anemia
-non-hodgkins: enlarged painless lymph node usually in neck region appears first then other nodes appear enlarged - recurrent infections & pruritis (itching) follow
-spleen & liver enlarge with GI disturbances & back pain, low grade fever, night sweats, weight loss, fatigue & anemia
-treatment: radiation & chemotherapy most successful, if reoccurrences, bone marrow or stem cell transplants also an option

89
Q

Infectious MononucleosisEpstein-Barr Virus

A

-epstein-Barr virus can cause mono
-kissing disease, by age 35 most people have been exposed with no symptoms
-part of Herpes virus family, never goes away, lifelong infection.
-virus spreads through bodily fluids, especially saliva
-fatigue, headache, fever, sore throat, swollen lymph nodes in neck, enlarged spleen, swollen liver, rash, usually mild symptoms.
-treatment: no specific treatment, avoidance

90
Q

Myalgic Encephalomyelitis (ME) – chronic fatigue syndrome

A

-extreme fatigue for longer than 6 months that can not be explained
-worsens with activity & does not improve with rest, restless sleep, memory focus & concentration problems, dizziness, may affect many body systems, previous infection with epstein-barr & rubella virus increases risk
-cause unknown, many theories; viral infections, immune impairment, hormonal imbalances, stress or trauma both emotional or physical
-fatigue, memory & concentration problems, sore throat, headaches, enlarged lymph nodes, unexplained muscles or joint pain, dizziness, restless sleep, extreme exhaustion, chronic insomnia,
-treatment: no cure or treatment, other than to treat the symptoms, lifestyle changes, often antidepressants, acupuncture, tai chi, yoga and massage help relieve symptoms.

PATHOLOGY I (17 decks)

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