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N351: Pathophysiology I > Module 2 > Flashcards

Module 2 Flashcards

1
Q

Physical and Chemical Barriers to Infection?

A

Skin and Mucous Membranes/Secretions

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2
Q

Is the inflammatory response specific or non specific?

A

non specific

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3
Q

When does the inflammatory response occur?

A

after tissue injury or infection

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4
Q

Inflammatory Response leads to …

A

Inflammation and Fever

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5
Q

The inflammatory response is a ____ and ____ protection against invasion by a _____ range of pathogens

A

immediate, general, wide

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6
Q

What parts of the immune system does the inflammatory response involve?

A

phagocytic WBC, antimicrobial substances, natural killer cells

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7
Q

Is the immune response specific or no specific?

A

specific

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8
Q

The immune response leads to …

A

antigen-antibody response

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9
Q

Self vs Non-self

A

-host versus foreign substance
-used in the immune response
-leads to recognition and elimination of altered host cells

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10
Q

The immune system develops more ___ and involves _____ cells to combat a ____ ____

A

slowly; specific; particular pathogen

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11
Q

1st Line of Nonspecific Resistance to Disease

A

Skin
Mucous Membranes
Mucus
Hairs
Cilia
Lacrimal Apparatus
Saliva
Urine
Defecation and Vomiting
Acid pH of Skin
Unsaturated Fatty Acids
Lysozyme
Gastric Juice
Vaginal Secretions
(these are Mechanical and Chemical Factors)

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12
Q

2nd Line of Nonspecific Resistance to Disease

A

Antimicrobial Proteins: Interferons and Complement System
Natural Killer Cells
Phagocytes
Inflammation
Fever

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13
Q

Interferons are glycoproteins with _____ activity

A

anti viral

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14
Q

Important Structures of the Immune System

A

-Lymph Nodes
-Thymus
-Spleen
-Tonsils
-Red Bone Marrow

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15
Q

How do lymph nodes work in the immune system?

A

Distributes lymph fluid among the body to remove bacteria and toxins from circulation. Also causes proliferation of immune cells

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16
Q

How does the thymus work in the immune system?

A
  • located in the mediastinum
  • produces T lymphocytes
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17
Q

How does the spleen work in the immune system?

A

-largest lymph organ
-reservoir for blood
-macrophages clear cellular debris and process hemoglobin

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18
Q

How does the tonsils work in the immune system?

A

-produces lymphocytes
-guard against airborne and ingested pathogens

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19
Q

How does the red bone marrow work in the immune system?

A

houses stem cells that develop into lymphocytes

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20
Q

Primary Lymphatic Organs

A

-organs providing the environment for stem cells to divide and mature
-crucial to the inflammatory responses maintenance
-Red Bone Marrow and Thymus Gland

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21
Q

Secondary Lymphatic Organs

A

-sites where most immune responses occur
-Lymph nodes and nodules, and the spleen

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22
Q

Lymphatic Flow

A

-lymph flow is similar to blood with a lower protein count and no RBC
-its made in tissue spaces and then gathered in small vessels to carry it to the thoracic or right lymphatic duct

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23
Q

What does lymph flow allow for?

A

the removal of things to large to cross the capillary membrane

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24
Q

Right Lymphatic Duct

A

drains the right side of the thorax, head, and neck (1/4 of the person)

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25
Q

Thoracic Duct

A

drains the lymph for all parts of the body except for the upper right fourth

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26
Q

Pathogen

A

Disease Agent

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27
Q

Microbial factors to be aware of?

A

Virulence
Dose
Portal of Entry
Organ Preference

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28
Q

Virulence

A

refers to how sick a pathogen can make you

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29
Q

What 3 Things does Response to Disease Rely on?

A

Pathogen (microbial factors, microbes)
Host (resistance, susceptibility, host factors)
Environment (conditions)

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30
Q

Epidemiologic Triangle

A

Triad of things leading to the disease response: Agent(infectious factor), Host(intrinsic), and Environment(extrinsic)

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31
Q

Agent

A

originally referred to as infectious microorganism until it became more broad

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32
Q

Biologic Agents

A

Allergens and infectious organisms

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33
Q

Chemical Agents

A

toxins and dust

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34
Q

Physical Agents

A

kinetic energy, radiation, thermal energy, noise

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35
Q

Are social and psychological stressors agents of disease?

A

yes

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36
Q

Infection

A

-Host organism’s response to a pathogen caused by tissue destroying microorganisms entering and multiplying in the body

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37
Q

-emia means?

A

“in the blood”

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38
Q

Sepsis

A

infection; contamination

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39
Q

Bacteremia

A

presence of bacteria in the blood

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40
Q

Viremia

A

presence of virus particles in the blood

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41
Q

Septicemia

A

systemic infection in which pathogens are present in the blood having spread from an infection in any part of the body

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42
Q

Do Bacteremia and Viremia always become Septicemia?

A

no, competent immune systems can keep the infection localized

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43
Q

Viruses

A
  • cause infection
    -microscopic genetic obligate intracellular parasites
  • protein coat + nucleic acid core + DNA or RNA
    -no Metabolic capability, need host cell
    -some can reproduce outside a living cell
    -can be dormant for long periods of times and produce symptoms years or months after infections
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44
Q

When do viruses activate?

A

in times of increased stress

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45
Q

Bacteria

A

-single celled microorganisms with no true nucleus
-larger than viruses
reproduce by cellular division
-contain cell damaging proteins

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46
Q

Endotoxins

A

released when the bacterial cell wall decomposes; can cause fever and are not affected by antibiotics

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47
Q

Exotoxins

A

released during cell growth from bacteria

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48
Q

How are bacteria classified?

A

-Shape
-growth requirements
-motility
-oxygen requirements
-gram stain

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49
Q

Gram Positive Stains?

A

purple

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50
Q

Gram negative stains?

A

it does not stain

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51
Q

Do gram positive or negative have more virulence?

A

Gram negative

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52
Q

Mycoplasmas

A

-1/3 the size of bacteria
-can reproduce independently
-NO rigid cell wall
-can cause atypical pneumonia (especially in crowded living conditions)

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53
Q

Rickettsiae

A

-needs a host for nutrients
-uses cell division
-has a rigid cell call
-infection caused by bite of infected arthropod

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54
Q

Examples of Infections/Diseases caused by Rickettsiae?

A

Typhus
Rocky Mountain Spotted Fever

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55
Q

Fungi

A

-non photosynthetic microorganisms
-asexual cell division or sexual division
-all fungi are spore based regardless of division type
-contains a true nucleus
-relatively large
-causes mycoses

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56
Q

Classifications of Fungi

A

Yeasts
Molds

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57
Q

Yeast

A

round, single cells, facultative anaerobes (live with or without oxygen)

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58
Q

Molds

A

filament like, multi nucleated, aerobic organisms

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59
Q

Mycoses

A

infections caused by fungi that release mycotoxins

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60
Q

When do mycoses become severe?

A

when the patients immune system is compromised (opportunistic infection) or if the fungi becomes systemic

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61
Q

Most mycotic infections are…

A

mild (athlete’s foot, candidiasis)

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62
Q

Parasites that cause infection?

A

Protozoa
Helminths
Arthropods
Ectoparasites

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63
Q

Parasite

A

depend on host for food and protective environment

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64
Q

Protozoa

A

-unicellular animals
-transmitted via arthropod vector or contaminated food/water

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65
Q

What causes malaria or amebic dysentary?

A

protozoa

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66
Q

Helminths

A

-worm like parasites
-transmitted by ingestion of fertilized eggs or larva penetration of the skin
-common in developing countries

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67
Q

Arthropods

A

-jointed exoskeleton and paired jointed legs
-can serve as vectors for other diseases

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68
Q

Examples of Arthropods

A

ticks, mosquitoes, biting flies

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69
Q

Ectoparasites

A

organism that lives on the outside of the body

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70
Q

How are ectoparasites transmit?

A

contact with infected clothing, bedding, or grooming articles

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71
Q

examples of Ectoparasites?

A

mites, lice, chiggers

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72
Q

Normal Body Flora

A

harmless microorganisms that reside in or on the body

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73
Q

Where is normal body flora found

A

skin, mouth, nose, pharynx, distal intestine, colon, distal urethra, vagina

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74
Q

Intestinal flora help synthesize …

A

Vitamin K

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75
Q

When can normal body flora become opportunistic?q

A

incompetent/compromised immune systems

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76
Q

What are host factors?

A

factors responsible for the degree to which the individual is able to adapt to the stressors produced by the agent (resistance). These can be controllable or not controllable depending.

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77
Q

Examples of Host Factors

A

-Genotype/Phenotype
-Nutritional Status
-Immune System
-Social Behaviors

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78
Q

How does environment influence infection?

A

influences the probability and circumstances of contact between the host and agent

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79
Q

What things does environment include?

A

sanitation, living conditions, pollution, social/political/economic factors

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80
Q

Chain of Infection

A

a model to conceptualize the transmission of a communicable disease from its source to a susceptible host

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81
Q

What do we want to do with the chain of infection?

A

break it!

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82
Q

What are the six links of the chain of infection?

A

Pathogen - Reservoir - Portal of Exit - Transmission - Portal of Entry - New Host

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83
Q

Reservoir

A

the habitat in which an infectious agent normally lives or grows (person, animal, environment)

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84
Q

Zoonoses

A

infectious animal reservoir

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85
Q

Important Cellular Elements in Infection/Inflammation

A

Granulocytes
Agranulocytes
Red Blood Cells
Platelets

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86
Q

Granulocytes

A

-Have granules in cytoplasm
-releases histamine and heparin in the inflammatory response
1. Neutrophils and Bands
2. Basophils
3. Eosinophils

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87
Q

Agranulocytes

A

-lymphocytes
-monocytes

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88
Q

Hematopoiesis

A

formation of new cells in the bone marrow

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89
Q

Hematopoietic Stem Cell Differentiation

A

Stem cell –> Common Lymphoid Progenitor –> B-cell or T-Cell –> Plasma Cell and Activated T Cell

Stem Cell –> Myeloid Progenitor –> Megakaryocyte and Erthrythroblast –> Platelets and Erythrocytes

Stem Cell –> Myeloid progenitor –> Leukocytes - - -> Basophils become Mast cells to release histamine and Monocytes become Macrophages

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90
Q

How much of the blood is WBC

A

less than 1 percent

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91
Q

What do WBC do?

A

protect the body against harmful bacteria and infection

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92
Q

Pyogenic

A

pus eating (this is WBCs)

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93
Q

the 3 Granulocytes are…

A

neutrophils, basophils, and eosinaophils

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94
Q

the 2 agranulocytes are…

A

monocytes and lymphocytes

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95
Q

Neutrophils

A

-WBC
-they phagocytosis “pyogenic infections”

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96
Q

Bands

A

-immature neutrophils (1-3 % of neutrophils)

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97
Q

How much of the Neutrophils are Bands?

A

1 to 3 %

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98
Q

What is a “shift to the left”?

A

When mature neutrophils have died battling infection and the average/mean size of the neutrophil gets smaller due to the release of Bands to compensate and the lessening of fighting ability, the whole bell curve shape shift left. This means a more bacterial infection is occurring

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99
Q

What does a shift to the left indicate

A

a bacterial infection

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100
Q

Basophils

A
  • become mast cells
    -involved in allergies and inflammatory responses
    -release histamine and heparin once they are mast cells
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101
Q

Eosinophils

A
  • release heparin and histamine
    -involved in delayed allergic reactions and parasitic infections
  • Hay fever leads to decreased amount
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102
Q

Monocytes

A

become macrophages which phagocytose in severe infections - more delayed in response (2nd responders)

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103
Q

Life span of neutrophils?

A

48 hours

104
Q

Lymphocytes indicate what?

A

viral infection

105
Q

2 Types of Lymphocytes

A

B and T Cells

106
Q

B-Cells

A

-become plasma cells and release antibodies

107
Q

T-Cells (T4 and T8)

A

-regulate cell mediated immunity
-T4 secrete cytokines to amplify inflammatory response, and T8 cells do cell to cell recognition and killing

108
Q

Macrophages

A

-scavenger cell created when monocytes enter tissue
-have receptors for Fc region and for complement
-they ingest and process antigen to tag
-secrete cytokines
- in both humoral and cell mediated responses

109
Q

How do macrophages tag after phagocytosis?

A

MHC (Major histo compatability complex) - MHCI are normal cell surface markers on all nucleated cells and platelets that are unique to you, while MHCII are specific tags telling T-lymphocytes to kill the macrophage that has phagocytosed an invader

110
Q

What cytokines do Macrophages release?

A

TNF(Tumor necrosis factor) and Interleukin-1

111
Q

What do cytokines cause?

A

fever

112
Q

Reticuloendothelial System

A

-System of macrophages throughout the body that filter and destory invaders, bad stuff, and worn out/abnormal cells

ex of name changing:
Lung - alveolar macrophages
Liver - kupffers cells
spleen - macrophages
lymph nodes - macrophages
intestine- peyers patches
CNS - microglial cells
skin - langerhans cells
connective tissue - histiocytes

113
Q

Function of Neutrophils

A

Bacterial Infection
Inflammatory Disorders
Stress
Certain Drugs

114
Q

Function of Eosinophils

A

Allergic Disorders
Parasitic Infestations

115
Q

Function of Basophils

A

Inflammation
Allergic Reaction

116
Q

Function of Lymphocytes

A

Viral Infection

117
Q

Function of Monocytes

A

Severe Infection

118
Q

Relative Count

A

percentage count of WBC adding up to 100%

119
Q

Absolute count

A

actual number of WBC in WBCC/CBC

120
Q

What do myelocytes indicate if on a blood count smear?

A

leukemia or severe bacterial infection since theyre only in bone marrow

121
Q

Absolute Value Equation

A

Relative Value (% put into decimal) * Total WBC

122
Q

Relative count values always add to 100%, so…

A

if one cell type increases, the others must decrease

123
Q

Relative increase and decreases are _____ but Absolute increase and decreases are _____.

A

relative = not important
absolute - absolutely important

124
Q

Total WBC Count

A

12.8x10^3 cells/mm^3 (12800)

125
Q

High Neutrophils indicate…

A

usually pyogenic bacterial infection

126
Q

Low neutrophil levels might indicate?

A

cancer

127
Q

low lymphocyte levels indicate what?

A

that it probably is not a viral infection

128
Q

Increased Values are indicated by what suffixes?

A

-cytosis and -philia

129
Q

Decreased values are indicated by what suffixes?

A

-penia

130
Q

What things can increased WBC count indicate?

A

infection
inflammation
tissue necrosis
leukemic neoplasia

131
Q

What things can decreased WBC count indicate?

A

chemotherapy
radiation therapy
marrow infiltrative diseases
overwhelming infections
dietary deficiencies
autoimmune diseases

132
Q

What may a persistent increase in WBC count indicate?

A

worsening of an infection

133
Q

What may a drastic decrease in WBC count indicate?

A

bone marrow failure and risk of infection

134
Q

Critical WBC count values?

A

anything less than 2500 or greater than 30,000

135
Q

WBC values are __ related?

A

age

136
Q

Normal Newborns and infants tend to have ___ WBC values

A

higher

137
Q

Elderly WBC count does what during infection?

A

potentially does not increase in the presence of severe bacterial infection

138
Q

ANC

A

Absolute Neutrophil count

139
Q

ANC calculation

A

WBC x(%neutrophils + %bands in decimal) = ANC

140
Q

ANC critical value

A

less than 1000

141
Q

How much of ANC should be bands/stabs?

A

1-3 percent (if more it indicates a shift to the left)

142
Q

Serologic Indicators of Inflammation and infection

A
  1. ESR - Erythrocyte Sedimentation Rate
  2. C Reactive Protein (CRP)
    3.WBC count and differential
143
Q

ESR

A

-Erythrocyte Sedimentation Rate
-Rate that RBC settle out of anticoagulated blood in 1 hour
-RBC form a Rouleaux when inflammation or necrosis is occuring thus leading to an increased ESR

144
Q

Is ESR diagnostic?

A

no, just provides info on disease processes to investigate

145
Q

When does ESR elevate?

A

in acute infections, it wont elevate for 6 to 24 hours and then peaks after several days

146
Q

C-Reactive Protein (CRP)

A

-abnormal liver protein present in blood during any process of necrosis, trauma, inflammation, or infection
-appears rapidly in injury situations
-a classic and most dramatic acute phase reactant increasing 1000x normal rapidly and then rapidly declining

147
Q

CRP is ____ _____

A

non specific; can say if theres inflammation, but not where

148
Q

Culture and Sensitivity - Lab Specimen In Vitro Growth Purpose?

A

to ID the organism and test antimicrobial effectiveness

149
Q

Remember that in vitro tests…

A

do NOT reflect plasma concentrations or attainable concentrations at the site of infection and do NOT take into account local factors like pH that may affect drug activity

150
Q

What is serial dilution used for?

A

to obtain a culture plate yielding a countable number of separate colonies and then calculate number of viable cells in original solution

151
Q

Gram Negative Bacteria are more …

A

virulent

152
Q

Urinalysis

A

-urine screening test that can give markers of infection due to appearance and color, odor, pH, leukocyte esterase test, nitrates

153
Q

Vaginal Secretions can cause what in urinalysis?

A

a false positive on nitrite screening/test

154
Q

Leukocyte Esterase

A

urinalysis test used to detect leukocytes in the urine with 90% accuracy

155
Q

When is a stool culture performed?

A

when patients have unrelenting diarrhea, fever, and abdominal bloating

156
Q

Examples of bacteria that can act as pathogens in a stool culture?

A

Salmonella
Shigella
Campylobacter
Yersinia

157
Q

Acute Inflammatory Response

A

a rapid and nonspecific protective response to cell injury of any cause only occuring in vascularized tissue

158
Q

Acute inflammatory response can only occur where?

A

in vascularized tissue

159
Q

“itis”

A

means inflammation

160
Q

Acute Inflammatory Response results in …

A

accumulation of fluid and cells at the inflammatory site

161
Q

Hallmarks of Inflammation

A

1.Redness (rubor)
2. Swelling (Tumor)
3. Heat (calor)
4. Pain (dolor)
5. Loss of Function (functio laesa)

162
Q

What causes swelling, redness, and heat in inflammation responses?

A

increased capillary permeability leading to more blood in the area

163
Q

Colonization of microorganisms alone _____ inflammation

A

DOES NOT PRODUCE (infection may just lead to cell injury and inflammation)

164
Q

The inflammation reaction of vascularized tissue is …

A

Active
Aggressive
Nonspecific

165
Q

The inflammation tissue response is _____ regardless of cause

A

the same

166
Q

Causes of inflammation

A

Infection by microorganisms
Heat burns and cold frostbite
radiation
trauma
chemicals
ischemic damage

167
Q

Hypoxia

A

lack of sufficient oxygen (can lead to cell injury and inflammation)

168
Q

Ischemia

A

reduced blood supply (can lead to cell injury and inflammation)

169
Q

Anoxia

A

Total lack of oxygen

170
Q

Infarction

A

cell death

171
Q

What are hypoxia, ischemia, anoxia, and infarction as they relate to inflammation?

A

they are etiologic factors of inflammation

172
Q

You can have ____ without Ischemia, but if theres Ischemia there is always ___

A

hypoxia, hypoxia

173
Q

Hyperemia

A

excess blood in vessels

174
Q

What is the vascular response of the acute phase response for inflammation?

A
  • Instant vasoconstriction followed by vasodilation leading to swelling (edema) and erythema (redness) due to hyperemia
    -The increased capillary permeability allows fluid to escape tissue and cause edema to dilute toxins
    -pain and impaired function determine tissue swelling and release of chemical mediators
175
Q

What is the cellular response of the acute phase response for inflammation?

A

-WBC move to damaged cells and do phagocytosis of dead cells and microorganisms
-Platelets move to damaged cells and controll excess bleeding
-Mast cells release heparin to maintain blood flow in the area

176
Q

Granulocyte job in acute phase response?

A

-neutrophils arrive early to phagocytosis
-eosinophils arrive to release chemical mediators of inflammation for allergies and parasites
-basophils release histamine to mediate inflammation and release heparin for blood flow
-Leukocytosis occurs causing increased WBC count

177
Q

Mononuclear Phagocyte job in acute phase response?

A

within 48 hours arrive and become the predominant cell, largest WBC, much longer lifespan, wall off material that cannot be digested to cause chronic inflammation, eat bad stuff, migrate to lymph nodes and play role in specific immunity

178
Q

Margination and Emigration of Leukocytes in acute phase response?

A

Blood viscosity increases since fluid is leaving the capillaries which leads to chemical mediator release (kinins, leukotrienes, and histamine) and cytokines to make endothelial cells of the capillaries more adhesive/sticky, marginate the area with leukocytes , and allow emigration/diapedesis through the capillary walls

179
Q

Diapedesis

A

movement of leukocytes through the capillary wall once it is more adhesive and marginates with leukocytes

180
Q

Commonality between histamine, leukotrienes, kinins, and cytokines

A

all help make the capillary wall more adhesive for leukocyte margination and emigration

181
Q

Chemotaxis

A

cytokines (chemokines and IL8), bacterial and cellular debris, and complement fragments (c3a and C5a) allow migration of leukocytes to the localized cellular response for inflammation

182
Q

4 Steps of the complete Phagocytosis process

A
  1. Chemotaxis
  2. Adherence plus opsonization (cover with Fc or C3a antigen)
  3. Engulfment (pseudopod inclosure and merge with lysosome and digest)
  4. Intracellular killing via enzymes, defensins,and toxic product
183
Q

5 Steps of phagocytosis?

A

attachment
ingestion
fusion of the lysosome and phagosome
digestion
release of digested products

184
Q

What cells do phagocytosis

A

neutrophils and macrophages

185
Q

Leukocyte

A

white blood cells

186
Q

Results of the Acute Phase Response

A
  1. changes in concentration of plasma proteins
  2. increase in ESR
  3. fever
  4. increase in leukocyte number
  5. skeletal muscle catabolism
  6. negative nitrogen balance
187
Q

Endotoxins stimulate fever, so what does the body need to do?

A

break skeletal muscle down for nitrogen when needed

188
Q

Main chemical mediator of inflammation?

A

Histamine

189
Q

Things Histamine does?

A

-Both parts of vascular response (increased blood flow and increased capillary permeability)
-bronchoconstriction
-gastric acid secretion

190
Q

Stress ulcers or asthma can be caused by…

A

histamine

191
Q

Bradykinin

A

plasma protease causing increased capillary permeability and pain

192
Q

Kinin

A

plasma proteases activated by complement proteins and clotting factors

193
Q

Prostaglandins (PGE)

A

-tissue injury leads to their production which makes fever very common (but does not mean infection)
-increase blood flow and capillary permeability
-potentiate histamine effects, cause fever, stimulate pain receptors

194
Q

What blocks prostaglandins?

A

NSAIDS like aspirin or ibuprofen (so blocking good prostaglandins in GI tract lead to GI bleeding)

195
Q

Does fever = infection?

A

no

196
Q

Leukotrienes

A

-increase vascular permeability
-affects WBC adhesion to capillary
-work in chemotaxis

197
Q

SRSA

A

-Slow reacting substance of anaphylaxis leading to bronchoconstriction in asthma
-this is due to leukotrienes

198
Q

Platelet Activating Factor

A

-from lipid in cell membranes
-affects many cell types
-induces platelet aggregation
-draws in eosinophils
-activates neutrophils

199
Q

Cytokines

A

-peptides made by many inflammatory cells and non inflammatory cells (fibroblasts and endothelial cells)
-named according to their function or a numbered interleukin
-act as local hormone to affect host response to injury or infection
-many effects: act as immune and inflammatory communication links (chemotaxis)

200
Q

Important Chemical Inflammatory mediators/

A

Histamine
Plasma Proteases (kinin, bradykinin)
Prostaglandins (PGE 1 and 2)
Leukotrienes
Platelet Activating Factor
Cytokines (IL-#)

201
Q

What chemical mediators cause swelling, redness, and tissue warmth?

A

histamine
prostaglandins
leukotrienes
bradykinin
platelet activating factor

202
Q

What chemical mediators cause tissue damage?

A

lysosomeal enzymes and products released by leukocytes and other inflammatory cells

203
Q

What chemical mediators cause chemotaxis?

A

complement fragments

204
Q

What chemical mediators cause pain?

A

prostaglandins
bradykinin

205
Q

What chemical mediators cause fever?

A

cytokines (IL)

206
Q

What chemical mediators cause leukocytosis?

A

cytokines (IL)

207
Q

Inflammatory Exudate

A

fluid, plasma protein, and cell contents in inflammation

208
Q

Serous Exudate

A

watery, low protein (plasma)

209
Q

Fibrinous Exudate

A

fibrinogen –> thick sticky meshwork like a clot

210
Q

Membranous Exudate

A

develop on mucous membrane surface–> necrotic cells enmeshed in fibrino purulent exudate

211
Q

Purulent or Suppurative Exudate

A

contains pus

212
Q

Hemorrhagic Exudate

A

RBC leakage

213
Q

Difference between Acute and chronic Inflammation?

A
  1. Acute - intact immune system leading to self limited and rapidly controlled by host defenses
  2. Chronic- lasts for a long time, involves fibroblast proliferation rather than exudate leading to increased scarring risk, involves low grade and persistent irritants or moderate/low virulence things that cant spread rapidly or penetrate deeply
214
Q

Abcess

A

-localized area of inflammation containing purulent exudate
-fibroblasts can enter and wall it off making antibiotics inaccessible and requiring surgical removal

215
Q

Ulceration

A

-inflammation where epithelial surface is necrotic and eroded or as a result of injury to epithelial surface from vascular compromise
-in chronic ulceration, fibroblastic proliferation leads to scarring and chronic inflammatory cell accumulation

216
Q

Granuloma Formation

A

-when acute response fails to rid of foreign particles, chronic inflammation occurs leading to a granuloma
-for example, cassius granuloma is due to Tb
-its a 1-2 mm lesion of macrophages surrounded by lymphocytes, where the outside is a collagen network that may calcify and become isolate, but the inside is a decris decay and liquid that has a “cheesy” necrotic center

217
Q

What things cause Granuloma formation?

A

foreign bodies like splinters, sutures, silica, asbestos, and microorganism that cause TB and syphilis since they cannot be easily digested and controlled

218
Q

Tumor Necrosis factor (TNF) and Interleukins cause…

A

lethargy

219
Q

Systemic Manifestation of Inflammation/Infectioin

A
  1. Lethargy from IL and TNF
  2. Skeletal muscle catabolism and negative nitrogen balance
  3. overwhelming infections when other debilitating diseases like cancer are present
  4. fever due to pyrogenic cytokines
220
Q

Lymphadenopathy

A

localized or generalized enlargement of the lymph nodes or vessels

221
Q

Lymphadenitis

A

-inflammation of lymph nodes
-nodes may be enlarged, hard, smooth, red, feelt hot, tender

222
Q

Location of lymphadenitis is indicative of …

A

where the origin of the disease/infection is

223
Q

Painful Lymph Nodes are associated with

A

inflammation

224
Q

Non-painful lymph nodes are associated with

A

neoplasms

225
Q

Opportunistic Infection

A

infections that occur as a result of altered or weakened host immune systems

226
Q

Autoimmune disorders

A

inflammatory response related to injury of ones own body tissue due to a hyperactive immune system

227
Q

Pyrexia

A

fever (cardinal manifestation of disease)

228
Q

A major surgery can be followed by

A

a normal 48-72 hour low grade fever

229
Q

The bodys thermostat is the …

A

hypothalamus

230
Q

Fever occurs when …

A

the hypothalamus is reset by the toxins released during the inflammatory process

231
Q

Pyrogens

A

fever producers

exogenous: microorganisms
endogenous: macrophages, T4 cells, prostaglandin, bradykinin

232
Q

What causes hyperthermia

A

the hypothalamus does not reset so the body keeps heating out of control

233
Q

How do endogenous pyrogens cause fever?

A

they stimulate prostaglandin E release from the hypothalamus which causes EP from the adrenal medulla to release and cause shaking chills from a lower calcium concentration and faster firing rate

234
Q

Stages of Fever

A

Prodromal
Stage 1: Cold or shaking chill stage
Stage 2: flush
Stage 3: Defervescence

235
Q

Prodromal Phase

A

general malaise, aches, pains, energiless - first part of a fever

236
Q

Stage 1 of a Fever

A

10-40 minutes with rapid and steady temperature rising and increased cell metabolism leading to no sweating and vasoconstriction = cold/shaking chills

237
Q

Stage 2 of a Fever

A

thermostat resets and vasodilation occurs leading to the skin being warm and flushed with potential dehydration

238
Q

Stage 3 of a Fever

A

Defervescence - sweating

239
Q

Defervescence

A

sweating

240
Q

Patterns of Fever

A
  1. Intermittent
  2. Remittent
    3.Sustained or continuous
  3. Recurrent or Relapsing
241
Q

Intermittent Fever

A

returns to normal at least every 24 hours

242
Q

Remittent Fever

A

varies a few degrees in either direction

243
Q

Sustained or continuous Fever

A

increased temperature remains with minimal variation

244
Q

Recurrent or Relapsing Fever

A

one or more episodes of fever each lasting several days with one or more days of normal temperature between

245
Q

Manifestations of Fever

A

Anorexia
Myalgia
Arthralgia
Fatiguq
Diaphoresis
Dehydration
Metabolic Acidosis
headache
Delirium and confusion
Incoordination and agitation
febrile convulsions
herpetic leasions or fever blisters

246
Q

Myalgia

A

muscle aches and pains

247
Q

Arthralgia

A

joint aches and pains

248
Q

FUO

A

fever of unknown origin: increased temperature of 101 present for more than 3 weeks

249
Q

100.5 fevers usually..

A

run their course

250
Q

fevers of 101 usually..

A

can sustain, and if so for over 3 weeks must be looked at for a root cause

251
Q

Persistent fever is a common indicator of…

A

cancer or liver cirrhosis

252
Q

Ways to treat fevers?

A

Modify external environment
treatment of underlying cause
fluid replacement and simple carbs
antipyretics like tylenol, NSAIDS, and ASA (aspirin)

253
Q

Fever in children…

A

are very common

254
Q

When is a child’s fever concerning?

A

when there is lethargy, poor feeding,k hypoventilation, poor oxygenation, cyanosis

255
Q

Elders and Fever

A
  1. May not have a febrile response or it is blunted
  2. they have lower basal temperatures, so a low grade fever may actually be more severe for them
  3. if an elder suddenly is falling, they may have pneumonia or a UTI

N351: Pathophysiology I (11 decks)

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