Patho Block 1 Flashcards
Group O blood has what Ag and Ab
No Ag
Both A and B Ab
What are the S/ s of Multiple Myeloma
Renal failure
anemia
leukopenia
Diagnosis based on x-rays, bone marrow biopsy, and serum protein electrophoresis
• Large gamma globulin spike (Bence-Jones proteins)
Why do the outer tissues retain their appearance in coagulative necrosis
rapid inactivation of hydrolytic enzymes prevents tissue lysis
thus tissues retain original form and consistency
What is the pathological path of an arterial emboli
Heart, to carotid artery, to brain, to stroke
UV light radiation causes what kind of cancer
Skin cancer
Squamous cell carcinoma (SCC),
Basal cell carcinoma (BCC),
Melanoma
What does amniotic fluid analysis
(Amniocentesis) in prenatal testing look for?
Fluid sampled from amniotic sac at 12 - 18 weeks
Chemical and chromosomal analysis
Which Ig does the Alternate pathway use
IgA
Carcinoembryonic Antigen (CEA)
Is a tumor marker for cancer where?
Colon, stomach
What is the most common method of staging
The TNM system
T: size of primary tumor
N: Lymph node involvement
M: metástasis or not
What are the two pathways of the arachodonic acid derivates
Lipoxygenase (LOX) pathway
Cyclooxygenase (COX) pathway
What is Shock
Simply hypo-perfusion resulting in tissue anoxia and organ failure
Loss or gain of a chromosome(s) alters genetic expression is called
A numerical abnormality
What does etiology mean
Origin of the disease
Underlying causes and modifying fxs
What is the difference between wet and dry gangrene
- “wet gangrene” = bacteria are active, necrosis is more liquefactive
- “dry gangrene” = as tissue dries, becomes black “mummified”
What are the three classifications of anemia
• Decreased hematopoiesis (inadequate production)
• Abnormal hematopoiesis
(incorrect production)
• Increased loss or destruction of RBCs (taken out of circulation)
Which WBC type is often seen in chronic infections
Eosinophils
- slower mobility
- survive longer
Macrophages
-long living
What patient population is Lupus most common in
Women
Describe the first step of wound healing
Hemostasis
Vasoconstriction, platelet activation, coagulation
Fibrin, platelets, and RBCs join to form clot
Vasoconstriction initially (briefly), then vasodilation as healing begins
What does RDW measure
Red Blood Cell Distribution Width
= variation of RBC volume
What are the characteristics of benign tumors
Remain localized
Do not spread to other tissues
Grow slowly (Atypical mitosis)
Well-differentiated cells resembling their normal counterparts
What is a common medication that can Lys the plasma membrane
Tylenol
Liver, kidney
What 4 things can tumor markers be used for
Diagnosis
Predict response to cancer tx
Asses response to tx
Monitor the patient for cancer return
What are three causes plasma membrane morphology
Lysis
Complement system
Free radicals
What are the 4 functions of neutrophils
Mobility Phagocytosis Bactericidal activity (Kill O2, radicals) Cytokines production (Prolongs Inflamation and promotes FEVER)
How can endonucleases causes pathology
DNA and chromatin fragmentation
Biopsy of what lymph node is oftenusedtodetect metastatic cells as part of cancer staging
The sentinel lymph node
What are some examples of Type IV hypersensitivity granulomas
TB (Mycobacterium tuberculosis), (M. leprae), and fungi, sarcoidosis
Due to their slow growth, benign tumors are…
Encapsulated- tumor contained within smooth walled, fibrous capsule
And
Expansive- Exerts a mass effect by compressing on other tissues
Adding fluids to the body will ______ Hct value
Decrease
Where do most PE arise from
DVTs in the legs or pelvis
What is the culminating purpose of the complement system
Membrane Attach Complex
Genotype vs Phenotype
Geno: genetic form
Pheno: physical expression
What are 5 types of cellular adaptation
Atrophy Hypertrophy Hyperplasia Metaplasia Dysplasia
What are the initial symptoms of Hypovolemic shock
Elevated HR Increased RR vasoconstriction “Cold and Clammy” Increased Thirst Light headedness
(COMPENSATION)
Hepatitis B virus causes what kind of cancer
Hepato-cellular carcinoma (HCC)
What is the normal adult heme composition
2 Alpha and 2 Beta chains
What are the 4 types of emboli
Thromboembolism
Solid Particle Embolism
Liquid emboli
Gaseous Emboli
What is the tx for Acute Myelogenous Leukemia (AML)
chemotherapy induces remission in 60%
- High recurrence rate - under 30% remain disease free at 5 years
- Radiation / chemotherapy, then bone marrow transplant (BMT)
What Ag and Ab do group AB have
Both A and B Ag
No Ab
Name that disease:
Onset ~65 y/o
Immature myoblasts
Spleen/ nodes enlarged
HIGH RECURRENCE RATE
Acute Myelogenous Leukemia
What are the S/s of Chronic Myelogenous Leukemia (CML)
Slow onset of symptoms: fatigue, ↓endurance, infxs, splenomegaly, thrombus
What are 4 S/s of a tumor
Impinge upon vital tissues
Impair function of surrounding tissues
Cause death of involved tissues
Provided a nidus for infection
What is pernicious anemia
autoimmune d/o of stomach parietal cells decreases B12 absorption
Name that disease:
Onset <5 y/o
Immature lymphoid cells
Rapid Course
Good Prognosis and remission
Acute Lymphoblastic Leukemia
Define structural chromosomal abnormalities
Similar to genetic changes with neoplasms
- Deletion -portion is lost during replication
- Inversion (or Breakage) -portion breaks off & reinserted upside down or in wrong location
- Translocation-portion of chromosome inserted into another location
What are the 5 cardinal signs of acute inflammation
Calor (warmth)
Rubor (erythema)
Tumor (edema)
Dolor ( pain )
Loss of function **
What is thrmbocytosis
Excess circulating platelets, such as after a splenectomy
All three pathways of the complement system end with
BIG MAC ATTACK
What is a Sarcoma
A cancer of mesenchymal origin
Bone, cartilage, fat, blood cells, connective tissue
Malignant cells retain only functions essential to _________
Live and proliferate
What part of the Ab attached to the Antigen it was designed for
The light chain
Nitrosamines cause
Colon Cancer
Bradykinin is formed throughout he activation of Hageman factor with is aka
COAG Fx XII
Tissues that are easily damaged by radiation are also
readily treated by radiation therapy
Describe the 3rd stage in wound healing
Proliferation
New tissue is made from collagen and fibronectin
Epithelialization occurs
Wound contracts and new blood vessels are constructed
What is the best method for preventing genetic disorders
Prevention is best method
– update immunizations
-good nutrition
-avoiding smoking/alcohol
What explains why a disease arises
The etiology
What does neutrophillia suggest
Bacterial infection
What is the major difference between dystrophic and metastatic calcification
Dystrophic is in damaged, dying, or dead tissues
Metastatic is in normal healthy tissues
In hereditary spherocytosis
How will the mcv, mch and mchc present
MCV decreased – smaller cells so smaller volume
• MCH/MCHC increased – hemoglobin compressed into smaller RBC
What are the two types of thrombotic thrombocytopenia purpura
Primary – antibodies against enzyme that BREAKS DOWN Von Willebrand (clotting) factor
Secondary – from cancer, pregnancy, HIV, anti-platelet drugs, immuno-suppression
Serum is…
Plasma is…
When there is a blood clot in a blood sample, the left over fluid is serum
When the blood sample is pereserved with anticoagulants and run through a centrifuge, the fluid that is not RBCs is plasma
What are three examples of abnormal hematopoiesis
Sickle cell (Defect in B chain Hgb) Thalassemia (Defect in Hgb A, Beta or Alpha chain) Hereditary spherocytosis (RBC protein error)
An increased retic count with anemia signifies what..
- Bone marrow responds to anemic state by increasing production
- ↑ retic count shows anemia is NOT caused by marrow failure
What are the S/s of Acute Myelogenous leukemia
Spleen and lymph nodes usually enlarged
• Neutropenia, thrombocytopenia, and anemia are common
EBV
(Epstein-Barr virus , a Herpes Virus )
Causes what kind of cancer
Burkitt’s Lymphoma and Hodgkin’s
Losing body fluids will _______ Hct value
Increase
What does Retic measure
Number of immature RBCs in blood sample
• Reflection bone marrow’s production of new RBCs
What is megaloblastic anemia from
usually inadequate intake or malabsorption of B12 or Folate
What causes mesothelioma
Asbestos (tumor of lung pleura)
How many days post injury does the maturation phase of tissue remodeling occur
21 days post injury
Define Morphogenesis
Morphogenesis = evolution and development of organ or other body part
How do free radicals damage the plasma membrane
By reacting with the membrane phospholipids
What does eosinophilia suggest
Allergies or parasitic infections
What actions do you take for a minor transfusion reaction
Give diphenhydramine, methyl prednisone, and epi
Where are cells sampled from in a chorionic villus sampling
Fetal cells obtained from the chorion- a part of the placenta
Uses a sampling tool that enters through the vagina.
What tissues does coagulative necrosis mostly effect
Solid organs
What is the most important cause of delayed healing
Infections
What is cachexia
Unexplained weight loss, common in cancer pts
Name that disease
Onset Adults >45 years old
Punched out appearance
Hypercalcemia
Protienuria
Death within 3-4 years
Myeloma
In lymphatic spread what is the first node that receives drainage from primary tumor site…
Sentinel Lymph node
What are two types of pathological calcification
Dystrophic and Metastatic
Marrow suppression by cytotoxic drugs, chemo/rad therapy, or viral infx, can lead to what type of anemia
Aplastic Anemia
Vaso and Angio are generic terms for
Vessels
Can be blood or lymph
Define Agenesis
absence of organ or part of organ contains primordial tissue
What is the principle mechanism of first/ primary intention wound healing
Epithelial regeneration
- staples
- sutures
- seri strips
- adhesives
Pyrogens are released by…
Cause what..
Released by neutrophils
Caused Hypothalmus to being prostaglandin synthesis
What is grading of a tumor
Based on histology of the tumor
Used for treatement and planning of certain cancers
Reflectes the degree of differentiation
With regard to cytoplasm..
Highly differentiated cells have______
Undifferentiated cells have_____
Very abundant amounts in highly differentiated cells (liver, kidney)
Scant amounts in undifferentiated cells (often have larger nuclei)
What plasma derived mediator starts the coag cascade
Bradykinin
What is the largest group of genetic disorders
Recessives are largest group of genetic disorders ;however over all incidence in population is low
Describe caseous necrosis
“Cheesy” area created as affected cells fall apart
Typically seen in TB and some fungal infections (histoplasmosis)
Why are red blood cells Biconcave
- Biconcave shape; increases surface area for O2 and CO2 diffusion
- Highly flexible; able to bend shape when passing through narrow capillary beds
Define mar fans syndrome
Connective tissue disorder impacting formation of fibrillin
tall and slender habitus with elongated head/forehead
Elongated fingers
Aortic aneurysms, aortic dissection & rupture
Cardiac valves poorly structured – “floppy valves”
HPV causes what kind of cancer
Carcinoma of the cervix and penis
What are the S/s of a Vaso-Vagal event
Prodrome
(light-headed, nausea, cold sweats, pale skin/face, tunnel vision)
Brief LOC (quickly regained) Without amnesia
What is the function of CD8 cells
(T-suppressor/cytotoxic cells)
Suppress unwanted antibody production
Cytotoxic killing of cells recognized as “foreign”
– viral infected cells, cancer (CA) cells
What is another name for hydrothorax
Pleural effusion,
-fluid in the chest, outside the lung tissue
Type I hypersensitivity is what Ig mediated response
IgE
Antigens (allergen) sensitize
B-lymphocytes→Plasma Cells→IgE
What are the three phases of shock
Compensated
Decompensated
Irreversible
What is melena
Dark sticky feces containing DIGESTED blood
Define gangrene
Secondary change in ALREADY necrotic tissue
What are the most frequent new cancer cases in men and women
Men: prostate
Women: breast
What are the three types of abnormal hematopoiesis anemia
- SickleCellanemia
- Thalassemia
- Spherocytosis
What is the highest rick factor for cancer
Environmental causes ~65% of cancer risk
What is inate vs acquired immunity
Inherited ves learned
How is type and screen blood held
places blood on “soft reserve” for low probability transfusion
How does aplastic anemia cause pathology
bone marrow becomes hypocellular as stem cells are replaced by fat
An platelet count less that 50,000 is a high risk for what..
Increased bleeding from surgery
What are the S/s of a major transfusion RXN
Fever, chills, back pain, dyspnea, RENAL FAILURE
Less differentiation in grading equals…
More aggressive tumor
What are the four imbalances that cause edema
Imbalances in: Vascular pressure Permeability Oncotic pressure Lymphatic Drainage
What disorder is an error in protein metabolism, specifically errors in. Phenylalanine to tyrosine conversion
Phenylketonuria
What kind of edema can you drain with a needle
Localized edema in a BODY CAVITY
What is the most important and common cause of cell injury
O2 Deprivation
Hypoxia, anoxia
What is an intravascular thrombosis
Thrombus clot in an intact blood vessel
Which type of cell is least effected by chemotherapy and radiation
- Labile
- stable
- permanent
Permanent
What is the most important and frequently encountered autosomal disorder in the US
Familial Hypercholesterolemia
Low-DensityLipoprotein(LDL)receptor deficiency on liver cells
Where does HIV replicate
Retrovirus – replicates via reverse transcriptase especially in T-lymphocytes
What are the 3 pathways of the complement system
Classical
Alternate
Lectin
What does chorionic villus biopsy in pre natal testing look for
Direct tissue sampling of placenta for chromosomal and enzyme analysis
What are the two types of Hemophilia
Hemophilia A (factor VIII) Generally mild bleeding problems, may be symptomatic
and
Hemophilia B (factor IX). Severe form w/ excessive bleeding even from minor injury
Chronic inflammation is most often associated with which WBC
Lymphocytes and macrophages
What is the definitive finding to diagnose Lupus
ANA
(Anti-nuclear antibodies) found by immunofluorescene microscopy
How can ATPases cause pathology
Speed up the depletion of ATP
What is a hypertrophic scar
Scar forms thicker than expected
Where do Arterial emboli originate from
Heart or large arteries
In an amniocentesis, where are the cells sampled from
Fetal cells obtained from fluid in the amniotic sac where the fetus is held during the pregnancy
Ultrasound is used to guide a large needle thought the abdomen into the amniotic sac
What are the three types of necrosis and which is the most common
Coagulative (Most common)
Liquefactive
Caseous
Does the alternate pathway involve antigen-antibody complexes
NO
What are the actions to take in a major transfusion RXNs
STOP THE TRANSFUSION
IV fluids to maintain UOP
IV Bicarbonate to alkaline the urine to reduce Hgb precipitation in the kidneys
Send donor and pt blood to LAB ASAP
What is the most significant complication of a venous emboli
Pulmonary Embolism
What are the specifics for
T1
T2
T3
T1- solitary tumor
T2- tumor <5cm
T3- At least one tumor >5cm
What are 4 examples of Type I hypersensitivity
Anaphylaxis
Allergic Rhinitis
Asthma (allergy induced)
Atopic dermatitis
What is the X linked recessive disorder that is amplification of a fragile portion on the X chromosome
Fragile X syndrome
- mental deficiency
Characteristic head and facial appearance
Broad forehead, elongated face, large prominent ears, strabismus (cross eyed), high arched palette
Define teratogens
Agents known to cause fetal malformations
S/s of sickle cell
Persons <40% total HbS are often asymptomatic
Sickle Cell Crisis – triggered by fever, resp dz, phys exertion, dehydration
• Hemolysis of abnormal cells leads to anemia, jaundice and biliary stones
Most cancers occur in what stage of life
Mid to later years >55yrs
What are the 3 things needed to diagnose an auto immune disorder
- Auto-antibodies can be documented
- Immune mechanisms are causing pathologic lesions
- Evidence the disorder has an immune origin
Name that disease:
Onset >30yrs
Philadelphia chromosome
Three phases
(Blast Crisis Phase)
HIGH MORTALITY RATE
Chronic Myelogenous Leukemia
What are the clinical features of Acute Lymphoblastic Leukemia (ALL)
- Lymph nodes enlarged & mild splenomegaly
* Rapid course - recurrent infections, malaise, bleeding into skin and major organs
What is the more common form of immunodeficiency
Acquired (secondary) Immunodeficiency
Immuno-suppression by chemotherapy or steroids
Diabetes
Bone marrow dysfunction
AIDs
What is the precursor to mast cells
Basophils
What is the presentation of classic hemophilia
Hemophilia A “classic hemophilia”
- Factor VIII
more common form, usually milder symptoms
Easy nose & oral bleeding
Bleeding into joints even from minor trauma Cerebral hemorrhage
What does the term “staging” mean with cancer
Determines the extent of tumor spread
Is more prognostic value that grading
Better at predicting 5yr survival
Basophils granules are rich in what chemical
Histamine
Define Hypoplasia
underdevelopment of tissue, organ, or entire body
What are three causes of JVD
HF
Cardiac Tamponade
Tension Pneumothorax
Define hyperplasia
Increased tissue or organ size due to an increase in the number of cells
Iron deficiency anemia is most common in ..
Women
Define hypertrophy
Increased size of tissues or organs due to enlargement of individual cells
What can lead to a folate (B9) deficiency
Pregnancy and Lactation
Or ETOH abuse
(Damage to the GI system)
Explain oncotic pressure imbalance in edema
Albumin in bloodstream helps hold fluid (H2O) inside blood vessels, if this becomes disrupted, fluid does not stay within blood vessel leading to edema
What are the 6 kinds of inflammation
Serous Fibrous Purulent Ulcerative Pseudomembranous Granulomatous
What demographic does thalassemia effect most
Mediterranean and southeast Asian ancestry
Morphological changes help determine what.. .
The nature fo the disease and its progression
What are two examples of permanent cells
Non-dividing; lack capacity to replicate, New cells can not be formed; healing by fibrous scarring
QNeurons,myocardium
What are the 4 types of Normocytic anemia
- Aplastic Anemia
- Myelophthisic Anemia
- SickleCellanemia
- RBC loss or destruction
(MCV NORMAL)
In what stage of wound healing does epitheliazation occur
3rd stage
Proliferation
What is secondary polycythemia
Over-production of RBCs stimulated by increased erythropoietin release
• Usually from prolonged hypoxia – lung & heart dz; renal cell CA; adaptive for high
altitudes
What is the function of NK cells
Natural Killer Cells
Subset of T-cells without antigen receptors
– part of innate immunity present at birth
Do not require antigen-sensitization to recognize and kill virally infected cells and some cancer cells
What is the term for disorders only expressed by homozygous recessive pairs
Autosomal recessive disorders
What is 47XX +21 or 47XY +21
Trisomy 21
Down’s syndrome
What is 47XXY
Kleinfelters
Is a male phenotype disorder
Little to no sperm production
2* sex characteristics do not develop fully
- Small penis with atrophic testes (infertility)
- Scant pubic and body (axillary, facial hair) hair
- Mild gynecomastia (partial breast development)
- Facial features are eunuchoid
- unclear gender characteristics ; little to no facial hair
- Body habitus – tall height w/ unusually long arms/legs
- Abnormal body. proportions (long legs & short trunk)
- Potential learning disabilities
Which cells are most effected by chemotherapy and radiation therapy
- labile
- stable
- permanent
Labile
Describe metastatic calcification
Occurs in normal (healthy) tissues
Other disease process creates a secondary hypercalcemia
Example: Hyperparathyroidism, Multiple Myeloma
Prostate-Specific antigen (PSA)
Is a tumor marker for cancer where?
Prostate
The classical complement pathway starts with….
And antigen antibody complex
What is the most reliable feature separating malignant from benign tumors
Is the tumor invasive or not
What are the two types of thalassemia
Alpha Thalassemia – alpha chain defect; less severe (often termed Thalassemia minor or trait)
• Beta Thalassemia – beta chain defect; severe lethal form
How does PKU effect children/ infants
- By 6 months old, phenylalanine excess affects developing CNS-mental retardation, seizures, etc
- Excess phenylalanine inhibits melanin synthesis – children have fair skin & hair, blue eyes
Which part of the Anitbody is Specific & Unique to each immunoglobulin class
The heavy Chain
What is the pilocarpine test
Diagnosis for cystic fibrosis
Sweat chloride test
Pilocarpine solution and electrical current applied to skin surface triggers excessive NaCl excretion into sweat
What are three types of Ionizing radiation
Alpha, Beta, Gamma
What are the risk factors for a DVT
Inactivity (blood stasis) Smokers Pregnancy Contraceptives Cancer Previous Hx of Thrombosis Advanced Age
What is signifigant about Rh and pregnancy
A Rh neg mother birthing a Rh pos baby
She creates Ab, and if she has a second Rh pos baby, then there will be complications
What are the clinical characteristics of cystic fibrosis
- Pulmonaryinfections–pneumonias
* Pancreatic insufficiency -malnutrition/ malabsorption
What is the Temporary & orderly change of one cell type to another (along same cell line)
Metaplasia
How does the body maintain normal BP during compensated shock
Tachycardia
Vasoconstriction
And reduced UOP
Describe the 2nd step of wound healing
Inflammation
Begins shortly after injury; blood vessels leak into wound
Localized swelling
Controls bleeding and prevents infection
Describe dystrophic calcification
Occurs in damaged, dying or dead tissues
•May occur even with normal calcium blood levels
• Encountered with any type of necrosis
• Example: atheroma of advanced atherosclerosis
What is needed to cure chronic idiopathic thrombocytopenia purpura
Splenectomy
What is the most common cause of inflammation
Infections (duh)
- bacterial
- viral
- fungal
- parasitic
What are oncgenes
Genetic cause of cancer that Arise from damaged or mutated normal genes
Allows uncontrolled cell growth and poor differentiation
What percentage of pediatric inpatients with have a genetic disorder
20%
Name and define the Lymphoid Cells
Non Granulated WBC w/ Large dense nucleus
- Lymphocytes (T & B cells)
- Natural Killer cells
What demographic is most effected by Chronic Lymphocytic Leukemia
Older patients older than 50
What are the 4 stages of wound healing
- hemostasis
- inflammatory
- proliferative
- remodeling
Name that disease:
Onset > 50 y/o Slowly progressive Increased Infxs Survive 7-9 years No response to Chemotx
Chronic Lymphocytic Leukemia
90 percent of pts with Chronic Myelogenous Luekemia have what chromosomal defect
Philadelphia chromosome 22 abnormality
How do most patients w/ aplastic anemia die
Uncontrollable infections and bleeding and
From overwhelming sepsis
What is the most preventable teratogen
Alcohol!
What is becks triad
Hypotension
Muffled Heart Sounds
JVD
What is a notorious post-op killer of otherwise healthy Pts?
PE
Pulmonary embolism
How does Ionizing radiation cause cancer, and what tissues are most susceptible
Creates free radicals
Most susceptible:
stem cells
hematopoietic (blood-forming)
reproductive organs
epidermis of skin & intestine
fetal tissue
(esp 1st trimester rapid organogenesis)
What are the later S/s of Hypovolemic shock
Low BP
Confusion/ AMS
What are the clinical features of Hodgkin’s Lymphoma
large nodes, especially in neck and mediastinum
• Reed-Sternberg cells - multi-lobed nucleus surrounded by clear halo (“owls eye”)
Bimodal peaks at ages 25 and 55
What is the most common paraneoplastic syndrome.
Indirect indicator of possible cancer
Hypercalcemia
Sweating from the skin contain…
Water loss from respiration contains..
Water and electrolytes
Pure water vapor only
What is the difference between petechia, púrpura, and ecchymosis
- Petechiae – pinpoint red spots
- Purpura – larger reddish or purple spots
- Ecchymosis – bruise, contusion
(ALL THREE DO NOT BLANCH)
What does lymphocytosis suggest
Viral infection or chronic infection (TB)
What is myelophthisic anemia
replacement of bone marrow by cancers, fibrosis, or granulomas
• Examples: leukemia; multiple myeloma
Define aplasia
entire organ mass composed of primordial/rudimentary tissue
What are the three subtypes of non Hodgkin’s lymphoma
Folicular
Dioffuse Large B cell Lymphoma
Burketts lymphoma
What is the order of events from Metaplasia to cancer
Metaplasia → Dysplasia → Neoplasia (irreversible)→ Cancer (irreversible)
Clinical characteristics: Familial hypercholesterolemia
Atherosclerosis and HD
Xanthomas- lipid rich, yellow-brown nodules or plaques
Deposits on eyelids are highly characteristic
What is anasarca
Fluid accumulation throughout the body
Edema is evident in many body location s
-typically due to heart, liver, or kidney failure, or extremely poor diets
Describe the LOX pathway
LOX produces Leukotrienes - promote chemotaxis (call in WBCs) & increase vascular permeability •
Lipoxins – act at end of inflammatory phase; signal phagocytosis (clean up) of dead cells
What are the S/s of a tension Pneumo
Increased RR and Air Hunger
(Progressive respiratory distress)
JVD
Tracheal Deviation
(Seen on X-ray, late late sign when seen anatomically)
What is leukopenia
WBCs below normal levels
- Rare; often induced by cytotoxins especially during chemo/rad therapy for cancers
- High risk for overwhelming infections
What is a pericardial effusion
Fluid in the pericardium
Define congenital disorders
present at birth, but NOT always genetic
Inflammation can occur in organisms capable of…
neurovascular & cellular response to injury
What is the most common type of emboli
Thromboemboli (blood clots, free floating fragments from thrombi)
What are examples of Labile cells
(Easily regenerate for wound healing)
-skin, GI tract, hematopoietic
blood-cell-forming
What are the three types of microcytic anemia
- Iron deficiency
- Thalassemia
- Spherocytosis
(MCV IS DECREASED)
What X linked recessive disorder has a defect with dystrophin protein in muscle cells
Duchenne’s muscular dystrophy
-leads to progressive muscular wasting and weakness
Describe Hemophilia
defect in coagulation factor which results in bleeding disorder.
What are the characteristics of malignant tumors
Easily spread to other tissues
Invade and destroy structures
Grow very fast with little to no differentiation (Anaplasia)
What does MHC measure
Mean Corpuscular Hemoglobin
= avg hemoglobin amount per RBC
What causes wound dehiscence
Too much tension of wound edges
When do Macrophages appear in acute infections
3-4 days after onset of infection or tissue destruction
What is hereditary spherocytosis
RBC disorder in caucasians
Structure protein defect! Not an iron issue
produces smaller & less flexible RBCs captured and lysed by the spleen
What is the most aggressive form of non Hodgkin’s lymphoma
Diffuse Large B-cell Lymphoma - most aggressive form but most responsive to tx
• Complete remission in 75% w/ 50% may remain disease free for several yrs
How is the alternate complement system activated
Bacterial/ fungal endotoxins, snake venoms
What is the most common acute leukemia in adults (average age 65)
Acute Myelogenous Leukemia (AML)
(radiation and benzene)
- Proliferation of myeloblasts = immature bone marrow cells
- Blast cells take over marrow and “choke out” normal stem cells
Neoplastic cells can be killed but not _______
Repaired
Neoplasia is irreversible
What is an example of metaplasia
Barrett’s esophagus
What does MCV measure
Mean Corpuscular Volume
= avg volume (size) per RBC
Transudative fluid is the result of what four factors
Increase vascular pressure ( pushes fluid out of vessels)
Increased permeability
(Allows for fluid to leak out of cells easily)
Decreased oncotic pressure
(Fluid is not held in vessels, loss of gravity)
Decrease Lymphatic drainage
(Interstitial fluid is not removed properly)
Risk of metastasis in increases with what four factors
Aggressive local invasion
Lack of differentiation
Rapid Growth
Large Size
What is the single most importation environmental factor for cancer risk
Smoking #1
Alcohol #2
What is the opposite of anemia
Polycythemia
What effect do steroids have on wound healing
Anti-inflammatory effects may weaken scar formation
What medication is contraindicated in vWF disease
Asprin
What is ascites
Abnormal amount of fluid in abdominal cavity
What are the 4 types of prenatal diagnosis
Ultrasound
Maternal blood analysis
Chorionic Villus Biopsy
Amniotic Fluid Analysis
What is 45XO
Turners syndrome
Female phenotype disorder
- 2° sex characteristics do not fully develop at puberty
- Amenorrhea with atrophic ovaries (infertility)
- Genitalia, vagina & uterus does develop normally
- Wide out set nipples with rudimentary breast buds only
- Body habitus – short stature
- Webbed (broadened) neck
- Cubitus Valgus arms angle out ward at elbows
- Heart defects common – Coarctation (stricture) of Aorta
What disorder Produce abnormally thick mucus secretions blocking airways and pancreatic ducts
Cystic Fibrosis
What are two examples of stable cells
Rarely self-divides; can be stimulated to replicate as needed
– Kidney (proximal renal tubules)
-Liver – can regenerate to some extent
Describe contracture Vs stricture
Contracture, linear scars become shorter
Stricture, circular scars become smaller
What are the clinical S/s of systemic inflammation
Fever Leukocytosis Increased HR and BP Decreased sweating Anorexia Somnolence Malaise
Prostacyclin acts to counteract
The COX pathway
(Prostaglandins and Thromboxane)
From getting out of control
What are two examples of COX pathway inhibitors
ASA (Asprin), NSAIDS
Inhibit prostaglandins and thrmboxane
Define atresia
absence or closure of body opening or tubular structure
lacks hollow portion / lumen
When is Rhogam given to a suspecting mother
Typically twitching 12 hours of delivery
Prevents mother from developing Anti Rh antibodies
Pts with Chronic myelogeneous luekemia usually die within,….
3-5 years
What are the three morphologies of anemia
- Microcytic
- Normocytic
- Macrocytic
What are the first WBC to appear in an acute inflammation
Neutrophils
Fibrinous inflammation is most indicative of
Bacterial infections
What are the two types of wound healing repair techniques
First or primary intention
And secondary intention
What is the pathogenesis of chronic lymphocytic leukemia
Slowly progressive; most survive 7-9 yrs
• Increased infections because neoplastic lymphocytes do not fight infx as well as neutrophils
What is the role of CD4 Cells
• Part of antigen response
→Help B-lymphocytes produce antibodies
Secrete cytokines (interleukin)
Stimulate macrophages to become phagocytic
Trigger IgE and other immunoglobulins to activate eosinophils & basophils
How much urine output is required to clear the byproducts of metabolism
500-800 ml/day
Describe Lymphangitis
infection spreading along the lymphatic vessels; seen as red streaks (blood poisoning)
Human chorionic Gonadotropin (HCG)
Is a tumor marker for cancer located where?
Testicle
Define involution failure
persistence of embryonic structures; normally lost during development
What does megaloblastic anemia do to RBCs and WBCs
Macrocytic RBCs & hypersegmented WBCs
What would a tumor thats <2.3 cm, with Positve lymph nodes, and no metastisis be in the TNM staging
<2.3= T1
Positive lymph node= N1
No meta= M0
What is the ratio of Na/K in the extracellular vs the intracelluar fluid
Extracellular: high NA low K
Intracellular: low NA high K
What causes cells start rapid proliferation in epithelization
Contact inhibition
Granulomatous inflammation is most associated with
Chronic inflammation not acute
TB, fungal, parasites
What is the normal CD4/CD8 ration and what is the ratio in AIDs pts
normally, CD4 outnumber CD8 by 2-4:1
with AIDS, ratio often drops to 0.5:1 or less
Group B blood has what Ag and what Ab
B Ag
Anti A Ab
Which organ is particularly vulnerable to fibrotic scarring
The spleen
autospleenectomy
How can you treat polycythemia
Cytotoxic drugs
• Therapeutic phlebotomy (blood letting)
What are the two primary lymphoid tissues
Thymus (T cells) Bone Marrow ( B cells)
What does the term aneuploid mean
cells possessing an abnormal number of chromosomes
H. Pylori causes
Peptic ulcers which can lead to adenocarcinomas
What is Lymphadenopathy
enlarged lymph nodes
reacting to an inflammatory or infection trigger
If slowly enlarging, persistent, and non-tender – possible early cancer
What does thrombotic thrombocytopenia purpura cause
Abnormal clotting in small vessels
microangiopathy
RBCs subjected to stress in narrowed vessels—
What is the prominent clinical presentation for polycythemia
Splenomegaly
What are two types of radiation causes of cancer
UV light Radiation
And
Ionizing Radiation
Alpha-fetoprotein (AFP)
Is a tumor marker for cancer where?
Liver and Testicle
Eosinophils are associated with what kind of reaction
Allergic reactions and parasitic infections
What is the clinical sign of Muliptle Myeloma
Surrounding bone destruction creates ‘punched-out’ appearance
• Calcium released from bones
What does CAUTION stand for
Possible signs of cancer
C• Change in bowel or bladder habits
A• A sore that does not heal
U• Unusual bleeding or discharge
T• Thickening or a lump in breast or elsewhere
I• Indigestion or difficulty swallowing
O• Obvious change in wart or mole
N• Nagging cough or hoarseness
What do mature RBCs and platelets lack..
A nucleus
What are the two distinctions of gangrene
Wet and Dry gangrene
Name that disease:
One set Bimodal age peaks
Neck and mediastinal nodes
Reed Sternberg cells
80% survival rate
Hodgkin’s
What are disorders called that skip generations
Familial Disorders
Frequently are NOT inherited according to Mendelian genetic rules
How can you tell the difference between thalassemia and Iron deficiency
With electrophoresis that identifies HbA2
What is liquefactive necrosis
Tissues dissolve; most often in brain
Lytic enzymes transform tissue into pus within an abscess
What are two examples of Type II hypersensitivity
Graves Disease (Thyroid) Hemolytic Anemia (RBCs)
Autoimmune disorders
What is a carcinoma
A cancer of epithelial origin
Skin, GI, GU, Lung
TORCH syndrome impacts which organ systems
Multiple
- Brain -mental retardation ,neurologic symptoms
- Eyes - small size, cataracts
The Ab are found in what component of blood
Mostly in the plasma
Platelet counts below 20,000 can result in…
Spontaneous bleeding
Expectant mothers older than 35 should receive prenatal counseling for what disorder
Trisomy 21
What are the two types of inflammation
Acute vs Chronic
What is the difference between transudative and exudative edema
Transudative: clear serous fluid w/ low protein content & little to no cellular material
(Low specific gravity, clear)
Exudative: cloudy, pus-like fluid w/ high protein content, WBCs and cellular debris
(Has thick proteins, and is not clear, purulent)
What gives rise to the presenting signs and symptoms of the patient
The pathology of the disease
What are the three phases of progression in Chronic Myelogenous Leukemia (CML)
Chronic phase – lasts 2-3 yrs w/ marked leukocytosis and thrombocytosis
Accelerated phase – increased blast production from marrow
Blast Crisis phase – usually heralds death
What is hematochezia
Bloody stools
How can phospholilapses cause pathology
cause membrane damage
How does the lectin complement system get activated
starts with carbohydrate binding on bacterial surface
What is leukocytosis
WBCs above normal levels
- Normal response to inflammation or infection
- Persistent leukocytosis may represent early malignancy
Acute inflammation is associated most with what WBC
Neutrophils
Describe Type III hypersensitivity
Antibodies are formed as part of an ‘appropriate’ immune response
However, antigen-antibody complexes incorrectly deposit in/on other structures
Immune complexes become trapped in semi-permeable membranes
• Accidently activates complement system→recruits WBCs→resulting in cell damage
What is aplastic anemia
Loss of stem cells from bone marrow.
Results in pancytopenia
decreased production of all blood cell lines
75% of congenital defects are…
Idiopathic
Explain Ischemia-reperfusion injury
Tissue damage occurring after re-establishing blood flow to an ischemic area
Lack of blood flow causes decrease O2 @ cellular level,
Na-K pump fails,
Permeability increases and cells swells
Free radical precursors are released
Blood flow is restored Damage cell leaks out toxic contents Neutrophils attack and destroy cells O2 activates free radical precursors More damage is caused
What describes how a disease develops
The pathogenesis
What are the three mechanisms of shock
Pump failure (cardiogenic shock) (The hypoperfusion is directly related to the heart failing to pump)
Volume problem ( Hypovolemic shock) (The hypoperfusion is directly related to an insufficient volume in the vessels)
Pipe problem ( hypotonic shock/ distributive shock) (The hypoperfusion is a result of a loss of vascular tone)
What are the 5 types of decreased hematopoiesis anemia
- AplasticAnemia
- Myelophthisic Anemia
- Iron deficiency
- B12 & Folate deficiency
- Protein deficiency
Exudative fluid arrises from what factor
Increase permeability (Allows larger proteins and molecules to get out of the vessel into the interstitium)
What are 5 known carcinogenic agents
Chemical Microbial Viral Radiation Genetic
Define: genome
The complete set of chromosomes
spontaneous abortions (miscarriage) often during 1st trimester without woman’s knowledge are often the result from
Morphogenesis
What percent is fluid of Total Body weight
60%
What is the pathogenesis of cystic fibrosis
Dysfunction in chloride transport
Mucus w/ less NaCL will also have less H20
Thicker mucus clogs the lumen of many organs
What is the WBC prominent associated with IgE
Basophils
Cellular hypoxia leads to…. Which in then leads too..
Decreased production of ATP, which leads to failure of the Na-K pump
Clinical Characteristics of Trisomy 21
Mental Retardation – most significant feature
intellectual disability ranges widely
Facial Features – wide face, low nose, slanted eyes w/ epicanthal folds
macroglossia (enlarged tongue) often protruding
Abnormal Extremities – hands w/ ‘simian’ crease; shortened limbs; 5th finger shorter
Internal Organ Defects – heart defects; GI tract atresia/stenosis; infertility (Males > Females)
Hematologic Abnormalities – anemia; predisposition for leukemia
What causes con wilderbrands disease
Deficiency of Von Willebrand’s factor (vWF)
• vWF helps platelet adhesion and stabilizes clotting Factor VIII - making it last longer
Explain permeability imbalance in edema
Higher permeability allows more fluid to leak out of blood vessels leading to more edema
What are the indirect indicators of possible cancer
Hypercalcemia
Hyper coagulation
Cancer Antigen 125 (CA125)
Is a tumor marker for cancer where ?
Lung Breast, ovary, and pancreas
What is the marked S/s of irreversible shock
Circulatory collapse
MARKED hypoprofusion
Hypotension, RR failure, acidosis, anuria, DIC
Napthylanmine dyes cause
Bladder cancer
How can proteases cause pathology
Break down membrane and cytopskeltal proteins
What can ultrasound be used for in prenatal testing
non-invasive, widely available, & inexpensive
• Look for fetal malformations & placenta development/placemen
What are the three major steps to inflammation
Dilation
Increased permeability
Emigration of Leukocytes
What are the three pathways of metastatic spread
Hematogenous spread
Lymphatic Spread
Direct seeding of body cavity surfaces
Aflatoxin (from aspergillus fungus) causes
Liver cancer
What are the three general etiologies of Hypotonic/ Distributive Shock
- Sepsis
- Anaphylaxis
- Neurogenic trauma
Purulent inflammation arises form
Pus forming bacteria
In what gender are X linked recessive disorders expressed in
Expressed in males only.
Females only carry the X-linked trait.
Describe Type IV hypersensitivity
Mediated by Previously Sensitized Cells
(T-lymphocytes and macrophages)
Antibodies are NOT involved
Macrophages take up antigen and present antigen to T-lymphocytes
What are paraneoplastic syndromes
May be an early sign of occult (hidden) neoplasm
- hypercalcimia
- hyper coagulation
What is the most common form of anemia
Iron Deficiency Anemia
What is the process of phenylketonuria
Phenylalanine is not metabolized causing phenylalanine to accumulate, which then breaks down into phenylketones, which is then secreted in the urine.
What are 3 clinical examples of type III hypersensitivity
Lupis (SLE)
Post streptococcal Glomerulonephritis
Polyarteritis nodosa
(Autoimmune disorders)
What kind of non hogskins lymphoma is endemic in children with EBV
Burkitts Lymphoma
Involves mandible & face; responds well to chemotx
What is the difference of Hypoxia/ Anoxia and Ischemia
Hypoxia/ Anoxia is a reduced or lack of O2 specifically
Where ischemia is insufficient blood flow to an area and causes more damage as tissue lacks both O2, nutrients, and results in an excess of waste build up
Grade X: Grade I: Grade II: Grade III: Grade IV:
X: unknown I: well differentiated, low grade II: moderately differentiated III: poorly differentiated IV: undifferentiated, High grade
What Ig mediates Type II hypersensitivity
IgM and IgG
Antibodies bind to antigens in/on cells or tissue component
Gets confused,
Activates complement system→Membrane Attack Complex (MAC)→Cell Lysis (Cytotoxicity)
What is the gene defect in Hemophilia
Gene defect of coagulation factors;
50% are X-linked & 50% are spontaneous mutations
What are the secondary lymphoid tissues
Lymph nodes (tonsils and adenoids)
Spleen
GI and Bronchial Mucosa (MALT)
What are the clinical features of Idiopathic Thrombocytopenia Púrpura
Petechiae or
- Easy bleeding from nose or gums
- Splenomegaly common - sequestration of platelet-antibody complexes
What is the defection sickle cell anemia
Defect w/ hemoglobin synthesis produces Hemoglobin S (HbS)
What are the clinical features of non Hodgkin’s lymphoma
- Painless lymph node enlargement, may be solitary or diffuse
- Extra-nodal tumor spread – tumor cells infiltrate major organs
- Systemic symptoms – fatigue, malaise, fever, sweating
Explain Vascular pressure imbalance in edema
– mostly impacts the venous return system
Increased hydrostatic pressure pushes fluid outside blood vessels leading to more edema
S/s for Thrombotic thrombocytopenia purpura
- Purpura and ecchymosis; bleeding from nose or gums
- Hemolytic anemia – leads to anemia, jaundice
- Small vessel disease affects brain, kidneys, eyes
What happens if an embolus gets lodged in the Brain- Intestine- Kidney- Lower Extremity-
- Brain – ischemic stroke or infarction
- Intestine – bowel (mesentery) ischemia or infarction
- Kidney – infarcts w/ hematuria
• Lower Extremity
-Tiny emboli - “blue toe” necrosis
-Large emboli - ischemia of tissues
cold, pulseless leg
What is the most common lethal autosomal disorder
Cystitis fibrosis
What is the tx for Acute Lymphoblastic Leukemia (ALL)
With modern chemotherapy, remission achieved in ~66%
- without chemotherapy – usually fatal in 3-6 months
- Prognosis is better for children than adults
Where is a common spot for DVT
Deep vein thrombosis typically occurs in the legs or pelvis
What are the three types of chromosomal structural abnormalities
Deletion
Inversion
Translocation
What area is most often effected by direct seeding metastatic spread?
Most often seen in the peritoneal cavity
What are 4 causes of cardiogenic shock
MI
Vfib
Pericardial Tamponade
Tension Pneumo
Oncogenes created by 4 main mechanisms:
- Point Mutation
- Gene Amplification
- Chromosomal Rearrangement (Translocation)
- Insertion of Viral Genome
Chrons disease, celiacs, GI ulcers, gastric bypass pts, can all lead to what type of anemia
Megaloblastic anemia (B12 deficiency)
Generally, Tumor Markers are NOT recommended for routine screening
With what Exception:
Prostate-specific antigen is used for prostate cancer screening
Define Atrophy
Decreased size or growth of tissue or organ often w/ diminished fxn
Histamine is released form what cells
Mast cells, basophils, and platelets
Preformed
Nuclear pathology results in failure of:
protein & enzyme synthesis; growth regulation, mitosis
Describe Lymphadenitis
lymph node itself is infected usually forming an abscess
Due to their rapid growth malignant tumors are..
Poorly demarcated, lacking a defined wall or capsule
And
Invasive, penetrating the surrounding tissue.
What is the presentation for Christmas Disease
Hemophilia B “Christmas Dz”
– Factor IX (Christmas factor)
Less common but often more severe form
Easy nose & oral bleeding
Bleeding into joints even from minor trauma Cerebral hemorrhage
What type of blood would be used in an emergency situation
O RBCs
A male with Iron deficiency anemia should be suspected for what
GI ulcer or Cancer
How are X-linked recessive disorders transmitted
Mother’s transmit disorder only to sons
Fathers w/ disease transmit trait to daughter.
FATHERS DO NOT TRANSMIT DISORDER TO SONS
What is the body’s first response to injury
Vascular changes (dilation)
What is the approx liters of water a day for intake
2.5 liters per day
75% from oral
25% from solid foods
What is the most signifiant feature of trisomy 21
Mental retardation
Ulcerative inflammation is from
Surface tissue breakdown from underlying inflammation
Body surfaces/ mucosa
What are the two classes of pathogenesis
Genetic and acquired
Group O is known as the …
Group AB
O is the universal donor because it has no antigens
AB is the universal recipient because they have no Ab
Iron deficiency anemia, canses RBCs to be…
Microcytic and Hypochromic
Smaller and less color
What does MCHC measure
Mean Corpuscular Hemoglobin Concentration
= avg conc of hemoglobin/RBC
How is Rh Ab formed
Only formed when Rh neg pt is exposed to Rh pos
Describe the 4th step in wound healing
Tissue remodeling
Maturation phase
(begins 21 days after injury)
Collagen is remodeled
Wound closes however subsurface remodeling continues
Full strength achieved after several months
What are 2 types of Macorcytic Anemia
b12 or folate deficiency
MCV ELEVATED
Slowly enlarging and persistent non tender lymph nodes is a warning sign for…
Cancer
What is the action of bradykinin
It’s a plasma derived acute inflammation mediator
Simular to histamine, but slower
Amplifies and prolongs inflammatory response
Capable of inciting pain
What are the 3 main functions of the complement system
Prolongs Inflammation
Phagocytosis through opsinaization
Cell Lysis through MAC attack
What are the clinical features/ S/s of DVT
Pain
Warmth
And Color changes
(Changes are seen unilaterally)
What is virchows triad of thrombosis
- Injury to endothelium
- Hemodynamics changes in vein
- Hypercoagulable state
What is the highest risk of blood compatibly reaxns
Whole blood transfusions
Minor are from preservatives not front he blood
What is the normal ration of CD4 to CD8 cells
Normally,
CD4 outnumber CD8 by 2-4 to 1
What are the three causes of iron deficiency anemia
Increased Iron Loss ( blood loss) Decreased Iron uptake (poor diet, absorption) Increased Iron requirement (Pregnancy, menses, surgery)
What determines a persons observed phenotype
Expressed genotype + Environmental influences
What are the two most frequently involved organs with hematogenous metastatic spread
Liver and the Lungs
What is thrombocytopenia
Abnormal low platelet count
How is cross-matched blood kept
held specifically for that patient only
What does the acronym TORCH stand for
Used for Microbial teratogens
T-Toxoplasmosis (parasite from cat feces)
O – Other less common microbes Epstein-Barr, Varicella, Listeria
R-Rubella (German measles)
C-Cytomegalovirus (CMV) (common human virus)
H-Herpes Virus
What is Chronic Myelogenous Leukemia (CML)
Bone marrow becomes overgrown w/malignant cells
90% w/ Philadelphia chromosome 22 abnormality
Most patients are older than 30yrs
What are the the S/s of polycythemia
Splenomegaly is prominent feature
- Skin appears dark red or flushed
- Blood is hyper-viscous & tends to clot easily
- Headaches, hypertension, visual and neurologic problems
What is the S/s of minor transfusion RXNs
Urticaria, fever, bronchospams
What are the 5 causes of “loss or destruction” of RBCs anemia
- Bleeding (acute/chronic)
- Malaria
- Hemolytic anemia
- Medications
- Spleen Sequestration
What is considered the hallmark of malignancy
Anaplasia
Lack of differentiation
Parasites such as Schistosoma haematobium are associated with what type of cancer
Bladder cancer
Hypertrophy can only occur in what type of muscle
Heart and striated
What does the term Neoplasia mean
“New Growth”
Neoplasms or tumors
NOT necessarily cancer
Can be Benign or Malignant
(example:wart vs. melanoma)
What happens if enzymes
(from lysosomes) accidentally leak within a cell
Injured cell cytoplasm becomes acidic; inappropriately activating enzymes
Once activated, the enzymes cause significant cell damage
Malignant cells regress to…
Fetal/ embryonic functions of that cells line
Hyperplasia is usually the result of what
Hormonal stimulation , mediations, or chronic injury
What is the Disorderly transition, arrangement and layering of cells types and is often considered precancerous
Dysplasia
Arsinic causes
Skin cancer
What are the 5 types of Morphogenesis
Agenesis Aplasia Atresia Hypoplasia Involution failures
What is the most common form of leukemia in children esp under age 5
Acute Lymphoblastic Leukemia (ALL)
- bone marrow w/ immature lymphoid cells (blasts)
- malignant lymphoid cells in peripheral blood
Define: Karyotype
the full chromosome set contained within a nucleus.
Often referred to as chromosomal count/code - 46XX (human female), 46XY (human male)
What is the difference between a pulmonary infiltrate and a pleural effusion
In an infiltrate the fluid has infiltrated the tissues (it is IN the tissue)
In an effusion, is it AROUND the tissue.
Name and define the Myeloid Cells
Granulated WBCs / Complex Nucleus
- Neutrophils, Eosinophils, Basophils
- RBCs and Platelets
What is a major physical teratogen
Radiatio
Medical X-rays
What is the normal urine output per day
1-1.5 liters per day
How do cyanide disrupt oxidative phosphorylation
Disrupts the Cytochrome C oxidase step
Decreases atp production, leads to cellular hypoxia
What is the result of Na-K pump failure
Na osmotically “tries” to get into the cell, but pump prevents this
If pump fails, then too much Na and water enter cell
Resulting in cellular edema, dysfunction, and possible lysis
Which is worse Hemophilia A or B
B is worse w. Excessive bleeding
Oxidative phosphorylation leads to…
ATP production, and energy for the cell
Group A blood has what Ag and what Ab
A-Ag
Anti-B Ab
Is Rh and dominant or recessive gene
Dominant
What leads to a Vaso-Vagal episode
- Deep brainstem activated by triggering stimuli
(sight of blood; extreme emotional distress)
- Enhanced parasympathetic (vagal) tone→sudden bradycardia (nausea, diaphoresis)
- Decreased sympathetic tone→sudden vasodilation (blood pressure drops, pallor)
2. Combination of sudden bradycardia and hypotension decreases the cardiac output
3. Brain becomes under perfused→syncope (faint)
What is the largest percentage of cancer deaths in men and women
Lung and bronchus cancers
What is the most common clinical form of Type IV hypersensitivity
Contact dermatitis
Serous inflammation is most indicative of
Physical agents
Burns, poison ivy
What are the lab value levels for anemia in men and women
Anemia Levels:
M < 13 g/dL
F < 11.5 g/dL
What are the criteria for SLE (Lupus)
SLE Criteria:
(4 or more required for diagnosis)
• Dermatitis - Malar rash and discoid rash
• Arthritis - Non-erosive arthritis in 2 or more peripheral joints
• Nephritis-Renal disorders foundin >50% of SLE patients
• Serositis - Pleuritis, pericarditis
• Neuritis–varietyofneurologicdisorders
• Vasculitis
• Hematologicdisorder-hemolyticanemia,leukopenia,lymphopenia
Pseudomembranous inflammation is most associated with
C. Diff
Interstitial space is often called …
“Third space”
Space between cells, not within vessels, cells, or body cavities
Is chemo effective for pts with multiple myeloma
No, death within 3-4 years
Name that disease:
Onset Any age
Painless lymph node
Extra nodal tumor spread
Variable survivability
Non-hodgkins
What is the most common outcome of inflammation
Complete resolution
What effect does histamine have on the endothelium
Increase permeability
Spleen enlargement causes what
Cytopenia from sequestration
Rapid hypoxia/ anoxia most often leads to what type of necrosis
Coagulative
What are the classic symptoms of a PE
Sudden chest pain, very rapid onset of seconds to mins
Sudden SOB and Tachypnea
Hemopytsis ( coughing up blood)
How does fetal alcohol syndrome progress
Causes intrauterine growth delay
Small baby w/ facial changes
What is the marked sign of decompensated shock
Hypotension and Acidosis
Deficiency in these 4 nutrients can lead to anemia
- Iron deficiency
- B12 & Folate deficiency
- Protein deficiency
What are 4 causes of chronic inflammation
Resistant microbes
Autoimmune diseases
Repeated toxic exposure
Foreign bodies
What are the two types of wound reactions
Regenerative (repair)
Scar formation
(often occur together)
Which cells are least sensitive to Ionization radiation
Nerve cells
Bone (not marrow)
Muscle
How can apoptosis cause pathology
Usually does not, nor does it trigger inflammation however lack of physiologic apoptosis can lead to leukemia or syndactyl (webbed toes)
To for hemophilia
Infusions of MAN MADE recombinant clotting factors
What are the two classes of inflammatory mediators
Plasma derived and cell-derived
Define an embolism
Freely mobile, intravascular mass carried from one site to another
What does maternal blood analysis in prenatal testing look for
Screen for fetal substances in maternal circulation
• Alpha-fetoprotein (AFP) ↓ levels associated with Down’s
Describe COX pathway
Produces Prostaglandins - vasodilation, vascular permeability, pain, and fever
Thromboxane - platelet aggregation, thrombosis, vasoconstriction
What does hemoarethrosis mean
Blood in a joint or synovial cavity
What are three common lab markers for irreversible cell injury
AST- Aspartate aminotransferase
ALT - Alanine aminotransferase
LDH - lactate dehydrogenase
Explain lymphatic drainage imbalance in edema
Interstitial fluid unable to drain away causing fluid accumulation which leads to edema
What are the 4 major groups of abnormal immune responses
- Type I – Anaphylactic or Atopic Reaction
- Type II – Cytotoxic Antibody-Mediated Reaction
- Type III – Immune Complex-Mediated Reaction
- Type IV – Cell-Mediated or Delayed-Type Reaction
What is primary polycythemia
(polycythemia vera)
• Myeloproliferative disorder considered neoplastic
• Hematopoietic stem cell proliferation WITHOUT external stimuli causes over-production of RBCs
