Patho Final Flashcards
INNATE IMMUNITY is ___ and ___ response
early and rapid
4 cells of innate immunity
Phagocytic granulocytes
Macrophages
Dendritic cells
NKCs
1st line of defense against viral infection
NKCs
Dendritic cells
antigen-presenting cells
Phagocytic granulocytes examples
Neutrophils, Eosinophils, Basophils
Substances that elicit adaptive immune responses are called
ANTIGENS
help B-cells make antibodies & help phagocytic cells destroy ingested pathogens
helper T cells
kill intracellular microbes
Cytotoxic T-cells
Vaccinations depend on ___ immunity
Humoral
Cell-Mediated Immunity involves the use of __ to influence other cells
Cytokines
Defends against intracellular microbes such as viruses
Cell-Mediated Immunity
immunity that recognizes abnormal cells from cancers, viruses, infections, and transplanted tissues
Cell-Mediated Immunity
Innate or adaptive, general protection
Innate
Innate or adaptive, early phase of host response
Innate
Innate or adaptive, lag time between exposure and maximal response
Adaptive
Bones of the skeleton house __% of body’s calcium and __% phosphorus
99% of body’s calcium & 85% phosphorus
Osteopenia
Metabolic bone disease
Osteopenia is characterized by a
reduction in bone mineral density
Osteopenia occurs because of a decrease in ___ ___, inadequate ___ ___, or excessive bone ____
decrease in bone formation, inadequate bone mineralization, or excessive bone deossification
Osteopenia is not a diagnosis but a term used to describe an apparent loss of __ __ seen on x-ray studies
bone density
The 5 major causes of osteopenia are:
- Osteoporosis
- Osteomalacia
- Malignancies
- Multiple myeloma
- Hyperparathyroidism
Osteoporosis is a metabolic bone disease characterized by
decreased bone density (i.e., increased porosity)
In addition to decreased bone density, Osteoporosis is characterized by decreased
strength because the bone matrix and mineralization are decreased.
Osteoporosis risk factors
50yrs or older Female White or Asian Small bone structure/low body weight Postmenopausal Family history Sedentary Calcium/Vitamin D deficiency High-protein diet Smoking, drinking, caffeine
The cause of osteoporosis remains largely unknown, but most data suggest an
imbalance between bone resorption and formation.
___ factors play a significant role in the development of osteoporosis, particularly in postmenopausal women.
Hormonal
Postmenopausal osteoporosis is caused by an ___ deficiency.
estrogen
Postmenopausal osteoporosis: The loss of bone mass is greatest during
early menopause
decreased physical ___ that often accompanies aging may also contribute to the loss of bone mass in the elderly.
Activity
associated with many conditions, including endocrine disorders, malabsorption disorders, malignancies (multiple myeloma), alcoholism, and certain medications.
Secondary osteoporosis
___ use is the most common cause of drug-related osteoporosis
Corticosteroid
Several groups of children and adolescents are at particular risk for decreased bone mass, including ___ infants with low birth weight
premature
Children with ___ ___ often have impaired GI function that reduces the absorption of calcium and other nutrients, and many also require frequent corticosteroid drugs.
cystic fibrosis
Premature osteoporosis is increasingly being seen in female ___ due to increased prevalence of eating disorders and amenorrhea.
athletes
The female athlete ___ refers to a pattern of disordered eating that leads to amenorrhea and eventually osteoporosis
triad
Osteoporotic changes occur in the diaphysis and __ of bone.
Metaphysis
Osteoporosis is usually a silent disorder. Often, the first manifestations of the disorder accompany a skeletal
Fracture
Hip fractures occur mainly in persons over the age of
65
An important advance in diagnostic methods used for the identification of osteoporosis has been the use of ___ assessment
BMD assessment.
The clinical method of choice for BMD studies is dual energy x-ray absorptiometry (DEXA) of the
spine and hip.
Measurement of serial ___ in older adults is another simple way to screen for osteoporosis.
Heights
Studies have indicated that premenopausal women need more than 1000mg/day of calcium, and postmenopausal women need at least ____ of calcium daily.
1200mg
A daily intake of ___ IU of vitamin D is recommended for adults aged 50 years and older.
800-1000
Rheumatoid arthritis (RA) is a chronic ___ systemic disease
autoimmune
Rheumatoid arthritis (RA) is a chronic autoimmune systemic disease that affects all ethnic groups throughout the worlds, with
women being affected more frequently than men.
Rheumatoid arthritis: The onset of the disease can occur at any age, but its peak incidence is between
50 & 75 years of age.
Rheumatoid arthritis: Evidence points to a ___ predisposition and the development of joint inflammation that is immunologically mediated.
genetic
It has been suggested that the disease is initiated in a genetically predisposed individual by the activation of a ___-cell mediated response to an immunological trigger, such as a microbial agent.
T-cell-mediated
____ is a strong risk factor for the development of RA and may also influence the severity of the disease.
smoking
The pathogenesis of RA can be viewed as an aberrant immune response that leads to ____ inflammation and ____ of the joint architecture.
Synovial, destruction
RA has an insidious onset marked by systemic manifestations such as
fatigue, weakness, and generalized aching and stiffness.
The person may complain of joint pain and stiffness that lasts for 30 minutes and frequently for several hours.
RA
RA: The limitation of joint motion that occurs early in the disease is because of pain; later, it is because of
Fibrosis
In early disease, the wrists, metacarpophalangeal joints, proximal interphalangeal joints of the fingers, the thumbs, and hands are most commonly affected.
RA
RA: A ___ cyst may develop in the popliteal area behind the knee.
Baker
RA frequently has constitutional symptoms such as
fatigue, weakness, anorexia, and weight loss that are due to systemic inflammation.
Osteoarthritis aka
degenerative joint disease
Osteoarthritis most ___ type of joint disease
Prevalent
Osteoarthritis is characterized by degenerative changes of the ___ cartilage
articular
OA appears ____, without any apparent initiating cause, as an aging phenomenon.
Insidiously
Joint changes associated with OA include a gradual loss of articular cartilage, combined with ____ of bones.
thickening
OA is a multifactorial disease that has genetic and environmental risk factors.
- Age (strongest factor)
- Gender (Women)
- Race (Hand-White women) (Knees- Black women)
- Obesity
- Wear-and-tear arthritis
Wear-and-tear arthritis
OA
OA has audible
Crepitus
RBCs are derived from precursor cells called
Proerythroblasts
Most maturing RBCs enter blood as
Reticulocytes
__ to __ % of oxygen is bound to RBCs
95%-98%
Lack of iron= lack of ___ in RBC
Hemoglobin
__% iron is in hemoglobin
65%
When red blood cells age and are destroyed in the spleen, the iron from their hemoglobin is released into circulation & returned to the
bone marrow for incorporation into new RBCs or to the liver and other tissues for storage.
After 20yrs old, RBC production takes place in:
vertebrae, sternum, ribs, and pelvis
Maturation from reticulocyte to erythrocyte takes
24-48 hours
During maturation, RBC loses its
mitochondria, ribosomes, and ability to produce hemoglobin
Decreased O2 content is sensed by the ___, which in turn produce the hormone erythropoietin to produce more RBCs
KIDNEYS
Mature RBCs have a life span of
120 days
Mature RBCs do NOT have a nucleus, mitochondria, or endoplasmic reticulum, but do have cytoplasmic enzymes that metabolize
glucose and form ATP
Rate of RBC destruction=
rate of RBC production
When red blood cell destruction takes place in the circulation, as in hemolytic anemia, the hemoglobin remains in the plasma where it binds to a hemoglobin- binding protein called
haptoglobin
Anemia usually results from excessive loss (bleeding) or destruction (hemolysis) of RBC or
deficient RBC production due to lack of nutritional elements (iron) or bone marrow failure.
Anemias caused by premature destruction of the RBCs
hemolytic anemia
anemia associated with hyperbilirubinemia, jaundice, and gallstones.
hemolytic anemia
Chronic blood loss does not affect blood volume, but instead leads to
IRON-DEFIECNCIEY ANEMIA
Without adequate ___, the body cannot produce enough hemoglobin for red blood cells.
Iron
The result is iron-deficiency anemia. This type of anemia can be caused by: An iron-poor diet, especially in infants, children, teens,
vegans, and vegetarians
Iron balance is maintained by absorption of 0.5-1.5 mg daily to replace __mg lost in feces.
1mg
Persons are commonly asymptomatic until the hemoglobin level is less than __g/dL
8 g/dL
Iron can be derived from meat and is absorbed in the small intestine, especially the
duodenum
Hemolytic anemia is characterized by the premature destruction of RBCs, the retention of Iron and the other products of hemoglobin destruction, and the compensatory increase in
erythropoiesis
Extravascular hemolysis produces jaundice and
Gallstones
Intravascular hemolysis occurs as a result of
mechanical injury.
Sickle cell anemia: RBCs break down ___, so oxygen does not get to the body’s organs, causing anemia.
rapidly
The crescent-shaped red blood cells can also get stuck in tiny blood vessels, causing
pain
Sickle cell disease is an inherited disorder in which abnormal hemoglobin leads to chronic hemolytic anemia, pain, and
organ failure
Most infants with sickle cell disease do not begin to experience the effects until
8-10 wks of age.
2 most common probs of sickle cell disease:
Vasocclusive pain crisis
Acute chest syndrome (Pulmonary infarction)
an inhibitor of DNA synthesis, has been shown to reduce pain crisis and prevent the complications of sickle cell disease.
Hydroxyurea
May occur when vitamin B12 ( aka cobalamin) and folate are deficient.
Vitamin-deficiency anemia
These two vitamins are needed to make red blood cells.
vitamin B12 ( aka cobalamin) and folate
Megaloblastic (enlarged RBCs) anemia : Vitamin B12 or folate or both are
deficient
Dietary deficiency: Eating little or no meat, cereals and fruits may cause a lack of
vitamin B12
overcooking or eating too few vegetables may cause a
folate deficiency.
Lead exposure is toxic to the bone marrow, leading to fewer
red blood cells
Diabetes is a disorder of carbohydrate, protein, and fat metabolism resulting from a
lack of insulin availability or a reduction in the biologic effects of insulin.
After digestion, glucose passes into our bloodstream where it is available for body cells to use for growth and
Energy
For the glucose to get into the cells, ___ must be present
Insulin
Insulin is a hormone produced by the
pancreas
When we eat, the pancreas is supposed to automatically produce the right amount of insulin to move the glucose from our blood into our cells. In people with diabetes, however, the pancreas either produces
little or no insulin, or the body cells do not respond to the insulin that is produced.
DM: glucose builds up in the blood, and overflows into the
Urine
DM: the body loses its main source of fuel even though the blood contains large amount of
glucose
Fasting plasma glucose (FGP) test measures plasma glucose levels after food has been withheld for at least
8 hours
Normal FGP
below 100mg/dL
Normal OGTT
below 140mg/dL
An elevated FPG or OGTT is classified as having impaired fasting plasma glucose (IFG) and/ or impaired glucose tolerance (IGT) → Persons with these are often referred to as being
prediabetic
known as insulin-dependent diabetes mellitus or juvenile diabetes
Type 1
In diabetes, the immune system attacks the insulin-producing
beta cells in the pancreas
One of the actions of insulin is the inhibition of ___ (fat breakdown) and release of free fatty acids from fat cells.
Lipolysis
In the absence of insulin, ___ develops when these fatty acids are released from fat cells and converted to ketones by the liver.
Ketosis
About 90 to 95 percent of people with diabetes have type __
2
form of diabetes usually develops in adults over the age of
40 and is most common among adults over age 55
In type 2 diabetes, the pancreas usually produces insulin, but for some reason,
the body cannot use the insulin effectively.
The end result of Type 2 is the same as for type 1 diabetes – an unhealthy buildup of
glucose in the blood and an inability of the body to make efficient use of it
Metabolic abnormalities involved in type 2 diabetes: Increased ___ production by the liver
Glucose
Gestational diabetes usually disappears when after
pregnancy
women who have had gestational diabetes have a greater risk of developing
type 2 diabetes later in their lives
greater risk of developing diabetes
African American, Hispanic, or Native American
Type 1 diabetes occurs equally among males and females, but is more common in
whites than in nonwhites.
A diet that is too high in sodium and too low in ___ puts you at risk for high blood pressure.
Potassium
Potassium is found in bananas,
potatoes, beans, and yogurt.
Men should have no more than __ drinks a day.
2
