Patho Test 1 Flashcards
2 types of feedback mechanism
1) negative feedback
2) positive feedback
3 components of feedback control
1) sensor
2) integrator/comparator/regulatory center
3) effector
Iatrogenic etiology
Caused by healthcare professional during treatment or diagnostic procedure
Clinical manifestations are investigated by acronym…
OPQRST
OPQRST means…
Onset Provocative Quality Region/radiation Severity Timing
Investigate symptoms asking about…
Location Quality Quantity Chronology Setting Aggravating/alleviating factors Associated manifestations Meanings to patient
Stages of the disease process…
Exposure Latent incubation Prodromal period Acute phase Remission Convalescence Recovery
Cells adapt by changing…
Size
Number
Type
Atrophy
Cell size decreases
Causes of atrophy
Disuse Denervation Loss of endocrine stimulation Inadequate nutrition Ischemia
Hypertrophy
Cell size increases which increases the cell functioning tissue mass
2 types of hypertrophy
1) physiologic - exercise
2) pathologic - hypertension
Hyperplasia
Cell number increases
Metaplasia
Reversible replacement of one cell type by another of same family
Response to chronic irritation
Reprogramming of stem cells
Dysplasia
Atypical form of hyperplasia
Changes to number size shape and organization
Precursor to cancer
Neoplasia
Abnormal proliferation of cells
Abnormally grow OR don’t die
Causes of cell injury
Hypoxia
Oxygen-derived free radicals
Impaired calcium homeostasis
Chemical injury
Reperfusion (hypoxia-reoxygenation) injury
Reperfused tissue must sustain loss of cells in addition to irreversibly damaged cells after ischemia
Reperfusion injury causes what major problem for remaining cells?
Highly reactive oxygen intermediates
OFR
Oxygen free radical
Examples of antioxidants
Alpha lipoid acid Vit A, C, E Coenzyme Q10 Selenium Polyphenols (green tea)
Parasympathetic
Rest and digest
Sympathetic
Fight or flight
GAS 3 structural changes
Enlarged adrenal glands
Decreased thymus gland
Gastrointestinal ulceration
3 stages of GAS
Alarm
Stage of resistance/adaptation
Stage of exhaustion
3 systems that respond to stress
Nervous
Endocrine
Immune
3 components of physiological stress
Stressor
Physical/chemical disturbance
Body’s counteracting response
3 types of flu virus
Type a, b, c
Type a flu virus subtype
H1n1
H1n2
H3n2
Thyrotropin releasing hormone (TRH)
Origin - hypothalamus
Target - anterior pituitary
Action - stimulates TSH
Corticotropin releasing hormone (CRH)
Origin - hypothalamus
Target - anterior pituitary
Action - stimulates ACTH
Gonadotropin releasing hormone (GnRH)
Origin - hypothalamus
Target - anterior pituitary
Action - stimulates LH and FSH
Growth hormone releasing hormone (GHRH)
Origin - hypothalamus
Target - anterior pituitary
Action - stimulates GH
Somatotropin release inhibiting hormone (SRIH)
Origin - hypothalamus
Target - anterior pituitary
Action - inhibits GH
Thyroid stimulating hormone (TSH)
Origin - anterior pituitary
Target - thyroid
Action - stimulates thyroid hormone
Follicle stimulating hormone (FSH)
Origin - anterior pituitary
Target - ovaries and testes
Action - stimulates ovarian follicles and sperm maturation
Luteinizing hormone (LH)
Origin - anterior pituitary
Target - ovaries and testes
Action - stimulates ovulation. Synthesize sex hormones
Growth hormone (GH)
Origin - anterior pituitary
Target - body
Action - stimulates protein synthesis and growth
Prolactin
Origin - anterior pituitary
Target - breasts
Action - stimulates milk production
Adrenocorticotropic hormone (ACTH)
Origin - anterior pituitary
Target - adrenal cortex
Action - secrete adrenal cortical hormones
Melanocyte stimulating hormone (MSH)
Origin - anterior pituitary
Target - skin cells
Action - stimulates melanin synthesis
Oxytocin
Origin - posterior pituitary
Target - breast and uterus
Action - stimulates milk ejection and contraction
Antidiuretic hormone (ADH)
Origin - posterior pituitary
Target - renal collecting ducts
Action - stimulates water reabsorption
L-thyroxine (T4)
Triiodothyronine (T3)
Origin - thyroid gland
Target - peripheral tissues
Action - skeletal growth, heat production, increased o2, protein, fat, and carbs use
Glucocorticoids (cortisol)
Origin - adrenal cortex
Target - peripheral tissue
Action - stimulates gluconeogensis, anti inflammatory, immunosuppression
Aldosterone
Origin - adrenal cortex
Target - renal tubules
Action - increase na reabsorption, k+ secretion, h+ secretion
Epinephrine
Origin - adrenal medulla
Norepinephrine
Origin - adrenal medulla
3 causes of endocrine disorders
1) hypo secretion
2) hyper secretion
3) lack of responsiveness
Panhypopituitarism
Condition if decreased production of all pituitary hormones
Somatotropin
Growth hormone
GH excess in children leads to
Gigantism
GH excess in adults leads to
Acromegaly
Dz of congenital hypothyroidism
Cretinism
Hashimotos’s dz
Destruction of thyroid cells by various cell and antibody mediated immune processes
Most common cause of hypothyroidism after age 6
Hashimoto’s dz
Subacute thyroiditis (SAT)
Hyperthyroidism from cell breakdown
Hypothyroidism after breakdown is metabolized
Returns to normal function
Graves dz
Autoimmune disorder that causes hyperthyroidism
Most common cause of hyperthyroidism
Most common cause of childhood thyrotoxicosis
Graves dz
Myxedema
Normally occurs in hypothyroidism
Can occur in other thyroid conditions
Usually in anterior tibial location
Adrenal cortical hormone categories
Glucocorticoids (cortisol) Mineralocorticoids (aldosterone) Adrenal androgens (androstenedione)
Cushings dz
Adrenal cortex dz
Too much cortisol
Body produces excess ACTH
Addison’s dz
Adrenal hypo function
Not enough steroids
Electrolyte imbalance from lack of aldosterone
Conn’s syndrome
Hyperaldosteronism
Sodium and water are reabsorbed
Decreased potassium
Pheochromocytoma
Tumor of adrenal medulla
Complications of seasonal flu
Bacterial pneumonia
Ear or sinus infection
Dehydration
Worsening of chronic condition
Groups more likely to have flu complications
> or = 65 < or = 2 Anyone with chronic medical condition Morbid obesity Native Americans Indigenous Alaskans
Number of weeks for body to compile flu antibodies
Two
Most common inhaled bacteria cause of pneumonia
Streptococcus pneumonia
Aka pneumococcus
Most common cause of all bacterial pneumonia
Pneumococcal pneumonia
Most common type of atypical pneumonia
Mycoplasma
Aka walking pneumonia
SIADH
Syndrome of inappropriate anti diuretic hormone
Diabetes insipidus
Not enough ADH
Four F’s of hypothalamus responsibilities
Feeding
Fighting
Fleeing
Fertility
Thyrotropin is aka
TSH
Wellness
Holistic process focusing on physical emotional spiritual and mental balance
Disease
The presence of a pathology
Illness
Patients perception of their health regardless of disease
Three aspects of disease process
Etiology - cause
Pathogenesis - mechanism of disease process
Clinical manifestations - consequences of the structural or biochemical alterations
5 adaptive cellular changes
Atrophy Hypertrophy Hyperplasia Metaplasia Dysplasia
Most common cause of cellular injury
Hypoxia
Mechanisms responsible for reperfusion injury
Reactive oxygen intermediates Reactive nitrogen species Overload of cytosolic calcium Production of cytokines Neutrophil influx *pg 15/16
Outcomes of cellular injury
Reversible injury/cell recovery
Apoptosis
Cell death/necrosis
Vacuolation
Hypoxic injury - membrane damage - Na K pump failure - shift of fluids into cell - ER up takes extra water causing distention - ruptures into large vacuoles that isolate water from cytoplasm
*pg 19
Apoptosis
Active process using ATP
does not have inflammatory response
Doesn’t affect surrounding cells
Necrosis
Occurs in irreversible damaged cells
Passive process
Affects surrounding cells
Significant inflammatory response
Normal apoptosis
Programmed destruction during embryogenesis
Involution of hormone dependent cells in withdraw
Cell loss in proliferating cell processes
Eliminating harmful self-reactive lymphocyte
Cells that have served their purpose ie after inflammatory response
Pathological apoptosis
DNA damage that self kills to prevent further damage
Accumulation of miss folded proteins
Cell death during infections
Pathological in organs after duct obstructions
*pg 21/22
Gangrene
Necrosis of an area of tissue usually do to interruption of blood flow
Dry gangrene
Caused by interference of ARTERIAL blood supply
NO venous interference
Dry shriveled skin brown - purple - black colored
Developers and spreads slowly
Irritation of dead tissue causes “line of demarcation”
Occurs mostly with pt that have blood vessel dz atherosclerosis
Wet gangrene
Interrupted VENOUS drainage caused by burn/frostbite/injury Area is cold swollen and pulseless Swelling blistering and wet appearance Skin is moist black and under tension Spreads rapidly
Gas gangrene
Infection of anaerobic spore forming rod shaped bacillus CLOSTRIDIUM species
Normal flora in GI and female genitourinary system and soil
Enters body after trauma or wound
Typically affects deep muscle tissue
Bubbles of hydrogen sulfide gas form
Crackling sound of skin (subq emphysema)
Internal gangrene
Gangrene affecting one or more organs
Blood flow to organ is blocked
Somatic death
Death of entire organism due to absence of respiration and heart beat
GAS
General Adaptation Syndrome
Cerebral cortex in regards to GAS
Perception and evaluation of the stressor based on past experiences, future consequences, and plans course of action
Reticular formation
RAS: reticular activating system
Sends impulses of alertness to lembic sys and cerebral cortex
Mild/acute stress and immune system
Immune system INCREASES in B cells and natural killer cells
Chronic stress and immune system
Immune system becomes SUPPRESSED
Sympathetic adrenal medullary system
Reduces flow to internal organs and mobilizes energy to heart and muscles
Mechanisms that regulate hormone release
Chemical factors (blood sugar) Endocrine factors (other hormone producing glands) Neural control
Somatostatin
Inhibits growth hormone production
GH is stimulated by
Hypoglycemia
Increased blood levels of amino acids
Stress conditions
GH is inhibited by
Increased glucose levels
Free fatty acid release
Cortisol
Obesity
Congenital hyposomatotropism (hypo growth hormone) symptoms
Birth ht and wt between 5-10%
Extreme hypoglycemia causing seizures
Neonatal growth curves
“Cherub-like” facial features
Somatopause
Declining growth hormone usually in adults
Pheochromocytoma
Catecholamine secreting tumor
