Quiz #2 Flashcards
Hypersensitivity Reaction
An altered immunologic response to an antigen that results in disease or damage to the host
Can ANAPHYLAXIS be life-threatening?
YES
What is the most severe manifestation of an ALLERGY?
ANAPHYLAXIS
Autoimmunity
Breakdown of tolerance during which the body’s immune system begins to recognize self-antigens as foreign
Alloimmunity
Individual’s immune system reacting against antigens on the tissues of other members of the same species — e.g. transfusion reactions
What are two significant effects of INFECTIOUS DISEASE?
DEATH and MORBIDITY
When does a person experience STRESS?
A person experiences stress when a demand exceeds the person’s coping abilities
What do STRESS and NEGATIVE EMOTIONS do?
Stress and negative emotions increase levels of PROINFLAMMATORY CYTOKINES, providing a possible link among stress, immune function, and disease
What is a significant clinical manifestation of HYPOVOLEMIC SHOCK?
Rapid heart rates - TACHYCARDIA
NEUROGENIC (vasogenic) SHOCK
Widespread vasodilation occurs from an imbalance between parasympathetic and sympathetic stimulation
What does NEUROGENIC (vasogenic) SHOCK cause?
Persistent vasodilation and relative hypovolemia
How do we treat ANAPHYLACTIC SHOCK?
Epinephrine
Antihistamines and steroids: stops inflammatory reaction
SEPTIC SHOCK
ANTI-INFLAMMATORY MEDIATORS are released: IL-4, IL-10, IL-13, epinephrine, nitric oxide, etc.
How do we treat SEPTIC SHOCK?
Start ANTIBIOTICS IMMEDIATELY
Primary MODS
Injury directly associated with HYPOPERFUSION (not enough blood/oxygen)
What is a significant issue associated with MODS?
HYPERMETABOLISM — impaired cellular metabolism results in a buildup of cellular waste products
What is a SECOND DEGREE BURN?
Superficial partial-thickness injury — painful, thin-walled, fluid-filled blisters develop within a few minutes after injury
What are considered MAJOR BURN INJURIES?
Burns exceeding 20% of TBSA in most adults
What is the SYSTEMIC RESPONSE to thermal injury and burns?
MASSIVE EDEMA associated with burn shock is inevitable with fluid resuscitation — failure to administer fluid resuscitation results in irreversible hypovolemic shock and death
What is the HYPERMETABOLIC RESPONSE to thermal injury and burns?
Extensive burn injury initiates the most significant alterations in body metabolism associated with any illness — for an extended period of time
What is the IMMUNOLOGIC RESPONSE to thermal injury and burns?
Fatal burn injury has often shown decreased levels of IL-2 which may result in decreased T helper lymphocytes
Who must go to a BURN CENTER?
Partial-thickness burns >10% of the total body surface area
Burns that involve the face, hands, feet, genitalia, perineum, or major joints
Lightening
Those with concomitant traumatic injuries
Examples of AUTOIMMUNE DISEASES
Systemic LUPUS erythematosus (SLE)
Multiple sclerosis (MS)
Rheumatoid arthritis (RA)
Type 1 diabetes mellitus (T1DM)
HIV/AIDS
What is CARCINOMA IN SITU?
Tumors of GLANDULAR OR SQUAMOUS ORIGIN
Have NOT broken through the BASEMENT MEMBRANE or INVADED surrounding stroma
NOT MALIGNANT
What is the first step in the metastatic process?
Invasion: Local spread — cancer often spreads first to regional lymph nodes through the LYMPHATIC SYSTEM and then to DISTANT ORGANS THROUGH THE BLOODSTREAM
What is crucial for metastatic cells during metastasis?
Metastatic cells must be able to withstand the physiologic stresses of TRAVEL IN THE BLOOD AND LYMPHATIC CIRCULATION
What is a significant environmental-lifestyle factor that increases risk for malignant tumors?
A combination of CIGARETTE SMOKING AND ALCOHOL CONSUMPTION increases a person’s risk for malignant tumors
How does the body partially counteract the negative consequences of unilateral upper urinary tract obstruction?
Growth factor causes the unobstructed kidney to increase in size and function
Kidney stone formation depends on presence or absence of STONE INHIBITORS, which are…
Potassium citrate
Uromodulin (Tamm-Horshall protein)
Pyrophosphate
Magnesium
How do STONE INHIBITORS work?
Normally reduce the risk of calcium phosphate or calcium oxalate precipitation in the urine and prevent subsequent stone formation
What treatment does an UNCOMPLICATED UTI require?
Uncomplicated UTI is usually SELF-LIMITING (can resolve WITHOUT TREATMENT)
What is a UTI symptom specific to the elderly population?
Altered mental status
What is ACUTE PYELONEPHRITIS?
Acute bacterial infection of the ureter, renal pelvis, and/or kidney interstitium — common causes are E. Coli, Proteus, or Pseudomonas
What are the clinical manifestations of NEPHROTIC SYNDROME?
Hypoalbuminemia
Peripheral edema
Hyperlipidemia
Hypothyroidism
Lipiduria
Vitamin D deficiency
What are the NEPHROTOXIC DRUGS that can lead to ACUTE KIDNEY INJURY?
AMINOGLYCOSIDES — gentamycin, amikacin, tobramycin
What is the treatment for HYPERKALEMIA related to acute kidney injury?
Administer GLUCOSE and INSULIN to drive potassium into the cells
Common UTI symptoms
Dysuria
Frequency
Urgency
Hematuria
Suprapubic pain (cystitis)
High-grade fever (pyelonephritis)
Flank pain (pyelonephritis)
Nausea (pyelonephritis)
Vomiting (pyelonephritis)
