TEST 1 Flashcards by lindsay mckenzie

ETIOLOGY DEFINITION: caused by something within genetic makeup

Inherited

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ETIOLOGY DEFINITION: condition existing at birth and often before birth, or that develops during the first month of life (neonatal disease), regardless of causation eg. fetal alcohol syndrome

CONGENITAL (hahaha… genital)

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ETIOLOGY DEFINITION: caused by wear and tear eg. arthritis, osteoarthritis

degenerative

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ETIOLOGY DEFINITION: caused by abnormal chemical reactions eg. diabetes

metabolic

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ETIOLOGY DEFINITION: caused from malnutrition anorexia

Nutritional deficiency

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ETIOLOGY DEFINITION: caused by a mental health disorder

Psychogenic

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ETIOLOGY DEFINITION: caused by an infectious agent eg. MRSA

Infectious

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ETIOLOGY DEFINITION: caused with malfunction of immunity

Immunologic

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ETIOLOGY DEFINITION: exposure to physical agents cause injury, eg. burn from fire

Physical agent

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ETIOLOGY DEFINITION: neo means new, plastic means growth = cancer

Neoplastic

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ETIOLOGY DEFINITION: caused by medical treatment, eg. side effects of medication

Iatrogenic

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ETIOLOGY DEFINITION: unknown cause, eg. some forms of epilepsy

Idiopathic

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CLINICAL MANIFESTATIONS DEFINITION: quick onset, quick completion (either cure or death)

acute

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CLINICAL MANIFESTATIONS DEFINITION: longterm, unknown cure

CHRONIC

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CLINICAL MANIFESTATIONS DEFINITION:

interval between exposure of a tissue to an injurious agent and the first appearance of signs and symptoms

LATENT PERIOD

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CLINICAL MANIFESTATIONS DEFINITION: the interval between the receipt of infection and the onset of the consequent illness or the first symptoms of the illness; sometimes also referred to as the latent period

INCUBATION PERIOD

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CLINICAL MANIFESTATIONS DEFINITION: the time during which a disease process has begun but is not yet clinically manifest

Prodromal period (prodrome)

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CLINICAL MANIFESTATIONS DEFINITION: when the disease is at it’s highest

Stage of manifest illness

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CLINICAL MANIFESTATIONS DEFINITION: 1. Gradual return to health and strength after illness; 2. The period needed for returning to health after illness

Convalescence

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CLINICAL MANIFESTATIONS DEFINITION: A pathological condition resulting from a disease. eg. scar

Sequela

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CLINICAL MANIFESTATIONS DEFINITION: A secondary disease, an accident, or a negative reaction occurring during the course of an illness and usually aggravating the illness.

complication

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CLINICAL MANIFESTATIONS DEFINITION: Not manifesting characteristic clinical symptoms.

subclinical

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CLINICAL MANIFESTATIONS DEFINITION: To increase the severity, violence, or bitterness of; aggravate

Exacerbation

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CLINICAL MANIFESTATIONS DEFINITION: The period during which the symptoms of a disease abate or subside

Remission

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CLINICAL MANIFESTATIONS DEFINITION: having severe symptoms and a short course

acute phase

DEFINITION: a disease that is native to a local region

endemic disease

DEFINITION: disease is disseminated to many individuals at the same time

epidemic

DEFINITION: epidemics that affect large geographic regions, perhaps spreading worldwide

pandemic

cell caps that shorten when chromosome divides

TELOMERES

every time ________________ shorten, it results in less capacity for cell to regain normal function

telomeres

in order to survive, a cell must _____________

adapt

adaptation is ____________

chronic

cells that have adapted maintain _____________ function

normal

CELL ADAPTATION DEFINITION: cells become smaller | Eg. Cells in the muscles shrink from disuse

ATROPHY

CELL ADAPTATION DEFINITION: cells get bigger Eg. Muscle cells from exercise Eg. Hypertension causing enlarged heart

HYPERTROPHY

CELL ADAPTATION DEFINITION: More cells in a confined area; usually occurs as a result of chronic friction Eg. Frequent bladder infections, Eg. Calluses on feet from poor fitting shoes

HYPERPLASIA

CELL ADAPTATION DEFINITION: Varying sized cells in an orderly growth pattern; One type of cell is being replaced by another less functional cell Capable of regeneration into normal cells Eg. Healthy lung cells will be replaced by less functional cells in smoker’s lungs

Metaplasia:

CELL ADAPTATION DEFINITION: Nuclei are varying shapes and size Cells do not follow normal pattern of growth Considered pre-cancerous

Dysplasia

when assault on cell is too severe, cell becomes ________________

injured

_____________ cells cannot maintain normal function

injured

___________ injury with a ___________ cell - cell may recover

mild | healthy

_____________ injury with an _____________ cell - cell may die

severe | unhealthy

CELL INJURY DEFINITION: after mild cell injury, cell may go back to normal function

reversibility

CELL INJURY DEFINITION: if cell injury is more severe, cell may die and will not return to normal function; cannot maintain homeostasis

irreversibility

DEFINITION: when cell is injured, sodium pump fails and causes sodium to come inside the swell causing cell to swell (Normally, ATP keeps sodium outside of cell & potassium inside the cell)

Hydropic Swelling

water accumulation from ____________ ___________ within cell causes damage to mitochondria

Hydropic Swelling

DEFINITION: ATP pump malfunction may cause faulty lysosomes resulting in foreign substance build up in cell

Intracellular Accumulation

in ___________ ______________, faulty metabolism with mitochondria damage causes substances to accumulate within the cell

Intracellular Accumulation

EXAMPLE OF INTRACELLULAR ACCUMULATION

Fatty liver is caused by chronic alcoholism causing lysosome failure to digest fat

WHAT KIND OF CELL INJURY? | Cells are physically destroyed

Physical and mechanical injury:

WHAT KIND OF CELL INJURY? | Extremes of temperature

Physical and mechanical injury:

WHAT KIND OF CELL INJURY? | Electrical injuries

Physical and mechanical injury:

WHAT KIND OF CELL INJURY? Bumps, bruises, scrapes, abrasions, contusions

Physical and mechanical injury:

WHAT KIND OF CELL INJURY? destruction that can destroy a cell or alter the metabolism of cell

chemical

WHAT KIND OF CELL INJURY? eg. lead poisoning in children can lead to neurological damage

chemical

WHAT KIND OF CELL INJURY? most common form of cell injury

ISCHEMIC

WHAT KIND OF CELL INJURY? caused by lack of blood and oxygen

ISCHEMIC

WHAT KIND OF CELL INJURY? if oxygen is not restored soon cells will die because of cell vulnerability

ISCHEMIC

IN ISCHEMIC CELL INJURY, once oxygen restoration is accomplished, _________ _____________ may occur

reprofusion injury

IN ISCHEMIC CELL INJURY, overflow of calcium disrupts mitochondria, results in __________ ____________ formation and ______________

free radical | inflammation

free radicals are __________ __________ molecules

unstable oxygen

DEFINITION: irreversible natural cell death; necessary to make room for new cells

APOPTOSIS

DEFINITION: irreversible premature cell death due to accidental injury

NECROSIS

WHAT KIND OF NECROSIS? Tissue made by denatured protein Gone through ischemia

Coagulative Necrosis

WHAT KIND OF NECROSIS? Occurs in areas where there is very little connective tissue, caused by ischemia, bacteria, toxins * Eg. Brain, absesses, cysts

Liquefactive Necrosis

WHAT KIND OF NECROSIS? Injured tissue secretes lipase which breaks down normal tissue

Fat Necrosis

WHAT KIND OF NECROSIS? Combination of liquifactive and coagualitive Cheese-like Typically found in lung tissue * Eg. TB

Caseous

DEFINITION: Clinical term for necrosis

GANGRENE

WHAT KIND OF GANGRENE: form of coagulative necrosis, usually on an area with a lack of circulation, skin becomes dry and shrivelled, eg. on a foot

DRY

WHAT KIND OF GANGRENE: commonly found on internal organs, eg. strangled hernia

WET

WHAT KIND OF GANGRENE: necrotic tissue has bubbles on it

GAS

Post-surgical patients will have elevated ________ __________ __________

white blood cells

ROLE OF BLOOD COMPONENTS? carry oxygen

RBCS

ROLE OF BLOOD COMPONENTS? blood clotting

PLATELETS

ROLE OF BLOOD COMPONENTS? protect from infection, play a huge role in inflammation (5000-10,000/mm3)

WBCS

- WBCs "first responders" | - Made in bone marrow

NEUTROPHILS

these are quickly released during acute inflammatory response

NEUTROPHILS

Stay in bloodstream for 6 hours

NEUTROPHILS

__________ cells are immature neutrophils

Band

2nd line | Antibodies

LYMPHOCYTES

Circulate in the blood Migrate into tissue and turn into macrophages Have the ability to engulf large bacteria

MONOCYTES

Mischief makers in asthma (shed their granules that release chemicals causing allergic reactions)

EOSINOPHILS

Contain granules that release chemicals causing inflammation Will be increased in a major trauma

BASOPHILS

WHICH STAGE OF INFLAMMATORY RESPONSE? | Inflammatory mediators are released, blood vessels dilate, pores in blood vessels open up, fluid leaks into tissue

WHICH STAGE OF INFLAMMATORY RESPONSE? | WBCs leave blood vessels and enter into the tissue; diapedesis

WHICH STAGE OF INFLAMMATORY RESPONSE? | WBCs destroy invading pathogens through phagocytosis

DEFINITION: WBCs start sticking to the sides of blood vessels

MARGINATION

DEFINITION: WBCs sliping out of the blood vessels after margination, and migrate to the site of injury

CHEMOTAXIS

Clinical Manifestations of Inflammation: LOCAL INFLAMMATION (6)

* Erythema * Heat * Edema * Pain * Loss of function * Exudate: drainage of dead WBCs

Clinical Manifestations of Inflammation: SYSTEMIC INFLAMMATION (4)

* Pyrexia (fever: interleukin 1 acts on hypothalamus to increase body temperature to fight infection * Fatigue * Anorexia * Leukocytosis: increased WBC count

DEFINITION: process by which bacteria divide

BINARY FISSION

WHICH MICRO-ORGANISM? * will cause infection by colonizing * if the conditions are not right they will destruct * living or non-living media

BACTERIA

WHICH BACTERIA? round, berry-shaped spheres

COCCI

WHICH BACTERIA? rod-shaped, long and narrow

BACILLI

WHICH BACTERIA? spiral-form

SPIROCHETE

DEFINITION: protective coat that is critical to bacteria survival

ENDOSPORE

DEFINITION: test used to identify bacteria

GRAM STAIN

WHICH MICRO-ORGANISM? * mycoses * eurkaryotic * well-developed

FUNGI

DEFINITION: disease caused by fungi

Mycoses

WHICH MICRO-ORGANISM? * well-developed * eukaryotic * 2 life cycles: * microorganism that lives in water, plants, soil * eg. bever fever

PROTOZOA

2 LIFE CYCLES OF PROTOZOA

1. trophozoite | 2. trophozoite turns into a cyst when conditions are too extreme (too hot, or ingested)

WHICH MICRO-ORGANISM? * parasites * eukaryotic * mouth that allows them to latch onto things * eg. flatworms, roundworms, tapeworms

HELMINTHS

WHICH MICRO-ORGANISM? * smallest of all the infectious agents * not living * cannot reproduce on their own * multiplies by cell invasion * cannot grow in non-living material * may have a long lifespan

VIRUSES

5 STAGES OF HEALING

1. INFLMMATION 2. GRANULATION 3. WOUND CONTRACTION 4. REGENERATION 5. REPAIR

WHICH STAGE OF HEALING? purpose: cleans up old debris so that tissue cells ready can repair lasts 0-3 days

INFLAMMATION

WHICH STAGE OF HEALING? * lasts 0-10 days * increase cell proliferation on both sides of the wound * increase in collagen (to form a bridge between two tissues) * new basement membrane will form underneath healing ridge * angiogenesis

GRANULATION

DEFINITION: new blood vessels to supply new tissue

ANGIOGENESIS

WHICH STAGE OF HEALING? * lasts 3-30 days * wound starts to shrink and mould * tissue starts to become aligned properly

WOUND CONTRACTION

wounds healing by ___________ intention: sutures or staples

first

wounds healing by __________ intention: leaving the wound open to heal from the bottom up, allows infection out

second

wounds healing by ___________ intention: wound left open until swelling subsides, after which wounds will be resutured

tertiary

WHICH STAGE OF HEALING? * new tissue replaces the old * looks and acts like new * some tissues have the ability to regenerate nicely * eg. skin

REGENNERATION

WHICH STAGE OF HEALING? * tissue will repair but won't look or act like it did before * eg. scar tissue

REPAIR

DEFINITION: when incision splits open

DEHISCENCE

DEFINITION: when incision splits apart and organs protrude

EVISCERATION

4 processes of nociception:

1. TRANSDUCTION 2. TRANSMISSION 3. PERCEPTION 4. MODULATION

2 sets of fibers in transmission

1. fast fibers (a fibers) | 2. slow fibers (c fibers)

DEFINITION: alleviates pain by inhibiting substance P and promotes endorphins and enkephalins

MODULATION

DEFINITION: the amount of pain a person can tolerate before the person becomes aware of the pain, the point at which a person becomes aware of the pain

PAIN THRESHOLD

DEFINITION: the amount of pain a person can bear before they seek relief

PAIN TOLERANCE

DEFINITION: when person first becomes aware of the pain

PAIN PERCEPTION

EFFECTS OF PAIN: RESPIRATORY

- actelectasis | - pneumonia

EFFECTS OF PAIN: MUSCULOSKELETAL

- dvt | - high blood pressure

EFFECTS OF PAIN: ENDOCRINE

- stress | - cortisol

EFFECTS OF PAIN: IMMUNITY

- cortisol decreases immunity

Difference between acute/nociceptive pain and neuropathic pain:

* acute is meant to be protective | * neuropathic pain has abnormal processing

TYPE OF PAIN: * Tissues deprived of oxygen * Lactic acid (biproduct of anaerobic) sets off neurotransmitters

ISCHEMIC

TYPE OF PAIN: Associated with chronic pain

NEUROPATHIC

``` TYPE OF PAIN: Characteristics * May not have high vitals * fatigue * Hyperalgesia * Allodynia ```

NEUROPATHIC

DEFINITION: increased sensitivity to pain

HYPERALGESIA

DEFINITION: pain is caused by something that doesn’t normally cause pain

ALLODYNIA

chronic pain is a _____________

stressor

DEFINITION: secreted by adrenal medula; also called epinephrine

ADRENALINE

ADRENALINE OR CORTISOL: * Increases heartrate and blood pressure, * dialate pupils, * contract skeletal muscle, * vasodilation to release blood for muscles * vasoconstriction around core and heart

ADRENALINE

ADRENALINE OR CORTISOL: - helps epinephrine - breaks down protein - decreases muscle mass - hyperglycemia - decreased protein synthesis - Decreases inflammatory response - Redistribution of fat - Decreased blood flow to gastric mucosa

CORTISOL

DEFINITION: Takes amino acids and burns them for energy and converts them into glucose (new glucose)

Gluconeogenesis

____ L total body water

___________ ___________ at greatest risk of dehydration because of a greater ratio of skin surface and kidneys cannot conserve water

premature infants

Two broad fluid compartments

1. Intracellular (25 L) | 2. Extracellular (17 L)

DEFINITION: movement of water through cell membrane as a result of hydrostatic pressure

FILTRATION

DEFINITION: moves water from blood vessels into interstitial space

HYDROSTATIC PRESSURE

DEFINITION: movement of water from an area of lesser concentration to one of more concentration

OSMOSIS

DEFINITION: pressure that moves water from interstitial space into blood vessels

COLLOID OSMOTIC PRESSURE

DEFINITION: protein in blood that affects the movement of water

ALBUMIN

Colloid osmotic pressure should __________ hydrostatic pressure

EQUAL

DEFINITION: measure of degree of concentration; number of particles per kilogram of solvent.

OSMOLALITY

DEFINITION: measures the amount of substance in our blood

SERUM OSMALALITY

SERUM OSMOLALITY IS _______-_______!!!

285-295

Signs of dehydration (12)

1. Sudden weight loss 2. Lightheadedness, dizziness, or syncope 3. Sunken fontanel (infants) 4. Rapid, thready pulse 5. Low urine output (oliguria) 6. Decreased skin turgor 7. Absence of sweat and tears (infants) 8. Hard stools 9. Soft, sunken eyeballs 10. Thirst 11. Confusion, lethargy 12. Hypovolemic shock

Signs of hypovolemia (8)

1. Acites (fluid buildup in the abdomen) 2. Crackles on auscultation 3. Edema (swelling) - particularly hands, feet, and ankles 4. Difficulty breathing while lying down 5. High blood pressure 6. Irritated cough 7. Shortness of breath (dyspnea) 8. Strong, rapid pulse

__________ output is the best indicator of fluid status

Urine

DEFINITION: when somebody has a collection of fluid in a place where it normally wouldn’t be

THIRD SPACING

DEFINITION: Excess water is accumulating in peritoneal space

THIRD SPACING

DEFINITION: A collection of fluid in the pleural cavity resulting from a disease process, causing atelectassis

PLEURAL EFFUSION

DEFINITION: Fluid that has the same particle concentration (osmolality) as normal body fluid, will not change size of cells.

ISOTONIC

DEFINITION: Fluid that has a higher particle concentration (osmolality) than normal body fluid; causes a net flow of water across cell membranes out of cells, causes water to come out of blood and the cells to shrink

HYPERTONIC

DEFINITION: Fluid that has a lower particle concentration (osmolality) than normal body fluid; causes a net flow of water across cell membranes into cells., causes water to become more watery and the cells to swell

HYPOTONIC

DEFINITION: | too much sodium in the blood, caused by dehydration and eating too much salt

HYPERNATREMIA

DEFINITION: too little salt in the blood

HYPONATREMIA

clinical manifestations OF HYPERNATREMIA

thirst, lethargy, confusion, seizures, death

CLINICAL MANIFESTATIONS OF HYPONATREMIA

Muscle cramps, anorexia, nausea, vomiting, malaise, headache, lethargy, seizures, coma

Sodium (Na+) _______–________ mmol/L

136 - 145

Potassium (K+) ______-_______ mmol/L

3.5 - 5.0

WHICH LYMPHOCYTES? * also known as immunoglobulins * immunoglobulins fit like lock and key mechanism

B Lymphocytes are also known as ____________ ____________

humoral immunity

WHICH IMMUNOGLOBULIN? | antibody that responds in blood transfusions

WHICH IMMUNOGLOBULIN? | accounts for most antibodies

WHICH IMMUNOGLOBULIN? respond to bacteria and viruses disease/virus-specific

WHICH IMMUNOGLOBULIN? | antibodies that mother passes on to infant

WHICH IMMUNOGLOBULIN? - antibodies found in body secretions - saliva and tears - born with them

WHICH IMMUNOGLOBULIN? | - normally present in blood in small amounts

WHICH IMMUNOGLOBULIN? | - elevated when allergic reaction present

WHICH IMMUNOGLOBULIN? | unsure of role

_____ Lymphocytes are also known as cell-mediated immunity

WHICH LYMPHOCYTE? going to mature into either helper cells or cytotoxic cells

mature cytotoxic t cells is going to kill an invader ____________

directly

mature helper t cells helps build ____________

antibodies

the HIV attacks t-helper cells because of ______

CD4

2 Different Types of Immunity

1. natural | 2. artificial

WHICH KIND OF IMMUNITY? | immunity that we get from being exposed

NATURAL

WHICH KIND OF IMMUNITY? something was deliberately injected into us

ARTIFICIAL

WHICH KIND OF IMMUNITY? active: antibodies made based on exposure (eg. to chicken pox) resulting in immunity

NATURAL

WHICH KIND OF IMMUNITY? passive: antibodies that infant receives from mother, resulting in immunity for first 3 months of life

NATURAL

WHICH KIND OF IMMUNITY? active: getting vaccinated

ARTIFICIAL

WHICH KIND OF IMMUNITY? passive: person has not been previously immunized, has become exposed, and is now receiving immunoglobulins via injections (ImG)

ARTIFICIAL

WHICH VIRUS? part of the retrovirus family

HIV

WHICH VIRUS? destroy T helper cells which means no antibodies are produced

HIV

3 ENZYMES INVOLVED IN HIV

* protease * integrase * reverse transcriptase

6 STEPS TO THE HIV PROCESS OF CAUSING DAMAGE

1. uses glycoproteins to latch onto cell 2. fuses to cell 3. injects RNA into the cell 4. reverse transcriptase takes RNA and turns it into DNA 5. integrase takes DNA and puts it with DNA in the nucleus 6. protease takes DNA and rebuilds it into RNA (rebuilds another RNA virus)

HIV 3 Modes of Transmission

* sexual contact * blood or blood products * mother to child transmission

NAME THE STAGE OF HIV/AIDS Progression - t helper cells are main targets (CD4 Molecules) - rapid replication following exposure

INITIAL INFECTION

NAME THE STAGE OF HIV/AIDS Progression - antibodies don't develop until 3 weeks to 6 months - might have general flu-like symptoms (lethargy, sore joints) as body trying to fight off infection

Seroconversion

NAME THE STAGE OF HIV/AIDS Progression - symptoms disappear - virus is still active and producing - cytotoxic T cells are still working and trying to kill off virus

CLINICAL LATENCY

NAME THE STAGE OF HIV/AIDS Progression - over time cytotoxic T cells are going to diminish - trying to destroy immune system at same time - lasts about 10 years

CLINICAL LATENCY

NAME THE STAGE OF HIV/AIDS PROGRESSION - CD count < 200 - recurrent pneumonia - opportunistic infections

AIDS

NAME THE STAGE OF HIV/AIDS PROGRESSION - kaposis sarcomma, thrush - wasting syndrome - associated neurological disease

AIDS

2 Tests for HIV infection

1. enzyme-linked immunosorbent assay (ELISA) test | 2. Western Blot test

WHICH HIV TEST? - looking for antibodies - possible false negatives if taken before antibodies are produced - because of 3 weeks "window period"

ELISA

WHICH HIV TEST? - tested on HIV positive person - helps to measure the progression

WESTERN BLOT TEST

DEFINITION: immune system is behaving inappropriately

Hypersensitivity

WHICH TYPE OF HYPERSENSITIVITY? - allergic reaction, asthma - histamines cause inflammation in the lungs resulting in: * SOB * bronchoconstriction * wheezing * increase in mucus production

WHICH TYPE OF HYPERSENSITIVITY? - also known as cytotoxic - tissue specific - antibodies (IgG & IgM) attack antigens on the surface of specific cells eg. Graves disease, hemolytic anemia (incompatible blood transfusion)

WHICH TYPE OF HYPERSENSITIVITY? - not tissue specific - damage ALL blood vessels in any and all tissue - destroys multiple tissues and organs at the same time * eg. lupus

WHICH TYPE OF HYPERSENSITIVITY? - t cells are culprits - tissue specific

Systemic Lupus Erythematosus (SLE) effects 6 key areas

``` kidneys heart brain lung skin joints ```

SYSTEMIC VS. DISCOID LUPUS? * joints: arthritis in the joints * lungs: resp. failure

SYSTEMIC

SYSTEMIC VS. DISCOID LUPUS? | skin: butterfly-shaped facial rash

DISCOID

CLINICAL MANIFESTATIONS OF LUPUS

- acute or insidious - arthralgia, fever, fatigue, joint deformities - malar rash, lattice like venular skin changes, - alopecia - raynaud's phenomenon - glomerulonephritis renal failure - myocarditis CHF - pleuritis, pleural effusion

PEOPLE WHO MOST COMMONLY GET LUPUS?

female 15-40 years, child-bearing age

LUPUS TESTS?

positive ANA test is usually present with positive anti-DNA (antibody to native DNA) and anti-Sm (antibody to Smith nuclear antigen)