Test 1

Question 0

how is patho related to nursing

Answer 0

it is the foundation upon which all nursing is built

Question 1

pathophysiology

Answer 1

the study of what happens when normal anatomy and physiology goes wrong

Question 2

what does understanding patho provide us with?

Answer 2

insight to why patients look the way they do when they have a certain disease, why medicines we give them work, why the side effects of treatment occur, why complications transpire, will assist the nurse to better anticipate situations, correct issues, and provide appropriate care

Question 3

why does cellular adaptation occur?

Answer 3

in an effort to maintain homeostasis, so the cell can survive

Question 4

decrease in cell size, usually to decreased work load

Answer 4

atrophy

Question 5

what things cause atrophy?

Answer 5

decreased work load, ischemia, decreased nutrition, decreased hormone stimulation in some organs

Question 6

where is atrophy common?

Answer 6

in skeletal muscle

Question 7

increase in cell size

Answer 7

hypertrophy

Question 8

what are the two types of hypertrophy and what is an example of each?

Answer 8

normal or physiologic - muscle enlargement with working out

abnormal or pathologic - hypertension enlarging the heart

Question 9

what happens to the size of the structure when it goes through hypertrophy?

Answer 9

usually, the entire structure size is increased

Question 10

increase in the number of cells

Answer 10

hyperplasia

Question 11

what are common reasons for hyperplasia?

Answer 11

wound healing and liver regineration

Question 12

not a true adaptive change. causes changes in the size, shape, and organization

Answer 12

dysplasia

Question 13

type of cellular adaptation that is considered “precancerous”

Answer 13

dysplasia

Question 14

is dysplasia reverisble?

Answer 14

yes if the stimulus is removed, some changes can be reversed

Question 15

where is dysplasia common?

Answer 15

in the respiratory and reproductive tracts

Question 16

reversible replacement of one mature cell by another?

Answer 16

metaplasia

Question 17

where is metaplasia common and why?

Answer 17

common in the respiratory tract because pcce can’t withstand the harsh environment so the pcce cells are replaced with epithelial cells that are tougher and more protective. this can become a problem because the epithelial cells don’t have mucous or cilia

Question 18

what is the rule for metaplastic changes?

Answer 18

changes will stay within the same cell type. epithelial cells won’t change into nervous system cells

Question 19

do metaplastic changes lead to cancerous changes?

Answer 19

no, but they will likely occur if the stimulus is not removed. pathological changes.

Question 20

when does cellular injury or death occur?

Answer 20

when the cell is unable to maintain homeostasis

Question 21

what are some causes of cellular injury?

Answer 21

chemicals, decreased oxygen supply, infection, radiation, nutritional problems, many more

Question 22

programmed cell death/ cell suicide. cells shrink up and die

Answer 22

apoptosis

Question 23

is apoptosis a normal process?

Answer 23

yes it needs to happen

Question 24

decreased blood flow to tissue or organs that causes cellular injury and death.

Answer 24

ischemia

Question 25

cellular death in which the cells swell

Answer 25

necrosis

Question 26

what is cancer?

Answer 26

a disease of problems with cellular growth, division, and differentiation

Question 27

new growth or neoplasm

Answer 27

tumor

Question 28

are all tumors cancerous

Answer 28

no

Question 29

what types of tumors are cancerous and which types are not?

Answer 29

malignant tumors are cancerous tumors

benign tumors are not cancerous

Question 30

can benign tumors cause the body problems?

Answer 30

yes, they can still be detrimental depending on their placement and size

Question 31

malignant tumor or neoplasm

Answer 31

cancer

Question 32

what are the differences between benign tumors and malignant tumors with regards to growth?

Answer 32

benign tumors grow relatively slow, they are an expanding mass that is frequently encapsulated
malignant tumors grow rapidly, cells do not adhere and they infiltrate other tissues, they are not encapsulated

Question 33

what are the differences in the cells in benign and malignant tumors?

Answer 33

benign tumor cells are similar to normal cels, differentiated and mitosis is fairly normal
malignant tumor cells are varied in size and shape, many are undifferentiated, mitosis is increased and atypical

Question 34

what is the difference between benign tumors and malignant tumors in the way they spread?

Answer 34

benign tumors remain localized

malignant tumors invade nearby tissue or metastasize to distant sites through blood and lymph vessels

Question 35

what are the systemic effects of benign tumors vs malignant tumors?

Answer 35

with benign tumors, systemic effects are rare because they usually stay where they are
with malignant tumors systemic effects are common

Question 36

when are benign tumors life threatening?

Answer 36

when they are in certain locations like the brain

Question 37

are malignant tumors life threatening?

Answer 37

yes, through tissue destruction and spread

Question 38

what are the seven warning signs of cancer?

Answer 38

change in bowel or bladder habits, a sore that does not heal, unusual bleeding or discharge, thickening lump, indigestion or difficulty swallowing, obvious change in wart or mole
nagging cough or hoarseness

Question 39

are the seven warning signs of cancer used to diagnose cancer?

Answer 39

no, but they are an indicator that further investigation is needed

Question 40

what are the clinical manifestations of cancer?

Answer 40

pain, fatigue, cachexia, anemia, leukopenia, infection

Question 41

what can cause pain in cancer patients?

Answer 41

pressure on other structures, blocking or obstructing of flow of normal body fluids and content

Question 42

why is fatigue seen in cancer patients?

Answer 42

can be the result of the disease process or the treatments

Question 43

what is cachexia, who is it most often seen with?

Answer 43

severe wasting away, often due to malnutrition in terminal cancer patients. characterized by dropping weight very quickly

Question 44

what is anemia and why is it seen in cancer patients?

Answer 44

it is a lack of red blood cells that causes the body to not get the oxygen that it needs. can be related to the cancer process depending on the type or to the treatment of the cancer.

Question 45

leukopenia

Answer 45

decreased white blood cell count

Question 46

thrombocytopenia

Answer 46

decreased platelents

Question 47

what can leukopenia and thrombocytopenia cause?

Answer 47

infection

Question 48

what does the staging of cancers have to do with?

Answer 48

its spread

Question 49

does one staging system work for all types of cancer?

Answer 49

no, many different types have their own unique staging systems

Question 50

what are the four stages of cancer?

Answer 50

stage 1 - confined to the organ of origin, hasn’t metastasized
stage 2 - locally invasive, has spread, but not much
stage 3 - spread to regional structures, such as lymph nodes
stage 4 - cancer has spread to distant sites

Question 51

what is the tumor staging system?

Answer 51

T - tumor spread. number indicates size of tumor and its local extent
N - node involvement. number indicates how many nodes are involved
M - metastasized. number indicates extent of spread

Question 52

substances produced by both benign and malignant tumor cells

Answer 52

tumor cell markers

Question 53

what are tumor cell markers used for?

Answer 53

to screen and identify individuals at risk for cancer, to help diagnose the specific type of tumors in individuals, to follow the clinical course of cancer

Question 54

how do tumor cell markers tell people who are at risk for cancer?

Answer 54

those who have elevated levels are at risk

Question 55

how do tumor cell markers hep diagnose the specific type of tumors in individuals?

Answer 55

by guiding us to where the cancer may be

Question 56

what do tumor cell markers have to do with the clinical course of cancer?

Answer 56

positive treatment should cause levels of them to go down

Question 57

what are some treatment options for cancer?

Answer 57

chemotherapy, radiation, surgery, immunotherapy, hormone therapy, hyperthermia, stem cell transplant, lasers

Question 58

the study of heredity

Answer 58

genetics

Question 59

basic units of inheritance, blueprints of proteins in the body

Answer 59

genes

Question 60

what are the three components of DNA

Answer 60

deoxyribose
phosphate molecule
nitrogenous base

Question 61

what is a nucleotide made of?

Answer 61

sugar, phosphate and a base

Question 62

how many chromosomes do humans have?

Answer 62

46 chromosomes in 23 pairs

22 pairs of autosomes, 1 pair of gametes

Question 63

what types of cells are gametes?

Answer 63

sperm and ovum

Question 64

which cells are haploid and which are diploid

Answer 64

gametes are haploid

autosomes are diploid

Question 65

visualization of a persons chromosomes

Answer 65

karyotype

Question 66

is it possible to have an abnormal genotype, but a normal phenotype

Answer 66

yes

Question 67

carries a gene for a disease without having the disease

Answer 67

carrier

Question 68

is it possible to be a carrier of a dominant disease process?

Answer 68

no. if the gene for that disease is there, it will be manifested no matter what

Question 69

do homozygous people have worse cases of autosomal dominant disorders than heterozygous people?

Answer 69

they tend to because it is like they have a “double dose” of the disease

Question 70

what causes Marfan Syndrome?

Answer 70

single gene mutation on chromosome 15

Question 71

what does the gene mutation in Marfan syndrome cause?

Answer 71

causes elastin and collagen defects which lead to ocular, skeletal, and cardiovascular disorders

Question 72

what are the clinical manifestations for Marfan Syndrome?

Answer 72

increased height, long extremities, arachnodactyly, sternum defects (funnel chest or pigeon breast), chest asymmetry, spine deformities (scoliosis or kyphosis), flat feet, hypotonia and increased joint flexibility, high arched palate, crowded teeth, small lower jaw, thin, narrow face, nearsightedness and lens displacement, valvular defects, coarctation of the aorta

Question 73

what is the most life threatening clinical manifestation of Marfan syndrome?

Answer 73

coarctation of the aorta

Question 74

what are the valvular defects that occur with Marfan syndrome?

Answer 74

redundancy of leaflets, stretching of the chordae tendinae, mitral valve regurgitations, aortic regurgitations

Question 75

what does lens displacement mean and what is it seen with?

Answer 75

the lens is not in the normal position on the eye. seen with Marfan syndrome

Question 76

what is coarctation of the aorta?

Answer 76

narrowing of a portion of the aorta - most life threatening problem seen with Marfan syndrome

Question 77

what are the complications that can occur with Marfan syndrome?

Answer 77

weak joints and ligaments that are prone to injury, cataracts, retinal detachment, severe mitral regurgitation, spontaneous pneumothorax, inguinal hernia

Question 78

how is Marfan syndrome diagnosed?

Answer 78

through a thorough history and physical exam that would reveal lens displacement and other symptoms of the disease, skin biopsy that would be positive for fibrillin, x-rays to confirm skeletal abnormalities, an ecg to reveal cardiac abnormality, dna analysis for the gene.

Question 79

is Marfan syndrome usually present in the patient’s family history?

Answer 79

yes, but as many as 30% of cases are spontaneous

Question 80

what are the treatments for Marfan syndrome?

Answer 80

usually focus on alleviating symptoms. surgical repair of aneurysms and valvular defects, surgical correction of ocular deformities, steroid and sex hormone therapy to aid in closure of long-bones and limit height, beta-adrenergic blockers to limit complications from cardiac deformities, bracing and physical therapy for mild scoliosis and surgical correction for severe cases

Question 81

disease that involves neurogenic tumors that arise from schwann cells

Answer 81

neurofibromatosis

Question 82

what are the types of neurofibromatosis and what is the difference?

Answer 82

type 1 - involves the skin, cutaneous lesions that may include raised lumps, cafe au lait spots, and freckling. caused by mutation on chromosome 17
type 2 - bilateral acoustic tumors (8th cranial nerve) that cause hearing loss. caused by a mutation on chromosome 22

Question 83

is there a cure of neurofibromatosis?

Answer 83

no

Question 84

is neurofibromatosis inherited?

Answer 84

yes, but 30-50% of cases occur spontaneously

Question 85

what are issues that may develop with type 1 neurofibromatosis?

Answer 85

small risk that the lesions may develop into cancer, ocular problems, scoliosis, and bone defects may also be problems

Question 86

an increased incidence of what is associated with neurofibromatosis?

Answer 86

learning disabilities and seizure disorders

Question 87

do homozygous dominant people have an autosomal recessive disease?

Answer 87

no. nor are they carriers

Question 88

how can you be a carrier for an autosomal recessive disorder?

Answer 88

if you are heterozygous. you have the trait, but your more influential allele is normal

Question 89

how can a person have an autosomal recessive disorder?

Answer 89

if they are homozygous recessive for the disease

Question 90

what are some examples of autosomal recessive disorders?

Answer 90

PKU and sickle cell anemia

Question 91

PKU is due to a mutation on what chromosome?

Answer 91

chromosome 12

Question 92

an inherited metabolic disorder in which the person cannot metabolize phenylalanine?

Answer 92

phenylketouria

Question 93

why is it a problem that people with PKU cannot metabolize phenylalanine

Answer 93

it is an essential amino acid that is obtained through eating. if we cannot metabolize it, it cannot be broken down and levels start to accumulate leading to toxic levels of phenylalanine in the blood, causing central nervous system damage

Question 94

if untreated, what can PKU lead to?

Answer 94

severe intellectual disability

Question 95

why are newborns screened for PKU?

Answer 95

because symptoms develop slowly and can go undetected. untreated cases almost always lead to intellectual disability

Question 96

how are newborns screened and when?

Answer 96

shortly after birth by testing for high serum phenylalanine levels

Question 97

what are the clinical manifestations of PKU?

Answer 97

failure to meet milestones, microcephaly, progressive neurological decline, seizures, hyperactivity, electrocardiograph abnormalities, learning disability, mousy smelling urine skin hair and sweat, eczema

Question 98

treatment for PKU

Answer 98

diet low in phenylalanine - avoid proteins and minimize starches, oral medications to lower phenylalanine, gene therapy

Question 99

who needs to be educated on diet regulations for a child with PKU?

Answer 99

both the parents and the child

Question 100

most sex-linked disorders are linked to what chromosome?

Answer 100

the x chromosome

Question 101

who is more often affected by sex-linked disorders and why?

Answer 101

men are more often effected because they only have one X, so if it is present, it will be manifested. women are more often carriers because they have two Xs

Question 102

X-linked dominant disorder associated with a single trinucleotide gene sequence (FMR1) on the X chromosome, which leads to failure to express a protein necessary for neural tube development

Answer 102

fragile X syndrome

Question 103

what are the clinical manifestations of fragile x syndrome, and which one is the most common?

Answer 103

intellectual, behavioral, and learning disabilities; prominent jaw and forehead; long, narrow face with long or large ears; connective tissue abnormalities; large testes; hyperactivity; siezures; speech and language delays; tendency to avoid eye contact
mental retardation is the most common manifestation

Question 104

what is the most common form of inherited intellectual and developmental disabilities?

Answer 104

fragile x syndrome

Question 105

what disease is fragile x syndrome most like?

Answer 105

autism

Question 106

what does diagnosis of fragile x syndrome consist of?

Answer 106

identification of clinical manifestations and a positive genetic test

Question 107

is there a cure for fragile x syndrome?

Answer 107

no, treatment focuses on controlling individual symptoms

Question 108

what supportive interventions are recommended for fragile x syndrome?

Answer 108

behavioral and psychological support for parents and child. speech, physical, and occupational therapy

Question 109

what happens to the chromosomes in fragile x syndrome?

Answer 109

areas on the chromosomes develop breaks and gaps

Question 110

what do chromosomal disorders result from most often?

Answer 110

alteration in chromosomal duplication or number

Question 111

when are chromosomal disorders most often caused?

Answer 111

in utero due to some environmental influences (maternal age, drugs, and infections)

Question 112

what is another name for trisomy 21?

Answer 112

down syndrome

Question 113

what causes down syndrom?

Answer 113

three copies of chromosome 21

Question 114

who is trisomy 21 most likely to affect?

Answer 114

the offspring of women over 35

Question 115

what increases the risk of trisomy 21?

Answer 115

greater maternal age and environmental teratogen exposure

Question 116

when are the clinical manifestations of trisomy 21 apparent?

Answer 116

at birth

Question 117

what are the clinical manifestations of Down syndrome?

Answer 117

hypotonia (low muscle tone), distinctive facial features, single crease on the palm (simean crease), white spots on the iris, intellectual disability, congenital heart defects, strabismus (lazy eye) and cataracts, poorly developed genitalia and delayed puberty, tend to be shorter

Question 118

what are the distinctive facial features that occur with Down syndrome?

Answer 118

low nasal bridge, epicanthal folds, protruding tongue, low-set ears, small,open mouth, eyes tend to slant upward

Question 119

what number of patients with Down syndrome also have cardiac abnormalities?

Answer 119

1/3 to 1/2 of patients

Question 120

what is there an increased likely hood of developing with Down syndrome?

Answer 120

leukemia

Question 121

what are some chromosomal disorders?

Answer 121

trisomy 21 (Down syndrome), monosomy x (turner’s syndrome), polysomy x (klinefelter’s syndrome)

Question 122

the result of deletion of part or all of an X chromosome

Answer 122

turner’s syndrome

Question 123

monosomy x

Answer 123

turner’s syndrome

Question 124

how many births does turner’s syndrome affect, what gender does it affect, and why?

Answer 124

affects 1 in 2,000 live births. only affects females because a male baby cannot live with only a Y chromosome and survive - there is very little genetic material on the Y chromosome

Question 125

are most babies with turner’s syndrome carried to term?

Answer 125

no, most don’t survive. usually ends in a miscairrage, or spontaneous abortion.

Question 126

what are the clinical manifestations of turner’s syndrome?

Answer 126

gonadal streaks instead of ovaries - no menstruation, short stature, lymphedema (swelling) of the hands and feet, broad chest with widely spaced nipples, low-set ears, small lower jaw, drooping eyelids, increased weight, small fingernails, webbing of the neck, coarctation of the aorta, horseshoe kidney, visual disturbances, ear infections, hearing loss, reduced bone mass which increases risk for fractures

Question 127

how is turner’s syndrome usually treated?

Answer 127

through administration of female sex hormones to promote development of secondary sex characteristics and skeletal growth, growth hormones may be administered to improve skeletal growth

Question 128

when is turner’s syndrome usually identified when symptoms are more subtle? what can confirm the diagnosis?

Answer 128

usually not identified until late childhood or early adolescence, chromosomal analysis can confirm the diagnosis

Question 129

what does early treatment of turners syndrome allow for?

Answer 129

early hormone replacement to minimize problems and detect complications

Question 130

polysomy x is also called…

Answer 130

klinefelter’s syndrome

Question 131

what is klinefelter’s syndrome

Answer 131

a chromosomal abnormality that results in an extra X chromosome so that a person has XXY

Question 132

does klinefelter’s syndrome affect men or women?

Answer 132

men because of the presence of the Y chromosome

Question 133

when does klinefelter’s syndrome usually become apparent, and why?

Answer 133

usually becomes apparent at puberty because the testicles fail to mature. boys are rendered infertile because of this

Question 134

how many chromosomes do a person with turner’s syndrome have? klinefelter’s syndrome?

Answer 134

turner’s syndrome - 45

klinefelter’s syndrome - 47

Question 135

what are the clinical manifestations of klinefelter’s syndrome?

Answer 135

small penis, prostate gland, and testicles; sparse facial and body hair; gynecomastia (female-like breasts); sexual dysfunction (impotence, decreased libido); long legs with a short, obese trunk; tall stature; behavioral problems; learning disabilities; increased incidence of pulmonary disease and varicose veins; tend to have high-pitched voice; usually sterile

Question 136

what are some problems that can develop with klinefelter’s syndrome?

Answer 136

osteoporosis and breast cancer

Question 137

what are the diagnostic procedures for klinefelter’s syndrome?

Answer 137

history, physical exam, hormone levels, and chromosomal testing.

Question 138

treatments for klinefelter’s syndrome

Answer 138

male hormone replacement to promote secondary sex characteristics, mastectomy in cases of gynecomastia and breast cancer. psychological counseling may helpful for patient and parents

Question 139

general adaptation syndrome

Answer 139

a cluster of systemic manifestations that represent an attempt to cope with a stressor

Question 140

what are the three stages of the general adaptation syndrome?

Answer 140

alarm stage, resistance stage, exhaustion stage

Question 141

what occurs during the alarm stage of the general adaptation syndrome?

Answer 141

generalized stimulation of the sympathetic nervous system resulting in the release of catecholamine and corisol - fight or flight response initiated

Question 142

what occurs during the resistance stage of the general adaptation syndrome?

Answer 142

the body chooses the most effective or advantageous defense. sympathetic system returns to normal and fight or flight disappears, body either adapts or alters its workings in an attempt to limit problems or become desensitized to the stressor. - stress management techniques can help here

Question 143

what occurs during the exhaustion stage of the general adaptation syndrome?

Answer 143

the stressor is prolonged or overwhelms the body. body becomes depleted and damage may appear because homeostasis cannot be maintained. disease or death results due to the utilization of the body’s defenses

Question 144

what are some diseases/ailments that have been attributed to stress?

Answer 144

anxiety, depression, headaches, insomnia, infections, cardiovascular disease

Question 145

what is the local adaptation syndrome?

Answer 145

a localized version of the general adaptation syndrome in which the body attempts to limit the damage associated by the stressory by confining it to one location

Question 146

what is an example of the local adaptation syndrome?

Answer 146

inflammatory reactions to tissue trauma

Question 147

what are factors that affect the stress response?

Answer 147

genetics, age, gender, life experiences, dietary status, social support

Question 148

what can help to limit or eliminate the negative aspects of stress?

Answer 148

implementation of one or more positive coping strategies

Question 149

an antibody made by the immune system that attacks an individual’s own proteins

Answer 149

autoantibodies

Question 150

what does the body’s first line of defense consist of?

Answer 150

physical and chemical barriers - skin and mucous membranes

Question 151

what are the physical aspects of the first line of defense?

Answer 151

skin - way cells are pushed to the surface when they die, waterproof, normal flora that resides on the skin
mucous membranes

Question 152

what are the chemical aspects of the body’s first line of defense?

Answer 152

perspiration. hydrochloric acid protects against ingested microorganisms. skin is slightly acidic which prevents bacterial growth, tears and saliva contain lysozyme which is an enzyme that destroys bacterial walls

Question 153

is the first line of defense specific against pathogens?

Answer 153

no, doesn’t distinguish between them or give a different response based on the type of pathogen present

Question 154

how does the first line of defense distinguish cell from nonself?

Answer 154

it allows normal flora to be present on the skin, while getting rid of pathogens that are not normal

Question 155

what is the body’s second line of defense?

Answer 155

inflammation

Question 156

when does inflammation occur?

Answer 156

immediately after there has been a breach in the body’s first line of defense

Question 157

what things, other than inflammation are included in the body’s second line of defense?

Answer 157

pyrogens, interferons, and complement proteins

Question 158

what things trigger the body’s second line of defense?

Answer 158

injuries and trauma, the presence of microorganisms

Question 159

is inflammation specific to the microorganism?

Answer 159

no

Question 160

what triggers the inflammation response?

Answer 160

a set of mediators or mast cells - histamines and prostaglandins

Question 161

what is the role of histamines?

Answer 161

they are a potent vasodilator that cause vessels to open up, and increase the permeability of vessels so that cells and fluid can leak out into the tissues. they contain a chemotactic factor that attracts white blood cells to where they need to be

Question 162

what are the steps of inflammation?

Answer 162

mast cells trigger a response, arterioles in the area vasoconstrict to limit bleeding and the extent of injury, vasodilation immediately follow to allow essential immune cells, nutrients and oxygen to enter the area and to dilute toxins. capillary permeability increases. endothelial cells react to biochemical mediators that cause vessels to retract allowing leukocytes enough room to enter the interstitial fluid. leukocytes begin phagocytizing foreign substances and cellular debris in order to clean the area up. fibrinogen is formed into fibrin which walls off the area and keeps the foreign invaders contained. a meshwork of new cells form to provide support for the healing process. blood clotting begins if any vessels have been damaged

Question 163

what are the classic symptoms of inflammation?

Answer 163

erythema, edema, heat, pain, and loss of function - can be due to pain or edema

Question 164

what are the white blood cells that participate in inflammation?

Answer 164

neutrophils, monocytes, and eosinophils

Question 165

what are the first WBCs to enter an area of injury or invasion?

Answer 165

neutrophils

Question 166

what is the neutrophil’s life span and what happens to them after they die?

Answer 166

a few hours - a few days. when they die they usually become part of pus or exudate from the wound

Question 167

what are macrophages?

Answer 167

mature monocytes

Question 168

at what point during the inflammatory process do monocytes and macrophages usually enter the area?

Answer 168

about 24 hours in

Question 169

what WBC levels would we expect to be higher in an infection that has been going on for a while?

Answer 169

monocytes and macrophages

Question 170

WBC that is usually present during an allergic reaction or parasitic infection.

Answer 170

eosinophil

Question 171

what are the benefits of inflammation?

Answer 171

limit and control tissue damage by preventing the spread of foreign substances to healthy tissues, keeps the damage contained. prevents and limits further infection and damage - immediately starts to take care of it and start the healing process. initiates adaptive immune response, innate healing

Question 172

what are pyrogens?

Answer 172

proteins released by macrophages that have been exposed to bacteria. they travel to the hypothalamus and raise it’s set point causing a fever

Question 173

why are fevers helpful?

Answer 173

mild fevers can cause the spleen and liver to remove iron from the blood which is necessary for bacterial reproduction, increases metabolism which facilitates healing and phagocytosis accelerates

Question 174

what can happen if a fever becomes too high? what is considered a dangerous level for a fever?

Answer 174

high fevers can denature proteins, especially enzymes needed for biochemical reactions. 105 is considered a dangerous fever

Question 175

what are interferons?

Answer 175

small proteins released from cells infected by viruses. they travel to neighboring cells and let them know there is an invasion going on. by binding to the uninfected cells they trigger the synthesis of enzymes that are capable of breaking down viral messenger RNA, and so they inhibit viral replication. when the virus enters the cell it cannot replicate or spread

Question 176

do interferons protect cells that are already infected with a virus?

Answer 176

no, only uninfected cells

Question 177

when do complement proteins become activated?

Answer 177

when foreign substances enter the body

Question 178

what are some functions of complement proteins?

Answer 178

plasma protein embeds in the membrane of bacterial cells, allowing fluid to enter the cell and causing them to lyse, some stimulate vasodilation, some increase the permeability of vessels, some trigger chemotaxis, some bind to microbes and create a rough coat to aid in phagocytosis

Question 179

what is the body’s third line of defense? is it specific or nonspecific?

Answer 179

the body’s immune system. specific.

Question 180

why are immunizations given prior to flu season?

Answer 180

because the immune system is slower to respond, but has memory

Question 181

what are the two major types of T cells?

Answer 181

regulator and effector/killer cells

Question 182

what are the two types of regulator T cells and what are their purposes?

Answer 182

helper cells - activate or call up B cells to produce antibodies
suppressor cells - turn antibody production off

Question 183

what is the purpose of effector/killer/cytotoxic cells?

Answer 183

destroy cells infected with viruses by releasing lymphokines that degrade cell walls

Question 184

what type of cells are responsible for hypersensitivity and transplant rejections?

Answer 184

T cells

Question 185

which cells participate in cell mediated immunity and which ones participate in humoral immunity

Answer 185

cell mediated immunity - T cells

humoral immunity - B cells

Question 186

where are T cells produced and where do they mature? what about B cells?

Answer 186

T cells are produced in the bone marrow and mature in the thymus
B cells are produced in the bone marrow and mature there

Question 187

what type of cell produces antibodies?

Answer 187

plasma B cells

Question 188

what is the difference between T cells and B cells with regards to the way they attack the antigen?

Answer 188

T cells directly attack the antigen through cytotoxic T cells, while B cells indirectly attack the antigen by secreting antibodies to attack the antigen

Question 189

what is the purpose of memory B cells?

Answer 189

allow faster recognition and response to an antigen

Question 190

what are immunoglobulins used in?

Answer 190

humoral immune responses

Question 191

what is IgG?

Answer 191

the most common antibody - 80-85% of plasma antibodies. main defense against bacteria.

Question 192

why is IgG the main antibody found in fetal blood?

Answer 192

it crosses the placenta

Question 193

which antibody is tested to see if a person has an immunity to something?

Answer 193

IgG

Question 194

what is IgM?

Answer 194

the largest immunoglobulin. it is the first one produced in the initial response to an antigen. first antibody made by the fetus

Question 195

which immunoglobulin tells us whether you have a current infection of something or have a recent infection with something?

Answer 195

IgM

Question 196

antibody present in body secretions such as tears, saliva, and perspiration

Answer 196

IgA

Question 197

least understood antibody. present in small amounts in blood serum and B cell surfaces. is a receptor for antigens and helps anchor cell membranes.

Answer 197

IgD

Question 198

antibody that protects the body through its presence in mucous membranes and skin. triggers allergic reactions. also important for parasitic infections.

Answer 198

IgE

Question 199

what is the difference between primary and secondary response to something, and what antibodies are most common during each?

Answer 199

primary response is when the antigen first enters the body. IgM levels are higher at this time
secondary response is an anamnestic immune response. IgG levels are higher

Question 200

what are the three different T cell classifications?

Answer 200

helper T cells (Th)
cytotoxic T cells (Tc)
suppressor T cells

Question 201

destroy cells with viruses or tumor cells

Answer 201

cytotoxic T cells

Question 202

what two T cells do we need a balance between and what happens if there is not one?

Answer 202

helper T cells and suppressor T cells. if helper T cells function more than suppressor T cells, exaggerated responses occur. if suppressor T cells function more than helper T cells, the immune system weakens

Question 203

immunity that is gained after birth

Answer 203

acquired immunity

Question 204

immunity produced by the host after either a natural exposure to an antigen or immunization. long lasting or short term?

Answer 204

active acquired immunity - long lasting

Question 205

immunity obtained by the transfer of preformed antibodies to the recipient passed to the individual or the host. short term or long term?

Answer 205

passive acquired immunity - short term

Question 206

what are the two types of active immunity and what are the differences between them?

Answer 206

natural active - pathogens enter the body and cause illness. antibodies are formed.
artificial active - vaccine is injected into the body. no illness results, but antibodies are formed.

Question 207

what are the two types of passive acquired immunity?

Answer 207

natural passive - antibodies are passed directly from mother to child to provide temporary protection
artificial passive - antibodies are injected into the body to provide temporary protection or to minimize the severity of an infection

Question 208

what type of immunity has memory and what type does not?

Answer 208

active acquired immunity has memory, passive acquired does not

Question 209

what is hypersensitivity?

Answer 209

when the immune system doesn’t respond as it should

Question 210

what are some common types of altered immune responses?

Answer 210

allergy, autoimmunity, alloimmunity

Question 211

exaggerated response against environmental agents

Answer 211

allergies

Question 212

what things can be environmental agents?

Answer 212

food, medications, pollen, doesn’t just have to be something occurring in nature

Question 213

immune response directed at one’s own cells. when the immune system starts fighting the persons own body

Answer 213

autoimmunity

Question 214

who are autoimmune disorders most common in?

Answer 214

women

Question 215

immune response directed against beneficial foreign tissues. transfusion reactions, and when a mother’s body tries to attack the fetus

Answer 215

alloimmunity

Question 216

what is the difference between immediate and delayed hypersensitivity reactions?

Answer 216

immediate occur within minutes to hours following exposure

delayed may take several hours

Question 217

what is type I hypersensitivity, and what is it mediated by?

Answer 217

IgE mediated immediate reaction that most of our allergic reactions come from (hay fever, food allergies, anaphylaxis), IgE binds to mast cells and upon a second exposure, the antigen binds to the IgE antibodies on the mast cells, causing the mast cells degranulate and release histamine and other mediators of the inflammatory response

Question 218

what are the clinical manifestations for type I hypersensitivity?

Answer 218

hives (erdecaria), itching (pruritis), angioedema (soft tissue swelling) immediate

Question 219

what are treatments of type I hypersensitivity?

Answer 219

epinephrine, antihistamines, corticosteroids, ad desensitizing injections which suppress all inflammatory activity

Question 220

what is type II hypersensitivity?

Answer 220

tissue or cells specific immediate reaction that has to do with IgG and IgM antibodies. these antibodies react with an antigen on the cell activating the compliment system. cell lysis and phagocytosis result.

Question 221

what are some examples of type II hypersensitivity?

Answer 221

blood transfusion reactions and erythroblastosis fetalis

Question 222

what are some treatments for type II hypersensitivity?

Answer 222

focus on prevention. includes insuring blood compatibility prior to infusions and administering medication to suppress immune activity and prevent maternal antibody development

Question 223

what is type III hypersensitivity?

Answer 223

immune complex-mediated hypersensitivity reaction. circulating antigen-antibody complexes accumulate and are deposited in the tissue. the body then tries to destroy these complexes triggering the complement system which causes inflammation locally to wherever they were deposited, due to vasodilation, more complexes accumulate. autoimmune condition (systemic lupus)

Question 224

what is treatment for type III hypersensitivity dependent on?

Answer 224

the disease

Question 225

what is type IV hypersensitivity?

Answer 225

delayed reaction because it is cell mediated tissue reactions rather than antibody mediated. delayed processing of the antigen by macrophages. once processed, the antigen is presented to the T cells resulting in the release of lymphokines that cause inflammation and antigen destruction

Question 226

what is type IV hypersensitivity seen with and what does treatment depend on?

Answer 226

transplant reactions, TB reactions (why you have to wait to have a TB test read), contact dermatitis. treatment is disease specific

Question 227

what are the four types of transplant possibilities and what is each?

Answer 227

allogenic - tissue comes from same species as host and is of similar tissue type, but not identical - what most transplants are
autologous - host and donor are same person
syngenic - from identical twin of host
xenogenic - tissue transplant from another species

Question 228

what are transplant rejections classified based on?

Answer 228

their timing

Question 229

when do hyperacute tissue rejections occur and why?

Answer 229

occur immediately to three days after transplant. a complement response where the host has antibodies against the donor tissue. triggers a systemic inflammatory reaction

Question 230

with hyperacute tissue reactions, often times the rejection occurs so fast that the new tissue did not have a chance to do what?

Answer 230

establish vascularization, so the tissue becomes permanently necrotic

Question 231

what is the most common and treatable type of tissue rejection?

Answer 231

acute tissue rejections

Question 232

when do acute tissue rejections occur and why?

Answer 232

occur four days up to three months after the transplant. cell mediated reactions result in tissue destruction or necrosis. exhibit signs and symptoms of the inflammatory response. may experience impaired function of the transplanted organ

Question 233

when and why does chronic tissue rejection occur?

Answer 233

occurs four months to years after the transplant. most likely due to antibody mediated immune response where antibodies and complement molecules become deposited in the transplanted tissue walls decreasing blood flow and causing ischemia

Question 234

what is the difference between host-vs-graft rejections and graft-vs-host rejections? which is the most common?

Answer 234

host-vs-graft the host is fighting the graft - most common

graft-vs-host the graft is fighting the host

Question 235

how and where do graft-vs-host reactions occur?

Answer 235

only occur with bone marrow transplants. the graft cells recognize the host cells as foreign and launch an attack. the host is usually immunocompromised and unable to fight back

Question 236

what is crucial to reversing a rejection?

Answer 236

identifying it quickly by assessing manifestations of a health and unhealthy transplant

Question 237

what are the diagnostic procedures for recognizing a transplant rejection?

Answer 237

lab tests to identify immune and inflammatory activity and specific tests to determine the function of the transplanted organ

Question 238

treatment for transplant rejections

Answer 238

usually begins with prevention by ensuring tissue match and initiating immunosuppressive therapy. once the transplant is suspected to be rejected, immunosuppressive therapy is intensified to try and reverse it

Question 239

occurs when the body’s defenses lose the ability to recognize self and become self destructive, attacking the host

Answer 239

autoimmune disorders

Question 240

what gender is most often affected by autoimmune disorders?

Answer 240

females

Question 241

what are autoimmune diseases characterized by?

Answer 241

frequent periods of exacerbations and remissions

Question 242

what things can trigger exacerbations?

Answer 242

physical and emotional stress

Question 243

what triggers autoimmune disorders?

Answer 243

the mechanism that triggers the response is unclear

Question 244

how do genetics play a role in autoimmune disorders?

Answer 244

if a family member is affected by an autoimmune disease, an individual has increased chances of having the disease, but it is not known to be passed down

Question 245

what is the frequent cause of autoimmune diseases?

Answer 245

an abnormal stressor, either physical or psychological

Question 246

what is do treatments for autoimmune diseases usually entail?

Answer 246

they are usually disease specific, but often include coping and stress management strategies to prevent exacerbations

Question 247

chronic, inflammatory, autoimmune disorder that can affect any connective tissue

Answer 247

systemic lupus erythematosus

Question 248

what is thought to happen with SLE?

Answer 248

B cells are thought to be activated for unknown reasons to produce autoantibodies and autoantigens which then combine to form immune complexes that fight against the body’s own tissues. hyperactive T cells helper T cells and subdued suppressor T cells are thought to create a prime environment for B cells to overproduce.

Question 249

which systems are most likely to be harmed with SLE

Answer 249

heart, joints, skin, lungs, blood vessels, liver, kidneys, and nervous system

Question 250

how much more likely are women to be affected by SLE than men?

Answer 250

9x more likely in women than in men

Question 251

who are the most likely to get SLE?

Answer 251

women, ages 15-50, Asians and African Americans

Question 252

When is the diagnosis of SLE strongly suggested?

Answer 252

when the person has four or more of the 11 criteria

Question 253

what are the 11 criteria of SLE

Answer 253

butterfly rash over the cheeks, skin rash of patchy redness with hyper and hypo pigmentation that can cause scarring, photosensitivity, mucous membrane ulcers, arthritis, pleuritis or pericarditis, renal abnormalities, brain irritation, blood abnormalities, immunologic disorder, immunologic disorder, antinuclear antibody

Question 254

what is pleuritis or pericarditis?

Answer 254

inflammation of the lining around the heart or lungs

Question 255

how are renal abnormalities associated with SLE detected?

Answer 255

abnormal amounts of urine protein or clumps of cellular elements, alled casts are detectable with a urinalysis. renal abnormalities due to lupus are the main cause of renal transplants

Question 256

how is brain irritation manifested with sle?

Answer 256

through seizures or psychosis

Question 257

what are the blood abnormalities of SLE?

Answer 257

low counts of white or red blood cells or platelets

Question 258

in addition to the 11 criteria of SLE, what other tests can be helpful in evaluating patients with SLE?

Answer 258

tests to determine the severity of organ involvement. these tests include routine testing of the blood to detect inflammation, blood chemistry testing, direct analysis of internal body fluids, and tissue biopsies. abnormalities can further support the diagnosis

Question 259

what does treatment for SLE consist of?

Answer 259

targeted at symptom management. stress reduction, exercise, and sleep. nonsterioidal anti-inflammatory drugs to reduce pain and inflammation in joints, muscle, and other tissues. corticosteroids. antimalarial drugs to treat fatigue, joint pain, rashes, and pleural inflammation by suppressing the immune system. plasmapheresis to remove antibodies and other immune substances from the blood to suppress immunity.

Question 260

what is the difference between primary or secondary immunodeficiencies?

Answer 260

primary reflect a defect with the immune system

secondary reflect an underlying disease or factor that is suppressing the immune system

Question 261

what are the most common forms of immunodeficiency caused by?

Answer 261

viral infections or are iatrogenic reactions to therapeutic drugs

Question 262

what do primary deficits involve?

Answer 262

developmental failures, many of which result from genetic or congenital abnormalities

Question 263

what do secondary or acquired immunodeficiencies refer to?

Answer 263

a loss of immune function because of a specific cause like infection, splenectomy, hepatic disease, drug therapy, or stress

Question 264

what are opportunistic infections?

Answer 264

infections caused by pathogens that do not usually cause disease in healthy individuals

Question 265

what do opportunistic infections usually result from?

Answer 265

a disruption of normal flora. they are difficult to treat and can become life threatening

Question 266

what does diagnosis of the immunodeficient state entail?

Answer 266

identification of recurrent or persistent infections. involve measurements of immunoglobulin levels, white blood cells, and T cell counts.

Question 267

what does treatment of immunodeficient diseases entail?

Answer 267

individualized for the specific deficiency and may include gamma globulin, bone marrow transplants, or thymus transplants

Question 268

which strain of HIV is the most common in the US, which is most common in Africa?

Answer 268

HIV 1 US

HIV 2 Africa

Question 269

how is HIV transmitted?

Answer 269

through direct contact with infected blood, blood products, or body fluids. it is not transmitted through saliva and kissing unless open sores are present

Question 270

what is the chance of a mother passing HIV to their offspring , what can decrease this risk, by how much?

Answer 270

13-40% chance of passing it, antiretroviral therapy can decrease the risk by 68%. Retrovir is the most common drug and has a high safety index. C-section can further decrease the risk of transmission

Question 271

how does HIV work?

Answer 271

once it gains access to the body it invades CD4 cells and uses an enzyme, reverse transcriptase, to convert the viral RNA to DNA. the viral DNA then becomes integrated into the CD4 cell’s DNA as the infected CD4 cell reproduces, it inadvertently produces viral copies. meanwhile the CD4 cells reproduce in the cells until the point when the cell membrane is comprimised, releasing millions of viral copies into the blood stream, starting the cycle over.

Question 272

what are the three forms that the HIV infectious process takes, what does each include?

Answer 272

immunodeficiency - includes opportunistic infections
autoimmunity - lymphoid interstitial pneumonitis, arthritis, and hypergammaglobulinemia
neurologic dysfunction - AIDS dementia complex, HIV encephaly, peripheral neuropathies

Question 273

what is the first sign of HIV?

Answer 273

a brief period of flulike symptoms referred to as acute retroviral syndrome. may not have any more symptoms. as more and more CD4 cells are destroyed, the individual begins to have symptoms

Question 274

how does the symptom process of HIV occur?

Answer 274

initial onset of flulike symptoms that disappear for a while until enought CD4 cells have been affected to begin showing symptoms (lymphopathy, diarrhea, weight loss, fever, cough, shortness of breath). over the next 10 years, serious clinical manifestations begin appearing as the individual moves into the late stage of infections

Question 275

what manifestations can children have that are infected with HIV?

Answer 275

difficulty gaining weight, difficulty growing normally, problems walking, delayed mental development, severe forms of common childhood illnesses such as ear infections (otitis media), pneumonia, and tonsillitus

Question 276

once HIV/AIDS is confirmed, what is done?

Answer 276

a test to predict the probable disease progression, or viral load (number of viral particles per milliliter) is done. the higher the viral load, the further the progression

Question 277

what is the aim of antiretroviral therapy?

Answer 277

to reduce the viral load to a point that the body’s immune system can keep the virus in check.

Question 278

what can be an indicator of treatment success in HIV/AIDS?

Answer 278

an indicator of treatment success, along with other indicators

Question 279

what two systems is the HIV infections progression classified on?

Answer 279

CD4 count and symptom presentation - these are used to track progression and treatment

Question 280

what is antiretroviral therapy used for?

Answer 280

to control the reproduction of HIV and slow the progression of the disease to help try to prevent AIDS from developing

Question 281

HAART

Answer 281

highly active antiretroviral therapy

Question 282

what are the five approved classes of antiretroviral therapy?

Answer 282

nucleoside/nucleotide reverse transcriptase inhibitors, non-nucleoside reverse transcriptase inhibitors, protease inhibitors, integrase inhibitors, fusion inhibitors

Question 283

can resistance occur to HAART?

Answer 283

yes if a patient does not strictly adhere to the prescribed regimen

Question 284

what are treatments other than HAART that can treat HIV?

Answer 284

medications to treat specific opportunistic infections as they arise, manage the numerous drug sid effects and prevent reexposure

Question 285

what can continued reexposure to HIV cause?

Answer 285

it can increase the viral load and introduce another strain - this can increase the disease’s progression

Question 286

what does prevention for HIV include?

Answer 286

avoiding contact with bodily fluids, avoiding activities that increase the risk to exposure to bodily secretions (drug use and multiple sexual partners) education, using condoms every time, preexposure to prophylaxis (daily antiretroviral therapy for people at high risk), male circumcision reduces male-to-female risk of transmission

Question 287

what are at risk individuals and states that put individuals at risk for developing an impaired immune system?

Answer 287

very young and old, poor nutrition, impaired skin integrity, circulatory issues, alterations in normal flora due to antibiotic therapy, chronic diseases especially diabetes mellitus, corticosteroid therapy, chemotherapy, smoking, alcohol consumption, immunodeficiency states

Question 288

what are stragegies to build a healthy immune system?

Answer 288

increased fluid intake, eating a well-balanced diet, increasing antioxidants and protein intake, getting adequate sleep, avoiding caffeine and refined sugar, spending time outdoors, reducing stress

Question 289

when does disease occur with blood?

Answer 289

when there are too few, too many, or dysfunctional blood components

Question 290

the process of blood formation. occurs primarily in the bone marrow.

Answer 290

hematopoiesis

Question 291

plasma is a transport medium that carries what?

Answer 291

blood cells, antibodies, nutrients, electrolytes, hormones, lipids, and waste products

Question 292

what does the shade of the color of blood tell us?

Answer 292

the hemoglobin saturation. the brighter the shade of red, the more blood that is saturated with oxygen

Question 293

refers to how much of the blood volume comprises erythrocytes

Answer 293

hematocrit

Question 294

the release of this causes a quick chain reaction that ends in clotting

Answer 294

thromboplastin

Question 295

what do platelets containing contractile proteins do?

Answer 295

they pull the edges of a wound together

Question 296

enzyme that dissolves clots once healing has occured

Answer 296

plasmin

Question 297

what are the granulocytes?

Answer 297

neutrophils, basophils, and eosinophils

Question 298

what are the normal levels of neutrophils?

Answer 298

3000-7000

Question 299

what are the normal levels of eosinophils?

Answer 299

100-400

Question 300

what are the normal levels of basophils?

Answer 300

20-50

Question 301

what are the normal levels of monocytes?

Answer 301

100-700

Question 302

what are the normal levels of lymphocytes?

Answer 302

1500-3000

Question 303

what are normal white blood cell levels?

Answer 303

5000-10,000 cells/mL3

Question 304

increased WBC levels

Answer 304

leukocytosis

Question 305

decreased WBC levels

Answer 305

leukocytopenia

Question 306

what can leukocytosis indicate?

Answer 306

an active infectious process

Question 307

what can leukocytopenia indicate?

Answer 307

an immune deficiency state

Question 308

what do most leukocyte disorders result from?

Answer 308

originate from deficiencies of one or more of the varying leukocytes

Question 309

which cells are the first to arrive on the scene of an infection?

Answer 309

neutrophils. they are attracted by various chemicals released by the infected tissue

Question 310

what do neutrophils do when they get to a site of infection?

Answer 310

they phagocytize microorganisms and prevent the infection from spreading

Question 311

what happens to the infected neutrophils that die?

Answer 311

the become part of yellowish wound drainage (pus)

Question 312

neutropenia

Answer 312

a decrease in circulating neutrophils to less than 1500

Question 313

how does a lower neutrophil count effect the body?

Answer 313

the lower the neutrophil count, the less the body’s ability to fight infections

Question 314

what are causes of neutropenia?

Answer 314

increased usage (infection and inflammation); drug suppression (immunosuppression and chemotherapies; radiation therapy; congenital conditions (periodic or cyclic); bone marrow cancers (leukemias and lymphomas); spleen destruction; vitamin deficiency

Question 315

what are the clinical manifestations of neutropenia?

Answer 315

signs and symptoms of bacterial and fungal infections. mouth ulcerations, ulcerations of the skin, vagina, and GI tract

Question 316

what antigens do each of the blood groups have on their surfaces, what antibodies do they produce?

Answer 316

type A - A antignes on surface, B antibodies
type B - B antigens on surface, A antibodies
type AB - A and B antigens on surface, no antibodies
type O - no antigens on surface, A and B antibodies

Question 317

which blood group is the universal receiver and which is the universal donor?

Answer 317

universal receiver - type AB

universal donor - type O

Question 318

homozygous dominant or heterozygous for the Rh gene are positive or negative?

Answer 318

Rh+

Question 319

homozygous recessive for Rh factor are positive or negative?

Answer 319

Rh-

Question 320

which Rh factor is able to receive blood that is the other type?

Answer 320

Rh positive can receive blood from Rh negative because Rh negative has not antigens on its surface, so there is nothing for the Rh positive blood to see as foreign. Rh negative blood cannot receive Rh positive though because Rh positive has antigens for Rh negative to see as foreign

Question 321

what are the indicators of infection?

Answer 321

malaise, fever, chills, body aches

Question 322

what are the diagnostic procedures for neutropenia?

Answer 322

serum neutrophil levels and a bone marrow biopsy may be conducted to determine the cause of neutropenia

Question 323

what are treatments for neutropenia

Answer 323

antibiotics therapy to treat infection.

Question 324

what is crucial to a positive outcome with neutropenia?

Answer 324

identification and treatment of the cause

Question 325

what causes infectious mononucleosis?

Answer 325

the Epstein-Barr virus

Question 326

what family is EBV in?

Answer 326

the herpes family

Question 327

do most people who are exposed to EBV develop infectious mononucleosis? explain.

Answer 327

no, because most people have been exposed to it as children, and because of this exposure, they have developed immunity

Question 328

how does EBV work in the body?

Answer 328

it infects B cells by killing the cells or being incorporated into their genomes. once the disease is eliminated, a few B cells still remain altered, giving an individual an asymptomatic infection for life and the potential to occasionally spread ebv to others

Question 329

how is infectious mononucleosis spread?

Answer 329

person-to-person through contact with saliva most commonly.

Question 330

why is ebv transmission through drinking or eating after someone a risk?

Answer 330

it can survive for hours outside the body

Question 331

what is the incubation period for infectious mononucleosis?

Answer 331

4-6 weeks

Question 332

according to the CDC, depending on the method used to detect the virus, individuals who have recovered from infectious mononucleosis will continue to excrete the virus through their saliva for….. why?

Answer 332

years due to periodic reactivations of viral infection

Question 333

who is the primary resevoir for ebv?

Answer 333

healthy individuals who secrete ebv particles are the primary reservoir for transmission among humans

Question 334

onset of clinical manifestations of infectious mononucleosis are usually called what?

Answer 334

insidious symptoms

Question 335

what are insidious symptoms?

Answer 335

a general feeling of being sick

Question 336

what are the insidious symptoms that manifest with infectious mononucleosis?

Answer 336

malais, fever, chills, anorexia

Question 337

what happens after the insidious symptoms that occur with infectious mononucleosis?

Answer 337

the manifestations intensify and include severe sore throat, fever, and lymphopathy.

Question 338

how long does the acute phase of infectious mononucleosis usually last?

Answer 338

2-3 weeks

Question 339

what are possible complications of mono?

Answer 339

ruptured spleen, hepatitis, and meningitis

Question 340

why can mono cause an enlarged spleen?

Answer 340

it causes the spleen to become congested with blood cells. this puts the patient at risk for their spleen rupturing

Question 341

how is mono diagnosed?

Answer 341

2-3 weeks post exposure, a heterophile antibody test is done. increased lymphocytes, increased monocytes, and atypical t lymphocytes in the blood will be present and can be identified and tested. leukocyte counts may also be increased

Question 342

how common is lymphoma in children and how common is it in the adult?

Answer 342

6th most common cause of cancer in the adult

3rd most common cause of cancer in the child

Question 343

what are the two types of lymphoma? which is the most common?

Answer 343

Hodgkin’s lymphoma

Nonhodgkin’s lymphoma - most common

Question 344

what are risk factors for both types of lymphomas?

Answer 344

HIV and EBV

Question 345

what are risk factors, other than HIV and EBV, for non-Hodgkin’s lymphoma?

Answer 345

the presence of an inherited immune or autoimmune condition and infection with helicobacter pylori or human T cell leukemia/lymphoma virus type 1 (HTLV-1)

Question 346

least common and most treatable lymphoma

Answer 346

Hodgkin’s lymphoma

Question 347

in what lymph nodes does Hodgkin’s lymphoma most commonly start?

Answer 347

the lymph nodes of the upper body - neck, chest, and upper arms

Question 348

how do Hodgkin’s lymphoma cancer cells usually spread?

Answer 348

from one lymph node to the next through the lymphatic vessels

Question 349

which lymphoma has Reed-Sternberg cells?

Answer 349

Hodgkin’s lymphoma

Question 350

is metastasis to other parts of the body, other than lymph nodes, common in Hodgkin’s lymphoma?

Answer 350

no, if it occurs it is usually late in the disease process

Question 351

an abnormal type of b lymphocyte that is much larger than normal lymphocytes

Answer 351

Reed-Sternberg cells

Question 352

are t lymphocytes affected with Hodgkin’s lymphoma?

Answer 352

yes, they appear defected as well and the total number of lymphocytes in general decreases

Question 353

what are the two types of Hodgkin’s lymphoma and what are they differentiated depending on?

Answer 353

classic and nodular - they differ in the way the cells appear under the microscope and the way they grow and spread - they are usually treated differently

Question 354

which type of Hodgkin’s lymphoma makes up 95% of hodkin’s cases?

Answer 354

classic Hodgkin’s lymphoma

Question 355

at what ages are you most likely to get Hodgkin’s lymphoma?

Answer 355

adults 20-40, with a second peak of occurrence in men 50+

Question 356

when is prognosis of Hodgkin’s lymphoma improved?

Answer 356

when the disease is localized and treated early

Question 357

those with Hodgkin’s disease that are treated with radiation may be at further risk for what?

Answer 357

stroke and transient ischemic attack

Question 358

what are the clinical manifestations of Hodgkin’s disease?

Answer 358

swollen, painless lymph nodes; weight loss; persistent fever; night sweats; generalized pruritis; coughing, trouble breathing, or chest pain; malaise; recurrent infections; splenomegaly

Question 359

what are the stages of Hodgkin’s lymphoma?

Answer 359

stage 1: lymphoma cells are in one node group, or only one part of a tissue or organ
stage 2: lymphoma cells are in at least 2 lymph node groups or tissues on the same side of the diaphragm
stage 3: lymphoma cells are above and below the diaphragm in lymph nodes, may be in a tissue or organ near the lymph node and in the spleen
stage 4: in several parts of one or more organs or tissues and in distant nodes

Question 360

what ethnic group is non-hodgkin’s lymphoma most common in?

Answer 360

caucasians

Question 361

how can non-hodgkin’s lymphoma be divided?

Answer 361

aggressive (fast-growing) and indolent (slow-growing) types and they can arise form either B cells (80%) of cases, or T cells

Question 362

how are hodgkin’s and non-hodgkin’s lymphomas the same and how are they different?

Answer 362

they are similar in their clinical manifestations, staging and treatment, but different in their spread and diagnosis. non-hodgkin’s lymphoma contains no Reed-Sternberg cells

Question 363

how does non-Hodgkin’s lymphoma spread?

Answer 363

it involves multiple lymph nodes throughout the body and metastasizes in an unorganized manner. metastasis is often present at diagnosis

Question 364

cancer of the leukocytes

Answer 364

leukemia

Question 365

what occurs with leukemia?

Answer 365

the bone marrow makes abnormal leukocytes, or leukemia cells, which do not die when they should and so they begin crowding normal leukocytes, erythrocytes, and thrombocytes. this makes it difficult for normal blood cells to function properly

Question 366

the most common blood cancer

Answer 366

leukemia

Question 367

is the exact cause of leukemia known?

Answer 367

no

Question 368

leukemia is the most common cancer in what age group?

Answer 368

although it affects 10x as many adults as it does children, it is the most common cancer among children

Question 369

what gender is at more of a risk for leukemia?

Answer 369

men

Question 370

what are risk factors for leukemia?

Answer 370

exposure to chemical, viral, and radiation mutagens; smokin; use of chemotherapies; certain disease conditions; immunodeficient disorders

Question 371

what are the four most common types of leukemias?

Answer 371

acute lymphoblastic leukemia (ALL), acute myeloid leukemia (AML), chronic lymphoid leukemia (CLL), chronic myeloid leukemia (CML)

Question 372

type of leukemia that affects primarily children - it accounts for approximately 75% of all childhood cases of leukemia. responds well to therapy and contains a good prognosis

Answer 372

acute lymphoblastic leukemia

Question 373

type of leukemia that affects primarily adults; responds fairly well to treatment and carries a good prognosis, but is a little worse than acute lymphoblastic leukemia

Answer 373

acute myeloid leukemia

Question 374

type of leukemia that affects primarily adults; responds poorly to therapy, yet many patients live for many years after diagnosis

Answer 374

chronic lymphoid leukemia

Question 375

type of leukemia that affects primarily adults; responds poorly to chemotherapy, but the prognosis is improved with allogeneic bone marrow transplants

Answer 375

chronic myeloid leukemia

Question 376

what are the clinical manifestations of leukemia?

Answer 376

leukopenia - characterized by frequent infections; anemia - pallor, fatigue, dyspnea, and decreased activity tolerance; thrombocytopenia - petechiae, bleeding gums, hematuria, and prolonged bleeding time; lymphadenopathy; joint swelling; bone pain; weight loss; anorexia; hepatomegal; splenomegaly; central nervous system dysfunction

Question 377

which types of leukemia respond better to chemotherapy?

Answer 377

the acute types

Question 378

cancer of the plasma cells that most often affects older adults.

Answer 378

multiple myeloma

Question 379

what is multiple myeloma characterized by?

Answer 379

BENCE JONES PROTEINS. excessive numbers of plasma cells accumulate in the bone marrow and crowd out blood-forming cells, causing bence jones proteins to be excreted in the urine. multiple bone tumors develop and bone destruction occurs leading to hypercalcemia and kidney impairment and neuromuscular issues. tumor cells can spread to lymph nodes and infiltrate organs

Question 380

this is the second most common blood cancer

Answer 380

multiple myeloma

Question 381

what people are at a greater risk for multiple myeloma?

Answer 381

men and african americans

Question 382

is multiple myeloma curable?

Answer 382

no

Question 383

because of the weakening of the bone, what are people with multiple myeloma more at risk for?

Answer 383

pathologic fractures

Question 384

when is multiple myeloma usually diagnosed?

Answer 384

often when the malignancy is well advanced

Question 385

what are the clinical manifestations of multiple myeloma?

Answer 385

anemia, thrombocytopenia, leukopenia, decreased bone density, bone pain, hypercalcemia, renal impairment, pathologic fractures

Question 386

how is the diagnosis of multiple myeloma often made?

Answer 386

incidentally during routine blood tests for other conditions

Question 387

pancytopenia

Answer 387

low numbers of erythrocytes, leukocytes, and platelets

Question 388

what are most diseases of the RBCs related to?

Answer 388

the quantity or quality of the RBCs

Question 389

anemia

Answer 389

a common acquired or inherited disorder of the erythrocytes that impairs the oxygen-carrying capacity of the blood

Question 390

what are the three things that anemia can result from?

Answer 390

a decrease in the number of circulating erythrocytes; a reduction in hemoglobin content; the presence of abnormal hemoglobin

Question 391

what do the clinical manifestations of anemia reflect regardless of the diseases cause, and what are these?

Answer 391

the decreased oxygen-carrying capacity of the blood - weakness, fatigue, pallor, syncope, dyspnea, tachycardia

Question 392

what are hematocrit levels in order for anemia to be diagnosed?

Answer 392

less than 41% males

less than 37% females

Question 393

what are hemoglobin concentration levels for the diagnosis of anemia?

Answer 393

men - 13.5 g/dL

women - 12 g/dL

Question 394

what are normal hemoglobin and hematocrit concentrations for men and women?

Answer 394

men: 13.5-18 g/dL; 41-52%
females: 12-16 g/dL; 37-47%

Question 395

why does syncope occur with anemia?

Answer 395

there are low blood oxygen levels and the brain isn’t getting enough oxygen so the person passes out

Question 396

why does dyspnea occur with anemia?

Answer 396

the body isn’t getting enough oxygen, so its natural response is to make the body breath more

Question 397

why does tachycardia occur with anemia/

Answer 397

compensatory mechanism to push as much oxygen as quickly as possible to the body

Question 398

the most widespread anemia in the world

Answer 398

iron-deficiency anemia

Question 399

who is iron-deficiency anemia most common in?

Answer 399

women of childbearing age, children younger than 2, and the elderly

Question 400

when does iron deficiency anemia occur?

Answer 400

when the supply of iron necessary to produce hemoglobin is inadequate to meet the demand of hemoglobin production.

Question 401

what are possible causes of iron-deficiency anemia?

Answer 401

low iron consumption, decreased iron absorption, increased bleeding (like what occurs with menstruation and as a result of some cancers), and pregnancy

Question 402

how much of the ingested iron is actually absorbed into the blood stream?

Answer 402

only about 10%

Question 403

what happens to erythrocytes when there is an iron deficiency?

Answer 403

they become pale and small

Question 404

hypochromic

Answer 404

pale

Question 405

microcytic

Answer 405

small

Question 406

what are the clinical manifestations of iron deficiency anemia?

Answer 406

usual manifestations of anemia, cyanosis of the sclera, brittle nails, decreased appetite, headache, irritability, stomatitis, unusual food cravings (pica), delayed healing

Question 407

what causes cyanosis of the sclera in iron-deficiency anemia?

Answer 407

oxygen deprivation

Question 408

stomatitis

Answer 408

sores in the fissures of the mouth - inflammatory response

Question 409

why are healing times prolonged with iron-deficiency anemia?

Answer 409

they body needs good oxygen supply to promote good healing

Question 410

why should foods high in vitamin c be given to people with iron-deficiency anemia?

Answer 410

vitamin c promotes the absorption of iron

Question 411

aka vitamin b12 deficiency and megaloblastic anemia

Answer 411

pernicious anemia

Question 412

what is pernicious anemia characterized by?

Answer 412

large, immature erythrocytes

Question 413

what does pernicious anemia usually result from and why does this occur?

Answer 413

a vitamin b12 deficiency that occurs due to a lack of intrinsic factor which is a protein produced by the stomach that is necessary for the absorption of vitamin b12

Question 414

what does the lack of intrinsic factor in pernicious anemia result from?

Answer 414

autoantibodies, and the subsequent immune reaction leads to atrophy of the gastric mucosa and glands

Question 415

what is vitamin b12 required for? what does too little b12 cause?

Answer 415

required for DNA synthesis of RBC and a deficiency leads to decreased cell division and maturation. too little b12 causes neurologic problems because it breaks down the myelin sheath.

Question 416

what are the clinical manifestations of pernicious anemia?

Answer 416

usual manifestations of anemia, bleeding gums, diarrhea, impaired sense of smell, loss of deep tendon reflexes, anorexia, personality and memory changes, positive Babinski’s sign, stomatitis, paresthesia of hands and feet, unsteady gait especially in the dark, confusion, pica, poor apetite, beefy red tongue that’s swollen and sore

Question 417

rare, but serious type of anemia that is the result of the bone marrow not making enough blood cells

Answer 417

aplastic anemia

Question 418

is aplastic anemia temporary or permanent?

Answer 418

it may be either

Question 419

causes of aplastic anemia:

Answer 419

autoimmune, idiopathic causes, medications and treatments (chemo), viruses, toxins, genetic abnormalities, infectious diseases, pregnancy, cancer, radiation

Question 420

what are the clinical manifestations of aplastic anemia?

Answer 420

usual manifestations of anemia, leukocytopenia, thromboxytopenia, as blood cell levels decline clinical manifestations worsen

Question 421

anemia that results from destruction of erythrocytes

Answer 421

hemolytic anemia

Question 422

what are causes of hemolytic anemia?

Answer 422

idiopathic causes, autoimmune causes, genetics, develops secondary to an infection, blood transfusion reactions, and blood incompatibility in the neonate

Question 423

what are the different types of hemolytic anemias?

Answer 423

sickle cell anemia and thalassemia and erythroblastosis fetalis

Question 424

type of genetic anemia in which the erythroblasts have an abnormal, or sickle shape

Answer 424

sickle cell anemia

Question 425

what is sickle cell anemia caused by?

Answer 425

an abnormal type of hemoglobin called Hemoglobin S which distorts the shape of erythrocytes, especially when the body’s supply of oxygen is low. these cells deliver less oxygen to the body’s tissues and clog easily into small vessels and break into pieces that disrupt flow

Question 426

is sickle cell anemia recessive or dominant?

Answer 426

it is neither recessive or dominant, it is co-dominant. if the person inhereits the sickle cell gene from one parent and the normal erythrocyte from the other, both will be expressed

Question 427

why do persons who only have one sickle cell allele (sickle cell trait) not have the symptoms of true sickle cell anemia?

Answer 427

fewer than half of their RBCs are sickled

Question 428

when does a person have sickle cell disease?

Answer 428

when they are homozygous for hemoglobin s

Question 429

why is sickle cell disease more severe than sickle cell trait?

Answer 429

almost all of the individual’s erythrocytes are abnormal

Question 430

who is sickle cell disease more common in?

Answer 430

people of african and Mediterranean descent, people from south and Central America, the carribean, and the Middle East

Question 431

do clinical manifestations of sickle cell disease usually appear in newborns? why?

Answer 431

no because fetal hemoglobin protects the RBCs from sickling

Question 432

when does a child start to show signs of sickle cell disease?

Answer 432

when the fetal hemoglobin is replaced with adult hemoglobin around the age of 4-5 months

Question 433

what is usually the first symptoms of sickle-cell disease?

Answer 433

swelling in the hands and feet, often in conjunction with a fever. the swelling results from sickle cells occluding the blood vessels and blocking blood flow in and out of the hands and feet

Question 434

crises

Answer 434

painful episodes with sickle cell anemia that can last for hours to days. these are caused by obstruction of small vessels as the sickled cells clog up the vessels leading to ischemia and necrosis. complications depend on location

Question 435

what can episodes of crises be triggered by?

Answer 435

dehydration, stress, high altitudes, fever, and extreme temperatures

Question 436

how long do most patients with sickle cell anemia live now?

Answer 436

into their 50’s

Question 437

what are the clinical manifestations of sickle cell anemia?

Answer 437

manifestations of anemia, abdominal pain, bone pain, dyspnea, delayed growth and development, fatigue, fever, jaundice, pallor, tachycardia, skin ulcers on the lower legs, angina, excessive thirs, frequent urination, painful and prolonged erection, vision impairment, frequent infections, acute chest syndrome, splenic sequestration, leg ulcers, stroke

Question 438

what is acute chest syndrome?

Answer 438

a potentially life-threatening condition that causes chest pain, coughing, difficulty breathing, and fever

Question 439

what is splenic sequestration?

Answer 439

a potentially life-threatening condition that causes sudden weakness, pale lips, tachypnea, extreme thirst, left quadrant abdominal pain, and tachycardia

Question 440

what ar the complications of blood vessel occlusions in sickle cell anemia in the bone

Answer 440

susceptibility to osteomyelitis due to staph infection

Question 441

what are complications of blood vessel occlusions in sickle cell in the papillae of the renal medulla?

Answer 441

gross hematuria and renal tubular concentrating defects

Question 442

what are the complications of blood vessel occlusions of sickle cell in the eye?

Answer 442

retinopathy and blindness

Question 443

what are the complications of blood vessel occlusions in sickle cell anemia in the sinus?

Answer 443

stroke

Question 444

what are the complications of blood vessel occlusion in sickle cell anemia that occurs in the spleen, liver, and what are miscellaneous complications that occur?

Answer 444

spleen - hyposplenism and susceptibility to infections
liver - jaundice and hepatomegaly
miscellaneous - cardiomegaly and slow-healing leg ulcers

Question 445

a rare disorder that is considered neoplastic. the bone marrow produces too many blood cells.

Answer 445

polycythemia vera

Question 446

why is polycythemia vera considered neoplastic?

Answer 446

because of the uncontrolled proliferation of the cells

Question 447

what gender is polycythemia vera most common in?

Answer 447

men

Question 448

how do complications arise with polycythemia vera?

Answer 448

as blood cell numbers increase, so does the blood volume and viscosity. blood vessels become distended and blood flow is sluggish.

Question 449

what complications can arise with polycythemia vera?

Answer 449

tissue ischemia and necrosis, thrombosis, hypertension, heart failure, hemorrhage, slpenomegaly, hepatomegaly, acute myeloblastic leukemia

Question 450

why might hypertension occur with polycythemia vera?

Answer 450

the heart is trying to pump against the high pressure in the vessels, so blood pressure goes up. over time the heart muscle becomes stretched out and doesn’t work well and congestive heart failure occurs

Question 451

what are the clinical manifestations of polycythemia vera?

Answer 451

cyanotic or plethoric skin (bluish or reddish), high blood pressure, tachycardia, dyspnea, headaches, visual abnormalities

Question 452

what are the normal platelet levels?

Answer 452

150,000-350,000 cells/mL3

Question 453

thrombocytosis increases the risk of what?

Answer 453

thrombus formation

Question 454

thrombocytopenia increases the risk for what?

Answer 454

bleeding and infection

Question 455

X-linked recessive bleeding disorder that involves a deficiency or abnormality of clotting factor VIII

Answer 455

hemophilia A

Question 456

what does the severity of hemophilia a depend on?

Answer 456

the amount of factor VIII present in the blood

Question 457

what is the main symptom of hemophilia a

Answer 457

bleeding

Question 458

what gender is affected more often with hemophilia a?

Answer 458

males

Question 459

what are the clinical manifestations of hemophilia a?

Answer 459

hemarthrosis (bleeding into the joints; painful), hematuria, GI bleed, ecchymosis, epistaxis (nose bleeds). internal bleeding can happen anywhere

Question 460

when does hemophilia a usually become noticed in people affected by it?

Answer 460

it can become noticed when the child starts walking or crying if it has not been detected before, mild cases can go unnoticed until trauma or surgery

Question 461

the most common hereditary bleeding disorder. results from a deficit of Von Willebrand’s factor which ordinarily causes platelets to aggregate and adhere to the vessel wall in times of injury

Answer 461

Von Willebrand’s disease

Question 462

the most common and mildest form of Von Willebrand’s disease. occurs in 70-80% of patents and follows an autosomal dominant inheritance pattern. the level of von Willebrand factor in the blood is reduced and most cases go undiagnosed. does not usually cause spontaneous bleeding, but significant bleeding can occur with trauma or surgery

Answer 462

type 1

Question 463

von Willebrand’s disease that occurs in 15-20% of cases. autosomal dominant or autosomal recessive. has 5 subtypes. the building blocks that make up the von Willebrand’s factor are smaller than usual or break down easily

Answer 463

type 2

Question 464

von Willebrand’s disease that follows an autosomal recessive pattern. severe bleeding problems with this type due to a lack of measurable von Willebrand’s factor or factor VIII.

Answer 464

type 3

Question 465

von willebran’s disease that occurs in persons with Wilms’ tomor, congenital heart disease, SLE, and hypothyroidism

Answer 465

acquired type

Question 466

what are the clinical manifestations of von willebrand’s disease?

Answer 466

abnormal bleeding

Question 467

a life threatening disorder that occurs as a complication of other diseases and conditions.

Answer 467

disseminated intravascular coagulation

Question 468

what occurs during disseminated intravascular coagulation?

Answer 468

normally during injury, clotting factors become activated and travel to the injury site to stop bleeding. however in persons with DIC these factors become abnormally active as an inappropriate immune reaction. small blood clots form within the blood vessel and some of these clots can occlude vessels. eventually, all of a person’s clotting factors are used up and the person is at serious risk even from a minor injury

Question 469

what are the typical triggers for DIC?

Answer 469

blood transfusion reaction, cancer, infection in the blood by bacteria/fungus, pregnancy complications (retained placenta after pregnancy, abruptio placentae, and eclampsia), recent surgery or anesthesia, sepsis, severe liver disease, severe tissue injury, cardiac arrest, poisonous snake bites

Question 470

what are the clinical manifestations of DIC?

Answer 470

signs and symptoms of tissue and organ ischemia (angina, confusion, dyspnea) and abnormal bleeding (petechiae, epistaxia, and hematuria). indicators of complications such as shock and multiple organ failure will appear

Question 471

DIC often causes necrosis where?

Answer 471

in the fingers and toes