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PATH 1 EXAM 3
NWHSU Path1 Exam 3
Question | Answer |
---|---|
The underlying immunologic reaction in granuloma formation is? | Type IV hypersensitivity |
What are the 2 cells that are unique to granulomas? | Epithelioid cells & Langhans giant cells |
When granulomas become necrotic, what do they show? | Caseous necrosis |
What are two risk factors for TB? | HIV infection, Multidrug resistant TB |
Define Primary TB? | Caused by inhalation of aerosolized tubercle bacilli and occurs in the lung with development of a granuloma (GHON FOCUS), occurs in previously infected person. |
If TB infection spreads to a pulmonary HILAR LYMPH the two granulomas are termed a? | Ghon complex |
Define Secondary (Reactivation) TB? | Occurs in previously infected person. Usually arises from reactivation of an inactive Gohn focus (often due to weakened host immune resistance). May also result from a second exogenous exposure by inhaling tubercle bacilli |
What organs does TB affect? | Lungs, bone marrow, intestine, spleen, adrenals, liver, kidney |
Define Miliary TB? | Presence of many small granulomas in ANY organ |
Symptoms of Miliary TB? | Cough hemoptasis, night sweats, night fever, loss of appetite, can lead to pneumonia |
In autoimmune disease the immune system recognizes...? | Self antigens presented to B cells or on self MHC molecules to T cells (protein antigens) |
Autoimmune disease, SYSTEMIC (non organ specific) include: | 1) Systemic Lupus Erythematosus 2)Sjogren's Syndrome 3)Systemic Sclerosis 4)Polymyositis 5)RA 6)Mixed connective tissue disease |
Autoimmune disease, ORGAN SPECIFIC include: | 1)Thyroid (Hashimoto) 2)Stomach (autoimmune chronic gastritis) 3)Adrenal Glad (Addison) 4)Type one (Junvenile) diabetes Mellitus 5)CNS (multiple sclerosis) |
ANA test screens for? | Systemic autoimmune disease |
Define SLE (Systemic lupus erythematosus)? | Antibodies develop against many auto-antigens, circulating immune complexes form and many be deposited in different organs and tissues |
What kind of immune complex formation is SLE? | HRIII |
The immune complex in SLE tends to deposit in what organ? | Kidney glomeruli with glomerular damage and in small arteries and arterioles in different tissue with necrotizing VASCULITIS resulting. |
___ occurs in the brain due to cerebral arteriolar narrowing | Microninfarcts |
What are the major causes of death in SLE people? | Renal failure and CNS involvement |
What organs and tissues are involved in SLE? | Skin, Serosal membrane, joints, small arteries, kidneys, heart, CNS |
Define Sjogren syndrome? | Autoimmune lymphocytic inflammatory destruction of the lacrimal and salivary glands resulting in dry eyes and mouth |
Define Systemic Sclerosis (Scleroderma)? | Cause excess deposition of collagen in multiple organs and tissues, skin, GI tract, kidneys, heart, lungs, muscles, blood vessels. *The skin is most often affected |
Define Dermatomyositis, Polymyositis, Inclusion Body Myositis? | Often show symmetric muscle weakness initially affecting large muscles of the neck, trunk, limbs |
Dermatomyositis often shows what? | An associated skin rash often affecting the upper eyelids and causing preorbital edema. |
What can develop on knuckles in Dermatomyositis? | Gottrons papules |
In RA patients, what is when the hands and fingers curl up? | Swan neck deformity |
Define RA (Rheumatoid Arthritis)? | A systemic chronic inflammatory autoimmune disease that mainly involves joints producing chronic synovitis |
RA can also affect what organs? | Heart, lungs, skin, muscles, blood vessels |
RA patients have an increased risk of? | Cardiovascular disease including coronary artery atherosclerosis. |
Rheumatoid factor is present in the blood plasma of ___ of RA patients. | 80% |
Patients with RA, it is an ___ antibody which is directed against ___ antigen. | IgM / IgG |
What happens to mixed connective diseased patients overtime? | One of the autoimmune diseases predominates |
What occurs in up to 85% of mixed connective diseased patients ? | Pulmonary involvement |
What are the 4 classes of factors that cause congenital abnormalities? (also called teratogenic factors) | 1)Drugs/chemicals (fetal alcohol) 2)Ionizing radiation (xray)3)Maternal infections (TORCH) 4)Genetic |
The embryonic period of development beings with ___ of the ovum and last for ____ weeks. | Fertilization / 8 |
What occurs during these eight weeks? | Major organ development, most sensitive to damaging influences. |
What major organs are developing during the 8 weeks? | CNS, heart, extremities, eyes, external genitalia |
Damaging influences in the first 2 weeks during organ development usually result in? | Fetal death |
What are the 4 neural tube defects? | 1)Spina bifida occulta 2)Meningocele 3) Meningocele 4)Anencephaly |
Define anencephaly? | Absence of calvarium and brain |
When does the neural tube close? | Between 22-28 days |
Define Atresia? | Failure of lumen to form |
Define Agenesis? | No sign of organ development. Absence of a primordium or anlage which is the earliest stage of a developing organ |
Define Aplasia? | Partial but incomplete development of an organ. Organ is small in size. |
Define Dysplasia? | An abnormally formed organ, may be of different sizes |
Define Ectopy (Ectopia)? | Abnormal location of an organ *Failure to thrive |
Define Syndactyly? | Fusion of digits |
What is the normal amount of chromosomes? | 46 |
Klinefelter Syndrome occurs in? | Males, XXY |
What causes Klinefelter Syndrome? | Due to an extra chromosome, so 47 total, 2 X, and 1 Y |
Define Klinefelter Syndrome? | Results in atrophy and hyalinization of testicular tubules, no sperm production |
What do leydig cells show in Klinefelter Syn? | Decreased testosterone production |
What is increased in the plasma in Klienfelter Syn? | FSH and LH |
Signs/Symptoms of Klienfelter Syn? | Tall with long arms/legs, small penis, female pubic hair profile, high pitched voice, reduced facial/body hair, Gyneacomastia (female features) |
X chromosome is also called? | Barr body |
Define Lyon hypothesis? | Before the 2nd X chromosome is inactivated it participates in ovarian development, two normal X chromosomes are required for normal ovarian development..therefore if the 2nd X chromosome is absent/abnormal, normal ovarian development will not occur |
Turner Syndrome occurs in? | Females - results in absence/abnormality of 2nd X chromosome |
Females with absent X chromosome will likely be? | Stillborn |
Females, with an abnormal X chromosome are infertile bc of why? | They have primary amenorrhea, fibrous streak ovaries that do not produce ova |
Truners Syn signs/symptoms? | Short, webbed neck, pigmented melanocytic nevi (moles), bicuspid aortic heart valve, coarctation (narrowing) of aortic arch, joint problems |
Down Synd is also known as? | Trisomy 21 - 3 chromosomes on chromo 21 |
Down Synd characteristic features include? | Flat facial features, horizontal palmar crease on hands, retardation, Alzheimers, cardiac abnormalities, infections/leukemia risk (hyperflexibility of joints, poor muscle tone) |
What is Marfan Synd? | Autosomal dominant disorder of connective tissue. Defect affects Fibrillin 1 (scaffold for elastic fibers) |
What 3 systems are mainly affect in Marfan Synd? | 1)Cardiovascular 2)Eyes 3)Skeleton |
In Marfan Synd, what happens to the cardiovascular system? | Weakened aortic media leads to aneurysm formation and dissecting aneurysm. Also can see aortic valve incompetence and mitral valve prolapse |
In Marfan Synd, what happens to the eyes? | Dislocation of optic lens |
In Marfan Synd, what happens to the skeleton? | Long extremities and fingers depressed or protruding sternum (PIGEON BREAST) and spinal deformities such as kyphosis and scliosis |
What causes Ehlers-Danlos Synd (EDS)? | Results from defects in typeI and typeIII collagen. |
What is the most severe for of EDS? | Type IV- may cause rupture of the colon or large arteries |
What are some other features of EDS? | Hyperelastic skin (Cotis hyperelestica) and hypermobile joints |
TORCH synd stems from? | A group of microogransisms that either infect the fetus in utero by crossing the placenta from the maternal blood of at time of birth |
What does the T stand for in TORCH? | Toxoplasmosis/Toxoplasma gondii |
What does the O stand for in TORCH? | Other vertically transmitted infections - syphilis, varicella-zoster, mycobacterium TB |
What does the R stand for in TORCH? | Rubella |
What does the C stand for in TORCH? | Cytomegalovirus |
What does the H stand for in TORCH? | Herpes Simplex virus 2 |
TORCH infections cause a syndrome characterized by? | Microcephaly, sensorineural deafness, chorioretinitis, hepatosplenomegaly (large live/spleen), thrombocytopenia (decreased platelets) |
Define Shock? | A condition that results from insufficient cardiac output to adequately perfuse the vital organs (brain, kidney, heart) leading to tissue hypoxia |
Define Hypovolemic shock? | Due to a primary decreased in blood volume |
Define Cardiogenic shock? | Due to a pathologic condition in the heart |
Define Septic shock? | Due to bacterial invasion into the blood stream |
Define neurogenic shock? | Neurological causes or popularly known as "nervous breakdown" |
All 3 primary causes of shock will cause a decrease in? | Cardiac output |
Decreased cardiac output causes what to multiple vital organs? | Anoxic cell injury |
Define hemorrhage? | Discharge of blood from the vascular compartment to the exterior or into non-vascular spaces |
Define Hemothorax? | Hemorrhage into pleural cavity |
Define Hemopericardium? | Hemorrhage into the pericardial sac |
Define Hemoarthrosis? | Hemorrhage into a joint |
Define Hematoma? | Collection of extravasated blood in tissue |
Define Purpura? | Diffuse hemorrhage into the skin in an area up to 1 cm |
Define Echymosis? | Larger than 1cm area of hemorrhage |
Define Petechia? | Pinpoint hemorrhage |
What two things determine the degree of shock? | Damage to vital organs (heart, brain, kidneys) and the damage of endothelial |
Define Hypovolemic shock? | Loss in vascular volume |
Cardiogenic shock is usually due to? | Extensive acute left ventricular myocardial infraction with loss of left pump failure |
Septic shock is usually due to what? | Bacterial invasion of the blood stream usually by gram positive bacteria |
What are the 3 clinical phases of shock? | 1) Initial (non-progressive) phase 2)Progressive phase 3)Irreversible phase leading to death |
Define Active congestion? | Due to increased arterial inflow of blood into an organ or tissue, inflammation or exercising muscle |
Define passive congestion? | due to decreased venous outflow of blood from an organ or tissue, congestive heart failure or venous obstruction |
During congestive heart failure, the left ventricular failure causes? | Pulmonary passive congestion |
During congestive heart failure, the right ventricular failure causes? | Passive congestion of the liver (first) and then of the spleen, kidneys, bowel |
Define Ischemic heart disease? | Heart disease resulting from reduced or absent blood flow to the LEFT ventricular myocardium |
What will happen if the blood supply to the left ventricle is suddnely cut off by coronary artery thrombosis | Acute myocardial infraction results |
Define thrombosis? | Blood clot occurring in an artery or vein |
Define ejection fraction ? | Precentage of the blood that is in each ventricle at the beginning of systole that is ejected during systole, normally 50-75% |
Define stroke volume? | The amount of blood ejected by each ventricle during systole, at rest it is 70-90 ml |
How much blood is in each ventricle at the beginning of systole? | About 130 ml |
Define cardiac output ? | The volume of blood ejected from the left ventricle per min= STOKE VOL x HEART RATE |
Define first degree burn? | No epidermal necrosis |
Define 2nd degree burn? | Necrosis of upper epidermis, basal layer preserved |
Define 3rd degree burn? | Full thickness necrosis of epidermis and necrosis of the dermal appendages |
Epstein Barr Virus infects which two cells? | Oropharyngeal epithelial cells, B lymph |