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Patho Exam 1 Study

Ch. 1, 2, 6, 12, & 13

QuestionAnswer
Define pathophysiology. The study of abnormalities in physiologic functioning of living beings and seeks to reveal physiologic responses of organisms to disruptions in its internal or external environment
What 4 topics does the study of pathophysiology include? Etiology, Pathogenesis, Clinical Manifestations, Treatment Implications
Define signs. Objective or observed manifestation of disease (Dr. can see) Example – rash, change in temperature
Define symptoms. Subjective feeling of abnormality in the body (patient can feel) Example – pain, nausea
What is epidemiology? The study of the patterns of disease involving populations (Examining the occurrence, incidence, prevalence, transmission, and distribution of diseases in large groups of populations/people)
Primary disease prevention. Altering susceptibility or reducing exposure for susceptible persons. Focus is on disease prevention. Example – Immunizations
Secondary disease prevention. Early detection, screening, and management of disease. Example – cancer screening, performing monthly breast examinations.
Tertiary disease prevention. Preventing further complications from the initial disease/disorder. Focuses on rehabilitation, supportive care, reducing disability, and restoring effective functioning. Example – PT/OT following stroke
Define homeostasis. A state in which all systems are in balance, a state of equilibrium. Maintaining internal conditions stable. Must be able to adapt.
What are the three different stages of the General Adaptation Syndrome (GAS)? Alarm, Resistance/Adaptation, Exhaustion.
Define the "Alarm" stage of GAS. "fight-or-flight response"
Define the "Resistance/Adaptation" stage of GAS. Activity of the nervous and endocrine systems in returning the body to homeostasis.
Define the "Exhaustion" stage of GAS. Point where body can no longer return to homeostasis after prolonged exposure to the stressor.
During fight or flight response, what does the hypothalamus secrete to active the Sympathetic Nervous System (SNS) & adrenocorticotropic hormone (ACTH)? Corticotropin-releasing hormone (CRH)
After SNS is activated during fight or flight response, the adrenal medulla is stimulated to do what? To release the catecholamines (norepinephrine & epinephrine)
Adrenocorticotropic hormone (ACTH) causes the adrenal cortex to do what during the fight or flight response? Release glucocorticoids (cortisol)
What happens to the body when hormones like adrenalin and cortisol are released during “fight-or-flight” response? Fast heart rate, slowing of digestion, shunting blood flow to major muscle groups, and changing various other autonomic nervous functions, giving the body a burst of energy and strength.
Define passive transport. When substances move down their concentration gradient; from HIGH concentration to LOW. Example – Osmosis, diffusion
Define active transport. When substances moves against their concentration gradient; from LOW concentration to HIGH. Requires ATP.
Define osmolality. Concentration of solutes.
Define high osmolality. High concentration of solutes (low concentration of water).
Define low osmolality. Low concentration of solutes (high concentration of water).
Define diffusion. The tendency of molecules or ions to distribute evenly throughout the environment from high concentration to areas of low concentration. Greater the difference in concentration - faster diffusion of particles occurs.
Define osmosis. The process which allows for fluid (water) distribution between interstitial space and intracellular compartment from high to low concentration.
Osmosis and water. Water moves from an area of low osmolality (low solute concentration) to an area of higher osmolality (high solute).
Define edema. The accumulation of fluid in the interstitial space - leading to tissue swelling.
What can contribute to edema? Increased cap hydrostatic pressure (blood vessel blockage, incompetent venous valves); Increased cap permeability (inflammation); CHF; High BP; Decreased plasma proteins (albumin); Blockage of lymphatic drainage (due to cancer or removal of lymph tissue).
Hypernatremia increased levels of sodium (Na+) in serum (>145 mEq/L)
Cause of hypernatremia. Dehydration, loss of water from ECF.
Manifestations of hypernatremia. Excessive thirst, lethargy, muscle twitching and convulsions.
Hyponatremia Decreased levels of sodium (Na+) in serum (<135 mEq/L)
Cause of hyponatremia. Water retention, loss of Na+ from vomiting, diarrhea, burns, excess H2O ingestion.
Manifestations of hyponatremia. Neurological dysfunction from brain swelling, can be fatal.
Hyperkalemia Excess potassium in serum (>5 mEq/L)
Cause of hyperkalemia. Renal failure, severe burns, crushing injury, over ingestion of potassium; supplements or IV potassium.
Manifestations of hyperkalemia. Intestinal cramping, diarrhea, irregular heartbeat.
Hypokalemia Too little potassium in serum (<3.5 mEq/L)
Cause of hypokalemia. Vomiting, diarrhea, improper diet, NPO, loop diuretic use, increased insulin and epinephrine (causes K+ to shift from ECF into cells).
Manifestations of hypokalemia. Muscle weakness, paralysis, irregular heartbeat.
Hypercalcemia Excess levels of calcium in blood (>10.5 mg/dL)
Causes of hypercalcemia. Hyperparathyroidism, excessive vitamin D, leukemia/bone tumors.
Manifestations of hypercalcemia. Diminished reflexes, headache, confusion, lethargy, muscle weakness (due to decreased neuromuscular excitability), renal calculi and cardiac arrhythmias.
Hypocalcemia Reduced levels of calcium in serum (<8.5 mg/dL)
Cause of hypocalcemia. Deficiency in vitamin D, burns, poor nutrition, alkalosis, hypoparathyroidism.
Manifestations of hypocalcemia. Increased excitability of muscles, hyperactive reflexes, tremors, tingling sensation in muscles, tetany (stiffening), cramps, positive Trousseau sign, positive Chvostek sign.
Hypermagnesemia Excess levels of magnesium in the blood (> 2.5 mEq/L)
Cause of hypermagnesemia. Renal failure, excessive laxative and antacid use.
Manifestations of hypermagnesemia. Similar to hypercalcemia; Diminished reflexes, headache, confusion, lethargy, muscle weakness (due to decreased neuromuscular excitability), renal calculi and cardiac arrhythmias.
Hypomagnesemia Low levels of magnesium (<1.8 mEq/L)
Cause of hypomagnesemia. Inadequate intake, chronic alcoholism, malnutrition, pregnancy, diarrhea, diuretics, and stress.
Manifestations of hypomagnesemia. Similar to hypocalcemia; Increased excitability of muscles, hyperactive reflexes, tremors, tingling sensation in muscles, tetany (stiffening), cramps.
Hyperphosphatemia Excess levels of phosphate in the blood (> 4.5 mg/dL)
Cause of hyperphosphatemia. Deficient excretion due to renal failure, hypoparathyroidism, adrenal insufficiency, hypothyroidism, laxatives, hypocalcemia, and acidosis.
Manifestations of hyperphosphatemia. Rarely seen alone, similar to hypocalcemia; Increased excitability of muscles, hyperactive reflexes, tremors, tingling sensation in muscles, tetany (stiffening), cramps.
Hypophosphatemia Low levels of phosphate (<2.5 mg/dL)
Cause of hypophosphatemia. Hyperparathyroidism, alkalosis, vitamin D deficiency, alcoholism, and decreased dietary intake.
Manifestations of hypophosphatemia. Similar to hypercalcemia; Diminished reflexes, headache, confusion, lethargy, muscle weakness (due to decreased neuromuscular excitability), renal calculi and cardiac arrhythmias.
What are the cardinal signs and symptoms of inflammation? Redness, heat, swelling, pain and loss of function.
What are "localized" s/s of inflammation? Five cardinal signs; occur with acute and chronic inflammation; can lead to systemic involvement.
What are "systemic" s/s of inflammation? Fever, neutrophilia, lethargy, muscle catabolism.
When there is a break in skin, it causes injury to capillaries which cause release of bradykinin from injured cells. Bradykinin stimulates pain receptors. What happens next? Stimulates mast cells and basophils to release histamine, prostaglandins, and leukotrienes (chemical mediators that cause vasodilation), increase blood flow and capillary permeability, and allows for movement of leukocytes to site of tissue injury.
Define the innate immune response. Immediate, occurs on initial exposure to antigen; includes chemical and physical barriers that prevent invasion; fever, inflammation, phagocytes.
Define the adaptive (specific) immune response. Slow to develop; more efficient on subsequent exposures, memory cells; includes B-cells and T-cells.
Active Immunity A protected state owing to the body’s immune response as a result of active infection or immunization.
Passive Immunity Transfer of preformed antibodies against specific antigen from a protected individual to an unprotected individual; provides immediate but temporary protection; short lasting, individual does not produce memory cells from transfer.
Examples of passive immunity. Mother to fetus – antibodies cross placenta Mother to infant – antibodies from breast milk Serotherapy - direct injection/infusion of antibodies (human or animal)
What is a hypersensitivity? An immunological state in which the immune system “over-reacts” to foreign antigens such that the immune response itself is more harmful than the antigen.
Type I hypersensitivity (Anaphylactic) Reaction mediated by IgE antibodies
Type II hypersensitivity (Cytotoxic) Cytotoxic reaction mediated by IgG or IgM antibodies
Type III hypersensitivity (Immune complex) Reaction mediated by immune complexes
Type IV hypersensitivity (Delayed cell-mediated) Delayed reaction mediated by cellular response
What are the steps of carcinogenesis? Initiation (Conversion), Promotion (Development), & Progression.
Initiation (Conversion) stage in carcinogenesis. Events which result in changes (mutations) to chromosomes or DNA; Initiators include radiation, UV, carcinogens
Promotion (Development) stage in carcinogenesis. Stage during which mutated cell proliferates; Example – hormones such as estrogen.
Progression stage in carcinogenesis. Mutant, proliferating cells begin to exhibit malignant behavior, permanent changes.
Define cachexia. Overall weight loss and generalized weakness- Loss of appetite (anorexia), Increased metabolic rate , Nausea/vomiting
Define Anemia. Deficiency in circulating red blood cells.
Define Leukopenia. Deficiency in circulating white blood cells.
Define Thrombocytopenia. Deficiency in circulating platelet.
Warning signs of cancer (CAUTION) Change in bowel/bladder habits A sore that doesn't heal Unusual bleeding/discharge Thickening or lump in breast Indigestion/difficulty swallowing Obvious change in wart/mole Nagging cough/hoarseness
"Benign" neoplasms Slow, progressive, localized, well-defined, does not usually result in death.
"Malignant" neoplasms Rapid growth, quickly spreads, highly undifferentiated, fatal if left untreated.
Metastasis Development of secondary malignant growths distant from primary site of cancer.
How can you promote a healthy immune system? Increase fluid intake, well-balanced diet, adequate sleep, avoiding caffeine, avoiding excessive sugar, reduce stress.
Define pyrogens. Fever producing molecule; produced by macrophages; metabolic changes in hypothalamus.
Define Interferons. Proteins released from virus infected cells; bind to uninfected cells; release an enzyme to prevent viral replication.
Define complement. Plasma protein that enhances antibodies; activated by antigen; present to destroy cells.
What is AIDS/HIV? Parasitic retro virus that infect CD4 cells and macrophages. Transmitted through blood & bodily fluids.
Kyphosis Curvature of thoracic spine outward; developed in adolescence; impairs lung function.
Lordosis Concave curve of lumbar spine; developed in adolescence; obesity increases risk.
Scoliosis Lateral deviation of the spine; more common in females; pulmonary compromise; chronic pain.
List the 5 P's of compartment syndrome. Pain, Paresthesia, Pallor, Paralysis, Pulselessness.
Define herniated disk. Protrusion of nucleus pulposus; may occur suddenly or gradually.
Complications of bone injuries Fat embolism; Pulmonary embolism; DVT; Bone infections.
Rickets Metabolic bone disorder; Osteomalacia in adults; Deficiency of vitamin D, calcium, or phosphate leading to weakened, soft bones.
Osteoporosis Metabolic bone disorder; Results in loss of bone calcium leading to brittle bones; Asymptomatic or bone pain.
Paget's disease Metabolic bone disorder; Disrupts the replacement of old bone tissue with new bone tissue.
What is idiopathic diseases? Any disease that is of uncertain or unknown origin.
What does the ABGs (arterial blood gases) test measure and what are the normal ranges? The acidity (pH) and the levels of oxygen and carbon dioxide in the blood from an artery. pH= 7.35-7.45 PaCO2= 35-45 HCO3= 22-26 PaO2= 80-100
What causes gout? A buildup of uric acid crystals in the joints.
What is the purpose of the stress response? To restore balance.
Who is known as the "father of stress?" Hans Seyle; the first scientist to identify "stress."
Name a few examples of adaptive coping strategies. Physical activity; relaxation; distraction; biofeedback.
Name a few examples of maladaptive coping strategies. Smoking; substance abuse; over eating.
What is an antigen? Something that makes you sick.
What is an antibody? Something our bodies make to kill antigens.
What is the "innate defense barrier?" The "built-in," immediate response; includes the skin, mucous membranes, and antimicrobial proteins found within the body.
What is cell mediated immunity? AKA cellular immunity; immune response that does not involve antibodies; activation of phagocytes, antigen specific T-cells, & release of cytokines.
What is humoral immunity? Form of immunity in which B-cells and plasma cells produce antibodies that bind to antigens in order to assist with their elimination.
What are the 3 main types of alterations of immunity? Hypersensitivity (Exaggerated immune response), autoimmune(makes self as non-self), & immunodeficiency (inadequate immune response).
What is SLE (Systemic Lupus Erythematosus)? A chronic inflammatory, autoimmune disorder which can effect any of the body's tissues causing a decrease in strength and flexibility to structures throughout the body.
Mitochondria Cell power plant, ATP is made
Lysosomes Breakdown cell products & foreign bodies
Ribosomes Make proteins, protein synthesis
Nucleus Contains genetic information for cell structure & function.
Nucleolus Produces ribosomal RNA.
Endoplasmic Reticulum: Smooth (No Ribosomes) Involved with making phospholipids.
Endoplasmic Reticulum: Rough (Has Ribosomes) Site of synthesis of enzymes and proteins.
Golgi Complex Sorts, modifies, and packages proteins produced on the rough ER.
Peroxisomes Break down potentially toxic molecules.
Cilia Propel materials along the surface of certain cells.
Meiosis The form of cell division that creates gametes, or sex cells (eggs or sperm); 4 cells produced.
Mitosis The form of cell division in which the nucleus divides into nuclei containing the same number of chromosomes; 2 cells produced.
Atrophy Decrease/ shrink in size.
Hypertrophy Increase/growth of muscle cells.
Hyperplasia Increased # of tissue cells.
Metaplasia Group of cells changing from 1 cell type to another.
Dysplasia Abnormal development of cells (can be cancerous).
Apoptosis Programmed cell death.
Ischemia Inadequate blood flow.
Necrosis Premature tissue death.
Free radicals Molecules with unpaired electrons robbing other cells of their electrons, causing damage or disease.
What are the 2 forms of fluid movement? Osmosis & diffusion.
What are the 4 main fluid compartments? Intracellular (within cell; higher potassium, magnesium, & phosphate), Extracellular (outside of cell; higher sodium & bicarb), Interstitial (Outside of blood vessels; where edema occurs), Intravascular (plasma; where majority of proteins live).
What are the 4 processes in which controls fluid balance? Thirst, ADH, Aldosterone, & ANP.
What effect does thirst have on fluid balance? Tells the body to increase water input.
What effect does ADH (Anti-diuretic hormone) have on fluid balance? Lowers osmolarity (reduces sodium concentration) by increasing water reabsorption in the kidneys, thus helps dilute bodily fluids.
What effect does Aldosterone have on fluid balance? Increase in salt and water reabsorption into the bloodstream from the kidney which increases the blood volume.
What effect does ANP (Atrial natriuretic peptide) have on fluid balance? Increases renal excretion of salt and water, vasodilation, and increased vascular permeability; lowers BP.
Hypovolemia Too little fluid in the intervascular space.
Hypervolemia Too much fluid in the intervascular space.
Dehydration Too little fluid in the intracellular space.
Water intoxication Too much fluid in the intracellular space.
Edema Too much fluid in the interstitial space.
A-B-C prioritization Airway, breathing, circulation
Acidosis pH levels are high
Alkalosis pH levels are low
What organs affect pH and acid based balance? Kidneys & lungs.
Contact dermatitis A skin rash caused by contact with a certain substance; pain, itchy skin, redness, blisters, hives, skin peeling, ulcers.
Vascular birthmark A discoloration of the skin caused by blood vessels that did not form correctly; painless and usually no other symptoms other than discoloration of skin.
Albinism Rare group of genetic disorders that cause skin, hair, or eyes to have little to no pigmentation; absence of color, vision problems.
Vitiligo Disease that causes skin color loss in patches; patchy loss of skin color, premature hair whitening, loss of color in tissues that line mouth and nose.
Atopic dermatitis (eczema) An itchy inflammation of the skin; Rashes, dryness, flakiness, bumps, fissures, skin peeling, redness, itching.
Urticaria (hives) Skin rash triggered by a reaction to food, meds, stress, or other irritants; raised area of skin, swelling, inflammation in response to touch, and itching.
Psoriasis Build up of skin cells forming scales/ itchy dry patches; pain in joints, rashes, dryness, flakes, peeling, bumps, redness, depression, itching, plaque.
Acne vulgaris Skin condition that occurs when hair follicles plug with oils and dead skin cells; pimples, redness, blackheads.
Rosacea Condition that causes causes redness and often small red pus-filled bumps on face; facial redness, swollen red bumps, and small, visible blood vessels.
Superficial partial thickness burn Involves the top 2 layers of the skin, painful with movement or temp changes, red and seep fluid, usually form blisters, and turn white when pressed; heal between 7-21 days.
Deep partial thickness burn Extend past top 2 layers of the skin, painful with deep pressure, blister, does not turn white when pressed; takes more than 21 days to heal.
Full thickness burn Involves all layers of the skin, completely destroyed skin, does not usually hurt, waxy white , leathery grey, or charred black color, skin is dry; needs surgical treatment.
Folliculitis Skin problem caused by bacteria or blockage in a hair follicle; groups of small red bumps, like pimples, blisters, pus-filled areas.
Impetigo Highly contagious skin infection that causes red sores on face; red sores around mouth and nose, itchy.
Cellulitis Bacterial skin infection; pain, blisters, warm skin, red rash, chills, swelling, fever, malaise, pus.
Necrotizing fasciitis (flesh eating disease) Serious bacterial infection that destroys tissue under the skin; blisters, fever, fatigue, pain, low BP, redness, cracking sensation under skin.
Herpes zoster A reactivation of chicken pox virus causing painful rash; rash, redness, pain
Verrucae Hard, grainy growths (warts) on heel or ball of feet; callus-like painful lump.
Tinea (ring worm) Fungal infection of skin or scalp; darkening of skin, fissures, red rashes, scaly patches, hair loss or itchy scalp.
Scabies Intensely itchy skin caused by tiny, burrowing mite; bumps, redness, itching, skin burrow.
Pediculosis Infestation with lice; asymptomatic, but may cause itchy scalp or allergic reaction.
How often should you reposition patient to prevent pressure ulcers? Every 2 hours.
What are scars primarily made of? A protein called collagen
What are some complications of scar formation? Lack of sensory, contractures, adhesions, keloid formation, and tenderness.
What is granulation tissue? New connective tissue and microscopic blood vessels that form on the surfaces of a wound during the healing process.
What is exudate? Bodily fluid that is discharged from the tissues during inflammation process.
Copious exudate Most severe amount; 75% saturation
Scant exudate Far below 25% saturation
Serous exudate Clear, thin, & watery; typical response of normal inflammatory stage healing; high amounts can indicate high bioburden.
Purulent exudate Thick & opaque, tan, yellow, green, or brown color; never normal in wound bed; often sign of infection
Sanguinous exudate Fresh bleeding, seen in deep partial & full thickness wounds; small amount is normal during inflammatory stage.
What is the purpose of the skeleton? Support, facilitating movement, protection of the internal organs, production of red blood cells, storing and releasing minerals and fat.
What is bone marrow and what does it do? Soft, sponge-like tissue in the center of most bones; produces WBCs, RBCs, and platelets.
What is hematopoesis? The production of all types of blood cells; prenatally occurs in yolk sack, then liver, and lastly bone marrow.
Osteoclast Breaks down spongy bone.
Osteoblast Rebuilds new compact bone.
Osteocytes Osteoblasts surrounded by calcified extracellular material.
Lamellae Thin layers of osteocytes.
How does the growth hormone contribute to bone health? Increases length of long bones, enhances mineralization, and improves bone density.
How does the thyroid hormone contribute to bone health? Required for skeletal development during childhood and regulates bone turnover and mineralization in adults.
How does calcitonin contribute to bone health? Inhibits osteoclast activity and stimulates calcium uptake by bones.
How does the parathyroid hormone contribute to bone health? Stimulates osteoclast proliferation and resorption of bone by osteoclasts; promotes reabsorption of calcium by kidney tubules; indirectly increases calcium absorption by small intestine
How does testosterone contribute to bone health? Inhibits bone resorption and maintains bone mass.
How does vitamin D contribute to bone health? It is needed for calcium absorption.
Synovial joint Found between bones that move against each other.
Amphiarthrosis joint Limited mobility.
Synarthrosis joint Essentially immobile.
Define skeletal muscle. Voluntary; attached to bones by tendons.
Define smooth muscle. Involuntary; Internal organs and digestive tract; contracts slowly and automatically.
Define cardiac muscle. Involuntary; only found in the heart; possesses contractile units known as sarcomeres.
What hormone is needed to help muscle growth? Testosterone
Traverse fracture Fracture line is perpendicular to the shaft (long part) of the bone.
Linear fracture Fracture is one thin line with no additional lines splintering from it & no compression or distortion of bones,
Oblique non-displaced fracture The bone cracks either part or all the way through, but does not move & maintains proper alignment.
Oblique displaced fracture The bone cracks either part or all the way through and moves out of proper alignment.
Spiral fracture Complete fractures of long bones that result from a rotational force; usually from high energy trauma.
Greenstick fracture When one side of a bone bends and the other cracks.
Comminuted fracture Bone is broken in more than 2 pieces.
Impacted fracture Known as a buckle fracture; a break where the ends are driven into each other; often with children's arm fractures.
Pathologic fracture When force or impact did not cause fracture; weak and brittle bones or underlying disease.
Stress or fatigue fracture Caused by over use or abnormal stress on bones.
Depressed fracture Especially of the skull; fragment is depressed below the normal surface.
What are complications of fractures? Delayed union, malunion, or nonunion; compartment syndrome; fat embolism; osteomyelitis; osteonecrosis or avascular necrosis.
How is compartment syndrome treated? Fasciotomy: surgeon cuts into skin and fascia to relieve the pressure.
What is the difference between a sprain vs strain? Sprain is an injury to the bands of tissue that connect 2 bones together (ligaments). Strain is an injury of a muscle or to the band of tissue that attaches a muscle to the bone (tendons).
What does RICE stand for and what does it treat? Rest to allow healing, Ice to cause local vasoconstriction (reduce swelling), Compression to provide support and reduce swelling, Elevation to decrease swelling; treats sprains and strains.
What is Ankylosing Spondylitis? Inflammatory arthritis affecting the spine and large joints; commonly affecting men.
Malignant bone cancer Osteoma; Osteosarcoma
Malignant cartilage cancer Chondroma; Chondrosarcoma
Malignant bone marrow cancer Hemangioma; Angiosarcoma
Malignant fibrous tissue cancer Fibroma; Fibrosarcoma
Cancer grading: Stage I Cancer cells that resemble normal cells and aren't growing rapidly.
Cancer grading: Stage II Cancer cells that don't look like normal cells and are growing faster than normal cells.
Cancer grading: Stage III Cancer cells that look abnormal and may grow or spread more aggressively.
True or False: The higher the grading the less differentiated . True.
What lab test can measure inflammation? Blood work to check for c-reactive protein and ESR.
Exotoxin Excreted by a living cell, with high concentrations in liquid. (Ex. Staph); proteins produced inside pathogenic bacteria.
Endotoxin Toxin that’s part of the bacterial cell wall; when bacteria is destroyed the toxin is released into the blood stream.
Created by: GChaos95
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