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Path 375 Topic 1

        Help!  

Vocabulary
Definition
parenchymal tissue   we have 2 types of tissue: performs function (others)  
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stromal tissue   we have 2 types of tissue: support function (connective)  
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differentiated cell   cell with function  
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undifferentiated cell   cell without specialized function  
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rough ER / smooth ER   protein / catabolism, synthesis  
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autocrine   control of cell - itself  
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paracrine   control of cell - neighbour  
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endocrine   control of cell - distant neighbour  
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CNS   Central Nervous System  
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ANS   Autonomic Nervous System  
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PNS   Peripheral Nervous System  
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Etiology   Cause of disease (defn path1)  
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Pathogenesis   Mechanism of disease (defn path2)  
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Morphology   Appearance of disease (defn path3)  
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Clinical Significance   Consequence of disease (defn path4)  
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Natural History   Progression of disease (defn path5)  
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Cell injury   when cell lose Homeostasis / balance  
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Reversible Cell Injury   type1 cell injury  
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Irreversible Cell Injury   type2 cell injury  
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Lack of Oxygen   An example of cell injury  
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Hypoxia   Decrease oxygen supply  
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Anoxia   Total lack of oxygen (heart1-2hr/brain4min)  
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Heart attack   Heart stops pumping effectively (hypoxia)  
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Atrophy   Adapt to cell injury1: smaller  
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Physiological atrophy (eg)   aging: Brain  
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Pathological atrophy (eg)   muscle denervation: skeletal muscle cells supplied by that nerve  
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Hypertrophy (eg)   adapt to cell injury2: larger  
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Physiologic hypertrophy (eg)   exercise: skeletal muscle  
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Pathologic hypertrophy (eg)   hypertension (systemic pressure): cardiac muscle cells  
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Hyperplasia   adapt to cell injury3: more cells  
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Physiologic hyperplasia (eg)   pregnancy: female breast  
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Pathologic hyperplasia (eg)   endometrial hyperplasia: endometrial cavity  
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Metaplasia (defn)   adapt to cell injury4: change cell type  
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Metaplasia (eg)   chronic smoking: columnar bronchial epithelium to stratified squamous  
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columnar bronchial epithelium   before smoking  
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stratified squamous   after smoking  
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dysplasia   abnormal growth of cells/tissue (any "bad cell")  
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squamous   scaly  
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exogenous   outside cell  
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endogenous   inside cell  
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anthracosis   accumulation of carbon particles (@ lungs)  
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hemosiderosis   accumulation of hemosiderin  
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steatosis   acculmulation of fat  
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Pathologic calcification   (blank)  
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Dystrophic calcification (defn)   Ca2+ deposit in damaged tissue  
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Dystrophic calcification (eg)   Atherosclerosis  
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Metastatic calcification (defn)   Ca2+ in normal tissue (only when hypercalcemia)  
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hypercalcemia   abnormally high Ca2+ in blood  
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hemosiderin   break-down product of Hb  
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Necrosis   MURDERED: death due to external force - change in appearance (morphological)  
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Apoptosis   NORMAL: death due to old age etc (also in viral bacteria)  
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Coagulative necrosis (morph)   SOLID: boiled meat (coagulated proteins), solid internal organs  
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The most common form of necrosis is...   coagulative necrosis  
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Coagulative necrosis (mechm)   inactivation of hydrolytic enzymes  
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if you don't have working hydrolytic enzymes...   coagulative necrosis  
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Liquefactive necrosis (morph)   dissolution of tissue, soft, filled with fluid  
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Liquefactive necrosis (eg)   Brain infarct  
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Caseous necrosis (morph)   cheese, limited liquefaction  
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Caseous necrosis (eg)   TB  
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Fat necrosis (morph)   white chalky  
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Fat necrosis (mechm)   enzyme complex with Ca2+  
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Inflammation (defn)   A response to injury: non-specific coordinated response by vascularized living tissue to injury  
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Why do tissue inflame?   1. contain/isolate 2. destroy 3. prepare healing BUT can be harmful  
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5 Clinical Signs of Inflammation   1. heat 2. redness 3. edema 4. pain 5. loss of function  
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What are the events in inflammation?   1spincter relax 2transient vasoconstriction 3v.dilation 4i.permeability 5.WBC arrive (PMN,Plalates,Fibrin,Leukocytes)  
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caliber   diameter  
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transient vasoconstriction   brief vasoconstriction  
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What are the mediators of inflammation? 4x (ie What compounds participate in inflammation?)   1Histamine 2Bradykinin 3Complement system 4Arachidonic acid derivatives  
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mediators   compounds released by cells to activate WBC  
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Histamine (func)   i. vessel permeability  
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Histamine is released by...   mast cells  
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Bradykinin (func)   1i. vessel permeability 2pain  
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Bradykinin is from...   derived from plasma proteins  
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plasma proteins   proteins in blood stream  
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Complement system (func)   help to kill bacteria  
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2 methods to activate Complement   1. classical pathway 2. alternate pathway  
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Complement activation: classical pathway   Ag-Ab initiated  
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Complement activation: alternate pathway   toxins mediated  
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How many ways can you activate complement system?   2  
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Arachidonic acid (AA) derivatives (func)   metabolize to form: 1leukotrienes 2prostaglandins 3prostacyclin 4thromboxane, affect inflammation  
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Arachidonic acid is from...   cell wall phospholipids  
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leukotrienes   from AA  
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prostaglandins   from AA  
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prostacyclin   from AA  
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thromboxane   from AA  
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What cells participate in inflammation? 5x   1. Neutrophil (PMN) 2. Eosinophils 3. Basophils/mast cells 4. MO 5. Lymphocytes/Plasma cells  
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Look at table for "Cellular components for inflammation"   (blank)  
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PMN also called...   Neutrophil  
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PMN / Neutrophil (func)   1kill 2engulf bacteria  
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Does PMN produce chemicals?   YES  
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Is PMN long-live/short-live?   short  
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Is PMN mobile?   YES, very.  
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Eosinophils (func)   1kill bacteria 2parasite 3allergic rxn  
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Is eosinophils mobile?   YES  
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Is eosinophils involve in chronic/acute inflammation?   Present in Chronic  
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What is the difference btw basophil and mast cell?   Basophil - in blood ; Mast cell - in tissue  
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Basophil/Mast cell (func)   release histamine  
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Macrophages (func)   phagocytosis  
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When does MO enters site of infection?   3-4 days after injury  
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Does MO involve in chronic/acute inflammation?   Chronic  
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Lymphocytes/Plasma cells (func)   adaptive immune response  
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Lymphocytes   Cells in lymph: only T and B  
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Plasma cells   differentiated B cells  
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What are the difference between lymphocytes and plasma cells?   T and B VS differentiated B  
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Does lymphocyte/plasma cell involve in chronic/acute inflammation?   Chronic  
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Inflammatory exudates   oozing-out stuffs during inflammation  
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How many types of inflammatory exudates are there?   3. 1exudate 2transudate 3pus(purulent)  
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Exudate   Protein+WBC+Fluid, formed only due to inflammation  
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Why does exudate form?   Inflammation  
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Transudate   Fluid only, forms due to disturbance in forces across vessel walls  
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Why does transudate form?   There is a disturbance of balance in forces across vessel walls  
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Pus (purulent) contains...   Neutrophils + dead bacteria  
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Is pus an inflammatory exudate or transudate?   Exudate  
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Purulent   pus  
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What is the difference btw exudate and transudate?   exudate: protein+WBC+fluid ; transudate: fluid only  
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What are the possible outcome of acute inflammation? 4x   1complete heal 2abscess 3fibrosis&scar 4becomes chronic  
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Abscess   fibrous capsule wall off inflammation  
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Fibrosis   replace usual tissue with fibrous tissue  
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Fibrosis will lead to...   scar  
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How many types of inflammation are there? 7x   1. Serous 2. Fibrinous 3. Purulent 4. Ulcerative 5. Pseudomembranous 6. Chronic 7. Granulomatous  
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Serous inflammation   A type of inflammatory infiltrate: clear fluid, few cells  
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Fibrinous inflammation   A type of inflammatory infiltrate: exudate rich in fibrin  
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Inflammatory infiltrate   abnormal stuffs that accumulate in cells/tissue  
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Purulent inflammation   A type of inflammatory infiltrate: exudate rich in PMN  
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Ulcerative inflammation   loss of an epithelial lining due to inflammation  
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Ulceration   sloughing of inflammed necrotic tissue, loss of epithelial lining  
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Pseudomembranous inflammation   2+3+4 (Fibrinous, Purulent, Ulceration) --> pseudomembrane over ulcer  
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Chronic inflammation   +weeks/months ; All at the same time: 1. active inflam 2. tissue destruction 3. healing  
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In chronic inflammation, 3 things occurs at the same time...   All at the same time: 1. active inflam 2. tissue destruction 3. healing  
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Chronic inflammation's exudate   1lymphocytes 2plasma cells 3MO  
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In chronic inflammation, one type of cell proliferate:   fibroblasts  
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Fibroblasts   a cell that will become connective tissue  
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Granulomatous inflammation   one kind of chronic inflammation: formation of granulomas  
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Granuloma   1. lymphocytes, 2. MO (chronic inflam cells) 3. +/- multi-nucleated giant cells --- in discrete nodules  
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multi-nucleated giant cells   sometimes found in granulomas  
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Caseating granulomas (eg)   TB  
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Non-caseating granulomas (eg)   sarcoidosis  
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What is the difference: Inflammatory exudate VS Inflammatory infiltrate?   exudate: oozing-out ; infiltrate: accumulation  
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Fibroblast proliferate when...   proliferate in chronic inflammation  
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What are healing and repair?   Cells' mechm to fix damaged tissue  
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Can epithelial cells regenerate (heal/repair)?   YES. Continually diving  
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Can liver cells regenerate (heal/repair)?   YES. If required.  
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Can neurons regenerate (heal/repair)?   NO.  
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What cells can regenerate themselves and what cannot?   YES: epithelial, liver cells NO: neurons  
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granulation tissue   small, bead-like bulge; consist NEW capillaries  
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How many types of wound-healing process are there?   2. 1st and 2nd intention  
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Wond healing by first intention (defn)   healing occurs after a surgical incision  
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Wound healing by first intention (steps)   1scab 2PMN 3granulation tissue 4fibrous tissue(scar, collagen) 5contract myofibroblast 6disappear  
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Wound healing by second intention (defn)   HUGE wound, cannot/not closed surgically  
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Wound healing by second intention (steps)   1granulation tissue 2fibrous tissue 3contracts **disfiguring  
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granulation tissue, fibrous tissue, scar, collagen, fibroblast   wound healing  
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scab   a crust discharged to cover healing wound (*dried up discharge)  
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Abscess, Sinus, Fistula   [Fig 2.15] When abscess gets too large  
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When an abscess gets too large...   rupture --> sinus, fistula  
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sinus (Ch2)   picture like pot (abscess)  
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fistula   2 pots of abscess connect  
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keloids   disfiguring scar, excess amount of collagen  
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Immune system (defn)   Immune system protects body against harmful substances  
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We have 2 types of immune system:   1natural 2acquired immunity  
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How can immune system cause disease? (Broad)   1too active (hypersensitivity, autoimmune) 2underactive (immunodeficiency) 3transfusion, transplants  
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What are our 4 lymphoid organs?   1lymph nodes 2spleen 3thymus 4mucosa associated lymphoid tissue  
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lymph nodes   lymphoid organs  
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spleen   lymphoid organs  
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thymus   lymphoid organs  
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mucosa associated lymphoid tissue (MALT)   lymphoid organs  
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MALT   mucosa associated lymphoid tissue  
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How many type of adaptive immune cells do we have?   4. 1T 2B 3Plasma 4NK  
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Receptor of T cells   TCR  
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T helper cells is also called...   CD4  
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T helper cells / CD4 T cells (func)   help B lymphocyte product Ab  
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T suppressor lymphocytes is also called...   CD8  
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T suppressor lymphocytes / CD8 (func)   1suppress Ab production 2kill viral infected cells  
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Natural killer cell (NK)   not B nor T  
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Natural killer cell (NK)   1.kill viral infected cells 2kill tumor 3kill foreign cells w/out prior exposure  
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MHC is found on...   APC  
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MHC Class I - Ag binds to... (T cell)..   CD8  
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MHC Class II - Ag binds to... (T cell)..   CD4  
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How many types of B cell antibodies do we have?   5x. IgG, M, A, D, E  
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Look at table for Antibodies in notes   (blank)  
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IgG is found in...   Blood  
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IgG   Ab when re-exposure  
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IgG (mechm)   1Floating in cell 2got bact 3Fc get recog by PMN, lymphocytes, MO, eosinophils, palate  
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opsonin   IgG: Increased phagocytosis by cell  
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IgM is found in...   blood  
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IgM   Ab when first encountered  
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IgM (shape)   pentamer held together by J-chain  
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Pentamer Ig   IgM  
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J-chain   IgM pentamer  
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IgM (func)   1.Ab 2. neutralize bact 3. complement activation  
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Which Ig activates complement?   IgM  
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IgD is found in...   surface of B cells  
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IgD (func)   Activate B if see Ag  
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IgE is found in...   surface of mast cell (tissue)  
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IgE (func)   mediate allergic Type I response  
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IgA is found in...   secretions, milk  
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IgA looks like...   Dimer  
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Which Ig comes in dimer?   IgA  
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Which Ig is a good oposonin?   IgG  
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How did immune specificity comes about?   1. TCR & 2. AB gene rearrangment  
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Ab (func)   1no entry 2complement 3spleen/liver removal 4cytotoxic response  
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How is our immune system activated? From bacteria to Memory   (Refer to notes)  
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previously sensitized B cells   B cells that have seen the Ag before  
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What are the 4 types of Hypersensitive reactions?   T1 Anaphylactic Type T2 Cytotoxic Type T3 Immune Complex Type T4 Cell mediated (Delayed response)  
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Type I Hypersensitive Reaction (defn, step, conseq)   Anaphylactic Type Reaction: Mediated by IgE -- Mechm: IgE on mast cell Conseq: Inflammation  
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Anaphylactic Type Reaction is also called...   Type 1 Hypersensitivity  
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Type 2 Hypersensitive reaction (defn, step, conseq)   Cytotoxin Type Reaction: Mediators IgM/IgG Mech: IgM/G binds to self /hapten Conseq 1complement killing 2PMN,MO,NK killing 3Ab block receptor (death / change in function)  
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hapten   small mol'c adapter (binding's middle person)  
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Cytotoxic type hypersensitivity is also called...   Type 2 Hypersensitive Rxn  
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Type 3 Hypersensitive Reaction (defn, step, conseq)   Immune Complex Type Reaction: Ab-Ag forms large clump, circulate, stuck in membrane, inflamme Conseq: Membrane inflammation (localized or systemic)  
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Immune Complex hypersensitive reaction is also called...   Type 3 Hypersensitive Rxn  
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Type 4 hypersensitive reaction (defn, step, conseq)   Cell mediated (delayed response): Mediated by T,MO Step: Infection drags on for a long time, MO-Epitheloid cells-Granulomas-Giant cell, memory Conseq 1. granuloma (TB) 2. no granuloma (contact dermatitis)  
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Cell mediated (delayed response) hypersensitive reaction is also called...   Type 4 Hypersensitive Rxn  
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epitheloid cells   1st step of MO transformation in granulomas  
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giant cells   2nd step of MO transformation after granuloma established  
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Allergic rhinitis (location, Ag, route, symp, treatment, eg)   Type 1: Hay Fever  
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Atopic dermatitis (location, Ag, route, symp, treatment, eg)   Type 1: Childhood rash  
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Asthma (some forms) Ch3 (location, Ag, route, symp, treatment, eg)   Type 1: Children asthma (inhaled, delayed response)  
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Anaphylactic Shock (location, Ag, route, symp, treatment, eg)   Type 1: Peanut Butter Shock, Bee Venom  
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What are the symptoms of an anaphylactic shock?   1.laryngeal constriction (choking) 2. shock 3. pulmonary edema  
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What is the treatment for anaphylactic shock?   epinephrine 1. i. artery contract 2. i. heart action  
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How many Type 1 hypersensitive reaction examples?   4  
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How many types of Type 2 hypersensitive reaction examples?   3  
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Hymolytic anemia (Ag, Ab, Consequence)   Type 2: Ag=RBC , hemolysis  
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Grave's Disease (Ag, Ab, Consequence)   Type 2: Ag=TSH receptor, overproduction of thyroid hormone  
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Hyperthyroidism   overproduction of thyroid hormone  
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Myasthenia gravis (Ag, Ab, Consequence)   Type 2: Ag=Acetylcholine receptor @ muscle (muscle weakness)  
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How many examples are there for type 3 hypersensitivity rxn?   3  
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Systemic lupus erythemastosus (location, Ag, Consequence, Preceed by)   Type 3: Circulating Ag-Ab  
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Post-streptococcal glomerulonephritis (location, Ag, Consequence, Preceed by)   Type 3: Streptococcal upper respiratory tract infection --> deposit BM (basal membrane) of glomeruli  
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BM (basal membrane of glomeruli)   Post-streptococcus glomerulonephritis (type3)  
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Streptococcal upper respiratory tract infection   Post-streptococcus glomerulonephritis (type3)  
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Polyarteritis nodosa (location, Ag, Consequence, Preceed by)   Type 3: vessel wall, weaken arteries, chronic Hep B  
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How many examples do Type 4 hypersensitive reaction has?   2  
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Tuberculosis (ch3)   Type 4  
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Contact Dermatitis   Type 4: latex gloves, poison ivy, gold rings  
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Tuberculin   Lab test for TB. Inject TB proteins to see if swell.  
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Induration   This is what you look for in TB test: hardening of normally soft tissue due to inflammation etc  
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Transplantation: What are the possible diseases?   1. Rejection 2. GVHD (Graft versus host disease)  
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Autograft   eg. skin graft, hair transplant  
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Allograft   HLA typing, blood grps (relatives + immunosuppresant)  
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HLA typing   Human leukocyte typing (before transplant)  
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Xenograft   pig heart valves, cornea  
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Transplant: Rejection: How many types are there?   3  
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Types of Transplant rejection:   1hyperacute 2acute 3chronic  
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hyperacute transplant rejection   (hours) preformed Ab  
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acute transplant rejection   (days/wks) develop Ab, CTL  
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chronic transplant rejection   (mths/yrs) develop Ab, CTL -- vascular obstruction, tissue destruction  
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Graft versus host disease (GVHD)   allogenic bone marrow transplants  
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GVHD   Graft versus host disease  
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Blood Transfusion: considerations --   ABO , Rh+/-  
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Hemolytic transfusion reaction (giving A blood to B person) symptoms:   1chills 2shivering 3fever 4shock 5DIC 6death  
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DIC   disseminated intravscular coagulation: small clots in blood vessel  
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hydrops fetalis   extensive edema + jaundice in fetus: by Rh incompatibility  
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What are the types of Rh Ag?   C,D,E. but only D important  
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What are the difference btw Rh and ABO incompatibility?   ABO has preformed Ab. Rh has no preformed Ab, wait for 1st child exposure.  
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How to prevent Rh incompatibility?   Immunoprophylaxis: inject Anti-D-Ig right after 1st child Rh+ birth  
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titre   concentration of Ab  
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systemic autoimmune disease   mechm unclear -- use immunosuppresant "dam-down"  
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organ specific autoimmune disease   mechm unclear -- use immunosuppresant "dam-down"  
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What is the hypothesis for etiology for systemic lupus erythematosus?   Malfunction T suppresor cells --> Polycolnal activation of B + Ab  
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What are the screening for lupus?   1. ANA test + 2. anti dsDNA Ab + 3. Ab against Extractable Nuclear Antigens +  
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ANA test   antinuclear antibodies, test for autoimmune diseases  
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anti dsDNA antibodies   test for lupus  
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Extractable Nuclear Antigens   test for lupus  
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Lupus is what type of hypersensitivity?   Type 3 (major) and 2 (minor)  
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What is the most serious complication for lupus?   Kidney failure  
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congenital   先天  
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What are the two types of immunodeficiency?   1congenital 2acquired  
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SCIDS   Severe combined immunodeficiency  
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Severe combined immunodeficiency   total lack of B and T "boy in bubble" (cause: bad lymphocyte precursors)  
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Isolated IgA deficiency   increase intestinal infections  
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DiGeorge Syndrome   T cell not developed 1.defective devp 2.no thymus  
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AIDS   acquired immunodeficiency  
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HIV infects what cells?   CD4, MO  
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HIV trasmitted by...   1. IVDA 2. sexual intercourse 3blood transfusion 4mom-fetal  
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IVDA   IV drug abuse  
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How many types of congenital immunodeficiency did we study?   3 -- SCIDS, Isolated IgA deficiency, DiGeorge Syndrome  
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How many types of acquired immunodeficiency did we study?   1. AIDS  
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What is the 4 stages of HIV infection?   1.acute sick 2. asymptomatic 3. lymphadenopathy 4. opportunistic infections/neoplasia etc  
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lymphadenopathy   swelling of lymph nodes, HIV  
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How to diagnosis HIV?   HIV Ab  
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How to monitor HIV patients?   CD4 counts  
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What are some opportunistic pathogens for HIV patients?   1pneomocystis carinii 2aspergillus 3MAI  
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What are some tumors for HIV patients?   1kaposi sarcoma 2lymphoma  
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pneomocystis carinii   HIV opp pathogen (fugus)  
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aspergillus   HIV opp pathogen (fugus)  
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MAI   HIV opp pathogen  
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kaposi sarcoma   HIV tumor  
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lymphoma   HIV tumor  
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How to treat HIV patients?   1antivirals 2treat opp pathogens  
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Amyloidosis   deposition of abnormal protein (amyloid) in various organs  
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Amyloid   Protein + Sugar from dead tissue, deposit in body =(  
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Describe amyloid protein   It's unusal. beta-pleated sheets  
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What are the typs of amyloid?   AL, AA  
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Neoplasm   is a mass of abnormal cells that grows autonomously: benign or malignant  
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Tumor   swelling (greek's 5 signs of inflam)  
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Cancer   malignant neoplasm  
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Benign neoplasms (charc 4x)   1well differentiated 2slow growth(few mitosis, no necrosis) 3no invasion (expansile growth, smooth border, encapsulated) 4no metastases  
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Malignant neoplasms (charc 4x)   1less well differentiated (anaplasia) 2grow quick(ischemic necrosis) 3locally invasive (irreg infiltrating border, no capsule, margin) 4metastasize  
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expansile growth   capable of expansion  
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anaplasia   complete lack of cell differentiation "backward, cell"  
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ischemic necrosis   necrosis due to stop of blood supply, in malignant neoplasm  
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infiltrating border   permeating border (malignant neoplasm)  
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margin   when remove malignant tumor, need to remove surround healthy tissue too  
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-oma   epithelial benign, soft tissue benign  
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-carcinomas   epithelial malignant  
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-sarcomas   soft tissue malignant  
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adenoma   gland tumor, epithlial benign  
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papilloma   finger-like projections, epithelial benign  
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adenocarcinoma   gland formation/mucin production, epithelial malignant  
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squamous cell carcinoma   intercellular bridge/keratin prod., epithelial malignant  
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transitional cell carcinoma   transitional cell epithelium, malignant  
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fibroma   fibroblast, soft tissue b  
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lipoma   fat cells, soft tissue b  
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chondroma   cartilage cells, soft tissue b  
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leiomyoma   smooth muscle, soft tissue b  
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fibrosarcoma   fibroblast, soft tissue m  
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liposarcoma   fat cells, soft tissue m  
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chondrosarcoma   cartillage cells, soft tissue m  
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leiomyosarcoma   smooth muscle cells, soft tissue m  
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melanoma   melanocytes: m  
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lymphoma   lymphocytes: m  
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leukemia   hematopoietic cells: m  
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carcinoid   neuroendocrine cells: m  
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Teratoma   Germ cells: m or b  
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Mixed tumor   epithelial & mesenchymal 2 layer tumor  
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mesenchymal   mesoderm origin tissue  
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melanocyte (func)   product melanin (pigment)  
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squamous cell (func)   1. intercellular bridge 2. keratin production  
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What are the predisposing factors of neoplasm? 6x   1geographic 2carcinogens 3age 4herditary factors 5clinical pre-conditional 6benign neoplasm transform  
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Predisposing fac: geographic (eg)   Japan gastric cancer  
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If you're exposed to asbestos, you're likely going to get...   mesothelioma of lung  
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mesothelioma   caused by asbestos  
🗑
neoplasms more common in children:   1leukemias 2neuroblastroma 3Wilm's tumor 4retinoblastoma  
🗑
leukemia (risk group)   children  
🗑
neuroblastoma (risk group)   children  
🗑
Wilm's tumor (risk group)   children  
🗑
retinoblastoma (risk group)   children  
🗑
Why is there familial adenomatous polyposis (FAP)   lots of polyps in colon: inherit a mutant gene =(  
🗑
Pre-medical condition: liver cirrhosis...   liver cancer  
🗑
Pre-medical condition: atrophic gastritis   stomach cancer  
🗑
Pre-medical condition: chronic ulcerative colitis   colon cancer  
🗑
Pre-medical condition of liver cancer   liver cirrhosis  
🗑
Pre-medical condition of stomach cancer   atrophic gastritis  
🗑
Pre-medical condition of colon cancer   chronic ulcerative colitis  
🗑
cirrhosis   chronic inflam of liver, yellow  
🗑
What kind of benign tumor will led to malignant colon cancer?   villous adenomas of colon  
🗑
Pre-medical condition: villous adenomas of colon   colon cancer  
🗑
What are the different grades of cancer?   2x. High grade: poorly differentiated ; Low grade: well-differentiated  
🗑
Is there grade and stage for both malignant and benign tumor?   NO. Malignant only.  
🗑
What are the different stages of cancer?   TNM system: (1-4) T size N amt in lymph node M metastasis (1 for <2.5cm etc)  
🗑
What is one eg of staging sytem for cancer?   TNM  
🗑
tumor burden   amount of malignant neoplasm in body  
🗑
Meningioma (...result)   There's no space for it to grow. Compression -- fatal  
🗑
What will tumor do to our body?   1. compression (fatal) 2. systemic (cachexia, weighloss, anorexia) 3. paraneoplastic syndroms (i. Ca2+, Cushing's synd, Syn of inapp ADH) 4Hormone-secreting tumor  
🗑
cachexia   "bad, condition" -- ill health, poor nutrition (cancer)  
🗑
anorexia   "no, appetite"  
🗑
Paraneoplastic syndromes (defn)   sydrome of symptoms of ppl with cancer but not explained but direct tumor effects  
🗑
Paraneoplastic syndromes (list)   1. Hypercalcemia 2. Cushing's syndrome 3. Syndrome of inappropriate ADH  
🗑
Hypercalcemia   is the most common paraneoplastic syndrome. 1i. blood Ca2+ 2produce PTH-rp protein  
🗑
PTH-rp protein   produced during hypercalcemia (neoplastic syndromes)  
🗑
Cushing's syndrome   Produce ACTH (neoplastic syndromes)  
🗑
ACTH   Produced during Cushing's syndrome (neoplastic syndromes)  
🗑
Syndrome of inappropriate antidiuretic hormone   Production of ADH (cancer paraneoplastic syndromes)  
🗑
Carcinogen   a cancer-producing substance  
🗑
Chemical carinogenesis (steps)   1Initiation (damage DNA irrev) 2Promotion (tumor form) 3Progression (tumor change, clonal expansion)  
🗑
Pro-carcinogen   chemical that must be modified in body to become a carcinogen  
🗑
Can all chemical carcinogens initiate & promote?   No. Some just initiate.  
🗑
Alkylating agents   eg of chemical carcinogen: used to treat cancer  
🗑
Aflatoxin   eg of chemical carcinogen: fungus, liver carcinogen  
🗑
Polycyclic hydrocarbons   eg of chemical carcinogen: skin, lung carcinogen  
🗑
Aniline dyes   eg of chemical carcinogen: bladder carcinogen  
🗑
Nitrosamines   eg of chemical carcinogen: gastric cancer  
🗑
amides   eg of chemical carcinogen: gastric cancer  
🗑
Incidence (of a cancer)   # of new case / year  
🗑
TOP RANKING CANCER OCCURANCE (female)   1breast 2lung 3colorectal 4uterine  
🗑
TOP RANKING CANCER OCCURANCE (male)   1prostate 2lung 3colorectal  
🗑
Mortality (of a cancer)   # of deaths / year  
🗑
TOP RANKING CANCER DEATHS (female)   1lung 2breast 3colorectal  
🗑
TOP RANKING CANCER DEATHS (male)   1lung 2prostate 3colorectal  
🗑
Can our immune system fight cancer?   YES. Can eliminate small ones. Spontaneous remissions.  
🗑
Immunotherapy (cancer)   drugs to enhance our immune destruction of cancer  
🗑
spontaneous remissions (cancer)   sudden disappear of cancer  
🗑
Teratogen   agent that cause fetal abnormality  
🗑
How many chromosomes do we have?   22 autosomes + 1 sex chromosome  
🗑
aneuploidy   "no, normal # chromome"  
🗑
monosomy - fatal?   (chart) NO for X  
🗑
trisomy - fatal?   (chart) NO for 13, 18, 21, X, Y  
🗑
morbidity   # of case in a population  
🗑
p and q arms of chromosome   p = upper q = lower  
🗑
carrier of genetic disease   (blank)  
🗑
exogenous factors (genetic)   inside body  
🗑
endogenous factors (genetic)   outside body  
🗑
dose effect   close relative have this genetic disease, yours is high too  
🗑
epigenetic factours   environmental factors  
🗑
What are the four ways of prenatal diagnosis?   1. Ultrasound 2. Chronic villus sampling 3. Amniotic fluid 4. Maternal blood (triple screen)  
🗑
Triple screen   prenatal diagnosis (of mother's blood)  
🗑
chorionic villi   placental villus  
🗑
Premature baby   delivered before 37 wks  
🗑
IUGR   Intrauterin Growth Restriction: birth <3200 g  
🗑
Immature baby   < 37wks <1500 g  
🗑
Placental insufficiency   failure of placenta to supply baby with nutrients  
🗑
Dura matter   Membrane covering brain and spinal cord  
🗑
A normal baby (time, weight)   40wks, 3500g  
🗑
Reasons of developmental malformities 6x   1. Unknown 75% 2. Genetic 20% 3. Chromosomal 2% 4. Infection 2% 5. Chemical 1% 6. Physical ?%  
🗑
20% genetic developmental malformities (types)   1. auto dominant 2. auto recessive 3. x-link 4multifactorial  
🗑
2% Chromosomal developmental malformities (types)   1. Number 2. structural  
🗑
2% Infection developmental malformities (types)   TORCH  
🗑
Autosomal dominant devlp disease   1.Achondroplastic dwarfism 2. Marfan's syndrome 3. Familial hypercholesterolemia  
🗑
Achodroplastic dwarfism   short arm & leg  
🗑
Marfan's syndrome   fibrillin gene (tall, thin, weak joints, dissecting aneurysms, retinal detachments)  
🗑
Familial Hypercholesterolemia   LDL receptor gene in liver (early atherosclerosis, heart disease, xanthomas) DD > Dd  
🗑
Autosomal recessive developmental malformities 4x   1. cystic fibrosis 2. Lysosomal storage disease (Tay-Sachs, Gaucher Disease, lipidoses, mucopolysaccharidoses, glycogenoses) 4 PKU  
🗑
meconium ileus   dark green fecal material in fetal ileus (cystic fibrosis)  
🗑
Chloride sweat test   diag of cystic fibrosis  
🗑
Cystic fibrosis   chlorine transport gene (thick mucous, infections, meconium ileus, mucus plugs) Chloridfe sweat test  
🗑
Lipodoses   lysosome can't digest fat dd  
🗑
Mucopolysacchridoses   lysosome can't digest complex sugar dd  
🗑
Glycogenoses   lysosome can't digest glycogen dd  
🗑
Tay-Sachs   Hexosaminidase gene: lysosome can't digest gangliosides dd (3-5 yrs, brain, eye)  
🗑
Gaucher disease   Glucocerebrosidase gene: lysosome can't digest gluccocerebroside (normal life, large spleen, anemia)  
🗑
PKU   phenylketonuria  
🗑
phenylketonuria PKU   phenylalanine hydroxylase gene: can't PheA -> Try (Ashkanazi Jews, psyconeural, heel prick, don't eat PheA)  
🗑
Hexosaminidase gene   Tay-Sach (gangliosides)  
🗑
Gangliosides   digest by hexosaminidase gene  
🗑
Glucocerebrosidase gene   Gaucher disease (glucocerebroside)  
🗑
glucocerebroside   Glucocerebrosidase gene  
🗑
How many types of x-link recessive developmental disorder?   3x. 1. hemophilia 2. Duchenne and Becker's Muscular Dystrophy 3. Fragile X syndrome  
🗑
Hemophilia   lack coagulation proteins (clotting factors), 2 types A&B, arthritis, factor replacement, Romanovs (Russian royal family) Xd  
🗑
hemophillia type A   Factor VIII gene 8 : more common 1 in 5000 Xd  
🗑
hemophilia type B   Factor IX gene 9 : rare 1 in 30,000 Xd  
🗑
Romanovs   Russian royal family with hemophilia Xd  
🗑
Duchenne and Becker's Muscular Dystrophy   lack dystrophin protein: weak cells, 2 types  
🗑
dystrophin protein   maintains cell structure by binding cytoskeletons (Duchenne and Becker's Muscular Dystrophy)  
🗑
Duchenne type   severe, common Xd  
🗑
Becker's type   less severe, rare Xd  
🗑
Fragile X syndrome   CGG triplet repeat on X-link (mental retard, enlarged testes) - acculmulation over time  
🗑
CGG triplets repeats   Fragile X syndrome Xd  
🗑
Pre-mutation **   individual who does not have critical number of repeat to cause expression of disorder (Fragile X syndrome) Xd  
🗑
HOw many multifactorial genetic disease?   5x 1. hare lip 2. dysraphias (anencephaly, spina bifida, meningocele) 3. diabetes melitus type 2  
🗑
Hare lip / cleft lip / cleft palate   multifactorial genetic  
🗑
Dysraphias   incomplete fusion of midline structures  
🗑
Anencephaly   no brain  
🗑
Spina bifida   vertebral bones (no skin)  
🗑
Meningocele   under skin vertebra protusion  
🗑
How to prevent dysraphias?   folate  
🗑
Diabetes Mellitus Type 2   multifactorial genetic. lack of insulin  
🗑
HOw many chromosomal number diseases?   3 1. turner's syndrome 2. down's syndrome 3. klinefelter's syndrome  
🗑
Turner's syndrome   XO monosomy (look female)  
🗑
Down's syndrome (trisomy)   21, 21, 21 trisomy (retard, short 5th finger, wide gap 1/2 toes, old mom)  
🗑
Down's syndrome (translocation)   21to14 (t21/14)  
🗑
t21/14   translocate from 21 to 14  
🗑
Klinefelter's syndrome   x,x,x trisomy (look male, breast, infertile)  
🗑
How many chromosome structure disorder?   3x. 1. WARG 2. Retinoblastomas 3. Down's syndrome 4%  
🗑
WARG   Wilm's tumor, Anairidia, Mental retardation, Genital malformation (delete p11)  
🗑
retinoblastomas   eye tumor (delete q13)  
🗑
anairidia   no iris  
🗑
How many Infections (developmental)   5 TORCH  
🗑
TORCH: Toxoplasmosis   parasite (brain microcalcification, hydrocephaly, skin lesions)  
🗑
TORCH: Others   syphilis, listeria  
🗑
TORCH: Rubella   German measle virus, microcephaly, heart, microphthalmia (small eyes)  
🗑
TORCH: Cytomegalovirus   brain microcalcification, hydrocephaly  
🗑
TORCH: Herpes simplex virus   developmental  
🗑
Fetal alcohol syndrome   chemical, mental retard  
🗑
thalidomide   sleeping pills (chemical developmental teratogen)  
🗑
Isotretinoin   acne drug (chemical developmental teratogen)  
🗑
Radiation   (physical developmental teratogen) nagasaki, hiroshima  
🗑
Neonatal respiratory distress syndrome   inadequate surfactant (lecithin), atelectasis, hyaline membrane, treat by corticosteriods  
🗑
lecithin   surfactant  
🗑
atelectasis   alveoli collapse "not, end, stretching out"  
🗑
hyaline membrane   glassy appearance membrane  
🗑
Birth injury   hurt when giving birth (large, bone fracture, nerve injury)  
🗑
SIDS   Sudden Infant Death syndrome  
🗑
Crib death   Sudden Infant Death syndrome  
🗑
Cot death   Sudden Infant Death syndrome  
🗑
Sudden Infant Death syndrome   apnea, hypothalamus immature, low social status  
🗑
apnea   "no breathing"  
🗑
Corticosteriods   treatment for neonatal respiratory distress syndrome  
🗑
anasarca   (blank)  
🗑
ascites   (blank)  
🗑
hydrothorax   (blank)  
🗑
hydrocardia   (blank)  
🗑
herniation   (blank)  
🗑
congestive heart failure   Na retention  
🗑
Hemoptysis   (blank)  
🗑
hematemesis   (blank)  
🗑
hematochezia   (blank)  
🗑
melena   (blank)  
🗑
hematuria   (blank)  
🗑
metrorrhagia   (blank)  
🗑
hemothorax   (blank)  
🗑
hemoperitoneum   (blank)  
🗑
hemopericardium   (blank)  
🗑
hemotoma   (blank)  
🗑
petechiae   (blank)  
🗑
purpura   (blank)  
🗑
echymoses   (blank)  
🗑
hypovolemia   (blank)  
🗑
Virchow's triad   thrombosis predispose factors 1. stasis of blood 2. hypercoagulable states 3. endothelial injury  
🗑
Why would there be thrombosis?   virchow's triad  
🗑
fibrinolysis   lyse a thrombus  
🗑
infarct   stop blood, necrosis  
🗑
site of impaction   where embolus got stuck  
🗑
saddle embolus   lung embolus, no blood at all , death  
🗑
pulmonary infarct   small localized, ok  
🗑
carotids artery   (blank)  
🗑
ischemia   stop blood  
🗑
Can heart, liver, brain heal infarcts?   yes heart (fibrosis) yes liver (replacement) NO brain  
🗑
Shock   inadequate blood to tissue, memnoic S, H, O, C, K, S  
🗑
arrhythmia   irregular heart beat  
🗑
oliguria   infrequent urination  
🗑
acidosis   (blank)  
🗑
stages of shock:   1.compensated/nonprograssive 2. decompensated(prograssive) 3.irreversible  
🗑
descending branch   (blank)  
🗑
circumflex branch   (blank)  
🗑
tricuspid valve   (blank)  
🗑
mitral valve   (blank)  
🗑
pericardial sac   (blank)  
🗑
epicardium   (blank)  
🗑
myocardium   (blank)  
🗑
endocardium   (blank)  
🗑
arotic valve   (blank)  
🗑
pulmonic valve   (blank)  
🗑
cardiac conducting system   (blank)  
🗑
endothelium (vessel)   (blank)  
🗑
media   (blank)  
🗑
adventitia   (blank)  
🗑
Ischemic heart disease   narrowing of vessel, not enough supply to heart muscle (atherosclerosis)  
🗑
angina   chest pain  
🗑
troponin   lab test for ischemic heart disease  
🗑
papillary muscle   muslce of heart valve  
🗑
congestive heart failure   heart is no good pump  
🗑
Hypertension   high blood pressure >90 d > 160 s  
🗑
benign hypertension   hyalinization on vessel walls  
🗑
malignant hypertension   onion skin (necrosis)  
🗑
hypertensive encelphalopahy   microinfarcts, strokes  
🗑
congenital heart disease cause:   rubella, alcohol, chromosome  
🗑
2 types of congenital heart disease   1septal defect 2tetralogy of fallot  
🗑
tetralogy of fallot   1pulmonic stenosis 2LV septal defect 3RV hypertrophy 4overriding aorta  
🗑
plumonic stenosis   narrowing (tetralogy of fallot)  
🗑
endocarditis   (blank)  
🗑
myocarditis   (blank)  
🗑
pericarditis   (blank)  
🗑
acute endocarditis   norm valve  
🗑
subacute endocarditis   abnorm valve  
🗑
result of endocarditis   emboli  
🗑
Rheumatic heart disease   bact (streptococcal) + autoimmune inflammation of heart  
🗑
Rheumatic fever   Rheumatic heart disease  
🗑
vegetations   scar  
🗑
hyalinization   deposit of amyloid (harden arteries, lost elasticity, Ca2+ deposit)  
🗑
Dilated cardiomyopathy   alcohol, virus  
🗑
Hypertrophic cardiomyopathy   young male  
🗑
Restrictive cardiomyopathy   infiltration/ amyloid  
🗑
atrial myxoma   benign  
🗑
it's rare to have metastatic tumor in heart, constantly pumping, if yes, from..   lungs  
🗑
Iatrogenic   doctor-induced heart disease (radiation x-ray, surgery, transplants of heart)  
🗑
cardiotoxic   (blank)  
🗑
atherosclerosis risk factors   1. constitutional 2. modifiable major 3. modifiable minor  
🗑
lesion   tissue damage  
🗑
atherosclerosis (mechm)   1. endothelial injury + hyperlipidemia 2. MO + lipid = foam cells (fatty streaks) 3lipid deposit, ulceration (lipid plaque) 4smooth muscle, fibrous tissue in-growth @ plaque (fibrous plaque) 5. calcification/hemorrhage  
🗑
hyperlipidemia   too much fat in blood  
🗑
foam cells   MO + lipid (atherosclerosis)  
🗑
fatty streaks   atherosclerosis  
🗑
liquid plaque   atherosclerosis  
🗑
fibrous plaque   atherosclerosis  
🗑
vasculitis : 2 types   inflam of vessel wall 1. polyarteritis nodosa 2. temporal arteritis  
🗑
polyarteritis nodosa   type 3. autoimmune. multiple organ  
🗑
temporal arteritis   temporal artery @ head, elderly  
🗑
Raynaud's disease   disorder contract of vessels (always cold @ fingers, toes) Treatment: reheating  
🗑
Deep vein thrombosis   to lung =(  
🗑
varicose vein   dilated, twisted (tortuous) veins (bad valves) @ legs (thrombus, stasis dermatitis)  
🗑
tortuous   twisted  
🗑
stasis dermatitis   no vein circulation, scaly legs (varicose vein)  
🗑
lymphangitis   inflam lymph of leg/hands  
🗑
dual blood supply   lung  
🗑
alveolar ducts   (blank)  
🗑
bronchial arteries   (blank)  
🗑
mucocilliary escalator   (blank)  
🗑
alveolar pneumocyte   (blank)  
🗑
basement membrane   (blank)  
🗑
What are the infections of the upper respiratory tract? 4x   1. cold/flu 2. strep throat 3. mononucleosis 4. diphtheria  
🗑
common cold/sore throat / flu   rhinovirus, parainfluenza virus  
🗑
strep throat   strep A  
🗑
Mononucleosis   EBV (enlarge nodes, sore throat)  
🗑
diphtheria   membrane formation  
🗑
What are the infections of the middle respiratory tract? 3x   1. croup 2. acute epiglottitis 3. bronchiolitis  
🗑
Croup   barking cough , parainfluenza virus, <3yrs  
🗑
Acute epiglottitis   H. influenzae B (bacteria), immunization, 3-7yrs  
🗑
Bronchiolitis   respiratory syncitial virus  
🗑
parainfluenza virus   flu, croup  
🗑
H. influenzae B   acute epiglottitis  
🗑
respiratory syncitial virus   bronchiolitis  
🗑
interstitial pneumonia   = atypical pneumonia  
🗑
lobar pneumonia   (blank)  
🗑
bronchopneumonia   (blank)  
🗑
Where do you get typical pneumonia?   1. community 2. hospital 3. travel/exotic  
🗑
Community acquired pneumonia   strep, staph, hemophilus  
🗑
streptococcus   typical pneumonia  
🗑
hemophilus   typical pneumonia  
🗑
staphlococcus   typical pneumonia  
🗑
Hospital acquired pneumonia   gram (-)  
🗑
gram (-)   Hospital acquired pneumonia  
🗑
hematogenous   route of infection: blood  
🗑
Mycoplasma pneumoniae   atypical pneumonia  
🗑
Legionella pneumophilia   atypical pneumonia (standing water)  
🗑
pleuritis   inflam of pleural cavity  
🗑
pyothorax   pus in pleural cavity  
🗑
empyema   loculated pus in pleural cavity  
🗑
bronchiectasis   chronic dilation of bronchi tubes  
🗑
chronic lung disease   unresponsive to drugs  
🗑
CBC   complete blood count  
🗑
differential test   lab test: # WBC  
🗑
arterial blood gas   lab test: hypoxnia?  
🗑
rigors   shiver  
🗑
dyspnea   difficult breathing  
🗑
mucopurulent discharges   pneunomia  
🗑
primary TB   (blank)  
🗑
secondary TB   reinfection / reactivation  
🗑
Ghon complex   lesion + enlarged hilar nodes + granuloma  
🗑
hilar nodes   lymph node in lungs  
🗑
granuloma   TB + MO + WBC  
🗑
caseous necrosis   TB  
🗑
Acid fast stain   TB (Ziehl-Nielsen) lab test  
🗑
Ziehl-Nielsen   TB acid fast stain lab test  
🗑
DNA Probes   TB lab test  
🗑
multi-drug regimen   TB  
🗑
Pneumonary function test   tell you whether it's obstructive or restrictive  
🗑
Asthma (defn)   (blank)  
🗑
reactive airway disease   asthma  
🗑
2 types of asthma   (blank)  
🗑
eczema   asthma atopic diseases associated  
🗑
smooth muscle contraction   asthma  
🗑
bronchi contriction   asthma  
🗑
status asthmaticus   bronchodilators no use  
🗑
unremitting asthma attack   persistant asthma attack  
🗑
steriods   asthma  
🗑
Chronic obstructive pulmonary diseases   1. chronic bronchitis 2. emphysema 3. bronchiectasis  
🗑
Chronic bronchitis   smoking. excessive sputum  
🗑
Emphysema   smoking. dilation of distal air space. 2 types  
🗑
2 types of emphysema   (blank)  
🗑
centrilobular emphysema   center of a lobule dilated  
🗑
panlobular emphysema   all air space in a lobule dilated  
🗑
alpha-1-anti-trypsin deficiency   panlobular emphysema  
🗑
alpha-1-anti-trypsin   inactivate proteases  
🗑
Bronchiectasis   wall damage, so permanent dilation of bronchus  
🗑
Pink puffer   empysema, overexpand chest "barrel chest", use accessory muscle, hyperventilate "puff"  
🗑
Blue bloater   Chronic bronchitis. obesed. cyanosis (hypoxemia)  
🗑
barrel chest   overinflated lungs, pink puffer  
🗑
lung compliance   lung flexibility  
🗑
restrictive lung disease   lost of lung function, honeycomb lung (end stage)  
🗑
types of restrictive lung diseases   1. organic (hypersensitive pneumonitis) 2. inorganic (pneumoconioses) 3. non-caeseatig granulomas (sarcoidosis)  
🗑
Hypersensitive pneumonitis   restrictive. inhaled organ dust. type 3/4  
🗑
farmer's lung   inhaled moldy hay (restrictive)  
🗑
pigeon fancier's lung   inhaled pigeon droppings (restrictive)  
🗑
pneumoconioses   restrictive. inhaled inorganic dusts.  
🗑
Coal-worker's lung   coal & silica (miners)  
🗑
silicosis   inhaled silica particles (sand blaster, miners, stone cutters)  
🗑
asbestosis   inhaled asbesto (shipyard, insulation) -- 1. pleural plaques 2. lung cancer 3. mesothelioma  
🗑
sarcoidosis   non-caeseating granuloma, systemic  
🗑
steriod   treat: sarcoidosis, asthma, SRDS  
🗑
Drowning: 2 types   (blank)  
🗑
wet drowning 90%   hypertonic seawater , pulmonary edema  
🗑
hypertonic sea water drowining   pulmonary edema  
🗑
dry drowning 10%   reflex largyngospasm (close glottis)  
🗑
reflex largyngospasm   close glottis (drowning) -- can save  
🗑
ARDS   adult repiratory distress syndrom  
🗑
adult repiratory distress syndrom   high death rate. sudden respiratory failure, even O2 no use. shock...  
🗑
atelectasis   collapse of alveoli (1surfactant, 2compress, 3obstruction by tumor-resorp air stuck)  
🗑
atelectasis (cause)   1surfactant, 2compress, 3obstruction by tumor-resorp air stuck  
🗑
dyspnea   shortness of breathe  
🗑
laryngeal carcinoma   squamous cell carcinoma, smoking/alcohol, hoarness loss of voice  
🗑
lung cancer (risk factors)   smoke, asbestos, radiation, arsenic/chrmoium metals, genetic  
🗑
arsenic, chrmoium   lung cancer  
🗑
What is a common site for metastatic tumor?   lung  
🗑
adenocarcinoma   lung cancer @ peripheral solitary nodule (most common)  
🗑
squamous cell carcinoma   lung cancer @ more centrally located, difficult to remove  
🗑
small cell carcinoma   lung cancer . over secretion of ADH (hormone)  
🗑
pneumothorax   air in pleural cavity - lung collapse  
🗑
pleural effusion   fluid in pleural cavity  
🗑
secondary pleuritis   from primary pneumonia  
🗑
pleural tumor   mesothelioma (asbesto)  
🗑


   

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