Duke PA pathology
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Pathology | Study of disease, focusing on physiologic, gross and microscopic morpholic changes in cells reacting to injury
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Disease | "an impairment of the normal state of the living animal or plant body that affects the performance of the vital functions"
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Etiology | cause of diseases
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Idipathic | unknown etiology
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latrogenic | "provider induced"
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pathogenesis | is a description of the mechanisms by which disease develop
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sign | objective evidence (a perceptible change) that signals disease
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symptom | a patient's subjective experience or interpretation of the disease
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syndrome | a group of signs and or symptoms that characteristically occur together as a part of a single disease process
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pathognomonic | a sign, symptom of characteristic of a disease that leads to its accurate diagnosis
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prognosis | reasonable predictions about the course of a disease or process taking into account the natural history, the expected effects of therapy and particular factors specific for the individual case
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paraenchyma | functional elements of an organ e.g., myocardial cell of the heart, neuron of the brain
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stroma | framework or support elements of an organ e.g., connective tissue
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lesion | any pathological abnormality of tissue structure or function
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What does disease result from? | cumulative effects of injury to individual cells
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How do different cell types respond to stress? | differently
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How do consequences of cell injury differ? | depends on cell type
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How do cells interact with their environment? | they are not static, must be able to adapt
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What do cells need to perform functions and maintain viability? | energy
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Deficiency | lack of necessary substance
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Types of deficiency | nutritional deficiency, inability to absorb or utilize nutrients, genetic defect leading to inadequate production or regulation
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Intoxication | presence of a substance that interferes with cell function
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Examples of endogenous intoxication | genetic defect, accumulation of metabolite
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Examples of exogenous intoxication | infectious agents, chemicals, drugs (illegal and prescription)
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Trauma | loss of structural integrity
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Examples of trauma | hypothermia, hyperthermia, mechanical pressure, infections
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Hypothermia | formation of ice crystals
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hyperthermia | denaturation or oxidation of proteins
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infections in trauma | cell rupture or lysis
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hypoxia | state of tissue or cell oxygen deficiency
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ischemia | oxygen deprivation due to lack of blood flow
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What do cells need oxygen? | anearobic glycolysis = 2 ATP vs. oxidative phosphorylation = 36 ATP
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What happens to cellular metabolism in state of hypoxia? | switches to anaerobic glycolysis as the primary source of energy
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What happens if O2 is lacking because of ischemia? | inflow of substrate decreases and efflux of metabolic end-products slows - no incoming glucose, no taking out of waste products - toxic to cell
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What do hypoxic cells consume first? | energy reserves
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Energy reservers | creatine phosphates in muscle, adenine nucleotides break down
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What happens to anaerobic glycolysis in state of hypoxia? | increase, with accumulation of lactic acid and inorganic phosphate
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What cellular processes are impacted first during hypoxia? | ion transport
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What happens when there is not enough energy to man ion pumps? | concentration gradient takes over
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What is Na+/K+ ATPase needed for? | keep intracellular Na+ from rising
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What happens when ion pump is off? | Na+ comes in and water follows
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What happens to tissue osmolality when there is not enough energy for ion pumps to function? | increases due to catabolism within ischemic cells, water flows in passively
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What is one of the first signs of ischemia? | swelling of the cell
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Where does lipid accumulation occur the most? | liver
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How does lipid accumulation affect lipoprotein synthesis? | impaired lipoprotein synthesis (ethanol, protein malnutrition)
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How does lipid accumulation affect fatty acid oxidation? | decreased fatty acid oxidation (hypoxia)
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How does lipid accumulation affect liberation of fat? | increased liberation of fat from peripheral stores (starvation)
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How does starvation accumulate fat in liver? | fat stores in body are liberated and liver picks them up
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What are the manifestations of cell injury? | acute cessation of specialized functions, persistent impairment of function after cessation of noxious stimulus, loss of ability to replicate
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What are the three main mechanisms of cell injury? | deficiency, intoxication, trauma
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