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NWHSU Path1 Exam 3

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