Patho Quiz 1

primary prevention

preventing a disease from occurring

secondary prevention

early detection of disease by screening

tertiary prevention

rehab of PT to prevent progression of disease

* try to minimize whats happening to PT

Cellular Adaptation

cellular response to stress

what is atrophy?

decrease in cell size

what is hypertrophy?

increase in cell size

what is hyperplasia?

increase in the cell #

what is dysplasia?

* aka: atypical hyperplasia

change in cell

* size
* shape
* uniformity
* arrangement
* structure

what is metaplasia?

reversible replacement of one mature cell type by another less mature cell

Pathology

* Atrophy

occurs as a result of decreased

* workload
* pressure
* use
* blood supply
* nutrition
* hormonal/nervous stimulation

What is muscle atrophy due to?

* lack of use
* nerve loss
* chronic malnutrition

Cerebral Atrophy

* decrease in size of cells in the cerebrum of the brain
* decrease in size of neurons

focal cerebral atrophy

localized to a particular region

global cerebral atrophy

affecting entire brain

Pathology

* Hypertrophy

caused by specific hormone stimulation

* Increased functional demand

Hypertrophy in Body Builders

increase in functional demand = increased size in skeletal muscles

Hypertrophy due to hypertension

increase functional demand of cardiac muscles DUE TO need to pump against high pressure

* excessive cardiac workload
* genetic trait

Cardiac Hypertrophy Clinical Manifestations

* SOB
* Chest Pain
* Syncope (fainting)
* impaired cardiac function

cells that DO NOT regenerate

* nerve
* skeletal muscles
* myocardial
* lens cells of eyes

Pathology

* Dysplasia

abnormal changes in size, shape & organization of mature cells

* precursor to cancer
* occurs in epithelial tissues in cervix & respiratory tract

Pathology

* metaplasia

substitution of cells that are better able to survive under certain circumstances

* function of cell changes

Cervical Metaplasia & Dysplasia Pathophysiology

cellular adaptation of the squamous & columnar epithelial cells in the transformation zone of the cervix

Cervical Metaplasia Risk Factors

* sexual activity
* multiple partners
* smoking
* HPV

Cervical Metaplasia Treatment

* Ablation→ removal of superficial cells
* Cold coagulation & electrocoagulation
* Surgical Excision

Mechanisms of Death

* Apoptosis

programmed cell death

* body send signals → cells kill themself

Mechanisms of Death

* Necrosis

irreversible cell damage

* death of cell

Cellular Injury & Death

* Causes of Injury

* physical
* mechanical
* thermal
* chemical

What is Cellular Proliferation?

new daughter cells generated from division of parent cells

meiosis

results in oocytes & sperm

mitosis

division & proliferation of all other nongerm cells

* is continuous

What is Cellular Differentiation?

orderly process of cellular maturation to achieve a specific function

* differentiated cells have a specific function
* undifferentiated cells respond to the needs of the body

What are stem cells?

cells that haven’t decided what they wanted to be

what are progenitor cells?

cells that have an assignment / they know what they wanna do

Altered Cellular Proliferation & Differentiation

gene malfunction goes unrepaired (makeup of cell got damaged)

* cell is allowed to grow uncontrollably (altered proliferation)
* cells lose ability to carry out its specified function (altered differentiation)

Genetic Mutations

* mutator genes

repair gene & protect genome

Genetic Mutations

* oncogenes

code for proteins involved in cell growth

* non stop growth

Genetic Mutations

* tumor suppressor genes

prohibits growth of cells & regulates apoptosis

Carcinogens

* radiation
* tobacco
* hormones
* chemicals
* microbes

Carcinogenesis

origin & development of cancer

Initiation-Promotion-Progression Theory

* initiation

EXPOSURE of cells to a carcinogenic agent//

Initiation-Promotion-Progression Theory

* Promotion

a promoter agent activates oncogenes

Initiation-Promotion-Progression Theory

* Progression

independent growth

Impact of Cancer on Tissue, Organs & Organ system

* Autonomy

unregulated proliferation of neoplasm

Impact of Cancer on Tissue, Organs & Organ system

* Anaplasia

loss of cell differential & function

Impact of Cancer on Tissue, Organs & Organ system

* Angiogenesis

development of new blood vessels to meet nutrient demands of tumors cells

Benign Tumors

* remain localized
* slow growing
* closely resemble
* easy to treat
* cells are mature & “stick” together to prevent spread
* may function as normal cells & produce hormones

Malignant Tumors

INVASIVE & DESTRUCTIVE

* proliferate rapidly
* spread to other sites (metastasize)
* does NOT resemble tissue of origin

What is a neoplasm?

new growth

Nomenclature for benign tumor

add “oma” to the tissue type

* bone→ osteoma
* fatty tumor→ lipoma

Nomenclature for malignant tumor

add “sarcoma” to the end

* bone→ osteosarcoma

Cancer Spread

* local spread

within tissue or organ

Cancer Spread

* direct extension

adjacent tisue/organ

Cancer Spread

* seeding

colonize to secondary site

Cancer Spread

* metastasis

spread to distant site

Cancer Spread

* tropism

primary tumors have affinity for a secondary site

Treatment of Cancer

* surgery
* chemo
* radiation
* bone marrow transplant
* hormones
* palliative care (provide best quality of life)

Lung Cancer Patho

leading cause of cancer deaths

* due to smoking & industrial exposure
* tumors originate in epithelial lining of bronchi, bronchioles, & alveoli

Lung Cancer Clinical Manifestations

* SOB
* persistent cough
* chest pain
* hemoptysis (coughing up blood)

Lung Cancer Treatment

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Leukemia Pathophysiology

malignant neoplasm of blood & blood forming organs

Leukemia Clinical Manifestations

* anemia
* bone pain
* weight loss
* fever
* lymph node enlargement
* bleeding
* nausea

Leukemia Treatment

* chemo
* radiation
* bone marrow or stem cell replacement

3 lines of defense

* skin & mucous membrane
* inflammatory response
* immune response

First Line of Defense

Healthy skin

* healthy tissue in the mucosal lining of resp, GI,GU tracts

If the invader penetrates the 1st line of defense

* sloughs off skin
* vomit from stomach
* cough up mucus
* flushes out in urine

What do normal flora do?

eradicate pathogens

Second Line of Defense

VASCULAR RESPONSE

* increased capillary permeability → allows plasma & cells to be released into the tissue
* tissue creates a barrier to prevent spread
* inflammatory mediators help widen/loosen the blood vessel

Inflammatory Mediators within WBC’s

messenger → tells body to start defense process

Mast Cells

secrete histamines

* body vasodilates
* histamines turn ON inflammatory response

Basophils

has enzymes that are released during allergic reactions & asthma

Cytokines

signaling proteins

Monokines

type of cytokines

Cell derived Inflammatory Mediators

* WBC
* PLT
* Endothelial/damaged tissue cells

Plasma derived Inflammatory Mediators

* Complement System

* cleans up damaged cells


* helps your body heal after injury/infection

Plasma derived Inflammatory Mediators

* Kinin System

system in control of pain

* prostaglandins causes pain
* give NSAIDS for pain

Plasma derived Inflammatory Mediators

* clotting system

clots around the problem so it doesn’t spread

What is a histamine?

MOST IMPORTANT VASODIILATOR

* Increase vascular permeability
* produced by mast cells
* seen early in inflammation
* counteracted w/ histamines

Clinical Manifestations of Acute Inflammatory Response

* what does it result in?

Begins seconds after injury

* first sign of inflammation
* arterioles constrict briefly then dilate
* rubor
* tumor (swelling)
* hyperemia
* dolor (pain)
* color (heat)
* altered function

The Cardinal Signs of Inflammation

* heat
* redness
* swelling
* pain
* loss of function

Mnemonic “DOCTOR”

Dolor

lOss of function

Calor

Tumor

lOss of function

Rubor

Treatment for inflammation

__**RICE**__

* reduce blood flow
* decrease pain
* decrease swelling
* block the action of chemical mediators

Healing & Tissue Repair Phases

* Inflammatory Phase

* seal wound
* acute inflammatory response

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Healing & Tissue Repair Phases

* Proliferative Phase

* clear the debris
* restore structural integrity

Healing & Tissue Repair Phases

* Remodeling Phase

* restore functional integrity

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Primary Intentions

* less risk of infection
* less scarring
* wound edges are lined up

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Secondary Intentions

* increased risk for infection
* increased risk for scarring
* slower healing
* wound is open & heals from wound to floor up

Complications of Healing

* infection

tissue has a tough time healing

Complications of Healing

* ulceration

resistant to healing

* redness
* inflamed
* edges are rough

Complications of Healing

* dehiscence

wound reopened

Complications of Healing

* Keloids

too much collagen

Complications of Healing

* Adhesions

fibrous connection between cavities & tissues

Chronic Inflammation

persistent

* lasting several weeks or longer
* formation of granulomas

Acute Inflammation

the response to sudden body damage

* ex: cutting your finger