Patho Exam 1

pathophysiology

study of the disease process

pathogenesis

sequence of cellular and tissue events that take place from the time of initial contact with an etiologic agent until the ultimate expression of a disease - describes how the disease process evolves

etiology

what sets the disease process in motion

risk factors

contributions that increase the chances that a certain disease will occur

types of risk factors

age - alcohol use - drug abuse - ethnicity - smoking - exposure - gender - genetics - isolation - poverty - poor hygiene - sexual practices - inadequate sleep - stress - poor nutrition

what do nurses do

education - motivate - facilitate

disease

interruption, cessation, or disorder of a body system or organ structure - abnormal functioning occurs

illness

the feelings that might come with having a disease - the subjective experience

subclinical/preclinical stage of disease

stage where the disease is present, but the patient is unaware

prodromal stage of disease

vague and non-specific symptoms

clinical stage of disease

disease is evident and identifiable - a diagnosis is clear

sign

objective, measurable

symptom

what the patient is feeling

prognosis

prediction about the outcome of a disease

sequelae

subsequent injuries related to the disease process

complications

new problems in addition to the original disease process

morbidity

number of illnesses per 100,000 people

mortality

number who died per 100,000

incidence

number of new cases

epidemic

rapid increase in incidence noted

passive transport

no energy - diffusion, osmosis, filtration, and facilitated diffusion

active transport

requires energy - includes transport by pumps and vesicles

diffusion

movement of particles from higher concentration to lower concentration

osmosis

diffusion of water down the concentration gradient through a selectively permeable membrane

autosomal dominant

abnormal gene is dominant - only one gene needed to express the trait - no carrier state - heterozygotes have less severe disease than homozygotes - most often signs and symptoms occur at delayed age

rules of inheritance - autosomal dominant

if the disease is present, most likely inherited from at least one parent - spontaneous mutation is rare - if one parent has the disease, 50% chance that each new pregnancy will result in diseased child - males and females equally affected

autosomal dominant inheritance

in a single gene disorder when the defective allele is dominant, it overrides the normally functioning allele and the disorder results - 50% chance of inheriting the defective gene and developing the disorder

marfan syndrom

autosomal dominant - connective tissue disorder with abnormalities in the skeletal, ocular, and cardiovascular systems

familial hypercholesterolemia

autosomal dominant - absent or dysfunctional LDL receptors, so cholesterol manufacture is not suppressed - fatty plaque buildup

autosomal recessive

offspring must inherit two copies of the defective allele before the disease manifests itself - carriers are children who inherit a single copy of the allele - child has a 25% chance of inheriting the defective allele from both parents and developing the disorder

PKU

autosomal recessive - defect in the gene that creates the enzyme PAH that converts phenylalanine to tyrosine, causing a lighter color of hair and skin - infants are routinely screened for PKU at birth

sickle cell disease

autosomal recessive - sickle hemoglobin can form stiff rods within the RBC changing it into a crescent shape - sickle cells are not flexible and can stick to vessel walls, causing blockage that slows or stops blood flow, when this happens, oxygen can't reach nearby tissues

sickle cell anemia

autosomal recessive - mutation causes structural fragility of the sickle cell anemia RBCs, where upon exposure to hypoxia or stress, the RBC contorts into a sickle shape

sickle cell vaso-occlusive crises

sickled RBCs become trapped, blocking blood flow and creating ischemia and consequent tissue hypoxia, which leads to organ damage and possible infarction

cystic fibrosis

autosomal recessive - chloride ions and water are blocked from moving in and out of cells, resulting in thick mucous secretions that block the lungs, pancreas, colon, and genitourinary tract

x-linked diseases

defect is carried on the X chromosome - 50% of males will have disease, 50% of women will be carriers - males cannot be carriers

hemophilia

x-linked - deficiencies of clotting factors cause a failure in producing clots - excessive bruising, hematomas, hemorrhage

multifactorial or polygenic dosorders

cannot predict outcome in offspring - environmental triggers are thought to be necessary for the trait to be expressed - patterns of inheritance are hard to predict, but strong familial tendencies are noted

cleft lip

multifactorial - during development, tissue and cells from each side grow toward the midline and join together - cleft lip occurs when the labial tissue does not join completely before birth, resulting in a cleft

cleft palate

multifactorial - occurs when the tissue that makes up the roof of the mouth does not join together

fetal alcohol syndrome

multifactorial - exposure to excess maternal alcohol consumption while in utero throughout entire pregnancy - retarded physical growth, intellectual disabilities, cardiac defects, and musculoskeletal abnormalities

apoptosis

programmed cell death

failure of apoptosis

can give rise to certain cancers, tumors, and detrimental hyperplasic cell changes

angiogenesis

ability for cancer cells to develop their own blood vessels

carcinogenesis

actual formation of a cancer, whereby normal cells are transformed into cancer cells

benign tumors

well-differentiated - remain localized - well demarcated from surrounding tissue - non invasive - do not break away or travel from the tumor cell mass

malignant tumors

range from well differentiated to poorly differentiated - invasive and destructive to surrounding tissue - lack adhesion to tumor mass and easily break free to travel to different sites

TNM scale

t is for tumor - n is for lymph node involvement - m is for metastasis to distant organs

atrophy

a decrease or shrinkage in size

hypertrophy

increase in cell size ex) lifting weights increases muscle size

hyperplasia

increase in the number of cells - ex) gingival hyperplasia common in pregnant women

metaplasia

reversible replacement of one type of cell with another type of cell in response to injury - ex) in esophagitis, the cells of the lower esophagus change into stomach cells

dyplasia

abnormal changes in size, shape, and organization of mature cells - may be irreversible - a precancerous condition

neoplasia

new growth - malignant or benign - lack normal cell function - divide uncontrollably - lack adhesiveness to other cells - break away and travel - invasive and destructive to other cells - abnormal structure and architecture - secrete inappropriate enzymes, hormones, clotting substance, tumor angiogenesis factor

anaplasia

poor cellular differentiation - reversion of cells to simpler and less differentiated form - not reversible, genetic damage has occurred to cells

hallmark of malignancy

anaplasia

differentiation

the extent that neoplastic cells resemble normal cells both structurally and functionally

lack of differentiation

anaplasia - total cellular disorganization - abnormal cell appearance - cell dysfunction

chemotherapy

cancer treatment used before surgery to shrink large tumors or after surgery to eradicate leftover cells - destroys all rapidly growing cells without differentiation

radiation

used to shrink solid tumors - localization may help reduce damage to surrounding tissues

reversible cell injury

cell experiences temporary damage that can be repaired and restored to normal function - disruption of function - common causes are edema, hypoxia, failure of Na/K pump

cell death

irreversible cessation of all cellular functions and processes

neurofibromatosis

autosomal dominant - genetic defect in tumor suppressing gene that regulates cell differentiation and growth - "elephant man" syndrome

tay sach's disease

autosomal recessive - infants appear normal until 6 months - generally fatal by 5 - characteristically a cherry red spot on the retina

OSHA

occupational health and safety administration - assure safe and healthful working conditions for working men and women by enforcing standards and providing training, outreach, education, and assistance

cyanosis

bluish coloration of the skin and mucous membranes caused by hypoxia

biopsy

a tissue sample removed for microscopic examination

proto-oncogene

genes that stimulate and regulate a cell's movement through the cell cycle, resulting in cellular growth and proliferation

oncogene

stimulate constant, unrelenting cellular proliferation and cell cycling

hypoxia

deficiency of oxygen

hypoxemia

deficiency of oxygen in blood

ischemia

local reduction of blood flow

infarction

an area of dead tissue to an organ caused by lack of blood flow to the area

necrosis

death of a small area of tissue or part of an organ that is surrounded by healthy tissue

gangrene

death of a large portion of tissue

eschar

blackened, thick layer of necrotic tissue often seen in burns and decubiti

viral induced cancer

mechanisms of action differ, but always involve the activation of growth-promoting pathways or inhibition of tumor suppressors in infected cells - ex) cervical cancer associated with HPV

cachexia of cancer

cancer patients who develop a progressive loss of body fat

tumor cell markers

products of cancer cells such as hormones, enzymes, genes, antigens, or antibodies that are found in blood, spinal fluid, or urine

manifestations of cancer

altered function - obstruction - effusion - hemorrhage - anemia - ulceration - necrosis - infection - vascular thrombosis - pain - cachexia - inappropriate production of hormones - hypercalcemia

early warning signs of cancer

change in bowel or bladder habits - a lesion that doesn't heal - unusual bleeding or discharge - thickening or lump noted - indigestion or difficulty swallowing - obvious changes in wart or mole - nagging cough or persistent hoarseness

dysplasia

healthy

benign tumor

malignant tumor - cancer