HOSA General Terms

Pathology

Study of disease; desc. of traits, causes, effects of abnormal conditions; Includes anything affecting homeostasis of body

Pathogenesis

Development of disease; incubation period, symptoms, remission, convalescence; Varies with patient, causes, medical interventions

Acute

Abrupt onset, brief course (>6 months)

Chronic

Disease develops slowly, intermittently, or lasts 6+ months

Elements of Pathogenesis

Predisposing factors, access to preventive health care, genetics, infection, inflammation, neoplasms, physical trauma, malnutrition, immune disorders, age, mental health

Predisposing Factors

Risk factors; Make person more vulnerable to disease; Does not predict development of disease; Age, Gender, Lifestyle, Environment, Heredity

Acute Inflammation

Normal protective response to tissue injury/disease. Attempts to wall off, destroy, and digest bacteria and dead/foreign tissue

Widespread Inflammation

Systemic symptoms of fever, malaise, loss of appetite associated w/. Elevated white blood cell count or elevated erythrocyte sedimentation rate (ESR). Infection, toxins, traumas, ischemia, or necrosis may initiate this nonspecific immune response

Phagocytes

Prevents infection spread by releasing cells w/ specific immune activity. White blood cells e.g.

Infection

redness, swelling, heat, pain, fever, pus, enlarged lymph glands, red streaks; disease-causing organisms (1) Invade and destroy local tissue (2) Intoxicate by producing poisons to body; endogenous/exogenous; By bacteria, viruses, fungi, or protozoa

Infection Defenses

Natural mechanical/chemical barriers (skin, cilia, body pH), acute inflammation, immune response; If defence fails, medical intervention required to identify agent and use antimicrobial therapy

E. Coli

Found in colon, manure. Can cause Enteritis, mild/severe

Staphylococcus aureus

Found in skin, hair, anterior nares; can cause pneumonia, cellulitis

Streptococcus (beta-hemolytic group A) Organisms

Found in oropharynx, skin; causes strep throat, rheumatic fever

Streptococcus (beta-hemolytic group B) Organisms

Found in adult genitalia; can cause UTls

Mycobacterium Tuberculosis

Found in lungs; causes tuberculosis

Neisseria gonorrhoeae

Found in genitourinary tract, rectum; causes gonorrhea, pelvic infla, conjunctivitis

Rickettsia rickettsi

Found in wood ticks; causes Rocky Mountain Spotted Fever

Staphylococcus epidermidis

Found on skin; causes bacteremia, wound infection

Hepatitus A

Found in feces, blood, urine; causes infectious Hepatitus

Hepatitus B

Found in feces, blood, all body fluids; causes serum Hepatitus

Herpes Simplex

Found in mouth lesions, skin, blood; causes cold sores, STDs

HIV

Found in blood, semen, vaginal fluids; causes AIDS

Hantavirus

Found in deer, mouse urine, feces; causes upper respiratory infection to lower respiratory infection to ARDS

West Nile

Mosquito-borne; causes fever, rash, Hepatitus, Encephalitis

Aspergillus

Found in soil, dust; causes aspergillosis

Candida albicans

Founds in mouth, skin, colon, genitals; causes thrush, dermatitis

Plasmodium falciparum

Found in mosquitos; causes malaria

Superbugs

Emergent, virulent, antibiotic resistant; MRSA causing fatal pneumonia, bone infections

Genotype

Genetic code of human chromosomes

Karyotype

Ordered arrangement of photographs of full chromosome set

Genetic Disorders

Produced by abnormality/mutation of genetic code on single gene, several abnormal genes (polygenic), or abnormal presence/absence of entire chromosome

Agents

Mutagens that can damage DNA; Chemicals, radiation, viruses

Phenotype

What is seen and expressed due to genetic coding

Autosomal Dominant

Gene located on autosome w/ mutant phenotype seen even if a normal gene is on the other chromosome; e.g. Marfan’s, Huntington’s

Autosomal Recessive

Gene located on autosome but insufficient to produce mutant phenotype in presence of normal gene on other chromo; Both must be afflicted to show; e.g. cystic fibrosis, phenylketonuria

X-linked Recessive

Sex linked; Located only on X chromo; Males much more affected; e.g. Duchenne’s Muscular Dystrophy, hemophilia A

Defective Gene Carriers

Individuals w/ one copy of chromo w/ recessive gene

Genetic Counseling

Communication process centered on occurrence or risk of genetic disorder in family; offered to all families affected by diagnosis of genetic disease; helps bridge gap between complex science and emotion of certain conditions; Talks w/ family, involves genetic testing, fixes discrimination

Cancer

Development of tumors/neoplasms, relentlessly growing mass of abnormal cells that proliferate at expense of organisms; Tumors benign/malignant

Carcinoma

Cancer of epithelial cells

Sarcoma

Cancer of supportive tissue; e.g. bone, muscle

Lymphoma

Cancer of lymph nodes and tissues of immune system

Leukemia

Cancer of blood cell precursors

Melanoma

Cancer of melanin-producing cells

Benign Tumors

Develop slowly, arising from any tissue; Do not infiltrate surrounding tissue; Complications arise as they take up space, results in compression of tissue by lesion or obstruction of organs; Resemble tissue of origin, no tissue destruction; Surgically removed w/ low recurrence rate

Malignant Tumor

Threat to life; Rapid growth, invasive to other tissue; Does not resemble tissue of origin, varying in size/shape, abnormal appearance; Metastasis; recurrence common; Cachexia

Cachexia

Pain; fatal if not controlled

Metastases

Secondary tumors; Makes neoplasm difficult to remove as cancer cells are carried by blood and lymphatics to other places

Causes of Cancer

Carcinogens, e.g. chemicals, radiations, viruses; Internal factors, e.g. hormones, immune conditions, inherited mutations; Frequency of cancer inc. w/ age

Cancer Prevention

Low-fat, high-fiber diet rich in fruits w/ Vitamins A/E; Elimination of active/passive smoke exposure; limited exposure to sunlight, avoidance of heavy alcohol use, radiation, carcinogens; Physical activity

Screening

Examination that can detect cancers of breast, rectum, colon, prostate, cervix, testes, tongue, mouth, and skin early; Finds tumor markers through blood serum levels

Cancer Stages

Reflects tumor size and extent of spread; Implications on choice of treatment + prognosis; standardized

TNM Staging System

Staging system most common; Assesses neoplasm based on size or extent of primary tumor (T), extent of regional lymph node (N), and number of distant metastases (M); Combined to stage number I/II/III/IV, advanced stage increasing (IV most); Subcategories defined as Ia, Ib, etc. to further aid treatment

Prognosis

Estimation of likelihood of cancer recurrence and death, independent of treatment given; A percentage for survival over 5 years; based on age, serum concentration of tumor markers, time between diagnosis/treatment, grade of tumor; tumor grade determined by microscopic evaluation, based on degree of differentiation of tumor cells

Well-Differentiated

Low-grade tumor cells which retain features of tissue cells they were derived from

Poorly-Differentiated

High-grade tumor cells which are abnormal in appearance, not resembling tissue from which they are derived; Faster mitosis, poorer survival

Gleason Grade

For prognosis of prostate cancer, due to knowledge of diff. patterns of growth and multiple patterns coexisting in prostate; Two predominant patterns scored 1-5 (1=well-diff, 5=poor), summed 2-10, correlating to extent of disease

Neoadjuvant Therapy

Preoperative measure to shrink tumor and facilitate surgical removal

Cancer Surgery

Attempt to achieve negative margins around tumor, removing certain amount of normal tissue w/ tumor to ensure entire tumor removal; Concurrently, regional lymph nodes evaluated to determine if cancer invaded lymphatic systems, removing affected nodes; Palliative surgery to relieve troublesome symptoms, e.g. obstruction; Relief achieved by tumor resection, bypass, stenting, or laser ablation

Chemotherapy

Use of chemical agents to destroy cancer cells; most drugs affect cell replication, chemo most effective against rapid mitosis; Side effects: alopecia, anorexia, vomiting, anemia, bruising, infertility

Hormone Therapy

Effective in hormone-dependent cancers, e.g. breast, prostate; Involves administration of drugs that suppress hormone synthesis, e.g. LHRH antagonists or aromatase inhibitors; Includes surgical removal of glands, e.g. oophorectomy, orchiectomy

Immunotherapy

Use of monoclonal antibodies designed to target certain products of cancer cells not found in normal cells; e.g. trastuzumab (Herceptin) for breast cancer HER2/neu protein

Hospice

Terminally ill put in this care for compassionate, holistic management

Angiogenesis Inhibitors

Stopping growth of new blood vessels can cause tumors to shrink; potential new cancer therapy; e.g. angiostatin or endostatin as inhibitors

Oncogenes

Genetic switches causing healthy cells to become disorderly

Immune Disorders

Breakdown in human defense system resulting in hypersensitivity (allergy), autoimmune diseases, or immunodeficiency disorders

Allergen

Substance ordinarily considered harmless that results in allergic disease instead; e.g. inhalants (dust, molds, fungi), food, drugs, physical agents (heat, cold, radiation)

Antigen

Substance causing allergic response; Initial allergen that is exposed; stimulates production of immunoglobulin E (IgE) antibodies sensitizing individual; Afterwards, subsequent exposures triggers antigen-antibody reaction releasing histamine etc, resulting in congestion, sneezing, coughing, etc.

Anaphylaxis

Severe, rapid, maybe fatal allergic reaction; Causes immune system to release excessive chemicals leading to airway constriction, low BP, shock; Epinephrine treatment essential

Status asthmaticus

Asthma attack that cannot be treated with normal inhalers

Autoimmune Diseases

Antibodies formed against self-antigens mistakenly labeled as foreign, confusing body, e.g. Hashimoto’s disease, rheumatoid arthritis

Immunodeficiencies

Characterized by decreasing # of T/B cells, leaving body unable to adequately defend itself; Can be secondary to disease or infection due to damaged immune disorder, e.g. drugs, radiation, surgery

Elderly Physical Exam

50+ yo; Includes blood cholesterol measurements for hyperlipidemia, ECG for heart disease, rectal exam for bowel cancer/prostate enlargement, BP check for hypertension, Pap smear for cervical cancer, mammogram for breast cancer, urinalysis for diabetes of renal disease

Systems Review

Physical exam head to toe to detect physical signs of disease

Auscultation

Trained listening

Complete Blood Count (CBC)

Complete Blood Count; Includes Red BC, Red BC indices, White BC, white BC differential, hemoglobin, hematocrit, platelet count, hematogram

Hemoglobin (HgB)

Measurement of Oxygen-carrying pigment of RBC

Hematocrit (HCT)

Measurement of % of RBC in volume of whole blood

Chemistries

Normal chemistry profiles contains blood serum levels for albumin, alkaline phosphatase, aspartate aminotransferase, bilirubin, calcium, creatinine, lactate dehydrogenase, phosphorous, total protein, urea nitrogen, and uric acid

Thyroid Function Tests

Thyroid thyroxine (T₄), triiodothyronine (T₃), thyroid-stimulating hormone (TSH)

Lipid Profile

Total cholesterol, triglycerides, high-density lipoproteins (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol

Electrolyte Tests

Blood serum tests for Cl, K, Na, CO₂

Coagulation

Clotting/Coagulation studies for partial thromboplastin time (PTT), prothrombin time (PT), platelet (thrombocyte) count, bleeding times

Erythrocyte Sedimentation Rate (ESR)

RBC (erythrocytes) fall out of well-mixed whole blood to bottom of test tube

Glucose Tolerance Test (GTT)

For fasting blood glucose (FBG) levels

Drug Level Tests

Digoxin, digitoxin, theophylline, lidocaine, Li, etc.

Arterial Blood Gas (ABG) Analysis

Measurements of dissolved O/CO₂; also pH and O₂ saturation of arterial blood

Cardiac Enzymes Test

Creatine kinase (CK), CK isoenzymes, lactate dehydrogenase (LD), LD isoenzymes, aspartate aminotransferase (AST, SGOT), alanine aminotransferase (ALT, SGPT)

C-Reactive Proteins (CRP)

Blood test to detect bacterial infection or inflammatory disorders; indicator of possible acute myocardial infarction

Urinalysis (UA)

Shows state of urinary tract; pH and specific gravity of urine, presence of ketones, protein, sugars, bilirubin, urobilinogen; Note of color and odor; presence of abnormal BC, casts, bacteria, other cells, or crystals

Culture and Sensitivity (C&S)

Culture and Sensitivity of urine; Culture: sample of urine placed on medium to see Y/N microbial growth, if growth pathogenic microbe detected; Sensitivity: portion of specimen placed on sensitivity disk impregnated with antibiotic to determine if pathogen resistant or responsive

ECG/EKG

Record of electrical activity of myocardium to diagnose ischemia, arrhythmias, conduction difficulties, activity of cardiac medications

Echocardiogram

Ultrasound of cardiac structure; Shows size, shape,  thickness, position, movements of cardiac structures, e.g. valves, walls, chambers

Holter Monitor

Miniature electrocardiograph that records electrical activity of heart for extended periods, 24-48 hrs; patient records all activity during to correlate activity w/ cardiac abnormalities

Thalium Scan

Indicates myocardial profusion and location/extent of myocardial ischemia + infarction to predict possible prognosis of cardiac condition

MUGA Scan

Assesses function of left ventricle + identifies abnormalities of myocardial walls

Exercise Tests

Stress tests, treadmill, etc. assess cardiac function during mild exercise after 12-lead ECG

Pulse Oximeter

Spectrophotometer provides noninvasive measurement of O₂ saturation of arterial blood

Catheterization

Fluoroscopic visualization of R/L side of heart by passing catheter being passed into coronary vessels where dye is injected and images recorded