Pathophysiology

Do RBC have a nucleus

NO

Osmolarity vs Osmolalily

miliosmoles/L vs miliosmoles/kg

Normal Na+ range in the body

136-145 mmol/L

Normal K+ body levels

3.5-5.0 mEq/L

Normal Ca+ body levels

9.0-10.5 mg/dL

Normal Mg+ body levels

1.3-2.1 mEq/L

Trousseau sign

Sign of hypocalcemia when a blood pressure cuff is inflated and there is palmar flexion.

Chvostek's sign

Involuntary twitching of facial muscles that occurs when the facial nerve is tapped, indicating hypocalcemia

Type 1 Hypersensitivity

Immediate, IgE, anaphlactic

Type 2 Hypersensitivity

Quick onset, antibody-resistant cytotoxicity, IgG, associated with blood, penicillin, etc.

Type 3 Hypersensitivity

Slow onset, Immune complex disease, specific disorders

Type 4 Hypersensitivity

Onset a few days, sensitive T-cells release lymphokines, ex: poison ivy, jewelry, etc.

Angioedema

Severe type of hypersensitivity type 1, usually caused by NSAIDs & ACEI

Anaphylaxis

Rapid, life-threatening, type 1 severe hypersensitivity, use epinepherane

Angioedema vs Anaphylaxis

Symptoms vs systemic

Usually paired together

Common 3 drugs for anaphylaxis

Antihistamines, Corticosteroids, Albuterol

What are the 5 antibody types (can be given through plasma as immunoglobulin)

IgA, IgD, IgE, IgG, IgM

five cardinal symptoms of inflammation

Warmth, redness/hyperpigmentation, swelling, pain, and decreased function.

Where are B and T immune cells produced

Thymus and bone marrow

emetogenic

a substance that can induce nausea and vomiting

Infiltration and extravasation

IV fluids or medications leaking from the vein into surrounding tissue

immune-related adverse events (irAEs)

Adverse events related to immunotherapy.

immunotherapy

Drugs activate immune system to attack cancer cells

nadir

When bone marrow suppression is the greatest and the patient is at highest risk for complications.

neutropenia

Decreased numbers of neutrophil white blood cells, leading to immunosuppression.

primary tumor

The original cancer cells and tumor.

thrombocytopenia

Decreased numbers of platelets, leading to impaired clotting and bleeding.

vesicants

Drugs that can cause severe tissue damage to surrounding tissue if they escape into subcutaneous tissue.

Another word for cancer

maliganancy

Cell regulation (4 parts)

Cell growth, replication, differentiation, and function

Difference between normal cells and cancer cells (4)

Nuclei size, conformity, cell structures, dividing rate

4 steps of metastasis

transformation, vascularization, penetration, invasion

Adeno-

epithelial glands

Chondro-

Cartilage

Fibro-

Fibrous connective tissue

Gilo-

Glial cells (brain)

Hemangio-

Blood vessel

Leiomyo-

Smooth muscle

Rhabdo-

Skeletal muscle

Squamous

Epithelial layer of skin, mucus membranes, and organ lining

Top 3 deadly cancers

Lung, breast/prostate, colon

Top 3 common new cases of cancer

Prostate/breast, lung, colon

Tumor, node, and metastasis (TNM) system

Grades for cancers

Grading the cancer tumor itself

Gx, G1, G2, G3, G4

7 Warning signs of cancer “CAUTION”

Changes in bowel or bladder habits, A sore that does not heal, Unusual bleeding or discharge, Thickening or lump in the breast or elsewhere, Indigestion or difficulty swallowing, Obvious change in a wart or mole, and Nagging cough or hoarseness

Types of cancer surguries

Prophylactic surgery (prevention), Diagnostic surgery, Curative surgery, Debulking surgery, Palliative surgery (pain relief), Reconstructive or restorative surgery

What happens to skin up to 1 year after radiation therapy?

Photosensitivity

Intrathecal drugs

delivers drug directly into CSF

Chemotherapy-induced peripheral neuropathy (CIPN)

loss of sensory perception or motor function of peripheral nerves associated with exposure to certain anticancer drugs

Extracellular fluid (ECF)

Consists of plasma and intersititial fluid

Osmosis

Movement of water through a semipermeable membrane

Hypervolemia

Too much water in the body

Insensible water loss

Body water lost from skin, spit, GI, and lungs

Obligatory urine output

Minimum urine needed to excrete in a day to get rid of toxins (400-600mL)

Hypertonic

High solute concentration drawing water out of cellsHy

Hypotonic

Low solute concentration drawing water into cells

RAAS is started by what from low tissue perfusion

Low BP, low blood volume, low O2, low blood sodium

RAAS steps

Renin, angiotensin 1, angiotensin 2

Aldosterone released from adrenal glands

Water and sodium reabsorber. Potassium excretor.

ADH released by pituitary gland

Only retains water

Naturic peptides (NP) on the heart in response to high BP and blood volume

opposite effect of aldosterone

Cyototoxic T cells

Selectivity attacks/destroys non-self cells.

Natural killer cells

Non selectively attacks and kills non-self cells

Regulatory T cell

Regulates balance between offensive and defensive inflammationthe

Helper T cell

Secretes cytokines and lymphokines to enhance immune activity

Memory cell

Remembers an 1 old specific antigen

Plasma cell

Secretes immunoglobulins

B lymphocyte

Uses helper T cells and macrophages to become sensitive to foreign cell proteins

Basophil

Releases histamines, kinins, and heparin in areas with damage

Eosinophil

Releases vasoactive amines during allergic reactions and parasite infestations

Monocyte

Clears dead debris

Macrophage and Neutrophil

Nonspecific indigestion of foreign proteins and microorganisms

Macrophage and Neutrophil difference

Macrophage assists in cell-mediated immunity. Neutrophil is prominent in inflammation/infection

What spleen does for immune system

Antibody producing organ

Endemic, epidemic, pandemic

Know where and when, in a country contained unexpected increase, crosses country boarders

Wound healing phases (3)

inflammation, proliferation, maturation

Inflammatory Response stages (3)

Vascular, cell exudate (pus high neutrophils), repair

When is the immune system the healthiest

20-30 years old

endogenous vs exogenous infection

patient infection from patient’s flora or from outside environment

IgA function

tags pathogens for destruction lives in the mucous membranes

IgD function

B-cell antigen receptor

IgE function

allergies. Protects against parasites

IgG function

Long term immunity activates upon second exposure

IgM function

B-lymphocyte forms this upon first interaction with a virus. Has up to 10 binding sites.

What issues would you find in someone with hypo/hypernatremia

Altered cerebral function. muscle weakness/twitching

What issues would you find in someone with hypo/hyperkalemia

Life threatening, cardiovascular, intestinal, mental, and muscle changes.

What issues would you find in someone with hypo/hypercalcemia

Neuromuscular, cardio, skeletal, and intestinal changes

What issues would you find in someone with hypo/hypermagnesemia

cardio, neuromuscular changes.

What cells does HIV target

Cells with CD4 on their membrane (T-cells and dendrocytes) by attaching to them with its gp120 molecule

CD4 function

Attach to and communicate with other immune cells

How does HIV reproduce

going into the cell with its RNA retrovirus (which uses reverse transcriptase to add to the half RNA strand and make a whole active bad DNA)

Why is the PTH hormone released.

Low blood calcium levels.

Why is the hormone calcitonin released

High blood calcium levels.

What part of the body controls temperature.

Hypothalamus

Are babies able to shiver

No

A person who takes salt substitutes are likely to have a high mineral level of what?

Potassium

What drug helps control fever

Antipyretics (most commonly acetaminophen)

Prostaglandin (fever creator) is released by what

hypothalamus

What is malignant hyperthermia

Post surgery fever