patho Exam 1 (final cards)

What is atrophy?

What is atrophy?

decrease in cell size

What is hypertrophy?

increase in cell size

What is hyperplasia?

increase in cell #

What is dysplasia?

change in cell size, shape, structure

What is metaplasia?

reversible replacement

• of a mature cell by another less mature cell

Why does atrophy occur?

decreased…

• workload

• use

• blood supply

• pressure

What is Cerebral Atrophy?

• decrease in size of cells in the cerebrum

• decrease in the size of neurons

Why does hypertrophy occur?

increase functional demand

Cardiac Hypertrophy Clinical Manifestation

• SOB

• Chest pain

• syncope

• impaired cardiac function

What is the precursor to cancer

Dysplasia

What is Apoptosis?

programmed cell death

• body send signals → cells kill themself

What is Necrosis?

irreversible cell damage

• death of cell

What Causes Cell Injury?

• physical (break)

• mechanical

• thermal (burn)

• chemical (radiation)

Cervical Metaplasia & Dysplasia Pathology

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

Cervical Metaplasia & Dysplasia Risk Factors

• early sex activity

• multiple sexual partners

• smoking

• HPV

Cervical Metaplasia & Dysplasia Treatment

• Abalation → removal of superficial cells

• Cold Coagulatation

• surgical excision

What is Cellular Proliferation?

new daughter cells generated from division of parent cells

Meiosis

results is ooeytes & sperm

Mitosis

division & proliferation of all nongerm cell

• is continuous

Cellular Differentiation

orderly process of cellular maturation to achieve a specific function

Stem Cells

cells that haven’t decided what they wanted to be yet

Progenitor Cells

cells that have an assignment

• know what they wanna be

Altered Cellular Proliferation & Differention

• gene malfunction goes unrepaired

  • cell is allowed to grow uncontrollably

    • cell loses ability to carry out its specific function

Carcinogens

• radiation

• tobacco

• hormones

• microbes

• chemicals

Carcinogenesis

origin & development of cancer

Oncogenes

code for proteins involved in cell growth or regulation

Tumor-Suppressor Gene

prohibits growth of cells & regulates apoptosis (cell death)

Benign Tumors

• remained localized

• slow growing

• easier to treat

• closely resembles tissue of organ

• may function as normal cells

Malignant Tumors

• invasive & destructive

• proliferates rapidly

• spreads to other sites

• does NOT resemble tissue of origin

Treatment of Cancer

• surgery

• chemo

• radiation

• bone marrow transplant

• immunotherapy

• palliative care

• hormones

Lung Caner Patho

• leading cause of cancer deaths worldwide

• from smoking & industrial exposure

• tumors originate most frequently in epithelial lining of bronchi, bronchioles & alveoli

Lung Caner Clinical Manifestations

• persistent cough

• SOB

• chest pain

• hemoptysis (coughing up blood)

Diagnosing Lung Caner

• Biopsy

• CBC

• Chest X-ray

• Bronchoscopy

Leukemia Patho

malignant neoplasm of blood & blood-forming organs

Leukemia Clinical Manifestations

• anemia

• bone pain

• weight loss

• lymph node enlargement

• fever

• nausea

• bruising

Leukemia Treatment

• chemo

• radiation

• bone marrow OR stem cell replacement

3 Lines of Defense

1. skin & mucous membranes

2. inflammatory response

3. immune response

First Line of defense

healthy skin & tissue

What happens If the invader penetrates the 1st line of defense?

• sloughs off skin

• vomit from the stomach

• coughs up mucus

• flushes out in urine

What do normal flora do

eradicate pathogens

Second Line of defense

VASCULAR RESPONSE

• increase capillary permeability

• tissue creates barriers to prevent spread

• inflammatory mediators help widen/loosen blood vessels

Histamine

MOST IMPORTANT VASODILATOR

• increase vascular permeability

• produced by mast cells

• seen early in inflammation

Acute Inflammation Response Clinical Manifestations

• arterioles constrict briefly

• hyperemia (due to arteriole dilation)

• rubor (redness)

• tumor (swelling)

• exudate

• dolor (pain)

• calor (heat)

• altered functions

Cardinal Signs of Inflammation

• heat

• redness

• swelling

• pain

• loss of function

Mnumonic “DOCTOR”

Dolor

LOss of function

Calor

Tumor

LOss of function

Rubor

Treatment of inflammation

RICE

• rest

• ice

• compression

• elevation

Chronic Inflammation

Persistent injury

• lasting several weeks or longer

  • ex: arthritis

Acute Inflammation

the response to sudden body damage

• Ex: cutting your finger

Rheumatoid Arthritis Patho

• chronic inflammation of synovial membrane & hyperplasia

Rheumatoid Arthritis Clinical Manifestation

• mildly-debilitating

• pain, stiffness

• redness, heat, swelling

• decrease mobility

Rheumatoid Arthritis Treatment

• meds that induce remission

• rest/activity balance

• physical therapy

• splints

• surgery

• swimming

Acute Pancreatitis Patho

caused by:

• duct blockage by gallstones

• excessive alcohol use

Acute Pancreatitis Clinical Manifestations

• dull steady ache

• radiating to back

• nausea, vomiting, anorexia, diarrhea

Acute Pancreatitis Treatment

• IV hydration

• Analgesics

• Surgery to remove gallstones

Chronic Pancreatitis Patho

duct obstruction by enzyme & proteins

• ischemia

• loss of function

• excessive alcohol use

Chronic Pancreatitis Clinical Manifestations

Abdominal Pain

• severe but gets better after eating

• mid or upper r.sided → radiating to back

• diarrhea

• weight loss

Chronic Pancreatitis Treatment

• pain management

• surgery

• behavior mods

  • stop smoking & drinking

  • exercise

  • nutrition

Acute Sinusitis Patho

blockage of ostia & outflow of mucus due to allergy, viruses, & other irritants

• impaired clearance of mucus of cilia

• alt mucus quality

• cystic fibrosis

Acute Sinusitis Clinical Manifestations

• facial pain over sinus region

• fever

• nasal congestion

• x-cessive nasla discharge

• persistent cough

• fatigue

Acute Sinusitis Treatment

• antibiotics

• antihistamines

• decongestants

• nasal spray

• surgical

Chronic Sinusitis Patho

MULTIFACTORAL

• environmental factors

  • allergens

  • persistent factors

• genetic factors

  • metabolic abnormalities

  • immune deficiencies

Chronic Sinusitis Clinical Manifestions

• nasal congestion

• nasal discharge

• fatigue

• sore throat

• pain/facial discomfort

• headache

• chronic cough

• foul breath

Chronic Sinusitis Treatment

• glucocorticoids

• antibiotics

• nasal saline irrigation

• surgery

What is Innate Immunity?

1ST RESPONDERS

• present @ birth

• cells of the immune system surround invader → invader is killed inside immune system cells (phagocytes)

• made up of skin, cornea, mucous membranes that live in Resp, GI, GU tracts

Major cell types of the innate immune system

• macrophage

• neutrophil

• basophil

• Eosinophil

• dendritic cell

• natural killer T cell

What is Adaptive Immunity

A type of immunity that develops when a person's immune system responds to a foreign substance or microorganism, such as after an infection or vaccination.

Active immunity

• development of antibodies to antigens (natural)

• achieved by having specific disease or vaccine (vaccination)

Passive Immunity

• immunity transfer from host to recipient

• achieved via mother → infant transfer injection of antibody

Major cell types of the adaptive immune system

• B-cell

• T-cell

• antibodies

• dendritic cell

• natural killer T cell

Specificty

targeted response to an antigen

Diversity

recognizes a multitude on antigens

Memory

rapid-response to a previously known antigen

Self & Non-Self recognition

can tell a foreign antigen from a normal body

• when this malfunctions = auto immune disease

Cytotoxic T-cells

CD8

• A type of immune cell that can kill certain cells, including foreign cells, cancer cells, and cells infected with a virus.

Helper T-cells

CD4 (master switch)

A type of immune cell that stimulates killer T cells, macrophages, and B cells to make immune responses.

Humoral Immunity

production of B-lymphocytes (fight all over)

• antibodies secreted from plasma cells

  • IgA, IgD, IgE, IgG, IgM

**MEMORY CELLS (take 4-5 days to develop)

Primary Adaptive Immune Response

activation w/ 1st recognition of a specific antigen

Secondary Adaptive Immune Response

reactivation w/later recognition of the same antigen

Altered Immune Function - Host Defense Failure

• antigen variation

• viral latency

• immunodeficiency (primary vs secondary)

Altered Immune Function - Hypersensitivity

• Type I

IgE mediated immediate reaction.

• allergies

Altered Immune Function - Hypersensitivity

• Type II

Antibody-mediated reaction (IgG or IgM antibodies)

Altered Immune Function - Hypersensitivity

• Type III

Immune complex-mediated reaction → autoimmune disease

Altered Immune Function - Hypersensitivity

• Type IV

Cytotoxic, cell-mediated, delayed hypersensitivity reaction.

Altered Immune Function - Autoimmunity

• failure to distinguish self from non-self

• causes damage to specific organs or to the entire system

Altered Immune Function - Alloimmunity

• graft rejection

• graft vs host disease

Altered Immune Function - clinical models

• Anaphylactic Reaction

Exaggerated systemic immune response due to a type 1 hypersensitivity reaction

• antigen exposure stimulates an IgE mediated response in a previously sensitized individual

• degranulation of mast cells & basophils → causes local & systemic response

Anaphylactic Reaction Triggers

• insect stings

• food allergies

• drug allergies

Anaphylactic Reaction Clinical Manifestation

• Phase 1

• difficulty breathing

• skin flushing & itch

• angioedema

Anaphylactic Reaction Clinical Manifestation

• Phase 2

• difficulty breathing

• severe hypotension

• severe edema

Anaphylactic Reaction Diagnosis

• allergy testing

• HX & physical exam

Anaphylactic Reaction Treatment

• Symptomatic

• drugs to relax bronchial smooth muscle

• drugs to constrict vascular smooth muscle

• limit inflammation

Anaphylactic Reaction Treatment

• Preventative

desensitization to allergy

IF an Rh- woman is carrying an RH+ fetus →…….

Rh+ cells enter her bloodstream during pregnancy or childbirth

• she produces Rh+ anti-bodies

Foreign antigens stimulates women’s body to make antibodies →……

Anti Rh+ antibodies bind antigen on RBC’s of Fetus

• Fetus RBC are destroyed

Rh Isoimmunization Pathology

Type II cytotoxic antibody-mediated reaction

• antibodies against the Rh antigen (anti-D) attack RBC’s causing hemolysis

  • often occurs in Rh-negative mothers exposed to fetal Rh- positive antigen

Rh Clinical Manifestations

• fetal effects

• anemia

• hydrops (edema)

• death

Rh Clinical Manifestations

• Infants

• lethargy

• hearing loss

• cerebral palsy

• kernicterus (bilirubin deposits in brain)

Rh treatment

• risk reduction

prenatal visits

Rh treatment

• Prevention

administration of Rh immunoglobulin to prevent maternal sensitization to fetal D antigen

Rh treatment

exchange transfusions to replace damaged RBC’s w/ healthy ones