Unit 6 - Medical

Characteristics of Bacterial Infections

* DNA only
* Either gram negative or gram positive
* Antibiotics typically effective
* Biofilm - films of bacteria (attacked by antibiotic); reason people get their tonsils removed
* Cysts

Characteristics of Viral Infections

* RNA or DNA
* Cellular takeover
* Retrovirus - inserts a DNA copy of its RNA genome into the DNA of a host
* Vaccines offer prevention
* Antibiotics typically not effective
* Potentially long contagious period
* Rapid mutations - RNA viruses can change, DNA viruses do not change (usually)
* Vaccines tend to be specific to the type of antigen
* Incredibly dangerous if uncontrolled (ex: only 3 people survived rabies)

What types of immunity can vaccines provide? (x2)

Sterilizing immunity - take the vaccine, never get that disease

Effective immunity - moderates virus, slows down, gives the body a better chance

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Purpose: your body can get used to a specific virus so it can fight back

Aspects of the innate system

* Physical barriers
* Mucous Membranes
* Bactericidal Fluids
* Macrophages
* Scavenger cells
* Kills everything and doesn’t care

Aspects of the adaptive system

* Cell based
* T cells
* B cells
* NK cells
* Antibodies

NK cells

NK = natural killer cells

* look for infected cells with a virus and kill them before they can produce any more of the virus

A simple way to remember the innate and adaptive immune system…

Simple innate: think walls, inflammation, swelling, blocking

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Complex adaptive: think assassins, precision, takes time to ramp up, specific to an invader

3 key points of cancer

1. Runaway cell division
2. Specific Cancer Pathway
3. Metasize or stay in one spot

Specific cancer pathway (journey) includes…

* dexposure to carcinogen
* activation of proto-oncogene
* suppression of tumor suppressor
* activated oncogene
* runaway cell growth
* disruption of physiology
* death

How can cancers be identified?

Via total body MRI’s

Stage 1 Cancer

Small number of cells bounded by a membrane in one location

Stage 2 Cancer

The cancer is growing exponentially, still bounded by a membrane and still in one location

Stage 3 Cancer

* Membrane ruptured
* Cells metastasized (could be everywhere)

Should cut them out and treat them with a gamma knife

Stage 4 Cancer

Terminal cancer; people don’t come back from it (in terms of time left

Para-neoplastic Syndrome

A group of rare disorders that occur when the immune system has a reaction to a cancerous tumor known as a "neoplasm”

* the body’s NK cells go overdrive
* Random

Dying and Death mean…

Sensation of effort and stopping of effort

Dissociation in death and dying:

* separating oneself from the environment
* creation of distance

Gallows Humor

Processing and Deflection

* A way fro medical professionals to process and deflect themselves from the situcation

CISD

CISD: Critical Incident Stress Debriefing

* The process in which teams of professional and peer counselors provide emotional and psychological support to incident personnel who are or have been involved in a critical (highly stressful) incident

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Be aware of the steps!

How does one’s passing (death) come by?

* Number of slow breaths
* Lose of moisture in eyes
* Pupils fix and dilate
* Usually people pass out before they die
* Dead Weight

DNR

Do Not Resuscitate form (pink slip)

* PT doesn’t want us to perform CPR, take to an ER, etc (depends)
* Can be overriden if PT verbally overrides it

Mast cells

Allergy cells responsible for immediate allergic reactions

* huge, inside a blood vessel, scans the blood stream for threats

The process of getting an allergic reaction:

Mast cells are allergy cells responsible for immediate allergic reactions. They cause allergic symptoms by releasing products called “mediators” stored inside them or made by them. In allergic reactions, this release occurs when the allergy antibody __IgE__, which is present on the mast cell surfaces, binds to proteins that cause allergies, called allergens. This triggering is called activation, and the release of these mediators is called degranulation.

What happens in your body when you have an allergy?

Your body doesn’t produce mast cells, basophils, eosinophils, when a person is young and aren’t exposed to certain things/food

* should try to get exposed to many things before 9 m/o (6 m/o

Anaphylaxis is a form of…

Distributive shock

When you have an allergic reaction, what do you do?

1. Call EMS
2. See if there is an EpiPen and help if needed
3. Keep calm or try to keep the person calm who is having an allergic reaction
4. Lie on your back or help the person lie on their back

key management strategies in Behavioral/Psychiatric

* Stay calm
* Stay apart
* Stay present (never leave the PT alone)
* Stay breathing
* Stay Safe - Get EMS

Histamine Pathway Blockers (x3)

* Zofran
* Phenergan
* Bendryl

Adult dosage vs Geriatric dosage

Explain the difference

Adult = 25 mg

Geriatric is 1/4 that amount

Geriatric = 6.25 mg

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As you get older, drugs last and leave longer in the system

Describe the stages of shock

point of assault → compensated → decompensated → irreversible

Types of shock

* Cardiogenic - pump failure
* Distributive - not enough fluid
* Obstructive - block in pipes


* Sepsis - bacteria breaks down capillary beds 
* Extreme response after an infection
* Complication of an infection - body responds improperly to an infection

Type 1 vs Type 2 Diabetes

Type 1

* the immune system is attacking and destroying the insulin-producing cells in your pancreas
* born with it

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Type 2

* cells don’t normally respond to insulin
* develops over time (age, obesity, diet, etc)

Borderline personality disorder (BPD)

long period of time, impulsive, fear of abandonment, reckless behavior, over attachment

What happens when a male happens tearing stomach pain?

What happens when a female happens tearing stomach pain?

Male having tearing stomach pain → abdominal aortic aneurysm (AAA)

Female having tearing stomach pain → ectopic pregnancy (if not ectopic pregnancy → AAA)

Disseminated intravascular coagulation (DIC)

End point of sepsis or cancer

* Small blood clots develop throughout the bloodstream, blocking small blood vessels. The increased clotting depletes the platelets and clotting factors needed to control bleeding, causing excessive bleeding
* Not a bleeding disorder, it is a clotting disorder

5Fs

5Fs - female, fat, fair, non fertile, forty

* If two or more of the 5 F's are present, your cardiac symptoms are random (ie; *not* crushing chest pain)

Parasites

* Pinworms - enter through the genitals (oral fecal route)
* Hookworm - going through the feet
* Ringworm is fungus

Know the Hepatitieses

* Hepatitis A is spread through the stool of an infected person
* Hepatitis B is spread through bodily fluids,
* Hepatitis C is spread through blood

None of them are spread through touching a person who is affected (oral fecal route only and bloodborne)

Toxidromes

* Anticholinergic
* Cholinergic
* Opioid
* Sedative-Hypnotic
* Sympathomimetic
* Histanergic/Nicotinic

Coma vs seizure vs Persistent vegetative state

Coma: a state of unresponsiveness in which the patient cannot be aroused with stimulation

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Seizure

* Absent seizures
* Focal / petit mal seizures
* Grand mal
* Diabetic

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Persistent vegetative state: a condition in which a medical patient is completely unresponsive to psychological and physical stimuli and displays no sign of higher brain function, being kept alive only by medical intervention.