patho exam 1

Hypermagnesemia causes

-Renal insufficiency or failure

-Excessive intake of magnesium-containing antacids

-Adrenal insufficiency

pathophysiology

the study of the disorder or breakdown of the human body's function

disease occurs when

there is a disruption of homeostasis

homeostasis

relatively constant internal physical and chemical conditions that organisms maintain; self regulating

etiology

study of causes or reasons for phenomena

idiopathic

unknown cause

iatrogenic

produced by a physician (the unexpected results from a treatment prescribed by a physician)

risk factor

A factor that when present increases the likelihood of disease

pathogenesis

development of disease

signs

observed manifestations

symptoms

subjective feeling of abnormality of the body

syndrome

etiology of signs and symptoms has not yet been determined (cold)

fever is objective

101.5

latent period

Time between exposure to first sign or symptoms

(incubation period)

CAN ALSO BE REFFERED TO WHEN SYMPTOMS BECOME MILD OR DISAPPEAR

proximal period

time between first symptom and full blown disease

acute period

the disease is at its height

subclinical stage

patient functions normally

acute clinical course

short-lived; may have severe manifestation

chronic clinical course

may last months to years, sometimes following an acute course

exacerbation

sudden increase in the severity of a disease or its symptoms

remission

decrease in severity; may indicate cure

convalescence

stage of recovery after a disease, injury, or surgical operation

sequela

subsequent pathologic condition resulting from an acute illness

(pnumonia is sequela of flu)

statistical normality

estimate of diseases in a normal population, based on a bell-shaped curve

reliability

test's ability to give same results in repeated measurements

validity

degree to which measurement reflects true value of what it intends to measure

predictive value

extent to which a test can differentiate between presence or absence of a person's condition

sensitivity

probability that a test will be positive when applied to a person with a particular condition

specificity

probability that a test will be negative when applied to a person without a particular condition

individual factors

culture, age, gender

epidemiology

study of patterns of disease involving populations and examining the occurrence, incidents, prevalence, transmission, and distribution of disease in large groups of population

endemic disease

localized to specific area

primary prevention

altering susceptibility or reducing exposure for susceptible persons

secondary prevention

early detection, screening, and management of disease

tertiary prevention

rehab, supportive care, reducing disability and restoring effective functioning

cell membrane

semipermeable

contains receptors

involved in electric conduction

regulates cell growth and proliferation

lipid bilayer

cell membrane proteins

major histocompatibility complex proteins (MHC)

cell membrane receptors

open and close ion channels, activate G protein linked signal, activate enzyme linked cell function

passive cell transport

Cell doesn't use energy to transport materials

osmosis

diffusion of water

diffusion

Movement of molecules from an area of higher concentration to an area of lower concentration.

facilitated diffusion

Movement of specific molecules across cell membranes through protein channels

active transport

Energy-requiring process that moves material across a cell membrane against a concentration difference

endocytosis

process by which a cell takes material into the cell by infolding of the cell membrane

pinocytosis

phagocytosis

pinocytosis

Cell drinking

phagocytosis

Cell eating

exocytosis

Process by which a cell releases large amounts of material

most diseases start with

cell injury, which is reversible, and in normal states is balanced with cell renewal

physiologic cell death

Death of a cell at the end of its normal lifespan

apoptosis (immune, protection)

programmed cell death

normal process of cell replacement and development; balance between death and regeneration

cell injury physical agents

mechanical, temperature, electrical

cell injury radiation agents

ionizing, ultraviolet, non-ionizing

cell injury chemical agents

poison, drugs

cell injury biological agents

nutritional imbalances

ischemia

not enough oxygen in blood

necrosis

tissue death

mechanisms of injury

ischemia, necrosis, free radicals

free radicals

chemical particles with an odd number of electrons

failure to prevent/repair contributes to cancer, aging, and degenerative diseases

antioxidants

can prevent and repair damage from free radicals

necrotic cell death (coagulate)

gelatinous protein; firm and opaque

necrotic cell death (liquefactive)

-brain & neurons

-walled-off liquid goo

necrotic cell death (caseous)

mycobacterium

cased off, encased globules

necrotic cell death (fatty)

breast, pancreas, glandular tissue

opaque, chalky soap

gangrene

caused by hypoxia injury

dry gangrene

Coagulative

wet gangrene

liquefactive

gas gangrene

clostridium (tissues not just cells; release gas into tissues)

somatic death

death of the entire organism

absence of respirations and heartbeat

rigor mortis within 6 hours

tissue deterioration and postmortem autolysis within 24-48 hours

postmortem autolysis

Breaks down muscle and other tissues

allostasis

-overall process of adaptive changes necessary to maintain survival and well being

-helps body achieve homeostasis

-may involve altering multiple physiological variables to match the resources of the body to environmental demands

stress

anything that disrupts homeostasis

physical state of tension

can be pos or neg

hans 3 stages

General Adaptation Syndrome (GAS)- alarm, resistance, exhaustion

hans seyle

observed bodily changes produced by stress

influenced by: natural reserve, time, genetics, age, gender, health issues, nutrition, sleep, hardiness, physiological factors

alarm stage

fight or flight

hypothalamic pituitary adrenal axis (HPA)

resistance stage

-second stage of the stress response; body attempts to return to homeostasis

-allostatic state

exhaustion state

-point where body is no longer able to return to homeostasis

-allostatic overload

Catecholamines

(norepinephrine and epinephrine) play a role in Allostasis, sympathetico adrenal system response mediates fight or flight

immune cytokins

Secreted by macrophages during stress --response. Enhance immune system response.

Prolonged stress can suppress immune functioning

adrenocortical steroids

cortisol and aldosterone

Critical to maintenance of homeostasis

May synergize or antagonize effects of catecholamines

sex hormones

dehydroepiadosterone, estrogen, and testosterone

effect stress response influencing allostasis

may help explain gender responses during stress

endorphins and enkephalins

natural painkillers

endogenous opioids

raise pain threshold

produce sedation and euphoria

growth hormone and oxytocin

can increase during stress to enhance immune function

prolactin

similar to structure of growth hormone

role in immune response

oxytocin

produced during childbirth lactation

associated with bonding

thought to mod stress response (calming)

coping

ability to deal with stressor

physical activity, sleep, diet, relaxation, distraction and biofeedback all play roles

maladaptive coping

Smoking, substance abuse, and overeating

body fluid

water within the body and the particles dissolved in it (intra and extra cellular)

total body water

maintained via fluid intake (oral and IV) fluid absorption, fluid distrtibution and fluid excretion

intravenous solutions

isotonic (.9% saline and lactated ringers), hypotonic (.45% saline), hypertonic (5% sugar, in .9% saline)

sources of fluid loss

urine, feces, emesis, wound drainage, blood loss, hemorrhage

insensible loss

sweat and water vapor in breath

extracellular fluid volume

Volume deficit or excess in the extracellular fluid compartment

body fluid concentration

The thirst center is stimulated when this is increased (hypo/hypernatremia)

interstitial fluid volume imbalance

edema

electrolyte abnormalities

imbalance in sodium, chloride and water balance

isotonic fluid loss; bleeding

isotonic fluid excess; IV fluid

isotonic alterations

total body water change with proportional electrolyte and water change; no change in concentration

normal: 135-145 mEq/L

hypernatremia causes

serum sodium is greater than or = 145 mEq/L

related to sodium gain or water loss

water movement from ICF to ECF (intracellular dehydration)

hypernatremia manifestations

Clinical: secretions of ADH from pituitary gland

weight gain, bounding pulse, increased blood pressure)

CNS: muscle twitching and hyperflexia, hyperactive reflexes, confusion, convulsions, cerebral hemorrhage and coma)

hypernatremia fried salt

FRIED

F - Fever (low), flushed skin

R - Restless (irritable)

I - Increased fluid retention & increased BP

E - Edema (peripheral and pitting)

D - Decreased urinary output, dry mouth

SALT

S - Skin flushed

A - Agitation

L - Low-grade fever

T - Thirst

CAUSE: MODEL

Medications, meals

Osmotic diuretics

Diabetes insipidus

Excessive water loss

Low water intake