EXAM 2 PATHO

Inflammation def

• Body's response to injury or infection aimed at removing harmful stimuli and initiating healing

signs of inflammation

• Redness - rubor

• heat - calor

• swelling - tumor

• pain - dolor

• loss of function

Neutrophils purpose

first repsonders

Macrophages purpose

phagocytize pathogens and debris

Lymphocytes purpose

Manage immune response

Keloid Formation

Excessive collagen causes thick scar tissue

Contractures

Excessive tightening of tissue leads to limited movement

Dehiscence

Wound reopens after partial healing

Evisceration

Internal organs protrude through a wound

Stricture

Narrowing of a tubular structure

Fistula

Abnormal connection between organs or tissues

Adhesions

Bands of scar tissue form, connecting tissues that shouldn’t be connected

fever pathophysiology

Pyrogens (e.g., cytokines) cause the hypothalamus to raise the body’s temperature set point

stages of fever

1. Prodromal: General malaise, fatigue.

2. Chill: Body temperature rising, shivering.

3. Flush: Skin becomes warm as the body releases heat.

4. Defervescence: Fever breaks; sweating occurs

benefits of a fever

• enhances immune function

• inhibits pathogen growth

risks of a fever

• febrile seizures in children

• dehydration

• excessive tissue damage

• brain damage

what medications can i use to reduce fever

• tylenol

• aspirin

how do medications reduce fever

inhibit prostaglandin production

Primary Intention

• Wound edges are brought together (e.g., surgical incision).

• Minimal scarring

Secondary Intention

• Wound heals by granulation tissue formation (e.g., large, open wounds).

• Regeneration takes longer and needs new tissue

• Increased risk for scarring

Tertiary Intention

• Delayed closure of a wound due to infection or other factors

• A combination of primary and secondary

• Usually left open to heal

• contaminated

• skin graft needed

• more scarring

Phases of Wound Healing

1. Hemostasis - Blood clot formation to stop bleeding.

2. Inflammatory Phase - White blood cells clear debris and prevent infection.

   • 5 cardinal signs of infection

3. Proliferative Phase - create new blood vessels to heal

   • Formation of granulation tissue, angiogenesis, and wound contraction.

4. Maturation/Remodeling Phase - Collagen is remodeled to increase strength.

   • Scar tissue forms but is weaker than normal skin

Systemic Factors Involved in Wound Healing

• Age: Older age slows healing.

• Nutrition: Adequate protein and vitamin C are critical.

• Oxygenation: Hypoxia slows tissue repair.

• Chronic diseases: Diabetes, immunosuppression, and cardiovascular issues hinder healing.

Local Factors Involved in Wound Healing

• Infection: Slows healing and increases scar formation.

• Mechanical stress: Tension or movement disrupts repair.

• Foreign bodies: Inhibit wound closure

Histamine is made

• mast cells

• basophils

• platelets

histamines cause

• arteriolar vasoconstriction (congestion)

• large arteriolar vasodilation (anaphylactic shock)

• increased permeability in the venules

histamines result in

• allergic responses

• runny nose

what do antihistamines do?

work to combat symptoms of histamines

Prostaglandins are derived from

arachidonic acid

Prostaglandins cause

• fever

• pain

• muscle spasms

cox 1

helps with mucous production to aid gastric mucosa

cox 2

causes inflammation, pain, swelling

NSAIDS ___ the cox pathway

inhibit

• provide pain relief

Prostaglandins are involved in

fever response by acting on the hypothalamus

NSAIDS block

prostaglandin production to reduce inflammation and pain

IgG

• Most abundant

• second in line

• provides long-term immunity after exposure or vaccination

IgA

• Found in mucosal areas (e.g., respiratory and digestive tracts) and secretions (saliva, tears, breast milk).

• Protects body surfaces from foreign invaders

IgM

• First immunoglobulin produced in response to an infection.

• Largest antibody and primarily found in the blood and lymphatic fluid

IgE

• Involved in allergic reactions

• Binds to mast cells and basophils, triggering histamine release

IgD

• Found on the surface of immature B cells

• Plays a role in initiating B-cell activation

• early stages of infection

Bacterial Meningitis etiology

Neisseria meningitidis

Bacterial Meningitis signs and symptoms

• Sudden high fever

• severe headache

• stiff neck

• photophobia

• altered mental status

• Petechial rash (specific for meningococcal meningitis).

Bacterial Meningitis Diagnosis

Lumbar puncture to analyze cerebrospinal fluid (CSF)

Bacterial Meningitis Treatment

• Immediate broad-spectrum antibiotics (e.g., ceftriaxone, vancomycin) until pathogen identification.

• Corticosteroids may be used to reduce inflammation

Bacterial Meningitis transmission

• droplet

• person to person

Erythema Infectiosum (5th Disease) Etiology

Caused by Parvovirus B19

Erythema Infectiosum (5th Disease) Signs and Symptoms

• slapped cheek / rash on face

• fever

• fatigue

• joint pain

Erythema Infectiosum (5th Disease) diagnosis

serology tests for parvovirus antibodies

Erythema Infectiosum (5th Disease) treatment

• supportive care (fluids, pain relief)

• goes away on its own

Erythema Infectiosum (5th Disease) transmission

droplet

Rubella etiology

rubella virus

Rubella signs and symptoms

• low grade fever

• rash

• swollen lymph nodes

• joint pain

• maternal fetal transmission

Rubella maternal fetal transmission can cause

• stillbirths

• abortions

• congenital defects for fetus

Rubella diagnosis

serological testing for rubella antibodies (IgM)

Rubella treatment

MMR vaccine (measles, mumps, rubella)

Rubella transmission

droplet

tapeworm etiology

• Taenia solium (pork)

• Taenia saginata (beef)

tapeworm signs and symptoms

• abdominal pain

• nausea

• weight loss

• segments of the worm in stool

tapeworm diagnosis

stool sample for eggs or worm segments

tapeworm treatment

anti-helminth drugs

tapeworm transmission

oral

Coccidioidomycosis (Valley Fever) etiology

Coccidioides immitis

Coccidioidomycosis (Valley Fever) signs and symptoms

• fever

• cough

• chest pain

• fatigue

• joint pain

Coccidioidomycosis (Valley Fever) diagnosis

chest x-ray

Coccidioidomycosis (Valley Fever) treatment

antifungal medication

Coccidioidomycosis (Valley Fever) transmission

airborne spores

Vaginal Candidiasis (Yeast Infection) etiology

candida albicans (yeast)

how does a yeast infection start

• overgrowth of candida albicans, a flora in the vagina

• moisture

• increased estrogen

Vaginal Candidiasis (Yeast Infection) signs and symptoms

• itching

• burning

• white cottage cheese discharge

Vaginal Candidiasis (Yeast Infection) diagnosis

• microscopic examination of vaginal discharge

• culture

Vaginal Candidiasis (Yeast Infection) treatment

antifungal medications

Vaginal Candidiasis (Yeast Infection) transmission

direct contact

innate immunity

• first line of defense

• non-specific (skin, mucous membranes)

• born with it

• EX: inflammation, fever, macrophages

adaptive immunity

• specific and slow defense

• memory cells (T and B cells)

• long lasting immunity

T lymphocytes

• made in the thymus

• C4 and CD8

normal CD4:CD8 ratio

2 to 1

HIV infection CD4:CD8 ratio

1 to 2

B lymphocytes

• bone marrow

• secrete Igs

adaptive immunity breaks off into two parts

1. humoral immunity (B-cell)

2. cell-mediated immunity (T-cells)

active acquired immunity

vaccines

passive acquired immunity

• actual antibodies

• created by T and B cells

type 1 hypersensitivity - immediate

• IgE and mast cells

• EX: allergies and asthma

type 1 hypersensitivity signs

• hives

• swelling

• bronchospasm

• hypotension

type 1 hypersensitivity treatment

• antihistamines

• epinephrine for anaphylaxis

type II hypersensitivity - cytotoxic

• antibody mediated

• IgG or IgM

• antibody targets cell → cell destruction

type II hypersensitivity examples

blood transfusion

type II hypersensitivity treatment

• immunosuppressive therapies

• corticosteroids

type III hypersensitivity - immune complex disorders

antigen-antibody complex deposit in tissues → causes inflammation

type III hypersensitivity examples

• systemic lupus erythematosus

• rheumatoid arthritis

type III hypersensitivity treatment

• anti-inflammatory drugs

• immunosuppressants

type IV hypersensitivity - delayed

• T cell mediated

• occurs 48-72 hours

type IV hypersensitivity examples

• poison ivy

• TB skin test

type IV hypersensitivity treatment

• corticosteroids

• avoid allergen

rheumatoid arthritis etiology

• auto immune disorder

• immune system attacks synovial joints

• smoking can trigger RA

rheumatoid arthritis signs and symptoms

• joint pain and swelling

• joint deformities

• fatigue

• weight loss

• fever

rheumatoid arthritis diagnosis

• ESR

• CRP indicating inflammation

• blood tests

rheumatoid arthritis treatment

• NSAIDS

• corticosteroids

• immunosuppressants

Systemic Lupus Erythematosus (SLE) etiology

• autoimmune disorder

• immune system attacks multiple organs and tissues

• multifactorial causes

Systemic Lupus Erythematosus (SLE) signs and symptoms

• butterfly rash on cheek and nose

• photosensitivity

• involvement of heart, lungs, and kidneys

• fever

• weight loss

• hair loss

• mouth ulcers

• reynauds phenomenon!! (fingers turning pink)

Systemic Lupus Erythematosus (SLE) diagnosis

• CBC

• positive antinuclear antibody test

• kidney function test