Midterm WCU Patho 370

Tertiary Prevention Examples

Counseling on medication; rehabilitation; supportive care; reducing disability

Latent Period

time between exposure of tissue to injurious agent and first appearance of signs and/or symptoms

Endemic

Native to local region

Subclinical Disease

no noticeable signs or symptoms (inapparent infection)

Etiology

cause of disease

Idiopathic

unknown cause

latrogenic

Cause results from unintended or unwanted medical treatment

Primary prevention

altering susceptibility or reducing exposure for susceptible persons ex: vaccinations

Allostasis

process by which the body achieves stability through homeostatis

Selye's 3 Phases of Stress

Alarm reaction; resistance; exhaustian

sympathetic nervous system: Norepinephrine

causes vasoconstriction & increases BP; Reduces gastric secretions; increases night and far vision

sympathetic nervous system: epinephrine

enhances myocardial contractility; increases HR & CO; causes bronchiodilation; increases glucose release from liver

Hormones released during the stress response

Cortisol

Antidiuretic Hormone (ADH)

Norepinephrine

Epinephrine

Endorphines

Oxytocin

RAA pathway (renin-angiotensin-aldosterone)

Types of intracellular accumulation

-Excessive amounts of normal intracellular substance

-Abnormal substances from faulty matabolism synthesis

-particles that the cell is unable to degrade

Cellular adaptation types

-Atrophy: Decrease cell size

-Hypertrophy: increase cell size

-Hyperplasia: increase cell number

-Metaplasia: conversion of one cell type to another

-Dysplasia: disorderly growth

Coagulative necrosis

this process begins with ischemia, ends with degradation of plasma membrane (heart)

Liquefactive necrosis

liquification of lysosomal enzymes, formation of abscess or cyst from dissolved dead tissue (brain)

Fat necrosis

death of adipose tissue, appears as chalk white area ,usually due to trauma or pancreatitis (pancreas)

Caseous Necrosis

characteristic of lung damage secondary to tuberculosis (bacterial infection; resembles clumpy cheese (lung)

Apoptosis

programmed cell death

Side effects of chemotherapy

anemia

nausea

bleeding

infections

-oma

tumor

carcinoma

cancerous tumor (begins in kin or tissue that lines or covers body organs)

sarcoma

malignant tumor (begins in bone or in soft tissue of the body)

staging

the process of classifying tumors with respect to how far the disease has progressed, the potential for its responding to therapy, and the patient's prognosis (stage 0 to 4)

grading

a way to classify cancer cells & is done by a pathologist

Degree of malignancy & differentiation

Low Grade (Grade I, II)

High Grade (Grade III, IV)

Deficits in immune system function in cancer

chemotherapy

cancer cells

cancer metastasis to bone marrow

malnutrition

tumor marker functions

help determine cancer origin

help identify progression of cancer

Hypersensitivity Type I

strong genetic or herediatry linkage regarding IgE responses (allergens)

immediate hypersensitivity

release of histamine

Hypersensitivity Type II

tissue specific, cytotoxic, or cytolytic hypersensitivity

occurs when antibodies attack antigens on surface of specific cells or tissues; causing lysis

Ex: Transfusion reaction; hemolytic disease of newborn

Hypersensitivity III

immune complex reaction

immune & phagocytic systems fail to effectively remove antigen-antibody immune complexes

Ex: immune complex glomerulonephritis; systemic lupus erythematosus

myeloma

Malignant disorder of mature antibody-secreting B lymphocytes called plasma cells; tumor of the bone marrow

acute lymphoid leukemia

immature lymphocytes predominate; malignant disorder of lymphoid cells. Transformation of B lymphocytes w/remaining T lymphocytes

Transfusion reactions involve RCB destruction caused by

recipient antibodies

Red Blood Cells

have no cytoplasmic organelles

iron deficiency has low

MCHC

MCH

MCV

Carbon dioxide

is transported in the bloodstream as bicarbonate ion

bilirubin

can detect excessive RBC lysis

Erythropoietin

produced by the kidneys

Aplastic anemia

leads to pancytopenia

pernicious anemia is due to

lack of intrinsic factor

Glucos-6-phosphate dehydrogenase deficiency anemia occurs when

exposed to certain drugs

Functions of the circulatory system

transport, protection, regulation

carries oxygen, nutrients, & hormones to cells and removes waste products like carbon dioxide.

Hemophilia

prolonged bleeding time, prolonged aPTT, normal platelet count

Vitamin K deficiency in newborns presents with

melena, bleeding from the umbilicus, and hermaturia

Vitamin K deficiency

normal bleeding time, normal platelet count, increased PT and INR

aspirin can prolong

bleeding time

PT/INR

prothrombin time/international normalized ratio

assesses the extrinsic pathway of coagulation by measuring the time it takes for a blood clot to form

aPTT

(activated partial thromboplastin time)

assess the intrinsic pathway of coagulation by measuring the time it takes for a clot to form

Bleeding time evaluates

vascular status and platelet function

Chemotherapy can cause

thrombocytopenia

Disseminated Intravascular Coagulation (DIC)

Acquired hemorrhagic syndrome in which clotting and bleeding occur simultaneously

dysfunction of the liver can lead to

clotting factor deficiency

Venous occlusion

- blockage of blood flow through a vein

-decreased amount of fluid returned to the heart, increase third spacing of fluid

- edema

arterial occlusion

blockage of blood flow through an artery

thrombosis

blood clot

embolism

the sudden blockage of a blood vessel by an embolus

peripheral edema is a result of

venous thrombosis

atherosclerosis

hardening of the arteries

DVT (deep vein thrombosis)

formation of a blood clot in a deep vein of the body, occurring most commonly in the legs or thighs

varicose veins

abnormally swollen and twisted veins, usually occurring in the legs

Primary hypertension

High blood pressure, the cause of which is unknown; also known as essential hypertension

Secondary hypertension

high blood pressure caused by the effects of another disease

hypertensive urgency

a situation in which blood pressure is severely elevated but there is no evidence of target organ damage

hypertensive emergency (crisis)

a situation in which blood pressure is severely elevated and there is evidence of actual or probable target organ damage

symptoms of hypotension

dizziness, blurred vision, fainting (syncope)

End organ damage from HTN

Heart: LVH, angina or MI, heart failure

Brain: stroke of TIA, encephalopathy

Eyes: Retinopathy

Kidney: Chronic Kidney Dz

Vascular: peripheral arterial disease

The first and most important intervention in managing hypertension

modifiable risk factors (lifestyle modifications)

B.P >120/<80

Normal BP

BP 120-129/>80

Elevated BP

BP 130-139 /or 80-89

High BP Stage I

BP 140 or higher/ or 90 or higher

High BP Stage 2

BP <180/or >120

Hypertensive crisis

ACE inhibitors

Inhibit conversion of ANG I to ANG II, thus reducing ANG II's affect on vasoconstriction and aldosterone levels

complications of orthostatic hypotension

Dizziness, blurred vision

Fainting (syncope), injury from falls

Also associated with increased risk of cardiovascular disease, stroke, cognitive impairment and death

Pulmonary stenosis

a narrowing of the pulmonary valve or pulmonary artery that results in obstruction of blood flow from the ventricles (hard to open)

What is the correlation of LDL levels and coronary artery disease?

LDL causes the build-up of fatty deposits within your arteries, reducing or blocking the flow of blood and oxygen your heart needs. This can lead to chest pain and heart attack.

stable angina

chest pain that occurs when a person is active or under severe stress

- Pain ceases with rest or nitroglycerin (potent peripheral vasodilator)

unstable angina

-superficial erosion of plaque leads to transient occlusion

- Unpredictable and not related to the usual demand for myocardial oxygen

- It is a symptom of disease progression

acute coronary syndrome

sudden symptoms of insufficient blood supply to the heart indicating unstable angina or acute myocardial infarction

Diagnostic tests and findings to detect myocardial infarction (MI)

● ECG changes

T-wave inversion

ST-segment depression or elevation

Abnormal Q wave

● Serum cardiac markers

Proteins released from necrotic heart cells

Myoglobin, creatine kinase, troponin

Arterial septal defect

Allows blood flow between atrias

endocardial cushion defect

No separation between the chambers of the heart

Ventricular septal defects

Allows blood flow between ventricles

Coarctation of the aorta

Narrowing of the aorta

Patent ductus arteriosus

passageway between the aorta and the pulmonary artery remains open after birth

Transposition of the great vessels

2 major vessels that carry blood away from the heart (aorta and pulmonary artery) are switched (transposed)

symptoms of left sided heart failure

**L for lungs

Decreased cardiac output, decreased tissue perfusion

Pulmonary congestion, orthopnea, paroxysmal nocturnal dyspnea (dyspnea or shortness of breath that occurs at night)

symptoms of right sided heart failure

Inadequate perfusion of the brain causing restlessness, confusion, anxiety, impaired memory, generalized fatigue, activity intolerance, and lethargy

paroxysmal nocturnal dyspnea

sudden awakening from sleeping with shortness of breath

heart failure

is the impaired ability of the heart to pump blood to maintain sufficient cardiac output to meet metabolic demands of tissues and organs

Complications of dysrhythmias

Hypotension

Tissue ischemia

Thrombi- low dose heparin, or ASA -->(severe change in LOC --> threw a clot?)

Heart failure

Shock

Death

signs and symptoms of anaphylactic shock

Tachycardia, increased respiratory rate, hypotension

Urticaria (hives), pruritus (itcy skin), angioedema (swelling under the skin)

Bronchoconstriction, which causes wheezing and cyanosis

Laryngeal edema, which causes hoarseness and stridor

risk factors of anaphylactic shock

when a sensitized person comes in contact with antibiotics

pathogenesis of anaphylactic shock

- type I anaphylactic reactions involve an antigen/immunoglobulin (IgE) antibody reaction on the surface of mast cells and basophils. IgE antibodies attach to receptors on these cells and when exposed to the antigen, become active and release vasoactive chemicals (histamine, leukotrienes, bradykinins, and prostaglandins)

Sepsis and Septic Shock

Sepsis results from the presence of microorganisms in the bloodstream (bacteremia) and the bodies systemic inflammatory response to the infectious agent

Types of obstructive shock

cardiac tamponade

tension pneumothorax

pulmonary embolism

cardiogenic shock

A state in which not enough oxygen is delivered to the tissues of the body, caused by low output of blood from the heart. It can be a severe complication of a large acute myocardial infarction, as well as other conditions.

Dry cough is a common sign of

viral pneumonia

immunosuppression is a risk factor for

active pulmonary TB