Pathophysiology Exam 1

Define diffusion.

movement of solutes towards lower solute concentrations

Define osmosis.

passive movement of water/solvent across membrane towards higher concentrations, to make even

Define active transport.

movement against concentration gradient, requires energy

What are the 3 types of active transport?

endocytosis, phagocytosis, pinocytosis

What are the three things cells need to function?

energy/ATP, proliferation/division, and differentiation/specialization

What are the 4 types of tissue?

epithelial, connective, muscle, and nervous

Define epithelial tissue.

acts as a barrier, tightly packed; can be simple or stratified; can be squamous, cuboidal, and columnar

Define connective tissue.

supports and connects other tissues, suspended in extracellular matrix (loose or dense)

Define muscle tissue.

contracts to enable body movement, consists of cell fibers with contractile proteins (actin and myosin)

Define nervous tissue.

senses, processes, and responds to stimuli; consists of neurons and neuroglia

What are the 5 types of cellular adaptation?

atrophy, hypertrophy, hyperplasia, metaplasia, dysplasia

Define atrophy regarding cell adaptation.

decrease in cell size, lowers functionality

Define hypertrophy regarding cellular adaptation.

increase in cell size, lowers functionality

Define hyperplasia regarding cellular adaptation.

increase in cell number, increases functionality

Define metaplasia regarding cellular adaptation.

a pathologic replacement of normal cells with abnormal cells

Define dysplasia regarding cellular adaptation.

a pathologic mutation of normal cells into abnormal cells

Define apoptosis regarding cell death.

programmed cell death, occurs through shrinking of cytoplasm and condensation of nucleus, localized, often beneficial

Define necrosis regarding cell death.

premature cell death, occurs through swelling of cytoplasm and mitochondria, pathological and due to external factors, affects continuously, always harmful

Define neoplasm.

new growth, uncontrolled and unregulated

Define carcinogenesis.

impacted by heredity (oncogenes) and carcinogen exposure

What are the 3 steps of carcinogenesis?

initiation, promotion, progression

Define benign cancers.

slow, progressive, localized, defined, and differentiated more like host tissue

Define malignant cancers.

rapid, metastatic, undifferentiated, fatal

What are ways to detect cancer? (7)

change in elimination habits, a sore that doesn’t heal, unusual bleeding/discharge, thickening or lump tissue, indigestion or difficulty swallowing, obvious change in wart/mole, nagging cough or hoarseness

What are some complications of cancer? (7)

cachexia, fatigue, infection, pain, anemia, leukopenia, thrombocytopenia

What are the 3 main types of cancer diagnostic procedures?

biopsy, tumor markets, imaging procedures

How is cancer classified?

staging (based on spread) and grading (based on histological findings at tumor differentiation)

What are autosomal dominant disorders?

transmitted from affected parent to offspring regardless of gender, 50% chance; delayed onset, typically involving abnormalities with structural protiens

What is an example of an autosomal dominant disorder?

Marfan syndrome: incurable, palliative tx; FBNI (chromosome 15) creates microfibrils for strength, growth factor, and tissue repair which reduces elasticity and increases growth factor

What are autosomal recessive disorders?

rare, both parents must be affects, occurs only in homozygous allele pairs, those with heterozygous are carriers; early onset, usually caused by deficient enzymes

What is an example of an autosomal recessive disorder?

Cystic fibrosis: progressive disorder of the mucus and sweat glands, primarily affects the lungs and pancreas, most cases diagnosed by age of 2

What are sex-linked disorders?

most are x linked, females are carriers of the traits, males are usually affected; if mom is carries kids have 50% chance

What is an example of a sex-linked disorder?

Fragile X Syndrome: associated with CGG trinucleotide repeat expansion of FMRI gene on the X chromosome, affects synaptic development; manifests physically as long face and mentally as learning disabilities/delays, behavioral issues, or autism

What are multifactorial inheritance disorders?

a common but unpredictable class of disorders resulting from an interaction of environmental and genetic factors, may be expressed at birth

What is an example of a multifactorial inheritance disorder?

Cleft lip/palate: improper formation of soft tissues in mouth/lips, leads to feeding/nutrition issues, diagnosed with prenatal ultrasound; risk factors include maternal smoking, diabetes, seizure medications; treated with surgery and speech therapy

What are chromosomal disorders?

result from nondisjunction during meiosis

What is Trisomy 21 (chromosomal disorder)?

Downs syndrome; diagnosed through parental screening and diagnostic testing; manifestations are upward slanted palpebral fissures, varying degrees of disability, organ defects, increased risk for early-onset Alzheimer’s

What is Monosomy X (chromosomal disorder)?

Turner’s syndrome; diagnosed in females with partial or complete absence of one x chromosome through serum hormones and genetic tests; manifestations include streak gonads, distinctive physiology, aortic coarctation with no intellectual disability

What is Klinefelter’s Syndrome (chromosomal disorder)?

47, XXY; diagnosed in males with multiple x chromosomes through genetic testing but often undetected; manifestations include small testes, hypogonadism, distinctive physiology, increased vulnerability to osteoporosis and breast cancer

Define innate immunity.

immunity you are born with, includes skin/mucus membranes/microbiome/chemicals

What are the barriers with innate immunity?

nonspecific but immediate, recognizes nonself but not specific pathogens, not completely impenetrable

What is the inflammatory response of innate immunity?

vascular reaction from damage or trauma to body tissue, nondiscriminatory, acute and chronic phases; vasodilation, vasoconstriction, phagocytosis, fibrinogen

What are pyrogens regarding innate immunity?

released by bacteria or immune cells, triggers fever, creates unfavorable environment for pathogens

What are interferons regarding innate immunity?

released by virus infected cells, bind to nearby uninfected cells, inhibit viral replication

What are complement proteins regarding innate immunity?

plasma proteins activated by pathogens, enhance inflammation and immune response, promote pathogen destruction

Define adaptive immunity.

acquired, pursuing those who escape innate defences, specific to organisms (have developing memory), distinguishes self/nonself between each pathogen

Define cellular immunity regarding adaptive immunity.

destroys the antigen, regulatory cells (helper/suppressor T) and effector cells (cytotoxic), 4 types of Th (helper) cells, viruses and cancers, hypersensitivity and transplant rejection

Define humoral immunity regarding adaptive immunity.

produces antibodies against the antigen, B cells (memory and immunoglobulin secreting), active and passive

How many types of hypersensitivity are there?

4

Define Type I Hypersensitivities.

IgE mediated (immediate), local or systemic, allergen exposure, mast cell and basophil activation, histamine release, requires prior sensitization

Define Type II Hypersensitivities.

cytotoxic (antibody mediated), usually immediate, IgG or IgM bind to self cells, complement activation, cell lysis or phagocytosis, targets specific cells

Define Type III Hypersensitivities.

immune complex mediated, delayed, local or systemic, antigen antibody complexes form, deposit in tissues, complement activation, inflammatory tissue damage

Define Type IV Hypersensitivities.

delayed, T cell mediated, NO antibodies, cytokine release, macrophage activation, tissue injury and fibrosis

What are two examples of Type II Hypersensitivities?

blood transfusion reactions and erythroblastosis fetalis

What are the 4 types of transplants

allogeneic, syngeneic, autologous, xenogenic

Define allogeneic.

doner and recipient are related or unrelated, similar tissue types, MOST common

Define syngeneic.

donor and recipient are identical twins

Define autologous.

donor and recipient are the same person, most successful method

Define xenogenic.

donor and recipient are different species

What are the 3 negative responses to transplants?

hyperacute tissue rejection, acute tissue rejection, chronic tissue rejection

Define hyperacute tissue rejection regarding transplants.

near immediate, due to complement system, causes necrosis

Define acute tissue rejection regarding transplants.

occurs within 3 months, is treatable, manifests in fever and edema

Define chronic tissue rejection regarding transplants.

from 4 months on, antibody mediated, due to ischemia in vessel walls of transplanted tissue

Define autoimmunity.

immune system cannot recognize itself and mounts immune response, triggering mechanism is unclear but affects any tissue, frequently progressive relapsing-remitting disorders with periods of exacerbation and remission, diagnosis often attempts to eliminate all other possibilities

What is systemic lupus erythematosus?

chronic stress related inflammatory condition affecting connective tissue, can be mild or severe, potentially due to B cells producing autoantibodies and autoantigens, stressors tend to trigger, more prevalent in women

What are the manifestations of systemic lupus erythematosus?

excessive tiredness, pain/swelling in joints, headaches, butterfly rash, hair loss, anemia, blood clotting; more often harms heart, joints, skin, lungs, blood vessels, liver, kidneys, and nervous system

Define immunodeficiency.

diminished or absent immune response increases vulnerability to opportunistic infections, may be acute or chronic; primary (w/i immune system) or secondary (underlying disease)

What is human immunodeficiency virus (HIV)?

retrovirus infecting CD4 and macrophages, transmitted via blood and bodily fluids, not transmitted through saliva, expecting moms risk infecting kids

What is acquired immunodeficiency syndrome (AIDS)?

develops from HIV after years; progression in either immunodeficiency (opportunistic infections), autoimmunity (arthritis), or neurological dysfunction (dementia)

What are the 3 lab based categorizations for AIDS?

Category 1: >500 cells

Category 2: 200-499 cells

Category 3: <200 cells

What are the 3 clinical presentations of AIDS?

Category A: asymptomatic

Category B: some less serious manifestations of immunodeficiency

Category C: AIDS-defining illness present

What are the 9 ways to develop a strong immune system?

avoid over sanitizing the environment to build immunity, smoking cessation and moderate alcohol consumption, exercise, vaccinations, increased fluid intake, well balanced diet, getting adequate sleep, weight management, reduce stress

Define intracellular fluid (ICF).

fluid inside the cell, about 40% of total body weight, total space within cells primarily defined as cytoplasm of cells

Define extracellular fluid (ECF).

fluid outside the cells, interstitial fluid (between cells), intravascular fluid (inside blood vessels), and transcellular fluid

Define osmolarity.

solute concentration, osmosis and diffusion

Define tonicity.

osmotic pressure of two solutions separated by a semipermeable membrane

Define isotonic solutions regarding tonicity.

equal solute concentrations, causes no fluid shifts

Define hypotonic solutions regarding tonicity.

lower solute concentration, causing fluids to shift outside of intravascular compartment

Define hypertonic solutions regarding tonicity.

higher solute concentrations, causing fluids to shift from the intracellular compartment

What are fluid intake sources?

oral intake, intravenous solutions (iso-, hypo-, or hypertonic)

What are the sources of fluid losses?

sensible (urine/feces) and insensible (sweat, respirations)

How is the thirst mechanism triggered?

in hypothalamus, triggered by decreased blood volume and increased osmolarity

What is antidiuretic hormone (ADH)?

released from pituitary gland and promotes reabsorption of water in the kidneys

What is aldosterone?

increases reabsorption of sodium and water in the kidneys (renal tubules)

What is atrial natriuretic peptide?

stimulates renal vasodilation and suppresses aldosterone, increasing urinary output

Define fluid excess.

referred to by several names depending on the compartment affected by poor fluid distribution, either too much going in or not enough coming out

Define edema regarding fluid excess.

excess in interstitial space, issues with distribution not always overload, anasarca (generalized)

Define hypervolemia regarding fluid excess.

excess in intravascular space, excessive sodium or water intake with insufficient loss

Define water intoxication regarding fluid excess.

excess in intracellular place, may lead to cell lysis with cerebral cells being most sensitive

What are the causes of excessive sodium or water intake? (5)

high sodium diet, psychogenic polydipsia, hypertonic fluid administration, free water, enteral feedings

What are the causes of inadequate sodium or water elimination? (6)

hyperaldosteronism, Cushing’s syndrome, syndrome of inappropriate antidiuretic hormone, renal failure, liver failure, heart failure

What are the manifestations of fluid excess? (13)

peripheral edema, periorbital edema, anasarca, cerebral edema, rapid weight gain, dyspnea, crackles, bounding pulse, tachycardia, hypertension, jugular vein distension, polyuria, bulging fontanelles (in babies)

Define fluid deficit.

total body fluid levels insufficient to meet body’s needs

Define hypovolemia regarding fluid deficit.

decreased fluid in intravascular space can occur independently without electrolyte defects

What can a decrease in fluid levels lead to? (3)

increased level of blood solutes, cell shrinkage, and hypotension

What are the causes of inadequate fluid intake? (2)

poor oral intake, inadequate IV fluid replacement

What are the causes of excessive fluid or sodium losses? (13)

gastrointestinal losses, excessive diaphoresis, prolonger hyperventilation, hemorrhage, nephrosis, diabetes mellitus, diabetes insipidus, burns, open wounds, ascites, effusions, excessive use of diuretics, osmotic diuresis

What are the manifestations of fluid deficit? (11)

thirst, dry mucous membranes, decreased skin turgor, weight loss, altered level of consciousness, hypotension, tachycardia, weak and thready pulse, flat jugular veins, oliguria, sunken fontanelles (in babies)

Define electrolytes.

cations and anions that play a crucial role in homeostasis, muscle and neural activity, acid-base and fluid balance

Define cations.

positively charged electrolytes