NUR1 209: Pathophysiology and Nursing Science

Comprehensive vocabulary flashcards covering the hematological system, immunology, genetics, integumentary pathophysiology, and cellular transport mechanisms from NUR1 209.

Albumin

The most abundant plasma protein (comprising $57\%$ of total plasma proteins), synthesized by the liver; functions as a critical carrier molecule and provides the primary colloidal oncotic pressure needed to retain fluid within the vascular compartment.

Kupffer Cells

Specialized tissue-resident macrophages anchored within the sinusoids of the liver that form an essential component of the mononuclear phagocyte system, filtering bacteria and debris from portal blood.

Hepcidin

A liver-derived peptide hormone that governs systemic iron balance; suppresses intestinal iron absorption and macrophage iron release when body iron is abundant by inducing ferroportin degradation, but decreases during iron deficiency to promote absorption.

Thrombocytopenia

A condition characterized by a circulating platelet count below $150{,}000/\text{mm}^3$ (becoming clinically significant below $100{,}000/\text{mm}^3$), which impairs primary hemostasis and elevates the risk of spontaneous or prolonged bleeding.

Pernicious Anemia

A macrocytic-normochromic anemia caused by vitamin $B_{12}$ malabsorption due to autoimmune destruction of gastric parietal cells or lack of intrinsic factor; characterized by irreversible peripheral nerve demyelination and spinal cord ataxia.

Iron Deficiency Anemia (IDA)

A microcytic-hypochromic anemia resulting from inadequate dietary iron intake or chronic blood loss, manifesting with cutaneous pallor, brittle spoon-shaped fingernails (koilonychia), glossitis, and cheilosis.

Polycythemia Vera

A myeloproliferative neoplasm driven by a somatic mutation in the $JAK2$ gene ($JAK2^{V617F}$), resulting in autonomous erythrocyte production independent of erythropoietin levels, increased blood viscosity, hypercoagulability, and aquagenic pruritus.

Philadelphia Chromosome

An acquired cytogenetic abnormality resulting from a reciprocal balanced translocation between chromosomes $9$ and $22$ ($t(9;22)(q34;q11)$), creating the $BCR\text{-}ABL$ chimeric fusion gene with constitutive tyrosine kinase activity in chronic myelogenous leukemia (CML).

Reed-Sternberg Cells

Giant, binucleated or multinucleated malignant transformed lymphocytes derived from germinal center B cells that secrete inflammatory cytokines and serve as the essential microscopic hallmark of Hodgkin lymphoma.

Burkitt Lymphoma

An aggressive, rapidly growing Non-Hodgkin B-cell lymphoma associated with Epstein-Barr virus (EBV) infection and chromosomal translocation involving the $c\text{-}MYC$ oncogene and the immunoglobulin heavy chain locus ($t(8;14)$), typically presenting as a rapidly expanding jaw or abdominal mass.

M Protein (Monoclonal Paraprotein)

An abnormal monoclonal immunoglobulin or light chain produced in massive quantities by malignant plasma cells in multiple myeloma, detectable as an 'M spike' on serum protein electrophoresis and as Bence Jones protein in the urine.

Virchow's Triad

The triad of primary pathophysiologic factors predisposing to thrombosis: endothelial vessel wall damage, alterations in normal laminar blood flow (stasis or turbulence), and systemic hypercoagulability.

Glucose-6-Phosphate Dehydrogenase (G6PD) Deficiency

An X-linked recessive metabolic enzymopathy that impairs erythrocyte generation of NADPH, leaving hemoglobin susceptible to oxidative precipitation (Heinz bodies) and acute hemolytic anemia upon exposure to sulfonamides, infection, or fava beans.

Sickle Cell Disease

An autosomal recessive hemoglobinopathy caused by a point mutation in the $\beta$-globin gene where valine substitutes for glutamic acid at codon 6, causing mutant hemoglobin S ($HbS$) to polymerize under deoxygenation and deform red cells into a sickle configuration with a shortened lifespan of $10-20\text{ days}$.

Defensins

Small cysteine-rich cationic antimicrobial peptides produced by epithelial cells and phagocytes that disrupt the membrane stability of bacteria, fungi, and enveloped viruses and help mobilize leukocytes.

Cardinal Signs of Inflammation

The five hallmark local manifestations of acute inflammation: rubor (redness from vasodilation), calor (heat from increased blood flow), tumor (swelling from exudation), dolor (pain from kinins and prostaglandins), and functio laesa (loss of function).

Chemokines

A specialized family of low-molecular-weight cytokines that establish chemotactic concentration gradients to direct leukocyte trafficking, rolling, and emigration toward sites of tissue injury or pathogen invasion.

M1 and M2 Macrophages

Polarized macrophage functional states: M1 macrophages are classically activated by interferon-gamma ($IFN\text{-}\gamma$) to promote pro-inflammatory microbial destruction, whereas M2 macrophages are alternatively activated by $IL\text{-}4$ and $IL\text{-}13$ to mediate tissue repair, resolution, and matrix remodeling.

Natural Killer (NK) Cells

Innate cytotoxic lymphoid cells that identify and destroy virally infected or malignant cells lacking normal cell-surface Class I major histocompatibility complex ($MHC\text{-}I$) expression via perforin- and granzyme-mediated apoptosis.

Bradykinin

The primary vasoactive end-product of the plasma kinin system, generated by kallikrein cleavage of kininogen; causes intense vasodilation, increased microvascular permeability, extravascular smooth muscle contraction, and stimulation of sensory nerve terminals generating pain.

Granuloma

A microscopic nodular lesion of chronic inflammation formed when macrophages coalesce into epithelioid cells and multinucleated Langhans giant cells surrounded by lymphocytes, designed to wall off indigestible foreign bodies or persistent organisms.

Type I Hypersensitivity

An immediate IgE-mediated allergic response wherein environmental allergens cross-link IgE bound to $Fc\epsilon RI$ receptors on sensitized mast cells and basophils, causing rapid degranulation of histamine and synthesis of leukotrienes and prostaglandins.

Type II Hypersensitivity

A tissue-specific immune reaction mediated by IgM or IgG antibodies binding to fixed cell-surface antigens, triggering cell lysis via complement activation (membrane attack complex), opsonization and phagocytosis, or antibody-dependent cellular cytotoxicity.

Type III Hypersensitivity

An immune complex-mediated reaction caused by the circulation and tissue deposition of soluble antigen-antibody aggregates that activate the complement cascade and attract neutrophils, precipitating microvascular damage (e.g., systemic lupus erythematosus).

Type IV Hypersensitivity

A delayed cell-mediated immune reaction mediated by sensitized CD4+ Th1 and CD8+ cytotoxic T lymphocytes and activated macrophages rather than antibodies, typically manifesting $24-72\text{ hours}$ following antigen re-exposure (e.g., poison ivy contact dermatitis).

Antigenic Shift

A major, abrupt genetic reassortment occurring when two different influenza strains co-infect an animal host and exchange whole segmented RNA segments, creating novel hemagglutinin or neuraminidase surface antigens capable of triggering pandemics.

Central Tolerance

The primary developmental screening process occurring in the thymus (T cells) and bone marrow (B cells) wherein developing lymphocytes that exhibit high affinity for self-antigen peptides presented on MHC molecules are eliminated via apoptotic clonal deletion.

Mutational Hotspots

Specific regions or base sequences along genomic DNA that display a significantly elevated mutation frequency compared to the average background genome, often contributing to recurrent genetic disorders.

Aneuploidy

A chromosomal alteration wherein a cell lacks or possesses an extra individual chromosome rather than a complete haploid set, such as trisomy ($2n+1$) or monosomy ($2n-1$).

Turner Syndrome

A sex chromosome monosomy characterized by a $45,X$ karyotype; affected females present clinically with short stature, webbing of the neck, coarctation of the aorta, ovarian dysgenesis, and absent secondary sexual development.

Klinefelter Syndrome

A sex chromosome aneuploidy characterized by a $47,XXY$ karyotype; affected males typically display tall stature, eunuchoid proportions, testicular atrophy with azoospermia, gynecomastia, and sparse body hair.

Cri du Chat Syndrome

A structural genetic deletion disorder caused by the loss of variable portions of the short arm of chromosome 5 ($5p-$), clinically recognizable by microcephaly, intellectual disability, hypertelorism, and a distinctive high-pitched, cat-like infant cry.

DNA Methylation

An epigenetic mechanism involving enzymatic attachment of a methyl group (typically to the 5-carbon position of cytosine in CpG islands), which condenses chromatin structure and transcriptionally silences the affected gene locus.

Genomic Imprinting

An epigenetic phenomenon whereby gene expression is selectively governed in a parent-of-origin specific manner through differential DNA methylation during gametogenesis, leaving only the maternal or paternal allele transcriptionally active.

Prader-Willi Syndrome (PWS)

A neurodevelopmental disorder resulting from the loss or deletion of the paternally inherited active region on chromosome $15q11-q13$ (while the maternal region is imprinted/silenced), characterized by infantile hypotonia, insatiable hyperphagia, truncal obesity, hypogonadism, and short stature.

Angelman Syndrome (AS)

A neurogenetic disorder resulting from deletion or loss of the maternally inherited active region on chromosome $15q11-q13$ (specifically the $UBE3A$ gene, with the paternal region silenced), clinically marked by profound cognitive disability, severe ataxia, recurrent seizures, and inappropriate outbursts of laughter.

Stratum Corneum Structural Variation

The physiological difference in skin barrier structure characterized by darker skin tones possessing a more compact stratum corneum comprising approximately $20$ cell layers compared to approximately $16$ layers in lighter skin over equivalent thickness, conferring reduced chemical penetration.

Psoriasis

A chronic autoimmune inflammatory papulosquamous skin disorder driven by hyperactivation of the $Th17/IL\text{-}23$ pathway, causing accelerated epidermal keratinocyte turnover (reducing transit time from $30\text{ days}$ to roughly $3\text{ days}$) and producing silvery-scaled, well-demarcated erythematous plaques.

Erythema Migrans

An expanding erythematous annular cutaneous lesion (often with central clearing, producing a characteristic 'bull's-eye' pattern) that represents the diagnostic hallmark of early localized Lyme disease caused by tick-borne Borrelia burgdorferi.

Pressure Injury (Decubitus Ulcer)

Localized cellular ischemia and tissue necrosis resulting from sustained external pressure over a bony prominence that compresses capillary beds beyond microvascular closing pressure, staged from Stage 1 (non-blanchable erythema) through Stage 4 (full-thickness skin loss with exposed muscle, tendon, or bone).

Lipid Rafts

Specialized, dynamic microdomains within the outer plasma membrane leaflet enriched in cholesterol, sphingolipids, and glycosphingolipids that exist in a liquid-ordered phase ($L_o$) and organize membrane signaling complexes.

Paracrine Signaling

A mode of local chemical intercellular communication in which a secreting cell releases signaling ligands into the interstitial space to modulate the function of distinct, neighboring target cells.

Autocrine Signaling

A mode of chemical signaling wherein a cell secretes an extracellular messenger that binds to cell-surface receptors located on its own plasma membrane to regulate its own activities.

Sodium-Potassium Pump ($Na^+/K^+$ ATPase)

An integral membrane transport enzyme that utilizes the free energy of ATP hydrolysis to export three $Na^+$ ions and import two $K^+$ ions against their concentration gradients, generating the primary electrochemical gradient required for cellular homeostasis.

Capillary Hydrostatic Pressure

The mechanical filtration force exerted by blood pressure against the endothelial lining of capillaries that pushes water and dissolved solutes out of the vascular lumen and into the interstitial space.

Capillary Oncotic Pressure

The osmotic inward-pulling force exerted by impermeable plasma proteins (primarily albumin) within capillary blood that reabsorbs water from the interstitial space back into the circulation.

Atrophy

A reversible decrease in individual cell size and functional cellular volume caused by decreased workload, denervation, loss of endocrine stimulation, or nutrient deprivation.

Metaplasia

The reversible adaptive replacement of one adult differentiated cell phenotype by another mature cell type better suited to endure chronic environmental irritation, such as respiratory columnar epithelium changing to stratified squamous epithelium in chronic tobacco smokers.

Dysplasia

Deranged, disorganized cellular proliferation resulting in abnormal variations in size, shape, and architectural orientation (often termed atypical hyperplasia), which is not a true adaptive response and may precede neoplastic progression.

Liquefactive Necrosis

A pattern of cell death characterized by rapid enzymatic dissolution of dead tissue into a viscous liquid viscous mass, characteristic of hypoxic infarction in the central nervous system and localized bacterial abscesses.

Respiratory Acidosis

An acid-base disturbance defined by systemic acidemia ($\text{pH} < 7.35$) resulting from primary hypoventilation and carbon dioxide retention ($PaCO_2 > 45\,\text{mmHg}$), which triggers compensatory renal retention of bicarbonate ($HCO_3^-$) and proton excretion.

Metabolic Acidosis

An acid-base disturbance characterized by a primary decline in serum bicarbonate concentration ($HCO_3^- < 22\,\text{mmol/L}$) and blood $\text{pH} < 7.35$, initiating compensatory respiratory hyperventilation (Kussmaul breathing) to reduce arterial $PaCO_2$.