patho exam 2

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stages of GAS

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113 Terms

1

stages of GAS

  • alarm

  • resistance

  • exhaustion

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alarm stage

initial reaction, sympathetic NS

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3

resistance stage

adaptation, limit the stressor

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4

exhaustion stage

adaptation failing, coping methods utilized, disease develops

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5

local adaptation syndrome

  • localized version of GAS

  • bodies attempt to minimize stress to a small location

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6

first line of defense

  • Innate Immunity

  • nonspecific, distinguishes self from non-self

  • does not distinguish between pathogens

  • skin and mucous membranes

  • immediate reaction

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second line of defense

  • Innate Immunity

  • responds to antigens that penetrate first line

  • inflammatory response

  • pyrogens, interferons, complement proteins

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8

histamine

triggers vasodilation

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9

prostaglandins

stimulates pain receptors

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10

manifestations of inflammatory response

erythema, edema, pain, warmth

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11

pyrogens

  • fever producing molecules

  • released by bacteria after exposure to antigens

  • travel to hypothalamus

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interferons

  • proteins released from virus of infected cells

  • bind to uninfected cells and prevent viral replication

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13

complement proteins

  • blood plasma proteins that enhance antibodies action

  • circulate in inactive state, activated by antigens

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third line of defense

  • adaptive (aquired)

  • specific, develops over time

  • uses memory system, able to recognize antigens

  • distinguishes between self, nonself, and pathogens

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15

T cells

cellular immunity

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B cells

humoral immunity

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cellular immunity description

  • mediated by T cells on recognition of antigen

  • T cells produced in bone marrow and mature in thymus

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T helper vs T suppressor

notify B cells vs turn off antibody production

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humoral immunity description

  • mediated by B cells on encountering agent

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B memory vs B immunoglobulin secreting

memory vs producing antibodies after initial reaction

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IgG

  • largest amount

  • main defense

  • passed through placenta or breastfeeding

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IgE

  • epipen

  • allergic reactions

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IgM

  • my first antibody

  • fights blood infections

  • triggers more IgG

  • first antibody made in fetus

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IgD

  • dispatch for B cells

  • signal to activate for B cells

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active acquired immunity

long lasting but takes a few days to be effective

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active acquired immunity (natural)

have the disease and antibodies are formed naturally

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active acquired immunity (artificial)

vaccines, no illness but antibodies are formed

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passive acquired immunity

short lasting

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passive acquired immunity (natural)

passed from mom to baby through placenta or breastfeeding

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passive acquired immunity (artificial)

antibodies injected directly into the body to provide temporary protection until the body can form its own antibodies

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hypersensitivity

inflated immune response to foreign substance

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autoimmune

mistakes self for nonself

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immunodeficiency

inadequate immune reaction

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Type I Hypersensitivity: IgE mediated

  • allergic reaction

  • immediate response

  • caused by repeated exposure to allergen

  • T helpers stimulate B cells to produce more IgE

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Type II Hypersensitivity: cytotoxic

  • IgG or IgM antibodies bind to antigen on individual cells

  • lysis occurs, immediate reaction

  • recognition by macrophages triggers antibody production

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Type III Hypersensitivity: immune complex mediated

  • delayed

  • circulating antigen/antibody complexes collect and enter tissue

  • triggers complement system, causing inflammation

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Type IV Hypersensitivity: Delayed

  • 2 phases: sensitizing and effector

  • cell mediated, causes severe tissue injury and fibrosis

  • antigen presentation results in interferon release causing inflammation

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38

periostem

  • connective tissue that covers compact bone

  • site for muscle attachment

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red bone marrow

site for hematopoiesis

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40

bone growth componenets

  • calcitonin and PTH: regulate bone remodeling and mineralization

  • estrogen: inhibits osteoclast formation in women

  • testosterone: increases bone length and density in men

  • vitamin D: controls absorption of calcium and phosphate

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41

congenital diseases

kyphosis, lordosis, scoliosis

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kyphosis

increase in curvature of the thoracic spine

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lordosis

exaggerated concave of the lumbar spine

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44

traumatic disorders

fracture, dislocations, sprains, strains, herniated disc

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simple vs comminuted fracture

single break vs multiple fracture lines and multiple bone pieces

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greenstick vs compression fracture

incomplete break in which bone is bent and outer curve broke vs bone is crushed or collapsed into small pieces

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complete vs incomplete fracture

bone is broken in 2+ pieces vs only partially broken

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impacted vs depressed fracture

one piece of bone is forced into adjacent bone vs broken piece of skull forced into brain

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pathologic fracture

  • results from weakness in bone structure

  • osteoporosis or tumors

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osteomyelitis vs osteonecrosis

infection of bone tissue vs death of bone tissue due to loss of blood supply

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dislocation

separation of two bones at a joint

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sprain

injury to ligament that involves stretching or tearing of ligament

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strain

injury to muscle or tendon that involves stretching or tearing of tendon

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herniated intervertebral disc

protrusion of nucleus pulposus through the annulus fibrosus

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55

osteoporosis

  • metabolic condition characterized by a loss of bone calcium that leaves bone brittle

  • spongy bone becomes porous and compact bone becomes thing

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osteoporosis manifestations

  • asymptomatic in early stages

  • osteopenia

  • low back or neck pain

  • height reduction over time

  • kyphosis, fractures, bone pain

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rickets

  • soft weak bone in children due to extreme/prolonged vitamin d/phosphate/ calcium deficiency

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osteomalacia

  • adult version of rickets

  • minerals shift out of bone

  • if blood levels become too low it causes weak/soft bones

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paget’s

  • progressive metabolic condition characterized by excessive bone destruction and replacement of the bone with fibrous abnormal bone

  • results in weak/fragile bones

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60

inflammatory joint disorders

osteoarthritis, rheumatoid arthritis, pathogenesis, gout, ankylosing spondylitis

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osteoarthritis

  • degenerative joint disease characterized by local deterioration of articulating cartilage and its underlying bone

  • tissue damage triggers enzyme release from local cells, accelerating cartilage disintegration

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osteoarthritis manifestations

  • gradual onset presenting after age of 40, develops slowly and worsens over time

  • joint pain that worsens with movement, tenderness with light pressure

  • limited ROM, crepitus, joint stiffness, joint swelling

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63

rheumatoid arthritis

  • systemic autoimmune condition involving multiple joints

  • inflammatory process primarily affects synovial membranes

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rheumatoid arthritis manifestations

  • insidious onset, progressively worsens

  • fatigue, anorexia, malaise, unsteady gait

  • lymphadenopathy, bilateral joint pain, muscle spasms, joint deformity

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RA: pathogenesis

synovitis, pannus formation, cartilage erosion, fibrosis, ankyloses

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gout

inflammatory disease resulting from deposits of uric acid crystals in tissues and fluids

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gout manifestations

  • varies depending on phase

  • intense pain at affected joint

  • joint redness, warmth, swelling, and tenderness

  • fever, joint deformities, limited joint mobility

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ankylosing spondylitis

  • progressive inflammatory disorder affecting sacroiliac joints, intervertebral spaces, and costovertebral joints

  • new bone forms in attempt to remodel inflammatory damage

  • results in joint fibrosis and calcification

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ankylosing spondylitis manfiestations

  • lower back pain, fatigue, weight loss, kyphosis

  • pain and stiffness with inactivity, muscle spasms

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chronic muscle disorders

muscular dystrophy, fibromyalgia, bone tumors

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muscular dystrophy

  • group of inherited, noninflammatory disorders characterized by degeneration of skeletal muscle (9 types)

  • Duchenne MD is most common and most severe

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muscular dystrophy manifestations

  • mental retardation, muscle weakness leading to hypotonia

  • por coordination, muscle spasms, delayed development of motor skills

  • progressive loss of joint mobility, unilateral calf hypertrophy

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73

fibromyalgia

  • syndrome predominantly characterized by widespread muscular pains and fatigue

  • affects muscles, tendons, and surrounding tissue

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fibromyalgia manifestations

  • vary depending on weather, stress/fatigue, physical activity, and time of day

  • widespread muscular pain, depression, IBS, headaches, memory loss

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bone tumors

  • majority are malignant and occur secondary to other tumors

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osteochondroma

tumor adjacent to growth plates, 10-20 years old

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osteosarcoma

aggressive, begins in bone cells most commonly in femur, tibia, and fibula, children and young adults

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ewing’s sarcoma

aggressive with unknown origin, children and young adults

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bone tumor manifestations

  • asymptomatic in early stages, pathologic fractures, bone pain, palpable mass

  • fatigue, weight loss

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80

congenital disorders integ

birthmarks and disorders of melanin

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81

inflammatory disorders integ

contact/atopic dermatitis, urticaria, psoriasis

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infectious disorder integ

bacterial, viral, parasitic

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chronic disorders integ

acne vulgaris, rosacea

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84

traumatic disorders integ

burns

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85

albinism

  • recessive condition that results in little or no melanin production

  • problems with eye development and function

  • eye changes: nystagmus, strabismus, photophobia, functional blindness

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86

vitiligo

  • rare, small patches of hypopigmentation

  • occurs when cells that produce melanin die

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87

contact dermatitis

  • acute inflammatory reaction triggered by direct exposure to an allergen or irritant

  • resolves in 2-4 wks

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irritant contact dermatitis

  • caused by chemicals, acids, soaps

  • does not involve immune system but triggers inflammatory response

  • manifestations: erythema, edema, pain, pruritus, vesicles

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allergic contact dermatitis

  • caused by chemicals, cosmetics, plants

  • sensitization occurs on the first exposure and following exposure trigger Type IV cell mediated hypersensitivity rxn

  • manifestations: erythema, edema, pain, pruritus, vesicles

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90

atopic dermatitis (eczema)

  • chronic inflammatory condition triggered by an allergen

  • accompanied by asthma and allergic rhinitis

  • manifestations: red/brownish gray colored skin patches, pruritus, vesicles, dry/cracked skin

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urticaria

  • raised erythematous skin lesions, result of Type I hypersensitivity rxn

  • occurs when histamine release is initiated by substances/conditions

  • manifestations: welts that blanch, pruritus

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psoriasis

  • common chronic inflammatory condition that affects the skin life cycle

  • cell proliferation increases causing build up of skin cells and thickening of the dermis/epidermis

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folliculitis

  • involving hair follicles

  • tender swollen areas that form surrounding the hair follicle

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94

furuncles

  • boils, begin in hair follicles and then spread into surrounding dermis

  • most common in neck, axillae, groin, butt, and back

  • starts as red painful nodule and forms into large red painful mass usually drains large amount of exudate

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impetigo

  • common and highly contagious (usually kids)

  • begins as small vesicles that enlarge and rupture, forming honey-colored crust

  • typically causes by staphylococci

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cellulitis

  • occurs deep in dermis and subcutaneous tissue

  • results from direct invasion of pathogens through break in skin

  • swollen, warm, tender area of redness

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necrotizing fascitis

  • rare/serious, aggresively destroys skin, fat, muscle, and other tissue

  • GRAM POSITIVE GROUP A BETA HEMOLYTIC STREPTOCOCCUS

  • bacteria releases harmful toxins that directly destroy tissues, disrupt blood flow, and break down tissue

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herpes simplex 1

  • begins in childhood, transmitted through saliva

  • cold sore

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99

herpes zoster

  • caused by varicella-zoster virus

  • lies dormant of cranial/spinal nerve, affects only this nerve

  • red/silvery vesicular rash that forms in a line over innervated nerve

  • shingles

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100

verrucae

  • caused by human papillomavirus

  • transmitted through direct skin contact

  • replication of skin cells causes thickening

  • warts

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