patho quiz 2

nucleus

nucleus

largest cytoplasmic organelle

-contains dna

mitochondrion

atp generator

-powerhoirse

-convert energy to forms that can be used to drive cellular reactions

lysosomes

digestion

er and ribosomes

protein and lipid assembly

golgi apparatus

protein and lipid processing for transport

plasma membrane

transport nutrients and waste products

-generate membrane potentials

-cell recognition and communication

-growth regulation

-sensor of signals that enable cell to respond and adapt to changes in environment

reversible

are cellular accumulations reversible or irreversible?

hydropic swelling

the first sign of reversible cellular injury

edema

abnormal accumulation of fluid

abnormal metabolism, abnormal proteins, lack of enzymes, indigestible materials

intracellular accumulations

-megaly

generalized enlargement of a specific organ d/t edema or other intracellular accumulations

Na K pump dysfunction

hydropic swelling is a sign of cellular injury associated with

atrophy, hypertrophy, hyperplasia, metaplasia, dysplasia

cellular adaptations

reversible

are cellular adaptations reversible or irreversible?

hypertrophy

increased cell size

atrophy

decreased cell size

hyperplasia

increased cell number

metaplasia

conversion of one cell type to another

dysplasia

disorderly growth of cells

increased workload

cause of hypertrophy

hyperplasia

increased functional demand, hormonal stimulation, persistent injury, chronic irritation are all causes of

persistent injury

metaplasia is caused by

metaplasia

___ is a response to increased metabolic demand in glandular tissue

necrosis, apoptosis

irreversible cellular injury

necrosis

premature cell death

-caused by factors external to the cell

-most commonly related to ischemia and oxygen deprivation

-organelles cease to function

-adjacent cells become inflamed

apoptosis

programmed cell death

-generally triggered by normal, healthy processes in the body

-most commonly related to normal aging process

-adjacent cells unaffected

ischemia

what is the most common cause of cell injury?

ischemia

inadequate blood supply to tissue or organ

reversible

up to a point, ischemic injury is reversible

cell death

……. …… occurs when plasma, mitochondrial, and lysosomal membranes are critically damaged

ischemia

thrombosis, embolism, trauma, arterial insufficiency are all common causes of

ischemia

increased WBC, fever, malaise, tachycardia, and loss of appetite are all general s/s of

ischemia reperfusion injury

calcium overload, formation of free radicals → subsequent inflammation

coagulative

solid tissues and organs necrosis

-most common form

-injured cell becomes encapsulated by denatured proteins d/t lack of lysosomal enzymes

-general tissue structure remains intact while slowly being dissolved by proteolytic enzymes (may take weeks)

liquefactive

brain necrosis

-digestive enzymes rapidly dissolve affected cells into liquid viscous mass

-typically in tissue lacking strong connective structure

-often localized infection that results in an abscess or cyst

fat

adipose tissue necrosis

-often associated with release of pancreatic enzymes d/t pancreatitis

-also seen in breast trauma or surgical cases

caseous

lung necrosis

-unique type of cell death seen in lung tissue infected with tb

-incomplete proteolytic digestion of the necrotic tissue

gangrene

cellular death in a large area of tissue

-results from interruption of blood supply to a particular part of the body

-dry, wet, or gas

dry gangrene

form of coagulative necrosis

-characterized by blackened, dry, wrinkled tissue separated by a line of demarcation from healthy tissue

-do not apply moisture

-keep dry

wet gangrene

form of liquefactive necrosis

-typically found in internal organs

-can be fatal

gas gangrene

results from infection of necrotic tissue by anaerobic bacteria

-characterized by formation of gas bubbles in damaged muscle tissue

-may also have crepitus

somatic death

death of entire organism

epidermis, dermis, hypodermis, subcutaneous

layers of the skin

keratinocytes

born from basal layer, 95% of the cells in the epidermis

-protect against invasion

-prevent moisture and heat loss

-immunomodulation

young children, elderly

…….. …….. and …….. have fewer functional sweat glands meaning they have less efficient evaporative heat loss capabilities

less

sebaceous glands become ___ active with age causing a predisposition to dry skin

rate

advanced age brings changes in ___ of cell turnover leading to wrinkles, sagging skin, grey hair, baldness

epidermis

degenerative changes with aging, cells reproduce more slowly, thins, exposure to sunlight is an important factor in the development of aged skin

dermis

___ is less elastic because of decreased amount of elastin and increase in the collagen to elastin ratio

senile purpura

aging purple spots caused by the dermis being less vascular with age

primary lesion

original appearance

secondary lesion

appearance modified by normal progress over time or by external agents

macule

flat, change in color

papule

raised, <5 mm diameter

nodule

raised, >5mm diameter

plaque

palpable, flat, solid disc shaped

vesicle

epidermal fluid collection <5mm diameter

bulla

epidermal fluid collection >5 mm diameter

wheal

subdermal fluid collection

pustule

purulence collection

crust

dried serum and exudate

scales

excess keratin

lichenification

epidermal thickening and roughening

keloid

excess scar tissue

excoriation

loss of superficial layer, friction related

erosion

loss of epidermis

ulcer

loss of tissue through the epidermis

woods light test

some fungal species have specific coloration under UV light

skin/patch test

method for determining induced sensitivity by applying or inoculating a suspected allergen or sensitizer into the skin and determining sensitivity to the specific antigen by an inflammatory skin reaction to it

viral

herpes simplex virus, human papilloma virus, and herpes zoster virus are all ___ infections

herpes simplex virus

may lie dormant along nerve ganglia - outbreak triggered by stress, injury, sunlight exposure

s/s include burning, tingling, erythema, vesicles, pustules, ulcers, crusts

tx options include local and systemic pain relievers, cold compress, anti-viral rx may shorten duration of outbreak

hsv 1

above the waist

hsv 2

genitals and perianal

human papilloma virus/verrucae

warts that may involve nay body site

-tx options include removal via laser, topical salicylic acid, liquid nitrogen

-preventable w vaccine

herpes zoster/shingles

reactivation of latent varicella zoster virus among nerve ganglia

-s/s include vesicles grouped along dermatomes on trunk and face, pain

-treatment options include antiviral rx, pain relievers, corticosteroids

-preventable w vaccine

tinea

s/s include erythematous macules or plaques with peripheral scaling and central clearing, vesicular lesions

-patch of red skin with peeling borders (blanchable erythema)

-tx options include antifungal cream or powder, barrier ointment, keep clean and dry

impetigo

contagious bacterial skin infection commonly caused by staph or strep species

s/s include vesicles, pustules, yellowing crusts

tx include topical antibiotic ointment, oral antibiotics

necrotizing fasciitis

flesh eating bacteria caused by group a strep, typically bacteria enters the body through a break in the skin

s/s include erythema and/or swollen area of skin that spreads quickly., severe pain including pain beyond the area of the skin that is red or swollen, changes in skin color, black spots upon skin

tx options include IV antibiotics and removal of infected tissue

scabies

contagious skin disease transmitted by the itch mite

-primary sites include web spaces, wrists, axillary folds, periumbilical skin, pelvic girdle, penis and ankles

s/s include intense pruritis (itching) especially at night, erythematous papules, excoriations and occasionally vesicles

tx include topical scabicides and topical sulfur

Cimicidae/bedbugs

nocturnal insect that feeds on human and animal blood

-hidden in darkened areas

-primary sites face neck hands arms

s/s include pruritis, oval or oblong wheals with puncture site in centers, appearing in clusters or rows

tx options include topical antipruritic, must be exterminated at the source

rocky mountain spotted fever

caused by carrier tick

-s/s include papule or macule at original tick bite site, fever, headache, muscle aches, nausea, vomiting, macular or popular rash originating on wrist or ankle then spreading to body, edema, photophobia, lethargy, AMS

treatment options include IV antibiotics

lime dz

caused by carrier tick

stage 1 erythematous papules “bullseye” lesions with pruritis, sting, or burning sensation, may have flulike s/s

stage 2 are more systemic and involve nervous system

primary sites thighs groin axilla

tx options include IV antibiotics and system management

lupus

scaly red disc shaped plaques with scarring that involves sun exposed skin; slow healing under therapy

-butterfly shaped erythema involving the cheeks and nose

tx options include topical corticosteroids

psoriasis

chronic idiopathic skin condition that runs in families and may be triggered by stress

-pruritic erythemous macular clusters covered with silvery scales

tx options include topical corticosteroids, vit d, uv light exposure, and saltwater immersion

lichen planus

common, chronic condition that may be stimulated by drugs or chemicals in susceptible persons

s/s include severe pruritis, shiny, white topped, purplish, polygonal papules on skin and mucous membranes

tx options include discontinue medications, antipruritics, topical corticosteroids, occlusive dressings

scleroderma morphea

idiopathic autoimmune disease that causes sclerosis or scar like changes to the skin

primary sites include trunk, extremities, head

s/s include asymptomatic, occasional itch, rarely painful, firm inelastic red or purple macules and plaques that slowly enlarge, centers usually thin out over time and turn whitish or brown

tx options include phototherapy, vit d, topical corticosteroids

eczema

genetic deficiency in barrier function, exacerbated by exogenous irritants

s/s include pruritis, papules, lichenification, scaling

tx options include moisturization, topical steroids, antihistamines, and antibiotics

contact dermatitis

hypersensitivity to specific irritant or allergen

s/s include pruritis, erythema, vesciles

tx options include topical steroids, cooling agents

corticosteroids

are commonly administered for management of skin disorders because they reduce inflammation

vitiligo

chronic autoimmune disorder, may occur at any age, melanocytes in certain areas lose their ability to produce melanin, leads to a loss of color in patches

tx options include topical immunomodulating agents, uv light, cosmetics

albinism

genetic condition present at birth, melanocytes throughout the body unable to produce melanin, causes white or very pale skin, eyes, and hair

tx options include limiting uv light exposure to skin and eyes

arterial insufficiency

blocked arteries prevent oxygen and nutrient-rich blood from flowing to the extremities → leads to deficiency tissue ischemia

venous insufficiency

incompetent venous valves causes venous hypertension and fluid extravasation → leads to congestive tissue ischemia

arterial ulcers

primary sites: ankles, feet, heels, toes

s/s: red, yellow, or black sores, deep wound, tight hairless skin, no bleeding, site is cold to the touch, leg reddens when dangled and turns pale when elevated

venous ulcers

primary sites: below the knee on inner areas of the ankle

s/s: inflammation, swelling, aching, itchy, hardened skin, scabbing or flaking, brown or black stained skin, discharge