Patho Exam 1
you’re patient is coming with some complaints. They’re telling you that they’re feeling dizzy when they stand up do I call this a sign or symptom ? symptom and it’s subjective it’s not a sign so it’s not objective
can you define homeostasis, is that when the bodies are equal at like that equilibrium equilibrium that’s the keyword so that’s the stat state of equilibrium or balance in the body OK
during the general adaptation syndrome or what we called GAS what does our body secrete or what chemicals are increased during the alarm phase ? epinephrine we called those catecholamines.
what is the function of mitochondria powerhouse of the cell produce ATP or energy
when there is an increase in the number of cells in the organ or tissue what we call that? hyperplasia
now tell me an example of systemic alteration in Homeostasis? a fever,.
What is the function of the endoplasmic reticulum? ribosomes and what do they do make proteins
which electrolytes are found extracellular? sodium and chloride,
which one of them which one is being regulated by the kidneys, and the aldosterone hormone ? sodium
which organelle in your in our cells is contains, the genetic information? nucleus,
which organelle is responsible for sorting and packaging proteins not taking to them. Golgi apparatus or Golgi complex
which organelles the digestive fatigued, organelles in materials in the cell the digested ? lysosome
which structure in the cell is a semi permeable lipid bilayer? Cell membrane., the plasma membrane
which process involves 1 cell dividing into two genetically identical and equal daughter cells ? mitosis,
which type of tissue is tightly packed and tightly, packed cells and acts as a barrier which type of tissue? epithelial tissue
what term do we use when we are talking about uncontrolled pressure proliferation with loss of differentiation there’s no differentiation? anaplasia
anaplasia there is a lot loss of differentiation
what can be a cause of edema ?
Hydrostatic pressure
what can cause fluid volume deficit if your patient has what? dehydration, so what causes that dehydration what are the experiencing ? vomiting and diarrhea.
water between compartments what do we call that?
Osmosis
If your patient has fluid excess in their body, what are the manifestations? Bounding pulses , high blood pressure.
If that fluid is accumulating in the lungs, what are we going to hear? Crackles
Which electrolyte will be in high concentration, intracellular? Potassium.
What is responsible for a lot of fluid excretion? Urine and sweating
What can you tell me about hyponatremia?
Low sodium , potentially fatal brain swelling
Anything with sodium remember N
Neuro, something in the brain .
and the potassium any imbalance in the potassium K Cardia so any question about in balancing hyper or hypo natremia you will pick something with the Nuro nervous system or brain OK and anything that is increase or a decrease in potassium. You will pick anything cardiac anything to the heart whatever answer you have discussed in the heart that’s what you will take for potassium for sodium you’ll take anything Nuro brain nervous system.
If your patients potassium is at a 1.5 what are you expecting to see? Irregular heart rhythm.
What can be a reason of metabolic alkalosis? Excessive vomiting.
Movements of solute not water from low to high concentration area and use in ATP energy what do you call this? Active transport
Which type of IV solution can causes fluid to shift from intracellular to extracellular? Hypertonic.
What is isotonic? Normal saline
Concentration of normal saline,? 0.9
Which ion is responsible for acid base imbalance? Hydrogen.
Your patient is deficient in calcium and have trousseaus and chvostek’s signs they are higher risk for?
Hypocalcemia
How does a patient become low in calcium and has trousseaus or chvostek’s signs ?
Alcohol abuse
Which process we call cell eating , where the cells are bringing any solid substance inside?
Phagocytosis
What do we call cell drinking?
Pinocytosis
0.9% of sodium chloride is ? isotonic solution.
What do we call the process where there are the solutes
Or the salts are moving from high concentration to lower concentration?
Diffusion
The salts are moving from high concentration to a lower concentration with a helper like a carrier molecule what do you call that? again solutes?
Facilitated diffusion
If the cell is pushing making pertein containing vesicles and fusing them to the cell membrane expelling them outside. What do we call that?
Exocytosis
Which type of transport uses the sodium potassium pump? Active transport
Know pH values
pH = 7.35-7.45
Acidosis < 7.35
Alkalosis > 7.45
CO2 = 35-45
Resp Acid pH < 7.35, CO2 > 45
Resp Alk pH > 7.45, CO2 < 35
HCO3 = 22-26
Metab Acid pH < 7.35, HCO3 < 22
Metab Alk pH > 7.45, HCO3 > 26
Sodium normal range : 135-145 mEq/L
Chloride normal range : 98-108 mEq/L
Potassium normal range : 3.5 – 5 mEq/L
Calcium normal range : 4-5 mEq/L
Phosphorus normal range: 2.5-4.5 mg/dL
Magnesium normal range: 1.8-2.5 mEq/L
Which one leads to cell swelling?
Hypotonic
Is carbon dioxide a acidic product of the cell?
Yes , remember ABG carbon dioxide is an acid
when there is a dehydration or fluid volume deficit in the body the patient will have thirst, and dry, mucous membranes
When you have a area of cellulitis which is information of that cell this area looks red and warm why is that? histamine increase blood flow.
what are the cells that are secreting histamine?mass cells.
Example of passive immunity
Breast milk, IGA
IGA is present in what? Breastmilk and saliva and tears
IgG passes through the placenta and gives immunity for the first 3 to 6 months
Hypersensitivity
Type 1 IgE mediated Ex. Allergic reaction to food, hives/urticaria.
Type 2 cytotoxic hypersensitivity, IgG or IgM. Ex. Erythroblastosis Fetalis. Cell lysis occurs due to activation of complement and phagocytosis.
Type 3 Immune complex-mediated, Circulating antigen-antibody complexes accumulate in tissue
Type 4 Delayed Hypersensitivity, Cell-mediated (T Cell), not antibody-mediated. Ex. Mantoux test – Poison Ivy
What is the role of neutrophils in the inflammatory process? They are the ones responsible for phagocytosis.
Which cells are mature, monocytes and migrate to that area through the blood and engulf any foreign antigen in the body?
Macrophage
If your patient has some allergies, what type of cells are you going to see that are elevated?
eosinophils and basal cells
What is the best way to prevent transmission of infection? handwashing
If your patient has a sprain or strain and their ankle is swollen, and we mention that the swelling is edema to increase the capillary permeability, and the hydrostatic pressure is the cause of this swelling which cells in your body are responsible for creating antibodies?
B-cells
Manifestations of local inflammation select all that apply?
Redness, swelling, pain, warm, loss of function
Fever is systemic It is not local information.
What is the name of small proteins that is released by virus, infected cells? Interferons
What is our first barrier to any microbes?
Skin ,, immune mucous membranes
If you see any Krushin butterfly rash, what is that? Lupus
What is an auto immune disease
That causes inflammation in synovial membranes around the joints
rheumatoid arthritis.
If you have labs values and you see the neutrophils elevated what does that mean what type of infection? Bacterial
Neutrophils increase when the body is trying to fight off a bacterial infection
Histamine is a vasodilator.
Give me example of active immunity? Vaccinations
can be considered artificial.
Natural, active immunity when you’re exposed to a virus
What is an example of an artificial passive immunity? Injection of immunoglobulin
Natural passive immunity Antibodies transmitted from mother to baby
What type of cells are specialized cells and are associated with the adaptive immunity response? Lymphocytes.
Macrophages are not adaptable
Lymphocytes are associated with adapted immune response
Opportunist and affection
What is that ?
Affections that immuno compromised
What is a foreign body or foreign agent that triggers immune response?
Antigen
When the monocytes are he differentiated they make the macrophages
The cells that develop from B cells and that are responsible for making antibodies. What are they? Plasma cells
Plasma cells, make antibodies and develop from the B - cells
Where do the T cells mature? The thymus gland.
Where do the B cells mature? Bone marrow
What are the substance or molecules that are released by the bacteria or the cells infected by the bacteria to regulate body temperature? Pyrogens
What type of T- cells they destroyed the virus infected cells when they release lymphokine lympha kinds ? The killer or cyto toxic T cells
Type of transplant where we use the tissue organs from the same species but they are not identical to the host what type of transplants is that?
Allogenic trans plant
Which transplant it going to be from another species that is not identical ? Xenogenic
Transplant, rejection reaction
Four days or 3 months after the transplant? Acute rejection reaction.
Which type of Immunoglobulin you will find in type one hypersensitivity reaction? IGE
Which lab test will be increased during inflammation? ESR
When our body is exposed to chronic stress what are we expecting? Blood pressure , high heart rate, blood sugar increase, depression
Are antibodies considered adaptive immune response? Yes.
when we were talking about type two hypersensitivity reaction and give an example of blastosis Vitalis we can also Calle this cytotoxic hypersensitivity reaction.
Type three hypersensitivity is an antigen antibody complex like lupus
HIV or aids what cells are affected?
CD4 or T helper
What is the difference between primary and secondary disease? Primary is genetic and secondary is medication’s.
Type four is a delayed hypersensitive reaction
So in the general adaptation syndrome, there are some stages know each one of them the resistance stage the alarm stage no the three of them the exhaustion stage I’m not gonna go over them, but they are exactly what are in the PowerPoint exactly OK so make sure to review those changes
General adaptation syndrome
Alarm stage = epinephrine
Resistance stage
Exhaustion stage
What are the function of T cells in protecting the body? Or what we Cell mediated immunity? Recognize that antigen and bind to it to produce that immune response from the white blood cells later
B cells make antibodies
Which patient is going to be at highest risk for being immune compromised or immune suppressed? Older patients with comorbidities which is a another disease
What does what do I mean by the term cachexia ? Yeah we mentioned that in when we were discussing cancer patients. overall weight loss or weakness
Properties of cancer cells. Cell proliferation,
Cancer cells going distance to other descent organs what are they called? Metastasize
No the three steps of carcinogenesis initiation, promotion , progression
Carcinogenesis
Initiation introduction of the agent
Promotion uncontrolled growth
Progression permanent malignant changes
How do we screen for breast cancer? Mammograms
Begin screening for colon cancer – 50 years old
New cellular growth. What am I looking for with this term? Neoplasia
Benign tumors are encapsulated
A patient has contact dermatitis what do I mean? Becoming in contact of the an allergen or foreign body to the skin
Derma skin,
titis is inflammation
the word linear bureaus what is that a key word for ? what Type of infection skin infection?
Scabies
And psoriasis what type of cells are rapidly proalifuationg? Keratinocytes
What do I mean by hemangioma? How does it look like ? Tumor of the blood vessels.
What are the types of bacteria that are you most commonly causing the skin infection?
Strep and staph
if we’re talking about lice, causing pediculosis What are they feeding on?
On the host blood
How does a patient develop pressure injury or pressure ulcer? The skin being on bony providence
Your patient is an athlete and they go to the gym lot and they do have a problem with around the toes with itchy rash, and erythematous what type of infections that? Tenia.
If we have a decreased or no melanin at all in the skin and the hair what do we call that ? albinism
An auto immune disease destroying the melanocytes? vitiligo
The shingles or the herpes zoster when you get to see vesicles , so what do I mean
when you are looking at a skin lesion and you are evaluating it according to the ABCD what do what do I mean by each letter of these? Asymmetry, border, color, diameter, evolving
What areas of the skin or more at risk of getting skin cancer? The exposed to the sun
A newborn lower back has a blue grayish patch what do we call this birthmark?
Mongolian spot
When we are talking albinism they are changes not only affecting their eyecolor a hair color. What else is it affecting? Optic nerve (vision)
If your patient has some skin lesions, and Looks like cone shape papules they are small they are pink due to pox virus infection what do we call that?
Molluscum contagiosum
No, the definition of a furuncle
Begin in hair follicles & Spread into the surrounding dermis
Carbuncles are clusters of furuncles. Start as firm red painful nodule that develops into a large painful masss which frequently drains large amounts of purulent exudate
if your patient has a pressure ulcer that is extending all the way to the dermis and subcutaneous tissue, so which stage is that? third stage
Rosacea what was the key word for rosacea? Spider like
If your patient has a third-degree burn, they will have a blackened tissue .
Adolescence, with inflamed pustules on the forehead and the cheeks, and they are painful. What is it? Acne
Another typical scenario related to vitiligo is when the patient is reporting patches of the skin they’re losing the pigmentation slowly and it’s growing in size.
What can cause gout? Barrick acid because there is a problem in the metabolism of what? Peering
What happens when your patient has Muscular dystrophy? Loss of muscle.
What’s the problem with Osteoarthritis?
Wear and tear
Osteoporosis is caused by the imbalance of osteoblast and osteoclast.
now when there is an increase in the concavity or curvature of the lumbar spine what do we call that?
Lordosis
What about Lateral curvature? Scoliosis
What do we call the infection of the bone? osteomyelitis
when your patient has a fracture or history of a fracture after surgery what are they at high risk for if they’re complaining of shortness of breath, fatigue .
Fatembolism
what if there is an impairment in the blood
supply due to edema under a cast what do we call that?
Compartment syndrome
If your adult patient has a deficiency in vitamin D, what does it put them at risk for?
Osteomalacia
And children, vitamin D deficiency is called rickets
When there is a joint and the two bones that are forming that joint are separated what do we call that? Dislocation.
Gangrene is called Gas grene
A tear in the tendon what do we call that? a strain
What happens in a herniated disc? Impaired nerve conduction and anesthesia.
Who are more at risk for stress fractures?
Marathon training
For fibromyalgia what’s going on here? They have a over sensitivity to substance P.
Genetic where the collagen in the bone decreases the amount of collagen the bone and causes the bones to be weakened fracture what is it? Osteogenesis imperfecta
genesis is the formation or creation of bone
imperfecta is not perfect so the bones the formation of bones is imperfect that’s what causes the brittle bones
The developmental hip dysplasia is when the ligaments around the hip joints are relaxed.
OK also no Paget disease you got a you might have another question about Paget disease and anti-losing spondylitis go to view those in the PowerPoint, OK?
osteosarcoma is that a benign or malignant tumor? Malignant tumor
If you see a question about bone cancer or bone tumor, it’s osteosarcoma
Know the five P of the compartment syndrome
Pain, Pallor, Paresthesia, Paralysis, Pulselessness
No compression fractures
Compression fracture: Bone is crushed or collapses into small pieces
Osteoporosis they are a high risk of what? Pathologic fractures.
When we have deformities in our spine what system does it affect in our body? Respiratory system
Systematic lupus is nine times more in women than men
Osteoporosis will lead to kyphosis of the spine
When the bones are protruding out of the skin because of a fracture, what do we call that fracture? Open fracture
Typical Scenario: Pt presents with radiating pain starting in the buttocks and extending down the back or side of one leg, with tingling and numbness.