Patho Exam #1 Review

Type II (cytotoxic) hypersensitivity

-Involve IgG or IgM antibody formation -When combined with action of complement, destroys target cell -occurs between 5-12 hrs Ex):Transfusion reactions Ex) Rh, Incompatibility

intake

-Most water enters the body through ingested liquids and solid food. -Some water produced by cellular metabolism = metabolic water

Over hydration (water intoxication)/hypotonic hydration

-Occurs when too much water is taken in too rapidly or renal activity is decreased -Concentration of water in ECF increases - causing concentration of electrolytes in ECF to drop -Often results in hyponatremia

Cardinal symptoms of inflammation

-Redness -Heat -Swelling -Pain -Loss of function

-Adaptive (specific) immune response

-Slow to develop -More efficient on subsequent exposures, memory cells -Includes B-cells and T-cells

passive immunity

-Transfer of preformed antibodies against specific antigen from a protected or immunized individual to an unprotected or nonimmunized individual -Provides immediate but temporary protection -Short lasting, individual does not produce memory cells from transfer -Examples include: Mother to fetus - antibodies cross placenta Mother to infant - antibodies from breast milk Serotherapy - direct injection/infusion of antibodies (human or animal)

herpes simplex virus

-Two types infect the skin: -HSV-1 - common on the lips, face, and mouth: can be triggered by fever, infection, or menses. -Cold sores - pain common, healing in 10 to 14 days, persists in latent form -HSV-2 - responsible for most infections in genital area -Usually begin with a burning or tingling sensation followed by vesicles and erythema, crusts before healing -Treatment - No cure, analgesics for pain, antivirals to shorten duration of outbreaks

fungal infections

-Typically manifests as a circular, erythematous rash accompanied by pruritus and burning -Reddened plaques with peripheral scaling and central clearing -ex) "tinea" -Treatment: topical clotrimazole and fluconazole ex) Yeast infections (candida albicans) -Treatment: nystatin and clotrimazole

carcinogenesis

-a potential cancer-causing agent Steps: Initiation (conversion)-events which result in changes (mutations) to chromosomes or DNA -Promotion (Development) - Stage during which mutated cell proliferates -Progression - Mutant, proliferating cells begin to exhibit malignant behavior, permanent changes

resistance/adaptation

-activity of the nervous and endocrine systems in returning the body to homeostasis -Body must move beyond the alarm stage -Cortisol levels and the sympathetic nervous system return to normal -Fight-or-flight symptoms begin to decline -The body either adapts or alters its workings to limit problems or become desensitized to the stressor

Malignant tumor

-cells ignore growth controlling signals -Proliferate despite lack of growth-initiating signals from the environment -Escape signals to die and achieve a kind of immortality -Display a lack of differentiated features (anaplasia) and contribute poorly or not at all to the function of their tissue -Greater degree of anaplasia is correlated with a more aggressive tumors -Anaplasia - indicated by variation in cell size and shape within the tumor, enlarged nuclei, abnormal mitoses, and bizarre-looking giant cells -Metastasis - process by which cancer cells escape their tissue of origin and initiate new colonies of cancer in distant sites

wart (verrucae)

-common benign papillomas (lesions) caused by DNA-containing papillomaviruses (HPVs) -transmitted by touch -Thickened composition of skin -Treatment - surgical removal by laser, liquid nitrogen, cryotherapy or salicylic acid, immunomodulators

pathogenesis

-development or evolution of disease, from initial stimulus to ultimate expression of manifestations of the disease -affected by time, quantity, location, and morphologic changes

Hypercalcemia

-excess levels of calcium in blood (>10.5 mg/dL) S/S: -diminished reflexes -headache, -confusion -lethargy -muscle weakness (due to decreased neuromuscular excitability -renal calculi and cardiac arrhythmias

Leukotrienes

-fatty molecules -contraction of bronchiolar smooth muscles -promote emigration of mature monocytes called macrophages (type of phagocyte) and platelets to site of injury

hypernatremia

-increased levels of Na+ in serum S/S: -excess thirst -lethargy -muscle twitching -convulsions

histamine

-increases the permeability of blood capillaries, vasodilation, urticaria, pruritis -Released by mast cells and basophils, especially during allergic reactions, triggering the inflammatory response. -increases the permeability of the capillaries to white blood cells and other proteins, allowing them to engage foreign invaders in the infected tissues.

Hypophosphatemia

-low levels of phosphate (<2.5 mg/dL) S/S: similar to hypercalcemia

Benign tumor

-more closely resembles original tissue type -grows more slowly -little vascularity -rarely necrotic -cells often retains original function -rarely fatal, but may be life-threatening depending on its location -does not invade adjacent tissue or spread to distant sites -strictly local, many are encapsulated

C) epinephrine

All of the following are mediators of inflammation EXCEPT: A) histamine B) prostaglandin C) epinephrine D) leukotriene

A) hypotension

All of the following contribute to edema EXCEPT: A) hypotension B) decreased plasma proteins C) increased blood volume D) increased capillary hydrostatic pressure

thrombocytopenia

An effect of cancer on the body including deficiency in circulating platelets

leukopenia

An effect of cancer on the body including deficiency in circulating white blood cells

cachexia

An effect of cancer on the body including: -overall weight loss and generalized weakness -Loss of appetite (anorexia) -Increased metabolic rate -Nausea/vomiting

anemia

An effect of cancer on the body: -deficiency in circulating red blood cells

hyponatremia

Low ECF concentration of Na+. Water moves from ECF to ICF- causing cells to swell with water. S/S -Nausea and vomiting Bounding pulses, hypertension -Crackles in lungs due to pulmonary edema -Muscular cramping -Cerebral edema ---> convulsions, coma and death

Endoplasmic Reticulum (ER)

Series of folded membranes that move proteins around the cell (Ribosomes attached to rough __________ are the site of protein synthesis

secondary disease prevention

early detection/diagnosis, screening, and management of disease ex) cancer screening, vision screening, performing monthly breast examinations, pap smears, BP screening, hearing testing, scoliosis screening, and tuberculin skin testing.

Hyperphosphatemia

excess levels of phosphate in the blood (> 4.5 mg/dL) S/S: rarely seen alone, similar to hypocalcemia

alarm stage

generalized stimulation of the sympathetic nervous system (SNS), resulting in the release of catecholamines (norepinephrine and epinephrine) and cortisol, also known as the fight-or-flight response -Hypothalamic-pituitary-adrenal (HPA) axis -Provides a surge of energy and physical alterations to either evade or confront danger

Extracellular fluid (ECF)

has high concentration of sodium (Na+), chloride (Cl-), and HCO3- (sodium bicarbonate)

Hypomagnesemia

low levels of magnesium (<1.8 mEq/L) S/S: similar to hypocalcemia

Peroxisomes

membranous sacs containing a variety of powerful enzymes such as oxidase (detoxify) and catalase (break down hydrogen peroxide) -found in liver and kidney cells

tertiary disease prevention

preventing further complications from the initial disease/disorder Focuses on rehabilitation, supportive care, reducing disability, and restoring effective functioning Ex) PT/OT following stroke

osmosis

process which allows for fluid (water) distribution between interstitial space and intracellular compartment. This is an example of passive transport: Water moves from an area of high water concentration (low solute concentration) to an area of low water concentration(high solute)

Hypocalcemia

reduced levels of calcium in serum (<8.5 mg/dL) -S/S: -Increased excitability of muscles, -hyperactive reflexes, -tremors, -tingling sensation in muscles, -tetany (stiffening), -cramps, -positive Trousseau sign, -positive Chvostek sign

diffusion

tendency of molecules or ions to distribute evenly throughout the environment. This is an example of passive transport where substances move down their concentration gradient (from high concentration to low)

epidemiology

the branch of science that analyzes patterns of disease in a group of people. Such tracking of disease patterns includes: -occurence -incidence -prevalence -transmission -distribution

clinical manifestations

the clinical effects or evidence of a disease. They may include both signs and symptoms

active immunity

-A protected state owing to the body's immune response as a result of active infection or immunization -Immunizations Vaccines contain altered microorganisms or toxins Retain ability to stimulate immune system Produces memory B and T cells Second exposure: quicker immune response

hypersensitivity

-Antigenic response beyond what is considered normal -Response to antigens (allergens) leading to damage

exhaustion

-If stressor is not removed/overcome/is prolonged or overwhelms the body , ________ occurs -As the body's defenses are utilized, disease or death results. Diseases and ailments that have been attributed to stress include anxiety, depression, headaches, insomnia, infections, and cardiovascular disease

Innate (nonspecific) defense system

-Immediate, occurs on initial exposure to antigen -Includes chemical and physical barriers that prevent invasion -Fever, inflammation, phagocytes

Hypermagnesemia

uexcess levels of magnesium in the blood (> 2.5 mEq/L) S/S: similar to hypercalcemia

signs

what can be seen/observed or measured (OBJECTIVE). Ex) rash, change in temperature, bruise

Type I Hypersensitivity (anaphylactic)

-occurs within 2-30 minutes of antigen exposure -Can be systemic or local Antigen binds to IgE attached to mast cells and basophils Mast cells and basophils undergo degranulation, which releases mediators: histamine, leukotrienes, and prostaglandins Ex) Mild: Hives, Seasonal allergic rhinitis, Eczema More problematic: Throat constriction, localized edema, wheezing, tachycardia Anaphylaxis: Most life-threatening reaction-occurs in very small number of highly allergic individuals....shock from drug injections and insect venom; common allergic conditions, such as hay fever, asthma

Antimicrobial Resistance

-resistant strains of microorganisms emerge following exposure to antibiotics -Caused by excessive use of antibiotics or subtherapeutic dosing -Susceptible strains die, creating a drug-resistant infectionpre

bradykinin

-stimulates pain receptors -induce vasodilation and contraction of smooth muscle

Treatment Implications

-strategies used to manage or cure a disease -May focus on eliminating the cause of the disease -May be used to alleviate the disease's clinical manifestations

etiology

-study of causes or reasons for phenomena -identifies causal factors, that, acting in concert, provoke a particular disease or injury -May include infectious agents, chemicals, and environmental influences.

pathophysiology

-the study of the disorder or breakdown of the human body's function -The study of changes in normal anatomy and physiology associated with disease or injury.

Hypokalemia

-too little potassium in serum (<3.5 mEq/L) S/S: -Muscle weakness -paralysis, -irregular heartbeat

symptoms

-what the patient describes -SUBJECTIVE feeling of abnormality in the body Ex.) pain, nausea, headache, loss of appetite

dehydration

-when water output exceeds intake over a period of time (extracellular volume deficit) -Water from ECF is lost/low water concentration--> solute concentration of ECF increases - water moves from ICF to ECF S/S include: -Dry or cotton mouth -Extreme thirst -Dry flushed skin -Decreased urine output (oliguria) -If prolonged, may lead to weight loss, fever, and mental confusion, hypovolemic shock (decrease in blood volume)

herpes zoster

:Shingles - acute localized inflammatory disease along a dermatomal segment of the skin caused by varicella zoster (chickenpox) :Results from reactivation of the latent virus :Eruption of painful vesicles with erythematous bases typically unilateral, causes paresthesias :Treatment - antiviral drugs, preferably within 48 hours :Prevention - vaccination

prostaglandins

A group of lipid compounds that have a variety of effects, including constriction or dilation of vascular smooth muscle cells, control of cell growth, and sensitization of spinal neurons to pain. -increase mucus secretion

B. Herpes zoster

A patient has an eruption of vesicles on one side of the body with erythematous bases along sensory neuron dermatomes. Which disorder will the clinician observe documented on the chart? A.Varrucae B.Herpes zoster C.Syphilis D.Impetigo

A) Cardiac dysrhythmias.

A patient presents to the emergency room with a K level of 6.5. What potentially life threatening complication would you assess for? A) Cardiac dysrhythmias. B) Decreased urine output. C) Nausea and vomiting. D) Ataxia.

Type IV (Delayed Cell-Mediated, or Delayed Hypersensitivity)

Cell-mediated immune responses caused by T cells causing sensitization -memory cells to release destructive cytokines occurs between 24-48 hrs Ex): Mantoux screening test for TB Contact dermatitis - reactions to poison ivy, certain metals, latex. Rejection of transplanted tissues, contact dermatitis, such as poison ivy; certain chronic diseases, such as tuberculosis

A) hyponatremia

Cerebral edema is a potentially fatal consequence of which electrolyte imbalance? A) hyponatremia B) hypernatremia C) hypocalcemia D) hyperkalemia

parasympathetic nervous system (PNS); "Rest and Digest"

Decreased heart rate, decreased blood pressure, pupil constriction, stimulate activity of intestines, inhibit release of glucose occur.

physiologic; stress (SNS)

Decreased motility, dilated pupils, and increased heart rate, increased respirations, and increased glycogenolysis occur as ________ responses to _____

Hypercalcemia and hypermagnesemia.

Decreased neuromuscular excitability can be seen in which two electrolyte disorders?

D) Exhaustion.

During which of the following stages of the General Adaptation Syndrome (GAS) has the body's coping methods been completely utilized? A) Alarm. B) Resistance. C) Transference. D) Exhaustion.

C) mitochondria

Enzymes that use oxidation to convert food materials into energy are found in sausage-shaped structures called __________. A) endoplasmic reticulum B) ribosomes C) mitochondria D) Golgi apparatus

Hyperkalemia

Excess potassium in serum. u(>5 mEq/L) S/S: -Intestinal cramping -diarrhea -irregular heartbeat

Type III (immune complex) Hypersensitivity

IgG antibodies and antigens form 'immune complexes' occurs between 3-8 hrs -Antibodies and antigens for complexes that cause damaging inflammation -Examples - rheumatoid arthritis (RA), glomerulonephritis (inflammation of kidneys), SLE, arthus reactions, serum sickness

C) reducing the impact of comorbidity on physical functioning and premature mortality.

In the context of aging, tertiary prevention refers to: A) prevention of incident diseases and geriatric conditions B) early detection, treatment and management of prevalent and recurrent conditions. C) reducing the impact of comorbidity on physical functioning and premature mortality. D) public health promotion of preventive healthcare.

C) reducing the impact of comorbidity on physical functioning and premature

In the context of aging, tertiary prevention refers to: A) prevention of incident diseases and geriatric conditions B) early detection, treatment and management of prevalent and recurrent conditions. C) reducing the impact of comorbidity on physical functioning and premature mortality. D) public health promotion of preventive healthcare.

C) Hypotonic fluids.

The most appropriate therapy for an individual with hypernatremia is: A) Volume expansion with normal saline. B) Administration of colloids. C) Hypotonic fluids. D) ACE inhibitors.

Intracellular fluid (ICF)

contains mostly potassium, magnesium, and hydrogen phosphate

Golgi Apparatus

Protein "packaging plant" - cell post office -Move materials within cell and out of the cell

B) Low concentration of plasma proteins

Reduced capillary osmotic pressure can be caused by which of the following? A) Dehydration B) Low concentration of plasma proteins C) Increased hydrostatic pressure in the veins draining the capillaries D) Edema

A) True

Sodium, bicarbonate, and chloride are found in higher concentrations in the extracellular fluid (ECF) compared to the ICF A) True B) False

D) Initiation, Promotion, Progression

The cancer growth continuum is divided into the following stages: A) Stage 1, Stage 2, Stage 3 B) Initiation, Progression, Promotion C) Preliminary, Evolutionary, Metastasis D) Initiation, Promotion, Progression

A) break down particles or worn-out cellular components.

The function of lysosomes is to: A) break down particles or worn-out cellular components. B) convert food materials into energy. C) produce digestive enzymes and antibody proteins. D) aid in cell division.

A) The kidneys.

The main source of serum bicarbonate is obtained from: A) The kidneys. B) Dietary intake. C) Synthesis by the liver. D) Medications containing sodium bicarbonate.

D) induces short-term protection

The major disadvantage of passive immunization is that it: A) is ineffective B) is expensive C) interferes with active immunization D) induces short-term protection

A) "Histamine dilates the vessels in the nose, so it is congested and stuffy."

The nurse conducts group education for patients with seasonal allergies, and teaches about the role of histamine. The nurse evaluates that the education has been effective when the patients make which response? A) "Histamine dilates the vessels in the nose, so it is congested and stuffy." B) "Histamine is inhibited by allergies, therefore leading to the signs and symptoms." C) "Histamine constricts vessels, causing capillaries to become more permeable." D) "Histamine is primarily stored in phagocyte cells in the skin."

1) Etiology 2) Pathogenesis 3) Clinical manifestations 4) Treatment Implications

The study of pathophysiology includes 1) ___________ 2) ___________ 3) ___________ 4) ___________

excretion

Water output ( ____________ ) occurs by several routes: Urine (60%), sweat, feces, and water vapor from lung via exhaled air

C) Blood vessels expand and become more permeable.

What happens when the vasodilator histamine is released by the mast cells? A) The inflammatory process is ended. B) Blood platelets adhere to collagen fragments and begin the healing process. C) Blood vessels expand and become more permeable. D) Blood vessels constrict and become less permeable.

D. Has greater degree of anaplasia

Which characteristic best describes a malignant tumor? A.Is encapsulated B.Is localized C.Has little vascularity D.Has greater degree of anaplasia

A) Elevated temperature

Which of the following are systemic effects from an inflammatory response? A) Elevated temperature B) Redness and swelling C) Blisters D) Pus

D) Elevated erythrocyte sedimentation rate Rationale: the other manifestations are local

Which of the following findings is a systemic sign of inflammation? A) Pain B) Loss of function C) Edema D) Elevated erythrocyte sedimentation rate

C) Epinephrine. Rationale: Epinephrine produces much of the "fight-or-flight" symptoms. Insulin is not produced during this response and is not produced by the adrenal medulla. Cortisol is released during this response but by the adrenal cortex. Corticotropin is produced by the hypothalmus.

Which of the following is a chemical released from the sympathetic nervous system by the adrenal medulla that is responsible for many of the physiological symptoms of the "fight or flight" response? A) Insulin. B) Cortisol. C) Epinephrine. D) Corticotropin.

D) Placental transfer of antibodies.

Which of the following is an example of passive immunity? A) Immunizations. B) Transplant rejection. C) Response to a disease. D) Placental transfer of antibodies.

D) A penicillin reaction characterized by fall in blood pressure and respiratory distress after an injection of penicillin in a person who has become sensitized to penicillin as a result of a previous penicillin injection

Which of the following is an immunoglobin E (IgE)-mediated hypersensitivity reaction? A) A transfusion reaction resulting from an infusion of incompatible blood into a person who has pre-existing antibodies directed against the transfused cells B) Organ or tissue damage resulting from deposition of antigen-antibody complexes in the organs or tissues of an affected person C) An area of swelling and tenderness in the skin after an intradermal injection of protein material derived from the tubercle bacillus D) A penicillin reaction characterized by fall in blood pressure and respiratory distress after an injection of penicillin in a person who has become sensitized to penicillin as a result of a previous penicillin injection

A. Type I hypersensitivity

Which of the following is mediated by mast cells and the production of IgE? A.Type I hypersensitivity B.Type II hypersensitivity C.Type III hypersensitivity D.Type IV hypersensitivity

A) Contraction of vascular smooth muscle

Which of the following is not a part of the inflammation process? A) Contraction of vascular smooth muscle B) Increased blood flow C) Increased permeability of vessels D) Dialation of vessels E) Intracellular gaps in vessels which passage of large proteins

B) 3.5 - 5 mEq/L

Which of the following is the normal range for potassium? A) 135 - 145 mEq/L B) 3.5 - 5 mEq/L C) 1.8 - 2.5 mg/dL D) 8.5 - 10.2 mg/dL

E) It exists in almost all chronic illness in the body.

Which of the following is true about inflammation? A) It is a specific response to an insult. B) It requires previous exposure. C) It is the second level of response to injurious agents. D) It only lasts for short periods of time E) It exists in almost all chronic illness in the body.

D) passive

Which type of immunity is developed following injection of antibodies synthesized by another human or animal? A) adaptive B) active C) innate D) passive

B) Hypercalcemia

While performing an admission assessment on a patient with the diagnosis of bone cancer, you determine that your patient has a history of Paget's disease. The patient's family informs you that the patient has had some recent muscle weakness and personality changes. You would want to assess the patient's lab values for which of the following? A) Hyperkalemia. B) Hypercalcemia. C) Hypokalemia. D) Hypocalcemia.

A) Type I

Within minutes after receiving an injection of penicillin, the patient complains of shortness of breath and chest pain. The nurse notifies the patient's healthcare provider because this patient is most likely experiencing which type of hypersensitivity? A) Type I B) Type II C) Type III D) Type IV

General Adaptation Syndrome (GAS)

a cluster of systemic manifestations that represent an attempt to cope with a stressor -Three stages—alarm, resistance, and exhaustion

homeostasis

a state in which all systems are in balance, a state of equilibrium -Maintaining internal conditions stable -the organism must be able to successfully adapt to challenges -this self-regulating, give-and-take system responds to minor changes in the body's status through compensation mechanisms. Compensation mechanisms attempt to counteract those changes and return the body to its normal state.

edema

accumulation of fluid in the interstitial space - leading to tissue swelling. Factors that contribute: -blood vessel blockage, incompetent venous valves -inflammation -Congestive heart failure -High blood volume or HTN -Decrease in plasma proteins (such as albumin) -Blockage of lymphatic drainage (due to cancer or removal of lymph tissue)

primary disease prevention

altering susceptibility or reducing exposure for susceptible persons. The focus is on disease PREVENTION ex) Immunizations/vaccines

impetigo

bacterial infection -Acute contagious skin disease characterized by vesicles, pustules, and yellowish crusts, "honey crusted lesions" -Usually caused by staphylococci or streptococci -Treatment: Topical antibiotics, Oral antibiotics for large area of infection or if febrile