Exam 1 Pathophysiology HSC4555 UCF

examples of malignant

"-carcinoma" "-sarcoma" leukemia lymphoma hepatomas melanoma (these "-oma"'s are an exception to the rule, all others typically benign)

Five signs of inflammation

"PLRSH" *P*ain *L*oss of function *R*edness *S*welling *H*eat

stage 3 clinical manifestation

"acute phase" disease/illness at full intensity

caseous necrosis

"clumpy cheese" EX: lung damage from TB

something to keep in mind with etiology

"correlation does not imply causation" Someone who's never smoked cigarettes can get lung cancer, or, someone who doesn't drink a lot can get liver cirrhosis.

Type IV hypersensitivity

"delayed" *T lymphocytes* = mediator slow onset and can last up to weeks after exposure IVa, IVb, IVc, & IVd

IgA antibody

"dimer": two antibodies joint plasma cells produce It found in: saliva, tears, breast milk, GI secretions

anaplasia definition

"downgrading" from high differentiation to low (from mature to immature)

Type I hypersensitivity

"immediate" "allergens" *IgE* = mediator Mast cells / basophils = effector cells

stage 4 clinical manifestation

"latent period" or "decline" time when signs/symptoms become mild, silent, or disappear

stage 1 clinical manifestation

"latent period" or "incubation period" from inoculation (exposure) to first showing signs/symptoms

Hypersensitivity

"normal" response that gets out of hand; often does not occur upon 1st exposure. (either excessive, creates wrong effects, or randomly triggered

IgM antibody

"pentamer": 5 joint first to get produced after exposure to antigens or after immunizations found on B cell surfaces (best one to activate compliment system)

stage 2 clinical manifestation

"prodromal period" nonspecific signs and symptoms arise (these are linked to many types of sickness/disease/ailments...i.e. cough, fever, headache...)

MHC class *II* protein

"professional cells only" -dendritic, macrophages, and B cells only get to express *extracellular* (helper T can only read It not express It)

Polygenic and Multifactorial Disorders (VERY COMMON)

"runs in the family" polygenic: many genes for one seen trait/disorder multifactorial: genes AND environment for one seen trait/disorder

stage 5 clinical manifestation

"subclinical stage" time when "normal" functioning returns, disease processes can also simply be well established by this point (EX: chronic renal disease)

Type II hypersensitivity pathogenesis (development)

"tissue specific" *IgG/IgM* = mediator Ex: transfusion of blood reaction (reactions occur only after antibody binds to antigen on cell surface)

cachexia

"wasting away" due to cancer -loss of appetite (anorexia) -immune system suppression -weakness -metabolic rate increased -nausea/vomiting

CAUTION mnemonic for cancer

*C*hange in bowel/bladder *A* sore that doesn't heal *U*nusual bleeding/discharge *T*hickening or lump *I*ndigestion/difficulty swallowing *O*bvious change in wart/mole *N*agging cough/hoarseness

grading of cancer

*how "abnormal" cell are / how aggressive they'll become*" (1, 2, 3, 4) (higher # = higher chance of malignancy) based on: size/shape, mitotic divisions, tubule formation

staging of cancer

*how far the cancer has spread* (I, II, III, IV) based on: size of tumor, its invasiveness, lymph node/organ spread

Mechanism of Cell-Mediated Immunity

-*cytotoxic T cells* along with *CD8* protein able to bind to MHC I -once cytotoxic T cells are activated they become *memory cells* and *effector cells* -effectors: cytotoxic effects by perforin (perforate/puncture holes in bad cells = apoptosis) -*T helper cells* along with *CD4* protein able to bind to MHC II -binding produces cytokines (interleukins + interferon)

components of healing

-*fibroblasts* (create connective tissue) -*endothelial cells* (form new capillaries) -*myofibroblasts* (occur at edges of the wound and help close it)

Mechanism of Humoral Immunity

-*memory B cells*: antigen receptors, memory B clones have memory, quick response in future exposure -*plasma cells*: create antibodies, bind specifically with antigen that triggered its creation -B cells engulf and present antigens to T helper cells which provide the B cell with cytokines it needs for proliferation and antibody synthesis

HUMORAL (adaptive immunity)

-B cells -extracellular defense -create antibodies

physical and mechanical injury

-Extremes in temperature -Abrupt changes in atmospheric pressure -Mechanical deformation -Electricity -Ionizing radiation

congenital (primary) immunodeficiency EXAMPLES:

-IgA deficiency (B cell disorder) -DiGeorge Syndrome (T cell disorder) -Severe combined immunodeficiency disorder "SCID" (absent or dysfunctional T cell and/or B cells) -Wiskott-Aldrich (X-linked, affects both T and B cells)

Example of Sex Chromosome Aneuploidy

-Klinefelter Syndrome (extra X in *males*: so its XXY or XXXY) -Turner Syndrome (monosomy X in *females*: one X no Y)

factors that flare up/trigger autoimmune response:

-MHC genes -gender (women more likely to get lupus) -environmental triggers (chronic infections wear you down = susceptible)

examples of autosomal dominant disorders

-Marfan syndrome (connective tissue issues) -Huntington disease (nervous system issues produced by *"huntingtin"* protein)

CELL-MEDIATED (adaptive immunity)

-T cells -intracellular defense -create cytokines

Example of Autosomal Aneuploidy

-Trisomy 21 (Down Syndrome) -Trisomy 18 (Edwards Syndrome) -Trisomy 13 (Patau Syndrome)

Four types of hypersensitivity

-Type I - immediate (allergy) -Type II- cytotoxic -Type III - immune complex -Type IV - cell mediated (delayed) (type I, II, + III by antibodies...IV is by T cells)

examples of autosomal recessive disorders

-albinism -PKU (phenylketonuria) -cystic fibrosis (deletion of phenylalanine in the CFTR)

Mendelian Single-Gene Disorders (predictable)

-alterations or mutations of single genes (can be on any of the 23 chromosomes!!) (transmission: dominant or recessive which are trackable through punnet squares and pedigrees)

Type III hypersensitivity pathogenesis (development)

-antigens form IC's which precipitate out of the blood /body fluid and deposit into tissue -since the IC's are left there the body creates inflammatory response which then damages the tissues due to phagocytosis

infectious and immunologic injury

-bacteria: release of endo- or exotoxins which triggers body's immune system to self attack -virus: gain entry into host and replicate its own DNA to cause cell injury (ex: Hep. B virus)

Primary organs of the immune system

-bone marrow -thymus

How does abnormal chromosome structure occur?

-chromosomal breakage in mitosis -crossing over errors in meiosis (portions can be deleted, inverted, etc)

key "traits" of malignant

-constant, rapid growth -ignore rules/laws by ignoring apoptosis -immature (step back, b/c not differentiated) -invasive (blood/lymph/tissues) -ability to migrate (spread to entire body over time)

treatments for autoimmune diseases

-corticosteroids -cytotoxins -tumor necrosis factor inhibitors -therapeutic plasmapheresis (plasma exchange bad with good...temporary)

mononuclear phagocyte system (MPS)

-dendritic cells, monocytes, and macrophages monocytes migrate to organs to become macrophages

Genetic Mechanisms of Cancer

-disorder of gene expression -carcinogens cause gene mutations (mishaps to occur) -two subclasses: 1. gain-of-function 2. loss-of-function

"treatment options"/therapy for cancer

-early detection -surgery (remove mass) -radiation therapy -drugs / chemo -anti-angiogenic drugs (stops blood vessel take over)

Type III hypersensitivity

-failure of immune system to remove antigen-antibody immune complexes (ICs) -tissue injury caused indirectly due to inflammatory rxn to the IC's which triggers the MAC and phagocytic cells cause tissue damage

example of sex-linked (x-linked) disorders

-hemophilia A (lack factor VIII/clotting factor) -color blindness

examples of polygenic/multifactorial disorders

-high BP -cancer -diabetes -atherosclerosis (artery plaque)

Secondary organs of the immune system

-lymph nodes -spleen (filters blood) -tonsils -peyer patches (contain B cells, make antibodies)

Neutrophils

-most abundant WBC's -"bands" (immature neutrophils) released in bacterial infections (help to see if it is bacterial or viral infection) self destruct when they ingest "bad guys"

macrophages (mature monocyte)

-phagocytic: "eat" cells -antigen presentation (display eaten parts on their surface for other cells to know what the "bad guys" look like) -secrete inflammatory mediators and proteins for wound healing

non-mendelian single-gene disorders (non-predictable)

-repeat mutations (CGG, CGG, CGG, CGG,...) -mitochondrial DNA mutations (ATP) -genomic imprinting (few syndromes from same mutation occurrence)

BRCA1 and BRCA2 genens (LOF)

-tumor supressor genes -tied to breast cancer

Sex-Linked (X-Linked) Disorders

-typically expressed in *men* because they only have one X (typically always recessive too) -females can be *carriers*, can only be affected if mom was a carrier and dad was affected (RARE)

two categories of the immune system

1) *innate defenses*(NK cells) (neutrophils, macrophages = phagocytic) (no past exposure, 1st exposure) 2) *specific defenses* (B and T cells) (selective in antigen recognition) (effective response for 2nd exposure)

subcategories of mendelian single gene disorders

1) autosomal-dominant disorders (AA, Aa affected) 2) autosomal-recessive disorders (aa affected) 3) sex linked (X-linked) disorders

four types of genetic disorders

1) chromosomal abnormalities 2) mendelian single-gene disorders 3) non-mendelian single-gene disorders 4) polygenic / multifactorial disorders

what are the 4 types of necrosis?

1) coagulative 2) liquefactive 3) fat (adipose) 4) caseous

factors that influence "normality"

1) culture (poor vs rich) 2) age (infant HR vs elderly) 3) gender (hemoglobin in men vs women) 4) situational (high vs low altitude) 5) time (day vs night)

what are the three types of gangrene

1) dry (dry, black, wrinkled) 2) wet (liquefactive) 3) gas (anaerobic bacteria)

four interrelated topics of pathophysiology

1) etiology 2) pathogenesis 3) clinical manifestations 4) treatment

in what two ways does radiation effect cells

1) genetic damage (changes the DNA code) 2) acute cell destruction (gonadal, mucosal, fetal, hematopoietic)

two types of carcinogens

1) initiator (triggers genetic damage) 2) promoter (encourages tumor growth)

change from proto-oncogene to oncogene (4 ways)

1) introduction to host cell by virus (HIV, papiloma, epistein barr) 2) proto-oncogene within cell suffers a mutagenic event 3) DNA sequence lost/damaged and allows proto-oncogene to become abnormally active 4) error in chromosome replication creates extra copies of proto-oncogene in genome

ways that malignant tumors can spread

1) invasion: spread into adjacent tissues (ex - cervix) 2) metastasis: spread to far places via blood/lymph (ex - breast spread to lung) 3) seeding: spread in body fluid/membranes (ex - ovarian)

what are the 5 stages of clinical manifestation?

1) latent (incubation) period 2) prodromal period 3) acute phase 4) latent period 5) subclinical stage

types of chromosomal rearrangement

1) translocations 2) inversions 3) deletions 4) duplications

3 ways cells respond to injury

1) withstand (reversible) 2) adapt (reversible) 3) cell death (irreversible)

carcinogenesis

1. *Initiation* (mutation/DNA damage; LOF or GOF) 2. *Promotion* (proliferation) 3. *Progression* (cancer expression)

functions of antibodies

1. *agglutination* (clumping together) 2. *precipitation* 3. *neutralization* (block bind sites) 4. *opsonization* (flagging for the kill) 5. *complement* (pop cells using MAC)

what are the two types of adaptive immunity?

1. *humoral* (extracellular defense with *pathogens*/"foreign invaders"; *B cells* create antibodies) 2. *cell-mediated* (intracellular defense with *infected* cells; *T cells* create cytokines)

cascade of events that occur in inflammation

1. *increased vascular permeability* (mast cells release: histamine, prostaglandin, + leukotrienes. platelets: clotting factor. prostaglandins = feeling of pain) 2. *emigration of leukocytes* (margination/rolling of WBCs on blood vessel walls, emigration + diapedesis) 3. *phagocytosis* (neutrophils and macrophages eat antigens, neutrophils die creating pus and the macrophages eat this and create a place for healing to start)

antibody class switching

B cells able to switch from one class to another (Ig-GAMED) by use of cytokines

which type of irreversible cell injury initiates an inflammatory response? A. apoptosis B. necrosis C. hydropic swelling D. intracellular accumulations

B. necrosis

natural passive immunity (acquired/adaptive)

Breast milk (IgA) placenta cross (IgG) protection of baby naturally

IgE antibody

Causes allergic/ inflammatory reactions

Rb Gene (LOF)

Codes for pRb "Master brake" of the cell cycle (occurs by binding to E2F) --> "inactivating mutation": removes ability to stop cell cycle = cancer

example of chromosome structural abnormality

Cri du Chat Syndrome (deletion of part of chromosome #5, cat cry)

apoptosis by *internal* pathways

DNA damage that is beyond repair, mitochondrial damage with leakage apoptosis activators, high levels of p53 protein

pathogenesis

Development/ evolution of a disease. (from stimulus to expression of disease via chain of cell --> tissue --> organ --> system)

intracellular accumulation

Excess accumulation of substances in cells which leads to cell injury b/c of toxicity, immune response, taking up excessive space needed for functioning. (anything from excess lipids, carbs, proteins, inorganic pigments, inorganic particles)

acquired primary immunodeficiency disorder example:

HIV/AIDS decreased number of CD4+ T lymphocytes AIDS = T count below 200μl

*Hemolytic disease* of the newborn is a disease where a mother's IgG's are Rh (rhesus) positive and cross the placental membrane to attack the fetus' RBC's...this is an example of type ______ hypersensitivity.

II

*Myasthenia gravis* a disease that affects the neuromuscular junction (ACh receptor) is an example of type ____ hypersensitivity

II

A patient who is receiving a donor organ cannot accept the organ due to conflicting antibodies trying to attack It. This is an example of type ____ hypersensitivity

II

Graves disease and lymphocytic thyroiditis both involve an inappropriate immune response on the thyroid gland (can be triggered by smoking, stress, diet, iodine...) leaving an excess of thyroid hormones T3 and T4. This is an example of type ____ hypersensitivity

II

*Immune complex glomerulonephritis* is a renal disorder which typically proceeds either strep or staph infection. It can cause kidney damage and is treated by corticosteroids...It is an example of type ____ hypersensitivity

III

systemic lupus erythematosus (SLE) occurs mostly in women. It is an autoimmune disorder which creates antibodies against DNA/RNA and can affect a variety of organ systems. This is an example of type ____ hypersensitivity

III

Example of Type II Hypersensitivity BLOOD TRANSFUSION

If I have blood type A my RBC have antigen A presenting on the surface of their cells BUT you have B antibodies in the blood (to kill any B antigen presenting cells) if given AB or B Blood your body will not accept/ will REJECT It because of the presence of antigen B markers on the RBC's *O is universal donor* (unmarked no antigens) *AB is universal recipient* (both A and B antigen markers)

what are the classes of antibodies

IgG, IgA, IgM, IgE, IgD Ig - "GAMED"

artificial passive immunity (acquired/adaptive)

Injection of *antibodies* (fighters of diseases) short term protection

tumor markers

PSA (prostate specific antigen for *prostate cancer*) CA-125 (*ovarian cancer*) -more and more you have show progression/proliferation

IVc (type IV hypersensitivity)

Stevens-Johnson Syndrome (allergic response to meds/ antibiotics) T cell mediated (IVc think: I've Ceen / "seen" steven)

TNM staging system (used for breast cancer)

T = tumor N = nodes involved M = metastasis

____ and ___ cells are a part of *adaptive/specific immunity* where as ____ cells, neutrophils, and macrophages are a part of *innate immunity*.

T and B = adaptive NK (natural killer) = innate

types of lymphocytes

T cells B cells NK (natural killer) cells

angiogenesis definition

ability of tumor to form its own blood supply/vessels (gain nutrients to continue its conquest)

neoplastic disease definition and example

abnormal growth of cells cancers

immunologic disease definition and example

abnormal weakness/susceptibility of immune system rheumatoid arthritis or HIV/AIDS

iatrogenic disease definition and example

accidental/ unwanted side effect of medical treatment anemia caused by chemotherapy

adaptive immunity AKA???

acquired immunity specific immunity

T and B lymphocytes function in ____________ immunity whereas NK cells function in ____________ immunity.

adaptive, innate

adenoma vs carcinoma

adenoma = benign tumor carcinoma = malignant tumor

teratogens

agents like chemicals, radiation, or viruses which damage a developing fetus and cause congenital malformation (environmental)

MHC class *I* protein

an antigen-presenting molecule found on all nucleated cells (display antigens from *intracellular* sources, allow cytotoxic T cells to read MHC Class I) (none alike in all humans...consider this for tissue/organ transplants!)

self vs non-self antigens

antigens provoke immune response. *self antigens*: proteins on OUR cell surface that get ignored and aren't targeted *non-self antigens*: proteins that are foreign and illicit an immune response "attack!"

physical agent-induced diseases definition and example

anything chemical that is airborne that can affect the human body asbestosis, mold exposure, CO2 poisoning

primary disorder general

can be B cell or T cell or BOTH B and T cell disorders either: 1. congenital 2. acquired

chronic inflammation

can impair healing and create a build up of macrophages, fibroblasts, and collagen called a granuloma

dendritic cells

capture and present antigens to lymph nodes "messenger" of invasion

gangrene

cell death in a large area of tissue which occurs when there is no blood supply to a part of the body

apoptosis

cell death via "suicide", clean, no inflammation

necrosis

cell death via rupture, messy, inflammation (due to ischemia or toxic injury)

phagocytic cells

cells that EAT/KILL foreign bodies or toxins (neutrophils, monocytes, macrophages, mast cells, and dendritic cells) -alveolar: lung -microglial: brain -kupffer: liver -histiocytes: connective tissue

Hydropic swelling (oncosis)

cellular swelling due to accumulation of water results from broken/damaged sodium-potassium (Na+/K)...creates a gradient that makes water ENTER the cell = swelling

specificity

chance that a test will be NEGATIVE when applied to a person WITHOUT a disease. EX: "strep throat swab with *specificity* of 95%" = 5% of people test positive to having when they don't (False Positive)

sensitivity

chance that a test will be POSITIVE when applied to a person WITH a disease EX: "strep throat swab with *sensitivity* of 80%" = 20% will test negative and HAVE strep (false negative)

proto-oncogenes (GOF)

code for the following: 1. growth factors (mitogens) 2. receptors 3. cytoplasmic signalling molecules 4. transcription factors (tells the cell: GROW, GROW, GROW!!)

infectious disease definition and example

commonplace virus, bacteria entering body TB, influenza (flu), measles, cholera, etc...

CT scan

computed tomography

IVa (type IV hypersensitivity)

contact/epidermal (ointments, clothing, detergents, cosmetics...) (a for *a*ttack from cont*a*ct)

example of multifactorial disease

coronary heart disease (many things cause It including: diet, cigarette smoking, mental stress, genetic, high BP...)

fat "adipose" necrosis

death of adipose tissue as a result of trauma or pancreatitis "chalky" fats are hydrolyzed into glycerol and fatty acids

somatic death

death of the entire body -cool, pale, diaphoretic (clammy), blood pooling, rigor mortis, etc

leukopenia

decrease in WBCs

thrombocytopenia

decrease in platelets

anemia

decreased RBCs

atrophy

decreased cell size, as well as reduced functioning (differentiation) in an attempt to save energy.

Coagulative necrosis

degradation of cell structures (nucleus, membrane, etc) "black" marked by mitochondrial dysfunction (begins with ischemia) EX: bed sores, necrosis from diabetes in feet

validity

degree to which that measurement is the "appropriate/correct" value (imagine a target hitting the bullseye repeatedly is both *reliable* for its repetition AND *valid* for its "correct" value)

Type I hypersensitivity pathogenesis (development)

inflammatory response caused by these mediators: 1. *histamine* (hives, bronchial/muscle constriction, itching, vasodilation/permeability) 2. heparin (clotting) 3. proteolytic enzymes (MAC activated) 4. chemotactic factors (request "backup")

artificial active immunity (acquired/adaptive)

injection of *antigen* (actual disease) stimulates antibody production (vaccination/ immunization ex: MMR vaccine)

ischemia and hypoxic injury

ischemia (low blood supply) causes hypoxia (low O2 levels) poor perfusion = low levels of power (ATP) in cell

nutritional disease definition and example

lacking in one/all nutritional category iron deficiency anemia

sex chromosomes

last pair of chromosomes (#23) what differentiates a man (XY) vs a woman (XX)

Both T and B cells are responsible for the bodies ability to "remember" invaders in providing ____________ lasting immunity against specific antigens.

long

hormones affect on cancer

long exposure to estrogen (F) or testosterone (M) can lead to ovarian, breast, uterine cancers in Females -OR- prostate cancer in Males

primary prevention

lowering the susceptibility of a pt. getting a disease or reducing their ability to get exposed EX: have pt. quit smoking

MRI scan

magnetic resonance imaging

malignant vs benign "growth"/tumors

malignant = cancerous (harmful, can spread, can take over blood vessels/lymphatic) benign = not cancer (easier to cure/remove, not able to spread, encapsulated)

consanguinity

mating of family members (incest)

MAC =

membrane attack complex

IgD antibody

monomer, present on the surface of B cells

P53 Gene (LOF)

most common tumor-suppressor gene identified in cancer cells -mutated/damaged p53 allows bad cells to survive and continue replication

IgG antibody

most common, smallest, and longest-lasting antibody

polygenic definition

multiple genes coding for one phenotypic response/trait EX: hundreds of genes code for height, weight, or intelligence

endemic

native/confined to a particular region or people EX: chicken pox outbreak in a classroom of children

nutritional injury

need adequate fats, proteins, carbs, vitamins for cell functioning and ATP some cells more likely to get injury than others (low iron intake affects RBCs and anemia or vitamin D with bones)

apoptosis by *external* pathways

neighboring cells give signals for each other to stay alive if these signals are removed, cell death program is activated (fas ligand

Neoplasia definition

new growth (cell divisions, collection becomes a tumor)

secondary disorders general

non-immune system disorders (malnutrition, hyperlipidemia, defective endocrine response)

B lymphocytes (B cells)

originate and mature in bone marrow, move to spleen and lymphoid tissue once mature. -plasma cells (antibody production) -B-memory cells (mass produce plasma cells with memory of illness to prevent exposure by pathogens)

T lymphocytes (T cells)

originate in bone marrow, *mature in thymus* TYPES: -cytotoxic T-killer cells -helper T cells -memory T cells

gain-of-function (GOF) genes

overactivity of gene Normal = proto-oncogene Abnormal = oncogenes ("backtracking" and become more immature/less differentiated)

IVb (type IV hypersensitivity)

persistent asthma T cell mediated (*b* for *bronchial* constriction in asthma)

hemorrhagic exudate

pinkish (has RBCs in it, only occurs in SEVERE inflammation)

Which type of leukocyte WBC produce antibodies?

plasma B cells

PET scan

positron emission tomography

congenital disease definition and example

present at birth spina bifida

what are the three levels of prevention

primary, secondary, tertiary

metabolic disease definition and example

processing of the metabolism central obesity

liquefactive necrosis

produced by liquification of lysosomal enzymes which creates a cyst/abscess of dead tissue "wet" EX: brain cysts

Complement System

proteins C1 - C9 activate during immune response by IgG or IgM punches a hole in the invader cell and causes inflammation /destruction

inflammation (innate immune response)

purpose: 1. neutralize/destroy invading agents 2. limit spread of harmful agents to other tissue (quarantine) 3. prepare damaged tissue for repair "-itis" = inflammation (ex: tonsilitis, conjunctivitis)

IVd (type IV hypersensitivity)

pustular psoriasis (think d = upside down p x2)

proliferation defintion

rapid production of cells, cell growth

tertiary prevention

rehab, supportive care, reducing disability, and restoring effective functioning EX: oxygen and aspirin given to a pt. who's had past MI

metaplasia

replacement of one differentiated cell type with another adaptation: a cell is replaced by one that is better suited to tolerate injurious stimulation (EX: ciliated columnar epithelium converts into squamous epithelium)

ischemia - re perfusion injury

restoring O2 can cause cell injury rather than reversing it calcium overload (due to low ATP, ion pumps don't work!) which leads to apoptosis

primary immunodeficiency disorder example:

selective IgA deficiency b-cell primary immunodeficiency disorder

sign vs symptom

sign: SEEN (can be tested) symptoms: FELT (only by pt.)

cytokines and chemokines

signaling molecules that affect the functions of other cells by stimulating surface receptors -activation signal for other WBC, controls inflammation

clinical manifestations

signs and symptoms of disease

chronic disease

signs/symptoms develop *gradually* and continues over a *long* period of time

acute disease

signs/symptoms develop *rapidly* but the disease lasts only a *short* time

abnormal vs normal in health care

someones "abnormal" could be someone else's "normal" It is very important to compare disease in a carefully selected "population" (think stats)

epidemic

spread of a disease to many people at the same general time EX: H1N1 influenza ("swine flu")

pandemic

spread to large geographic areas (world wide not just targeting one population) EX: ebola when It came across seas to US/other countries

convalescence

stage of recovery after a disease, injury, or surgical procedure

clotting factors

stops bleeding, provides a "barrier" to stop spread of infection chemotaxis of neutrophils

congenial malformation

structural defects caused by errors in fetal development (typically genetic, but can also be environmental)

pathology

study and diagnosis of disease

pathophysiology

study of abnormalities in physiologic functioning of living beings

physiology

study of physical and biochemical functions of living organisms

etiology

study of the cause of disease (why did this happen?)

sequela

subsequent pathologic condition resulting from an acute illness (EX: post acute rheumatic inflammation...heart having scaring/deformation forever)

adaptive immune response

system capable of seeing foreign invaders, destroying them, then storing "memory" of the fight to be even more effective in defense in future exposures (adaptive). mediated by T and B lymphocytes

cancer cells and telomerase

telomerase enzyme enables cancer cells to ignore the cellular "laws/rules" which say they can only divide 20-80 times and grants them "immortality" (*∞ divisions*)

reliability

test's ability to give same results repeatedly (imagine a target, hitting the far right corner repeatedly is reliable not valid)

remission

the temporary, partial, or complete disappearance of the symptoms of a disease without having achieved a "cure"

fibrinous exudate

thick/sticky (high protein)

chemical injury

toxic chemicals, poisons, or pollutants cause cellular injury (direct or indirect) direct: lead poisoning (on neural tissue) indirect: carbon tetrachloride (in cleaning agents) converts into CCl3- in liver, causing liver failure

multifactorial definition

traits and disorders brought about by BOTH multiple *genes* and *environmental* factors

diploid (2n)

two copies of each chromosome (23 + 23 = 46)

loss-of-function (LOF) genes

under activity of gene called "tumor suppressor genes"

Treatment Implications

understanding the etiology, pathogenesis, and clinical manifestations tell us which treatment is best

idiopathic disease definition and example

unknown causes some forms of epilepsy

haploid (n)

unpaired chromosomes (23) (get one set from egg and one from sperm)

kinins

vasodilation and vascular permeability (pain)

serous exudate

watery/clear (low protein)

tumor suppressor genes (LOF)

what regulates "proliferation-*inhibiting* pathways" make cancer when they're NOT present or don't work (think of brakes in a car)

syndrome

when causes (etiology) of signs/symptoms haven't been determined (obscure) EX: AIDS when first discovered

purulent exudate

white/yellow "pus" (contain's dead WBCs)

chromosomal abnormalities

wrong NUMBER of chromosomes (called aneuploidy) change in shape of one or more chromosomes

aneuploidy

wrong number of chromosomes (either >46 or <46) (caused by nondisjunction)

two types of etiology

idiopathic (unknown cause) iatrogenic (unwanted/accidental cause)

Monocytes (myeloid lineage)

immature macrophages "mature" when they enter the tissues (from the blood)

Autoimmunity

immune system attacks own self ("self" antigens) -organ specific (MS or Type 1 diabetes -organ nonspecific (SLE lupus)

hyperplasia

increase in cell *number* (in cells capable of undergoing mitosis). Can be either physiologic or hormonal.

hypertrophy

increase in cell mass/size in response to physiologic (body building) and pathophysiologic (heart muscle enlargement due to high BP) demands.

exacerbation

increase in the severity of a disease or its signs/symptoms

two types of "excessive" immune response

1. autoimmunity 2. hypersensitivity

what are the two types of "inappropriate" immune response?

1. excessive (over functioning) 2. deficient (inadequate functioning)

two types of "deficient" immune responses

1. primary disorders 2. secondary disorders

types of diagnostic testing for cancer

1. routine screening (early detection) 2. self-exams 3. blood tests 4. radiographic, ultrasound, MRI, CT scans (monitor changes in tissues/organs) 5. cytologic tests via biopsy/cell sample

Types of inflammatory exudate

1. serous 2. fibrinous 3. purulent (pus) 4. hemorrhagic

parts of the immune system

1. skin/mucous membranes 2. mononuclear phagocyte system 3. lymphoid system (comprised of: spleen, thymus, lymph nodes) 4. bone marrow

during the ___ to ___ weeks of gestation, the embryo is highly susceptible to teratogens (especially when the organs are developing in the 4th/5th weeks)

3rd, 9th

Which of the following is an example of primary prevention? A. Maintaining routine immunizations B. Screening for cancer C. Rehabilitating after a stroke D. Performing monthly breast examinations

A. Maintaining routine immunizations

in the adaptive immune response _____ cells are used in humoral immunity to produce antibodies; whereas, ____ cells are used in cell-mediated immunity.

B, T

which of the following is an example of a clinical manifestation SIGN? A. nausea B. bruising C. headache D. loss of appetite

B. Bruising

which of the following is an example of a factor that would affect the epidemiology of a particular disease? A. predictive value B. southeast Asian ethnicity C. circadian rhythms D. clinical manifestions

B. Southeast Asian ethnicity

negative predictive value

disease is ABSENT if test is NEGATIVE (NO disease if -)

positive predictive value

disease is PRESENT if test is POSITIVE (YES disease if +)

congenital disorder

disorder present at birth (can be genetic or environmental)

dysplasia

disorganized appearance of cells because of abnormal variations in size, shape, and arrangement (adaptation gone wrong)

what can cause atrophy of cells

disuse, denervation, ischemia, nutrient starving, lack of endocrine signaling, persistent cell injury

secondary prevention

early detection, screening, and management of disease EX: early screening for breast cancer, getting lumps removed if potentially risky

patterns of disease distribution types

endemic epidemic pandemic

examples of signs

enlarged lymph nodes, vomiting, high BP, high BGL, bruising, swelling...

Type I hypersensitivity Treatment

epinephrine (Beta-adrenergics), antihistamines, corticosteroids, anticholinergics

natural active immunity (acquired/adaptive)

exposure to antigens naturally Ex: Chicken pox (how I got It)

risk factor

factor present in pt. which increases chances of disease arising (helpful in disease prevention)

autosomes

first 22 pairs of chromosomes

Exudate definition

fluid that leaks from blood vessels, combined with neutrophils and debris from phagocytosis. HELPS WITH: 1. transport of WBC and antibodies 2. dilute toxins 3. transport nutrients for repair

example of *Non-Mendelian* disorder

fragile x syndrome (repeating nucleotide)

polysomy

gamete having too many chromosomes

monosomy

gamete lacking 1 chromosome

degenerative disease definition and example

gets worse as time goes on Alzheimers or MS (multiple sclerosis)

"Trisomy" meaning

having 3 sets of a chromosomal "pair" (should only be 2 in a pair not 3)

examples of symptoms

headache, anxiety, nausea, fatigue, sore throat....