OTH 3416 Exam 1

HIV diagnostic criteria

All individuals aged 13-64 years old should get routine screening. o It takes 3 months after virus to form antibodies- Seroconversion o Classification of stages of HIV infection are based on CD4 T-lymphocyte counts. o Progressive worsening of symptoms= decrease in CD4 helper T lymphocyte

Rh Isoimmunization pathophysiology

Caused by maternal alloantibodies o Antigen usually involved is D(Rho) o D-antigen positive= Rh positive o D-antigen negative= Rh negative o If mother's blood has no previous exposure to fetus's D-antigen, can't stimulate immune response to antigen o Transplacental passage of maternal antibody (IgG) to fetus targets D-antigen and destroys fetal red blood cells, resulting in hemolytic anemia

Hyperchloremia

- blood chloride levels of >108 mEq/L o Can result from dehydration, kidney failure, hemodialysis, TBI o Can result in hyperchloremic metabolic acidosis, deep rapid breathing, weakness, headache, diminished cognitive ability, cardiac arrest

Hypermagnesemia

- blood magnesium levels of >2.5 mEq/L o Less frequent than other electrolyte imbalances o Result of excessive intake of magnesium containing products or end-stage renal disease o Neuromuscular transmission reduced, leading to hypotension, diminished reflexes, muscle weakness, flaccid paralysis, respiratory depression

Hypocalcemia

- calcium blood levels of <8.5 mg/dL o Leads to enhanced neuromuscular irritability o Can be caused by heparin and glucagon (medications), thyroid disorders, burns, kidney failure, vitamin D deficiency, sepsis o Can cause anxiety, irritability, muscle twitching, cramps, spasms, tetany, laryngospasm, seizure

Hypophosphatemia

- occurs when blood phosphate levels are less than 2.5 mg/dL ○ Can result from severe burns, malnutrition, malabsorption, alcoholism, kidney disease, vitamin D deficiency, or prolonged diuretic use ○ Manifests as muscle weakness, tremor, paresthesia, weight loss, and bone deformities

Mechanism for Alkalosis development

-decreased H+ ions -increased HCO-3 ions -loss of CI- ions

When bacteria affects the system Effect on immunity

-destroy or block component of immune system -mimic self-antigens -change antigenic profile

B lymphocytes

-develop in the bone marrow, migrate from the bone marrow to the peripheral lymphoid tissues where they become activated -recognize specific antigens because of the B receptors bound to the cell membrane

Anion gap

-elevation indicated metabolic acidosis -determines the presence of unmeasured anions -normal anion gap depends on serum phosphate and serum albumin concentrations Values • NORMAL AG: 4-12 mmol/L • Metabolic acidosis: AG>30mmol/L

Portal of exit

-excretion, secretion, skin, droplet -broken with hand washing, covering secretions, trash disposal

Hypovolemia

-expansion of extracellular volume involving the interstitial or vascular space o Causes= heart failure, cirrhosis of the liver, kidney failure, excessive fluid replacement, administration of osmotically active fluids o Mean arterial pressure is increased-->inhibiting the secretion of ADH and aldosterone-->increase urinary sodium and water elimination

2) Incubation

-extends from exposure to the onset of any sign -the individual often has no idea that they has been exposed to the illness

Process of altering immune function

-failure to host defense mechanisms: unable to have am immune defense -Hypersensitivity: inappropriate excessive immune response -Autoimmunity: inappropriate response to self -Alloimmunity: reactions directed at tissue antigens from other individual

Genetic Mutation

-follows mendelian pattern of inheritance in a clearly identifiable and predictable manner -mutation can lead to an error in the transcription of a single codon Include the following -deletion -duplication -inversion -insertion -translocation

Management of Genetic and Environmental Disorders: Prenatal screening

-genetic risk can be determined when a complete family and pregnancy history is obtained -karyotypes help determine the presence of chromosomal abnormalities

Type of immunity: Passive

-immune response involves antibodies obtained from outside the body e.g: antibodies a mother passes to her infant through her breastmilk -immediate most times -natural form- antibodies transferred in breast milk as mentioned -artificial form- the use of antidotes such as that for rabies where specific antibodies are injected into an infected individual

Mechanisms for how acidosis develops:

-increased production of nonvolatile acids; caused by fasting, ketoacids, and lactic acidosis -decreased secretion of acids by the kidneys leads to renal failure -increased loss of bicarbonate; caused by diarrhea, gastrointestinal secretion -increase of CI-; caused by excessive chloride reabsorption in the kidney. sodium chloride infusion

Two types of diuretics

-loop diuretics- reduce the absorption of sodium into the loop of henle and impair the ability to concentrate urine at the loop -thiazide diuretics- prevents the reabsorption NaCI in the distal convoluted tubule, which promotes the excretion of sodium and water

4. Acute clinical illness

-manifestation of signs and symptoms -diagnosis is applied more confidently during the time -immune response peaks and the body is able to overcome pathogen

T lymphocytes

-mature in the thymus, require contact with antigen that signals it to proliferate -Cytotoxic T lymphocytes: direct destruction of the antigen carrying cells -Helper T lymphocytes: enhance humoral and cell mediated responses of immune system

CA pathophysiology

-may be caused by decreased stimulation from the reduction in physical and intellectual activities -can result from mechanicals injury or injury due to toxins--> loss of neurological cells, tissue , and associated functions

autosomal dominant disorders

-most hereditary disorders involve the genes on autosomes oUsually 22 chromosomes (pairs) compared to sex chromosomes (1 pair) -When one parents is hererozygous for the dominant diseased gene, the child has a 50% chance of being uneffected -when both parents are heterozygous, the child has only 25% chance of being uneffected and 75% chance of having the disease.

Sex linked Disorder

-mutations of genes located on the X or Y chromosomes -many of these disorder are linked to genes on the X chromosomes oBecause females have 2 copies of the X chromosomes, and for this reason there is a gender difference in expression of X-linked disorders oAdditionally because females have two copies of the X chromosomes and they are usually carrier of disease, compared to males who have one X chromosome and likely to be affected

Type of acquired immunity

-naturally acquire oActive- infection: contact with pathogen oPassive- antibodies pass from mother to fetus via placenta or to infant in her milk -Artificially acquired oActive- vaccine; dead or attenuated pathogens oPassive- infection of immune serum (gamma globulin)

Bacteria contains

-nucleus -cytoplasm called a cytosol -includes the ribosome -proteins

Virsuses

-obligate intracellular parasite -cant replicate without host oBind to host cell receptors and move inside -converts host metabolism to nucleic acids and proteins that are encoded and controlled by the virus oCan kill host directly or modify function oCell loses function oReleases virions to control other cells

Microbes Resident Flora

-organism that live on or within the body in nonsterile areas without causing harm -resident flora competes with disease-producing microorganism for providing a natural immunity and prevention from infection

herpes zoster virus

-original infection with herpes zoster virus causes varicella or chickenpox -recurrence with the virus results in shringles

Oxidative stress:

-oxidative stress occurs as a result of increased reactive oxygen species (ROS), decreasing antioxidants or inability to neutralize/repair damage caused by ROS with ROS scavengers -can be caused by biological aging, infection, inflammation, ischemia, radiation, and use of chemical and drugs oSuperoxide, hydrogen peroxide, hydroxyl radical, peroxynitrite -ROS produces damages to cell by targeting DNA

Reserviors

-people, equipment, water -broken with sanitizing environment and antimicrobial drugs

Innate immunity: First responder to insult

-rapid and initiated by many pathogens without requiring prior exposure -macrophages, neutrophils and dendritic cells -work in harmony with adaptive immune system to initiate and direct continued protection from infection.

Mode of transmission

-refers to the machanism of transference from the reservior to the portal of entry -

Fungi

-relatively large organism compared to bacteria and viruses -posses nuclear membrane, cytoplasm, and organelles -Unicellular forms=yeasts oHave tubules that branch out to form hyphae (cluster of this form mycelium) -Superficial/deep-tissue invasion occurs when pseudohyphae or hyphae multiply oResults in inflammatory and immune responses

protein buffer system

-responds to moment-to-moment changes to retain pH -largest buffering system -able to function as either acids or bases (amphoteric)

Mechanism that promote thirst and water excretion regulate total body water

-sensory neurons called osmoreceptors in the hypothalamic thirst center are activated by cell dehydration in blood volume -stretch receptors in the carotid and aorta senses changes in the arterial blood pressure and contribute to thirst

Memory cells allow the body to respond faster when re-exposed to the same antigen

-shortens and intensifies the immunological response -higher antibody secretion -higher affinity to antigen

Altered lymphocyte ignorance (lymphocytes convert from nonresponsive to self-reactive)

-stimulate, such as infection, overriding the nonresponsive nature of T lymphocyes oImpaired T lymphocyte inactivation (prolonged or irreversible oFailure to recognize antigen due to MHC-antigen complex interaction oRelease of antigens sequestered during development -Close resemblance b/w foreign and self-antigen also know as molecular mimicry -inappropriate activation of TCRs by superantigens

Each B lymphocytes has a specific receptor that recognized a unique antigen pattern

-the antigen gets recognize by a BCR, which activates the lymphocyte -Causes proliferation and differentiation of targeted B lymphocytes into effector cells -effector cells usually undergo apoptosis after they are done eliminating the antigen

he life cycle of chlamydiae has the following distinct phases:

1. Metabolically inactive elemental body enters body, attaches to an internalize host cell 2. Elemental body becomes metabolically active --> reticulate body ---> takes over host cell 3. Chlamydiae are capable of replication 4. Each pathogen goes through the cycle and causes epithelial cell necrosis

Immune Maladaptation: AIDS

-Aids: altered host defense -Secondary immunodeficiency caused by infection with the human immunodeficiency virus (HIV) oHIV: enveloped retrovirus that infects the CD4 helper T lymphocytes, dendritic cells and macrophages oSymptoms of acute HIV: flu-like oCD8 cytotoxic T lymphocytes and CD4 TH1 lymphocytes activated

The Watson and Crick model

-American biologist James Watson and English physicist Francis Crick (1950S) - Charagaff rule (an austrian biochemist)- the total number of purines equal the total number of pyrimidines -Purines=A-G -Pyrimidines=C-T-U -breaking of hydrogen bond is key in reproduction -Watson-Crick Structure of DNA. Deoxyribonucleic Acid (DNA) is a double-stranded, helical molecule. It consists of two sugar-phosphate backbones on the outside, held together by hydrogen bonds between pairs of nitrogenous bases on the inside

Humoral immune response:

-B cells (plasma cells) -Anitbodies (immunoglobulins_ oProtection against viruses, bacteria and bacteria toxins

Why do we care about the citric acid cycle

-Breaks down sugar, fats and protein to produce products used for energy production in the mitochondria -it generates hydrogen atoms and carbon dioxide -Pyruvate from the glycolysis of glucose, products of amino acid and fatty acid degeneration after entering the TCA cycle contribute to the generation of ATP

(CD molecules) They determine specific functions and responses of the T-cell subtypes

-CD8 is expressed in the surface of cytotoxic T lymphocytes -CD4 is expressed on helper T lymphocytes -Provide a regulatory function to enhance other T lymphocyte reponses -2 classes THI TH2

Bacteria are name by their shape

-Cocci-spheres -Bacilli-rods

Huntington's disease-Autosomal dominant disorder

-Degenerative neurological disorder

Secretion

-For secretion to occur, the Golgi apparatus and ht endoplasmic reticulum must work together to package the product and direct it out of the cell. -The process of the product moved form the Golgi apparatus, to the endoplasmic reticulum and then out of the cell is called exocytosis. oThe Golgi apparatus contains enzymes that attach sugars to proteins to form large glycoproteins. And forms lysosomes, which are responsible for digestion

Free Radicals and Reactive Oxygen Species (ROS)

-Free radicals are molecules processing unpaired electrons and are very short lived because they are processing the electrons and need to complete a specific reaction -ROS comprises of free radicals and non-free radicals. This means stable and unstable molecules. ROS because of their variable nature are concerned as an important cellular signaling factor. So think of all the hydroxyl, peroxide, etc. ions. They all have oxygen molecules and are ready to facilitate reactions and enhance cellular reactions

Immune cell origin

-Have a common origin in the pluripotent hematopoietic stem cells -originating in the bone marrow, the pluripotent hematopoietic stem cells produce two precursor cell types: Lymphoid progenitor and myeloid progenitor

Clinical Manifestation of Hyperlactatemia

-Hepatic steatosis (fatty liver) is often associated with symptomatic Hyperlactatemia, resulting from NRTI-stimulated fat deposition in the liver -Hepatomegaly-enlarged liver

cell-mediated response

-T cells are responsible for cell-mediated immune response: they attack the antigen directly -Travel through the thymus, where hormones enable them to recognize a variety of antigens that they will encounter throughout life -when they exit the thymus they are mature, immunocompetent T lymphocytes, with plasma receptors that are able to bind antigen -the thymus atrophies at puberty and practically disappears in adulthood (while bone marrow is maintained throughout life)

2 main components are the type of antigen presented to the cells and the type of cells to which antigen is presented Cellular Component of Immunity:

-The initial response to foreign invaders is known as immune response, a nonspecific response associated with inflammation -The cellular components involved in innate immunity are also important in adaptive immunity as they can process the foreign antigens through phagocytosis

Acidosis Alkalosis/Metabolic-Respitory

-acid-base disorder -to physiologic processes that cause accumulation or loss of acid and/ or alkali; blood pH may or may not be normal -more than one primary acid-base disorder may be present simultaneously -Changes in carbon dioxide partial pressure (PCO2)-Respitory serum bicarbonate (HC03-)-metabolic -Lab evaluation of acid-base disorders-measurements of arterial blood gages and serum electrolytes and calculation of anion gap

Treatment of maladaptive immune responses

-control of unwanted immune responses decreases the signs/symptoms associated with disease and illness -Goal: suppression of immune to suppress the inappropriate immune response

Infectious disease can be caused by microorganisms that range in size from

20 nanometers (nm) (poliovirus) to 10 meters (m) (tapeworm)

Down syndrome is a trisomy of chromosome

21

How many pairs of chromosomes does the human body have?

23

Process

1. tissue damage carries bacteria into the wound 2. wounded cells release chemicals that stimulate mast cells 3. Mast cells release histamine 4. histamine increase capillary blood flow and permeability 5 phagocytes leave capillaries and ingest bacteria and dead cells

B lymphocytes

1. to mature they migrate through the bone marrow and gut 2. produce antibodies (immunoglobulins) when they encounter an antigen 3. responsible for humoral immunity (also called antibody-mediated immunity)

T lymphocytes

1. to mature they migrate through the thymus gland 2. Attack the antigen either directly or by secreting lymphocytes 3. Responsible for cell-mediated immunity

Third Line

Adaptive immune response which is targeted and specific involving cell-mediated immunity and humoral immunity

Renal Tubulopathy

4 variants of this disorder: 1. Classic Bartter Syndrome (cBS) 2. Gitelman Syndrome (GS) 3. Hyperprostaglandin-E syndrome (HPS), also known as antenatal Bartter Syndrome (aBS) 4. Hyperprostaglandin-E syndrome with sensorineural deafness (HPS + SND)

There are how much classes of immunoglobulins(Ig)

5

Recessive

Alleles that are less influential, requiring homozygous alleles to be expressed in the phenotype.

Transcription and Translation

DNA-->MRNA-->Polypeptide bond

Altered sodium balance: Dehydration

Diarrhea most common cause; dehydration second leading cause of infant mortality ● Pathophysiology: decreased fluid intake, increased fluid output, inadequate fluid shifts; typically associated with blood sodium concentration ● Manifestations: dry mucus, decreased level of consciousness, decreased urine, change in vital signs ● Diagnostic Criteria — family/personal histories, fluid intake evaluations, blood sodium concentration readings, etc ● Treatment — generally, just increase fluid intake with correct balance of electrolytes/glucose. etc

Cells develop into tissues with specialized structure and function through the process of

Differentiation

Type 1, immediate hypersensitivity reaction

Etiology: IgEmediated Activated Immune Cells: Helper T (Th2), mast cells, basophils Injury: Allergic reaction:local (atopic) inflammation; system (anaphylactic) life threatening

Type 3, immune complex-mediated reaction

Etiology: IgG and IgM mediated Activated Immune Cells: Complement and neutrophils Injury: Deposition of insoluble antigen-antibody complex

Type 2, antibody mediated reaction

Etiology: IgG or IgM mediated Activated Immune Cells: Macrophages Injury: Reaction against normal "self" antigens; opsonization and lysis of cells

Type 4, cell-mediated hypersensitivity reaction

Etiology: T-cell mediated Activated Immune Cells: CD8 T lymphocytes, CD4 TH1 lymphocytes Injury: Inflammatory response leading to cell lysis

Low pH

High amount of hydrogen ions

Antibodies

Immunoglobulins that react with an antigen in a specific way

Movements of solutes and fluids

Movement of water across a semipermeable membrane. Water moves from the side that has fewer non-diffusible particle to the side that has more. The osmotic pressure is equal to the hydrostatic pressure needed to oppose water movement across the membrane

The damaging effects of free radicals, especially activated oxygen species such as Oxygen, OH•, and H2O2, called_

Oxidative stress

Pathophysiology of Parenteral nutrition

Parenteral nutrition is intravenous administration of nutrition (protein, carbohydrate, fat, mineral, electrolytes, vitamins and other trace elements) for patients who cannot eat or absorb enough food through tube feeding formula or by mouth to maintain good nutrition status -to prevent acid-base disturbances, a patient must excrete the daily metabolic production of acid -risk for metabolic acidosis is much higher when individual has a thiamine deficiency

cystic fibrosis (CF)-Autosomal recessive disorder

Pathology -sticky build-up of mucus in the lungs -mucus clogs the airway and traps bacteria-infections-lungs damage-respitory failure Genetic: more than 1700 know mutation of the disease-tests screen only most common mutations not all of them -Diagnosis occurs at age 2 years -the median predicted age is 40 years -25% (1 in 4) the child will have CF -50% (1 in 2) the child will be a carrier but will not CF -25% (1 in 4) the child will not be carrier and will not have CF

Altered Fluid Balance: Cirrhosis

Pathophysiology: form of liver diseases characterized by interference of local blood flow and hepatocyte damage -most common complication ascites -accummulation of fluid in the peritoneal cavity oCauses: increased hydrostatic pressure and capillary permeability; decreased colloid osmotic pressure -increased vascular resistance to blood flow causes portal hypertension -progressive pathology may lead to renal impairment, which, eventually leads to hypatorenal syndrome(renal failure caused bu severe renal (vasocanstriction)

Treatment for Hyperlactatemia

Subclinical hyperlactatemia requires no treatment, usually resolved without intervention. Drug treatment may influence development. Resolution of treatment confirmed by: Normalization of sodium bicarbonate, pH, liver function, and a serum lactate level of less than 3.0 mmol/L

Histamine

These are involved in local immune responses and are Generated in mast cells The main reason the release of histamines causes vasodilatation and increase in permeability is presence of hyper polarizing factors that assists in anaphylaxis

Latency

another way pathogen evade detection: period of inactivty

IgE

antibody against enviormental antigents

Opsonization

antibody becomes bound or coats the antigen -phagocytes can then recognize that and come destroy the pathogen

Self vs non-self antigens

antigens that are on your own cells that originate in your body are called SELF antigens and antigens that fo not originate in your body are called non-self antigens. When we talked about our immune system responding to antigens and creating antibodies, we were referring to the NON-self Antigens. You do not want your body to attack itself! failure of your body to recognize a self from a non-self antigens leads to autoimmunity!

__is known as regulated or programmed cell death and is characterized by "dropping off" of cellular fragments.

apoptosis

Proteasomes

are involved in proteolysis or the breakdown of proteins. They have the ability to recognize abnormally formed proteins

Peroxisomes

are similar to lysosomes; neutralize harmful oxygen free radicals

Peripheral organs

are site of maintenance and where immune responses are often initiated. -include spleen, lymph nodes, tonsils, appendix -Lymph maintains signal to lymphocytes that have not encountered an antigen -Without that signal, it results in apoptosis

Lysosomes

are small sacs that have membrane. their main purpose is to digest debris in the cell using hydrolytic enzymes. They are also important to metabolize some substances

Organells

are structures that have a specific function. This includes structures such as endoplasmic reticulum, golgi apparatus, lysosomes, peroxisomes, proteasomes, and mitochondria

Mitochondria

are the primary producer of ATP, contain the cytochrome enzymes necessary to produce ATP -site of aerobic respiration

First line

barriers like the skin and mucous membrane

Integral proteins

binds to the lipids tails of the PM (through noncovalent interaction) and becomes a part of the membrane itself (only removable using detergents and other drastic measure) -Integral proteins often form channels that al- low for the transport of ions (atom with an electrical charge) across the plasma membrane

Occluded

blocked

Hypercalcemia

blood calcium levels >10.5 mg/dL o May result from excessive bone breakdown, thyroid disease, excessive calcium intake (antacids) o Decreased neuromuscular irritability results in confusion, fatigue, constipation, nausea/vomiting, weakness, arrhythmia, headaches, irritability

Hypochloremia

blood chloride levels of <98 mEq/L o Result of vomiting, diarrhea, use of diuretics o Associated with hyponatremia, hypokalemia, metabolic alkylosis o Muscle effects include excessive tone and tetany, weakness, twitching o Shallow, depressed breathing, paralysis, mental confusion

Hypomagnesemia

blood magnesium levels of < 1.5 mEq/L o Often associated with hypokalemia and hypocalcemia o Due to malnutrition, malabsorption syndromes, burns, alcoholism, diuretic use o Can cause tetany, muscle cramping, seizures, due to altered neuromuscular transmission; arrhythmia, hypotension due to alteration of electrical currents due to low Na+ , Ca2+, K+

Hypernatremia

blood sodium levels of >145 mEq/L -cell metabolism altered and can lead to agitation, restlessness, decreased consciousness -fluid shifts can lead to thirst, hypertension, tachycardia, edema, weight gain -sodium id the most abundant intracellular cation; most found in muscle, so amount is related to body size/muscle mass

Types of Pathogen Microorganism that cause disease

bacteria viruses fungi protozoa

Anion Gap

calculation of the major measure cations and anions in the plasma which gives an indication of acid-base balance

Toxins

can cause endogenous harm or exogenous -Endogenous- harm to the body from within the body system (ex. allergic reaction) -Exogenous- harm to the body from external environment (ex. alcohol)

Binding to an immune system cell: pathogen resists destruction by using systems cells and host cells

can cause immunosuppression -immunosuppression--> immunodeficiency -primary immunodeficiency is usually caused by a genetic mutation that impairs immune responsiveness -occurs frequently when recurrent, severe infections are seen in young children -Main Idea: inadequate immune response can lead to overwhelming infection

Diagnostic Criteria for Renal Tubulopathy

Ultrasound, electrolyte and fluid imbalances in urine

metabolic Acidosis

Where: reduction in serum bicarbonate leading to an increase in the concentration of hydrogen ions. pH: pH<7.45 Compensation: respiratory CO2(hyperventilation Acid-base abnormality: decrease in bicarbonate, increased non-carbon acids

Self and non-self-recognition

ability to distinguish b/w antigens on body cells and foreign antigen

TH2

activate B cells to produce antibodies

The non-specific components

acts either as barriers or as eliminators of wide range of pathogen irrespective of antigenic specificity

Other components of the immune system

adapt themselves to each new disease encountered and are able to generate pathogen-specific immunity

humoral immunity

adaptive immunity involving antibodies

Adaptation

alternation in function that allows cells, tissues, and organs to adjust to new conditions; survival due to the capacity to adjust to an adverse environment

Immune Maladaptation: Anaphylactic Reaction

can occur from exposure to drugs, environmental compounds, insect venom or stings, or food products that stimulated an exaggerated immune response -exposure to an allergen is responsible for triggering the IgE-mediated event

deoxyribonucleic acid (DNA)

carrier of genetic information

Fungal infection can be opportunistic

cause disease only in a host w/ compromised immune system -most common opportunistic yeast infection is Candida -yeast grows well in warm, moist, dark environment

epigentic inheritance

caused by environment and metabolic agents that stimulate chemical modifications.

Thermal injury

caused by extremes temperature (ex. burn)

Mechanical injury

caused by impact of a body part which causes a direct injury (ex. falling off a bike)

Metaplasia

cell changing from one type tp another -usually happens in response to a stressor like smoking or gerd

Major Histocompatibility Complex (MHC)

cell surface proteins essential for the acquired immune system to recognize foreign molecules

Cellular Adaptation

cells adapt to prevent environmental stressors from impacting their function (alternative is death)

Immunity

cells lines of lymphocytes: 1. B-cells 2. T-cells 3. NK-cells-- characteristics of each of the above -- development, maturation and competency of B cells and T cells

lymphatic system

central and peripheral organs important in establishment of immune reponse

Death

cessation of life; cessation of integration of cellular, tissue, and organ function

Our body is constantly providing defenses against

harmful substances

Innate vs Adaptive

once microorganisms penetrate the first line of defense and invade the tissue, the inflammatory response is initiated by the host- in the inflammatory response, neutrophils and later macrophages, phagocytes (attach, engulf and destroy) the microorganism The next step is the immune response (immunity): -B-lymphocytes produce antibodies against the infectious microorganisms and their toxins -T-lymphocytes either attack the infectious microorganisms directly or secrete lymphokines to recruit macrophages and other immune components

Haploid

one copy of each chromosome

Autoimmunity

one of our immune system functions to distinguish itself from non-self in order to eliminate foreign substances

Chain of infection and infection control

helps recognize the factors that cause transmission and spread of the disease

Which of the following terms most appropriately describes the study of genetics (passage of characteristics from parents to off springs):

heredity

Pathophysiology of Hyperlactatemia

hyperlactatemia believed to be caused because of the inhibition of DNA polymerase by NRTI's --> leads to mitochrondria dysfunction - the loss of mitochondrial DNA prevents ETC--> oxidative phosphorylation is impaired---> promoting formation of lactic acid for use by the cells for energy

passive immunity

immunity transfer from host to recipient -achieved via mother to infant transfer via placenta or breast milk or injection with high concentrations of antibodies , such as immune gamma globulin

IgG is the most abundant class of

immunoglobulins

TH1

important in bacterial intracellular infection control -activates macrophages, secrete chemokines and cytokines to attract macrophages, and promote fusion of lysosomes to stimulate phagocytosis

virus can evades defenses by hiding

in host cells -As virus moves from cell to cell immune response is activated oSparks a strong response oExaggerated immune response allows for neutralization of virus oInfected host cells are elimated ovirus such as common cold are classified as self-limiting -infection ceases after a period of time

Pathophysiology of Renal Tubulopathy

in salt-losing tubulopathies, electrolytes reabsorption in the renal tubules is impaired because of gene defeat altering 5 renal membrane proteins.Inhibition of Na reabsorption is desirable because excretion of Na means excretion of H20 and maybe K+ as well-->resulting in hypokalemia

Where does it occur in the absence of oxygen GLYCOLITIC PATHWAY

in the absence of oxygen, the process of anaerobic catabolism is completed in the cytoplasm to form pyruvic acid which is converted to lactic acid due to the absence of oxygen

Postnatal screening diagnosis

in the newborn, screening for the most common genetic conditions results in early identification of many disorders

Where does it occur in the presence of oxygen GLYCOLITIC PATHWAY

in the presence of oxygen, the process of aerobic catabolism occurs in the cytoplasm to form pyruvic acid which then enters the mitochondrion to enter the Krebs cycle with the help of the mitochondrial enzymes

proliferation

increase in cell number

Hyperplasia

increase in the number of cells -can be caused hormone signaling and increased workload -often seen in conjunction with hypertrophy

metabolic alkalosis

increased pH caused by plasma excess of HCO-3

Edema

increased the extracellular compartment of the interstitial fluid -movement of fluid into the interstitial compartment can be driven by: o increased capillary filtration pressure; decreased capillary osmotic press o Increased capillary permeability o Obstructed lymph flow (lymphedema) o Clinical manifestations are determined by the sites of occurrence joints= pain and impaired movement brain/lungs=function impaired and could cause death o May be recognized as a local area of swelling, increased body weight, and pain

The _________ phase extends from exposure to the onset of any signs or symptoms.

incubation

Memory cells

induce the secondary immune system

Chronic infection

infection that last several weeks to years

Second line

inflammatory response

HIV clinical manifestations

initial infection with HIV is asymptomatic. CD4 helper T-lymphocyte number gradually declines as disease progresses. This leads to risk for opportunistic infections. Lowered immune function in HIV-infected individuals also leads to increased risk for non-AIDS defining cancer

Electrolytes

ionizable substances in solution; conduct electricity in solution

Golgi apparatus

is a membranous structure that helps in the secretion of items produced by the ER out of the cell

Coinfection

is a phenomenon of hosting two or more pathogens simultaneously

Infection

is a state of cellular, tissue or organ destruction die to an infectious organism

preimplantation genetic diagnosis

is an alternative to prenatal diagnosis and allows for identification of abnormalities before implementation

fluid regulation

is an essential part of homeostasis

Alkalinity

is cause by decrease in hydrogen concentration or increase in base ions concentration

Acidity

is caused by increase in hydrogen ion concentrations or decrease in the base concentration

IgD

is involved in binding of antigen and stimulation of differentiation of B lymphocytes into plasma cells

Homeostasis

is require to keep balance the different types of resident flora. An unbalanced population can cause infection

IgM

is the initial circulating antibody produced in response to antigen challenge

Glycolysis

is the process of breaking down glucose in the cytosol, which occurs the mitochondria when there is no oxygen present. Remember DNA replication and some other major processes occur within the cell

Variable expressiveness in genetics

it is the extent of variability associated with expression of genes by varying clinical manifestations. Example: two siblings from the same set of parents with cystic fibrosis can have different levels of severity of the disorder

Centromeres

joins two chromatids togethers

natural killer cells

large granular lymphocytes, NK cells are active in innate immunity -circulate until they become in contact with cells they can recognize as a threat Myeloid

Monocytes

large, mononuclear leukocytes representing 3 to 7 percent of total number of circulating leukocytes. These become activated when in contact with an antigen, prompting differentiation into macrophages

The period during which the virus is integrating itself into the host cell's genetic material is called

latency

Hyperaldosteronism

leads to alkalosis as a result of sodium bicarbonate retention and loss of hydrogen and potassium

Water moves between the ICF and ECF compartments principally by the process of

osmosis

Diagnostic Criteria for Hyperlactatemia

liver function test; analyze electrolytes and blood pH levels

IgE

located in surfaces of B cells that have not yet been exposed to antigens, activates mast cells

Inheritance of chromosomal alterations

loss, addition, rearrangement of genetic material

High pH

low amount of H+

Cytoskeleton

made up of tubule and filaments and it helps with the shape of the cell, movement, and transport. Inside the cytoskeleton are structures such as: -Microtubules: thin proteins composed of tubulin -Microfilaments: can be thin, thick, or intermediate

Clinical Manifestations of Renal Tubulopathy

manifestations of HPS occurs in utero; neonates present with severe effects. Initial manifestation is excessive amniotic fluid because of increased fetal urine output

Histamine is released from the _____ cells

mast cell

Cells become specialized through the process of

maturation

septicemia

microorganisms gain access to blood and circulate throughout the body -when its causes by bacteria-- bacteremia -once pathogen gains acess to all the perfused tissues, can lead in septic shock

The organelle that is involved in cellular respiration and is linked to the development of oxidative stress is known as the

mitochondria

The process of nuclear division is called

mitosis

buffer system

mixing and acid and base to resist pH change -responsible for trading stronger acids and bases for weaker varieties

blood transfusion

most common form of tissue transplant, through blood typing and cross-matching

DS clinical manifestations

multiple birth defects; including mental retardation, characteristics facial features, and additional health problems

An inherited alteration of genetic material is called

mutation

Infections with fungi are called

mycoses

Fungi infection =

mycoses or mycotic infections

___is characterized by rapid loss of the plasma membrane structure, organelle swelling, mitochondrial dysfunction. Correct!

necrosis

How does it impact the quality of life of an individual diagnosed with hemophilia

negative impacts of physical, psychological, economic and social wellbeing of the affected children and family

Anions

negatively charged ions

Fluid regulation

neural and hormonal mechanisms control fluid balance

Differentiation

changes in physical and function properties, which then directs the cell to develop into specific cell types.

Fluid transport Aquaporins

channels in the cell membrane that allows for the movement of water

Adaptive immunity

characterized by a slower response to the introduction of microorganisms than that of the innate immune system. Key properties of the adaptive immune system include: ● Specificity ● Diversity ● Memory ● Self and non-self recognition

Mechanism of Transportation Passive Energy

no energy is requires ex. diffusion

Autosomes

chromosomes other than sex chromosomes (44)

sex chromosomes

chromosomes that are sexually determinants (2)

Basophils

complement the action of mast cells

Glycolipids

comprised of a carbohydrate bound to a lipids; another major components embedded in the phospholipid bilayer (although mot as significant as phospholipids)

Metabolic Acidosis

condition in which too much acid accumulates in the body

1. Exposure

contact with the pathogen through any of the modes of transmission

Defense against disease

nonspecific external barrier (skin, mucous membranes)-->if they barriers are penetrated, the body response with---> innate immune response (phagocytic and natural killer cells, inflammation, fever)--> if the innate immune response is insufficient, the body responds with---> Adaptive immune response (cell-mediated immunity, humoral immunity)

Polygenic

containing several MHC classes I and II genes

Nucleus

contains DNA and is surrounded by a nuclear envelope.

DNA

contains heredity material with genetic instructions that is copied in reproduction -There are 23 chromosomes made of chromatin which contains genes. Genes determine the production of proteins which determines certain functions of the cell

Potassium-hydrogen exchange

contributes to the regulation of acid-base balance

Altered electrolyte balance

critical to metabolic function of cells to prevent disruption of action potentials and fluid balance -sodium is the most abundant cation in ECM and determines blood osmolarity -transported out of cell using cell using active transport via Na+/K+-2ATPase membrane transport

IgG is the only immunoglobulins that is able to

cross placenta, providing passive immunity to fetus

Type of T cells

cytotoxic T cells regulatory t cells memory cell

Pathogens

disease producing microbe -to cause disease must bind to the specific receptors of the hosts -if unable to bind: host not affected- some microorganism in the environment do not affect us

communicable disease

disease spread from person to person: often through contact with an infected blood and body fluid -all communicable disease are infections, but not all infectious diseases are communicable

treatment of cirrhosis

diuretics, but not excessive usage -paracentesis (insertion of cannula into peritoneal cavity to remove ascites) in bad cases

peripheral proteins

do not cross the entire thickness of the membrane and project into the intracellular or extracellular environment; they do not perform transport functions

Acids

donate H+ ions

Chromosomes

double stranded DNA containing threadlike sections of genes, most commonly found in the cell's nucleus

Diuretics

drugs that increase urine production. This is done to decrease the amount of sodium reabsorbed in the kidney

aerobic glycolysis

during aerobic glycolysis oxygen, glycolytic and critic acid cycle by products enter the metabolic pathway in the mitochondria---> energy production through oxidative phosphorylation (30-38 molecules of ATP per each molecule of glucose metabolized)

Which of the following are you NOT required to wear while dealing with universal precautions?

ear puffs gloves. mask and protective eyewear

SCD diagnostic criteria

early identification of individuals with SCD is vital to decreased morbidity and mortality

ions

electrically charged particles resulting from gain or loss of one or more electrons; negatively charged particles known as anions; positively charged particles known as cation

Not replication

not detected by immune system

aerobic respiration

occurs when there is a chemical reaction b/w oxygen and nutrients products, therefore producing ATP

Ions

of opposite charge attract one another

Eosinophils

offer greatest protection against parasites

IgE

on the cells surfaces of mast cells and basophils leads to cellular degranulaiton upon antigen binding, triggering release of chemical mediators involved with inflammation and allergies.

hyperlactatemia

elevation of lactic acid in the blood

Beckwith-Wiedemann syndrome

epigenetic inheritance, it is associated with pediatric overgrowth and predisposition to tumor growth

Mutations

errors in DNA duplication

hemorrhage

excessive bleeding, may caused hypovolemia -condition is isotonic because water and sodium are lost at comparable rates -fluid replacement for volume expansion is often necessary

Acute infection and complications: Acute infection in both communicable and noncommunicable infectious disease progresses along five distinct phases

exposure incubation prodrome acute clinical illness convalesence

cell adaptation

exposure to stressors causes changes in the cell structure and function. These adaptations occur to help the cell survive. (if stressor is too great, the cell may loss ability to adapt and die)

5. Convalescence

extends from warning clinical manifestaitons to full recovery of the disease

Barriers are the ____ line of defense.

first

igM

first antibody produced during intial or primary response

Body regulates

fluid and electrolytes and dysregulation a disease

Extracellular compartment

fluid outsides the cells in the interstitial tissues and plasma that makes up 1/3 of the body water -plasma fluid:5% of body weight -Interstitial fluid: 14% of body weight

Fluid Imbalance Intracellular components

fluids inside the cells makes up 2/3 of body water and 40% of body weight

DS treatment

focused in promotion of maximal independence and quality of life -treatment of cardiac or gastro complications may require surgical repair

Treatment

focused on correction of renal salt and fluid losses

constant region

forms the base of the Y-shaped antibodies and is the most stable component

Genotype

genetic makeup of an individual

autograft

graft from different sites in the same person

Allograft

grafts b/w unrelated individuals is often rejected after 10-13 days without drugs to control immune response -T lymphocytes (CD4 and CD8) are responsible for rejection of all grafted tissues due to the recognition of alloantigents as foreign

syngeneic

grafts from genetically identical individuals

Tissues

groups of similar cells type that combine to form a specific function -four major types: connective (support), epithelia (barriers), muscle (motility), nerve (conductive communication)

Diiffusion

passive movement of particles from a higher concentration to a lower concentration. Particles ultimately are evenly distributed across the membrane -stimulus for transport is chemical or electric gradient

Osmosis

passive movement of water to an area of higher concentration from an area of lower concentration. Flow of water is ultimately directed by active osmotically active particles. o Stimulus for transport is concentration gradient

After penetrating protective barriers (invasion)

pathogens then multiply and spread through the lymph and blood to tissues and organs, where they continue multiplying and cause disease

incomplete penetrance in genes

penetrance is the percentage of the indiviuals with the mutation who develop the disease. It is the proportion of the indiviuals carrying a particular variant. In incomplete penetrance, some individuals will not express the gene even through they have an allelle. Example is incomplete penetrance of the BRCA1 gene that is responsible for breast cancer.

Proteins

perform functions related to cellular communication (receptors) and the transport of molecules across the membrane (channels) -Proteins are often suspended in the plasma membrane, acting as receptors that bind substances, including hormones

The cellular process for the elimination of pathogens and foreign debris is called _______

phagocytosis

Diagnostic Criteria of Cirrhosis

physical examination and change in body weight

Acidosis (pH < 7.35)

physiologic processes that cause acid accumulation or alkali loss

Alkalosis (pH > 7.45)

physiologic processes that cause alkali accumulation or acid loss

MHC molecules are

polygenic and polymorphic

Cations

positively (+) charged ions

__________ is the predominant ICF ion; it regulates ICF osmolality, maintains the resting membrane potential, and is required for deposition of glycogen in liver and skeletal muscle cells.

potassium

Virulence

potency of the pathogen indicated by the ration of number of cases of disease in a population compared with the number of people exposed to the microorganism

Mendelian pattern

predictable trait transmission based on autosomal dominant or recessive genotypes

IgA

predominant in mucosal areas (GI, urinary, and respiratory tracts) and in secretions (saliva, tears)

Neutrophils

present in the greatest number and are the most important in the rapid response to bacterial infection

Graft versus host disease (GVHD)

presents a contrast to graft rejection, in that the transplantation of hematopoietic stem cells, cells that differentiate into health blood cells

SCD treatment

prevention of complication to infection is important for management of sickle cell anemia. Treatment is often symptom specific

Glycolytic pathway

process of oxidizing sugar

Osmosis

process of water movement across the PM with its gradient -regulated by the concentration of particles that do not diffuse across the membrane -osmotic pressure is generated as water move across the membrane

The ___________ phase involves the onset of vague, nonspecific signs and symptoms

prodromal

Lymphocytes

produced and differentiated in central organ, bone marrow and thymus

Lymphokines

produced by lymphocytes and are a type of immune cell. They are typically produced by T cells. The main role of the lymphokines is to attract immune cells like macrophages and other lymphocytes. They also assit B cell in producing antibodies

Anaerobic gylcolysis

produces 2 molecules of ATP for each molecule of glucose metabolized and chemical products.

Huntington's disease

progressive, autosomal dominant disorder caused by a defeat in the huntington gene on chromosome 4 -disease results in a triplet cytosine-adenine-guanine (CAG) expansion mutation in the (HTT gene) with an increased number of mutations associated with earlier onset of the clinical manifestations of disease -creates the abnormal huntingtin protein, which accumulates to toxic levels and destroys nerve cells, ultimately resulting in atrophy in the brain -individuals suffers from involuntary movements, cognitive impairment and emotional disturbance -No current treatment for care. Supportive care provided can help

transmembrane proteins

proteins that pass through the entire plasma membrane; often have communication and transport functions

Messenger RNA (mRNA)

provides a template for protein synthesis dependent on codon sequence that is based on the complementary strand of DNA (cDNA)

IgA

provides passive immunity from mother to baby thru breast milk

Pathogenicity

qualities that promotes the production of disease multiply factors including: -pathogen potency -invasiveness -ability to evade the immune system

Memory

rapid and robust response to previously recognized antigens

3) Renal buffer system

reacts within hours-days through the production, absorption and excretion of acids, bases, and ions -circulating fixed acids are considered nonvolatile because they are unable to be excreted by the lungs and require buffering and excretion by the kidney -The main mechanism are ○ Hydrogen ion Elimination/Bicarbonate conservation ○ Tubular buffer systems ○ Potassium-Hydrogen exchange ○ Chloride-Bicarbonate exchange

2) Respiratory buffer system

reacts within minutes to excrete CO2 through change in respiratory rate -2nd system that responds to changes in pH -contributes to regulation of CO2-CO2 in gaseous form considered volatile because it can be excreted by the lungs -unable to completely restore homeostatic pH but it is essential to provide additional time needed for renal correction of acid-base imbalances

!)Plasma buffer system

reacts within seconds in response to hydrogen ion concentration; rapid reponses -the buffer of free H+ is central to the effectiveness of the plasma buffer systems

Pathogens-a disease producing microbe in order to produce disease in humans, must be capable of binding to specific ________ on the human host. Correct!

receptors

Diversity

recognition of a wide variety if antigen

Communication Feedback Mechanisms

regulate gene activation, therefore controlling the production of proteins and preventing cell damages caused by over/underproduction

antidiuretic hormone (ADH)

regulates the fluid volume by controlling the excretion of water. It is stored in the posterior pituitary gland until needed

Regulation of Acids and Bases

regulation of acid and bases is critical to the metabolic activities of the body. A narrow pH is required for proper functioning.

_______________are enzymes that promote secretion of aldosterone and thus regulate sodium and water balance.

renin and angiotensis

Chlamydiae

reproduce through binary fission yet are obligate intracellular parasites -use host metabolism to reproduce

igG

responsible for innate immunity

water intoxication(hypotonic hypovolemia)

results from decreased sodium concentration/ water replacement after strenuous activity or excessive loss of sodium from diuretic therapy inhibiting ADH o Cellular swelling= movement of water from Extracellular space to intracellular o Increase in cellular water trigger clinical manifestations: muscle weakness, cramps, fatigue, headache o Treatments: limiting water or increasing sodium intake

lactic acidosis

results from hyperlactatemia; characterized by the buildup of lactate (especially L-lactate) in the body; rare but serious complication of NRTI use

Aids

secondary immunodeficiency caused by infection with the Human immunodeficiency virus (HIV). HIV is an enveloped retrovirus that infects CD4 helper T lymphocytes, dendritic cells, and macrophages.

Regulatory T cells

secrete lymphokines (proteins that affect other immune cells by activating or suppressing them; the "hormones" of the immune system) a. T helper cells (Th): facilitate both cell-mediated and humoral immune responses by secreting certain lymphokines b. T suppressor cells (Ts): suppress both cell-mediated (other T cells) and humoral (B-cells) immune responses by secreting lymphokines

Infection control measures

seek to break the infectious links - For example, breaking the chain of infection at the level of the pathogen requires sterilization of the environment to remove all pathogens from contact with the human cell. -Sterilization is performed using physical or chemical agents, heat being the most important.

____________is a process of systemic vasodilation due to severe infection which may lead to poor perfusion to vital organs

septic shock

Codon

sequence of 3 nitrogenous bases; each code for a specific amino acid

Fragile X Syndrome

sex-linked genetic disorder, leading to inherited intellectual disability

Ligands

signaling molecules. Lock and key model - paracrine signaling occurs when a ligand binds to a receptor and a signal transduction results

SCD pathophysiology

single gene mutation that follows mendelian inheritance patterns ---> Hemoglobin S is the abnormal type of hemoglobin found in people with sickle cell anemia

Hypertonic

solutions that have a greater osmolality than the IC, which promotes water movement out of the cell

Hypotonic

solutions that have a lower osmolality than ICF which promotes water movement into the cell

Receptors

special proteins that are located on the cell membrane or within the cell and allow for the target cell to communicate

Immunity involves both

specific and non-specific components

variable region

structured to allow binding to specifc antigen

Bases

substances that accepts H+ ions - the ratio b/w acids and bases in the ECF is closely regulated to provide a good environment for metabolic cellular functions

Plasma Membrane

surrounds and protects the cell by separating the cell from the extracellular environment; phospholipid bilayer structure containing a variety of components

Smooth ER

synthesizes lipids, lipoproteins and steriod hormones. It also regulates calcium in the cell.

Rough ER

synthesizes protein via ribosomes and produces lysosomal enzymes

Specificity

targeted response to a distinct antigen

How many phosphate bond in an ADP molecule

the ADP molecule has 2 phosphate bonds

the total concentration of sodium is higher in the

the ECF in comparison to the ICF

Infectivity

the ability of pathogen to attach to cell surfaces, release enzymes that dissolve protective barriers, multiply rapidly, escape the action of phagocytes or resist the effect of low pH

Toxigenic

the ability of the pathogen to produce harmful toxins that increase host cell and tissue damage

Dysplasia

the change in cell size, shape, uniformity, arrangement, and structure. This occurs when there is an abnormal division of cells, and it will resolve when the stressor is removed oMutations sometimes occur during cell reproduction, which is changes in the genetic material that makes up the chromosome. These mutated cells can progress into cancerous cell over time

pH

the clinical measurement of the balance b/w acids and bases

atrophy

the decrease in the size of a cell -decreased in functional demand for on a cell can cause this oSpinal muscular atrophy- results from disuse caused by neural innervation to muscle tissue. Signals are decreased because of loss of motor cells (IE a cast from broken bones can cause this)

What is the final byproduct during anaerobic catabolism

the final products of anaerobic catabolism which occurs in the cytoplasm is lactic acid

IgM

the first antibody produced during initial response to antigen (primary immune response) before there is sufficient IgG

Genetic code

the information contained in genes for making specific proteins

Antigenicity

the level to which a pathogen is viewed by the host immune as foreign

Phsopholipids

the main components of the plasma membrane; consists of 2 nonpolar hydrophobic fatty acid chains and a polar hydrophilic phosphate head bound to glycerol, giving it amphipathic character -hydrophilic- having an affinity for water -hydrophobic- lacking an affinity for water

What is the main source of the energy in the ATP molecules

the main source of energy in the ATP molecule is b/w the second and third phosphate binds

Name the process after the cycle is completed

the major end products are carbon dioxide (co2) and two dinucleotides-reduced nicotinamide adenine dinucleotide (NADH) and the reduced form of flavin adenine dinucleotide (FADH2)- both of which transfer their electron into the electron-transport chain

Amino Acid

the monomers of protein; 20 amino acids from the basis of all human proteins

Tonicity

the osmotic pressure or tension of a solution. This is determined by solutes that cannot cross the semipermeable cell membrane

Gametes

the ova and sperm; contains only one copy of each chromosomes and are haploid

Heredity

the passage of characteristics from parent to offspring

facilitated diffusion

the passage of substances through a membrane aided by transport proteins. (not energy depended) ex. glucose is an example

IgG

the predominant circulating Ig (80-85%), provides the main antibody-based immunity (secondary immune response); had 4 subgroups

IgE

the principle antibody in allergic response (binds to allergens to trigger histamine release from mast cells) and in prevention of parasitic infections

alternative splicing

the process by which certain pieces of RNA are removed and others are retained; splicing location is directed by genetic code. Exons are kept, introns are expunged

Osmosis

the process where water moves passively through a cell membrane -area of high water concentration to low

Route of entrance of many pathogenic microorganism may also become

the site of shedding of new infectious agents to other individuals, completing a cycle of infection

Immunity

the state of having sufficient biological defences to avoid viral, bacterial, fungal infection or other unwanted biological invasion

Bilayer

the structure of plasma membrane; literally "two-layers"

Genomics

the study of human genome; or the full DNA sequence

Immunology

the study of structure and function of the immune system along with immunity, induced sensitivity and allergy

Phenotype

the traits that are apparent of observable

Interleukins

these promote differentiation of the T and B lymphocytes.

Reactive Oxygen Species (ROS)

this is the chemically active form of oxygen that are available for use. Molecule oxygen is stable and is not ready to be use for various processes within the cell. Reactive oxygen species is active within the cell and our bodies for processes like cell signaling and homeostasis. Too much of this form if oxygen could be potentially harmful. Increased contents of reactive oxygen are seen in the presence of environment stressors like UV rays

single-gene trait

traits passed on by the transmission of a single gene

Polygenic

traits that results from the interaction of several genes and are influenced by environmental factors

The process by which RNA directs synthesis of polypeptides is called

translation

cation exchange

transport of one positively charged ion for another in opposite directions

active transport

transport of particles across the cell membrane against a grandient with the use of energy. Proteins pump the ions across the membrane.

Down Syndrome: Alteration in chromosome number

trisomy occurs on chromosome 21, 3 copies of chromosome 21

All immunogens are antigens but not all antigens are immunogens.

true

Hypernatremia with marked water deficit is manifested by hypovolemia and dehydration.

true

Resident flora compete with disease-producing microorganisms to protect the body against certain infections and to provide a type of natural immunity.

true

Endoplasmic Reticulum

tubules that produces proteins and fats. Important for the regulation of ions in a cell

Diploid

two copies of each chromosomes

Complications of infection

two major complication include septicemia and chronic infection

Immunoglobulins are composed of

two regions

Receptors

types of cell the pathogen will bind to ex. influenza virus-respiratory tract epithelial cells

graft rejection Grafts

unattached tissues or organs used for implantation that are used in treatment of disease -must match MHC molecules

Rickettsiae, Mycoplasmas, and Chlamydiae

unique pathogens that have characteristics of both bacteria and viruses

Manifestation of Cirrhosis

usually related to severity of ascites

SCD clinical manifestations

vaso-occlusion and hemolysis related to increased proportion of HbS in circulation. Jaundice and anemia are two most common

Homozygous

when a individual has identical alleles on each chromosomes

Hypochloremia metabolic alkalosis

when acid loss is caused by vomiting, renal compensation is not very effective because of chloride (an anion) in hydrochloric acid (HCI) stimulates renal retention of bicarbonate (an anion)

Heterozygous

when an individual has two different alleles in each chromosomes

Superinfection

when an infection arises in addition to one that is already present

Adaptive immunity is stimulated

when antibodies encounter an antigen (often recognized as foreign)

Lactic academia

when individuals develop hyperlactatemia but are not symptomatic and they experience subclinical episodes that are self-limiting

autoimmune disease

when recognition of itself fails to this happens by specific recognition of self-antigens or by overzealous responses to chronic infection -Can be chronic if antigen is not cleared or if a positive feedback loop

Airborne transmission:

○ Smaller respiratory particles in the air ○ Could remain in air for extended period f time ○ Tuberculosis and chickenpox are examples

Vector transmission:

○ Vehicle that harbors the pathogen and carries it to the host ○ Ex: arthropods are vectors

respiratory acidosis

Where: Changes in carbon dioxide partial pressure- excess carbon dioxide in the blood (hypercapnia) pH: pH<7.35 Compensation: Renal bicarbonate retention and hydrogen elimination Acid-base abnormality: excess CO2 in blood-leading to increase in hydrogen ion concentration

Respiratory alkalosis

Where: changes in carbon dioxide partial pressure- excessive reduction in plasma carbon dioxide levels (hypocapnia) pH: pH > 7.45 Compensation: renal bicarbonate elimination and hydrogen retention Acid-base abnormality: reduction in CO2 in blood-leading to reduced bicarbonate concentration

Metabolic alkalosis

Where: increase in serum bicarbonate pH: pH>7.45 compensation: respiratory co2 retention (hypoventilation) Acid-base abnormality: increase bicarbonate, decrease non-carbon acids

IF strong immune response is not triggered after a acute infection, individuals more prone to host

a chronic viral infection Promoted by: 1. size of virus that is inoculated into body 2. Process of viral replication 3. Viral genotype 4. Host susceptibility

Bronchopulmonary Dysplasia (BPD)

a condition where cellular changes lead to chronic, irreversible tissues changes o the bronchial and alveolar tissues of the lungs become thickened which reduces the ability to breath air into the lungs

Hemophilia- Sex (x) Linked Recessive

-classic hemophilia -caused by factor VIII deficiency -passed on from parents to children. It also occurs by spontaneous mutation -Hemophilia A is more common than hemophila b

Hypokalemia

- potassium levels of <3.5 mEq/L in blood o Alter membrane potential can result in dizziness, hypotension, arrhythmia, cramps, weakness o Smooth muscle decrease in motility contributes to nausea, anorexia, and abdominal distension

Hyperkalemia

- potassium levels of >5 mEq/L in blood o Often iatrogenic cause (caused by inappropriate use/management of drugs) o Alters membrane potential and can lead to cardiac arrest, abdominal cramps, flaccid paralysis

Citric Acid Cycle

- second stage of cellular respiration -oxygen is the key component -occurs after glycolysis

ADP-ATP

-ATP is consumed in the cell by energy-requiring processes and can be generated by energy-releasing processes -in this way ATP transfers energy b/w separate biochemical reactions in the cell -ATP is the main source for the majority of cellular functions, including the production of organic molecules, including DNA and protein -Plays a critical role in the trnasport of organic molecules across cell membranes, for example, during exocytosis and endocytosis

Structural properties critical to the pathogenicity of bacteria are

-Independent survival- bacteria can survive outside of the human host and can infect other cells -Stimulation of an inflammatory response- bacteria can stimulate an inflammatory and immune response that can destroy host tissue -Bacteria Capsule- encapsulated bacteria are resistant to phagocytosis -Endotoxin- endotoxin causes inflammatory mediators to be released which lead to an inflammatory response. This lead to diarrhea, fever, and leukocytosis. when it leads to fever a fever it is known as pyogenic -Exotoxins- bacteria can excrete this toxin which results in host cell dysfunction and lysis in the brain, spinal cord, GI tract, liver or blood -endospore- some bacteria produce spores that can survive in extreme conditions that can infect a host

3. prodrome

-Involves the onset of vague signs and symptoms including fatigue -under the weather phase

active transport

-Primary Active transport- similar to active transport, requires the use of energy. Such energy is required because there is a higher concentration of sodium outside of the cell than inside -Secondary active transport- takes place when the movement of a second substance is directly dependent on the energy produces by the active transport of the primary substance

Understand the difference b/w purines and pyrimidines

-Purines include Adenine and Guanine -Pyrimidines include Cytosine and Thymine -Base pairs include A-T and C-G across strands of DNA

Adaptive Immune defense:

-Specificity: immune cells seek and destroy invaders -Memory: immune cells produce substances that remember and therefore more easily destroy repeat offenders

respitory alkalosis

-alveolar hyperventilation (deep, rapid respirations) -excessive reduction in plasma carbon dioxide levels (hypocapnia) decrease carbonic acid concentration -can be acute or chronic Causes: -Hyperventilation is causes by: hypoxemia (caused by pulmonary disease, congestive heart failure, high altitudes), hypermetabolic states (eg, fever, anemia, thyrotoxicosis), early salicylate intoxication, hysteria, cirrhosis, and gram-negative sepsis. -Improper use of mechanical ventilators also can cause iatrogenic (treatment related) respiratory alkalosis and secondary alkalosis may develop as a result of hyperventilation stimulated by metabolic or respiratory acidosis -the kidneys compensate by decreasing hydrogen excretion . and bicarbonate reabsorption SYMPTOMS: • dizziness, confusion, tingling of extremities (paresthesias), convulsions, and coma. • Cerebral vasoconstriction --- cerebral blood flow. • Carpopedal spasm (spasm of muscles in the fingers and toes), tetany

Respitory Acidosis

-alveolar hypoventilation, resulting in an excess of carbon dioxide in the blood (hypercapnia) -Can be acute or chronic Causes: -depression of the respiratory center, paralysis of the respiratory muscles, structural disorders of the chest wall and disorders of the lung parenchyma (e.g., pneumonia, pulmonary edema, emphysema, asthma, bronchitis). -renal compensation occurs by elimination of hydrogen ion and retention of bicarbonate SYMPTOMS: • headache, blurred vision, breathlessness, restlessness, and apprehension followed by lethargy, disorientation, muscle twitching, tremors, convulsions, and coma. • Respiratory rate is rapid at first and gradually becomes depressed as the respiratory center adapts to increasing levels of carbon dioxide. Skin may be warm and flushed because the elevated carbon dioxide concentration causes vasodilation

Process

-antigen are processed by an APC with the antigen epitope placed onto an MHC on the APC surface -The T lymphocytes can recognize and bind to that process the antigen and cause death of the affected cell

cell-mediated response

-antigen-induced proliferation: when T cells encounter an antigen, they bind to it and proliferate -Daughter T cells can recognize the same antigen -End product: a large number of T cells capable of acting against a specific antigen and a line of memory cells for that specific antigen

Two majors ways that cell die

-apoptosis- programmed cell death prompted by a genetic signal which is designed to replace old cells with new ones. -Necrosis-death of cells due to cell injury, such as injury to mitochondria which affects how ATP functions for cellular processes

Treatment Strategies

-assess literacy level of individual/family -ask for interpretation of info. About testing procedures and possible outcomes -provide info about rates of risk in both positive and negative terms -promote ability to informed decisions

autosomal recessive disorders

-because of the recessive nature of the gene involved, a child must be homozygous for the mutated gene to express the disease oIn other words, both parents must have at least one copy of the damaged gene for the disease to be passed on to their children oNote* gene may be present in genotype but not phenotype (physical attribute)

Neutralization

-binding antigen to antibody -prevents antigen from infecting cells -resulting complex is removed in 2 ways: agglutination (clumping together) or precipitation (falling out of solution)

Type of Immunity: Active

-bodies direct response to an unknown pathogen -not immediate as it takes time to have create enough of the correct antibodies to fight the pathogen -natural form- the normal process of an individual contracting an infection and their immune system responding -artificial form- immunization, where an individual is deliberately exposed to a weakened form of a particular pathogen in order to elicit an immune response

Causes of cell injury and death

-can occur due to infection from bacteria, virus, protozoa or fungi

metabolic alkalosis

-caused by an increase in bicarbonate concentration which occurs when excessive loss of metabolic acids occurs SYMPTOMS: • weakness, muscle cramps, confusion, convulsions, and atrial tachycardia. • Respirations may be shallow and slow ventilation as the lungs attempt to compensate by increasing carbon dioxide retention. • Hyperactive reflexes and tetany (intermittent muscular spasms) occur because alkalosis increases binding of Ca++ to plasma proteins, thus decreasing ionized calcium concentration. The decreased ionized calcium concentration causes excitable cells to become hypopolarized, initiating an action potential more easily and causing muscle contraction.

During a period of Dormancy, A virus may:

-causes no/minima changes to cell function -low antigenicity -continues replication through mitosis 2. immunicompromise as a result of physical and emotional stress can provide a medium for active viral replication 3. Active viral replication can be triggered weeks to years after the initial inoculation 4. Can result in cell death 5. Replication triggered by immunocompromise 6. Local necrotic cells removed by inflammatory/immune response 7. Ex. Herpes Zoster Virus

Metabolic Acidosis

-the concentration of non-carbonic acids increase or bicarbonate is loss from the extracellular fluid or cannot be regenerated by the kidney -manifested by changes in the function of the neurologic, respiratory, gastrointestinal and cardiovascular systems . Early symptoms include headache and lethargy, which process to confusion and coma in sever acidosis Symptoms: -Kussmaul respirations- which are deep and rapid: the body's attempt to increase pH by expelling carbon dioxide, which decreases carbonic acid concentration • Anorexia, nausea, vomiting, diarrhea, and abdominal discomfort. • Death can result in the most severe and prolonged cases preceded by dysrhythmias and hypotension.

humoral immune response

-the humoral immune response begins during stage 2, when an antigen binds to the plasma membrane receptors of a mature B cell - this interaction results in proliferation and differentiation, the end products of which are 1. Antibody-secreting plasma cells 2. A set of long-lived memory cells

Common causes of cell injury death: TIPS

-toxins (chemical, pathogenic) -infections -Physical injury (mechanical, chemical, thermal) -serum deficit injury (nutrition, hydration, oxygenation)

Functions of the cell

-transport -ingestion -secretion -respiration -communication -reproduction

Immune Maladaptation: Rh Isoimmunization

-type II cytotoxic antibodies mediated reaction -Antigen-antigen mediated reaction -Can lead to cell destuction of fetal red blood cells (making it a hemolytic condition)

Protozo

-unicellular complex microorganism -irregular shape without cell wall, many are motile -transmission through: ○ Sexual contact ○ Contaminated food/water ○ Insect/arthropod -Some parasites and some can live independent of the host -Parasitic ones compete for and deprive host of nutrition--> tissue destruction

Immune Response in Disease Management

-use of the body's own immune system to attack pathologic cells -Drugs that promote the ability of the immune system to distinguish b/w normal cells and cancer or other harmful cells

Immune response in the prevention of disease

-vaccines stimulate immunity through exposure to an antigen -this immune response reactivates when re-exposed to the antigen (immunologic memory)

Alloimmunity

-when an immune response is stimulated in response to the presence of cells from another individual of the same species -can occur after allograft

Factors affecting the quality and intensity of the immune response:

1. Antigenic challenges (type and amount of antigen 2. Exogenous factors such as trauma, disease, pollutants, radiation, ultraviolet lights, drugs 3. Endogenous factors such as age, gender, nutritional status, genetic background, reproductive status 4. Malnutrition is the most common determinate of immunodeficiency, especially protein malnutrition - important micronutritents for proper immunity include zinc, selenium, iron, copper, and vitamins A, E, C, B-6, Folic acid - Example: low birth weight infants may have a prolonged immunity impairment, which may be partly restored by providing extra dietary zinc

Hepatitis B

1. Chronic condition in 10% of adults 2. 90% of newborn who contract from mother 3. Difference is the result of the newborn incapable immune system

Mechanisms by which pathogens cause disease:

1. Direct destruction of the host cell by the pathogen 2. Interference with the host cell's metabolic function 3. Exposing the host cell to toxins produced by the pathogen

There are two steps to antibody production

1. Generating mature B cells that have receptors for all potential antigens -antigens independent -performed in the bone marrow and gut, --- the mature b lymphocytes express receptors to all potential antigens 2. When mature B cells encounter an antigen for the first time they become plasma cells -antigen-specific and antigen-driven -results in proliferation and maturation of antibody-secreting plasma cells -plasma cells are specific i.e, they make antibodies (immunoglobulins) against only one invader (antigen)

3 ways antibodies protect cells from pathogen

1. The binding of the antigen to the antibody, which prevents the antigen from infecting cells (n eu - tralization). The antigen-antibody complex is removed by agglutination (clumping together) or precipitation (falling out of solution). 2. The promotion of phagocytosis and destruction of the pathogen through the phagocyte's ability to recognize the constant region of the antibody that isboundtoorcoatingtheantigen(opsonization) 3. The activation of complement, which supplements that of the innate system, further enhancing the actions of the antibodies

inflammatory response

1. histamine and prostaglandis released 2. capillaries dilate clotting begins 3. chemotatic factors attract phagocytic cells 4. Phagocytes consume pathogens and cell debris

Respiration

ATP, which is crucial for the cell survival, is produced by cellular respiration. Cellular respiration can be defined as a series of metabolic processes that transform fuel molecules into energy (ATP)

Which of these is an energy-transferring molecule?

Adensoine Triphosphate

Metabolic Acidosis in Parenteral Nutrition

An example of supplemental nutrition that bypasses typical processes of eating and digestion

B cells produce

Antibodies

_____________ is secreted in response to an increase in plasma osmolality or a decrease in circulating blood volume.

Antidiuretic hormone (ADH)

Host defense failure:

Antigenic variation: one of the most effective ways pathogens evade detection from immune system -multiple variations -variations appear to be new to pathogen to T and B lymphocytes -occur due to genetic mutation

atrophy vs hypertrophy

Atrophy is a decrease in the size and function of a cell or an organ. Hypertrophy is an increase in the size leading to potentially abnormal functioning of an organ. three mechanisms in which atrophy can potentially occur- mechanical stretch, agonists activity and growth factor bindings

Sickle Cell Disease

Autosomal recessive disorder

Laws of Genetic traits

Autosomal= dominant and recessive Sex-linked-dominant and recessive

B and T cells

B lymphocytes and T lymphocytes possess two important characteristics: 1. Specificity: they are specific; i.e., each lymphocyte recognizes and fights against only 1 specific antigen (invader) 2. Memory: they create a long lasting protection against specific antigens (immunity) - They do so by producing memory cells that can remember the antigen and act faster against it when it invades the host again (producing a stronger and more rapid response on subsequent encounters)

ICF is low in

Ca2+, Na+, HCO3-, Cl-; moderate levels of Mg2+,PO42-; high in K+

____is a reversible, structural, or functional response both to normal or physiologic conditions and to adverse or pathologic conditions. Cells can adapt to physiologic demands or stress to maintain a steady state called___________

Cellular adaptation and homeostasis

Electrolyte transport

Electrolytes cant cross PM (because of their charge) so they require transporters -transport b/w like charged electrolytes can be paired to maintain electrolytes balance

SLE pathophysiology

Exact events that trigger SLE are unknown; however a genetic/familial tendency combined with hormonal and environmental influences seems to make a person more susceptable to developing the disease. It tends to run a course with exacerbations and quiescence (decrease symptoms)

Rh Isoimmunization Clinical Manifestations

Fetuses with condition at higher risk for anemia, hydrops, and premature death Severe hemolysis made worse by erythropoiesis, causing heavy production of immature erythrocytes

Altered Acid-Base Balance: Highly Active Antiretroviral Therapy (HAART)-Associated Acidosis

HAART are medications used to treat HIV infection. It prevents the HIV virus from making copies of itself and limits how much virus is in the body

HIV pathophysiology

HIV is transmitted through sexual contact, blood contamination and perinatally b/w individuals. Infections occurs through mucosal surfaces that are found in areas such as vagina, cervix, and anus. Numerous mutations lead to antigenic variation

Humoral Vs Cell mediated Immunity

HUMORAL IMMUNITY • Involves antibodies (secreted from B cells) dissolved in the blood plasma. • Demonstrated as a immune response using only the blood serum. • Defense against bacteria, bacterial toxins, & viruses CELL MEDIATED IMMUNITY • Involves the activities of specific white blood cells (T cells). • Defense against cancer cells, virus -infected cells, fungi, animal parasites, & foreign cells from transplants.

The concentration of potassium is higher in the

ICF than in the ECF

Direct contact

Implies physically touching or otherwise coming in contact with the reservoir ○ Ex: touching the blood or body fluids of an infected person

SLE clinical manifestations

Joint pain and swelling, skin rashes, fatigue, pericardial effusion (swelling around the heart), pleural effusion (swelling around the lungs)

Altered Calcium balance: Hypoparathyroidism

Main cause is low levels of parathyroid hormone -calcium homeostasis is tightly controlled through negative feedback regulation Pathophysiology: Parathyroid hormone is released to increase blood calcium; so, it is inhibited with this condition ● Manifestations — bone loss, hair dryness, seizures, muscle cramps ● usually difficult to differentiate from hypocalcemia. Need lab confirmation ● Diagnostic Criteria — family/personal histories, but most importantly, lab testing ● Treatment — Long term care requiring supplemental calcium and vitamin D

Plasma in vascular space (blood vessels) is high in

Na+, Cl-, Ca2+; low in K+, Mg2+, PO4 2-;moderate levels of HCO3-

Alteration in chromosome number

Nondisjunction, failure to seperate -Monosomy, when nondisjunction results in cells with one copy of a chromosome instead of two -Trisomy, presence of three copies of a chromosome

Parasites include

Obligate parasites: require the host for metabolism and reproduction Facultative parasite: may live on the host but can survive independently

septic shock

Process of systemic vasodilation due to severe infection which leads to poor perfusion of vital organs

Transfer RNA (tRNA)

RNA molecule that form part of the ribosomes

Anion exchange

Reciprocal transport of negatively charged ions

Rickettsiae

Rickettsiae, like viruses, are obligate intracellular parasites that cannot replicate outside -Rickettsiae target human endothelial cells -Mycoplasmas lack a cell wall- survive on surface of host cells but do not enter for replication

EC and IC Distribution on fluid

Sodium= ECF>ICF Potassium= ECF<ICF Calcium=ECF>ICF Chlorine=ECF>ICF Bicarbonate=ECF>ICF

Clinical Manifestations of Parenteral nutrition

Symptoms are variable; typical manifestations may prompt need for parenteral nutrition; extreme conditions may include neurological manifestations including coma and seizures

Anaphylactic Reaction Pathophysiology

The IgE bound to receptors on mast cells induce the release of chemical mediators when binding with the allergen, thus the allergen occurs locally, but is spread throughout the bloodstream Vascular smooth muscle dilates, bronchial smooth muscle constricts, vascular permeability increases

Ingestion

The cellular PM acts as a barrier from the outside environment , however, ingestion into the cytoplasm occurs when necessary

Bicarbonate buffer system

The primary buffer of the extracellular fluid

alteration of chromosome structure

Translocation, large segment of DNA breaks from one chromosome and reattaches to a different chromosome

Treatment for Parenteral nutrition

Treatment with HCO3- base; Hydration and oxygen

Immune maladaptation: Systemic Lupus Erythematosus (SLE)

Type III hypersensitivity reaction. Resulted from persistent antigen-promoting complex deposition and inflammation. The location of these complexes and the organs that are involved determine the symptoms of the disease

factors that affect the variability in which the pathogen is able to elicit disease.

Virulence toxigenic antigenicity Antigenic variability coinfection superinfection

lymphiod progenitor cells: WBC

WBC, also know as leukocytes are the basic functioning units of the immune system. three major categories of WBCs are derived from the lymphoid progenitor cells and play an essential role in immune function. These cell types include: 1. T lymphocytes 2. B lymphocytes 3. Natural killer cells

Phagocytosis

a another type of endocytosis. However, phagocytosis os the process of ingesting large particles, including: cells, bacteria, and damaged cellular components.

Some virus sustained for

a long period of time

immune memory leads to

a more rapid and intense immune response

characteristic of chronic viral infections is

a period of latency, or dormancy

Filtration and reabsorption are caused by

a pressure differences that either force fluid movement from within a vessel to the interstitial space or pull fluid from the interstitial space into the intravascular space

Net Filtration-Osmosis

a process by which molecules of a solvent tend to pass through a semipermeable membrane from a less concentrated solution to a more concetrated one, thus equalizing the concentration on each side of the membrane

Antigenic variability

a process of eluding the human host defenses and is often a result of altering the antigens present within or on the surface of the microorganism

Alleles

a series of two or more different genes occupying the same location on a specific chromosomes

Isotonic

a solution that has the same osmolality as the ICF (a balanced cell)

Pinocytosis

a type of endocytosis that require ATP and involves the ingestion of small liquid-containing vesicles

Endocytosis

a type of ingestion that occurs in order for large substances to be transported into the cell

Dominant

alleles more likely to express in a person

Hypersensitivity

allergens are antigens commonly considered to be harmless -responses to allergens can range from mild to severe -They may be environmental or from certain proteins/components in drugs -allergic reactions to insect stings cause cutaneous reaction with the potential for severe systemic reactions

familial tendency

also know was propagation of autoimmunity among family members. is a common trait in autoimmunity

facilitated diffusion

assisted movement of particles across cell membrane with no use of energy. A carrier system moves the particles across the membrane o Stimulus for transport is the binding of substance to transporter

Cells require specialized signal to maintain function

atrophy is often the response when these signals are removed

Cytotoxic T cells (Tc)

attack and destroy antigen directly

citic acid cycle

breaks down the sugars, fats, and proteins in order for the energy production to occur in the mitochondria

Hypersensitivity to allergens can be determined

by a scratch/prick skin test, intradermal skin test, skin patch test, measurement of serum IgE and elimination diet

Communicable diseases are infections caused

by microorganisms that live and reproduce in a human host.

Ischemia

decreased oxygen supply to cell can also cause atrophy

Some Terminology associated with a chromosome

chromatids are components of chromosomes. Centromere is the central part of the DNA that holds various components together. Chromatids are made of chromosomes

Involution

decreased size of tissues and organs

receptor binding

clues to racial and geographic differences in human infection ex. malaria: some African Americans lack receptors for it so they are not susceptible to it

Agglutination

clump together

T lymphocytes displace membrane membrane surface molecules called

clusters of differentiation to contribute to cell specificity

Developmental Disorders

cognitive disorders are linked to events that occur at critical points in development -risk is greatest during weeks 3-8 of gestation--> because organogenesis is occuring -substance that cause damage to developing embryos are called teratogens oIt is known that maternal alcohol consumption(teratogens) during pregnancy is the sole causative factor identified for the development of Fetal alcohol syndrome (FAS)

cerebral atrophy

common feature of many diseases that affects the brain rather than a disease -reduction in the size of the neurons--> reduction of the brain tissue -Neurons=conducts neural impulses within the brain and to other areas of the body

deficit injury

damage to the cell due to a lack of oxygen, hydration, and nutrients

Hyponatremia

decreased levels of sodium in the blood -can be results of vomiting, diarrhea, sweating -blood sodium levels of <135mEq/L -osmotic swelling of cells contributes to muscle twitching and weakness

Hypovolemia

deficits of body fluid volume -caused by: excessive body fluid loss, reduction of fluid intake, or loss of fluid to 3rd space-->decreased in ECF volume oClinical manifestation: thirst, dry mucous membrane, weight loss, flattened neck veins, diminished skin turgor, prolonged time for capillaries to refill after blanching -body tries to compensate with physiologic responses to counter the manifestation: Decreased blood flow to the kidneys→ activation of renin-angiotensinaldosterone system → increase water and sodium reabsorption Decreased blood pressure→ stimulation of sympathetic nervous system → increase heart rate/constrict arteries/ increase contractility of the heart

Primary Immune cell-Cytotoxic T lymphocyte

detects pathogen inside of cells -where they cannot be recognized by antibodies -identifies cell that present viruses on the cell surface oKills cells before viral replication is complete and the virus can spread oCytotoxoc T lymphocytes recognize foreign antigens involves -on antigen-presenting cells (APCs)

Anaphylactic Reaction clinical manifestations

determined by the amount of antigen specific IgE present, dose of the antigen and the route of antigen transmission, The initial response varies from minutes to hours and include severe bronchospasm, skin flushing, urticaria (itching) and angioedema (sudden subcutaneous edema). During the second phase, severe bronchospasm reoccurs and is accompanied by severe hypotension and edema.

active immunity

development of antibodies to an antigen -achieved through having a specific disease or vaccine immunization

neural tube defects

developmental maladaptation, involves birth defects associated with the tissues of the nervous system (brain and spine)

Diagnostic Criteria of Parenteral nutrition

diagnosed through Arterial Blood Gas sampling to determine pH. pH of <7.35 and decreased HCO3- levels; also, electrolyte balance and calculation of anion gap

The diffusion of potassium from the ICF to the ECF is an

energy consuming process

Percipitation

fall out of solution

Organs

fully differentiated body parts with specialized functions

Granulocytes

knows as polymorphonuclear leukocytes, include neutrophils, eosinophils, and basophils

Alternate names for citric acid cycle

krebs cycle tricarboxylic (TCA) cycle

Altered Acid-Base Balance

metabolic disorders results is an alteration of f HCO3- caused by the addition or loss of nonvolatile acid or the base in the extracellular fluid

____is a cellular adaptation process that is the reversible replacement of one mature cell type by another less mature cell type

metaplasia

Reproduction

oGenes control the growth of cells, timing of the division of cells and the differentiation of cells. oCell size is determine by the amount of functional DNA within the cell oCell division occurs at different times based on the type of cell and signals

polymorphic

occurring in more than one form

anaerobic respiration

occurs when ATP is produced with no oxygen

Hyperphosphatemia

occurs when blood phosphate levels are above 4.5 mg/dL ○ Can result from fractures, bone disease, hypoparathyroidism, acromegaly, systemic infection, and intestinal obstruction ○ There are no symptoms associated

Cells

the basic unit of tissues; sites where changes in structure and function leads to symptoms and diseases.

Factors influencing the capacity of pathogens to cause infection

• Communicability: Ability to spread from one individual to others (e.g., measles and pertussis spread very easily; human immunodeficiency virus [HIV] is of lower communicability) • Infectivity: Ability of the pathogen to invade and multiply in the host (e.g., herpes simplex virus can survive for long periods in a latent stage) • Virulence: Capacity of a pathogen to cause severe disease (e.g., measles virus is of low virulence; rabies and Ebola viruses are highly virulent) • Pathogenicity: Ability of an agent to produce disease —success depends on communicability, infectivity, extent of tissue damage, and virulence (e.g., HIV can kill T lymphocytes) • Portal of entry: Route by which a pathogenic microorganism infects the host (e.g., direct contact, inhalation, ingestion, or bites of an animal or insect) • Toxigenicity: Ability to produce soluble toxins or endotoxins, factors that greatly influence the pathogen's degree of virulence

Portal of entry

• Refers to the access point for microorganisms into the host • Common locations include through the mucous membranes, eyes, and respiratory tract ● Loss of skin and chemical barriers can also be portal of entry Host Factors: • Factors that increase host susceptibility are related to impaired host defense mechanisms including problems with skin, impaired inflammation and decreased immunity.

Means of transmittion

■ Direct contact, ingestion, fomites, airborne ■ Broken with isolation, food handling, airflow control, universal precautions, sterilization, hand washing

Susceptible host

■ Immunosuppressed, diabetic, surgery, burned, eldery ■ Broken by treating underlying disease and recognizing high-risk patients

Portal of entry

■ Mucous membrane, GI tract, GU tract, respiratory tract, broken skin ■ Broken by covering potential entry points

Treatment

○ Antimicrobial drugs commonly used to destroy pathogens or decrease growth ■ Alter cellular structure or disable enzymes produced by pathogens ○ Antibacterial drugs can inhibit synthesis of bacteria cell wall. Damage cytoplasmic membrane, and disable nucleic acid metabolism or protein synthesis ○ Antifungals bind to fungal cell membrane, increase permeability, and reduce viability of fungal cells ■ Not active against bacteria ○ Antiviral treatment has limited success because viral growth employs the host cell so destruction of virus can damage host cells ○ All infections include symptomatic treatment like fluids, rest, and analgesics

Droplet transmission:

○ Larger respiratory particles, produced by sneezing or coughing ○ The host must be within 3 feet of the reservoir ○ Most respiratory illnesses spread this way

Infections Manifestation

○ Pain, heat, redness, swelling, lymph node enlargement and tenderness, and site dependent loss of function ○ Purulent: containing pus ○ Systemic manifestations include fever, malaise, weakness, anorexia, headache, nausea