Patho Exam 2
GAS (General Adaptation Syndrome)
- Stage 1: Alarm Fight or Flight response is activated - Stage 2: Resistance AKA the "stage of adaptation" If the stress continues the body adapts - Stage 3: Exhaustion Body's resistance to stress is gradually eroded, so you see decreased immunity.
GAS: Stage 1- Alarm
Stage 1: Alarm During the alarm stage, the stressor is identified. The body produces stress hormones, and activates the fight or flight response system. The sympathetic branch of the ANS is activated, adrenal gland releases hormones. The "stress" hormones, such as adrenaline, noradrenaline, and cortisol, enable you to perform activities at a capacity you're normally not capable of. Your blood pressure also begins to raise, putting you at predisposition of damaging brain tissue and blood vessels.
megaloblastic anemia
a blood disorder characterized by anemia in which the red blood cells are larger than normal -Vitamin B12 or Folate -Certain Meds
CHF (congestive heart failure)
a heart disorder that permits shunting of blood from its normal path through the pulmonary circuit, thereby preventing adequate aeration/oxygenation of blood, can also cause polycythemia
Hodgkin's lymphoma (HL)
a malignancy of the lymphatic system that is distinguished from non-Hodgkin's lymphoma by the presence of Reed-Sternberg cells -Much more uncommon -Reed-sternberg cell- atypical b-cell lymphocyte -Arises from a single lymph node -Lymph node involvement above level of diaphragm -Mediastinal masses -5-year cure rate of 85% after radiation/chemo
Aplastic Anemia
a normocytic-normochromic type of anemia characterized by the failure of bone marrow to produce red blood cells -Chemo,radiation, certain drugs, Bone Marrow Cancer, Antibiotics, Chemicals -Treatment: Time
Hyperphosphatemia
a serum phosphorus level that exceeds 4.5 mg/dL Can be caused by impaired kidney excretion of phosphate and crush injury. Manifestations: -Usually asymptomatic -If severe, associated with hypocalcemia and it's manifestations Treatment: -Phosphate Binding drugs
graft-versus-host disease (GVHD)
an immune response initiated by T lymphocytes of donor tissue against the recipient's tissues (skin, gastrointestinal tract, liver); an undesirable response May occur after an allogeneic transplant. The donated bone marrow or peripheral blood stem cells view the recipient's body as foreign, and attack the body.
Microflora
bacteria inhabiting exposed surfaces of the body
Chronic Myelogenous Leukemia (CML)
both mature and immature granulocytes are present in large numbers in the marrow and blood Associated with the presence of the Philadelphia Chromosome Tends to affect men ages 30-50
Hyponatremia
Low Sodium Causes: -Water shifts from ICF to ECF -Water Retention -Low Sodium Intake/Loss of Sodium Manifestations -Muscle cramps -Weakness -Headache -Depression -Anxiety -Lethargy -Altered consciousness -Anorexia -Nausea -Vomiting -Edema Treatment (based on cause): -Treat underlying cause -Increase Dietary Sodium -Hypertonic Saline Solution (Very slowly and carefully!)
Hemolytic Anemia
Lysis of RBC's due to autoimmunity
Primary Polycythemia Vera
Manifestation of diffuse marrow hyperplasia of unknown etiology Overproduction of red cells, white cells, and platelets Some cases evolve into granulocytic leukemia
Vitamin B12 deficiency anemia
Manifestations same as other anemias but also has: - Severe neurological issues(if severe): Depression Can be caused from problems associated with intrinsic factor that is released from the stomach from a carrier protein and transported in the blood. Pernicious anemia Lack of B12 in diet Shilling test useful to diagnose Macrocytic RBC's Increased MCV Bleeding ulcer After a vasectomy Megaloblastic anemia Symmetric Paresthesis Ataxia (loss of muscle control/balance)
Classes of Anemia
Megaloblastic- Presence of macrocytic or immature RBCs, usually a result of B12 or Folate deficiency Pernicious- Type of megaloblastic, but caused by lack of intrinsic factor, usually due to B12 deficiency Normocytic- Reduced number of RBCs that are otherwise normal. Results in decreased Hgb. Result from defective release of RBCs from bone marrow, such as aplastic anemia. (Hct-% of RBCs in blood volume) Microcytic- Primarily due to defective Hgb synthesis. RBC's are smaller than normal and often pale in color (hypochromic) Sickle Cell- Caused by genetic variation in hemoglobin, which causes RBCs to develop abnormal shape. Can cause obstruction of blood flow in capillaries Not a nutritional anemia Hemolytic- Result of increased rate of destruction of RBCs Variety of causes (vit. E deficiency, rare)
microbiota (microbial flora)
Microorganisms that are normally associated with a particular tissue or organ.
Newborn Hemolytic Disease (Erythroblastosis Fetalis)
Mom is Rh- and fetus is Rh+ During the first pregnancy fetus is fine, but placental mixing of blood causes production of antibodies so that if second baby is Rh+, the antibodies destroy the fetal RBCs
ALL- Acute Lymphoblastic Leukemia
Most common Childhood Leukemia, B-cell leukemia a form of leukemia, or cancer of the white blood cells characterized by excess lymphoblasts. malignant, immature white blood cells continuously multiply and are overproduced in the bone marrow which causes damage and death by crowding out normal cells in the bone marrow, and by spreading to other organs
The male body contains more water by body weight because
Muscle holds more water than fat
Leukemia
Neoplasm of blood cells Abnormal and excessive production of specific types of white blood cells (granulocytes and agranulocytes) Classified according to predominant cell type and whether acute or chronic Acute Leukemias: -Fast Advancing -Involve immature cells -"Blast" -Associated with the young Chronic leukemias: -Slow advancing -Last longer -Associated with mature cells -"-cyte" -More elderly Etiologies: -Genetics -Exposure to environmental -carcinogens -Often a secondary cancer that follows chemo -Genetic predisposition: -Down's syndrome and other congenital disorders -Neurofibromatosis as well General manifestations: -Due to some of the bone marrow issues. -Anemia -Pallor -Fatigue -Bruising/Bleeding -Bone Pain -Leukopenia (reduced WBC count of normal WBCs) -Leukostasis (increased WBC count) -Leukoblastic emboli In advanced stages: -Lymphadenopathy -Splenomegaly -Hepatomegaly -Hemorrhages -Infections Diagnosis: -Blood tests -Bone marrow biopsy -Ct scan/imaging -Lumbar puncture, mainly because propensity for metastasis to the brain is large Treatment: -Radiation and Chemo -Blood Transfusion -Antibiotics -Allopurinol- helps decrease uric acid -CNS prophylaxis (into CSF) -Bone marrow or stem cell transplantation
Lymphoma
Neoplasms of abnormal B and/or T-cell lymphocytes associated with lymph nodes and tissues.
Non-neoplastic vs Neoplastic WBC disorders
Non-Neoplastic -Neutropenia -Infectious Mono Neoplastic -Lymphomas (Hodgkins/Non-Hodgkins) -Leukemias (ALL, AML, CLL, CML)
pH: Acidosis vs Alkalosis
Normal blood pH is 7.35-7.45 Acidosis: -below 7.35, with potential death at 6.8 -Increased concentration of hydrogen ions, due to accumulation of acids OR the loss of bases. Alkalosis: -above 7.45, with potential death at 8. -Decreased concentration of hydrogen ions, due to either a loss of acids or accumulation of bases.
Type 4 (Delayed Type) Hypersensitivity
Occurs after 24 hours and is initiated by helper T-cell lymphocytes that release cytokines to stimulate T-cells to destroy body tissues along with macrophage phagocytosis. Examples: -Tuberculosis Skin test: you use inactivated tuberculin and inject it under the skin, if you have it, the local area becomes very red in 8-12 hours because T-cells and macrophages accumulate in that tissue. -Hepatitis -Hypersensitivity pneumonitis -Poison ivy, oak, sumac -Cosmetics -Metals -Topical medication -Drugs Treatment: Corticosteroids
Why does Multiple Myeloma cause bone pain?
Osteoclasts start to break down bone matrix and there is also bone marrow expansion.
Which of the following statements is true regarding the portal entry of pathogens into the body?
Pathogens that enter the body through the intestinal mucosa can cause diseases in the lungs or liver
Vitamin B12 Anemia
Pernicious Anemia
Thrombocytopenia can be caused by each of the following EXCEPT:
Polycythemia Vera
What ion is found in greatest concentration inside the cell?
Potassium
Immunoglobulin A Deficiency is associated with what type of Immunodeficiency?
Primary Humoral Immunodeficiency
Agents of Infectious Disease
Prions, viruses, bacteria, Rickettsiaceae and Chlamydiaceae, fungi, and parasites.
A pt reports general malaise and fatigue and has a mild fever. which of the following disease stages would you expect the patient to be in?
Prodromal Stage The hallmark of the prodromal stage is the initial appearance of symptoms in the host that are mild and nonspecific. In the incubation, convalescent, and resolution stages, these symptoms would not be as prevalent.
Captain miles standish has a lung tumor that has destroyed about half of his alveoli. He is unable to blow off CO2 as fast as it is produced. As a result he has:
Respiratory acidosis and Increased Serum K
How are infectious diseases transmitted?
Some infectious diseases are spread from one person to another through coughing, sneezing, or physical contact. Other infectious diseases are spread through contaminated water or food. Still others are spread by infected animals. -Penetration -Direct Contact -Ingestion -Inhalation
Old and damaged RBCs are broken down in the
Spleen and Liver
Sickle Cell Disease
- Autosomal Recessive/Codominant Disorder - Abnormal hemoglobin in RBCs - Common amongst people who are along the equator - Low oxygen conditions cause them to sickle, chronic sickling leads to hemolytic anemia and blood vessel occlusion
Which of the following are possible mechanisms that trigger Type 2 Hypersensitivity? Select all that apply.
* A viral or bacterial antigen that appears similar to a body cell antigen causing the production of antibodies that attack pathogens as well as the specific type of antibody cells. * A drug/chemical that binds to a body cell causing B-cells to produce antibodies that bid to these cells and promote phagocytosis.
Graft verses Host disease can be potentially treated/prevented by which of the following?
* Administering Immunosuppressive and Anti-inflammatory Drugs * Selectively removing or destroying the donors T-Cells from the Transplanted tissue -- In GvH disease, donated tissue attacks the host, providing these drugs help keep the immune system from attacking the donated tissue, removing T-cells from the donated tissue prevents the tissue from attacking the donor.
Hypernatremia could result from which of the following?
* An excess of Sodium * A disproportionate loss of water
The EBV virus does which of the following? Select all that apply.
* causes B-cell Lymphocytes to produce heterophil antibodies * Incorporates into the host DNA of B-Cell Lymphocytes
Diuretics: Classes
-Decrease fluid volume by increasing urine output -inhibitors of renal ion transporters that decrease the reabsorption of Na at different sites in the nephron -use: managing abnormal fluid retention (edema) or treating HTN (reduce blood volume) classes: 1. Loop (high ceiling ) -Furosemide -Work on the Nephron Loop -Inhibit Na/K reabsorption 2. Thiazides -Hydrochlorothiazide -Work on DCT and inhibit sodium reabsorption, increase urine output/electrolyte output 3. Potassium-Sparing -Work on Collecting Duct and DCT -Reduce water in the body without potassium loss 4. Carbonic Anhydrase inhibitors -Inhibit Hydrogen Ion Secretion in the kidneys, increases the secretion of K/Na -Increases Urine Output 5. Osmotic -Promotes loss of water from the kidneys by increasing osmolality of blood. Causes fluid compartments to expand and leads to impaired urine concentration at the nephron loop. -Mannitol 6. Antidiuretic hormone antagonist (ADH) -Aldosterone Antagonist -Vasopressin
How is Edema Treated?
-Diuretics: increase arterial pressure, increase extracellular volume -Albumin: Low colloidal Osmotic Pressure -Shunts/Paracentesis -Light Pressure Massage -Compression/Support Wear -ROM exercises
Type 1 Immediate Hypersensitivity
-IgE mediated -mast cells release histamine, IL5 Examples: -Food, Dust, Grass, Insects, Latex, Mango =P Manifestations: -Swelling/Inflammation -Irritation/Hives -Anaphylaxis Process of Type 1: -B-cells exposed to the allergen make IgE antibodies against the allergen -IgE binds to mast cell receptors (sensitization) -The next time the body is exposed to the same allergen, the allergen binds to the IgE antibodies on mast cells. -Mast cells degranulate and release histamine and other inflammatory chemicals, causing the manifestations. Treatment: -Antihistamines: bind to histamine receptors and help stop the action of histamine -Epinephrine: relaxes bronchial smooth muscle and reduces sympathetic vasodilation (in severe cases) -Corticosteroids -Avoiding allergen
HIV is most contagious during which stages?
1 and 3
What are the main causes of edema? Examples for each.
1. Increased Capillary Filtration Pressure -Increased Arterial Pressure (HTN) -Increased Venous Pressure (Liver Disease) -Increased Blood Volume (Kidney Disease) 2. Decreased Capillary Colloidal Osmotic Pressure -Severe burns, liver disease, starvation 3. Increased Capillary Permeability -Burns, Inflammation, Immune Responses 4. Obstruction of Lymph Flow -Infection, Trauma, Lymphatic Tumors, Nodectomy
Periods of Disease
1. Incubation - Occurs after the initial entry of the pathogen into the host. - Multiplication occurs with not enough instance of the pathogen to cause signs and symptoms. 2. Prodromal - Signs and symptoms emerge - Immune system activates 3. Illness - Signs and symptoms are most obvious and severe. 4. Decline -Pathogen particles begin to decrease -Patients may become susceptible to developing secondary infections because their immune systems have been weakened by the primary infection. 5. Convalescence - Patient returns to normal functions - Some diseases may have unrepairable/permanent damage.
Classification of Antibacterial Agents
3 Main Groups: 1. Inhibition of cell wall synthesis Penicillin, cephalosporin, glycopeptide derivitives, carbopenems 2. Inhibition of protein synthesis Aminoglycosides, tetracyclines, macrolides (erythromyocin) 3. Inhibition of bacterial nucleic acid synthesis Sulfonamides, Metronidazole, Trimethoprim
Kwashiorkor
A disease of chronic malnutrition during childhood, in which a protein deficiency makes the child more vulnerable to other diseases, such as measles, diarrhea, and influenza. Protein and caloric deficiency Most devastating during brain development -Hypoalbuminemia, Ascites, Hepatomegaly -Skin depigmentation -Thinning hair -Stunted Growth -Decreased heart rate and BP -Decreased body temp -Increased infections -More swelling than marasmus due to protein deficiency
Marasmus
A disease of severe protein-calorie malnutrition during early infancy, in which growth stops, body tissues waste away, and the infant eventually dies. Progressive loss of muscle mass and fat due to inadequate food intake -Reduction of body weight -Stunted growth -Sparse hair -Dry Skin -Diarrhea -Decreased body temperature -Increased heart rate and blood pressure -Increased risk of infection
infectious disease
A disease that is caused by a pathogen and that can be spread from one individual to another.
PTSD
A disorder in which a person has lingering memories, nightmares, and other symptoms for weeks after a severely threatening, uncontrollable event Results from chronic activation of the stress response after a traumatic event or multiple traumatic events. Flashbacks, nightmares, mood disorders, depression, panic and anxiety disorders, substance abuse as well as physical manifestations such as hypertension, asthma and chronic pain disorders.
Type 2 antibody mediated hypersensitivity
A drug or chemical binds to surface of a body cell, appears foreign. B-cells produce IgM and IgG antibodies that bind to body cells marking them for phagocytosis. IgM antibodies act upon cells with complement and cause cell lysis. Includes some autoimmune diseases; Mom to Fetus A virus/bacteria may have a surface antigen/protein that resembles a surface antigen on a body cell. B-cells produce antibodies against the pathogen which other attack the body cells with the similar "appearing" antigen. Examples: -ABO/Rh transfusion reactions -Post streptococcal rheumatic fever -Pernicious Anemia -Post streptococcal glomerulonephritis -Hashimoto's Thyroiditis -Diabetes Type 1 -Myasthenia Gravis Treatment: Corticosteroids Immunoglobulins
immunodeficiency diseases
A group of inherited or acquired disorders in which some part or parts of host defense are either absent or defective. Hyposensitivity/immunosuppression: lack of immune response or impaired immune response, due to one or more dysfunctional parts of the immune system. Primary and Secondary B-Cell Immunodeficiency Primary and Secondary T-Cell Immunodeficiency Combined B and T cell Immunodeficiency Disorders of the Complement System and Disorders of Phagocytosis
A nurse evaluates which of the following patients to be at high risk for developing hyponatremia?
A patient who suffers from syndrome of inappropriate ADH
Effusion
A process by which gas particles pass through a tiny opening Movement of fluid out of BV's into Body Cavities
Selye's Definition of Stress
A state manifested by symptoms that arise from coordinated activation of the neuroendocrine or immune systems, called the GAS
Hypersensitivity Type 3
ABO complex reactions, Serum Sickness, RA (Rheumatoid Arthritis), Scleroderma, SLE (Systemic Lupus Erythematosis)
Hypersensitivity Type 2
ABO/Rh transfusion reactions, autoimmune hemolytic anemia, post streptococcal rheumatic fever, post streptococcal glomerular nephritis, Hashimotos Thyroiditis, Graves Disease, DM1, Myasthenia Gravis, ITP (Idiopathic Thrombocytic Purpura)
What causes the conversion of angiotensin I to angiotensin II?
ACE
Which of the following types of leukemia originate from B-cells?
ALL and CLL (Acute and Chronic Lymphoblastic Leukemia)
Hypocoagulation
Abnormal and decreased coagulation - Thrombocytopenia - Genetic diseases: -Von Willebrand -Bone marrow/Liver disease -Blood thinners -Eclampsia -Vitamin K deficiency Treatment? -Manage underlying condition -Activated prothrombin complex
Hypocoagulation
Abnormal and decreased coagulation When hemostasis is decreased, there is increased risk for blood vessel perforation and bleeding leading to hypoxia and necrosis of tissues. Etiologies: -Decrease in platelet # (thrombocytopenia) Plasma Clotting Factor deficiencies: -Von Willebrand Disease -Hemophilia -Liver Disease -Diarrhea -Starvation -Vitamin K Deficiency Blood vessel abnormalities -Vitamin C Deficiency -Cushing's Syndrome -Immune or Idiopathic Purpura(ITP)
Hypercoagulation
Abnormal increased tendency to form blood clots that occlude vessels and cause tissue damage. When hemostasis is increased, there is increased risk for thrombosis and BV occlusion. Due to (Etiology): -Increased platelet function -Increased clotting activity due to activation of the coagulation system Treatment: -Anticoagulants -Clot reserves or Busters: dissolve a clot that has already formed (thrombolysis by plasmin) Etiology: - Increased platelet function: Increase in platelet number, thrombocythemia (increased platelet number) ***Examples: Splenectomy Bone Marrow diseases Chronic inflammatory conditions Disseminated intravascular coagulation Acute infections Sensitivity of platelets to factors that increase aggregation and adhesion: Increase in RBCs (example: polycythemia) Disturbances in blood flow (example: atherosclerosis) Damage to endothelium (example: smoking) -Increased clotting activity due to activation of the coagulation system: Genetic disorders Disturbances in blood flow Immobilization Heart failure Post surgery Damage to the endothelium (example: smoking) Increased estrogen Autoimmune disorders (example: antiphospholipid syndrome)
Secondary Humoral B-Cell Immunodeficiency
Acquired later in life due to pathophysiologic states Examples: -Bone marrow disorders -Malnutrition -Drugs -Particularly anti-epileptic drugs -Infections -Nephrotic Syndrome: A kidney disease that leads to increased loss of immunoglobulins
Secondary Cell-Mediated, T-Cell Lymphocyte Immunodeficiency
Acute Viral Infections Idiopathic Example: AIDS - Acquired Immunodeficiency Syndrome Caused primarily by HIV 1 and 2 A retrovirus that frequently mutates Transmission: -Blood -Semen -Cervical fluid -Placenta Pathogenesis: -Infects epithelial cells that line entry sites, macrophages, dendritic cells, and CD4 helper T-cells. -Initially epithelial cells and eventually gets into the blood and infects helper T-cells. -Binds to CD4 receptors and several other co-receptors on the surface and enters cell. -Virus is internalized and uncoated. -Reverse transcriptase is used to make a copy from vRNA to vDNA. vDNA integrates with the host DNA (integrase enzyme) Transcription of vDNA to make vRA (instructions for building new viruses) -vRNA is packaged into a protein coat using the enzyme protease. -Now, many virions are made, undergo surface budding and are released from the helper T-cell and thus killing it.
Health risks associated with Obesity
All causes of Mortality High Blood Pressure (HTN) High LDL cholesterol, Low HDL cholesterol High levels of triglycerides (Dyslipidemia) Type 2 Diabetes Coronary Heart Disease Stroke Gallbladder Disease Osteoarthritis
What is the relationship between calcium, phosphorus and magnesium in the body?
All three occur in bone. The small amount of calcium not in the bone is a component of extracellular fluid; magnesium and phosphate on the other hand are components of intracellular fluids, and the phosphate radical appears to be essential in an ever increasing number of metabolic reactions.
What role does the spleen play in RBC production?
An enlarged spleen might be caused by various types of hemolytic anemia (early destruction of RBCs) specifically Iron-deficiency anemia because the spleen holds iron in the forms of ferritin and hemosiderin. Old/Damaged RBC's are broken down in the spleen, THEN the liver if the spleen is bad.
Host
An organism on which a parasite lives.
Upper vs Lower body obesity
An upper body/visceral fat distribution in obesity is closely linked with metabolic complications, whereas increased lower body fat is independently predictive of reduced cardiovascular risk
How are fluids and electrolytes assested and tested for?
Anion Gap Blood Test Serum Osmolality (general and specific) Urine and Stool Osmolality BUN (Blood Urea Nitrogen)
The body's nonspecific defenses include all of the following, except
Antibodies
Anticoagulants vs. Clot Reservers
Anticoagulants to stop the formation of a clot: -Heparin: stops the conversion of prothrombin -Coumadin: a vitamin K antagonist -Warfarin: synthetic derivative of coumadin, a vitamin K antagonist -Aspirin, Ibuprofen, Plavix: stop platelet aggregation **************** Clot Resolvers or Busters: dissolve a clot that has already formed (thrombolysis by plasmin): -Streptokinase: a protein produced by streptococcus that works as a thrombolytic drug -Recombinant tissue plasminogen activator (rtPA) An engineered drug that is based on an enzyme produced by endothelial cells.
At what end of the capillary bed is the capillary filtration pressure the highest?
Arteriole End
CML- Chronic Myelogenous Leukemia
Associated with the presence of the Philadelphia Chromosome
Immune or Idiopathic Thrombocytopenia Purpura (ITP)
Auto-antibodies interact with the membrane proteins on platelets leaving them vulnerable to destruction by the spleen. Manifestations: -Bruising -Bleeding (petechiae and purpura) -Splenomegaly -Internal hemorrhage
BMI vs Body Circumference
BMI is the amount of body fat based on weight and height, circumference is the waist measurement. Circumference has been closer linked to mortality rates.
Once they have reacted with antigen molecules, the B-cell lymphocytes of the immune system
Become plasma cells that secrete antibodies.
Hemorrhagic Anemia
Can be caused by a bleeding ulcer
Hypercalcemia
Can be caused by hyperparathyroidism, prolonged immobilization, Vitamin D Metabolic Disorders, or other Malignancies Manifestations: -Kidney Stones -Bone Pain -Polyuria -Heart Arrhythmias -Coma -Cardiac Arrest Treatment: -Bisphosphonates -IV osteoporosis drugs -Treat underlying cause
Iron Deficiency Anemia
Can result from a nutritional deficiency as well as loss of blood
AIDS (acquired immune deficiency syndrome)
Caused primarily by HIV 1 and 2 A retrovirus that frequently mutates Transmission: -Blood -Semen -Cervical fluid -Placenta Pathogenesis: -Infects epithelial cells that line entry sites, macrophages, dendritic cells, and CD4 helper T-cells. -Initially epithelial cells and eventually gets into the blood and infects helper T-cells. -Binds to CD4 receptors and several other co-receptors on the surface and enters cell. -Virus is internalized and uncoated. -Reverse transcriptase is used to make a copy from vRNA to vDNA. -vDNA integrates with the host DNA (integrase enzyme) -Transcription of vDNA to make vRA (instructions for building new viruses) -vRNA is packaged into a protein coat using the enzyme protease. -Now, many virions are made, undergo surface budding and are released from the helper T-cell and thus killing it. Staging of AIDS: Stage 1: asymptomatic or transient flu-like symptoms. Very contagious. Can last for months or years while other cells get infected. Stage 2: aka the AIDS related complex- fatigue, malaise, swollen lymph nodes, night sweats, nausea, fever. Not as contagious in this stage. Can be here for months or years. Most times the vDNA is just resting in the host. Stage 3: declining number of T-cells, development of secondary life-threatening and opportunistic infections (pneumonia, thrush, cytomegalovirus) and cancers (kaposi sarcoma). Immune functioning is at a loss. AIDS patients usually die of secondary infections. Diagnosis: -ELISA (sero + (sufficient antibodies to be detected) and sero -(insufficient));Detects antibodies in the blood. -Western Blot Test -Viral Antigen or Viral RNA Treatments for HIV/AIDS: -Restoration of immune function -Prevention of viral replication (Highly Active Antiretroviral Therapy) Treatment: "AIDS cocktail" Reverse Transcriptase, Integrase, and Protease inhibitor drugs Entry-fusion inhibitor drugs Colony stimulating factors, Interferons, and recently growth hormone There are many serious side effects to these drugs and it is difficult to stay on the regimen.
Systemic Lupis Erythematosus (SLE)
Chronic Disease that causes inflammation in connective tissues, such as cartilage and the lining of BV's. Its an autoimmune disorder. Cells that have went through apoptosis are not cleared away properly. Type 3 Immune Complex Hypersensitivity
Aldosterone from the adrenal cortex causes sodium ions to be:
Conserved and potassium ions to be excreted.
What is the stress hormone/neurotransmitter?
Cortisol
A patient comes to your floor NPO with an IV of NORMAL SALINE at 20cc/h. His urine outpit in the next 8 hours will:
Decrease
Hypodipsia
Decrease in the ability to sense thirst associated with cerebral lesions in the hypothalamus. Possibly due to: -Head Trauma -Malignancy -Hemorhhage -Hydrocephalus -Elderly (stroke/dementia)
Respiratory Alkalosis
Decreased CO2 (carbonic acid) > Increased pH Causes: Hyperventilation Compensation: -Systemic chemical buffer systems of the body -As is possible: (respiratory) hypoventilation, which slows loss of CO2 -(Renal) decreased H+ excretion, decreased reabsorption of HCO3-
Metabolic Acidosis
Decreased pH due to abnormal accumulation of non-respiratory acids or loss of bases (HCO3) Causes: Loss of bicarbonate ions due to prolonged diarrhea/vomiting (that empties intestinal contents), accumulation of acid (ketosis in diabetes mellitus), renal dysfunction due to reduction of renal filtration/reabsorption (uremic acidosis) Compensation: -Systemic chemical buffer systems of body -(respiratory) hyperventilation, increases loss of CO2 -As is possible if renal disease is involved: (renal) increased excretion of H+, reabsorption of HCO3-
The hormone ADH promotes water reabsorption through the walls of the
Distal convoluted tubule and collecting duct.
AML- Acute Myelogenous Leukemia
Down Syndrome indiviuals have an increased risk of developing this
Primary Humoral B-cell Immunodeficiency
Due to genetic causes Lead to decreased immunoglobulin production or reduced activation of B-cell lymphocytes Increased risk for bacterial infections Example: Selective immunoglobulin A deficiency: -Decrease in IgA antibodies. Normally IgA protects against infection in mucous membranes. -Most common primary immunodeficiency. 1 in 700 people have this. -Increased risk of bacterial infection
GAS: Stage 2- Resistance
During the resistance stage, your body is learning to cope with the stress, or adapt to the environment's strains and demands. The parasympathetic branch of the ANS counteracts the stress, and attempts homeostasis. Your body struggles to adapt. This can increase glucose levels in the blood and raise BP. Body's focus shifts from alertness to repair. Your body has limited resources, and can't keep up forever. The resources get gradually depleted and defenses become weaker. Cortisol is released and continues to be released (the stress hormone) which comes with its own side effects. This will lead to stage 3...
Laboratory Testing for circulating antibody to the HIV virus is accomplished by
ELISA and Western Blot
Which of the following is associated with Polycythemia Vera?
Enlarged Spleen, Blood Clotting
The hormone which stimulates erythrocyte production is released in response to
Hypoxic Kidney Cells
Multiple Myeloma
Excessive and abnormal plasma cell division in bone marrow leading to unregulated production of monoclonal antibodies (in the blood they are) M-proteins: IgG or IgA and Bence Jones proteins Bence Jones proteins are basically fragments of antibodies Proliferations of osteoclasts leading to bone destruction Most frequently seen in older adults (>60) and higher incidence in men and african americans. Etiologies -Genetics -Chronic immune stimulation -Environmental carcinogens -Agent orange, dioxin -Viruses -Multifactorial General manifestations: -Bone: pathologic fractures -Hypercalcemia -Vertebral collapse -Bone pain -Anemia -Angiogenesis (bone marrow) -Thrombocytopenia (purpura) -Recurrent infections -Hyperviscosity of body fluids, amyloid deposits in the heart and kidney (from plasma cell secretions) inappropriate release of proteins -Kidney damage and failure Treatment: -High dose chemo (Melphalan) -Autologous stem cell transplantation or allogeneic stem cell transplantation -Individuals generally have to rebuild entire immune system
Hypersensitivity Disorders
Excessive or inappropriate activation of the immune system' Type 1: Immediate Hypersensitivity Type 2: Antibody-Mediated Hypersensitivity Type 3: Immune Complex-Mediated Hypersensitivity Type 4: Delayed Hypersensitivity
Spacing
First Space: Blood Compartment Second Space: Interstitial Fluid Third Space: Fluid in places that dont normally contain fluid -body cavities -muscle compartments -etc.
Anasarca
Generalized edema that presents with profound subcutaneous tissue swelling
Syndrome of Inappropriate Antidiuretic Hormone (SIADH)
HIGH ADH -Can be temporary or chronic
Hypernatremia
HIGH Sodium Causes: -Loss of Water through GI, Lungs, or Skin -Inability to drink water -Rapid sodium ingestion without enough water. -Diabetes Insipidus -Adrenal Gland Dysfunction With Hyperaldosteronism -Kidney Disease where you cannot excrete excess sodium. Manifestations: -Polydipsia- excessive thirst -Oligiouria- Decreased Urine Output -Dry skin and Mucous Membranes -Headache, agitation -Decreased reflexes -Seizure/Coma -Decreased vascular volume (decreased BP) -Vascular Collapse Treatment (based on cause): -Treat underlying cause -Fluid replacement therapy with glucose, --electrolyte solution (oral or IV)
Hyperkalemia
HIGH potassium Can be caused by decreased renal secretion of potassium, rapid administration of K+ by IV and the shift of K+ from ICF to ECF, or from excessive K+ in the diet. Manifestations: -Cardiac Arrhythmia -Weakness -Fatigue -Muscle paralysis -Shortness of breath -Palpitations -Cardiac Arrest (if severe)
Hypersensitivity Type 1
Hayfever, food allergies, dust, grass, pet allergies, asthma, drug allergies, latex, bee stings
Polycythemia (erythrocytosis)
Hematocrit (volume % of RBCs in the blood) is elevated (MORE RBCs than other BC's) Makes blood thicker and harder to transfer into organs and BV's Apparent Polycythemia-RBC count normal but there is reduced plasma (Overweight, smoking, drinking, diuretics) Relative Polycythemia- (Dehydration) Absolute Polycythemia- Body produces too many RBC's -Primary -Secondary ***An underlying condition causes an increase in erythropoietin production. (produced by kidneys to stimulate marrow to produce RBCs) ***Can be caused by COPD, Sleep Apnoea or Kidney problems
Bilirubin is a bile pigment formed from the breakdown of
Hemoglobin
HLA (human leukocyte antigen)
Human MHC is called this They have four major genes: A, B, C, and D Very diverse in humans "MHC" stands for "major histocompatibility complex," while "HLA" is the short version of "human leukocyte antigen." ... The main difference between the two groups is that MHC is often found in vertebrates, while HLA is only found in humans. To simplify, HLA is the human body's version of MHC.
type 3 immune complex hypersensitivity
Humoral. antibody bound to antigen. Involves a situation in which antibody-antigen complexes (immune complexes) that normally would be removed by the spleen or liver stay in free circulation. Immune complexes will be in large amount, and will cause antigen overload. These complexes then precipitate on the walls of blood vessels and other epithelial surfaces of organs/tissues activating the complement system leading to inflammation and blood vessel wall destruction. Excess immune complex are deposited in tissues -> localized inflammation and tissue damage. Non-self antigens: -serum sickness (ex- horse serum proteins) Self antigens: -Autoimmune disease -RA -lupus -glomerilonephritis -ABO complex reactions Scleroderma Erythematosus
Carbonic acid dissociates into
Hydrogen ions and bicarbonate ions
Ascites
Hydroperitoneum Excessive fluid in the peritoneal Cavity
Heart failure is associated with
Hypercoagulation
GAS: Stage 3- Exhaustion
If the stressor is not dealt with during the resistance stage and continues, the person enters the exhaustion stage. Signs of the alarm reaction may appear but the stressor is not able to be dealt with. Resources are depleted, resistance against disease is weak and the person becomes vulnerable to physical and psychological illness. A person is unable to bounce back from the situation.
Respiratory Acidosis
Increased CO2 (turns to Carbonic Acid in presence of water) > decreased blood pH Causes: -hypoventilation/diseases that decrease gas exchange and respiratory membrane surface (COPD, pulmonary edema), respiratory trauma (injury to brain stem, airway obstructions). Compensation: -Systemic chemical buffer systems of the body -(Renal) increased excretion of H+, reabsorption of HCO3 -As it is possible: (respiratory) hyperventilation, increases loss of CO2
Which result in response to dexamethasone suppression test is considered a specific marker for PTSD?
Increased sensitivity of cortisol receptors.
Stress induced tachycardia is a result of which of the following?
Increases in the secretion of catecholemines
Serum Sickness, associated with Type 3 hypersensitivity reaction, is characterized by:
Inflammation of the joints, fever, and rash
Sickle Cell Anemia
Inherited Hemoglobin Abnormality
The ability of an organism to get into a hosts tissues and multiply is called
Invasiveness
If there is decreased resistance to blood flow through the capillary sphincters (like in hypoxia), how does this lead to edema?
It causes increased capillary filtration pressure
When comparing Non-Hodgkin Lymphomas (NHLs) and Hodgkins Lymphoma (HL), which of the following would be true of HL?
It includes the presence of Reed-Sternberg Cells. HL also originates in a single node or a contiguous chain of nodes (rather than extranodal sites). Both can be found in adults.
Which of the following is true of the hepatitis that is often seen in cases of infectious mono?
It resolves without causing permanant liver damage.
Which of the following is associated with a protein deficiency and impaired brain development as a result?
Kwashiorkor
diabetes insipidus (DI)
LOW ADH antidiuretic hormone (ADH) is not secreted, or there is a resistance of the kidney to ADH -Excessive Urination -Neurogenic (a defect in synthesis/release) -Nephrogenic (kidneys can't respond properly) -Polyuria (Lots of water loss) -Can lead to hypertonic dehydration
Hypocalcemia
LOW CALCIUM Can be caused by Hypoparathyroidism, Vitamin D Deficiency, Chronic Kidney Disease, Malabsorption of Ca2+, or Acute Pancreatitis Manifestations: -Neuromuscular irritability -Seizures -Confusion -Memory Loss -Muscle Spasms Treatment: -IV calcium gluconate -Chronic hypocalcemia is treated with oral calcium and Vitamin D
Hypomagnesemia
LOW Magnesium Can be caused by low intake, chronic diarrhea, alcoholism, malabsorption, certain diuretics Manifestations -Muscle cramps -Weakness -Cardiac Arrhythmias Treatment -Oral/parenteral magnesium salts for 3-4 days
Neutropenia
LOW NEUTROPHILS (<1,000 cells/uL) AGRANULOCYTOSIS= SEVERE NEUTROPENIA Etiology: - Aplastic Anemia and Bone Marrow Issues - Autoimmune Disorders - Drugs -Splenomegaly - Congenital Neutropenia (Kostmann Syndrome-Autosomal Dominant Disorder) - Infections - HIV Manifestations: -Depend on severity and cause -General malaise -Chills/weakness/fever -Risk for bacterial and fungal infections -Skin and respiratory infections Treatment: -Antibiotics to assist the immune system until bone marrow can stabilize and neutrophil count goes back to normal. -Colony Stimulating Factor (to stimulate maturation of neutrophils
Hypokalemia
LOW potassium Can be caused by inadequate K+ reabsorption and/or intake, excessive loss through the GI, Kidneys, or Skin, or the shift of K+ from ICF to ECF. Manifestations: -Palpitations -Skeletal muscle weakness/cramping -Paralysis, Paresthesias -Constipation -Nausea/Vomiting -Abdominal Cramping -Polyuria -Nocturia -Polydipsia -Psychosis/Hallucinations/Delirium Treatment: -Discontinue Diuretics/Laxatives -Treat underlying cause (diarrhea/vomiting) -H2 Blockers
Metabolic Alkalosis
Loss of H+/increased HCO3 > increased pH. Causes: Loss of aci due to vomiting(only stomach contents) and gastric suctioning, use of certain diuretics, excessive intake of alkaline drugs and antacids. Compensation: -Systemic chemical buffer systems of body -(Respiratory) hypoventilation, which slows loss of CO2 -(Renal) decreased H+ excretion, decreased reabsorption of HCO3-
Isotonic Fluid Volume Deficit
Loss of Na and Water including hemorrhage, wound drainage, diuresis, intestinal losses, Addison disease, acute weight loss. -Characterized by decreased extracellular fluid -Results in signs and symptoms of dehydration -Increases HR because it decreases CO -Causes fever because HR and metabolism are sped up to compensate -Hct rises because they are losing water and not RBC's Caused by: ***GI Loss/Fever/Hemorrhage/Diuretics/3rd Space Fluid Shifts (Not in Vascular Space) -Solutes are mostly lost from ECF -Diseases that increase urine output/diuresis: ***DI/Endocrine Disorders -If the BV is decreased as a result, it causes hypovolemia -Manifestations include: **Thirst/Decreased Body Weight/Decreased Urine Output (oligiouria)/Decrease in BV (Tachycardia/Hypotension)/Sunken Eyes/Decreased Skin Turgor/Sunken Soft Spot
Thrombocytopenia
Low Blood platelet Count
How does stress affect the ANS, Endocrine, Immune, and Musculo-skelatal systems? (PLEASE LOOK UP FURTHER)
Stress is a state of threatened homeostasis caused by intrinsic or extrinsic adverse forces (stressors) and is counteracted by an intricate repertoire of physiologic and behavioral responses aiming to maintain/reestablish the optimal body equilibrium (eustasis). Key components of the stress system are the hypothalamic-pituitary-adrenal (HPA) axis and the autonomic nervous system (ANS), which interact with other vital centers in the central nervous system (CNS) and tissues/organs in the periphery to mobilize a successful adaptive response against the imposed stressor(s). Chronic Stress is more severe on the body whereas acute may be looked at as good from time to time. Chronic stress is linked to High BP, Heart Disease, High Cholesterol, DM2, and depression. It increases HR, BP, Glucose, and decreases immune responses. Cortisol helps regulate Na+/H2O balance and can affect normal heart functioning. Decreases energy.
Hypersensitivity Type 4
TB skin Test, Chronic Infections of TB and Hep, Hypersensitivity Pneumonitis, Allergic Contact Dermatitis, Poison Oak/Sumac, Metal Reactions, Cosmetics, Detergents, Chemicals, Topical Meds and Drugs
CLL- Chronic Lymphocytic Leukemia
Tends to occur in older people (men) and is characterized by abnormal B-cell Lymphocytes
Arterial Blood Gas Interpretation
The arterial blood gas is used to evaluate both acid-base balance and oxygenation, each representing separate conditions. Acid-base evaluation requires a focus on 3 of the reported components: pH, PaCO2, and HCO3. The steps are: 1. Assess the pH to determine if the blood is within normal range, alkalotic or acidotic If it is above 7.45, the blood is alkalotic. If it is below 7.35, the blood is acidotic. 2. If the blood is alkalotic/acidotic, we now need to determine if it is caused primarily by a respiratory or metabolic problem. To do this, assess the PaCO2 level. Remember that with a respiratory problem, as the pH decreases below 7.35, the PaCO2 should rise. If the pH rises above 7.45, the PaCO2 should fall. Compare the pH and the PaCO2 values. If pH and PCO2 are indeed moving in opposite directions, then the problem is primarily respiratory in nature. 3. Finally, assess the HCO3 value. With a metabolic problem, normally as the pH increases, the HCO3 should also increase. As the pH decreases, so should the HCO3. Compare the two values. If they are moving in the same direction, then the problem is primarily metabolic in nature.
After platelets clump along the rough spots on the lining of an injured blood vessel, they release chemicals which directly cause
The cascade of chemicals that lead to the conversion of prothrombin to thrombin.
Isotonic Fluid Volume Excess
The gain of both extracellular fluids and solutes. (Sodium and H2O) When the gain is restricted to the vascular space(BV is increased), hypervolemia is the result. In the interstitial spaces, edema is the result. Decrease in sodium and fluid elimination and increase in sodium and fluid retention -Kidney Disease -Heart Failure -Steroid Hormones -Liver Disease -Excessive Sodium Intake (Food/IV) Manifestations include: -Weight gain -Edema (Ascites, Pleural Effusion) -Jugular Venous Distention -Increased Blood Pressure -A Bounding Pulse -Shortness of Breath, Crackles, Cough (pulmonary edema) Treatment: -Restriction of Sodium and Water -Diuretics
Serum Sickness
The immune system reacts to medicines that contain proteins used to treat immune conditions. It can also react to antiserum, the liquid part of blood that contains antibodies given to a person to help protect them against germs or poisonous substances. -Characterized By: **Inflammation of the Joints, Fever and Rash -Type 3 Hypersensitivity of Non-self Antigens
Osmolality refers to
The osmolar concentration of 1 kilogram of water
How do helper T-cell lymphocytes engage with B-cell lymphocytes and cytotoxic T-Cell lymphocytes?
They release cytokines that activate B and T cell lymphocytes.
Acute Lymphoblastic Leukemia (ALL)
This is the overproduction of immature lymphocytes. The lymphocytes divide rapidly but fail to mature. Abnormal B or T cell Lymphocytes. Lymphoblasts rise and crowd out normal WBCs, RBCs & platelets. The most common leukemia of childhood has highest incidence in Caucasian boys 3-4 years of age.
What can excessive blood clotting potentially lead to?
Travel to the heart, kidneys, lungs or limbs, causing heart attack, stroke, damages to organs, or even death.
Thrombi are more likely when there is a stasis of blood. (true or false)
True
The general name for an organism that can transmit disease to a human without itself getting the disease is called a:
Vector
Folic Acid Anemia
Very common among alcoholics
Which of the following is true about viruses?
Viruses can produce symptoms of disease months to years later.
All of the following can increase hypercoagulation except:
Vitamin K Deficiency
Primary Cell-mediated, T-Cell Lymphocyte immunodeficiency (CD4 or CD8)
Vulnerable to viral, fungal and opportunistic infections Many babies don't survive and maternal antibodies don't help either Defective identity-marker proteins Defective cytokine production Defects in T-cell activation Examples: X-linked immunodeficiency
Emphysema
abnormal distension of lungs with air, is a chronic pulmonary disease and may produce hypoxemia (reduced oxygen tension in the blood) which leads to absolute polycythemia.
Chronic Lymphocytic Leukemia (CLL)
abnormal numbers of relatively mature lymphocytes predominate in the marrow, lymph nodes, and spleen Chronic, long lasting Abnormal B-cell lymphocytes, become immunologically incompetent Are not able to properly divide into plasma cells and release antibodies Elderly and men
Disseminated Intravascular Coagulation (DIC)
abnormal activation of the proteins involved in blood coagulation, causing small blood clots to form in vessels and cutting off the supply of oxygen to distal tissues A condition in which there is widespread coagulation and bleeding in blood vessels. Etiology: -Infection and inflammation leading to inappropriate hypercoagulation Pathogenesis: -Thrombi may form occlude vessels, and cause tissue necrosis and possibly lead to organ failure. So much of the coagulation proteins and platelets get used up that in other areas of the body there is minor bleeding to severe hemorrhage. Treatment: -Replacement of clotting factors by transfusions of plasma and platelets.
iron deficiency anemia
anemia resulting when there is not enough iron to build hemoglobin for red blood cells Erythrocytes produced are very small and pale - Low Hemoglobin, - Low hematocrit, - low serum iron, - low ferritin - RBC's are decreased in number, microcytic and hypochromic (Athletes, pregnant women, newborns, bleeding ulcers, bleeding polyps and excessive menstrual difficulties) Treatment: Supplements
Where is the thirst center located?
anterior hypothalamus
Non-Hodgkin's Lymphoma (NHL)
cancer of the lymphatic tissues other than Hodgkin's lymphoma Many different types Originates from multiple lymph nodes and lymphatic tissues anywhere in the body Much more frequent than Hodgkin lymphoma Abnormal B-cells or T-cell lymphocytes or both. Frequently low grade tumors that can transform into aggressive forms of cancer after time. Types: - Follicular Lymphomas - Diffuse Large B-cell Lymphomas 60-80% cure rate - Small Lymphocytic Lymphomas - Burkitt's Lymphoma - EBV virus association - Seen in children commonly Etiologies: - Genetic Factors - Immune system dysfunction - Exposure to environmental carcinogens - Dioxane, benzene - Viruses - EBV General Manifestations of Most Lymphomas: - Painless lymph node enlargement (lymphadenopathy) - Intermittent chills and fever - Weight loss - Fatigue In advanced/metastasized stages: - Increased bacterial, viral and fungal infections - Anemia - Infiltration of liver, spleen, bone marrow and other lymph nodes Diagnosis: - Biopsy of lymph nodes/bone marrow - CT scan/imaging - Blood tests Treatment: - Radiation/Chemo - Antibiotics
Hemolytic Anemia
characterized by an inadequate number of circulating red blood cells due to the premature destruction of red blood cells by the spleen
mononucleosis
condition caused by the Epstein-Barr virus and characterized by an increase in mononuclear cells (monocytes and lymphocytes) in the blood along with enlarged lymph nodes (lymphadenopathy), fatigue, and sore throat (pharyngitis) Self-limiting lymphoproliferative disorder Infection caused primarily by the EBV (85%) Epstein Barr Virus, also: Cytomegalovirus Hep A HIV Rubella Characterized by an increased number of abnormal leukocytes Transmission: oral EBV contaminated saliva "Kissing disease" Pathogenesis: Oral contact initially, virus spreads to lymphoid tissues in the oropharyngeal region, salivary gland cells, and B-cell lymphocytes The virus binds to receptors on B-cells and infects them, killing some and incorporating with the DNA of others. Abnormal B-cells produce heterophile antibodies Cytotoxic killer T-cell lymphocytes (Tc) and natural killer cells (NK cells) attack free virus and EBV-infected B-cells. Not all B-cells are killed, the virus remains in some B-cells and are intermittently shed in saliva. The virus persists in a person for a lifetime. Manifestations: incubation period is 4-8 weeks Days 1-4: malaise, fatigue, anorexia, chills Days 5-7: fever, sore throat, swollen lymph nodes, nausea, jaundice, splenomegaly (up to 2x its regular size), hepatomegaly The acute phase lasts 2-3 weeks, but lethargy may last as long as 2-3 months. Complications: CNS problems, rupture of spleen, other infections.
Polycythemia Vera
condition characterized by too many erythrocytes; blood becomes too thick to flow easily through blood vessels Myeloproliferative Disorder - JAK2 Gene causes bone marrow cells to produce too many RBCs -Can lead to thrombocytosis (too many platelets) and Leukocytosis (too many WBCs) -Genetic, but not inherited Hyper-coagulation disease, very slow developing Bone marrow produces too many cells (RBC's and platelets) TREATMENT: -Prevent symptoms and complications and treat underlying causes -Venesection- Removing a pint of blood at a time to decrease amount
Anemia
low oxygen in the blood due to low number of RBCs and/or abnormal hemoglobin. Can be hemorrhagic or hemolytic. -Vitamin/Iron deficiency -Chronic Disease (cancer/HIV/RA/Renal Disease/Crohn's) -Aplastic Anemia-body doesn't produce ENOUGH rbc's -Bone Marrow Anemia (Leukemia/Myelofibrosis/Cancer) -Hemolytic Anemias- RBCs destroyed faster than marrow can make them -Sickle Cell anemia Causes: * decreased Hgb synthesis --- iron deficiency --- thalassemia (hereditary disorder) * decreased RBC synthesis --- folate deficiency --- B12 deficiency --- chronic inflammation (anemia of chronic disease) --- lack of erythropoietin (kidney disease) * excessive RBC destruction --- Vitamin E deficiency (rare) * excessive blood loss --- need to identify underlying cause (ie. GI bleed)
Plasma cell dyscrasias
neoplasms of *immunoglobulin secreting cells* (plasma cells) that *mostly arise in bone* (general) and result in the secretion of a single immunoglobin produced by the tumor plasma cells Excessive production of single type of plasma cells in bone marrow Increased serum levels of single monoclonal antibodies Types: -Multiple Myeloma
Opportunistic Pathogens
normal microbiota that cause disease under certain circumstances
Allogenic Transplant
donor and recipient are related or unrelated, but share similar tissue types stem cells are collected from a matching donor and transplanted into the patient to suppress the disease and restore the patient's immune system. An allogeneic stem cell transplant is different from an autologous stem cell transplant, which uses stem cells from the patient's own body. The primary targets of the immune response to allogeneic tissues are MHC molecules on donor cells.
Polydipsia
excessive thirst Possibly due to: -Anticholinergenic drugs -Psychopathic issues -Decreased Salivary Gland Secretion -Increased Angiotensin Levels
Acute Myelogenous Leukemia (AML)
form of leukemia that arises from abnormal immature bone marrow cells (myeloblasts) Affects older People Strongly linked with Downs/Congenital Problems
Saprophytes (decomposers)
heterotrophic plants, bacteria, and fungi that feed on dead and decaying organisms
Hypermagnesemia
high magnesium Can be caused by meds given to kidney failure patients Rare Manifestations: -Weakness -Nausea -Vomiting Treatment -Diuretics, water pills, IV Ca+
Folic acid deficiency anemia
inability to produce sufficient red blood cells (RBCs) due to the lack of folic acid, a B vitamin essential for erythropoiesis Folic acid is needed for DNA synthesis and for RBC maturation. Associated with alcoholism, because alcohol will disrupt folate metabolism. Associated with pregnancy, the elderly, and certain tumors. Megaloblastic anemia -DNA synthesis is inhibited. -RBC's become large (macrocytosis) -Anorexia, diarrhea
Normal ABG values
pH: 7.35-7.45 PCO2: 35-45mm Hg PO2: 80 to 100 mm Hg HCO3: 21-28 mEq/L pH Measurement of the acidity or alkalinity, based on the hydrogen (H+) ions present. Indicates Acid/Base status The normal range is 7.35-7.45 PaO2 The partial pressure of oxygen that is dissolved in arterial blood. The normal range is 80-100 mm Hg. SaO2 The arterial oxygen saturation. The normal range is 95%-100% PaCO2 The amount of carbon dioxide dissolved in arterial blood. Partial Pressure of CO2; Indicates the adequacy of pulmonary ventilation The normal range is 35-45 mm Hg. HCO3 The calculated value of the amount of bicarbonate in the bloodstream. Indicates the activity in the kidneys to retain or excrete bicarbonate The normal range is 22-26 mEq/liter
Autoimmunity
pertaining to one's immune system attacking its own tissues or cells Occurs when the immune system fails to distinguish "self" from "non-self" and then attacks body cells/tissues inappropriately. Some are highly specific while others are generalized. Disruption at any step in the antigen recognition process can produce autoimmune disease. Exact mechanisms are not known but it's probably multifactorial Possible mechanisms: -Genetics -Gender -Hormones -Environmental Factors -Impaired T-cell function -Release of sequestered antigens -Molecular mimicry -Superantigens -Difficult to diagnose Autoimmune disorders Treatment: -Corticosteroids -Immunosuppressive drugs -Interferons -Plasmapheresis
Hypophosphatemia
serum phosphorous level that is LESS than 2.7 mg/dL Can be caused by malignancies, genetic disorders, chronic alcoholism, malnutrition. Manifestations: -Mainly asymptomatic -If severe, generalized muscle weakness Treatment: -Oral or IV replacement of Phosphate
virulence factors
traits used to invade and establish themselves in the host, also determine the degree of tissue damage that occurs - severity of disease
transudate vs. exudate
transudate is hypocellular and protein poor exudate is cellular and protein rich *EX-udate has EX-tra stuff in it!
