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67 Cards in this Set
- Front
- Back
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5 signs of inflammation
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rubor
calor dolor tumor loss of function |
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purpose of inflammation
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protective response with ultimate goal of ridding the organism of the initial cause of cell injury and its consequences, such as necrotic cells & tissues
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four major functions of inflammation
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brings phagocytic cells to the area to engulf foreign material
brings in antibodies walls off area prevents systemic spread |
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exudate
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high protein, inflammatory extravascular fluid (sp grav >1.020)
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4 types of exudate
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fibrinous
sanginous purulent (suppurative) serous |
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fibrinous exudate
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lining of body cavities; fibrous strands seen (pericardium)
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serous exudate
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outpouring of thin fluid, der from either serum or mesothelial cells (effusion)
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purulant/suppurative exudate
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large amounts of pus and/or neutrophils, necrotic cells and edema fluid (abcesses, appendicitis)
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sanguinous
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Blood in exudate (more often purulosanginous - pus & blood - eww)
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Stages of Inflammation
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acute
chronic |
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acute inflammation - definition, mechanisms
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immediate & early response to an injurious agent; short duration (minutes-days); exudation of fluid & plasma proteins (edema); emigration of leukocytes esp neutrophils
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Chronic inflammation
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prolonged duration (weeks/months); monocyte/macrophage dominant
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What three things are present simultaneously in chronic inflammation
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Active INFLAMMATION
Tissue DESTRUCTION Attempts at REPAIR |
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resolution
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go back to normal cells
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When do we get scars?
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when resolution fails in acute inflammation
ongoing necrosis/chronic inflammation when cell necrosis can't be repaired |
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5 Stages of scar formation
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PREPARATION (remove debris)
GRANULATION tissues (highly vascularized; fibronectin) COLLAGENATION (tensile strength) MATURATION (pale, lacks circulation) CONTRACTING/STRENGTHENING (type III to type I collagen) |
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cells in stages of scar formation
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preparation - phagocytes
granulation - fibroblasts collagenatin - fibroblasts maturation - contraction/strengthening - myofibroblasts |
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3 possible results of an injury
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Regeneration (normal returns)
Healing (scar formation/organization of exudate) Fibrosis (tissue scar) (persistent damage) |
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Cirrhosis is a form of what type of wound repair?
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Fibrosis (altered architecture, persistent damage)
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Healing by first intention (wounds with opposed edges) (Primary Union)
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edges are approximated (no gap)
eschar (scab) epidermal cells proliferate under scab dermis - scarred; epithelium not |
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Healing by Second Intention (wounds with separated edges)
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poor apposition (dehiscence); foreign material; extensive necrosis; infection
more fibrin/more granulation tissue/scarring of both epidermis and dermis; wound contraction c/b disfiguring |
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dehisence
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rupture or pulling apart of a wound
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What do vitamin B2, Vit C bioflavinoids, zinc and sulfur have to do with wound repair?
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deficiencies can cause defective wound healing
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What are two conditions that would lead to defective collagen?
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Ehlers-Danlos; Marfan syndrome
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what is a keloid?
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excess collagen formation
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Three factors in defective wound healing?
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Diabetes
Radiation/Chemo Exogenous steroids |
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angiogenesis
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formation of new blood vessels (neo-vascularization) in healing; branching of adjacent vessels
recruitment of EPC (endothelial progenitor cells from bone marrow) (new bv not as strong, removed by apoptosis) |
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when would you see angiogenesis?
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cancer, healing, regeneration
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Pathological fracture
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bone not healthy, so breaks
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Greenstick fracture
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periosteum intact, inside broken
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comminuted fracture
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shattered (lots of little broken parts)
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compound fracture
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breaks skin too (osteomyelitis poss)
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non-union fracture
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motion of the bony ends & incomplete healing more than 6 months
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3 stages of fracture healing
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PROCALLUS - anchorage, no stability
FIBROCARTILAGENOUS CALLOUS OSSEOUS CALLOUS & remodeling |
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etiology of auto-immune dz
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many theories - cross-reactivity w/ common epitopes & HLA antigens; self-tolerance lost (micro organisms act as triggers)
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some microorganisms that can act as triggers for auto-immune dz
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Coxsackie B - myocarditus
Klebsiella - ankylosing spondylitis Virus - Type I Diabetes Yersinia Pestis - Graves Dz, Reiders sy Strep A-Beta - rheumatic fever, endocarditis |
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Vit D and autoimmune
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UV-B radiation & Vit D reduce risk of viral infex, reducing sequelae (autoimmune dz, some cancers)
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central tolerance - T cells - where
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thymus
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peripheral tolerance mechanisms
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anergy - stimulated, no costim
suppression - Treg Activation induced cell death |
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SLE
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Systemic lupus erythmatosis
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silicone implants
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trigger "Lupus-like" illness
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ubiquitin
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"stress protein" - flag that says "kill me" assoc with autoimmune
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SLE anti-histone antibodies
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seen in drug-induced lupus
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symptoms of Lupus
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chronic exacerbations and remissions of immune injury to SKIN, JOINTS, KIDNEYS, SEROSA; characteristic red "mask" on face
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Etiology of lupus
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Failure of self tolerance (Ab to nuclear proteins - ANA)
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SLE - ANA
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Anti-nuclear antibodies
anti ds-DNA; anti-sm are close to diagnostic |
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SLE - dogs?
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dogs of lupus pts more likely to have ANA
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SLE - genetics?
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20% concordace in twins;
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SLE - Environmetal, drug, dietary fax
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alfalfa
Hydralazine, procainamide, D-pennicillamine, Isoniazid Steroids UV exposure |
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SLE - Solvents & UCTB
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paint thinner/petroleum - 3x
perfume/cosmetic mfg - 7x furniture refinishing - 9x |
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SLE - sulfur metabolism
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sulfur - phase II detox (also estrogen)
abnormal - more sens to xenobiotics, steroids exacerbations - sulfur, pregnancy, menstruation |
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UCTD
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Undifferentiated Connective Tissue Dz - more than one autoimmune dz in same pt (aka M(ixed)CTD
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SLE - incidence
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10:1 childbearing women:men
2:1 post-menopausal:men 1:1000 US women 1:2500 worldwide women 1:700 childbearing 1:245 AfroAmerican |
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SLE - L.E. cell
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any phagocyte that contains coagulated nucleus of an injured cell (used to be diagnostic, now blood test)
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SLE - vasculitis
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occurs most often in SKIN, muscle, spleen
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SLE - fibrinoid necrosis
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in vessel walls.
aka "onion skin lesions" fibrin laid down in wall; Ab to phospholipids stick to wall |
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SLE - glomerulonephritis
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4 types of Lupus nephritis - common
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SLE - skin lesions
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butterfly rash - 50% of cases
atrophic lesions (destruction & loss of cell substance) on trunk & extremities ERYTHEMA & SCALING |
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SLE - joints
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non-erosive synovitis without deformity (polyarthritis)
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SLE - CNS
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occlusion of small vessels by intimal proliferatin or arteritis; Ab to synaptic membrane; increased hypercoagulability
depression/psychosis/strokes |
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SLE - Heart
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serousitis, pericarditis (fibrinous exudate); endocarditis (warty deposits on both sides of valves); atheroslerosis
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SLE - spleen
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splenomegaly (tho not giant)
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SLE - lymph
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lymphadenopathy - generalized
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SLE - lungs
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pleuritis, effusio, interstitial fibrosis (exercise intolerant)
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SLE - liver
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Lupoid hepatitis - vasculitis of portal tracts with lymphocytic infiltration
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SLE - 11 criteria
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Malar rash
Discoid rash photosensitivity oral ulcers arthritis serositis renal d/o neruological d/o (seizures/psychosis) hematological d/o immunological d/o (anti-dsDNA, anti-Sm, anti-phospholipid ANA |
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SLE - clinical
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Protean (highly variable, unpredictable)
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