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248 Cards in this Set

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treatment may cause a disease?
iatrogenic
objective indicators; fever, rash
signs
subjective feelings; pain, nausea
symptoms
period of recovery
convalescence
disease rate within a group
morbidity
number of new cases in a given populated within a stated time period
incidence
increased number of cells
hyperplasia
one mature cell type if replaced by a different mature type
metaplasia
tissue in which different cell size and shape are present
dysplasia
causes of inflammation?
direct physical damage (cuts, sprains)
chemicals
ischemia
allergic reactions
heat or cold extremes
foreign bodies (splinters, glass)
systemic effects of inflammation?
fever
malaise
fatigue
headache
anorexia
local effects of inflammation?
redness, warmth, swelling, pain
watery exudates are called ____?
serous
thick and sticky exudates, increases risk for scar formation?
fibrinous
thick, yellow-green in color exudates? indicate bacterial infection.
purulent
the course of inflammation and healing?
1- tissue injury
2- acute inflammation
3- release of chemical mediators
4. vasodilation, increased capillary permeability, chemotaxis (wbcs to area), irritation of nerve endings
5. clot/fibrin mesh walls off area, phagocytosis
6. preparation for healing
7. regeneration or resolution
what does RICE stand for?
Rest, Ice, Compression, Elevation
Rule of nines
total head= 9% (front 4.5, back 4.5)
each arm= 9% (front 4.5, back 4.5)
each leg = 18%
anterior trunk= 18%
posterior trunk-18%
groin= 1%

half of arm= 4.5%
When would an immune response be more rapid and severe, 1st exposure or 2nd?
2nd time exposure occurs
foreign substances?
antigen
primary cell in the immune response?
lymphocyte
which 2 cells determine which type of immunity will be initiated? (cell mediated or humoral)
B lymphocytes & T lymphocytes
T lymphocytes initiate which immune response?
cell mediated
B lymphocytes initiate which immune response?
humoral
which cell produces antibodies or immunoglobulins?
b lymphocytes
Purpose of complement system?
Inflammatory response
IgG?
Most common
activates complement
antibacterial
crosses placenta- passive immunity in newborns
IgA?
secretions
colostrum-protects newborn
IgM
bound to B lymphocytes
complement
1st to increase in immune response
ABO incompatibility
IgE?
mast cells
releases histamine
inflammation
IgD?
activates B cells
which immunity is species specific?
Natural Immunity
two steps of immune response?
primary and secondary response
What is a primary immune response?
when a person is first exposed to an antigen, takes 1-2 weeks
What is a secondary immune response?
when a person is exposed to the same antigen a second time, explains why a person usually only has chickenpox one time
Active immunity?
when the person's own body develops antibodies to an antigen
Passive immunity?
when antibodies are transferred from one person to another, temporarily
when a person has an infection and develops antibodies, which type of immunity?
natural active (chickenpox)
when a specific antigen is purposefully introduced to body?
artificial active (vaccine)
when IgG is transferred from mother to baby through placenta or breast milk?
passive natural
results from injection of antibodies from a person or animal to another person
artificial passive (hepatitis b)
when a recipient's immune system rejects a graft or transplant?
host versus graft (kidney transplant)
when graft tissue contains t cells that attack the host's cells?
graft versus host (bone marrow transplant)
examples of type I hypersensitivity: allergic reaction
hay fever, anaphylaxis, food allergies, asthma, atopic dermatitis, eczema
Pathophysiology of type I reaction?
exposure to allergen
develops IgE antibodies that bind to mast cells
histamine released
inflammation
redness, swelling, itching
second phase, delayed reaction
why is anaphylaxis serious?
decreased b/p
decreased loc
hypoxia
airway obstruction
examples of type II: cytotoxic?
blood transfusion reaction
what happens in a cytotoxic reaction?
complement
lysis
phagocytosis
examples of type III:immune complex?
glomerulonephritis
rheumatoid arthritis
lupus
pathophysiology of type III complex?
antigen combines with antibody, forming complex
complement
inflammation, tissue destruction
examples of type IV: cell mediated or delayed?
transplant rejection
contact dermatitis
tb skin test
poison ivy
which cell mediator is involved in a cell mediated hypersensitivity?
lymphokines
Common symptoms of SLE?
painful joints, butterfly rash, proteinuria, renal damage, pleurisy in lungs causing chest pain, carditis, raynaud's, bone marrow suppression
characteristics of bacteria?
external capsule-prevents phagocytosis
release of toxins (endo/exo)
produced by gram positive bacteria
exotoxins
vasoactive compounds that can cause septic shock, DIC, inflammation?
endotoxins
bacilli, spirochetes, cocci; bacteria or virus?
bacteria
characteristics of viruses?
require living host
undifferentiated, non functional cells?
anaplasia
well differentiated cells, reproduce at a higher rate than normal, well encapsulated, do not spread ?
benign tumors
undifferentiated, non functional cells, rapid reproduction, infiltrate/spread into lymph nodes or distant sites?
malignant
why is infection likely to occur at tumor site?
blood deprivation
tumor cells release substances that affect neurologic function and may have hormonal effects

example-bronchogenic cancer releases ACTH (cushing's)
paraneoplastic syndrome
staging of cancer uses what acronym?
Tumor size
Node involvement
Metastasis
leading cancer killers in the united states?
1. lung
2.colon
3.breast
4.pancreatic
5.prostate
type of skin cancer that is least dangerous, rarely metastasizes?
basal cell
most common cancers in women?
breast, lung, colon
most malignant and lethal skin cancer?
melanoma
raised, dark lesion with irregular borders
melanoma
Causes of hypokalemia?
diarrhea, bulimia
diuretics, addison's
alcoholism, anorexia
insulin, alkalosis
Signs and symptoms of hypokalemia?
paresthesia
shallow respirations
decreased GI motility
dysrhythmias- flat T wave, ST depression
Causes of hyperkalemia?
renal failure, lack of aldosterone, diuretics, crush injuries, burns, acidosis
signs and symptoms of hyperkalemia?
paralysis
paresthesia
cardiac arrest
flat P wave, wide flat QRS, depressed S, ELEVATED WIDE T WAVE (tenting)
causes of metabolic acidosis?
diarrhea- loss of bicarb
shock, DKA
renal failure-decreased excretion of acids
causes of metabolic alkalosis?
vomiting
antacids
causes of respiratory acidosis?
drugs (shallow respirations), congestion
copd, emphysema
causes of respiratory alkalosis?
hyperventilation-anxiety, aspirin od
effects of acidosis?
headache, lethargy, weakness, confusion, coma, death
effects of alkalosis?
restlessness, muscle twitching, tingling, numbness, tetany, seizures, coma
agents that cause damage during embryonic development.
teratogens
examples of teratogens?
alcohol
cocaine
thalidomide
mercury
radiation
TORCH
nutritional deficiencies
major effect of teratogens occurs during which weeks of pregnancy?
2-8 weeks
signs of down syndrome?
small head
protruding tongue
slanted eyes
single palmar crease
cognitive impairment
trisomy 21?
3 chromosomes instead of 2 in the 21st position
how many chromosomes does a down syndrome person have?
47
monosomy X indicates what disorder?
turner's syndrome
what is monosomy X?
occurs when only 1 X chromosome is present and the person has only 45 chromosomes
polysomy X indicates what disorder?
klinefelters
what is polysomy x?
when an extra X chromosome is present (XXY) instead of (XX or XY)
short stature, webbed neck, broad chest, wide spaced nipples, congenital heart disease, infertile, no puberty
characteristics of Turner's syndrome
long legs, short trunk, shoulder equal to hip size, large breasts, infertility, small amounts of hair, small, firm testicles, tall height
characteristics of Klinefelter's syndrome
which syndrome has a defective gene for a connective tissue protein-fibrillin?
Marfan's
which syndrome usually causes death from ruptured dissecting aneurysms?
Marfan's
Marfan's is what type of genetic disease?
autosomal dominant
results in weak connective tissues of the tendons, heart valves, blood vessels, eyes?
Marfan's
what type of genetic disease is tay sachs?
autosomal recessive
which disease is classified as a liposomal storage disease?
Tay Sachs
In tay sach's disease, the defective gene is on ____ chromosome?
15
Normal til age 6 months
loss of developmental milestones
seizures, MR, blindness, cherry red spot, paralysis
death by age 3-5 ???
Tay Sachs
what is the hallmark symptom of Tay-sach's?
cherry red spot
Fight or Flight?
General Adaptation Syndrome
3 stages in the stress response?
alarm stage
resistance stage
stage of exhaustion
alarm stage?
body's defenses are mobilized
resistance stage?
hormones peak
exhaustion stage?
body is unable to respond
effects of norepinephrine?
vasoconstriction
effects of epinephrine?
bronchodilation, increase glucose
effects of aldosterone?
retain na and water
increase blood volume
increase bp
effects of ADH?
increase bp, increase volume
effects of cortisol?
increase glucose
decrease inflammatory response
microcytic hypochromic anemias?
thalassemia
iron deficiency
macrocytic, normochromic anemias?
b12 deficiency
folic acid deficiency
Iron deficiency anemia?
class: microcytic, hypochromic
(low MCV, MCH)

etiology: diet, blood loss, impaired absorption, liver disease

s/s: pallor, fatigue, cold intolerance, menstrual irregularities
megaloblastic anemias?
pernicious
b12
folic acid
pernicious anemia?
lack of intrinsic factor, antibodies to parietal cells
causes of vitamin b12 deficiency anemia?
gastrectomy, poor intake, gastritis, gastric atrophy
folic acid deficiency?
poor intake, malabsorption, chemotherapy
common signs in pernicious and b12 deficiencies?
paresthesias and ataxia
aplastic anemia?
normocytic, normochromic
pancytopenia
idiopathic
bone marrow suppression
s/s of aplastic anemia?
infections-leukopenia
bleeding-thrombocytopenia
s/s of anemia
death by infection
what is hemolytic anemia?
destruction of RBC, drop in HgB
what causes hemolytic anemia?
hgb defects
immune reactions
malaria
transfusion reactions
erythroblastosis fetalis
what type of genetic disease is sick cell?
autosomal recessive
symptoms of sickle cell?
anemia, jaundice, gallstones, splenomegaly
types of hemolytic anemias?
aplastic
sickle cell
thalassemia
which anemia is described as a genetic defect in genes for globin chains of hemoglobin?
thalassemia
thalassemia major signs and symptoms?
splenomegaly, hemosiderosis, hepatomegaly, hyperplasia of bone marrow (frontal bossing, malar prominence, hypertelorism)
increased production of RBC?
polycythemia vera
factors that affect clotting?
chemo, radiation, ESRD, aspirin, vit K deficiency, liver disease, coumadin, hemophillia, DIC
hemophillia A is what type of genetic disease?
x linked recessive
description of DIC?
excessive clotting, excessive bleeding
DIC is a complication of what types of problems?
placenta abruption
infections
carcinomas
major trauma
labs in DIC?
prolonged PT, aPTT
low fibrinogen
thrombocytopenia
Reed Sternberg cell is seen with what type of lymphoma?
Hodgkin's lymphoma
single-enlarged lymph node?
Non-Hodgkin's lymphoma
malignant disease of plasma cells with overgrowth of these cells in bone marrow? "moth eaten appearance"
Multiple Myeloma
describe arteriolsclerosis?
elasticity is lost
thick/hard walls
narrow lumen, obstruction
leads to ischemia/necrosis (brain, kidneys, heart)
most common cause of a MI?
atherosclerosis
When does a MI occur?
when the coronary artery is totally obstructed
3 common mechanisms of a MI
thrombus
embolus
vasospasm
most MI's involve which part of the heart?
left ventricle
is blood to the heart is restored within ____ minutes, damage may be reversible?
30 minutes
Warning signs of a heart attack?
1. pressure, heaviness, burning in chest, especially with increased activity
2. sudden SOB, sweating, weakness, fatigue
3. nausea, indigestion
4. anxiety, fear
hallmark sign of a MI?
substernal pain radiating to the left arm, shoulder, jaw, or neck

no relief with rest or vasodilators
what is the gold standard for MI?
cardiac troponin elevated
after a heart attack, sudden death may occur due to what?
ventricular fibrillation
complications of a MI?
sudden death- v fib
cardiogenic shock-damaged LV
CHF
cardiac tamponade
thromboembolism - CVA
or pulmonary embolism if RV MI
treatment for MI?
rest
anticoagulants
oxygen
analgesics
thrombolytics
major cause of death in 1st hour after a MI?
v fib
Ventricular Fibrillation?
the muscle fibers contract independently and rapidly, often uncoordinated or quivering. This makes the ventricles ineffective in ejecting blood, the lack of cardiac output causes severe hypoxia and contraction ceases
atrial fibrillation?
no filling of the heart, no output
PVC
may induce fibrillation
total heart block?
decrease in output, syncope
interferes with conduction is one of the bundle branches,doesn't interfere with output?
bundle branch block
stokes adam attack?
sudden syncope, may have seizures
what would you see on an ekg with a third degree heart block?
QRS at their own rate, dependent on P wave
pulmonary disease affects the ___ ventricle first?
right
causes of left sided heart failure?
Left ventricle infarction
aortic valve stenosis
hypertension
hyperthyroidism
effects of left sided heart failure?
decreased output
pulmonary congestion
what is the "forward effect" of CHF?
when cardiac output or stroke volume decreases
what is "back up" effect?
congestion
s/s of left sided heart failure?
orthopnea
cough
sob
rales
night time dyspnea
differences in right and left sided heart failure?
left sided: orthopnea, cough, sob, nocturnal dyspnea, hemoptysis, rales

right sided: edema, hepatomegaly, splenomegaly, ascites, distended neck veins, headache, flushed face
left sided congestive heart failure?
left ventricle weakens, can't empty
decreased output
decreased renal flow
stimulates renin system
backup of blood into pulmonary vein
high pressure in pulmonary capillaries
pulmonary congestion
right sided congestive heart failure?
right ventricle weakens, can't empty
decreased output
decreased renal flow
backup of blood in systemic circulation
increased pressure=edema in legs, liver, abdomen
high pressure causes distended neck veins, cerebral edema
what is cor pulmonale?
right sided CHF due to pulmonary disease
first sign of kids with CHF?
feeding difficulty
also have- tripod position for playing, gallop
shunting of blood?
blood will always shunt from area of high pressure to low pressure
left to right shunting is which type of defect?
acyanotic
in left to right shunting, blood from the left side flows back to the right side, which increases blood volume in ______?
pulmonary circulation
right to left shunting is which type of defect?
cyanotic
blood bypasses the lungs and goes into the systemic circulation?
right to left shunting
causes mixing of un-oxygenated blood with oxygenated blood?
right to left shunting (cyanotic)
septal defects?
mixing of oxygenated and unoxygenated blood
valvular defects?
interfere with the flow of blood
most congenital defects can be detected by the presence of???
heart murmur
most common congenital heart defect and known as "hole in heart"
ventricular septal defect
ventricular septal defect causes what type of shunt?
left to right (due to the higher pressure in the LV)
acyanotic
4 defects of tetraology of fallot?
pulmonary stenosis
vsd
RV hypertrophy
dextroposition of the aorta over the VSD
most common cyanotic congenital heart disease?
tetraology of fallot ("blue babies")
what happens in tetraology of fallot?
1. pulmonary stenosis restricts outflow of blood to RV which causes it to hypertrophy.
2. the pressure in the RV is now higher than the LV which leads to a right to left shunt via VSD.
3. the flow of blood from the RV directly into systemic circulation is promoted by the position of the aorta, over the VSD
4. end result= pulmonary circulation gets small amt of deoxygenated blood from RV and the systemic circulation gets larger amount of mixed blood =great oxygen deficit
acute systemic inflammatory response to infection with group A beta-hemolytic streptococcus?
rheumatic heart disease
rheumatic fever is what type of hypersensitivity?
type II hypersensitivity immune reaction
signs and symptoms of rheumatic fever which indicate cardiac involvement?
new murmur
chest pain from pericarditis
friction rub
signs and symptoms of rheumatic fever?
low grade fever
leukocytosis
malaise
anorexia
fatigue
tachycardia
chest pain
murmur
sites of inflammation from rheumatic heart disease?
large joints of extremities
erythema marginatum- pink macules on trunk
non tender subcutaneous nodules
jerky movements of face, arms, legs- syndenham chorea (st. vitus's dance)
osler's nodes occur with ____?
infective endocarditis
destruction of aveolar walls and septae?
COPD-emphysema
blebs or bullae?
advanced emphysema
bronchiectasis?
dilation of walls and allows pooling of secretions

PURULENT FOUL SMELLING SPUTUM
mediastinal flutter?
occurs with open pneumothorax
more air enters during inspiration, see a shifting of mediastinum, impairs air entry into unaffected lung, impedes venous return from IVC
results from fractures of ribs, allows ribs to move during inspiration?
flail chest
what causes stale air from a damaged lung to cross into the other lung and mix with new air?
flail chest
lack of surfactant in alveoli?
infant respiratory distress syndrome
laryngotracheobronchitis (croup)
cause: influenza/adenovirus
ages: 3mo-3yrs
gradual onset
barking cough, inspiratory stridor
characteristic: steeple sign xray
____ is a sign of pneumococcal pneumonia?
rusty sputum
epiglottitis?
caused by influenzae b
round red ball obstruction
drooling is seen, inspiratory stidor
tripod position
what type of pneumonia causes inflammation of alveolar wall, leakage of cells, fibrin, and fluid into alveoli-causing consolidation, pleura inflammed?
lobar pneumonia
which type of pneumonia causes inflammation and purulent exudate, exudate arising from pooled secretions?
bronchopneumonia
which type of pneumonia causes interstitial inflammation around alveoli and necrosis of bronchial epithelium?
interstitial pneummonia (primary atypical)
which type of pneumonia causes headache, aches, hacking cough?
interstitial (pap)
which type of pneumonia causes productive cough with yellow sputum and dyspnea?
bronchopneumonia
which type of pneumonia causes high fever, chills, rusty sputum, rales or absence of breath sounds?
lobar pneumonia
how is RSV transmitted?
oral droplets
another name for bronchiolitis?
RSV
pathophysiology of RSV?
causes necrosis in small bronchi with edema, increased secretions leading to obstruction.
respiratory and GI problems with cystic fibrosis?
lungs-mucus obstructs airflow, atelalectasis, scarring, mucus breeds infections, CLUBBING

GI- steatorrhea, meconium ileus, abdominal distention

blockage of pancreatic ducts, obstruction of bile ducts-fat absorption
significance of meconium ileus in cystic fibrosis?
in the digestive tract, the 1st indication of abnormality may be a meconium ileus.

small intestine is blocked by mucus at birth, preventing excretion of meconium
cause of cystic fibrosis?
autosomal recessive genetic disorder
patho of cystic fibrosis?
defect in chloride transport, affects exocrine glands, causes sticky mucus which obstructs passages
intrinsic vs extrinsic asthma?
intrinsic- exercise, chemicals, smoke
extrinsic-allergen-pollen
immediate response of asthma?
antigen reacts with IgE, inflammation, bronchospasm, edema
delayed response of asthma?
eosinophils, leukocytes result in prolonged inflammation, bronchoconstriction, obstruction and hypoxia
signs and symptoms of asthma?
wheezing
pulsus paradoxus (pulse differs on inspiration and expiration)
respiratory alkalosis (hyperventilation)
causes of constipation?
weakness of smooth muscle
lack of fiber
lack of fluids
immobility
neuro disorders
drugs
antacids, iron
obstructions (tumor, strictures)
when the esophagus is unable to relax after swallowing and causes food to remain there
achalasia
term for a disorderthat makes it difficult to use or control the muscles of the mouth, tongue, larynx, or vocal cords, which make speech.
dysarthria
causes of acute gastritis?
infection, allergies, spicy foods, alcohol, aspirin, toxic substances, radiation, chemo
common sites for peptic ulcers?
proximal duodenum
antrum of stomach
lower esophagus
what causes pre hepatic jaundice?
RBC destruction
what causes intrahepatic jaundice?
liver disease
what causes posthepatic jaundice?
obstruction of bile flow
how is hep a transmitted?
oral-fecal
how is hep b,c and d transmitted?
blood, fluids
manifestations of liver disease?
systemic effects
ascites-aldosterone
varices-collateral
tremors-ammonia
itching-bile salts
bleeding-vitamin k
crohn's disease?
ileum, inflammation and fibrosis leading to thick rigid wall, can form abscess, fistulas
RLQ tenderness
skip lesions
ulcerative colitis?
inflammation of rectum and colon
serious complication- toxic megacolon-inflammation impairs peristalsis, obstruction and dilation of colon, risk of colorectal cancer
celiac disease?
villi atrophy
malabsorption syndrome-gliadin
1st appears when cereal is added
causes of mechanical bowel obstruction?
tumors
adhesions
hernias
intussusception-telescope
volvulus-complete twisting
hirschsprung disease
what disease of kidney's is characterized by proteinuria??
nephrotic syndrome
nephrotic syndrome?
proteinuria-damage to glomeruli
hypoalbuminemia-loss of protein
hypercholesterolemia-liver stimulation
edema-hydrostatic pressure
drop in bp-loss from vasculature
development of post strep glomerulonephritis?
strep infection--antibody formation--complex--acute inflammation--hematuria, albuminuria, congestion and decreased GFR, oliguria, elevated serum urea, elevated bp, edema,
**What are the causes of hydronephrosis??
occurs as a complication of kidney stones, tumors, scar tissue, prostate enlargement
causes renal calculi?
hypercalcemia
alkaline urine
inadequate fluid intake
hyperuricemia
causes of acute renal failure?
bilateral kidney disease
heart failure
septic shock, crush injuries
nephrotoxins
causes of chronic renal failure?
chronic kidney disease
polycystic kidney disease
nephrotoxins
signs of ESRF?
azotemia
anemia
acidosis
early sign of renal failure?
increased output
non pitting edema of the face and extremities, thickening of the tongue, due to accumulation of mucopolysaccharides in tissues, associated with hypothyroidism??
myxedema
complications of hypothryoidism?
myxedema coma: hypotension, hypoglycemia, hypothermia, LOC, lfie threatening
which endocrine disorder causes deficit of glucocorticoids, high risk of infection, poor stress response, weight loss, fatigue, hyperpigmentation??
Addison's
which endocrine disorder causes excess glucocorticoids, moon face, buffalo hump, muscle wasting, striae, hypertension?
cushing's
excess cortisol?
cushings
cortisol deficit?
addisons
hormonal imbalance in diabetes insipidus?
deficit of ADH- pee too much
which endocrine disease causes excess GH, broad, heavy bones, enlarged hands, feet, thicker skull??
acromegaly
most common cause of hyperthyroidism?
graves disease (toxic goiter)
signs and symptoms of graves disease?
increased body temp
sweating
soft silky hair
insomnia