PTHA 1321 - Human Diseases: A Systemic Approach - Zelman book and Miele lecture - Exam 1

a branch of medicine that studies the characteristics, causes and effects of disease

the unhealthy state of a body part, a physiological system, or the body as a whole.

there is a disordered structure of function

abnormal growth patterns

an increased number of cells, resulting in tumor formation

incomplete development or underdevelopment of an organ or tissue

(e.g., a child with cerebral palsy that presents with an underdeveloped limb or muscle tissue)

the absence of a structure of tissue

(e.g., plastic anemia, where the bone marrow fails to produce erythrocytes, leukocytes, and platelets and the patient is unable to fight infection

the conversion of normal tissue cells into an abnormal form following chronic stress or injury

(e.g., cancer)

abnormal development of a structure

(e.g., congenital heart defect, or hip dysplasia in a dog)

the study of the causes of diseases

- bacteria
- fungi
- parasites
- viruses

defective gene(s) or genetic disease

an error in development of the fetus

- maternal infection during pregnancy (e.g., rubella)
- use of certain drugs or excessive alcohol intake during pregnancy
- industrial waste exposure during pregnancy
- accident at time of delivery (e.g., interference with oxygen supply

- sun exposure (e.g.,, skin cancer)
- radiation exposure
- asbestos exposure
- chemical exposure

- lack of adequate food supply
- patient's inability to digest properly/absorb nutrients properly

- arthritis
- normal aging

altered thyroid function due to improper hormone secretion as seen in thyroid disease

coronary artery disease

a new growth of cancer (actually, a new and abnormal growth of tissue in some part of the body, but especially as a characteristic of cancer)

- congenital birth defects
- hereditary disease
- environmental factors
- malnutrition
- infectious disease
- degenerative factors
- endocrine disturbances
- obstruction of hollow organs
- neoplasm
- trauma or injury
- idiopathic

etiology

the use of scientific and/or clinical methods to determine the nature of a disease

- signs
- symptoms
- lab tests
- diagnostic imaging (e.g., MRI, X-ray, etc.)
- patient history

you will need to know when even minute changes occur, to determine whether treatment should be discontinued or modified

OBJECTIVE evidence of disease observed on physical examination

(e.g., fever, elevated pulse rate, pallor)

a SUBJECTIVE indication of disease perceived by the patient

(e.g., pain, dizziness, itching)

certain signs and symptoms that tend to occur concurrently in some diseases

sign

the predicted course and outcome of the disease, as made by a physician after examining all the signs and symptoms and deriving a diagnosis

prognosis

sign

chronic

relapse

homeostasis

sequela

fatigue

pathology

etiology

sign

syndrome

true

false

false

(it is maintaining within normal limits, not completely unchanging)

true

false

false

false

(pathogenesis is the cause of the disease, together with its development;

pathology is the study of disease in general;

pathophysiology is the study of the physiological processes leading up to disease)

true

false (this is characteristic of chronic disease)

false

(diseases can be infectious, but they can also be caused by:
- congenital birth defects
- heredity
- environmental factors
- malnutrition
- infection
- degenerative factors
- endocrine disturbances
- obstructions in hollow organs
- neoplasm
- trauma/injury
- idiopathic origin

abnormal paleness

influenza

atrophy

complication

sequela

hyperplasia

hypoplasia

prognosis

lesion

immunity

idiopathic

lesion

etiology

sign

incidence

pathogenesis

prognosis

prevalence

symptom

treatment

a protective response to injury or invasion by disease-producing organisms

- foreign substances (e.g., splinter)
- allergies
- chemical agents (e.g., poison, venom)
- trauma or injury
- pathogenic organisms (e.g., bacteria, virus, fungus)
- physical agents (e.g., radiation, temperature extremes)

no

you can have inflammation without infection (e.g., sunburn)
but you can't have infection without inflammation

invading pathogenic organisms

(e.g., bacteria, viruses, fungi, parasites)

- by local infection
- by secretion of a toxin
- by initiating an allergic response

- local blood vessels, arterioles, and capillaries dilate, resulting in increased blood flow
- increased blood flow causes heat and redness associated with the inflammatory process
- with increased blood flow, more leukocytes (WBCs) reach the injury or infection
- specialized WBCs called neutrophils or polymorphs line up within capillary walls
- damaged tissue releases histamine, which causes capillary walls to become more permeable
- increased permeability allows plasma and neutrophils to pass in and out of blood vessels easily
- phagocytic neutophils engulf and digest bacteria and cellular debris
- escaping plasma and WBCs comprise inflammatory exudate, which causes swelling associated with inflammation
- increased fluid in the tissues (edema) puts pressure on sensitive nerve endings, causing pain

increased blood flow

histamine

a mixture of plasma and white blood cells that causes the swelling associated with inflammation

swelling

a cell that consumes and digests other cells

- redness
- heat
- swelling
- pain

- connective tissue cells called fibroblasts produce collagen fibers that contract and close the gap between cut edges of injured tissue

- scar tissue is the fibroblasts and their collagen fibers that heal the cut

a connective tissue cell that produces collagen fibers to aid in healing/scar formation

occurs when connective tissue fibers anchor adjacent tissues together

occurs when connective tissue fibers are laid down in an irregular network

a foreign element that triggers an immune response

antibodies and activated lymphocytes

they are normally a protein or large polysaccharide (complex carbohydrate)

the ability of the body to defend itself against infectious agents, foreign cells, and abnormal body cells

- innate immunity (nonspecific defenses), and
- acquired immunity (specific defenses)

- Fever
- Interferon (group of substances that stimulate immune system)
- Physical or chemical barriers (skin & secretions)
- Phagocytosis
- Inflammation
- Natural killer cells (leukocyte that recognizes body cells with abnormal membranes)

- humoral immunity
- cell-mediated immunity

- circulating antibodies capable of destroying foreign invaders

[B lymphocytes, which comprise memory cells and plasma cells (immunoglobulins)]

none, they mean the same thing

activated lymphocytes responsible for resistance to infectious diseases caused by certain bacteria and viruses

(T lymphocytes, processed by the thymus gland into activated lymphocytes, comprise the cytotoxic, helper, and suppressor T lymphocytes)

- lymph vessels
- lymph nodes
- spleen
- thymus gland
- tonsils

it is the fluid within lymphatic vessels

it is comprised of water, WBCs, nutrients, hormones, salts, carbon dioxide, oxygen, and urea

- lymph nodes
- spleen
- bone marrow
- tonsils
- adenoids

intercept invading organisms

T lymphocytes
B lymphocytes

- killer cells capable of killing invading organisms
- important in destroying cells invaded by viruses and cancer
- a.k.a. CD8 T lymphocytes

- they increase the activity of killer cells, B lymphocytes, and suppressor T cells by secreting lymphokines
- also activate macrophages that destroy invading organisms by phatocytosis

- they slow down the cytotoxic (CD8 T/killer) lymphocytes
- help stop the immune response (homeostasis--so the response doesn't go too far)

plasma cells which divide rapidly and produce a large number of cells that secrete antibodies into lymph

dormant until reactivated by the same antigen (memory cells)

A B lymphocyte that remains dormant until reactivated by a subsequent exposure to the same antigen.

because memory cells produce a more potent and longer lasting antibody response

a virus that carries its genetic code on the RNA instead of teh DNA

it causes severe immunodeficiency of T-cell functions

it attacks helper (CD4) T lymphocytes and destroys their ability to fight infection and renders them incapable of stimulating the B-lymphocytes and cytotoxic (CD8/killer) T cells

- it manifests as an immune response consistent with a viral infection
- no known cause or cure
- generally affects young professionals ("Yuppie flu")

- severe and persistent fatigue
- muscle and joint pain
- fever
- difficulty with concentration and memory/retention

the ability of the immune response to recognize the difference between the individual's own body cells and cells of an invading pathogen

autoimmune disease

activated T-cells and antibodies attack the body's own tissues

- systemic lupus erythematosis (SLE)
- discoid/cutaneous lupus
- drug-induced lupus erythematosus
- neonatal lupus

systemic lupus erythematosis (SLE)

autobodies against RNA and DNA can attack any body cell and threaten the organs, especially the heart, lungs, kidneys, liver, and blood
also can affect joints and muscle tissue

- rash
- skin overly sensitive to sunlight
- joint and muscle pains
- hypertrophy of joints (appear similar to RA)
- fever
- enlarged lymph nodes and spleen
- fatigue
- Raynaud's phenomenon
- periods of exacerbation and remission

NSAIDs/corticosteroids to relieve inflammation

no specific treatment except corticosteroids to control inflammatory symptoms of redness, heat, swelling, and pain

fatal

usually due to organ (renal/heart) failure or pneumonia

- active immunity
- passive immunity

person is given a vaccine or toxoid as antigen, and he/she then forms antibodies to counter it

a low dose of inactivated (dead) or attenuated (weakened) bacteria or viruses used to induce immunity

a chemically altered poisonous material/toxin

(toxin--the poisonous material produced by a pathogenic organism)

long-lived

a situation where a person is given doses of “preformed antibodies” from the immune serum of an animal, usually a horse

it is used in situations where there is not time to vaccinate the patient and develop active immunity (e.g., snake bite--hospital administers antivenin)

short-lived

a malfunction of the immune system in which it (over)reacts to one or more substances that do not bother most people

destructive

abnormally formed antibodies

the system overproduces IgE immunoglobulins instead of IgG

- body forms IgE vice IgG
- IgE attaches to mast cells containing histamine, heparin, serotonin, and bradykinin
- allergen binds with other end of IgE
- mast cells break down and release their chemical loads of histamine, etc.
- blood vessels dilate and release plasma into tissues
- tissues swell

- allergy shots can desensitize
- oral antihistamines can relieve minor reactions

- large quantities of antigens are introduced to the body when large numbers of antibodies are already present
- antigens and antibodies interact
- cellular damage triggers histamine release from mast cells and basophils throughout the body
- blood vessels dilate
- capillaries become more permeable and leak plasma into tissues
- blood pressure drops
- hypotension causes poor return of venous blood to the heart
- cardiac output is reduced
- blood pools in body instead of circulating
- person goes into shock
- smooth muscle contraction in respiratory tract can occur as well

- skin flush
- hives
- swelling of lips/tongue
- wheezing
- abdominal cramps

- profound weakness
- collapse due to low blood pressure
- decreased cardiac output
- inability to breathe or labored breathing
- seizures

all of the above

Plasma cells

answers 1 and 2 are both correct

memory cells

all of the above

preformed antibodies

B lymphocytes

suppression of the immune system

hypersensitive responses of the cellular immune system

systemic release of histamine, which drastically lowers blood pressure

false

false

false

true

true

true

false

true

false

(it is very serious)

true

agglutination

pyogenic

mast cell

antigen

autoimmune

pain

allergens

hypersensitive

anaphylactic

E
(IgE)

epinephrine

infection

Histamine

Most common form of transplant

blood incompatibility

RhoGam

autoimmune diseases

HIV

suppurative
(by pyogenic bacteria)

phagocyte

invading pathogenic microorganisms

- human-to-human (contagious/communicable)
- by other elements in environment (e.g., rabies from rat bite, cholera from fouled water) (noncommunicable)

contagious or communicable

noncommunicable

- bacteria
- viruses
- fungi
- helminths
- protozoa
- arthropods
- prions (proteinaceous infectious particle)

- microscopic single-celled organisms
- no nucleus or membranous organelles
- grow rapidly and split in half through binary fission (in as little as 30 minutes)
- some produce endospores

they grow rapidly and split in half through binary fission (in as little as 30 minutes)

bacilli - rod-shaped
cocci - round/spherical
spirilla - spiral-shaped
spirochetes - corkscrew-shaped
vibrios - comma-shaped

- swelling
- redness
- pain
- fever
- pus

- basically, a stripped-down, dormant bacteria waiting for better conditions to reactivate
- contains genetic material of the cell/bacteria
- resistant to desiccation, acid, temperature extremes, radiation
- germinate and form growing cells
- contaminate food, water, wounds

- infectious particles made of a core genetic material (either RNA or DNA)
- wrapped in a protein coat (capsid)
- may have a lipid membrane around the capsid
- may have spikes for attachment
- not a living organism; needs a host to grow and replicate

certain types of cells
cold virus - respiratory epithelium
herpes virus - nervous tissue
HIV - T- cells

abnormal cell growth
cancer

single-celled microorganisms with complex internal structures (nucleus, organelles, etc.--eukaryotic)

no

- amoeboids
- flagellates
- sporozoans
- ciliates (very few are pathogens)

using cell membrane extensions called pseudopodia

Amoebic dysentary--an intestinal infection from feces-contaminated food or water

they swim by using their whiplike appendages (flagella)

- African sleeping sickness
- giardiasis - an intestinal infection

non-mobile

malaria (transmitted by mosquito bite)

- single- or multicelled
- can move easily
- readily infect damaged tissue (more so than healthy tissue)
- cause disease by producing toxins that interfere with normal organ structure/function or induce inflammation/allergy
- reproduce via spores (which are allergens)

Candidiasis - yeast infection/thrush
Histoplasmosis - lung infection from bird/bat-dropping contaminated soil
Microsporum - causes ringworm
Trichophyton - athlete's foot

- parasitic worms
- complex multicellular organisms (roundworms and flatworms)
- well developed reproductive systems
- complex lifecycles and infection strategies

an infestation

- ascaris
- pinworms (Enterobius vermicularis)
- hookworms (Necator americanus)

- roundworms
- flatworms

pinworms (Enterobius vermicularis)

hookworms (Necator americanus)

- using the host’s nutrients
- feeding on blood and causing anemia
- blocking or perforating the intestines
- inducing severe inflammatory responses

animals with jointed legs and hard exoskeletons

- ticks
- mites
- lice
- flies
- mosquitoes
- fleas

transmitter of a pathogenic organism
(e.g., mosquito transmits Plasmodium when it feeds on humans)

- the source of an infectious agent
- can be human, animal, insect, soil, water

the number of new cases of a disease in a population

the number of existing cases of a disease in a population

when a disease is always present at low levels in a population

when a disease occurs in unusually large numbers over a specific area

when an epidemic has spread to include several large areas worldwide

when a disease suddenly occurs in unexpected numbers in a limited area and then subsides

- the precautions taken to prevent spread of disease
- assumption that all bodily fluids are contaminated
- use of any/all available protective equipment and procedures to prevent contact with such substances

study of transmission, occurrence, distribution and control of disease

transmission from infected human to uninfected human

transmission from one generation to the next

type of pathogen

antibiotics
(some act on the cell wall, especially in gram-positive bacteria; others target the cell membrane and cause lysis; others target the protein synthesis of the cell, interfere with metabolism, or DNA or RNA synthesis)

no

antiviral drugs can interfere with
- replication, or
- attachment of virus to host

- treatment includes antifungal drugs that attack cell walls and membranes

- they are difficult to treat because the cells are similar to human cells and both are often destroyed by the treatment (topical agents aren't as dangerous as systemic agents)

infections once considered under control, but are again becoming health threats

- increased antibiotic resistance
- changes in climate (alter arthropod vector breeding)
- urbanization/crowding
- rapid world travel
- disruption of social and governmental structure (e.g., war)
- human demographics and behavior

- tuberculosis
- cholera
- malaria
- mumps
- strep throat/impetigo
- pneumonia/meningitis

infectious

measles, mumps, tuberculosis

(anything transmitted from human to human)

vectors

absence of a nucleus

all of the above

bacilli

a specific host tissue

endemic

syphilis

a nosocomial infection

false

(epidemiology is the study of the transmission, occurrence, distribution, and control of disease)

true

true

false

true

false

true

false

true

false

(injection of an ANTIGEN, not an antibody)

intestines, skin

hand washing

gram stain

D

(IgD)

tick

roundworm

rods

animal

a pandemic

tuberculosis

epidemic

contagious

binary fission

helminths

rabies

antibiotic

vaccination

malaria

yeast
thrush

Lyme disease

new and abnormal formation of tissue

- benign
- malignant

- not usually dangerous (but may grow to a size that impedes function)
- not spreading by metastasis or infiltration of tissue
- cells adhere together
- generally encapsulated, with clearly defined edges
- non-cancerous
- grow as a single mass within tissue
- can grow within an organ causing considerable damage (e.g., brain tumor)

- grows worse
- metastasizes
- often recurs after attempts at surgical removal
- irregularly shaped
- harmful and usually life-threatening
- typically larger than benign neoplasia

malignant

adenoma - glandular tumor
angioma - red birth mark (a.k.a. port wine stain)
lipoma - fatty tumor
nevus - mole
papilloma - wart

papilloma

malignant tumors

via
lymph fluid (carcinoma) or
blood (sarcoma)

malignant

carcinoma
sarcoma
melanosarcoma

carcinoma

epithelial tissue

lymphatic system

skin, mouth, lungs, breast tissue, stomach, colon, and uterus

(all of which open or are exposed to the outside of the body)

sarcoma

in the connective tissues, bones, muscles, cartilage

via blood circulation

lungs
(since all blood eventually goes through your lungs)

skin

a nevus or melanoma

- high survival rate
- tumor tissue differentiated and closely resembles parent tissue

- moderate survival rate
- cells moderately or poorly differentiated

- low survival rate
- cells so undifferentiated that tissue origin not easily recognized

- initiation
- promotion
- progression

the cell undergoes genetic changes due to altering of DNA by agents such as chemicals, radiation, or oncogenic viruses

the altered cells proliferate and look benign; the mass may:
- regress (immune system handles it), or
- evolve into cancer (it's possible to prevent at this stage)

- a change from a precancerous lesion to a malignant lesion
- growth rate increased
- malignancy invades and metastasizes

- environmental agents (air/water/soil/food pollutants)
- radiation (X-ray, UV light)
- chemical carcinogens
- use of tobacco products (30% of all cancer)
- genetic predisposition
- hormonal imbalances (e.g., prostate cancer)
- viruses (invade cells and alter DNA)

use of tobacco products

- stop using tobacco products
- improve diet and nutrition
- decrease UV/sun exposure
- caution with chemical usage
- regular preventive health examinations

- pain at late stage or if infection is present
- abnormal bleeding or discharge
- blood in urine, stool, vomit or sputum
- unusual thickening or lumps
- persistent cough or hoarseness
- change in bowel or bladder habits
- increased healing time of cuts, lesions or ulcerations
- moles or skin discolorations that change color, darken, enlarge, or become raised, crusty, scaly, or itchy
- unexplained rapid weight loss
- severe anemia

- Change in bowel or bladder habits
- A sore that does not heal
- Unusual bleeding or discharge
- Thickening or lump in breast or elsewhere
- Indigestion or difficulty in swallowing
- Obvious change in wart or mole
- Nagging cough or hoarseness

- X-ray - use of contrast dyes to show site of tumor/mass
- biopsy - small sample of suspected tissue collected and examined microscopically
- exfoliative cytology - microscopic examination of scrapings, washings, or secretions from suspected area

- surgery
- radiation therapy
- hormone therapy
- chemotherapy

abnormal tissue is removed, as well as some of the surrounding tissue

effective for early stages of breast and uterine cancer; radiation often follows

sign of possible cancer

used for treatment of fast-growing, undifferentiated tumors

the destructive effects are greater on fast-growing cells than on normal cells

effective treatment for leukemia and Hodgkin's disease; usually combined with chemotherapy

hormone therapy is a type of chemotherapy used to treat prostate cancer by either:
- removing the androgen source which stimulates the cancer growth, or
- administering estrogen to inhibit the growth of the tumor

a neoplasm

progression

warning signs of cancer


Change in bowel or bladder habits
A sore that does not heal
Unusual bleeding or discharge
Thickening or lump in the breast or any other part of the body
Indigestion or difficulty swallowing
Obvious change in a wart or mole
Nagging cough or hoarseness

adenocarcinoma

bone and muscle

all of the above

two of the above are true
(not always fatal)

all of the above

all of the above are dangerous, carcinogenic types of radiation

smoking

true

true

false

true

true

true

true

false

false

false

prostate

lymphatic

papilloma

genital warts

staging

lung

progression

human papilloma

skin

oncogenes

leukemia

change in urination control

sore that will not heal

nagging cough

hoarseness

change in bowel habits

black color in mole

glial cells

bloody (non-menstrual) vaginal discharge

Reed-Sternberg cells

homeostasis

disease

functional disequilibrium
( a change in function or structure considered to be abnormal)

pathology

pathophysiology

- patient history
- physical exam
- signs
- symptoms
- laboratory data
- diagnostic (imaging) tests

- sudden onset
- short duration

- slower, less severe onset
- long duration

a period of time in which the signs and symptoms of a disease subside

the period in which the signs and symptoms of a disease recur in all their severity

when a disease returns weeks or months after its apparent cessation

a disease or other abnormal state that develops in a person already suffering from a disease

the sequela

as a measure of the number of deaths attributed to a disease in a given population over a given period of time

as a measure of the disability and extent of illness caused by a disease

it could be
- a damaged gene or enzyme; or
- abnormal cells, tissues, or organs

a lesion

stress
heredity
inflammation/autoimmunity/allergy
neoplasm
infection
malnutrition

- cure
- reduction of symptoms

- palliative
- symptomatic

- nature of the disease
- characteristics of the patient
- goals of the patient and physician

- medical (pharmacologic)
- surgical
- psychiatric/psychological
- combination of any/all of the above

intact skin

tears
saliva
sweat
oil
mucus

they recognize and destroy body cells with abnormal membranes

when phagocytes find and destroy foreign invaders, they release substances that raise body temperature

it stimulates phagocytosis, increases metabolism, and inhibits multiplication of some organisms

fever is a sign of the normal interplay between the immune system and microorganisms

a group of substances that stimulate the immune system by interfering with viral multiplication

virus-infected cells and other agents produce interferon

often used to treat infections and cancer

protective tissue response

increased blood flow to an inflamed area

a leukocyte (WBC) that defends the body against invading microorganisms and speeds healing by engulfing cell debris in injured tissues

histamine

causes the cell walls to become more permeable

plasma and neutrophils move out of the blood vessels and into the tissues

the attraction of the WBCs to the site of inflammation

plasma and WBCs that escape from the capillaries to the site of inflammation

hyperemia
inflammatory exudate

bone marrow
lymph nodes

it may rise to 30,000 or more

leukocytosis

the neutrophils die soon after ingesting the bacteria and toxins and release substances that liquefy the surrounding tissue

liquefied tissue
dead neutrophils
inflammatory exudate

monocytes or macrophages

a plasma protein carried in the inflammatory exudate

helps create clots in damaged tissue and walls off infection to prevent its spread

pyogenic

suppurative inflammation

abscesses
boils
styes

regeneration
fibrosis

replacement of destroyed tissue with the same type of cells

fibroblasts (a type of connective tissue cell) produce collagen fibers that contract and draw the cut surfaces together

a meshwork of collagen fibers created from fibroblasts during fibrosis

A scar that is raised and hard
it is actually a benign tumor

adhesions

due to high pressure of cardiovascular system, fluids leak from capillary beds into tissues

most fluid is reabsorbed, but about 3 liters per day stays in the tissues

this must be returned to the bloodstream or it will cause swelling and low blood volume

the lymph circulates through the lymph vessels and is filtered in the lymph nodes, where macrophages phagocytize bacteria, viruses, etc.

WBC produced by lymph nodes

responds to bacteria, viruses, and foreign material in lymph

lymphocytes

- some interact with antigens and become activated
- some are transformed into plasma cells which divide rapidly and produce large numbers of antibodies

plasma proteins which are
gamma globulins called immunoglobulins (Ig)

they bind to antigens and tag them for destruction by the immune system

IgA - local protection at mucosal surfaces

found in mucosal secretions and colostrum

IgG - produced in primary and secondary immune responses; neutralizes toxins, bacteria, and viruses

found in blood plasma, crosses placenta

IgE - allergy

found in trace amounts in serum
secreted by sensitized plasma cells in tissues and locally attached to mast cells

IgM - protects newborns

bound to B lymphocytes in circulation
usually the first to increase in the immune response

IgD - activates B lymphocytes

found attached to B lymphocytes

- cytotoxic (CD8 or killer) T lymphocytes
- helper (CD4) T lymphocytes
- suppressor T lymphocytes

they have receptor proteins on their surfaces which bind tightly to cells or organisms that contain a specific antigen

once bound, they release poisonous substances into the attacked cell

- cells invaded by viruses
- cancer cells

some T lymphocytes that participate in an immune response remain as memory T lymphocytes that can rapidly mobilize should the same antigen be encountered again

locally (confined areas such as skin or mucous membranes)
systemically (anaphylaxis)

they cause an increase of IgG in the bloodstream
IgG coats the allergen in the blood, blocking it from binding to IgE in the tissues and reducing the amount of tissue damage

epinephrine
glucocorticoids
cortisone derivatives

allergic or anaphylactic hypersensitivity

triggered by allergen binding to IgE on mast cells, which produces either local severe or systemic severe inflammation

cytotoxic or cytolytic

involve IgM or IgG interacting with foreign cells to cause their destruction

the RBCs agglutinate (clump together)

massive hemolysis (rupture) of RBCs occurs

immune complex

antigens combine with antibodies to form immune complexes which deposit in tissues and blood vessels and cause inflammation and tissue destruction

(e.g., glomerulonephritis after strep, or farmer's lung from inhaling mold spores)

immediate
develop within about 30 minutes of exposure to antigens or allergens

cell-mediated or delayed

initial exposure activates T lymphocyte-mediated immune response which is slow to develop

first exposure leads to sensitization, thereafter, the T lymphocytes will release cytokines that damage tissue at point of exposure (e.g., contact dermitits or TB test)

heart
lung
kidney
liver
intestine
pancreas

tissue graft from one site to another in the same patient

tissues from identical twin

tissues from different species

most common
from another donor not an identical twin

blood type must match
cell membrane antigens must be at least 75% match

Type IV or delayed hypersensitivity

connective tissue

- localized (skin and underlying muscle)
- systemic (skin, tissues under skin, blood vessels, major organs)

morphea (local patches or generalized patches)
linear scleroderma (single line or band)

limited cutaneous scleroderma (gradual onset, mostly limbs)
diffuse cutaneous scleroderma (sudden onset, much of body)

the glands and other tissues

- primary (occurs alone)
- secondary (occurs with lupus, scleroderma, RA, etc.)

the entire body (kidneys, GI system, blood vessels, lungs, liver, pancreas, nervous system)

incidence of lymphoma (cancer of the lymph nodes) is significantly higher in Sjögren's patients

two-thirds

- patient to have one of the AIDS indicator diseases, and
- helper (CD4) T-lymphocyte count less than 200

- highly active antiretroviral therapy
- targets HIV replication and can render the viral load almost undetectable

- causes increased production of cortisol
- cortisol decreases production of antibodies and substances released by leukocytes that stimulate other immune system cells

are less likely to produce immunity

an infectious agent or disease-causing organism

a disease under constant surveillance in the US

physicians are required to report cases to the CDC

measles
mumps
polio
tuberculosis
tetanus
Legionnares' disease
chlamydia

the normal flora in and on our bodies that comprises about 100 trillion microorganisms

normal flora of the body that take advantage of an opportunity to become harmful

not a problem in a healthy person, but may cause disease if host is weakened or immunocompromised

one who harbors an infectious agent but does not have signs or symptoms of the disease

the respiratory tract

- gastrointestinal
- genitourinary

through a puncture, injection, bite or surgery

individual is infected by contact with the reservoir

(e.g., touching/kissing/having sex with infected person;
bitten by animal/insect;
inhaling infectious respiratory droplets)

when the pathogen can withstand the environment outside the host for a long period of time before infecting another individual
(e.g., airborne transmission - longer hang time than respiratory droplets, which are considered direct contact)

an inanimate object that is contaminated by direct contact with the reservoir
(e.g., used syringe, kleenex, ingesting contaminated food/water)

- proteinaceous infectious particle

- causes spongiform encephalopathies (holes in the brain) by inducing abnormal folding of brain proteins

viruses insert themselves in cells and do not reproduce

later, a trigger, such as stress, infection with another pathogen, or weakened immunity allows the virus to activate (e.g., herpes infection)

a sticky sugar coat on a bacteria

a glycocalyx that is organized and firmly attached to the cell wall of a bacteria

capable of protecting bacteria from phagocytosis

a glycocalyx that is unorganized and loosely attached to the cell wall of a bacteria

helps bacteria attach to surfaces

short, hair-like appendages that help bacteria attach to surfaces

longer (than fimbrae) hair-like appendage bacteria use to join together to transfer DNA from one cell to another (sex pili)

most bacteria only have one or two

antibiotic resistance

a toxin released into tissues when gram-negative cells die

causes life-threatening shock

small, circular, double-stranded DNA molecule contained in many bacteria along with the bacterial chromosome

they replicate independently of the bacterial chromosome and contain genetic information for antibiotic resistance, production of toxins, tolerance to toxic metals, and synthesis of enzymes

most do not cause disease, however, they may invade and destroy certain tissues or provoke damaging inflammatory responses

a special polysaccharide contained in the cell walls of fungi

specialized filaments fungi use to absorb nutrients from their surroundings

another term for fungal infection

- patient's normal flora
- contact with healthcare staff
- contaminated instruments/needles
- healthcare environment

- direct contact transmission from healthcare staff to patient
- indirect contact transmission through fomites and hospital's ventilation system

with drugs that interfere with protein synthesis and metabolism

some antibiotics are used to treat protozoal infections

they are susceptible to drugs that
paralyze their muscles or
interfere with their carbohydrate metabolism

preventive measures
because treatment can result in
- resistant microorganisms
- toxic side effects
- allergies

- outbreaks of previously unknown diseases
- known diseases whose incidence in humans has significantly increased in the past two decades

(emerging diseases have been identified at the unprecedented rate of one or more per year since the 1970s)

the rubeola virus
the paramyxovirus
the rubella virus

grayish spots that develop in the mouth before the rash of measles appears

inflammation of the testicles

the largest of the salivary glands, and the ones that swell in the case of the mumps

cancer

- growth factors
- growth inhibitors
- cell cycle proteins (cyclins)
- programmed cell death (apoptosis)

programmed cell death

genetic mutations

a change in the biochemistry of a gene, resulting in the production of abnormal cells

several genes are mutated

- oncogenes
- tumor suppressor genes
- DNA repair genes

a gene that when mutated or expressed at abnormally high levels contributes to converting a normal cell into a cancer cell

protooncogenes, or growth-promoting genes and are activated genetic alterations induced by retroviruses

cell growth,
differentiation, and
apoptosis

dysregulation of cell growth,
increased proliferation,
loss of apoptosis

by inactivation or deletion of tumor suppressor genes

loss of function,
reduced restrictions on cell growth and division,
genetic instability,
loss of apoptosis, and
enhanced possibility of malignant behavior

caretaker genes

repair of errors in normal DNA replication

persistent DNA damage and
consequent further mutations and genetic instability

this may result in loss of tumor repair genes and conversion of a protooncogene to an oncogene and an increased susceptibility to cancer

in the laboratory

genetic makeup (sex, heredity, hormones, immunity, etc.)

smoking

asbestos exposure (mesothelioma)

radon

chemical compounds such as benzene, benzidine, arsenic, soot, coal tars, wood dust

leukemia (cancer of WBCs)
breast cancer
thyroid cancer

skin cancer

diet and obesity

hepatitis B/C
HPV
HIV
Helicobacter pylori bacteria

lung cancer

non-small cell lung cancer
small cell lung cancer

adenocarcinoma

breast cancer

stomach cancer

liver

accumulation of fluid in abdominal cavity

cervical

uterine bleeding

difficult urination

difficulty speaking

age

undescended testes

blood in the urine

lymphoid tissue

Hodgkin's disease or
non-Hodgkin's lymphoma

Epstein-Barr (EBV)

Reed-Sternberg cells

HIV/AIDS
immunosuppresive therapy
viral infections with HTLV1 or Epstein-Barr virus (EBV)
Helicobacter pylori infection (gastric lymphoma)

slow-growing

massive proliferation of immature forms of WBCs

lymphoid (B cells or T cells in lymph tissue)

myeloid (bone marrow cells)

pigment-producing cell

elevated RBC count

slight paralysis

membranes covering the brain

second

leukemia