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171 Cards in this Set
- Front
- Back
Purpose of Tissue Response to Injury
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Destroy and remove substances recognized as foreign
prevent minor infections from becoming overwelming prepare damaged tissue for repair |
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What is Acute Inflammation?
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short term
completely resolves mostly polymorphonuclear leukocytes/ neutrophils |
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What is Chronic Inflammation?
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long term
may or may not be completely resolved |
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Etiology of Inflammation
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Infection
Physical trauma chemical trauma irradiation thermal injury immunity ischemia nutrient deprivation failure to recognize self |
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what is a wound
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disruption of tissue integrity
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what is mechanical injury
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incision
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what is physical injury
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car wreck, burns, etc.
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what is an incision
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produced by a cutting instrument
wound edges are close together and aligned |
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what is a contusion
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a bruise
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what is an abrasion
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rubbing or scraping off of epidermis or mucous membrane by friction
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what is a laceration
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tissue or organ tearing by blunt or irregular instrument
tissues not aligned and not close together loose flaps of tissue |
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what is a puncture
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piercing of tissue or organ with sharp instrument
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projectile or penetrating wound
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foreign object enters body at high velocity
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Signs and Symptoms of Inflammation
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Rubor (redness)
Calor (heat) Tumor (edema) Dolor (pain) Functio laesa (alteration in functioning) |
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Signs of Lymphadenopathy
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enlarged lymph node due to filtering
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Signs of Lymphangitis
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imflammation of lymphatic vessel
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Sign of Lymphadentitis
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inflammation and localized infection of lymph nodes
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for every one degree F the heart rate increase ?
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10
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Systemic Lab Signs of Inflammation
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elevated WBC
Elevated Erythrocyte Sedimentation Rate (ESR) |
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Neutrophils function
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pyogenic bacteria
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Eosinophils function
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parasitic worms
allergy |
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lymphocyte function
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viruses
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what are the two types of inflammatory repsonses
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cellular
vascular |
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what cell is the first to arrive at inflamed site
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neutrophils
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Neutrophils have a long or short lifespan?
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short
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when an increased need for neutrophils is occuring what does the bone marrow produce?
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immature neutrophils (bands)
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what cell's function is to respond to chemical messengers?
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eosinophils
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what cell is least abundant of the WBC's?
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basophils
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which cell functions similar to mast cells?
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basophils
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where are mast cells located?
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mast cells
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where are basophils located?
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blood stream
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what do mast cells and basophils release?
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histamine and serotonin
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what does basophils release that mast cells do not?
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heparin
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what does heparin do in inflammatory response?
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makes blood thinner so fluid and cells can get to the site faster
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where are histiocytes?
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in connective tissue
a macrophage |
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where are microglials?
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in the brain
a macrophage |
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where are Kupffer cells?
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in the liver
a macrophage |
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what is the function of lymphocytes?
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immunity
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lymphocytes make up what percent of WBC's?
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25%
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what are lymphokines?
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substances released from T lymphocytes
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what attracts monocytes to the area of inflammation?
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neutrophils
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where are macrophages located?
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tissue
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what do monocytes/ macrophages do in chronic inflammation?
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wall off area that can't be repaired, trap the antigens
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what do polymorphonuclear neutrophils secrete?
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powerful chemotactic chemicals
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why does margination occur?
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blood flow slows
blood thickness increases electrical charge changes chemical mediators |
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what is pavementing?
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sticking of neutrophils to vascular endothelium
only in veins |
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what is diapedesis?
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when neutrophils squeeze through or pass through the endothelial gaps into tissue
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what are the chemotactic factors?
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C5a
bacterial components LTB4 (metabolite of arachidonic acid) |
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opsonisation
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tagging antigen for phagocytosis
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initial vascular response is
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vasoconstriction
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why does vasodialation occur in vascular response?
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to increase blood flow and fluid
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what does bradykinin do?
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stimulates capillary and venule endothelial cels to retract
end result: creates space that allows leukocytes to squeeze through |
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where is receptor H1
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lungs
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where is receptor H2
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gut
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what cells release histamine
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platelets
mast cells basophils |
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histamine causes
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widening of capillaries
decrease in BP increase gastric juices tightens smoot muscles of bronchi and uterus |
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where is serotonin released from?
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platelets
GI tract vasodilation |
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why are chemicals important in acute inflammation?
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vasodilation
emigration chemotaxis increased vascular permeability |
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Where is arachidonic acid released from?
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injured cells by phospholipase
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two pathways of AA
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leukotrienes
prostaglandins |
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leukotrienes are chemotaxis for
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neutrophils and eosinophils
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prostaglandins are chemotaxis for
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neutrophil chemotaxis
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Platelet activating factor is synthesized by what?
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endothelial cells
injured tissue |
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cytokines are made by
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lymphocytes
macrophages |
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what do cytokines do?
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assist in inflammatory response
direct growth of bone marrow cells |
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what does nitric acid do?
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relaxes vascular smooth muscle
reduces platelet aggregation regulates WBC recruitment aids phagocytic cells |
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what are complements?
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inactive proteins circulating in the blood
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what is the classic pathway?
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C1- antigen-antibody complexes
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what is the alternative pathway?
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C3
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what does the complement system do?
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opsonization
chemotaxis induce granulation of mast cells produces cell lysis HELPS KILL |
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fibrinogen converts to fibrin in what system?
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clotting system
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what is the purpose of clotting?
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prevents spread of infection
keeps antigens at site of greatest phagocytosis |
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what factor is hageman factor?
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seven
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where is kallikrein located?
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body fluids
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what is the kinin system activated by?
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decrease pH
temp change contact with abnormal surfaces hageman factor |
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what does bradykinin do?
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powerful vasodilator
induces pain |
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what does the hageman factor do?
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activates coagulation, kinin and fibrinogen systems
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what are the good effects of inflammation?
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dilute toxins
entry of antibodies drug transport fibrin formation deliver of O2 and nutrients stimulates immune system |
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harmful effects of inflammation
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digest normal tissue
swelling inappropriate inflammatory response |
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labile cells
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undergo complete regeneration
epithelium bone marrow |
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stable cells
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regenerate if stimulated
hepatocytes endothelium |
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permanent cells
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no regeneration
neurons cardiac |
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what is chronic inflammation?
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lasts longer than 2 weeks
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what happens during chronic inflammation?
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foreign material walled off from healthy tissue but not destroyed or removed
scar tissue |
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what is lost by second intention healing?
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tissue
hair follicles melanocytes sweat glands |
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what are keloids?
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bulging tumorous scars from abnormalities in collagen synthesis and breakdown
*if removed returns* |
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exuberant granulation?
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excessive scar tissue
*if removed no return* |
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contracture
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migration of wound margins towards center
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dehiscence
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bursting open of previously closed wound
collagen not strong enough |
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evisceration
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protrusion of abdominal organs
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stenosis
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narrowing or obstruction of opening by formation of scar tissue around a tubular area
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adhesions
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inflamed serous or mucous membrane
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what is normal count for WBC's
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5 to 10 thousand
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Leukopenia
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too few WBC
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Leukocytosis
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too many WBCs
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what is the count in neutropenia?
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less than 1500
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what is the count in agranulocytosis?
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less than 200
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what is aplastic anemia?
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all myleoid cells are low
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what percent of WBCs are Neutrophils?
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50 to 70
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what percent of WBCs are eosinophils?
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0-4
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what percent of WBCs are basophils?
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0-1
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what percent of WBCs are Lymphocytes?
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20-40
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what percent of WBCs are monocytes?
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1 to 6
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in Neutrophilic Leukocytosis what does it mean to "shift to the left"
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increase in bands (immature)
onset or progression of infection |
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in Neutrophilic Leukocytosis what does it mean to "shift to the right"
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decrease in bands
resolution of infection |
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what is the lab CD 4+ testing for?
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helper T cells
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what is the lab CD 8+ testing for?
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affector T cells
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what are B lymphocytes?
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humoral mediated immunity
antibodies fight bacteria and viruses |
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what type of immunity are natural killer cells?
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innate (born with)
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what type of immunity are T cells?
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cell mediated immunity
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WBCs in Leukemia do not...
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mature correctly
phagocytize provide immunity |
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Signs and Symptoms for ALL and AML
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fatigue
pallor weight loss repeated infections easy bruising nosebleeds hemorrage |
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Signs and Symptoms of ALL
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bone pain (bone marrow expansion)
infection (too few neutrophils) CNS and Pulmonary involvement Hyperuricemia |
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Treatment of ALL
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chemotherapy
irradiation bone marrow transplant |
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Massive necrosis of malignant cells during therapy of ALL can lead to
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hyperkalemia
hyperphosphatemia hyperuricemia HYPOcalcemia HYPOmagnesemia acidosis |
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what happens in lymphoma
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lymphocytes multiply
crowd out healthy cells create tumors that enlarge lymph nodes or other parts of immune system |
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what is the distinguishing cell factor in Hodgkins Lymphoma?
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Reed-Sternberg cell
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sysns and symptoms of HL
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painless increase in single node or multiple
dry cough persistant fever night sweats weight loss pain in node after drinking alcohol? |
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Clinical manifestations of HL?
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impaired immunity
elevated neutrophils mild anemia eosinophilia hypergammaglobulinemia (early) hypogammaglobulinemia (late) |
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stageing of HL based on what?
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number (how many nodes involved)
locations (on one or both sides) has disease metastisized to bone marrow or liver or both |
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NHL
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suspected to be caused by virus
in older adults and immunosupressed most originate in B cell spread slowly |
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NHL pathology
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monocytes affected
painless enlarged nodes may progress to extranodal involvement (nasopharynx, GI tract, abdomen, bone marrow) Humoral immunity impaired (Hypogammaglobulinemia) |
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what is Multiple Myeloma?
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disorder of plasma cells in which IgG and IgA produced
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where do malignant plasma cells gather
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in bone marrow to produce a tumor
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why does MM affect the skeletal system?
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it causes lysis of bone (cytokines) which leads to bone pain, fractures, hypercalcemia, and osteoporosis
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how does MM affect the hematological system?
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bone marrow infiltration
bone marrow replacement anemia thrombocytopenia bleeding hypogammaglobulinemia |
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how des MM affect the renal system?
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hyperuricemia due to rapid turnover of cells
hypercalcemic nephropathy renal infiltration by plasma cells |
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how does MM affect the nervous system?
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cord suppression
intracranial plasma cell masses neuropathy |
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what is Hyperviscosity Syndrome?
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sludging in capillaries
purpura retinal hemorrage papilledema coronary ischemia CNS symptoms (vertigo,seizures) |
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a standard, average, or typical example of a set objects or values
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normal
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specific illness or disorder characterized by a recognizable set of signs and symptoms
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disease
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a state of complete physical, mental, and social well-being, not merely the absense of disease or infirmity
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health
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cause of a disease
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etiology
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the development or evolution of the disease
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pathogenesis
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changes in life proccess which can be observed
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manifestations
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abnormal outcome of a disease, treatment, or injury
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sequelae
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new or separate condition arising from existing condition, often alters prognosis
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complication
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vital functions of a cell
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obtain nutrients and CO2
metabolism elimination/ excretion adaptation to enviornment replication/ reproduction |
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controls cell division
holds all genes |
nucleus
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composed of pieces of RNA that are the instructions for making protein
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ribosomes
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reads ribosomes instructions to make protein
packages new protein and sends it to golgi body |
rough ER
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contains hormones and enzymes
help breakdown toxins |
smooth ER
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post office of the cell
packages items in the cell and sends them where they need to go |
golgi apparatus
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powerhouse of the cell
aerobic metabolism |
mitochondria
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breading down stored nutrients to produce energy
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catabolism
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building up more complex molecules out of simpler ones for energy
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anabolism
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proteins break down to
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amino acids
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fats break down to
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fatty acids
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carbohydrates break down to
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glucose
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waste products of aerobic metabolism
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CO2 and water
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if O2 is not present pyruvate becomes
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lactic acid
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process by which cells divide and reproduce
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cell proliferation
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the degree to which a gene or a particular group of genes is active
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expression
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decrease in cell size
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atrophy
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increase in cell size
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hypertrophy
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increase in the number of cells
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hyperplasia
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conversion of one type of cell to another
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metaplasia
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abnormal cell growth of specific tissue results in cells that vary in size, shape and appearance
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dysplasia
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critical lack of blood supply to an area
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ischemia
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death of tissue caused by lack of blood supply
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infarction
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localized tissue death that occurs in groups of cels in response to disease or injury
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necrosis
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an electrically uncharged atom or molecule having an unpaired electron
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free radical
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ex.
partial thickness burns heat stroke |
low intensity heat injury
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ex.
electrical burns full thickness burns |
high intensity heat injury
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complication of radiation therapy
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radiation proctosigmoiditis
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injured tissue infiltrated with calcium
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dystrophic
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normal tissue infiltrated with calcium
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metastatic
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area of coagulative necrosis
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gangrene
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rigor mortis
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stiffness
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algor mortis
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temperature change
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livor mortis
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color change
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