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91 Cards in this Set
- Front
- Back
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Simple Squamous Epithleium Disease
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Arterial Endothelium Dysfunction - Tissue tear in endothelial wall causes repair process to start depositing crystal cholesterol in vessel wall (The Beginnings of Atherosclerosis)
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Ciliated Columnar Epithelium Disease
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Trachea Tissue from a Smoker - freezes/destroys cilia in lung tissue as well as disorganizes the columnar epithelial cells
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Diseases involving overproduction of collagen fibers
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Lung Fibrosis (Cystic Fibrosis)
Liver Cirrhosis Atherosclerotic Heart Disease |
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Lung Fibrosis (Cystic Fibrosis) description
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excess glandular secretions (like mucous)
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Causes of Lung/Cystic Fibrosis
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Caused by a mutation in the CTFR gene (which produces the ion channel)
This channel is important in creating sweat, digestive juices, and mucous (this is why there is high salt contentin the sweat of CF kids) |
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Life Span of Lung/Cystic Fibrosis Patients
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Life span used to be limited to 20-30 years
It now can be possibly 40-50 years if treated properly |
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How Lung/Cystc Fibrosis affects the body
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Obstructions and fluid in lungs causes breathing disorders and numerous infections. These result in low oxgen transport form the lungs and therefore hinder oxygen transport to the rest of the body.
Obstructions in the pancreas decrease digestive enzyme production which therefore decreases nutrient absorption. Malnutrition hinders growth so decreased nutrient absorption due to obstructions in the pancreas also hinders growth |
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Liver Cirrhosis description
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Irreversible scarring (fiber deposition) in the liver
Excess scarring in the liver |
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Causes of Liver Cirrhosis
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Hepatitis B, Hepatitis C, alcoholism, and as of late and more commonly obesity can cause it as well
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How does Alcohol affect the liver?
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Alcohol blocks the normal metabolism of protein, fats, and carbs which causes injury to the liver and therefore scarring (or cirrhosis)
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How does Cirrhosis affect the bod
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Cirrhosis causes edema and ascites (fluid in the periotneal space) which causes the liver to not be able to produce albumin. Albumin is the most comon protein in the blood and important for maintaining osmotic pressure, so during cirrhosis bood loses its osmotc (or sucking/pushing) pressure
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increased risks and signs of cirrhosis
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increased infection risk, jaundice, bruising and bleeding, portal hypertension
cirrhosis will als elevate aminotransfease enzmes like ALT, GGT, and AST (aka SGOT - largely elevated SGOT is linked to alcoholism) |
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How atherosclerotic heart disease is linked to cirrhosis
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Atherosclerotic heart disease causes high SGOT, wich is also associated with alcoholism, so elevation of SGOT tells us that cirrhosis is a possibility
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Autoimmune Disorders that affect collagen
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Lupus Erythematosus
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Lupus Erythematosus description
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production of "auro antibodies" that target body tissues
This is a nonspecific disease that sometimes does not get diagnosed |
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Lupus Erythrematosus symptoms
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90% of Lupus patients will experience joint and muscle pain which is caused by collage damage and destruction (collagen is a vital componenet of tendon)
Collagen damage and inflammation can occur anywhere in the body, but the most commonly affected areas are: -Skin (rashes that result from sunlight exosure) -articular tissue -lungs -blood vessels -liver -kidneys -nervous system |
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Unique Charateristics to Lupus erythematosus
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course of the disease is unpredictable with attacks and remissions
most common in women ages 18-40 |
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Diseases of Insufficient Collagen Production
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Ehlers-Danos Syndrome
Osteogenesis Imperfecta Scurvey |
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Ehlers-Danos Syndrome
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"Rubber man" or contortionists disease
Characterized by weakening of collagen cross link bonds |
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Osteogenesis Imperfecta
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Brittle Bones
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Scurvey
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Vitamin C Deficienc
Too few hydrogen bonds occur in the formation of the collagen molecule Causes inferior tissue formation in bones, blood vesels, skin, and teeth |
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"Double Jointed" vs. Ehlers-Danos Syndrome
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Is inherited like Ehler-Danos Syndrome
has the same mutation as the syndrome just to a lesser degree Double jointed is a variation of the syndrome in the genes - a small amount of extra flexibility vs extreme amount of flexibility in the syndrome |
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Therapy for Cystic Fibrosis
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Clearance techniques for excess lung secretions
pancreatic enzyme replacement for pancreatc duct obstruction healthy diet and exercise ( increases lung capacity, RBCs, delivery of oxygen to tissues, capillarization in muscle, and clearance of mucous) Drugs: -Ibuprofen (slows rate of decline of pulmonary function) -Corticosteroids (decrease inflammation in lungs, joints, and vasculature) -Antibiotics (to treat and reduce the incidence of lung infections *Rotation of drugs prevent development of resistance Immunoglobulin (antibody) experimental research (currently in human trials hase) |
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Therapy for Lupus
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Drugs
-Disase Modifying Anit-Rheumatic Drugs (DMARDs) (Decrease flare ups) -NSAIDs -Corticosteroids and other immunosuppresants -Hydroxychoroquine (decreases inflammation and activation of inflammation causing dendritic cells, also used as an antimalarial drug) -Experimental Drugs (inhibits stimulation of antibody production) Autograft bone marrow stem cell infusion has been very promising in reducing symptoms Ultraviolet Radiation Therapy (Phase 2 clinical trials) |
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Human Trials Phases
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Phase 1 - 10 or 20 people in study, low doses, used to pick up onte effect of the drug
Phase 2 - Raise number of people in study and vary the doses people are taking, trying to discover adverse affects as well as starting to look for signs of efficacy Phase 3 - Proving the efficacy of the drug, multiple sites administer drug and compare this new treatment to od treatments and compare results Phase 4 - Post marketing surveillance, studying long term effects |
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Bone Diseases
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Pagets Disease
Osteoporosis Osteopenia Osteomyelitis Osteoarthritis Rheumatoid Arthritis |
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Pagets Disease Description
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enlarged deformed bones
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Symptoms of Pagets Disease
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Pain, pinched nerves
Pinched nerves also cause tingling and numbness, leg bowing, hip and knee pain |
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How Pagets Disease affects the body
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Increased bone reabsorption and deposition rates (overactivity of osteoblasts and osteoclasts cause inefficent bones)
This causes weak bones, bone pain, increased fracture risk, and arthritis |
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Characteristics of Pagets Disease
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Affects about 1% of adults
rarely diagnosed in people under 40 years of age |
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Osteoporosis Description
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decreased bone density which increases fracture disposition
2.5 standard deviations below the mean bone density of young people Doesn't measure relative to what your bone density originally was, its just a preset number for all people |
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Osteopenia Description
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bone loss bu not as seere as osteoporosis
1.5 standard deviatins below the mean bone density of young people |
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How Osteoporosis affects the body
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decrease in bone resorption in the presence of bone metabolism
decrease both cortical (thick) and trabecular (porous) bone density, although it affects cortical bone more |
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Characteristics of Osteoporosis
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Women start losing bone density about age 40
Men start losing bone density about age 60 Over 28 million people in the US have osteoporosis (80% of these are women) Many women experience up to a 20% decrease in cone mas by 5 to 7 years after menopause 1 in 2 women and 1 in 4 men over age 50 will have an osteoporosis related fracture in their lifetime |
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Common fracture sites with osteoporosis
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thoracic vertebra, distal radius (close to wrist), FEMUR NECK (hip fracture)
Bone density is highest in your 20s |
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Why are osteoporosis drugs used to treat Pagets disease
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use osteoporosis drugs to buld bone density and decrease turnover rate and increase bone strength
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Causes of Osteoporosis
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Prolonged treatment with corticosteroids
anorexia nervosa inadequate diet, especially during pregnancy and breast feeding Amenorrhea causes an increase in estrogen metabolism disturbaces and results in bone loss (usually osteopenia) |
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Treatments for Osteoporosis
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Estrogn replacement (for postmenopausal women) or EVISTA (selective estrogen receptor modulator that decreases bone resorption)
Calcium supplementation Vitamin D Supplementation Biphosphonate drugs (also called diphosphonates) - decrease osteoclast activity (this is also used to treat bone cancer andother bone weakening diseases) Calcitonin (calcimar or miacalcin) - increases osteoblast activity PTH analog (teriparatide) - increases osteoblast activity because intermittent exposure to PTH will increase osteoblast activity more than osteoclast activity Weight bearing exercise can increase bone mineral density and decrease falls |
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Osteomyelitis description
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bone inflammation and destruction
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Causes of osteomyelitis
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caused by bacteria and fungi spreading from oter infection sites
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Symptoms of Osteomyelitis
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fever
localized wamth and swelling localized pain |
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Treatment of osteomyelitis
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antibiotics
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Osteoarthritis Description
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degenerative changes in cartilage and bone
Loss of articular cartilage (due to proteoglycan loss which causes water loss and decreases compliance of cartilage) in hands, hips, and knees |
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Symptoms of Osteoarthritis
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Roughening, pitting, and destruction of hyaline cartilage causes an increase in joint stiffness
May result in formation of osteophytes (bone spurs) or nodes (Bouchard's nodes) |
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How des osteoarthritis affect the body
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IL1beta (stimulates destruction of bone) and TNFalpha from chondrocytes causes a decrease in collagen production and and increase in catabolism of articular cartilage
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Who is usually diagnosed with osteoarthritis?
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80% to 90% of people over age 65 have some evidence of osteoarthritis
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Cause of osteoarthritis
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heredity (50% to 65%), infection endocrine disorders, joint injury, OVERUSE
Fracture of ligament injury causes bad joint alignment and instability which increases "wear and tear" |
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Treatments of Osteoarthrits
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Exercise - helps maintain ROM, healthy cartilage, strengthens muscle stabilizing the joint, and reduse pain (Immobilization worses the disease by reducing blood flow and reduce muscle strength)
Weight loss for osteoarthritis in weight bearing joints NSAIDs and COX2 inhibitors for pain Injections of hyaluronic acid or new artificial injectible materials Corticosteroid injections may be useful when inflammation is present (acute inflammation of the joint) Joint replacement (when conservative therapy fails) "Tissue engineering" to regenerate cartilage has had some success, but is more of a future treatment than present Glucosamine and chondroitin supplements, but definitive meta analysis says no real benefit |
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Rheumatoid Arthritis Description
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Autoimmune inflammaory disease that affects the joints
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Possible causes of Rheumatoid Arthritis
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may be related to genetic factors, environment triggering autoimmune response, or infectious agents such as viruses, bacteria, and fungi
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How Rheumatoid Arthritis affects the body
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Rheumatoid factor (autoantibody) plus globulins make up immune complexes which activate the compliment system which causes INFLAMMATION
Involves synocial membranes of joints (most common manifestation) - inflammtion leads to swelling and thickening of synovial membrane (increasing ESR or erythrocyte sedimentary rate which is an indicator of inflammation) |
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Characteristics of Rheumatoid Arthritis
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usually occurs between ages 25 and 55 and affects mostly young to middle aged females - may fluctuate substantially in severity
60% of RA patients are unable to work 10 years after disease onset Most research suggests that life span is reduced five to ten years |
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Symptoms of Rheumatoid Arthritis
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Heart - endocarditis, pericarditis, CHF, valvular fibrosis, MI (RA and other autoimmune patients have a raised risk for CHD)
Lungs - fibrosis and pleural effusion Kidneys - amyloidosis (deposition of insoluble proteins in organ tissue) GI Tract - anemia resulting from chronic disease and constant NSAID use (most RA patients are anemic) Fibrin deposition (fibrosis) and necrosis are also present |
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Sclerotic Tissue
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damaged tissue
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Treatments for Rheumatoid Arthritis
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NO CURE (just managing symptoms like decreasing pain)
NSAIDs COX2 inhibitors Corticosteroids DMARDs Exercise to maintain joint stability Surgery (synovectomy or joint replacement) Gene therapy (injection of genes tat produces desired protein bia a vector aka carious types of viruses) |
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DMARDs in Rheumatoid Arthritis
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Disease Modifying Anti-Rheumatic Drugs
Methotrexate -decreases TNF, neutrophils, histamine, lymphocyte number and function -decrease growth of certain cells in blood, skin, GI Tract and immune system -cytotoxic and inhibits metabolism causing decreased immune function -developed in 1940s as chemotherapy for leukemia Sulfasalazine - decreases immune function Hydroxychloroquine (PLAQUENIL) - an antimalarial drug Gold Salt injections |
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Major Difference between Rheumatoid Arthritis and Osteoarthritis
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RA - Autoimmune disease
OA - degenerative disease/overuse injury |
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Nerve Diseases
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Multiple Sclerosis
Parkinson's |
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Multiple Sclerosis Description
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an autoimmune disease in which auto-reactive T cells cross the blood-brain barrier and attack the myelin sheath leading to a cascade of inflammation
The result is demyelination, acute axonal transection, gliosis and subsequent axonal degeneration |
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What are the most common types of Multiple Sclerosis?
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Of the 4 types of multiple sclerosis the 2 most common are:
primary progressive (12.5%)relapsing-remitting (85%) |
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What are the causes of Multiple Sclerosis?
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-autoimmune factors (exact antigen not identified)
-virus triggers (not proven) -possible genetic predsposition -various forms of physical trauma |
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Sympoms of Multiple Sclerosis
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weakness, numbness ("pins and needles"), lossof balance, loss of coordination, bowel and bladder dysfunction, muscle spasticity, optic nerve neuritis
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What is the nature of the symptoms of multiple sclerosis?
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Symptoms are episodic
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Therapies for Multiple Sclerosis
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Immunomodulator drugs (decrease inflammatory effects of lymphocytes)
-inhibits cytokines which decreases inflammation and the number of episodes -inteferon beta (1a and 1b) - AVONEX, BETASERON,REBIF First line drugs -Glatimar Acetate - COPAXONE second line drug Immunosuppressants (decrease inflammatory effects of lymphocytes, decrease inflammation) - third line drug -Mixantrone, Cyclophosphamide, Methylprednisone, ACTH -Danger of infecton from copromised immune system Natalizumab - TYSABRI - precents activate lymphocytes from crossin blood-brain barrier Weakness Therapies: dopamiergic drugs - similar to those for Parkinson's patients, exercise (WATER EXERCISE AND SWIMMING MOST BENEFICIAL) Spacticity Therapies: reflex inhibitors (example is alpha2 agonists that inhibit spinl motor neurons), muscle relaxer drugs Incontinence Therapies: muscarinic acetylcholine receptors antagonists (relaxes bladder detressor muscle), antidiuretic hormone analogs Tremmor Therapies: anticonvulsant drugs Visual Problem Theraies: corticosteroids to reduce ocular inflammation |
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Parkinson's Description
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loss of production of the neurotransmitter dopamine in the basal ganglia (loss of 80% of dopamine producing cells) causes a disruption of balance between dopamine and Acetylcholine an therefore decreases volntary movement control
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Causes of Parkinson's Disease
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-free radical damage (theory)
-toxins (theory) -age related decrease in dopamine producing neurons -genetic predisposition -repeated head trauma (boxing) -illegal drug use -hydrocephalus (CSF accumulation in venricle of the brain) -encephalitis (most often viral - inflammation of white and gray brain matter) |
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Symptoms of Parkinson's Disease
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resting tremor - "pill rolling" motion (70%)
bradykinesia (inability to generate movement) Rigidity postural instability difficulty rising from sitting position shuffling gait |
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Therapy for Parkinson's Disease
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Levodopa: increase dopamine levels in the brain (the current gold standard of treatment)
Stem Cells: Increase dopamine neurons (Parkinson's is likey to be the first disease "cured" by stem cells) Caechol-O-methylransferase inhibitors: inhibits levodopa's peripheral metabolism and causes more levodopa to be available for transport across blood-brain barrier Dopamine Agonists: stimulate post-synaptic dopamine receptors Monoamine Oxidase B Inhiitors: slow dopamine neuron degeneration Embryonic tissue transplantation: not very successful so far DBS Surgery: brain "pacemaker" sends electrons to parts of the brain (promising) |
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Muscle Diseases
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Fibromyalgia
Muscular Dystrophy |
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Fibromyalga Description
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chronic non-inflammatory pain in muscles and connecive tissues
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Characteritics of Fibromyalgia
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affects over 6 million Americans
Most people who have it are women 20-50 years old |
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Theoretical Causes of Fibromyalgia
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Thyroid problems
Overgrowth of yeast bacteria trauma stress hormone malfunction infection immune system dysfunction autonomic nervous ystem malfunction abnormal spinal cord pain processing decreased gray brain matter density dopaminergic neurotransmission in the brain |
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Symptoms of Fibromyalgia
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"aching"
"unrefreshed by sleep" GI problems fatigue anxiety and depression "decreased energy" presence of pain trigger points |
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What characteristic do all the symptoms of Fibromyalgia share?
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All tend to be chronic, better one day and worse the next
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Fibromyalgia s often associated with what other co-morbid conditions?
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Anxiety
Migraine headache depression sleep disturbances irritable bowel syndrome restless leg syndrome TMJ Syndrom Chronic Fatigue Syndrome |
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How do you diagnose fibromyalgia?
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Process of exclusion, if its not all these other things it has to be fibromyalgia
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Therapy for fibromyalgia
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stress reduction
exercise growth hormone therapy psychiatric help acupuncture NSAIDs tricyclic antidepressants muscle rlaxants of the cyclobenarine family opiods SSRI's SNRI's anticonvulsants |
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Muscular dystrophy description
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an inherited disorer characerized by progressive proximal muscle weakness with destruction of muscle fiber and replacement with connective tissue
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Common characteristics of Muscuar Dystrpohy (not symptoms)
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diagnosed between 2 and 5
wheelchair by 10 or 12 eath in the 20's blood creatine kinase is elevated (indicator of muscle damage) some are mildly mentally challenged |
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Causes of Muscular Dystrophy
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genetic related absence of dystrophin, a muscle membrane protein
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Initial Symptoms of Muscular Dystrophy
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"waddling" gait
falls difficulty standing difficulty climbing or descending stairs all of these difficulties in locomotion cause muscle wastig, contractures (any condition that affects mobility or ROM of a joint and usually involves fiber depostion in skin, fascia, muscle, or joint capsul), cardiac involvement, respiratory muscle weakness with complications (such as respiratory infections) |
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Therapy for Muscular Dstrophy Patients
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daily steroids produce long term symptom improvement, exercise should be continud as long as possible, surgery may be done to release contractures, pneumonia vaccine (prophylactic), physical therapy to delay development of contractures
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Factors thought to contribute to fatigue and subsequent exercise induced muscle cramps
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Exercising in hot, humi environments (due to dehydration and electrolyte deficiencies such as hyponatrmia/kalemia/calcaemia/magneasmia)
Overexertion (fatigue)causing muscle hypoxia Disturbances in carbohydrate (hypoglycemia), fat, or protein metabolism Nutritional deficiences inadequate amounts of elerolytes, vitamins b1 (thiamine), B% (pantothenic acid) |
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Why is pantothenic acid (or vitamin B5) important for exercise and reduction of Exercise Induced Muscle Cramps?
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Pantothenic Acid is the backbone for Coenzyme A, which is used in the Krebs byble as acetyl coenzyme A, and is therefore important for enery production
It is also strongly correlated to strength gain without hypertrophy when in excess because it increases the amount of ATP available for use |
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Hypothesized Cramp Mechanisms supported by recent literature
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Fatigue causes and increase in spindle firing rate and a decrease in GTO firing rte causing an increase in alpha motor neuron activity
Overproduction of reflex alpha motor neuron activity n a shortened muscle causes cramps |
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Factors thought to Contribute to Idiopathic Leg Cramps (although noconsensus on exact etiology)
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Metabolic disturbance (hyponatremia, hypo/hyperkalaemia, hypocalcaemia, hypomagnesia, hypoglycaemia)
Chronic or severe acute diarrhea Pregnancy, especially in late months Cirrhosis of the liver (difficult digestion and electrolyte imbalance indirectly, decrease i albumin which maintains osmotic pressure and the bod cant regulate fluids down to the issue level) Renal dialysis, possibly owing to plasma volume contraction Thyroid disease (hyperthyroid myopathy and hypothyroidism) Havy alcohol ingestion may induce severe muscle cramps Lead tosicity Disorders of the lower motor neurons (amyotrophic lateral ssclerosis ALS, MS, polyneuopathies involving the motor neurons, recovered poliomyelitis, peripheral nerve injury, and root compression) |
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Describe Hyperthyroid myopathy and hypothyroidism with symptoms and treatments
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Hypertyroid Myopathy: autoimmune disease whose smptoms include palpitations, heatintolerance, weight loss, and nail looseness. It is treated with drugs to interfere with thyroid hormone production and radioactive iodine.
Hypothyroidism: weaknessand painful muscle spasms, decrease in protein and carbohydrate metabolism. Symptoms inclue fatigue, weakness, weight gain, coarse dry hair, dry skin. Treatment is Levothyroxine. |
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Treatment for cramps
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Stretching - activation of GTO helps relax the muscle
Movement - walking allows muscle spindles to rese Mssage Cold application -reduces alpha motor neuron activity transcutaneous electrical nerve stimulation Quinine - (antimalaria, antipyretic, an analgesic drug) - used for chronic cramping and works by decreasingthe excitability of the motor end plate and increasing the refractory period of skeletal muscle |
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How do you help prevent cramps?
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Stretching
Correction of muscle weaknesses and strength imbalances Conditioning to prevent onset of fatigue Strength training - reduce spindle sensitivty whih causes a decrease in reflex alpha motor neuron activity Proper nutrition before and durig event (replacement of fluid and energy substrate decreases fatigue) |
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Common drugs that might cause or increase the risk for cramps
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Beta blockers and Calcium channel blockers (these two are used for heart disease), beta agonists 2 (for kids with asthma), THORAZINE (for psychosis)
DANOZOL (corticosteroid fo endometriosis), LITHIUM, PREDNISONE, LASIX |
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Why is Gatorade not all that freat for regular exercisers or preventing cramps?
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rare you dont get enough sodium in your diet so things like fatorade are not beneficial for the normal people, especially kids
May be useful after extremely intense or long bouts oexrcise where electrolytes may be depleted (marathons, two a day practices, etc) |
