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151 Cards in this Set
- Front
- Back
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Myeloid stem cells
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in bone marrow- differentiate into red cells, neutrophils or megakaryoctyes.
Differentiation controlled by proteins |
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Erythropoietin
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made in kidney, boosts red cell production
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G-CSF
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boosts granulocyte production
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Hgb/Hct
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Hgb- amount of oxygen carrying protein
Hct- fraction of blood volume occupied by RBCs |
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Leukocytes
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WBCs
Neutrophils- phagocyte lymphocytes- make antibodies monocyte, eosinophil, basophil |
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T cells
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regulate immune system
from bone marrow, thymus, lymph nodes |
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B cells
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antibody production
from bone marrow, lymph nodes, spleen |
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NK cells
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neither T nor B
kill infected cells |
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Monocyte/macrophage
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phagocytose, produce cytokines
macrophage in tissue, monocyte in blood |
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lymph nodes
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spleen=lymphoid organ
allow coordination of various immune cells |
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Anemia
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reduction in total circulating red cells (low hgb and hct)
fatigue, dyspnea, chest pain, tachycardia, pallor |
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Aplastic anemia
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decreased number stem cells, macrocytic or normocytic
cause- cytotoxins, radiation, infection, autoimmune |
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Anemia of inflammation
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iron held in macrophages not released to red cells
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Iron deficiency anemia
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most common cause
microcytic, hypochromic from blood loss, pregnancy, poor diet |
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Vitamin B-12 deficient anemia
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Pernicious anemia
megalobastic often due to stomach disorder |
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Thalassemia
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inherited disorder of hemoglobin production
microcytic major requires RBC transfusions |
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Hemolytic anemia
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increased rate of RBC production, increased reticulocytes
high bilirubin- jaundice |
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Sickle cell anemia
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recessive inherited structural abnormality of hemoglobin-- polymerization of hemoglobin
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Autoimmune hemolytic anemia
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production of antibodies against
detected by coombs test treat w immunosupressants or splenectomy |
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Polycythemia
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too many RBCs, blood is thick
vera/primary- myeloproliferative disorder- mutation in marrow secondary- increased erythropoietin d/t low O2 |
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Neutropenia
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decreased neutrophils
decreased production- marrow failure or chemo increased consumption- autoimmune, infection, enlarged spleen |
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Neutrophilia
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increased production d/t infection
d/t demargination- unstick from vessel walls |
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Leukemia
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cancerous proliferation of leukocyte production
acute- proliferation of immature cells (blasts)- rapid chronic- proliferation of mature cells- slow |
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Manifestations of leukemia
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marrow failure, accumulation in blood, accumulation in other tissues, release of toxins from leukemic cells
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Acute lymphoblastic/lymphocytic leukemia
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rapidly growing B or T cell blasts
most common cancer in children often curable |
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Acute myelogenous leukemia
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proliferation of immature granulocyte blasts
most common leukemia in adults treatable, occasionally curable |
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Chronic myelogenous leukemia
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proliferation of myeloid stem cells- overproduction of WBCs and platelets
treatable/curable "philadelphia chromosome" mutation |
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Chronic lymphocytic leukemia
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slow growing b-cell mature appearing cells
primarily in older adults treatable but not curable |
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Lymphoma
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proliferation of lymphocytes
behave as solid tumors |
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Non-Hodgkins lymphomas
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low grade- slow growing but mature appearing cells, incurable but live long
high grade- faster growing less mature cells, potentially curable but aggressive |
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Hodgkins disease
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Reed-sternberg cells (large, multinucleated)
One of the most common cancers in teens predictable progression most patients cured |
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Multiple myeloma
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plasma (antibody producing) cell
secrete monoclonal immunoglobulin causes bone destruction not curable |
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Symbiosis
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host and organism both benefit
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Commensalism
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organism doesn't really help or hurt the host
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Saprophytic
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organisms living off dead/decaying matter
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Parasitism
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organism inteferes with host function
pathogenic-- disease causing virulent- poisonous |
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Barriers to infection
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mechanical (skin)
secretions epithelial (exfoliation) chemical (pH) microbial (normal flora compete with bad bugs) |
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Antibody mediated immunity
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B cells
immunoglobulin binds to antigens |
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Cell mediated immunity
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T cells
secrete substances to attract macrophages |
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Toxins
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produced by organism or released when the organism is destroyed by the body
some organisms not toxic but damage is caused by body's effort to get rid of them |
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Candida albicans
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fungal opportunistic pathogen
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Spreading factors
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produced by organisms and help breakdown tissues to allow organisms to spread
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Transmission methods
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fomites
food fingers flies feces |
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Bacteria
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prokaryotes
capsules can make them harder to kill Anaerobic- no oxygen |
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Cross antigenicity
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antibodies look like antigens normally in the body
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Immune complex formation
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causes inflammation
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Bacteremia
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viable bacteria in the blood
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Septicemia
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presence of pus forming organisms, pathogens and their toxins in the blood
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Sepsis
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systemic disease of organisms/toxins in blood
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Gram + cocci
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Staphylococcus
Streptococcus- beta is most dangerous |
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Streptococcus pyogenes
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the only group A- causes strep, impetigo and endocarditis
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Streptococcus pneumoniae
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causes pneumonia and meningitis
capsule encased |
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Neisseria meningitidis
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gram - cocci
causes fatal spinal meningitis |
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Gram - bacilli
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E. coli
Shingella |
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Tuberculosis
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acid fast bacteria
ingested by neutrophils but bacteria live and neutrophil dies |
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Superinfection
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destroys the barrier, giving other parasites opportunity to cause infection
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Rotavirus
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most frequent cause of viral gastroenteritis
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Viruses
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obligate intracellular parasites
RNA or DNA lyse of bud off of host cell |
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Yeasts
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unicellular
reproduce via budding |
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Molds
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long branching tubular cells
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Cutaneous fungi
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ringworm, athletes foot, jock itch
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Candida albicans (monilia)
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fungi
normal flora, can cause thrush and vaginitis |
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Aspergillosis
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mold
common opportunistic pulmonary infections |
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Protozoa
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unicellular eukaryotes
uncommon pathogenically in the US |
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Amebiasis
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caused by entamoeba histolytica
usually in colon (diarrhea) but can spread |
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Malaria
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replication in and rupture of RBCs
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Worms (helminths)
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roundworms, tape worms
infestation associated with high eosinophil count |
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Enterobiasis
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pinworm
cause inflammation and itching on perianal skin |
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Neoplasias have relative autonomy
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grow with little regard for host but still somewhat dependent
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Benign neoplasms
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slow growing, don't spread
can still cause morbidity by exerting local effects, producing hormones, causing pain or inducing bleeding |
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Malignant neoplasms
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grow rapidly, spread beyond origin (invasion and metastasis)
carcinoma- in epithelium sarcoma- from mesenchymal cells |
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Invasion
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contiguous growth beyond their site of origin
requires malignant cells to be broken down by protolytic enzymes |
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Dysplasia
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neoplastic cells that stay within tissue of origin but have features of malignancy
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Metastasis
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non-contiguous spread of neoplastic cells
invasion intravasation intravascular circulation extravasation grow in new location angiogenesis |
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Differentiation
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degree of resemblance of neoplasm tissue to tissue of origin
Anaplastic- no differentiation, high grade |
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Benign
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non-invasive
encapsulated no metastasis normal N:C ratio |
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Malignant
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invasive
metastatic rapid growth anaplastic high N:C ratio |
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Stage determined by:
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TNM
tumor (size, characteristics) nodes (extension to) metastases (presence of) |
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Cancer is a disease of genes
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if germ cells are altered, affect all cells in body from birth
if altered during lifetime, affect subset of cells |
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Cancer is clonal
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population of malignant cells is ultimately derived from a single mutated cell
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Carcinogenesis is a multistep process
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takes multiple mutations
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8 basic functions in cells commonly disrupted by cancer
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self sufficiency in growth signals
insensitivity to growth-inhibitory signals evasion of apoptosis defective DNA repair limitless replicative potential |
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Self-sufficiency in growth signals
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oncogene- mutated gene encoding growth factors-- activating mutation (only takes 1)
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Insensitivity to growth-inhibitory stimuli
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p53= most commonly mutated tumor suppressor gene (both alleles need to be mutated)
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Evasion of apoptosis
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BCL-2- anti apoptotic
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4 causes of original mutation
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familial
chemical radiation microbes |
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Chemical exposure
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initiation- appearance of permanent damage
promoter stimulates proliferation further accumulation (progression) |
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Cause of death
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injury or disease producing physiological derangements in the body resulting in death
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Mechanism of death
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the actual physiological derangement that results in death
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Manner of death
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the circumstances surrounding the death (SHAUN)
suicide, homicide, accident, undetermined, natural |
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Cocaine death
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benzoylecgonine indicates recent use
cocaethylene= cocaine+ethanol |
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Opioid death
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pulmonary edema
foam cone respiratory depression |
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Heroin death
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monoacetylmorphine (6-MAM) indicates recent heroine use
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Alcohol death
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oxylate crystalizes in the kidneys
hepatic steatosis cirrhosis |
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Vitreous humor
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vitreous humor lags 2 hours behind blood, so can judge stage of alcohol intake
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Carbon monoxide death
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saturates hemoglobin so O2 cant bind- 50% sat is lethal
causes cherry red color (CO, cyanide, cold) |
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Judging time of death
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algor mortis (cooling- within 12 hrs)
rigor mortis (12s- stiffens, fixed, relaxes) livor mortis (blood settles and becomes fixed) |
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Osteoblasts
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synthesize bone
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Osteocytes
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bone cells
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Osteoclasts
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reabsorb bone
multinucleated |
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Collagen
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type 1 in bone and ligaments
type 2 in articular cartilage |
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Endochondral ossification
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bone formation in long bones
cartilage mineralizes to become bone |
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Osteomalacia
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defect in mineralization of bone d/t vitamin D deficiency
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Osteoporosis
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absolute decrease in bone mass
no serological changes exercise for treatment |
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Process of fractures
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Inflammatory phase
Reparative phase (callus) Remodeling phase |
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Comminuted (high energy) fractures
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multiple bone fragments
blood supply to bone disrupted |
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Osteomyelitis
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infection of bone
hematogenous spread or direct inoculation |
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Osteosarcoma
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neoplastic bone disease of children
highly malignant tumor that produces bone |
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Ewing sarcoma
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malignant tumor of primitive mesenchymal cells in kids
systemic symptoms |
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Multiple myeloma
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most common primary bone tumor in adults
disease of abnormal plasma cell production |
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Metastatic bone diseases
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more common than primary bone tumors
stabilization to prevent pathologic fractures |
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Joint types
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synoarthroses- no motion
amphiarthroses- little motion diarthroses- most common, most mobile |
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Articular cartilage
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made of type 2 collage
fibers parallel to axis of motion except deepest layer |
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Synovial tissue
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lines diarthrodial joints
very vascular |
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Osteoarthritis
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"wear and tear"
most common arthritis normal ligaments- cartilage worn away |
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Rheumatoid arthritis
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systemic autoimmune disease
primarily a disease of the synovium |
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Septic arthritis
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more common in children
release inflammatory mediators which destroy cartilage |
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Gout
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abnormal metabolism of uric acid
crystalizes in joints |
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Herniated disk
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nucleus ruptures through annulus
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Hyperventilation
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low PaCO2
stimulate breathing |
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Hypoventilation
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high PaCO2
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Hypoxemia
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caused by low inspired O2, impaired diffusion, hypoventilation, low V/Q (ventilation/perfusion ration- most common)
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Hyperinflation
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increased lung compliance
easy to inflate but bad recoil |
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Restriction
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hard to inflate but recoil easily
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Restrictive lung disease
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decreased total lung capacity
secondary to parenchymal abnormality (decreased RV) secondary to respiratory weakness (RV increased) |
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Airflow obstruction
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best evaluated by FEV1/FVC
narrowing of airway lumen dynamic airway narrowing |
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Pulmonary hypertension
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acute in pulmonary embolism
chronic from lung disease or heart disease |
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Airway barriers
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nose traps large
cillia traps medium macrophages trap small neutrophils against bacteria and fungi anti-oxidants against gasses/pollutants |
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Bronchiolitis
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infection of peripheral airway
viral common in kids |
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Bronchitis
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infection of central airway
viral or bacterial common in adults |
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Bronchial obstruction
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tumor, foreign body, secretions
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Bronchiectasis
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permanent dilation of airway secondary to destruction of elastin and muscle
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Pneumonia
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infection of lung tissue
inflammation red hepatization gray hepatization resolution |
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Community acquired pneumonia
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commonly bacterial
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Nosocomial pneumonia
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caused by gram - organisms or staph aureus
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Opportunistic pneumonia
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Pneumocystic carinni
Aspergillosis Cytomegalovirus |
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Lung abscesses
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local accumulation of pus
caused by aspiration complicated by hemoptysis or empyema |
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Adult respiratory distress syndrome (ARDS)
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rapid respiratory failure in in previously healthy patient
exudative phase, organizing phase, resolution |
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Diffuse alveolar damage (DAD)
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non-specific pulmonary reaction to acute insults- counterpart of ARDS
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COPD
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non reversible decreased expiratory flows on PFTs
chronic bronchitis- chronic productive cough for 3 months emphysema- enlarged airspaces w/o significant fibrosis (a1-anti-trypsin) |
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Asthma
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reversible airway obstruction caused by increased airway responsiveness
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Pneumothorax
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accumulation of air in pleural space
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Pleural effusion
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accumulation of fluid in pleural space d/t increased pressure or inflammation
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Idiopathic pulmonary fibrosis
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fibrotic interstitial lung disease
Usual Interstitial Pneumonia- extensive fibrosis and abnormalities Desquamative interstitial pneumonia- milder, minimal fibrosis, inflammation with macrophages |
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Sarcoidosis
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chronic granulomatous interstitial lung disease
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Hypersensitivity pneumonitis
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pulmonary inflammation secondary to immune reaction to organic dusts
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Pneumoconioses
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disease caused by inhalation of inorganic dusts
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Silicosis
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silicone from sand blasting cause inflammation and fibrosis
increased risk for TB |
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Asbestosis
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causes fibrosis that is apparently 20-30 years after exposure
can cause mesothelioma (lethal cancer) or bronchogenic carcinoma |
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Small cell carcinoma
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highly malignant that is commonly metastatic
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Non-small cell carcinoma
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more localized and metastasize gradually usually surgically removed
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