Principles Of Disease Comprehensive Final

Front 1

Define resolution, in terms of tissue repair, and identify the type of cells that can achieve this kind of restoration.

Back 1

Resolution is when the repaired tissue may be close to normal structure if damage is minor no complications occur and destroyed tissues are capable of restoration is the **

Front 2

2. Describe a major outcome of the complement activation.

Back 2

Can destroy pathogens directly

Front 3

Activates or collaborates with every other component of the inflammatory response

Back 3

( Product have 4 functions: Opsonization, anaphylatoxic activity resultion in mast cell degranulation, leukocyte chemotaxis and cell lysis.

Front 4

3. Describe the effect of chemotactic factor on the inflammatory process.

Back 4

Is to diffuse from the site of inflammation forming a gradient and causing the directional movement (chemotaxis) of cells towards the inflammation

Front 5

4. Identify the predominant immune cells in the later stages of an inflammatory response that are involved in the phagocytosis process.

Back 5

Neutrophils or phagocytes

Front 6

1. Identify the process during acute inflammatory response by which fever is produced.

Back 6

Fever
Caused by exogenous and endogenous pyrogens
Act directly on the hypothalamus
Portion of brain that controls body thermostat
Leukocytosis
Increased numbers of circulating leukocytes
Increased plasma protein synthesis
Acute-phase reactants
C-reactive protein, fibrinogen, haptoglobin, amyloid, ceruloplasmin, etc.

Front 7

2. Identify the plasma protein system that forms a fibrinous network at an inflamed site to prevent spread of infection to adjacent tissues and to keep microorganisms and foreign bodies at the site of greatest inflammatory activity.

Back 7

Coagulation (clotting) system
Forms a fibrinous meshwork at an injured or inflamed site
Prevents the spread of infection
Keeps microorganisms and foreign bodies at the site of greatest inflammatory cell activity
Forms a clot that stops bleeding
Provides a framework for repair and healing
Main substance is an insoluble protein called fibrin

Front 8

3. Describe the reason why many older adults have impaired inflammation and wound healing processes.

Back 8

Impaired inflammation is likely a result of chronic illnesses:
Diabetes, cardiovascular disease, etc.
Chronic medication intake decreases the inflammatory response.
Healing response is diminished due to loss of the regenerative ability of the skin.
Infections are more common in the elderly

Front 9

Describe the criteria for benign versus malignant tumors; and whether or not benign tumors can become malignant.

Back 9

Benign grow slowly with low mitotic index, are differentiated, are not invasive and do not spread; named by their original tissue. Malignant grow rapidly and have high mitotic index, poorly differentiatied. Benign can some become malignant

Front 10

. Predict the relationship of frequent infection with certain viral infection (due to increased number of sexual partners) and the incidence of cervical cancer.

Back 10

With more partners, HPV’s are more likely to be transmitted and be high-risk for cancer

Front 11

Describe oncogenes.

Back 11

A gene that in certain circumstances can transform a cell into a tumor cell or (Mutant genes that in their normal non-mutant state, direct synthesis of proteins that positively regulate proliferation)

Front 12

Identify the cancers that are known to be influenced by smoking.

Back 12

Hepatocellular carcinoma, lung and pulmonary adenocarcinomas, cancer of the lower urinary tract, upper areodigestive tract, liver, kidney, pancreas, cervix uteri, and myeloid leukemia

Front 13

. Identify the virus that, if infects the cervical region of the uterus, would result in cervical cancer.

Back 13

Human Papilloma Virus (HPV)

Front 14

. Describe the ability or functionality of cancer cells in terms of adhering to one another as compared with that cellular feature in normal cells.

Back 14

Cancer cells decrease adhesion in normal cells

Front 15

Identify the most common route for distant metastasis of cancer cells.

Back 15

Lymph and blood or (The cancer cell detach from its primary location, survive a passage through the body, and then successfully attach, invade, multiple and simulate angiogenesis in a new location)

Front 16

Identify the commonly known cause of hyperpituitarism

Back 16

Decrease in TH lowers metabolism, and heat production, low BMR, Cold intolerance, lethargy, tiredness, and slightly lowered temperature. Decreased TH can lead to excessive TSH production and goiter. The characteristic sign of severe or long-standing hypothyroidism is myxedema

Front 17

2. Describe the reason why visual disturbances are caused by a pituitary adenoma.

Back 17

Local expansion of the adenoma may impinge on the optic chiasma and cause various visual distubances, depending on the portion of the nerve compressed.

Front 18

3. Predict the outcome of the hypersecretion of growth hormone in adults.

Back 18

Giantism

Front 19

4. Describe the clinical manifestations of hypothyroidism.

Back 19

Decrease in TH lowers metabolism, and heat production, low BMR, Cold intolerance, lethargy, tiredness, and slightly lowered temperature. Decreased TH can lead to excessive TSH production and goiter. The characteristic sign of severe or long-standing hypothyroidism is myxedema

Front 20

Describe the clinical signs of thyroid crisis that commonly seen in Graves’ disease.

Back 20

Graves’ disease is the most common cause of thyrotoxicosis and is the result of stimulation of the thyroid with antibodies against the TSH receptor. The antibodies stimulate the thyroid cells to produce high concentrations of T3 and T4. The combined action of the antibodies and increased serum levels of TH produce the symptoms of Graves’ disease

Front 21

1. Explain the reason why polyuria occurs in patients with diabetes mellitus.

Back 21

Hyperglycemia acts as an osmotic diuretic; the amount of glucose fitered by the glomeruli of the kidney exceeds that which can be re-absorbed by the renal tubules; glycosuria results accompanied by large amounts of water lost in the urine.

Front 22

2. Identify the result of the lab test that would indicate a patient with type 1 diabetes is developing nephropathy (renal failure).

Back 22

Microalbuminuria is the first manifestation of renal dysfunction. Later, hypoprotienemia, reduction in plasma onconic pressure, fluid overload, anasarca (generalized body edema), and hypertension may occur

Front 23

3. Describe the type of anemia that can develop after a gastrectomy.

Back 23

Pernicious anemia

Front 24

4. Discuss the relationship of chronic hepatitis “C” with the risk for liver cancer.

Back 24

Chronic hepatitis C is associated with liver cancer, caused by HBV or HVC. Co-factor is alcohol

Front 25

6. Predict the structural/mechanical cause of gastroesophageal reflux disease (GERD).

Back 25

Abnormal functioning of lower esophageal sphincter

Front 26

Describe the most common cause of intestinal obstruction in the small intestine.

Back 26

Simple obstruction

Front 27

8. Explain the accumulation of fat in the liver in alcoholic cirrhosis.

Back 27

It progresses with fatty infilteration fibrosis and cirrhosis. Fat deposition within the liver is caused primarly by increased fatty acid oxidation by hepatocytes

Front 28

Describe the clinical manifestations of appendicitis.

Back 28

Gastric or per- umbilical pain is the typical symptom of an inflamed appendix. Nausea, vomiting, and anorexia follow the onset of pai, and a low grade fever is common. Some have constipation, but (mostly in children) have diarrhea.

Front 29

Identify the most common type of renal stone.

Back 29

The most common stone types include calcium oxalate or phosphate (70 to 80%), struvite (magnesium, ammonium, and phosphate) (15%), and uric acid (7%) (p. 787).

Front 30

Describe how acute unilateral renal obstruction predisposes people to hypertension.

Back 30

Occasionally, relief of obstruction will cause rapid excretion of large volumes of water, sodium or other electrolytes resulting in a urine output of 10L/day or more. Rapid postobstructive diuresis causes dehydration and fluid imbalances. Risk factors are Hypertention.

Front 31

. Identify the most common pathogen that causes uncomplicated urinary tract infections.

Back 31

The most common cause of UTI infection is Escherichia coli (E. coli) (p. 793)

Front 32

Identify the kidney disorder which is characterized by low serum albumin, edema, and high level of lipids in both the serum and urine.

Back 32

Nephrotic Syndrome (p. 799)

Front 33

Explain how proteinuria (protein in the urine) cause generalized edema.

Back 33

Increased glomerular permeability, decreased proximal tubule reabsorption results in Edema, increased susceptibility to infection from loss of immunoglobulin. (p.799)

Front 34

. Name the exogenous agent that can successfully treat anemia due to renal failure.

Back 34

Inadequate production of erythropoietin decrease red blood cess production and requires treatment with recombinant erythropoietin (p.780).

Front 35

. Describe the clinical manifestations of dysfunctional uterine bleeding. P. 852

Back 35

Unpredictable and variable bleeding in terms of amount and duration especially during premenopausal.
• Flooding and passing of large clots indicating excessive blood loss
• Anemia may occur, but healthy woman usally don't become anemic unit 1.6L of blood loss
• Amenorrhea (lack of menstruation), but can be perceived by individuals as a miscarriage

Front 36

Identify a major dietary intake that provides protection against prostate cancer. P. 881

Back 36

antioxidants (vitamin E, selenium, and lycopene), retinoids (vitamin A) and prostate carcinogenesis

Front 37

29-32. describe the following conditions: P. 872-873

Back 37

Varicocele: abnormal dilation of a vein in the spermatic cord, also known as bag of warms, most common in infertile men, less likely in obese men. Occur 95% on left side.
• Hydrocele: collection of fluid within the tunica vaginalis, most common cause of scrotal swelling. Often resolve in the 1st year of life. In adults it’s caused by imbalance between secreting and absorptive scrotal tissue. Scrotal may be grapefruit size or larger.
• Testicular torsion: p. 874. Testis rotate on its vascular pedicle, interrupting its blood supply and reducing/stopping circulation to the testis, causes acute sscrotum (testicular pain and swelling) most common among neonates and adolescents.
• Spermatocele: painless diverticulum of the epididymis located between the head of the epididymis and the testis. Its filled with milky fluid containing sperm

Front 38

38. Name the virus that is a necessary precursor for developing cervical intraepithelial carcinoma and cervical cancer. P. 863

Back 38

HPV Human papillomavirus

Front 39

Identify the neurotransmitter that is deficient in patients with Parkinson’s disease.

Back 39

Dopamine

Front 40

4. Describe the initial clinical manifestations associated with acute spinal cord injury.

Back 40

Spinal shock: reflex function completely lost below the lesion including muscles, bladder, bowel, and sexual function and autonomic control.

Front 41

Identify the cellular type of the most common primary tumors that occur in the CNS.

Back 41

Intracerebral: Neuroglia, neurons, cells of blood vessels, and connective tissue
Extracerebral: meningiomas, pituitary and pineal glands

Front 42

6. Predict the site of contrecoup damage to a person’s brain after a car accident in which his
forehead struck the windshield

Back 42

Injury opposite side of brain from site of forceful impact, impact within skull shearing forces through brain

Front 43

Predict the status of the pupils of the eyes in a patient with raised intracranial pressure

Back 43

The pupils will end up as bilateral dilation and fixation, Small and sluggish

Front 44

11. Describe the likely causes of the cerebral edema following head injuries.

Back 44

Increased permeability of the capillary endothelium of the brain after injury to the vascular structure; Caused by distortion of blood vessels, displace of brain tissues, and eventual herniation of brain tissue from one brain compartment to another. Brain insult from trauma, infection, hemorrhage, tumor, ischemia, infarct, or hypoxia

Front 45

13. List the possible clinical presentations of lacunar cerebral infarcts in patients.

Back 45

Area of brain loses blood supply because of vascular occlusion. Abrupt vascular occlusion, gradual vessel occlusion, vessels that are stenosed (abnormal narrowing) but not completely occluded
This stroke is associated with smoking, hypertension, and diabetes mellitus. Because of the subcortical location and small area of infaction, these strokes may have pure motor and sensory deficits

Front 46

Describe the likely clinical signs and symptoms of Alzheimer's disease

Back 46

The initial clinical sign is often forgetfulness, emotional upset and other illnesses. Memory loss increases as the disorder advances, and the person becomes disoriented and confused and loses the ability to concentrate. Dyspraxia may appear.

Front 47

18. Identify the most common site of formation of atheroma plaques in the brain arteries that are a
major contributing factor to the development of cerebrovascular accident (CVA).

Back 47

Middle cerebral artery

Front 48

22. Describe the outcome of improper reduction or immobilization of a fractured bone.

Back 48

Unnatural alignment, swelling, muscle spasm, tenderness, pain and impaired sensation and decreased mobility.

Front 49

. Describe factors that increase the risk of malunion of a fractured bone

Back 49

Improper reduction or immobilization. Taking cast off early.

Front 50

. Know the relationship between certain hormones, e.g., estrogens, and the protective effect
against development of osteoporosis

Back 50

Post- menopausal women may have been given estrogen and progestin to prevent bone loss. However combined estrogen –progestins therapy increases the risk for invasive breast cancer, heart disease, stroke and pulmonaty embolism. PTH has been widely studied, and the results are encouraging. PTH directly stimulates bone formation, particularly in trabecular bone.

Front 51

31. Describe the characteristics osteoarthritis.

Back 51

Degenerative joint disease (OA) includes pain in one or more joints (1st characteristic)

Front 52

5. Identify the cellular component that is most vulnerable to folate and vitamin B12 deficiency.

Back 52

Intrinsic factor

Front 53

Identify the type of anemia that arises as a result of defective secretion of intrinsic factor by special cells in the stomach.

Back 53

Pernicious Anemia

Front 54

. Identify the most common cause of iron deficiency anemia.

Back 54

Normal red cell production, but insufficient amount of Iron is the clinical cause. The main cause of IDA in developed countries is because of pregnancy and the continuous loss of blood

Front 55

10. Describe the Schilling test and its purpose.

Back 55

A test for Pericious Anemia

Front 56

12. Explain the reason why pancytopenia develops in patients with aplastic anemia.

Back 56

It can be due to auto immune functions, renal failure parvovirus infection, or exposure to radiation, drugs, and toxins, and it might also be congenital

Front 57

14. Describe a major clinical consequence of polycythemia vera.

Back 57

Tissue injury (ischemia) and death (infarction) is the outcome of blood vessel blockage, and it occurs 40% of the time

Front 58

15. Identify the most likely anemia that would be a suitable candidate for bone marrow transplantation.

Back 58

Aplastic Anemia

Front 59

Identify the hormone or chemical mediator that is most likely responsible for the hypertrophy of the myocardium due to chronic hypertension.

Back 59

Myocardial hypertrophy in response to hypertension is mediated by several neuro-hormonal substances, including catecholanimes from SNS and angiotensin

Front 60

20. Predict the usual source of pulmonary emboli.

Back 60

Pulmonary embolism (PE) is a blockage of the main artery of the lung or one of its branches by a substance that has travelled from elsewhere in the body through the bloodstream (embolism). Usually this is due to embolism of a thrombus (blood clot) from the deep veins in the legs, a process termed venous thromboembolism

Front 61

Identify the risk factors that are responsible for a 2-3 fold increase in the coronary artery disease.

Back 61

Advanced age, male gender or women after menopause, and family history. Modifiable major risks includes dyslipidemia, hypertension, cigarette smoking, diabetes and insulin resistant, obesity, sedentary lifestyle, and atherogenic diet

Front 62

Identify the serum lipoprotein that is protective or preventive for the development of atherosclerosis.

Back 62

HDL

Front 63

27. Identify the clinical manifestations of acute pericarditis.

Back 63

low-grade intermittent fever, dyspnea/tachypnea (a frequent complaint and may be severe with myocarditis, pericarditis, and tamponade), cough, and dysphagia. In tuberculous pericarditis, fever, night sweats, and weight loss were commonly noted (80%)

Front 64

29. Identify the common cause of infective endocarditis.

Back 64

Bacteria

Front 65

Differentiate atherosclerosis from arteriosclerosis.

Back 65

Atherosclerosis is the most common form of arteriosclerosis. Arteriosclerosis is characterized by soft deposits of intra-arterial fat and fibrin in the vessel walls that harden over time.

Front 66

1. Name the pathological condition involving infection the pleural cavity.

Back 66

Pneumothorax or Empyema

Front 67

2. Describe acute respiratory distress syndrome.

Back 67

Acute lung inflammation and diffuse alveolocapilary injury. Most common predisposing factors are sepsis and multiple traumas. All disorders causing ARDS cause massive pulmonary inflammation that injures the alveolcapillary membrane and produces severe pulmonary edema, shunting, and hypoxia. Initial lung injury also damages to alveolar.

Front 68

3. Identify the inflammatory mediators that are produced as a result of asthma.

Back 68

IgE

Front 69

4. Relate decreased exercise tolerance, wheezing, shortness of breath, and productive cough to the most likely chronic lung disease.

Back 69

Bronchitis

Front 70

5. Describe major clinical manifestations of pneumonia.

Back 70

Upper respiratory infection, which is often viral. Fever, chills, productive or dry cough, malaise, pleural pain, and sometime dyspnea and hemoptysis. Physical examination may show signs of pulmonary consolidation, such as dullness to percussion, inspiratory crackles, increased tactile fremitus, egophony, and whispered pectoriloquy. Sepsis

Front 71

Define hypoxemia versus hypoxia.

Back 71

Hypoxemia is abnormally low oxygen concentration in blood. Hypoxia is deficiency in amount of oxygen reaching tissues

Front 72

Justify whether or not persons with Alpha-antitrypsin deficiency are predisposed to emphysema

Back 72

Primary emphysema is commonly linked to an inherited deficiency of the enzyme -antitrypsin. Deficiency increases likelihood of emphysema because proteolysis in lung tissues is not inhibited

Front 73

8. Identify the greatest single risk factor for reactivation of tuberculosis.

Back 73

HIV

Front 74

22. Explain the reason why obese people are at greater risk for dehydration than lean people.

Back 74

Individuals who are comatose or paralyzed continue to have insensible water losses through the skin and lungs with minimal obligatory formation of urine. Syndrome of inappropriate ADH (SIADH)
ADH secretion in the absence of hypovolemia or hyperosmolality
Hyponatremia with hypervolemia
Manifestations: cerebral edema, muscle twitching, headache, and weight gain

Front 75

Identify the buffers that work rapidly (within minutes to hours) to establish blood pH.

Back 75

Carbonic acid-bicarbonate and the protein hemoglobin

Front 76

Explain why insulin is used to treat hyperkalemia (too much potassium in blood).

Back 76

Insulin promotes cellular entry of potassium, insulin deficits are accompanied by hyperkalemia

Front 77

22. Identify the populations (e.g., infants, normal adults, elderly, obese persons, thin women or men, teanagers, etc) who at higher risk for fluid imbalance and provide reasons.

Back 77

AGE
Infants and growing children have much greater fluid turnover than adults because their higher metabolic rate increases fluid loss. Infants lose more fluid through the kidneys because immature kidneys are less able to conserve water than adult kidneys.
GENDER AND BODY SIZE
Total body water also is affected by gender and body size. Because fat cells contain little or no water and lean tissue has a high water content, people with a higher percentage of body fat have less body fluid. Women have proportionately more body fat and less body water than men. Water accounts for approximately 60% of an adult man’s weight, but only 52% for an adult woman. In an obese individual this may be even less, with water responsible for only 30% to 40% of the person’s weight.
ENVIRONMENTAL TEMPERATURE
People with an illness and those participating in strenuous activity are at risk for fluid and electrolyte imbalances when the environmental temperature is high. Fluid losses through sweating are increased in hot environments as the body attempts to dissipate heat. These losses are even greater in people who have not been acclimatized to the environment.

Front 78

Explain why patients with metabolic acidosis breathe deeply and rapidly (Kussmaul respiration).

Back 78

The respiratory system’s efforts to compensate for the increase in metabolic acids result to kussmaul respiration. This represents the body to compensate for the increase pH by blowing off carbon dioxide, which decreases carbonic acid.