refers to a situation in which there is a large break in the tissue and consequently more inflammation, a longer healing period, and formation of more scar tissue; a compound fracture would heal in this manner
second intention
Occurs in hyperthyroidism and with Grave's disease
exophthalmos
another name for alcoholic liver disease that generally tends to progress in stages, and each stage is usually more dangerous than the last; can potentially kill a person if not treated appropriately and quickly. symptoms are varied, but the best-known sy
Laennec's cirrhosis
involve a basic developmental failure somewhere in the system (Ex: in the bone marrow's production of stem cells) the thymus, or the synthesis of antibodies
primary deficiencies
refers to loss of immune response resulting from specific causes and may occur at any time during the lifespan
secondary immunodeficiency (acquired)
a nitrogen waste resulting from protein metabolism in the intestine or liver, is removed from the blood and converted to urea, enabling it to be excreted by the kidneys. correlates well with the signs of hepatic encephalopathy. an end product of protein m
ammonia
releases ammonia
urease
auto digestion follows premature activation of the pancreatic proenzymes within the pancreas itself- appears that activation of the proenzyme trypsinogen into trypsin is the trigger and in turn trypsin converts other proenzymes and chemicals into active f
acute pancreatitis
lacks a fibrous capsule that might contain the effects of auto-digestion; abscesses may develop if the local inflammatory response is successful in localizing the injury; otherwise destruction by trypsin and other enzymes progresses into tissues surroundi
pancreas
damaging products such as cytokines and prostaglandins released by tissue necrosis lead to widespread inflammation of the peritoneal membranes; inflammatory response includes vasodilation an increased capillary permeability, leading to hypovolemia and cir
pancreas injury
is often a life-threatening condition involving both excessive bleeding and excessive clotting. early detection of bleeding, both occult and overt, must be a primary goal of a patient with this. often treated by anticoagulation with heparin or low-molecul
disseminated intravascular coagulation (DIC)
damage the epidermis and may involve the upper dermis; usually appear red and painful (sunburn. mild scald)
partial-thickness burns
involves the destruction of the epidermis and part of the dermis; area is red, edematous, blistered, and often hypersensitive and painful during the inflammatory stage
deep-partial thickness
result in destruction of all skin layers and often underlying tissues as well
full-thickness burns
tends to have a more insidious onset, with milder signs, and may be diagnosed during a routine blood check; early signs include fatigue, weakness, and frequent infections. adults greater than 50 years
chronic leukemia
most common in young children
acute lymphocytic leukemia
cancer common in adults
acute myelogenous leukemia
cancer common in adults 30-50 years old
chronic myelogenous leukemia
cancer common in males greater than 50 years
hairy cell leukemia
results in an accumulation of dysfunctional cells because of a loss of regulation in cell division. number of adults with this disease is approximately 10 times that of children. no single causative agent of this disease, most result from a combination of
leukemia
occurs in an anaphylactic reaction when the mediators remain localized; characterized by a pale wheal containing edematous fluid surrounded by a red flare from the hyperemia; occurs in minutes or hours and is usually not dangerous
wheal-and-flare reaction
causes edema of airways and larynx; bronchial constriction; urticaria; angioedema; pruritis; nausea, vomiting, diarrhea, and shock
histamine
bronchial constriction; enhanced effect of histamine on smooth muscle
leukotrienes
wheal-and-flare reaction on skin; hypotension; bronchospasm
prostaglandins
increase in pulmonary artery pressure; systemic hypotension
platelet-activating factor
angioedema with painful swelling; bronchial constriction
kinins
mucosal edema; bronchial constriction
serotonin
same as histamine
anaphylatoxins
account for 2-4% of all WBCs; one of their primary functions is to engulf-anitbody complexes formed during an allergic response. increase in this usually indicates an allergic response
eosinophils
make up less than 2% of all leukocytes; have cytoplasmic granules that contain heparin, serotonin, and histamine
basophils
drugs useful in the early stages of an allergic reaction because they block the response of the tissues to the released histamine
antihistamine drugs
block H1 receptors to reduce allergic response
antihistamines
occurs a few hours after exposure; increased leukocytes, particularly eosinophils, release of additional chemical mediators such as leukotrines, resulting in prolonged inflammation, bronchoconstriction and epithelial damage
second stage of allergic response
the cause of this disease has not been identified, although a number of genes on various chromosomes have been linked to the disease. 10% of cases are considered familial; invariable data over time. a progressive degenerative disease affecting both upper
amyotrophic lateral sclerosis (ALS)
asymptomatic disease with mild discomfort, diarrhea, or constipation and flatulence which can be excused for other reasons. during acute episodes, food intake should be reduced along with antimicrobial drugs taken as needed; treated by increasing the bulk
diverticulosis
secrete hormones directly into the blood, in contrast to exocrine glands that secrete into a duct
endocrine glands
chemical messengers that affect blood glucose levels, including insulin, glucagon, epinephrine, cortisol, and growth hormone
hormones
develops more frequently in patients with Type 2 diabetes; often the patient is an older person with an infection or one who has overindulged in carbs, thereby using more insulin than anticipated. condition may be difficult to diagnose initially; severe c
HHNC
decreased mobility, hormonal factors, calcium deficits, low vitamin D, or low protein are all factors of... osteoporosis
osteoporosis
excessive ___ intake is a contributor to osteoporosis
caffeine
this kind of pregnancy test should be performed if it is ectopic
serum pregnancy test
this level is expected to double about every 48 hours in a normal pregnancy; if failed to double, the pregnancy may be ectopic
beta- hCG
administered to newborns to prevent hemorrhagic disorders. the sterile gut of a newborn lacks intestinal bacteria necessary for the synthesis of this vitamin. required for the production of clotting factors such as prothrombin and fibrinogen
vitamin K
results from fluid accumulation in the pericardial sac, constriction of the pericardium by tumor, or pericarditis secondary to radiation therapy to the chest. manifestations include heavy feelings over the chest, shortness of breath, tachycardia, cough, d
cardiac tamponade
indicative of angina pectoris; condition in which the heart has outgrown its blood supply
hypertrophy
right ventricular hypertrophy occurs in this condition
Tetralogy of Fallot
can lead to ventricular hypertrophy;
afterload, hypertension
an increase in the muscle mass and cardiac wall thickness in response to overwork and strain; occurs slowly because it takes time for increased muscle tissues to develop; generally follows persistent or chronic dilation and thus further increases the cont
hypertrophy
used when heart failure occurs. necessary when drugs have failed; is a short term bridge to cardiac transplantation; needed if acute myocardial infarction occurs with ventricular aneurysm accompanied by ventricular dysrhythmias, acute ventricular septal d
intra-aortic balloon pump therapy
dislodging of plaque, aortic dissection, and compromised distal circulation are common complications. patients with this in place are prone to infection
IABP
a "clot-busting agent" used to reduce the effects of CVA in some individuals. contraindicated for anticoagulant drugs
tissue plasminogen activator (tPA)
nonspecific S/S include: tachycardia, palpitations, fatigue, or altered mood
most common nonspecific symptoms include: fatigue and depression, accompanied by other manifestations such as changes in energy level, alertness, sleep patterns, mood, affect, we
diabetic polydipsia
essential for the stress response and play an important role in "turning off" or blunting aspects of the stress response
corticosteroids
involves a progressive demyelination of the neurons in the brain, spinal cord, and cranial nerves
characterized by remissions and exacerbations, but nevertheless is marked by progressive degeneration; second most common cause of disability in the US. betw
multiple sclerosis
Common disorder in older men. 50% of men over 65 experiencing some form. Hyperplasia of the prostatic tissue leading to compression of the urethra and urinary obstruction. Not associated with malignancy
BPH
Common occurrence when contractility of the ventricle is reduced and SV declines. May occur a few days after an MI or later as activity is resumed. Occurs when the heart is unable to pump sufficient blood to meet the metabolic needs of the body. Usually o
CHF
Infarction of left ventricle, aortic valve stenosis, hypertension, hyperthyroidism
left-sided CHF
Infarction of right ventricle,pulmonary valve stenosis, pulmonary disease
right-sided CHF
the release of insulin antagonists by adipose tissue; an increased proportion of body fat results in insulin resistance and changes in metabolism. changes in metabolism of lipids and glucose eventually leading to cardiovascular disease and Type 2 diabetes
metabolic syndrome
the volume of blood ejected by a ventricle in one minute and depends on heart rate and stroke volume, the volume pumped from one ventricle in one contraction
cardiac output
refers to a deficiency of adrenocortical secretions, the glucocorticoids, mineralocorticoids, and androgens; an autoimmune reaction is the common cause. high risk of infection, poor stress response, weight loss, fatigue, anorexia, nausea, diarrhea, hypote
Addison's disease
most common leukocyte, comprising 50% to 60% of WBCs, but survive only 4 days and are the first to respond to any tissue damage and commence phagocytosis
neutrophils
will stimulate an increase in neutrophils, whereas allergic reactions or parasitic infections increase the eosinophil count
infection
an increase in WBCs in the circulation often associated with inflammation or infection
leukocytosis
as WBCs and platelets decrease this is likely
infection
a specific defense responding to particular substances, cells, toxins, or proteins, which are perceived as foreign to the body and therefore unwanted or potentially dangerous
immune response
a fracture complication that may occur as local pain and irritation cause strong muscle contractions at the fracture site; pulls the bone fragments further out of position, causing angulation, rotation of a bone, or overriding of the bone pieces
muscle spasm
a complication that develops in a limb following treatment as edema increases during the first 48 hours after the trauma and casting; if peripheral area becomes pale or cold and numb or pulse decreases or is absent, it is likely that the cast has become t
ischemia
may develop shortly after the fracture occurs when there is more extensive inflammation, such as with crash injuries; increase pressure of fluid within the fascia, (non-elastic covering of the muscle) compresses nerves and vessels, causing severe pain and
compartment syndrome
are a risk when fatty marrow escapes from the bone marrow into a vein within the first week after injury. More common in patients with fractures of the pelvis of long bones such as the femur, particularly when the fracture site has not been well immobiliz
fat emboli
leakage of protein and large numbers of erythrocytes into the filtrate. usually originate as upper respiratory infections, middle ear infections, or "strep throat", certain strains of staph are occasionally responsible for initiating the immune disorder i
glomerulonephritis
filtrate travels through this and electrolytes and water are adjusted to the body's current needs. furosemide acts on this to decrease reabsorption of sodium and water. reabsorption of Na+ and Cl- in ascending limb; reabsorption of water in descending loo
Loop of Henle
in patients with this, the antigen reacts with immunoglobulin E on the previously sensitized mast cells in the respiratory mucosa, releasing histamine, kinins, prostaglandins, and other chemical mediators, which cause inflammation, bronchospasm, edema, an
extrinsic asthma
onset occurs during adulthood; in this disease other types of stimuli target hyper-responsive tissues in the airway, initiating the acute attack (respiratory infections, exposure to cold, exercise, drugs such as aspirin, stress, and inhalation or irritant
intrinsic asthma
bronchi and bronchioles respond to the stimuli with three changes, inflammation of the mucosa with edema, contraction of smooth muscle, and increased secretion of thick mucus in the passages
asthma
occurs a few hours later after an asthma attack in which leukocytes are increased, particularly eosinophils, releasing additional chemical mediators such as leukotrienes, resulting in prolonged inflammation, bronchoconstriction and epithelial damage
second stage
the destruction of the alveolar walls and septae, which leads to large, permanently inflated alveolar air spaces. in some, there is a genetic deficiency of alpha1- antitrypsin, a protein that normally presents in tissues and body fluids that inhibits the
emphysema
the formation of a thrombus in association with inflammation in the vein; the most common disorder of the veins. a disorder involving a thrombus in a deep vein, most commonly the iliac and femoral veins
deep vein thrombosis (DVT)
occurs when the valves are dysfunctional or the muscles of the extremities are inactive; occurs more frequently in people who are obese or pregnant, have chronic heart failure or atrial fibrillation, have been traveling on long trips without regular exerc
venous stasis
occurs because of glucose intolerance and increased gluconeogenesis by the liver; high glucose levels due to lack of insulin. deficit of insulin
hyperglycemia
a process of wound healing that occurs when there is minimal tissue damage, damaged cells recover, and the tissues return to normal within a short period of time (ex: after a mild sunburn)
resolution
wound healing that occurs in damaged tissue in which the cells are capable of mitosis; some types of cells are constantly replicating, here as other cells such as hepatocytes in the liver are able to undergo mitosis when necessary; damaged tissue is thus
regeneration
refers to the process involved when the would is clean, free of foreign material and necrotic tissue, and the edges of it are held close together, creating a minimal gap between the edges; seen in some surgical incisions
first intention healing
dysfunction of the extrapyramidal motor system occurs because of progressive degenerative changes in the basal nuclei, principally in the substantia nigra. a decreased number of neurons in the substantial nigra secrete dopamine, an inhibitory neurotransmi
Parkinson's disease
involves progressive, irreversible loss of kidney function. leading causes are diabetes and hypertension. patient goals for this disease include maintaining an acceptable body weight and fluid balance with dietary modifications or with peritoneal dialysis
chronic kidney disease
stage of CKD with kidney damage with > 90 normal or increased GFR
stage 1
stage of CKD with 60-89 mild decreased GFR
stage 2
stage of CKD with moderate decreased GFR (30-59)
stage 3
stage of CKD with severe decrease in GFR (15-29)
stage 4
stage of CKD with kidney failure (<15 or dialysis)
stage 5
two types of antibody-induced injury can initiate this
glomerular damage
cause a person to develop antibodies against his or her glomerular basement membrane
anti-GBM antibodies
antistreptococcal antibodies create an antigen-antibody complex that lodges in the glomerular capillaries, activates the compliment system to cause an inflammatory response in the glomeruli of both kidneys
glomerulonephritis
patient may not experience abdominal pain with this but may have numbness and pain in a lower extremity secondary to compression of the lateral cutaneous nerve, located in the region of the first to third lumbar vertebrae. places pressure on abdominal org
retroperitoneal bleeding
known as "shock lung", "wet lung", "stiff lung", "post perfusion lung", and a variety of other names related to specific causes. systemic sepsis, prolonged shock, burns, aspiration, and smoke inhalation may cause this. fat emboli cause this
ARDS (adult/acute respiratory distress syndrome)
normally 95-100 mm Hg
PaO2
normally 32-48 mm Hg
PaCO2
normally 22-26 mEq/L
bicarbonate (HCO3-)
normally +2.0 mEq/L
base excess
normally 96%-98%
arterial O2 saturation
measured to determine oxygenation status and acid base balance
ABGs
causes a greater decrease in pH than COPD or metabolic acidosis. impaired functioning of the nervous system; headache, lethargy, weakness, and confusion develop leading to coma and eventually death
respiratory acidosis
thrombus dislodged from peripheral venous system; lodged in pulmonary arterial system. should be suspected in any patient complaining of tachypnea, dyspnea, and tachycardia, particularly when the patient is already receiving oxygen therapy. because of hig
pulmonary embolism
caused by an increase in uric acid production, under excretion of uric acid by the kidneys, or increased intake of foods containing purines, which are metabolized to uric acid by the body
gout
a hereditary error of purine metabolism leads to the overproduction or retention or uric acid
primary gout
may also be caused by drugs that increase the rate of cell death; may be related to another acquired disorder or may be the result of drugs known to inhibit uric acid excretion
secondary gout
characterized by multiple joint involvement and visible deposits of sodium urate crystals (tophi)
chronic gout