atrophy
decrease or shrinkage in cellular sizes
hypertrophy
increase in mass of cell but not in number of cells
hyperplasia
increase in number of cells from increased rate of cellular division
dysplasia
atypical changes in size, shape and appearance (not normal looking)
metaplasia
reversible replacement of one mature cell with another (normal to normal)
State the Starling forces on the capillary
1-blood osmotic pressure
2-interstitial osmotic pressure
3-blood hydrostatic pressure
4-interstitial hydrostatic pressure
blood osmotic pressure
blood pulling force that favors reabsorption
H?O -->blood
interstitial osmotic pressure
tissue pulling force that favors reabsorption
H?O -->tissue
blood hydrostatic pressure
blood pushing force that favors filtration
blood --> H?O
interstitial hydrostatic pressure
tissue pushing force that favors filtration
tissue --> H?O
4 most common mechanisms of edema
1-increased capillary pressure
2-decreased plasma oncotic pressure
3-increased capillary membrane permeability
4-lymphatic obstruction
respiratory acidosis
elevation of PCO?
respiratory alkalosis
depression of PCO?
metabolic acidosis
depression of HCO3?
metabolic alkalosis
elevation of HCO3?
haploid
only one member of each chromosome pair having a total of 23 chromosomes (ex. sperm or egg "gamete")
dipoid
chromosome occur in pairs (ex. somatic cells)
autosomes
22 of 23 homologous chromosome pairs
sex chromosome
remaining pair of chromosomes; determines gender (X or Y)
homologous
in 1st 22 pairs; two members of each pair are virtually identical in microscope appearance (X,X in females)
non-homologous
non-identical chromosomes (chromosome 9 & 22, X, Y in males)
karyotype
an ordered display of chromosomes; image taken during metaphase
euploid
cells that have a multiple of normal # of chromosomes
polyploid
when an euploid cell has more than the diploid # of chromosomes (liver; epithelial tissues)
triploid
when a zygote having three copies of each chromosome rather than usual two (polyspermy)
tetraploid
four copies of each chromosome (92 chromosomes)
aneuploid
somatic cell that does not contain a multiple of 23 chromosomes
trisomy
a cell containing 3 copies of one chromosome (Down's syndrome)
monosomy
presence of only one copy of a given chromosome in a diploid cell (Turner's syndrome, only on X)
disjunction
normal separation of chromosomes during mitosis
nondisjunction
an error in which homologous chromosomes or sister chromatids fail to separate normally (Klinefelter syndrome, XXXY or XXXXY)
incidence rate
# of new cases of a disease reported during a specific time period (usually a year)
prevalence rate
proportion of population affected by a disease at a specific point in time
relative risk
incidence rate of disease among individuals exposed to the risk factors divided by incidence rate of disease among individuals not exposed to risk factor
polygenic
involving multiple genes (ex. hair color, weight)
multifactoral
when environmental factors are also believed to cause variation in the trait
inflammatory cells release cytokines to:
-stimulate cellular proliferation
-angiogenesis
-promote healing
stage 1 of cancer
neoplastic cells in original site; well-differentiated
stage 2 of cancer
metastatic cell in original site & local lymphatics; moderately-differentiated cell
stage 3 of cancer
cells in original site & distant lymphatics; poorly-differentiated cells
state 4 of cancer
metastatic cells are found in many body areas; very poorly-differentiated cells
structural characteristics and function of RBC
-called erythrocytes
-life span 80-120 days
-function in gas transport
-high surface-to-volume rate due to bi-concave disk shape
-demonstrates reversible-deformity (ability to squish through tight spaces)
sequence of events in hemostasis
1-vascular spasm
2-platelet plug formation
3-activation of the coagulation cascade
macrocytic-normochromic
-large cells
-normal color
microcytic-hypochromic
-small cells
-pale in color
normocytic-normochromic
-normal size
-normal color
iron deficiency anemia
most common d/t excessive bleeding and/or poor diet
high risk: pregnant women, adolescents, children, elderly or anyone with chronic blood loss
microcytic-hypochromic anemia
pernicious anemia
intrinsic factor deficiency leads to insufficient absorption of vitamin B??; autoimmunity
S&S: digestive symptoms, glossitis, peripheral neuropathy
macrocytic-normochromic anemia
folic acid deficiency
dietary deficiency inhibits DNA synthesis; alcoholics and malnourished are high risk
S&S: similar to pernicious anemia, but no neurological symptoms
macrolytic-normochromic anemia
siderblastic anemia
dysfunctional iron uptake by erythroblasts producing siderblasts & resulting in decreased synthesis of heme
causes: lead, ethanol, other drugs
S&S: hepatosplenomegaly and hemochromatosis
microcytic-hypochromic anemia
aplastic anemia
bone marrow hypo or aplasia; causes: acquired d/t drugs (chemotherapy), viruses, genetics, and neoplasia
S&S: petechia, bleeding, infection, pancytopenia
normocytic-normochromic anemia
hemorrhagic anemia
anemia d/t blood loss; surgery or trauma
S&S: shock and acidosis
normocytic-normochromic anemia
hemolytic anemia
anemia d/t red cell lysis; fragile cells, infections, drugs, autoimmunity, circulating antibodies
S&S: enlarged spleen and jaundice
normocytic-normochromic anemia
granulocytes (neutrophilia)
evident in 1st stages of infection or inflammation; if need for neutrophils increase beyond supply, immature neutrophils (banded neutrophils) are released into blood; termed a "shift-to-the-left
neutrophenia
all etiologies represent severe disease, prolonged severe infection-depletes cellular numbers, decrease production-starvation, aplastic bone marrow, chemotherapy-reduced survival, autoimmune diseases: lupus & rheumatoid arthritis
eisonophilia
increase in allergic disorders-asthma, hay fever, drug reactions-increase in parasitic invasions
monocytosis
measurement in blood has poor correlation with disease; usually occurs within neutrophenia in later stages of infections, needed to phagocytize organisms and debris
lymphocytosis
acute viral infections, malignancies, lymphocytic leukemias
(increased lymphocytes)
lymphocytopenia
immune deficiencies, drug destruction, viral destruction (AIDS); (decreased lymphocytes)
acute lymphoblastic leukemia (ALL)
acute, T & B cells, lymphoblasts (children ?)
chronic lymphocytic leukemia (CLL)
chronic with lengthy survival, primarily seen in elderly; usually B cells
acute myeloblastic leukemia (AML)
acute, myeloblasts, poor survival rate
chronic myeloblastic leukemia (CML)
gradual onset, most demostrate the Philadelphia chromosome
two causes of hemolytic disease of newborn
1-ABO incompatibility, most common, but usually mild - difference in maternal and fetal blood types
2-Rh factor incompatibility; mothers antibodies attack fetus
hemophilia A
x-linked recessive deficiency of factor VIII
von Willebrand disease
autosomal dominant
vWF (von Willebrand factor) performs platelet adhesion and carrier protein/protector of factor VIII
defects-abnormal platelet adhesion
fever in acute inflammation
up to 105 degrees; limits bacterial growth, is exogenous & endogenous chemical mediators act on hypothalamus
leukocytosis
increased number of circulating neutrophils
increased plasma proteins
elevates so-called "acute phase reactants"
lab tests are ESR (erythocyte sedimentation rate) tells if inflammation is present, but not where
CRP (C-reactive protein) indicates severity of inflammation
local signs of inflammation
heat, redness, swelling, pain
mast cell degranulation
caused by stimulus, is releasing granules in itself, provides immediate response; releases histamine, chemotatic factors & cytokines
cytokines
influence adaptive immune response, degree of inflammation
histamine
causes vasodilation of capillaries and increases vascular permeability; contracts smooth muscle; stimulate nerve ending to cause pain and itching
leukotrienes
slow-reacting lipid molecules that induce effects similar to histamine
prostaglandins
have similar effects to leukotrienes; but also induce pain
antigens
molecule recongized by products of immune system; is an antibody generator
antibody
result of an antigen detected in body; called immunoglobulins
cell-mediated immunity
developed by T-cell differentiation
antibody-mediated immunity
when antibodies circulates in blood & binds to antigens on infectious agents; primarily responsilbe for protection against many bacteria and viruses
antigen-presenting cells (APC)
presents antigens to immune system
T-helper cells
helps antigen-driven maturation of both B & T cells; facilitate & magnify interaction between APC and immunocompetent lymphocytes
T-cytotoxic
targets abnormal cells (viruses; cancers)
T-regulator
suppresses
B cells
from bone marrow"; turns into plasma cells; recognize foreign antigen
plasma cells
is a differentiated B cell, can be found in blood; is a factory for antibody production
memory cells
long lived, capable of "remembering" antigen & respond rapidly on subsequant exposure to same antigen
type I hypersensitivity
IgE; mast cells; targets: allergens; immediate hypersensitivity
allergic reactions and anaphylatic shock
type II hypersensitivity
IgM, IgG, macrophages; targets: tissues (cells); tissue-specific hypersensitity, transfusion reactions, hemolytic disease of newborn
type III hypersensitivity
IgG, IgM, neutrophils; target: immune system, circulate around body & gets stuck in tissue
lupus, rheumatoid arthritis
type IV hypersensitivity
T-cells, macrophages; target: cells, cell-mediated reactions; T-cell attack tissues & recruit macrophages; delayed hypersensitivity
poison ivy, TB skin tests
graft-versus-host disease
WBC in transfused blood or bone marrow attack host (recipitant) who's own immune system in immunocompromised
amblyopia
lazy eye
strabismus
deviation of one eye from the other when looking directly at a specific object, caused by weak muscle in one of the eyes
cataract
clouding of the lens
glaucoma
increase of intraocular pressure in anterior chamber; causes death of retinal ganglions and optic nerve; vision impairment and blindness
retinal detachment
when fluid separates the photoreceptors from retinal pigment epithelium; deprives outer retina of oxygen and nutrients
macular degeneration
loss of critical neurons and overall atrophy of cell; black circles in vision
presbyopia
loss of elasticity of lens
myopia
when light rays are focused in front of retina when looking at distant object (nearsightedness)
hyperopia
when light rays are focused behind the retina when looking at near object (farsightedness)
alteration in color vision
caused by mutations on green pigment gene
(colorblindness)
deuteranopia
deletion/ loss of green pigment
Alzheimer disease
loss of orientation to person, place and/or time; loss of memory; when neurons die in brain, brain shrinkage occurs,
'plagues' noted at autopsy
Huntington disease
causes onset of dementia and chorea (writhing, dance-like movements); caused by degeneration of basal ganglia
multiple repeats of codon CAG (glutamine)
Parkinson disease
neurons in the substania nigra (that make dopamine) die for unknown reasons; dopamine is no longer reaching basal ganglia, causing "pill-rolling" tremors at rest, slow movement (bradykinesia), stooped posture and demetia
extradural (epidural hematoma)
-bleeding is usually arterial
-bleeding between skull and dura mater
-can be insidious (slow onset)
-S&S: headache of increasing severity, vomiting, drowsiness, confusion and seizure, may cause brain herniation
subdural hematoma
-collection of blood puts pressure on brain causing shift in midline
-S&S: more insidious and chronic, headache, drowsiness, slowed cognition and confusion
subarachnoid hematoma
-bleeding into the subarachnoid space (between arachnoid membrane and pia mater)
-S&S: severe headache with rapid onset, vomiting, confusion or lowered level of consciousness, sometimes seizures
intraparenchymal hemorrhage
-extension of intracerebral hemorrhage with bleeding within brain parenchyma
-accounts for 8-13% of all strokes
-more likely to result in death or major disability
-S&S: hypertension, fever, cardiac arrhymias, nuchal rigidity (neck stiffness), altered lev
bacterial meningitis
extends beyond meninges to involve CSF; usually more severe; rapid onset; CSF visibly cloudy
elevated protein, decrease glucose
pathogens: N.meningitidis, S.pneumonaie, H.influenzae
S&S: throbbing headache, N/V, neck stiffness, petechial rash on palms, pr
viral meningitis
sometimes called 'aspetic' meningitis; usually develops gradually and is less severe; CSF visibly clear
mild elevation of protein, normal levels of glucose
pathogens: Enteroviruses, HSV type 1
S&S: similar to bacterial menigitis but more mild
meningitis
inflammation of pia and arachnoid, caused by anything that can inflame tissues of brain, all types exhibit increase of intracranial pressure
encephalitis
acute inflammation of brain matter, usually viral, caused by anthropod-born viruses and HSV type 1, causes widespread nerve cell degeneration, increased intracranial pressure may progress to herniation
S&S: fever, delirium, dementia, seizures, palsies & p
multiple sclerosis
autoimmune disease where patient's immune system attacks myelin sheaths surrounding nerve axons
syndrome of inappropriate ADH (SIADH)
inappropriate secretion ADH (increased) in absence of normal physiologic stimuli; results in water retention; hypervolemia, decreased sodium; shift water to intracellular space (edema); edema leads to headache and other neurological S&S; urine is inapprop
diabetes insipidus
opposite of SIADH (decreased secretion of ADH); lack of aquaporins; increase in normal urine output; very dilute urine; two types: neurologic (lesion on hypothalamus) or nephrogenic (insensitivity of renal tubules of ADH)
type I diabetes mellitus
typically immune disease of children; genetic factor is triggered by something (virus, food, chemical, drug); beta cells are gradually destroyed by islet cell antibodies; results in deficiency of insulin production; usually diagnosed under 30 years of age
type II diabetes mellitus
typically a complex multifactoral disease of adults; genetic susceptibility ; obesity; usually develops after age 45; pancreas doesn't keep up with demand and/or there is resistance at receptor level
arteriosclerosis
chronic disease of arterial system; abnormal hardening and thickening of vessel walls; smooth muscle cells and collagen fibers migrate causing stiffen and thickened tunica interna; restricts ability of lumen to change size
athersclerosis
form of arteriosclerosis; thickening and hardening of vessel wall by deposits of intra-arterial fat (LDL cholestrol) and fibrin harden over time
atherosclerosis begins with:
1-endothelial injury
2-fatty streak
3-fibrotic plaque
4-complicated lesion
coronary artery disease (CAD)
diminishes myocardial blood supply; leads to reversible myocardial ischemia (angina); irreversible myocardial infarction (MI) and death; both inhibit pumping ability of the heart
angina
temporary; caused by atherosclerosis; blood test normal;
tx: rest, nitro, beta-blockers, calcium, antagonists
complications: vasoconstriction
myocardial ischemia (MI)
irreversible, necrosis; blockage by atherosclerosis, emboli, etc; blood test elevated;
tx: narcotics, anticoagulants, ACE inhibitors, beta blockers, surgery
complications: dysrhythmias, pulmonary congestion, reduced myocardial contractability, pain , feve
dilated cardiomyopathy
remodeling d/t overfilling and weak myocardial contractions; often the result of other cardiomyopathies; R/T heart attacks; ventricles enlarge
hypertrophic cardiomyopathy
thickening of the myocardium often a result of hypertension and valve disease
restrictive cardiomyopathy
d/t infilrative disease; ventricular walls are excessively rigid and impede ventricular filling; another cause of heart failure in many under-developed countries