N220 final

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latent period

from 1st exposure to 1st s/sx

prodromal period

from 1st s/sx and on

iatrogenic

cause is the result of an unintended medical tx

sequela

consecquence of going through an illness

sensitivity

probability that it will be positive

specificity

the probability that a test will be negative

what ae the 3 components of GAS

Alarm reaction, Stage of resistance, State of exhaustion

in Gas, what is the Alarm reaction:

fight-or-fight response due to
stressful stimulus

in Gas, what is the State of exhaustion:

point where the body can
no longer return to homeostasis
-allostatic overload

in Gas, what is the Stage of resistance:

allostatic return

name the scites of action in the hormonal pathway

hypothalamus, anterior pituitary, adrenal cortex

what does the hypothalamus secret

corticotropic-releasing hormone

what does the pituitary gland secret

adrenocorticotropic hormone (ACTH)

what does the adrenal cortex release

glucocorticoids, cortisol, aldosterone

explain the neuro-pathway

hypothalamus activates sympathetic nervous system, then the SN stimulates the adrenal medulla

in the neuro-pathway, what does the adrenal medula secrete

catecholamines (nor-epi, and epinephrine)

normal values WBC

5,000 - 10,000/mm3

RBC Normal Adult Values

4.5 - 5.5 million/mm3 (4 - 5 females)

Normal Adult Values Platelets

140,000 - 400,000/mm3

Mean Corpuscular Volume (MCV) formula

(Hct X 10)/RBC

Mean Corpuscular Hemoglobin (MCH) formula

(Hgb X 10)/RBC

Mean Corpuscular Hemoglobin Concentration (MCHC) formula

(Hgb/Hct) X 100

Neutrophil Primary roles

57 - 67%
Removal of debris
Phagocytosis of bacteria
Prepare the injured site for Healing

Eosinophil Primary roles

Allergy - Ingest antigenantibody complexes
Mediate vascular effects of histamine and serotonin in allergic reactions
Bind to and degranulate onto parasites (worms)

Monocytes Are directed by

TH1 lymphocytes

what lymphocyte is humoral immunity

B lymphocytes

what lymphocyte is cell mediated immunity

T lymphocytes

Classic Signs of Anemia

Pallor
Fatigue
Dyspnea on Exertion (DOE)
Dizziness

cortisol increases

glucose

aldosterone increase

blood volume

what is hydropic swelling

accumulation of water b/c of malfunction of Na/K pump, whic is ATP dependent

give ex of cells that can experience hydropic swelling

epithelial, cubodial

name the 4 normal intracellular accumulations

lipids, carbs, glycogen, protein

Atrophy

cell gets smaller

hypertrophy

cell gets bigger

hyperplasia

increase in cell #

Metaplasia

conversion of one cell type to another

Dysplasia

disorderly growth

hypoxia

lack of oxygen

what are the different types of necrosis

Coagulative, Liquefactive, Fat necrosis, Caseous necrosis

what is Dry gangrene

Form of coagulative necrosis characterized by blackened, dry, wrinkled tissue

Wet gangrene is a form of what type of necrosis

liquefactive

Gas gangrene Results from infection of necrotic tissue by

anaerobic bacteria (Clostridium),

phenotype

physical characteristics that are outwardly apparent

genotype

an organism's genetic makeup, or allele combinations

Chromatids

The two identical halves of a chromosome

Cri du Chat, French word "cry of the cat" is caused by deletion of the short arm of chromosome _______.

5

what are the 2 Sex chromosome disorder

Klinefelter syndrome and Turner syndrome

Klinefelter syndrome only affects

men

Klinefelter syndrome-lacks

testosterone

Turner syndrome only affects

females

what is Marfan syndrome

connective tissue disorder a Medelian (single gene) disorder

Marfan syndrome-features:

tall, slender, thin long arms and legs

Huntington syndrome- describe the features.

also called chorea, involentary movement of arms, mental deterioration. happens around age 40

What is autosomal recessive? Who is the carrier? who will get it

both parents must carry the genes. men and women can get it

hemophilia- the bleeding disorder associated with a deficiency of factor

8 (VIII)

When is congenital malformation most vulnerable?

3 to 9 weeks

leukopenia

Low WBC count

leukocytosis

abnormal increase of white blood cells

Immunoglobulins are proteins that are produced by

B cells

complements- the 20 inactive proteins in circulation. When activated they release chemical to promote:

inflammation, chemotaxis, and lysis

CD4 is what T cell

T helper

CD8 is which T cell

cytotoxic T

IgD is found where

on B cell

which is the most common Ig

Ig G

Types I, II, III Hypersensitivity mediated by antibodies produced by

B lymphocytes.

Type IV Hypersensitivity mediated by

T cells

Type I Hypersensitivity Peak action

immediate

Type I Hypersensitivity: what kind of allergies are they

food allergies, drug allergies

what receptor triggers increased vascular permeability, vasodilation (flushing) urticaria formation (hives), smooth muscle constriction (bronchoconstriction), increase mucus secretion and pruritis (itching), and increased gut permeability

H1

Type II Hypersensitivity Peak action

15 min to 30 min

Type II Hypersensitivity

antibody attack antigen. ex:blood transfusion, Hemolytic Disease of the newborn

Type III Hypersensitivity -define

allergen can come from animals, plants, bacterial. not tissue specific

what Hypersensitivity can cause Glomerulonephritis

Type III Hypersensitivity

define Type IV Hypersensitivity

Tissue damage resulting from delay cellular reaction to antigen

what Hypersensitivity is this about: The principal mediators are lymphocytes-release lymphokines that directly kill cells. 48 to 72 hours

Type IV

what Hypersensitivity has these conditions: Contact dermatitis
Tuberculin-type hypersensitivity
Transplant rejection, graft versus host disease

Type IV

Primary immunodeficiency

congenital, genetic or acquire disorders

Secondary immunodeficiency

Acquired- stress, nutrition, drugs

SCID

Severe Combined Immunodeficiency- lack T cells, and nonfunctioning B cells

Systemic Lupus erythematosus

chronic autoimmune inflammatory disease of collagen in the skin, of joints, and of internal organs

DiGeorge syndrome

congenital disorder-Lack of thymus function, T cell disorder

s/sx of blood transfusion reaction

fever, chills, flushing, tachycardia, hypotension, low back pain , chest pain, nausea, vomiting, restlessness, anxiety, headache, shock, death.

Systemic Lupus erythematosus is caused by what type of Hypersensitivity

Type III

What are hallmark lupus s/sx

fever, joint pain, butterfly-shaped erythema involving cheeks and nose

silver sulfadazine (Silvadene) treatment of

infections in burns and wounds(debidement).

Vitamin C (ascorbic acid) and zinc improve

wound healing

what is Dakin's

bleach solution for Wound care

What immune cell does HIV attack

CD4 T helper

how low does the T cell count have to be in order to be diagnosed as full blown AIDS?

< 200 cells/ μL

Seroconversion

Period when HIV proteins can be detected in the blood

Seroconversion occurs

3 - 17 weeks after infection

When infected (i.e.: from a needle stick) how long can it take for the test to be positive?

4-7 weeks

Average time from initial infection to AIDS is about

10 years

what class of drug can elevate plasma level of cholesterol & triglycerides, may cause new onset of diabetes, exacerbate existing diabetes by incr. blood glucose. Risk of bleeding in hemophiliacs, accelerate bone loss ->osteoporosis. Lipodystrophy also

Protease inhibitors

What is the plasma made of?

Water, Proteins,

What portion of blood is plasma?

50 - 55%

What portion of blood is made up of formed elements

45 - 50%

normal values for CBC

...

normal values for Hct

45%

normal values for Hgb

15 grams

normal values for Neutrophils

57 - 67%

What are the three most numerous plasma proteins

Albumin53% , Globulins43% , Fibrinogen ~4%

What are the three classes of formed elements

Erythrocytes, Leukocytes, Platelets

Megaloblast Anemias(Macrocytic-Normochromic)

Pernicious Anemia (B12), Folate deficiency

which anemia is IF dependent

Pernicious Anemia

name the Microcytic-Hypochromic Anemia

iron defic, sideroplastic

name the 4 Normocytic-Normochromic Anemias

aplastic, post hemorhegic, hemolytic, Anemia of chronic disorder

What is the Virchow triad?

endothelial injury, circulatory stasis, hypercoagulable

WHAT IS THE ANTIDOTE for heparin

protamine

fro heparin what labs will you monitor?

aptt/ptt

what are the labs that you monitor with coumadin

PT and INR

what disorder has the tall tale sign of bleeding that looks like coffee grounds

Gastritis

Manifestation of gastritis?

Vague abd pain
Tenderness Bleeding
Discomfort with food

Superficial ulcers

erosions of top layer, no involvement of muscularis

True ulcers

extend through muscularis, cause bleeding

Which location is most common for PUD?

Duodenal

PUD - Pain begins

30 min - 2 hours after eating

what disorder has these manifistations: Stomach is empty
Food-pain-relief
Bleeding
Remission-exacerbation

PUD

How do we test for PUD

stool, blood, edoscopy, and breath test

We treat PUD with

antacids

what drug -coats the stomach to prevent acids and ulcers. and you can mix the tablet as a "slurry"

Sucralfate

what receptor sites in the stomach will cause vasoconstriction so severely so that ischemia will occur.

Alpha 1 adrenergic

Curling ulcers

from burns

Cushing ulcer

head trauma, brain surgery

Dumping syndrome

food will not get fully digested

Anemia after post-gastrectomy-why?

b/c IF affected, now have B12 anemia

Afferent loop obstruction

obstruction that can occur because the duodenum and the jejunum are now stretched and distended because of a small stomach

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