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UA Pathophysiology (Lachel Story) Ch. 1 - Cellular Function
Pathophysiology at University of Alabama's Capstone College of Nursing "Pathophysiology" by Lachel Story - Ch. 1 Cellular Function
Terms in this set (46)
Cells numbers and size decrease due to decreased cellular work demands. i.e. after wearing a cast
Cells increase in size and number to meet increased cellular work demands. Common in cardiac and skeletal muscles. i.e. body building; hypertension
Incase in the number of cells (that divide by mitosis) in an organ or tissue. i.e. wound healing, liver regeneration, menstruation, skin warts.
Process of one adult cell being replaced by another cell type, usually due to chronic irritation and inflammation. Can lead to cancer if stimulus isn't removed. ex. cigarette smokers; trachea starts off w/ normal cells. After years of smoking they're replaced w/ diff type of cells that are non-mucous producing cells. Leads to dry, hacky cough. If smoking stops, they abnormal cells are replaced w/ normal healthy cells eventually.
Cells mutate into cells of a different size, shape, and appearance, often an implication of precancerous cells. Usually found in the reproductive and respiratory tract and can often be reversed by removing the trigger. ex. HPV virus -> dysplastic cells on cervix.
Decreased blood flow to a tissue or organ which strangles the tissue by limiting oxygen and nutrients. ex. Burn victims develop "eschar" on surface which strangles the oxygen flow to healthy tissue, so must be sloughed off regularly.
Occurs when a cell is damaged (often by ischemia) and cannot survive. They swell and burst/lyse.
"Walled off" liquid goo like hard candies w/ liq inside; occurs when caustic enzymes dissolve and liquefy necrotic cells. Most common in the brain because the brain contains plenty of these enzymes.
'Cased'-off cheese globules; occurs when the necrotic cells disintegrate but the cellular debris remains for months or years. Has a cottage cheese like appearance and is most common with tuberculosis.
Occurs when lipase enzymes break down intracellular triglycerides into free fatty acids which then combine with magnesium, sodium, and calcium-forming soaps. Has an opaque, chalky, soapy appearance. Often in breast, liver, pancreas.
Firm & opaque like Jello; usually results as an interruption in blood flow. Most often occurs in the kidneys, heart, and adrenal glands.
form of coagulative necrosis that is a combination of impaired blood flow and a bacterial invasion. Usually occurs in the legs because of arteriosclerosis or in the gastrointestinal tract. Must be removed or can cause system-wide sepsis infection.
Coagulative; occurs when bacterial presence is minimal, and the skin has a dry, dark brown, or black appearance.
Lots of WBCs and bacteria which produce a liquid wound. Can occur in extremities and internal organs.
Worst type; develops because of Clostridium, an anaerobic bacteria, that releases gas into the tissue. The bacterium releases toxins that kill surrounding cells, thus spreading rapidly. Treatment usually results in removing limb(s).
"new growth" that is no longer responding to normal regulator processes usually because of a mutation. The associated disease state is cancer.
process by which cancer develops in three phases-initiation, promotion, and progression.
genes that have high potential of causing cancer
Clinical manifestations of cancer
Change in bowel or bladder habits; A sore that doesn't heal; Unusual bleeding or discharge; Thickening or lump in the breast or elsewhere; Indigestion or difficulty swallowing; Obvious change in a wart or mole; Nagging cough or hoarseness.
Diagnosis tools for cancer
biopsy, tumor markers, various scans (x-rays, computed tomography, endoscopy, ultrasounds, positron emission tomography)
TNM (Tumor Node Metastasis); the grade is based on spread of disease.
Cancer stage 0
Insitu; boundaries are obvi and surgeon can easily get it all
Cancer stage 1
it is just in the organ of origin.
Cancer stage 2
gray area; may or may not have spread
Cancer stage 3
larger cancer and in a lymph node closest to origin.
Cancer stage 4
cancer is in a different organ from organ of origin.
Curative; Palliative; Prophylactic. Can involve surgery, radiation, and/or chemo; Hormone/antihormone therapy; biotherapy
the loss of differentiation that occurs with cancer. The less the cell resembles the original cell the more anaplastic the cell.
a generalized wasting syndrome where a person appears emaciated, often occurs due to malnutrition.
unintended effect of a medical treatment.
Primary level of prevention
do not have the disease and you are trying to prevent it; ex: vaccines (ideal)
Secondary level of prevention
disease detection; ex: Pap smears and yearly physicals
Tertiary level of prevention
trying to prevent problems from the disease or problem; ex: rehabilitation (USA system)
Autosomal dominant disorders
always shown; 50/50 chance transmitted to either sex child; typically delayed onset. ex. Marfan Syn and neurofibromatosis
AutDom connective tissue disorder on chrom 15 results in elastin and collagen defects; ClinMan: Very tall m/f w/ long arms and fingers, kyphosis hump, ocular, skeletal, and cardiovascular issues; Diag-history, phys exam, skin biopsy shows presence of fibrillin, genetic testing. Treatment-none, palliative to fix ClinMan symptoms.
Neurogenic(nervous sys) tumors from Schwann cells; Type 1: chrom 17; ClinMan: subcutaneous lesions, at least 6 café-au-lait spots at birth, scoliosis, erosive bone defects, and nervous system tumors. Type 2: chrom 22; ClinMan: hearing loss caused by tumors of the acoustic nerve. Treatment: Palliative removal of tumors.
Autosomal recessive disorders
1:4 will be affected; 2:4 will be carriers that can transfer to later generations; early onset; usually caused by deficient enzyme. ex. PKU & Tay-Sachs
chrom 12 mutation leads to error in converting phenylalanine to tyrosine; ClinMan: fail to meet dev milestones, microcephaly, progressive neurological decline/MR, seizures, hyperactivity, LD, eczema. Diag: serum phenylalanine by 3 days old. Treatment: diet low in protein and starches, gene therapy, phenylalanine lowering agents.
Deficiency of absence of hexosaminidase A necessary to metabo some lipids, so lipids accumulate and demyelinate nerve cells which leads to progressive mental and motor deterioration. Death by 5 yo. ClinMan: lifeless seeming at birth, exaggerated Moro reflex (startle) at birth, apathy to loud sounds by 3-6mo, difficulty with motor skill milestones, vision loss, deafness, seizures, paralysis, spasticity, pneumonia. Diag: fam history, phys exam, low serum/amniotic hexosaminidase A levels. No cure. Treatment: supportive/palliative for infant/family.
Almost always X linked. Males have 50% chance of getting disorder from mother. Females have 50% chance of being carriers. All daughters of affected males will be carriers, but none of their sons. ex. Fragile X Syn.
Fragile X Syndrome
Associated w/ a single trinucleotide gene sequence on the X chrom. Lack of protein necessary for neural tube development. ClinMan: long face and large jaw, large ears, large testicles, MR, LD, speech delays, connective tissue disorders, behavioral issues. Diag: history, phys exam, genetic testing. No cure. Treatment: symptomatic and supportive.
Multifactorial inheritance disorders
results from interaction btwn the environment and genetic factors. Very common but unpredictable. Expressed either at birth (cleft lip, clubfoot, congenital disloc of hips & heart defects, pyloric stenosis, urinary tract malformations) or later (hypertension, diabetes mellitus, cancer, psychiatric disorders).
More than 60 exist. May be related to abnormality in chromosomal number and/or structure that occurs at meiosis. Accounts for most of early abortions.
Down's Syndrome/Trisomy 21
Risk increases w/ maternal age. Caused from nondisjunction during meiosis. ClinMan: small square head, upward slant of the eyes, small low set ears, fat pad on the back of the neck, open mouth with protruding tongue, Simian crease, and MR. Also assoc w/ congenital heart defects, ocular issues, leukemia, respiratory complications. Diag: parental screening/amniocentesis, hormone levels, 4D ultrasound. Treatment: symptomatic and supportive.
Monosomy X / Turner Syndrome
Is female. Deletion of all or part of an X chrom. ClinMan: short, lymphedema of hands & feet, broad chest w/ wide spaced nipples, low set ears, small lower jaw, sterile, increased weight, webbing of neck, coarctation of aorta, horseshoe kidney, visual issues, ear infections, hearing loss. Diag: history, phys exam, chrom testing. Treatment: estrogen and growth hormones.
Polysomy X / Klinefelter's Syndrome
Is male with XXY chroms. ClinMan: gynecomastia (breasts), small testes and penis, tall, increased weight, sparse body hair, LD, behavioral problems, sexual disfunction, pulmonary disease, varicose veins. Associated w/ osteoporosis and breast cancer. Diag: history, phys exam, hormone levels, chrom testing. Treatment: Testosterone.
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