Exam 1

1 / 112
Click the card to flip 👆
Terms in this set (112)
What are the five parts of clinical history?- History of current illness - Patient's Medical history - Family history - Social history - Review of symptoms/signsDescribe the "history of current illness" part of a clinical history.Severity, time of onset, and character of patient's symptomsDescribe the "patient's medical history" part of a clinical history.Details of general health and previous illnesses that may shed light on current problemsDescribe the "family history" part of a clinical history.Health of patient's parents and family members; diseases that run in familiesDescribe the "social history" part of a clinical history.Patient's occupation, lifestyle behaviors (habits, alcohol and tobacco consumption, etc.), general health, current problemsDescribe the "review of symptoms/signs" part of a clinical history.Eliciting additional information about symptoms other than those disclosed in history of present illness (e.g., not sleeping well at night)Physical Examination- Systematic examination of patient, with emphasis on parts of body affected by illness - Abnormalities noted correlated with clinical historyDifferential Diagnosis- Consideration of various diseases or conditions that may also explain patient's symptoms and signs - Diagnostic possibilities narrowed by selected laboratory tests or other diagnostic procedures - Opinion of medical consultant/specialist may be soughtWhat does etiology (of a disease) mean?cause (of a disease)PathogenesisSource or cause of disease, together with its developmentIdiopathicThe term used to describe diseases of unknown etiologyLesionUsually at the root of most causes of disease; could be a damaged gene or enzyme, or abnormal cells, tissues, or organsRisk factorAnything that predisposes an individual to the development of a diseasePrognosisThe predicted course and outcome of the disease... includes chance for recovery, chance of permanent loss of some function, chance of survivalAcuteQuick onset, short duration, e.g., influenza, measles, and the common coldChronicA disease may begin insidiously and be long-lived; e.g., arthritis, hypertensionTerminalA disease that will end in deathRemissionSigns and symptoms subsideExacerbationSigns and symptoms recur in all severityRelapseSigns and symptoms return weeks or months laterComplicationA related disease or other abnormal state that develops in one already suffering from a diseaseThe U.S. spend more on healthcare than any other nation (T/F).TrueSteps to promote healthy lives:- By physically active - Eat wisely - Maintain healthy weight - Be tobacco free - Limit alcohol - Get recommended screening tests and immunizations - Manage stress - Get proper sleep - Social connections/friendshipsFall prevention steps:- Be physically active - Be mindful of medications - Keep vision sharp - Eliminate hazards in living spaceSpecific treatment (curative)- Directed at underlying cause - Exerts a highly specific and favorable effect on the basic cause of disease (e.g., antibiotic for bacterial infection in throat)Symptomatic (palliative) treatmentAlleviates symptoms but does not influence course of disease (e.g., treatment of fever, pain, and cough)Screening tests for detection of a diseaseDetect early asymptomatic diseases amenable to treatment to prevent or minimize late-stage organ damageScreening for genetic diseases- To screen for carriers of some genetic diseases transmitted from parent to child as either dominant or recessive trait - Identifying carriers allows affected persons to make decisions on future childbearing or management of current pregnancyImmunityThe ability of the body to defend itself against infectious agents, foreign cells, and abnormal body cellsInnate immunity (nonspecific defenses)Immunity that is present before exposure and effective from birth. Responds to a broad range of pathogens.What are examples of innate immunity?- Barriers - Phagocytosis - Natural Killer cells - Fever - Interferon - InflammationAcquired immunity (specific defenses)Immunity that is present only after exposure and is highly specific.What are examples of acquired immunity?- Cell-Mediated - HumoralPhysical and chemical barriers- Intact skin (physical) - Skin produces secretions (tears, sweat, saliva, oils) that contain chemicals that can destroy foreign invadersPhagocytosisLeukocytes destroy infectious agents through phagocytosis (cell eating: they engulf and digest invading materials)Natural Killer CellsOne type of leukocyte that works by recognizing abnormal membraneFever- Raise in body temperature - Stimulates phagocytosis - Increases metabolism, inhibits multiplication of certain organismsInterferons- Anti-viral proteins that boost immunity - Remain after viral infections in some cells; stimulate the cells to resist infection - Increase activity of NK cells - "Interfere" with virus replicationLeukocytosisAn increased level of WBC circulating through blood, trying to fight off somethingExudateFluid, such as pus, that leaks out of an infected woundWhich system is involved in acquired immunity?Lymphatic systemPassive acquired immunityResults when a person receives protective substances produced by another human or animalActive acquired immunityDevelops following direct exposure to the pathogenic agentCellular (Cell-Mediated) immunity- Involves the production of T cells and natural killer (NK) cells. - These defense cells are cytotoxic - They physically attack and destroy pathogenic cellsHumoral immunity- Refers to the production of B lymphocytes, also called B cells - B cells respond to antigens by producing a protective protein, an antibody. - Antibodies combine with the antigen to form an antigen-antibody complex. - It either targets the foreign substance for phagocytosis, or prevents the infectious agent from damaging healthy cellsHypersensitivity- Diseases that occur as a result of immune response - An extreme immune response to a harmless antigen (a.k.a. allergen)Type 1 hypersensitivityImmediateType 2 hypersensitivityCytotoxicType 3 hypersensitivityImmune-complexType 4 hypersensitivityDelayedType 1 hypersensitivity (immediate)- Reaction of IgE antibody on mast cells with antigen, which results in release of mediators, especially histamine. - Most common, localized - Antihistamine used as first line of defenseType 2 Hypersensitivity (cytotoxic)- Reaction of IgG with host cell membrane or antigen absorbed by host cell membrane. - Immediate cell destruction - ex) response to incompatible blood transfusionType 3 hypersensitivity (immune-complex)- Antigens combine with MANY antibodies, forming a soluble mass (immune complexes) - The complexes can deposit in tissues and vessels and trigger inflammation and tissue destruction - Example: glomerulonephritis (deposits in kidney after a strep infection)Type 4 hypersensitivity (delayed)- Take time after exposure to develop/react - Ex) Reactions to poison ivy/oak, contact dermatitis from wearing latex glovesWhich types of hypersensitivity are the most serious?Types 1 and 4AutoimmunityWhen the immune system attacks the body's own tissueToleranceImmune response normally recognizes the difference between the individual's own tissues and those of invadersAutoimmune diseases occur when individuals...... develop antibodies to their own tissues or self- antigensAutoantibodiesThose that attack the individual's own tissuesSystemic Lupus Erythematosuschronic autoimmune inflammatory disease of collagen in skin, joints, and internal organsHow many Americans are affected by Lupus?1.5 millionWhat percentage of Lupus patients are women?90%Lupus diagnosis usually occurs between ages of _____.15-44Describe the stress response on the immune system.Stress -> Increased production of epinephrine and norepinephrine -> Increased production Of serum cortisolBy middle age, the thymus is only about _____ of its maximum size.15%The diversity of _____ is reduced with age.T LymphocytesCommon problems with age and the immune system include:- Increased infection risk - Decreased ability to fight disease - Autoimmune disordersEpidemiologyThe study of the transmission, occurrence, distribution and control of diseaseIncidenceThe number of new cases of a disease in a population in a specified period of timePrevalenceThe number of total cases of a disease in a population at a specific point in timeEndemicDisease that always occurs at low levels in a specific populationEpidemicDisease that occurs in unusually large numbers over a specific areaPandemican epidemic has spread to include larger geographic areasTypes of infectious diseases- Communicable - NoncommunicableCommunicableTransmitted from human to human either directly or indirectlyNoncommunicableNot transmitted directly from humansReservoirThe source of an infectious agent. Examples include humans, animals, insects, soil, and waterHorizontal transmissionHappens when an ID is transmitted directly from an infected person to a susceptible personVertical transmissionOccurs from one generation to the nextFomitesInanimate objects that are contaminated by direct contact with the reservoirTypes of direct transmission- Direct physical contact (e.g., sex) - Droplet spread (e.g., coughing, sneezing)Indirect transmission through an intermediary mechanism- Contaminated food or water - Vectors - FomitesWhat are the steps to break transmission?1) Immunization 2) Identify, isolate, treat 3) Controlling indirect transmissionPrions- An infectious agent composed only of protein. - Induces abnormal folding of normal cellular proteins in the brain. - Usually progress rapidly and are currently untreatable and fatalWhat are examples of diseases caused by prions?- Creutzfeldt-Jakob Disease; - Kuru DiseaseViruses- Core genetic material (RNA or DNA) enclosed in a capsid - Does not independently grow, metabolize, or reproduce - Carries out life processes by entering cells and redirecting energy, materials, and organelles (metabolism activities)Bacteria- One-celled organisms - Small, no nucleus or membranous organelles (prokaryote) - Able to adapt and survive in a number of different environmentsWhat characteristics are used to describe bacteria?- Shape & Arrangement - Gram Stain Reaction - Growth RequirementsProtozoa- One-celled organisms - Eukaryotic (contain nucleus and organelles) - Larger than bacteria with complex internal structures - Classified as amoeboids, flagellates, ciliates, and sporozoansFungi- Multi-celled, plant-like organisms without chlorophyll - Two types: yeasts and molds - Reproductive structures are called spores - Most are obligate aerobes, opportunistic - Natural habitat is our environment - Can cause inflammation or hypersensitivity - Can interfere with normal organ structure and function in humansHelminths- Parasitic worms (round and flat) - Reproductive system - Complex life cycle - Mostly found in tropical, subtropical areas - Borne transmission most commonNosocomial infections- Hospital-acquired infections - The principal routes of transmission: - direct contact between healthcare staff to patient - indirect contact through fomites and the hospital's ventilation system - Most are bacterial in natureHow many patients in U.S. contract nosocomial infection each year?~1.7 millionHow many people die as a result of nosocomial infections in the US each year?~99,000Top 3 nosocomial infections- UTI's - Site of Surgery - In lungsAntibiotic treatment of bacterial infections- One of the great discoveries and advances in medicine - Specific antibiotics target specific bacteria - Four principal mechanisms of actionWhy does antibiotic resistance occur?- Over-prescribing or Inappropriate prescribing - Overuse as feed supplement for livestock - Improper use/compliance by patient - Spread of resistant strains of bacteria worldwideAntiviral treatment- Nucleic acid analogues mimic correct DNA or RNA bases. - Interfere with assembly of new virus particles within the cell or interfere with the attachment of viruses to host cellsAntifungal treatment- Targets cell walls and membranes - Affect human cells, therefore, may be toxicAntiprotozoals- Interfere with protein synthesis and metabolism - But, resistant microorganisms evolve, rendering existing treatments uselessRe-emerging infectious diseaseKnown infectious diseases that re-appear after a significant decline in incidence (or a perceived eradication)Causes for re-emerging infectious diseases- Environmental: Changes in climate, natural disasters - Societal/Behavioral: urbanization (crowding, poverty); globalization (rapid world travel); - Political: disruption of government structures, war, civil unrest