Pathophysiology Lecture Notes

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Pathophysiology Lecture Notes
2012-04-23 17:13:41
Aspects Disease

Test 1
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  1. What are the 7 aspects of disease?
    • Pathophysiology
    • Etiology
    • Signs and Symptoms
    • Diagnostics
    • Treatment Modalities
    • Sequelae/Complications
    • Prognosis
  2. What are the causes of disease at the cellular level?
    • Ischemia or hypoxia - low oxygen
    • Physical Damage - heat, cold, radiation
    • mechanical - pressure, tearing
    • chemicals - toxins
    • microorganisms - viruses, bacteria
    • abnormal metabolites
    • low nutrients
    • low or high fluids and electrolytes
  3. What are the four signs of inflammation?
    • Swelling - Tumor
    • Redness - Rubor
    • Heat - Calor
    • Pain - Dolar
  4. What are the 2 types of inflammtion?
    • Acute - tissue damage, short-term, no granuloma
    • Chronic - from chronic irritation, granulomas can be formed
  5. Describe the pathophysiology of acute inflammation.
    • Injury, then damaged cell and WBC will release chemical mediators
    • CMs cause and increase in capillary permeability
    • Increase CP causes increased plasma proteins travelling to the site (albumin, globulins, fibrinogens)
    • CM cause increase in chemotaxis and diapedesis of WBC
    • WBC (macrophages and neutrophils) phaygocytosis bacteria and parts of damaged cells
  6. What are Big 7 of Acute Inflammation?
    • Et - trauma
    • S/S - redness, pain, swelling, heat, fever, exudate (puss)
    • D/x - WBC count, CRP, ESR
    • R/x - NSAIDs, Tylenol, Prednisone (glucocorticoids), RICE (rest, ice, compressions, elevation)
    • Seq/Ccx - chronic inflammation
    • Px - good
  7. What are the 3 healing options/outcomes?
    resolution, regeneration, replacement
  8. What are PMN cells? What are some examples?

    NEBs - neutrophils, eosinophils, basophils
  9. Seven Aspects of Type 1 Hypersensitivity
    • Pa - allergen acts as an antigen binding to IgE on B cell. B cells activate without CD4 and make IgE. Allergen - IgE causes degranulation of mast cells/basophils - release of histamine
    • Et - immunological dysfunction
    • S/S - hives, itching, swelling, airway obstruction, etc
    • Dx - skin test (positive)
    • Rx - mild: antihistamine(chemotherapy)
    • acute: EpiPen (epinepherine) - stimulates CV system
    • Seq/Ccx - swelling can cause airway obstruction and death
    • Px - very good when allergen is avoided or with prophylactic treatment
  10. Seven Aspects of Type II Hypersensitivity
    • Pa: IgG binds to A, B, or D antigens causing complement activation which causes lysis
    • Et: Iatrogenic - mistake (wrong blood tpye given to patient in transfusion)
    • Px: very poor
  11. Seven Aspects of Type III Hypersensitivity
    • Pa: Antigen-Antibody complexes form and deposit in tissues. Inflammation in tissue where deposited
    • Et: Immunological dysfunction, iatrogenic (often a seq or ccx)
    • S/S: depends on tissue that traps complexes
    • Dx: IgG or antigen levels
    • Rx: depends on tissue that traps complexes
    • Px: Again, depends on tissue
  12. Seven Aspects of Type IV Hypersensitivity
    • Pa: Allergen acts as antigen and binds to MHC 1, which stimulates CD8 activation. stimluates cytotoxic killing of the allergen. cell mediated immunity. delayed b/c after exposed still need to wait for CD8 cells to clone
    • Et: Immunological dysfunction
    • S/S: skin rashes
    • Dx: By signs (rash)
    • Rx: Anti-inflammatory medications
    • Seq/Ccx: Sweelincg can cause airway obstruction and death
    • Px: very good when allergen avoided or w/prophylactic treatment
  13. Seven Aspects of Systemic Lupus Erythematosus
    • Pa: IgG antibodies are made whose antigens are "self" molecules. B cell is being activated without APC recognizing foreign.
    • Et: Immunological dysfunction
    • S/S: Prodromal symptoms, butterfly rash, joint inflammation
    • Dx: ANA levels (high), anti-nuclear antibody, high levels of immunoglobulins
    • Rx: Prednisone (steroids) - inhibits the immune system, plasmophoresis - filter blood and remove antibodies
    • Seq/Ccx: relapsing
    • Px: getting better, longer life expectancies
  14. Seven Aspects of AIDs (Acquired Immunodeficiency Syndrome)
    • Pa: HIV infects and destroys CD4 cells, hides in MOs and neurons, which prevents AMI and CMI activation. CD8 cells will attack and destroy CD4 cells
    • Et: microorganism
    • S/S: Flu symptoms, Asymptomatic, AIDS (low CD4, infections, cancers, etc)
    • Dx: ELISA, counts CD4 (low), viral RNA levels (high)
    • Rx: Drugs to stop viral replication (HAART therapies)
    • Seq/Ccx: numerous secondary infections that cause death
    • Px: good in US, considered liveable or curable
  15. What are the stages in the course of infectious diseases?
    • 1. Pathogen enter the host
    • 2. Pathogen colonizes proper site - travel to desired place
    • 3. Rapid reproduction
    • 4. Prodromal S/S
    • 5. Acute S/S (immune response)
    • 6. Decreased Reproduction or Overwhelming Infection
    • 7. Recovery (signs subside) Septicemia
    • 8. Total Recovery Death
  16. Seven Aspects of Malignant Tumors
    • Pa: varies, depends on where located
    • Et: Risk factors- Initiating: genetic, radiation, viruses, chemicals
    • Promotors: hormones, chemicals, age
    • Host defenses- Immunodeficiency
    • S/S: local: pain, obstruction, tissue necrosis
    • systemic: weight loss, anemia, infections, bleeding, paraneoplastic syndromes

    Dx: blood tests, imaging, biopsies - grading: I (close to benign) - IV (most malignant)

    Rx: surgery, chemotherapy, radiation, combination

    Seq/Ccx: spread, metastasis

    Px: depends on grading
  17. Seven Aspects of Iron Deficiency Anemia
    • Pa: too little iron
    • Et: nutrient deficiency - low intake, loss, absorption problems, liver problems, infections
    • S/S: mild anemia symptoms - pallor, fatigue, irritability, stomatitis, glossitis, menstrual irregularities, slow healing, syncope
    • Dx: low Hb, HCT, MCV decreases, low blood iron and ferritin, hypochromatic and microcytic RBC
    • Rx: resolve cause or increased iron
    • Seq/Ccx: see symptoms
    • Px: cood with treatment
  18. Seven Aspects of Pernicious Anemia
    • Pa: deficiency in B6 (folic acid) or B12
    • Et: nutrient deficiency or immunological dysfunction
    • S/S: mild anemia symptoms, tongue(enlarged, red, sore, shiny), digestive discomfort, s/s demyelination
    • Dx: macrocytic or megaloblastic cell, increased megaloblasts, decrease B12, MCV increase
    • Rx: supplement
    • Seq/Ccx: cardiac and neurological damage
    • Px: good with treatment