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MeganM
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What is infectivity?
Aility to enter the host and replicate
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What is an example of infectivity?
coagulase (enzyme that creates a special sticky coating around staphg to protect it from the host's defenses.)
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What is pathogenicity?
ability to produce disease in a healthy host
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What is virulence?
disease-producing potential; potency of pathogen and speed of its replication
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Virulence is measured in terms of what?
in terms of the number of microorganisms required to kill its host
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What is toxigenicity?
the amount and tye of toxin produced as a byproduct of the disease.
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What does the hemolysin byproduct do? and an example?
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What does the leukocidin byproduct do? and an example?
- destroys WBCs
- Staph aureus
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What is an endotoxin and an example?
byproduct of gram (-) bacteria that cause pyrogenic effects and the resulting disease.
- Sugar + fat molecule create disease states.
- ex = Cholera
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Other than coagulase, what are two more examples of infectivity?
TB & cammo wax
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What is an exotoxin?
Protein enzymes released from living microbes that cause body to swell.
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What is an example of an exotoxin?
Staphylococcus (gram +) can grow and reproduce in salt. Toxins create the "sickness" we feel. No smell, no spoilage. Lots of vomiting.
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What type of immunity is B-cell immunity?
Humoral (directed against pathogens in EXTRAcellular fluid)
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What do B-cells target?
bacteria and viruses
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What do T-cells do?
target infected cells and kill tumors!
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What is cellular immunity?
- (aka cell-mediated)
- directed against pathogens WITHIN the cells (INTRAcellular)
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What do b-cells secrete?
antibodies
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What do t-cells secrete?
cytokines
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Where are b-cells found?
in the spleen
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Where are T-cells found?
blood & lymph nodes
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Type of ab (immunoglobulin) that can fix complement.
IgM
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Type of ab (immunoglobulin) that is found mainly in mucus, but also in histamine.
IgA
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Type of ab (immunoglobulin) that is important in activation of B-cell.
IgD
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Type of ab (immunoglobulin) that can crossthe placental barrier.
IgG
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Type of ab (immunoglobulin) that is involved in allergies.
IgE
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There are fixed macrophages in two of our important body organs. Name the macrophages and the corresponding organ of each.
- Kupffer cells = LIVVER
- Microglia = BRAIN
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What is chemotaxis?
- It's how the specialized WBCs know how to get to injury and where exactly to lay down the protein to make a clot;
- Movement of a cell toward or away from a chemical substance.
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Chemotaxis is part of what system?
The kinin system
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How can we give people immunity?
In the form of an IV (IVG)
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What kind of rxn is a type I hypersensitivity?
anaphylaxis
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What kind of rxn is a type II hypersensitivity?
Specific Cytotoxic Rxn
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What kind of rxn is a type III hypersensitivity?
Immune Complex - A rxn agains soluble antigens in serum.
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What kind of rxn is a type IV hypersensitivity?
Cell-mediated
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Explain what (and which) ab do in a type I hypersensitivity rxn.
IgE ab bind to mast cells & basophils which cause degranulation and a release of histamine
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Explain what (and which) ab do in a type II hypersensitivity rxn.
IgG or IgM bind to an antigenic cell and the cell lyses.
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What are two examples of a type II hypersensitivity?
- Goodpasture's Syndrome;
- Blood transfusion rxn (given wrong type of bld)
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With a type II hypersensitivity rxn, which ab does the body produce and what do they do?
- immunoglobulin ab that can damage tissue cells
- the allergen gets attacked and cells are also destroyed
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What is Goodpasture's Syndrome?
- A type II hypersensitivity rxn (cytotoxic) to Paraquat weed killer, chem in cigs, cocain, benzene, kerosene
- Defective ab are produced which attack RBCs
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What is destroyed and what can it cause in those with Goodpasture's Syndrome?
Collagen, which clogs the kidneys an lungs and causes renal failure (glomerulonephritis) and widespread hemoptysis
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What is an arthus?
a type III hypersensitivity rxn (immune complex) to a vaccine which causes edema, hemorrhaging and necrosis at the site
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How are soluble antigens normally removed and what happens to them in a type III hypersensitivity rxn?
- normally removed by macrophages in the spleen and liver.
- they form in lg amts and overwhelm the body immunocomplexes, deposit in tissues and cause inflammation
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Which type of cells or ab are involved in a type IV hypersensitivity rxn?
T-cells. NOT antibodies.
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Why is the type IV hypersensitivity rxn delayed a day or two?
b/c the macrophages and T-cells need time to migrate to the rxn site
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Where does the type IV hypersensitivity rxn show up?
on the skin
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What is Stevens-Johnson Syndrome?
a Type IV SEVERE allergic hypersensitivity to MEDICATION
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What happens to the skin in those with SJS?
- Degloving (secondary to cytotoxic T-cells)
- epidermal apoptosis
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What are the 3 types of autoimmune disorders?
- Type II (Cytotoxic Rxns)
- Type III (Immune complex)
- Type IV (Cell-mediated)
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What is Grave's Disease?
A Type II Autoimmune Disorder in which the body attacks the thyroid (overproduction of thyroid hormone; thyroid swells)
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What is Myasthenia Gravis and what does it affect?
- A Type II Autoimmune Disorder in which ACh receptors are blocked by ab.
- Muscles that control the eyes, face, neck and limbs are commonly affected. ("tosis" of the eye)
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What are two examples of a type II autoimmune disorder?
- Grave's Disease
- Myasthenia Gravis
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What is Systemic LUPUS Erythematosus?
- a type III autoimmune DO
- autoantibodies react agains DNA, blood cells, neurons
- after apoptosis, immune complexes form under the skin, in kidneys and in joints.
- widespread inflammation
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What are the symptoms (cluster) of lupus?
- rash
- oral ulcers
- arthritis
- proteinuria
- leukopenia
- thrombocytopenia
- photosensitivity
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What is Rheumatoid Arthritis?
- a type III autoimmune DO
- IgM auto ab collect inside joints, cause swelling and heat and damage the joint
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What are two examples of type III autoimmune DO and who do they affect?
- Lupus and arthritis;
- primarily women
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What is Type I diabetes?
- A type IV autoimmune DO
- Insulin Dependent
- The body attacks its own BETA cells in the PANCREAS = destroys ability to produce insulin
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What is MS?
- A type IV autoimmune DO
- caused by myelin-reactive T-cells activated by a trigger (infection?)
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What are some signs/symptoms of MS?
- axonal loss & scarring
- brain atrophy
- impaired eye movements, blurry vision
- noncoordination in extremities & gait
- tremors
- heat intolerance
- incontinence, retention, constipation
- cognitive impairment & confusion
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What are two examples of type IV autoimmune DO?
- Type I DM
- Multiple Sclerosis
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What is the temp range considered to be a sign/symptom of sepsis?
96 - 101.4
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What is the heart rate that is considered to be a sign/symptom of sepsis?
sustained HR 90 or more bpm
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What is the respiratory rate range that is considered to be a sign/symptom of sepsis?
sustained 20 or more per min
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What is the range of WBC count considered to be a sign/symptom of sepsis?
- less than 4,000/mm3
- OR
- more than 12,000/mm3
- OR
- more than 10% immature neutrophils
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When is BP a sign of sepsis?
Severe hypotension (90/40)
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What are two signs of sepsis that do not involve numbers?
- bacteria and toxins are in the blood & growing OOC
- cytokines produce widespread systemic VASODILATION
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At what level of UOP is considered a sign of sepsis?
No, or minimal UOP (10 cc/hr)
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When testing for HIV, and the second HIV test (Blot or IFA) is negative, when do you retest?
in 6 mos to cover the window of poss seroconversion
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The ______ test is used to confirm the _______ HIV test
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_____ describes what sets the disease process in motion (initial contact); ______ explains how the disease process evolves (cellular & tissue events after contact).
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A bacterial infection on top of the flu is an example of what?
A complication (secondary infection)
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Excessive bleeding when injured is an example of what in regards to a person with hemophilia?
sequelae (consequence)
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Decreasing risk factors BEFORE disease occurs.
Primary prevention
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Early detection of the POTENTIAL for dev of a disease.
Secondary Prevention
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Examples of primary, secondary, and tertiary prevention.
- Primary - immunizations
- Secondary - Pap smear to detect HPV
- Tertiary - coctail to treat HIV AFTER diagnosed
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Clinical interventions to prevent further deterioration or reduce the complications of a disease once diagnosed.
tertiary prevention
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What are SElye's 3 stages of GAS (General Adaptation Syndrome)?
- Alarm stage
- Resistance/Adaptation stage
- Exhaustion stage
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What is the alarm stage of Selye's General Adaptation Syndrome (GAS)?
- the first stage;
- generalized stimulation of the sympathetic NS and the HPA axis
- results in release of catecholamines (NE & Epi)
- and cortisol
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What is the second stage of Selye's General Adaptation Syndrome (GAS)?
- Resistance/Adaptation
- body selects most effective & economic channels of defense
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During this stage of GAS, cortisol levels drop because they are no longer needed.
Resistance/Adaptation stage
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What is the Endocrine Response #1 to stress?
- Adrenal MEDULLA dumps epi, dopamine, and sm amts of NE after stimulation by sympathetic NS
- Liver releases glycogen to increase BGL
- Heart contraction and CO increase
- Increase in free fatty acids & serum cholesterol
- Inhibition of insulin from pancreas = increase in glucose
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What is the Endocrine Response #2 to stress?
- ADH released from post. pit. = water retention
- CRF in hypoth. stim post pit to release ACTH = stim release of cortisol from adrenal CORTEX
- PRL & GH also released from Post pit
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Main effect of cortisol (hydrocortisone).
to increase BGL & aa
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Other than it's main affect, what else does cortisol do?
- suppreses B & T cell activity initially while increasing humoral immunity in time
- supports higher BP
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What are the two patterns of reversible cell injury?
- Cellular swelling
- Fatty Change
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How does cellular swelling occur and what is it?
- It is a pattern of reversible cell injury
- occurs with impairment of the Na+/K+ pump, usually as a result of hypoxic cell injury
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Fatty changes are linked to __________. When they occur, small vacuoles of fat disperse throughout the _______.
- INTRAcellular accumulation of fat;
- cytoplasm
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What does a fatty change in cells usually indicate?
a severe injury
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How may fatty changes occur?
- normal cells are presented with an increased fat load, or
- injured cells are unable to metabolize the fat properly
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How does hypoxia contribute to cellular swelling and membrane damage?
- It causes an inflammatory response - deprives cell of O2 and interrupts oxidative metabolism and generation of ATP.
- Reduced ATP causes acute cellular SWELLING
impairment of Na+/K+ pump causes intracellular K+ levels to decrease, and Na+ and H20 accumulate in the cell (swells!)
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Some causes of hypoxia.
- Inadequate amt of O2 in air
- Respiratory disease
- Edema
- Ischemia
- Hypermetabolic states
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Fatty change occurs mainly in which organ?
Liver
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A protective nonspecific defense response to cell injury.
Inflammation
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What is the purpose of inflammation?
- To remove the aggravating agent and
- to initiate the healing process
- Limit the injuriuos effect of pathological agent
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Inflammation MOST OFTEN occurs when?
with infection. But also develops as a result of an injury to a cell
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In inflammation, the adhesion of WBCs to endothelial lining.
pavementing
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The first responders in the vascular response to inflammatin (chemical mediators).
- histamine & seratonin;
- initial vasodilation & capillary permeability
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How is redness produced in the inflammation process?
- dilation of arterioles and increased circulation;
- localized bluch from capillary distention
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How is heat produced in the inflammation response?
- vasodilation
- fluid leakage into interstitial spaced
- increased BF
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How is pain produced in the inflammation process?
- pain receptors are stimulated by swollen tissue,
- local pH changes,
- and chemicals excreted during the inflammatory process
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How is edema produced in the inflammation process?
- vasodilation,
- leakage of fluid into interstium;
- blockage of lymphatic dranage
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How is loss of fxn produced in the inflammation process?
result of edema & pain
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Local or systemic manifestation of inflammation? pyogenic microbes that present infection
local
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Local or systemic manifestation of inflammation? hemorrhagic
local
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Local or systemic manifestation of inflammation? abscesses
local
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Local or systemic manifestation of inflammation? leukococytosis
systemic
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Local or systemic manifestation of inflammation? increase in plasma proteins
systemic
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Why do we feel pain with inflammation?
the tissue is swollen, full of exudate & presses on the nerves
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What biochemical mediators initiate pain in the inflammation process?
prostaglandins. They also damage nerves.
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Chronic inflammation is characterized by infliltration of ______ instead of ______.
- monocytes and lymphocytes;
- neutrophils
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What are the 3 phases of would healing?
- Inflammatory
- Proliferative
- Remodeling
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What happens in the proliferative stage of wound healing?
- new tissue is built
- fibroblasts secrete collagen
- granulation starts forming (pink-red)
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Which phase of wound healing includes hemostasis and vascular & cellular phases?
Inflammatory
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