Term
| What are the gas transport abbreviations? |
|
Definition
P= partial pressure
a=arterial
v=venous
c=capillary
S=saturation |
|
|
Term
|
Definition
| fraction of inspired oxygen; % O2 someone is being given |
|
|
Term
| What is the O2 percentage of room air? |
|
Definition
|
|
Term
| How does O2 travel in the body? |
|
Definition
| It is bound to hemoglobin |
|
|
Term
|
Definition
| drives it to bind or separate from hemoglobin; tight in lungs, loose in tissues |
|
|
Term
| What is the rule of O2 transport? |
|
Definition
| 30-60-90; relationship between PaO2 and SaO2 |
|
|
Term
| What happens when there is a shift to the left in the oxyhemoglobin dissociation curve? |
|
Definition
| increased affinity of hemoglobin for O2; More difficult for hemoglobin to release bound O2 |
|
|
Term
| What causes a shift to the left in the oxyhemoglobin dissociation curve? |
|
Definition
| decreased PaCO2; alkalosis; decreased metabolism; increased altitude |
|
|
Term
| What happens when there is a shift to the right in the deoxyhemoglobin dissociation curve? |
|
Definition
| decreased affinity of hemoglobin for O2; easier for hemoglobin to release O2 |
|
|
Term
| What causes a shift to the right in the oxyhemoglobin dissociation curve? |
|
Definition
| increased PaCO2; acidosis; increased metabolism (stress); fever |
|
|
Term
| What form does most of the CO2 in the body take? |
|
Definition
| bicarbonate in a buffered form; 60-90%; HCO3 (same as CO2 in electrolyte profile) |
|
|
Term
| What is the pH of arterial blood? |
|
Definition
|
|
Term
| What is a key determinate of blood pH? |
|
Definition
|
|
Term
| What is the most important buffering system? |
|
Definition
| carbonic acid bicarbonate system |
|
|
Term
| Describe the Henderson-Hasselbach relationship |
|
Definition
| 1 CO2 (as carbonic acid) balances with 20 bicarb |
|
|
Term
| The respiratory system compensates for ____ problems while the renal system compensates for _____ problems |
|
Definition
|
|
Term
| ____ is a measure of metabolic status which is managed by the ____ |
|
Definition
|
|
Term
ID acid-base imbalance:
depression of HCO3- |
|
Definition
|
|
Term
ID acid-base imbalance:
elevation of PCO2 due to hypoventilation |
|
Definition
|
|
Term
ID acid-base imbalance:
elevation of HCO3- |
|
Definition
|
|
Term
ID acid-base imbalance:
depression of PCO2 due to hyperventilation |
|
Definition
|
|
Term
|
Definition
|
|
Term
| What can cause metabolic acidosis? |
|
Definition
| lactic acidosis, shock, renal failure |
|
|
Term
| What are the clinical manifestations of metabolic acidosis? |
|
Definition
| headache, lethargy, tachycardia, anorexia; deep rapid respirations (kussmaul) to compensate |
|
|
Term
| What is the purpose of the anion gap? |
|
Definition
| to distinguish different types of metabolic acidosis |
|
|
Term
| What is the cause of respiratory acidosis? |
|
Definition
| hypoventilation r/t various lung disorders |
|
|
Term
| What are the clinical manifestations of respiratory acidosis? |
|
Definition
| rapid RR followed by depressed RR; lethargy; seizures |
|
|
Term
| What are the clinical manifestations of metabolic alkalosis? |
|
Definition
| shallow slow respirations; weakness; confusion; tachycardia |
|
|
Term
| The clinical manifestations of respiratory alkalosis are similar to what? |
|
Definition
|
|
Term
| What are the normal values for ABG? |
|
Definition
PaO2= 80-100
PaCO2= 35-45
pH=7.35-7.45
HCO3= 22-26
SaO2= 93-100 |
|
|
Term
| Label the 4 components of ABG |
|
Definition
Oxygen analysis= PaO2 and SaO2
acid base= pH
respiratory= PaCO2
metabolic= HCO3 |
|
|
Term
| What are the 3 steps of ABG analysis process? |
|
Definition
| evaluate oxygenation, pH (acidosis/alkalosis), determine primary problem (ROME) |
|
|
Term
|
Definition
| Respiratory, Opposite, Metabolic, Equal; If respiratory is opposite of pH its a respiratory issue. If metabolic component is equal in direction to pH then issue is metabolic |
|
|
Term
| How do the lungs compensate for metabolic issues? |
|
Definition
| increase RR for metabolic acidosis; decrease RR for metabolic alkalosis |
|
|
Term
| How do kidneys compensate for respiratory issues? |
|
Definition
| retain HCO3 for acidosis; make less HCO3 for respiratory alkalosis |
|
|
Term
ID compensation:
pH is abnormal; compensating values WNL |
|
Definition
|
|
Term
ID compensation:
pH is abnormal; compensating system values are abnormal with evidence of compensation |
|
Definition
|
|
Term
ID compensation:
pH is normal; compensating system values are abnormal with signs of compensation |
|
Definition
|
|
Term
| What are the 4 components of blood? |
|
Definition
| plasma, rbc, wbc, platelets |
|
|
Term
| What components of the RBC are proportional? |
|
Definition
|
|
Term
| What are the two types of leukocytes? |
|
Definition
| granulocytes and agranulocytes (immunocytes) |
|
|
Term
|
Definition
|
|
Term
| What two areas of the body are responsible for hematopoiesis? |
|
Definition
| liver/spleen and bone marrow |
|
|
Term
| What are the two stages of hematopoiesis? |
|
Definition
| proliferation and differentiation |
|
|
Term
|
Definition
|
|
Term
| What are the two types of CFUs? |
|
Definition
| myeloid stem cell; lymphoid stem cell |
|
|
Term
| Define globulins; what are they made of? |
|
Definition
| plasma proteins; two pairs of polypeptide chains |
|
|
Term
| What is hemoglobin made of? |
|
Definition
| four iron proroporphyrin complexes |
|
|
Term
| What are the 3 types of Hgb? |
|
Definition
| OxyHgb (carries O2); DeoxyHgb (has released its O2), Methemoglobin (cannot carry O2) |
|
|
Term
| What are the 3 building blocks of Hgb? |
|
Definition
| proteins, vitamins, minerals |
|
|
Term
| What is the purpose of vitamin b12? |
|
Definition
| erythrocyte maturation; facilitator of folate metabolism; stored until needed for erythropoiesis |
|
|
Term
| What is needed for B12 absorption? |
|
Definition
|
|
Term
| What is the purpose of folic acid? |
|
Definition
| synthesis of DNA/RNA; erythrocyte maturation; not IF dependent |
|
|
Term
| What is the function of iron? |
|
Definition
| critical for hgb synthesis |
|
|
Term
| How is iron removed from the body? |
|
Definition
| MPS; mononuclear phagocyte system after 120 days in spleen |
|
|
Term
| What are the storage forms of iron? |
|
Definition
|
|
Term
| What are the 7 Ds of psychopathology? |
|
Definition
| distress, dysfunction, danger, duration, degree, deviance, and depression |
|
|
Term
| What are the 4 aspects of the stress diathesis model? |
|
Definition
| biological, environmental, psychological, social |
|
|
Term
| What was the first historical record of depression? |
|
Definition
| Hippocrates clinically described melancholia |
|
|
Term
| Depression is most common in what two groups? |
|
Definition
|
|
Term
| What are the 5 major types of depression? |
|
Definition
| major depressive disorder, dysthymic disorder, postpartum onset, seasonal affective disorder, depression with psychotic features |
|
|
Term
| Describe serotonin r/t depression |
|
Definition
| kicks off production of brain cells; depression occurs with imbalance; can't be measured |
|
|
Term
| Describe norepinephrine r/t depression |
|
Definition
| decreased in depression; emotion regulation |
|
|
Term
| What are the 5 biological influences on depression? |
|
Definition
| hormonal, nutritional and medicational imbalance, neurological disorder, electrolyte imbalance |
|
|
Term
|
Definition
| hypothalamus (CRH)-Anterior Pituitary (ACTH)-Adrenal cortex (CORT); negative feedback; increased activity leads to increased cortisol |
|
|
Term
| Who coined the term melancholia? |
|
Definition
|
|
Term
| Who was involved in the learned helplessness experiment? |
|
Definition
| Dogs (beaten); Martin Seligman |
|
|
Term
ID age group of depression:
feeding problems, failure to thrive, developmental delays |
|
Definition
|
|
Term
ID age group of depression:
aggression, accident prone, phobias |
|
Definition
|
|
Term
ID age group of depression:
physical complaints, clingy, aggression |
|
Definition
|
|
Term
ID age group of depression:
morbid thoughts excessive worry, not playing |
|
Definition
|
|
Term
ID age group of depression:
running away, delinquency, apathy |
|
Definition
|
|
Term
ID development stage:
appreciation of interdependence and relatedness |
|
Definition
| trust vs mistrust; infant-1 |
|
|
Term
ID development stage:
acceptance of life cyle |
|
Definition
|
|
Term
ID development stage:
humor, empathy, resilience |
|
Definition
|
|
Term
ID development stage:
humility; acceptance of course of one's life |
|
Definition
| 6-12; industry vs inferiority |
|
|
Term
ID development stage:
sense of complexity of life; merge sensory, logic, and aesthetic perception |
|
Definition
| Identity vs confusion; 12-19 |
|
|
Term
ID development stage:
sense of complexity of relationships; loving freely |
|
Definition
| intimacy vs isolation; 20-25 |
|
|
Term
ID development stage:
caring for others, empathy, concern; agape |
|
Definition
| 26-64; generativity vs stagnation |
|
|
Term
ID development stage:
sense of integrity strong enough to withstand death of self |
|
Definition
| 65-death; integrity vs despair |
|
|
Term
| What is the 3rd leading COD for 15-24 and 4th for ages 10-14? |
|
Definition
|
|
Term
| The peritubular cells of the kidney produce what? |
|
Definition
|
|
Term
| What stimulates the production and release of erythropoietin? |
|
Definition
|
|
Term
| Every time an RBC dies ____ is produced and must be processed by the _____ |
|
Definition
|
|
Term
ID RBC Disease:
reduction in total number of erythrocytes in blood or hgb |
|
Definition
|
|
Term
| What 3 events in the body can lead to anemia? |
|
Definition
| impaired RBC production, acute/chronic blood loss, increased RBC destruction |
|
|
Term
|
Definition
| mean cell/corpuscular volume (size) |
|
|
Term
|
Definition
| mean cell/corpuscular hgb |
|
|
Term
|
Definition
| mean cell/corpuscular hgb concentration (hemoglobin content); hyper chromic, normochromic, hypochromic |
|
|
Term
| What are the two types of anemia? |
|
Definition
| anisocytosis (RBC in many sizes) and poikilocytosis (RBC in many shapes) |
|
|
Term
| Describe the 2 magnitudes and onsets of anemia |
|
Definition
| gradual (less symptomatic), sudden (more symptomatic); Hgb of 8g is more symptomatic than 12g |
|
|
Term
| What are the 6 classic signs of anemia? |
|
Definition
| pallor, fatigue, weakness, dypnea, DOE, dizziness |
|
|
Term
| What are the compensatory manifestations of anemia? |
|
Definition
| CDV (tachycardia, palpitations, vasoconstriction); tachypnea; increase ADH |
|
|
Term
| What are the 3 anemia classifications? |
|
Definition
| macrocytic, microcytic hypochromic, normocytic normochromic |
|
|
Term
| Macrocytic anemias can be ___ or ____ |
|
Definition
| normochromic; hyperchromic |
|
|
Term
| What are two possible causes of Macrocytic normochromic anemias? |
|
Definition
| vitamin b12 deficiency; folate deficiency |
|
|
Term
| Describe pernicious anemia |
|
Definition
| vitamin b12 deficiency; formerly fatal; congenital, appears following gastrectomy; |
|
|
Term
| What is considered severe anemia and what are some of its clinical manifestations? |
|
Definition
| <7g/dl; beffy red tongue, hyperbilirubinemia, jaundice, parathesias |
|
|
Term
|
Definition
| immature RBCs; no nucleus; 1% of RBC |
|
|
Term
| What are the indications of a low retic count? High? |
|
Definition
| Low= aplastic anemia, ineffective erythropoiesis; High=bone marrow response to anemia caused by hemolysis or blood loss; corrected value is most important |
|
|
Term
| What is the equation for retic correction? |
|
Definition
| Retic% x (patient Hct/Normal hct) |
|
|
Term
| What are the clinical manifestations of folate deficiency anemia? |
|
Definition
| classic signs of anemia; dysphagia watery diarrhea; painful ulcerations of cheeks and tongue |
|
|
Term
|
Definition
| red cell distribution width; detects subtle size variations before MCV changes |
|
|
Term
| In what 3 cases does RDW increase before MCV becomes abnormal? |
|
Definition
| early iron deficiency anemia, b12 deficiency, and folate deficiency |
|
|
Term
| What is microcytic hypochromic anemia related to? |
|
Definition
| disorders of iron metabolism, heme and globin synthesis |
|
|
Term
| What are the two types of Microcytic hypochromic anemias? |
|
Definition
| iron deficiency and sideroblastic |
|
|
Term
| What is the most common cause of iron deficiency anemia in the US? |
|
Definition
|
|
Term
| What is a sign of iron deficiency anemia? |
|
Definition
| craving non food items (dirt and ice); called PICA |
|
|
Term
| What are the clinical manifestations of iron deficiency anemia? |
|
Definition
| classic signs, chlorosis (green/yellow skin), koilonychias, glossitis, tingling, gastritis; bluish tinge under the eye |
|
|
Term
| Describe sideroblastic anemia |
|
Definition
| group of disorders characterized by anemia; altered mitochondrial metabolism r/t ineffective iron uptake; ringed sideroblasts in bone marrow |
|
|
Term
| Describe normocytic normochromic anemia |
|
Definition
| red cells normal in size and Hgb but insufficient in number |
|
|
Term
| What are the 4 possible types of normocytic normochromic anemia? |
|
Definition
| aplastic anemia, posthemorrhagic anemia, hemolytic anemia, anemia of chronic disease/inflammation |
|
|
Term
| Describe the patho of aplastic anemia |
|
Definition
| caused by bone marrow failure; acquired or hereditary; acquired is unknown cause (primary) or chemotherapy and other chemical (secondary); precursor for leukemia |
|
|
Term
| What are the clinical manifestations of aplastic anemia? |
|
Definition
| classic signs of anemia, infections (if low WBCs) and bleeding (if low platelets) |
|
|
Term
| Describe the patho of post hemorrhagic anemia |
|
Definition
| caused by acute blood loss (orthopedic surgery); volume depletion, hypovolemic shock |
|
|
Term
| What are the clinical manifestations of post hemorrhagic anemia? |
|
Definition
| SNS stimulation; shock; classic signs of anemia; iron deficiency anemia (if chronic) |
|
|
Term
| Describe hemolytic anemia |
|
Definition
| premature destruction of RBCs; elevated bilirubin; acquired (infections or traumatic) or hereditary (structural or sickle cell) |
|
|
Term
| What are the clinical manifestations of hemolytic anemia? |
|
Definition
| classic signs of anemia, jaundice, splenomegaly |
|
|
Term
| What is the most common form of hemolytic anemia? |
|
Definition
|
|
Term
ID test:
tests for autoimmune hemolytic anemia, detects IgG antibodies |
|
Definition
|
|
Term
ID test:
used in prenatal testing and in blood prior to transfusion, detects antibodies against RBCs that are unbound in plasma; agglutination is positive |
|
Definition
|
|
Term
| What does the haptoglobin assay screen for? |
|
Definition
| hemolytic anemia; causes an increase in free hemoglobin which causes a decline in haptoglobin (b/c it binds to it) |
|
|
Term
ID:
test done to check different types of hgb in the blood |
|
Definition
|
|
Term
ID Hgb type:
normally found in fetuses and newborns; replaced by hgb A shortly after birth |
|
Definition
|
|
Term
ID Hgb type:
Most common type of Hgb found in adults |
|
Definition
|
|
Term
ID Hgb type:
Normal type of Hgb found in small amounts in adults |
|
Definition
|
|
Term
ID Hgb type:
Present in sickle cell disease |
|
Definition
|
|
Term
ID Hgb type:
inherited variant of normal adult hgb; most common in asians |
|
Definition
|
|
Term
ID Hgb type:
present in sickle cells or thalassemia |
|
Definition
|
|
Term
ID Hgb type:
heavy hgb; present in certain types of thalassemia |
|
Definition
|
|
Term
ID:
most common anemia in hospitalized patients; associated with chronic infections |
|
Definition
| Anemia of chronic disease/inflammation (ACD/ACI) |
|
|
Term
| What are the two myeloproliferative RBC disorders? |
|
Definition
| polycythemia and relative polycythemia |
|
|
Term
| Describe relative polycythemia |
|
Definition
| result of dehydration; results in relative increases of RBC, Hgb and Hct |
|
|
Term
| What are the symptoms of polycythemia vera? |
|
Definition
| dizziness, hypertension, pruritis, dyspnea, tingling |
|
|
Term
|
Definition
| event that results in bleeding cessation |
|
|
Term
| What are the 3 hemostatic components? |
|
Definition
| platelets, vascular endothelium, clotting factors |
|
|
Term
| What is another term for platelets? |
|
Definition
|
|
Term
| How long do platelets circulate? |
|
Definition
|
|
Term
| What are the two functions of vascular endothelium? |
|
Definition
| control hemostatic mechanisms; cause coagulation to be controlled by anticoagulant substances |
|
|
Term
| What are the three steps in the sequence following vascular damage? |
|
Definition
| vasoconstriction/spasm, platelet plug, clotting cascade |
|
|
Term
| Platelet aggregation is ___ dependant |
|
Definition
|
|
Term
| What is the result of the coagulation/clotting cascade? |
|
Definition
| fibrin that stabilizes the platelet plug; intrinsic or extrinsic pathway |
|
|
Term
|
Definition
| fibrin degradation products |
|
|
Term
| Describe Adjusted partial thromboplastin time |
|
Definition
| aPTT; measures activity of intrinsic and final common pathways; means of 30 seconds; monitors coagulation in those taking heparin |
|
|
Term
| Describe prothrombin time |
|
Definition
| measures activity of extrinsic and final common pathways; monitors coagulation time of those takin Coumadin; 12 seconds |
|
|
Term
| Describe international normalized ratio |
|
Definition
| INR; 1; monitors coagulation of those taking Coumadin (preferred) |
|
|
Term
| Describe ecchymosis and its two classifications |
|
Definition
| red and purple/black/blue skin discoloration r/t extravasation of blood in subcutaneous tissue; purpura, petechiae |
|
|
Term
|
Definition
| cough up blood from lungs |
|
|
Term
|
Definition
|
|
Term
| Define coffee ground emesis |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| black tarry stools (digested blood) |
|
|
Term
| What are the two magnitudes of quantitative platelet disorders? |
|
Definition
<50k=bleeding potential
<20k= high risk for spontaneous bleeding |
|
|
Term
| What are two causes of quantitative platelet disorders? |
|
Definition
| disordered platelet distribution and accelerated platelet destruction (spleen) |
|
|
Term
| Describe qualitative platelet dysfunction |
|
Definition
| qualitative alterations of platelet function with normal platelet count |
|
|
Term
| What is a high platelet count? |
|
Definition
|
|
Term
| What is the role of vitamin K in coagulation? |
|
Definition
| production of prothrombin |
|
|
Term
ID:
stationary clot adhering to the vessel wall |
|
Definition
|
|
Term
ID:
floating clot within the blood |
|
Definition
|
|
Term
|
Definition
| factors favoring clot formation; loss of integrity of vessel wall (atherosclerosis), abnormalities of blood flow (sluggish), alterations in blood constituents (thrombocytosis) |
|
|
Term
| What is the effect of heparin on aPTT? |
|
Definition
| prolong it to 60-90 seconds (74-105 is preferable) |
|
|
Term
| What is the effect of Coumadin on PT and INR? |
|
Definition
|
|
Term
| What are the 4 types of sickle cell disorders? |
|
Definition
| sickle cell anemia, sickle cell trait, sickle cell Hgb C, sickle cell thalassemia |
|
|
Term
| Priapism is what specific type of sickle cell crisis? |
|
Definition
|
|
Term
| Most sickled cells regain normal shape after ____ and ____ |
|
Definition
| reoxygenation and rehydration |
|
|
Term
| What are 5 sickling stimuli? |
|
Definition
| hypoxemia, deoxygenatino, acidosis, hypertonicity, hypothermia |
|
|
Term
| How does acidosis promote sickling? |
|
Definition
| decreases Hgb affinity for O2 |
|
|
Term
| What are the 4 types of sickle cell crisis? |
|
Definition
| vasoocclusive, aplastic, sequestrian, hyperhemolytic |
|
|
Term
| What is the RBC lifespan in sickle cell anemia? |
|
Definition
|
|
Term
| If the WBC is normal ____ the differential |
|
Definition
|
|
Term
| What is the difference between blasts and bands? |
|
Definition
| bands (teenagers); blasts (NEVER normal to be in blood stream) |
|
|
Term
|
Definition
| when leukocyte count is more than normal (>10k) |
|
|
Term
| Describe the shift in neutrophils during a bacterial infection |
|
Definition
| shift to the right; mature neutrophils |
|
|
Term
| If the need for neutrophils increases beyond the supply ____ are released into the blood |
|
Definition
| banded neutrophils (immature); causes shift to the left |
|
|
Term
| When the neutrophil population returns to normal from a change there is a shift to the ____ |
|
Definition
|
|
Term
| Eosinophilia is increased in what two situations? |
|
Definition
| allergic disorders and parasitic invasions |
|
|
Term
| What is the purpose of basophilia? |
|
Definition
| response to inflammation hypersensitivity reactions |
|
|
Term
| Monocytosis often indicates what? |
|
Definition
| chronic infectious disease; in later stages of infections when neutrophils are depleted |
|
|
Term
| Lyphmocytosis is a response to what? |
|
Definition
|
|
Term
|
Definition
| when WBC count is <5k; caused by bone marrow disease, drugs or viruses |
|
|
Term
| What is the ANC and how is it calculated? |
|
Definition
absolute neutrophil count;
WBC x (%polys + %Bands)
<500-1k = immunodeficient |
|
|
Term
| Describe ALC and how it is calculated |
|
Definition
| absolute leukocyte count; WBC x (%T-helper); <500 is immunodeficient |
|
|
Term
| Increased polys= ____ infection |
|
Definition
|
|
Term
| How will knowing what WBC is low help diagnose the pt? |
|
Definition
| It doesn't; it indicates vulnerability only |
|
|
Term
| What is the purpose of the white pulp of the spleen? |
|
Definition
|
|
Term
| What is the largest lymphoid organ? |
|
Definition
|
|
Term
|
Definition
| mononuclear phagocyte system; ingest and destroy microorgs and foreign material; spleen, liver, lungs, etc |
|
|
Term
| What are the clinical manifestations of mono? |
|
Definition
| infect B lymphocytes; lymphadenopathy, splenomegaly, fever, sore throat |
|
|
Term
| increased spleen function is associated with what? |
|
Definition
|
|
Term
| Describe polycythemia vera |
|
Definition
| neoplastic disorder of abnormal growth of myeloid stem cells, self-destructive expansion of red cell mass; normal erythropoietin levels; increased WBCs and platelets; cause clots that may lead to ischemia |
|
|
Term
| What are the clinical manifestations of polycythemia vera? |
|
Definition
| plethora, engorgement of retinal and cerebral vessels, angina, hepatosplenomegaly |
|
|
Term
| Describe secondary polycythemia |
|
Definition
| physiologic response to hypoxia r/t secretion of erythropoietin; may not require treatment |
|
|
Term
ID hemophilia type:
classic, factor 8 deficiency |
|
Definition
|
|
Term
ID hemophilia type:
christmas disease, factor 9 deficiency |
|
Definition
|
|
Term
ID hemophilia type:
Factor 11 deficiency, autosomal recessive |
|
Definition
|
|
Term
ID hemophilia type:
factor 8 deficiency; autosomal dominant |
|
Definition
|
|
Term
|
Definition
| congenital; easy bruising; bleeding in various areas of the body |
|
|
Term
| What is a form of treatment for hemophilia? |
|
Definition
| FFP (fresh frozen plasma administration); trauma avoidance |
|
|
Term
|
Definition
| disseminated intravascular coagulation; acquired coagulopathy where clotting and hemorrhage occur in vascular system; NEVER the primary condition |
|
|
Term
| What are the effects of DIC? |
|
Definition
| vascular occlusion; ischemia |
|
|
Term
| Describe the abnormal coagulation profile of DIC |
|
Definition
| thrombocytopenia, decreased clotting factors, increased clotting measurements, increased FDPs (d-dimer) |
|
|
Term
| Mood is to ____ as _____ is to weather |
|
Definition
|
|
Term
ID bipolar term:
mixed state; agitated depression |
|
Definition
|
|
Term
ID bipolar term:
more than 4 episodes a year |
|
Definition
|
|
Term
| What is the 6th leading cause of disability in the middle age group? |
|
Definition
|
|
Term
| high levels of ___ are related to mania |
|
Definition
|
|
Term
| ___ serotonin leads to ___ epinephrine |
|
Definition
|
|
Term
| What platelet factor stimulates coagulation cascades? |
|
Definition
|
|
Term
| What platelet factor is heparin neutralizing and promotes clot formation? |
|
Definition
|
|
Term
|
Definition
| Immune thrombocytopenic purpura; IgG coats platelets that are removed from circulation; progress from petechial to purpura to major hemorrhage |
|
|
Term
|
Definition
| thrombotic thrombocytopenic purpura; platelets aggregate, form microthrombi and cause occlusion of arterioles and capillaries |
|
|
Term
| What are the 3 systemic manifestations of inflammation? |
|
Definition
| fever, leukocytosis, increased plasma protein synthesis |
|
|
Term
| Describe the two components of increased plasma protein synthesis |
|
Definition
| acute phase reactants (c-reactive protein) and increased erythrocyte sedimentation rate (ESR) |
|
|
Term
| Describe the immune response |
|
Definition
| slow and specific response involving B (humoral) and T (cell mediated) lymphocytes |
|
|
Term
| What aspect of the immune response is responsible for distinguishing between self and non self? |
|
Definition
|
|
Term
| What is the immune response? |
|
Definition
| the body's response to antigenic challenges |
|
|
Term
|
Definition
| produce antibodies against specific antigens; create memory cells |
|
|
Term
|
Definition
| attack antigen directly; specific; memory cells |
|
|
Term
| What two qualities are unique to immunity? |
|
Definition
|
|
Term
| B lymphocytes mature to be what? |
|
Definition
|
|
Term
| What are the two types of antibody function and how is it measured? |
|
Definition
| direct (neutralization, agglutination, precipitation), indirect (opsonizatino); antibody titer |
|
|
Term
ID Immunoglobulin:
found predominantly in body secretions; secretory immune system |
|
Definition
|
|
Term
| In the secretory immune system, where are the antibodies located? |
|
Definition
| tears, sweat, saliva, mucous and breast milk |
|
|
Term
|
Definition
| largest immunoglobulin; first antibody produced during primary response to an antigen |
|
|
Term
| Which immunoglobulin is of the most abundant glass (80-85%)? |
|
Definition
|
|
Term
| In the primary response what is created after 5-7 days? |
|
Definition
|
|
Term
| Describe primary response |
|
Definition
|
|
Term
| Describe the secondary immune response |
|
Definition
| more rapid due to memory cells; larger amounts of antibody are produced; large amounts of IgG |
|
|
Term
| What is used to measure the amount of antibodies present at any one point? |
|
Definition
|
|
Term
| Which immunoglobulin mediates allergic responses and defends against parasites? |
|
Definition
|
|
Term
| We know the least about which immunoglobulin? |
|
Definition
| IgD; B cell antigen receptor |
|
|
Term
| Describe the two aspects of acquired immunity |
|
Definition
| active (produced by host after antigen exposure; natural; immunization with biological material); passive (does not involve immune response, temporary, maternal antibodies, immunizations with preformed antibodies) |
|
|
Term
| What are the 3 types of hypersensitivity in an immune response? |
|
Definition
| allergy, autoimmunity and alloimmunity (isoimmunity) |
|
|
Term
ID Hypersensitivity:
exaggerated immune response to nonself |
|
Definition
|
|
Term
ID Hypersensitivity:
Misdirected immune response against self |
|
Definition
|
|
Term
ID Hypersensitivity:
normal reaction against beneficial foreign tissue |
|
Definition
| alloimmunity (isoimmunity) |
|
|
Term
| Define and give examples of haptens |
|
Definition
| antigens reacting with skin self-proteins; metals, chemicals, resins |
|
|
Term
| What are 3 possible triggers for autoimmunity? |
|
Definition
| drugs, virus (encephalitis), unknown (Lupis) |
|
|
Term
ID autoimmunity mechanism:
body recognizes self-antigens as foreign |
|
Definition
|
|
Term
ID autoimmunity mechanism:
self antigens not normally seen by the immune system |
|
Definition
|
|
Term
ID autoimmunity mechanism:
molecular mimicry |
|
Definition
|
|
Term
ID autoimmunity mechanism:
haptens become immunogenic when they bind to host proteins |
|
Definition
|
|
Term
ID autoimmunity mechanism:
during differentiation lymphocytes produce receptor that react with self-antigens |
|
Definition
|
|
Term
ID autoimmunity mechanism:
defects in regulatory cells |
|
Definition
| ineffective peripheral tolerance |
|
|
Term
| Transplant rejection is what type of immunity? |
|
Definition
|
|
Term
| What are the 3 possible responses after re-exposure to antigen? |
|
Definition
| immediate (minutes), delayed (hours), anaphylaxis (rapid and severe immediate) |
|
|
Term
ID hypersensitivity immune mechanism type:
IgE mediated; most common allergic reactions; histamine release; generic predisposition |
|
Definition
|
|
Term
| manifestations of type 1 hypersensitivity are mediated by what? |
|
Definition
|
|
Term
ID hypersensitivity type:
tissue specific, antibody mediated, receptor blockage causing target cell malfunction |
|
Definition
|
|
Term
| What are 4 examples of type 2 hypersensitivity? |
|
Definition
| immune thrombocytopenia purpura (ITP), hemolytic anemia, graves disease (autoimmune hyperthyroidism), myasthenia gravis |
|
|
Term
ID hypersensitivity type:
immune complex mediated, antigen-antibody complexes are formed in one place and deposited elsewhere ( |
|
Definition
|
|
Term
| What is an example of type 3 hypersensitivity? |
|
Definition
| SLE (lupis; kidneys, blood vessels and joints are most at risk |
|
|
Term
ID hypersensitivity type:
does not involve antibodies directly; cytoxic t lymphocytes; direct killing |
|
Definition
|
|
Term
| What are two examples of type 4 hypersensitivity? |
|
Definition
| transplant rejection, contact allergic reactions, contact dermatitis |
|
|
Term
|
Definition
| type 1 hypersensitivity; inflammatory disease of airways; exaggerated immune response to exogenous antigens |
|
|
Term
|
Definition
| classic type 2 hypersensitivity; platelets are coated with autoantibodies to platelet membrane antigens; splenic sequestration and phagocytosis of mononuclear macrophages; decreased platelet count |
|
|
Term
| Describe autoantibody stimulation in ITP |
|
Definition
| surface of platelets become immunogenic, stimulating production of platelet autoantibodies; stimulus is unknown |
|
|
Term
| What is the role of the spleen in ITP? |
|
Definition
| site of autoantibody production (white pulp) and phagocytosis of autoantibody coated platelets (red pulp) |
|
|
Term
| What are the two treatments of ITP? |
|
Definition
| corticosteroids and splenectomy (if meds don't work) |
|
|
Term
ID disorder:
deposition of circulating immune complexes with antibodies against host DNA; classic type 3 hypersensitivity; diver deposition |
|
Definition
| SLE(systemic lupus erythematous) |
|
|
Term
| What constitutes a diagnosis of SLE? |
|
Definition
| serial or simultaneous presence of 4/11 common findings of the disease |
|
|
Term
| What is another name for the butterfly rash? |
|
Definition
|
|
Term
| What is the mnemonic for the 11 criteria of SLE? |
|
Definition
(SOAP, BRAIN, MD)
Serositis
Oral ulcers
Arthritis
Photosensitity
Blood changes
renal involvement
ANA
Immunological changes
Neurological signs
Malar rash
Discoid rash |
|
|
Term
| Describe the discoid rash |
|
Definition
| coin shaped on areas of skin exposed to sunlight; red, raised scaley lesions; painless and do not itch |
|
|
Term
|
Definition
| inflammation of serious tissues (pleura, pericardium, peritoneum); seen in SLE, crohn's disease, and chronic renal failure) |
|
|
Term
|
Definition
|
|
Term
| What are the 3 types of reactions to graft rejection? |
|
Definition
| hyperacute (immediate, rare, pre-existing antibodies); acute (weeks after transplant, cell mediated, managed by immunosuppressive drugs); chronic (slow progressive organ failure) |
|
|
Term
| What are the clinical manifestations and treatment for graft rejection? |
|
Definition
| signs of failure of transplanted tissue; immunosuppression and antirejection meds (for life) |
|
|
Term
|
Definition
| Graft vs. host disease; bone marrow transplant complication |
|
|
Term
| ID and describe the two types of immune deficiencies |
|
Definition
| Congenital (T or B cells deficient; primary); acquired (secondary; caused by another illness [cancer]) |
|
|
Term
| What are the classic clinical representations of immune deficiencies? |
|
Definition
| opportunistic infections (PCP, CMV, MAI, fungus and yeasts) |
|
|
Term
|
Definition
| bacteria that must have iron to multiply |
|
|
Term
| What are the two main types of bacteria? |
|
Definition
| gram positive and gram negative |
|
|
Term
| What are 3 characteristics of bacteria? |
|
Definition
| capsules, toxins and enzymes |
|
|
Term
|
Definition
| based on chemical and physical properties of bacterial cell walls; 1st step in bacteria ID; often takes <1 hr |
|
|
Term
|
Definition
| from lysed gram negative bacteria; activates inflammatory response |
|
|
Term
| Bacterial protein toxins are strongly ___ |
|
Definition
|
|
Term
| Endotoxins refers to the ____ complex associated with outer membrane of gram-negative pathogens |
|
Definition
|
|
Term
| Endotoxins have strongly ___ effects |
|
Definition
|
|
Term
| LPs acts as the ___ ____ which promotes secretion of pro-inflammatory cytokines |
|
Definition
|
|
Term
|
Definition
|
|
Term
| A disease caused by fungi is called what? |
|
Definition
|
|
Term
| What is a sign of a dermophyte fungal infection? |
|
Definition
|
|
Term
| What are the 3 countermeasures against pathogen defenses? |
|
Definition
| innate, vaccines, antimicrobials |
|
|
Term
| Describe bacterial culture sensitivity |
|
Definition
| When an organism has been cultured and is subjected to various antibiotics to determine sensitivity or resistance |
|
|
Term
| Describe early hyperdynamic septic shock |
|
Definition
|
|
Term
| Describe late hypodynamic septic shock |
|
Definition
| typical shock manifestations of tachycardia and cold clammy skin; hypotension |
|
|
Term
| What types of mutations occur in the cancer cell? |
|
Definition
| signal from cell surface receptor is in on position; mutation in ras intracellular signaling protein; activation of protein kinases; inactivation of tumor suppressor genes (p53) |
|
|
Term
|
Definition
| causes cell growth and differentiation; mutation can cause inappropriate transmission signals inside a cell |
|
|
Term
| What allows cancer cells to divide indefinitely? |
|
Definition
| telomerase gene is turned on producing an enzyme that rebuilds telomeres so instead of division stopping when the telomeres are gone it can continue |
|
|
Term
| What is the benefit of the G0 phrase? |
|
Definition
| helps us understand cancer treatment protocols with rounds of treatment |
|
|
Term
| What are the 6 characteristics of malignant cells? |
|
Definition
| autonomy, anaplasia (loss of differentiation), transformation (normal cell becomes cancerous), progress, hyperplasia, dysplasia (variation of cell shape and size) |
|
|
Term
| How are cancer cells able to migrate to other areas of the body? |
|
Definition
| Low levels of fibronectin |
|
|
Term
|
Definition
| ability to create a blood supply |
|
|
Term
| What substance do bacteria use to get their nutrition? |
|
Definition
|
|
Term
| What is the result of cancer cells that produce plasminogen activating factor? |
|
Definition
| production of fibrin that degrades extracellular tissue during tumor invasion |
|
|
Term
ID cancer type from the affected area:
epithelial tissue |
|
Definition
|
|
Term
ID cancer type from the affected area:
CT |
|
Definition
|
|
Term
ID cancer type from the affected area:
glandular |
|
Definition
|
|
Term
ID cancer type from the affected area:
CNS tissue |
|
Definition
|
|
Term
ID cancer type from the affected area:
lymphatic tissue |
|
Definition
|
|
Term
ID cancer type from the affected area:
bone marrow |
|
Definition
|
|
Term
| Describe the aspects of the TNM system |
|
Definition
|
|
Term
ID cancer stage:
cancer is confined to organ of origin |
|
Definition
|
|
Term
ID cancer stage:
locally invasive |
|
Definition
|
|
Term
ID cancer stage:
regional structures |
|
Definition
|
|
Term
ID cancer stage:
distant sites |
|
Definition
|
|
Term
| What are the two theories regarding carcinogenesis? |
|
Definition
| monoclonal (single mutated cell is great grandfather of tumor); cell accidents (several cell accidents occur resulting in tumor development) |
|
|
Term
|
Definition
| chemical found in an organism that is not expected to be there; |
|
|
Term
| Describe the tumor immune surveillance theory of carcinogenesis |
|
Definition
| the immune system can recognize tumor cells and kill them |
|
|
Term
| What are the two important steps of metastasis? |
|
Definition
| penetration into lyphatics, blood vessels or body cavities; transport into lymph or blood |
|
|
Term
| What are the 4 common sites of distant mesastasis? |
|
Definition
| lungs, liver, bones and brain |
|
|
