Term
| What do you not do with melanoma biopsy? |
|
Definition
| DONT shave-biopsy, shave-excise, or electrocauterize. |
|
|
Term
| What is basal cell carcinoma? |
|
Definition
| Most common cancer, most easily treated, least likely to spread. |
|
|
Term
What is fat emboli caused by?
How long does it take to occur?
What can it cause?
What are common s/sx? |
|
Definition
CLosed fx of long bone, pelvis, or ribs.
occurs 24-72 hours after injury as fat enters blood stream and blocks arteries.
can travel to the lungs and cause ARDS and poor gas exchange. Can also travel through the blood to renal.
Fever, often higher than 101 with really high pulse. drowsiness with oliguria. |
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Term
| What are total hip precautions |
|
Definition
| No driving, avoid 90 degree flexion of hip, and extreme internal rotation for 4-6 weeks |
|
|
Term
| At what age does the rate of destruction begin to exceed rate of creation of new bone? |
|
Definition
|
|
Term
| What are s/sx of fracture? |
|
Definition
| pain preventing weight bearing/ROM, swelling, numbness/tingling distal to injury, bruising |
|
|
Term
| What are the affected joints of Rheumatoid arthritis vs osteoarthritis? |
|
Definition
Rheumatoid - small joints first, wrists, elbows, shoulders, usually bilateral and symmetrical
Osteoarthristis - weight bearing joints of knees, hips, and small joints, spin, often asymmetrical. |
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Term
What is post-traumatic osteomyelitis?
What can it cause? |
|
Definition
| bone infection either indirect or direct cause, abscess may block blood supply and destroy bone, surgical intervention to drain abscess and restore circulation may be necessary. |
|
|
Term
What are the actions of the epidermis?
melanocytes? langerhan's cells? vascular or avascular? How long for cells to move? What does the basal layer contain? |
|
Definition
| melanocytes distributed basal layer to filter UV radiation. Langerhan's cells protect against infection and involved in skin allergy development. Stratum corneum is avascular. Movement of cells takes about 4 weeks. Basal layer contains melanocytes and keratinocytes. |
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Term
What does the dermis do?
What is contained here? |
|
Definition
vascularized, provides energy/nutrition ot epidermis, involved in thermoregulation, involved in healing.
Also contains nerves, lymphatic vessels, hair follicles, sebaceous glands. |
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Term
| What does a brown discoloration of the skin indication? |
|
Definition
| Darkening of melanin. Pituitary, adrenal, or liver disease. |
|
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Term
Where is squamous cell carcinoma usually found?
s/sx?
What is an SSC redux? |
|
Definition
Lips, ear, nose or in immunocompromised.
A wart-like growth that crusts over and occasionally bleeds. Persistent, sclay red patches with irregular borders that sometimes crust or bleed. An open sore that bleeds and crusts and presists for weeks.
An elevated growth with central depression that occasionally bleeds. This can rapidly increase in size |
|
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Term
|
Definition
| Occurs when life cycle of skin cells is affected. cells build up rapidly causing thick patches. These skin cells are attacked by T-cells, causing mulitple reactions in dermis leading new skin cells to move to epidermis in days rather than weeks. |
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Term
What an necrotizing fasciitis lead to?
What bacteria is it caused by?
What does it look like?
Pain? |
|
Definition
Widespread effects such as shock.
Strep pyogenes getting into insect bite, burn or cut
Puruple patch that grows quickly and may have black center.
Pain that goes away in the first 24 hours and comes back more severe |
|
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Term
What skin condition is Herpes Zoster characterized by?
What is it also called?
Tx? |
|
Definition
Strip of painful small blisters on body.
Shingles
Antiviral |
|
|
Term
|
Definition
| Blisters may form after 24 hr, heal in 3-6 days without scarring. More painful if partial thickness. Deep thickness appears white and waxy. Cap refill is decreased. Can be wet or dry |
|
|
Term
|
Definition
| wet, shiny, weeping surface, blisters, blacnes with pressure |
|
|
Term
|
Definition
| Very pale to bright red but little cap refill. Wound surface is dry, firm, and may be leathery. No pain. Needs skin graphs. |
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|
Term
What are the two components of burn shock?
End result? |
|
Definition
Cellular component is result of cell damage and it alters membrane potential (cell permeability). This leads to The second component (hypovolemic CV) as there is systemic edema
BP and CO decrease to compensate for blood volume loss so there is tachy, vasoconstriction so there is increased systemic vascular resistance and pulmonary vascular resistance. This increases o2 consumption and causes electrolyte imbalances and arrhythmias. |
|
|
Term
| What do you not use on burns? |
|
Definition
|
|
Term
| What do basophils produce during inflammatory reactions? |
|
Definition
|
|
Term
When do macrophages become mobile?
They interact with _______ to facilitate _______________ |
|
Definition
When stimulated by inlammation. otherwise immobile
Lymphocytes, facilitate antibody production |
|
|
Term
| When its humoral response what do you think? |
|
Definition
|
|
Term
| What are osteoclasts derived from? |
|
Definition
| macrophages formed in bone marrow |
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|
Term
Whare are osteoprogenitor cells?
What are bone lining cells thought to be responsible for? |
|
Definition
Form osteoblasts and are found along the surface of bones.
Transport of phosphate and Calcium in and out of bone |
|
|
Term
| What is Vitamin C needed for in the activation phase? |
|
Definition
| Vitamin C needed for synthesis of collagen, the main bone protein and helps with differentiation of osteoblasts into osteocytes. |
|
|
Term
How are Vitamins K and B12 used in Activation?
Vitamin A? |
|
Definition
K and B12 needed for protein synthesis
A stimulates activity of osteoblasts |
|
|
Term
| What is the end result of remodeling? |
|
Definition
| Old haversian systems destroyed, new ones built |
|
|
Term
What are the vague symptoms of fatty emboli and when do they occur?
signs? |
|
Definition
Occurs 12-72 hours after injury.
Vague pain in chest and shortness of breath.
Drop in platelet levels and petechiae due to decreased O2. Fever with high pulse rate, chest pain, tachypnea, cyanosis, dyspnea, drowsiness with oliguria, HA, restlessness, memory loss, confusion |
|
|
Term
| What are Tx of osteoporosis? |
|
Definition
| hormone therapy, lifestyle changes, biphosphonates, calcitonin, tamoxifin, evista, physical therapy treatments |
|
|
Term
| What are T scores a measurement of? |
|
Definition
|
|
Term
What nutrients does bone need to maintain health?
When is it important to take these? |
|
Definition
calcium, phosphorus, copper, zinc, manganese, Vitamins D,A,C,K, and protein.
Dietary intake before mid 30s and during pregnancy important to decrease loss. |
|
|
Term
T/F
Chronic alcohol consumption, particularly during adolescence and young adulthood, can dramatically affect bone health and may increase the risk of developing osteoporosis later. |
|
Definition
|
|
Term
| How are tobacco use and loss of bone density related? |
|
Definition
-May break down estrogen rapidly
-May decrease serum calcium
-Associated with low activity level
-Decreases calcium absorption
-Increases resistance to calcitonin which assists with bone growth
-Associated with increased ETOH use and decreased nutrition |
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|
Term
| What are s/sx of osteomyelitis? |
|
Definition
| Fever that may be abrupt, night sweats, irritability/lethargy, pain in the ear, warmth over the area, swelling and redness over the area |
|
|
Term
|
Definition
Decreased consumption of red meat and seafood
Avoid alcohol
Increased intake of whole grains and low fat diary products
Weight loss
NSAIDS, steroids |
|
|
Term
What is Raynaud's Syndrome?
Who is it seen with?
Three stages? |
|
Definition
Paroxysmal vasospasm of the digits with some paresthesia
Seen in lupus and scleroderma patients
1) white phase (diminished blood flow)
2) blue phase (cyanosis)
3) red phase (erythema during rewarming) |
|
|
Term
What is the purpose of the hypodermis?
What is distribution dependent on? |
|
Definition
The SubQ or fatty layer. Attaches skin to muscle and bone. Stores lipids, regulates temp, provides shock absorption.
Distribution dependent on heredity, gender, age, nutritional status |
|
|
Term
What are skin appendages?
Where do skin appendages develop and what nourishes them? |
|
Definition
nail, hair, and glands
Develop in epidermis, nourished by dermis |
|
|
Term
| What is the assessment for moles/skin lesions? (ABCD) |
|
Definition
Assymetry
Border
Color
Diameter |
|
|
Term
| How do burns (and burn shock) affect Na concentration and fluid shifts? |
|
Definition
| The integrity of the NA pump is compromised so Na remains in cell. Allows plasma to seep into interstitial space. This increases capillary permeability and permits fluid shift. causes osmotic gradient -> increases intercellular and interstitial fluid and decreases intravascular fluid volume, causing hypotension |
|
|
Term
| What is burn shock compensation by the body? |
|
Definition
| body responds by shunting blood toward vital organs. Lack of renal blood flow decreases GFR and decreases urinary output. Blood flow is diminished to the mesenteric bed and Curling's ulcers develop. With adequate fluid resuscitation body begins to absorb edema and diuresis begins. |
|
|
Term
| Adults with what % burn surface area require fluid resuscitation? |
|
Definition
|
|
Term
| What is the function of B lymphocytes? |
|
Definition
| B cells produce antibodies that attack |
|
|
Term
| What is the function of T lymphocytes? |
|
Definition
| T cells regulate cell mediated immunity. T cells attack infection directly. |
|
|
Term
| What is the function of NK cells? What is a major difference between them and B and T cells? |
|
Definition
They are innate immune cells. They effectively kill tumor cells and virally infected cells without prior exposure.
Not specific for a particular antigen and can respond to a variety of them. |
|
|
Term
What is the function of monocytes?
What are they called if they have migrated from the blood stream into the tissue? |
|
Definition
They are phagocytic. Also show antigens to T cells.
Called Macrophages. |
|
|
Term
| What is the function of neutrophils? |
|
Definition
| First to appear after injury, phagocytosis |
|
|
Term
What is the function of eosinophils?
How can they migrate? |
|
Definition
Allergic reactions, parasite infections, phagocytosis.
Migrate by diapedesis (through capillary wall into tissue) |
|
|
Term
| What is the function of basophils? |
|
Definition
| Have little or no phagocytic action. They secrete histamine. This increases capillary wall permeability and eases passage from capillaries into body tissue. |
|
|
Term
| What is the role of the Complement C System? |
|
Definition
To cause lysis of immunogens.
Causes opsonization (tags antigens to be destroyed) |
|
|
Term
| What type of allergic reaction is SLE? |
|
Definition
| Type III: immune-complex reaction whereby tissue damage occurs secondary to antigen-antibody complexes that deposit in tissues. |
|
|
Term
| An antigen triggers which immunoglobin to cause damange to synovial membranes and cartilage in rheumatoid arthritis? |
|
Definition
| Triggers abnormal IgG. Antibodies called RF combine with IgG and the resulting complexes cause damage to synovial membranes and cartilage. |
|
|
Term
| Describe the process of cancer formation. |
|
Definition
| Proto-oncogenes are genes coded to maintain proper cell growth. They mutate into oncogenes that engage in indiscriminate cellular growth and division so cells grow and divide continuously. Tumor suppressor genes help stop tumors from forming and control cell growth but they are turned off. DNA repair genes that help cells to recognize and repair DNA are also turned off so cells dont recognize mutations and DNA isn't repaired. Neighboring cells excrete a chemical growth inhibitor which is also ignored. Cancer cells also lack the tumor suppressor gene inhibitory process. |
|
|
Term
| What does the p53 gene do? |
|
Definition
If DNA cant be repaired, p53 signals cell to undergo apoptosis.
50% tumors have mutation of this gene. |
|
|
Term
| How does the body initiate immune response? |
|
Definition
| MHC "presents" antigen to the WBCs, T cells, NK cells and macrophages. |
|
|
Term
|
Definition
| Major histocompatibility complex |
|
|
Term
| How do helper T-cells regulate the immune response? |
|
Definition
| By releasing cytokines to signal other immune system defenders |
|
|
Term
| How do helper t cells become activated? |
|
Definition
| Respond to antigen on Class II MHC marker found on macrophage or dendritic cell. Information presented to resting Helpter T and it converts to active Helper T cell. Cytotoxic T cells activated to destroy damaged cell. |
|
|
Term
What do Cytotoxic T cells do?
How does cancer escape it? |
|
Definition
Recognize surface markers on other cells that label those cells for destruction.
Cancer cells may shed proteins that are identified as antigens by the CTL. |
|
|
Term
What is the NK mechanism of action?
How do they kill? |
|
Definition
attacks cells with low level of MHC class I molecules on the cell surface.
Kill by releasing perforin, which damages the cells membrane |
|
|
Term
| What is Tumor Necrosis Factor (TNF)? |
|
Definition
Type of cytokine
protein secreted by WBC in response to antigen or infection.
Thought to cause death of certain types of tumor cells. |
|
|
Term
| What is the function of plasma? |
|
Definition
Liquid portion of the blood.
Comprises 55% of the blood
Composed primarily of water but also proteins, electrolytes, gases, nutrients, and waste products. |
|
|
Term
| What is the function of Erythrocytes (RBCs)? |
|
Definition
| Carries O2 to tissue. Helps maintain acid-base balance by carrying away CO2, flexible cell wall able to alter shape to pass through small capillaries, biconcave shape to facilitate the diffusion of gases. Primarily composed of hemoglobin, a protein-iron compound that binds with oxygen and CO2. O2 attaches to iron (heme) and CO2 attaches to protein (globin). |
|
|
Term
What is anemia defined as?
What are normal levels? |
|
Definition
Hgb less than 10 g/100 mL
14-16 in men, 12-14 in women |
|
|
Term
What is the function of leukocytes (WBCs)?
What are the 2 types? |
|
Definition
Protection against bacteria
Granulocytes (contain granules in cytoplasm) and Agranulocytes (no granules in cytoplasm) |
|
|
Term
What are bands?
What is a shift to the left?
what is neutropenic precautions? |
|
Definition
bands are immature (nonsegmented nucleus) neutrophils
a shift to the left = increase in % bands
Neutropenic precautions (ANC less than 500) |
|
|
Term
When are monocytes elevated?
what are they called in liver, bone and in the lung? |
|
Definition
In chronic disease
Kupffer cells, osteoclasts, alveolar macrophages |
|
|
Term
| What releases thrombocytes into circulation? |
|
Definition
| cells in the bone marrow called megakaryocytes |
|
|
Term
| What are the three stages of hemostasis? |
|
Definition
Vasoconstriction
Formation of platelet plug
Coagulation or formation of a fibrin clot |
|
|
Term
| What is the difference between intrinsic and extrinsic fibrin clot formation? |
|
Definition
Intrinsic: activated when plasma comes in contact with damaged vessel surface. Antigen-antibody reactions and endotoxins. Damage to the blood vessels
Extrinsic: Injury occurs outside of the vessel as trauma. When damaged tissue cells release thromboplastin and it comes into contact with one of the clotting factors (factor VII) |
|
|
Term
|
Definition
| Process that results in the dissolution of the fibrin clot. |
|
|
Term
| What is Myelodysplastic Syndrome? |
|
Definition
| Group of hematologic disorders characterized by changes in quantity and quality of bone marrow elements. Cytopenias combined with hypercellular bone marrow are characteristic. |
|
|
Term
What are most acute hemolytic reactions caused by?
How long until symptoms occur? |
|
Definition
By ABO incompatible blood products. Hemolysis of RBCs releases free hemoglobin into the plasma which can obstruct renal tubules, leading to acute renal failure, DIC, and death.
Symptoms generally occur within first 15 minutes |
|
|
Term
| What do most febrile reactions result from? |
|
Definition
Leukocyte incompatibility.
Allergic reactions result from recipients sensitivity to plasma proteins in the donor blood. More common in pts with history of allergic reactions |
|
|
Term
|
Definition
| Only one to cross the placenta and give passive immunity |
|
|
Term
|
Definition
| Neutralizes toxins in blood |
|
|
Term
|
Definition
| Primary response to antigen on RBC (transfusion) and lymph system. It is the 1st to produce antibodies |
|
|
Term
|
Definition
| allergy response, binds to mast and basophil cells |
|
|
Term
|
Definition
| helps receptor sites B cells in selection process |
|
|
Term
| What are the 2 major signs of SLE? |
|
Definition
| butterfly rash and swan neck fingers |
|
|
Term
| Tx of compartment syndrome |
|
Definition
|
|
Term
|
Definition
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