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Principles of Disease
a class all about disease
142
Pathology
Undergraduate 3
02/13/2012

Additional Pathology Flashcards

 


 

Cards

Term
Pathology
Definition
the study of suffering
Term
aetiology
Definition
the cause of a disease process
Term
pathogenesis
Definition
the mechanism of development of disease
Term
lesions
Definition
the structural altercations of disease
Term
clinical significance
Definition
the functional consequences of disease
Term
incidence
Definition
the number of new cases of a disease each year
Term
prevalence
Definition
number of occurrences of the disease in a year and is the total number affected
Term
morbidity
Definition
the percentage of a given population that will become affected
Term
case fatality rate
Definition
proportion of individuals who contract a disease that die of that disease in a set period of time, usually one year
Term
mortality rate
Definition
ratio of the number of deaths from a given disease to the total population
Term
actual risk
Definition
a statistical measure of the chance of developing or dying from a disease
Term
free radicals
Definition
molecules that have an unpaired electron, they release considerable energy, most common are derived from oxygen (ODFR)
Term
free radical scavengers
Definition
these are antioxidants
Term
healing
Definition
an injury involves regeneration and scar tissue formation in variable amounts
Term
regeneration
Definition
occurs when injured cells are able to be replaced with cells of an identical or similar type
Term
scarring
Definition
when the cells are replaced with fibrous tissue
Term
the 4 stages of the cell cycle
Definition

1. G1 (presynthetic)

2. S (DNA synthesis)

3. G2 (premitotic)

4. M (mitotic)

 

>resting cells are in the G0 phase, then they enter the cell cycle they enter at the G1 stage

Term
terminally differentiated
Definition

cells are not capable of division, they are nondividing, they are also called permenant cells

>example: neurons, muscles cells of heart and skeletal muscle...  they have left the cell cycle and do not reenter

 

>short lived, incapable of replication

Term
continuously dividing tissues
Definition

LABILE

>have stem cells that proliferate and replace the mature or terminally differentiated cells

 

Term
quiescent or stable cells
Definition

-present in a resting state

-when injured have cells that are able to divide

>ex: liver, kidney, pancreas, mesenchymal cells (fibroblasts/sm muscle), vascular endothelial cells and resting lymphocytes

Term
Growth Factors
Definition

-epidermal  (EGF)

-transforming (TGF beta)

-insulin like (IGF)

>have major roles in controlling cell proliferation and differentiation

>there are both activators and inhibitors of each part of cell cycle, operate to stop cycle at transition phases especially b.w. G1 and S (CHECKPOINTS)

Term
hypertrophy
Definition
an increase in cell size or tissue size bc of an enlargment in the size of the cell(s)
Term
atrophy
Definition
a tissue or cell reduces its size
Term
hyperplasia
Definition
increase in number of cells and it is common response to increased demand of cells that are continuously dividing (labile)
Term
metaplasia
Definition
when under sufficient demand usually chronic irritation, one cell type changes to another
Term
cell degeneration
Definition
the result of an injurious process that results in impairment of cell function from which recovery can occur (reversible injury)
Term

cell swelling

aka hydropic degeneration

Definition

-most common manisfestation of cell injury

-cells swell bc they cannot control entry or loss of water

-lose ability to maintain ions such as N and K bc of membrane damage

Term
fatty degeneration
Definition

or fatty change

-manisfestation of type of reversible injury

-occurs in those organs where fat is metabolized...especially the liver!

Term
oncotic necrosis
Definition

death from cell swelling

>enzymes from lysosomes leak in the cell and degrade nuclear and cytoplasmic components...this allows detection of tissue specific injury by using serum ->creatine kinase is released from damaged heart muscle and is used to detect necrosis of heart muscle in a heart attack

Term

death by apoptosis

morphologically

Definition
apoptotic cells have nuclear fragmenation, cellular shrinkage, fragmentation and engulfment by surrounding cells
Term

death by apoptosis

biochemically

Definition

apoptosis is the result of biochemical pathways that involve caspase induced destruction of proteins

>ex: coagulative necrosis is a morphological descriptor, describes what happens when cells die and remain same size  ->meat in super market

Term
frostbite
Definition

freezing usually occurs relatively slowly and large ice crystals form within the cells

-these ice crystals have the same effect as a series of knives, cut and lacerate the normal cytological structures

-as cell begins to thaw frozen cells with their disrupted membranes will break and undergo hydropic degeneration bc of the breeches in the cell membrane

 

Term
ischemia
Definition
lack of blood flow
Term
hypoxia
Definition
reduction in oxygen tension in the tissue
Term
capillaries
Definition
composed of endothelial cells, form barrier bw the intra/extravascular space
Term
what does Starling's force do?
Definition

>determines the movement of fluid in the capillary bed

>blood pressure = peripheral resistance x cardiac output

Term
where is blood pressure highest?
Definition
>arteries
Term
what regulates teh pressure within the capillary bed?
Definition
precapillary sphincter
Term
Capillary blood pressure
Definition

>it's low, but must be maintained in a narrow range to ensure a net movement of fluid from the blood vasculature into the tissues

>movement of fluid into extracellular compartment around tissue cells will increase the oncotic pressure within the blood vascular system

>proteins such as ALBUMIN create this oncotic pressure

>as blood moves from arterial to venous, hydrostatic pressure is overcome by the draw of oncotic pressure

>increas in oncotic pressure results in a net flow of water back into the vascular system

>ensures a continuous movement of fluid through and flushing of the extravascular space

>excessive fluid in extravascular space is removed by a specialized vascular system called lymphatic system

 

Term
edema
Definition
excessive amount of fluid in a tissue (interstitial space) or a body cavity or space
Term
noninflammatory edema
Definition

occurs when there are alterations to the forces at the venous end of the capillary, either with a reduction in oncotic pressure or an increase in venous hydrostatic pressure

 

Term
ascites
Definition
excessive fluid in the abdominal cavity
Term
hydropericardium
Definition
excessive fluid within the pericardial sac
Term
hydrothorax
Definition
excessive fluid within the thorax
Term
peripheral edema
Definition
excessive fluid within the extravascular space of peripheral tissues of feet, hands and other external appendages
Term
hypoproteinemia
Definition
reduced amount of protein (usually albumin) in the blood
Term
hypoalbuminemia
Definition

oncotic pressure in the intravascular space is reduced and there is less attraction for fluid to reenter the blood vascular system

>ex: kwashiorkor, severly malnourished children with ascites

Term
hyperaemia
Definition

active process where the precapillary sphincter opens to allow a greater amount of into the capillary beds of a tissue

>ex: blushing

Term
congestion of blood flow
Definition
a passive process where blood builds up in capillaries and is usually caused by obstruction of veins
Term
ischemia
Definition
reduced blood in capillaries, 'to keep back blood', a result of vasoconstriction
Term
hypoxemia
Definition
reduction of oxygen tension in the blood
Term
infarction
Definition
when tissue dies bc of ischemia
Term
haemorrhage
Definition

-very dramatic vascular disturbance

-means release of blood or RBCs from the vascular system

Term
haemotoma
Definition

>most extrememe form of haemorrhage

>swelling (oma) of blood

Term
diapedesis
Definition

>smaller haemorrhaging

>RBCs move out of capillaries bc of widening of the gaps bw endothelial cells

Term
petechia
Definition

>smallest haemorrhage

>pinpoint haemorrhaging

Term
ecchymosis
Definition

>variant bw petecia and haemotoma

>usually a whole series of petecial haemorrhages that appear as though blood was wiped on the tissue, 'paintbrush haemorrhaging'

Term
thrombus
Definition
blood clot that develops within the vessels of a living organism
Term
postmortem clot
Definition
clot that forms in vessels after death
Term
haemostasis
Definition
stopping of haemorrhage, normal function
Term
3 major components of haemostasis
Definition

>endothelial cells; very active, normally anticoagulative

>platelets; cell membrane bound fragments of the cytoplasm of megakaryocytes of the bone marrow, recognize breaches in endothelial layer, adhere to collagen/extracellular matrix, secrete thromboxane which stimulates platelet function

>coagulation cascade; series of proteins found in blood, mostly produced by liver

Term
aggregation
Definition
facilitated by the plasma protein fibrinogen
Term

Normal Haemostasis

>at site of vascular injury

Definition

-initial vasoconstriction induced by local nerve reflex and augmented by chemical vasocontrictors such as endothelin

-platelts adhere to exposed extracellula matrix, undergo a shape change and recruit other platelets to form a primary plug

-tissue factor activates coagulation cascade

-produce fibrin mesh that forms secondary plug

-platelets and fibrin combine to form permanent plug

-regulatory factors ensure plug does not expand to form large thrombus

Term
thrombogenesis
Definition
process where blood clots are formed
Term
hypercoagulability
Definition
blood becomes increasingly susceptible to coagulation
Term

DIC

>dissmeinated intravascular coagulation

Definition
widespread thrombi, consumption of coagulation factors results in haemorrhage as well as the downstream effects of thrombi in vessles
Term
embolism
Definition

clustering/aggregation of a substance within the blood stream

>emboli can be thrombi

>the bends; emboli of bubbles of gas

Term
shock
Definition
circulatory disturbance that is a widespread hypoperfusion of tissues
Term
cardiogenic shock
Definition

-occurs in heart failure

-heart function greatly reduced

Term
hypovolemic shock
Definition
occurs bc of a lack of blood vol. and occurs in dehydration or massive haemorrhaging
Term
septic shock
Definition
sepsis or the products of bacterial infection cause blood to pool in the capillary beds
Term
neurogenic shock
Definition
sympathetic NS response to an insult, injury or observed situation
Term
anaphylactic shock
Definition
systemic hypersensitivity/allergic respons
Term
Neutrophil
Definition

>aka polynorphonuclear granulocyte

>short-lived, rapidly mobilized

Term
Macrophage
Definition

>monocyte, histiocyte, microglial cell, kupffer cell, mesangial cell, langerhans cell

>slower to respond, longer life span, links innate and adaptive immunity through antigen presentation

Term
Antigens
Definition

-substances that are recognized by cells of the adaptive immune system as being either 'self' or 'foreign'

 >Ag specific immune response is lead by lymohocytes

 

Term
lymphocytes
Definition

-replicate in response to Ag exposure producing a clone (epitope) of Ag responsive cells

-clonal proliferation increases the number of lyphocytes that recognize the same epitope on subsequent exposure >>more rapid and enhanced (memory)

 

lymph+Ag+stim. envt. >proliferation/clones of epitopes/sensitive cells >>efector cells and memory cells

 

Term
***stopped here with immunology
Definition
Term
direct transmission
Definition

vertical >from mother before or at birth

 

horizontal > from one to another after birth

 

...some are contagious; transmitted directly to another host of the same species

Term
infectious agents of vertebrates
Definition

prion >infectious protein

viruses >obligate intracellular

chlamydiae >ob intra

rickettsiae >ob intra

bacteria >intracellular/extracellular

fungi >intra/extra

protozoa >intra/extra

helminths >intra/extra

mycoplasma >extracellular

arthropods >extracellular

 

 

Term
viruses
Definition

-mobile genetic elements

-multiply in cells

-have genome for RNA and DNA, protective protein coat/capsid that allows them to pass from one cell to another

-transmitted via direct/indirect contact

 

Term
viral pathogenicity
Definition

-viruses cause damage by entering a host cell and replicating at its expense

-have  tropism for particular cell bc of specific receptor on the cell

-may inhibit hose cell DNA/RNA/protein synthesis

-may damage cell membrane or cell lysis (due to replication within cell)

-some integrate proteins w/in cell mem. which inscites immune attack by host >causes lysis, or may activate cell

 

Term
host response to viruses
Definition

-after infection, body responds with inflammation, Ab formtn and or cellular immunity

-in some cases interferon is formed

Term
interferon
Definition

-protein produced by virus-infected cell

-prevents viral reproduction in neighbouring cells

Term
prevention of virus
Definition

-avoidance (quarantine)

-acquisition of immunity by vaccination >usually given before exposure to an agent by can be given after exposure if incubation period is long or disease is really serious

Term
treatment of virus
Definition

-tx with antiviral drugs is limited by the toxicity of most drugs and by their limited range of effectiveness

-interferon, only mucosal surfaces cz too toxic

-acyclovir inhibits DNA syntheses

-azidothymidine inhibits revers transcriptase of HIV

Term
herpes virus
Definition

1. human herpesvirus 1 >cold sore

2. human herpesvirus 2 >genital herpes

3. vaicella zoster >chicken pox, shingles

4. cytomegalovirus >CMV

5. human herpesvirus 6>roseloa infantum

6. epstein barr virus >western world infectious mononucleosis; africa, burkitts lymphoma

 

Term
Bacteria
Definition

-seperated into two groups; Gram +ve and Gram -ve

 

Gram +ve >have thick cell wall

Gram -ve >thin wall and an outer membrane of phospholipid, lipopolysaccharide and protein

Term
bacterial mechanisms
Definition

-rapid multiplication (competes with the host for nutrients, the production of exotoxins/endotoxins and by inducing host response)

 

Term
exotoxins
Definition

produced by bacteria and released into the environment

-toxins may be waste products or factors that assist the organism to survive, reproduce or be carried to the next host

Term
Endotoxins
Definition

structural components of the cell walls of Gram -ve bacteria

-complex of lipopolysaccharide and protein

-potent activator or macrophages and stimulates the production of IL-1 and TNF

 

Term
bacteraemia
Definition
bacteria in the blood
Term
sepsis
Definition
toxins of bacteria spread from a local infection
Term
toxemia
Definition
toxins in the blood
Term
septicaemia
Definition
bacteria and their products, including endotoxins and exotoxing in the blood
Term
host response to bacteria
Definition

primary response >neutrophil, usually forming pus (pyo)

-purulent or suppurative and in some cases granulomatous, inflammation are the main ways that the body responds

-complement macrophages and humoral (Ab) and cell immunity assist in removal of bacteria

Term
prevention of bacteria
Definition

-avoidance and sanitation

-active immunity >stimulated by vaccination (often with toxoids; like toxins...they are antigenic but not pathogenic)

 

toxoids >made from exotoxin, antitoxin (or antiserum) can be given to prevent disease in an exposed individual

Term
tx of bacteria
Definition

antibiotics >antibacterial drugs derived from microorganisms

-synthetic antimicrobials are called chemotherapeutic agents

-they work in two main ways: bacteriocidal,kill bacteria/bacterostatic, stop them from multiplying

 

Term
metaplasia
Definition

is change of cells of one tissue type to another

-occurs bc of injury or excessive stimulation

Term
dysplasia
Definition

abnormal development or growth of cells or tissues

-often preneoplastic change and is therefore a prelude to neoplasia

Term
neoplasia
Definition

'net growth'

-at the heart of neoplasia is uncontrolled growth, 'the presence of abnormal growth regulatory mechanisms'

Term
neoplastic cells
Definition

-have genetic and epigenetic changes that are passed onto future generations of cells so that they are no longer responsive to the normal control of growth

-despite genetic change, avoid checkpoints in the normal cell cycle...causing perpetual cell cycle

-act independently

Term
cancer
Definition

-type of neoplasia

-'crab', refers to the affects of some neoplasms in the body (clawing at the internal organs)

-commonly used to denote any neoplastic disease, more often a malignant one

-cancer also means malignant epethelial neoplasia or carcinoma

Term
tumour
Definition

-means swelling

-common usage is for neoplasia that is benign

Term
criteria of malignancy
Definition

demarcation >poor

invasion >yes

rate of growth >high

differentiation and anaplasia >poor

pleomorphism >marked

metastasis >yes

mitosis per high power field >high

Term
carcinomas
Definition
-malignant epithelial neoplasms
Term
sarcomas
Definition
-malignant stromal or mesenchymal neoplasms
Term
metastasis
Definition

spread of a disease process from one location to another without direct connection between them

-occurs bw surfaces and cavities, via lymphatics, haematogenously and by contact

Term
MIDTERM II STUFF
Definition
Term

gastric erosion

-ulcer

Definition

gastric erosion is the loss of gastric mucosa bc of death of epithelium

-ulcer is deep 'erosion' that penetrates muscularis mucosa

Term
peptic juice contains?
Definition
-HCL and pepsin ...secreted by the gastic glands, begins protein digestion and kills unwanted microbes
Term
peptic ulcer
Definition
ulcers that occur in area exposed to action of peptic juices, stomach and duodenum (most common)
Term
where do the pancreatic/biliary juices enter?
Definition
duodenum
Term

mature eneterocytes secrete what for what?

 

Definition

enzymes for the final breakdown of food

>this includes dipeptidases/disaccharrides for the absorption of food

...fat that is processed, forms chylomicrons, released into lymphatics

Term
most nutrients absorbed where?
Definition
>sm. intestine
Term
what is cholera caused by?
Definition
a toxin released by the bacterium Vibrio cholerae
Term
rotavirus and coronavirus attack what?
Definition
the villous epithelium and cause atrophy of the villus
Term

what is diarrhea?

what are the mechanisms of diarrheal disease?

Definition

>presence of water in feces in relative excess in proportion to the fecal dry matter

>secretory, malabsorptive, exudative, osmotic and deranged motility

Term
secretory diarrhea
Definition

-occurs when secretion of fluid by immature cells is in excess of the absorption by mature cells

-happens in cholera, toxin causes increase secretion of fluid

Term
malabsorptive diarrhea
Definition

-occurs when there is a loss of mature cells so absorption can't occur

-rotavirus

Term
exudative diarrhea
Definition

-complete destruction of villi/crypt and exudation of plasma proteins through eroded surface

-salmonellosis or radiomimetic injury

Term
osmotic diarrhea
Definition

-osmotically active substances are [resent on the lumen

-MgSO4 or seawater ingestion, lactose intolerance

Term
deranged motility
Definition
-irritable bowel syndrome reulst in diarrhoea
Term

Traveler's Diarrhoea

-Agents

-Prevention

-Tx

Definition

agents >enterotoxigenic escherichia. coli, shigella sp, campylobacter jejuni ...passage of at lease 3 unformed stools in 24 hour, nausea, vomiting, abdominal pain/cramps, fecal urgency, tenesmus or passage of bloody stool

 

prevention >depends on amt of time spent in new area, long = natural immunity, short = dietary restriction/chemoprophylaxis are alternatives

 

tx >fluids/electrolytes, ex: flavoured mineral water and saline crackers

Term
neutrophils, basophils and eosinophils are what?
Definition
granulocytes of the WBC...  there are also monocytes
Term
haematopoiesis or myelopoieses is what?
Definition

production of the cells of the blood

-erythropoiesis = production of erythrocytes

-granulocytopoiesis = production of granulocytes

-thrombopoiesis = production of platelets

Term
where are old blood cells removed?
Definition

in the spleen

...granulocytes exit to the tissues

...lymphocytes home to lymph nodes/spleen/other lymphoid tissue/form long lived circulating pool

Term

PCV or hematocrit

-what does this do?

Definition

-evaulates erythrocytes

-red cell mass in comparison to fluid in blood

Term
Blood Doping
Definition

young red cells are larger than older cells and have more RNA in cytoplasm, stain blue, vary in colour (polychromasia)

-detect blood doping by looking at avg age or red cells

-transfused cells age prematurely, sm mature cells

Term
regenerative anaemia
Definition

or 'responsive'

-many young red cells, indicates release from BM

ex: haemolysis, loss of red cells

 

-reduced PCV, RBC, Hb

-increased numbers of young red cells, presence of polychromasia and reticulocytes 

Term
what is the hormone that is released from the kidney during hypoxia?
Definition
EPO, erythropoietin stimulates red cell production, erythropoiesis is at its max by 5-7 days
Term
non-regenerative anaemia
Definition
maens the bone marrow is not responding, that is not able to release young red cells
Term
polycythemia
Definition

increase in number of red cells

>caused by dehydration, situations where there is increased erythropoietin secretion, ....hypoxemic conditions predominate and include aerobic training (esp at high altitude), heart/lung diseases 

Term
'-osis' or '-ilia'
Definition
an increase in the number of cells involved
Term
'-penia'
Definition
values below the reference range 
Term
what is an increase in the number of bands in circulation called?
Definition

a left shift.... indicates a marrow response to infection or  death of tissue

 

Term
degenerative left switch
Definition
the number of bands exceeds the number of segmented cells and the demand for neuts that exceeds the rate of production = indicator of serious disease
Term
what is seen in controlled infections?
Definition

-leukocytosis

-neutrophilia 

-left shift

Term
Leukemia
Definition

-dramatic or marked leukocytosis, number of neoplastic leukocytes increase

 

 

Term
obstructive lung disease
Definition
-reduce airflow in the bronchi and bronchioles (contraction of smooth muscle in the airways...bronchoconstriction...or plugging of airway lumens with mucus or leukocytes)
Term
restrictive lung disease
Definition

-damage the alveoli or the alveolar walls

-reduction of the functional vol and elasticity of the lung = increase effort of breathing

-cause thickening of the barrier bw the alveolar air and blood (results in poor oxygen exchange)

 

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