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Patho final 2
Julie A. 2
71
Health Care
Undergraduate 2
06/01/2008
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Term
Immunity present at birth:
Definition
This is also called innate immunity. This is immunity is inherent within a species and develops regardless of exposure. This is present at birth and functions similarly regardless of the pathogen.
Term
Molecule that elicits immune response: 
Definition
The term antigen originally referred to a molecule that caused antibodies to be generated, but it has now been refined to mean any molecule that can bind with a specific antibody. The term Immunogen refers to any molecule that elicits an immune response. This can include viruses, bacteria, pollen, toxins, foods, or transplanted organs.
Term
Phagocytic Cells:
Definition
These types of cells will engulf the invader in an amoeboid- like process. The cell membrane distorts and wraps around the particle until the two sides of the cell touch. This type of cells are Monocytes that later become Macrophages.
Term
HIV spread
 Definition
It is transmitted by blood, semen. Vaginal or cervical secretions and breast milk.
Term

CD4 + count regarding HIV diagnosis:  

 Definition
• During the initial infection there may be a high viral load and a dramatic drop in the CD4 cell count.
• The development of a CD4 + below 200 cells/ul is the establishment of AIDS.
• CD4+ lymphocytes are the primary target of the virus, therefore they decline, are there is a greater risk for opportunistic infections.
Term
 T lymphocytes and immunity:
Definition
• T lymphocytes divide early and develop in the killer T cells and helper T cells. T cells develop in the bone marrow, once they leave the bone marrow the travel the thymus where they continue their development.
• Immunity is divided into two different categories: innate and acquired. We have already gone over innate. Acquired immunity is immunity that is not present at birth and develops either as a result of exposure of through and external source, i.e. colostrum or injection of immunoglobulin.
Term
Kaposi’s sarcoma:
Definition
This is a type of skin cancer that is usually rare, but is happens a lot in people with HIV.
• It manifests in maculopapular lesions that range in color from pink to bluish- purple.
Term
ELISA test
 Definition
This test is a enzyme-linked immunosorbent test and it tests for HIV antibodies, the results provide an indeterminate report.
Term
 Teaching for SLE lupus:
Definition
• Teaching appropriate skin care
• Nutrition
• Minimizing the risk of opportunistic infections
• Avoid sun exposure.
Term
 Graft vs. host disease:
Definition
This is a result of a transfusion of blood or a tissue transplant with cells that are incompatible with the host. This is where the T cells from the donor attack and destroy the vulnerable cells of the host, this will usually happen 7-30 day after the transplant.

• Allograft: refers to cells and tissues obtained from the same species, as from a close relative or unrelated donor, who has similar type of cell compatibility.
Term
Diffusion
 Definition
Is the movement of solutes from an area of high concentration of solutes to an area of low concentration of solutes. “High to low”
Term
Osmosis
 Definition
The movement of water across a semi permeable membrane. “Movement of water”
Term
Normal serum levels of major electrolytes (See hand out)
 Definition
Sodium- 135-145
Potassium- 3.5-5.0
Calcium- 8.5-10.5
Phosphorus- 1.7-2.6
Magnesium- 1.6- 2.6
Term
ASSESSMENT FOR ' HYPOCALCEMIA'
 Definition
C=convulsion
A=arythmias
T=tetany
S=spasm and stridor
Term
HYPONATREMIA
 Definition
S=stupor/coma
A=anorexia, n/v
L=lethargy
T=tendon reflex decreased
also,
L= limp muscle(weakness)
O=orthostatic hypotension
S=seizure/headache
S=stomach cramping
Term
HYPERNATREMIA
 Definition
S=skin flushed ( fever)
A=agitation
L=low grade fever
T=thirst
also;
F=fever (low grade) flushed skin
R=restless ,irritable
I= increased fluid retention, increased BP
E= edema
D= decreased urinary output
Term
HYPERKALEMIA
 Definition
M=medication(ACE inhibitors, NSAIDS)
A=acidosis(metabolic, respiratory0
C=cellular destruction(burns, traumatic injury)
H=hypoaldosterone, hemolysis
I= intake - excessive
N=nephrons, renal failure
E=excretion impaired
Term
Blood pressure readings indicating postural hypotension:
Definition
A decrease in systolic blood pressure of more than 20mm Hg when going form lying to standing, along with an increase in heart rate of 10 beats per minute, or a decrease in diastolic blood pressure of more than 10mm Hg along with a 10 beat per minute increase in heart rate is considered postural hypotension.
Term
Signs of fluid volume deficit in the child:
Definition
(Not the depressed fontanels )
Term
Acid vs. base ABG’s and determining whether compensating fully or partially:Normal values:
 Definition
PH: 7.35-7.45
PCO2: 35-45 mm Hg
HCO3: 22-26mEq/L
**Ok I really don’t understand this very well so I’m doing my best here.**
First: look at the PH if it is less then 7.4, even though it is with the normal limits it is concerned acidic, if it is over 7.4 it is concerned basic.
Second: look at the PCO2 and the HCO3, and find out if they are acidic or basic. If the PCO2 is higher it is acidic, and if it is lower it is basic, because it is an acid. If the HCO3 is high it is basic, and if it is low then it is acidic, because HCO3 is a base.
Third: Find out which one of the PCO2 or the HCO3 matches the PH. If the PCO2 matched the PH then it is a respiratory problem, if the HCO3 and the PH match, then it is a metabolic problem. If the problem was acid then it is acidosis, and if the problem was basic then it if alkalosis.
Forth: find out if has fully compensated or partially compensated. If the PH is back in normal rang but the PCO2 or the HCO3 if off, then it has fully compensated. However if the PH is off and PCO2 or the HCO3 are off then it is only partially compensated.
Term
S/S fluid volume deficit
 Definition
Intravascular deficit
 Hypotension
 Tachycardia
 Postural hypotension
 Decrease in urine output
Interstitial Deficit
 Dry mucous membranes
 Depressed fontanelles
 Decreased skin turgor
General
 Weight loss
Term
Trousseaus sign chvosteks sign:
Definition
Trousseaus sign- is assessed by placing a blood pressure cuff on the arm. The cuff is inflated to just above the patient’s systolic pressure for up to 4 minutes. A positive sign is the hand, will spasm.
Term
Chvosteks sign-
Definition
Tapping the facial nerve, a positive sign is associated with a spasm of the facial muscles on the side that is tapped.
Term

Malabsorption syndrome:

Definition
This is where transport of the intestinal contents across the mucosal membrane of the lumen is impaired. This happens when:
• There is a reduction in the absorption surface of the intestine (resection)
• Genetic abnormalities (celiac disease, disaccharidase deficiency)
• Inflammatory of infiltrative disorders.
Term

S/S of an appendicitis:

Definition
• Periumbilical pain that can spread over the lower abdominal region.
• In time the pain will localize in the RLQ
• Low grade fever, N/V
• They will have rebound pain.
Term
Diagnosis of and s/s of diverticular disease:
Definition
• A CT scan is the best way of detecting abscesses and complications evidenced in diverticulitis.
• CBC can show elevated WBC
• Lower GI series (barium enema)
S/S
• Constipation or diarrhea
• Lower abdominal pain in the left lower quadrant.
• IBS
• Abdominal cramping
• Lower grade fever
• Bleeding and inflammation
Term

S/S of colorectal CA:

Definition
 Fatigue
 Unintended weight loss
 Change in bowel habits
 Bloody stools
 Alternating between constipation and diarrhea
 Signs of an early obstruction
Term
 Medication for and characteristics of IBS:
Definition
Medications that are used are: Imodium and Lomotil. Some herbal remedies are anise, peppermint, and sage.
Characteristics: Abdominal pain, diarrhea, constipation or both. Stress will exacerbate the manifestations as will a diet high in fat, smoking, ETOH, irritating foods.
Term
Hepatitis A
 Definition
Spread by Fecal- oral.
There is a vaccine. s/s mild viral flu like symptoms.
Term
Hepatitis B:
Definition
Spread by Blood and body secretions
There is a vaccine. s/s anorexia, low grade fever, jaundice, rashes, vomiting
Term
Hepatitis C
 Definition
Spread by Blood and plasma to skin and mucous membranes.
There is NO vaccine for this. s/s Influenza type symptoms, may be more sever then HAV
Term
Hepatitis D
 Definition
Similar to HBV
Preventing HBV will prevent this. s/s coinfection symptoms are more sever then HBV infection
Term
Hepatitis E
 Definition
Spread by Fecal- oral route
Coinfection is when HDV is acquired.
Term
Hepatitis F:
Definition
Possibly a variant of HBV
Term
Hepatitis G:
Definition
: Spread by Blood and plasma to skin and mucous membranes.
No vaccine. s/s influenza like symptoms.


More on pages 1702-1707
Term
Common complications of a liver biopsy
 Definition
hemorrhage
Term
Biliary Atresia:
Definition
Extrahepatic biliary atresia is a rare gastrointestinal disorder characterized by destruction or absence of all or a portion of the bile duct that lies outside the liver (extrahepatic bile duct). The bile duct is a tube that allows the passage of bile from the liver into the gall bladder and, eventually, the small intestine. Bile is a liquid secreted by the liver that plays an essential role in carrying waste products from the liver and breaking down fats in the small intestine. In extrahepatic biliary atresia, absence or destruction of the bile ducts results in the abnormal accumulation of bile in the liver. Affected infants may have yellowing of the skin and whites of the eyes (jaundice) and scarring of the liver (cirrhosis). In some cases, additional abnormalities may be present, including heart defects and kidney and spleen malformations. The exact cause of extrahepatic biliary atresia is unknown.(webmd.com)
Term
TX and management of ascites:
Definition
Treatment: 400 mg of spironolactone or 30mg of amiloride, plus 120mg of furosemide daily for two weeks.
Term
 Postnecrotic Syndrome:
Definition
This normal happens in the wake of a hepatitis infection. Hepatitis C is the predominant cause of viral related cirrhosis. Drug- induced liver damage can become necrotic and cause cirrhosis to develop
Term
 Chronic Pancreatitis:
Definition
• Happens when there is irreversible damage to the pancreas.
• Chronic alcoholism is implicated in about 70 percent of all chronic pancreatitis cases.
• Characterized by: pain, malabsorption, and diabetes.
• Cystic fibrosis is the most common cause of pancreatitis in children.
• Also can be caused by actual physical trauma or cancer to the organ.
Term
S/S of glomerulonephritis
 Definition
 The first symptom is often dark urine, which is described as brown tea or cola colored.
 Periorbital edema occurs suddenly
Usually noticed on waking.
The result of the defect in renal excretion of salt and water.
 Hypertension is present in approximately 80% of pts.
Term
Stone compositions
 Definition
Calcium, magnesium, phosphate, amonia, and uric acid.
Term
Resistant polycystic kidney disease and meds used
 Definition
Resistant infection following the use of cephalosporins, penicillin derivatives and aminoglycosides may call for treatment with lipid-soluble antibiotics to penetrate the less permeable cysts: Clindamycin & newer derivatives and Gentamycin.
Term
Assessment of Oliguria
 Definition
 Oliguria-Less than 400 mL per 24 hours of urine.
* The most common clinical manifestation of ARF.
Term
Labs and administration of gentamicin
 Definition
 Monitor peak and trough levels.
 Given IM, IV, and Intrathecal
 Serum peak, drawn at 30-60 min after IV infusion or 60 min after IM injection, and trough level drawn just before next dose; blood level should be 2-4 times bacteriostatic level; peak = 4-12 mcg/mL, trough = 1-2 mcg/mL.
Term
Hemodialysis
 Definition
The patients blood is pumped through semi permeable capillaries in a hemodialyzer.
 Dialysate fluid containing a premixed concentrate of electrolytes flows countercurrent to blood flow through the intercapillary spaces of dialyzer.
 Typical HD treatment duration is 3-4 hours on a three times weekly schedule.
 Dialysis catheters are placed in a femoral, subclavian, or jugular vein.
Term
Peritoneal Dialysis-
Definition
Requires filling the peritoneal cavity with a prescribed volume of peritoneal dialysate, allowing it to dwell for a prescribed period of time then draining and discarding the effluent(waste materials).
 Can be performed at home or when traveling and while sleeping.
Term
Typical meds given to renal transplant patients
 Definition
 Glucocorticoids: Block cytokines & migration of phagocytes indirectly block T cell activation.
 Azathioprine: Blocks DNA to prevent lymphocyte proliferation following antigenic stimulation.
 Mycophenolate: Selective inhibition of T & B lymphocyte proliferation.
 Cyclosporine: Inhibits calcineuron, blocks interleukins and TNF.
 Tacrlimus: Inhibits calcineuron & T cell activation.
 Rapamycin(Sirolimus): Inhibits T cell activation.
Term
Teaching to prevent UTI’s
 Definition
 Drink 6-8 glasses of water daily.
 Drink cranberry juice.
 Urinate before and after sex.
 Limit your sexual partners.
 Instruct the client to finish all of their antibiotics.
 Use anticholinergics cautiously(they may leave residual urine in the bladder)
Term
Care of patient with pyelonephritis
 Definition
 Monitor vital signs and fluid balance.
 Ensure adequate hydration via an accurate intake and output record.
 Encourage and provide at least 2 liters a day of fluid or maintain an IV access.
 Monitor electrolytes, WBC, BUN, and creatinine.
 Provide adequate pain management.
 Assist with hygiene.
Term
Anasarca
 Definition
Edema that is present throughout the entire body.
 Major goal is to preserve renal function.
 Need to be put on a low sodium diet.
 May be put on diuretics.
Term
Prerenal
Definition
causes of ARF are those that result in decreased blood flow to the kidney. May be caused by dehydration from fluid loss or as complex as the vascular expansion of sepsis or the deficient pumping of cardiac failure. *Most common cause of ARF
Term
Intrarenal
Definition
causes of ARF are intrinsic to the kidney. These include inflammation of the renal parenchyma, intrarenal vascular thrombosis, or tubular necrosis from nephrotoxic agents.
Term
Postrenal
Definition
failure is caused by obstruction to urine flow. More commonly the obstruction is caused by an enlarged prostate gland or a calculus. There is no route for the urine to exit.
Term
 S/S Hyperprolactinemia men and women
 Definition
Women
Decrease in estrogen, Galactorrhea, Amenorrhea, oligomenorrhea with a nnovulation and infertility, vaginal dryness, hot flashes. Osteoporosis, and osteopenia.
Men
Decrease in testosterone, decreased facial and body hair, erectile dysfunction, decrease in libido, small testicles and infertility, gynecomastia.
Term
Acromegaly/ Gigantism
 Definition
 A condition occurring in adults, that is caused by hyper secretion of the pituitary GH over a long period of time. Hypersecretion in childhood causes gigantism.
 Usually are secondary to a benign tumor of the pituitary gland.
 Can grow to 7 feet or taller.
Term
Cretinism
 Definition
 Thyroid hormone deficiency.
 Results from absence or atrophy of the thyroid gland during fetal life.
Term
Grave’s disease(diffuse toxic goiter)
 Definition
 The most common cause of thyrotoxicosis.
 Occurs most often in women between the 2nd and 4th decade.
 Causes overproduction of thyroid hormones.
 Causes a hyper metabolic state with an increase in Oxygen consumption.
Term
Cushings syndrome(Hypercorticolism)
 Definition
 Most often caused by excessive production and release of ACTH secreting adenomas.
 Most commonly occurs in women between 20 and 40 years old.
 S/S can be interpreted as an exaggeration of hypercortisol which affects glucose, protein, and fat metabolism .
Easy bruising Poor wound healing Excess hair growth
Hypertension Edema Moon face
Voice changes Hyperlipidemia Dysrhythmias
Emotional Liability Irritability Depression
Poor memory Euphoria psychosis
Suicidal tendencies Muscle wasting osteopenia
Osteoporosis Renal calculi Polyuria
Amennorhea Decrease in libido Impotence
Protruding abdomen Buffalo hump Hyperinsulemia
Abnormal glucose tolerance test
 Altered body image is a great concern.
 Instruct healthy eating and teach the cause for weight gain.
Term
Addison’s disease
 Definition
 The leading cause is autoimmune disease.
 Can also be caused by adrenal hemorrhage, infections, metatastic cancer or lymphoma, amyloidosis, hemochromatosis, congenital adrenal hyperplasia, familial glucocorticoid deficiency, and hyperplasia.
 Occurs over weeks and months.
Term
Hyperaldosterism
 Definition
 An increased stimulation of the adrenal glands may lead to this disorder.
 Hypokalemia may cause cardiac conduction abnormalities.
 Pt needs to have continuous cardiac monitoring.
 Serum Potassium levels are monitored q4-6hrs.
 Cardiac and resp. assessment should be completed every 4 hours.
 Monitor vital signs in relation to activity.
 Monitor daily I’s & O’s.
 Monitor for hypertension.
Term
SIADH
 Definition
 Hypersecretion of ADH.
 Pts need to be assessed for neurological symptoms that occur as a result of cerebral edema.
 Early symptoms are headache, weakness, muscle changes, and some weight gain.
 Later symptoms are personality changes, hostility and sluggish reflexes. Nausea, vomiting, and diarrhea may also be present.
 Impending crisis may be predicted id the pt develops confusion, lethargy, and change in resps.
 Idenity and eliminate the underlying cause.
 Restrict fluids to 600 to 1200 mL per day.
Term
Tx for hyperthyroidism
 Definition
 Patient will be put on levothyroxine(T4).
 Pt needs to drink a minimum of 8 glasses of water per day.
 Radioactive iodine
Term
Osteoarthritis
 Definition
 Noninflammatory degenerative joint disease characterized by degeneration of the articular cartilage, hyperatrophy of bone at the margins, and changes in synovial membrane.
 The incidence of OA increases with age, weight, and incidence of injury within a joint.
 Signs- Crepitus, Heberden’s nodes and Bouchards nodes.
 The types of surgeries that can be performed are arthroscopy, tibial astronomy, and arthroplasty(joint replacement).
Term
Osteomalacia
 Definition
 A metabolic disease that causes poor and delayed mineralization of the bone cells in mature bones.
 The main cause is vitamin D deficiency. Lack of it in the diet or lack of sun exposure.
 Goal is to prevent osteomalacia and to prevent further bone loss in already established disease.
Term
Four stages on oncogenesis
 Definition
Initiation- A nonreversible event that occurs when a carcinogen invades and damages the DNA of the cell, causing a change in the DNA structure.
Promotion- A reversible event. Repeated exposure by a promoter stimulates cellular proliferation of the initiated cell.
Progression- The transformed cancer or malignant tumor experiences morphological change, growing in size and malignancy and becoming more anaplastic and less differentiated. The primary malignant tumor is formed during this stage.
Metastasis- The spread of the malignant tumor to other locations.
Term
High beta-carotene diet
 Definition
 Beta-carotene is a member of the carotenoids, which are highly pigmented (red, orange, yellow), fat-soluble compounds naturally present in many fruits, grains, oils, and vegetables (green plants, carrots, sweet potatoes, squash, spinach, apricots, and green peppers).
 The carotenes possess antioxidant properties.
 Foods containing antioxidants have been identified by a number of researchers as cancer protective or chemo-protective, a substance or agents that are used t to protect healthy tissues from the effects of cancer therapies and cancer.
Term
Tumor marker PSA
 Definition
 Prostate-specific antigen.
 Elevated in such conditions as benign prostatic hypertrophy in addition to prostate cancer.
 An excellent marker for determination of response to treatment.
Term
Tumor staging using the TNM system
 Definition
 Used to describe the primary tumor (T), the nodal involvement (N), and the presence or absence of metastasis (M) .
 The primary tumor is described as Tx (Cannot be assessed), T0 (No evidence of tumor), Tis (tumor in situ), or T1, T2, T3, T4 (dependent on size and reflective of increasing in size).
 The (N) describes the regional lymph involvement as Nx (cannot be assessed), N0 (no evidence of regional lymph node metastasis), or N1, N2, N3 (dependent on increasing extent of involvement).
 The presence or absence of distant metastasis is indicated by Mx(unable to assess), M0 (No presence of metastasis), or M1 (Presence of mestastasis).
Term
Teaching regarding internal radiation Pg 418
 Definition
 Limit the amount of time you are in contact with the pt.
 Observe a distance of at least 6 feet from the source when possible.
 Prohibit pregnant staff, family, and visitors and children from interacting or visiting with the patient.
Term
Process of chemotherapy
 Definition
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