Term
| Explain the reasoning behind the subjectivity of disease in regards to the function of time. |
|
Definition
| Disease is so subjective because of the definition many years ago versus today's definition. Ex: 200 years ago disease was viewed as a religious punishment. |
|
|
Term
| What does it mean to say that disease is on a continuum? |
|
Definition
| Disease is on a continuum from normal to abnormal and where things are placed on this continuum defines whether or not it is a disease. |
|
|
Term
| Explain how our body acts as a double edged sword in regards to our immune system and cell repair. |
|
Definition
| If our immune system is overoperated or exacerbated, we get allergies and if our system responsible for cell repair is accelerated, we get cancer (this is our body's natural repair system). |
|
|
Term
| What is the DSM? Explain why it has become controversial. |
|
Definition
| The DSM is where all psychiatric diseases are listed. It is controversial because in the 1930s there were only 85 diseases listed, but today, there are around 585 diseases. We are forced to question this and have come to realize that the only benefit of defining things as a disease is money (third party reimbursment/insurance companies). |
|
|
Term
| What does "Etiology" mean? What do we know about it? |
|
Definition
| Etiology means the "cause of". We know very little Etiology, but really know CORRELATIONS. The media often portrays cause and effect relationships and percentages incorrectly. |
|
|
Term
| What are the four categories of cell injury/insult? Explain each. |
|
Definition
1. Lack of oxygen/nutrients - on a continuum since some cells are more dependent on oxygen/nutrients (brain cells vs. skin cells)
2. Physical/Mechanical injury - disrupted cell to cell relationships and disrupted organelles within cells (ex: thermal injuries/burns cause a disruption of organelles because the heat evaporates the water within the organelles).
3. Living Agents - disrupt cell chemistry ex: bacteria, fungus, parasites, "viruses" (viruses not alive until invade living cells).
4. Chemical Agents - disrupt metabolic process (ex: cyanide poisoning) |
|
|
Term
| Why is it that cells won't necessarily die when they are injured? |
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Definition
| Cells are extremely adaptive, especially over a slow period. It is in acute situations that the body cannot adapt. |
|
|
Term
| What are sublethal injuries and what is another name for them? |
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Definition
| Sublethal injuries are changes in injured cells and usually represent the cell on the continuum from normal to death. They are also known as degenerative changes. |
|
|
Term
| Where do you initially see change in the cells involving sublethal injuries? |
|
Definition
| These changes are often seen first in the cytoplasm where the cell gets larger because of the accumulation of water. Some cells, including the liver, heart, and kidney, accumulate fat in the cytoplasm. Ex: alcoholic = fatty liver |
|
|
Term
| In what three organs does fat accumulate in response to cell injury? |
|
Definition
|
|
Term
| What happens when the pathway leads to malignancy insteady of death? Give an example. |
|
Definition
| Early in the degenerative proccess the body breaks down the cells and gets rid of them. Ex. Autophagocytosis is when the skin cells are eaten to prevent skin cancer and pigmentation is left behind. |
|
|
Term
|
Definition
|
|
Term
| What are the three types of necrosis? |
|
Definition
| Coagulative, Liquifactive, and Caseous. Gangrene is usually correlated with Coagulative necrosis and is when tissue is infected as well. |
|
|
Term
| Explain Coagulative Necrosis. |
|
Definition
| This is when blood is occluded and cells are dead, but the tissue maintains its' architectural features. |
|
|
Term
| Explain Liquifactive Necrosis. |
|
Definition
| When cells die in a place (like the brain) where dead cells cannot stay. They are liquified and become a part of the spinal fluid. Highly unlikely to become infected. |
|
|
Term
| Explain Caseous Necrosis. |
|
Definition
| This is when there is a cavity formation due to dying cells. This is a classic sign of TB. If the patient is coughing up blood that means they have had TB for a couple years. |
|
|
Term
| What is Dystropic Calcification? |
|
Definition
| This is when the body begins to calcify in places there should not be calcium in response to injury. It is normal for calcium in teeth and bones, but not normal in kidney stones, gall stones, and arterioschlerosis (hardening of the arteries that causes problems with contractility and dilating) |
|
|
Term
| Explain the idea of Somatic Death. |
|
Definition
| If cells die, then tissue dies, then organ dies, then organ systems die, then we die. |
|
|
Term
| What is the Harvard Criteria for determining somatic death? |
|
Definition
| Two EEG flatlines 48 hours apart with two separate interpretations. |
|
|
Term
|
Definition
| It means stiff death. This is when the muscles tighten up because there is no longer any sliding filaments. Sometimes in extremely muscular people it can set in with movement. |
|
|
Term
|
Definition
| This is the cooling of the body after death because the temperature regulation is lost. Can determine time of death by taking temp of Liver and comparing to environment. |
|
|
Term
|
Definition
| This is when the blood stops circulating and pools in favor of gravity. Can determine if a body has been moved. |
|
|
Term
|
Definition
|
|
Term
| How much bacteria do we carry in/on our bodies? |
|
Definition
| 3 lbs. mostly in the GI tract that produce gas. Could be dangerous if it erupts and spills gas on people. |
|
|
Term
| What are two criteria for embalming? |
|
Definition
| Must embalm within 24 hours and if shipping body across state lines. |
|
|
Term
| What is the name of embalming fluid and in what products can you find this? Any diseases related to its' use? |
|
Definition
| Formulin is a wonderful disinfectant found in mascara, lipstick, shampoo. It is NOT a gas like Formaldehyde is. It is correlated with kidney cancer. |
|
|
Term
| What are the two reasons for disease? |
|
Definition
| Extrinsic (negative outside effects: trauma, infectious agents) and Intrinsic factors (inside: age, sex, genetics) |
|
|
Term
| What two things can be wrong with chromosomes? |
|
Definition
| Abnormal number and abnormal structure on the chromosome (gene). |
|
|
Term
| How many chromosomes do we have? |
|
Definition
| 46. 23 pairs. 23 from egg/23 from sperm. |
|
|
Term
| Who determines the sex of a child? |
|
Definition
|
|
Term
| What determines a disease being sex-linked? Give an example. |
|
Definition
| If the abnormality is on a sex chromosome (23rd pair). Hemophilia is usually seen in males because it is carried on the X chromosome and they do not have a backup X. |
|
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Term
|
Definition
| A sex-linked, neurological disease usually seen in males. They are normally dead by six months. If female carries the gene and has a male child they have 50% chance of getting it. |
|
|
Term
| T/F Are the majority of gene disorders single gene disorders? |
|
Definition
|
|
Term
| Explain Turner Syndrome and its presentations. |
|
Definition
| Has one X chromosome but is missing the other sex chromosome. Usually looks like a female with female sexual anatomy, are short, sexually immature, and infertile. |
|
|
Term
| Explain Super Female and its presentations. |
|
Definition
| They have three X chromosomes (XXX). Most women don't even realize they have it. |
|
|
Term
| Describe Klinefelter's and its presentations. |
|
Definition
| This is when they have an extra sex chromosome but don't know whether it is the X or the Y (XXY). They look like males, have underdeveloped malem anatomy, are infertile, and tend to be tall and lanky. They usually feel as though there is a woman trapped inside and have a high rate of gender reassignment surgeries. |
|
|
Term
| What does it mean to say a disease is genetic? |
|
Definition
| it means the gene on the chromosome that is responsible for it has been found. |
|
|
Term
| What does congenital mean? |
|
Definition
| it means you are born with it. May or may not be genetic. |
|
|
Term
| Is mutation always a bad thing? |
|
Definition
| No, it could result in a benefit, negative effect, or no change. |
|
|
Term
| What are the three ways in which you can change chromosomes? |
|
Definition
| Raditation, Drugs, Viruses |
|
|
Term
| How does a virus invade a cell. |
|
Definition
| A virus invades a cell by incorporating itself into the host's DNA. |
|
|
Term
| What is the Human Genome Project? What is the next step? |
|
Definition
| Blueprint of a human being. Next step is to determine where the abnormal genes are that are associated with particular diseases. |
|
|
Term
| Describe Phenylketonuria (PKU) along with the restrictions for this patient. |
|
Definition
| PKU is when there is a lack of or deficiency of a hepatic enzyme than breaks down phenylalinine into tyronsine. This is controlled by watching the intake of protein (like aspartame) in the diet. Excess phenylalinine is excreted through urine. Uncontrolled cases can result in a lot of neurological problems due to the lack of mylination. |
|
|
Term
| Explain Albinism and diseases associated with it. |
|
Definition
| Albinism is the inability to break down tyrosine. These people usually lack pigment in the hair, eyes, and skin. They are associated with skin cancer, glaucoma, and cataracts. |
|
|
Term
| Explain Glycogen Storage Disorder and what population it is normally seen in. |
|
Definition
| This is when they cannot store glycogen for use after glucose is used. The body usually burns glucose, then glycogen, then fat, the protein (starvation). This is usually seen in children and they seem as though that are failing to thrive and look hypoglycemic. Cannot gain weight because they burn through so much fat. This disorder is NOT common. |
|
|
Term
| Explain Gaucher's Disease and Tay-Sachs. What population do these normally affect. |
|
Definition
| These are neurological diseases shown in the Jewish population. Gaucher's is lack of hepatic enzyme that causes neurological problems and skin lesions. Tay-sach's is just neurological. |
|
|
Term
| Explain G-6-PD (glucose 6 phosphatate dehydrogenase). |
|
Definition
| This is normally seen in African Americans. They can go without ever knowing they lack this unless they are subjected to acidosis, sulfa drugs, apririn, or certain infections. Without this the red blood cells are excessively hemolyzed. |
|
|
Term
| Explain Down's Syndrome (Trisomy 21) and its presentations. |
|
Definition
| Down's is seen more in the white population and is recessive on the 21st gene pair. They usually have webbing of fingers, eye problems, small brain, high incidence of heart problems, compromised immune systems, and high incidence of specific leukemias. Must higher chance of Alzheimer's which is why they are studying chromosome 21. |
|
|
Term
| Explain first, second, and third degree burns. |
|
Definition
| First (epidermis), Second (epidermis & dermis), Third (epidermis, dermis, and subq to bone and muscle). |
|
|
Term
| What are the percentages for the Rule of Nines? |
|
Definition
Head = 9%
Arms = 9%
Legs = 18%
Trunk = 36%
Perineum = 1% |
|
|
Term
| What are the four complications of burn patients? |
|
Definition
| Shock, Pulmonary Edema, Stress Ulcers, and Infection |
|
|
Term
| Explain what is happening when a burn patient is experiencing shock? |
|
Definition
| The heat has evaporated a lot of the water, which has lowered the blood pressure due to the loss of blood volume. The kidneys are most suseptible to low BP. |
|
|
Term
| Explain Pulmonary Edema in burn patients. |
|
Definition
| This always interferes with gas exchange. They are not getting enough oxygen and are unable to get rid of the CO2 in their lungs and acidosis occurs. This is acute and does not take much smoke. |
|
|
Term
| Eplain Stress Ulcers in burn patients. |
|
Definition
| Fight or flight kicks in and after 2-3 days erosion of a vulnerable area in the stomach may cause a bleeding ulcer from the physiological stress. |
|
|
Term
| Explain how Infections can affect a burn patient? What are two most common infections with burn patients? |
|
Definition
| This is normally how burn patients die. They need to be in reverse isolation because without their skin they are extremely vulnerable. Most common infection is Staph and then E. coli. |
|
|
Term
| What are the four temperature related conditions from least severe to most severe? |
|
Definition
| Heat Cramp, Heat Exhaustion, Heat Injury, Heat Stroke. |
|
|
Term
|
Definition
| This is from physical activity and causes pain in the large muscle that is refelctive of dehydration. Water is down, sodium is up, electrolytes are off, and there is muscle pain. Can happen at night if dehydrated. |
|
|
Term
| Describe Heat Exhaustion. |
|
Definition
| This is more severe dehydration that causes dizziness, nausea, light-headedness, and a drop in blood pressure, but they usually do NOT pass out. It requires more intense hydration than with a Heat Cramp to fix. |
|
|
Term
|
Definition
| Usually passed out, 102-104 temperature, shivering, nauseated, low blood pressure with a high heart rate. This requires a trip to the hospital. |
|
|
Term
|
Definition
| Worse Case Scenario: internal temp of 112-115, virtually no blood pressure, the skin is hot and dry, blood is concentrated. You almost hope they die at this point because their brain is fried. This is an EXTREME emergency that requires packing them in ice because there are no veins available for IV. |
|
|
Term
| What is Malignant Hyperthermia? How do you stop this? |
|
Definition
| This is a genetic condition that most people don't know they have until they are exposed to a general anesthetic. Enormous muscle activity gives off so much heat that their temp can QUICKLY spike to 120. Their temp will immediately go down when taken off the gas and put on oxygen. |
|
|
Term
| What body temperature constitutes Hypothermia? |
|
Definition
|
|
Term
| Do we do better with hypothermia or hyperthermia? |
|
Definition
| We do better with hypothermia as long as it is done slowly. |
|
|
Term
| What constitutes a vitamin being a vitamin? |
|
Definition
| It is a Vitamin if our body cannot make it. There are a couple exceptions though. |
|
|
Term
| What are the Fat soluble vitamins? What do they require? |
|
Definition
| A, D, E, K. Can penetrate a lipid membrane, are stored in adipose tissue, and need fat in the diet to be absorbed. Have a much greater chance for toxicity since they are stored in adipose tissue (especially in children). |
|
|
Term
| Why is it less likely to see toxicity with water soluble vitamins? |
|
Definition
| Because we take them in and pee them out. |
|
|
Term
| Essential Amino Acid versus Non-essential Amino Acid. |
|
Definition
| Essential must come from our diet and non-essential in made in the body. |
|
|
Term
| What are Vitamin A deficiencies associated with? |
|
Definition
| Eye problems, specifically night blindness. This is due to the inability to renew Rodopsin (protein in rentina) to see different images because of the lack of Vitamin A. |
|
|
Term
| What was Vitamin A once used for and what is it correlated with? |
|
Definition
| It was used to induce spontaneous abortions and has been correlated with neurological birth defects and cancer. |
|
|
Term
| Explain the importance of Vitamin D. |
|
Definition
| When our skin is exposed to UV light, our body makes an inactive form of vitamin D, then a process in the kidneys changes it to active Vitamin D, which allows up to absorb calcium. Without this Calcium absorption, you see Rickett's in children. |
|
|
Term
| Why is it important to get at least 15 minutes of sun per day without sunscreen? |
|
Definition
| Sunscreen prevents skin from making Vitamin D. This is why most people are Calcium deficient. |
|
|
Term
| How much Calcium do we need a day? |
|
Definition
| 1200 mg (1500 mg if pregnant) |
|
|
Term
| What is Vitamin D inactive derived from? Does this pose any problems for certain population? |
|
Definition
| Inactive Vitamin D is derived from cholesterol. Being, like african americans, who are dark pigmented absorb less sun so their bodies make up for this by having more endogenous cholesterol for producing Vitamin D. This is why they have a higher incidence of heart disease. |
|
|
Term
| What is the result of too much Calcium? |
|
Definition
| It predisposes you to kidney stones and bone cysts. |
|
|
Term
| What is Vitamin K used for, where is in made in our bodies, and what foods do we see it in? |
|
Definition
| Vitamin K activates four coagulation factors. It comes from the E. coli in our GI tract. It is found in green leafy vegetables. |
|
|
Term
| What would a Vitamin K deficiency result in? At what age range is this a HUGE concern? |
|
Definition
| A deficiency would result in the inability to form blood clots and a person could possibly bleed to death. Newborns are all given a shot of Vitamin K because they lack a lot of E. coli in the GI tract to produce it. |
|
|
Term
| What is the deficiency we see in relation to Thiamine (B1)? What are the side effects? |
|
Definition
| Beri Beri is seen a lot in alcoholics and people with eating disorders. They have a lack of muscle strength and are very weak. |
|
|
Term
| Explain physiologically what is happening when there is a deficiency in Thiamine (B1). What is the danger in this? |
|
Definition
| Without Thiamine (B1), pyruvic acid cannot move into the citric acid cycle which then goes to the Kreb Cycle. This causes an accumulation of pyruvic acid that leads to a decrease in blood pH. If a person is acidotic like this, potassium begins to increase and the heart rate goes down. This is why Potassium injection can stop your heart and kill you. |
|
|
Term
| Is Riboflavin deficiency seen frequently? What symptoms would you see? |
|
Definition
| No, because we need very little and it is in most foods. Symptoms include problems with the oral cavity: swollen gums, dry and cracked lips. |
|
|
Term
| What bodily process is Pyridoxine (B6) involved in and what three things has it been used to treat? |
|
Definition
| Pyridoxine (B6) is involved in neurofunctioning and neurotransmitter production. It has been used in PMS pills, in TB treatments, and for peripheral neuropathy. |
|
|
Term
| What is the deficiency related to Nicotinamid (Niacin) called and what are the symptoms? How was this HUGE problem taken care of? |
|
Definition
| Pellagra means rough skin. With this you will have the four D's: dermatitis, diarrhea, dementia, and death. The epidemic was counteracted by putting Niacin in grains and bakery products. |
|
|
Term
| What is the common side effect of Niacin? |
|
Definition
|
|
Term
| What can Niacin be very effective in treating? |
|
Definition
| Lowering LDL cholesterol and raising HDL cholesterol. |
|
|
Term
| What do we need in order to absorb B12? |
|
Definition
| Intrinsic factor in the stomach. |
|
|
Term
| What disease do people get when B12 is not absorbed? |
|
Definition
|
|
Term
| Name two types of patients that would probably get an injection or nasal spray of B12. |
|
Definition
| Someone with AIDS or a tapeword. |
|
|
Term
| What vitamin is only needed in small amounts and with which a deficiency is usually only a concern when lots of raw eggs are consumed? |
|
Definition
|
|
Term
| What is Avidin? How can it pose a problem? |
|
Definition
| Avidin is a protein found in raw eggs that has an exact fit for Bioting and the joining of the two creates a molecule that is too large to be absorbed by the intestines so it is excreted through the urine. This causes a deficiency in Biotin. |
|
|
Term
| What are the side effects of a Biotin deficiency? |
|
Definition
| Muscle weakness and ringing of the ears. Also has been linked to neurological symptoms if not taken in prenatal vitamins. |
|
|
Term
| What is the deficiency called related to Vitamin C and what are its side effects? |
|
Definition
| Scurvy includes poor wound healing, bone deformities, and bleeding gums. |
|
|
Term
| What two vitamins are antioxidants? |
|
Definition
|
|
Term
| Why is Vitamin E useless in shampoos, makeup, and hand lotions? |
|
Definition
| Vitamin E is not absorbed in the skin unless the skin is chapped or broken. |
|
|
Term
| Why was Vitamin E used in a drug for premature babies? Why is it not used anymore? |
|
Definition
| It was used because premature babies do not have enough surfactant to inflate and deflate their lungs. The free oxygen in their blood stream could get too high, attach to optic nerves and cause blindness. The vitamin E would soak up the free oxygen. It is not used much anymore because we have synthetic surfactant. |
|
|
Term
| What is the definition of inflammation? |
|
Definition
| It is an adjunct tissue response designed to deliver fluid and cellular components to injured or necrotic cells. It is in response to insult and injury. |
|
|
Term
| What are the four basic characteristics of inflammation as described by Hippocrates? |
|
Definition
| Rubor (red), Calor (heat), Dolor (pain), Tumor (swelling) |
|
|
Term
| What are two things that can be the cause of swelling? |
|
Definition
1. If white blood cells are sent to the area because of infection and they die, they could begin accumulating and turn to pus which causes swelling.
2. If there is no infection and interstitial fluid is sent to the area this will cause swelling as well. |
|
|
Term
| What causes the pain involved in swelling? |
|
Definition
| It is the white cells or fluid pressing against the small nerves in the area. |
|
|
Term
| What change has to occur in the blood vessels in order for fluid to enter the injured area? |
|
Definition
| The permeability must immediately change in order for fluid to leak out of the vessels. |
|
|
Term
| What sort of fluid is leaking out right after an injury compared to a couple weeks after? |
|
Definition
| The fluid right after the injury is made up of protein and the fluid that leaks out when the tissue is repaired is no longer protein but water. |
|
|
Term
| What four things will you be dealing with within an hour of a severe burn? |
|
Definition
1. Skin Damage
2. Electrolyte Disturbances
3. Water and Protein Levels Dropping
4. No blood vessels to put an IV in |
|
|
Term
|
Definition
| The process of moving white cells into an area. |
|
|
Term
| What is almost always causing vessel dilation during injury? |
|
Definition
|
|
Term
| What is one of the last things activated in the inflammation process and what is its purpose? |
|
Definition
| Hageman Factor (factor 12 coagulation) are strands of fiber (almost like a hairnet) that surround the area and hold fluids and cells in place so that repair can occur. |
|
|
Term
| True or False? The healing process happens from the outside in? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| What are the five types of Exudates? |
|
Definition
| Serous, transudate, fibrous, neutrophilic, and mixed. |
|
|
Term
|
Definition
| It looks like serum and contains water and a lot of protein. |
|
|
Term
| What is Transudate? Give an example. |
|
Definition
| It has less protein than serous and is mostly just water. It is generally not associated with inflammation. Ex. Interstitial fluid is mostly water. |
|
|
Term
| What is a Fibrous Exudate? Where are two places this is commonly seen? |
|
Definition
| It has an abundant amount of fibrinogen (like a hairnet). Commonly seen in the pericardial sac and the pleural space in the lungs. This causes what is know as a friction rub. |
|
|
Term
| What is Neutrophilic Exudate? What is it also know as? |
|
Definition
| Made up of white blood cells. Also known as pus or purulent. |
|
|
Term
| True or False? If there is pus, it is infected? |
|
Definition
|
|
Term
| What is the type of inflammation that does not work? How does this potentially pose a problem? Give an example. |
|
Definition
| Granulomatous Inflammation does not work. This poses a problem because in this instance of inflammation the body brings in fluids and histamines and when the process does not work it leaves these components behind and keeps trying to start over because the body cannot handle what it is trying to repair. Ex: is patients with TB developing nodules. |
|
|
Term
| Each time your body goes through a 1st, 2nd, or 3rd intention of healing, scar tissue is left behind. How can this be problematic? What are we now doing to prevent this? |
|
Definition
| If the scar tissue left behind is internal it can cause adhesions. This is when the scar tissue fuses internal components together than wouldn't otherwise be attached. Laparoscopic surgery has greatly lowered the risk for large adhesions. |
|
|
Term
|
Definition
| Something the body interprets as a foreign protein. |
|
|
Term
|
Definition
| A protein the immune system produces to inactivate the antigen. |
|
|
Term
| If we draw blood, put it in a test tube, and let it clot, what are the three areas or layers we would see? |
|
Definition
| Serum would be on top, the buffy coat in the middle and the red blood cells on the bottom. |
|
|
Term
| What does the buffy coat contain? |
|
Definition
| White blood cells and platelets. |
|
|
Term
| What protein component of the serum are antibodies found in? |
|
Definition
|
|
Term
| What is serum composed of? |
|
Definition
|
|
Term
| How are serum and plasma different? |
|
Definition
| Serum is clotted blood and Plasma is from anticoagulated blood. Also, Serum is just water and protein while Plasma is water, protein, and coagulation factors. |
|
|
Term
| Proteins are made up of what? |
|
Definition
|
|
Term
| What constitutes different proteins? |
|
Definition
| The number of amino acids and the electrical charge. |
|
|
Term
| Explain the process of protein electrophoresis. |
|
Definition
| If you expose a drop of serum to an electrical current it will separate the proteins out and cause them all to move towards the negatively charged end. |
|
|
Term
| What are the five components of protein in serum? |
|
Definition
| Albumin, Alpha 1 and Alpha 2, Beta, and Gamma. |
|
|
Term
| 95% of antibodies are found in what portion of protein? |
|
Definition
| In the Gammaglobulin protein portion. |
|
|
Term
| Why would you give someone a shot of gammaglobulin? What is this process called? |
|
Definition
| If you don't know if someone has antibodies to something they have been exposed to. This is giving someone Passive Immunity. |
|
|
Term
| If someone, like the Bubble Boy, had a gammaglobulin anemia, what would you see in diagnostical electrophoresis? How would his antibody production/storage be affected? |
|
Definition
| You would only see Albumin, Alpha 1 and Alpha 2, and Beta. The Bubble Boy made antibodies but had nowhere to store them so they dissipate. |
|
|
Term
| What is another name for an antibody? |
|
Definition
|
|
Term
| What are the five categories of immunoglobulins from most abundant to least abundant? |
|
Definition
|
|
Term
| What category of immunoglobulins acount for 80% of all antibodies? |
|
Definition
|
|
Term
| Where is IgG found and what are they the primary antibodies against? |
|
Definition
| IgG antibodies are found in plasma and leaks into tissue fluids. They are the primary antibodies against viruses, bacteria, and toxins. |
|
|
Term
| Where are IgA antibodies found and what are they the first to be in contact with? |
|
Definition
| IgA antibodies are found in plasma and in exocrine gland secretions - nasal fluid, mucous membranes, and breast milk. These antibodies are the first to come into contact with viruses you breathe in. |
|
|
Term
| What is the quickest way to change neurotransmitters? |
|
Definition
|
|
Term
| Where are IgM antibodies found, what can they be used to test for, and what are they effective against? |
|
Definition
| IgM antibodies are largely found in blood and lymph fluid. They can be used to test whether or not someone is having an initial response to an antigen, because they are commonly the first on site. They are effective against viruses and bacteria. |
|
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Term
| Do we have a lot of IgD? Is this level different for any specific age range? |
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Definition
| No, we have very little IgD. Levels are higher in children and infants. |
|
|
Term
| What do IgD antibodies typically attach themselves to? |
|
Definition
|
|
Term
| What antibody do we have the least of? What condition may elevate these levels? |
|
Definition
| We have the least of IgE (<1%), unless you have allergies. IgE is what causes the symptoms of allergies. |
|
|
Term
| What are the two broad categories of allergic responses? |
|
Definition
| Immediate response (anaphylaxis) and delayed repsonse (usually seen in food allergies). |
|
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Term
| What is the key action on antibody producing cells, like lymphocytes, plasma cells, and mast cells, the first time an antigen is introduced? |
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Definition
| The key is that these cells are overstimulated so that they will make antibodies for response to future exposure. |
|
|
Term
| What constitutes a cell being sensitized? |
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Definition
| Certain cells like mast cells, platelets, and eosinophils have receptor sites for IgE. When the IgE antibody attaches to the receptor site, the cell is said to be sensitized. |
|
|
Term
| When the antibody inactivates the antigen, what does the cell release? |
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Definition
|
|
Term
| What three things do histamines do to the body? |
|
Definition
| Vasodilation, Decrease in blood pressure, and Bronchoconstriction |
|
|
Term
| What can Epinephrine do to counteract Histamines? |
|
Definition
| Vasoconstriction and Bronchodilation |
|
|
Term
| What are the two most common food allergies? |
|
Definition
|
|
Term
| What other two products are released from a cell during an allergic reaction, but don't play as big a role as Histamines? |
|
Definition
| Heparin and Acetylcholine |
|
|
Term
| What causes seasonal allergies? |
|
Definition
| An overproduction of antibodies and too many sensitized cells, but not to the degree of anaphylactic response. |
|
|
Term
| What exactly are you allergic to in a delayed food reaction? |
|
Definition
| The breakdown product (haptin) mixed with a certain protein is the antigen. The breakdown poduct alone is NOT an antigen. |
|
|
Term
|
Definition
| The breakdown product of your food (incomplete antigen). |
|
|
Term
| What is almost always the presentation or manifestation of food allergies? |
|
Definition
|
|
Term
| What group of people are food allergies strongly correlated with? |
|
Definition
|
|
Term
| Name three types of ways to test for allergies. |
|
Definition
| Skin tests, Rast testing, and allergy shots. |
|
|
Term
| What is the process of skin testing? |
|
Definition
| Diluted amounts of antigens are introduced underneath the skin and then observed for 20 minutes and then the response is graded - redness, hives, etc. |
|
|
Term
| True or False? An anaphylactic response cannot occur with skin testing. |
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Definition
| False. You CAN have an anaphylactic response with skin testing. |
|
|
Term
| What is the process of Rast testing? Can an anaphylactic response occur? |
|
Definition
| Blood is drawn and the serum is used to calculate levels of IgE antibodies against various panels of antigens. Anaphylactic responses then cannot happen this way. |
|
|
Term
| How do allergy shots work? |
|
Definition
| Through desensitization (removing the antibody from the cells). This is done by giving extremely diluted amounts of the antigen so it uses up some of the antibodies, but is not strong enough for more antibodies to be made. This is done on a weekly basis. This is not yet an exact science. |
|
|
Term
| What are three things we usually say a disease could be if we don't really know the cause? |
|
Definition
| Viral, genetic, or autoimmune. |
|
|
Term
| What is an autoimmune disease really? |
|
Definition
|
|
Term
| What does the terms Idiopathic thrombocytopenia pupura (ITP) mean when broken down? |
|
Definition
Idiopathic: unknown cause
Thrombocytopenia: platelets go down
Pupura: purple |
|
|
Term
| What does the purple come from in ITP? What is this called? |
|
Definition
| When platelets nose dive and you can see the blood leakage under the skin. When this blood accumulates, it is called a petechiae (looks like a bruise). |
|
|
Term
| Petechiae are almost always correlated with what? |
|
Definition
|
|
Term
| Why are platelets destroyed with ITP? |
|
Definition
| The body views a protein on the platelets as an antigen and destroys them. |
|
|
Term
| If someone is given a transfusion from someone with ITP, will they then develop ITP? |
|
Definition
| Yes, because you are giving them the antibody against a protein that all people have. |
|
|
Term
|
Definition
| Lupus means "wolf" because a characteristic of SLE is a rash that develops underneath the eyes, across the bridge of the nose and above the eyebrows. |
|
|
Term
| Are autoimmune diseases more common in males or females? |
|
Definition
|
|
Term
| Explain the process of Systemic Lupus Erythematosus (SLE). |
|
Definition
| A protein in the large nucleus of the white blood cells is interpreted as an antigen, so the body creates antibodies to inactivate these antigens. The nucleus is then pulled out of the white blood cell and the antibody attaches itself to it (this forms an LE cell). |
|
|
Term
| Why would the kidneys be compromised in a patient with SLE? |
|
Definition
| Blood goes through kidneys one cells at a time and LE cells are too large to pass through the nephrons, so they plug them up. With less available nephrons available, less blood can pass through the kidneys. Renal transplants are needed at this point. |
|
|
Term
| What is the process of Rheumatoid Arthritis? What precipitating effect often occurs prior to this? |
|
Definition
| A protein in the synovial fluid is interpreted as an antigen. When the antibodies created inactivate the antigen in the synovial fluid, the cushioning effect of the fluid in the joints is lost. Viral infections are frequently a precipitating effect to Rheumatoid Arthritis. |
|
|
Term
| What is Sjogren's Syndrome commonly characterized by? |
|
Definition
| Dry mucous membranes - lips, eyes, trouble crying, must use eyedrops. |
|
|
Term
| Is it common to see multiple autoimmune diseases? |
|
Definition
|
|
Term
| What is another autoimmune disease that is highly correlated with Lupus and Rheumatoid Arthritis? |
|
Definition
|
|
Term
| What are we looking for when we do a type and cross-matching for patients involved in transfusions? |
|
Definition
Type matching is comparing A to A, B to B, O to O.
Cross-matching is determining whether this patient has an antigen on the RBCs to which the donor has the corresponding antibody in their serum and vice versa. |
|
|
Term
| What is an example of an antigen that is genetically determined? |
|
Definition
|
|
Term
| How many antigens are we aware of that can be on a RBC? |
|
Definition
|
|
Term
| What is the probability of finding a donor with the exact same antigens as a patient? |
|
Definition
|
|
Term
| What is the probability of a transfusion reaction? |
|
Definition
|
|
Term
| What are the two drugs given before giving a blood transfusion and Why? |
|
Definition
Benadryl is given as an anti-histamine in case of an allergic reaction (it also causes drowsiness).
Tylenol is given to potentiate the Benadryl and reduce fever. |
|
|
Term
| What is the first thing you should do when a patient shows signs of a transfusion reaction? |
|
Definition
| Discontinue or stop the transfusion immediately. |
|
|
Term
| What is the only way you could find two people with a perfect match for transfusion? |
|
Definition
| Identical twins have the same blood types and same 130 antigens on the RBCs. |
|
|
Term
| Why is blood warmed before it is given? |
|
Definition
| There are some antibodies that only react to their antigens when the temperature is cold. |
|
|
Term
| Give an example of when a cold antigen reacts to an antigen. |
|
Definition
| Raynaud's Disease is when the reaction between antibody and antigen plugs up the capillaries (usually in the extremities). If the blood cannot get through, the tissue is not nourished and it gets cold. The colder it gets, the more antigen/antibody reactions occur and the more vessels are plugged up. |
|
|
Term
| Why would someone carrying the Mono antibody test negative for it? |
|
Definition
| Since the Mono antibody is a cold antibody, it will test negative if not tested in a cold environment. |
|
|
Term
| What is occuring in the case of a transplant rejection? |
|
Definition
| The body is interpreting a protein on the transplanted tissue, a liver for example, as an antigen and has produced antibodies for it. |
|
|
Term
| What category of anti-rejection drugs are people normally put on prior to a transplant and why? How does this pose a potential problem? |
|
Definition
| Steroids are used to suppress the entire immune system so antibodies do not build up against the transplant. This can be a problem because then the body cannot build up antibodies for things like viruses either. |
|
|
Term
| Give an example of a system in the body that can accept any tissue without recognizing it as foreign. Why? |
|
Definition
| The Central Nervous System is immunologically privileged, because the Blood Brain Barrier cannot be crossed by antibodies. Ex: we do not cross match patients and donors for cornea transplants. |
|
|
Term
| Why do we need a new flu shot every year? |
|
Definition
| The influenza virus changes minutely and since the anitbodies are extremely specific to certain antigens we need a new shot every year. |
|
|
Term
| What can Strep throat sometimes lead to and why? |
|
Definition
| It can lead to Rheumatic fever and Glomerular Nephritis because there is a protein on the heart valve and in the kidneys that is very similar to the hemolysins (break down RBCs) that caused antibody production when the person had Strep throat. This is the only scenario that can cause Rheumatic Heart Disease, but other things can cause Glomerular Nephritis. |
|
|
Term
| Why is it so important to properly diagnose children with recurrent strep infection? In what age range is this seen most often? |
|
Definition
| Each new strep infection gives a new introduction of hemolysins, which is more antigen, so more antibodies are produced. This ups the chances of the child having complications like Rheumatic Fever and Glomerular Nephritis. Usually around ages 8 or 9. |
|
|
Term
| What are the four categories of transplant-grafts? What is the risk for rejection with each? |
|
Definition
Autografts: taking tissue from one part of the body to another. There are never rejection concerns.
Isografts: these come from identical twins and there are never rejection concerns.
Homografts: grafts in the same species (most commonly thought of). There is definitely concern for rejection.
Heterografts: grafts between different species (ex: pig valves). There can be less problems with heterographs than with homographs. |
|
|
Term
| Humans are genetically most like what animal? |
|
Definition
| Baboons. There is only a 2% difference in the DNA. |
|
|
Term
| What percentage of bacteria are pathogenic in humans? |
|
Definition
| Only 1% cause disease in humans |
|
|
Term
| Give two examples of a time in which the normal flora on humans and the environment can infect humans. |
|
Definition
When someone wakes up the morning after lots of drinking and have a soar throat. This is because the alcohol killed some of the bacteria in the throat which allowed other bacteria to overgrow.
Another example is when a female is put on an antibiotic and gets a yeast infection. This is because the antibiotic killed the bacteria in the vagina which allowed the yeast to overgrow. |
|
|
Term
| What did Florence Nightingale die from? |
|
Definition
|
|
Term
| B. pertussis causes what? |
|
Definition
|
|
Term
| True or False? The Clostridium bacteria (including tetanus and botulism) are anaerobic. |
|
Definition
|
|
Term
| What percentage of viruses cause disease in humans? |
|
Definition
|
|
Term
| What is meant by saying viruses work on a continuum? |
|
Definition
| Some viruses infect and you never even know you have them, but others infect and it is a guarantee you will die. |
|
|
Term
| Why don't antibiotics and white blood cells have any effect on viruses? |
|
Definition
| They do not perceive them as being foreign invaders since they become part of the host DNA. |
|
|
Term
| If antibiotics and white blood cells cannot detect viruses, then how do we fight them? |
|
Definition
| The immune system is designed to get rid of viruses by creating antibodies to get rid of it. |
|
|
Term
| Herpes Simplex I virus versus Herpes Simplex II virus |
|
Definition
| Herpes Simplex I is fever blisters or cold soars and Herpes Simplex II is an STD. |
|
|
Term
| What is the Mono virus caused by? |
|
Definition
|
|
Term
| Rubella is also known as? |
|
Definition
|
|
Term
| What animals are most common to have viral Rabies? |
|
Definition
|
|
Term
| What does AIDS stand for? |
|
Definition
| Acquired Immune Deficiency Syndrome |
|
|
Term
| True or False? Viruses are made up of both DNA and RNA. |
|
Definition
| False. All viruses are made up of either DNA or RNA, never both. |
|
|
Term
| Are RNA or DNA viruses more common? |
|
Definition
| DNA viruses, like the flu, measles, and mumps, are more common. |
|
|
Term
| How does an RNA virus invade a cell? |
|
Definition
| When an RNA virus invades a cell, it brings reverse transcriptinase. This enzyme changes the viral RNA into DNA so it can incorporate itself into the host DNA. |
|
|
Term
| What is AZT (Zidovudin)? How does it work? What is the downside to its use? |
|
Definition
| This is a drug used to delay the development of AIDS in patients with HIV. It works by interfering with the activity of reverse transcriptinase so that the virus cannot change into DNA. The downside is that their is an enzyme reaction in bone marrow that is involved in RBC production that is similar and AZT cannot tell the difference. AIDS patients usually require a lot of transfusions because this stops RBC production. |
|
|
Term
|
Definition
| Through blood, semen, and vaginal secretions. These cells have an exact fitting receptor for the AIDS virus, which is how it gains entry into the cell. |
|
|
Term
| How do we know we are dealing with a virus we have had before? What about one we have never had? |
|
Definition
| With a virus we have had before, it only affects us for a short time because we have memory cells that will quickly mobilize the antibodies for it. If a virus affects us for ten days then we have never had it before, because that is how long it takes for new antibodies to be made after an antigen is introduced. |
|
|
Term
| Why is AIDS such a brilliant virus? |
|
Definition
| The AIDS virus invades the cell, replicates, and moves on to another cell. As it moves, it will mutate itself about every ten days, which is how long it takes for the body to create a new antibody. The body is constantly trying to catch up. |
|
|
Term
| Why are people worried about the Avian flu virus? |
|
Definition
| If it gets to our population, a lot of people will die because it will take us ten days to build an antibody for it. |
|
|
Term
| What are viruses two main goals? |
|
Definition
| To invade and to replicate. |
|
|
Term
| Where do we think AIDS was probably introduced? |
|
Definition
| From monkeys in Haiti in the 1960s. If a virus runs out of a population, it can jump species. |
|
|
Term
| What are two ways in which viruses have ingeniously adapted a way of entry to humans? |
|
Definition
| Most viruses are respiratory, because all humans breathe and also sexually transmitted, because humans are made to breed. |
|
|
Term
| What do AIDS patients normally die from? |
|
Definition
| Opportunistic diseases, because the lymphocytes are infected and compromised enough that they can't build up antibodies. |
|
|
Term
| What percentage of lymphocytes are infected in a patient with full blown AIDS? |
|
Definition
|
|
Term
| What do many AIDS patients eventually end up getting? |
|
Definition
|
|
Term
| What is the number of people are infected with AIDS in our country in comparison to many sub-Saharan African countries? |
|
Definition
| 1 in 250 people are infected in our country compared to 75% of the population of many sub-Saharan African countries. |
|
|
Term
| What age group has the greatest AIDS cases increase in our country? |
|
Definition
|
|
Term
| What are three problems contributing to the AIDS epidemic in Africa? |
|
Definition
| Lack of condom availability, lack of education, and lack of treatment. |
|
|
Term
| What two viruses were thought to be the cause of AIDS but are now known to simply be opportunistic infections? |
|
Definition
| Cytomeglia Virus (CMV) and Epstein-Barr (thought to cause mono). |
|
|
Term
| What is a Subclinical Infection and in what profession do you see a lot of them? |
|
Definition
| A subclinical infection is one that does not show any manifestations or signs. Nurses have a lot of subclinical infections, because they have a lot of short-term exposure to stuff. This is good because their immune systems are working at a higher level than most people in the general population. |
|
|
Term
| Does a subclinical infection give the same degree of immunity as a clinical infection? |
|
Definition
|
|
Term
| What is something we see commonly that is meant to give a subclinical infection? |
|
Definition
| Flu shots and MMR are meant to induce subclinical infections. |
|
|
Term
| What happens if a virus given in a vaccination that has been attenuated is too weak or too strong? Explain this "fine line". |
|
Definition
| If it is too weak, there is no immunity built up to it and if it is too strong, the person will get the virus. |
|
|
Term
| Who (professionally) is in the highest risk group for AIDS? |
|
Definition
| Nurses, because of needle-stick injuries. Most needle sticks are pricks and not injections, so the infection probability is low but still possible. |
|
|
Term
| Where do toxins come from? |
|
Definition
| Toxins are harmful metabolic products of bacteria. |
|
|
Term
| What are the categories of toxins? What is the difference between the two? |
|
Definition
Exotoxins: are produced by the bacteria on the cell wall.
Endotoxins: stay inside the bacteria until the bacteria is killed.
|
|
|
Term
| Give an example of a bacteria that is only pathogenic because of an Exotoxin. |
|
Definition
| Clostridium tetani produces an exotoxin that is the sole reason it is pathogenic. Tetanus is a chemical poisoning from the exotoxin produced by the bacteria. |
|
|
Term
| What are booster shots called? How are they made? |
|
Definition
| A booster shot is a toxoid (like toxins) that is made by removing the exotoxin produced by a culture of a bacteria like C. tetani. This inactivates the exotoxin so the bacteria can be injected to help build up antibodies in a person. |
|
|
Term
| Why can antibiotics be dangerous when giving them to a patient with sepsis (bloodstream overwhelmed by bacteria)? |
|
Definition
| If the bacteria in the blood has endotoxins in it, when the antibiotic kills the bacteria, it will release the endotoxins. This leads to vasodilation, paralyzing of smooth muscle and cardiac muscle, and the kidneys will shut down. This is called endotoxic shock or gram-negative shock. The mortality rate is 40-50%. |
|
|
Term
| How do Bacteriocidal antibiotics work? |
|
Definition
|
|
Term
| How do Bacteriostatic antibiotics work? |
|
Definition
| Bacteriostatic antibiotics keep the bacteria from reproducing. It causes the bacteria to die of old age so there is a gradual release of endotoxin and we can compensate. If all of the bacteria dies at once, the release it too acute and the body cannot handle it. |
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