Pathology-Exam 1

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  1. Definition:
    • continuum where wellness is on one end and illness is at the other
    • --reflects biological, psychological, spritual and sociological state
    • --dynamic process of interactions between an individual and internal and external environment
  2. Definition:
    a sickness or deviation from a healthy state
  3. Definition:
    a biological or psychological alteration resulting in malfunction of body organ or system
  4. Identify health care disperities
    • minorities less likley to receive health care
    • racial and ethnic minorities less likely to receive health care
  5. Strategies to improve health care disperities
    • education to address discrimination, biases, and stereotypes
    • cross cultural education
    • standardized data collection
    • treat everyone fairly
  6. Racial and ethnic minorities are less likely to receive what?
    • Angioplast
    • CABG
    • Mammograms
    • Hip fracture repair
    • African American are 2.5X more likely to get orchiectomy
    • After hip fracture, decreased PT for African Americans in actue and skilled nursing facilities
    • Medicare and Medicaid patients less likely to get PT/OT for a hip fracture repair
  7. Identify lifestyle factores and behaviors involved in health
    • Culture
    • Gerneration
    • Socioeconomic status
    • Adverse childhood experiences
    • Smoking and tobacco use
    • Alcohol and substance abuse
    • Stress
  8. Implications of lifestyle factors that are involved in health
    multiple practice pattersn associated with risk factor reduction and prevention of disorder and disease
  9. Describe the lifestyle factor of:
    • perception of health
    • compliance with therapy
    • language barriers
    • physical contact
  10. Describe the lifestyle factor of:
    • Matures
    • --passive and accept treatment recommended
    • Baby Boomers
    • --question authority
    • Generation X & Y
    • --consumers, often seek a second opinion
  11. Describe the lifestyle factor of:
    Socioeconomic Status
    • greatest influence on health
    • decreased SES have more health problems
    • decreased SES have activity limitaions 2o disease 3X more
    • decreased SES have a lack of health care/access delays/postponed treatments
  12. Identify the role of PT and the therapist in health and disease management
    • prevention and screening to promote health and reduce chronic disease
    • --cardiovascular and integumentary 2o to decreased activity level
    • --behavior modification for physical activity
    • --build endurance tolerance
  13. Identify the mechanisms of cell/tissue injury
    • Ischemia
    • Infections agents
    • Immune reactions
    • Genetic factors
    • Nutritional factors
    • Physical factors
    • Chemical factors
  14. Describe:
    • altered blood flow
    • below the minimum needed for cell homeostasis and metabolic function
  15. Describe:
    Infectious Agents
    • bacteria
    • viruses
    • --both are responsible for majority of infections
  16. Describe:
    Immune Reactions
    • Allergies
    • --mild reactions - runny nose, watery eyes
    • --moderate reactions - hypoxia 2o bronchoconstruction
    • --anaphylaxic shock - whole body allergic response
    • --autoimmune disorders - reacts and destroys normal body tissue
  17. Describe:
    Genetic Factors
    • alterations in structure or number of chromosomes
    • single mutation of genes that cause change in amount of proteins
    • multiple gene mutations interacting with environmental factors
  18. Describe:
    Nutritional Factors
    • deficiencies in essential amino acdids interfere with protein synthesis, which is required for cell replication
    • --deficiency of Iron - anemic
    • --deficiency of Vitamin C - scurvey
    • --deficiency of Vitamin D - rickets
  19. Describe:
    Physical Factors
    • trauma (MVA) - leading killer in US
    • extremes in physical agents
    • --cell death due to burn or freezing (ice crystals)
    • --irradation of cells
  20. Describe:
    Chemical Factors
    • toxic substances
    • --directly injure cells
    • *heavy metals: mercury, chemo drugs
    • --indirectly injure through metabolic transformations
    • *carbon tetrachloride, acetominophen are inert but must be metabolized to cause cell damage
  21. Describe:
    • mild reaction - runny nose, watery eyes
    • moderate reaction - hypoxia 2o bronchoconstriction
  22. Describe:
    • A whole body reaction
    • circulatory collapse
    • multiple symptoms
  23. Symptoms of Anaphalaxis
    • abdominal pain/cramping
    • abnormal (high-pitched) breathing
    • anxiety
    • confusion
    • cough
    • diarhea
    • difficulty breathing
    • difficulty swallowing
    • slurred speech
    • fainting/light headed
    • hives/itchiness
    • nasla congestion
    • naseau/vomiting
    • palpitations
    • skin redness
    • wheezing
  24. Describe:
    Autoimmune Disorder
    • reacts to and destroys normal body tissue
    • can affect more than one tissue type
  25. Discuss intrinsic factors of cell death/injury
    • genetic
    • --alteration in structure or number of chromosomes
    • --single mutation of genes that cause changes in amount or funtion of proteins
    • --multiple gene mutations that interact with environmental factors
    • nutritional
    • --deficiencies in essential amino acids
  26. Discuss extrinsic factors of cell death/injury
    • physical
    • --trauma
    • --extremes in physical agents
    • mechanical
    • --applied load exceeds failure tolerance of tissue
    • ~rate of load
    • ~compression
    • ~direction
    • chemical
    • --directly injure cells
    • --indirectly injure through metabolic transformation
  27. Identify components of healing
    • fibronectin
    • protectoglycans
    • elastin
    • collagen
  28. Identify stages of healing
    • inflammatory- 1st few days
    • proliferative - day 2 - 3 weeks
    • remodeling - 3rd week - closure
  29. Identify different types of immunity
    • Innate - natural or native
    • Acquired - adaptive or specific
  30. Describe Innate Immunity
    • natural or native
    • first line of defense
    • consists of all immune defenses that lack immunologicl memory
    • responses remain unchanged
    • does not distinguish between different invaders (bacteria vs. virus)
  31. Types of Acquired Immunity responses
    • Humoral
    • Cell-mediated
  32. Describe Acquired Immunity
    • adaptive or specific
    • recognizes and destroys invaders and prevents proliferation of mutant cells
    • has memory so subsequesnt invasions result in quick response
  33. Describe Humoral-Immunity
    • a response
    • antibodies pressent in body fluids (saliva, blood, vaginal secretions)
    • effective against free0floating organisms
    • B lymphocytes (B-cells) circulate in extracellular fluid
  34. Describe Cell-Mediated Immunity
    • specific cells (T-lymphocytes) recognize hidden organisms
    • --search and destroy bacteria and viruses
    • reponsible for rejection of transplanted tissue
    • basis for many skin tests (TB, allergies)
    • cellular immunity cannont be transferred
  35. What are the various cells involved with immunity and function?
    • Innate
    • --phagocytic cells
    • --inflammatory mediator-releasing cells
    • --natural killer cells
    • Acquired
    • --B lymphocytes
    • --T lymphocytes
  36. Describe cells involved with innate immunity
    • phagocytic cells
    • --neutrophiles, monocytes, macrophages
    • --ingest microorganisms and foreign particles
    • inflammatory-mediated cells
    • --basophils, mast cells, eosinophil
    • --assist immune cells by coating invading organisns so they can be phagocytosed
    • natural killer cells
    • --large granular lymphocytes
    • --function to kill:
    • ~viruses, other intracellular microbe-infected cells, tumor cells
  37. What do natural killer cells destroy?
    viruses, other intracellular microbe-infected cells, tumor cells
  38. What are B-lymphocytes?
    • cells involved with acquired immunity
    • --immunoglogulin-related immunity
    • --part of humoral immunity
    • --originate and mature within bone
    • --float in extracelluar fluid
    • --coated with immunoglobulin
    • --each B-cell has a receptor that recognizes specific anitigen
    • --becomes plasma cell and memory B-cell
    • --secretes specific antibody
    • --memory cells circulate for about 1 year
    • --responsible for rapid and strong response
  39. What are T-lymphocytes?
    • cells involved with acquired immunity
    • part of cell mediated immunity
    • originate in bone, mature in thymus
    • consistanly circulating in blood and lymph
    • recognizes hidden organisms
    • --all viruses, some bacteria
    • interacts with antigen, now as active lymphocyte, produces Helper T cells and cytotoxins. T-cells to recognize and destroy virally infected cells
    • also help natural killer cells kill infected cells
  40. What factors affect immunity?
    • nutrition
    • environmental pollution
    • chemical exposure
    • trauma
    • medications
    • splenectomy
    • burns
    • stress
    • SES
    • sleep
  41. Describe the nutritional influence on immunity
    • immune response of GI tract and host defense
    • reduction of normal bacteria
    • deficits in calories, proteins and vitamins
    • ~decrease in T-cell function (Vitamin A, E, and Zinc)
  42. Describe how medications affect immunity
    • may suppress blood cell formation in bone marrow
    • induce inappropriate immunologic responses
    • affect (depress) B and T-cell function
  43. Describe how splenectomy would influce immunity
    • surgery and anesthesia can suppress T and B cell function up to one month post-op
    • invasivenature of surgery increases exposure to pathogens
    • splenectomy results in depressed humoral response against encapsulated bacteria
  44. Describe how stress would affect immunity
    • drepress immune function
    • acute stress triggers myocardial ischemia, platelet function, ovarian dysfunction, increased blood viscosity
    • prolonged stress can lead to other responses
  45. Describe how burns affect immunity
    increased susceptibility to severe bacterial infections
  46. what are the clinical manifestations of HIV
    • musculoskeletal
    • neuromuscular
    • cardiopulmonary
    • integumentary
    • other symptoms
  47. How does exercise help HIV patients
    • provide pain relief
    • improve appetite
    • reduce muscle atrophy
    • inprove quality of life
    • regulare boweels
    • improve function
    • enhance immune function
  48. Describe hypersensitivity disorders
    • allergies
    • exaggerated or inappropriate immune response
    • immediate - reaction in minutes
    • late-phase - hours/days after
    • delayed - symptoms come several days later
  49. Type I Hypersensitivity
    • immediate hypersensitivity reaction
    • allergic disorder
    • ~anaphylaxis
    • ~allergic rhinitis, uticaria, extrinsic asthma
  50. Type II Hypersensitivity
    • cytotoxin reactions to self-antigens
    • sees own tissues as foreign
    • cell membranes are disrupted and destroyed
  51. Type III Hypersensitivity
    • immune complex disease
    • normally, immune complexes are gone
    • deposited into tissues near smll blood vessels
    • ~begin acute inflammation and local tissue injury
    • affects skin, joints, kidneys, pleura and pericardium
  52. Type IV Hypersensitivity
    • cell mediated hypersensitivity
    • delayped response after sensitaization to an allergen
    • cell by cell response
  53. Autoimmune disorders
    • body unable to discern self from nonself
    • organ-specific and non-organ specific
    • affects skin, joints, organs and systems
  54. Lupus
    a chronic inflammatory autoimmune disorder
  55. Manifestations of Lupus
    • Musculoskeletal - arthralgia and arthritis
    • Integumentary - cutaneous lesions
    • Cardio - dyspnea, pleuritis
    • Treatment - symptomatic relief
  56. Fibromyalgia
    • chronic muscle pain syndrome
    • most common musculoseletal disorder
    • muscle pain = major symptom
  57. What are the fungal skin infections?
    • Ring Worm
    • Athlete's Foot
  58. What are the bacterial skin infection?
    • Impetigo
    • MRSA
  59. What are the viral skin infections?
    • Warts
    • Chicken Pox/Shingles
    • Fifth disease
    • Hand, Foot, Mouth
    • Measles
    • Molluscm Contagiosum
    • Roseola (sixth disease)
    • Rubella
  60. What are the viral respiratory infections?
    • Common cold
    • Influenza
    • Croup
    • Strep Throat
    • Scarlet Fever
    • Tuberculosis
    • Whooping cough
  61. What are the misc. viruses
    • Cytomegalovirus
    • TORCH
    • Hepatitis A
    • Hepatitis B
    • Mononucleosis
    • Bacterial Meningitis
    • Mumps
    • Conjunctivitis
    • Otitis Media
    • Lyme Disease
  62. What are the parasitic infections?
    • Lice
    • Scabies
    • Bed bugs
  63. What are the symptoms of Ring Worm?
    itchy, red, scaling patches. Usualoy round with raised and scaly borders. May be on scalp and body. Roughly dime sized
  64. What are the symptoms of Athlete's Foot?
    Mild scaling with or without redness and itching in the warm, moist areas between the toes. Maceration and fissuring possible
  65. What are the symptoms of Impetigo?
    Pustular rash, cellulites, very itchy. Lesions frequently on the face. Fluidy
  66. What are the symptoms of MRSA
    • Staph skin infection: red, swollen and painful area on the skin
    • Skin abscess: with pus or other fluids from the site. With or w/o odor
  67. What are the symptoms of Warts?
    rough- surfaced, round, firm and may be yellow, grey brown or black
  68. What are the symptoms of Chicken Pox/Shingles?
    itchy pustular patch, fever, malaise. Rash starts on scalp, then trunk, then extremities
  69. What are the symptoms of fifths disease?
    symmetric or maculopapular rash
  70. What is hand, foot, and mouth disease?
    fever with small blisters on the hands and feet and oral ulcers
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Pathology-Exam 1
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