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What are the 6 specific stages of acute illness we talked about in class?
- Physical Symptoms
- Cognitive Awareness
- Emotional Response
- Assumption of sick role
- Dependency
- Recovery or rehab.
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What are the 3 characteristics of chronic illness we talked about?
- Permanent impairment of disability
- Residual physical or cognitive disability
- Need for special rehab or long term care
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Nagi Model
- D
- I
- F
- D
- diseaseimparimentfnctionallimitationsdisability
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There are many factors for indicating health. Name ten.
- 1.Physical activity
- 2. Overweight/obese
- 3. Tobacco use
- 4. Susbstance abuse
- 5. Sexual behavior
- 6. Mental health
- 7. Injury/violence
- 8. Environmental quality
- 9. Immunization
- 10. Access to health care. (this is the one we can help the most with)
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What are some of the causes of cellular aging?
- Wear and tear
- Antioxidant damage to DNA
- Genetically predetermined
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Ischemia doesn't directly cause cell injury, describe the sequence to arrive at cell injury via ischemia.
Clot-ischemia-hypoxia-lessATP-accumulation of ions-swelling-rupture
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How do infectious agents cause cell damage?
- Bacteria-release endotoxins and exotoxins
- Virus- Directly: RNA viruses disrupt function of plasma membrane and ion transport and cause rupture of cell. Indirectly: They integrate themselves in the cellular genome, make copies of themselves and cause the host cell to be tagged and destroyed by T-cells
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How can an immune system attack cause cell damage?
Antibodies attach to the tagged cell. There is activation of the complement system and the inflammatory cells.
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how would a genetic problem affect cell health?
By changing the genome, cell production would be altered. This would directly affect the cells function, and usually result in its destruction.
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Discuss the affect of nutrition, chemical, and physical damage to a cell.
- Nutrition-if cells lack nutrition they will die.
- Chemical- injury to cells directly, pH and antioxidants
- Physical- Temperature, electricity, trauma, radiation
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What are the cellular adaptions made by cells that are undergoing chronic trauma?
- Atrophy-decrease in size
- Hypertrophy-increase in size
- Hyperplasia-increase in number
- Metaplasia-change in cell
- Dysplasia-increase in different cells
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What are some changes that a cell can't really adapt to?
Damage to the cell nucleus, mitochondria, lysosomes, and ruputre of the cell membrane.
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Define inflammation.
The coordinated reaction of body tissue to cell injury and cell death that involves vascular, humeral, neurlogical, and cellular responses.
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What happens to a vessel wall during acute inflammation?
- If wall injury: small arteries contrict d/t neural reflex. Surrounding blood increases in pressure. Flow slows and you get clots.
- If no wall injury: Vasodialation occurs. Hydrostatic pressure rises. Transudate leaves vessels and enters the area.
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What is the reaction of leukocytes during acute inflammation? What do the leukocytes do?
- Margination: The binding of Leukocytes to the margins of the vessel do to the slowing of blood and increase in adhesive glycoprotiens.
- Diapedesis: Chemoactic agents cause migration from intravascular to extravascular locations.
- Leukocytes release enzymes and toxic substances to kill, they phagocytoses, and release growth factor to induce healing.
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What do we call the hyperplasi of leukocytes in the lymph nodes?
What doe we call the inflammation of lymphatics
- Lymphadenopathy
- Lymphangitis
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What are the major chemical mediators of inflammation?
- Histamine: Endothelial contraction and vasodialation, bronchoconstriction
- Platelet activating factor: induces aggregation and infiltration of leukocytes
- Cytokines: local-stimulates margination, activates fibroblasts, chondrocytes, osteoclasts. Systemic-induces fever, increase metabolism, causes hypotension
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Which systems are part of the protein protease system?
- Blood coagulation system: Hageman-Prothrombin-thrombin-fibrinogen-fibrin
- Fibrinolytic systems: Hageman-Plasminogen-plasmin
- Kinin system: Hageman-bradykinin-pain and vasodilation
- Complement system: Chemical activation- Vasodilation,chemoactic agent, Opsonization, MAC
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Steps in phagocytosis.
Opsonization-binding to leukocytes-invagination d/t calcium influx-incapsulation-digestion(pus/purulence)
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Characteristics of chronic inflammation.
- Accumulation of specific leukocytes (macrophages and lymphocytes) and plasma cells
- Granulation tissues, endothelial cells and fibroblasts
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If I had tissues in the process of healing and fibroblasts where present to stimulate the ECM, what other chemicals would be present?
Fibronectin, proteoglycans and elastin, collagenh
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What is tissue regeneration?
What is tissue Repair?
What do keloids cause?
What happens in the brain?
- Regeneration: When the perenchymal cells experience regrowth
- Repair: Formation of scare tissue
- Keloids: hypertrophic deposition of collagen
- Brain: permanent, no regeneration, no fibroblast for scar tissue, so there are holes. no collagen. astrocytes form glail scars.
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What is the first line of defense?
The innate immune system. Non-specific, non-adaptive. Skin and inflammatory response. Macrophages responding to any pathogens, not specific ones.
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What do we know about acquired immunity?
- Specific antigen = specific response
- Humeral and cell mediated components
- Active v. Passive
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What are the main Leukocytes used by innate immunity?
- NK cells -
- Neutrophils - PMN cells
- Monocytes - become macrophages
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Humeral Immunity
B-Cells bind with antigens. Very rapid. Can be passively transmitted.
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Cell-Mediated immunity
Helper t-cells. 75% of t cells. Stimulate b cells to make more antibodies. The antibodies will bind with antigens to help the innate leukocytes, like the macrophages other T-cells and NK cells kill them.
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How is the brain linked to the immune system?
Via the Autonomic nervous system and the neuroendocrine outflow via the pituitary. May explain how stress and emotion cna modify a person capacity to cope with infection or cancer and influence autoimmune disease.
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What is an iatrogenic Immunodeficiency?
- One that occurs from a physicians actions.
- Cytotoxic drugs, Corticosteroids, cyclosporine, Radiation Splenectomy
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Levels of HIV infection?
- Asymptomatic: CD4>500cells/mm3 (unresticted exercise)
- Early Symptomatic stage: CD4=200-500 cells/mm3 (Cytomegalovirus, Pneumocysti carinii pneumonia)
- HIV advances CD4<200 cells/mm3
- Normal=600-1200 cells/mm3
- 40,000 new infections/year
- 50%-drugs use, 41% MSM 20-49
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