________: study of functional or physiologic changes in the body that result from disease processes.
Most homeostatic control mechanisms operate based on a _____ feedback.
_____ is the sum of deviations from normal, not the abnormal state in an d of itself.
_______: how the disease develops.
______ ______: functional consequences of altered homeostasis.
_______: the cause of a condition is unknown.
_______: the cause of a condition is due to medical treatment or error.
_____: objective and observable indicators (fever, reddening of the skin, palpable mass)
_____: subjective feelings (nausea, pain, malaise)
_____: collection of signs and symptoms that occur together.
4 stages of a disease:
________: time between exposure to an injurious or infectious agent and the appearance of signs and symptoms.
________: the appearance of the first s/s indicating onset of disease.
_________: s/s reach their full severity.
_________: recovery stage of a disease.
- latent or incubation period
- prodromal period
- acute phase
______: s/s of the disease are increased
______: s/s of a disease subside
Types of Disease
______: relatively severe manifestation; runs a short course
______: generally more mild manifestation; s/s develop gradually; tissue damage usually mre permanent; may have intermittent acute episodes.
_______: when a disease spreads to a large number of people at the same time in a given area
________: worldwide spread of a disease
Prevention of disease:
_____: prevention of a disease by reducing susceptibility or exposure
_____: early detection, screening, and management of a disease
_____: once a disease is established (med intervention, rehab, surgical management)
________: study of drugs and their actions, dosage, therapeutic uses, and adverse effects.
_______: substance that alters biologic activity.
______: stimulate or inhibit cell function
______: approved uses or diseases drug has been proven to be effective for.
______: drug shown to be effective for treatment, but not for the use it was approved for (botox).
______: MILD unwanted actions of drugs (dry mouth).
______: additional effects are significant/dangerous/life threatening or cause tissue damage (chemo).
- off-label uses
- side effects
- adverse effects
_______: increased drug effect. Positve: reduces dose of each drug. Negative: life threatening or decreased responsivity.
_______: decreased drug effect. Positves: used to counteract overdose. Negatives: failure to receive full benefit from drug.
________: one drug enhances effect of 2nd drug.
____: chronic autoimmune inflammatory disease resulting in pain, swelling,stiffness, deformity, and loss of function.
RA affects a little more than __% of the population and men (greater, less than, or the same) women.
Etiology of RA is _____ but has an unknown cause (genetic factor recognized). __ is present, an antibody to IgG, however RA can occur even when this is not present.
Initially, RA presents in what nature?
symmetrical involvement of small joints (hands and feet) followed by larger joint involvement
_____: red, swollen, and painful joint caused by inflammation and proliferation fo synovial cells.
_____ _____: granulation tissue from synovium spreads.
_____ _____: unstable joint caused by enzymes from pannus, and by blocking of nutrients from synovial fluid by pannus.
- pannus formation
- cartilage erosion
______: pannus becomes fibrotic and calcifies.
______: joint fixation and deformity
All patients with RA have affected joints, almost all include ___/___/____.
hand wrist fingers
______: joint deformitiy (osteophyte) that is hard to the touch, not painful, most common in DIP (heberdens) and PIP (bouchards).
______: joint deformity present in 25% of patients with RA that presents with granulomatose, fibrous, soft tissue masses. Sometimes can be painful. Often found on the extensor surface of the ulna.
American College of Rheumatology criteria for RA: must meet _/7 symptoms for diagnosis
1. morning stiffness greater than _ hour
2. arthritis in greater than _ joints
3.arthritis of ____ joints
4. _____ arthritis
5. _____ _____
6. __ present
7. ______ changes
- morning stiffness greater than 1 hour
- arthritis greater than 3 joints
- arthritis of hand joints (wrist, mcp, pip)
- symmetrical arthritis
- rheumatoid nodules
- RF present
- rdiographic changes
Stages of RA
Stage _: ____: no destructive changes on roentgen graphic exam/possible radiographic evidence of osteoporosis.
Stage_: ____: radiographic evidence of osteoporosis, cartillage and bone destruction; joint deformity, extensive muscle atrophy, and possible presence of nodules.
Stage_: _____: radiographic evidence of osteoporosis adn slight cartilage destruction; no joint deformities but slight limitation of joint movility; adjacent muscel atrophy and possible presence of nodules.
Stage _: ______: fibrous or bony ankylosis; radiographic evidence; joint deformity; extensive muscle atrophy; possible presence of nodules.
- Stage 1: early
- Stage 3: severe
- Stage 2: moderate
- Stage 4: terminal
Medical Treatement for RA: balance of ____ and _____.
rest and moderate activity
Causative agent, the HIV belongs to a family of viruses that have ____ as their core genetic material and are known as _______.
HIV has a special affinity for cells known as _____ and _____.
Name the 4 types of T-cells:
Where are they made?
Macrophages first activate the T-____ cells (known as CD-4 lymphocytes).
- helper, killer, suppressor, memory
____ T cells migrate to the site of the invading organism and kill the invader and any infected cells.
Macrophages also activates the ___ cell which are the immune cells responsible for the production of antibodies.
______ destroy invading cells indirectly by stimulating chemical reactions against them.
_______ T cells release a chemical that subdues the activated B and T cells and brings the production of new lymphatic cells to a halt.
Suppressor T cells
______ B and T cells remain, giving the individual immunity to that specific strain of virus.
Memory B and T cells
HIV has a high affinity for _____ protein found on surface of T cells and macrophages.
CD4 counts below ______, the infected persons develop infections suc has shingles or thrush.
CD4 counts below______, they are diagnosed with AIDS.
HIV is _____, meaning it infects the CNS causing a progressive demeanting illness.
Significant obstacles to the use of HAART include:
4 things (describe/try)
- side effects
- difficulty adhering to complex dosing regimens
- drug resistance and clinical deterioration
Wound healing Models:
_______: shearing, friction, contusions, first degree burns.
_______: surgical incisions, lacerations. Wound edges are approximated to achieve closure. Healilng occurs 3-7 days with minimal scarring.
________: contaminated wounds or large amount of tissue loss. Stitches placed in subcutanous and fascial layers, closed 5-7 days later.
- Primary Intention
- Delayed Primary Intention
______ ______: abrasions, skin tears, stage II pressure ulcers, second-degree burns. Heal by repair, migration of epithelial cells from wound edge and dermal appendages.
_______ _____: wounds with infection, debris, necrosis presen; full thickness loss, may extend to deeper structures. Wound cavity is filled from the bottom up. Muscles, tendons, nerves are replaced by scar tissue not replicated.
_____ _____: not the same as the tissue it replaces. 80% of its original tensile strength. Increased risk for future breakdown.
_____: formation of blood clot to prevent further blood loss after injury.
______: lasts 3-7 days from initial injury.
_______: lasts several weeks; granulation, wound contraction, epithelialization.
_______: 21 days to 2 years; scar formation, changes from reddened to rosy, then more natural pigmentation.
_____ _____: sebaceous glands, sweat glands, hair follicles.
______: refers to a drying out or lack of moisture in the tissues.
______: separation of a surgical incision.
______: linear scratches on the skin.
______: rolling of the wound edge.
______: dry, brittle, fragile.
- dermal appendages
________: overgrowth of dead, keratinized epithelial cells. Refers to callus, corn, and scaly periwound condition.
________: abnormal hardening of tissue at the wound margin.
________: dead, devitalized tissue
________: softening of connective fibers by soaking until they are soft and friable. Tissues in this state lose pigmentation.
_______: pale, pink granulation tissue; cells that are metabolically active but non-prolifertive or proliferating at much slower rates.
_______: course or pathway of tissue loss away from the open wound; results in dead space with potential for abscess formation.
_______: erosion of tissues under intact skin at the wound margin.
Documentation should include: 9 things
location, dimensions,exudate, odor, tissue types, periwound skin condition, pain, procedures/interventions, dressings applied
____ orientation is used for describing tunneling and undermining.
Types of Exudate:
______: watery plasma, thin, clear or light color.
______: thin, red, bloody
______: plasma and red blood cells, thin, light red to pink.
______: contains some white blood cells and living or dead organisms, cloudy, yellow to tan.
______: (pus)contains white blood cells and living or dead organisms, thick, creamy yellow, green or brown.
_______: "beefy" red, highly vascular tissue.
________: excess growth of granulation tissue above the epithelium, "proud flesh".
______: dry, black, leathery thick tissue.
______: loose, stringy necrotic tissue; liquefying necrosis.
_______: removal of necrotic tissue to minimize risk or presence of infection, and to eliminate physical berriers to granulation, contraction, and epidermal resurfacing.
_______ ______: unpleasant sense of discomfort with a slow onset that progresses over a long period of time.
About ____% of the U.S. population is affected by chronic pain. Usually more common in (males or females).
Pain is perceived via ______. These sensory nerves are stimulated by thermal, mechanical, or chemical means. The nerve fiber then sends a message to the spinal cord and brain.
Chronic pain is transmitted by sensory afferernt __ fibers. Message is sent to DRG and into the spinal cord.
Neurons transmit the pain signal to the brain via the _______ tract.
Chronic pain delivers slower impulses via the ________ tract. This connects to the reticular formation and ascend to the parietal lobe, where the site and characteristics of pain are recognized.
- Spinothalamic tract
- Paleospinalthalamic tract
________ tract: acute pain, sharp, short pain, myelinated A delta fibers.
_______ tract: chronic pain, dull, aching pain, unmyelinated C fibers.
____ ____: permits the pain impulses to travel to the brain.
_____ _____: reduces the pain stimulus to the brain; other stimuli may "overpower" the pain stimulus; also may be occluded by prior conditioning to pain, emotional state, or by distraction.
- Gate-control theory
_______ tools: measure pain intensity, e.g. visual analog scales, verbal rating scale, numeric rating scale.
_______ tools :measure several aspects of pain including intensity, frequency, quality of life. e.g.: brief pain inventory, mcgill pain questionnaire, minnesota multiphasic personality inventory.
Physical examination for chronic pain diagnosis should include the following: 4 things
- 1. Gait analysis
- 2. examining of pain sites
- 3. musculoskeletal system
- 4. neurological system
______ ______ pain: pain that does not get better or worse over a period of six months or longer (LBP).
______ ______ pain: pain caused by a chronic condition. Episodes occur frequently for six months to life (migraines).
______ ______ pain: pain experienced for more than six months and is likely to get worse due to a certain condition or disorder (DJD).
- Chronic benign pain
- Recurrent acute pain
- Chronic progressive pain
10 ways to prevent chronic pain:
- maintain a healthy diet
- protection from harmful chemicals
- quit bad habits
- maintain a healthy body weight
- regular sleep pattern
- protect yourself from the sun
- moderate exercise regularly
- maintain good posture
- be aware of family medical history
______: used to send electrical signal across the skin to excite neurons. Thought to "close" the pain gate.
TENS (transcutaneous electrical nerve stimulation)