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Homeostasis
as frequent minor changes occur in the body, the compensation mechanisms respond, and homeostasis is quickly restored.
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Microscopic
Cellular level
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Biopsy
excision of very small amounts of living tissue, or surgical specimens.
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Autopsy
examination after death.
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Diagnosis
Identification of a specific disease through evaluation of signs and symptoms, laboratory tests, or other tools.
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Disease
a deviation from the normal state of health or from a state of wellness. Disease develops when significant changes occur in the body, leading to a state in which homeostasis cannot be maintained without intervention.
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Etiology
Causative factors in a particular disease; may include congenital defects, inherited or genetic disorders, microorganisms such as viruses or bacteria, immunologic dysfunction, metabolic derangements, degenerative changes, malignancy, burns and other trauma, environmental factors, and nutritional deficiencies.
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Idiopathic
the cause of a disease is unknown.
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iatrogenic
a treatment, a procedure, or an error may cause a disease.
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Pathogenesis
refers to the development of the disease or the sequence of events involved in the tissue changes related to the specific disease process.
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Manifestations
clinical evidence or effects, the signs and symptoms, of disease. May be local or found at the site of the problem (redness or swelling); Or systemic, meaning they are general indicators of illness (fever).
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Clinical Course
marked by remissions and exacerbations, it is the progress of a disease.
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Syndrome
a collection of signs and symptoms, often affecting more than one organ, that usually occur together in response to a certain condition.
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Incidence
a measure of the risk of developing some new condition within a specific period of time. (Number of new cases)
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Prevalence
the number of new and old or existing cases within a specific population and time period
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Positive predictive value
proportion of subjects with positive test results who are correctly diagnosed.
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Negative predictive value
proportion of subjects with a negative test result who are correctly diagnosed
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Sensitivity
measures the proportion of actual positives which are correctly identified as such; (the percentage of sick people who are correctly identified as having the condition).
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Specificity
measures the proportion of negative which are correctly identified; ( the percentage of healthy people who are correctly identified as not having the condition).
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Atrophy
decrease in the size of cells (ex. shrinkage of skeletal muscle that occurs when a limb is immobilized in a cast for several weeks).
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Hypertrophy
an increase in the size of individual cells (ex. enlarged heart muscle from being overworked).
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Hyperplasia
physiological proliferation; increase in the number of cells (ex. proliferation of basal layer of epidermis to compensate skin loss).
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Metaplasia
cell type conversion; is the reversible replacement of one differentiated cell type with another mature differentiated cell type (ex. cigarette smoke that causes the mucus-secreting ciliated peseudostratified columnar respiratory epithelial cells that line the airways to be replaced by stratified squamous epithelium).
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Dysplasia
maturation abnormality; generally consists of an expansion of immature cells, with a corresponding decrease in the number and location of mature cells. Often indicative of an early neoplastic process (ex. epithelial dysplasia of the cervix consists of an increased population of immature (basal-like) cells which are restricted to the mucosal surface, and have not invaded through the basement membrane to the deeper soft tissues).
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Neoplasm
New growth; is the abnormal proliferation of cells, causes a lump or tumor.
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Anaplasia
Dedifferentiation; a reversion of differentiation in cells and is characteristic of malignant neoplasms (tumors).
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Desmoplasia
Connective tissue growth; may occur around a neoplasm. (ex. causing dense fibrosis around the tumor, or scar tissue (adhesions) within the abdomen after abdominal surgery)
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apoptosis
programmed cell death; a normal occurence in the body, which may increase when cell development is abnormal, cell numbers are excessive, or cells are injured or aged. Cells self-destruct, appearing to digest themselves enzymatically, and then disintegrate into fragments.
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Ischemia
a restriction in blood supply, generally due to factors in the blood vessels, with resultant damage or dysfunction of tissue. It also means local anemia in a given part of a body sometimes resulting form congestion.
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Cellular Injury
Ischemia, physical agents (heat or cold), mechanical damage (pressure), chemical toxins, microorganisms (biologic agents), abnormal metabolites accumulating in cells, nutritional deficits, non-ionizing radiation, ionizing radiation, imbalance of fluids or electrolytes, electrical injury.
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Hypoxia
reduced oxygen in the tissue; complete deprivation of oxygen is anoxia.
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anaerobic
absence of oxygen
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exogenous
from the environment
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endogenous
inside the body
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microorganisms
bacteria, viruses, and parasites
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morphologic
structural changes occur in the nucleus and the cell as well.
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lysosomal
destructive enzymes
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inflammation
swelling, redness, and pain
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cells under attack
biochemical lesion occurs; cell may adapt; may see morphological changes (particles will accumulate in the cell); inflammatory process may be set off; necrosis may occur (coagulative, liquefactive, caseous types); calcification of tissue possible; may lead to death.
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necrosis
a group of cells die
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liquefaction necrosis
dead cells liquefy under the influence of certain cell enzymes (ex. when brain tissue dies of in some bacterial infections in which a cavity or ulcer may develop in the infected area).
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Coagulative necrosis
cell proteins are altered or denatured, and cells retain some form for a time after death (myocardial infarction when a lack of oxygen causes cell death).
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Fat necrosis
when fatty tissue is broken down into fatty acids in the presence of infection of certain enzymes, may increase inflammation.
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Caseous necrosis
form of coagulation necrosis in which a thick, yellowish, "cheesy" substance forms (ex. TB's first stage of a granuloma).
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Infarction
an area of dead cells resulting form lack of oxygen (ex. when part of the heart muscle is infarcted or dies, that area can no longer contract to pump blood).
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Gangrene
area of necrotic tissue that has been invaded by bacteria (wet or dry types).
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Telomere
regions of repetitive DNA sequence at the end of a chromosome, which protects the end of the chromosome form deterioration or from fusion with neighboring chromosomes; (specialized ribo-nucleoprotein structures that prevent chromosomal damage).
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In a nut shell chapter 1
cells might adapt through adaptive cell changes; there are many potential causes of cell injury; structural and/or functional changes occur with disease; all injury may be reversible or irreversible leading to different types of necrosis and chemical changes can cause death; predictive value, prevalence, and incidence contribute to identifying disease; natural changes such as apoptosis are involved in biological aging; lab tests are important in diagnosing disease and vary in specificity and value.
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phagocytosis
is the process by which neutrophils (a leukocyte) and macrophages, "the vulture cells," randomly engulf and destroy bacteria, cell debris, or foreign matter.
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interferons
are nonspecific agents that protect uninfected cells against viruses.
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Hydrostatic pressure
is the pressure exerted by a fluid at equilibrium due to the force of gravity.
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osmotic pressure
is the pressure which needs to be applied to a solution to prevent the inward flow of water across a semipermeable membrane.
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inflammation
is the body's nonspecific response to tissue, resulting in redness, swelling, warmth, and pain, and perhaps loss of function.
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systemic
refers to something that is spread throughout, system-wide, affecting a group or system such as a body.
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vascular changes
momentary constriction of small vessels followed by rapid vasodilation of arterioles and venules (redness). Vessels increase their permeability (swelling); allows protein to escape into extra vascular spaces-- where protein goes, fluid follows. Dilutes offending agent.
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chemical mediators
a chemical release in the body during an inflammatory response or immune response. The damaged mast cells and platelets release chemical mediators including histamine, serotonin, prostagladins, and leukotrienes into interstitial fluid.
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vasodilation
relaxation of smooth muscle causing an increase in the diameter of arterioles.
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hyperemia
increased blood flow in the area
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permeability
allowing plasma proteins to move into the interstitial space along with more fluid.
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chemotaxis
is the phenomenon in which somatic cells, bacteria, or other single cell or multicellular organisms direct their movements.
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diapedesis
process in which leukocytes secrete proteases that degrade the basement membrane, allowing them to escape the blood vessel. (First neutrophils and later monocytes and macrophages collect along the capillary wall and migrate out through wider separations in the wall into the interstitial area.)
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exudate
refers to a collection of interstitial fluid formed in the inflamed area.
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serous
or watery exudates consists primarily of fluid with small amounts of protein and white blood cells. (ex. allergic reaction or burns.)
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fibrinous exudates
are thick and sticky and have a high cell and fibrin content (increases risk for scar tissue in the area.)
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Purulent exudates
are thick, yellow-green in color, and contain more leukocytes and cell debris as well as microorganisms. (bacterial infection, "pus").
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abscess
localized pocket of purulent exudate or pus in a solid tissue (ex. around a tooth or in the brain.)
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Hemorrhagic exudate
may be present if blood vessels have been damaged.
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anorexia
loss of appetite.
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pyrexia
(fever) low grade or mild fever is common in inflammation if it is extensive.
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pyrogens
fever-producing substances (ex. interleukin-1.) from WBCs or macrophages. Pyrogens circulate in the blood and cause the body temperature control system to be reset at a higher level. Heat-production mechanisms are activated to increase cell metabolism.
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leukocytosis
increased WBCs in blood.
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erythrocyte sedimentation rate or ESR
the rate at which RBCs sediment in a period of 1 hour. Hematology test that is non-specific measure of inflammation. (RBCs settle out of a blood specimen containing anticoagulant.)
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fobrinogen
is a soluble plasma glycoprotein, synthesized by the liver, that is converted by throbin into fibrin during blood coagulation.
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isoenzymes
cell enzymes, specific to certain organs, that differ slightly in structure, but have similar functions.
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perforation
erosion through the wall
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cellular changes
Relates to the movement of WBCs into the area; granulocytes are involved; neutrophils arrive first (lifespan of 10 hours immature "shift to the left."; neutrophil count in the blood increases especially with bacterial infections; Eocinophils increase during allergic reactions and parasitic infections; Basophils also respond in allergic reactions; Monocytes are the largest circulating WBCs, they are released from the bone marrow in response to inflammation and start appearing in 24-48 hours; Can engulf larger particles. Play a part in chronic inflammation.
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Stages of the leukocyte response
margination and adhesion, emigration, chemotaxis, activation and phagocytosis.
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Inflammatory mediators
these are chemical mediators that are released and are derived from both plasma and cells. The cells release histamine, serotonin, arachidonic acid, metabolites, platelet activating factor, cytokines, and nitric oxide. Plasma releases kinins, products of coagulation, and proteins of the complement system.
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manfestations of inflammation
local (exudate and ulceration), systemic (leukocytosis or leukopenia).
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Shift to the Left
this phrase refers to an increase in immature WBCs (called bands), so an increase is seen in immature neutrophils (lacking- neutropenia).
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differential WBC lab test
increase in neutrophils with bacterial infections, increase in eosinophils with allergic responses, decrease in neutrophils with viral infections and increase in lymphocytes (lymphocytosis), leukopenia occurs in infections that overwhelm persons with other diseases like cancer.
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chronic inflammation
may last for weeks, months, or years; may be recurrent or continuous; see increases in macrophages and lymphocytes rather than neutrophils (increased fibroblasts contribute to scaring and deforming). (ex. of multiple cases- keloids.)
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2 patterns of chronic inflammation
nonspecific chronic inflammation (diffuse and scattered) and granulomatous inflammation
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fibrblasts
connective tissue cells
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granuloma
a small mass of cells with a necrotic center and covered by connective tissue, or may develop around a foreign object such as a splinter, or as part of the immune response in some infections such as TB.
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Glucocorticoids
sometimes referred to as corticosteroids or steroidal anti-inflammatory drugs, are synthetic chemicals that are related to the naturally occurring glucocorticoids (hydrocortisone), hormones produced by the adrenal cortex gland in the body.
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Intra-articula
into joint
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resolution
the process that occurs when there is minimal tissue damage. The damaged cells recover, and the tissue returns to normal within a short period of time; (ex. after a mild sunburn.)
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Regeneration
the healing process that occurs in damaged tissue in which cells are capable of mitosis; the damaged tissue is replaced by identical tissue from the proliferation of nearby cells.
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Replacement
by connective tissue (scar fibrous tissue formation) takes place when there is extensive tissue damage or the cells are incapable of mitosis; (ex. the brain or myocardium). The wound area must be filled and covered by some form of tissue. Chronic inflammation or complications such as infection result in more fibrous material.
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granulation tissue
highly vascular and appears moist pink or red in color; it contains many new capillary buds from the surrounding tissue; this tissue is very fragile and is easily broken down by microorganisms or stress on the tissue.
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collagen
a protein that is the basic component of scar tissue and provides strength for the new repair.
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contracture
scar tissue is nonelastic and tends to shrink over time; this process may restrict the range of movement of a joint and eventually may result in fixation and deformity of the joint, a condition known as contracture.
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stenosis
shrinkage of the scar tissue may also cause shortening or narrowing (stenosis) of structures, particularly tubes or ducts. (ex. if the esophagus is shortened, malposition of the stomach (hiatal hernia) or narrowing esophagus causing obstruction during swallowing can result.)
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adhesions
are bands of scar tissue joining two surfaces that are normally separated. (ex. adhesions between loops of intestine or between the pleural membrane). Adhesions prevent normal movement of the structures and may eventually cause distortion or twisting of the tissue.
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hematocrit
the percentage of RBCs in the volume of blood.
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hematopoiesis
the production of blood cells in bone marrow.
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various agents of infectious disease
prions (is an infectious agent composed of protein in a misfolded form), viruses, bacteria, rickettsiae and chlamydiae, fungi, parasites, helminths( Parasitic worms or helminths are a division of eukaryotic parasites that, unlike external parasites such as lice and fleas, live inside their host; They are worm-like organisms that live and feed off living hosts, receiving nourishment and protection while disrupting their hosts' nutrient absorption, causing weakness and disease), vectors.
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mechanics of infection
portal of entry, source, symptomatology, disease course.
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diagnosis and treatment
culture, serology (Serology is the scientific study of blood serum and other bodily fluids. In practice, the term usually refers to the diagnostic identification of antibodies in the serum), DNA and RNA sequencing.
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bioterrorism
the deliberate release of viruses, bacteria or other germs (agents) used to cause illness or death in people, animals, or plants; found in nature but can be altered; bioterrorism agent categories A,B,C with A being the most serious.
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wound healing
healing by first (primary) or secondary (secondary) intention. Angiogenesis as involved with healing (angeogenic capillary sprouts; new vessels invade thrombing clot that forms in area, forms microvacsular network.) Factors that affect wound healing (age, nutrition, hemoglobin, circulation, clean wound, no infection).
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What have you learned
what inflammation involves on a cellular level, and s/s in the patient, difference between acute and chronic inflammation, lab tests that help us ID inflammation, what to expect with normal wound healing.
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detoxification
inactivation and removal of foreign chemicals from the body
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ecosystems
a biological environment consisting of all the organisms living in a particular area, as well as all the nonliving, physical components of the environment with which the organisms interact.
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toxicology
a branch of biology, chemistry, and medicine concerned with the study of the adverse effects of chemicals on living organisms. it is the study of symptoms, mechanisms, treatments and detection of poisoning, especially the poisoning of people.
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leukemia
a form of cancer in which one or more leukocyte is an immature, nonfunctional neoplastic cell developing in the bone marrow and peripheral blood, leading to increased risk of infection and hemorrhage.
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Hemolytic anemia
destruction of erythrocytes leading to low hemoglobin levels.
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demyelination
myelin sheath of neurons is damaged.
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neuritis
inflammation and demyelination of neurons in the brain.
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seizures
(convulsion) sudden, involuntary movement with loss of awareness, caused by uncontrolled neuronal discharge in the brain.
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particulate
also known as particulate matter (PM), fine particles, and soot are tiny subdivisions of solid matter suspended in a gas or liquid, (ex. asbestos and silica).
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solvents
(ex. carbon tetrachloride) is a liquid, solid, or gas that dissolves another solid, liquid, or gaseous solute, resulting in a solution that is soluble in a certain volume of solvent at a specific temperature.
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occlusion
an obstruction or blockage
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tympanic membrane
eardrum
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paralysis
(ex. poisonous snakes containing neurotoxins)
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tinnitis
ringing in the ears
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pica
the craving for nonfood substances such as clay.
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