Cellular Responses, Adaptations, and Dysfunction: A Study Guide for Pathophysiology, Exams of Nursing

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PATHOPHYSIOLO

GY

MODULE 2 –

CELLULAR

RESPONSES,

ADAPTATIONS,

AND

DYSFUNCTION

TERRI MARSH, MSN-RN

BIOLOGY OF CELLS

Normal Cells

 Specific morphology

 Small nuclear-to-cytoplasmic ratio

 Differentiated function

 Tight adherence

 Non-migratory – stay put

 Orderly and well-regulated growth (cellular

regulation) – replace dead tissue, develop normal

tissue

 Mitosis – cell division

 Contact inhibition – stops mitosis

 Apoptosis – programmed cell death

 Normal chromosomes (euploidy) 23 pairs

Cancer Cells

 (^) Anaplasia – don’t look right  (^) Lack of differentiation  (^) Large nuclear-to-cytoplasmic ratio  (^) Specific functions lost – no useful purpose  (^) Loose adherence  (^) Migration (metastasis)  (^) Rapid or continuous cell division  (^) No contact inhibition  (^) No apoptosis  (^) Abnormal chromosomes (aneuploidy)  (^) Often succumb to necrosis

ALTERATIONS IN CELL GROWTH AND REPLICATION

Neoplasia = “new growth”  (^) Lacks normal controls and regulation  (^) Can originate in one organ (Primary site)  (^) Prostate most common in men  (^) Breast most common in women  (^) Lung leading cause of death in men and women  (^) Can also spread from another site (Secondary Site)  (^) Metastasis  (^) Steps in carcinogenesis

1. Initiation: introduction of the agent 2. Promotion: initiation of uncontrolled growth 3. Progression: permanent malignant changes 4. Metastasis : Moves to other sites  (^) Heredity – Thanks Mom  (^) Oncogenes – All cells have these  (^) Carcinogens – What were you exposed to? Benign Slow, progressive, localized, well defined, resembles host (more differentiated), grows by expansion, does not usually cause death, causes less damage to host – adenoma, papilloma Malignant Rapid growing, spreads (metastasis) quickly, fatal, highly undifferentiated. Sarcoma, Carcinoma

ABCD METHOD OF MONITORING SKIN LESIONS / MOLES

 (^) A = Asymmetry  (^) are the two halves of the mole the different? Less symmetrical shapes are generally more concern.  (^) B = Borders  (^) are the edges of the mole are poorly defined? Is it ragged, irregular, or blurred? Again, regular shapes are less concerning.  (^) C = Color  (^) is the color uneven with shades of tan, brown or black? Some melanoma is blue or pink.  (^) D = Diameter  (^) has there been a change, particularly an increase, in lesion size? Increasing size, especially over 6mm diameter is more concerning.

COMPLICATIONS OF CANCER

 (^) Anemia  (^) Cachexia  (^) Overall weight loss and weakness  (^) Fatigue  (^) Infection  (^) Leukopenia  (^) Thrombocytopenia  (^) Pain

Common types of Cancer

Osteosarcoma/bone – highly

malignant

Breast cancer – Highly hereditary

Prostate cancer

Skin

Lung

Colorectal

IMMUNE SYSTEM

 (^) Self-regulated  (^) Self-limiting  (^) Must be able to distinguish self from non-self  (^) Antigens - something that makes us sick- triggers immune response  (^) Antibody – what our body makes to kill the antigen – adaptive immune response  (^) Two major actions: defending and attacking Innate Defense Barriers (Built in) Nonspecific Immediate response Distinguish self from non-self Do not distinguish between pathogens Include Skin and mucous membranes Chemicals – antimicrobial proteins found in the body Additional bloodborne innate defenses include 1.Inflammatory response Histamine, bradykinin, prostaglandins 2.Pyrogens 3.Interferons 4.Complement proteins

ADAPTIVE AND SPECIFIC IMMUNITY

 (^) Specific  (^) Develop over time  (^) Use memory system  (^) Develop antibodies  (^) Distinguish self from non-self and between pathogens  (^) Include White blood cells  (^) T cells: cell-mediated immunity  (^) They become sensitized to the disease. They learn to recognize the disease and trigger an immune response so other WBC can fight it off  (^) Killer T cells – release lymphokines to degrade cell walls and destroy virus infected cells  (^) B cells: humoral immunity – Responsible for creation of antibodies – antibodies fight off future infections  (^) Macrophages – Engulf foreign substances

ALTERATIONS IN IMMUNITY

• Exaggerated immune response to a

foreign substance (antigen)

Hypersensitivity

• Mistakes self as nonself

Autoimmune

• Inadequate immune reaction

Immunodeficien

cy

TRANSPLANTS

 (^) Allogenic – tissues come from same species of similar tissue type but not identical; most are this type  (^) Autologous – host and donor are the same person – such as giving your own blood prior to surgery  (^) Syngeneic – tissue from the identical twin of the host  (^) Xenogeneic – tissues from another species – such as a pig heart valve

WHICH TYPE OF

REACTION IS

ASSOCIATED

WITH POISON

IVY?

1. Type I
2. Type ii
3. Type iii
4. Type iv

WHICH TYPE OF IMMUNITY WILL AN INDIVIDUAL DEVELOP AFTER RECEIVING AN IMMUNIZATION?

1. Passive
2. Temporary
3. Active
4. Haptens