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NU545 Patho Study Guide Unit 1
What is metabolic absorption? (p.2) - correct answer ✔✔• 1 of 8 cellular functions of eukaryote cell
- Chief function is to take in & use nutrients or other substances from surroundings
- Ex: kidney (fluid absorption and synthesize proteins) and Intestinal epithelial cells (fluid absorption/protein enzyme synthesis) What uses oxygen to remove hydrogen atoms in an oxidative reaction? (p.8) - correct answer ✔✔• Peroxisomes contain enzymes that use O2 to remove H+ in oxidative reactions that produces hydrogen peroxide which is then used by catalase to further oxidize other substances like: phenols, formic acid, formaldehyde, and alcohol During cell injury what is released that is capable of cellular autodigestion? (p. 8) - correct answer ✔✔• Lysosomal enzymes (hydrolases), or the digestive enzymes within the lysosome
- Autolysosomes, or autophagosomes Where is the genetic info contained in the cell? (p. 2) - correct answer ✔✔Nucleus, specifically the nucleolus Cell membranes contain which major chemical components? (p. 12) - correct answer ✔✔Lipids & Proteins in a complex lipid bilayer What allows potassium to diffuse in and out of cells? (p. 31-32) - correct answer ✔✔• The Na+-K+-ATP pump. Uses direct energy of ATP; found in excitable tissues (muscles/nerves) & also in kidneys & salivary glands. Involves the movement of Na+ & K+ against a concentration gradient.
- Protein enzyme ATPase allows potassium to move in and out of the cell.
- Mediated transport = channel protein through which ions can diffuse (K+ leak channel). How is a cell protected from injury? (p.12) - correct answer ✔✔• Plasma membrane - Acts as a barrier to toxic molecules, macromolecules, & foreign organisms/cells.
- Exists in a state of change & modulation. Alternates receptor numbers & patterns.
- Gating protects cells from release of Ca from injured cells by sealing off or decreasing permeability at junctional complexes. In cirrhosis, what does cholesterol have to do with the erythrocytes? (p.68) - correct answer ✔✔• Associated with chemical changes that result in structural & metabolic abnormalities of the erythrocyte membrane leading to cell shape changes & hemolytic anemia.
- Increase in unesterified serum cholesterol owing to lecithin cholesterol acyl transferase (LCAT) deficiency in cirrhosis leads to expansion of the lipid bilayer & macrocytosis without megaloblastic changes in precursors. Substitutions of phosphatidyl choline (PC) moieties in the erythrocyte lipid bilayer lead to echinocytes (disaturated PC) or to stomatocytes (diunsaturated PC). In some patients, high density lipoprotein (HDL) abnormalities lead to erythrocyte surface changes causing rapid formation of echinocytes. (Ann Clin Lab Sci. 1990 May-Jun;20(3):169-74.Mechanisms of hemolysis in liver disease.Morse EE1. Department of Laboratory Medicine, University of Connecticut School of Medicine, Farmington 06032)
- Alters fluidity & function of cell membrane as well as intercellular transport What is platelet-derived growth factor? (p.39) - correct answer ✔✔Stimulates production of connective tissue cells & neuroglial cells What is cell communication? How does it occur? (p.20) - correct answer ✔✔• Required for homeostasis, regulate cellular growth/division & development/organization into tissues, & coordinate cellular function.
- Occurs in 3 ways: -via protein channels & gap junctions that directly coordinate activities of adjacent cells (must be touching) -via plasma membrane-based signaling molecules (receptors) that affect the cell itself & cells that come in direct contact -via chemical signals that must enter the distant cells to affect the receptors inside of the distant cell (the most common means of communication).
- Primary modes of intercellular signaling are hormonal, neurohormonal, paracrine, contact-dependent, & neurotransmitters. There is also Autocrine signaling where the cell signals itself. What is chemical signaling? (p.20) - correct answer ✔✔Involves the secretion of chemicals, such as hormones, neurohormones, paracrine, autocrine, and neurotransmitters. Chemical signaling may occur through the bloodstream or in small discrete spaces
Do all cells continue to replicate or divide? (p. 39) - correct answer ✔✔• No, all types of cells undergo mitosis during formation of the embryo, but adult cells including: nerve cells, lens cells, & muscle cells, lose the ability to replicate.
- When a need arises for new cells, as in the repair of injured cells, previously non-dividing cells must be rapidly triggered to reenter the cell cycle.
- Neurons are fixed at birth & are unable to be replaced. When normal columnar ciliated epithelial cells of the bronchial lining are replaced by stratified squamous cells, the process is called? (p. 54) - correct answer ✔✔• Metaplasia: the reversible replacement of one mature cell by another, sometimes less differentiated cell type.
- However, lose protective ability, because new cells don't secrete mucus or have cilia.
- Bronchial metaplasia can be reversed if inducing stimulus is removed, such as cigarette smoking. What is the relationship between ischemia and ATP? (p. 55-57) - correct answer ✔✔• When a hypoxic injury occurs to myocardium, which causes an abrupt lack of contraction (caused by quick decline in mitochondrial phosphorylation), causing insufficient ATP production.
- Lack of ATP leads to increase in anaerobic metabolism, which generates ATP from glycogen when there is insufficient oxygen.
- When glycogen stores are depleted, even anaerobic metabolism ceases. When does sodium enter the cell and cause swelling? (p. 57) - correct answer ✔✔• A reduction in ATP levels cause the plasma membrane's Na-K pump & Na-Ca exchange to fail.
- Causes intracellular accumulation of Na & Ca & diffusion of K out of cell.
- Na & H2O enter cell freely, leading to cellular swelling. What are free radicals in relation to cell damage? Progression of diseases? (p. 59-61) - correct answer ✔✔Membrane damage is initiated by injury induced by free radicals, primarily by excess reactive oxygen species (ROS) called oxidated stress. Free radical is an electrically uncharged atom or group of atoms having an unpaired electron; thus causing the molecule to be unstable. To stabilize the molecule, it gives up an electron or steals one. This process is capable of injuries through chemical bond formation with proteins, lipids, & carbs. Free radicals aren't easily controlled & they initiate chain reactions. These reactive species are important in regard to cell injury by lipid peroxidation, alterations of proteins causing fragmentation of polypeptide chains, & alterations of DNA (breaking single strands). Diseases & disorders have been linked directly & indirectly to these reactive species.
Know all about lead poisoning. How does it cause damage within the cell? (p. 65-67) - correct answer ✔✔• A heavy metal, primary hazard to children.
- Can cause learning disabilities, hyperactivity, & ADD
- Found in paint, soil, dust, debris from houses, baby formula mixed with lead contaminated water, newsprint, water that flows through lead pipes, hair dyes, gasoline, & tin cans or pottery made with lead based glaze.
- Nervous system, hematopoietic system, & kidneys are primarily affected
- Interferes with Ca. Can increase intracellular Ca concentrations & become a substitute & some Ca- binding proteins are capable of binding with lead. PKC (protein kinase C) mediated lead induced rise in intracellular free Ca causing cellular disruption.
- Inhibits enzymes involved in hemoglobin synthesis (ie anemia)
- Other s/s: convulsions, delirium, & peripheral nerve involvement to the wrist, fingers, & feet, glycosuria, aminoaciduria, & hyperphosphaturia, n/v, loss of appetite, wt loss, & abd cramps. Know about the affects of fetal alcohol syndrome on infants. (p. 68-69) - correct answer ✔✔• Can lead to growth retardation, cognitive impairment, facial anomalies, & ocular disturbances. How does alcohol affect the nervous system? (p.67-68) - correct answer ✔✔• Acts as a depressant affecting the subcortical structures first (brainstem reticular formation). Motor and intellectual activities then become distorted. At high levels, medullar centers become depressed, affecting respirations. Where do lipids accumulate? (p. 63, 75, 84-85) - correct answer ✔✔• During chemical injury lipids accumulate within the cytoplasm, starting within cisternae of the endoplasmic reticulum (p.63).
- Lipids primarily accumulate in the cells of the spleen, liver, CNS (p.84).
- The most common site of intracellular lipid accumulation also known as fatty change is liver cells (p.85).
- Heart, liver, & muscle in hyperlipidemia (p.75). What is hemosiderosis? (p. 86) - correct answer ✔✔• Excess iron is stored as hemosiderin in the cells of many organs & tissues. Common w/multiple blood transfusions or prolonged parenteral administration of iron or excessive alcohol
-coagulative = results from protein denaturation, where protein albumin changes from gelatinous, transparent to firm, opaque like cooked egg whites -liquefactive = digestive juices eat their own hydrolases, & tissue liquefies, gets walled off from healthy tissue, & forms cysts
- Dead cells disintegrate but debris is not digested completely by hydrolases. Tissues appear soft & granular. A granulomatous inflammatory wall encloses areas of caseous necrosis.
- Gangrene is a term usually used to refer to death of tissue & results from severe hypoxic injury usually from arteriosclerosis. Hypoxia and bacterial invasion occurs.
- Dry gangrene is d/t coagulative necrosis & the skin is dry & shrinks w/color changes (black).
- Wet gangrene occurs when neutrophils invade the site & cause liquifactive necrosis, usually in internal organs, causes site to be swollen, cold, & black. Foul odor is present produced by pus.
- Gas gangrene is caused by Clostridium that produces hydrolytic enzymes & toxins that destroy connective tissue, cellular membranes & causes gas bubbles to form in muscle cells. Can be fatal if enzymes lyse the membranes of the RBCs, resulting in shock. Infants are susceptible to significant total body water loss, why? (p. 104) - correct answer ✔✔In newborns, TBW is about 75%-85%, w/a decr to about 67% during first year. Infants are susceptible to significant changes in TBW because of their high metabolic rate & accelerated turnover of body fluids caused by greater BSA Why are obese people at greater risk for dehydration? (p. 104 see table 3-3) - correct answer ✔✔• Fat is hydrophobic. Very little water is contained in adipose cells. Individuals with more body fat have proportionately less TBW &tend to be more susceptible to fluid imbalances that cause dehydration With low plasma albumin you have edema, why? (p. 106-107) - correct answer ✔✔• Less plasma albumin = decr plasma oncotic pressure = causes fluid to move into interstitial space. Retention of sodium and water causes edema because of an increase in? (p. 106) - correct answer ✔✔Capillary hydrostatic pressure through volume overload What causes hypernatremia? (p. 111) - correct answer ✔✔• NA > 147 mEq/L.
- Caused by incr Na or decr H2O
- DI, ADH deficiency, polyuria, profuse sweating, diarrhea, dehydration, gastric feedings w/deficient H2O, hypertonic saline, hyperaldosteronism, Cushing's syndrome w/incr ACTH which causes incr aldosterone. Can insulin be used to treat hyperkalemia? (p. 119) - correct answer ✔✔• Management of hyperkalemia is r/t to treating causes & correcting K excess.
- Insulin facilitates cellular entry of K
- Calcium gluconate can restore normal neuromuscular irritability. What does hyperaldosteronism cause in relation to fluid and electrolyte balance? (p. 108-109,111) - correct answer ✔✔Hypernatremia
- What causes the neuron symptoms in hypernatremia? (p. 111) - correct answer ✔✔• Alterations in membrane potential & shrinking of brain cells. Why does a pt have decreased urine output with SIADH?( Pg 112-114) - correct answer ✔✔• The amount of ADH is inappropriate r/t Na levels.
- Not caused by excess H2O intake but by incr renal absorption of H2O r/t inappropriate incr in ADH.
- Na & osmolality are reduced by dilution. The kidney continues to excrete sodium while urine sodium and urine osmolality are elevated. During acidosis how does the body compensate for increased hydrogen ion?( Pg 123-126) - correct answer ✔✔• Protein buffering = H+ binds with hemoglobin & CO2. Hemoglobin bound hydrogen becomes a weak acid. Venous blood (less saturated hemoglobin) = better buffer than arterial (saturated with O2).
- Renal buffering = distal tubule of the kidney secretes H+ into urine & reabsorbs HCO3. •Ammonia (NH3) is lipid soluble and can cross the cell membrane. Ammonia binds with H+ to form ammonia ion (NH4) which is eliminated in the urine. The renal buffering of H+ requires the use of CO2 & H2O to form HCO3.
- Shifts in K+ •Bicarbonate Buffering-Carbonic Acid = in lung & kidneys. Carbonic acid is proportionate to PaCO What is the significance of deep, rapid breathing in metabolic acidosis? (Pg 126) - correct answer ✔✔• Lungs can decr carbonic acid by exhaling CO2 & leaving H2O.
- Deposition of iCa into bone or soft tissue - pancreatitis releases lipases into soft tissues, which then binds Ca; neoplastic bone metastases inhibit bone resorption & increase Ca deposition into bone thereby decreasing serum Ca.
- Vitamin D deficiency - can result from inadequate sunlight or malabsorption; causes decreased intestinal absorption.
- Decreases in PTH - caused by removal of parathyroid gland.
- Metabolic or respiratory alkalosis - changes in pH enhances protein binding of ionized Ca.
- Hypoalbuminemia - decreases amount of bound Ca in plasma. When someone vomits extensively, what causes the metabolic alkalosis? (p.128-129) - correct answer ✔✔• Depletion of ECF & chloride (hypochloremic metabolic alkalosis), renal compensation becomes ineffective due to volume depletion & loss of electrolytes (Na, K, H, Cl).
- Kidneys increase Na & HCO3 reabsorption & excrete H+. HCO3 is reabsorbed to maintain anionic balance since the Cl in the ECF is decreased. H+ moves to the intracellular space when K is depleted & is excreted to maintain electrochemical balance. The urine is more acidic and the reabsorbed bicarbonate prevents correction of alkalosis. What causes edema during inflammation? (p.107, 195) - correct answer ✔✔• Increases in capillary permeability = proteins escape from plasma & produce edema through loss of capillary oncotic pressure & a gain in interstitial fluid proteins.
- Vasodilation
- Incr WBC accumulation What is the purpose of inflammation?(p.191, 195-196) - correct answer ✔✔• Second line of defense; occurs in response to tissue injury or infection; protects against further injury, prevents infection of injured tissue, & promotes healing
- Incr local blood flow; incr RBC's & leukocytes, & biochemical mediators
- kill, contain, dilute bacteria
- promote clotting & prevent extensive inflammation What causes the erythema and induration during inflammation? (p. 195) - correct answer ✔✔• Vasodilation - incr blood flow & RBCs at site = warmth & redness.
- Increased vascular permeability & leakage of fluid out of the vessels - biochemical mediators stimulate the endothelial cells lining the capillaries & venules to contract, creating spaces between cells which allows leukocytes & plasma to enter surrounding tissue.
- White blood cell adherence to inner walls of vessels and migration to site of injury. After prolonged antibiotic therapy, what bacterium grows in the intestine? (p.194,1500) - correct answer ✔✔Clostridium difficile When histamine is released from mast cells, what is the vascular effect? (p.199,206) - correct answer ✔✔• Constriction of large vessel walls & dilation of post capillary venules - results in increased blood flow into the microcirculation. (p.206)
- Increased capillary permeability and vasodilation(p.199) Which leukocyte elevates when there is an early, acute inflammatory reaction? (p.208) - correct answer ✔✔Neutrophils What produces fever? (p.213) - correct answer ✔✔• Fever causing cytokines = endogenous pyrogens; released by inflammatory cells after phagocytosis, exposure to bacterial endotoxin, or after exposure to antigen-antibody complexes.
- Exogenous pyrogens are pathogen-produced.
- Pyrogens act directly on the hypothalamus, which is the portion of the brain that directly controls temperature regulation What is the process of repair after tissue damage? (p.215-218) - correct answer ✔✔• Healing begins during acute inflammation. Resolution = return of tissue to its original structure & function. Repair = replacement of destroyed tissue w/scar tissue.
- Repair begins w/phagocytosis of the particulate matter found at the site. Cleanup = debridement & involves dissolution of fibrin clots (scabs) by fibrinolytic enzymes. After debridement, the remaining debris is drained away & the vascular dilation & permeability associated w/inflammation are reversed to prepare for repair.
- Healing involves processes that: Fill in, Seal, & Shrink the wound. Primary intention are wounds that heal under conditions of minimal tissue loss, very little sealing (epithelialization) or shrinkage (contraction) is needed due to close apposition of the wound edges. Secondary intention is the healing of open wounds and requires a great deal more tissue replacement (fill in). Epithelialization, scar formation, and contraction take longer.
invades surrounding tissue, commonly recurs after surgical removal, familial tendency common, more common in blacks than whites, do not regress over time. Why do some neonates have a transient depressed inflammatory response? (p.220) - correct answer ✔✔• Lack of phagocyte plasma membrane fluidity impairs pseudopod formation & migration resulting in neutrophils (& perhaps monocytes) being incapable of efficient chemoyaxis
- Neonates stressed by in utero infection or respiratory insufficiency - neutrophils have diminished oxidative & bacterial responses
- Partially deficient in complement (esp. components of the alternative pathway)
- Relative deficiency of factor B
- Low levels of mannose-binding lectin
- May be deficient in some of the collectins & collectin-like proteins Adults? (p. 220) impaired inflammation & wound healing in older adults - correct answer ✔✔Can be linked to chronic illness (cardiovascular disease, diabetes mellitus); Medications (anti-inflammatory steroids interfere with healing process); Impaired sensation &/or mobility; Physiologic skin changes; Decreased subcutaneous fat (protective layer); Thicker collagen fibers; loss of elastin; Age-associated changes in epidermis (atrophy of underlying capillaries); Decreased perfusion - increased susceptibility to adverse effects of hypoxia in the wound bed; Slow proliferation of aging fibroblasts; Decreased number (alveolar macrophages) or activity (neutrophil chemotaxis, degranulation, & phagocytosis) of cellular components of innate resistance; Decreased inflammatory activity may be caused by decrease in expression & function of toll-like receptors After the initial infection with herpes, why is the virus inaccessible to antibodies? (p. 319) - correct answer ✔✔• Symbiotic relationship between cell & virus results in persistent unapparent infection (latency)
- Envelope - viral capsid completely surrounded by cellular plasma membrane highly similar to that of an uninfected cell Which type of immunity is produced after natural exposure to an antigen? (p. 227) - correct answer ✔✔• Active acquired immunity- type of immunity produced by an individual after natural exposure to an antigen (also occurs after immunization) Where are antibodies produced? (p.229) Which one is detected to indicate a typical primary immune response?(229-230) - correct answer ✔✔• Antibodies - produced by plasma cells (p. 229)
- IgM first antibody produced during initial (primary) response to an antigen (p.229-230) What is hypersensitivity? (p.262) - correct answer ✔✔• "a state in which the body undergoes an exaggerated immune response to an antigen". (p.1764); an altered immunologic response to an antigen that results in disease or damage to the host (p.256) During an IgE hypersensitivity reaction, which leukocyte is activated? (p. 263) - correct answer ✔✔• mast cells What reverses the effects of histamine during an anaphylactic reaction? (p. 272) - correct answer ✔✔• ANS mediators (epinephrine, acetylcholine) bind to specific smooth muscle receptors to reverse histamine's effects & cause muscle relaxation. Graves Disease (p.277, 726-728) - correct answer ✔✔• An autoimmune disease resulting in stimulation of the thyroid gland thus causing hyperthyroidism
- Generally consists of: Hyperthyroidism; Diffuse thyroid enlargement (goiter) due to increased iodide uptake and rate of metabolism; Ophthalmopathy (protrusion of the globe) double vision, irritation, pain, lacrimation, photophobia, & blurred vision; Dermopathy (shown as pretibial myexedema: subcutaneous swelling on anterior legs with indurated and erythema of skin)
- Genetic factors: major histocompatibility complex (MHC) genes associated with graves disease
- Pathology: Normal regularity mechanisms are overridden by abnormal immunologic mechanisms; T lymphocytes sensitized to antigens and B cells stimulated to produce IgG antibodies which bind to TSH receptors increasing release of TH; Autoantibodies known as thyroid-stimulating immunoglobulin's (TSI) or thyroid receptor antibodies (TRAb)
- Therapy: Anti-thyroid drugs (proiouracil and methimaxole), radioactive iodine, surgery Myasthenia Gravis: (p.277, 624-626) - correct answer ✔✔• Chronic autoimmune disease mediated by acetylcholine receptor (AChR) antibodies that act at the neuromuscular junction with unknown etiology (although some persons may have genetic susceptibility)
- Characterized by exertional fatigue, weakness that worsens with activity, improves with rest, and reoccurs with activity
- Increases risk for other diseases such as SLE, RA, polymyositis, and thyroitoxicosis
- Subtypes of MG: o AChR: Involves proximal musculature throughout body and has several courses including...
What is the positive reaction to a Tb skin test? (p. 270) - correct answer ✔✔A positive reaction is considered a type IV cell mediated hypersensitivity reaction
- Reaction follows injection of Tb antigen in a sensitized individual
- Considered a delayed hypersensitivity skin test d/t slow onset (24 to 72 hours)
- Reaction site infiltrated with T lymphocytes and macrophages resulted in clear hardened center (induration) and a reddened surrounding area Understand the characteristics of HIV. (p. 322-329) - correct answer ✔✔• AIDS is a viral disease caused by HIV
- HIV infects & depletes a portion of the immune system (specifically Th cells) which makes individuals extremely susceptible to life threatening infection and malignancies
- Major cause of worldwide morbidity & mortality
- It is a blood borne pathogen present in blood, vaginal fluid, semen, breast milk
- There is a striking decrease in the number of CD4+ Th cells in individuals infected with HIV What is the role of reverse transcriptase? (p. 324) - correct answer ✔✔• A viral enzyme that retroviruses, such as HIV, use to convert RNA into double-stranded DNA What are the primary target cells for HIV? (p. 325) - correct answer ✔✔• Cd4-positive Th cells
- Dendritic cells (depending on the level of chemokine receptors the cell expresses)
- Macrophages (express low levels of CD4 but high amounts of heparin sulfate proteoglycans and other molecules that bind to gp120 and absorb HIV)
- CD8-positive Tc cells (low rate of infection but CD4 can be expressed by activated CD8-positive Tc cells)
- NK cells
- Neural cells of monocyte origin (macrophages and microglial cells) What acts as a reservoir in which HIV can be relatively protected from antiviral drugs?(p.327) - correct answer ✔✔• Cells in the CNS Which cells are decreased with AIDS? (p.327) - correct answer ✔✔• CD4+Th cells; normal is 600-
How long does it take for HIV antibodies to appear after infection thru blood products?(p.326) - correct answer ✔✔• Within 4-7 weeks After sexual transmission, a person can be infected but sero-negative for how long?(p.326) - correct answer ✔✔6-14 months What is colonization?(p.300) - correct answer ✔✔Infectious organisms that exist in reservoirs, either in an environmental setting or colonization can occur in people: microorganisms are deposited in a receptive environment,. Organisms that colonize are usually contained in specific areas where infections occur, i.e. respiratory, GU. How are vaccines against viruses made? (p.332) - correct answer ✔✔Development of a vaccine includes: characterizing the desired protective response, identifying the appropriate antigen to induce that response, determining the most effective route of administration, optimizing the number and timing of vaccine doses, and deciding the most effective and safe form to administer the vaccine. Most vaccines against viruses contain live viruses that are weakened to continue expressing the appropriate antigens but are unable to establish more than a limited and easily controlled infection. What is the general adaptation syndrome?(p.339) - correct answer ✔✔A nonspecific response to noxious stimuli. Includes 3 stages: alarm stage (begins when stressor triggers the actions of hypothalamus/pituitary gland/adrenal gland)-CNS is aroused & the body's defenses are mobilized; stage of resistance or adaptation (begins with the actions of the adrenal hormones cortisol/norepi/epi); & stage of exhaustion (occurs if the stress continues & adaptation not successful) How is the limbic system stimulated when there is an anticipatory response to stress? (pg 339, 341- anticipatory learning of stressor, 343) - correct answer ✔✔• The limbic system indirectly elicits an endocrine stress response by stimulating neural pathways responsible for receiving sensory info and central response by directly stimulating the locus ceruleus to release norepinephrine. Which hormone causes anxiety and arousal during a stress response? Pg 339, 343 - correct answer ✔✔norepinephrine During the response to stress what decreases lymphocytes, eosinophils, macrophages, and prostaglandin? See page 348 (Ch. 11) - correct answer ✔✔Cortisol (glucocorticoid). Released by the adrenal cortex which is activated by ACTH. Therapeutic levels of glucocorticoids inhibit the accumulation of leukocytes at site of inflammation, inhibit the release of kinins, plasminogen-activating factor,
- *Essentially the adrenal cortex releases cortisol and cortisol stimulates the production of glucose and blocks the peripheral use of glucose. Therefore, causing hyperglycemia. During stress, ACTH activates the adrenal cortex to release cortisol (glucocorticoid). Cortisol mobilizes substances needed for cellular metabolism. One effect is the stimulation of glycogenesis (formation of glucose from noncarbohydrate sources such as amino acids or free fatty acids from the liver). Cortisol enhances the elevation of blood glucose levels promoted by other hormones (epinephrine, glucagon, and growth hormone). Cortisol also inhibits the uptake and oxidation of glucose by many body cells. The overall action increases blood glucose concentration for the body to be able to fight the stressor. When you have increased epinephrine, glucagon, and growth hormone secretion, what happens? Page 345 (Ch. 11) - correct answer ✔✔• Increased epinephrine, cortisol, and GH all lead to increased lipolysis and gluconeogenesis.
- *End result is usually hyperglycemia as the body breaks down fat and uses it in the production of glucose. Epinephrine has inotropic (enhances myocardial contractility) and chronotropic (increases heart rate) effect and increases venous return to the heart thereby increasing cardiac output and blood pressure. Promotes gluconeogenesis and glycogenolysis thereby elevating glucose levels. Dilates blood vessels for greater oxygenation. Part of development of flight or fight response. Growth hormone affects protein, lipid, and carbohydrate metabolism and counters the effects of insulin. Involved in tissue repair and may participate in growth and function of immune system. Which hormone helps to explain the mood cycles, anxiety, and eating disorders in women? See page 350 (Ch. 11). - correct answer ✔✔Estrogen directly stimulates the CRH gene promoter and the central noradrenergic (norepinephrine) system. Estradiol downregulates glucocorticoid receptor binding in the anterior pituitary, hypothalamus, and hippocampus—this tends to increase the HPA activity by interfering with glucocorticoid-negative feedback, thus alterations in estradiol levels during normal menses, perimenopause, and menopause alter the regulatory feedback loop, and adaptations over time. These changes increase the incidence of mood alterations, eating disorders, anxiety, depression, weight alterations, and inflammatory and immune disorders. Does estrogen affect lymphocytes? (p. 353) - correct answer ✔✔• Yes, estrogen can affect cells of the immune system and may play a role in modulating lymphocyte development and function. Estrogens are associated with a depression of T-cell dependent immune function and enhancement of B-cell functions.
Do androgens affect lymphocytes? (p.353) - correct answer ✔✔• Androgens suppress both T and B-cell responses, and appear to induce a greater degree of cell apoptosis following injury-this may elicit a greater immunosuppression in males rather than females who are injured. p. 353 Hydrostatic pressure, osmotic pressure-understand both. See page 29 and 30 (Ch. 1) - correct answer ✔✔Hydrostatic pressure is the mechanical force of water pushing against cellular membranes (ie blood pressure). Blood reaching the capillaries has a hydrostatic pressure of 25 to 30mmHg which is enough to push water across the membranes into the interstitial space. Hydrostatic pressure is partially balanced by osmotic pressure, whereby water moving out of the capillaries is partially balanced by osmotic forces that then to pull water into the capillaries. Osmotic pressure is the amount of hydrostatic pressure required to oppose the osmotic movement of water. Factors that determine osmotic pressure are the type and thickness of the plasma membranes, the size of the molecules, the concentration of molecules, or the concentration gradient, and the solubility of molecules within the hydrostatic the membrane. Nutritional deficiencies and the immune system. See page 290 (Ch. 9) - correct answer ✔✔Malnutrition is the predominant cause of secondary immune deficiencies worldwide. Severe deficits in calorie and protein lead to deficiencies in T-cell function and numbers. The humoral immune response is less effected, but complement activity, neutrophil chemotaxis, and bacterial killing with neutrophils often are depressed, resulting in infections with microscopic organisms normally destroyed by opsonization and phagocytosis. Deficient zinc intake can depress both T- and B- cell function. Deficiency in vitamins such as pyridoxine, pantothenic acid, folic acid, vitamins A, C, E, and B12 may also show depression in B- and T- cell function, phagocytosis, and complement activity. Know the stress-age syndrome. See page 358 (Ch. 11) - correct answer ✔✔A set of neurohormonal and immune alterations alone with tissue and cellular changes which have been defined as stress-age syndrome and can influence the course and developing stress reactions and lower adaptive reserve and coping.
- Alterations in the excitability of sturcutres of the limbic system and hypothalamus 2.Increase of blood concentrations of catecholamines, antidiuretic hormone (ADH), ACTH, and cortisol
- Decrease in the concentrations of testosterone, thyroxine, and others
- Alterations in opioid peptide concentration
- Immunodepression and pattern of chronic inflammation
- Alterations in lipoproteins
- Hypercoagulation of blood
- Free radical damage of cells
