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Quiz 3 Study Topics
Digestive System Anorexia: lack of desire to eat despite physiological stimuli that would normally produce hunger. For example: illness. Causes of diarrhea: Presence of loose watery stool - can be either acute or persistent *Large volume diarrhea- caused by excessive amounts of water or secretions or both in the intestine Small volume diarrhea- volume of feces is not increased, usually results from excessive intestinal mobility *(Illness like H.Pylori) (osmotioc, from drinking too many fluids and it flushes you out) Major Mechanism: Osmotic Secretory Motility Systemic effects: Dehydration Electrolyte imbalance Weight loss Can be associated with malabsorption syndrome; can be treated with fluid restoration, antimotility Or with water-absorbent medications, treatment of causal factor **Effects of vomiting โ Hypersalivation, tachycardia, dehydration, hypokalemia/electrolyte imbalance โ (flexion of the core, reverse peristalsis, straining muscles of the esophagus) โ Erosions due to acidic content coming back up, effects teeth, and lining) โ At risk for losing weight, electrolyte/mineral/nutrition disturbance Causes of constipation: Defined as infrequent or difficult defection Lack of fiber, medications, fluids, bowel obstructions โ Primary condition โ Normal transit (function) โ Slow transit โ Pelvic floor or outlet dysfunction โ Secondary condition- caused by many different factors, such as: โ diet medications, various disorders, aging
โ Manifestations of constipation : โ Straining with defecation โ Hard stool โ Sensation of incomplete emptying โ Manual maneuvers to facilitate stool evacuation โ Fewer than three bowel movement per week โ Treatment would be to manage underlying disease Differentiate upper vs lower GI bleed โ Upper GI bleeding: caused in the mouth, esophagus, stomach or duodenum (bright red blood) โ Lower GI bleeding: jejunum, ileum, colon, or rectum( darker color cuz GI digested the blood, dark stool ) โ Causes: occult bleeding, physiologic response depend on rate and amount of blood loss Dysphagia - mouth and esophagus โ Difficulty swallowing โ Causes: can be either mechanical obstruction or functional disorder โ Achalasia: related to loss of inhibitory neurons in the myenteric plexus with smooth muscle atrophy in โ the middle and lower portions of the esophagus โ Manifestations: Stabbing pain at the level of obstruction, discomfort after swallowing, regurgitation of โ Undigested food, unpleasant taste sensation, vomiting, aspiration, weight loss โ Symptoms can be managed by eating small meals slowly, taking fluid with meals and sleeping with โ The head elevated to prevent regurgitation and aspiration Hiatal hernias : may feel chest discomfort, difficulty breathing, acid reflux like burning. *Diaphragmatic hernia with protrusion of the upper part of the stomach through the diaphragm and into the thorax Conservative treatment is used for management. Conservative treatment is without the use of surgeries or any invasive treatment. Last resort TX is surgery. Primary, core exercises, refraining of straining. GERD : reflux of acid and pepsin from the stomach to the esophagus that causes esophagitis Resting tone of the LES tends to be lower than normal Conditions that increase abdominal pressure or delay gastric emptying can contribute to the development of reflux esophagitis **(TX : reduce acid H2 blockers, PPI, Calcium antacids, carafate or sucrofate to protecting coating. TX with antibiotics if test comes back positive) Manifestations: heartburn, acid regurgitation, dysphagia, chronic cough, asthma attacks, laryngitis, upper abdominal pain within 1 hour of eating GERD treatment: proton pump inhibitors are the agent of choice for controlling symptoms and healing Esophagitis Gastric vs duodenal ulcers- acidic erosions
Symptoms associated with liver dysfunction โ Yellow skin (Jaundice) and eyes (icteric sclera) โ Dark urine color โ Pale stool color โ Elevated ammonia levels (loss/altered consciousness) Cancer The process of the cell cycle (my drawing in class) INVOLVES: -Proto Oncogene (starts off cell cycle) (best form of itself) -Tumor suppressor gene (could initiate apoptosis if unable to repair itself) (stops cell cycle to check for mutations and repairs, prevents angiogenesis if needed) -*Care taker gene (initiates repairs if needed) *These are part of the normal cell cycle Roles of tumor suppressor cells (P53) โ Make proteins that regulate the growth of cells, and they play an important role in preventing the development of cancer cells. Stops cell cycle Checks for mutations, and needed repairs. Could initiate apoptosis if the cell cant be repaired. Prevents angiogenesis. Genes that work to suppress the mutations of cancer cells. Telomere caps and cell replication/division โ Telomere caps: Repetitive regions at the very ends of chromosomes; caps that protect the internal regions of chromosomes. *Provide shelf life for cell division. Erase after every cell division until the Cell is done for and undergoes apoptosis. *Cancer hijacks telomere caps so they never erase, therefore causing infinite cell division/mutation)
Self Defense/Immunity Characteristics of First, second, third lines of immunity 1st/2nd line of defense is innate immunity, 3rd is apaptive
- **First: (part of innate immunity/non-specific) (natural barriers) * If a knife wound penetrate the skin it penetrates this level) โ Natural/Physical barriers such as: Skin and mucous membranes โ Biochemical barriers: Mucus, sweat, saliva, ear wax โ Normal Flora: โ Non-pathogenic microorganisms on skin, GIT, urethra and vagina โ Opportunistic microorganisms: e.g. pseudomonas aeruginosa
- **Second: The inflammatory response (innate/non-specific) (Vasodilation, increased vascular permeability WBCโs) โ Induced by septic cell/tissue injury/damage โ Part of innate immunity/non-specific โ Quick response, within seconds of injury โ First response to injury โ Occurs in vascularized tissue โ Depends on both cellular and chemical components โ Prevents infection and further damage โ Prepares area of damage for healing โ Protein component (complement) โ Cellular component (Macro Kills Granny Den) โ Macrophages: big eaters Natural Killer Cells (In circulation, called monocytes. In tissue called macrophage) โ Granulocytes: โ Mast cells: release Histamine โ Phils: (Neutrophils, Eosinophils [parasites], and Basophils[heparin/histamine]) โ good short term line of defense โ Dendritic cells: (head hunters) take a dead piece of microorganism and present it. Connect innate and adaptive immunity *Neutrophils, the first to act in killing bacteria. Then the phagocytes take over and engulf bacteria. Five Manifestations of Inflammation:
Innate (1st and 2nd) vs adaptive immunity(3rd ) โ Innate immunity means it responds to all pathogens the same way without identifying them, while adaptive is specific and has to recognize the specific invader first before attacking it. (it gets to know the invader and finds out how to tear it down). Innate is Fast to react. Characteristics of hypersensitivity โ **An altered immunological response to an antigen that results in disease or damage to the individual ****An excessive/inappropriate response to a sensitizing antigen (overreaction) (DRAMA QUEEN) โ Allergy: refers to a hypersensitivity to environmental antigens โ medicines, natural products [pollens, bee stings], infectious agents) โ Autoimmunity: is a disturbance in the immunologic tolerance of self-antigens โ autoimmune diseases e.g. SLE). We think our body is foreign and attack ourselves. โ Alloimmunity (isoimmunity): reaction against tissues (antigens) of another individual โ blood transfusions, transplanted tissue, fetus during pregnancy Ex: Rejection of a transplant We got this
