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Patho NR283-Exam 1 Study Guide quiz
Chapter 1
Atrophy:
▪ Decrease in the size of cells ▪ Results in reduced tissue mass ▪ Common causes: reduced use of the tissue (in cast), insufficient nutrition, decrease neurologic or hormonal stimulation, aging
Hypertrophy:
▪ Increase in cell size ▪ Results in enlarged tissue mass; ex) enlarged heart w/ heart failure ▪ Causes: additional work by the tissue( lifting weights), excessive hormonal stimulation
Hyperplasia:
▪ Increased number of cells ▪ Results in enlarged tissue mass ex) uterus in pregnancy ▪ Causes: compensatory mechanism to meet increased demand, or pathologic when there is a hormonal imbalance
Metaplasia:
▪ Mature cell type is replaced by a different mature cell type ▪ Adaptive mechanism that provided more resistance tissue
Dysplasia:
▪ Cells vary in size and shape within a tissue ▪ Chronic irritation infection, or it may be a precancerous change
Anaplasia:
▪ Undifferentiated cells with variable nuclear and cell structures ▪ Characteristic of cancer
Neoplasia:
▪ New growth ▪ Commonly called tumor
Causes of cell death:
- Ischemia: Most common cause of cell death; Decreased supply of oxygenated blood to a tissue or organ due to circulation obstruction
- Hypoxia : Reduced oxygen in tissues/blood; Result insufficient oxygen and reduced cellular metabolism
- Physical damage: extreme heat/ cold
- Mechanical damage: pressure, tumor, obstruction
- Chemical toxins: exogenous-pollution endogenous-free radicals
- Microorganisms/pathogens -bacteria/viruses
Stages
- Initial: start; loss of function; reversible
- Infections
- Chemicals/toxins
- Biological factors
- Age
- Diet
- Hormones (^ estrogen levels= breast cancer)
cachexia
- Unusual bleeding or discharge anywhere in the body
- Change in bowel or bladder habits
- Change in wart or mole
- A sore that does not heal
- Unexplained weight loss
- Anemia, low hemoglobin and persistent fatigue
- Persistent cough or hoarseness without reason
- A solid lump; in the breast/testes, or anywhere in the body
Local Effects of Tumors:
▪ Pain: o May be absent until very late stages o Occurs when tumor is well advanced o Severity depends on the type of tumor ▪ Obstruction: o Occurs when tumor compresses a duct or passageway o Blood supply or lymphatic flow may be restricted o Digestive tract o Airflow in bronchi ▪ Tissue Necrosis/Ulceration: o May lead to bleeding or infection around the tumor (ischemia necrosis)
Systemic Effects of Malignant Tumors:
▪ Weight loss and (weakness and wasting): o Anorexia, fatigue, pain, stress o Increased demands on the body from tumor cells ▪ Anemia: o Caused by blood loss at tumor site o Nutritional deficits may reduce hemoglobin synthesis ▪ Severe fatigue: o Caused by inflammatory changes, cachexia and anemia o Stress of treatment schedule o Psychological factors ▪ Infections: o Often occur as resistance declines ▪ Bleeding: o Tumor cells may erode the blood vessels/platelets ▪ Paraneoplastic syndrome: o Associated with certain tumor types o Tumor cells release substances that affect neurological function and may have hormonal effects
Spread:
- Invasion:
- Local spread
- Tumor cells grow into adjacent tissues
- Example: uterine carcinoma invades the vagina
2. Metastasis:
Warning Signs of Cancer:
- Example: carcinoma of the colon spreads to the liver
Staging:
▪ Describes the extent of the disease ▪ Used to estimate prognosis ▪ TMN system o Size of primary tumor (T) o Involvement of regional lymph nodes (N) o Spread of tumor (M)-metasistes ▪ Stage 1: small, localized, good prognosis ▪ Stage IV: well advanced, difficult to treat, spread, poor prognosis
Diagnostic tests:
- Blood test
- Tumor markers
- Imaging
- Cytologic tests (for screening high risk individuals); Confirms cancer via biopsy
Treatment
- Chemo
- Radiation
- Gene therapy
- Stem cell transplant
- Drugs
Chapter 2
Filtration
▪ Movement into interstitial (filtering goods from blood into the space for the cell)
Osmosis
▪ Movement into intervascular
Fluid Volume Excess
Causes
- Kidney failure
- Liver failure
- Heart failure
- Increased sodium intake
- IV fluids
- Blood transfusions
Manifestations
- Dyspnea
- Decreased lab values (everything is diluted)
- Increased urine output
- High BP
- JVD
- Edema
▪ Lymphatic obstruction
- Lack of albumin causes abdominal swelling ▪ Decreased plasma osmotic pressure
- Swelling of ankles associated with heart problems ▪ Increased hydrostatic pressure
Dehydration:
▪ Insufficient body fluid resulting from inadequate intake or excessive loss
Hyponatremia <135 Hypernatremia >
Causes Causes
- Sodium deficient 1. Loss of water
- Excess water 2. Excessive intake of sodium
Risk factors
- Excessive sweating
- Vomiting, diarrhea
- Excessive water intake
Risk factors
- Excessive sweating
- Vomiting, diarrhea
- Decreased water intake Manifestations Manifestations
- Muscle cramp, weakness, fatigue 1. Signs of fluid deficit
- Abdominal cramps 2. Thirst
- Lethargy, confusion, seizures 3. Headache, agitation
Causes of Dehydration:
▪ Vomiting and diarrhea ▪ Excessive sweating with loss of sodium and water ▪ Insufficient water intake in older adults or unconscious persons
Effects of Dehydration:
▪ Dry mucous membranes in the mouth ▪ Decreased skin turgor or elasticity ▪ Lower blood pressure ▪ Tachycardia ▪ Decreased mental function or confusion
➔ Review of Sodium
◆ Normal lab value: 135-145mEq/L ◆ The main electrolyte in the extracellular fluid (ECF) ◆ Primarily controlled by the kidneys via Aldosterone ◆ Sodium Linked with Neuro (Cerebral edema) ◆ Essential for ● Nerve impulses ● Muscle contraction ● Osmotic pressure ◆ Sources of sodium- food and beverage ◆ Excreted through sweat, urine, and feces
Sodium Imbalance
➔ Review of Potassium
◆ Essential for ● Nerve impulses ● Muscle contractions ◆ Sources of potassium: food and beverage ◆ Excreted through urine and feces
Potassium Imbalance
Hypokalemia <3.5 Hyperkalemia >5.
Causes
- Diuretics
- Inadequate K+ intake
- Excessive diarrhea
Manifestations
- Muscle fatigue/cramps
- nausea/vomiting/
- Constipation
- Cardiac dysrhythmias
Causes
- Renal failure
- K+ sparing diuretics
- Burns/crush injuries
Manifestations
- Muscle weakness( paralysis)
- Paresthesias
- Cardiac dysrhythmias ( cardiac arrest)
➔ Review of Calcium
◆ Normal lab values: 8.5-10.5mEq/L ◆ Linked with bones and muscle ◆ Stored in bones and remaining in extracellular fluid ◆ Controlled by the parathyroid hormone (PTH) and Calcitonin ◆ Vitamin D promotes the movement of Ca+ from bone and intestines to the blood ◆ Essentials for ● Muscle contractions ● Strength of teeth and bones ● Stability of nerve membranes ◆ Sources of calcium include milk and milk products ◆ Excreted through urine and feces
Calcium Imbalances
Hypocalcemia <8.5 Hypercalcemia >10.
Causes
- Hypoparathyroidism
- Malabsorption
- Vitamin D deficiency
Causes
- Hyperparathyroidism
- Bone cancer
- Immobility
- Hyperreflexia (can’t relax so its tense)
- Insomnia
- Respiratory depression
Acid-Base:
▪ Normal pH range 7.35-7. ▪ Co2: 35- ▪ HCO3: 22-
▪ Acidosis o Excess hydrogen ions/CO2/water, decrease in pH ▪ Alkalosis o Deficit of hydrogen ions, increase in pH ▪ Respiratory system can alter carbonic acid levels to change pH ▪ Kidneys can modify the excretion rate of acids and absorption of bicarbonate to regulate pH o Most significant control mechanism o Slowest mechanism
Respiratory Acid osis Respiratory Alkal osis
Causes
Risk
Manifestation (^ CO2 creates vasodilation- brain
depression)
Causes
Risk
- Panic attacks
- Fever
- Brain injuries
- Mechanical ventilation
Manifestations (Vasoconstriction- brain is flustered/overactive)
- Agitated
- Irritable
- Light-headed
- Tetany
- Paresthesis
- Seizures
- Strenuous exercise (lactic acid)
- Sepsis Decrease in HCO3:
- Diarrhea
Manifestations
- Headache
- Confusion
- Lethargy
- Coma
- Kussmaul’s respirations
- Nausea/vomiting/abdominal pain
- Cardiac dysrhythmias
Gain in HCO
- Excess intake of antacids Manifestations
- Agitation
- Irritable
- Light-headedness
- Tetany
- Paresthesias
- Seizures
Chapter 5
First Line of Defense: ▪ Nonspecific ▪ Mechanical barrier o Unbroken skin and mucous membranes o Secretions such as tears and gastric juices
Second Line of Defense:
▪ Nonspecific ▪ Phagocytosis ▪ Inflammation
Third Line of Defense:
▪ Specific disease
▪ Production of specific antibodies and cell-mediated immunity
Inflammation:
▪ A normal protective mechanism (second line of defense) ▪ Localizes and removes injurious agents ▪ Disorders ending in – itis ▪ Not always a sign of infection o Infection is one cause of inflammation ▪ Signs and symptoms serve as warning sign o Problem may be hidden within the body
Causes of Inflammation:
- Direct physical damage
- Caustic chemicals
