Pathophysiology

通報

問題一覧

Oxygen is restored to cells creating a ROS leading to cell membrane damage.

Reperfusion Injury

How do you know hypoxia is occurring?

Lactate, Troponin, Transaminases

Ischemia causes increase in extra cellular calcium. Na Ca pump fails. Water and Ca moves into the cell and swells and damages nucleic acids, proteins, cell membrane. Ca activates enzymes lead to cell death.

Calcium Influx Injury

Mitochondria can’t make ATP. Electrolyte pump fails and cell swells. ER can’t work to make proteins. Looses membrane potential and structure fails.

Mitochondrial Injury

Activated as part of stress response leading to lysozymes breaking down Cellular components in order to salvage primarily ATP.

Autophagy

Not a true cellular adaptation. Disordered cell growth with a changes in cell size, shape, and organization associated with chronic irritation, inflammation, pre-cancerous and cancerous growths.

Dysplasia

Cellular adaptation that may be reversible in which one cell type is replaced by another.

Metaplasia

Pseudostratified columnar epithelium replaced with squamous epithelium.

Metaplasia

Squamous epithelium replaced with Columnar epithelium (Barrett’s Esophagus).

Metaplasia

Achondroplasia

Dysplasia

Cervical Cancer

Dysplasia

Cellular adaption by increasing number of cells leads to increased tissue and organ size.

Hyperplasia

Endometrium during menses

Hyperplasia

Bone marrow in anemia

Hyperplasia

Benign prostatic hypertrophy

Hyperplasia

Cellular adaptation increasing cell size leading to increased protein synthesis and tissue and organ size.

Hypertrophy

Weightlifting and Pregnancy

Hypertrophy

Cardiac muscle response to hypertension

Hypertrophy

Cellular adaption decreasing cell size and metabolic demand leads to increased cellular efficiency.

Atrophy

Thymus in infant

Atrophy

Tonsils in adolescents

Atrophy

Skin and brain in aging

Atrophy

Disuse of muscle (leg in cast)

Atrophy

Denervation

Atrophy

hydroxyl radicals, superoxide, hydrogen peroxide, nitric oxide

reactive oxygen species

must give up or gain electron binding to lipids (cell membrane)

free radical

causes inflammation implicated in many diseases (CV disease, DMII, aging, cancer, autoimmune) as a result of damage to cell membrane, DNA, and mitochondria.

reactive oxygen species

Can damage cell membrane directly or creating ROS that does the damage, leads to calcium influx injury.

Chemical agents

Drugs, metals, ethanol, carbon monoxide

Chemical agents

Tylenol, Vancomycin, Cephalosporins, Quinolones.

Therapeutic Medications

Arsenic and Cyanide

Non-Therapeutic Medications

Occurs naturally, treats leukemia, replaces phosphate in ATP to damage mitochondria

Arsenic

Slow accumulation over time deadly

Arsenic

Blocks intercellular use of oxygen

Cyanide

Single exposure deadly

Cyanide

Disrupts calcium homeostasis and substitutes for other substances (iron, Vit D, Mag, Zinc) in metabolism

Lead

Found in paint dust soil, builds up over time causing neurological, musculoskeletal, endocrine, reproductive, and dental problems.

Lead

Metabolized to Acetaldehyde

Ethanol

Replaces nutrients causing deficiencies in magnesium, Vit B6, phosphorus, folic acid and alters protein synthesis.

Ethanol

Hepatotoxicity and Cirrhosis caused by.

Acetaldehyde

Wernicke Encephalopathy and Peripheral Neuropathy

Ethanol

colorless, odorless, created from burning wood, gas, propane, charcoal.

Carbon Monoxide

Has a stronger affinity for hemoglobin than oxygen causing ischemia and cell injury

Carbon Monoxide

Slows metabolism and ATPase pump for therapeutic effect

Hypothermia

Non-Therapeutic Hypothermia

Generates ROS

Dose related effects with a “safe” threshold

Deterministic

Effect is not dose related, there is no “safe” threshold

Stochastic

Physiologic programmed cell death requiring ATP with no negative effects

Apoptosis

Pathophysiologic cell destruction, breaking down cell membrane leak into extracellular space resulting in inflammation.

Necrosis

Cell destruction for survival activated in stress response leading to lysosomes to catabolize cellular components.

Autophagy

Cell recycling to salvage cellular components, primarily ATP. Implicated in cancer and dementia.

Autophagy

Thymus, Lymph Nodes, and Mucosal associated with Lymph Tissue

Lymphatic System

Nonspecific Response

Innate Immunity

Specific Response

Adaptive Immunity

Non-specific response to foreign substance in phases, no memory

Inflammation

First line of defense with layers of protection (skin, low PH stomach urine, ciliary action).

Innate Immunity Barriers

Second line of defense. Respond immediately that includes stages of protection (vascular, plasma protein, and cell mediator responses).

Innate Immunity: Inflammatory Response

Vasodilation increases vascular permeability cause WBC to migrate causes redness, swelling, heat, and pain.

Vascular Response

Complement, Clotting,and Kinin Cascades.

Stages of Plasma Protein Response

Found in connective tissue close to blood vessels and lungs and GI tract.

Mast Cells

Release Histamine I and Histamine S. Chemotaxic factors - neutrophils and eosinophils.

Mast Cells

Synthesize leukotrines, prostaglandins, platelet-activating factors.

Mast Cells

Proteins that produce factors that destroy pathogens activating innate and adaptive responses.

Complements

Antigen-Ab complex, complements activated, mast cell degranulation, histamine release, leukocyte chemotaxis, opsonization, cell lysis.

Complememt Cascade

Prevents spread, traps antigen, stops bleeding, creates fibrin mesh

Purpose of a clot

Short acting, rapidly degrade, primary protein is bradykinin

Kinin Cascade

Local effects: vasodilation (common), vascular permeability, smooth muscle contraction, nerve cell stimulation, leukocyte chemotaxis (common).

Kinin Cascade

Post injury facilitates blood clotting and passage of cells (RBC, PLT, WBC) and fluid to site.

Cell Mediated Response

Recognize patterns and cell damage, and activates complement cascade.

Cellular Receptors

Send messages and coordinate the inflammatory response.

Cellular Products

In early inflammation, engulf bacteria dead cells and debris.

Neutrophils

initiate cellular inflammatory response, long term clean up and healing.

Monocyte

Engulf parasites and regulate mast cell response, associated with allergic reactions.

Eosinophils

Associated with allergic response, important for Ab response in B-Cells.

Basophils

Not a true leukocyte, engulf viruses and some cancer cells.

Natural Killer Cells

complement brings leukocyte to inflammation site to recognize, engulf, fuse, and destroy antigen.

Leukocyte Role in Phagocytosis

Phagocytes use oxygen to generate ROS, what turns off this destructive mechanism?

Serum Inhibitors

Messenger cells that create chemical communication network and mediate ramping up or slowing down immune system.

Cytokines

IL, TNF-a, Interferons, Chemokines

4 Cytokine Classes

Produced by Macrophages and Leukocytes, alter adhesion molecule expression, stimulate leukocyte production in bone marrow and bring them to inflammation site to enhance and suppress inflammation.

Interleukins

Pro-Inflammatory

IL-1 and IL-6

Anti-Inflammatory

IL-10

Pro-Inflammatory

TNF-a

Enhances endothelial cell molecules, starts chemokine production, leads to fever, septic shock, and cachexia.

TNF-a

produced my cells infected by viruses. functions to attach to cells not affected by virus to stimulate proteins that prevent viral replication enhancing acquired immunity.

Interferons

Produced by macrophages, fibroblasts, endothelial cells in response to PRO-inflammatory cytokines. induces leukocyte chemotaxis and involved in cancer growth.

Chemokines

IL-1 act on hypothalamus causing fever, leukocytosis (left shift), synthesize plasma proteins (acute phase reactants, C reactive protein, fibrinogen, ferritin).

Signs of Acute Inflammation

Too many cytokines released too quickly at once (PRO-inflammatory ILs). Fever is hallmark symptom. COVID and CAR-T cells.

Cytokine Storm

Damages cells and weakens immune system seen in: periodontitis, DMII, obesity, CV disease, Alzheimer’s, insulin resistance, frailty.

Chronic Inflammation

Always ready to respond, general response, short duration.

Innate Immunity

Must be induced, specific response, generates long term protection and memory.

Acquired Immunity

Antigen that induces an immune response.

Immunogenic

Presents the antigen to the lymphocytes.

Antigen Presenting Cell

too small to be Immunogenic so binds with larger proteins.

Haptens

Cellular immunity, stimulate cytokine response to activate leukocyte response or kill target directly. Do not produce Abs. Slow to respond. When impaired likely to have opportunistic infections.

T-Cells

Humoral Immunity, work outside cells binding to and neutralizing antigens, secretes Abs, responds quickly, when impaired cause systemic responses and more susceptible to encapsulated organisms.

B-Cells

Presenting and packaging known antigen.

Marcophage

Presenting and packaging naive antigen

Dendritic cells

Occurs in Thymus, has two chains

T-cell

100

On cell surface working as markers for T-cells

Memory T-cells (CD2)

Patho Renal

Patho Renal

Two Clean Queens · 34問 · 2年前

Patho Immunology

Patho Immunology

34問 • 2年前

Patho Hematology

Patho Hematology

Two Clean Queens · 76問 · 2年前

Patho Hematology 2

Patho Hematology 2

76問 • 2年前

Patho Respiratory

Patho Respiratory

Two Clean Queens · 54問 · 2年前

Patho Respiratory 2

Patho Respiratory 2

54問 • 2年前

Patho Cardiovascular

Patho Cardiovascular

Two Clean Queens · 56問 · 2年前

Patho Cardiovascular 2

Patho Cardiovascular 2

56問 • 2年前

Two Clean Queens · 52問 · 2年前

Patho MSK

Patho MSK

52問 • 2年前

Two Clean Queens · 35問 · 2年前

Patho Acid Base

Patho Acid Base

35問 • 2年前

Two Clean Queens · 10問 · 2年前

Renal 2

Renal 2

10問 • 2年前

Two Clean Queens · 43問 · 2年前

Fluid Balance

Fluid Balance

43問 • 2年前

Patho Endocrine

Patho Endocrine

Two Clean Queens · 42問 · 2年前

Patho Endocrine 2

Patho Endocrine 2

42問 • 2年前

Two Clean Queens · 58問 · 2年前

Infections

Infections

58問 • 2年前

Two Clean Queens · 31問 · 2年前

Patho Shock

Patho Shock

31問 • 2年前

Two Clean Queens · 18問 · 2年前

GI 2

GI 2

18問 • 2年前

Two Clean Queens · 54問 · 2年前

Cancer

Cancer

54問 • 2年前

Two Clean Queens · 94問 · 2年前

Neuro

Neuro

94問 • 2年前

Two Clean Queens · 20問 · 2年前

Psychopathology

Psychopathology

20問 • 2年前

Two Clean Queens · 77問 · 2年前

Bone Pharm

Bone Pharm

77問 • 2年前

Two Clean Queens · 68問 · 2年前

Urology Pharm

Urology Pharm

68問 • 2年前

Two Clean Queens · 97問 · 2年前

Lifestyle Considerations Outline_Pharm

Lifestyle Considerations Outline_Pharm

97問 • 2年前

Two Clean Queens · 23問 · 2年前

Prescribing Basics Outline_Pharm

Prescribing Basics Outline_Pharm

23問 • 2年前

Two Clean Queens · 31問 · 2年前

Pharmacokinetics_Pharm

Pharmacokinetics_Pharm

31問 • 2年前

Diabetes Pharm

Diabetes Pharm

Two Clean Queens · 41問 · 2年前

Diabetes Pharm 2

Diabetes Pharm 2

41問 • 2年前

Neuroendocrine Obesity Pharm

Neuroendocrine Obesity Pharm

Two Clean Queens · 43問 · 2年前

Neuroendocrine Obesity Pharm 2

Neuroendocrine Obesity Pharm 2

43問 • 2年前

Two Clean Queens · 106問 · 1年前

Dermatology Pharm

Dermatology Pharm

106問 • 1年前

Two Clean Queens · 24問 · 1年前

Dermatology Pharm 2

Dermatology Pharm 2

24問 • 1年前

Cardiac/Renal Pharm 1

Cardiac/Renal Pharm 1

Cardiac/Renal Pharm 2

Cardiac/Renal Pharm 2

Two Clean Queens · 86問 · 1年前

Cardiac/Renal Pharm 3

Cardiac/Renal Pharm 3

86問 • 1年前

Two Clean Queens · 46問 · 1年前

Anticoagulants Pharm

Anticoagulants Pharm

46問 • 1年前

Two Clean Queens · 48問 · 1年前

Herbals

Herbals

48問 • 1年前

N5220 Exam Pearls

N5220 Exam Pearls

Two Clean Queens · 67問 · 1年前

DRIQ

DRIQ

67問 • 1年前

Two Clean Queens · 76問 · 1年前

Clinical Pearls Test 2

Clinical Pearls Test 2

76問 • 1年前

Two Clean Queens · 94問 · 1年前

Test 2 Seidel's Part I

Test 2 Seidel's Part I

94問 • 1年前

Two Clean Queens · 98問 · 1年前

Test 2 Seidel's Part II

Test 2 Seidel's Part II

98問 • 1年前

Two Clean Queens · 66問 · 1年前

NURS 5112 Exam Review Part 1

NURS 5112 Exam Review Part 1

66問 • 1年前

NURS 5140 Exam 1 Review Part 1

NURS 5140 Exam 1 Review Part 1

NURS 5140 Exam 1 Review Application Part 1

NURS 5140 Exam 1 Review Application Part 1

Two Clean Queens · 50問 · 1年前

NURS 5410 Exam 1 ApplicationPart 2

NURS 5410 Exam 1 ApplicationPart 2

50問 • 1年前

Two Clean Queens · 8問 · 1年前

Exam 2 NURS 5140

Exam 2 NURS 5140

8問 • 1年前

Two Clean Queens · 90問 · 1年前

NURS 5112 Exam 2 ChatGPT

NURS 5112 Exam 2 ChatGPT

90問 • 1年前

Two Clean Queens · 66問 · 1年前

Exam 3 NURS 5410 Anxiety

Exam 3 NURS 5410 Anxiety

66問 • 1年前

Two Clean Queens · 44問 · 1年前

Exam 3 NURS 5410 Pain

Exam 3 NURS 5410 Pain

44問 • 1年前

Two Clean Queens · 72問 · 1年前

Exam 3 NURS 5410 Sleep

Exam 3 NURS 5410 Sleep

72問 • 1年前

Two Clean Queens · 25問 · 1年前

NURS 5410 Exam 3 Quizzes

NURS 5410 Exam 3 Quizzes

25問 • 1年前

Two Clean Queens · 71問 · 1年前

Psychopharm Exam 1

Psychopharm Exam 1

71問 • 1年前

Two Clean Queens · 62問 · 1年前

Gero Psych Exam 1

Gero Psych Exam 1

62問 • 1年前

Two Clean Queens · 19問 · 1年前

Psychopharmacology Exam 2 (part 1)

Psychopharmacology Exam 2 (part 1)

19問 • 1年前

Two Clean Queens · 19問 · 1年前

Peds Psych Exam 2 (part 1)

Peds Psych Exam 2 (part 1)

19問 • 1年前

Two Clean Queens · 50問 · 1年前

Peds Psych Exam 2 (part 2)

Peds Psych Exam 2 (part 2)

50問 • 1年前

Two Clean Queens · 67問 · 1年前

Peds Psych Exam 2 (part 3)

Peds Psych Exam 2 (part 3)

67問 • 1年前

Two Clean Queens · 20問 · 1年前

Peds Psych Exam 2 (part 4)

Peds Psych Exam 2 (part 4)

20問 • 1年前

Two Clean Queens · 80問 · 1年前

Psychopharmacology Exam 2 (part 2)

Psychopharmacology Exam 2 (part 2)

80問 • 1年前

Two Clean Queens · 46問 · 1年前

Psychopharmacology Exam 2 (part 3)

Psychopharmacology Exam 2 (part 3)

46問 • 1年前

Two Clean Queens · 22問 · 1年前

Psychopharmacology Exam 2 (part 4)

Psychopharmacology Exam 2 (part 4)

22問 • 1年前

Two Clean Queens · 86問 · 11ヶ月前

Psychopharm Depressive Disorders

Psychopharm Depressive Disorders

86問 • 11ヶ月前

Two Clean Queens · 58問 · 11ヶ月前

Psychopharm Bipolar Disorder

Psychopharm Bipolar Disorder

58問 • 11ヶ月前

Two Clean Queens · 32問 · 11ヶ月前

Psychopharm Anxiety Disorders

Psychopharm Anxiety Disorders

32問 • 11ヶ月前

Two Clean Queens · 56問 · 11ヶ月前

Child Psych Anxiety

Child Psych Anxiety

56問 • 11ヶ月前

Two Clean Queens · 34問 · 11ヶ月前

Child Psych OCD/Gen Dysph

Child Psych OCD/Gen Dysph

34問 • 11ヶ月前

Two Clean Queens · 49問 · 11ヶ月前

Child Psych Eating Disorders 1

Child Psych Eating Disorders 1

49問 • 11ヶ月前

Two Clean Queens · 14問 · 11ヶ月前

Child Psych Eating Disorders 2

Child Psych Eating Disorders 2

14問 • 11ヶ月前

Two Clean Queens · 19問 · 11ヶ月前

Gero Mood Disorders

Gero Mood Disorders

19問 • 11ヶ月前

Two Clean Queens · 13問 · 11ヶ月前

Gero Anxiety Disorders

Gero Anxiety Disorders

13問 • 11ヶ月前

Two Clean Queens · 15問 · 11ヶ月前

Gero OCD & PTSD

Gero OCD & PTSD

15問 • 11ヶ月前

Two Clean Queens · 34問 · 10ヶ月前

Psychopharm Sleep

Psychopharm Sleep

34問 • 10ヶ月前

Two Clean Queens · 20問 · 10ヶ月前

Psychopharm ADHD

Psychopharm ADHD

20問 • 10ヶ月前

Two Clean Queens · 6問 · 10ヶ月前

Psychopharm Eating Disorders

Psychopharm Eating Disorders

6問 • 10ヶ月前

Two Clean Queens · 32問 · 10ヶ月前

Psychopharm Reward and Pleasure

Psychopharm Reward and Pleasure

32問 • 10ヶ月前

Two Clean Queens · 7問 · 10ヶ月前

Psychopharm Impulsivity/Compulsvity/Addiction

Psychopharm Impulsivity/Compulsvity/Addiction

7問 • 10ヶ月前

Two Clean Queens · 81問 · 10ヶ月前

Gero Exam 4 Review

Gero Exam 4 Review

81問 • 10ヶ月前

Two Clean Queens · 58問 · 10ヶ月前

Child Psych Sleep/Wake Disorders

Child Psych Sleep/Wake Disorders

58問 • 10ヶ月前

Two Clean Queens · 49問 · 10ヶ月前

Child Psych ODD/CD/SUD

Child Psych ODD/CD/SUD

49問 • 10ヶ月前