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NURS243 EXAM 1 -
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Pathogenesis refers to mechanisms whereby an etiologic factor leads to the typically observed clinical manifestations of disease Manifestations of a disease process vary among individuals Epidemiology is the study of patterns of disease among human population Health and illness perceptions are affected by individual cultures pathophysiologic basis of most disease Disruption in cellular function and or communication Idiopathic the specific cause of some diseases such as hypertension, is unknown iatrogenic An undesirable condition that develops because of a treatment pandemic HIV infection of millions of individuals across several countries exacerbation increase in clinical manifestations remission
manifestations decrease secondary prevention Early detection of disease by screening procedures incidence The probability that a disease will occur in a certain population homeostasis A dynamic balance in the body marked by appropriate and effective responses to stimuli, thereby keeping the body in a steady state systemic manifestations During a health care screening the client describes the following: achiness, lethargy, and vague abdominal discomfort. These are categorized as critical components to the text definition of pathophysiology understand how something works before grasping what occurs when something goes wrong functional changes in the body; how the body responds to unexpected or undesired changes. pathology the study of the structural and functional changes in cells and tissues as a result of injury pathophysiology a combination of pathology and physiology; that is, structural and functional changes at a cellular and tissue level that impact the entire body. Describe what caring for the person and not the disease means
- emphasis on care is the person
- people aren't referred by the name of their disease
- their seen as having meaningful lives outside the healthcare setting signs observable or measurable expression of the altered health condition; objective
first line of defense Involves surface and chemical barriers. Intact surrounding skin prevents entry of harmful substances. second line of defense
- Effective inflammatory response.
- Inflammatory mechanisms are activated, vasodilation and increased capillary permeability causes redness (erythema and swelling.
- Phagocytes move in to, engulf, and destroy harmful substances. third line of defense
- Activated through the immune response. - Immune cells recognize and destroy harmful substances. fever rationale
- is a result of chemical mediators acting directly on the hypothalamus.
- The hypothalamus is responsible for controlling temperature in the body.
- An elevated body temperature stimulates phagocytosis and can also inhibit the growth of certain microorganisms leukocytosis rationale
- an elevation in the white blood cell, or leukocyte, with acount usually above 10,000/mm3.
- Typically, the individual has a white blood cell count of 5,000 to 10,000/mm3. - demonstrates the increased circulation of white blood cells to aid in healing. plasma protein rationale
- increased as a result of the three plasma protein systems (complement, kinin, and clotting).
- These proteins are called acute phase reactants and can be measured through the use of laboratory tests, such as C-reactive protein(CRP). explain why the ESR test is a non specfic test for inflammation when elevated inflammation is occurring somewhere in the body, but the exact source or location is not identified by the test. what happens in the ESR test for inflammation
- During the inflammatory process, the coagulation cascade results in increased circulating levels of fibrinogen, which causes cells to stick together. = When measured in a tube in the lab, RBCs exposed to the inflammatory process will fall faster and will clump together.
- The ESR test then measures (in mm/hr) the level of RBC stacking.
- The test takes about 45 minutes.
- Typically, a higher result equates to more severe inflammation. identify the three treatment principles in acute inflammation
- Reduce blood flow to the site
- decrease swelling
- block the action of chemical mediators. three phases of tissue and healing repair inflammatory phase proliferative phase remodeling phase inflammatory phase
- vascular and cellular response regulated by plasma protein systems
- activated/inhibited by chemical mediators
- goal is to bring forth the products of healing to the site of injury and to remove foreign substances and necrotic tissue remodeling phase a process of continued tissue reconstruction that occurs over several months Describe the role of the basement membrane is tissue healing.
- critical component of tissue healing serves to provide a supportive architectural structure, support
- reepithelialization, or the movement of epithelial cells to form a covering over the wound
- store growth factors
- restore neuromuscular function at the site
- support the development of parenchymal tissues parenchymal tissues
Mast Cell How dose the inflammatory response know when to retreat or stop? Feedback mechanisms regulated by plasma protein systems. What causes excessive scarring in chronic inflammation? fibroblast activity. Formation of these is a protective mechanism during some cases of chronic inflammation where an area is walled off in order to protect surrounding unaffected tissues Granulomas Eosinophils defend against parasites; degrade vasoactive substances released by mast cells Mast Cells Release chemicals that initiate the inflammatory response Natural Killer Cells Eliminate virus-infected cells Macrophages
- phagocytize microorganisms and cellular debris;
- secrete chemicals that promote tissue healing;
- activate adaptive immunity Neutrophils phagocytize microorganisms and cellular debris soon after injury, secrete chemicals that call in longer-acting phagocytes allergy Deleterious effects of hypersensitivity to non infectious environmental antigens Hypersensitivity
Altered adaptive immune response that causes disease or damage to the host Alloimmunity Altered adaptive immune response that causes disease or damage to the host Autoimmunity Adaptive immune response misdirected against the body's own cells anatomic barriers The first line of defense against microorganisms One innate immune cell can recognize many different types of pathogenic bacteria because it has pattern recognition receptors dendritic cells most effective in presenting antigen to naïve immunocompetent T cells an individual is sensitized when when an adequate amount of antibodies or T-cells is available to cause a noticeable reaction on re-exposure to the antigen Delayed hypersensitivity reactions involve T lymphocytes In an antibody-dependent cell-mediated, target cells often die by phagocytosis Although Type II hypersensitivity reactions can affect cells by several different mechanisms,they all involve antigens that are expressed in specific tissues The primary lymphoid organs are bone marrow and thymus
mast cell nonphagocytic innate lymphocyte adpative macrophage phagocytic innate neutrophil phagocytic innate Neonate does not develop an infection because they have maternal antibodies that they receivedin breast milk passive Child does not develop an infection because they have been immunized against it. active Adult does not develop an infection because they were infected with that same microorganism previously and recovered active Adult does not develop an infection because they were given gamma globulin after being exposed to an infected person passive Child develops systemic anaphylaxis after eating peanut butter type 1 (IgE-mediated). adults develop rejection of a transplant heart type IV (cell-mediated).
Adults develop hemolysis after mismatched blood transfusion type II (tissue-specific) Adolescents develop systemic anaphylaxis after being stung by a wasp type 1 (IgE-mediated) What is innate immunity? born with it; general type of immunity innate immunity when being compared to adaptive
- first responder to pathogens macrophages, neutrophils, and dendritic cells
- prevention of microbial colonization, entry, spread
- early and rapid
- initiated by pathogens without requiring prior exposure adaptive immunity when being compared to innate
- occurs slowly
- involves T and B lymphocytes
- stimulated by phagocytosis and activation of antigen presenting cells promoting against reinfection
- specificity
- diversity
- memory
- self vs. non self How do white blood cells know how to get to an infected area?
- injured area sends out chemical distress signals
- Some of the white blood cells leave the blood and follow the chemical agents which get stronger the closer they get to the infection When immune complexes form, phagocytic cells are supposed to remove them. Why does immune complex hypersensitivity occur instead?
- when immune complexes are of a certain intermediate size, they are not phagocytized as effectively.
IgA Most abundant in body secretions IgD Low concentration in blood; are surface receptors on developing B lymphocytes Virulence Capacity of an organism to cause severe disease Opertunistic Normally not causing disease, but able to do so when an individual's immune system is suppressed Agent that carries infectious microorganisms froman infected organism to uninfected ones vector Ability to spread from one individual to others andcause disease communicability emerging infections Previously unknown infections housefly example of mechanical vector exotoxins are secreted endotoxins are released when the bacteria die colonization
an organism's ability to adhere to host tissue is important in the process capsule bacteria with these are difficult to phagocytize Aspergillus fungus Staphylococcus bacterium candida fungus plasmodium parasite Pneumocystis fungus M. tuberculosis bacterium histoplasma fungus e-coli bacterium giardia parasite salmonella
bacteria that produce b-lactamase are resistant to many penicillins The transmission of an infection from one person to another requires five unbroken events reservoir, portal of exit, mode of transmission, portal of entry, host susceptibility. Certain characteristics increase the risk for contracting an infection and should prompt diligencein prevention and assessment for infection. These include
- disrupted skin or mucous membranes
- very young or old
- immunosuppression
- poor nutrition
- chronic illness When no signs or symptoms of disease are present, the presence of microorganisms on the skinand mucous membranes is called colonization viruses must gain entry into cells to establish an infection unlike most microorganism that affect humans from the extracellular space The microorganisms that affect humans can be grouped into four broad categories: Bacteria, fungi, viruses, and parasites The microorganisms that inhabit the gastrointestinal tract may alter the host's physiology If viruses reproduce inside the cell why should a person get a flu shot to make antibodies outside the cell? a virus must reach the cell and attach to it before it can go inside and reproduce, If you have antibodies against the flu virus, the antibodies can bind to the virus outside the cells and keep I from attaching and entering the cells What does it mean if you have an opportunistic infection?
This means an infection with a microorganism that dose not cause infection in persons whose immune system are functioning fully but that can cause infection in persons whose immune system are suppressed. You are expecting your first child and are told that the child has a 1 in 800 chance of being born with a congenital anomaly. This statistic refers to the: incidence You decide that it has been too long since your last physical examination, so you schedule an appointment for a routine health screening. You have a blood cholesterol level checked, and it is within the expected range. This activity represents which level of prevention? Secondary prevention At your health screening, you describe the following: achiness, lethargy, and vague abdominal discomfort. These are categorized as systemic manifestations The study of functional alterations in human health because of an injury, disease, or syndrome describes which of the following? Pathophysiology A patient wants to know what has caused the illness. This information is termed the etiology Joe has many risk factors for the development of lung cancer. Which of these is NOT modifiable? Smoking Which of the following terms indicates the dynamic steady state that the body strives to achieve every day? Homeostasis Which of the following contributes to evidence-based practice and high-quality patient care? Primary research Clinical expertise Meta-analysis studies
Inflammation is ultimately needed to: prepare the site for healing. A wound is 6 cm × 6 cm × 4 cm. A wound with these dimensions needs to heal through: secondary intention. A major difference between the acute and chronic inflammatory response is that in chronic inflammation: granulomas form around certain invaders. Which is not a local manifestation of acute inflammation? Leukocytosis During flu season, you get exposed to the influenza virus. Which component of your immune system will be the first to respond to this foreign pathogen? Innate The following season, you are concerned about getting the flu again. Which of the following statements is true? Vaccination for prevalent strains of influenza virus can provide improved protection against the disease. Immune suppression in AIDS is related to: decreased lymphocyte count. Immunodeficiency is the result of: failure of host defense mechanisms. Which of the following is true regarding pharmacologic treatment for AIDS? drugs are used to inhibit HIV replication. A hypersensitivity reaction resulting from a yellow jacket sting is an example of: type I, immediate hypersensitivity reaction.
A hypersensitivity reaction resulting from complement activation due to insoluble antigen-antibody deposition is an example of: type III, immune complex reaction. You are looking to break the chain of infection by washing your hands frequently as you provide care for patients. Which of the following links in the chain will be broken by this activity? Mode of transmission Which of the following may make a person more susceptible to getting an infection? Experiencing a surgery that is healing by primary intention The feeling that "something is not quite right" is considered which stage in infection? Prodrome We have an expert-written solution to this problem! Which of the following clinical manifestations is not typically found with inflammation but is more characteristic of a bacterial infection? Purulent exudate A white blood cell differential shows an increase in the number of monocytes and macrophages in the blood. This typically means that: this is a chronic infection. Given the mode of transmission for influenza, how would you break the chain of infection and prevent spread? Wear a mask Which of the following would be an effective prevention measure for malaria? Wearing long sleeves, pants, and a hat with face netting The patient is diagnosed with influenza. Which of the following best describes the route of transmission for this disease? Respiratory droplets
