PATH370 MIDTERM STUDY GUIDE.

PATH370 MIDTERM STUDY GUIDE. WEEKS 1-2 CHAPTER 1: INTRODUCTION TO PATHOPHYSIOLOGY AND PATHOPHYSIOLOGY TERMINOLOGY Know all vocabulary and definitions from this chapter Acute: short-lived; may have severe manifestation Chronic- may last months to years, sometimes following an acute course Clinical manifestations- symptoms, signs, syndrome, latent period, prodromal period, subclinical stage, acute clinical course, chronic clinical course, exacerbation, remission, convalescence, sequelae Diagnosis- the designation as to the nature or cause of a health problem Endemic- native to a local region Epidemic- spread to many people at the same time Epidemiology- study of the patterns of disease involving populations Etiology- study of causes/reasons for phenomena Exacerbation- increase in severity, signs, or symptoms Iatrogenic- cause results from unintended or unwanted medical treatment Idiopathic- cause is unknown Incidence- reflects the number of new cases arising in a population at risk during a specified time Incubation period- the phase during which the pathogen begins active replication without producing recognizable symptoms in the host. The duration is influence by additional factors, including the general health of the host, the portal of entry, and the infectious dose Insidious- coming on gradually and subtle development Latent period- time between exposure of tissue to injurious agent and first appearance of signs and/or symptoms Morbidity- describes the effects an illness has on a person’s life. Not only concerned with the occurrence or incidence, but with persistence and the long term consequences Mortality- death rates for a specific population. Also described in terms of the leading causes of death according to age, sex, race, and ethnicity Multifactorial- multiple alleles at different loci affect the outcome Occurrence- frequency of a disease without defining incidence or prevalence Pandemic- spread to large geographic areas Pathogenesis- development or evolution of disease, from initial stimulus to ultimate expression of manifestations of disease Pathology- focuses on the changes in body tissues and organs that cause or are caused by disease Pathophysiology- the functional changes associated with or resulting from disease or injury Physiology- the science of the functioning of the living organism and its parts and processes Prevalence- the number of cases of a specific disease present in a given population at a certain time Prodromal period- time during which first signs and/or symptoms appear or onset of disease occurs Prognosis- the probable outcome and prospect of recovery from a disease Remission- decrease in severity, signs, or symptoms; may indicate disease is cured Risk factor- a factor that when present increases the likelihood of disease Sensitivity- probability that a test will be positive when applied to a person with a particular condition Sequelae- subsequent pathologic condition resulting from an acute illness Signs-objective or observed manifestation of disease Specificity- probability that a test will be negative when applied to a person without a particular condition Subclinical stage- patient functions normally; disease processes are well established Symptoms-subjective feeling of abnormality in the body Syndrome- a set of signs and symptoms not yet determined to delineate a disease CHAPTER 2: HOMEOSTASIS AND ADAPTIVE RESPONSES TO STRESSORS - 3 stages of Selye’s General Adaptation Syndrome Alarm reaction: fight-or-flight response due to stressful stimulus. It provides a surge of energy and physical alterations to either evade or confront danger. +allostatic state: refers to the activity of various systems in attempting to restore homeostasis Stage of resistance: the activity of the nervous and endocrine systems in returning the body to homeostasis. To survive the body must move past alarm and into this supportive stage of the allostatic return of homeostasis. As the body moves into the stage of resistance, the SNS and the adrenal medulla and cortex are functioning at full force to mobilize resources to manage stressors. Stage of exhaustion: point where body can no longer return to homeostasis. +Selye’s postulated that when energy resources are completely depleted, death occurs bc the organism is no longer able to adapt. +Allostatic overload: cost of body’s organs and tissues for an excessive or ineffectively regulated allostatic response - role of hypothalamus and function of corticotropin releasing hormone Hypothalamus: responsible for the production of many of the body’s essential hormones, chemical substances that help control different cells and organs. The hormones released are for temperature regulation, thirst, hunger, sleep, mood, sex drive, and the release of other hormones within the body. (catecholamines, norepinephrine & epinephrine released here) Corticotropin releasing hormone: (CRH) stimulates the release of corticotropin by the anterior pituitary gland. Normally released by the mother and embryo soon after embryo implants the uterus. Protects it from immunologic rejection by the mother (miscarriage) - role of anterior pituitary and function of adrenocorticotropic hormone (ACTH) Anterior pituitary: regulates stress, growth, reproduction, and lactation. Its regulatory functions are achieved through the secretion of peptide hormones that act on target organs including adrenal gland, liver, bone, thyroid gland, and gonads Adrenocorticotropic hormone: (ACTH) stimulates the production and release of cortisol from the cortex to the adrenal gland. CRH from the hypothalamus acts on the pituitary which secretes ACTH - role of posterior pituitary and function of antidiuretic hormone/vasopressin (ADH)Posterior pituitary: stores and secretes oxytocin and antidiuretic hormone Antidiuretic hormone: (ADH) acts on the collecting ducts of the kidney to facilitate the reabsorption of water into the blood and to constrict blood vessels - Role of adrenal glands and functions of: ( catecholamines- epinephrine/norepinepcorticosteroids- cortisol/aldosterone) adrenal glands: produce hormones that help the body control blood sugar, burn protein and fat, react to stressors, and regulate blood pressure (cortisol and aldosterone) Catecholamines: enable the body to rapidly take action to fight or flee the stressor; through the sympathetic adrenal medullary system. Which releases norepinephrine and epinephrine. Catecholamines: ● Aide in elevation of cardiac output ● Vasomotor (constriction of blood vessels) changes ● Lipolysis (breakdown of fats and other lipids) ● Glycogenolysis ● Insulin suppression ● Increased respiration ● Enhanced blood coagulation Corticosteroids: they have regulatory roles in the cardiovascular system and in maintaining fluid volume, and contribute to metabolism, immunity, and inflammatory responses, brain function, and even reproduction. They are lipid-soluble hormones. ● Primary is cortisol/ aldosterone: secreted by the adrenal cortex in response to ACTH from the anterior pituitary; which is in turn affected by the release of CRH. ○ Gluconeogenisis ○ Protein catabolism ○ Inhibition of glucose uptake ○ Suppression of protein synthesis ○ Stabilization of vascular reactivity ○ Immune response suppression ( cortisol is the primary glucocorticoid. Aldosterone is the primary mineral corticoid.) - functions of endorphins/enkephalins and Immune Cytokines endorphins and enkephalins: endogenous opioids (body’s natural pain relievers) +raise pain threshold; produce sedation and euphoria Cytokines are a group of proteins secreted by the immune system that act as chemical messengers. Cytokines released from one cell affect the actions of other cells by binding to receptors on their surface. You can think of these receptors as mailboxes. They receive the cytokine's chemical message, and then the receiving cell performs activities based on that message. - Physical, behavioral, and emotional indicators of stress Physical indicators: low energy, headaches, upset stomach, aches, insomnia, frequent colds Behavioral indicators: lack of punctuality, withdrawal, exhaustion, excessive behavior, unhealthy eating habits Emotional indicators: depression, moodiness, loneliness, feeling overwhelmed, isolation - Describe allostasis and explain what occurs due to allostatic overload Allostasis: addresses complexities and variable levels of activity necessary to maintain or re-establish homeostasis. The body's response to stress. The process of achieving stability through physiological or behavioral change. +carried out by a superordinate set of systems that support homeostasis in light of environmental and lifestyle changes Allostatic overload: Refers to the state in which the normal allostatic processes wear out or fail to disengage or shut off; the physiological systems are not able to adapt contributing to long term effects that can be damaging to one’s health. - Explain why each of the following can occur due to stress: hypertension, stroke, cartery disease, gastrointestinal problems, immune suppression, diabetes mellitus Hypertension- caused by excessive catecholamine levels and bad stress coping like smoking and bad eating habits. As well as the supply of cortisol receptors in fat cells. Stroke- excessive catecholamine levels and the repeated or prolonged elevation of blood pressure, especially in combination with the effects of elevated cortisol levels. Coronary artery disease- increased platelet activity, resulting in clot formation and elevated serum lipid levels. Gastrointestinal problems- the sympathetic nervous system releases norepinephrine which reduces gastrointestinal motility and gastric acid secretion. Immune suppression- chronic activation of the stress mediators produces immunosuppression and increases the risk of infection and has been implicated in the development of autoimmune diseases. Diabetes Mellitus- when cortisol levels are increased by chronic stress of either a physiological or a psychological origin, this results in obesity; which is a risk factor for decreased effectiveness of glucose transport into the cells (insulin resistance), the pathophysiologic basis for diabetes type 2. - Define glycolysis, gluconeogenesis, glycogenolysis Glycolysis: breakdown of glucose by enzymes, releasing energy and pyruvic acid Gluconeogenesis: metabolic pathway that results in the generation of glucose from non-carbohydrate carbon substrates Glycogenolysis: biochemical breakdown of glycogen to glucose. Takes place in the cells of muscle and liver tissues in response to hormonal and neural signals CHAPTER 4: CELL INJURY, AGING, AND DEATH - describe and give causes and examples of each of the following cell adaptations:hypertrophy, hyperplasia, metaplasia, dysplasia, anaplasia, neoplasia, necrosis Atrophy: cells shrink and reduce their differentiated functions in response to normal and injurious factor +Causes: disuse, denervation, ischemia, nutrient starvation, interruption of endocrine signals, persistent cell injury, aging +Example: muscles shrinking Hypertrophy: increase in cell mass accompanied by an augmented functional capacity in response to physiologic and pathophysiologic demands +Causes: increased cellular protein content +Example: working out more makes your muscles bigger; when one kidney is removed, the cells of other kidney divide at an increased rate Hyperplasia: increase in functional capacity related to an increase in cell number due to mitotic division +Causes: in response to increased physiologic demands or hormonal stimulation, persistent cell injury, chronic irritation of epithelial cells +Example: cells near your heart begin to reproduce so rapidly and abnormally that your organs are impaired due to their enlargement from excessive cell growth Metaplasia: replacement of one differentiated cell type with another +Causes: an adaptation to persistent injury, with replacement of a cell type that is better suited to tolerate injurious stimulation +Example: cigarette smoking that causes the mucus-secreting ciliated psuedostratified columnar respiratory epithelial cell that line the airways to be replaced by stratified squamous epithelium Dysplasia: disorganized appearance of cells because of abnormal variations in size, shape, and arrangement. Represents an adaptive effort gone astray. Significant potential to transform into cancerous cells, thus referred to as preneoplastic lesions +Causes: an adaptive effort gone wrong +Example: cervical dysplasia Anaplasia: loss of differentiation of cells and their orientation to each other, a characteristic of tumor cells +Causes: unknown? +Example: tumor cells Neoplasia: new, uncontrolled growth of cells that is not under physiologic control. Can be benign or malignant +Causes: multiple mechanisms +Example: granuloma Necrosis: irreversible cell death. Occurs as a consequence of ischemia or toxic injury and is characterized by cell rupture, spilling of contents into the extracellular fluid, and inflammation. Fours types of necrosis 1. Coagulative- most common! Caused by ischemic cell injury 2. Liquefactfive- the dissolution of dead cells occur very quickly, may form abscess or cyst. May be seen in the brain. 3. Fat- death of adipose tissue and usually results from trauma or pancreatitis, appears as a chalky white area of tissue. 4. Caseous- characteristic of lung tissue damaged by TB. - Describe ischemia, hypoxia, and hypoxemia along with why/when each condition Ischemia: insufficient supply of blood to an organ, usually due to a blocked artery resulting in decreased oxygen and nutrient supplies to a tissue -Can be acute, due to a sudden reduction in blood flow. Cab be chronic, due to slowly decreasing blood flow Hypoxia: derives the cell of oxygen and interrupts oxidative metabolism and the generation of ATP in tissues -results from an inadequate amount of oxygen in the air, respiratory disease, ischemia, anemia, edema, or inability of the cells to use oxygen -occurs from severe asthma attack Hypoxemia: an abnormally low concentration of oxygen in the blood - when partial pressure of oxygen in blood is less than 60 mm Hg.