NUR Patho Final
gh gh
Immunodeficiencygh-ghcorrectghanswers-
Immuneghsystemghweakenedghtoghextentghthatghitghcannotghdestroyghforeignghinvadersghandghant
igensghcanghoverwhelmghtheghbody.
Immunocompetencegh-ghcorrectghanswers-
refersghtoghanghindividual'sghabilityghtoghprotectghoneselfghfromghinfectiousghagentsghdueghtoghaghstr
ongghimmuneghsystem.
Immunosuppressiongh-ghcorrectghanswers-
indicatesghthatghthereghisghaghdefectiveghimmuneghsystemghthatghisghputtingghtheghptghatghriskghforghi
nfection.
OpportunisticghInfectiongh-ghcorrectghanswers-
anghinfectionghthatghwasghcausedghbyghaghmicroorganismghthatghflourishedghbecauseghofghitsghhos
t'sghdeficientghimmuneghsystem.
HospitalghAcquiredghofghHealth-Careghacquiredghinfectiongh-ghcorrectghanswers-
whenghaghpt'sghinfectionghisghcausedghbyghmicroorganismsghthatghoriginatedghwithinghtheghclinical
ghenvironment.
Difficultghtoghtxghdueghtoghantibiotic-resistantghbacteria
Typegh1:ghImmediateghhypersensitivitygh-ghcorrectghanswers-allergicghreaction
Typegh2:ghCytotoxicghhypersensitivitygh-ghcorrectghanswers-
mediatedghbyghIgsghthatghtargetghantigenghonghcellsghandghcauseghcellghdestruction.
Incompleteghbloodghtransfusion
Typegh3:ghImmuneghComplexghhypersensitivitygh-ghcorrectghanswers-
antigenghcombinesghwithghIgghwithinghcirculationghandghcomplexesghareghthenghdepositedghintoght
issues.
SLE,ghautoimmuneghdisorders
Typegh4:ghDelayedghhypersensitivitygh-ghcorrectghanswers-initiatedghbyghT-
cellsghthatghhaveghpreviousghexposureghtoghantigen
Dermatitisghfromghexposureghtoghpoisonghivy
KeyghlabghvaluesghinghInfectionsgh-ghcorrectghanswers-WBCgh4,000-10,000ghcells/mcL
Neutrophils:gh40%-80%ghofghWBCsgh/ghelevationgh=ghbacterialghinfection
Lymphocytes:gh20%-40%ghofghWBCsgh/ghelevationgh=ghviralghinfection
Eosinophils:gh1%-7%ghofghWBCsgh/ghelevationgh=ghallergicghreaction
Basophils:gh0%-2%ghofghWBCsgh/ghelevationgh=ghParasiteghorghallergicghreaction
Monocytes:gh2%gh-
gh10%ghofghWBCsgh/ghelevationgh=ghInflammation,ghchronicghinfections,ghautoimmuneghdisease
Howghcanghyoughdetermineghinflammationghvs.ghinfectionghfromghaghCBC?gh-ghcorrectghanswers-
YoughwouldghlookghatghtheghdifferencesghinghtheghWBCsghonghtheghCBC,ghwhichghprovidesghinfogha
boutghthegh%ghofghdifferentghtypesghofghwhiteghbloodghcells.
Anghincreaseghinghneutrophilsgh(makeupgh40%-
80%ghofghWBCs)ghcanghbeghindicativeghofghaghbacterialghinfection.
Anghincreaseghinghmonocytesgh(macrophages)gh(2%-
10%ghofghWBCs)ghcanghbeghindicativeghofghinflammationgh/ghautoimmuneghdisease.
, Hypervolemiagh-ghcorrectghanswers-
ExcessghfluidghinghISFgh&ghICFghcausedghbyghincreasedghhydrostaticghpressureghcausingghedem
a
Canghbeghcausedghby:ghHighghSaltghdiet,ghheartghfailure,ghkidneyghfailure,ghorghliverghfailure.
Hypernatremiagh-ghcorrectghanswers-
Highghsodiumghcontentghofghtheghblood.ghRaisesghsoluteghcontentgh(moreghsalt),ghinghturn,ghraisin
gghOSMOTICghPRESSURE.
Osmoticghpressuregh-ghcorrectghanswers-
Theghpressureghexertedghbyghtheghsolutesghinghsolution,ghcausesghwaterghtoghshiftghfromghICFghint
oghtheghECFgh->ghCausingghcellularghdehydration.
ECFghgainsghfluidgh>ghSecretedghbyghtheghkidneysgh>ghmoreghdehydration!
Polyuriagh-ghcorrectghanswers-excessghurineghbeingghexcreted.
Thisghcontinuesghuntilghfluidghisghreplenishedghappropriately
(Partghofghhypernatremia)
Hypovolemiagh-ghcorrectghanswers-
Isghcausedghbyghdehydration;ghaghdiminishedghlevelghofghcirculatingghbloodghvolumeghthatghincrea
sesghtheghosmolarityghofghblood.
Hydrostaticghpressuregh-ghcorrectghanswers-
theghforceghexertedghbyghtheghbloodghconfinedghwithinghtheghbloodghvesselsghorghheartghchamber.
Isotonicgh-ghcorrectghanswers-Noghfluidghshifts-
ghsolutionsghonghbothghsidesghareghatghequilibrium.ghEqualghosmoticghpressure.ghNogh"tugghofghwar
".gh
Example-ghHumanghblood.
Caution:ghTooghmuchghisotonicghfluidsghcanghcauseghfluidghvolumeghoverload
Monitor:ghBPghdueghtoghHTNghcrisis.ghRiskghforghCVAghstroke.gh
Ex:gh0.9gh%ghsodiumghchloridegh(NS),ghlactatedghringersgh(LR)
Use:ghRehydrateghbody,ghincreaseghlowghBP,ghbloodghtransfusions,ghbloodghloss,ghDKA,ghHHNS
(riskghforghtypegh2ghdiabetesghpatients)-ghwhenghbloodghsugarghhigh
Hypertonicgh-ghcorrectghanswers-HIGHgh&ghdry-ghHigherghosmolarityghthanghbodyghfluids-
ghveryghthick,ghveryghsalty,ghmoreghsolutes,ghlessghwater.ghFluidghdrawnghoutghofghtheghcell.
Monitor-ghBP,ghHTNghcrisis
Useghfor-
ghhypovolemia,ghheatghrelated,ghperitonitis,ghperitonealghdialysis*(drawghfluidghoutghofghtheghbod
y)-ghNeedghtoghgiveghslowly
Ex:gh3%ghsodiumghchloride,gh5%ghsodiumghchloride,gh10%ghdextroseghinghwater,gh5%ghdextrosegh
ingh0.9%ghsodiumghchloride,gh5%ghdextroseghingh0.45%ghsodiumghchloride,gh5%ghdextroseghinghla
ctatedghringer'sgh(Memoryghtrick-
veryghlittleghfluidghinsideghtheghcell=ghveryghlittleghnumbersghbeforeghtheghwords)
Hypotonicgh-ghcorrectghanswers-
LOW.ghLowerghconcentrationghofghsolutesghorghsaltghthenghtheghICF,ghlowerghosmolarityghthanghbo
dyghfluids.ghFluidghdrawnghintoghcellsghcausesghtheghbodyghtoghswellghup.gh
Monitor-ghheadache,ghmentalghstatusghchanges,ghseizures,ghcoma
gh gh
Immunodeficiencygh-ghcorrectghanswers-
Immuneghsystemghweakenedghtoghextentghthatghitghcannotghdestroyghforeignghinvadersghandghant
igensghcanghoverwhelmghtheghbody.
Immunocompetencegh-ghcorrectghanswers-
refersghtoghanghindividual'sghabilityghtoghprotectghoneselfghfromghinfectiousghagentsghdueghtoghaghstr
ongghimmuneghsystem.
Immunosuppressiongh-ghcorrectghanswers-
indicatesghthatghthereghisghaghdefectiveghimmuneghsystemghthatghisghputtingghtheghptghatghriskghforghi
nfection.
OpportunisticghInfectiongh-ghcorrectghanswers-
anghinfectionghthatghwasghcausedghbyghaghmicroorganismghthatghflourishedghbecauseghofghitsghhos
t'sghdeficientghimmuneghsystem.
HospitalghAcquiredghofghHealth-Careghacquiredghinfectiongh-ghcorrectghanswers-
whenghaghpt'sghinfectionghisghcausedghbyghmicroorganismsghthatghoriginatedghwithinghtheghclinical
ghenvironment.
Difficultghtoghtxghdueghtoghantibiotic-resistantghbacteria
Typegh1:ghImmediateghhypersensitivitygh-ghcorrectghanswers-allergicghreaction
Typegh2:ghCytotoxicghhypersensitivitygh-ghcorrectghanswers-
mediatedghbyghIgsghthatghtargetghantigenghonghcellsghandghcauseghcellghdestruction.
Incompleteghbloodghtransfusion
Typegh3:ghImmuneghComplexghhypersensitivitygh-ghcorrectghanswers-
antigenghcombinesghwithghIgghwithinghcirculationghandghcomplexesghareghthenghdepositedghintoght
issues.
SLE,ghautoimmuneghdisorders
Typegh4:ghDelayedghhypersensitivitygh-ghcorrectghanswers-initiatedghbyghT-
cellsghthatghhaveghpreviousghexposureghtoghantigen
Dermatitisghfromghexposureghtoghpoisonghivy
KeyghlabghvaluesghinghInfectionsgh-ghcorrectghanswers-WBCgh4,000-10,000ghcells/mcL
Neutrophils:gh40%-80%ghofghWBCsgh/ghelevationgh=ghbacterialghinfection
Lymphocytes:gh20%-40%ghofghWBCsgh/ghelevationgh=ghviralghinfection
Eosinophils:gh1%-7%ghofghWBCsgh/ghelevationgh=ghallergicghreaction
Basophils:gh0%-2%ghofghWBCsgh/ghelevationgh=ghParasiteghorghallergicghreaction
Monocytes:gh2%gh-
gh10%ghofghWBCsgh/ghelevationgh=ghInflammation,ghchronicghinfections,ghautoimmuneghdisease
Howghcanghyoughdetermineghinflammationghvs.ghinfectionghfromghaghCBC?gh-ghcorrectghanswers-
YoughwouldghlookghatghtheghdifferencesghinghtheghWBCsghonghtheghCBC,ghwhichghprovidesghinfogha
boutghthegh%ghofghdifferentghtypesghofghwhiteghbloodghcells.
Anghincreaseghinghneutrophilsgh(makeupgh40%-
80%ghofghWBCs)ghcanghbeghindicativeghofghaghbacterialghinfection.
Anghincreaseghinghmonocytesgh(macrophages)gh(2%-
10%ghofghWBCs)ghcanghbeghindicativeghofghinflammationgh/ghautoimmuneghdisease.
, Hypervolemiagh-ghcorrectghanswers-
ExcessghfluidghinghISFgh&ghICFghcausedghbyghincreasedghhydrostaticghpressureghcausingghedem
a
Canghbeghcausedghby:ghHighghSaltghdiet,ghheartghfailure,ghkidneyghfailure,ghorghliverghfailure.
Hypernatremiagh-ghcorrectghanswers-
Highghsodiumghcontentghofghtheghblood.ghRaisesghsoluteghcontentgh(moreghsalt),ghinghturn,ghraisin
gghOSMOTICghPRESSURE.
Osmoticghpressuregh-ghcorrectghanswers-
Theghpressureghexertedghbyghtheghsolutesghinghsolution,ghcausesghwaterghtoghshiftghfromghICFghint
oghtheghECFgh->ghCausingghcellularghdehydration.
ECFghgainsghfluidgh>ghSecretedghbyghtheghkidneysgh>ghmoreghdehydration!
Polyuriagh-ghcorrectghanswers-excessghurineghbeingghexcreted.
Thisghcontinuesghuntilghfluidghisghreplenishedghappropriately
(Partghofghhypernatremia)
Hypovolemiagh-ghcorrectghanswers-
Isghcausedghbyghdehydration;ghaghdiminishedghlevelghofghcirculatingghbloodghvolumeghthatghincrea
sesghtheghosmolarityghofghblood.
Hydrostaticghpressuregh-ghcorrectghanswers-
theghforceghexertedghbyghtheghbloodghconfinedghwithinghtheghbloodghvesselsghorghheartghchamber.
Isotonicgh-ghcorrectghanswers-Noghfluidghshifts-
ghsolutionsghonghbothghsidesghareghatghequilibrium.ghEqualghosmoticghpressure.ghNogh"tugghofghwar
".gh
Example-ghHumanghblood.
Caution:ghTooghmuchghisotonicghfluidsghcanghcauseghfluidghvolumeghoverload
Monitor:ghBPghdueghtoghHTNghcrisis.ghRiskghforghCVAghstroke.gh
Ex:gh0.9gh%ghsodiumghchloridegh(NS),ghlactatedghringersgh(LR)
Use:ghRehydrateghbody,ghincreaseghlowghBP,ghbloodghtransfusions,ghbloodghloss,ghDKA,ghHHNS
(riskghforghtypegh2ghdiabetesghpatients)-ghwhenghbloodghsugarghhigh
Hypertonicgh-ghcorrectghanswers-HIGHgh&ghdry-ghHigherghosmolarityghthanghbodyghfluids-
ghveryghthick,ghveryghsalty,ghmoreghsolutes,ghlessghwater.ghFluidghdrawnghoutghofghtheghcell.
Monitor-ghBP,ghHTNghcrisis
Useghfor-
ghhypovolemia,ghheatghrelated,ghperitonitis,ghperitonealghdialysis*(drawghfluidghoutghofghtheghbod
y)-ghNeedghtoghgiveghslowly
Ex:gh3%ghsodiumghchloride,gh5%ghsodiumghchloride,gh10%ghdextroseghinghwater,gh5%ghdextrosegh
ingh0.9%ghsodiumghchloride,gh5%ghdextroseghingh0.45%ghsodiumghchloride,gh5%ghdextroseghinghla
ctatedghringer'sgh(Memoryghtrick-
veryghlittleghfluidghinsideghtheghcell=ghveryghlittleghnumbersghbeforeghtheghwords)
Hypotonicgh-ghcorrectghanswers-
LOW.ghLowerghconcentrationghofghsolutesghorghsaltghthenghtheghICF,ghlowerghosmolarityghthanghbo
dyghfluids.ghFluidghdrawnghintoghcellsghcausesghtheghbodyghtoghswellghup.gh
Monitor-ghheadache,ghmentalghstatusghchanges,ghseizures,ghcoma
