Understanding Necrosis, Healing Factors, and Cancer in Cellular Regulation and Infection, Exams of Health Physics

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NURSING 390 Exam 1 study guide Patho Cellular Regulation & Infection Latest Update 2024 Assured Success Week 1 vocabulary: Acute disease - relatively severe but running a short course Chronic disease - disease that lasts for a long time (6 m. - year) Clinical manifestations - functional consequences associated alterations in cells/tissue that are either related to Disease or diagnostic Complication - new/separate process that may arise secondary because of some change produced by the original entity Diagnosis - identifications of the nature of an illness or other problem Disease - sum of the deviations from normal structure or function from any part, organ, or system Etiology - study of the assignment of causes or reasons for phenomenon Morbidity - the condition of being diseased Mortality - the state of being subject to death Pathogenesis - development or evolution of disease Prevalence - the fact or condition of being prevalent, commonness Primary prevention - the first level of health promotion: prevent disease (e.x. immunization) Prognosis - a forecast about the probable outcome of the disease Risk factors - characteristics related to the probability of a certain outcome. Can cause or be correlated from outcome Secondary prevention - 2nd level of health promotion, based on early detection of disease (e.x. Regular exams) Sequelae - a condition or conditions caused by and following a disease NURSING 390 Exam 1 study guide Patho Cellular Regulation & Infection Latest Update 2022/2023 Assured Success NURSING 390 Exam 1 study guide Patho Cellular Regulation & Infection Latest Update 2024 Assured Success Signs - objectively identifiable manifestation of the disease Symptoms - subjective feeling than an affected individual can report to observer Syndrome - collection of signs and symptoms that occur together Tertiary prevention - 3rd phase of health promotion, preventing further disease - related deterioration (e.x. rehab) NURSING 390 Exam 1 study guide Patho Cellular Regulation & Infection Latest Update 2022/2023 Assured Success NURSING 390 Exam 1 study guide Patho Cellular Regulation & Infection Latest Update 2024 Assured Success - Granulomatous inflammatory wall keeps necrosis and bacteria in the clumps NURSING 390 Exam 1 study guide Patho Cellular Regulation & Infection Latest Update 2022/2023 Assured Success NURSING 390 Exam 1 study guide Patho Cellular Regulation & Infection Latest Update 2022/2023 Assured Success  Describe normal cellular aging in regards to replicative senescence, genetic, and environmental Influences. ● Replicative senescence or programmed senescence theory: cellular genome, the result of telomere shortening that ultimately triggers a DNA damage response. ● Genetic influences ● Environmental influences/ free radical theory ● Premature aging  Describe the mechanism of cellular injury caused by free radicals and reactive oxygen species. If the cell is unable to maintain homeostasis it will die. Causes of cellular injury: Physical ● UV radiation ● trauma/ surgery Toxic injury ● Internal ● Exter NURSING 390 Exam 1 study guide Patho Cellular Regulation & Infection Latest Update 2022/2023 Assured Success NURSING 390 Exam 1 study guide Patho Cellular Regulation & Infection Latest Update 2022/2023 Assured Success nal Infectious injury ● Bacteria ● Fungus ● Parasites ● virus es Hypoxic injury ● Decreased perfusion ● Hypoxia ● Anemia ● Ischem ia Deficiency injury ● Nutrients ● Water Cell injury can be reversible (degeneration, atrophy) or irreversible (necrosis, severe ischemia, interruption of cellular membrane). NURSING 390 Exam 1 study guide Patho Cellular Regulation & Infection Latest Update 2022/2023 Assured Success NURSING 390 Exam 1 study guide Patho Cellular Regulation & Infection Latest Update 2022/2023 Assured Success ● Glutathione (antioxidant in plants, animals, fungi, and some bacteria prevents the damage free radicals can cause) ● Catalase ● Exogenous ● Vitamin C, E, A -FRUITTTTT  Describe the phases and influences of wound repair. 1)Hemostasis, angiogenesis, and ingrowth of granulation tissue 2)Emigration of fibroblasts and deposition of the extracellular matrix 3)Maturation and reorganization of the fibrous tissue (remodeling) - Usually begins within 24 hours of injury - Evidenced by the migration of fibroblasts and the induction of fibroblast and epithelial cell proliferation Inflammatory phase: damaged cells, pathogens, and bacteria are removed from the wound area. These white blood cell growth factors, nutrients and enzymes create the swelling, heat, pain and redness commonly seen during this stage of wound healing Proliferative phase: when the wound is rebuilt with new tissue made up of collagen and extracellular matrix Maturation/remodeling: is when collagen is remodeled from type III to type I and the wound fully closes. The cells that had been used to repair the wound but which are no longer needed are removed by apoptosis, or programmed cell death. NURSING 390 Exam 1 study guide Patho Cellular Regulation & Infection Latest Update 2022/2023 Assured Success NURSING 390 Exam 1 study guide Patho Cellular Regulation & Infection Latest Update 2022/2023 Assured Success Fact ors that affec t wou nd heali ng: ● nal status ● Blood flow/oxygen delivery ● Impaired inflammatory and immune responses ● Wound complications 1. Discuss cellular adaptations in both healthy and pathologic states including: atrophy, hypertrophy, hyperplasia, dysplasia, and metaplasia. Cause of alterations: aging, adaptation, injury, and neoplasia Atrophy: cells shrink and reduce their functions in response of injury - Disuse - Denervation - Ischemia (inadequate blood supply) - Nutrient starvation - Interruption of endocrine signals - Persistent cell injury Hypertrophy: an increase in cell mass accompanied by an augmented functional capacity - Liver enlargement from alcohol use - Uterus and breast enlargement in response to hormones Hyperplasia: An increase in the number of cells caused by increased workload, hormonal stimulation, or decreased tissue. - Hormonal: occurs mostly in estrogen-dependent organs (uterus & breast) - Compensatory: Liver cells (hepatocytes), Epidermal (callus) Dysplasia: disorganized appearance of cells because of abnormal variations NURSING 390 Exam 1 study guide Patho Cellular Regulation & Infection Latest Update 2022/2023 Assured Success NURSING 390 Exam 1 study guide Patho Cellular Regulation & Infection Latest Update 2022/2023 Assured Success in size, shape, and Arrangement - Can transform into cancer “preneoplastic lesions) - Cervical pre-cancer and Cancer r/t Human Papillomavirus (HPV) Metaplasia: replacement of one differentiated cell type with another - Replacement of glandular epithelium with squamous epithelium - Ciliated columnar epithelium to stratified squamous in irritated bronchial mucosa NURSING 390 Exam 1 study guide Patho Cellular Regulation & Infection Latest Update 2022/2023 Assured Success NURSING 390 Exam 1 study guide Patho Cellular Regulation & Infection Latest Update 2022/2023 Assured Success The body starts to produce ATP without O2 which leads to the build up of by-product formation (lactic acid) Organelles begin to fail - Pumps stop working which leads to Na+ build up in the cells which leads to water in the cell which leads NURSING 390 Exam 1 study guide Patho Cellular Regulation & Infection Latest Update 2022/2023 Assured Success NURSING 390 Exam 1 study guide Patho Cellular Regulation & Infection Latest Update 2022/2023 Assured Success To swelling and eruption  Compare and contrast apoptosis and cell necrosis. Apoptosis = programmed cell death ● It is planned and organized ● The organelles are cleaned up by WBCs Necrosis = death caused by external factors that the cell could not withstand ● Organelles are exposed to the other cells and external environment ● Can be fat, liquefactive, coagulative, and caseous  Identify examples of non- or mal-healing wounds. Non-healing wound = wounds that do not heal within 5-8 weeks Examples: - Pressure ulcers - Diabetic foot ulcers - Venous ulcers - Arterial insufficiency ulcers Discussed in Class 2:  Describe the properties of autonomy and anaplasia. Autonomy - independence from normal cellular control: cancer cells Anaplasia - cells lacking uniformity: loss of differentiation  Compare benign and malignant tumors (neoplasms) Benign: ● Noncancerous NURSING 390 Exam 1 study guide Patho Cellular Regulation & Infection Latest Update 2022/2023 Assured Success NURSING 390 Exam 1 study guide Patho Cellular Regulation & Infection Latest Update 2022/2023 Assured Success ● Grows slowly ● Defined capsule -wall ● Non invasive (mostly) ● Well differentiated ● Low mitotic index ● Does not metastasize NURSING 390 Exam 1 study guide Patho Cellular Regulation & Infection Latest Update 2022/2023 Assured Success NURSING 390 Exam 1 study guide Patho Cellular Regulation & Infection Latest Update 2022/2023 Assured Success ● Increases risk for metastasizing ● Initiation ● Promotion ● Progression NURSING 390 Exam 1 study guide Patho Cellular Regulation & Infection Latest Update 2022/2023 Assured Success NURSING 390 Exam 1 study guide Patho Cellular Regulation & Infection Latest Update 2022/2023 Assured Success  Understand the involvement of the tumor suppressor gene with cancer disease Tumor-suppressor gene: encode proteins that inhibit proliferations and prevent or repair mutations (normal) NURSING 390 Exam 1 study guide Patho Cellular Regulation & Infection Latest Update 2022/2023 Assured Success NURSING 390 Exam 1 study guide Patho Cellular Regulation & Infection Latest Update 2022/2023 Assured Success If the tumor-suppressor gene is mutated this leads to uncontrolled cell division which leads to cancer.  Discuss changes in cancer cell characteristics and their functional importance in cancer initiation, promotion, and progression. NURSING 390 Exam 1 study guide Patho Cellular Regulation & Infection Latest Update 2022/2023 Assured Success NURSING 390 Exam 1 study guide Patho Cellular Regulation & Infection Latest Update 2022/2023 Assured Success Leukemia = cancer of blood forming cells  Recognize the method used for grading and staging cancer. Grading cancer: histology (looking at the cells itself) Grade 1: cells differ slightly from normal cells and are well differentiated Grade 2: cells more abnormal and moderately differentiated Grade 3: cells very abnormal, poorly differentiated Grade 4: cells are immature, undifferentiated, cell or origin difficult to determine NURSING 390 Exam 1 study guide Patho Cellular Regulation & Infection Latest Update 2022/2023 Assured Success NURSING 390 Exam 1 study guide Patho Cellular Regulation & Infection Latest Update 2022/2023 Assured Success Staging: the location and amount of cancer in a person’s body (how big and where the cancer came from; where on stage) Stage 0: cancer in situ Stage 1: tumor limited to tissue of origin - localized tumor growth Stage 2: limited local spread Stage 3: extensive local and regional spread NURSING 390 Exam 1 study guide Patho Cellular Regulation & Infection Latest Update 2022/2023 Assured Success NURSING 390 Exam 1 study guide Patho Cellular Regulation & Infection Latest Update 2022/2023 Assured Success Stage 4: metastasis NURSING 390 Exam 1 study guide Patho Cellular Regulation & Infection Latest Update 2022/2023 Assured Success NURSING 390 Exam 1 study guide Patho Cellular Regulation & Infection Latest Update 2022/2023 Assured Success - Used to damage and/orr kill cells in a specified treatment area - Commonly administered over a period of six weeks - Can cause localized and systemic side effects Chemotherapy = - Most of the cytotoxic drugs that are used disrupt the DNA in the cells - Drugs affect any that is dividing at the time: bone marrow, hair follicles, mucosal cells Immediate effects of chemotherapy = ● Extravasation ● Hyperkalemia ● Hyperphosphataemia ● Hypocalcemia ● Renal impairment Acute post-chemotherapy (w/in 24 hours) = ● NV 10-14 days after administration = ● Blood count falls ● Mouth ulcers occur ● Taste changes ● Diarrh ea Several months later = ● Heart/kidneys mostly affected Late toxicities = ● infertility/early NURSING 390 Exam 1 study guide Patho Cellular Regulation & Infection Latest Update 2022/2023 Assured Success NURSING 390 Exam 1 study guide Patho Cellular Regulation & Infection Latest Update 2022/2023 Assured Success menopause Other therapy = ● Hormone or antihormone therapy ● Immunother apy Class 3: lung cancer 1. Describe risk factors for the development of lung cancer and how these factors alter cellular structure and function. Risk factors: ● Smoking: causes irritation which can initiate metaplasia and increase cell replication thus increasing risk for developing cancer. Smoking can also alter the tumor suppressor gene ● Radiation: treatment for breast cancer can cause lung cancer ● Pollutants: unhealthy air can cause irritation and increase the risk of cancer 2. Differentiate among the four types of lung cancer. Small cell: very aggressive and difficult to diagnose Non-small cell: - Adenocarcinoma: common in women and nonsmokers, affects outer area of lungs does not always cause Coughing S&S - Squamous cell: more central causes cough, linked to smoking NURSING 390 Exam 1 study guide Patho Cellular Regulation & Infection Latest Update 2022/2023 Assured Success NURSING 390 Exam 1 study guide Patho Cellular Regulation & Infection Latest Update 2022/2023 Assured Success - Large-cell: grows and spreads NURSING 390 Exam 1 study guide Patho Cellular Regulation & Infection Latest Update 2022/2023 Assured Success NURSING 390 Exam 1 study guide Patho Cellular Regulation & Infection Latest Update 2022/2023 Assured Success 2. Describe the body’s counter measures against pathogens. The body’s counter measures against pathogens are: Structural defense: Natural barriers include the skin, mucous membranes, tears, earwax, mucus, and stomach acid. Also, the normal flow of urine washes out microorganisms that enter the urinary tract. Innate/first line of defense =skin Immune response: Inflammatory - is the immune system's response to harmful stimuli, such as pathogens, damaged cells, toxic compounds, or irradiation [1], and acts by removing injurious stimuli and initiating the healing process [2]. Inflammation is therefore a defense mechanism that is vital to health T or B cells - T cells are involved in cell-mediated immunity, whereas B cells are primarily responsible for humoral immunity (relating to antibodies). The function of T cells and B cells is to recognize specific "non- self" antigens, during a process known as antigen presentation. Phagocytosis 3. Apply ways pathogens have found to circumvent these countermeasures. Toxins: Virus and Bacteria produce endo and exotoxins Exotoxins: released during growth, causing specific responses Endotoxins: contained in the cell walls of gram - pathogens, causes vasodilation which can lead to septic shock Adhesion factors: mechanisms that make it difficult to attack or flush out the pathogen NURSING 390 Exam 1 study guide Patho Cellular Regulation & Infection Latest Update 2022/2023 Assured Success NURSING 390 Exam 1 study guide Patho Cellular Regulation & Infection Latest Update 2022/2023 Assured Success Slime or mucous layer Fimbriae Evasion factors: Encapsulated organisms evade phagocytosis Adaptation to survive within a phagocytic cell “Change their coats” (surface proteins) to go undetected Coagulase to cause a place to hide Neutralizes the surroundings (Acid) Invasion factors: 4. Explain how bacterial resistance to antibiotics occurs. Bacterial resistance: Bacteria fight antibiotics by: Inactiving antibiotics Altering antibiotic binding NURSING 390 Exam 1 study guide Patho Cellular Regulation & Infection Latest Update 2022/2023 Assured Success NURSING 390 Exam 1 study guide Patho Cellular Regulation & Infection Latest Update 2022/2023 Assured Success sites Using different metabolic pathways Changing cell walls to keep antibiotics out Resistance occurs when bacteria acquire a gene for resistance through mutation. The antibiotics kill the bacteria that Does not have the mutation and the ones that do survive and replicate. Examples: MRS A TB C- diff VRE 5. Describe the disease course of infection. Stages of infection: Incubation period - the bacteria replicates within the host no symptoms Prodromal stage - the host begins to develop basic symptoms of infection (fever, fatigue) Illness period/acute - the host develops clinical manifestation NURSING 390 Exam 1 study guide Patho Cellular Regulation & Infection Latest Update 2022/2023 Assured Success NURSING 390 Exam 1 study guide Patho Cellular Regulation & Infection Latest Update 2022/2023 Assured Success 6. Identify agents of infectious diseases, including basic characteristics, reproduction, and relationship with host. Agents of infectious disease Prions: Viruse s: ● No genome ● Small, modified, infectious proteins ● Abnormally shaped versions of your own proteins ● Cause normal proteins to change shape and become new prions ● Can clump together and damage cells ● Cause degenerative disease in the central nervous system (mad cow disease) ● Proteins that clump together and damage your cells - Protein coat surrounding nucleic acid core NURSING 390 Exam 1 study guide Patho Cellular Regulation & Infection Latest Update 2022/2023 Assured Success NURSING 390 Exam 1 study guide Patho Cellular Regulation & Infection Latest Update 2022/2023 Assured Success ● So m e ha ve en ve lo pe s ● D N A or R N A (r et ro vi ru s - HI V) - *Can not reproduce without a host - Uses the host cell’s metabolic machinery to make new viruses NURSING 390 Exam 1 study guide Patho Cellular Regulation & Infection Latest Update 2022/2023 Assured Success NURSING 390 Exam 1 study guide Patho Cellular Regulation & Infection Latest Update 2022/2023 Assured Success NURSING 390 Exam 1 study guide Patho Cellular Regulation & Infection Latest Update 2022/2023 Assured Success NURSING 390 Exam 1 study guide Patho Cellular Regulation & Infection Latest Update 2022/2023 Assured Success Influenza: Pathophysiology - droplets from an infected person/contaminated object are inhaled where it travels to the lungs and infects the host Etiology - the virus invades the epithelium of the respiratory tract, causing inflammation and desquamation Clinical manifestations - ● Symptoms appear in 24-48 hours (incubation period) ● Chills ● Temperature 101-104 ● Headache ● Malaise ● Myalgia ● Nonproductive cough Risk factors - Older age - Poor nutrition - Immune deficiency - Impaired skin integrity - Circulatory disturbances - Altered normal flora - DM - Steroid therapy - Chemotherapy - Smoking - Alcohol consumption NURSING 390 Exam 1 study guide Patho Cellular Regulation & Infection Latest Update 2022/2023 Assured Success NURSING 390 Exam 1 study guide Patho Cellular Regulation & Infection Latest Update 2022/2023 Assured Success 2. Discuss therapies used in the treatment and prevention of influenza. Adequate fluid intake Anti-pyrogenic medications Antitussives Prophylactic antibiotics (COPD pts) Amantadine and rimantadine (antivirals) Educate pts about influenza immunizations - 6 months and older CDC recommends annual vaccination - Inactivated form of the vaccine is recommended for pregnant women - Live-attenuated influenza is available as a nasal spray (2-49 years) 3. Describe the pathophysiology, etiology, clinical manifestations, and direct and indirect causes of Tuberculosis. Pathophysiology: it is spread airborne droplets (it is airborne) when a person coughs, speas, sneezes, and hugs. Bacteria Enters the lungs and multiplies on the bronchioles or alveoli. Replicates slowly and spreads via the lymphatic system Cells divide every 25-32 hours NURSING 390 Exam 1 study guide Patho Cellular Regulation & Infection Latest Update 2022/2023 Assured Success NURSING 390 Exam 1 study guide Patho Cellular Regulation & Infection Latest Update 2022/2023 Assured Success When the cellular immune system is activated leads to: - Tissue granuloma forms - Contains the bacteria and prevents replication and spread of disease - Solid necrosis - Caseous necrosis - Activated within 2-3 weeks - Restricts further growth and establishes latency Etiology: it spread from one person to another when in close, frequent, and prolonged exposure, spreads via airborne droplets Clinical manifestations: ● Fatigue ● Malaise ● Anorexia ● Weight loss ● Low-grade fever ● Night sweats ● Symptom free (latent) Direct and indirect causes: - Direct contact with the bacteria - Indirect spreading of bacteria: sneezing, coughing 4. Identify risk factors associated with tuberculosis. ● Immune compromised ● DM NURSING 390 Exam 1 study guide Patho Cellular Regulation & Infection Latest Update 2022/2023 Assured Success