Patho Midterm Review
• Innate and adaptive defense
o Types of immunity
- Innate – non specific
Skin, mucous, chemicals, inflammatory, pyrogens,
interferons, complement proteins
- Adaptive – recognizes and attacks antigens
A. T Cells- 2 types regulator and
effector Regulator
Helper – activate B cells to produce antibodies
Suppressor – depress B cells (turn off)
Effector – destroy cells infected by virus by lymphokines
B. B Cells – destroy antigens and produce antibodies
o Hypersensitivity reaction
- Type I: IgE mediated
A. Immediate response
B. Local or systemic
C. Allergen > Trigger T cell > trigger B cell > IgE
D. ALLERGY
- Type II: cytotoxic hypersensitivity reaction
A. Blood Transfusion reaction
- Type III: immune complex–mediated
A. Antigen – antibody complexes accumulate and are deposited into
tissues
- Type IV: delayed hypersensitivity reaction
A. Cell mediated
B. Antigen presentation results in cytokine release, which leads to
INFLAMMATION
• Transplant reactions
- Allogenic: donor and recipient are related or unrelated, but share similar
tissue types
- Syngenic: donor and recipient are identical twins
- Autologous: donor and recipient are the same person; most successful (ex.
Person storing their own blood prior to surgery)
- Xenogenic: use of tissue from another species (ex. Using pig heart valve
, - Hyperacute
a. immediate – 3 days
b. due to complement
c. tissue becomes necrotic
- Acute
a. Most common; 4 days – 3 months
b. Treatable
c. Fever, edema, site tenderness, impaired function
- Chronic
a. 4 months – years
b. antibody mediated
c. antibodies and complement deposit into tissue walls resulting in ISCHEMIA
- Host vs. Graft
a. host fights graft
- Graft vs. Host
a. graft fights host
b. FREQUENT AND POTENTIALLY FATAL IN BONE
MARROW TRANSPLANTS
• Immunity
o Stress reaction
- Includes increased heart rate, increased respirations, diaphoresis, increased
blood flow to muscles, increased muscle strength, increased mental
alertness, increased fat and protein mobilization, increased glucose
availability, and decreased inflammation
- General Adaptation Syndrome
a. Alarm
Stimulation of SNS
Fight or flight
b. Resistance
Body chooses the best defense
Returns to normal
Fight or flight ends
Adapts or alters to desensitize stressor
c. Exhaustion
Body becomes damaged and depleted
Homeostasis cannot be maintained
Disease or death results
- Local Adaptation Syndrome
, a. Confines stressor to one area of the body (local inflammatory
response)
o HIV/AIDS
- Caused by human immunodeficiency virus
- 2 types of HIV
Type 1 is the most common strain
Type 2 is common in West Africa, Progresses to disease more slowly
- Transmitted through blood and bodily fluids
- Phases:
Asymptomatic – virus is reproducing (usually several years)
Infection – viral number increases, DESTROYS CD4 CELLS
- Progression:
Immunodeficiency
Autoimmunity
Neurologic dysfunction
- Diagnosed by testing for the HIV
antibody Rapid Test
Heme Test
Polymerase Chain Reaction (measures amount of HIV DNA
or viral load; good for infants and infected mothers)
- 2 classifying systems
a. Lab tests CD4 COUNT
Category 1: > 500
Category 2: 200 – 499
Category 3: < 200 (turns into AIDS)
b. Clinical Presentation
Category 1: asymptomatic
Category 2: some less serious manifestations of immune deficiency
Category 3: AIDS defining illnesses present
- NO CURE
COMBINATION THERAPY
VACCINES
TRANSMISSION PREVENTION
o Diabetes
• Cell functionality
- Atrophy – decrease in cell size because of decrease in demand
- Hypertrophy – increase in cell size due to increased workload
- Hyperplasia – increase in number of cells in a tissue or organ
- Metaplasia – 1 adult cell replaced by another cell type (chronic irritation
and inflammation)
, - Dysplasia – cells mutate into different cells of different size, shape,
and appearance
- Apoptosis – programmed cell death
o Homeostasis
- Relative consistency of the body’s systems
- Equilibrium is necessary for all cells
- Self-regulating; compensatory
- Negative feedback – most common (works to maintain a deficit in the
body) – BODY DETECTS A CHANGE AND CAUSES AN
OPPOSITE RESPONSE
- Positive feedback – detects stimulus and enhances the response –
(CHILDBIRTH – BODY DETECTS STRETCH OF UTERUS –
CAUSES CONTRACTIONS TO FURTHER STRETCH)
• Neoplasms
o Cancer staging- TNM (tumor node metastasis); based on spread of the disease
o Grading- according to histology (I, II, III and IV: as it increases, the tumor is
less differentiated)
• Carcinogenesis: cancer development
o steps in carcinogenesis- normal cells undergo change
- 1. Initiation: introduction of the agent
- 2. Promotion: initiation of uncontrolled growth
- 3. Conversion
- 4. Progression: permanent malignant changes
o Heredity
o Oncogenes: transforms a normal cell into a cancer cell. It is a mutated form of a
gene involved in normal cell growth.
o Environmental
o Clinical Manifestations
- Change in bowel or bladder habits
- A sore that doesn’t heal
- Unusual bleeding or discharge
- Thickening or lump in the breast or elsewhere
- Indigestion or difficulty swallowing
- Obvious change in a wart or mole
- Nagging cough or hoarseness
o Complications
- Anemia, cachexia, fatigue, infections, leukopenia, thrombocytopenia, pain
o Diagnosis
- Biopsy, tumor markers, miscellaneous procedures
• Innate and adaptive defense
o Types of immunity
- Innate – non specific
Skin, mucous, chemicals, inflammatory, pyrogens,
interferons, complement proteins
- Adaptive – recognizes and attacks antigens
A. T Cells- 2 types regulator and
effector Regulator
Helper – activate B cells to produce antibodies
Suppressor – depress B cells (turn off)
Effector – destroy cells infected by virus by lymphokines
B. B Cells – destroy antigens and produce antibodies
o Hypersensitivity reaction
- Type I: IgE mediated
A. Immediate response
B. Local or systemic
C. Allergen > Trigger T cell > trigger B cell > IgE
D. ALLERGY
- Type II: cytotoxic hypersensitivity reaction
A. Blood Transfusion reaction
- Type III: immune complex–mediated
A. Antigen – antibody complexes accumulate and are deposited into
tissues
- Type IV: delayed hypersensitivity reaction
A. Cell mediated
B. Antigen presentation results in cytokine release, which leads to
INFLAMMATION
• Transplant reactions
- Allogenic: donor and recipient are related or unrelated, but share similar
tissue types
- Syngenic: donor and recipient are identical twins
- Autologous: donor and recipient are the same person; most successful (ex.
Person storing their own blood prior to surgery)
- Xenogenic: use of tissue from another species (ex. Using pig heart valve
, - Hyperacute
a. immediate – 3 days
b. due to complement
c. tissue becomes necrotic
- Acute
a. Most common; 4 days – 3 months
b. Treatable
c. Fever, edema, site tenderness, impaired function
- Chronic
a. 4 months – years
b. antibody mediated
c. antibodies and complement deposit into tissue walls resulting in ISCHEMIA
- Host vs. Graft
a. host fights graft
- Graft vs. Host
a. graft fights host
b. FREQUENT AND POTENTIALLY FATAL IN BONE
MARROW TRANSPLANTS
• Immunity
o Stress reaction
- Includes increased heart rate, increased respirations, diaphoresis, increased
blood flow to muscles, increased muscle strength, increased mental
alertness, increased fat and protein mobilization, increased glucose
availability, and decreased inflammation
- General Adaptation Syndrome
a. Alarm
Stimulation of SNS
Fight or flight
b. Resistance
Body chooses the best defense
Returns to normal
Fight or flight ends
Adapts or alters to desensitize stressor
c. Exhaustion
Body becomes damaged and depleted
Homeostasis cannot be maintained
Disease or death results
- Local Adaptation Syndrome
, a. Confines stressor to one area of the body (local inflammatory
response)
o HIV/AIDS
- Caused by human immunodeficiency virus
- 2 types of HIV
Type 1 is the most common strain
Type 2 is common in West Africa, Progresses to disease more slowly
- Transmitted through blood and bodily fluids
- Phases:
Asymptomatic – virus is reproducing (usually several years)
Infection – viral number increases, DESTROYS CD4 CELLS
- Progression:
Immunodeficiency
Autoimmunity
Neurologic dysfunction
- Diagnosed by testing for the HIV
antibody Rapid Test
Heme Test
Polymerase Chain Reaction (measures amount of HIV DNA
or viral load; good for infants and infected mothers)
- 2 classifying systems
a. Lab tests CD4 COUNT
Category 1: > 500
Category 2: 200 – 499
Category 3: < 200 (turns into AIDS)
b. Clinical Presentation
Category 1: asymptomatic
Category 2: some less serious manifestations of immune deficiency
Category 3: AIDS defining illnesses present
- NO CURE
COMBINATION THERAPY
VACCINES
TRANSMISSION PREVENTION
o Diabetes
• Cell functionality
- Atrophy – decrease in cell size because of decrease in demand
- Hypertrophy – increase in cell size due to increased workload
- Hyperplasia – increase in number of cells in a tissue or organ
- Metaplasia – 1 adult cell replaced by another cell type (chronic irritation
and inflammation)
, - Dysplasia – cells mutate into different cells of different size, shape,
and appearance
- Apoptosis – programmed cell death
o Homeostasis
- Relative consistency of the body’s systems
- Equilibrium is necessary for all cells
- Self-regulating; compensatory
- Negative feedback – most common (works to maintain a deficit in the
body) – BODY DETECTS A CHANGE AND CAUSES AN
OPPOSITE RESPONSE
- Positive feedback – detects stimulus and enhances the response –
(CHILDBIRTH – BODY DETECTS STRETCH OF UTERUS –
CAUSES CONTRACTIONS TO FURTHER STRETCH)
• Neoplasms
o Cancer staging- TNM (tumor node metastasis); based on spread of the disease
o Grading- according to histology (I, II, III and IV: as it increases, the tumor is
less differentiated)
• Carcinogenesis: cancer development
o steps in carcinogenesis- normal cells undergo change
- 1. Initiation: introduction of the agent
- 2. Promotion: initiation of uncontrolled growth
- 3. Conversion
- 4. Progression: permanent malignant changes
o Heredity
o Oncogenes: transforms a normal cell into a cancer cell. It is a mutated form of a
gene involved in normal cell growth.
o Environmental
o Clinical Manifestations
- Change in bowel or bladder habits
- A sore that doesn’t heal
- Unusual bleeding or discharge
- Thickening or lump in the breast or elsewhere
- Indigestion or difficulty swallowing
- Obvious change in a wart or mole
- Nagging cough or hoarseness
o Complications
- Anemia, cachexia, fatigue, infections, leukopenia, thrombocytopenia, pain
o Diagnosis
- Biopsy, tumor markers, miscellaneous procedures
