PATHOPHYSIOLOGY DAILY QUIZZES FOR EXAM I:
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REVIEW OF CELL STRUCTURE AND TERMINOLOGY:
Loss of homeostasis or the condition where physical or mental capacities cannot be fully utilized is called: disease. *
Fever is considered to be a : sign.*
Nausea is considered to be a : symptom. *
If a disease condition is widely distributed throughout the body it is said to be : systemic. *
What is the structure of the cell membrane? The cell membrane is composed of a bilayer of phospholipid molecules in which proteins are embedded. The phospholipid molecules allow only certain substances to enter the cell, mostly lipid soluble substances. The proteins in the membrane serve as receptors for hormones, cell recognition proteins ( such as the MHC I), channels, pumps and enzymes. *
Inside a cell proteins are manufactured by the rough endoplasmic reticulum and packaged by the Golgi apparatus. *
The Krebs or Citric Acid Cycle takes place inside: mitochondria. *
Which part of cellular respiration can produce small amounts of ATP without oxygen? Glycolysis. *
The four types of tissue are: Epithelial tissue, connective tissue, muscle and nervous tissue. *
What is the difference between hypertrophy and hyperplasia? Both increase the size of an organ, but the underlying cause is different. Hypertrophy involves an increase in cell size due to increased protein synthesis within the cell (actual increase in the organelles in a cell, not edema) and hyperplasia is an increase in the number of cells within the tissue due to increased cell division. *
In smokers, the normal ciliated pseudostratified columnar epithelium of the trachea is replaced by non-keratinized stratified squamous epithelium. This is an example of : metaplasia. *
Of metaplasia, hypertrophy, dysplasia, neoplasia and atrophy, which one is NOT considered to be a reversible change? Neoplasia. *
What is the difference between ischemia and hypoxia? Ischemia is a decrease in blood flow to a tissue. This can lead to hypoxia, which is a deficiency of oxygen to a cell or tissue. *
What are the three basic causes of cellular injury? Deficiencies, intoxication and trauma. *

NEOPLASIA
Of hypertrophy, hyperplasia, metaplasia, dysplasia, atrophy and neoplasia, which ones are reversible? *All except neoplasia are reversible.*
What are proto-oncogenes? * These are normal chromosomes that control cell division. They may become damaged or mutated into oncogenes, which cause rapid and uncontrolled cell division.*
What are telomeres? *Telomeres are repeating sequences of nucleotides found on the ends of chromosomes. Every time the cell divides, some of these sequences are lost. When enough of these telomeres are lost, the cell can no longer divide. Telomerase is an enzyme which replaces lost telomeres. Activation of this enzyme gives a cell virtual immortality.*
Of Lipoma, Adenocarcinoma, Liposarcoma, Glioma and Chondroma, which are benign and which are malignant neoplasms? * Lipomas and Chondromas are benign, Liposarcoma and Adenocarcinomas are malignant (watch for hte carcinoma and sarcoma endings). Gliomas may be either! *
What is meant by autonomy and anaplasia? *Autonomy is the ability of a cell to divide outside of the normal controls of the body and without the normal growth signals given by the body. Anaplasia means that cell has become less differentiated and lost its function. In other words, the cell has become more like an embryonic cell or stem cell. *

REVIEW OF INFLAMMATION AND FEVER:
Inflammation is what type of a response to injury? Non-specific. *
What are the cardinal signs of inflammation? Redness, heat, swelling and pain, and some add loss of function.*
What causes most of the signs of inflammation? The vasodilation and increase in permeability of vessels during the first stage of inflammation.*
What forces drive fluids in and out of vessels? The forces that drive fluids out of vessels are hydrostatic pressure, and osmotic pressure of the tissues. The forces that retain fluid in the vessel or that draw or force fluid into vessels are the osmotic pressure of the proteins of the blood, and hydrostatic pressure of the tissue fluid.*
Both transudates and exudates are fluids and substances forced out of vessels. Which would have the higher specific gravity? Exudates because they contain cells and more plasma proteins than transudates do. *
What are the functions of exudates? To dilute toxins; the pain caused by the swelling due to exudates limits the use of the body part and prevents additional injury; to carry blood cells and proteins to the area, and to carry toxins  and wastes away from the site, mostly through the lymphatic system. *
Which leukocytes are the first to arrive at the site of acute inflammation? Neutrophils*
What differences do we see in chronic inflammation instead of acute inflammation?  In chronic inflammation the time frame is much longer and we see lymphocyte infiltration instead of neutrophils, and fibroblast proliferation instead of exudates.*
What factors can impair or reduce inflammation? Excess bleeding at the site; poor circulation at the site of injury prevents blood and blood cells and proteins from reaching the area; decreased functioning of bone marrow where the leukocytes involved in inflammation are formed; decreased immune system response since this also can contribute to inflammation; and nutritional status, especially protein deficiency since many of the factors involved are proteins. *
What can we do to reduce inflammation if it becomes excessive? Apply cold compresses that cause vasoconstriction, but only for 10 minutes or less. Elevate the affected part to reduce blood flow to the area. Administer anti-inflammatory drugs, such as steroids.*
What is the difference between the "heat" of inflammation and fever? The heat of inflammation is often a localized response due to vasodilation and increased blood flow to an area. Fever refers to an increase in the body's temperature set point by the hypothalamus.  Fever may accompany inflammation, but can also occur for other reasons such as infection. *
Lipopolysaccharides in the walls of gram negative bacteria can act as: exogenous pyrogens. * These substances cause body cells such as macrophages to produce endogenous pyrogens that induce the formation of prostaglandins which cause the hypothalamus to raise the body's temperature set point.  Substances such as aspirin decrease fever by blocking the production of : prostaglandins. *
How do the release of thyroid stimulating hormone and the decrease in the production of ADH increase body temperature? Thyroid stimulating hormone causes the thyroid gland to produce T3 and T4, the hormones that regulate the basal metabolic rate of the body. When these increase metabolism speeds up, and heat is produced as a by-product of metabolism. ADH, or antidiuretic hormone causes the body to retain water. When less is produced, the body loses water. But it takes a lot of energy to raise the temperature of water, so with less water in the body, it becomes easier to raise the body temperature.*
What are the benefits of fever? The increase in temperature slows the growth and reproduction of microorganisms in the body. It also decreases serum levels of substances such as iron, copper and zinc that are needed by bacteria for reproduction. It causes the lysosomes in infected cells to break and release their enzymes, destroying infected cells. It facilitates or aids the immune response, enhances phagocytosis and increases the production of interferon which protects uninfected cells.*
Fevers are most likely to be harmful in what groups of people? Those who are pregnant or who have heart disease or stroke.*
IMMUNITY
What are some non-specific body defenses? Barriers, such as skin and mucous membranes; flushing action; anti-microbial chemicals such as acids, salt, lysozyme, antibiotics produced by normal microbiota; Natural Killer Cells; Inflammation; and Fever.*
What are specific body defenses? Only immunity. *
A freshman goes to the doctor and receives a vaccine against meningococcal meningitis so that he will not come down with the disease living in the dormitory. This is an example of what type of immunity? Artificial active acquired immunity*
A Susan  receives a kidney from a relative. Her older sister, Sally, comes home from school with chickenpox. Susan is given antiserum containing antibodies against the chickenpox virus. This is an example of what type of immunity? Artificial passive acquired immunity. *
Where do B cells mature? In the bursal equivalent in the bone marrow. *
What do B cells produce? B cells can become activated into plasma cells and produce antibodies. This is humoral or Antibody Mediated Immunity.*
Where do T cells mature? In the thymus gland. *
What is the difference between a T_H cell and a Tc Cell? Both are lymphocytes that react to specific antigens, but they have very different functions in the immune system. The T_H cell or helper T cell produces interleukin 2 (or 4 or other) which acts as the second signal in the activation of both Cell Mediated Immunity and Antibody Mediated Immunity. The Tc or T cytotoxic cell is the lymphocyte that attacks infected or diseased cells directly and is the basis for Cell Mediated Immunity. The helper T cell is sometimes called the T4 cell and the Tc cell is the T8 cell due to different receptors on the cell surface.*
Which immunoglobulin would you expect to find in secretions such as tears and breast milk? IgA. *
Which immunoglobulin is produced first during the immune response? IgM. This has five "Y" shaped units held together. *
The fact that the secondary immune response or anamnestic response is so much faster and stronger that the primary immune response is due to : the formation of many memory cells the first time the antigen is encountered.*
Name three characteristics of the immune response. It is specific, long term, and inducible. *
What characteristics make for a good antigen? The substance should be large, complex, and recognized by the body as foreign. *
HYPERSENSITIVITY AND VIRAL INFECTION
Immediate type hypersensitivity occurs when *IgE* antibodies bind to * mast cells*. When an allergen cross-links the antibodies it causes the *mast cell* to release *histamine.*
Type II hypersensitivity is also called *tissue specific or antibody-dependent cytotoxicity.* It occurs when antibodies  *bind to tissue specific antigens* on the membranes of cells. The cells are destroyed by: * complement mediated lysis; phagocytosis by macrophages (remember - this may be "frustrated phagocytosis"; and destruction by Tc cells that are not antigen specific, such as K cells; or by blocking receptors the cell needs to function.*
Type III hypersensitivity occurs when *antigen-antibody complexes* are deposited in vessel walls or other tissues. Thus, this type of hypersensitivity is not organ specific. Its effects are caused by *activation of complement which results in the chemotaxis of neutrophils. The neutrophils try to phagocytize the complexes, but can't because they are bound to the tissues, so the neutrophils release lysosomal enzymes into the tissue.*
Type IV hypersensitivity is due to *cell-mediated  tissue reactions.* Damage to the tissues is caused by:*destruction of tissue by Tc cells or inflammatory response caused by Td cells.*
What would you do if a person went into anaphylactic shock? * Maintain an airway; give epinephrine, antihistamines and corticosteroids; provide intravenous fluids and oxygen. *
When are the steps involved in infection of a cell by a virus? * adsorption to receptor on host cell surface; penetration into the host cell; removal of viral coat; replication of viral nucleic acids and protein; assembling of new virus particles; and release of virus from the cell.*

IMMUNODEFICIENCIES and HIV/AIDS
If a person is born without a thymus gland, they will have a congenital deficiency of * T cells.*
A person that had a tendency to develop unusual or recurrent infections with viruses, fungi and yeast may have a deficiency in their *T cells.*
True or false. All immune defieciencies are caused by the Human Immunodeficiency Virus. *False - there are many types of congenital and acquired immunodeficiencies. *
The HIV most likely arose in the *chimpanzee* population in *central Africa* and was transferred to the human population there.
The most common route of transmission of HIV in most of the world is *sexual intercourse.*
Other means of acquiring the HIV are: *Sharing needles with infected drug abusers; receiving infected blood products (intentionally or unintentionally) and transmission from an infected mother to child.*
The HIV is a retrovirus, meaning that its genetic material is *RNA that is copied into DNA by reverse transcriptase once inside the host cell.*
The HIV virus shuts down both cell-mediated immunity and antibody-mediated immunity by attacking *the helper T cell which provides the second signal for both types of immunity, and without which, neither the B cell nor the Tc cell can reproduce and fight infection.*
A person infected with the HIV comes down with flu-like symptoms that last a few weeks and the resolve. This is known as the * acute phase.*
True or false: all persons infected with HIV show flu-like symptoms or symptoms similar to mononucleosis or meningitis. *False 30- 60% of infected individuals do not show these symptoms.*
True or false: We could prevent AIDS if we could get our bodies to make antibodies against the virus. *False - we do make antibodies against the virus, but they are not effective in getting rid of the virus. *
When is a diagnosis of AIDS made? *When the person has a positive lab test for the HIV virus and has clinical symptoms - unusual infections or neoplasms. These do not usually occur until the T4 (helper T) cell count reaches 200/mm3 or less.*
What three classes of drugs have been helpful in treating HIV positive individuals? * reverse transcriptase inhibitors, such as AZT; protease inhibitors; and integrase inhibitors.  Immunomodulators (immune system stimulators) such as interferon and interleukin have also been used. *