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ACNM - Human Disease Processes

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What do T-Cells do?
They facilitate cellular immunity by targeting foreign invaders and destroying them.
What are five signs of inflammation?
a) redness
b) heat
c) swelling
d) pain
e) loss of function
What is the purpose of B-Cells?
They produce antibodies specific to particular antigens and combat them by slowing them down and making them a target for macrophages
What is a bacterium?
a) they are unicellular
b) they are living organisms
c) they have DNA
d) they have cell walls
e) they dont have nuclei
Describe a virus.
a) They are non-living organisms
b) they have no metabolism
c) they cant replicate or reproduce on their own
d) they dont have organelles or cytoplasm
e) they can be dormant for long periods of time
f) they are parasitical
What are the differences between parasites and viruses?
a) some viruses have DNA, some have RNA
b) parasites have different forms of parasitic arrangements
c) anything parasitic gets its energy from the host organism
d) viruses are intracellular and can only reproduce when inside a cell
e) parasites are usually living and may be intracellular or extracellular and still require our energy
What are crions?
They are similar to viruses but they contain only protein and no genetic material.
Describe fungi.
Fungi can be singular or multicellular and is mostly known as yeasts and moulds.
What are parasites?
Parasites include protozoa and are unicellular with no cell walls.
Why are parasites referred to as being of the animal kingdom?
Because they have no cell walls.
Why is bacteria referred to as being of plant origin?
They have a cell wall.
What are helminths?
Worms.
What are anthropods?
Insects.
Name 5 portals of entry?
1) skin
2) mucous
3) mucous membranes
4) eyes
5) breathing
Name 4 portals of exit.
1) coughing
2) sneezing
3) any exudate
4) any body fluid
Name 4 methods of transmission of disease.
1) bloodborn
2) waterborn
3) airborne
4) exchange of body fluids
What are the factors that determine if a person gets the disease or not after being exposed to it?
a) immune status (presence of antibodies to a particular antigen
b) age
c) gender
d) nutrition
e) stress
What are the factors contributing towards host resistance?
a) previous exposure (build up of antibodies)
b) age
c) gender
d) nutrition
e) stress
What factors affect the virulence of a pathogenic organism?
a) what type it is (virus or bacteria)
b) if the person has immunity
c) nutritional status
d) age
e) exposure to the reservoir
f) immune evasion ability ( capsule of bacteria)
if they are intracellular they could escape attack
How does HIV invade immune defences?
By hiding within cells.
How would you prevent an epidemic involving coughing?
a) by isolating the infected person
b) by having the infected person wear a mask
c) by having uninfected people wear masks
What is incubation?
The time between the infection taking place and the first sign of symptoms.
What are prodromal conditions?
The feeling of being unwell without having identifiable symptoms of the disease.
What is the difference between the prodromal illness and the illness itself?
The period between the onset of symptoms and the actual diagnosis.
If we talk about recovery from an infection, does the person still have the disease or not?
Yes
In the recovery phase is the person still going to be infective?
Possibly, some diseases are not infective in the recovery period but most diseases will still remain infective during that period.
What does etiology cause?
Cancer formation.
What is a differential diagnosis?
The system of looking at symptoms in order to determine the most likely cause of the illness.
What sort of tests might be done if a person presented with a condition of blood in the stool?
a) faecal testing
b) colonoscopy
c) imaging (CT, X-Ray etc)
d) barium enema
e) Blood tests
What sort of tests might be done in the case of anorexia and what would you be looking for?
Tests might include blood tests, faecal tests and urine tests. These would be done to test for the presence of bacteria or ketones.
What are the limitations of pathology testing of a swab taken from a suppurating sore?
a) cross contamination
b) not all microbes can be cultured (we ant culture viruses)
c) there may be more than one infective organism and it may not be possible to culture all of them
d) some organisms take a long time to culture
Given the problems associated with pathology testing of swabs, what other testing options are available?
Blood testing for the presence of a virus and haemoglobin tests.
What tests might be carried out on a person with a productive cough?
a) testing of sputum
b) lung scans (CAT, MRI, X-Ray)
c) swab tests
d) lung function tests
What sort of things does a standard blood test show?
a) viscosity
b) antibodies
c) ferritin
d) cell count (red blood cells,white blood cell fractions and platelets)
How do natural killer T-Cells work?
They work in the same way as antibiotics by breaking down the wall of the pathogen and allowing water to rush in, thereby destroying it.
What action do neutrophils and monocytes have?
They are phagocytic.
How many lines of defence are there?
Three
Which of the lines of defence are specific and non-specific.
The first 2 are non-specific, while the 3rd of specific.
How does the 1st line of defence work?
The first line of defence prevents entry of foreign invaders into the tissue, while they can intrude by way of various portals of entry, they are prevented from entering the cells.
How does the 2nd line of defence work?
Complement proteins are produced by the liver and plasma proteins are activated by the presence of foreign antibodies. The proteins enter poke holes in the pathogenic cells, water enters, they swell and die. Neutrophils and macrophages are drawn to the foreign invaders which will then undergo phagocytosis.
How does the 3rd line of defence work?
By the production of antigens specific to the organism.
How many types of hypersensitivity are there?
Four
What is Type I Hypersensitivity?
Immediate allergic reactions, which mean that thee has been previous exposure to the allergen.
What is the immunoglobulin responsible for the response of Type I hypersensitivity?
IGE
What would be some signs of Type I hypersensitivity?
a) skin rashes
b) asthma
c) eczema (atopic or contact)
d) hayfever
e) vomiting & diarrhoea
f) allergic conjunctivitis
What is the treatment for an aphylaxis?
The administering of adrenalin (epinephrine)
What is an anaphylaxis and what causes it?
It is an extreme and life threatening form of Type I Hypersensitivity and is caused by things such as insect stings, food allergies and drug allergies.
What clinical features would likely be present with anaphylaxis?
a) itching or tingling sensations
b) coughing and difficulty breathing
c) weakness, dizziness or fainting
d) fear and panic
e) oedema around eyes, lips, tongue, hands and feet
f) the appearance of hives on the skin
g) collapse and loss of consciousness in minutes
What are the pathiophysiology effects of an anaphylaxis?
a) release of large amounts of chemical mediators from mast cells
b) general or systemic vasodilation
c) Sudden severe decrease in blood volume
d) oedema of the lungs constricting oxygen exchange
e) bronchoconstriction obstructing airflow
f) respiratory and circulatory impairment causing lack of oxygen availability
g) loss of consciousness
h) rapid death if untreated
What is Type II Hypersensitivity?
It is cytotoxic hypersensitivity where the reaction can be to something that is normal in the body, like autoimmunity. It can also be activated as a result of organ transplants, blood transfusions etc.
What is Type III Hypersensitivity?
It is an immune complex type of hypersensitivity which is a result of the normal mechanisms of neutrophils and macrophages performing phagocytosis not clearing antigen antibodies, resulting in deposits in some tissues and possible localised inflammation.
What is Type IV Hypersensitivity, how long does it take to develop and what causes it?
It is delayed cell mediated hypersensitivity in which the response can take 48-72 hours and is caused by things such as cosmetics, dyes, soaps and metals.
Name five things that cause cancer to develop.
a) damage to DNA
b) exposure to chemicals
c) exposure to viruses
d) exposure to ionising radiation
e) injuries that are continually exacerbated
Where does ionising radiation come from?
a) the sun
b) X-Rays
C) gamma rays
d) light
What is neoplasia?
The uncontrolled, progressive multiplication of cells.
What are the three steps in the formation of a tumour?
1. initiating factors or the first exposure to a cancer causing agent
2. promotors can be hormones or further exposure to either the same initiating factor or chemical
3. actual start of cancer
What would be the treatment of Type IV Hypersensitity?
a) immunosuppressive drugs
b) corticosteroids
c) removal of the antigen
What clinical features could be present in Type IV Hypersensitivity?
a) localised rach
b) pruritis
c) redness
d) vesicles
e) serous exudate
What are the possible outcomes of the responses to Type II Hypersensitivity?
a) death
b) loss of function
c) increased function (dysfunction)
What is virulence of an organism?
The degree of pathogenicity and potential of the organism to establish itself and cause harm.
In order for a micro-organism to obtain pathogenicity, what must occur?
a) it must gain entry to a host
b) it must attach itself to the host tissues and multiply
c) it must evade the hosts defence mechanisms
d) it must damage tissue and produce disease symptoms
What is metastasis?
It is the spread of the tumour to distant sites by the blood or lymphatics.
What specimens could be used for diagnosis?
a) swabs
b) blood
c) urine
d) CSF
e) faeces
f) sputum
g) saliva
h) biopsy
What is meant by self limiting when it comes to diseases?
It means that the disease runs a course and finishes in its own predetermined time (eg viruses)
What are the major portals of entry on the body?
a) skin
b) respiratory tract
c) gastrointestinal tract
d) genitourinary system
What is dysplasia?
Abnormal and often reversible changes in size, shape and organisation of mature cells.

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