Podcast
Questions and Answers
Which of the following is NOT a symptom of the exhaustion stage of the general adaptation syndrome?
Which of the following is NOT a symptom of the exhaustion stage of the general adaptation syndrome?
What is the primary function of the epidermis?
What is the primary function of the epidermis?
Which of the following is NOT an unhealthy coping strategy for stress?
Which of the following is NOT an unhealthy coping strategy for stress?
What does the term 'homeostasis' refer to in the context of stress?
What does the term 'homeostasis' refer to in the context of stress?
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What is a possible consequence of chronic stress on the body?
What is a possible consequence of chronic stress on the body?
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Which of the following is NOT a physical symptom of stress?
Which of the following is NOT a physical symptom of stress?
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What is the primary function of the skin?
What is the primary function of the skin?
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What is the term used to describe the stages of the body's response to stress?
What is the term used to describe the stages of the body's response to stress?
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What is the primary cause of bronchitis in non-smokers?
What is the primary cause of bronchitis in non-smokers?
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What is the main characteristic of chronic bronchitis?
What is the main characteristic of chronic bronchitis?
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What is the primary difference between chronic bronchitis and emphysema?
What is the primary difference between chronic bronchitis and emphysema?
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Which of the following is NOT a potential cause of bronchitis?
Which of the following is NOT a potential cause of bronchitis?
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What is the temperature range for hyperthermia?
What is the temperature range for hyperthermia?
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What is the direct consequence of cilia loss in the bronchi?
What is the direct consequence of cilia loss in the bronchi?
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What is the clinical diagnosis criterion for chronic bronchitis?
What is the clinical diagnosis criterion for chronic bronchitis?
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What is a major risk factor for hypothermia?
What is a major risk factor for hypothermia?
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What is the main difference between a URTI and bronchitis?
What is the main difference between a URTI and bronchitis?
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What is the definition of a stressor?
What is the definition of a stressor?
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What is the core body temperature range for hypothermia?
What is the core body temperature range for hypothermia?
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Which of the following is NOT a common symptom of URTI?
Which of the following is NOT a common symptom of URTI?
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What is the definition of homeostasis?
What is the definition of homeostasis?
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What type of stress can lead to growth and satisfaction?
What type of stress can lead to growth and satisfaction?
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What is the definition of a stress response?
What is the definition of a stress response?
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What is the primary cause of heat stroke?
What is the primary cause of heat stroke?
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Which type of pneumonia is characterized by the presence of tiny lesions (1-5 mm) widely disseminated throughout the body?
Which type of pneumonia is characterized by the presence of tiny lesions (1-5 mm) widely disseminated throughout the body?
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What is the main cause of pulmonary embolism?
What is the main cause of pulmonary embolism?
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Which of the following is NOT a risk factor for pulmonary embolism?
Which of the following is NOT a risk factor for pulmonary embolism?
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Which type of pleural effusion is characterized by high protein content in the excess fluid?
Which type of pleural effusion is characterized by high protein content in the excess fluid?
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What is the common name for pleuritis?
What is the common name for pleuritis?
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Which of the following is NOT a common site affected by tuberculosis?
Which of the following is NOT a common site affected by tuberculosis?
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What type of bacteria are responsible for aspiration pneumonia?
What type of bacteria are responsible for aspiration pneumonia?
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Which condition is often a complication of pneumonia?
Which condition is often a complication of pneumonia?
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What is the normal range for PaCO2 in arterial blood?
What is the normal range for PaCO2 in arterial blood?
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What is the term used to describe a decrease in the number of circulating platelets?
What is the term used to describe a decrease in the number of circulating platelets?
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Which of the following is NOT a manifestation of hypovolemic shock?
Which of the following is NOT a manifestation of hypovolemic shock?
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What is the normal range for bicarbonate (HCO3-) in the blood?
What is the normal range for bicarbonate (HCO3-) in the blood?
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Which stage of hemostasis involves the formation of an insoluble fibrin clot?
Which stage of hemostasis involves the formation of an insoluble fibrin clot?
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What is the term for the stoppage of blood flow?
What is the term for the stoppage of blood flow?
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Which of the following is NOT a possible cause of thrombocytopenia?
Which of the following is NOT a possible cause of thrombocytopenia?
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What is the term used to describe platelet counts greater than 1,000,000/mm3?
What is the term used to describe platelet counts greater than 1,000,000/mm3?
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What is the primary function of hemoglobin in red blood cells?
What is the primary function of hemoglobin in red blood cells?
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Where does the destruction of red blood cells primarily occur in the body?
Where does the destruction of red blood cells primarily occur in the body?
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What is the hormone responsible for regulating red blood cell production?
What is the hormone responsible for regulating red blood cell production?
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What is the life span of a red blood cell, on average?
What is the life span of a red blood cell, on average?
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What is the primary cause of anemia?
What is the primary cause of anemia?
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Which of the following is NOT a cause of anemia?
Which of the following is NOT a cause of anemia?
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During the destruction of red blood cells, what happens to the iron from hemoglobin?
During the destruction of red blood cells, what happens to the iron from hemoglobin?
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Flashcards
Sustained Fever
Sustained Fever
Continuous elevated temperature above 38°C with little fluctuation.
Relapsing Fever
Relapsing Fever
Fever periods alternated with normal temperature intervals.
Hyperthermia
Hyperthermia
Elevated body temperature from poor heat regulation, >37.5-38.3°C.
Heat Stroke
Heat Stroke
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Hypothermia
Hypothermia
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Risk Factors for Hypothermia
Risk Factors for Hypothermia
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Eustress
Eustress
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Distress
Distress
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General Adaptation Syndrome
General Adaptation Syndrome
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Alarm Stage
Alarm Stage
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Resistance Stage
Resistance Stage
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Exhaustion Stage
Exhaustion Stage
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Homeostasis
Homeostasis
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Effects of Stress
Effects of Stress
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Healthy Coping Strategies
Healthy Coping Strategies
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Unhealthy Coping Strategies
Unhealthy Coping Strategies
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Upper Respiratory Tract
Upper Respiratory Tract
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Lower Respiratory Tract
Lower Respiratory Tract
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URTI (Upper Respiratory Tract Infection)
URTI (Upper Respiratory Tract Infection)
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Symptoms of URTI
Symptoms of URTI
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Acute Bronchitis
Acute Bronchitis
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Chronic Obstructive Pulmonary Disease (COPD)
Chronic Obstructive Pulmonary Disease (COPD)
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Chronic Bronchitis
Chronic Bronchitis
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Emphysema
Emphysema
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Bacterial pneumonia
Bacterial pneumonia
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Viral pneumonia
Viral pneumonia
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Mycoplasma pneumonia
Mycoplasma pneumonia
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Aspiration pneumonia
Aspiration pneumonia
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Tuberculosis (TB)
Tuberculosis (TB)
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Primary TB
Primary TB
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Pulmonary embolism
Pulmonary embolism
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Pleural effusion
Pleural effusion
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Erythropoiesis
Erythropoiesis
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Erythropoietin
Erythropoietin
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Anemia
Anemia
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Hemoglobin
Hemoglobin
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Bilirubin
Bilirubin
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Iron Recycling
Iron Recycling
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Acute Blood Loss
Acute Blood Loss
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Reticulocytes
Reticulocytes
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PaCO2
PaCO2
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Normal range of PaCO2
Normal range of PaCO2
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Acidosis (respiratory)
Acidosis (respiratory)
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HCO3-
HCO3-
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Normal range of HCO3-
Normal range of HCO3-
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Hypovolemic shock
Hypovolemic shock
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Thrombocytosis
Thrombocytosis
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Thrombocytopenia
Thrombocytopenia
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Study Notes
Respiratory System
- The upper respiratory tract consists of the nose, mouth, sinuses, pharynx, and larynx.
- The lower respiratory tract consists of the trachea, bronchi, bronchioles, and lungs.
Upper Respiratory Tract Infection (URTI)
- Illnesses caused by an acute infection involving the nose, sinuses, pharynx, or larynx.
- Commonly caused by viruses and sometimes bacteria.
- URTI includes rhinosinusitis (common cold), sinusitis, pharyngitis/tonsillitis, and laryngitis.
Symptoms of URTI
- Nasal congestion
- Cough
- Running nose
- Sore throat
- Fever
- Sneezing
- Symptom onset is usually 1-3 days after exposure to a microbial pathogen.
- Symptoms typically last 7-10 days but may persist longer.
Acute Bronchitis
- Superficial inflammation of the bronchi.
- Causes include viruses, bacteria, irritant inhalation, and allergic reactions.
- Considered an acute illness.
- In non-smokers, bronchitis is typically caused by a virus or bacteria that initially infects the nasal passages and upper airways and then progresses to the chest.
Bronchitis Pathophysiology
- Characterized by hypertrophy and hyperplasia of mucus-secreting glands.
- Loss of cilia and subsequent mucus accumulation reduces clearance of particles and microorganisms, increasing the risk of infection.
Chronic Obstructive Pulmonary Disease (COPD)
- Chronic disorders characterized by irreversible airway obstruction.
- Severe hypoxia and hypercapnia can lead to respiratory failure.
- Causes include smoking, pollution, chemical irritants, and genetic mutations.
- Two main conditions include chronic bronchitis and emphysema.
Chronic Bronchitis
- Characterized by inflammation of the bronchi, productive cough, and excessive mucus production.
- A clinical diagnosis requires a history of a chronic productive cough for at least 3 months in at least 2 consecutive years.
Emphysema
- Destruction of alveolar walls and loss of lung elasticity leads to large, permanently inflated alveoli
- Causes include inherited conditions (deficiency of α1-antitrypsin) and smoking.
Bronchial Asthma
- Chronic disorder resulting in intermittent, reversible airway obstruction.
- Characterized by: airway constriction, airway inflammation, and airways lined with excessive amounts of mucus.
- Triggers include allergens, respiratory tract infection, environmental tobacco smoke, exercise or exertion, emotional stress, drugs (aspirin, beta blockers, and penicillin), air pollution, and a cold environment.
- Symptoms include wheezing, shortness of breath, chest tightness, and coughing.
- Severe asthma attacks that don't respond to usual treatment are called status asthmaticus.
Bronchiectasis
- Localized, irreversible dilatation of part of the bronchial tree.
- The involved bronchi are dilated, inflamed, and easily collapsible, causing airflow obstruction and impaired clearance of secretions.
- Causes include congenital damage to the bronchiolar muscle and connective tissue and damage secondary to necrosis associated with recurrent infections.
- Types include fusiform (cylindrical, most common), varicose (beaded walls with areas of constriction), and saccular (cystic, ballooning peripherally).
Atelectasis
- Defined as a state in which the lung, in whole or in part, is collapsed or without air.
- Causes can include blockage of bronchioles/bronchi (foreign bodies, mucus plugs), external compression (tumors, lymph nodes, tubercles), and post-surgical conditions.
- Smokers and elderly individuals are at higher risk
Pneumonia
- Infection of the small air sacs (alveoli) of the lungs and surrounding tissues.
- Symptoms include cough with thick, colored sputum, fever, chills, chest pain, tiredness, weakness, muscle aches, noisy or painful breathing, and shortness of breath.
- Classification includes: community-acquired, hospital-acquired, bacterial, viral (mycoplasma), lobar, and bronchopneumonia.
Aspiration Pneumonia
- Caused by bacteria entering the airways when the gag reflex doesn't function properly due to head injury, general anesthesia, or the use of drugs or alcohol.
- Anaerobic bacteria are common culprits.
Tuberculosis (TB)
- Common, deadly infectious disease caused by acid-fast bacilli (Mycobacterium tuberculosis).
- Acquired via airborne infection, resulting in granulomatous lesions.
- Common sites of attack include the lungs (pulmonary TB), central nervous system (CNS), lymphatic system, circulatory system, genitourinary system, bones, joints, and skin.
- Types of pulmonary TB include primary (Ghon focus) and miliary (wide dissemination with small lesions).
Pulmonary Embolism
- Obstruction of a pulmonary artery or branch by a blood clot.
- Obstructed area has diminished or absent blood flow.
- Risk factors include deep vein thrombosis, heart disease (HF), trauma (hip fracture), postoperative procedures (orthopedic), postpartum conditions, advanced age (>50), pregnancy, and obesity.
- Clinical manifestations include dyspnea, tachypnea, chest pain, tachycardia, and hemoptysis.
Pleurisy (Pleuritis)
- Acute inflammation of the pleura
- Characterized by severe pain worsened by deep breathing, coughing, or sneezing.
- Not a disease but often a complication of other diseases like viral respiratory infections or pneumonia.
Pleural Effusion
- Excess fluid accumulation in the pleural space around the lungs.
- Two major types include transudative (low protein) and exudative (high protein).
Other Respiratory Diseases
- Pyothorax: Purulent fluid in the pleural cavity due to chest infection.
- Hydrothorax: Serous fluid accumulating in the pleural cavity due to liver cirrhosis.
- Hemothorax: Hemorrhagic fluid in the pleural cavity due to malignant tumors.
Pneumothorax
- Potential medical emergency caused by air or gas accumulation in the pleural cavity, leading to lung collapse.
- Types: spontaneous (occurs with or without lung disease or tumors) and tension (air in the pleural cavity due to a tear in lung tissue, impeding breathing).
Pulmonary Edema
- Abnormal fluid accumulation in lung tissue (alveolar space) or both.
- Rapid shift of fluid from plasma to pulmonary interstitial tissue and alveoli.
- Causes impaired gas exchange.
- Clinical manifestations include dyspnea, air hunger, cyanosis, anxiety, agitation, and blood-tinged sputum.
Acute Respiratory Distress Syndrome (ARDS)
- Severe inflammatory process causing diffuse alveolar damage, leading to pulmonary edema.
- Results from rapid fluid accumulation in alveoli, not primarily cardiac in origin.
- Consequences include alveoli filled with fluids, severe dyspnea, hypoxemia, and reduced lung compliance.
Respiratory Failure
- Sudden, life-threatening deterioration of gas exchange function, leading to inadequate oxygenation of the blood.
- Causes include COPD, asthma, ARDS, neuromuscular dysfunction disorders, brain hemorrhage, head trauma, and chest trauma.
- Respiratory failure can be acute or chronic, and classified as hypoxemic or hypercapnic.
Cardiovascular System
- Disorders of the pericardium include pericarditis, pericardial effusion, and cardiac tamponade.
Pericarditis
- Inflammatory process of the pericardium.
- Can be caused by infections, uremia, rheumatic fever, connective tissue diseases, and myocardial infarction.
- Classified as acute, chronic, and constrictive.
Pericardial Effusion
- Accumulation of fluid in the pericardial cavity.
- Small amounts may not produce symptoms, but large amounts can increase intracardiac pressure, compress the heart, and interfere with venous return.
Cardiac Tamponade
- Life-threatening condition of increased intrapericardial pressure due to fluid or blood accumulation in the pericardial sac.
- Can occur as a result of trauma, cardiac surgery, cancer, uremia, or myocardial infarction.
- Seriousness stems from diastolic filling impairment and reduced stroke volume and cardiac output.
- Clinical manifestations often include rapid fluid accumulation leading to elevated central venous pressure, jugular vein distention, decreased venous return, decreased cardiac output despite increased heart rate, decreased systolic blood pressure (pulsus paradoxus), and circulatory shock symptoms.
Coronary Heart Disease (CHD)
- Heart disease caused by impaired coronary blood flow.
- In most cases, CHD is caused by atherosclerosis.
- Diseases of the coronary arteries can cause angina, myocardial infarction (heart attack), cardiac dysrhythmias, conduction defects, heart failure, and sudden death.
Angina Pectoris
- Recurring episodes of chest pain or pressure sensation associated with myocardial ischemia.
- Hallmarks are chest pain.
- Classified into stable, unstable, and vasospastic angina.
Myocardial and Endocardial Disease
- Myocarditis: an inflammation of the heart muscle and conduction system, without evidence of myocardial infarction.
- Manifests from an absence of symptoms to profound heart failure or sudden death.
- Commonly manifests as a flu-like syndrome (malaise, low-grade fever, tachycardia), often following an upper respiratory or gastrointestinal tract infection.
- Cardiomyopathy: characterized by progressive cardiac hypertrophy and dilation; impaired pumping ability of one or both ventricles (ventricles more dilated than atria).
- Causes can include myocardial trauma, infections, toxic agents, metabolic and neuromuscular influences, and immunological disorders.
- Endocarditis: a potentially life-threatening infection of the endocardial surface of the heart (including the heart valves).
- Bacteria are common culprits (referred to as bacterial endocarditis).
- Two factors contribute to its development: endocardial surface damage and a portal of entry for the organism to access the circulatory system. The condition produces intracardiac vegetative lesions with both local and distant effects. They consist of a collection of infectious organisms and cellular debris.
- Rheumatic Heart Disease: an acute autoimmune inflammatory disorder that follows a group A beta-hemolytic streptococcal infection.
- Acute symptoms include involvement of the heart, blood vessels, joints, and subcutaneous tissues. A common lesion is the Aschoff body (localized tissue necrosis surrounded by immune cells).
Valvular Heart Disease
- Stenosis: incomplete opening of a valve, leading to increased heart workload and impaired filling within affected chamber.
- Regurgitation: incomplete closure of a valve, leading to increased heart workload in the heart chamber responsible for ejecting blood.
Heart Failure
General condition where the heart's structure or function is compromised, impairing its ability to adequately fill or pump blood. Classified by side; right-sided failure and left-sided failure.
Cardiogenic Shock
- Shock due to the heart's inability to maintain adequate cardiac output, often caused by conditions like heart failure and myocardial infarction.
- Typical symptoms include decreased blood flow and resulting circulatory and organ dysfunction.
Alterations in Blood Flow
- Atherosclerosis: A form of arteriosclerosis (hardening of arteries) marked by fibrofatty lesions within the arterial lining.
- This often affects large and medium-size arteries like the aorta, coronary arteries, and those supplying the brain.
- Risk factors (modifiable & non-modifiable) for the development of atherosclerosis include: age, gender, hereditary factors (family history), high LDL, low HDL, hypertension, smoking, diabetes, physical inactivity, obesity, and stress.
Varicose Veins
- Abnormally dilated and tortuous superficial veins of the leg.
- Often a result of compromised venous valves in deep veins, causing increased intraluminal pressure that stretches leg veins.
- Common in women.
- Factors affecting development of varicose veins include heredity, multiple pregnancies, obesity, aging, prolonged standing, and abdominal straining.
Deep Vein Thrombosis (DVT)
- Formation of a blood clot in a deep vein of the upper limbs or lower extremities.
- Differs from superficial thrombophlebitis, which involves inflammation of the vein wall and thrombus formation.
- Virchow's triad (three factors) are important in producing DVT:
- Venous stasis
- Hypercoagulability of blood
- Endothelial injury
- Conditions associated with DVT include bed rest, immobilization, obesity, increasing age, pregnancy, surgery, and conditions affecting blood clotting.
Pressure Ulcers (Decubitus Ulcers, Bedsores)
- Ischemic lesions of skin or underlying structures caused by external pressure that impairs blood and lymph flow.
- Most likely to develop over bony prominences.
- Factors affecting the development include external pressure, friction, and shearing forces.
Compartment Syndrome
- Condition of increased pressure in a muscle compartment, compromising blood flow to nerves and muscles, potentially leading to tissue death.
- Symptoms (the Five P's) often associated with the syndrome include pain, pallor (pale skin), paresthesia (numbness), pulselessness (faint pulse), and paralysis (weakness with movements).
Blood Pressure
- Arterial blood pressure reflects rhythmic ejection of blood into the aorta.
- Blood pressure is the amount of force on arterial walls during blood circulation.
- Healthy adults ideally display systolic pressure below 120 mmHg and diastolic pressure below 80 mmHg.
- Blood pressure depends on cardiac output (stroke volume × heart rate) and peripheral resistance (affected by humoral control, sympathetic and local control).
Hypertension
- Prolonged elevation of blood pressure (systolic above 140 mmHg and diastolic above 90 mmHg).
- Risk factors include advancing age, ethnicity, heredity (family history), obesity, physical inactivity, smoking, excessive alcohol intake, high-sodium diet, stress, and diabetes mellitus.
- Symptoms can include headache, blurry vision, chest pain, and frequent urination at night (though sometimes asymptomatic).
- Types include essential (primary, idiopathic) and secondary hypertension (result of some other disorder).
- Secondary Hypertension can result from renal disease, pheochromocytoma, coarctation of aorta, brain tumors, pregnancy, medications, and thyroid dysfunction.
- Types of systemic hypertension include benign (slowly progressive increase in pressure) and malignant (rapidly progressive increase in pressure, typically with diastolic readings above 120 mmHg).
Orthostatic Hypotension
- Abnormal drop in blood pressure when standing upright.
- Due to blood pooling in lower body, leading to insufficient blood flow to the brain if unable to compensate rapidly.
- Many authorities consider a systolic drop of 20 mmHg or more or a diastolic drop of 10 mmHg or greater as diagnostic.
- Common causes include acute and chronic conditions such as reduced blood volume, drug-induced hypotension, aging, bed rest, and autonomic nervous system dysfunction.
Renal System
- Kidneys' role in long-term blood pressure control (renin-angiotensin system and sodium/water balance), vitamin D activation, and erythropoietin synthesis.
- Obstructive disorders involve issues with urine flow from urethra to renal pelvis potentially causing infection and backpressure damaging kidney structures (hydroureter).
Renal Calculi
- Kidney stones (urinary calculi) are a frequent cause of upper urinary tract obstruction.
- Theories for stone formation include saturation (supersaturation of components like calcium, uric acid, etc.; dependent on factors such as pH, solute concentration, ionic strength, complexation), matrix (organic materials, particularly mucopolysaccharides, act as a nidus), and inhibitor deficiency (deficiency in proteins that inhibit stone formation).
Urinary Tract Infections (UTIs)
- Common bacterial infections affecting the urinary tract (from the urethra to the kidneys).
- Escherichia coli is a frequent causative agent.
- Risk factors include female gender, urinary obstruction (neurogenic bladder), postmenopausal women, men with prostate disease, elderly age, improper personal hygiene, instrumentation, and urinary catheterization.
- Uppers tract infections tend to involve kidney/pelvis, leading to an acute inflammatory response.
- Infections that propagate in urine can cause irritative voiding symptoms.
Glomerulonephritis
- Bilateral inflammatory disorder of the glomeruli, often following a streptococcal infection.
- Leads to renal failure due to impaired kidney's ability to process waste and excess fluid.
- Can manifest as acute or chronic conditions.
Renal Failure
- Condition where the kidneys fail to remove metabolic waste products from the blood while not properly controlling fluid, electrolyte, and pH balance of extracellular fluids.
- Can be classified as acute or chronic conditions; acute failure can be temporary, while chronic is irreversible.
- Azotemia (accumulation of nitrogenous waste—urea nitrogen, uric acid, and creatinine—in the blood) is a common indicator of renal failure.
Acute Renal Failure
- Rapid, significant decline in kidney function causing increased nitrogenous waste build-up and fluid/electrolyte imbalance..
- Causes include prerenal (decreased blood flow to kidneys), intrarenal (problems within kidneys hindering their function), and postrenal (obstructions impeding urine flow).
- Classified into three phases depending on the progression of the failure.
- Onset phase
- Maintenance phase
- Recovery phase
Chronic Renal Failure
- Represents progressive, irreversible destruction of kidney structure and significant decrease in glomerular filtration rate (GFR).
- Can be categorized into four progressive stages: Diminished renal reserve, renal insufficiency, renal failure, and end-stage renal disease (ESRD).
- Factors contributing to the development of chronic renal failure include diabetes mellitus, hypertension, chronic glomerulonephritis, chronic pyelonephritis, drug toxicity, and urinary tract obstruction.
Burns
- Injury to the skin or other organic tissue, often caused by heat (flame, hot liquids), radiation, electricity, or chemicals.
- Severity determined by factors including age, depth of burn/extent of damage, body surface area affected, presence of inhalation injury, and other coexisting injuries.
- Depth of injury is classified in stages, from first-degree (superficial, epidermis involvement), second-degree (partial-thickness, epidermis and dermis involvement), and third-degree (full-thickness, involving epidermis, dermis, subcutaneous tissue)
- Methods to estimate total body surface area (TBSA) affected include the rule of nines and the palm method.
- Effects of burn injuries can include fluid loss, infection, hypothermia, scarring, compromised immunity, changes in function, cardiovascular effects (hypovolemia, decreased blood pressure), edema, electrolyte imbalances (hyponatremia, hyperkalemia), upper/lower airway injuries (tissue hypoxia, bronchospasm, atelectasis), renal alterations (acute tubular necrosis, renal failure), immunological alterations (high infection risk), gastrointestinal alterations (paralytic ileus, acute gastric erosion/bleeding).
Homeostasis, Stress, and Adaptation
- Homeostasis: body's state of balance (physiologic, psychological, etc.) maintaining equilibrium across various needs.
- Stress: condition disrupting homeostasis owing to demands (stressors) on the body.
- Types include eustress (positive stress, promotes growth/satisfaction) and distress (negative stress, leading to debilitating strain).
- Common stressors may include physiological (aging, injury, infection, pain, noise, pollution), psychological (fear, insecurity, failing tasks, loss of family members), social (isolation, threat to safety, poverty), and spiritual (guilt, hopelessness, doubt).
- Factors determining individual response to stressors include age, gender, health status, nutritional status, and coping mechanisms.
- Response components depend crucially on the individual's perception of a situation; this is measured using appraisal mechanisms:
- Primary appraisal: judging the meaning of the event
- Secondary appraisal: evaluating methods to handle the event
- Physiologic responses to stress have two categories:
- Local Adaptation Syndrome (LAS): reactions directly at the site of the stressor (such as injury redness, swelling).
- General Adaptation Syndrome (GAS): Includes three phases
- Alarm Stage: body prepares for action (fight-or-flight response).
- Stage of Resistance: body attempts to normalize function and repair any damage done to affected areas or processes.
- Stage of Exhaustion: continued exposure depletes body reserves; leading to potential illness or even death.
Hematology System
- Hematology refers to the study of blood components.
Alterations in Platelets (Thrombocytes)
- Thrombocytosis: platelet counts exceeding 1,000,000/mm³ normally occurring in malignancies/inflammatory states and after splenectomy.
- Thrombocytopenia: platelet counts below 100,000/mm³, due to altered production/pooling in the spleen and/or reduced survival time owing to immunologic/non-immunologic causes.
Mechanism of Hemostasis
- Hemostasis is a sequence of steps stopping bleeding:
- Vessel spasm
- Platelet plug formation
- Blood coagulation (fibrin clot formation)
- Clot retraction
- Clot dissolution
Hypercoagulability States (Increased Blood clotting)
Hypercoagulability represents states in which blood clotting is exaggerated.
- Arterial thrombi are usually composed of platelet aggregates, forming in turbulent blood flow conditions (e.g., atherosclerosis).
- Venous thrombi are primarily composed of platelet aggregates and fibrin complexes, typically forming in conditions of slow blood flow, vein stasis (e.g., immobility).
Thrombocytosis and Thrombocytopenia
- Thrombocytosis: Elevated platelet count (greater than 1,000,000/mm³).
- Thrombocytopenia: Reduced platelet count (less than 100,000/mm³).
Coagulation Defects
- Defects are from deficiencies in clotting factors (e.g., caused by liver disease, vitamin K deficiency, genetic factors like hemophilia A, Von Willebrand disease, or increased consumption and use of factors, such as in disseminated intravascular coagulation (DIC)). Coagulation defects result in a higher risk of bleeding.
Disseminated Intravascular Coagulation (DIC)
- DIC is widespread intravascular clot formation and consumption of clotting factors.
- Not a primary disease, but a complication from assorted conditions. Conditions associated with DIC include obstetric issues, cancers, infections, trauma or sepsis, and hematological issues (blood transfusions, certain autoimmune disorders).
Alterations in Red Blood Cells (Erythrocytes)
- Red blood cells are responsible for carrying oxygen throughout the body.
- Critical changes in erythrocyte count or function constitute anemia.
Red Blood Cell Production
- Erythropoiesis: the process by which red blood cells are produced in bone marrow, influenced by the hormone erythropoietin, secreted by the kidney when oxygen levels (hypoxia) are low.
- The availability of iron is crucial for hemoglobin synthesis (the molecule carrying oxygen in red blood cells).
Red Blood Cells
- RBCs transport oxygen from lungs to tissues
- Hemoglobin is the oxygen-carrying molecule in RBCs
- RBC lifespan is approximately 120 days
- Iron from old RBC destruction is recycled and used in new RBC production
- Bilirubin is the heme byproduct excreted in bile
Anemia
- Anemia is an abnormally low level of hemoglobin/red blood cells, reducing the body's oxygen-carrying capacity.
- Types include blood loss anemia (acute or chronic), hemolytic anemia (premature destruction of red blood cells), and anemias arising from reduced red blood cell production (e.g., iron deficiency, megaloblastic anemias (caused by defects in the DNA synthesis process), and aplastic anemia (bone marrow dysfunction))
Blood Loss Anemia
- Acute blood loss is accompanied by a loss of vascular volume and can lead to hypovolemia and shock.
- Chronic blood loss usually does not cause a significant change in blood volume, but it can lead to iron deficiency anemia, as iron's recycling is less effective.
Hemolytic Anemia
- Characterized by premature red blood cell destruction and retention of iron/hemoglobin breakdown products in the body. -Intrinsic causes involve issues directly related to RBC structure/function (e.g. defects in the RBC membrane, hemoglobinopathies, enzyme defects).
- Extrinsic causes involve components external to RBCs (e.g. drug/chemical exposure, bacterial toxins, antibodies, physical trauma).
Thalassemias
- Inherited disorders involving impaired ability to produce hemoglobin.
- Types include α-thalassemia (synthesis of alpha globin chains impaired) and β-thalassemia (synthesis of beta globin chains impaired).
- Severity depends on the number of defective genes, heterozygotes exhibit milder forms. Homozygotes often require blood transfusions.
- Manifestations include significant expansion of bone marrow and abnormal bone growth, particularly in the facial and cranial areas.
Aplastic Anemia
- Condition of bone marrow depression causing decreased production of all blood cells (RBCs, WBCs, & platelets).
- Causes include exposure to high doses of radiation, chemicals, and toxins impacting hematopoiesis and immunological alterations.
- Chemotherapy and/or radiation treatment commonly lead to bone marrow suppression.
Iron Deficiency Anemia
- Dietary deficiency, chronic blood loss, or increased demands of iron exceeding the body's capability to provide it.
- Results in decreased hemoglobin production and reduced oxygen delivery.
- Most frequent causes in adults are chronic gastrointestinal bleeding (peptics ulcers, intestinal polyps, hemorrhoids, undifferentiated ulcers/cancer), in men and post-menopausal women.
Megaloblastic Anemias
- Characterized by elevated mean corpuscular volume (MCV) values due to large and immature red blood cells
- Caused by defects in the DNA synthesis pathway impacting the development of red blood cells.
- Two main types are caused by either low cobalamin (vitamin B12) or folic acid in the body.
- Pernicious anemia (low cobalamin)
- Folic acid deficiency
Alterations in White Blood Cells
- Leukopenia: A decrease in the total number of white blood cells.
- Leukocytosis: An increase in the total number of white blood cells.
- Can be specific to a decrease/increased count of granulocytes (most commonly neutrophils). Categorized as non-neoplastic disorders of white blood cells.
Neutropenia and Agranulocytosis
- Neutropenia: A decrease in neutrophils, the most common type of granulocyte.
- Agranulocytosis: A severe form of neutropenia characterized by a circulating neutrophil count of less than 200 cells/μL.
- Symptoms include susceptibility to bacterial or fungal infections, malaise, chills, fever, pronounced weakness, and fatigue. Often affect the respiratory tract.
Neoplastic Disorders of Hematopoietic and Lymphoid Origin
- Leukemias: Malignant neoplasms deriving from hematopoietic stem cells.
- Characterized by unregulated proliferation of immature neoplastic cells, eventually replacing bone marrow and interfering with normal blood cell development and function. Often infiltrating other organs.
- Lymphomas: Solid tumors arising from lymphoid tissue cells (lymphocytes). Divided into Hodgkin's lymphoma (characterized by the presence of abnormal Reed-Sternberg cells) and non-Hodgkin's lymphomas (more varied, multicentric origin)
Altered Body Temperature
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Homeothermic: Human capacity to maintain body temperature within a relatively narrow range.
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Temperature measured under the tongue, axilla, or rectum; oral temp is typically 0.5°C lower than rectal temp.
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Normal Circadian fluctuation of about 1°C; typically lowest at night and highest during day. Can vary with body activity and hormonal cycles (e. g., women show higher temp during second half o the menses).
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Temperature (hot/cold) is the difference between heat production by body processes and loss to external environments.
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Fever: Elevation exceeding normal daily variation and hypothalamic set point. Different patterns exist (e.g., intermittent, remittent, sustained, relapsing).
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Hyperthermia: Elevation due to regulatory failure—body produces more heat than it dissipates. Heat stroke is a dangerous, potentially fatal form of hyperthermia.
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Hypothermia: Core body temp falls below 35°C affecting compensatory heat-conserving mechanisms.
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Test your knowledge about stress management, the body's response to stress, and respiratory health. This quiz covers various aspects of the general adaptation syndrome, skin functions, and bronchitis. Challenge yourself and see how much you know about maintaining health under stress.
