Exam 1 Study Guide PDF - Infection, Cancer, Lab Values

EXAM 1 STUDY GUIDE Infection ​ Virulence ○​ Ability to cause severe disease ​ Stages of infection ○​ Incubation ​ Initial exposure to first symptoms ○​ Prodromal ​ Symptoms, pathogen start multiplying (cough sore th...

EXAM 1 STUDY GUIDE Infection ​ Virulence ○​ Ability to cause severe disease ​ Stages of infection ○​ Incubation ​ Initial exposure to first symptoms ○​ Prodromal ​ Symptoms, pathogen start multiplying (cough sore throat) ○​ Invasion ​ Pathogen replicating fast ​ Severe (fever, chills) ○​ Convalescence ​ Healing, death ​ Signs/symptoms of Inflammation (acute aka local) ○​ s/sx: redness/erythema, swelling, warmth, pain, tenderness, loss of function ​ Systemic ○​ s/sx: fever, chills, diaphoresis/sweat, elevated WBC ​ Bacteria ○​ Patho for infection: endotoxins → inflammatory response, abx (antibiotics) ○​ bacteremia : bacteria in the blood ○​ Septicemia : fever, chills, sweat → DIC, shock ​ Virus ○​ Need host ○​ No abx ​ Effect of stress ○​ s/sx: high BP, high HR (tachycardia), high glucose levels → think of sympathetic nervous system activation/fight or flight ○​ Effects: CV disease, atherosclerosis, obesity, metabolic syndrome, decrease bone density, shortening of telomeres ​ Hypersensitivity:  ​ Cancer/heme ​ Importance of lab values ○​ WBC ​ Normal: 5k-10k ​ High: 10k> leukocytosis (infection) ​ Low: 5k< leukopenia (radiation/chemo, immunodeficiencies, bone marrow suppression) ​ Neutrophils (increases with infection) ​ Normal ANC: 3-7 (3000-7000) ○​ Erythrocytes (RBCs) ​ Normal: 4-6 ​ High: polycythemia vera ​ Low: anemia ○​ Platelets (PLT) ​ Normal: 150k-400k ​ High: >400k thrombocytosis (clotting→ DVT) ​ Low: uncontrolled growth ​ Leukemia ○​ Patho: cancer of bone marrow affect blood cells ○​ Labs: decreased WBC (leukopenia), decreased platelets (thrombocytopenia), decreased RBC (anemia) ○​ s/sx: fever from an infection (that won't go away), weight loss/anorexia, bleeding, pallor/fatigue (persistent) ○​ Tx (chemo) makes pt immunodeficient ​ Hodgkin vs non-Hodgkin ○​ LYMPHOMA: Cancer of the lymphatic system ○​ Hodgkin  ​ s/sx: fever, weight loss, night sweats, mass (mediastinal or abdominal), swollen painless lymph nodes ​ Diagnostic marker: reed-sternberg cells ○​ Non-Hodgkin: group of symptoms ​ Types of neoplasms/cancers ○​ Benign: not cancerous ​ Well differentiated, even boarders, no metastasis, slow, encapsulated ​ Harmful if … brain, vessels, nerves (skull is a closed cavity, increase pressure within the skull) ○​ Malignant: cancerous ​ Multi colored, not well differentiated, no capsule, fast, metastasize ○​ Stages ​ DIC: death is coming ○​ Patho: clotting and bleeding out at the same time ○​ Cause: sepsis, infection, shock (burn shock) ○​ s/sx: pallor (drop in hemoglobin from bleeding), bleeding, bruising, hematoma ○​ TREAT THE CAUSE (ex. give abx if septic, fluids) ​ HIV/AIDS ○​ CD4 count paralysis (nerve damage, unrelieved pressure) ○​ Risks: casts too tight (cut cast!), crush injuries→ rhabdo ​ Osteoporosis ○​ Patho: poorly mineralized bones, osteoclasts break down faster than osteoblasts produce ○​ Cause: lack vit d, inactivity, meds (steroids), menopause ○​ Women higher risk ○​ Risk for falls! ○​ Teach weight bearing exercises ​ Gout ○​ Patho: overproduction of uric acid, accumulate in joints ○​ s/sx: redness, pain, swelling, tophi, renal stones ○​ Trigger: diet high in purines (wines, aged cheeses, organ meats, red meat, alcohol, shellfish) ○​ Males ​ Rhabdomyolysis ○​ Patho: rapid uncontrolled breakdown of muscle tissue → myoglobin in bloodstream→ kidneys ○​ Cause: crush injuries, overworking muscles, bedrest/immobility, elderly pt that fell, dehydration, seizure ○​ CK elevated ○​ s/sx: dark urine, muscle pain/tenderness/soreness/weakness  ○​ Treatment: tx cause, fluids ​ Fibromyalgia ○​ Patho: autoimmune, chronic pain (cause not well known, difficult to diagnose) ○​ s/sx: neuropathic pain, fatigue tenderness, affects sleep, tender points that are sensitive to touch, anxiety and depression ​ Osteomyelitis ○​ Patho: bone infection  ○​ Cause: bacteria, open fractures, surgeries, wounds ○​ s/sx: low grade fever, lymphadenopathy, pain, swelling, fatigue ​ Osteomalacia/rickets ○​ Patho: inadequate/delayed mineralization of bones ○​ Cause: vit d deficiency (low sun exposure, diet, malabsorption) ○​ s/sx: bone malformation (bowing), pain, fractures, vertebral collapse ​ RA vs OA ○​ Rheumatoid arthritis: ​ Affects women more than men, genetic ​ Patho: inflammation of synovial fluid within joints, autoimmune ​ S/Sx: occur bilaterally→ stiffness, tenderness, pain with rest and better when you use it, ulnar deviation, swan neck deformities ○​ Osteoarthritis: ​ Patho: loss/damage of cartilage, bone-on-bone ​ S/S: unilateral→ pain with movement and gets better with rest, enlargement, tenderness, stiffness, limited motion, bouchard (close to body) and heberden nodes (further away) ​ Cause: aging, wear and tear, increased weight, trauma  ​ Osteosarcoma ○​ Patho: bone cancer ○​ Cause: aging, radiation Skin ​ Pressure ulcers ○​ Pressure over a bony prominence ○​ Cause: bedrest/immobility, moisture, friction and shear forces  ○​ Stage 1: non-blanchable redness, INTACT SKIN ○​ Stage 2: epidermis and/or dermis, SKIN open, red or pink wound bed ○​ Stage 3: FULL THICKNESS SKIN LOSS, with fat present, NO BONE OR MUSCLE PRESENT ○​ Stage 4: FULL THICKNESS DOWN TO BONE OR MUSCLE EXPOSED ○​ Unstageable: wound is covered by too much stuff (slough, eschar) to see wound bed, cannot stage ○​ Deep tissue injurie: discoloration (purple) ○​ Prevention: Q2 turns, keep them dry and clean, and avoid friction, skin assessment ​ Burns, types ○​ First degree: epidermis ​ Appearance: sunburn-like appearance, redness, dry, painful ○​ Second degree: Epidermis and dermis (dermis NOT YET DESTROYED COMPLETELY) ​ Appearance: red, moist/blisters, SWELLING, VERY PAINFUL ○​ Third degree: epidermis, ALL OF DERMIS, and some subq tissue ​ Appearance: painless, white and shiny, looks charred ○​ Fourth degree: ALL LAYERS, right down to the bone ​ Appearance: possible exposed muscle and bone ​ SHOCK: “reduction in the volume of perfusing blood” ○​ Burn → destruction of blood vessels → evaporative loss of body water, vessels are leaky, increased capillary permeability → hypovolemic shock ○​ S/S: ​ Decreased LOC ​ Pale ​ Hypotension ​ Tachycardia ​ Cool to the touch ○​ Primary tx: ​ aggressive IV fluid replenishment ​ Nutrition ​ Tx infection ​ Manage wounds ​ Thermoregulation ​ Skin cancer ○​ Basal cell carcinoma ​ Slow growing, ulcer/crusty looking ○​ Squamous cell carcinoma ​ Raised pearl, defined boarders on face ○​ Melanoma ​ Asymmetrical, uneven/irregular boarders, different colors, diameter >6 cm, evolving, funky looking  ​ Metastasis ​ Wound healing process ​ Scleroderma ○​ Thickening of the skin ○​ s/sx: hard, hypopigmented, taut, shiny ​ Cellulitis ○​ Infection of dermis and subq from bacteria entering through a cut/tear in the skin ○​ s/sx: warm, pain, erythema, edema ○​ Mark redness, spreads rapidly ​ Candidiasis ○​ Opportunistic fungal infection ○​ Grows on dark, moist environments (mouth, vagina, skin, GI) ○​ Cause: abx, warm moist, pregnancy, diabetes, immunosuppression ​ Herpes ○​ HSV1: oral ○​ HSV2: genital ○​ s/sx: cluster of inflamed, painful vesicles ○​ VZV ​ Chickenpox, shingles (dormant in dorsal root ganglia) ​ Reactivated when immune system is weakened ​ s/sx: painful fluid filled vesicles, follows dermatome, asymmetrical, burning and painful (lasts), fever ​ Hair loss ○​ Alopecia: hair loss ○​ Hirsutism: male pattern hair growth on females ○​ Androgenic alopecia: hair loss in males as a response to androgens ○​ Female pattern alopecia: thinning and hair loss over the center part of the scalp ​ Lupus (SLE): autoimmune  ○​ Systemic, autoimmune ○​ s/sx butterfly rash on face ○​ Triggers: trauma, viral infection, pregnancy ​ Stevens-Johnsons/toxic epidermal necrosis ○​ s/sx: peeling skin, looks like severe red burn, lesions, crusted over lesions, etc. ○​ Immune cell mediated hypersensitivity reaction to certain drugs (type 4) ○​ Medical emergency