Secondary prevention - ANSWERDetection and screening
Tertiary prevention - ANSWERTreating or reducing relapse/disability/chronicity
,What are the 4 common mechanisms of cell injury and death? - ANSWER1. ATP
depletion
2. O2 and oxygen-derived free radicals
3. Intracellular calcium and loss of steady state
4. Membrane permeability defect
What is ATP depletion? - ANSWERInability of cell to produce adequate ATP to fuel
normal activities
-most common: hypoxia
How does hypoxia affect cellular energy production? - ANSWERHypoxia leads to the
inability to perform oxidative phosphorylation (aerobic) and glycolysis (anaerobic) kicks
in
What are the consequences of ATP depletion in terms of ion regulation? -
ANSWERATP depletion leads to the failure of the NaK pump, causing the leakage of
Na+ and Ca2+ into the cell, and the production of lactate
How does NaK pump failure impact the cell? - ANSWERNa normally outside and K
normally inside
Na+ leaks in and pump can't maintain balance
Water follows, cell and contents swells
What does a drop in pH do to the cell? - ANSWERPyknosis, karyorrhexis, and
karyolysis
Disruption of cell membrane allowing calcium influx
Pyknosis - ANSWERClumping of nuclear material as a result of a drop in pH
Karyorrhexis - ANSWERFragmentation of nuclear material
Karyolysis - ANSWERDissolution of nuclear material
What are free radicals? - ANSWERUnstable compounds with an unpaired electron and
high affinity for lipids, normal byproduct of cellular metabolism
What is lipid peroxidation? - ANSWERBinding of free radicals to phospholipid bilayer
membrane around the cell and its organelles causing dissolution or a hole
What are reactive oxygen species (ROS) - ANSWERChemically reactive molecules
formed as natural oxidant species in cells during mitochondrial respiration and energy
generation
, How does the body handle free radicals and ROS to prevent tissue injury -
ANSWERAntioxidants remove
problems occur when free radicals are produced in amounts that overwhelm
antioxidants
How can membrane permeability defect? - ANSWERInherited / genetic
acquired / exposure to mutagenic or carcinogenic environmental factors
lysis by enzymes, virus, or direct injury from stressors
What is bilirubin? - ANSWERPigment released when RBC's breakdown
What is unconjugated bilirubin? - ANSWERType of bilirubin that is fat-soluble and can't
be excreted
What is conjugated bilirubin? - ANSWERType of bilirubin that is water-soluble and able
to be excreted
What is the role of glucuronic acid in bilirubin metabolism? - ANSWERIt is required from
liver cells to convert unconjugated bilirubin to conjugated bilirubin
What is hemolytic hyperbilirubinemia? - ANSWERExcessive hemoglobin breakdown
that the liver can't keep up with
What is hepatocellular hyperbilirubinemia? - ANSWERLiver cells are sick and unable to
uptake unconjugated bilirubin
What is obstructive hyperbilirubinemia? - ANSWERBlockage in hepatic/common bile
duct which prevents bilirubin from entering intestines; leads to clay colored stool and
very dark urine
What is kernicterus? - ANSWERCondition where prolonged hyperbilirubinemia in infants
(esp preterm) passes the BBB more easily, which is toxic to nerve tissue
What is reperfusion injury? - ANSWERResults from the generation of highly reactive O2
intermediates (oxidative stress) - these radicals can all cause further membrane
damage and mitochondrial calcium overload
WBCs especially affected
Antioxidant treatment can help, as well as blockage of inflammatory mediators and
inhibition of certain cell death pathways
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