01 Aug Using the video from Episode 8 on Rowena,?answer two of the following prompts: Please identify each prompt you answer by number. Prompt 1: Explain in detail the different
Using the video from Episode 8 on Rowena, answer two of the following prompts: Please identify each prompt you answer by number.
Prompt 1: Explain in detail the different types of dementia.
Prompt 2: Explain in detail the difference between ischemic vs. hemorrhagic stroke.
Prompt 3:Explain the use of tPAs (Tissue Plasminogen Activator)
Prompt 4: Describe additional treatments and management that could be used in Rowena’s case.
Please correlate your responses to Rowena’s case. Content in this case scenario incorporates topics from Chapters 44 and 45.
- 1-2 references to support your responses.
- 2 full paragraph responses
B R I E F C O N T E N T S
UNIT I Pathophysiologic Processes
1 Introduction to Pathophysiology, 1
2 Homeostasis, Allostasis, and Adaptive Responses to Stressors, 12
UNIT II Cellular Function
3 Cell Structure and Function, 26
4 Cell Injury, Aging, and Death, 59
5 Genome Structure, Regulation, and Tissue Differentiation, 77
6 Genetic and Developmental Disorders, 94
7 Neoplasia, 117
UNIT III Defense
8 Infectious Processes, 141
9 Inflammation and Immunity, 158
10 Alterations in Immune Function, 194
11 Malignant Disorders of White Blood Cells, 215
12 HIV Disease and AIDS, 233
UNIT IV Oxygen Transport, Blood Coagulation, Blood Flow, and Blood Pressure
13 Alterations in Oxygen Transport, 259
14 Alterations in Hemostasis and Blood Coagulation, 298
15 Alterations in Blood Flow, 313
16 Alterations in Blood Pressure, 337
UNIT V Cardiac Function
17 Cardiac Function, 354
18 Alterations in Cardiac Function, 382
19 Heart Failure and Dysrhythmias: Common Sequelae of Cardiac Diseases, 411
20 Shock, 434
UNIT VI Respiratory Function
21 Respiratory Function and Alterations in Gas Exchange, 451
22 Obstructive Pulmonary Disorders, 478
23 Restrictive Pulmonary Disorders, 499
UNIT VII Fluid, Electrolyte, and Acid-Base Homeostasis
24 Fluid and Electrolyte Homeostasis and Imbalances, 521
25 Acid–Base Homeostasis and Imbalances, 541
UNIT VIII Renal and Bladder Function
26 Renal Function, 551
27 Intrarenal Disorders, 575
28 Acute Kidney Injury and Chronic Kidney Disease, 593
29 Disorders of the Lower Urinary Tract, 609
UNIT IX Genital and Reproductive Function
30 Male Genital and Reproductive Function, 626
31 Alterations in Male Genital and Reproductive Function, 641
32 Female Genital and Reproductive Function, 656
33 Alterations in Female Genital and Reproductive Function, 671
34 Sexually Transmitted Infections, 689
UNIT X Gastrointestinal Function
35 Gastrointestinal Function, 697
36 Gastrointestinal Disorders, 720
37 Alterations in Function of the Gallbladder and Exocrine Pancreas, 742
38 Liver Diseases, 754
UNIT XI Endocrine Function, Metabolism, and Nutrition
39 Endocrine Physiology and Mechanisms of Hypothalamic-Pituitary Regulation, 783
40 Disorders of Endocrine Function, 799
41 Diabetes Mellitus, 815
42 Nutritional and Metabolic Disorders, 838
UNIT XII Neural Function
43 Structure and Function of the Nervous System, 850
44 Acute Disorders of Brain Function, 891
45 Chronic Disorders of Neurologic Function, 915
46 Alterations in Special Sensory Function, 936
47 Pain, 955
UNIT XIII Neuropsychological Function
48 Neurobiology of Psychotic Illnesses, 971
49 Neurobiology of Nonpsychotic Illnesses, 989
UNIT XIV Musculoskeletal Support and Movement
50 Structure and Function of the Musculoskeletal System, 1001
51 Alterations in Musculoskeletal Function: Trauma, Infection, and Disease, 1020
52 Alterations in Musculoskeletal Function: Rheumatic Disorders, 1042
UNIT XV Integumentary System
53 Alterations in the Integumentary System, 1058
54 Burn Injuries, 1093
Evolve Student Resources for Banasik: Pathophysiology, 6th Edition, include the following:
• Review questions with rationales.
• Key Points.
• Glossary with audio pronunciations.
• Answers to key questions.
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PATHOPHYSIOLOGY TH EDITION6
JACQUELYN L. BANASIK, PhD, ARNP Associate Professor College of Nursing
Washington State University Spokane, Washington
LEE-ELLEN C. COPSTEAD, PhD, RN Professor Emerita
Department of Nursing College of Nursing and Health Sciences
University of Wisconsin—Eau Claire Eau Claire, Wisconsin
3251 Riverport Lane St. Louis, Missouri 63043
PATHOPHYSIOLOGY, SIXTH EDITION ISBN: 978-0-323-35481-3
Copyright © 2019 by Elsevier Inc. All rights reserved.
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This book and the individual contributions contained in it are protected under copyright by the Publisher (other than as may be noted herein).
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International Standard Book Number: 978-0-323-35481-3
Executive Content Strategist: Kellie White Content Development Specialist: Jennifer Wade Publishing Service Manager: Jeffrey Patterson Book Production Specialist: Carol O’Connell Book Designer: Renee Duenow
Printed in Canada
Last digit is the print number: 9 8 7 6 5 4 3 2 1
Loved ones, past and present,
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Brent A. Banasik, PhD, MA, BS Scientist Chemistry Banasik Consulting Seattle, Washington
Brianne N. Banasik, BS Environmental Science, MS Marine Resources Management
Research Associate Pediatric Vaccinology University of Texas Medical Branch Galveston, Texas
Jacquelyn L. Banasik, PhD, ARNP Associate Professor College of Nursing Washington State University Spokane, Washington
Robin Y. Beeman, BSN, MSN, PhD Chair and Professor Nursing University of Wisconsin—Eau Claire Eau Claire, Wisconsin
Cheryl L. Brandt, PhD, RN, ACNS-BC Professor College of Nursing and Health Sciences University of Wisconsin—Eau Claire Eau Claire, Wisconsin
Ann Futterman Collier, PhD Associate Professor and Chair Psychological Sciences Northern Arizona University Flagstaff, Arizona
Lee-Ellen C. Copstead, PhD, RN Professor Emerita Department of Nursing College of Nursing and Health Sciences University of Wisconsin—Eau Claire Eau Claire, Wisconsin
Carol L. Danning, MD Staff Rheumatologist Rheumatology Department Gundersen Health Systems La Crosse, Wisconsin
Michael R. Diestelmeier, MD Fellow American Academy of Dermatology Dermatologist, Retired Mayo Clinic Health System Eau Claire, Wisconsin
Ruth E. Diestelmeier, RN, MSN Clinical Instructor Department of Nursing University of Wisconsin—Eau Claire Eau Claire, Wisconsin
C O N T R I B U T O R S
Roberta J. Emerson, PhD, RN Associate Professor, Retired Washington State University College of Nursing Spokane, Washington
Linda Felver, PhD, RN Associate Professor School of Nursing Oregon Health & Science University Portland, Oregon
Rosemary A. Jadack, PhD, RN Professor Nursing University of Wisconsin—Eau Claire Eau Claire, Wisconsin
Debra A. Jansen, PhD, RN Associate Dean, Professor College of Nursing and Health Sciences University of Wisconsin—Eau Claire Eau Claire, Wisconsin
Marie L. Kotter, PhD, MS, BS Professor Emeritus Health Sciences Weber State University Ogden, Utah
Teresa Grigsby Loftsgaarden, MSN, RN, OCN,ONN-CG
Oncology Nurse Navigator Regional Cancer Center Sacred Heart Hospital Eau Claire, Wisconsin
Joni D. Marsh, BSN, MN Advanced Registered Nurse Practitioner Medical Oncology Summit Cancer Centers Spokane, Washington
Benjamin J. Miller, PhD, ARNP, FNP-C, ACNPC, ENP-C
Assistant Professor Seattle University Seattle, Washington
Sarah Ogle, DO, MS Banner University Medical Center-Phoenix University of Arizona College of Medicine
Phoenix Phoenix, Arizona
Nirav Patel, MD Assistant Professor, Infectious Diseases and
Critical Care Medicine Internal Medicine Saint Louis University School of Medicine; Chief Medical Officer SSM Health Saint Louis University Hospital; Infection Control Officer/Director of
Antibiotic Stewardship SSM Health Saint Louis University Hospital Saint Louis, Missouri
Faith Young Peterson, BSN, MSN, MPA, CFNP
Family Nurse Practitioner Marsing, Idaho
Cheryl Rockwell, RN, MSN Clinical Assistant Professor Nursing Department Indiana University-Purdue University at
Fort Wayne; Staff/Clinical Nurse Surgical Trauma Intensive Care Unit Parkview Health Systems Fort Wayne, Indiana
Samantha Cody Russell, Psychology, MA Graduate Student Psychological Sciences Northern Arizona University Flagstaff, Arizona
Jeffrey S. Sartin, MD Consulting Physician Infectious Diseases Infectious Disease and Epidemiology
Associates; Consulting Physician Infectious Diseases Nebraska Medicine; Consulting Physician Infectious Diseases CHI Hospitals Omaha, Nebraska
Lorna L. Schumann, PhD Heritage UGM Women and Children’s
Clinic Medical Clinic Heritage Health Coeur d’Alene, Idaho
Susan G. Trevithick, RN, MS, NE-BC Compliance Officer VA Salt Lake City Healthcare System Salt Lake City, Utah
Marvin Van Every, MD Staff Urologist Urology Department Gundersen Health Systems La Crosse, Wisconsin
Linda D. Ward, PhD, FNP-C Assistant Professor College of Nursing Washington State University Spokane, Washington
Brianne N. Banasik, MS Research Associate Pediatric Vaccinology University of Texas Medical Branch Galveston, Texas
Deb Cipali, RN, BSN, MSN, EdD(c) Des Moines Area Community College Nursing Lab Coordinator/Adjunct Professor Ankeny, Iowa
Janie Corbitt, RN, MLS Milledgville, Georgia
Maria Fleurdeliz Cuyco, BS Instructor Preferred College of Nursing Los Angeles, California
Abimbola Farinde, PhD Professor Columbia Southern University Orange Beach, Alabama
Annette Gunderman, DEd, MSN, RN Associate Professor of Nursing Bloomsburg University Bloomsburg, Pennsylvania
Barbara Hunter, RN, MSN School of Nursing, Klamath Falls Campus Oregon Health & Science University Klamath Falls, Oregon
Sandra L. Kaminski, MS, PA-C Assistant Professor Seton Hall University School of Health and Medical Sciences; Physician Assistant VA NJ Healthcare System Medical Service/Infections Disease Clark, New Jersey
Steven Krau, PhD, RN, CNE Associate Professor Vanderbilt School of Nursing Nashville, Tennessee
Clarice Perry, MS Research Associate Pediatric Vaccinology University of Texas Medical Branch Galveston, Texas
R E V I E W E R S
Janet Pinkelman, MSN, RNC-Maternal Newborn Nursing
Professor of Nursing Owens Community College Toledo, Ohio
Linda Turchin, RN, MSN, CNE Associate Professor of Nursing Fairmont State University Fairmont, West Virginia
Kim Webb, MN, RN Adjunct Nursing Instructor Pioneer Technology Center Ponca City, Oklahoma
Janice Williams, RN, ACNS-BC, CDE Professor of Nursing and Program Director Armstrong McDonald School of Nursing College of the Ozarks Point Lookout, Missouri
The pace of scientific discovery in health and medicine continues to transform our understanding of physiology and disease. To be clinically relevant and useful to health care students and professionals, a text must synthesize a vast amount of detailed knowledge into overarching concepts that can be applied broadly. As in previous editions, the goal of the sixth edition of Pathophysiology is to include recent and relevant information on anatomy, biochemistry, cell physiology, genomics, and pathophysiology while not overwhelming the reader. Attention is given to major concepts relevant to clinical practice while still providing enough detail for deep understanding.
ORGANIZATION Pathophysiology uses a systems approach to content, beginning with a review of normal anatomy and physiology, followed by pathophysiology and application of concepts to specific disorders. The text is organized into 15 units, each of which includes a particular body system or group of interrelated body systems and the pertinent pathophysiologic concepts and disorders.
FEATURES An understanding of normal structure and function of the body is necessary for any detailed understanding of its abnormalities and pathophysiology. The first chapter in most units includes a fully illustrated review of normal physiology. Age-related concepts are highlighted in boxes titled Geriatric Considerations and Pediatric Considerations.
Each chapter opens with Key Questions, which are designed to alert the reader to important conceptual questions that will be discussed in the chapter. Although the chapters are meant to be read from beginning to end to develop an understanding of the material, the text also serves as a reference for looking up specific content. Chapter Outlines are included at the beginning of each chapter to help the reader locate specific content. Within every chapter, Key Points are identified at the end of every major discussion and are presented in short bulleted lists. These recurring summaries help readers to focus on the main points.
Nearly 900 illustrations elucidate both normal physiology and pathophysiologic changes. The entire book is in full color, with color
used generously in the illustrations to better explain pathophysiologic concepts.
A study of pathophysiology requires a new vocabulary, and many of these terms are defined in a comprehensive Glossary, which appears at the end of the text. Common prefixes and suffixes as well as root words are included in the back matter to help with basic understanding of the language of pathophysiology.
ANCILLARIES Student Learning Resources on Evolve The student section of the book’s website hosted on Evolve offers nearly 700 Student Review Questions in a variety of question formats, an Audio Glossary, Animations to help readers visualize pathophysiologic processes, Case Studies with questions, and Key Points Review. Visit the Evolve website at http://evolve.elsevier.com/Banasik/pathophysiology.
Study Guide Pathophysiology can be a daunting subject for students because of the large volume of factual material to be learned. The student Study Guide is designed to help students focus on important pathophysiologic concepts. Questions to check recall of normal anatomy and physiology are included for each chapter. A number of activities that help the student focus on similarities and differences between often-confused pathologic processes are included. More than 1500 self-assessment test questions with answers are included to help students check their understanding and build confidence for examinations. Case studies, with more than 250 questions including rationales for correct and incorrect answers, are used to help students begin to apply pathophysi- ologic concepts to clinical situations.
Instructor Learning Resources on Evolve The Instructor Learning Resources on Evolve provide a number of teaching aids for instructors who require the text for their students. The materials include a Test Bank presented in Exam View with approximately 1200 test items, a Teach for Nurses instructor manual detailing the resources available to instructors for their lesson planning, a PowerPoint lecture guide with more than 4000 slides with integrated case studies and audience response questions to facilitate classroom presentations, and an Image Collection of more than 900 color images from the text.
P R E F A C E
Revising this 6th edition of the text has been possible because of the tremendous dedication of authors, artists, reviewers, and editors. Sincere gratitude goes to all who helped with this and previous editions. In particular, grateful appreciation is extended to all of the contributing authors who have given exhaustively of their time over many editions over the decades. Thank you to the many thoughtful experts who gave their time to read and critique manuscripts and help ensure excellence in chapter content throughout the text.
Grateful recognition is made to the staff at Elsevier: Kellie White, Executive Content Strategist; Jennifer Wade, Content Development Specialist; Jeffrey Patterson, Publishing Service Manager; Carol O’Connell, Book Production Specialist; Renee Duenow, Book Designer; and Vikraman Palani, Multimedia Producer.
We would like to recognize those who provided a foundation for the revised text through their contributions to earlier editions: Arnold A. Asp, Donna Bailey, Barbara Bartz, Linda Belsky-Lohr, Tim Brown, Carolyn Spenee Cagle, Karen Carlson, Katherina P. Choka, Arnold Norman Cohen, Cynthia F. Corbett, Lorri Dawson, Leslie Evans, Patricia Garber, Jane Georges, Karen Groth, Christine M. Henshaw, Carolyn Hoover, Jo Annalee Irving, Marianne Genge Jagmin, Debby Kaaland, Naomi Lungstrom, Rick Madison, Anne Roe Mealey, David Mikkelsen, Carrie Miller, Linda Denise Oakley, Maryann Pranulis, Mark Puhlman, Edith Randall, Bridget Recker, Cleo Richard, Dawn Rondeau, Mary Sanguinetti-Baird, Billie Marie Severtsen, Jacqueline Siegel, Gary Smith, Sheila Smith, Martha Snider, Pam Springer, Angela Starkweather, Patti Stec, Julie Symes, Lorie Wild, and Debra Winston-Heath.
A C K N O W L E D G M E N T S
C O N T E N T S
UNIT I Pathophysiologic Processes
1 Introduction to Pathophysiology, 1 Lee-Ellen C. Copstead
Framework for Pathophysiology, 2 Etiology, 2 Pathogenesis, 2 Clinical Manifestations, 3 Treatment Implications, 3
Concepts of Normality in Health and Disease, 4 Statistical Normality, 4 Individual Factors Influencing Normality, 5
Patterns of Disease in Populations, 6 Concepts of Epidemiology, 6
2 Homeostasis, Allostasis, and Adaptive Responses to Stressors, 12 Debra A. Jansen and Roberta J. Emerson
Homeostasis and Allostasis, 12 Homeostasis, 12 Allostasis, 13
Stress as a Concept, 13 The General Adaptation Syndrome and
Allostasis, 14 Stressors, Gender and Developmental Influences,
and Risk Factors, 16 Neurohormonal Mediators of Stress and
Adaptation, 17 Catecholamines: Norepinephrine and
Epinephrine, 17 Adrenocortical Steroids: Cortisol and
Aldosterone, 18 Endorphins, Enkephalins, and Immune
Cytokines, 19 Sex Hormones: Estrogen, Testosterone, and
Dehydroepiandrosterone, 19 Growth Hormone, Prolactin, and
Oxytocin, 19 Adaptation, Coping, and Illness, 20
Adaptation, Coping, and Resilience, 20 Allostatic Overload and Illness, 21
UNIT II Cellular Function
3 Cell Structure and Function, 26 Jacquelyn L. Banasik and Brianne N. Banasik
Plasma Membrane, 27 Membrane Structure, 27 Lipid Bilayer, 27 Membrane Proteins, 29
Organization of Cellular Compartments, 30 Cytoskeleton, 30 Nucleus, 30 Endoplasmic Reticulum, 31 Golgi Apparatus, 32 Lysosomes and Peroxisomes, 33 Mitochondria, 34
Cellular Metabolism, 34 Glycolysis, 36 Citric Acid Cycle, 36 Oxidative Phosphorylation, 36
Functions of the Plasma Membrane, 39 Membrane Transport of Macromolecules, 39 Membrane Transport of Small Molecules, 40 Cellular Membrane Potentials, 45
Intercellular Communication and Growth, 48 Cell Signaling Strategies, 48 Cell Surface Receptor–Mediated Responses, 49 Intracellular Receptor–Mediated Responses, 53 Regulation of Cellular Growth and Proliferation, 54
4 Cell Injury, Aging, and Death, 59 Jacquelyn L. Banasik
Reversible Cell Injury, 59 Hydropic Swelling, 60 Intracellular Accumulations, 60
Cellular Adaptation, 63 Atrophy, 63 Hypertrophy, 63 Hyperplasia, 63 Metaplasia, 63 Dysplasia, 64
Irreversible Cell Injury, 64 Necrosis, 64 Apoptosis, 66
Etiology of Cellular Injury, 68 Ischemia and Hypoxic Injury, 68 Nutritional Injury, 70 Infectious and Immunologic Injury, 70 Chemical Injury, 72 Physical and Mechanical Injury, 72
Cellular Aging, 74 Cellular Basis of Aging, 74 Physiologic Changes of Aging, 75
Somatic Death, 75 5 Genome Structure, Regulation, and Tissue
Differentiation, 77 Jacquelyn L. Banasik
Structure and Function of DNA, 78 Structure of DNA, 78 DNA Replication, 79 Genetic Code, 80 Transcription, 81 Translation, 82
Regulation of the Genome, 84 Transcriptional Controls, 84
Differentiation of Tissues, 86 Cell Diversification and Cell Memory, 86 Mechanisms of Development, 86 Differentiated Tissues, 87
6 Genetic and Developmental Disorders, 94 Linda D. Ward
Principles of Inheritance, 95 DNA Mutation and Repair, 96
GENETIC DISORDERS, 98 Chromosomal Abnormalities, 99
Aberrant Number of Chromosomes, 99 Abnormal Chromosome Structure, 100 Examples of Autosomal Chromosome
Disorders, 100 Examples of Sex Chromosome Disorders, 101
Mendelian Single-Gene Disorders, 102 Autosomal-Dominant Disorders, 103 Autosomal-Recessive Disorders, 104 Sex-Linked (X-Linked) Disorders, 106
Nonmendelian Single-Gene Disorders, 107 Anticipation, 109 Mitochondrial Gene Mutations, 109 Genomic Imprinting, 110
Polygenic and Multifactorial Disorders, 110 Environmentally Induced Congenital
Disorders, 111 Periods of Fetal Vulnerability, 111 Teratogenic Agents, 111 Other Disorders of Infancy, 113
Diagnosis, Counseling, and Gene Therapy, 113 Prenatal Diagnosis and Counseling, 113 Genetic Analysis and Therapy, 114 Recombinant DNA Technology, 114
7 Neoplasia, 117 Jacquelyn L. Banasik
Benign Versus Malignant Growth, 118 Characteristics of Benign and Malignant
Tumors, 118 Tumor Terminology, 118 The Malignant Phenotype, 118
Epidemiology and Cancer Risk Factors, 120 Tobacco Use, 120 Nutrition, 120
Genetic Mechanisms of Cancer, 123 Proto-Oncogenes, 124 Tumor Suppressor Genes, 127
Multistep Nature of Carcinogenesis, 129 Initiation, 129 Promotion, 131 Progression, 131
Metastasis, 132 Patterns of Spread, 132 Angiogenesis, 133 Grading and Staging of Tumors, 134
Effects of Cancer on the Body, 136 Cancer Therapy, 137
Surgery, 137 Radiation Therapy, 138 Drug Therapy, 138 Immunotherapy, 138 Gene and Molecular Therapy, 138 Stem Cell Transplantation, 139
UNIT III Defense
8 Infectious Processes, 141 Brent A. Banasik
Host–Microbe Relationship, 142 The Human Microbiome, 142
Host Characteristics, 142 Pathogen Characteristics, 144
Transmission of Infection, 147 Routes of Transmission, 148 Emerging Infectious Diseases, 148 Weapons of Bioterrorism, 149
Types of Pathogenic Organisms, 149 Bacteria, 149 Viruses, 150 Fungi, 151 Parasites, 152
9 Inflammation and Immunity, 158 Jacquelyn L. Banasik
COMPONENTS OF THE IMMUNE SYSTEM, 159
Epithelial Barriers, 159 Mononuclear Phagocyte System, 159 Lymphoid System, 160
Primary Lymphoid Organs, 160 Secondary Lymphoid Organs, 161
Leukocytes, 162 Neutrophils, 162 Eosinophils, 163 Basophils and Mast Cells, 164 Monocytes and Macrophages, 164 Dendritic Cells, 165 Lymphocytes, 165
Chemical Mediators of Immune Function, 167 Complement, 167 Kinins, 169 Clotting Factors, 169 Cytokines and Chemokines, 169
INNATE DEFENSES AND INFLAMMATION, 169 Inflammation, 171
Increased Vascular Permeability, 171 Emigration of Leukocytes, 172 Phagocytosis, 172 Chronic Inflammation, 174
Healing, 174 Inflammatory Exudates, 175 Systemic Manifestations of Inflammation, 175 SPECIFIC ADAPTIVE IMMUNITY, 176 Major Histocompatibility Complex, 176 Antigen Presentation by MHC, 176
MHC Class I Presentation, 177 MHC Class II Presentation, 177
Mechanisms of Cell-Mediated Immunity, 178 T Helper Cells (CD4+), 178 Cytotoxic T Cells (CD8+), 181
Mechanisms of Humoral Immunity, 181 Antigen Recognition by B Cells, 181
Antibody Structure, 183 Class Switching and Affinity Maturation, 185 Antibody Functions, 186
Passive and Active Immunity, 187 Passive Immunity, 187 Active Immunity, 187
INTEGRATED FUNCTION AND REGULATION OF THE IMMUNE SYSTEM, 189
Integrated Response to Microbial Antigen, 189 Integrated Response to Viral Antigen, 191 Regulation of Immune Function, 192
10 Alterations in Immune Function, 194 Faith Young Peterson
EXCESSIVE IMMUNE RESPONSES, 195 Autoimmunity, 195
Genetic Factors, 196 Environmental Triggers, 196 Pharmacotherapies, 197
Hypersensitivity, 198 Type I Hypersensitivity, 199 Type IIa Hypersensitivity, 201 Type IIb Hypersensitivity, 204 Type III Hypersensitivity, 204 Type IV Hypersensitivity, 207
DEFICIENT IMMUNE RESPONSES, 210 Primary Immunodeficiency Disorders, 210
B-Cell and T-Cell Combined Disorders, 210 T-Cell Disorders, 211 B-Cell Disorders, 212
Secondary Immunodeficiency Disorders, 212 11 Malignant Disorders of White Blood Cells, 215
Marie L. Kotter and Jacquelyn L. Banasik Classification of Hematologic Neoplasms, 215 Etiology of Myeloid and Lymphoid Neoplasms, 216 General Principles of Management, 217
Diagnosis of Hematologic Neoplasms, 217 Principles of Treatment, 218 Prevention and Management of Complications, 219
Myeloid Neoplasms, 221 Chronic Myeloid Leukemia, 221 Acute Myeloid Leukemia, 222
Lymphoid Neoplasms, 223 Chronic Lymphoid Leukemia, 223 Acute Lymphoblastic Leukemia/Lymphoma, 223 Hairy Cell Leukemia, 224 Plasma Cell Myeloma (Multiple Myeloma), 224 Hodgkin Disease, 227 B-Cell, T-Cell, and NK-Cell Lymphoma
(Non-Hodgkin), 229 12 HIV Disease and AIDS, 233
Faith Young Peterson Epidemiology, 234
History, 234 Types of HIV, 234 Transmission, 236 Prevention of Transmission, 238
Etiology, 239 HIV Structure, 239 HIV Binding and Infection, 239
Pathogenesis, 242 Effect of HIV on Immune Cells at the Cellular
Level, 242 Viral Production and Cell Death, 242 Progression of HIV Infection From Seroconversion
to AIDS, 244 CDC HIV Classification System, 245
Diagnostic Testing, 245 Monitoring the Progression of HIV, 246 Clinical Manifestations, 248
Systemic Manifestations, 248 Gastrointestinal Manifestations, 249 Pulmonary Manifestations, 249 Mucocutaneous Manifestations, 250
Gynecologic Manifestations, 251 Neurologic Manifestations, 252 Ocular Manifestations, 253 Cardiovascular Manifestations, 253 Manifestations in Other Systems, 253 Manifestations in Children, 254
Treatment, 254 Antiretroviral Therapy Recommendations, 254 Nucleoside Reverse Transcriptase Inhibitors, 255 Nucleotide Reverse Transcriptase Inhibitors, 255 Nonnucleoside Reverse Transcriptase
Inhibitors, 255 Protease Inhibitors, 257 Fusion Inhibitors, 257 CCR5 Inhibitors, 257 Integrase Strand Transfer Inhibitors, 257 Other Treatments and Vaccines, 257
UNIT IV Oxygen Transport, Blood Coagulation, Blood Flow, and Blood Pressure
13 Alterations in Oxygen Transport, 259 Susan G. Trevithick
Composition of Blood, 260 Organic and Inorganic Components, 261 Cellular Components, 261
Structure and Function of Red Blood Cells, 262 Hematopoiesis, 263 Hemoglobin Synthesis, 265 Nutritional Requirements for Erythropoiesis, 266 Energy and Maintenance of Erythrocytes, 267 Red Cell Production, 267 Red Cell Destruction, 268
Gas Transport and Acid–Base Balance, 268 Oxygen Transport, 268 Carbon Dioxide Transport, 270 Alterations in Oxygen Transport, 270
Anemia, 272 General Effects of Anemia, 272
Anemia Related to Decreased Red Cell Production, 277 Aplastic Anemia, 277 Anemia of Chronic Renal Failure, 277 Anemia Related to Vitamin B12 (Cobalamin)
or Folate Deficiency, 278 Iron Deficiency Anemia, 279
Anemia Related to Inherited Disorders of the Red Cell, 279 Thalassemia, 279 Sickle Cell Anemia, 281 Hereditary Spherocytosis, 282 Glucose-6-Phosphate Dehydrogenase
Deficiency, 282 Anemia Related to Extrinsic Red Cell Destruction or
Loss, 284 Hemolytic Disease of the Newborn, 284 Antibody-Mediated Drug Reactions, 284 Acute Blood Loss, 285 Other Extrinsic Abnormalities, 285
Transfusion Therapy, 286 Polycythemia, 286
Polycythemia Vera, 286 Secondary Polycythemia, 292 Relative Polycythemia, 293
14 Alterations in Hemostasis and Blood Coagulation, 298 Cheryl Rockwell
The Process of Hemostasis, 298 Stages of Hemostasis, 298 Platelets, 299 Blood Coagulation Factors, 299 Fibrin Clot, 299 Fibrinolysis, 301
Evaluation of Hemostasis and Coagulation, 301 Clinical Assessment, 301 Laboratory Tests, 304
Vascular and Platelet Disorders, 304 Vascular Disorders, 304 Platelet Disorders, 306
Coagulation Disorders, 308 15 Alterations in Blood Flow, 313
Teresa Grigsby Loftsgaarden Organization of the Circulatory and Lymphatic
Systems, 315 Vessel Structure, 315 Lymphatic Structure, 317
Principles of Flow, 317 Hemodynamics of the Circulatory System, 317
Control of Flow, 322 Control of Blood Flow, 322 Control of Lymphatic Flow, 323
General Mechanisms That Cause Altered Flow, 323 Blood Vessels: Obstructions, 323 Blood Vessels: Structural Alterations, 325 Lymphatic Vessels, 326
Alterations in Arterial Flow, 326 Arteriosclerosis/Atherosclerosis, 326 Thromboangiitis Obliterans (Buerger Disease), 330 Raynaud Syndrome, 330 Aneurysms, 330 Acute Arterial Occlusion, 331
Alterations in Venous Flow, 332 Valvular Incompetence, 332 Varicose Veins, 332 Chronic Venous Insufficiency, 333 Deep Vein Thrombosis, 3
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