Hello everybody. Welcome back Andrea here. So let's go through our general pathology quiz. We'll be going through these questions and the answers why the correct answer is the most correct and Rationals behind it. So number one, what is the first cardinal sign of inflammation? The first sign is redness. So if you guys go in your oral pathology notes textbook, however, you want to do it You will notice there's these different signs of inflammation. So if they're present Whether it be one or all of them that is a sign of inflammation in the real world It's more so, you know, if a client comes in and they have swelling on their cheek. Well, that's not normal You can even say to them. Well, you have signs of inflammation Swelling is not normal in the dental office if a client comes in and is calling about an Emergency, their tooth really hurts. The receptionist will likely ask them these things. Do you notice any redness? Heat, swelling, pain. Those are signs of inflammation and an anti-inflammatory May have to be given or antibiotics, but that's a whole nother story for another day So this is where the cardinal signs of inflammation come from. Redness is the first sign They love to ask this on the exam because they want you to know that So redness is the only answer in this case because it's the first sign This is something you would have had to memorize So you can't always just know the signs of inflammation You have to memorize those stages and those steps. Redness is the first sign Now does anybody remember the second sign of inflammation? In fact, I even have to check my notes here because as a dental hygienist This isn't something where we talk about often. Oh, did you know that redness is the first sign? This is the second sign. This is the third. So the first sign, like I said, obviously is redness. The second is the tumor Three is heat and four is pain. So that was easy So these are what you have to know. Another sign of inflammation just so you know is loss of Function. Now that isn't in all of the textbooks, but it's in the newer oral pathology textbooks So you do need to know there's another sign of inflammation and that is loss of function Okay, next one. What is the first cell to? Immigrate to the site of injury so neutrophils are that first cell Meaning neutrophils will be there prominently there that cell That's their most if that makes sense. There are many cells involved but you need to know that that one is the first one there and The most of if that makes sense. So again, you guys, I'm just checking my notes in case you're wondering what I'm doing Just so I don't forget to mention a couple things to you. So D is the best answer. Okay, so just so you guys know hopefully you did figure this out but B for acute that is not a cell Now, do you guys remember what acute would be part of and another Type is chronic acute and chronic Talking about general pathology. So we're not talking about acute or chronic gingivitis or periopurse but just we're talking about general pathology so things can be acute or chronic and Inflammation in general pathology, it means the types of inflammation So is that inflammation acute or is it chronic? So B would not be correct because that's not a cell a C and D are Cells so any of those could have been the correct answer, but we want the first cell So pick out the keyword that would be the neutrophil. So if you guys are kind of I Guess looking through this and thinking oh, I don't remember what the second cell would be or the third cell Definitely restudy this in your general pathology unit. Okay, very very important a quick overview I left some notes for myself here is neutrophils are involved in acute Inflammation, okay, so not chronic, but they're involved in acute Different cells are for different types of inflammation either chronic or acute the second cell Which is the most prominent other than the neutrophil would be the monocyte or the macrophage So you do need to know the different sites I talked about that more in a couple other questions. So I'm not going to go too far into it. Yeah, anyway Number three, what is another cell that emigrates first to the site of injury other than neutrophils? So see how this question might kind of Make you think a little bit because remember how I just mentioned Neutrophils is the first cell the second cell. Do you guys remember what I just said? Do you guys remember? Monocytes or macrophages, but guess what number three is not asking you what the second cell is It's asking you what the other cell is First to the site of injury. So we already established that neutrophils are first. So what's another cell the P? M ends. So this is the correct answer Polly Molecular. Oh gosh, let me check my notes again. See guys.  Oh, that wasn't so bad So that is the other cell that comes first to the site of injury So definitely know this know your sites of I'm sorry know which cells are Starting with inflammation going to that site of injury It's kind of fun to know for the the real world too, you know When you get to talking about gingivitis and perio you can talk about things like It's almost like getting a cut on your arm, you know those neutrophils will start to come first to try to Heal that cut. It's like gingivitis It's like perio where certain cells try to come first to really help to heal But that's why I'm suggesting three month recares three month scalings I should say to clean the teeth because those neutrophils will keep coming back, you know things like that, right? We'll talk about that more in another Topic probably our gingivitis and perio unit, but you get the idea so but for any exam You don't really have to worry about the real world too much I help you guys with that at a later stage So that's why it be is the best answer because that's the only other cell That's with the neutrophils to go to that site of injury first, but then look you guys We have plasma cells. We have lymphocytes and we have phagocytosis Okay, so those are different ones Those are just kind of different cells that I talked about in a little bit I'm not going to go through it too much yet. Just because I will be asking some more questions on that Okay, guys number four What cell is involved in both acute and chronic? Inflammatory reaction so remember how I mentioned before the two of the different types are acute and chronic inflammation, right? so All of these cells are different cells So you would have to know okay, which ones are for acute which ones are for chronic and which ones are for both So I mentioned this to my students all the time, but even as you're going through mock exams Let's say you knew that mass cells was the right answer because you remembered studying that that's involved in both chronic and acute Inflammation, but what about lymphocytes? Do you remember what type of inflammation that is? What about plasma cells? So don't just know the right answer and then move on look at the other answers too and say to yourself lymphocytes darn What was that involved in again or? acute or chronic inflammation if you don't know look it up that's Focused studying and the best type of studying you can do because you'll be kicking yourself if on the exam They ask you What cell is involved in chronic inflammation and lymphocytes is part of the answer But you're like, oh shoot I don't remember what that cell was if you took the time to look it up You will remember it so much easier But you might not have known to look it up unless you had seen this mock exam questions So see how mock exam questions are so important and so helpful. I don't just do it to annoy everybody I do it to really help you. Okay, so lymphocyte. So this is both chronic and immune response So there's different types. It's not involved in acute, but it's involved mostly of chronic So I'm not gonna give you the answers for all of them unless you guys want me to I suppose Should I what do you think? Okay, so I will so math cells we talked about it. This is for acute and chronic Sorry guys, just double checking my notes here Plasma cells I just kind of threw that in there for now That goes ahead with lymphocytes. Okay, so lymphocytes and plasma cells are more so for chronic and immune response The PN sorry PMN Do you guys remember what that is the polymorpho nuclear? Leucocyte, do you guys remember so this would be acute? Inflammation and going back to what we learned Neutrophils and PMNs are the first cells that go to that site of injury and Remember what I just said about PMN PMNs as well. It's involved in acute Inflammation so this is another way to kind of study go. Oh, I've just talked about PMNs What was that in the last question again? I get excited about mock exams, but maybe that's because I'm a teacher and I know the answer So I understand that you guys might not be as excited as I am, but this is truly the best way to help you study Number five. What does stasis stasis? Refer to this is concentration of the red blood cells in small vessels WBC Refers to white blood cells in case you didn't know I'm assuming you did But I just kind of always like to mention that as well. Now. Does anybody have any questions about this one so far now? sepsis I put this in here because I suspect a lot of you will look at stasis and Think I'm referring to sepsis. That's different. So sepsis is a Systemic, you know something that's happening. Not a good thing, you know, your body can go into shock so to speak not good But stasis is different. So specifically the concentration of the red blood cells in small vessels The bacteria infection I literally just threw that in there just to kind of confuse you guys So don't worry about that that really has nothing to do with the question I'm just trying to find my notes everybody. Sorry. Let's see Where did I put that I did want to talk about stasis a little bit more, but it's amazing how You kind of lose your spot for a second. Okay. Here it is. So So just pretty much if you guys didn't know this stasis refers to the blood I mean, I'm sure you guys knew that because it does say concentration of the red blood cells in small vessels But that's basically what it is it's in the small vessels and increased viscosity of Blood that's Basically what that is. Okay. So they talk about this when they're talking about the different cells How they go to the site of injury and kind of how that works Okay, I talk more about the white blood cells in a little bit So I don't want to go through it too much yet But I want you guys to really think about a different term too So this is where they're starting to talk about where the cells are going and how they're traveling So I also just want to make a note of think about leukocytes. Do you guys remember the term? Pavementing Leucocytes and pavementing so also talking about those cells and where they're going This just basically means that those leukocytes are attaching to the endothelium And they will soon migrate Through the wall into the tissues. So just kind of think about how all of that works together But let's move on to the to the next question and then I do talk about it a little bit more So number six, how long do you neutrophils predominate during the first stages of inflammation? So remember neutrophils and PMNs are first cells to the site of injury But guess what? Do you know how long neutrophils are there in the majority of the numbers? It's actually six to 24 hours. That's a long time So you do need to know the different lengths of times as well. Just as a little side note Neutrophils are replaced by monocytes in 24 to 48 hours. Do you guys remember monocytes? That's the second cell that goes to the site of injury So the first ones are the neutrophils and the PMNs six to 24 hours that takes and then what did I just say and Then monocytes come in after 24 hours 24 hours to 48 hours So you do need you do need to know the different timings Okay, what is chemotaxis? So chemotaxis is the chemical attraction of leukocytes to immigrate in tissues So you do need to know all of that Please look at all of these terms and know what they are So it's not always good enough to just know the correct answer I want you guys to look at all of the other answers to and say do I know these ones? This is focused studying and this is how I will get you to pass. I've been doing this now for 15 years I know what I'm doing trust me on this Okay, take the time to go through all of these questions, but because I'm nice I'm gonna tell you guys what they are So I left myself notes because as a dental hygienist, this isn't something you talk about in the real world So do you guys remember those cells attaching to host receptors what that involves? Do you guys remember? So hopefully everybody's kind of confused, right? So we weren't really talking about this and this isn't something that's involved in the other definitions Do you remember? Fagocytes so they eat things up But it has nothing to do with kind of all of this So sometimes and I did this on purpose because sometimes the board exam or any exam will try to trick you So, please keep that in mind now see so neutrophils PMNs are the first cells and then the cells are now Monocytes after 24 hours Next one after phagocytosis What undergoes cell death and are ingested by macrophages? So the correct answer is Neutrophils so remember up here how I kind of said eating of a bad waste cells So you could kind of say that phagocytosis has to do something with that Okay, so hopefully when you were looking at this you're kind of thinking okay So bad cells kind of sounds familiar cells are dying phagocytes phagocytosis. That's a good way of thinking Okay, but back to number eight here. So this is just something this is the best answer The other ones don't really apply to be honest Phagocytes might but that's just not the right answer because imagine how that would sound so after phagocytosis Phagocytes undergo cell death It just doesn't make sense But of course if you had no idea what the answer was you might pick phagocytes because it looks right So this is where you really have to think about things like that Okay, and I'll say it again. Sorry if I sound like a broken record Neutrophils. Oh, sorry, which I just realized I spoke that wrong Neutro let me fix that neutrophils the first cells and then Macrophages are after that, but where are those neutrophils gonna go?  This is always on the exam. Oh my goodness. Like can you tell? 4,000 to 10,000 is just simply normal if it's more than obviously 10,000 That's a lot that's like too much and when you have too many white blood cells You have to kind of think What's going on the body is trying to fight itself Which I think I did actually ask that in the next question. Sorry, I should have stopped myself but so obviously more than 10,000 would be a lot but 40,000 okay, something's really going on. There's something really bad Okay, so white blood cells is our our body's way of trying to heal itself But when there's too many there, that's not good I mean, it's good because it's trying to heal us, but it means something's bad like something's going on Okay, when do fibroblasts begin to form after injury? What do you guys think? Think about it So you do have to know things like You know the different days the different hours I'll be honest. I kind of just threw a bunch of things in here But fibroblasts begin to form three to five days after injury. So you do need to know the different things like Which cell form when does that make sense definitely something to know And I just made a couple notes here for you guys. So Always think site of injury. What's happening? What sells first? So neutrophils and PMNs are first Remember that can take up to 24 hours and after 24 hours you have the macrophages And think about all of the other cells. So fibroblasts three to five days. Well, what's happening? Before that so always think try to connect the dots. So I just left myself some notes here So within 24 to 48 hours. So remember those are now the macrophages That is when a scab starts to form starts to close the wound Within three days As I had kind of mentioned Neutrophils are replaced by macrophages. Notice how it says within three days. So it's after 24 hours But within three days, there's no longer neutrophils.  They're getting eaten basically And then the macrophages form After that by day five the Wound is filled with scar tissue And it's kind of made a note for that During week two This is when the proliferation of collagen and fibroblasts continue But the fibroblasts were obviously happening before then as well By week four, there's a very obvious scar. So kind of know things like that. Okay, and a quick side note Tissues often recover approximately seven to eighty percent of their strength Over three months period compared with intact skin. So skin and tissue is different the way things heal Is a bit different as well Okay, so next one. So within how many days are neutrophils replaced by macrophages So I did mention that were you guys paying attention? So it's three days neutrophils are first with the pm n's and then the macrophages after 24 hours But within what time frame? Okay, guys, so I hope this helped let me know of any questions And keep checking back for more mock exams, and I'll see you guys in the next video


When you just talked about innocence and perpetrators, I have an issue that is so known for several months now about animal abuse and is calling up so much anger and so much sadness. And I have worked with it with Holy Spirit for several times and then I am at peace at the end of the exercise and then I see it again and again it comes around and around and every time I ask Holy Spirit to help me with this I see animals suffering and I see this and this and it's hurting me, I hurt inside and is there anything else I can do about feeling about helping me with this? That's my question. It's beautiful. Actually we were just in Denmark and the venue that they had was a donated venue right next to a slaughterhouse. We literally pull up, we can hear the animals wailing and we, a five day retreat, not out in the country, in the city, but right there. And so probably like the fourth day of the five day retreat or whatever they pulled me up and I come out of the car, my head comes up and I can see over into the holding yard and it's literally like a ramp of steel things and they're lined up and there's a whole group of cows looking at me and we did eye gazing. And it would be no different if it was a concentration camp in Nazi Germany and you had a whole row of people lined up and they're just kind of looking at me, the cows are doing some eye gazing looking at me and they're just like, what is this, what's going on? And so this is good, I'm glad you're raising this because I want to go really deeply into this, really, really, really deeply and thoroughly into this using the course and really coming at this with Jesus in the deepest way possible. When we perceive a world where there is killing or murder or death, it doesn't really matter the degree of the death.  Even when we see a little flower growing through the cracks that keeps getting stepped on and stepped on, there's something that gets triggered. When we perceive animals being mistreated even or killed or whatever, there's something that gets triggered. And we have to realize that what created this world, what created this linear perceptual world, wasn't God, then it was the ego. So this whole world is an invention of the ego and that's why one of the early lessons is I have invented the world. I see it starting to pull the idea that God, like we learned from Genesis in the beginning, God created the heavens and the earth. Oh, God created the heavens, all right, but not celestial heavens with stars and black holes and different kinds of realms and so forth. Oh, God created the eternal, the eternal heavens and the ego projected the earth and the cosmos. And so the ego is a death wish. So everything that the ego projects is from the death wish. For example, in this world we get apples from apple trees. We get pears from pear trees. We get bananas from banana trees. In heaven, spirit comes from spirit. All the creations of God are spirit. Christ is actually not a man or a woman. It's a purely spiritual extension. That's what creation is. You get the same from the same. You don't get different from the same. It would be like getting carrots from an apple tree.  Even in this world we don't see getting different from the same. You get the same from the same. Two people that can see the child, you have a human being that can see. You don't have two people conceiving elephants or parrots or snails. You get humans from humans and you get spirit from spirit. So everything in this linear world as cosmos is coming from the ego. It has no validity, no reality. It actually has no existence except as a hallucination in the mind that believes in the ego. So when you get disturbed by what you're perceiving, what your eyes and your ears are perceiving, it's really that you're not taking in a perception everything that we perceive is projected from the ego's belief system. And remember, the ego is a death wish. So when we look at people dying, whether it's in Nazi Germany or animals dying or so forth, we still have the death associated with the form. But the death wish is in the mind. And the form is just being used to hide the death wish. The ego wants us to get upset and projected and blame and see the cause in the world because that's how the death wish is projected by seeing the cause outside, by seeing the cause in the world. And so in terms of killing, we need a reorientation to start to realize that perceiving a fragmented world is death. If you perceive differences in time and space, in perception, if you perceive death differences, that is the death. The death isn't happening to cows. The death isn't happening to people or animals. The death is in the fragmented perception. And that's why the Course is so helpful because it keeps saying one problem, one solution. It keeps saying, I mean, I just said this recently, and I keep saying this in Course groups all over the world. In 12-step groups, in AA groups, they go around, they say, hi, my name is So-and-so, and I'm an alcoholic. Now everyone reads them. They say, we have to start doing this in Course groups. Hi, I'm So-and-so, and I have a perceptual problem because you have to admit the problem so you can accept the solution. If you say, hi, my name's So-and-so, I'm here because I'm having a hard time with my relationship. No, I've got financial difficulty. No, you don't. Not really. I'm having a problem with the animals being killed, with the pollution that's ruining Mother Earth. I'm having a problem with wars, with countries, politically taking over other countries' invasions. You could go on and on and on. I'm having trouble. I don't like bacteria. I just decided I really don't like bacteria. I just have an issue with viruses in general. It doesn't matter. You could say anything. Because until we come to an admission that we have a perceptual problem, that we're looking at a fragmented world, the Bible said in Corinthians, looking through a dark west, until we come to an admission that the problem is the fragmented perception and the problem is seeing linear time and all the objects strung out in linear time, then we're just going to keep projecting it out onto specific problems that aren't the problem. And that's how you protect the ego. It's always in something in form, and it doesn't really matter what that form is. And that's also where the healing is. I mean, when I had people start to come and live with me years ago in the peace house, they would do things to try to see what would happen with me. One time, the people in the house, they had a gallon of milk that was really old, this really old, sour milk, and they left it in the refrigerator for me.  And they were like, they couldn't believe that I just drank the whole glass of milk. They just couldn't believe it. When you go into these transcendent states of mind, what is sour milk? I mean, it doesn't even have any meaning.  It's really lovely. In fact, in the Course, Jesus says, you will tell, you've practiced well by this, the body should not feel at all. That's the direction this is going in. It's not from a desensitized kind of thing or a repressed denial sense, but it's from a sense, nothing I see means anything. Nothing I smell means anything. Nothing I hear means anything. You know, it starts to transcend. You go into these transcendent states. And that's where this is all heading. It's just another opportunity for you to remind yourself, no, the animals being killed is not what's really happening here. It's the fragmented perception of everything. It's the filter that I'm looking through that needs to be cleansed and healed. And believe me, in the same place, they've had other kind of gatherings there, and people have come and go, oh, no, oh, please don't have the meaning, the spiritual meaning here. So they've told us healing has been going on there for years around that. It wasn't something that was a one-time thing. They've been meeting at the same place for years, just because they had to transcend it. They had to get beyond that. Yeah, in Ireland on this tour, we actually showed a movie called Anger Management. And it's actually a movie that a lot of people will have triggers in watching just because the movie actually shows the guy, almost portray the guy as a victim and the whole movie at the beginning till maybe three-quarters of the movie was just showing how the guy was mistreated. And for a lot of people who first watched this movie, they couldn't stay all throughout the movie because it brings up so much anger and so much frustration of watching someone or something being mistreated on the screen. But really, it is this huge self-hatred or guilt that's been triggered inside. And David used to use this metaphor of the eagle as being throw poison into the ocean and you sip it a little bit of the time, but you never... Basically, you dilute the poison, but it's still poisonous. So every time there is a huge amount of guilt and self-hatred inside, and every time we project it a little bit onto outside specifics, we kind of feel... we minimize the guilt because it doesn't feel too horrendous, but we keep it. That's the way we keep the guilt going every time. The story can be the same over the years, over decades, it's the same. But that's exactly how the eagle used the stories and specifics to keep the guilt, but it doesn't make... it's too outrageous and you can't manage it. You can manage it, but that's the way we keep it. But Jesus was saying, hold my hand and let's go within together. Let me show you what you think was so horrendous is innocent, but you have to be willing to hold my hand and we work together. So basically what he was saying is, do not keep projecting outside, do not keep logging into the story outside. Lesson 79 says, to the degree that you don't define the problem, you will be able to see the solution. So basically it's very practical. If there is a story that seems to run in your life and keeps becoming a trigger every time, Jesus is just there waiting to say, can you let go of this story in your mind so that you have a space for me to show you what is really the source of this? And you were too terrified to go within, but I'm going to show you there is only innocence and light within. So please let go of this story. That's really what it's about.


When they were younger, my kids referred to us as the toy police, which we affectionately call ourselves as well. I think a consumer assumes when they walk into a store that the products they're looking at are safe, and that's where we come in. Anything that could potentially harm consumers, my job is to stop it here. We're co-located with CBP, Customs and Border Protection, at the ports. Make sure these products are safe and are not going to harm children, loved ones or their home. We review incoming merchandise based on what's listed on the manifest and the shipping lines. We decide what shipment might be the highest risk and what we really want to take a look at. We bring the merchandise into a warehouse.  We open up the boxes, we see what's inside. Now if that's toys and children's products, we're screening for lead, we're screening for small parts, we're screening for certain labeling requirements. Then we try to decide if it's something that we need to test further, if it's something that might be hazardous, if it's something that we cover, and we think it may look like it poses a little bit of a hazard, then we'll go ahead and we'll do some screening and some testing here at the port. Unfortunately, when we're screening products, we still see lead. That's lead in paint, lead in content. When you go out and you buy a toy for your child, for the most part you're thinking that this is something that is going to be fun and that your child is going to like, and you shouldn't have to worry that it's going to harm them. It's easy to be passionate about our job because we keep people safe. We all go to the store.  Most of us are consumers, most of us are parents.