Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
70 Cards in this Set
- Front
- Back
|
bronchopneumonia
|
agents: (HPS) Hemophilus, pseudomonas (in cystic fibrosis abfter 6 month of age), staphylococcus (acquired by contamination from skin microbes-->form abscess-->cavitary lesions
rales +/- rhonchi on auscultation due to inflammation confined to alveoli contiguous to bronchi X-ray: peribronchial infiltrate |
|
|
Lobar pneumoina
|
entire lobe
dullnes on percussion decreased sounds on auscultaion due to consolidation (xray) agents: #1 Pneumococcus: strep pneumonia: casues caugh, fever, rigors Process: congestion (lobar filled wiht bacteria and mucin)-->red hepatization (lobe filled with RBC)-->Gray hepatization (lobe filled wiht fibrin)--.resolution #2: Klebsiella pneumonia: prolonged onset of progresseive dyspnea, cough, fever, CURRANT JELLY SEPUTUM (coagulation of necrotic tissue) |
|
|
Atypical pneumonia
|
patchy pneumonia bilaterally
Rales on auscul pulmo infiltrates bila on xray agents: Viruses: children: RSV, adenovirus, influenza adults: Influenza A and B Mycoplama pneumonia ( Eaton agent): most common lung patho in ages 5-35: cause bullos myringitis (bullae in tympanic memb), pharyngitis, bhronchitis, pneumonia. casues "walking pneumonia" that evolves on weeks to productive cough for mucupurulent sputum. |
|
|
legionnaire's dis
|
unilat patchy or lobar infiltrate on Xray
rales High fever+PNEUMONIA+DIARRHEA+cough agent: legionella pneumophila |
|
|
strep pneumonia
|
#1 cause of pneumonia overall
|
|
|
Aspiration pneumonia
|
#1: Gastric acid: cause pink frothy sputum, SOB, cyanoisi, Etc, due to aspiration of vomit during inebriation or drug OD
#2; anaerobic Bacteria (from gingivae): purulent foul smelling sputum due to aspiration of gigival organism in saliva secondary to decreased consciousness, decreased pharyngeal controll (MS, ALS) #3: mechanical obstruction: drowning or aspiration of objexts |
|
|
Hamartoma
|
benign
overgrowth of native tissue to the site |
|
|
adenoma
|
benign tumor of glandular structure
|
|
|
leiomyoma
|
benign tumor of smooth muscle
|
|
|
carcinoid
|
specialized serotonis-histamine producing benign or malignant tumore usually arising from the GI.
if metast to liver develop carcinoid syndrome: flushing (clavicles upward (pathognomic)), diarrhea, bronchospasm, Rt heart valve lesion, hypotension Dx: 24 hr urinary 5-HIAA can also develop in lung to cause same symps but usually develop in GI |
|
|
carcinoma
|
malignant tumor of epithelial origin
1st symp: new onset cough or change in existing cough |
|
|
adenocarcinoma
|
assoc. wiht preexisting lung scar from TB, pneumonia, trauma etc.
in peripheral lung in non smokers also |
|
|
squamous cell carcinmona
|
smoking
parneoplastic syndrome: PTH like peptide-->hypercalcemia centrall lung |
|
|
Large cell carcinoma
|
smoking
periphery of lung |
|
|
small cell carci (oat cell carci)
|
smoking
worst px centrally parneoplastic: ADH-->fluid overload-->pulmo and systemic edema paraneo: ACTH: cause cushings syndrome may cause Eatern Lambert syndrom: antibody to presynaptic Ca channels on neurons of NMJ-->proximal muscle weakness (hip and shoulder) |
|
|
nephritic syndrome
|
acute onset inflmamatory process-->decrease filtering
S&S: HEMATURIA RBC CASTS (pathognomonic) hypertension, edema, increased BUN, CREATININE-->represent azotemia (accumulation of nitrogenous compounds in blood) |
|
|
neprotic syndrome
|
change in glomerular permeability-->loss of protein greater than 3.5g/day
S&S: severe proteinuria frothy urine hypoalbuminemia hyperlipidemia edema (secondary to decreased oncotic pressure) |
|
|
Rapidly progressive (crescentic) glomerulonephritis (RPGN)
|
severe glomerular injury, severe acute form of nephritic syndrome
cresents (prolif. of epitheium of bowmans capsule that surrounds glomerulus) type 1 RPGN: antibody mediated cytotoxicity: causes: idiopathic, goodpastures Type 2: (immune complex dis) casues: idiopathic, SLE, Henoch schonlein, post infectious Type III: (pseudo-immune-->+ANCA dix) casues: idiopathic wegners, microsopic polyangitis, advanced terminal polyartertitis nodosa |
|
|
Minimal change dis/ lipid nephrosis/foot process dis
|
Nephrotic
most common nephrotic synd in children idiopathic some have recent Hx of URI Bx; loss of foot processes |
|
|
Membranous glomerulonephritis
|
nephrotic
30-50 age most common adult nephrotic usually idiopathic but can be asso. wiht colon or lung cancer, chronic inf, heavy metal exposure, drugs microscopic hematuria RENAL VEIN THROMBOSIS IS COMMON BX: thick BM, subepithelial deposits of IgG and C3 complement in a spike and dome ESRD in few years |
|
|
focal segmental glomerulosclerosis
|
nephrotic
less than 3 usually idiopathic, chronic ureteral reflux or heroin abuse, HIV hematuria, HTN, renal insuffi Bx: sclerosis or glomerulus in a focal and segmental pattern-->progress to diffuse-->renal failure very similar pathology to minimal change |
|
|
membranoproliferative glomerulonephritis (messangiocapillary GN)
|
5-30, females>males
immune complex deposition in glomerulus, closely assoc. wiht RECENT UPPER RESP INFX, HEPATITIS C, other autoimmune idss start as nephritic but become nephrotic BX: messangial prolferation, BM thickining and splittting, subendothelial deposits of IgG and C3 show as "TRAM TRACKING" LABS: decreased complement levels ESRD in 10 years |
|
|
acute proliferative glomerulonephritis (acute post strep glomerulonephritis)
|
nephritic
3-14 age, risk declines wiht age 3-4 weeks after GABHS infx labs: (+) ASO TITER and decreased C3 complement BX; mesangial proliferation, subepithelial deposits of IgG and C3 in granular "LUMPY BUMPY" pattern |
|
|
Antiglomerular Basement memb (goodpasture's dis)
|
nephritic
11-39 strong prediliction for males antiglomerular BM antibodies-->activate complemnt-->sever inflammation Hemoptysis: because same BM in lungs progress to RPGN Bx: mesangial proliferation, "LINEAR" deposition of IgG adn C3 on BM, Cresecent in RPGN ESRD in months to years |
|
|
IgA nephropathy
|
nephritic
most common overall primary glomerular dis. 11-29 strong predilection for males IGA immune complex depostion usually follows VIRAL upper resp infx, non-specific viral syndrome, GI syndrome BX: focal and segment glomerular mesangial prolif, igA immune complex deposits Labs: increased serum IgA usually benigh |
|
|
Diabetic glomerulosclerosis (kimmelstiel wilson syndrome)
|
nephritic + nephrotic
any age about 20 years after onset of diabetes most common secondary glomerular dis microalbuminuria is early finding Bx: small kidneys, diffuse glomerulosclerosis of BM-->nodules of mesangial prolif (kimmelsteil wilson nodules) |
|
|
Acute tubular necrosis
|
death of cells that line the renal tubules
pre-renal acute renal failure is the the #1 cause of ATN: little blood is delivered to renal and too little fluid reaches the tubules MUDDY BROWN CASTS: pathognomonic also caused by toxins: Free HgB (from massive hemolysis), myoglobin (from rhabdomyolysis), ethylene glycol, aminoglyosides, Amphothericin B, Cisplatin, contrast media if treated early: full recovery in 7-21 days |
|
|
Pre-renal acute renal failure
|
due to hypoperfusion of kidneay with inadequate blood delivry to glomerulus
casues: hypotension, dehydration, hemorrhage, severe CHF, shock oliguria Labs: High BUN and CREATININE, with a BUN:CREATININE ratio of >20:1 (kidney retains urea in attempts to conserve volume) Tx: IV fluids |
|
|
renal (intrinsic) actue renal failure
|
due to damage to the kidney tissue and its tubules
casues: Acute tubular injury: from drugs, metals, contrat, prolonged pre-renal ARF (# 1 cause of renal ARF) Acute glomerulonephritis Acute tubulointerstitial nephritis: inflammation of tubules or renal parenchyma secondary to allergic rxn ( usually to drugs), or to infx. Acute vascular nephrophahy: vasculits, malignant HTN, TTP, atheroembolism infiltrative dis: sarcoidosis, amyloidosis, etc. LABS: Hi BUN, CREATININE, BUN:CREATININE RATIO OF >10:1, elevated K, Na, Mg, Cl, and decreased Ca Tx: treate the cause |
|
|
post renal ARF
|
obstruction of outflow from the urine
causes: BPH, Bladder stone, urolithiasis of ureters, renal collecting system injury from trauma oliguria/anuria increase K levels as it worsens |
|
|
Calcium stones
|
usually percipitated by dehydration
most common type of kidney dis primary treatment: hydration thiazides reabsorb Ca from renal tubule decreasing stones |
|
|
MG-NH4-phosphate stone
|
triple stone/staghorn calculus/struvite stone
casued by urea-splitting organism: proteus and staphylococcus saprphyticus tx: ABX to eradicate the pathogens |
|
|
Uric acid stone:
|
uric acid crystal serve as core on which Ca oxalate can deposit
causes: increase consumption pf purines, gout, leukemia, tumor lysis syndrome, high cell turnover |
|
|
cystine stone
|
due to cystinuria (AR disorder)
impaired tubular reabsorption of cysteine, ornithine, arginine, lysine (COAL: black stone), cystine crystalizes to form a stone, OAL pass in urine |
|
|
candidiasis
|
casued by candida spp.
yeast infx DOC: miconazole symps: pruritis, erythema, satellite lesions, curd-like white or adherent white discharge due to overgrowth of yeast natural to the area (opportunistic infx) ph:< 4.5 color: bright white odor: bready microscopic: germ tubes, pseudohyphae |
|
|
Trichomonas(STD)
|
thrichomonas vaginalis
DOC: metronidazole symps: extreme pruritis, frothy green discharge ph: <4.5 color: yellow green odor: putrid micro: darting trichomonads |
|
|
Bacterial vaginosis
|
overgrowth of normal flora gardnerella and mobiluncus due to disruption of flora by douching, feminie products
DOC: metronidazole profuce grey white discharge wiht or without prutits + whiff test ph: <4.5 color: grey white odor: fishy micro: clue cells |
|
|
Gonorrhea
|
neisseria gonorrheaa
DOC: ceftriaxone + doxy (for chlamydia) thich purulent discharge if left untreated in female: ascends to casue PID, salpingitis-->may cause infetility, ectopic pregancy |
|
|
trichomoniasis
|
often carried asymptomatically in the rectum
trichomonas vaginalis extreme pruritis because very motile DOC: metronidaxole |
|
|
non-gonococcal urethritis
|
infectiour urethritis in male due to anything but gonorrha
usually due to chlamydia trachomais DOC: doxy +ceftriaxone |
|
|
lymphogranuloma venereum
|
primalily in tropics
hits lymph nodes wiht granulomas-->develop granuloma in inguinal nodes-->eruption/ulcers on surface Chlamydia tracho. DOC: doxy |
|
|
granuloma inguinale
|
Klebsiella granulomatis (calymmatobacterium granulomatis or donovania granulomatis)
bacterium in macrophage: donovan body hits the groin then blocks the inguinal are-->granulomas develp on the genitals-->blocks lymphatic drainage from genital region DOC: tetracycline |
|
|
chancroid
|
primarily tropics
hemophilus ducreyi micro: school of fish (bacteria mover together like fish) soft PAINFUL CHANCRE DOC: ceftriaxone |
|
|
syphilis
|
treponema pallidum
DOC: PEN G 3 stages: 1st stage: PAINLESS HARD CHANCRE (appears 2-10 weeks after infx) 2nd stage: maculopapular red rash on palms, condylama on geitals 3rd stage: gummas (granulomas in skin (painless) in bone (painful), tabes dorsalis, phychosis, dementia, leutic aneurysm, aortitis, arotic regurgitation |
|
|
condyloma acuminatum
|
genital warts
painless BX: koilocytes (marker for HPV, epithelial cells wiht perinuclear clearing) usually type 6 and 11 types 16,18: oncogenic viral proteins E6, E7 inteerfere wiht p53, RB tumor suppresson genes tx; cryotherapy |
|
|
Genital herpes
|
HSV1 (oral), HSV 2 (genital)
exquisitely painful fluid filled vesicles that erupt in a group on a erythematous base recur during physical or emotional stress live virus become latent in sensory ganglion cells (trigeminal ganglion (oral herpes), lumbar and sacral ganglion(genital herps) + TZank test: multinucleated giant cells DOC: acyclovir |
|
|
chlamydial cervicitis
|
chlamydia trachomatis
if untreated-->ascend to cause PID in females DOC: Doxy |
|
|
Germ cell tumors
|
from cells that would normally become sperm
|
|
|
seminoma
|
germ cell tumor
painless enlargement of testes peak 35 #1 most common germ cell tumor always malignant very radiosensitive +/- elevated hCG |
|
|
Embryonal
|
germ cell tumor
painful with early metasteses peak <35 #2 most common germ cell tumor ELEVATED HCG POOR PX |
|
|
choriocarcinoma
|
rare peak in teens-20s
always malignagn very high hcg |
|
|
yolk sac
|
germ cell tumo
infantile type peak in infany always malignant ELEVATED SERUM ALPHA FETOPROTEIN |
|
|
TERATOMA
|
2 or mor germ layers
usually malignant: comprised of immature neoplastic cells |
|
|
non germ cell tumors
|
from nonspermatozoan cells
2 types: stromal sex cord tumors, non stromal sex cord tumors |
|
|
leydig cell tumor
|
stromal sex cord tumor
usually benign + intracytoplasmic reinke crystals precociuos puberty if occurs before puberty gynecomastia: if after puberty |
|
|
sertoli cell tumor
|
stromal sex tumor
benign asymp |
|
|
lymphoma
|
non stromal sex tumor
in elderly and AIDS |
|
|
surface epithelium ovarian tumors
|
in females>20 years
1: serous 2: mucinous 3: endometriod 4; clear cell 5: brenner |
|
|
serous
|
cystadenoma/cystadenocarcinoma
cystic lined wiht fallopian tube epithelium (ciliated adn secrete a watery secretion) half of all ovarian cancers, and bilateral |
|
|
mucinous
|
cystadenoma/cystadenocarcinoma
cytic lined wiht columnar cells that make mucus may cause: pseudomyxoma peritonei |
|
|
endometioid
|
glandular tissue resembling endometrial tissue, usually malignant
solid tumor |
|
|
clear cell
|
solid tumor
large epith cells with large clear cytoplasm can occur wiht endometriosis, endometriod carcinoma or ovary usually malignagnt |
|
|
brenner/celioblastoma
|
solid tumor
transitional epi |
|
|
germ cell tumor of ovary
|
#1 type in women <20
1: teratoma 2: dysgerminoma 3: endodermal sinus tumor 4: choriocarcinoma |
|
|
teratoma
|
2 or more germ layers
either mature (90%) or immature (20%) dermoid cyst: mature teratoma: cyst lined by skin wiht hair follicles+/- nails, sebaceous glands, bones, teeth, GI, neurologicla resp, thrroid tissue 2: stroma ovarii: only one 1 type of layer, can cause hyperthyroidism |
|
|
stromal sex cord tumors
|
3 types:
1: granulos-theca cell tumor 2: sertoli-leydig cell tumor 3: fibroma |
|
|
granulosa-theca cell
|
secrete large amt of estrogen
+ call-exner bodies (follicle filled wiht eosinophilic material) assoct: wiht casueing secondary endomettial hyperplasia, or endometrial ca |
|
|
sertoli-leydig cell (androblastoma)
|
make large amt to testosterone
cause virilization of females (clitoromegaly, hirsutism, deep voice-irreversible) |
|
|
fibroma
|
benign
casue meigg's syndrome-->ascites, pleural effusion+ovarian tumor solid tumor of spindle shaped fibroblasts |
|
|
Krukenbery tumor
|
metas tumor to tumor, characterized by bilater replacement of ovaries wiht mucin-producing SIGNET-RING CELLS
primary source is oftern STOMACK TUMOR |
