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80 Cards in this Set
- Front
- Back
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Chronic Reflux/Barrett's Esophagus
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Esophageal epithelium (stratified squamous) metaplasia to gastric epithelium (simple columnar)
Dysplasia may be present Inflammation, scarring, dysphagia |
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Pernicious Anemia
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VitB12 malabsorption leading to insufficient RBC synthesis
Can stem from a problem with Intrinsic Factor (IF) synthesis or a deficiency in Vitamin B12 Can also be caused by AutoAb preventing binding of B12 and IF |
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Prader-Willi Syndrome
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will have eleveted levels of Ghrelin, stimulating hunger in the hypothalamus
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Acute gastritis
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Can be caused by alcohol, anti-inflammatory drugs, stress
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Chronic gastritis
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Can be caused by:
Chemical - EtOH, reflux of bile into stomach Autoimmune Infection - Helobacter pylori |
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Helobacter pylori
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causes chronic gastritis by attaching to surface epithelium and interfering with the formation of the gel-coat --> loss of protective layer. This causes inflammation, acid-induced ulceration and necrosis, and fibrous scarring. An obstruction can occur due to scarring at the lower esophagus or pylorus. At end, the effects of H. pylori can lead to hemorrhage or perforation
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Zollinger-Ellison syndrome
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hyperplasia of fundic stomach, gastrin-secreting tumors (gastrinomas)
high HCl secretion inactivates pancreatic lipases --> diarrhea, steatorrhea gastric ulcers |
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Malabsorption syndromes
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deficits in absorption of fats, proteins, carbs, salts, or water
some causes: brush border enzyme abnormalities defective bile secretion abnormal pancreatic enzyme secretion |
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Gluten enteropathy (celiac disease)
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Immune-mediated inflammatory disease of small intestine
Atrophy and flattening of intestinal villi, hyperplasia of intestinal glands Results in malabsorption syndrome from loss of SA |
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Diverticular Disease
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High intralumenal pressure (possibly due to low residue diet) and weakened muscularis results in herniation of mucosa through weakened muscularis
Complications include inflammation, perforation, and hemorrhage |
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Crohn's Disease
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Chronic inflammatory disease of unknown etiology affects small intestine (mainly terminal ileum) but may also affect colon
Patchy distribution w/ normal segments btw Domed areas of edematous mucosa and submucosa w/ fissured ulcers and granulomas Inflammation may be transmural and can lead to fibrosis and obstruction Predisposes to cancer |
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Ulcerative colitis
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unknown etiology, affects colon especially rectum
Acute phase characterized by inflammation w/ neutrophils accumulating in lamina propria and crypts forming abcesses of pus Superficial ulcers w/ normal mucosa projecting above ulceration (inflammatory pseudopolyps) Inflammation rarely transmural High incidence of dysplasia and adenocarcinoma in chronic cases |
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Colon polyps (adenomas)/adenocarcinoma
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Benign adenomas, varying degrees of dysplasia
tubular, tubulovillus, villus (most potential for neoplasia) Adenocarcinoma: sigmoid colon most frequent site, malignant |
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Appendicitis Stages
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Acute inflammation w/ surface ulceration and exudates
Spread through layers and into peritoneum Peritonitis of right iliac fossa If perforates, widespread peritonitis |
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Anosmia
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loss of olfaction
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Bitemporal hemianopsia
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loss of lateral (temporal) visual fields in both eyes
can be caused by pituitary tumor |
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Ipsilateral nasal himianopsia
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loss of medial (nasal) visual field on one side
can be caused by internal carotid aneurysm |
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Contralateral homonymous hemianopsia
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lesion of the optic tract causing loss of lateral (temporal) visual field same side, medial (nasal) visual field opposite side.
results in loss of either left or right visual fields. |
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Papilledema
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bulging of the optic disc
usually caused by an increase in cranial pressure (CSF) |
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Horner's Syndrome
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injury to sympathetic trunk in neck
partial ptosis due to loss of tarsal muscle innervation miosis (pupil constriction) enopthalmos (retraction of eye) Ipsilateral anhidrosis Vasodilation |
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Strabismus
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inability to direct both eyes towards same object
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Diplopia
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double vision
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Lesion of CN VI causes
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paralysis of LR --> strabismus and diplopia. Pt compensates by turning head so object is brought into alignment w/ affected eye
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Lesion of CN IV causes
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paralysis of SO, weakness of downward medial gaze (intorsion) most noticeable when going down stairs. Pt compensates by tilting head towards unaffected side. Should consider DDx of torticollis (lesion of XI)
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Torticollis
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lesion of CN XI
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Oculomotor opthalmoplegia
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lesion of entire CN III
Eye moves down and out, strabismus Ptosis due to loss of innervation to levator palpebrae superioris m. (pt compensates by raising frontalis muscle, wrinkled forehead) Dilated pupil b/c CN III carries parasympathetic innervation for constrictor pupillae m (leaving dilator pupillae to rule over iris tone) Lack of accommodation |
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Stye
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an infection in the ducts of the eyelids sebaceous glands which empty directly onto the surface of the eye
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Chalazion
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blockage of tarsal glands leads to inflammation on inside of eyelid
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ptosis
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drooping of the upper eyelid, aka "lazy eye"
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miosis
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pupil constriction
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anhidrosis
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lack of sweating
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a lesion in CN IV will present as
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eye will be extorted (lack of intorsion from Superior Oblique)
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a lesion in CN VI will present as
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eye will be adducted (lack of abduction from Lateral Rectus)
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a lesion in CN III will present as
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eye will be down and out
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ankyloglossia
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aka tongue-tie
insufficient cell degeneration under tongue during development |
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microglossia
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small tongue
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macroglossia
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large tongue
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macrostomia
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"big mouth"
insufficient fusion of maxillary and mandibular processes at labial commissure |
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microstomia
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"small mouth"
excessive fusion of maxillary and mandibular processes at labial commissure |
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bifid or forked tongue
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results from incomplete union of 2 lateral lingual swellings
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Diabetes Insipidus
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Chronic renal disease caused by genetic defects in receptors for ADH or nonresponsive receptors for ADH
Results in hypotonic urine (increased water --> dilution) |
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Dwarfism
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caused by decreased GH
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Gigantism
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caused by increased GH in children*
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Acromegaly
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caused by increased GH in adults*
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Prolactin-secreting tumor symptoms
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anovulation in females
decreased libido infertilitiy galactorrhea in males |
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Cretinism
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congenital absence of the thyroid leading to profound neurological damage
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Graves Disease (Hyperthyroidism)
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Autoimmune antibodies to TSH receptors mimic* TSH leading to chronic activation
Presents with enlarged thyroid (goiter), exopthalmos, tachycardia, and fine finger tremors |
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Hypothyroidism
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-Congenital hypoplasia of pituatary: decreased cell metabolism, mental lethargy, hypothermia, myxedema
-Hashimoto's disease: autoimmune antibodies to Tg --> destruction of thyroid follicles -Insufficient dietary iodine |
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Hashimoto's disease
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a type of hypothyroidism where autoimmune antibodies attack Tg leading to destruction of thyroid follicles
DO NOT CONFUSE w/ GRAVES DISEASE |
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Hyperparathyroidsim/Hypoparathyroidism
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Can be genetic mutation of chief cells, cells can't sense calcium levels which can lead to hyper or hypo
Benign adenomas of gland can cause hyperparathyroidism. Increased PTH causes increased bone demineralization and calcium excretion (lead to renal calculi) Idiopathic hypoparathyroidism, tissues don't respond to PTH |
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Cushing's Disease
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caused by ACTH-producing pituatary tumor
Overproduction of cortisol leads to fat redistribution and muscle wasting as wells as immunosuppression Increased androgens |
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Cushing's Syndrome
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caused by functional tumor of adrenal cortex
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Addison's Disease
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chronic destruction of cortex caused by autoimmune responses or TB
Increased ACTH levels due to cortisol deficiency Hypotension, muscle weakness, increased skin pigmentation |
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Diabetes mellitus : Type 1 (juvenile)
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Insulin dependent
Autoimmune destruction of B cells, absent or deficient insulin secretion ~90% are juvenile (but can occur in adults) |
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Diabetes mellitus : Type II (adult-onset)
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Insulin independent
Genetic predisposition Insulin levels can be normal or elevated Insulin resistance of peripheral target tissues may be due to increased number of insulin receptors or deficient signaling of GLUT4 transporter |
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corpora arenacea
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aka brain sand
increases w/ age is the precipitation of calcium phosphates and carbonates on carrier proteins |
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Hemolytic disease of the newborn (eythroblastosis fetalis_
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mother lacks D antigen (Rh-), first child is Rh+, mother is sensitized to D antigen and produces antibodies. If future children are Rh+, maternal antibodies to D antigen cross placenta and lyse infant's RBC
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Anemia
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decreased oxygen-carrying capacity of blood
decreased # of erythrocytes (decreased Hct) Defective or deficient Hb Sickle Cell anemia: genetic mutation of hemoglobin polypeptide |
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Polycythemia
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increased erythrocyte count (increased Hct)
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Hemophilia Type A
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defective or deficient factor VIII
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Hemophilia Type B
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defective or deficient glycoprotein 1b-factor IX
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Thrombocytopenia
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decreased platelets
caused by decreased production or increased destruction of platelets induced by drugs or autoAb to platelets or megakaryocytes |
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Thrombocytosis
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increased platelets (increases probability of thrombosis)
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Neutrophilia
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An increase in circulating neutrophils, caused by:
Epinephrine - transient, due to dilation of capillaries and release of neutrophils from marginating compartment Glucocorticoids - increases mitosis Infection - increased # of immature neutrophils released from bone marrow (clinically referred to as "shift to the left") Band cells = immature neutrophils which have a curved, rod-shaped nucleus |
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Metastatic cancers of blood cell formation
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Bone marrow is a common site for blood-borne metastasis of malignant tumors
Carcinomas of the breast, lung, kidney, and thyroid most common Tumors lead to destruction of trabecular bone and osteolytic deposits Prostatic cancer stimulates growth of new woven bone with osteosclerotic deposits |
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Chronic Leukemia
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neoplastic proliferation of more mature leukocyte precursors (cells more differentiated) allows for normal production of other WBCs, RBCs, and platelets
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Acute Leukemia
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proliferation of immature "blast" cells, more malignant since these precursors are early stem cells for other cell types
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Tumor in floor of Fourth ventricle
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may affect VI and VII: adducted eyes, total ipsilateral loss of VII motor
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Acoustic Neuroma
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affects VIII and VII: auditory and vestibular problems, total ipsilateral loss of VII function
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Bell's Palsy
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may be due to viral infection in facial canal before it exits stylomastoid foramen: ipsilateral facial paralysis
can't close eye --> crocodile tears due to lacrimal punctum falling away from eye droop of angle of mouth loss of nasolabial fold eyebrow droop buccinator paralysis causes food to lodge in cheek |
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Genetic storage diseases
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Inborn errors of metabolism result in accumulation of metabolites in hepatocytes
Glycogen storage disease, lipidoses, mucopolysaccharidoses, haemochromatoses |
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Acute Hepatitis
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may resolve or become chronic
due to toxins, drugs, virus hydropic degeneration of hepatocytes, progresses to spotty necrosis with aggregates of inflammatory cells around necrotic hepatocytes (Councilman bodies) Kupffer cells proliferate Regeneration |
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Chronic Hepatitis
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Viral, toxins, autoimmune
Classified according to how far it progresses (stage) and how active (grade) Necrosis of hepatocytes, fibrosis |
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Cirrhosis
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End stage of several liver diseases where there is hepatocyte loss
Regeneration nodules encased in CT Disruption of architecture affects blood flow, bile flow |
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Liver cancer
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Hepatocellular carcinoma - most common
Common site of secondary metastasis of other cancers |
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Gallstones
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calculi, solid concretions of bile which attract calcium and salt deposits
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Pancreatitis
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May be acute or chronic
Release of pancreatic enzymes causing chemical peritonitis Hemorrhage and necrosis of pancreas and surrounding tissues |
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Lymph node reactive hyperplasia
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Lymph nodes enlarge due to infection
Follicular hyperplasia: if response is mainly humoral, nodules in outer cortex enlarge due to B cell proliferation Parafollicular hyperplasia: T cell activation Increased macrophage activity causes dilation of sinuses |
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Hodgkin's Lymphoma
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Different subtypes, usually manifests first in lymph nodes but can spread to other lymphoid organs and bone marrow
Characteristic Reed-Sternberg cells: tumor cells that usually arise from activated T cells, but may also arise from B cells and macrophages. Different subtypes have different prognoses |
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Non-Hodgkin's Lymphoma
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Most tumor cells arise from B cells
Usually manifests first in lymph nodes but may arise from any lymphoid tissue, very commonly arises from MALT |
