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219 Cards in this Set
- Front
- Back
acute bacterial endocarditis
|
- infection of endocardium
~ caused by Staph aureus ~ in IV drug users ~ tricuspid valve |
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subacute bacterial endocarditis
|
- infection of endocardium
~ caused by Strep virdans - can happen during dental procedures - thrombus or vegetation on damaged valve -complications: thrombus embolizes causing septic infarcts, valvular dysfxn, abscess formation - asymptomatic for mths ~ #1- MV, #2- AV, #3- AV (#1 in IV drug users) |
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atherosclerosis
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- plaques in vessels
- can calcify and cause rigidity and distortion ~ plaques of cholesterol, foam cells, and calcium - complications: thrombus, embolization, acute arterial occlusion vessel narrowing and ischemia, calcification of plaques ~ #1- abdominal aorta; also coronary a, circle of willis, ICA, popliteal a. - M |
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ischemic heart disease (IHD)
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- angina due to interruption of blood flow to myocardium
- caused by coronary artery disease (CAD) (narrowing of coronary arteries) ~ #1 cause of death for men and women in US - decreased O2 supply due to plaques in coronary aa; acute cessation of circulation when plaques rupture - stable angina: pain w/ exertion - unstable angina: pain at rest..MI - varient/prinzmetal angina: intermittent pain at rest; less common; vasospasm of coronary aa. |
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ischemia (IHD) vs. infarction (MI)
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- ischemia: REVERSIBLE mismatch b/t supply and demand for O2; pain relieved by nitroglycerine (vasodilator)
- infarction: IRreversible mismatch resulting in cell death; pain not relieved |
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myocardial infarction (MI)
heart attack |
- coronary a. occluded by thrombus from atherosclerotic a
- sympt: angina, SOB, diaphoresis, nausea, vomiting, - consequences: death, arrythmias (most common immediate cause of death), CHF, myocardial rupture...cardiac tamponade...death, thrombus on dead tissue..systemic embolism |
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Left-sided CHF
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- from any heart disease affecting LV
~ dyspnea (exertion), paroxysmal nocturnal dyspnea, orthopnea, tachypnea, pleural effusion, pulmonary edema |
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Right-sided CHF
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- causes: L-sided CHF (#1), L-sided lesions (MS), pulmonary HTN, cardiomyopathy, tricuspid or pulmonary valvular disease
~ peripheral edema (ankles and feet), enlarged liver or spleen, distention on neck veins |
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valvular stenosis
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fibrotic, stiff, thickened valves; resulting in reduced blood flow
|
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valvular regurgitation/insufficiency
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valves are unable to close completely
|
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valvular prolapse
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- "floppy valves"
~ w/ or w/o regurgitation ~ #1 valvular defect |
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rheumatic fever
|
- was the most common cause of valvular disease before antibiotics
- group A strep respiratory infection - affects all 3 layers of the heart ~ Aschoff bodies - focal necrosis surrounded by a dense inflamm. infiltration - most common in MV ....MS / MR |
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acute pericarditis
|
- inflamm of pericardium
~ caused by virus, bacteria (Staph, Pneum), TB, MI, SLE, or rheumatic fever - fever, angina, pericardial friction rub on cardiac auscultation ~ consequences: restricted ventricular expansion (prevents normal filling) |
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cardiac tamponade
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- accumulation of fluid in the pericardium
- severe condition ~ can impair ventricular filling and rapidly decrease CO, causing death ~ hypotension, jugular venous distension, distant heart sounds |
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bacterial pneumonia
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- Strep pneumonia (#1)
- Staph aureus - H. influenza - Klebsiella pneumonia - anaerobic bacteria from mouth (aspiration) - affects pulmonary parenchyma |
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viral pneumonia
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- influenza
- parainfluenza - adenovirus - RSV - affects interstitial tissues (interstitial pneumonia) - fever, dyspnea, productive cough |
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lobar pneumonia
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- infects entire lobe of lung
- intra-alveolar exudates form dense consolidations ~ Strep pneumonia |
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bronchopneumonia
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- infects DISTAL airways, bronchioles and alveoli
~ patch distribution ~ Staph aureus, H. influenzae, and K. pneumoniae |
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lung abscesses
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- localized suppuration
- causes: bacterial pneumonia, bronchiectasis, aspiration of anaerobic bacteria from mouth (impaired gag reflex, alcoholics), bronchial obstruction (cancer) - productive cough, foul odor, cyanosis, dyspnea - most commonly due to alcoholism (aspiration) |
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TB
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- weight loss, anorexia, night sweats, fever, productive cough, hemoptysis
- Ghon's complex = primary lesion + lymph node involvement - tx: multidrug therapy: rifampin, ethambutol, and isoniazid |
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COPD (chronic obstructive pulmonary diseases)
|
- chronic bronchitis
- emphysema - bronchiectasis - asthma |
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chronic bronchitis
|
- narrowing and obstruction of airways
~ hypersecretion of mucus, chronic productive cough for @ least 3 mths straight for past 2 years - smoking ~ consequences: cor pulmonale (R-sided hypertrophy) and bronchogenic carcinoma - thickening of alveolar wall - hemosiderosis |
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emphysema
|
- destruction of alveolar walls by proteases (elastase), released by inflamm. cells
- a-1-antitrypsin normally inhibits elastase ~ smoking inhibits a-1-antitrypsin, allowing elastase to break down alveolar walls - lungs have decreased elasticity 1. CENTRIlobular emphysema - UPPER lobes, smoking 2. PANacinar emphysema - ENTIRE lung, hereditary a-1-antitrypsin defic |
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bronchiectasis
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- permanent dilation of bronchi
- due to chronic lung infections causing inflamm and necrosis of bronchial wall, cystic fibrosis, lung tumor, chronic sinusitis, Kartagener syndrome - productive cough, foul odor, hemoptysis, recurrent lung infections, lung abscesses |
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sarcoidosis
|
- African-Americans
- non-caseating granulomas; Schaumann and asteroid bodies - lung disease - enlarged hilar lymph nodes, uvetitis, erythema nodosum, polyarthritis, hypercalcemia |
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cystic fibrosis
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- nucleotide deletion on c'some 7 causing abnormal Na+/Cl- channels
- #1 hereditary disease in Causasians - autosomal recessive - affects all exocrine glands, lungs, pancreas, salivary glands, intestines - thick secretions or mucous plugs obstruct airways - ultimately fatal - sweat test - increased Cl- - chronic pulmonary disease, pancreatic exocrine insufficiency, meconium ileus (intestinal obstruction in infants and newborns) |
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atelectasis
|
- collapse of alveoli
- due to: failure of expansion, bronchial obstruction, external compression - deficiency of surfactant / hypoventilation of alveoli |
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Sjogren's syndrome
|
- autoimmune disease salivary and lacrimal glands
- ANA's against salivary ducts - triad: xerostomia, RA, kertaoconjunctivitis - Milkulicz syndrome - enlargement of salivary and lacrimal glands - lymphocytes - Warthin's tumor - benign, parotid gland - pleomorphoic adenoma - benign; most common salivary gland tumor |
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mucoepidermoid carcinoma
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- one of the most common malignant salivary gland tumors
- parotid gland |
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Mallory-Weiss syndrome
|
- lacerations in the esophagus due to vomiting (alcoholics)
- causes bleeding at distal esophagus, proximal stomach - Boerhaave syndrome - esophagus ruptures, causing massive upper GI hemorrhage |
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esophageal varices
|
- varices (collateral channels) from portal HTN
- due to blockage of portal vein or liver disease - rupture of varices cause massive hemorrhage into esophagus and hematemesis (vomiting of blood) - common in pts with liver cirrhosis |
|
GERD gasteroesophageal reflux disease (reflux eophagitis)
|
- reflux of gastric contents into lower esophagus
- dysphagia and substernal pain (heartburn) - chronic or severe can lead to Barrett's esophagus, hemorrhage, or stricture (abnormal narrowing) - tx: diet, antacids (H2 blockers), protein pump inhibitors |
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Barrett's esophagus
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- replacement of squamous epithelium with metaplastic columnar epithelium
- increased incidence of esophageal adenocarcinoma, stricture, or hemorrhage |
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peptic ulcer disease
|
- Helicobacter pylori, long term NSAIDS, acid hypersecretion
- erosion of stomach lining or duodenum (more common) causing hemorrhage and perforations - NOT a precursor to stomach cancer - epigastric pain, worse when eating |
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acute pancreatitis
|
- early activation of pancreatic enzymes, autodigestion
- due to alcoholism, biliary tract disease, gallstones, cystic fibrosis - knife-like abdominal pain, radiates to back, nausea, vomiting, jaundice, pale stool - complications: enzymatic hemorrhagic fat necrosis, hypocalcemia, calcium soap formation ~ increased serum lipase and amylase ~ decreased serum calcium - severe abdominal pain |
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jaundice
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- excess conjugated/unconjugated serum bilirubin
- 1. hepatocellular jaundice: due to liver disease (cirrhosis, hepatitis) 2. hemolytic jaundice: due to hemolytic anemias 3. obstructive jaundice: due to blockage of common bile duct by gallstones or carcinomas of head of pancreas |
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cirrhosis
|
- excessive scarring and nodule formation
~ males; #3 cause of death age 45-65 (after heart disease and cancer) - causes: alcoholism (#1), viral hepatitis, biliary obstruction, hemochromatosis, drugs, chemical agents, Wilson's disease - ascites, splenomegaly, jaundice, bleeding disorders, hepatic encephalopathy, portal HTN, A/V shunts, esophageal varices ~ increased serum transaminases (SGOT and SGPT) - increased hepatocellular carcinoma ~ Wilson's disease: decreased ceruloplasmin (binds copper)...metastatic copper deposits; affects liver (cirrhosis), basal ganglia, cornea (Kayser-Fleischer, green rings) |
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small intestine diseases
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- malabsorption syndromes: celiac spure, Chron's disease
- Peutz-Jeghers syndrome |
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large intestine diseases
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- Hirschsprung's disease
- ulcerative colitis |
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malabsorption syndromes
|
- main symptom is steatorrhea (excess fat in feces)
- decrease in nutrients absorbed, including fat-soluble vitamins |
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celiac spure
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- malabsorption and mucosal lesions of sm. intestine
- due to allergy to gluten - histo: intestinal villa - flat - weight loss, weakness, diarrhea - risk of GI lymphoma, MALToma |
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Crohn's disease
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- chronic inflamm bowel disease of entire GI (mostly SMALL intestine)
- textured, COBBLESTONE intestinal mucosa due to submucosal edema - TRANSMURAL chronic inflamm and edema - non-caseating granulomas - SKIP lesions - AUTOIMMUNE |
|
Peutz-Jeghers syndrome
|
- dark, freckle spots on skin, lips, and oral mucosa
- interstitial polyps...malignant 10% of the time - autosomal dominant |
|
Hirschsprung's disease
|
- congenital disease
- section of aganglionic colon that failed to develop normally - bowel obstruction - distention of bowel proximal to affected area |
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ulcerative colitis
|
- inflamm bowel disease of colon/lg. intestine
- chronic inflamm and ulceration of COLON and RECTUM - limited to MUCOSA and SUBMUCOSA (vs. transmural) - CRYPT abscesses - chronic, bloddy diarrhea - complications: toxic megacolon, colon cancer, perforation of colon |
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glomerulonephritis
|
- inflamm of glomerulus
- clinical maifestations: nephrotic and nephritic syndrome |
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nephrOtic syndorme
|
- caused by glomerulonephritis
1. prOteinuria 2. hypOalbuminemia 3. hyperlipidemia (LDL and cholesterol) 4. severe edema (from decreased colloid osmotic pressure due to decreased serum albumin) - amylodosis, cancer, diabetes, HIV, glomerulonephritis, leukemia, lymphoma, multiple myeloma, SLE - loss of appetite, malaise, puffy eyes, abdominal pain, muscle wasting, tissue swelling, frothy urine |
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nephritic syndrome
|
- inflamm rupture of glomerular capillaries, leaking blood into urinary space
- post-streptococcal glomerulonephritis - due to group A b-hemoytic strep - autoantibodies - oliguria - hematuria - HTN - edema - azotemia (increased serum urea nitrogen and creatine) |
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polycystic kidney disease
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- cysts and partial replacement of renal parenchyma
- autosomal dominant - HTN, hematuria, palpable renal masses, erythrocytosis, kidney infection, flank pain - progression to end-stage renal failure - associated with berry aneurysms - autosomal recessive form in infants - serious, rapid, leads to end-stage renal death |
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nephrosclerosis
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- disease of renal arteries
1. benign/arterial nephrosclerosis 2. malignant nephrosclerosis |
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benign/arterial nephrosclerosis
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- atherosclerotic plaques in renal a
- narrowing of arterioles |
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malignant nephrosclerosis
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- due to malignant HTN
- severe HTN, retinal hemorrhages hypertrophy of LV - rapid deterioration of renal fxn - may lead to rupture of glomerular capillaries |
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renal tubule diseases
|
- acute tubular necrosis
- pyelonephritis - Fanconi's syndrome |
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nephrosclerosis
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- disease of renal arteries
1. benign/arterial nephrosclerosis 2. malignant nephrosclerosis |
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acute tubular necrosis
|
- destruction of renal tubule epithelium
- due to ischemia of renal tubules, from renal tubular injury or problems with vascular flow - can also be due to toxins or drugs - most common cause of acute renal failure - reversible, although fatal |
|
pyelonephritis
|
- bacterial infection of renal tubules, interstitium, and renal pelvis
- due to G- enteric rods: E.coli (#1), Proteus, Klebsiella, Enterobacter - endogenous infection - associated with UTI (acute) and obstruction (chronic) - vesicoureteral refulx (retrograde) |
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Fanconi's syndrome
|
- failure of proximal renal tubules to absorb a.a., glucose, and phosphates
- inherited or acquired - glycosuria, hyperphosphaturia, hypophosphatemia, aminoaciduria, and systemic acidosis |
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nephrolithiasis, urolithiasis
|
- calculi (calcium stones) in kidney or urinary tract (males)
- associated with hyperparathyroidism (Ca2+) - urinary tract obstruction, severe pain, pyelonephritis - can also be due to enlarged prostate |
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urinary tract infection
|
- G- enteric rods (E.coli)
- frequent urination, dysuria, pyuria (PMNs), hematuria, bacteriuria - can lead to infection of urinary bladder (cystitis) or kidney (pyelonephritis) |
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PRIMARY hemostasis disorders
|
- problems of BLOOD VESSELS or PLATELETS
- EARLY in life - bleeding in superficial areas - petechiae - due to vascular and platelet abnormalities or alterations in plasma proteins for adhesion - prolonged bleeding times - vascular abnormalities: scurvy - platelet abnormalities: thrombocytopenia, thrombocytopenic pupura |
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scurvy
|
- vascular abnormality
- vit C defic, decreased collagen synth - delayed wound healing - petechiae (purpura <3mm) - ecchymosis (purpura >1cm) - gingival bleeding, swelling, and ulcerations |
|
thrombocytopenia
|
- #1 most common bleeding disorder
- decreased platelets - increased bleeding time - mucosal oozing, petechial cutaneous bleeding, hemorrhage into tissues - due to: aplastic anemia, myelophthisis, splenic sequestration, DIC, idiopathic and thrombotic thrombocytopenic purpura |
|
thrombocytopenic purpura
|
- purple spots on skin and mucous mem, due to small bleeding vessels
- decreased platelets 1. idiopathic: anti-platelet antibodies destroy platelets; due to viral URI 2. thrombotic: hyaline microthrombi; microangioathic hemolytic anemia; qualitative platelet disorders - Von Willibrand's disease |
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SECONDARY hemostasis disorders
|
- due to problems with CLOTTING FACTORS
- LATER in life - bleeding in deeper areas and larger vessels - abnormal PTT (partial thromboplastin time; measures BOTH pathways; all factors but 7) - abnormal PT (prothrombin time; EXTRINSIC only) - does NOT affect bleeding time - hemophilias, vit K defic |
|
hemophilia
|
- deficiency of clotting factors
- affect INTRINSIC pathway - increased PTT, normal PT, normal bleeding time - continuous bleeding - bleeding into joint cavities (hemarthroses) and muscle - hemophilia A/classic: deficiency of factor 8 (antihemophilic factor); sex-linked recessive (only males) - hemophilia B/christmas: deficiency of factor 9 (plasma thromboplastin); sex-linked recessive (only males); lower incidence than A - hemophilia C/Rosenthal's synd: deficiency of factor XI, not sex-linked, less severe bleeding |
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Vit K deficiency
|
- malnutrition and malabsorption of fats and warfarin
- decrease in factors 2, 7, 9, and 10 and prothrombin - increased PT and PTT, normal platelet count |
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primary and secondary hemostasis disorders
|
- von Willibrand's disease
- liver disease - DIC |
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von Willibrand's disease
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- defective vWF
- affects primary hemostasis by affecting platelet adhesion to endothelium - affects secondary hemostasis by a defective factor 8 - autosomal dominant - #1 hereditary bleeding disorder |
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liver disease
|
- results in a decreased production of coagulation factors and can lead to problems with hemostasis
|
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DIC (disseminated intravascular coagulation)
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- clots throughout the vasculature
- uses up all available clotting factors and platelets, resulting in problems with bleeding - uncontrolled bleeding and clotting - fibrinolysis - decreased platelets, clotting factors, and fibrinolytic proteins - increased PT, PTT - hypofibrinogenemia - due to: amniotic fluid embolism, infection, malignancy, major trauma |
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leukemia
|
- uncontrolled proliferation of abnormal, monoclonal cell
- bone marrow and blood are saturated with blasts...decreased production of normal RBCs, WBCs, and platelets - recurrent infections bc of low normal WBC count - severe anemia, pallor, fatigue bc of low RBC production - bleeding problems, petechiae - leukocytosis - leukocytes in other organs: splenomegaly, hepatomegaly, and lymphadenopathy - spontaneous bleeding of mucus membranes - gingival hyperplasia - mucosal ulcerations |
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acute leukemias
|
- rapid onset
- children or over 60 - proliferation of immature blast cells - fever, weakness, fatigue - pallor (pale due to decreased oxyHb) - bone and joint pain - lymphadenopathy 1. acute lymphocytic or lymphoblastic leukemia 2. acute myelogenous leukemia |
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acute lymphocytic or lymphoblastic leukemia (ALL)
|
- children
- #1 malignancy in children - lymphoblasts as null cells - high cure rate |
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acute myelogenous leukemia (AML)
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- adults
- most malignant leukemia - Auer rods in blast cells in blood smear |
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chronic leukemias
|
- proliferation of mature cells
- less severe than the acute form - similar symptoms to acute, but slower onset - weight loss 1. chronic myelogenous leukemia 2. chronic lymphocytic leukemia |
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chronic myelogenous leukemia (CML)
|
- proliferation of myeloid cells (become erythrocytes, granulocytes, and platelets)
- Philadelphia c'some - translocation of c'somes 9 and 22 - prominent splenomegaly - enlarged liver and lymph nodes - middle age |
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chronic lymphocytic leukemia (CLL)
|
- #1 common leukemia
- least malignant leukemia - proliferation of abnormal B cells, can't produce Abs - susceptible to bacterial infections - over 60 - lymphoblasts as smudge cells in blood smear |
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Hodgkin's disease/lymphoma
|
- enlarged lymph nodes
- Reed-Sternberg cells - spreads from lymph node to lymph node - enlarged cervical lymph nodes first - cause is unknown - before age 30 |
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Non-Hodgkin's lymphoma
|
- tumor formation in lymph nodes
- do not spread contiguously - proliferation of abnormal B cells - after 40 - Burkitt's lymphoma: EBV; translocation of C-myc gene from c'some 8 to 14; African type - mandible and maxilla; U.S. type - abdomen; histo starry sky |
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multiple myeloma
|
- plasma cell neoplasm causes proliferation of monoclonal plasma cells
- produce non-fxnl Ig's - monoclonal IgG spike - Bence-Jones proteins in urine - "punched out" radiolucencies in bones |
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hypothyroidism
|
- decreased metabolism, weight gain, retarded growth
- enlarged face, tounge, eyelids, larynx, and hands - mental and physical slowness - decreased heart rate - sensitive to cold - goiter 1. Hashimoto's thyroiditis (autoimmune against thyroid; F) 2. Myxeema (adults; F; due to tx for hyperthyroidism) 3. Creatinism (children; due to embryonic malformation and iodine def; mental retardation and dwarfism; macroglossia, prolonged retention of teeth, delayed eruption) |
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hyperthyroidism / thyrotoxicosis
|
- increased metabolism, weight loss
- irratability, nervousness, tremor - tachycardia, arrhythmias, palpitations - goiter - early loss of primary teeth, early eruption of permanent 1. Grave's disease (autoimmune antibodies bind TSH..constant release of T3 and T4; exopthalamos; F) 2. Plummer's disease ( nodular growth or adenoma; elderly F) - epi may cause thyrotoxic crisis in pts with hyperthyroidism |
|
hyperparathyroidism
|
- hypercalcemia, hypophosphatemia, increased serum alkaline phosphatase
- loss of bone density, metastatic calcifications, kidney stones - ground glass bone in x-ray - symptoms: bones, stones, moans, abdominal groans - primary: caused by a parathyroid adenoma - SECONDARY: due to chronic renal disease or renal failure (no vit D..low calcium absorption...activates PTH) |
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hypoparathyroidism
|
- accidental surgical removal of parathyroid gland during thyroid surgery
- DiGeorge's syndrome (rare) - hypocalcemia - increased neuromuscular excitability and tetany |
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growth hormone deficiency
|
- due to decreased GHRH from hypothalamus, decreased GH from ant. pit., or decreased response of cells to GH
- dwarfism: smaller maxilla and mandible, delayed eruption of permanent teeth |
|
excessive growth hormone
|
1. gigantism: before epiphyseal plate closure; enlarged mandible
2. acromegaly: after epiphyseal plate closure; gradual enlargement of hands, feet, skull |
|
diabetes insipidus
|
- polyuria (large amnts of dilute urine)
- polydipsia 1. central: deficiency of ADH due to damage to hypothalamus 2. nephrogenic: decreased sensitivity of kidney tubules to ADH; sex-linked or lithium |
|
Sheehan's disease
|
- lack of anterior pituitary functioning, causing decreased FSH, LH, TSH, ACTH, etc
- due to necrosis of ant. pit. after complicated childbirth |
|
pheochromocytoma
|
- benign tumor of adrenal chromaffin cells
- if from extra-adrenal chromaffin cells, called paraganglioma - increased epi and norepi - associated with Sturge-Weber syndrome and multiple endocrine neoplasia (MEN) type IIa and IIb - secondary HTN - increased heart rate, palpitations |
|
neuroblastoma
|
- malignant catecholamine -producing tumor of immature medullary cells
- #1 malignant tumor in children - increased epi and norepi - amplification of N-myc oncogene |
|
Addison's disease
|
- primary: adrenal cortex damage (has increased ACTH); secondary: due to decreased ACTH from pituitary
- decreased steroid hormone secretion (cortisol), causes increase in ACTH - darker pigmentation of skin and mucosa from increased melanin due to increased MSH and ACTH - poor response to stress - anemias, GI problems, hypotension, weakness - decreased cortisol and serum Na+, increased serum K+ - tx: cortisol |
|
diabetes mellitus
|
- hyperglycemia
- polyuria -polydipsia - polyphagia - blurred vision, weakness, weight loss (only I) - complications: retinopathy, nephropathy, peripheral neuropathy, cardiovascular disease (#1 cause of death for diabetics), increased perio disease, increased candidiasis |
|
Type I diabetes / juvenile-onset / insulin-dependent
|
- autoimmune destruction of b-cells..no insulin production
- before 25 - severe hyperglycemia and ketoacidosis - tx: insulin and diet control |
|
Type II diabetes / adult-onset / non-insulin-dependent
|
- decreased sensitivity of peripheral insulin receptors, insulin receptor dysfxn, or decreased production of insulin
- after 40 - obese - more prevalent than type I - tx: diet control - diabetic shock: don't have enough carbs after insulin injection...very low blood glucose |
|
decreased bone mass
|
- osteogenesis imperfecta
- osteoperosis - osteomalacia |
|
increased bone mass
|
- osteopetrosis
- rickets - paget's disease |
|
osteoporosis
|
- decrease in bone mass
- increased osteoclasts and decreased osteoblasts - due to: change in serum calcium/phosphorus or vit D due to parathyroid disorder, decreased estrogen, physical inactivity, hypercorticism, or hyperthyroidism - compression fractures |
|
Vit D deiciency
|
- failure of new bone to mineralize
- abnormal growth of epiphyseal plates - growth retardation 1. osteomalacia: adults, F; defective calcification of osteoid matrix 2. rickets: children; inadequate calcification; increased thickness in epiphyseal growth plates; skeletal deformities - delayed tooth eruption, malocclusion - abnormal formation of dentin |
|
Scurvy
|
- Vit C defic
- impaired osteoid matrix formation - subperiosteal hemorrhage - osteoporosis - epiphyseal cartilage is not replaced by osteoid |
|
osteogenesis imperfecta / brittle bones
|
- defective type I collagen formation
- fragile bones and deformed skeleton - fractures - blue sclerae - dentinogenesis imperfecta |
|
osteopetrosis / Albers-Schonberg disease / marble bone
|
- abnormal osteoclasts
- defective bone remodeling - increased bone density (into bone marrow space) - severe defects in infants: anemia and infections; deafness, blindness, paralysis (narrowed cranial nerve foramen); life-threatening; delayed eruption of teeth - less severe in adults |
|
Paget's disease (osteitis deformans)
|
- abnormal bone remodeling
- increased serum alkaline phosphatase - cotton wool x-ray - complications: osteosarcoma, fractures, heart disease, deafness, blindness - spaces b/t teeth |
|
osteomyelitis
|
- infection of bone
- Staph aureus and Strept - pain - systemic signs of infection |
|
fibrous dysplasia
|
- replacement of normal bone with irregular bone containing fibrous c.t.
- ground glass x-ray 1. monostotic (asymptomatic) 2. polystotic 3. McCune Albright's syndrome: polystotic with cafe au lait spots and endocrine abnormalities (precocious puberty) |
|
osteochondroses
|
- osteonecrosis of epiphyseal plates or ossification centers
- reossification and necrosis - children and adolescents - young boys; sports 1. Legg-Calve-Perthes disease: epiphyseal plates of femur 2. Osgood-Schlatter disease: tibial tuberosity (knee) 3. Scheuermann's disease: vertebral endplates 4. Kohler's: foot 5. Freiberg's: second toe (F) 6. Panner's: elbow |
|
Langerhans cell granulomatosis (histocytosis X)
|
- group of diseases caused by proliferation of langerhans cells
- causes bone lesions - langerhan's cells with Birbeck granules and eosinophils 1. Letterer-Siwe disease: acute, disseminated, fatal in infants 2. HandSchuller-Christian disease: chronic, disseminated, before 5, bone lesions (loose teeth), exophthalmous, diabetes insipidus 3. eosinophilic granuloma of bone: localized, least severe, can heal w/o tx, young adults, loose teeth in mandible |
|
osteosarcoma (osteogenic sarcoma)
|
- #1 true primary bone tumor (#2 - chondrosarcoma)
- increased serum alkaline phosphatase - codman's triangle on x-ray - children and adolescents |
|
metastatic carcinoma
|
most common bone tumor
|
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multiple myeloma
|
most common primary bone tumor
|
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osteochondroma
|
most common benign bone tumor
|
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Ewing's sarcoma
|
- extremely anaplastic
- small- cell malignant tumor - long bones or pelvis - before 20 - intermittent pain, fever, and swelling |
|
achondroplasia
|
- delayed or abnormal growth of cartilage (shortened skeleton)
- dwarfism with short extremities - mandibular prognathism |
|
osteochondroma
|
- bony growths surrounded by cartilage
- most common benign bone tumor - before 30 - distal long bones |
|
chondrosarcoma
|
- malignant cartilaginous tumor
- men; 30-60 - second most common true primary bone tumor (excluding multiple myeloma) (#1- osteosarcoma) - pelvis, spine, femur, scapula |
|
rheumatoid arthritis
|
- autoimmune
- women, 20-50 - inflamm of synovial membrane - granulation tissue - PANNUS - destroys cartilage...fibrotic changes and ankylosis - scarring, contracture, and deformity - swollen joints, anywhere in body |
|
osteoarthritis
|
- most common arthritis
- unknown cause - women after 50 - degeneration of articular cartilage - OSTEOPHYTES - stiff, painful joints (hand and weight-bearing) - Heberden's NODES: distal interphalangeal - Bocard's nodes: proximal |
|
myasthenia gravis
|
- autoimmune to Ach receptors at NMJ
- muscle weakness, inability to maintain long muscle contractions - eyes: diplopia, ptosis - neck: dysphagia, problems swallowing and speaking - tx: cholinesterase inhibitors, auto-immune therapy |
|
rhabdomyoma
|
- benign tumor of skeletal muscle
|
|
leiomyoma
|
- benign tumor of smooth muscle
- #1 tumor in women - #1 pelvic tumor - uterus - increase in size with estrogen |
|
rhabdomyosarcoma
|
- malignant tumor of skeletal muscle
- #1 sarcoma in children - head and neck area |
|
seborrheic keratosis
|
- round, brown, flat wart
- benign - middle aged to older |
|
verruca vulgaris
|
- common wart
- HPV - benign - contact or inoculation transmission |
|
actinic keratosis
|
- dry, scaly plaques with red base
- similar to actinic cheilosos (vermillion border) - due to sun damage - dysplactic lesion - may be premalignant |
|
nevus
|
- common mole (nevocellular nevus)
- benign, pigmented tumor of melanocytes, deep in c.t. 1. junctional: confined to epidermal-dermal jxn, only type considered pre-malignant 2. compound: epidermal-dermal jxn and in dermis 3. intraepithelial: w/in dermis, usually not pigmented |
|
psoriasis
|
- scaly, white plaques
- rapid proliferation of the dermis - autoimmune |
|
keloids
|
- progressively enlarging scar
- abnormal accumulation of collagen at site of injury - African-Americans |
|
erythema multiforme
|
- red, ulcerative lesions on skin and oral mucosa
- round, bull's eye - due to allergic rxn (Type III) - due to drugs, infections, HSV, mycoplasma - Stevens-Johnson syndrome: severe case, lesions on skin, mucosa, eyes, and genital area - tx: corticosteroids |
|
pemphigus
|
- ulcerative lesions on skin and oral mucosa
- autoimmune against HEMIdesmosomes of EPIDERMIS cells - ACANTHOLYSIS (epidermal cell detachment) seen in Tzanck smears - life-threatening if un-tx. - positive Nikolsky sign (rubbing causes exfoliation) - tx: corticosteroids |
|
pemphigoid
|
- ulcerative lesions on skin and oral mucosa
- autoimmune against BASAL cells (DESMOSOME attachment to basement membrane) - entire epithelium separates from c.t. - NO acantholysis - positive Nikolsky sign - blindness due to ocular lesions - tx: corticosteroids |
|
lichen planus
|
- skin lesions: clusters of purple papules
- oral lesions: white intersecting Wickman's striae on buccal mucosa - histo: saw-tooth rete ridges and Civatte bodies - self-limiting w/in a few years |
|
Peutz-Jeghers syndrome
|
- small, melanotic, freckle lesions
- on skin, orla mucosa, lips, hands, feet - interstitial polyps, may develop into a GI carcinoma - autosomal dominant |
|
lysosomal (lipid) storage diseases
|
- autosomal recessive
- deficiency of lysosomal enzymes 1. Gaucher's disease 2. Tay-Sachs disease 3. Niemann-Pick disease |
|
Gaucher's disease
|
- lysosomal/lipid storage disase
- autosomal recessive - deficient GLUCOCEREBROSIDASE - accumulation of glucocerebroside - affects MACROPHAGES |
|
Tay-Sachs disease
|
- lysosomal/lipid disease
- autosomal recessive - defieient HEXOSAMINIDASE A - accumulation of G M2 GANGLIOSIDE - affects NEURONS - motor and mental deterioration - blindness - dementia - Ashkenazi Jews |
|
Niemann-Pick disease
|
- lysosomal/lipid disease
- autosomal recessive - deficient SPHINGOMYELINASE - accumulation of sphingomyelin - affects NEURONS |
|
glycogen storage diseases (glycogenoses)
|
- autosomal recessive
-buildup of glycogen 1. von Gierke disease (type I): deficient G-6-P; liver 2. Pompe disease (type II): deficient a-glucosidase (acid maltase); heart 3. Cori disease (type III): deficiet debranching enzyme (amylo-1,6-glucosidase); heart, liver, skeletal muscle 4. Brancher glycogenosis (type IV): deficient branching enzyme; liver, heart, skeletal muscle, brain 5. McArdle syndrome (type V): deficient muscle phosphorylase; skeletal muscle |
|
Marfan's syndrome
|
- c.t. disease
- autosomal dominant - defective microfibril glycoprotein - fibrillin - tall, hyperextended joints, mitral valve prolapse, dilation of ascending aorta, spider-like fingers, lens dislocation |
|
Ehlers-Danlos syndorme
|
- c.t. disease
- autosomal dominant or recessive - defects in collagen - hypermobile joints, stretchable skin, bruises easily - Gorlin's sign (touch tounge to nose or elbow) - TMJ subluxation (dislocation) - fragile oral muosa |
|
Down Syndrome (trisomy 21)
|
- most common c'somal disorder
- affects autosomes - meiotic non-disjunction in the mother - mental retardation, congenital heart defects - increased risk of leukemia and severe infections - macroglossia, delayed eruption, and hypodontia |
|
Edwards syndrome
|
- trisomy 18
- micrognathia, small head, mental retardation, heart defects, rocker bottom feet - prognosis - months |
|
Patau's syndrome
|
- trisomy 13
- celft lip and palate, mental retardation, microencephaly, microphthalmia, polydactyly, heart defects - meiotic non-disjunction - more severe than trisomy 21 - die w/in months due to congenital heart disease |
|
Kleinfelter's syndrome
|
- common cause of male hypogonadism
- 2 or more X and 1 or more Y - ususally XXY - meiotic non-disjunction - gynecomastia, tall stature, and lower IQ - diagnose at puberty - associated with increased maternal and paternal age |
|
Turner's syndrome
|
- amenorrhea
- only 1 X; XO - under-developed female genitalia, short stature, webbed neck, sterile, coarctation of aorta - NO mental retardation - diagnosed at birth or puberty |
|
Treacher Collins syndrome (mandibulofacial dysostosis)
|
- autosomal dominant, rare
- abnormal development of first and second brachial arches - underdeveloped zygomas and mandible - deformed ears - cleft palate - small or absent parotid glands |
|
bacterial meningitis
|
- pyogenic, suppurative infection
- E.coli in newborns - H. influenzae in infants and children - N. meningitis in young adults - Strep. pneumoniae and Listeria monocytogenes in older adults - severe headaches, irritability, fever, stiff neck - fatal if un-tx - spinal tap: cloudy CSF under increased pressure, increased protein, decreased glucose |
|
viral meningitis
|
- due to CMV, herpes virus, rabies, or HIV
- CSF: mononuclear cells, high protein, normal glucose |
|
demyelinating and degenerative diseases
|
- multiple sclerosis
- amyotrophic lateral sclerosis (Lou Gehrig's) - alzheimer's disease - parkinson's disease - huntington's disease |
|
multiple sclerosis
|
- most common demyelinating disease
- forms plaques of demyelinated neurons - women, 20-50 - affects any neuron (esp. optic nerve) - triad: scaning speech, intention tremor, nystagmus |
|
amyotrophic lateral sclerosis (Lou Gehrig's disease)
|
- rapid degeneration of motor neurons in spinal cord and corticospinal tract
- men, 50s - rapidly progressive muscle atrophy due to denervation - fasciculations, hyperreflexia, spasticity, pathologic reflexes - death w/in a few years due to respiratory failure or infection |
|
Alzheimer's disease
|
- most common cause of dementia in elderly
- degeneration of neurons in cerebral cortex - amyloid plaques and neurofibrillary tangles - years to develop - loss of cognition, memory, and ability to communicate - motor problems, contractures (shortening of muscle), and paralysis |
|
Parkinson's disease
|
- degeneration of neurons of basal ganglia (substantia nigra and striatum)
- Lewy bodies - involuntary and voluntary mvmts are affected - pin-rolling tremor, slow mvmts, shuffling gait, muscular rigidity |
|
Huntington's disease
|
- causes dementia
- autosomal dominant - degeneration of striatal neurons, affects cortical and basal ganglia function - affects movement and cognition - ultimately fatal |
|
carcinoma
|
malignant tumor of epithelial cells
|
|
sarcoma
|
malignant tumor of mesenchymal cells
|
|
lymphoma
|
malignant tumor of lymphoid cells
|
|
teratoma
|
malignant tumor of all 3 developmental germ layers
|
|
premalignant tumor
|
- non-invasive neoplasm
- may become malignant - dysplasia (disordered cells): potential to invade, but has not yet invaded; reversible - hyperplasia (increase in number) - metaplasia (replacement) - carcinoma in situ: anaplastic cells confined w/in epithelium of origin; no invasion of basement membrane; very likely to invade |
|
oral cancer: squamous cell carcinoma
|
- #1 oral cancer
- tumor of keratinocytes - poor prognosis - males over 50 - metastasis via lymphatic system to cervical lymph nodes - risk: smoking, chewing tobacco, excessive alcohol nutritional deficiencies - high risk sites: vermillion border (#1), lateral and ventral tounge, floor of mouth, soft palate, tonsillar pillars, buccal mucosa |
|
skin cancer (basal cell carcinoma)
|
- #1 cancer in the US
|
|
squamous cell carcinoma
|
- tumor of keratinocytes
- sun-exposed skin - indurated, crusting ulcer with raised margins - risk of metastasis lower than oral squamous cell carcinoma |
|
basal cell carcinoma
|
- tumor of basal cells
- sun-exposed areas (head and neck) - most common type of skin cancer - good prognosis, metastasizes slowly - nevoid basal cell carcinoma syndrome (Gorlin-Goltz syndrome): basal cell carcinomas, odontogenic keratocysts, bone abnormalities, calcifications of cranium |
|
malignant melanoma
|
- tumor of melanocytes or nevus cells
- most severe form of skin cancer - rare intraorally - related to sunburns in childhood - 4 types: 1. superficial spreading: most common, any age, caucasians; flat, irregular shape and color, black/brown 2. nodular: raised/nodular area, black/blue or blue/red, worst prognosis, vertical growth 3. lentigo maligna: elderly, pre-existing lentigo maligna, large, flat, tan 4. acral lentiginous: least common, palms, soles, under nails, african-americans -growth: a. rapid/initial phase: growth in all directions, esp. lateral; no metastasis b. vertical/later phase: deep growth, metastasis |
|
bronchogenic carcinoma (lung cancer)
|
- #1 cancer death in men and women
- risk - smoking 1. squamous cell carcinoma - most common form; hilar mass w/ central cavitation 2. adenocarcinoma - peripheral of lung 3. small (oat) cell carcinoma - most malignant form; rapid metastasis; worst prognosis; short, blunted anaplastic cells - metastasis: brain, liver, adrenal gland |
|
colon and rectal cancer
|
- most common form - adenocarcinoma
- sigmoid colon or rectal areas - from villous adenomas - blood in stool and rectal bleeding |
|
breast cancer
|
- most common form - adenocarcinoma from ductal epithelium
- #2 most common cancer death in women - 1/2 have estrogen-receptor proteins - risk: age, family history, obesity, early menarche, late menopause, pregnancy |
|
prostate cancer
|
- most common form - adenocarcinoma from glandular epithelium
- #2 most common cancer death in men - high PSA (prostate specific antigen) - high serum alkaline (ACID)? phosphatase |
|
gingival hyperplasia causes
|
- lymphoproliferative diseases
- calcium channel blockers - phenytoin (dilatin) - cyclosporin |
|
diseases that cause increased alkaline phosphatase
|
- hyperthyroidism
- paget's disease - osteosarcoma - multiple myeloma |
|
von Hippel-Lindau disease
|
- autosomal dominant
- c'some 3, VHL gene - hemangiomas (retina and cerebellum) - cysts and adenomas (liver, kidney, adrenal glands, pancreas) |
|
toxic epidermal necrolysis
|
- aka TEN/Lyell's synd
- multiple large blisters that coalesce and slough off skin and mucous membranes |
|
acanthosis nigricans
|
- velvety hyperkeratosis and pigmentation of skin
- axilla, neck, flexures, anogenital region - marker of visceral malignancy (gastric carcinoma, breast, lung, uterine cancer) - in diabetics - acanthosis |
|
xanthoma
|
- yellow papule/nodule composed of focal dermal collections of lipid-laden histiocytes
- eyelids, tendons, joints - associated with hypercholesterolemia |
|
hypovolemic shock
|
- due to decreased blood volume
- ex: hemorrhage, dehydration, vomiting, diarrhea, fluid loss from burns |
|
cardiogenic shock
|
- due to pump failure (LV), sudden decrease in CO
- ex: massive MI, arrhythmia |
|
distributive shock - septic
|
- due to infection (G-)
- causes vasodilation |
|
distributive shock - neurogenic
|
- due to CNS injury
- causes vasodilation |
|
distributive shock - anaphylactic
|
- due to type I hs, histamine release, vasodilation
- ex: anaphylactic allergic rxn |
|
rheumatic fever
|
- acute inflamm. disease
- due to group A beta strep - due to cross-reactivity, not direct effect, of bacteria - type III hs - skin, joints, heart, brain - Aschoff bodies: focal myocardial inflamm, fragmented collagen and fibrinoid - Aschoff myocytes: multi-nucleated giant cells - Antischkow cells: large, unusual cells - increased ASO and ESR - Jones criteria: major: carditis, arthritis, chorea, erythema marginatum, subcutaneous nodules; minor: fever, arthralgias, EKG changes, history of rheumatic fever - tx: penicillin |
|
rheumatic fever
PECCS FEVERSS |
Polyarthritis
Erythema marginatum Chorea Carditis Subcutaneous nodules Fever Erythema marginatum Valve damage ESR Red-hot (polyarthritis) Subcutaneous nodules St. Vincent's dance (chorea) |
|
emphysema
|
- type of COPD
- pink puffer - dyspnea, labored breathing, no productive cough, no cyanosis, barrel chest - PO2 near normal - increased TLC and RV - decreased FEV1/FVC |
|
restrictive lung diseases
|
- decreased lung compliance
- decreased all lung volumes - increased FEV1/FVC |
|
chronic bronchitis
|
- type of COPD
- blue bloater - productive cough, wheezing, ausculation (noisy chest) - increased PO2, cyanosis |
|
idiopathic pulmonary fibrosis
|
- chronic inflamm and fibrosis of alveolar wall
- progression: alveolitis, fibrosis, fibrotic lung - death w/in 5 yrs |
|
interstitial fibrosis
|
- due to fibrosing alveolitis
- thickened/fibrotic alveolar interstitium (space b/c alveolus and capillary) - results in restrictive lung diseae - idiopathic or secondary to ct disorders (SLE, PAN, RA) |
|
lobar pneumonia
|
- Pneumococcus
- exudate w/in alveolus and consolidation - middle age |
|
bronchopneumonia
|
- Staph. aureus, H. influenza, Klebsiella, Strep. pyogenes
- bronchiole and alveolar infiltrates, patchy - infants and elderly |
|
interstitial pneumonia
|
- RSV, adenovirus, mycoplasma, legionella
- diffuse, patchy infiltrates w/in interstitium - young children |
|
achalsia
|
- decreased peristalsis - propulsion of food down the esophagus
- failure of lower esophageal sphincter to relax - birds beak on barium swallow - nerve-related - dsyphagia and regurgitation - tx: botox, dilation |
|
tropical spure
|
- malabsorption syndrome
- unknown cause - ppl in tropics - steatorrhea, diarrhea, weight loss, sore tounge (decreased vitB) |
|
whipple's disease
|
- due to tropheryma whippelii
- middle aged men - skin darkening, inflamed joints, diarrhea - fatal w/o tx |
|
chronic pancreatitis
|
- due to alcoholism, hyperipidemia, hyperparathyroidism
- abdominal pain, nausea, vomiting, fatty stool - complications: pseudocyst, pancreatic abscess, ascites |
|
kernicterus
|
- high levels of bilirubin in the brain in newborn infants
- form of crippling - athetoid cerebral palsy |
|
acute nephritic syndrome
|
- ex: acute post-strep glomerulonephritis
- boys 3-7, or any age - acute glomerular inflamm, sudden hematuria, RBC casts, proteinuria |
|
rapidly progressive nephritic syndrome
|
ex: rapidly progressive glomerulonephritis
- uncommon, age 50-60 - glomeruli are destroyed - results in renal failure |
|
chronic nephritic syndrome
|
- aka chronic glomerulonephritis
- due to SLE, Goodpasture's syndrome, acute GN, slowly progressive disease, inflamm of glomeruli - eventual renal failure |
|
sickle cell anemia
|
- autosomal recessive
- abnormal HbS (valine for glutamic acid) - heterozygote - trait, less severe - homozygote - disease, more severe - fibrous precipitates, decreased fxn of RBCs - sickle cell pain crisis, hemolytic crisis, splenic sequestration crisis, aplastic crisis |
|
thalassemias
|
- Hb synthesis disorders
- autosomal recessive - decreased globin chain synth..abnormal Hb..decreased RBCs..chronic anemia |
|
pernicious anemia
|
- B12 defic
- autoimmune gastritis - failure to produce intrinsic factor - anti-intrinsic factor and anti-parietal cell antibodies - megaloblastic , macrocytic anemia - abnormal schilling test - impaired B12 absorption - hypersegmented neut. - yellow skin, stomatitis, glossitis, subacute degen of SC - also strict vegetarians and gastric and ileal resection |
|
folate defic
|
- megaloblastic, macrocytic anemia
- hypersegmented neut - lack of folate..delayed DNA replication - due to: diet, malabsorption, pregnancy, dilantin |
|
iron defic
|
- hypochromatic, microcytic anemia (small, pale RBCs)
- due to chronic blood loss, causes decreased bone marrow stones and decreased serum ferritin - due to dietary defic - pallor, fatigue, SOB, glossitis, koilonychias |
|
primary polycythemia / polycythemia vera
|
- myeloproliferative disease
- genetic - decreased sensitivity of myeloid precursors to erythropoietin - erythrocytosis, leukocytosis, thrombocytosis, splenomegaly, decreased or normal erythropoietin |
|
secondary polycythemia
|
- increased RBCs, secondary to increased erythropoietin
- due to: renal disease (PKD, renal cell ca), chronic hypoxia (pulmonary disease, smoking, high altitude, CHF), tumors (hepatocellular ca, meningoma, pheochromocytoma, cerebellar hemangioma, adrenal adenoma), androgen therapy, and Bartter syndrome - plethora (red skin and mm), deccreased blood viscosity, no splenomegaly |
|
PAN
|
- only autoimmune disease and only c.t. disease thats more common in men
- blood vessel disease - inflamm and damage of small and med vessels, decreased blood supply to organs - antigen implicated: HepB, sulfa drugs, penicillin |
|
polymyalgia rheumatica and temporal arteritis
|
- closely related and occur together
-PR: pain and stiffness around large muscles; neck, shoulder, hips - TA: inflamm of lg. arteries, esp. temporal; headaches, visual changes |
|
ankylosing spondylitis
|
- inflamm of spine and large joints
- stiffness, pain - HLA-B27 - men |
|
Reiter's syndrome
|
- HLA-B27
- triad: arthritis, eye inflamm, urethritis |
|
Behcet's syndrome
|
- in Turkey and Japan
- chronic, relapsing inflamm disease - mouth sores, skin blisters, genital sores, swollen joints, CNS involvement, hypopyon (pus-like fluid in anterior chamber of eye), pyodermas (pus-producing skin disease) |
|
osteitis fibrosa cystica
|
- brown tumor = von Recklinghausen disease of bone
- bone lesion in hyperparathyroidism - cystic spaces with multinucleated osteoclasts, fibrous stroma, brown discoloration from hemorrhage - increased PTH, Ca2+, and alkaline phosphatase - decreased phosphorus |
|
benign, mesenchymal tumors
|
-leiomyoma
- rhabdomyoma - lipoma - fibroma - chondroma - osteoma |
|
malignant, mesenchymal
|
- leiomyosarcoma
- rhbdomyosarcoma - liposarcoma - fibrosarcoma - chondrosarcoma - osteosarcoma |
|
cancer in women
|
- incidence:
1. breast 2.lung 3. colorectal 4. uterine -death: 1. lung 2. breast 3. colorectal 4. leukemia and lymphoma |
|
cancer in men
|
- incidence:
1. prostate 2. lung 3. colorectal 4. urinary tract - death: 1. lung 2. prostate 3. colorectal 4. leukemia and lymphoma |
|
brain tumors in adults
|
- glioblastoma multiforme: most common primary brain tumor
- meningioma: 2nd most common primary brain tumor, from arachnoid - pituitary adenoma: secretes prolactin, bitemporal hemianopia |
|
brain tumors in children
|
- craniopharyngioma: benign, bitemporal hemianopia, from Rahke's pouch
- low-grade astrocytoma: posterior fossa - medulloblastoma: malignant cerebellar tumor, form of neuroectodermal tumor - ependymoma: in 4th ventricle, causes hydrocphalus |
|
keratoacanthoma
|
- common, low-grade malignancy
- from pilosebaceous glands and resembles SCC - causes: sunlight, chemical carcinogens, trauma, HPV, genetic factors, immunocompromised - on face, neck, dorsum of upper extremities - solitary, firm, round, skin colored/red papules; progress to dome shaped nodules w/ smooth shiny surface and keratin plug - rapid growth, spontaneous resolution - can progress to invasive or metastatic carcinoma (rare) |
|
superior vena cava (SVC) syndrome
|
- decreased venous return from above heart
- facial swelling, cyanosis, dilation of head and neck veins - due to compression of SVC - related to malignancy - central bronchiogenic carcinomas (small cell and squamous cell) - causes: 1. malignancy: bronchiogenic carcinoma, lymphoma, leiomyosarcoma, plasmacytoma 2. infection: TB, syphilis, histoplasmosis 3. other: goiter, thrombus, indwelling IV lines, pacemaker wires |
|
hypertrophic pulmonary osteoarthropathy
|
- unknown cause
- clubbing of fingers and toes, enlargement of extremities, painful joints - new periosteal bone - associatd with bronchiogenic carcinoma (not squamous cell), benign mesothelioma, diaphragmatic neurilemmoma |
|
gastric cancer
|
- risks: H. pylori, nitrosamines, salt, achlorhydria, chronic gastritis
- adenocarcinoma - distal stomach - local spread...lymph node (Virchow's node - supraclavicular node with metastatic gastric carcinoma)...distant metastasis (Krukenberg tumor - bilateral ovaries) |
|
gastric lymphoma
|
- associated with H. pylori
- MALToma - better prognosis than adenocarcinoma |