Patho Exam 2

Front 1

Abdominal Aorta Aneurysm (AAA)

Back 1

Arterial bulging
S/S: Abdominal and/or back pain, abdominal mass, anxiety, N/V, diaphoresis, tachycardia, shock
C: HTN, smoking, Marfan's Synd. (conn tissue disorder)

Front 2

Berry Aneurysm

Back 2

Arterial bulging in the brain
S/S: HA, eye pain, visual changes, numbness/weakness in face, ALOC: increased ICP
C: Age, HTN, Smoking, Genetic - AV malformation

Front 3

Diaphoresis

Back 3

Sweating

Front 4

Peptic Ulcer

Back 4

Ulcerations of stomach lining (Gastric, duodenal, esophageal)
S/S: Pain, N/V, Wt loss, Hemoptysis, Melena (black tarry feces)
C: H. pylori, NSAIDS (>50%), Smoking, Stress, ETOH

Front 5

Hemophilia

Back 5

Clotting disorder
A: factor VIII def
B: factor IX def
Von Willebrand's: VIII def (AD inheritance)
S/S: spontaneous or disproportionate bleeding
C: Genetic - X linked

Front 6

DIC - Disseminated Intravascular Coagulation

Back 6

State of hypercoagulation; thrombosis and hemorrhage occur simultaneously
S/S: bleeding, bruising, hypotension, thrombocytopenia
C: Sepsis, bacterial infxns, cancer, retention or abruption of placenta, anesthesia, burns, major trauma
*Poor prognosis; high mortality rate

Front 7

What is the DIC initiating mechanism?

Back 7

Release of tissue factor (TF) released into circulation in response to vascular inj, cytokines, or bacterial endotoxins; TF not normally in contact with blood

Front 8

DIC - Disseminated Intravascular Coagulation

Back 8

State of hypercoagulation; thrombosis and hemorrhage occur simultaneously
S/S: bleeding, bruising, hypotension, thrombocytopenia
C: Sepsis, bacterial infxns, cancer, retention or abruption of placenta, anesthesia, burns, major trauma
*Poor prognosis; high mortality rate

Front 9

Dysfunctional Uterine Bleeding (DUB): List 4 types.

Back 9

Menorrhagia, Metrorrhagia, Menomentrorrhagia, Polymenorrhea

Front 10

What is the DIC initiating mechanism?

Back 10

Release of tissue factor (TF) released into circulation in response to vascular inj, cytokines, or bacterial endotoxins; TF not normally in contact with blood

Front 11

DIC - Disseminated Intravascular Coagulation

Back 11

State of hypercoagulation; thrombosis and hemorrhage occur simultaneously
S/S: bleeding, bruising, hypotension, thrombocytopenia
C: Sepsis, bacterial infxns, cancer, retention or abruption of placenta, anesthesia, burns, major trauma
*Poor prognosis; high mortality rate

Front 12

Dysfunctional Uterine Bleeding (DUB): List 4 types.

Back 12

Menorrhagia, Metrorrhagia, Menomentrorrhagia, Polymenorrhea

Front 13

Menorrhagia

Back 13

Prolonged, excessive bleeding at regular intervals

Front 14

What is the DIC initiating mechanism?

Back 14

Release of tissue factor (TF) released into circulation in response to vascular inj, cytokines, or bacterial endotoxins; TF not normally in contact with blood

Front 15

Menorrhagia

Back 15

Prolonged, excessive bleeding at regular intervals

Front 16

Metrorrhagia

Back 16

Irregular, frequent uterine bleeding

Front 17

Dysfunctional Uterine Bleeding (DUB): List 4 types.

Back 17

Menorrhagia, Metrorrhagia, Menomentrorrhagia, Polymenorrhea

Front 18

Menorrhagia

Back 18

Prolonged, excessive bleeding at regular intervals

Front 19

Metrorrhagia

Back 19

Irregular, frequent uterine bleeding

Front 20

Metrorrhagia

Back 20

Irregular, frequent uterine bleeding

Front 21

Menometrorrhagia

Back 21

Combo of meorrhagia and metrorrhagia; prolonged, excessive, irregular, and frequent uterine bleeding

Front 22

Polymenorrhea

Back 22

Regular bleeding but at < 21 day intervals

Front 23

Causes of DUB

Back 23

Leiomyomas, polyps, ectopic pregnancy, endometriosis, cancer, IUD inj, PID, trauma, endometritis, foreign bodies

Front 24

Leiomyoma

Back 24

Uterine fibroids (Benign smooth muscle tumors)
S/S: DUB, pain, pressure in lower abd, urinary freq, constipation, backache, abdominal fullness, cramping w/ periods, enlarged, assymetrical uterus on pelvic exam
C: Genetic, hormonal, idiopathic

Front 25

Endometriosis

Back 25

Abbnormal growth of endometrial tissue outside uterus
S/S: onset after menses and stops after menopause, pelvic pain, infertility, dysmenorrhea, menorrhagia, dyspareunia, GI sxs

Front 26

What is responsible for controlling the body's temperature?

Back 26

Hypothalamus

Front 27

Two functions of a fever

Back 27

1. Stimulate the immune system
2. Create an inhospitable environment for invading pathogens

Front 28

Four benefits of a fever

Back 28

1. Incr antibody, interferon, WBC prod/mobilization
2. Incr lymphocyte recruitment to nodes
3. Sequestered Fe
4. Inhib pathogen replication (102-104 optimal)

Front 29

Reminder: Review Mod 5 ppt slide # 8

Back 29

Blood stem cell produces Myeloid stem cell and lymphoid stem cell; Myeloid SC differentiates into RBC, platelets, and myeloblasts; myeloblasts differentiate into granulocytes (Eosinophils, basophils, and neutrophils) What do Lymphoid SC differentiate into?

Front 30

Leukemia

Back 30

Malignant d/o of the blood or bone marrow w/ uncontrolled proliferation of malignant leukocytes

Front 31

How are leukemia's classified?

Back 31

1. Pre-dominant cell of origin
2. Degree of differentiation before becoming malignant

Front 32

Four types of leukemia

Back 32

1. Acute Lymphocytic Leukemia (ALL)
2. Acute Myelogeneous Leukemia (AML)
3. Chronic Lymphocytic Leukemia (CLL)
4. Chronic Myelogeneous Leukemia (CML)

Front 33

Acute Leukemia

Back 33

Accumulation of blast cells (undifferentiated/immature cells) in marrow suppresses normal hematopoiesis by overcrowding; results in pancytopenia

Front 34

Pancytopenia

Back 34

Shortage of RBCs, WBCs, and Platelets

Front 35

Other S/S of Acute Leukemia

Back 35

Anemia, Neutropenia, Thrombocytopenia (Petechiae, ecchymoses, epistaxis) , Night sweats, Clotting disorders, Bone pain, Lymphodenopathy, Hepatosplenomegaly (upper quad fullness), DIC

Front 36

A disease the predisposes a child to acute leukemia

Back 36

Down Syndrome

Front 37

Acute Myelogeneous Leukemia (AML)

Back 37

Usually occurs in adults about 65 y.o.; Idiopathic, some links to prior chemo or radiation or exposure to benzene (cleaner).
*Auer rods are observed in bone marrow: abnormal, red-staining, rod-like granules inclusions

Front 38

Acute Lymphocytic Leukemia (ALL)

Back 38

Most common type of childhood leukemia, 1/3 of all pediatric cancer (ages: < 15 and >50); B cell (85%) or T cell (15%); 5yr survival rate = 80%

Front 39

Chronic Leukemia

Back 39

Progresses more slowly; permits greater numbers of mature, functional, normal cells to be produced; often asymptomatic (20%), anemia, anorexia, splenomegaly, night sweats, low fever; leukemic cells infiltrate liver, lymph nodes and spleen

Front 40

Chronic Lymphocytic Leukemia (CLL)

Back 40

Most common leukemia in adults (usually > 40); B cell origin; suppression of Ab production increases risk of infxns; poor prognosis

Front 41

Chronic Myelogenous Leukemia (CML): List the three phases and what they entail.

Back 41

Chronic Phase: milder symptoms; may last 4-5 yrs
Accelerated Phase: incr blast cells, splenomegaly, hard to control WBC levels w/ chemo
Blast Crisis Phase: incr blast cells, anemai, thrombocytopenia, neutropenia (resembles AML at this point)

Front 42

How are leukemia's diagnosed?

Back 42

CBC (blasts seen in smear); PT/PTT (clotting time factors); Bone marrow aspirate and biopsy (staging and grading); Xray/CT (show enlarged lymph nodes in chest)

Front 43

Lymphoma

Back 43

Cancer of the lymphocytes in the nodes

Front 44

Burkitt's Lymphoma

Back 44

B cell lymphoma
S/S: Tumors manifest at extranodal sites (African BL: mass on maxilla or mandible; Sporadic BL: mass in abd organs)
C: EBV
*Biopsy shows "Starry Sky" pattern

Front 45

Hodgkin's Lymphoma

Back 45

B cell lymphoma - High cure rate
S/S: Painless lymphodenopathy, Reed-Sternberg cells, along w/ other lymphoma sxs
C: FHX, EBV

Front 46

Non-Hodgkin Lymphomas

Back 46

B cell neoplasms 14 diff't types; worse prognosis than Hodgkin's Lymphoma; 5 yr survival rate is 59%
S/S: Fever, wt loss, night sweats

Front 47

Multiple Myeloma (MM)

Back 47

Plasma cell neoplasm - involvement of the skeleton at diff't sites
S/S: Punched out lesions/patho fractures, anemia, hypercalcemia (confusion, weakness, lethargy, constipation), suppressed humoral immunity (recurrent infs)
C: Idiopathic, poss chrom 13 deletion, link to inf by HHV-8 (Kaposi's sarcoma)
M>F; Peak age 50-60

Front 48

What proteins are commonly found in the blood of a patient with MM?

Back 48

M-protein: most common; due to large number of malignant plasma cells
Bence Jones protein (80% of cases): Immunoglobulin light chain found in blood and urine; contributes to damage of renal tubular cells

Front 49

Rheumatic Fever

Back 49

Inflammatory disorder
S/S: Carditis - Endocardium: Heart valves, polyarthritis, chorea (jerking muscle twitches), Erythema Marginatum (Never on hands/face; often mistaken for ringworm)
C: Strep throat (Group A Beta-hemolytic streptococcus), Delayed exaggerated immune response

Front 50

Pericarditis

Back 50

Inflammation of the pericardium
S/S: Acute onset chest pain, dyspnea, low grade fever, feeling sick, pain may radiate to the back, pericardial effusion (friction rub)
C: Viral (90%), MI, AI, Trauma
EKG: PR segment depression, ST elevation w/o Q waves

Front 51

Infective Endocarditis

Back 51

Infection of the endocardium (inf of the heart chambers or valves)
S/S: inf sxs, new onset murmur, arthritis sxs, SOB, cough, edema
C: Poor dental health, Indwelling (catheters, IV, Foley), IV drug use, Artificial heart valves

Front 52

Pleurisy and Pleural Empyema

Back 52

Inflam of the pleura; inf of the pleural space
S/S: SOB, Chest pain increases w/ respiration, inf sxs
C: Viral, Bacterial, AI, TB, PE

Front 53

HIV/AIDS

Back 53

Immunodeficiency - RNA virus
S/S: 2-4 wks - Fever, sore throat, lymphodenopathy, rash; Chronic- Wt loss, diarrhea, cough, opportunistic infs, night sweats
Testing: ELISA, Western Blot, Rapid HIV test

Front 54

Sepsis

Back 54

Massive inflammatory response to trigger
S/S: Fever, tachycardia, tachypnea, diarrhea, ALOC, Hyptotension, U/O
C: Bacterial/Viral release of toxins

Front 55

Toxic Shock Syndrome

Back 55

Life threatening bacterial infection
S/S: Sudden onset; high fever, hypotension, V/D, rash, ALOC
C: Staph aureaus, Group A beta hemolytic strep, tampons/contraceptive sponges/diaphragm, wounds

Front 56

Syphilis (Three stages of symptoms)

Back 56

Infections w/ Treponema pallidum
Primary: Painless chancer at site of transmission, 10-90 incub period, lymphodenopathy
Secondary: 3-6 wks after sore appears - non-itchy rash on body, palms and soles, "ill" feeling
Tertiary: Systemic - Cardia, CNS
C: STD, Childbirth, Transfusion

Front 57

What symptoms differ between pharyngitis and laryngitis?

Back 57

Laryngitis involves the voice box and causes a raspy or loss of voice.

Front 58

What are some of the shared causes of pharyngitis and laryngitis?

Back 58

Viral - common cold, flu, mono
Bacterial - group A Streptococcus
Other - allergies, GERD, dehydration, tumor, smoking

Front 59

Name three complications that can arise if Strep throat goes untreated.

Back 59

Rheumatic Fever, Infective Endocarditis, and Post-Streptococcal Glomeruloephritis

Front 60

What are the S/S and Tx for Post-Streptococcal Glomeruloephritis?

Back 60

S/S: Red or cola colored urine due to dmgd filter (hematuria), HTN, Decreased GFR
Tx: Antibiotic therapy and control the symptoms (HTN and kidney failure)

Front 61

What is the virus responsible for mononucleosis?

Back 61

EBV

Front 62

What else is caused by EBV?

Back 62

Burkitt's Lymphoma and Hodgkin's Lymphoma

Front 63

What is the mononucleosis symptom triad?

Back 63

Fever, Pharyngitis, and Lymphodenopathy

Front 64

What are other S/S of mononucleosis?

Back 64

Malaise, HA, Fatigue, Arthralgia, Viral sxs, dysphagia, enlarged spleen, and rarely spleen rupture

Front 65

What does the Monospot/EBV test detect?

Back 65

Heterophil Ab

Front 66

What does GERD stand for?

Back 66

Gastroesophageal Reflux Disease

Front 67

What is GERD?

Back 67

A return of stomach contents into the esophagus because of relaxation or incompetence of the lower esophageal sphincter that leads to such complications as bleeding, dysphagia, or failure to thrive.

Front 68

What are the causes of GERD?

Back 68

Abnormal esophageal sphincter, spicy foods, ETOH, Meds, stress, smoking, obesity, and peptic ulcer

Front 69

If untreated, what can GERD lead to?

Back 69

Barrett's esophagus - metaplasia in the esophagus

Front 70

What do H2 blockers do?

Back 70

They block histamine to reduce the influence on the parietal cells to produce HCl; work faster (1-12 hrs)

Front 71

What are PPls and what do they do?

Back 71

Proton Pump Inhibitors - They bind to the pump to stop HCl production; take longer to work but last longer (1-3 days)

Front 72

Differentiate between dysphagia and dysphasia.

Back 72

Dysphagia - difficulty swallowing
Dysphasia - an impairment of comprehension or the production of language

Front 73

What is Aphasia?

Back 73

The complete loss of the comprehension or production of language

Front 74

Where in the brain is the speech center located?

Back 74

Left hemisphere, parietal lobe

Front 75

What is the Broca's area and where is it in relation to the Wernicke's area?

Back 75

Broca's area is responsible for speech production; motor speech control; located anterior to the Wernicke's area

Front 76

What is the Wernicke's area?

Back 76

Wernicke's area is responsible for understanding language; sensory language control

Front 77

Which cerebral artery supplies most of the temporal lobe, anterolateral frontal lobe, and parietal lobe and can disrupt speech if involved in a stroke?

Back 77

Middle cerebral artery

Front 78

Name the reflex our bodies use to clear airways.

Back 78

Cough

Front 79

What is hemoptysis?

Back 79

Coughing up blood

Front 80

What can hemoptysis be caused by.

Back 80

Infection, inflammation, CA, infarction

Front 81

What is Dyspnea?

Back 81

Difficult or labored breathing

Front 82

What is orthopnea?

Back 82

Dyspnea while lying down

Front 83

What is Paroxsymal Nocturnal Dyspnea (PND)?

Back 83

Waking up at night with dyspnea

Front 84

What are the S/S of dyspnea?

Back 84

Stridor, wheeze, anxious/distressed expression, flaring nostrils, use of accessory muscles to breathe (scalenes, SCM, traps, pecs), gasping

Front 85

Describe the respiratory pattern of Kaussmaul breathing.

Back 85

This is a consistent, deep breathing pattern. Some exhibiting Kaussmaul may have an increased TV.

Front 86

What could Kaussmaul breathing be a symptom of?

Back 86

Metabolic acidosis

Front 87

Describe Labored breathing.

Back 87

Labored breathing exhibits itself with a slow RR, large TV, and prolonged inhalation and exhalation.

Front 88

What can labored breathing be a sign of?

Back 88

An obstruction in the airway

Front 89

What is Restricted breathing?

Back 89

Difficulty getting air into the lungs

Front 90

What could restricted breathing be a sign of?

Back 90

Restrictive lung disease

Front 91

What is Cheyne-Stokes breathing?

Back 91

It is periodic breathing, alternating between apnea and tachyapnea.

Front 92

Who might exhibit Cheynes-Stokes breathing?

Back 92

Neo-natal infants with underdeveloped lungs, those with diminished stem cell perfusion or damage to the respiratory centers, and those near death

Front 93

What causes Tuberculosis (TB)?

Back 93

Mycobacterium tuberculosis

Front 94

What are the S/S of Tuberculosis?

Back 94

Someone infected with start of asymptomatic. Later a cough the produces purulent sputum will develop slowly. Later symptoms include night sweats, fatigue, fever/chills, pleurisy, caseous necrosis; it can eventually become systemic and affect other organs

Front 95

What is caseous necrosis?

Back 95

A type of tissue death that results in a cheeselike material

Front 96

What can be seen in a chest Xray of a person who has or had TB?

Back 96

Spots

Front 97

What is pneumonia?

Back 97

An inflammatory process that can involve all or part of the lungs; 6th leading cause of death in the U.S.

Front 98

What are the causes and treatments for pneumonia?

Back 98

Infection-bacterial, viral, or fungal
Bacterial inf can be treated with antibiotics; No tx for viral inf; supplemental oxygen may be used

Front 99

What would a chest Xray look like in a person that has pneumonia?

Back 99

Cloudy

Front 100

What are two major differences between pneumonia and TB?

Back 100

1- TB can affect other organs and tissues
2- TB requires significantly longer tx than does pneumonia

Front 101

What is acute bronchitis?

Back 101

An inflammation of the bronchial tree caused by infection or irritating factors (ie smoke)

Front 102

What are the causes and S/S of acute bronchitis?

Back 102

C: secondary to UTI, evironmental toxins, GERD
S/S: Productive cough, chest pain/congestion, wheezing, fever/chills, DIB

Front 103

What are the three types of COPD?

Back 103

1- Chronic bronchitis
2- Emphysema
3- Asthma

Front 104

Chronic Bronchitis - definition

Back 104

Inflammation of bronchioles w/ excess mucus production; bronchitis > 3 mo for 2 or more consecutive yrs; airway obstruction and hyperplasia of mucus-producing glands

Front 105

Chronic Bronchitis - Cause and S/S

Back 105

C: Long term pulmonary d/o, smoking, scarring & tissue dmg
S/S: "Blue Bloaters," hypoxemia, polycythemia, right heart failure, productive cough, SOB, DIB, wheezing

Front 106

Chronic Bronchitis - Testing

Back 106

Pulmonary functional tests, Chest Xray/CT, sputum culture

Front 107

Emphysema - definition

Back 107

Alveolar destruction (alveolar don't collapse)

Front 108

Emphysema - cause and S/S

Back 108

C: smoke, genetic
S/S: "Pink Puffers," increased RR, cough, dyspnea, fatigue, wt loss, clubbing, barrel chest, pursed lipped breathing

Front 109

Emphysema - testing

Back 109

Pulmonary functional tests (decrease in TV), chest Xray, arterial blood gases test

Front 110

Asthma - definition

Back 110

Inflammatory airway d/o w/ bronchoconstriction - mast cells produce histamine which causes smooth muscle contraction

Front 111

Asthma - cause and S/S

Back 111

C: Allergies, URI, Exercise, Cold air, Pollution
S/S: Cough, wheezing due to difficulty in breathing out, mucus production, use of accessory muscles, SOB

Front 112

Asthma - tests

Back 112

PFTs w/ and w/o bronchodilator

Front 113

Pulmonary Embolism - definition

Back 113

Occlusion of a portion of the pulmonary vascular bed by an embolus; It can cause an infarction. If no infarction, clot will be dissolved by fibrinolytic system

Front 114

Pulmonary Embolism - cause and S/S

Back 114

C: 90% are due to clots formed in the leg and pelvis veins (esp in immobile ppl)
S/S: Sudden onset of chest pain, SOB, wheezing, cyanosis, syncope

Front 115

Cystic Fibrosis - definition

Back 115

A multiorgan, autosomal recessive inherited disease that is most problematic in the lungs; results from defective epithelial Cl ion transport

Front 116

Cystic Fibrosis - S/S

Back 116

Cough or wheeze and recurrent or severe pneumonia; over time it can result in a barrel chest and digital clubbing

Front 117

Cystic Fibrosis - diagnosis & Tx

Back 117

D: sweat test reveals sweat Cl concentration > 60mEq/L
Tx: Focus on pulmonary health (bronchodilators and Rx to liquify mucus) and nutrition; pancreatic enzymes, antibiotics

Front 118

Fibrotic lung disorders - cause and S/S

Back 118

C: Silicosis (mining), asbestosis, sarcoidosis, dust, animal droppings
S/S: cough, wheezing, DIB, chest pain, clubbing

Front 119

Bronchiectasis - definition

Back 119

Persistent abnormal dilation of the bronchi; usually in conjunction w/ another respiratory condition

Front 120

Bronchiectasis - cause and S/S

Back 120

C: Infection (acute or chronic), CF, TB
S/S: Productive cough (foul smelling/blood), DIB, fatigue, clubbing, cyanosis

Front 121

Atelectasis - definition

Back 121

Collapse of the alveoli; may lead to collapse in lung but usually does not

Front 122

Atelectasis - cause and S/S

Back 122

C: Anything that diminishes surfactant: Immobility (bed rest, anesthesia), lung disease, foreign objects, tumors
S/S: DIB, chest pain, cough

Front 123

Atelectasis - risk factors

Back 123

Premature birth, lung disease, bed confinement, abdominal or chest surgery, anesthesia, shallow breathing, respiratory muscle weakness, obesity

Front 124

Atelectasis - Tx

Back 124

Depends on the cause; remove underlying cause, if only in a small area of lung it may take care of itself or be helped with meds to thin mucus and/or dilate bronchioles

Front 125

Pneumothorax - definition

Back 125

Collapsed lung (whole or in part), due to a change in the pressure in the pleural space which causes pressure on the exterior surface of the lung

Front 126

Pneumothorax - cause and S/S

Back 126

C: chest injury, underlying lung disease, ruptured air blisters (blebs), mechanical ventilation

Front 127

Pneumothorax - risk factors

Back 127

Sex (M>F), smoking, age, genetics, lung disease, mechanical ventilation, a history of pneumothorax; tall, thin men are the most likely to develop blebs on the top of their lungs which can burst causing this condition

Front 128

Shared S/S of Bronchiolitis, Croup, and Epiglottitis

Back 128

Wheezing, retractions, cyanosis, cough, tachypnea

Front 129

Bronchiolitis - general

Back 129

Inflammation of bronchioles; common ages: 2-12 mo
C: RSV - respiratory syncitial virus, also common after lung transplants

Front 130

Croup - general

Back 130

Inflammation of epiglottis
Common ages: 6mo-5yrs
C:Parainfluenza virus
S/S:Barking cough, stridor (harsh or grating squeaking sound)

Front 131

Epiglottitis - general

Back 131

Inflammation of epiglottis
Common ages: 2-7yrs
C: flu or strep
S/S: drooling, leaning forward to breath, fever, stridor
Med emerg - obstruc airway

Front 132

What is the "street name" for Coccidioidomycosis?

Back 132

Valley fever

Front 133

Coccidioidomycosis (Valley Fever) - general

Back 133

Fungal infection acquired by inhaling the arthrospores in dust in the Southwest
S/S: flu-like symptoms, fever, chest pain, cough, night sweats, BOB, erythema nodosum (painful nodules in the lower legs)