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77 Cards in this Set

  • Front
  • Back
Chronic bronchitis Morphology
-hypertrophy of mucus glands in large airways
-increase in goblet cells of small airways
-enlargement of mucus secreting glands
-squamos metaplasia of and dysplasia of epithelium
-narrowing bronchioles
-boggy, swollen, hyperemic mucus membranes
-excessive mucopurulent secretions layer epithelium
-pus can fill bronchioles and bronchi
Peptic ulcer clinical manifestations
o Epigastric pain (burning, stabbing)
o Nausea & vomiting
o Bloating
o Belching
o Weight loss
o anemia
May present with all symptoms except pain, in this case the ulcer may be hemorrhageing and coating nerve ending preventing pain. Stress usually produces multiple ulcers
Iron deficiency anemia etiology
o dietary lack
o impaired absorption
o increased requirement
o chronic blood loss
Chronic bronchitis Etiology
-chronic irritation by inhaled substances
-microbiologic infections
- most common causes are air pollution and cigerrete smoking
-repeated exposure predispose to infection and chronic inflammation
Pathogenesis of Obstructions
Acute, complete obstruction
· Accumulation of urine behind the obstruction with retrograde increases in hydrostatic pressure
· Increases in pressure are transmitted to proximal tubule
· Usually not seen unless morphological changes are allowed to continue.

Chronic, partial obsturctuion
· Compression of kidney structures with ischemic atrophy of papilla and medulla
· Progresive atrophy of the kidneys with tubular damage (Causing interference wit tubular resabsorption, secretion, & excretion)
Mucociliary clearance
The transport of mucus within the sinuses and into the nose and pharynx is programmed genetrically from birth
- predetermined pattern cannot be chagned or redirected through creating new openings in the sinuses.
- Mechanism is part of the non-specific immune system
Warm antibody hemolytic anemias
o Most common form of immune hemolytic anemia
o Idiopathic ~ 60%
o Drug-associated ~40%
o Involves IgG autoantibodies
o Spleen major site of destruction
Interference with airway clearance - Risk for pneumonia
Increased mucus buildup - (smokers) decreases lung surface area & provides a medium for growth of pathogens
Inability to cough - (neuronal conditions) can not get rid of mucus and other liquids
Decreased or not functioning cilia (smokers) - secretions and pathogens are allowed to remain in the lungs.
Decreased chest expansion - decreased ariflow allows secretion to pool and pathogens to buildup.
Decreased macrophages in alveoli (smoking) - allows pathogens to multiply and invade healthy tissue
Acute pylelonephritis Etiology
· common causative organism: E coli
· nosocomial causative organisms: proteus and pseudomonas
Gas Uptake
- as inspired air reaches alveoli, air flow becomes zero
- diffusion moves oxygen molecules to and through the alveolar-cap membrane
- oxygen dissolves in membrane, passes though to plasma and diffuses through palsma and red cell membrane
Apthous ulcers morphology
· shallow, hyperemic ulceration
· thin layer of exudates
· hyperemic rim (reddened)
Small intestine motility
o Segmenting contraction
o Mixes the contents
o Brings contents in contact with epithelium
o Forces contents downward
o Peristaltic contractions
o Occur after most of absorption
o Travel slowly and short distances
o Provide slow transit to complete absorption
Empysema etiology
SMOKING plus irritants
4 Pathophysiological processes that occur as a result of allergies
- mucosa comes in contact with a foreign antigen to which the immune system has previosly been sensitized.
-antigen binds to specific IgE on the surface of mast cells
- mast cells are stimulated to degranulate, releasing histamine to tissue
- immediate dilation of capillaries, localized tissue edema, increased secretion of thickened mucous, and promotion of other active substances that increase inflammation.
Pathogenesis of MI
o Vessel lumen narrows
o Plaque ruptures
o Platelets aggregate to site
o Vasospasm occurs around the occluded area
Usually the spasm causes the occlusion of the vessel
o Infarction of distal tissue
o Necrosis causes ventricular wall changes
4 Functions of the Turbinates
- covered with mucus membrane rich in goblet cells, and secrete extensive amounts of mucus in the nose
- epithelium secretes IgA into the nose which is of benefit in the immune response to inspired allergens, bacterial & viral particles, and other irritants
- promenently located in the nasal airway creating a turbulent airflow, provides warmth, and humidification and conditions air for presentation to lower resp. tract
-turbinates expand and contract q6-8hr that presents differing volumes of airflow to each side of the nasal cavity
Iron deficiency anemia tissue and cell morphology
o increased erythropoietic bone marrow activity
o increased normoblasts
o no iron in reticulyte cells
o red cells small and pale
o microcytic, hypochromic
o HgB narrow peripheral rim
Chronic bronchitis
periods of hypoxic vasoconstriction
- persistent bough with excessive sputum production for most days over 3 months in atleast 2 successive years
Tubular excretion
Excretion is a major process in the collecting duct.
· The urine that is excreted is a product of the primary urine undergoing reabsorption and secretion.
Hypoxic vasoconstriction
physiologic mechanism that occurs when an area of lung tissue beomes hypoxic.
Blood vessels that go to this area will constrict, and force blood to other areas in an effort to maintain carbon dioxide/oxygen exchange ration
Salivary secretion function
o Softens and lubricates food for swallowing
o Facilitates chewing and speaking
o Neutralizes acids and prevents dissolving of tooth enamel
o Regulates the sensation of thirst
o Prevents infections
Chronic bronchitis Pathogenesis
due to inhaled irritants
-interfere with ciliary action
-directly damage epithelium
-inhibit action of respiratory leukocytes
Pathogenesis of glomular sclerosis
Glomerular sclerosis is when sclerotic changes happen in the nephron. Can be due to age, htn, or diabetes
o Glomerulus
o Basement membrane folding
o Thickening
o Hyalinization
o Collapse of tuft
o Arterioles - atrophy
o Renal mass
o Progressive loss of cortical renal mass
o Increased percent of sclerotic or abnormal glomeruli
Acute gastritis etiology
· Unknown
· Associated with:
o Alcohol
o Smoking
o Severe stress
o Medical therapies
Inotopic effects on the heart
· Positive inotropic effect - Any agent that increases the strength of cardiac contractions. Ex are excessive thryoird hormone, epinephrine, norepienephrine, dopamine, isoproterenol, calcium.
· Negative inotropic effect - Any agent that decreases the strength of cardiac contraction. Examples are alcohol, quintatdine, propranelol
Peptic ulcer morphology
o Ulcers will be located in the deuodenum
o Usually a single ulcer
o Almost 1 cm
o Ulcer is well demarcated, can have infectious material in crater
o Often surrounded by gastritis
Acute pylelonephritis
· infection of renal pelvis and interstitium
o unilateral or bilateral
o occurs more frequently in women
Acute glomerulonephritis Etiology
· immunologic abnormalities (most common)
o throat and skin infections: beta hemolytic streptococcus
o bacterial endocarditis: streptococcus & staphylococcus
o viral diseases: varicella and hepatitis B
· effect of drugs or toxins (overdose of drugs, or toxins)
· vascular disorders
· systemic diseases
Chronic bronchitis clinical manifestations
o Persistent productive cough
o copious sputum
o Eventually dyspnea on exertion
o Hypercapnea
o Hypoxemia
o Cyanosis
o Concurrent bacterial infections
Pernicious anemia nonspecific effects
o Blood hemolysis
o Generalized tissue hypoxia
Free Radical Theory of Artherogenesis
o OH (hydroxide) reacts with and peroxidizes lipids
o Located in vascular endothelium cell membrane
o Damage results in vascular lesion
o Attracts macrophages
o Upward migration of basement cells
o Results in a foam lesion
o Then becomes a Fatty streak lesion
o Calcified plaque
o Central area of the plaque becomes necrotic and ruptures (aneurysm).
o Smaller vessels occlude more easily, and can be a bigger problem than larger ones
Acute pylelonephritis Risk factors
· renal calculi
· vesicoureteral reflux
· pregnancy
· neurogenic bladder
· instrumentation
· female sexual trauma
Emphysema Morphology
o Septal wall destruction
o Fusion of adjacent alveoli
o Destruction of parts of capillary bed
o Bronchioles and blood vessels are deformed and compressed
o Small airways narrowed, tortuous, decreased in number, thin, atrophied walls
o On xray lungs overlap and hide heart
o Upper 2/3rd of lungs affected
o Blebs and bullae form
Apthous Ulcers
· superficial ulceration of the oral mucosa (cancre sores)
Baroreceptor reflex
§ Mediated by tissue pressure receptors (tissue pressure receptors) in the aortic arch and carotids
§ Nerve endings that respond to stretch
§ With increased pressure, the receptors increase their rate of discharge
§ Impulses are sent via the vagus nerve to the medulla
§ Parasympathetic activity is increased and sympathetic activity is decreased
§ Causes blood vessels to dilate and heart rate to decrease

Apthous ulcers clinical manifestations
· painful lesion(s) on mucus membranes
· single or multiple in strings
· frequently recur
· more common under 20
Neural Reflexes
Bainbridge Reflex
Lung Reflex receptors
Baroreceptor reflex
Large intestine motility
o Pretty quiet most of the time
o Stores contents in the distal colon
o Motility is via segmental contractions
o Propulsive mass movements
Tubular reabsorption & secretion
o The processes of reabsorption and secretion actually take place all along the tubular system.
o It is just that in some places one occurs more than in other places.
o Reabsorption is a major process in the proximal tubules S
o Secretion is important in the loop of Henle and the distal tubule.
Acute gastritis
· Acute, transient inflammation of gastric mucosa
· Inflammation of the bladder
· Most common type of UTI
· More common in women than men
o Shorter urethra
o Closeness of urethra to anus
o Contamination from vaginal secretions
Oral candidiasis Etiology
· Candida (Always present in mouth)
Bainbridge reflex
§ Causes the heart rate to either increase or decrease after IVF. It is thought to be due to receptors in the atria, and the vagus nerve. If the initial heart rate is slow, infusion will speed it up. If the rate is high, infusion will slow it down.
Spherocytosis Etiology
o Inheritied
o Prevalent in northern Europeans
o 1 in 5,000
Lung Reflex receptors
§ Increase heart rate during inspiration
§ Decrease heart rate during expiration
§ Caused by stretching activation of vagal fibers that inhibit cardioinhibitory center of the medulla. Allows an unopposed SNS acceleration of the heart
Apthous ulcers Pathogenesis
· inflammatory infiltrate
· secondary bacterial infection
· neutrophilic invasion
Do get infected, mouth full of bacteria, worsens
Pathogenesis of Hypertension
o Increased sympathetic nervous system activity (reactivity)
o Increased rennin-angiotensin-aldosterone activity - rennin is constantly stimulated, especially in renal pts. This leads to too much angiotensin and aldosterone. May be a factor in HTN with increasing age (by age 60 looses 60% of functioning nephrons).
o Altered activity of
o ANF (antirneurtic factor) decreased
o EDCF increased
o Endothelin increased
o Nitric oxide decreased
All of which can lead to HTN
Acute gastritis pathogenesis
· Increased HCL secretion
· Decreased bicarbonate production
· Decreased blood flow
· Damaged mucus layer
· Damaged epithelial layer
Cystitis clinical manifestations
· Frequency, urgency, and dysuria
· Suprapubic and low back pain
· Hematuria
· Cloudy urine
· Flank pain
· 10 percent have no symptoms
· 30 percent with symptoms have no bacteria
· children and elderly have non-specific symptoms: fever & malaise
Ulcerative colitis pathogenesis
o Affects only the large colon
o Involves the inflammation and ulceration
o Affects only the mucosa and submucosa layers
o Always extends proximally from the rectum
o Initial lesion in rectal area is nongranulomatous
Clinical manifestations of MI
o Substernal pressure, pain, tightness
o Radiation to jaw, shoulder, left arm
o Dyspnea
o N/V
o Diaphoresis
o Dizziness
o Onset associated with:
o Stress
o Cold
o Exercise
o Relieved with rest
o ST segment depression on ECG
o In women, frequently presents as shoulder pain or upset stomach
Pernicious anemia (Defective DNA synthesis) Patho
Folate deficiency anemia
Pathological mechnism
o Automimmune destruction of gastric mucosa
o Decrease in parietal cells
o Lymphocyte infiltration
o Theories
o Blocking antibody
o Binding antibody
o Parietal antibody
o T-cell response triggers gastric mucosal injury
o May be CD4+ cells
o Iniates autoantibody formation
o Antibodies cause further mucosal injury
Glomerular filtration
o Occurs in the glomerulus
o Start of urine formation where the hydrostatic pressure in the capillaries is very high and a filtrate of the plasma is pushed out and enters the Bowmans capsule.
Peptic ulcers Pathogenesis
Patho unknown
o H pylori
o Hyperacidity (optimal stomach pH 1-2, trouble with too little mucus)
o Hyperpepsinity
o hypomucosity
Risk Factors for Hypertension
o Increasing age
o Obesity
o Sedentary lifestyle
o Family history
o Smoking
o Excessive alcohol intake
o High Na+ intake
o Low K+ and Mg++ intake
These risk factors usually associated with primary or idiopathic hypertension
Warm antibody hemolytic anemias Idiopathic etiology
o Cause of auto-antibody formation unknown
o Antibodies against Rh blood group antigens
Iron deficiency anemia
o Most common nutritional disorder
o Common in the US
o Women more vulnerable
Bioavailabiity of iron
o heme iron more absorbable than inorganic iron
o inorganic iron absorption enhanced by Vitamin C, inhibited by Ca & oxalic acid
Pernicious anemia cell morphology
o Bone marrow with accumulation of megaloblasts
Acute glomerulonephritis pathogenesis
· immune complex deposits in the glomerulus
· diffuse capillary endothelial cell proliferation
· thickened glomerular membrane
o contributes to decreased GFR
Pernicious anemia tissue morphology
o Alimentary tract
o Tongue shiny, glazed, and beefy
o Stomach chronic gastris
o Central nervous system
o Spinal tracts myelin degeneration
Spherocytosis Pathogenesis
o Defect in red cell membrane
§ Spheroidal shape
§ Less deformable
§ Splenic sequestration and destruction
o Deficiency in spectrin
§ Reduced red cell membrane stability
§ Spontaneous loss of red cell membrane
§ Causes cell to assume spherical shape
o Hapless spherocytes
§ Trapped in spleen
§ Circulation decreases
§ Increase in macrophage contact

Apthous ulcers etiology
· unknown
· runs in families
· strep sanguis??
Acute gastritis morphology
· Hyperemia and edema of lamina propria
· Presence of neutrophils in mucosa and epithelium
· Loss of mucosa
· Hemorrhage and necrosis
Spherocytosis Tissue Morphology
o Red cells spheroidal and small
o Moderate splenomegaly
o Increased erythropoiesis
o Bone changes

Apthous ulcers Risk factors
· inflammatory bowel disease
· emotional stress
· injury (from foods i.e. nuts, hard candy)
· hormonal changes
Acute gastritis clinical manifestations
· Severe epigastric pain (more painful than an ulcer)
· Nausea
· Vomiting
· Hematemesis
· melena
Peptic ulcers Etiology
· Lesions that extend from mucosal layer into submucosal layer
· Lesions located in areas of GUT that produce acid and pepsin
Your GUT is always somewhat iinflammed, physiological inflammation.
Acute pylonephritis Clinical manifestations
· majority of adults have ACUTE onset
o fever
o chills
o flank and/or groin pain
o frequency
o dysuria
o costavertebral tenderness
Oral candidiasis pathogenesis
· grows as yeast forms
· surface molecules mediate tissue adherence
· can spread to esophagus
Acute glomerulonephritis clinical manifestations
· hematuria
· RBC casts
· Proteinuria
· Deceased GFR
· Oliguria
· Edema
· Hypertension
· Third spacing of fluid
Ulcerative colitis morphology
o reddened mucosa
o friable, bleeds easily
o ulcers of the mucosa
o damage is continuous
o mucosal bulging (pseudopolyps)
o serosa normal
Oral candidiasis clinical manifestations
· difficulty swallowing
· anorexia
· superficial lesions on mucus membrane
· lesions curdy, gray to white
· lesions easily removed

Acute glmerulonephritis
· inflammation of the glomerulus
· most common cuase of renal failure
Warm antibody hemolytic anemias Idiopathic Pathogenesis
o IgG-coated red cells bound to receptors
o Attempted phagocytosis of IgG-coated cell
o Partial loss of red cell membrane
o Spheroidal transformation
o Spherocytes sequestered and removed by spleen
Oral candidiasis Risk factors
· Antibiotic therapy
· Diabetes
· immunosuppressed
Small intestine absorption
o Movement of fluid and dissolved particles from the lumen through the epithelial cells into the blood and lymph
o Most absorption occurs by midway
o Exception is B12 and bile salts
o Lower small intestine acts as a reserve for absorption
o Absorptive surface
o Highly folded
o Convoluted with villi
o Microvilli form a brush border membrane
o Absorption of water
o 9 liters enter small intestine per day
o 2 liters ingested; 7 liters secreted
o All but 500 ml are absorbed
o Absorption occurs by osmosis
o Proteins
o Lipids
Acute pylenonephritis Pathogenesis
· infection is spread by:
o organisms ascending the ureters
o organisms in the blood stream
· inflammatory process is focal and irregular