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390 Cards in this Set
- Front
- Back
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The cognitive system involves what 3 neural systems? |
-Attentional -Memory/language -Affective/emotive |
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the state of being awake and aware of one's surroundings.
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Consciousness |
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______ is the state of being awake, mediated by the reticular-activating system. |
Arousal |
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Which part of the brain deals with alterations in arousal? |
-suptratentoria: Above the tentorium cerebelli (above cerebellum) -Infratentorial: Subtentorial, below the tentorium cerebelli (Below cerebellum) |
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What produces a coma? |
-Bilateral hemisphere damage or suppression -Brain stem lesions or damage or suppression of the reticular activating system. *Coma is a total lack of arousal |
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Whats the importance of oculomotor function is relation to arousal? |
Help determine the levels of brain dysfunction E.g. Doll's eyes |
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What is the importance of pupillary changes in relation to arousal? |
-Evaluate the presence and level of brainstem dysfunction. -Severe ischemia and hypoxia: Both pupils are wide (5 mm) and fixed *Drugs may affect pupillary changes |
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How is motor response important in determining alterations in arousal? |
-They help health care providers evaluate the level of brain dysfunction, and determine the side of the brain that is maximally damaged -Pattern of response can be: -Purposeful (means intact corticospinal system) -Inappropriate or not purposeful (Severe dysfunction of the corticospinal system) |
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What part of the brain controls vomiting, yawning, and hiccuping? |
Medulla |
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What is Total brain Death? |
-Irreversible cessation of the entire brain, including brainstem and cerebellum. -The body cannot maintain internal homeostasis |
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What are the requirements for a patient to be considered brain dead? |
-Completion of all appropriate, therapeutic procedures -Unresponsive coma -No spontaneous respirations (apnea) -No brainstem function -Isoelectric (flat) electroencephalography |
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This is a irreversible coma in which the brain is still able to maintain internal homeostasis. This is death exclusive of the brainstem and cerebellum. |
Cerebral Death |
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Survivors of cerebral brain death experience what? |
-Locked-in syndrome (a medical condition, usually resulting from a stroke that damages part of the brainstem, in which the body and most of the facial muscles are paralyzed but consciousness remains and the ability to perform certain eye movements is preserved). -Progress into a minimal conscious state (MCS) -Emerge into a persistent vegetative state -Remain in coma |
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knowledge or perception of a situation or fact.
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Awareness *includes all cognitive functions |
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What is selective attention? |
the capacity for, or process of, reacting to certain stimuli selectively when several occur simultaneously.
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What is unilateral neglect syndrome? |
a state in which there is a lack of
awareness and attention to one side of the body. |
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______ is any impairment of memory.
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Dysmnesia |
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_______ is loss of past memories while ______ is the inability to form new memories. |
Retrograde amnesia, Anterograde amnesia |
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______ is the recognition of an objects identity and function. |
Detection |
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What area(s) of the brain mediate the functions of memory? |
The frontal areas |
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What causes alternations in awareness? |
-Direct destruction from ischemia and hypoxia -indirect destruction as a result of compression -Effects of toxins and chemicals or metabolic derangement |
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Define agnosia |
inability to interpret sensations and hence to recognize things, typically as a result of brain damage.
-Can be visual and auditory as well |
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______ is total loss of comprehension or production of language. |
Aphasia |
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Define Dysphasia |
Language disorder marked by deficiency in the generation of speech, and sometimes also in its comprehension, due to brain disease or damage.
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These are a state of severe confusion or an abrupt change in mental status, due to either psychiatric or organic disease. Clinical findings Lethargy, agitation, confusion, disorientation, delirium.
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Acute confusional states |
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There currently no cure for dementia, only treatment. True or false |
False there is no cure or specific treatment |
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What is the leading cause of dementia? |
Alzheimer Disease |
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What happens on a microscopic level in Alzheimer disease? |
-Causes neurofibrially tangles and neuritic plaques -Cholinesterase inhibitors can enhance cholinergic transmission |
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What are some sign and symptoms of Alzheimer's? |
-Forgetfulness -emotionally upset -disorientation -confusion -lack of concentration -declines in -abstraction -problem solving -judgment |
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A sudden, transient alteration of brain function caused by an abrupt explosive, disorderly discharge of cerebral neurons. |
Seizures disorders e.g Epilepsy |
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______ is a recurrence of seizures with no known cause |
epilepsy |
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_____ is a tonic-clonic jerky, contract-relax) movements associated with some seizures. |
Convulsions |
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What type of seizure disorders involve both hemispheres and cause loss of consciousness? |
Generalized Seizures |
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What type of seizures originate in one hemisphere and DON'T cause a loss of consciousnesses? |
Partial (focal) Seizures |
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What are Secondary Generalized Seizures? |
Partial seizures that move to generalized |
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What is status epilepticus? |
Status epilepticus (SE) is a medical emergency associated with significant morbidity and mortality. SE is defined as a continuous seizure lasting more than 30 min, or two or more seizures without full recovery of consciousness between any of them.
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What is the treatment for seizure disorders? |
-Antiseizure medication -Ketogenic diet for epilepsy -Surgery; vagal nerve stimulus |
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These cause alterations in cerebral blood flow, intracranial pressure, and oxygen delivery. |
Cerebral hemodynamic injuries |
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Alternations in cerebral hemodynamic cause what? |
-Increased intracranial pressure -Cerebral edema -hydrocephalus |
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What is the normal intracranial pressure? |
5-15 mm Hg |
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What causes an increase in intracranial pressure? |
An increase in intracranial content -tumor growth -Edema -Excessive cerebrospinal fluid -hemorrhage |
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What causes herniation in the brain? |
-Shifting of brain tissue -Disrupts blood flow and damages brain tissue |
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____ is an increase in the fluid (intracellular or extracellular) with in the brain. |
Cerebral edema |
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What are the three different types of cerebral edema? |
Vasogenic: Disruptions of the blood-brain-barrier (clinically is the most important type). Cytoxic: Toxic factors affect the brain parenchyma (cells). -Active transport is inhibited and the cells lose K+ and gain Na+ causing cells to swell. Interstitial: CSF moves from the ventricles into the extracellular spaces -Volume increases around the ventricles (Very Cold idiot) |
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a condition in which fluid accumulates in the brain, typically in young children, enlarging the head and sometimes causing brain damage.
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Hydrocephalus *fluid accumulates within the cerebral ventricles, subarachnoid spaces, or both |
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What causes hydrocephalus? |
-Decreased reabsorption -Increased fluid production -Obstruction in the ventricular system |
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What are the 3 types of hydrocephalus? |
-Non-communicating (intraventricular): Obstruction -Communicating (extraventricular): Impaired reabsorption -Acute: Caused by head injury (No Cranky Alligators) |
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What are the clinical manifestations of Hydrocephalus? |
-If acute, than intracranial pressure increases -Memory declines with a loss of cognitive function (frontal lobe and subcortical dementia) -Gait is unsteady and broad based. -Urinary urgency an incontinence occur. |
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Movement is controlled by what parts of the brain? |
-Cerebral cortex -Pyramid system -Extrapyramidal system (e.g. basal ganglia, substantial nigra) -muscle motor units |
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Dysfunctions in motor complex areas of the brain, can cause what? |
-Alterations in muscle tone -Alterations in movement -Extrapyramidal motor syndromes -Alterations in complex motor performance |
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_______ is deceased muscle tone while _____ is increased muscle tone. |
Hypotonia, Hypertonia
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Define dystonia |
Increased involuntary muscle reflexes |
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What is hyperkinesia? |
refers to an increase in muscular activity that can result in excessive abnormal movements, excessive normal movements, or a combination of both.
-Chorea (Huntington's), Wandering, tremors at rest, postural tremors |
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______is a disorder in which nerve cells in certain parts (basal ganglia and frontal cortex) of the brain waste away, or degenerate. The disease is passed down through families. Causes abnormal movements without conscious effort and dementia.
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Huntington Disease (chorea) *Rare, autosomal dominant degenerative disorder |
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What is the treatment for Huntington's disease? |
There is no known cure, but dopamine receptor-blocking agents are used |
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_____is characterized by a partial or complete loss of muscle movement due to a disruption in the basal ganglia. Patients with hypokinetic disorders like Parkinson's disease experience muscle rigidity and an inability to produce movement.
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Hypokinesia |
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Define Akinesia |
Absence, poverty, or lack of control of voluntary movements. |
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_____ is the slowness of voluntary movements. |
Bradykinsia |
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_______ is a progressive disease of the nervous system marked by tremor, muscular rigidity, and slow, imprecise movement, chiefly affecting middle-aged and elderly people. It is associated with degeneration of the basal ganglia of the brain and a deficiency of the neurotransmitter dopamine.
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Parkinson's disease *Cognitive-affective symptoms and dementia |
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What are the clinical manifestations of Parkinson Disease? |
-Wide-eyed, unblinking, staring expression with immobile facial muscles. -Slow gait -Short, shuffling steps -Flexed and abducted arms held stiffly at the side -Slightly forward bending trunk |
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Whats the treatment for Parkinson disease? |
-Drug therapy: Levodopa, anticholinergic drugs -surgery -Rehabilitation -Physiotherapy and speech thereby |
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________is a condition typified by a weakness of voluntary movement, or partial loss of voluntary movement or by impaired movement.
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Paresis |
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Define diplegic. |
Paralysis of either both upper extremities or both lower extremities. |
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_______is weakness of the entire left or right side of the body.
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Hemiparesis |
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_______is paralysis of the entire left or right side of the body.
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Hemiplegia |
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________is a specific term that relates to the loss of all neurological activity below the level of injury. This loss of neurological activity include loss of motor, sensory, reflex and autonomic function. |
Spinal shock |
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________is the condition of below normal or absent reflexes.
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Hyporelexia AKA areflexia |
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________is a serious and incurable form of progressive neurodegeneration - over time the nerves in the spine and brain progressively lose function.
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Motor neuron diseases -Inflammatory process may injure or destroy anterior horn or cranial nerve eg: Amytrophic lateral sclerosis (ALS), Paralytic poliomyelitis (almost nonexistent) |
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_______ is the partial inability to perform purposeful or skilled motor acts, while _____ is complete inability. |
Dyspraxias, aprexias |
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Amytrophic lateral sclerosis (ALS) is also called what?
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Lou Gehrig disease |
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What is Amytrophic lateral sclerosis (ALS)? |
-A degenerative disorder involving the lower and upper motor neurons. -Movement is more affected than the brain -Progressive muscle weakness leads to respiratory failure and death usually 2-5 years -upper and lower motor neuron syndrom |
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What are the clinical manifestations of Amytrophic lateral sclerosis (ALS) |
-Limb cramping or weakness -Incoordination -Slurring of speech -Difficulty swallowing -Single muscle group paresis that spreads -Hypotonia |
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What is the treatment for Amytrophic lateral sclerosis (ALS)? |
-Administer antiglutamate which is standard treatment that prolongs life for months but does not cure -Maintain quality of life -Involve family |
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________ is a state of abnormal muscle tone resulting in muscular spasm and abnormal posture,
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Dystonia |
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What do upper motor neuron dysfunction do to gait? |
spastic injury, shuffling and swing leg |
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What do cerebral (ataxic) disorders do to gait?
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cause staggering |
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What do basal ganglion injuries do to gait?
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cause small steps with decreased arm swings |
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What do senile (psudoparkinsonian) injuries do to gait?
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cause small steps with decreased arm swing *Frontal lobe injury |
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Who is at risk for a traumatic brain injury? |
-Children 4 and under -Adolescents 15-19 -Adults older than 65 -Men: Highest number of incidents in all the age groups |
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Define Traumatic brain injury |
it's a nondegenerative, noncongenital insult to the brain from an external mechanical force, possibly leading to permanent or temporary impairment of cognitive, physical, and psychosocial functions, with an associated diminished or altered state of consciousness.
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What are the causes of a traumatic brain injury? |
-Falls -Motor vehicle related injuries -Strike or blow to the head from or against an object -Unknown |
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Whats the difference between blunt (closed) and open (penetrating) trauma? |
-Blunt (closed) trauma -Dura remains intact; brain tissues are not exposed to the environment -Causes focal (local) or diffuse brain injury -More common than open trauma injuries -Open (penetrating) trauma -injury breaks dura and exposes the cranial contents to the environment -Causes primarily focal injuries |
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Explain Primary, secondary and tertiary brain injuries. |
Primary injury -Caused by the impact; involves neural injury, primary glial injury, vascular response, and shearing and rotating forces. Secondary Injury -Is the indirect consequences of the primary injury; includes cascade of cellular and molecular brain events Tertiary injury -Can develop days or months later, such as pneumonia, fever, infections, and immobility, which contributes to further brain injury or delays repair. |
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What are the 2 different classifications of brain injury? |
-Focal:Affects one area of the brain -accounts for more than 2/3 of the head injury deaths. -Diffuse (diffuse axonal injury(DAI)):Affects more than one area of the brain. -DAIs cause less than 1/3 of deaths -DAI's account for the greatest number of severely disabled survivors. |
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_____ are blood leaks from an injured vessel (bruising of the brain). Can cause loss of consciousness (usually less than 5 mins). |
Contusions **The smaller the area of impact, the greater the severity of the injury. |
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How are contusions treated? |
-Control of intracranial pressure(ICP) -Possibly surgery |
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Contusions can cause what 3 types of hemotomas? |
-Extradural (epidural)hemorrhage or hematoma -Bleeding between the dura mater and the skull -Usually arterial and with a skull fracture -Subdural hematoma -Blood between the dura mater and arachnoid mater -Usually venous -Intracerebral hematoma -Bleeding into the brain |
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What do Diffuse Brain injuries do to neuron axon's? |
Cause shearing, tearing, or stretching of nerve fibers |
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What are the different categories of Diffuse Brain injuries? |
-Mild concussion -Classic concussion -mild to severe DAI |
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_______ is a temporary axonal disturbance causing attention and memory deficits but no loss of consciousness. |
Mild Concussion |
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What are the symptoms of the different grades of mild concussions? |
-I: Confusion, disorientation, and momentary amnesia -II:Momentary confusion and retrograde amnesia -III: Confusion with retrograde and anterograde amnesia -IV (classic concussion) -Physiological & neurologic dysfunction without substantial anatomic disruption -Loss of consciousness (<6 hours) -Anterograde and retrograde amnesia -Post-concussive syndrome (a complex disorder in which various symptoms — such as headaches and dizziness — last for weeks and sometimes months after the injury that caused the concussion). |
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In what situations would a person experience secondary brain injury? |
with brain or spinal cord trauma and stroke syndromes -Occurs within hours-days of the primary injury -Is an indirect result of the primary injury |
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What are the mechanisms of Secondary Brain injuries? |
-Altered cerebral blood flow -Ischemia -Inflammation -Cerebral edema -Brain herniation |
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Who is at the highest risk for spinal cord injuries? |
young adult men |
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What causes Spinal cord injuries? |
-MVAs -Falls -Violence |
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Spinal cord injuries have what types of results? |
Ranges from incomplete paraplegia to complete quadriplegia. |
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What causes primary spinal cord injuries? |
Most commonly occurs due to vertebral injuries -Simple fracture -Compression fractures -Comminuted fracture and dislocation Traumatic injury of vertebral a neural tissues as a result of compressing, pulling, or shearing forces. Can occur is an injured spin is not adequately immobilized |
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Where in the spine do primary spinal cord injuries occur? |
-Most locations are cervical (1,2,4-7) and thoracic-lumbar (T1-L2) vertebrae. |
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Whats a secondary spinal cord injury? |
A spinal cord injury that begins within a few minutes after injury & continues for weeks |
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What are the mechanisms of a secondary spinal cord injury? |
Includes -Hemorrhage -edema -ischemia -Inflammation -necrotic and apoptotic cell death **Cord swelling makes it difficult to determine which changes are permanent (If the injury is in the cervical area it can become life threatening) |
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What are the clinical manifestations of spinal shock |
-Loss of the continuous tonic discharge from the brain -Complete loss of reflex function, flaccid paralysis, sensory deficit, loss of bladder and rectal control -Transient drop in BP and poor venous circulation -Loss of thermal control, body temperature drops. -Resolving when reflexes return or badder relaxes. |
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_______is a condition in which your involuntary nervous system overreacts to external or bodily stimuli. This reaction causes a dangerous spike in blood pressure, rapid heartbeat, constriction of your peripheral blood vessels, and other changes in your body’s autonomic functions.The condition is most commonly seen in people with spinal cord injuries above the sixth thoracic vertebra, or T6.
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Autonomic hyperreflexia AKA Dysreflexia Imbalance is present between the sympathetic and parasympathetic nervous system |
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What re the clinical manifestations of Autonomic Hyperreflexia? |
-Hypertension (up to 300mm Hg systolic) -Bradycardia (30-40 bpm) -Pounding headache -Blurred vision -Sweating above the lesion -Hypothermia -Piloerection (involuntary erection or bristling of hairs due to a sympathetic reflex usually triggered by cold, shock, or fright or due to a sympathomimetic agent.) |
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__________a term used to describe the normal changes in your spinal discs as you age.
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Degenerative disk disease Its not really a disease, it just happens over time. info received from www.webmd.com/back-pain/tc/degenerative-disc-disease-topic-overview |
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Define spinal stenosis |
Spinal stenosis is a narrowing of the open spaces within your spine, which can put pressure on your spinal cord and the nerves that travel through the spine to your arms and legs. Spinal stenosis occurs most often in the lower back and the neck.
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What are risk factors for low back pain? |
-Occupation -Exposure to Vibrations -Psychosocial workplace factors -Obesity |
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What causes lower back pain? |
Extruded or herniated nucleus pulposus irritates dural membranes *About 75%-90% of the population is affected at some time |
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What are the clinical manifestations of low back pain? |
-Pain between the lower rib cage and gluteal muscles -Often radiating into the thigh |
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What is the treatment for lower back pain? |
-Analgesics -Nonsteroidal antiinflammatory medications -Exercise -Physical therapy -Education (how to lift heavy items, ect) -Surgical treatments: Disectomy and spinal fusions -Radiotherapy (Killing sensory nerves in that specific area for clients with chronic back pain) |
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What is a herniated intervertebral disk? |
A herniated disc is a condition in which the annulus fibrosus (outer portion) of the vertebral disc is torn, enabling the nucleus (inner portion) to herniate or extrude through the fibers.
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What are the clinical manifestations of a herniated intervertebral disk? |
Pain radiating along the sciatic nerve |
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What is the treatment for a herniated invertebral disk? |
-NSAIDs (nonsteroidal anti-inflammatory drugs) -Bed-rest -Exercise -Surgery |
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________refers to a group of conditions that affect the circulation of blood to the brain, causing limited or no blood flow to affected areas of the brain.
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Cardiovascular diseases |
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What are 2 types of cerebrovascular diseases? |
1)Ischemia with or without infarction 2)Hemorrhage |
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Define cerebrovascular accident |
is the medical term for a stroke. A stroke is when blood flow to a part of your brain is stopped either by a blockage or a rupture of a blood vessel.
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What is the greatest risk factor Cerebrovascular accidents? |
Hypertension |
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What are the 2 types of cerebrovascular accidents? |
-Thrombotic ischemic stroke -Embolic ischemic stroke |
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What is a transient ischemic attack? |
a brief episode of neurological dysfunction resulting from an interruption in the blood supply to the brain or the eye, sometimes as a precursor to a stroke. (effects are not permanent)
*Approximately 30% will have a CVA within a year |
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What is a thrombotic ischemic stoke? |
A stroke that occurs because of a clot in an artery that supplies the brain or in intracranial vesicles. This can can due to atherosclerosis and inflammatory disease processes. |
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What is a embolic ischemic stoke? |
A stroke that occurs when fragments from a thrombus (clot) that is formed outside the brain break off. A secondary stroke usually occurs. |
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What are the clinical manifestations of cerebrovascular accident? |
-Neurons surrounding the ischemic or infarcted areas are damaged. -Cellular edema causes compression of capillaries. -Depends on the artery affected. -Contralateral weakness weakness in arms, legs, and/or face -Possible motor,speech, and/or swallowing. |
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What is the treatment for a cerebrovascular accident? |
-Thrombolysis (tissue-type plasminogen activator) for embolic stroke -Antiplatlet, anticoagulant, cholesterol-reducing agents are prescribed. -Hypertension is NOT aggressively treated |
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__________is a cerebrovascular disorder in which weakness in the wall of a cerebral artery or vein causes a localized dilation or ballooning of the blood vessel.
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Intracranial aneurysm |
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Where are most intracranial aneurysms located? |
At bifurcations near the circle of wills. Bifurcations are the division of something into two branches or parts. The circle of Willis (also called Willis' circle, loop of Willis, cerebral arterial circle, and Willis polygon) is a circulatory anastomosis that supplies blood to the brain and surrounding structures. |
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Define migraine |
a recurrent throbbing headache (4-72 hours) that typically affects one side of the head and is often accompanied by nausea and disturbed vision. |
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Whats the mechanisms of migraines? |
-Activation of the trigeminal system -Cortical spreading depression -Distinct activity of brain nuclei |
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What are the symptoms of migraines? |
When any 2 symptoms occur: unilateral head pain, pulsing, pain worsening with activity, moderate or severe pain One of the following symptoms: Nausea or vomiting, or both, photophobia, phonophobia |
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_________ is a chronic, typically progressive, inflammatory, autoimmune disease involving damage to the sheaths (demyelination) of nerve cells in the brain and spinal cord, whose symptoms may include numbness, impairment of speech and of muscular coordination, blurred vision, and severe fatigue.
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Multiple sclerosis * Woman are more affected *Occurs in white and grey matter |
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What typically causes MS? |
-Genetics -Infections -Autoimmune reactions -Environment toxins -Unknown factors |
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What is Guillain-Barre syndrome |
-Acquired, acute inflammatory autoimmune disease causing demyelination of the PNS |
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What are the clinical manifestations of Guillain-Barre syndrome? how is it treated? |
Clinical Manifestations -Acute onset, ascending motor paralysis -More common in kids Treatment -Ventilation support -Management of autoimmune nervous system dysfunction -After disorder remits, rehabilitation |
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This chronic autoimmune disease occurs when the IgG antibodies are produced against acetylcholine receptors on the postsynaptic membrane. This causes defects in nerve impulse transmission at the neuromuscular junction; make the nerve impulses slower. |
Myasthenia gravis |
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What are the clinical manifestations of Myasthenia gravis? |
-Exertional fatigue and weakness that worsens with activity, improves with rest. -Weakness and fatigue of muscles of the eyes and the throat causing difficulty swallowing, chewing, and talking. -Myasthenic crisis: severe muscle weakening, leading to respiratory distress. |
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How is Myasthenia gravis treated? |
-Anticholinesterase drugs -Coticosteriods -Immunosuppressent drugs |
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What is the tumor called that originates from brain substance such as neuroglia and neurons. |
Primary intracerebral tumors |
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What are the tumors called that originate from outside the brain (Mengioma, Acoustic nerve tumors, tumors of the pituitary and pineal glands)? |
Primary extracerebral tumors |
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Define gliomas |
a malignant tumor of the glial tissue of the nervous system.
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What are the clinical manifestations and treatments of gliomas? |
Clinical manifestations -Seizures -Visual disturbances -Loss of equilibrium -Cranial nerve dysfunction Treatments -Surgical or radio-surgical excisions -Surgical decompression if total excursion is not possible -Chemotherapy, radiation therapy, or a combination of both -BBB is an obstacle to delivering chemotherapeutic agents |
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Slow-growing, often encapsulated tumors arising from arachnoid (meningeal) cap cells in the dural coverings of the brain. |
Meningiomas |
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What are the clinical manifestations and treatment(s) of meningiomas? |
Clinical manifestations -Seizures Treatments -Surgical &/or radiotherapy |
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What are the most common tumors to metastasize? |
lung and breast |
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a long-term mental disorder of a type involving a breakdown in the relation between thought, emotion, and behavior, leading to faulty perception, inappropriate actions and feelings, withdrawal from reality and personal relationships into fantasy and delusion, and a sense of mental fragmentation.
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Schizophrenia *affects 1% of the population *tends to emerge in young adults |
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When looking at the brain of someone who is schizophrenic, what is different than that of a normal brain? |
-Enlargement of lateral and 3rd ventricles -Widening of frontal cortical fissures and sulci -Loss of cortical tissue -Alternations in brain dopamine pathways -Underactivations of glutamate receptors |
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Whats the importance of dopamine in relation to schizophrenia? |
There is increased dopamine and dopamine receptors in the brain of schizophrenics -Drugs that increase dopaminergic transmission (cocaine & amphetamine) produce schizophrenic-like psychosis. |
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What are the clinical manifestations of schizophrenia? |
-hallucinations -Delusions -Disorganized behavior -Disorganized speech: poverty of speech -Disorganized or bizarre behaviors -Disruptions in normal emotional states and expressions -Inability to perform daily tasks requiring attention and planning |
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Whats the treatment for Schizophrenia? |
-Conventional anti-psychotic medications -They block dopamine (ineffective in 20%) -Atypical anti-psychotic medications -Block a range of neurotransmitter receptors -treat a broader range of symptoms -Successful in 80-09% of people -Maintenance therapy shows a 30-50% relapse -A combination of pharmacotherpy and psychosocial treatments are the most successful. |
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______ brief emotional feelings. |
Affective states |
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What are the 2 different types of depression disorder? |
Unipolar -AKA major depression or clinical depression -Most common mood disorder; woman are more at risk Bipolar -Classifications: depression with mania (Bipolar I) or depression with hypomania (Bipolar II) -3-5% of the population |
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Whats the importance does the environmental influence of serotonin in relation to depression? |
-Individuals with 2 copies of the s allele are more likely to develop major depression and have suicidal thoughts. -Individuals who carry 2 s alleles risk major depressive episode twofold after experiencing 4 or more stressful events |
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What is the monoamine hypothesis? |
The monoamine hypothesis is a biological hypothesis stating that depression is caused by the underactivity in the brain of monoamines, such as dopamine, serotonin, and norepinephrine.
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Elevations in what hormone leads to mood disorders in 30-70% of patients? |
Glucocorticoid (Altered immune and inflammation from cortisol cause this) |
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What are the clinical manifestations of depression? |
-Unremitting feelings of sadness and despair -Dysphoric mood ( profound state of unease or dissatisfaction) -Insomnia, loss of appetite and body weight -Reduced interest in pleasurable activities and interpersonal relationships -Suicidal thoughts |
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What are the clinical manifestations of mania? |
-Elevated levels of euphoria, self-esteem, and feelings of grandiosity (refers to an unrealistic sense of superiority) and extreme levels of energy. -May show poor judgment in spending money, may become hypersexual, or may make poor business commitments. -Excessive, rapid and loud speech |
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What is the treatment(s) for depression? |
-Antidepressants -Psychotherapy -Combination of both -Electroconvulsive therapy (ECT) -Deep-Brain stimulation |
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What are the 3 major classifications of antidepressant medications? |
-Monoamine Oxidase inhibitors (MAOIs) -Tricyclic antidepressants (TCAs) -Selective serotonin re-uptake inhibitors (SSRIs) *All increase monoamine neurotransmitter levels within the synapse |
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What is the treatment(s) for bipolar? |
Bipolar I -Lithium: first line of therapy;must watch for toxicity -Anticonvulsant agents -Atypical anti-psychotic medications -ECT (Electroconvulsive therapy) -Psychotherapy Bipolar II -Antidepressants alone |
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a psychiatric disorder in which debilitating anxiety and fear arise frequently and without reasonable cause. Its characterized by intense autonomic arousal. |
Panic disorder |
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What are the clinical manifestations of panic disorder? |
-Lightheadedness -Racing heart -difficulty breathing -Chest discomfort -generalized sweating -general weakness -Trembling -Abnormal distress -Chills or hot flashes |
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What is a serve complication of panic disorder? |
Agoraphobia which can cause someone to be home bound |
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What is the treatment(s) for panic disorder? |
-Cognitive Behavioral Therapy (CBT) -Antidepressants (SSRIs, TCAs) -Can be both |
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What is generalized anxiety disorder? |
a psychological disorder characterized by excessive or disproportionate anxiety about several aspects of life, such as work, social relationships, or financial matters.
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What are the clinical manifestations of generalized anxiety disorder? |
-Motor disturbances -irritability -Fatigue -Norepinephrine ans serotonin abnormalities -Anticipatory anxiety and attentional bias to threats (Cingulate cortex and amygdala abnormalities) -GABA receptor alterations |
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What is the treatment(s) for generalized anxiety disorder? |
-Serotonin/norepinephrine (NE) re-uptake inhibitors -Behavioral therapy |
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What is PTSD? |
Post-traumatic stress disorder a condition of persistent mental and emotional stress occurring as a result of injury or severe psychological shock, typically involving disturbance of sleep and constant vivid recall of the experience, with dulled responses to others and to the outside world. *Pediatric: Generalized effect of trauma, caused reduction of total brain volume. |
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What parts of the brain does PTSD affect? |
-Amygdala -prefrontal cortex -Adults: Small hippocampus |
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What is the treatment(s) for PTSD? |
-Group or family therapy, CBT (Cognitive behavioral therapy) -First-line treatment for chronic PTSD: SSRIs (Selective serotonin re-uptake inhibitors) |
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What is obsessive-compulsive disorder? |
-Repetitive, intrusive thoughts &/or compulsions
-Obsession: Involve a preoccupation with contamination, doubting, religious or sexual themes, or the belief that a negative outcome will occur if a specific act is not performed. -Compulsions: Involve physical and mental ritualized acts. -Washing hands, checking, counting, organizing, hoarding, & repeating specific thoughts or prayers. |
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What is the brain abnormality of those with obsessive-compulsive disorder? |
they have basal ganglia-frontocorical circuitry abnormalities and a lack of serotonin control over the dopamine system. |
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What is the treatment(s) for obsessive-compulsive disorder? |
-SSRIs (Selective serotonin re-uptake inhibitors): First-line of pharmacotherapy -Neurosurgery-lesioning procedure (disconnect basal ganglia from frontal cortex) -If uncontrollable: Deep-brain stimulation |
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What are different dysfunctions of endocrine glands? |
-Inability to produce or obtain hormone precursor -Inability to convert precursors to the active hormone -Excessive or inadequate hormone production -Altered hormone inactivation or degradation (excessive hormones can be a cause of tumors) |
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What do receptor-associated hormone disorders do cells? |
-decrease the number of receptors -Impair receptor function -produce the presence of antibodies against specific receptors -Antibodies that mimic hormones can be produced (toxic goiter) |
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What do intracellular hormone disorders do to the cell? |
-Create an inadequate synthesis of a second messenger -Create an abnormal response to the second messenger |
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What is Syndrome of inappropriate antidiuretic hormone (SIADH) secretion? |
is defined by the hyponatremia and hypo-osmolality resulting from inappropriate, continued secretion or action of the hormone (ADH) despite normal or increased plasma volume (Hypervolemia), which results in impaired water excretion.
Ectopic secretion of ADH by tumors is the most common cause |
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What is the treatment for Syndrome of inappropriate antidiuretic hormone (SIADH) secretion? |
-Correction of underlying causal problem -Emergency correction using hypertonic saline -Fluid restriction between 800 & 1000 mL/day -Drugs to block ADH |
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This is an uncommon disorder characterized by intense thirst, despite the drinking of fluids (polydipsia), and the excretion of large amounts of urine (polyuria). In most cases, it's the result of your body not properly producing, storing or releasing a key hormone, but it can also occur when your kidneys are unable to respond properly to that hormone.
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Diabetes Inspidus Nurogenic reason: Body produces insufficient amounts of ADH. Nephrogenic reason: Insensitivity of the renal collecting tubules to ADH Dispogenic reason: Excessive fluid intake, lowering plasma osmolarity to the point that falls below the threshold for ADH secretion. |
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What are the clinical manifestations ans treatment for diabetes Insipidus? |
Clinical manifestations -Polyuria -Noturia -Continual thirst -hypernatremia Treatment -Neurogenic treatment: Synthetic vasopressin (a pituitary hormone that acts to promote the retention of water by the kidneys and increase blood pressure). -Nephrogenic treatment: Correction of electrolyte disorders; administration of drugs to improve salt and water resorption -Dispogenic: Management of water retention |
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diminished hormone secretion by the pituitary gland, causing dwarfism in children and premature aging in adults.
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Hypopituitarism Pituitary is vascular and vulnerable to ischemia. and infarction. |
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What causes hypopituitarism and how is it treated? |
Causes -inadequate supply of hypothalmic-releasing hormones -Damage to the pituitary stalk -Pituitary infarction -Tumor or surgical removal Treatment -Replace the deficient hormone |
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What hormones can be affected with Hypopituiatrism? And what are their characteristic symptoms? |
-Adrenocorticotropic hormone (ACH) deficiency -Cortisol deficiency -Thyroid-stimulating hormone (TSH) deficiency -Altered metabolism -Follicle stimulating hormone (FSH) And luteinizing hormone (LH) deficiency -Lack of secondary sex characteristics -Growth hormone (GH) deficiency -Lack of GH in children -Panhypopituitarism (all hormones are affected) |
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_______is a condition due to the primary hypersecretion of pituitary hormones, it typically results from a pituitary adenoma.
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Hyperpituitarism |
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What are the clinical manifestations and treatments for hyperpituitarisum? |
Clinical manifestations -Headache and fatigue -Visual changes -Hypersecretion of pituitary cells from tumor -Hyposectrion of neighboring anterior pituitary hormones Treatment -Surgery and radiation therapy -Hormone regulation: Control hypersecretion or replace deficient hormone |
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What is gigantism? |
Hypersecretion of growth hormone in children and adolescents. |
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Whats acromegaly? |
abnormal growth of the hands, feet, and face (bony and tissue proliferation) in adulthood, caused by overproduction of growth hormone by the pituitary gland or a slow progressive pituitary adenoma.
People show CNS symptoms: Headache, seizure activity, visual disturbances. Other symptoms: hypertension, atherosclerosis, cardiac hypertrophy. |
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What are the treatments for acromegaly? |
-Surgery and radiation therapy -GH antagonist and GH receptor blockers |
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What causes hypersecretion of prolactine? |
Caused by prolactinomas -most common hormonally active tumor |
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What are the clinical manifestations of prolactine? and what are the treatments? |
Clinical manifestations -Men: hypogonadism, erectile dysfunction -Woman: Amenorrhea, glactorrhea, hirtism, and osteoporosis Treatment -Dopaminergic agonists -Surgery and radiotherapy |
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Hyperthyroidism is also known as______ |
Thyrotoxicosis *excess amount of thyroid hormone released from the thyroid gland |
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What are the clinical manifestations and treatment(s) for hyperthyroidism? |
Clinical manifestations -increased metabolic rate -increased tissue sensitivity to stimulation by the sympathetic nervous system -Enlargement of they thyroid (goiter) Treatment -Antithyroid drugs -Radioactive iodine therapy -Surgery |
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What is Graves disease? |
a swelling of the neck and protrusion of the eyes resulting from an overactive thyroid gland (autoimmune disorder).
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What are the clinical manifestations an treatments for graves disease? |
Clinical manifestations -Exophthalomas (abnormal protrusion of the eyeball or eyeballs) and diplpia (double vision). -Peritibal myxedema (Graves dermopathy): Leg swelling Treatment -Antithyroid drugs, radioactive iodine, or surgery -Does not reverse opthalmopathy or pretibial myxedema |
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What are the 3 different categories of hypothyroidism? |
Primary hyperthyroidism -iodine deficiency (endemic goiter): most common -Autoimmune thyroditis (Hashimoto disease) -Postpartum throiditid Congenital hypothyroidism -thyroid hormone deficiency present at birth -if not treated, cretinism develops -Administration of T4 Thyroid carcinoma -tumor growth may impinge on the trachea or esophagus -some may have normal T3 & T4 levels |
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What are the clinical manifestations and treatment(s) for hypothyroidism? |
Clinical manifestations -Low basal metabolic rate -cold intolerance -lethargy -tiredness -slightly lowered basal body temperature -myxedema (nonpitting, boggy edema, especially around the eyes, hands, and feet; thickening of the tongue) Treatment -Synthetic hormone |
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What are the 2 different categories of hyperparathyroidism? |
Primary hyperthyroidism -Excess secretion of PTH and hypercalcemia -80%-85% caused by parathyroid ademomas Secondary hyperparathyroidism -Increase in PTH, secondary to a chronic disease -chronic renal failure -Dietary deficiency of vit D, calcium -Hypercalcemia |
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What are the clinical manifestations and treatments of hyperparathyroidism? |
Clinical manifestations -Most asymptomatic -Hypercalcemia and hyopophosphatemia, possible kidney stones, pathologic fractures -Secondary:low serum calcium but elevated PTH Treatment -Surery, bisphosphonates, corticosteroids, and calcinimetics |
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What is hypoparathyroidism? |
diminished concentration of parathyroid hormone in the blood, which causes deficiencies of calcium and phosphorus compounds in the blood and results in muscular spasms.
Usual causes: Parathyroid damage in thyroid surgery, autoimmunity, or genetic mechanisms. |
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What are the clinical manifestations and treatment(s) of hypoparathyroidism |
Clinical manifestations -Hypocalcemia -lowering of the threshhold for nerve and muscle excitations -Muscle spasms; hperreflexia;tonic-clonic convulsions;laryngeal spasms; death from asphyxation Treatment -Calcium & vit D |
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How is diabetes diagnosed? |
-Fasting plasma glucose (FPG) levels -2-hour plasma glucose during oral glucose tolerance testing (OGTT) |
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This is a chronic condition in which the pancreas produces little or no insulin, a hormone needed to allow sugar (glucose) to enter cells to produce energy.
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Type 1 diabetes mellitus |
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What are the 2 types of Type 1 diabetes? |
Autoimmune -loss of insulin production and a relative excess of glucagon contributes to hyperglycemia. Nonimmune -Occurs secondary to other diseases, such as pancreatitis. |
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What are the clinical manifestations and treatment(s) of type 1 diabetes? |
Clinical manifestations -polydispsia -Polyuria -polphagia -weight loss -fatigue Treatment -Combination of insulin -Meal planning -Exercise -Self-monitoring of glucose -Transplant: islet cells and whole pancreas |
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You get this when your body does not use insulin properly. This is called insulin resistance. At first, your pancreas makes extra insulin to make up for it. Beta cell mass is decreased and glucagon increases hepatic production(pancreatic alpha cells are less responsive to glucose inhibition).
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Type 2 diabetes mellitus |
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What puts a person at risk for Type 2 diabetes mellitus? |
-Genetic predisposition (Family history) -Age -Obesity -Physical inactivity |
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What are the clinical manifestations and treatment(s) for type 2 diabetes mellitus? |
Clinical Manifestations -Fatigue -Pruritus (severe itching of the skin) -recurrent infections -visual changes -symptoms of neuropathy (parethesia (an abnormal sensation, typically tingling or pricking (“pins and needles”), caused chiefly by pressure on or damage to peripheral nerves)or weakness). Treatment -Exercise -Diet -Treatment of obesity -Oral hypoglycemics -Bariatric surgery |
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What is hypoglycemia? |
-deficiency of glucose in the bloodstream.
-less than 45-60 mg/dl -AKA insulin shock or insulin reaction |
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What are the clinical manifestations and treatment(s) of hypoglycemia? |
Clinical manifestations -Tachycardia -Palpitations -Diaphoresis (sweating) -Tremors -Pallor -Anxiety Treatment -Glucose (15g-20g) |
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_______is a serious complication of diabetes that occurs when your body produces high levels of blood acids called ketones, and increases fat mobilization with the release of fatty acids.
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Diabetes Katacidosis (DKA) |
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What are the clinical manifestations and treatment(s) for Diabetes Katacidosis (DKA)? |
Clinical manifestations -Polyuria -Dehydration -Kussmaul respirations (Air hunger, or the rapid, deep, and labored breathing) -Sweet or "fruity" breath odor -Serum glucose levels >250 mg/dl Treatments -Administration of insulin -Fluids |
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This is the term used to describe an abnormal early-morning increase in blood sugar (glucose) — usually between 2 and 8 a.m. — in people with diabetes.
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Dawn phenomenon -Related to nocturnal GH elevation |
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What is the treatment for Dawn phenomenon? |
Alter timing and dose of insulin |
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What are the 3 microvascular diseases related to Diabetes mellitus? |
Diabetic retinopathy -damage occurs to the retina due to diabetes -Diabetic Nephronpathy -Glomerular enlargement, glomerular basement membrane thickening -Diabetic neuropathies -Is the most common complication of diabetes -Sensory deficits generally precede motor involvement -Axonal and schwann cell degeneration |
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What are macrovascular diseases? And what are macrovascular diseases related to diabetes mellitus (DKA)? |
macrovascular diseases
-lesions develop in large- and medium- sized arteries from hyperglycemia -Promotes inflammation, endothelial and muscle dysfunction, and hyperlipidemia -Is a consequence of accelerated atherosclerosis, hypertension, and increased risk for thrombus formation Macrovascular diseases related to DKA -Coronary artery disease -Can result in myocardial infarction -Stroke -Is twice as common in those with diabetes (especially type 2) -Peripheral arterial disease -Occlusions, ulcers, and gangrenous changes of the lower extremities occur. |
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Whats the difference between cushing syndrome, cushing disease, and cushing-like syndrome? |
Cushing syndrome: Chronic excessive cortisol level, regardless of cause. Cushing disease: Over production of pituitary ACTH by a pituitary adenoma Cushing-like Syndrome: Exogenous administration of glucocorticosteroids. |
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What are the clinical manifestations and treatment(s) of Chusingism? |
Manifestations -Weight gain of adipose tissue in the trunk, facial, and cervical areas ("moon face" & "buffalo hump") Sodium and water retention, glucose intolerance, protein wasting -Bronze or brownish hyperpigmentation of the skin |
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This is an excessive aldosterone secretion by the adrenal cortex. |
Hyperaldosteronism |
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What are the 2 categories of hypersldosteronism? |
Primary Aldosteronism -Aldosterone-producing adrenal adenoma Secondary Aldoseronism -Most often antiotensin II, through a renin-dependent mechanism. |
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What dose the hypersecretion of estrogen lead to? |
-Leads to feminization and development of female sex characteristics. -Leads to early development of secondary sex characteristics in female children. -Most evident in men and results in gynecomastia (breast enlargement), testicular atrophy, and decreased libido. |
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What does hypersection of androgens lead to? |
-Leads to virilization (maleization of female) and the development of male sex characteristics -Causes hirsuism, clitorial enlargement, deepening of the voice, amenorrhea, acne, and breast atrophy in women. -Virilizing tumors promote precocious sexual development. -Treatment: Surgical excision |
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This is a rare, chronic autoimmune, endocrine system disorder in which the adrenal glands do not produce sufficient steroid hormones (glucocorticoids and mineralocorticoids) and have an elevated ACTH.
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Addisons disease |
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What are the clinical manifesations and treatment(s) of addisons disease? |
Clinical manifestations -Hypocortisolism and hypoaldosteronism -Weakness, hyperpigmentation Treatment -Glucocorticoid and mineralocorticoid replacement. |
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is when a person who is genetically male (who has one X and one Y chromosome) is resistant to male hormones. As a result, the person has some or all of the physical traits of a woman, but the genetic makeup of a man.
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Androgen insensitivity *Female phenotype, male genotype -Absence of cervix, uterus and ovaries -Testes palpable in the libia majoria |
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A patient is given the diagnosis of delayed puberty when they do not show secondary sex characteristics or menarche (periods) by what age? |
13 in girls, 14 in boys -Menarche by 15 or 16 -95% are caused physiological reasons (delay due to hormone levels) -5% are due to some kind of disruption of the hypothalamic-pituitary-gonadal axis. |
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What is the treatment for those with delayed puberty? |
Hormonal replacements |
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This refers to the appearance of physical and hormonal signs of pubertal development at an earlier age than is considered normal.
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Precocious puberty |
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Showing signs of puberty at what age in considered to be precocious puberty? What is the treatment? |
-Sexual maturation before 6 in black girls and 7 in Caucasian girls (1 in 10,000). -Sexual maturation before age 9 in boys (1 in 50,000) Treatment -Potent GnRH-agonist analogs |
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What are the 2 categories of precocious puberty? |
Central (GnRH dependent) -Normal but premature working of of the HPG axis Peripheral (GnRH independent) -Sex hormone produced by mechanism other than stimulation by the gonadotropins |
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painful menstruation, typically involving abdominal cramps.
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Dysmenorrhea Primary dysmenorrhea -Painful menstruation associated with prostaglandin release in ovulatory cycles (most ppl grow out of it). Secondary dysmenorrhea -Painful mensuration related to pelvic pathological conditions (eg. ovarian cysts, endomentriosis) occurring later in life. |
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What are the treatments for abnormal uterine bleeding? |
-NSAIDs (Non-steroidal Anti-inflammataory Drugs) -Oral contraceptives |
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What is polycystic syndrome? |
-androgen-excess disorder (hyperandrodism) -Dysfunction of follicle development -Leading cause of infertility in USA -Multifactorial -Hyperandrogenic state and hperinsulinism |
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What are the clinical manifestations and treatment(s) for polycystic syndrome? |
Clinical Manifestations -Dysfunction bleeding (amenorrhea) -Hirsutism -Acne -Infertility Treatment -Oral contraceptives -Antiandrogens -Fertility agents -Weight loss |
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This has a wide variety of symptoms, including mood swings, tender breasts, food cravings, fatigue, irritability and depression. It's estimated that as many as 3 of every 4 menstruating women have experienced some form of this.
Symptoms tend to recur in a predictable pattern. But the physical and emotional changes you experience with premenstrual syndrome may vary from just slightly noticeable all the way to intense. |
Premenstrual syndrome (PMS) |
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Whats the treatment for PMS? |
-Hormonal cycle regulation -Use of selective serotonin-uptake inhibitors (SSRIs) -Antidepressants -Counseling |
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What is pelvic inflammatory disease (PID)? |
Acute inflammation of upper reproductive tract. -Salpingitis: Inflammation of the fallopian tubes -Oophoritis: Inflamation of the ovaries -STIs migrate from the vagina to the upper genital tract (gonorrhea and chlamydia). |
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What are the clinical manifestations and treatment(s) of pelvic inflammatory disease (PID)? |
Clinical manifestations -Sudden, severe abdominal pain with fever or no symptoms Treatment -Antibiotics Complications -Infertility -ectopic pregnancies |
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This is an infection of the vagina usually caused by sexually transmitted pathogens. |
Vaginitis |
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What are the clinical manifestations and treatment(s) of vaginitis? |
Clinical manifestations -Copious (lots), malodorous, or Irritating discharge Treatment -Maintain acidic environment and relieve symptoms (usually pruritius (severe itching)) -Administer antimicrobial or antifungal medication -Administer probiotic supplements |
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Inflammation of the cervix |
Cervicites -Mucopurulent cervicitis (MPC) -is caused by one or more sexually transmitted pathogens |
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What causes vulvitis? |
-Contact with soaps, detergents, lotions, menstrual pads, perfumed toilet paper, or non-absorbing or tight fitting clothing. -Vaginal infections that spread to the libia |
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inflammation of one or both of the two Bartholin's glands, which are located one on either side of the opening of the vagina, behind the labia. The inflammation narrows the distal portions of the ducts.
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Bartholinitis or Bartholin cyst Caused by microorganisms that infect the lower female reproductive tract. |
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What are the clinical manifestations and treatment(s) of Bartholinitis or Bartholin cyst? |
Clinical manifestations -Cysts may be reddened and painful with puss at the opening. Treatment -Administer broad-spectrum antibiotics and drain the cyst. |
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What are the causes of pelvic organ prolapse? |
-Childbirth -Pelvic surgery -Damage to pelvic nerves |
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What is uterine prolapse? |
When the cervix or uterus descends into the vaginal canal. |
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This is a medical condition that occurs when the tough fibrous wall between a woman's bladder and her vagina (the pubocervical fascia) is torn by childbirth, allowing the bladder to herniate into the vagina.
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Cystocele |
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What is rectocele? |
a prolapse of the wall between the rectum and the vagina.
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What is enterocele? |
herniation of the peritoneal sac between the vagina and the rectum. Unlike other types of pelvic organ prolapse,enterocele is a true herniation with a peritoneal sac containing small bowel or sigmoid colon
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What is the treatment for enterocele? |
-Kegel exercises -Maintain a healthy BMI -Surgical reapir |
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What are benign ovarian cysts? |
-are non-cancerous fluid-filled sacs or pockets within or on the surface of an ovary (unilateral). -Are produced when follicle(s) are stimulated but no dominant follicle develops to reach maturity. |
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These are abnormal growths (teratoma) containing epidermis, hair follicles, and sebaceous glands, derived from residual embryonic cells.
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dermoid cycts |
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What is an endometrial polyp? What is the treatment? |
-Its a benign mass of endometrial tissue. -Contains a variable amount of glands, stoma, and blood vessels. -its the common cause of intermenstrual or excessive menstrual bleeding. -Malignancy is rare Treatment -polpectomy: the removal of the poly |
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This is a benign smooth muscle neoplasm that very rarely becomes cancer (0.1%). They are common and can occur in any organ, but the most common forms occur in the uterus, small bowel, and the esophagus. |
Leiomyomas (myomas or uterine fibroids) Risk factors -Nullipartity (never being pregnant), obesity, polycystic ovary syndrome, diabetes mellitus, African-American race, hypertension |
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What are the clinical manifestations and treatment(s) for leiomyomas? |
Clinical manifestations -Abnormal uterine bleeding, pain Treatments -Surgery: myomectomy -Selective estrogen-receptor modulators, gonadotropin-releasing hormone agonists, progesterone-receptor agonists |
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What is endometriosis? |
-a condition resulting from the appearance of endometrial tissue outside the uterus and causing pelvic pain.
-Responds to hormone fluctuations of the menstrual cycle. -Possible causes: -Retrograde menstruation, endometrail cells spread through vascular or lymphatic systems, immune cells tolerate ectopic tissue |
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What are the clinical manifestations and treatment(s) for endometriosis? |
Clinical manifestations -Infertility -Pain -Dysmenorrhea -Dyschezia (pain on defecation) -Dyspareunia (pain on intercourse) Treatment -Oral contraceptives suppresses ovulation -GnRG agonists -Anti-progestational steroid -Surgical removal |
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This is a type of cancer that occurs in the cells of the cervix
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Cervical cancer |
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What is generally a precursor of invasive carcinoma of the cervix? |
-Cervical carcinoma in situ (in place) |
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Cervical cancer is almost exclusively caused by what? |
HPV infection |
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What is the treatment for cervical cancer? |
-Surgery, chemotherapy and radiation -Early detection (Pap smear) and treatment: excellent prognosis |
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This is the rarest form of cancer that starts as intraepithelial lesions and occurs in sexually active women; its associated with HPV infections and tends to be asymptomatic until farly late stages? |
Vaginal cancer Risk factors: -utero diethlstilbestrol (DES) exposure -Prior or concurrent cervical cancer |
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What is vulvar cancer? |
its a rare disease in which malignant (cancer) cells form in the tissues of the vulva. Having vulvar intraepithelial neoplasia or HPV infection can affect the risk of vulvar cancer.
-Other risk factors include smoking and HIV infections |
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What are the clinical manifestations for vulvar cancer? |
Clinical manifestations -Chronic vulvar irritation -Pruitis -Bloody discharge -Hard, ulcerated area of the vulva Peak incidence -Postmenopausal women, but younger woman can be affected |
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What is endomentrial cancer? |
Endometrial cancer is a type of cancer that begins in the uterus. Endometrial cancer begins in the layer of cells that form the lining (endometrium) of the uterus.
Risk factors -Unstoppable estrogen exposure, obesity, infertility, failure to ovulate, early menarche or late menopause. -Oral contraception use protects against endometrial and ovarian cancers |
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What are the clinical manifestations and treatment(s) of ovarian cancer? |
Clinical manifestations -Vague and include persistent abdominal distention, loss of appetite as a result of early satiety (a feeling or condition of being full after eating food) and pelvic pain. Treatments -Surgery, radiation, and chemotherapy |
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The inability to conceive after how long is considered infertility? |
1 year *the most common cause include ovulatory factors and tubular blockage |
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What is the treatment for infertility? |
-Ovulation-inducing drugs -assisted reproductive technologies |
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What is the treatment for proliferating breast lesions with atypia? |
-Avoid hormone therapy and oral contraceptives -Decrease caffeine -Increase iodine and omega-3 fatty acids -Exercise |
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This is the most common cancer among american woman and the second most killer after lung cancer? |
Breast cancer |
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What are the risk factors of breast cancer? |
-Younger age of first child decreases the risk of breast cancer -reduced risk in parous(bearing offspring) women, compared to nulliparous women. -Involution (the shrinkage of an organ in old age or when inactive, e.g., of the uterus after childbirth) is associated with reduced risk of breast cancer. -Extensive breast density: is one of the strongest risk factors for developing breast cancer and is second only to age and carrying BRACA1 or BRACA2 mutation. -Radiation, chemicals, weight, alcohol: increase risk -Diet: Fiber, iodine, and soy decrease risk -Physical activity decreases risk -breast cancer in first degree relatives (mother or sister) increase woman's risk 2-3x -BRACA1 and BRACA2 genes |
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This is the presence of abnormal cells inside a milk duct in the breast. Its considered the earliest form of breast cancer. Its noninvasive, meaning it hasn't spread out of the milk duct to invade other parts of the breast.
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Ductual carcinoma in situ (DCIS) |
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What is lobular carcinoma in situ? |
is an uncommon condition in which abnormal cells form in the lobules or milk glands in the breast. LCIS isn't cancer. But being diagnosed with LCIS indicates that you have an increased risk of developing breast cancer.
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What is lobular neoplasia? |
-its atypical lobular hyperplasia -The term ‘lobular neoplasia’ describes a range of changes within the breast lobules including atypical lobular hyperplasia (ALH) and lobular carcinoma in situ (LCIS). In situ means the changes only occur in the breast lobules and do not affect the surrounding tissue. |
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What are the clincial manifestations and treatment(s) for breast cancer? |
Clinical manifestations -Painless lumps -Palpable lymph nodes in the axilla -Dimpling of the skin, nipple, and skins retractions, nipple discharge, ulcerations, reddened skin. Treatment -Based on extent or stage -Surgery, radiation, chemotherapy, hormone therepy |
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What is urethritis? |
-inflammation of the urethra
-Usually caused by STDs -Non sexual origins can be the result of urologic procedures, foreign objects, anatomic abnormalities, or trauma. |
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What are the clinical manifestations and treatments for urethritis? |
Clinical manifestations -Dysuria (pain or burning) on urination -increased frequency an urgency on urination -Purulent (pussy) or clear, mucus-like discharge from the urethra Treatment -Antibiotic therapy for infectious urethritis and the avoidance of future chemical or mechanical irritation. |
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What are the clinical manifestations and treatments of urethral structure disorders? |
(urethral structure disorders; fibrotic narrowing of urethra caused by scaring. Can be due to trauma or untreated urethral infections) Clinical manifestations -Caused by bladder outlet obstruction (diminished urinary stream post-voiding dribbling) Treatment -Surgery; may involve urethral dilation or urethrotomy. |
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a congenital narrowing of the opening of the foreskin so that it cannot be retracted.
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Phimosis Treatment: Circumcision |
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Define Paraphimosis |
Paraphimosis is a urologic emergency in which the retracted foreskin of an uncircumcised male cannot be returned to its normal anatomic position. It can cause edema of the glans penis.
Treatment: Surgery |
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persistent and painful erection of the penis.
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Priapism -usually associated with spinal cored trauma, pelvic tumors or infections, or penile trauma in 40% of cases. |
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What are the treatments for pirapism? |
-Iced saline enemas -Spinal anesthesia -Needle aspiration of blood from the corpus, catherization and pressure dressing to maintain decompression. -Vascular shunts to maintain blood flow |
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This is an inflammation of the glans (the rounded head) of the penis. Posthitis is inflammation of the foreskin. The foreskin is the loose skin that covers the head of the penis if the male has not been circumcised.
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balanitis Treatment: Antimicrobial agents to treat infection; possibly circumcision. |
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this is a malignant growth found on the skin or in the tissues of the penis
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Penile cancer (rare) -Mostly squamous cells -Risk factors: HIV, smoking -Often diagnosed in men older than 55 years of age -High incidence in uncircumcised men -Treatment: Surgery, radiation, chemotherapy |
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a mass of varicose veins (inflamed and dilated) in the spermatic cord.
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Vericocele ("Bag of worms") -Causes: inadequate or absent valves in the spermatic veins |
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What is the treatment for vericocele? |
-Ligation (the surgical procedure of closing off a blood vessel or other duct or tube in the body by means of a ligature or clip) of the spermatic vein or occlusion of the vein by a balloon catheter and sclerosing fluids. -Scrotal support: If disorder is mild and not an issue. |
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is a fluid-filled sac surrounding a testicle that causes swelling in the scrotum.
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scrotal hydrocele -imbalances between fluid secretion and reaborption |
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What is the treatment for scrotal hydrocele? |
-Treatment is only required if disorder causes considerable physical discomfort. -Aspiration of the fluid and injection of a sclerosing agent |
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This is an abnormal sac (cyst) that develops in the epididymis. Non-cancerous and generally painless, this is usually filled with milky or clear fluid that might contain sperm.
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Spermatocele Treatment: None or excised or scrotal support |
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What is cryptorchidism? Whats the treatment? |
a condition in which one or both of the testes fail to descend from the abdomen into the scrotum.
-Complications: Testicular cancer; if untreated, infertility Treatment -Hormones or surgery |
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What are ectopic testis? |
testis that has strayed from the normal pathway of descent.
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is the twisting of the spermatic cord, which supports the testes in the scrotum. When this occurs, blood supply is cut off to the testicles and nearby tissue in the scrotum. This causes painful and swollen testis.
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Torsion of the testis -May be spontaneous or follow physical exertions or trauma -tends to be a medical emergency |
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What is the treatment for testicular torsion? |
-If torsion cannot be reduced manually, then surgery must be performed within 6 hours after the onset of symptoms to preserve normal testicular function. |
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This is the acute infection of the testis. It tends to be a complication of a systemic disease (mumps) or related to epidymitis. |
Orchitis |
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What is the treatment for orchitis? |
-Antimicrobial drugs for bacterial orchitis -Corticosteroids for nonspecific granulomatous orchitis (autoimmune inflammatory disease in middle-aged men) |
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What are the treatments and risk factors for testicular cancer? |
Treatment -Surgery -radiation and chemotherapy Risk factors -High androgen levels, genetic predisposition -History of cryptorchidism, trauma |
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This is among the most curable cancers. Its common between men 15 and 35 years of age and causes painless testicular enlargements. |
Cancer of the testis |
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This is an inflammation of the coiled tube (epididymis) at the back of the testicle that stores and carries sperm. Males of any age can get this. It is most often caused by a bacterial infection, including sexually transmitted infections (STIs), such as gonorrhea or chlamydia.
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Epididymitis |
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What are the main symptoms and treatments of epididymis? |
Main symptoms -Pain -The prehn sign (elevation of the scrotum) Treatment -Antibiotics -Analgesics -Ice -Scrotal elevation |
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What is benign prostatic hyperplasia (or hypertrophy)? |
Its an enlarged prostate gland . The prostate gland surrounds the urethra, the tube that carries urine from the bladder out of the body. As the prostate gets bigger, it may squeeze or partly block the urethra. Its related to age.
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What are they symptoms associated with benign prostatic hyperplasia, as well as the evaluation of it and the treatment? |
Symptoms -Urge to urinate often -Decreased force of the urinary stream Evaluation -Digital rectal examinations -Prostate-specific antigen (PSA) monitoring Treatment -Drugs -Minimally invasive therapies -Surgery |
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The inflammation of the prostate gland.
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Prostitis **Bacterial infection: ascending infection of the urinary tract |
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What are the clinical manifestations and treatments for prostitis? |
Clinical manifestations -Signs of inflammation Treatment -Antibiotics -NSAIDs |
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What are the treatments for prostate cancer? |
Surgical treatments -Total prostatectomy -Transurethral resection of the prostate (TURP) Nonsurgical treatments -Radiation therapy -Hormone therapy -Chemotherapy |
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What causes man sexual dysfunction? |
-Physical or psychologic factors that impairs erection, emission, or ejaculation. -Vascular -Endocrine-reduce testosterone production -Neurological disorders -Chronic diseases -Renal failure and diabetes mellitus -Penile trauma-damage to erectile tissue, arteries or nerves. -Latrogenic factors -Surgery and pharmaceuticals |
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What causes impaired spermatogenesis? |
-Disruptions of the HPG axis that reduces testosterone secretion -Testicular trauma or atrophy |
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What causes impaired sperm production? |
-Neoplasmic disease -Cryptorchidism -Any factor that causes testicular temperature to rise (temporary infertility) |
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What causes impaired sperm quality? |
-Chromosomal abnormalities resulting from genetic factors, irradiation, or toxins |
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What is gynecomastia? |
-Over development of the breast tissue in a man (common in adolescent boys that are over weight) -Incidence greatest among adolescents and men over 50 (Andropause). -May develop breast cancer |
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What causes gyecomastia and whats the treatment? |
Causes -results from hormone alterations -High estrogen or low testosterone Treatment -Usually resolves itself in adolescents -Man should be taught to perform breast self-examination |
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Whats the difference between leukocytosis and leukopenia? |
Leukocytosis -White blood cell counts are higher than normal -Is a normal protective physiologic response to stressors or to the invasion of microorganisms. -Can be pathological Leukopenia -White blood cell counts are lower that normal -Is always abnormal -Low white blood cell (WBC) count predisposes a person to infections. |
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is the presence in peripheral blood of an increased number of granulocytes, a category of white blood cells. Often, the word refers to an increased neutrophil granulocyte count, as neutrophils are the main granulocytes. |
Granulocytosis (neutrophilia) Is evident in the first stages of infection or inflammation. |
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This is the presence of abnormally few neutrophils in the blood, leading to increased susceptibility to infection. It is an undesirable side effect of some cancer treatments.
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Neutropenia Primary -Congenital immunodeficiency diseases -Acquired anemia (bone marrow), leukemias, lymphomas Secondary -Other disorders (E.g., immune disorders and drugs) |
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What is granulocytopenia (agranulocytosis) and what causes it? |
A marked decrease in the number of granulocytes.
Causes -Interference with hematopoiesis -Immune mechanisms -Chemotherapy destruction -Ionizing radiation ----Can result in recurrent and persistent life threatening infections (Particularly of the respiratory system) ----Sepsis, caused by agranulocytosis, often results in death within 3-6 days |
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This is an increase in the number of eosinophils in the blood, occurring in response to some allergens, drugs, and parasites, and in some types of leukemia.
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Eosinopilia |
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What is eosinopenia? |
This is a form of agranulocytosis where the number of eosinophil granulocytes is lower than expected.
Primary cause: Migration of cells to inflammatory sites Other causes: Shock, trauma, burns |
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_____means too many cells, while _______means too few cells. |
Polycythemias, amemias |
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This is a condition marked by a deficiency of red blood cells (erythrocytes) or of hemoglobin in the blood, resulting in pallor and weariness.
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Amemia -Can be acute or chronic blood loss |
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How are different types of anemia's classified? |
by... -Etiologic factor (cause) -Size: "-cytic" -Macrocytic (large), microcytic (small), normocytic (normal) -Hemoglobin content: "-chromic" -Normochromic (normal amount), hypochromic (decreased) |
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What are the clinical manifestations and treatment(s) for anemia? |
Clinical manifestations -Reduced oxygen-carrying capacity:Hypoxia -Syncope (fainting when you stand up), angina (pain in the chest), compensatory tachycardia, and organ dysfuntion. -Classic anemia symptoms; -Fatigue, weakness, dyspnea, elevated heart rate, and pallor Treatment -Transfusion, dietary correction, and administration of supplemental vitamins or irons |
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What is pernicious anemia? |
-This occurs when the body cant absorb enough vitamin B12. -The body lacks the intrinsic factor from the gastric parietal disorder. -This is the most common macrocytic anemia. -Conditions that increase the risks include: -Past infection with Helicobacter pylori -Gastrectomy |
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What is the treatment for pernicous anemia? |
-Parenteral or high doses of vit B12 are administered -If left untreated, death will result -Life-long treatment is required |
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Define microcytic-hypochromic anemia.And what causes it? |
-Are characterized by RBCs that are abnormally small and contain reduced amounts of hemoglobin Causes -Disorders of iron metabolism -Disorders of porphyrin and heme synthesis -Disorder of globin synthesis |
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This a condition in which blood lacks adequate healthy red blood cells. Red blood cells carry oxygen to the body's tissues. As the name implies, this type of anemia is due to insufficient iron.
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Iron-deficiency anemia Highest risk: Older adults, women, infants, and those living in poverty. -associated with cognitive impairment in children |
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What causes Iron-deficiency anemia? |
-Inadequte dietary intake -Excessive blood loss -Chronic parasite infections -Metabolic or functional iron deficiency -Menorrhagia (excessive bleeding during menstruation) |
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This is a deficiency of all types of blood cells caused by failure of bone marrow development.
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Pancytopenia |
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What is Pure RBC aplasia? |
Aplastic anemia when only RBCs are affected |
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What is the pathophysiology of aplastic anemia? |
Hypocellular bone marrow that has been replaced with fat -Most aplastic anemia's are autoimmune disorders; some are due to chemical exposure |
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What are the clinical manifestations, evaluation techniques and treatment(s) for aplastic anemia? |
Clinical manifestations -Hypoxia, pallor -Weakness, fever and dyspnea with hemorrhaging if platelets are affected Evaluation -Bone marrow biopsy Treatment -Bone marrow transplantation -Peripheral blood stem transplantation -May receive radiation or chemotherapy before procedure -Immunosupression -Cortiocosteroidial medications -If not treated or identified, death occurs. |
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What is posthemorrhagic anemia? |
Its a condition in which a person quickly (acute) loses a large volume of circulating hemoglobin.
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What are the clinical manifestations and treatment(s) for posthemorragic anemia? |
Clinical manifestations -Depends on the severity of the blood loss Treatment -Intravenous administration of saline, dextran, albumin, or plasma -Large volume losses: fresh whole blood |
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This is a condition in which red blood cells are destroyed and removed from the bloodstream before their normal lifespan is over. This can either be drug induced or due to autoimmunity.
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Hemolytic anemia Drug-induced -Usually the result of an allergic reaction against a foreign antigen -Called the hapten model -Penicillin, cephalosporins (more than 90%), hrdrocortisone Autoimmune -Auto-antibodies against antigens normally on the surface of erythrocytes |
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What are the clinical manifestations, evaluation techniques and treatment(s) for hemolytic anemia? |
Clinical manifestations -May be asymptomatic -Jaundice -Spenomegaly Evaluation -Bone marrow: abnormally increased numbers of erythrocyte stem cells (erythroids hyperplasia) Treatment -Removal of the cause or treatment of the underlying disorder -Corticosteroids, may require splenectomy |
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Define polycythemia |
-Overproduction of RBCs -Result of dehydration (temporary situation) -Fluid loss results in relative increases of RBC counts and hemoglobin and hematocrit values. -Resolves with fluid intake |
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What is iron overload? |
-Common inherited, autosomal recessive disorder of iron metabolism -Characterized by increased gastrointestinal iron absorption with subsequent tissue iron deposition -Excess iron deposition in the liver, pancreas, heart, joints, and endocrine glands, causing tissue damage. |
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What are the clinical manifestations and treatment(s) for iron overload? |
Clinical manifestations -Fatigue, malaise (a general feeling of discomfort, illness, or uneasiness whose exact cause is difficult to identify) -Abdominal pain, arthralgias (joint pain), and impotence -Hepatomegaly, abnormal liver enzymes, bronzed skin, diabetes, and cardiomegaly Treatment -Phlebotomy (the surgical opening or puncture of a vein in order to withdraw blood or introduce a fluid, or (historically) as part of the procedure of letting blood.) -Refrain from taking iron and vit C supplements |
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What's the difference between basophilia and basopenia?
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Basophilia -Circulating numbers of basophils increase. -Ocurs in inflammation and hypersensitivity reactions. -Contains histamine that is released in allergenic reactions. Basopenia -Circulating numbers of basophils decrease. -Occurs in acute infections, hyperthyroidism, and long-term steroid therapy. |
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Whats the difference between monocytosis and monocytopenia?
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Monocytosis -Numbers of circulating monocytes increase. -Usually occurs with neutropenia in later stages of bacterial infections. -Found in chronic infections and correlates with extent of myocardial damage. Monocytopenia -Number of circulating monocytes decrease. -Very little is known about this condition. -Prednisone treatments -Hairy cell leukemia |
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Whats the difference between lymphocytosis and lymphocytopenia? |
Lymphocytosis -Circulating lymphocytes increase -Occurs from acute viral infections -Epstein-Barr virus (EBV) -Other causes -Leukemia, lymphomas, some chronic infections Lymphocytopenia -Circulating lymphocyte counts decrease -Occurs from immune deficiencies, drug destruction, viral destruction, radiation, or acquired immunodeficiency syndrome (AIDS) |
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What is infectious mononucleosis? |
-Often called the kissing disease due to its mode of transmission (through saliva) -Its an acute, self-limiting viral infection of B lymphocytes -Commonly caused by the EBV-85% |
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What are the clinical manifestations, diagnostic testing(s) and treatment for infectious mononucleosis? |
Clinical manifestations -Malaise (general feeling of discomfort), arthralgia (pain in a joint) -Classic triad symptoms: Fever, pharyngitis, and lymphadenopathy of the cervical lymph nodes. Diagnostic testing -Antibody testing Treatment -Rest and alleviation of symptoms -Ibuprofen, not aspirin, for children and adolescents because of reported incidence of Reye syndrome |
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This is a malignant progressive disease in which the bone marrow and other blood-forming organs produce increased numbers of immature or abnormal leukocytes. These suppress the production of normal blood cells, leading to anemia and other symptoms.
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Leukemia -Classifications: predominate cells of origin and rate of progression. |
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What is acute lymphocytic leukemia (ALL)? |
Acute lymphocytic leukemia (ALL) is a type of cancer of the blood and bone marrow — the spongy tissue inside bones where blood cells are made. The word "acute" in acute lymphocytic leukemia comes from the fact that the disease progresses rapidly and creates immature blood cells, rather than mature ones. -Most common childhood leukemia -Greater than 30% lymphoblasts in bone marrow or blood -Genetic anomaly: Philadelphia chromosome -reciprocal translocation between chromosomes 9 and 22. -Risk factors -Prenatal x-rays -Postnatal exposure to high-dose radiation -Viral infections with HTLV-1, can cause a rare form of ALL and ESV -Downs syndrome |
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What is acute myeloid leukemia (AML)? |
Acute myeloid leukemia (AML), also known asacute myelogenous leukemia is a cancer of the myeloid line of blood cells, characterized by the rapid growth of abnormal white blood cells that accumulate in the bone marrow and interfere with the production of normal blood cells.
-Most common adult leukemia -Downs increases risk -Results from -Abnormal proliferation of myeloid precursor cells -Decreases rate of apoptosis -Risk factors -Exposure to radiation, benzene, and chemotherapy -Hereditary conditions |
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What are the clinical manifestations, tests and treatments for leukemia? |
Clinical manifestations -Fatigue caused by anemia -Bleeding resulting from thrombocytopenia -Fever caused by infection -Anorexia, weight loss, wasting away of muscle, and difficulty swallowing Tests -Peripheral blood smear (initial test) -Bone marrow tests (better test) Treatments -Chemotherapy -Supportive measures: blood transfusions, antibiotics, antifungal, antivirals -Stem cell transplant -Bone marrow transplant |
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What are the complications of leukemia? |
-Anemia -Treatment: blood products -Neutropenia -Treatment: Colony-stimulating factors (G-CSF or GM-CSF) -Low WBC count -Treatment:Colony-stimulating factors to prevent infections |
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What is chronic myelogenous leukemia (CML)? |
Chronic myeloid leukemia (CML), also known as chronic myelogenous leukemia, is a type of cancer that starts in the blood-forming cells of the bone marrow and invades the blood. Only about 10% of leukemias are CML.
-Usually diagnosed in older adults -is a myeloproliferative disorder |
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What are the clinical manifestations of myelogenous leukemia? |
-Infections, fever, weight loss -Chronic phase -lasts up to 2-5 years (may be asymptomatic) -Accelerated phase -lasts 6-18 months -Primary symptoms develop: splenomegay -Terminal blast phase -survival: only 3-6 month -No cure |
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What is chronic lymphocytic leukemia (CLL)? |
Chronic lymphocytic leukemia (CLL) is a type of cancer that starts from cells that become certain white blood cells(called lymphocytes) in the bone marrow. The cancer (leukemia) cells start in the bone marrow but then go into the blood.
-Affects the monoclonal B lymphocytes -Has a familial tendency -Is common in adults older than 50 |
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What are the clinical manifestations for chronic lymphocytic leukemia (CLL)? |
-Advances slowly and in insidiously. -Is asymptomatic at the time of diagnosis -Lymphadenopathy (Lymph nodes swell and become tender) is the most common finding. -Suppresses humoral (fluid) immunity, and increases infections with encapsulated bacteria |
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What is lymphadenopathy and what are the 2 categories? |
Enlarged lymph nodes that become palpable and tender categories -Local -Drainage of an inflammatory lesion located near the enlarged node -General -Occurs in the presence of malignant or nonmalignant diseases. |
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What are primary and secondary lymphoid tissues? |
Primary -Thymus and bone marrow Secondary -Lymph nodes, spleen, tonsils, intestinal lymphoid tissue |
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What are the 2 main categories of malignant lymphomas? |
-Hodgkin lymphoma (related to EBV) -Non-Hodgkin lymphoma **Result from genetic mutations or viral infections |
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What are the causes and clinical manifestations of Hodgkin lymphomas? |
Causes -B cells in the germinal center has unsuccessful immunoglobulin gene rearrangement; should undergo apoptosis but survives -Virus might be involved in the pathogenesis -Familial clustering (unknown genetic mechanism) Clinical manifestations -Enlarged painless neck lymph nodes -Lymphadenopathy, causing pressure or obstruction -Mediastinal mass -Fever, weight loss, night sweats, pruritus, fatigue |
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How is Hodgkin lymphomas diagnosed and tests used to diagnose. |
Diagnosis -Reed-sternberg cells in the lymph nodes -Malignant B cells that usually become binucleate (go through mitosis but don't survive) Tests -Chest x-rays, lymphangiography, and biopsy |
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What is the treatment for Hodgkins lymphoma? |
-Approximately 75% cure rate -Combined treatment with radiation therapy and chemotherapy -High-dose chemotherapy with bone marrow or stem cell transplantation -Monoclonal antibodies |
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This is a form of malignant lymphoma distinguished from Hodgkin's disease only by the absence of binucleate giant cells (B cells).
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Non-Hodgkind lymphoma -Now called B cell neoplasms and includes T-cell and natural killer (NK) neoplasms. -Its linked to chromosome translocations -Changes into proto-oncogenes and tumor-suppressor genes to an increase in malignant cells. |
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What are the clinical manifestations, diagnostic tests, and treatment for non-hodgkins lymphomas |
Clinical manifestations -Localized or generalized painless lymphadenopathy -Retroperitoneal and abdominal masses -Ascites (fluid in the peritoneal cavity) and leg swelling Tests -Biopsy Treatment -Survival: Extended periods but less than the survival rate for Hodgkin lymphoma -Chemotherapy and/or radiation -Monoclonal antibody -Radioimmunotherapy: Combination of radiation therapy with monoclonal antibody therapy |
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What are the conditions that mimic lymphomas? |
-TB -Syphilis -Systemic lupus erthematosus -Lung cancer -Bone cancer Important distinction -Lymphomas usually involve lymphadenopathy -More generalized lymphadenopathy with systemic signs and systems characterize infectious precursors of malignant lymphomas |
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Low levels of platelets? |
Thrombocytopenia |
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This is a blood disorder characterized by the destruction of blood platelets due to the presence of antiplatelet autoantibodies.
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Immune thrombocytopenic purpura (ITP) -Acute form develops after viral infections -Is one of the most common childhood bleeding disorders -Chronic form usually is found in adults |
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What are the clinical manifestaions and treatment(s) for immune thrombocytopenic purpura (ITP)? |
Clinical manifestations -Petechiae (a small red or purple spot caused by bleeding into the skin) and progressing to major hemorrhage. Treatment -Not curative -Prednisone (synthetic drug similar to cortisone, used to relieve rheumatic and allergic conditions and to treat leukemia) -Splenectomy -If unsuccessful, immunosuppressive drugs are used |
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What is disseminated intravascular coagulation (DIC)? |
-Disseminated intravascular coagulation (DIC) is a serious disorder in which the proteins that control blood clotting become over active. -Clinical conditions that release tissue factors cause an increase in fibrin and thrombin activity in the blood. -Characterized by a cycle of intraveascular clotting, followed by active bleeding |
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What are the clinical manifestations and treatment(s) of disseminated intravascular coagulation (DIC)? |
Clinical manifestations -Initial consumption of coagulation factors and platelets -Hemorrhage: is secondary to the abnormally high consumption of clotting factors and plates. -Bleeding from arterial lines, surgical wounds... -Purpura, petechiae, and hematomas -Cyanosis of the fingers and toes -Clots in the circulation interferes with blood flow to organs Treatment -Remove the stimulus -Restore homeostasis -Control thrombosis -Maintain organ function -Administer replacement therapy |
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This results from a fixed (thromus) or moving (embolus) clot that blocks flow within a vessel. |
Thromboembolic disease -Denies nutrients to tissues distal to the occlusion. -Death can result when clots obstruct blood flow to the heart, brain, or lungs. |
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Whats the treatment for thromboembolic disease? |
-Anticoagulants -Thrombolytic |
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What is hypercoaguability? |
Its an abnormality of blood coagulation that increases the risk of thrombosis. Results from a deficiency of anticoagulation proteins.
-Primary:defects in proteins that are involved in homeostasis. -Secondary: Condition or disease that promotes anticoagulation proteins. |
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This is a blood disorder that causes blood clots to form in small blood vessels. This leads to a low platelet count (thrombocytopenia).
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Thrombotic thrombocytopenic purpura (TTP)
Types -Familial:chronic, relapsing, and observed in children. -Acquired idiopathic: Is more acute and more severe; observed mostly in women in their 30s. |
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What is the clinical manifestations and treatment(s) for thrombotic thrombocytopenic purpura (TTP)? |
Clinical manifestations -Ischemic signs ans symptoms most often involving the CNS (approximately 65% exhibit memory disturbances, behavioral irregularities, headaches, or coma) -Kidney failure -Fever Treatment -Untreated acute TTP: Mortality rate of 90% -Prompt treatment of acute TTP: Mortality rate reduced to 10%-20% -Plasma exhange with fresh frozen plasma -Steroids -Splenectomy: performed if no response to treatment -Immunosuppresive therapy |
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This is the presence of high platelet counts in the blood, and can be either primary (also termed essential and caused by a myeloproliferative disease) or reactive (also termed secondary).
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Thrombocytemia AKA thrombocyosis -Causes: accelerated platelet production in the bone marrow -Treatment: Interferon, drugs that prevent platelet maturation, aspirin: prevent clots pr bleeding |
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What are the 2 main things that cause disorders of coagulation? |
-Vitamin K deficiency -Liver disease |
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What is deep vein thrombosis (DVT)? what is the treatment? |
-thrombosis in a vein lying deep below the skin, especially in the legs. It is a particular hazard of long-haul flying.
-Tests: Computed tomograhy (CT) or MRI -Treatment -Heparin, antithrombin agent, aspirin -Thromoytic therapy |
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What are the three categories of hypertension? |
Prehypertension -120-139 mm Hg systolic, 80-90 mm Hg diastolic Isolated systolic hypertension -Normal diastolic pressure Hypertension -Sustained elevation over 140 mm Hg systolic or 90 diastolic -Systolic hypertension is the most significant factor in causing organ damage. -Increase the risk for myocardial infarction (MI), kidney disease, and stroke |
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What are the risk factors and causes of hypertension? |
Risks -Family history, advancing age, race:black -Gender: Female >70 years of; male < 55 -Sodium intake, Glucose intolerance (diabetes), heavy alcohol use -Obesity, cigarettes -Electrolyte imbalances Causes: by increased in cardiac output or total peripheral resistance, or both. -Cardiac output increased: Any condition that increases heart rate or stroke volume -Peripheral resistance increased: Any factor that increases blood viscosity, reduces vessel diameter (vasoconstriction) or increases vessel length (obesity). |
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What is the difference between primary and secondary hypertension? |
Primary -No known cause, 95% of those with hypertension -Complicated interactions of genetics and the environment -Over-activity of sympathetic nervous system and renin-angiotension-aldosterone system (RAAS) -Inflammation, endothelial dysfunction, obesity-related hormones, and insulin resistance. Secondary -caused by a systematic disease that raises peripheral vascular resistance and/or cardiac output |
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What is complicated and malignant hypertension? |
Complicated hypertension -occurs due to long-term hypertension -Hypertrophy and hyperplasia with associated fibrosis of the tunica intima and media in a process called vascular remodeling. Malignant hypertension -Rapidly progressive hypertension -Diastolic pressure is usully >140 mmHg -Can lead to encephalopathy |
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What are the clinical manifestations, diagnosis, and treatment of hypertension? |
Clinical manifestations -Early stages of hypertension have no clinical manifestations other than elevated blood pressure -Called silent (lanthanic) disease Diagnosis -Measurements of blood pressure on at least 2 separate occasions. Treatment -Reducing or eliminating risk factors -Restricting sodium intake, increasing potassium intake, restricting saturated fat and calorie intake -Dietary approaches to stop hypertension (DASH) -Cessation of smoking and exercise -Pharmacologic therapies -Reduce risk of end-organ damage, and prevent major diseases such as myocardial ischemia stroke. -Thiazide diuretics and beta-blockers -Angiotention-converting enzyme (ACE) inhibitors -Angiotension-receptor blockers (ARB), or aldosterone antagonists (effective for those with heart failure, chronic kidney disease, after an MI, or a recurrent stroke). -Calcium channel blockers- causes vasodilation |
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This is known as a head rush or dizzy spell, is a form of low blood pressure in which a person's blood pressure falls when suddenly standing up or stretching.
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Orthostatic (postural) hypotension |
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Whats the difference between a true and false aneurysm? |
True -Involvement of all three layers of the arterial wall -Fusiform aneurysm (circumferential widening) -Saccular aneurysms False -Hematoma forms due to a leaking hole in an artery |
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What are the clinical manifestations and treatment(s) of an aneurysm? |
Clinical manifestations -Heart -Includes dysrthmias, heart failure, and embolism of clots to the brain or other vital organs -Aorta -Is asymptomatic until it ruptures, then it becomes painful. -Thoracic -Dysphagia (difficulty in swallowing) and dyspnea are caused by the pressure -Abdomen -Flow to an extremity is impaired, causing ischemia Treatment -Maintenance of low blood volume and low blood pressure to decrease the mechanical force -Smoking cessation -B (beta)-adrenergic blockage -Surgery |
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This is an obstruction in a blood vessel due to a blood clot or other foreign matter that gets stuck while traveling through the bloodstream. |
Embolism -Occlusion of a coronary artery-MI -Occlusion of a cerebral artery-Stroke |
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This is a disease characterized by spasm of the arteries in the extremities, especially the fingers. It is typically brought on by constant cold or vibration, and leads to pallor, pain, numbness, and in severe cases, gangrene.
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Raynaud's disease |
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Whats the difference between the Raynard phenomenon and Raynard's disease? |
Raynard phenomenon: Secondary to other systemic diseases or conditions (autoimmune dieases) -Treatment: Arm exersices and medication Raynard's disease: Primary vasospastic disorder of unknown origin -Treatment: Avoidance of emotional stress and cold and cessation of cigarette smoking |
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This is a disease of the arteries characterized by the deposition of plaques of fatty material on their inner walls.
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Atheroclerosis |
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What is the progression order of atherosclerosis? |
-Endothelium injury -Inflammation of endothelium -Cytokines released -Cellular proliferation -Macrophage migration -Low-density lipoproteins (LDL) oxidation (foam cell formation) -Fatty streak -Fibrous plaque -Complicated plaque |
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What are the clinical manifestations and treatment for atherosclerosis? |
Clinical manifestations -Depends on the organ affected -Symptoms ans signs are the result of inadequate perfusion of tissue. Treatment -Focuses on reducing risk factors, removing the initial causes of vessel damage, and preventing lesion progression. -Exercising, smoking cessation, and controlling hypertension and diabetes when appropriate while reducing LDL cholesterol levels by diet or medication or both. |
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This is a common circulatory problem in which narrowed arteries reduce blood flow to your limbs. When you develop this, your extremities — usually your legs — don't receive enough blood flow to keep up with demand.
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Peripheral artery disease |
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What is intermittent claudication? And whats the treatment for it? |
-obstruction of arterial blood flow in the iliofemoral vessels, resulting in pain with walking. -Treatment: Vasodilators, anti-platelet or anti-thrombotic medications (e.g aspirin), cholesterol-lowering medication, and exercise rehabilitation. |
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What is dyslipidemia? |
- A disorder of lipoprotein metabolism, including lipoprotein overproduction or deficiency. Dyslipidemias may be manifested by elevation of the total cholesterol, the "bad" low-density lipoprotein (LDL) cholesterol and the triglyceride concentrations, and a decrease in the "good" high-density lipoprotein (HDL) cholesterol concentration in the blood.
- is an important risk factor for coronary heart disease (CHD) and stroke. |
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What are the modifiable risk factors of coronary artery disease? |
-Dyslipidemia (high levels of lipid in the blood) -Hypertension (endothial injury, increase in LDL, increase in myocardial demand) -Cigarette smoking (vasoconstriction an increase in LDL. decrease in high-density lipoproteins (HDL)) -Diabetes mellitus and insulin resistance (endothelia damage, thickining of the vessel wall) -Obesity (elevated gulcose, triglycerides...) -Atherogenic diet (high in cholesterol =, saturated fats and trans fats) |
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define myocardial ishemia. and whats the treatment? |
Myocardial ischemia occurs when blood flow to your heart is reduced, preventing it from receiving enough oxygen. The reduced blood flow is usually the result of a partial or complete blockage of your heart's arteries (coronary arteries).
Treatment -Nitrates, beta-adrenergic-reseptor blockers, calcium channel blockers. -Percutaneous conronary interention (antioplasty with stent) -Coronary artery bypass graft (CABG) |
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What are the 3 different types of myocardial ishemia? |
-stable angina: causes predictable chest pain -Silent ischemia: causes no detectable symptoms. -Angina pectoris: Causes transient chest discomfort. |
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This is a condition in which your heart doesn't get enough blood flow and oxygen. It may lead to a heart attack. This is a type of chest discomfort caused by poor blood flow through the blood vessels (coronary vessels) of the heart muscle (myocardium).
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unstable angina Treatment -Immediate hospitalization with the administration of oxygen, aspirin and nitrates -Anti-thrombotic agents |
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What are the clinical manifestations and treatment of an myocardial infarction? |
Clinical manifestations -Sudden severe chest pain -ECG changes -Biomarkers -Cardiac troponin I: Most specifc, elevates in 2-4 hours -Isoenzymes: creatine phosphokinase-MB (CPK-MB), LDH -Hyperglycemia Treatment -Hospitalization -Supplemental oxygen and aspirin -Thrombolytic, antithrombotic, vasodilators -Percutaneous coronary intervention (PCI) angioplasty with stent -surgery Possible complications -Dysrythmias -Cardiogenic shock -Pericarditis -Dressler (post-infarction) syndrome_ delayed inflammation -Organic brain syndrome |
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What are the clinical manifestations and treatment(s) of acute pericarditis? |
-Acute inflammation of the pericarditis Clinical manifestations -fever, myalgias, and malaise, followed by the sudden onset of severe chest pain. Treatment -Rest, salicylates and nonsteroidal antiinflammatory drugs; combined nonsteroids and colchine |
