Copy of Pathology Test 2 (1).txt

Pathology Test 2 Colon Cancer Dietary Factors: Red meat, especially when consumed in excess, high levels of fat, and sugar have been associated with an increased risk. In contrast, a diet rich in fiber, chicken, fish, fruits, and vegetables is linked to a reduced risk. Smoking: Smoking is another fa...

Pathology Test 2 Colon Cancer Dietary Factors: Red meat, especially when consumed in excess, high levels of fat, and sugar have been associated with an increased risk. In contrast, a diet rich in fiber, chicken, fish, fruits, and vegetables is linked to a reduced risk. Smoking: Smoking is another factor that can increase the risk of colorectal cancer. It’s essential to quit smoking to reduce this risk and improve overall health. Indications Suggesting Pre-Existing Polyps: Colorectal cancer often develops from pre-existing polyps in the colon. The type of polyp can influence the likelihood of malignancy. Sessile polyps are more likely to be malignant, while pedunculated polyps are usually benign. Common Locations: Colorectal cancer is most frequently found in the recto-sigmoid region, which is the lower part of the colon and the sigmoid colon. The cecum and ascending colon are the next most common sites for the development of this cancer. Prognosis: Regular screenings, such as colonoscopies, are essential for early diagnosis and successful treatment. Detecting and removing pre-cancerous polyps can significantly improve outcomes. Peritonitis Peritonitis Inflammation of the peritoneum, the thin lining of the abdominal cavity. Spread of Infection: Peritonitis can occur when an infection from abdominal organs spreads to the peritoneum. Examples include appendicitis, inflammation of the appendix, and salpingitis, inflammation of the fallopian tubes. Rupture of the GI Tract: If the gastrointestinal tract (GI tract) ruptures, it can release its contents, which are often filled with irritating substances such as bile, digestive enzymes, and bacteria, including E. coli. This can lead to peritonitis. A common example is the rupture of the appendix in cases of appendicitis. Penetrating Abdomen Wounds: Peritonitis can also result from penetrating wounds to the abdomen caused by trauma, accidents, or surgical procedures. Peritonitis is a serious medical condition that typically requires prompt medical intervention and treatment with antibiotics. Left untreated, it can lead to severe complications and is considered a medical emergency. Hirschsprung Disease Hirschsprung’s Disease (Congenital Megacolon) Characterized by the absence of nerve ganglia in the distal rectum, typically involving the anal sphincter. This leads to a functional obstruction of the bowel, resulting in a set of distinct symptoms Pathogenesis: The aganglionic segment of the bowel remains contracted and lacks peristalsis, which is the coordinated muscular contractions that move contents through the digestive tract. This functional obstruction causes gross dilation of the bowel adjacent to the narrowed segment, leading to the development of a condition known as “megacolon,” which refers to the abnormally large or expanded colon. Feces are retained in the dilated portion of the bowel due to the blockage, resulting in symptoms and complications associated with Hirschsprung’s Disease. Symptoms: No Bowel Sounds: Newborns typically have no bowel sounds shortly after birth. Failure to Pass Meconium: Meconium, the first stool passed by infants, is not passed as expected. Abdominal Distention: The abdomen becomes swollen or distended due to the bowel obstruction. Poor Weight Gain: Affected infants may have difficulty gaining weight and may experience poor growth. Vomiting: may occur due to the inability of the intestine to properly move stool. In Older Children: Constipation- Older children often experience severe and persistent constipation. Abdominal Distention: Abdominal swelling and discomfort continue to be present. Small Caliber Stool: Stools are typically narrow in diameter. Hirschsprung’s Disease requires prompt diagnosis and surgical intervention to address the absence of nerve cells and alleviate the associated symptoms and complications. Hirschsprung Disease Imperforate Imperforate Anus Is a congenital condition characterized by the absence of a normal communication between the rectum and the exterior of the body. Obstruction preventing the passage of stool and gas from the rectum to the outside Pathogenesis: Imperforate anus is often considered an “embryological accident,” meaning it occurs during fetal development. The nature and location of the imperforation can vary, ranging from a membrane-like blockage to a complete atresia, where there is no opening for stool or gas to exit from the rectum. Typically diagnosed shortly after birth when it becomes evident that the baby is unable to pass stool. Surgical intervention is almost always required to create an opening (anus) and allow for the normal passage of feces. Biliary Anatomy Biliary Anatomy: The liver, bile production, ducts, and the gallbladder. Bile, produced in the liver at a rate of approximately one quart per day, is a crucial component of the digestive system. It is then transported through various ducts to the gallbladder, where it is stored and concentrated. Bile plays a significant role in the digestion of fats, aiding in the breakdown and absorption of dietary fats. Liver Function: Any impairment or disease affecting the liver can disrupt the production of bile and impact the overall digestive process; Liver diseases, such as cirrhosis, hepatitis, or fatty liver disease, can affect bile production. Bile Duct Obstruction: Blockages or obstructions within the bile ducts can lead to a buildup of bile, causing discomfort and potentially leading to complications like cholecystitis or jaundice. Gallbladder Issues: Conditions such as gallstones or inflammation of the gallbladder (cholecystitis) can cause significant abdominal pain and may require medical intervention. Pancreatic Duct: The pancreatic duct and the bile duct join together before emptying into the duodenum. Conditions affecting the pancreas, like pancreatitis or pancreatic cancer, can affect the proper release of both bile and pancreatic enzymes. Gallbladder Removal: In cases of severe gallbladder disease or gallstones, the gallbladder may be surgically removed. While this can alleviate some issues, it can also result in changes in digestion due to the constant flow of bile into the digestive tract. Gallstones RUQ Pain: Right upper quadrant (RUQ) abdominal pain is a common and characteristic symptom of gallstones. This pain can range from mild to severe and is often described as a sharp or cramping discomfort. Increase in Pain After Fatty Food/Eating Late: Gallstone pain is typically triggered or exacerbated by the consumption of fatty foods. Eating a heavy or high-fat meal can lead to more pronounced pain. Radiating Pain: The pain associated with gallstones can radiate, or spread, to the right shoulder or even the back. This radiating pain is often referred to as “referred pain.” Gallstone Development: Gallstones form when there is an imbalance between cholesterol, bile salts, and lecithin in the gallbladder. This imbalance leads to the precipitation of cholesterol crystals and the formation of gallstones. Radiolucent Stones: Most gallstones are radiolucent, which means they do not appear clearly on conventional X-ray imaging. They are often better visualized with other imaging techniques like ultrasound or CT scans. Initial Exam Is Ultrasound: When gallstones are suspected, the initial diagnostic examination of choice is usually an abdominal ultrasound. Ultrasound is an effective tool for visualizing the gallbladder and detecting the presence of gallstones. Gallbladder and BIliary ducts Cholecystography: It is often used to detect the presence of gallstones or other gallbladder abnormalities. Cholangiogram: This is a radiographic examination of the biliary ducts. It is used to visualize the bile ducts and is often performed to diagnose conditions like blockages or strictures in these ducts. Choleography: This is a general term used to describe specialized examinations of the biliary ducts. It can encompass various imaging techniques that focus on the biliary system. Cholecystocholangiogram: This examination involves visualizing both the gallbladder and the biliary ducts. It provides comprehensive information about both the gallbladder and the biliary system. Cholecystopaques (OCG): This term refers to the visualization of the gallbladder using contrast media. It often involves the use of oral contrast agents to enhance the visibility of the gallbladder during imaging. Percutaneous Transhepatic Cholangiography: Percutaneous Transhepatic Cholangiography (PTC): Procedure that involves the direct injection of a contrast agent into the liver under fluoroscopic control Used to visualize the biliary ducts, primarily the intrahepatic and extrahepatic bile ducts Obstructive Jaundice: PTC is commonly used in cases of obstructive jaundice. Occurs when there is a blockage in the bile ducts, preventing the normal flow of bile from the liver to the intestine. This blockage can result from various conditions, such as gallstones, tumors, or strictures. PTC helps identify the location and cause of the obstruction. Stone Extraction & Biliary Drainage (Interventional Procedure): If gallstones are causing a blockage in the bile ducts, PTC can be used to guide the removal of these stones. Biliary drainage- relieve pressure and alleviate symptoms in cases of biliary obstruction. PTC Next Steps: Next steps depend on what we find and the patient’s condition: Biopsy: If there are suspicious findings, we might take a small tissue sample to check for cancer or other issues. Drainage: If there’s a blockage causing problems like jaundice, we can insert a tube to help bile flow better and relieve symptoms. Stent: Sometimes, we use a tube (stent) to keep bile ducts open if they are narrow. Stone Removal: If there are stones causing issues, we can remove them during or after the PTC. Palliative Care: For patients with serious conditions, we may focus on providing comfort and symptom relief. Laparoscopic Cholecystectomy A Laparoscopic Cholecystectomy is a minimally invasive surgical procedure to remove the gallbladder. Procedure: Small Incisions: Instead of a large incision, the surgeon makes several small cuts in the abdomen. Inserting a Camera: A tiny camera and special surgical instruments are inserted through these small incisions. Visualizing the Gallbladder: The camera allows the surgeon to see inside the abdomen and specifically the gallbladder on a screen. Gallbladder Removal: Using the instruments, the surgeon carefully removes the gallbladder. Closing Incisions: The small incisions are closed with stitches or adhesive strips. Recovery: Recovery is typically quicker and less painful compared to traditional open surgery. Operative Cholangiography Operative Cholangiography: is a procedure performed during gallbladder (GB) surgery to assess several important factors. Purposes: Duct System Patency: It’s used to check if the ducts responsible for carrying bile are open and not blocked. This is crucial for proper bile flow and digestion. Detecting Duct Injuries: It helps identify any accidental injuries to the ducts that may have occurred during surgery. These injuries are referred to as iatrogenic and need immediate attention. Finding Residual Stones: The procedure can uncover any remaining gallstones or other obstructions in the ducts that need to be addressed. Evaluating Sphincter Function: It assesses how well the sphincter of Oddi, a muscular valve that controls the release of bile, is functioning. T-tube Cholangiography T-Tube Cholangiography is a medical procedure that involves the use of a T-tube to assess the biliary duct system. Tube Placement: After gallbladder surgery, a T-tube is often inserted into the common bile duct, which is a tube that carries bile from the liver and gallbladder to the small intestine. Dye Injection: Contrast dye is injected through the T-tube into the common bile duct. This dye helps make the bile ducts visible on X-ray images. X-ray Imaging: X-ray images are taken while the contrast dye flows through the bile ducts. These images provide a detailed view of the biliary system. Assessment: The images obtained through T-tube cholangiography are used to assess the patency of the bile ducts, detect any blockages or abnormalities, and ensure that there are no leaks or injuries in the ducts. Monitoring and Treatment: T-tube cholangiography can be used for postoperative monitoring and may guide further treatment if any issues are identified, such as the removal of gallstones or the management of duct obstructions. Endoscopic Retrograde Cholangiopancreatography (ERCP) Purpose: Diagnosis of biliary and pancreatic issues. Therapeutic/interventional procedures, such as stone removal or stent placement. Procedure: A flexible endoscope with a camera is passed through the mouth and into the duodenum. Throat is numbed, and the patient fasts before the exam. The endoscopist finds the ampulla of Vater, the opening where the common bile duct (CBD) and pancreatic duct drain. Cannulation: A tube is inserted into either the CBD or the pancreatic duct. Contrast dye is injected to assess patency and detect stones or tumors. Contraindications: Hypersensitivity to iodinated contrast. Esophageal obstruction, Acute pancreatitis, Pancreatic pseudocyst, Elevated BUN and/or creatinine levels. Preparation: Fasting for at least 8 hours before the procedure. ERCP is a valuable tool for diagnosing and treating biliary and pancreatic conditions, offering both diagnostic and therapeutic benefits. Pancreatitis Pancreatitis is an inflammatory disease of the pancreas characterized by the premature activation of digestive enzymes within the pancreas, leading to the digestion of pancreatic tissue. Causes: Pancreatitis can be caused by various factors, including excessive alcohol consumption, gallstones, hypercalcemia (elevated calcium levels), smoking, a family history of the condition, and substance abuse. Diagnostic Tools: Medical professionals typically use imaging techniques such as ultrasound (US) and computed tomography (CT) scans to diagnose pancreatitis. Jaundice Jaundice, also known as icterus, is a condition characterized by yellowing of the skin and eyes due to an excess of bilirubin in the body. Hemolytic Jaundice: This occurs when there is an increased breakdown of red blood cells, leading to elevated bilirubin levels. Hepatocellular Jaundice: Diseased or damaged liver, such as in cases of cirrhosis or hepatitis, can result in the liver’s inability to process and excrete bilirubin effectively. Obstructive Jaundice: Obstruction in the bile ducts, often caused by factors like gallstones or pancreatic cancer, hinders the normal flow of bile and bilirubin from the liver, resulting in jaundice. Cholecystitis and cholelithiasis Cholecystitis and cholelithiasis are two common diseases of the biliary system. Cholelithiasis Refers to the formation of gallstones in the gallbladder or bile ducts. These gallstones are solid particles that can vary in size and composition and may block the normal flow of bile. Gallstones can lead to symptoms such as abdominal pain, especially after eating, and can cause complications like obstruction of the bile duct Cholecystitis Is the inflammation of the gallbladder, often associated with gallstones. When gallstones block the cystic duct, it can lead to the buildup of bile in the gallbladder, causing irritation and inflammation. This condition can result in symptoms such as severe abdominal pain, nausea, and fever. While cholelithiasis and cholecystitis can occur independently, they often coexist. Cholecystitis can be a complication of cholelithiasis when gallstones lead to inflammation in the gallbladder. Cirrhosis of the Liver Cirrhosis of the liver is a serious and progressive condition characterized by the replacement of healthy liver tissue with fibrous scar tissue. Causes: Alcohol Abuse: Chronic excessive alcohol consumption is a leading cause of cirrhosis. It can lead to post-necrotic viral hepatitis, which further damages the liver. Hepato-toxic Drugs and Chemicals: Certain medications and exposure to toxic substances can damage liver cells and contribute to cirrhosis. Diseases of the Bile Ducts: Conditions affecting the bile ducts can obstruct bile flow and lead to cirrhosis. Increased Deposition of Iron Pigment: Conditions like hemochromatosis, where excess iron is deposited in the liver, can lead to cirrhosis. What Happens: In the early stages, the liver may enlarge and show signs of fatty infiltration. At this point, regeneration of liver tissue is still possible. As the disease progresses, fibrous scar tissue gradually replaces healthy liver parenchyma. The liver contracts, leading to a bumpy and nodular surface- This scarring is often permanent and can impair liver function Signs and Symptoms: Early-stage cirrhosis may present with symptoms like fatigue, weakness, nausea, vomiting, unexplained weight loss, and an enlarged liver. In later stages, additional symptoms may develop, including ascites (abdominal fluid accumulation), edema (swelling), dark urine, jaundice (yellowing of the skin and eyes), the appearance of caput medusa (dilated blood vessels around the navel), hepatic encephalopathy (confusion and coma due to liver dysfunction), and, in severe cases, the potential for liver failure and death. Cirrhosis is a serious condition that often requires medical management and lifestyle changes to slow its progression and manage complications. Hepatocellular Carcinoma Hepatocellular carcinoma (HCC) is the most common type of liver cancer, often arising in the context of cirrhosis. Symptoms: Mild upper quadrant (abdominal) pain, unexplained weight loss, hemorrhagic shock (due to bleeding within the tumor), and jaundice (yellowing of the skin and eyes). Diagnosis: HCC is typically diagnosed through imaging techniques like CT and MRI scans. These imaging studies may reveal the presence of a large solitary mass or a number of small lesions in the liver. HCC can distort the liver’s normal contour and may invade the hepatic and portal venous systems. The imaging findings may include non-uniform enhancement of the tumor. Treatment: The prognosis for HCC can be quite bleak, particularly when it’s diagnosed at an advanced stage. May include surgery, chemotherapy, and sometimes liver transplantation, depending on the extent of the disease. Metastases (spread of cancer to other parts of the body) from HCC often occur late in the disease. HCC can be associated with the risk of fatal bleeding. Pancreatic Cancer Pancreatic cancer- is a type of cancer that originates in the tissues of the pancreas. Most common type begins in the cells that line the ducts responsible for carrying enzymes, known as pancreatic ductal adenocarcinoma. Causes: The exact causes of pancreatic cancer are not entirely clear, but there are some associated risk factors. Increased risk factors for pancreatic cancer include smoking, inherited gene mutations (particularly in families with a history of genetic syndromes or pancreatic cancer), obesity, diabetes, and a history of pancreatitis. Most people diagnosed with pancreatic cancer are over the age of 65. Symptoms: Pancreatic cancer is often not detected early, as it typically doesn’t produce noticeable symptoms until it has spread to other organs. Symptoms of pancreatic cancer may include abdominal pain that radiates to the back, loss of appetite, unintended weight loss, jaundice (yellowing of the skin and whites of the eyes), changes in stool and urine color, itchy skin, blood clots, and fatigue. Treatment: The choice of treatment for pancreatic cancer depends on the extent of the disease. Treatment options may include surgery, chemotherapy, radiation therapy, or a combination of these. The prognosis for pancreatic cancer can vary greatly based on the stage of the disease at the time of diagnosis. Pancreatic cancer often has a poor prognosis, and survival rates are relatively low. Median survival for untreated cases is around 3.5 months, but treatment can extend survival to around 8 months, and in some cases, individuals may live for several years. Early detection and treatment can significantly improve the prognosis for pancreatic cancer, which is why it’s crucial for individuals at higher risk or experiencing symptoms to seek medical attention promptly.