Pathophysiology Revision Diseases PDF

Pathophysiology revision diseases: **CARDIOVASCULAR -- WEEK 1** 1. **Aneurysm** [Definition:] Localized outpouching or dilation of weakened vessel wall [Result from: ] - Atherosclerotic plaque formation - Loss of elastin or collagen in vessel wall - Congenital abnormalities in media of...

Pathophysiology revision diseases: **CARDIOVASCULAR -- WEEK 1** 1. **Aneurysm** [Definition:] Localized outpouching or dilation of weakened vessel wall [Result from: ] - Atherosclerotic plaque formation - Loss of elastin or collagen in vessel wall - Congenital abnormalities in media of arterial wall - Trauma - Infection [Common locations:] - Abdominal aorta: between renal arteries and iliac branches - Thoracic aorta - Cerebral artery (bottom of brain) - Femoral and popliteal arteries 2. **Cardiac shunt** [Definition:] abnormal pathway or connection that allows blood to flow in a way it normally shouldn\'t, between chambers or blood vessels of the heart Blood from high pressure -\> low pressure OR high resistance -\> low resistance 3. **Embolus** [Definition:] substance that circulates from one location in body to another through bloodstream [Results from: ] - Blood clots from thrombus - Pieces of tissue - Air bubble - Amniotic fluid - Fat - Bacteria - Tumor cells - Foreign substance 4. **Stenosis** [Definition:] narrowing blood vessel or heart valve [Symptoms:] - ischemia (reduced blood supply in body) - abnormal function of tissues and organs - death of tissues and organs - Blood build up in the chamber before the valve, increasing pressure in that chamber Left-side valve stenosis → Lung problems → Right-sided heart strain/failure. Right-side valve stenosis → Body fluid buildup (e.g., swollen legs). 5. **Thrombus** [Definition:] blood clot that from in vascular system - Platelets - Fibrin - Red blood cells - White blood cells [Results from (Virchow's triad):] - Endothelial injury: attracts platelets - Sluggish blood flow (stasis): allows platelets and other clotting factors to accumulate and adhere to blood vessel wall - Hypercoagulability: promotes clot formation -- valve incompetence 6. **Acute coronary syndromes** [Definition:] sudden reduction or blockage of blood flow to the heart muscle [Results from:] a fatty deposit (plaque) inside the coronary artery wall ruptures or erodes (wears away). This exposes the plaque's inner contents to the bloodstream. [Types:] determined by degree of coronary ertery occlusion - Unstable angina: no heart muscle dies - Non -- ST -- segment elevation MI: some heart muscle damage - ST -- segment elevation MI: major heart muscle damage 7. **Renin-angiotensin-aldosterone system (RAAS)** [Definition:] regulation of blood pressure and fluid balance in body 8. **Hypertrophic Obstructive Cardiomyopathy (HOCM)** [Definition:] primary disease of caridac muscle and intraventricular septum [Results from:] thickened intraventricular septum and decreased chamber size 9. **Restrictive cardiomyopathy** [Definition:] disease of heart muscle fibers Irreversible if severe 10. **Heart Failure** [Definition:] heart can't pump enough blood to meet body's metabolic needs [Causes: ] - intravascular and interstitial volume overload - poor tissue perfusion 11. **Hypertension** [Definition:] intermittent or sustained elevation of systolic blood pressure (\>139mm Hg) or diastolic blood pressure (\>89mm Hg) 2 types: essential (primary) and secondary 12. **Hyperlipidemia** [Definition:] excess levels of cholesterol ad triglycerides (primary or secondary) 13. **Myocarditis** [Definition:] focal or diffuse inflammation of myocardium May be acute or chronic Can occur at any age 14. **Mitral insufficiency** [Definition:] Inadequate closing of mitral valve Backflow of blood from left ventricle -\> left atrium 15. **Mitral stenosis** [Definition:] narrowing of mitral valve orifice, valve leaflets thickened by fibrosis and calcification 16. **Mitral prolapse** [Definition:] mitral valva doesn't close properly, leaflets bugle BACKWARDS Backflow of blood from left ventricle -\> left atrium [Symptoms: ] - Left atrium becomes overloaded -\> irregular heartbeat - Decreased blood flow into aorta - Decreased blood flow into coronary arteries (myocaridum) -\> chest pain and syncope More frequent in women than men 17. **Endocarditis** [Defintion:] infection of endocardium, heart valves or prosthetic heart valves [Results from:] bacterial or fungal invasion 18. **Pericarditis:** [Definition:] inflammation of pericardium [Types: ] - Acute pericarditis: fibrous or effusive, with purlent, serous or hemorrhagic exudate - Chronic constrictive pericarditis: dense, fibrous pericardial thickening 19. **Beck Triad** [Includes: ] - Hypotension - Jugular venous distension - Muffled heart sounds [Symptoms: ] - Low blood pressure - Elevated central venous pressure with jugular vein distention - Muffled heart sounds - Pulsus paradoxus: insipartory drop in systemic blood pressure greater than 15 mm Hg) - Increased heart rate 20. **Cardiogenic shock (pump failure)** [Definition:] diminished cardiac output that severly impairs tissue perfusion 21. **Hypovolemic shock** [Definition:] reduced intravascular blood volume which causes circulatory dysfunction and inadequate tissue perfusion 22. **Peripheral arterial disease (arterial insufficiency** Definition: arteriosclerotic plaque obstructing arterial blood flow in leg Caused by: arteriosclerosis of lower extremity Symptoms: leg muscle can become ischemic or infarcetd if not treated 23. **Deep vein thrombosis (venous thromboembolism)** [Definition:] inflammation and clot formation in deep vein of leg [Course of disease: ] - Venous clot can travel from leg into inferior vena cava and then into right side of heart - From right ventricle the clot can travel into pulmonary artery and lungs - When in lungs, the clot can obstruct circulation in the lung and hinger oxygen transfer from alveoli into blood Clot: pulmonary embolism (PE) A large PE can lead to death [Symptoms:] - Sudden dispnea - Chest pain - Tachycardia - HOWEVER, PE is most often WITHOUT symptoms **RESPIRATORY -- WEEK 2** 1. **Atelectasis** [Definition:] partial or complete lung collapse [Occurs when:] alveolar sacs or entire lung segments expand incompletely -\> lung collapse [Symptoms:] unoxygenated blood passes unchanged and causes hypoxia May be chronic or acute, common in patients after abdominal or thoracic surgery 2. **Bronchiectasis** [Definition:] chronic abnormal dilation of bronchi and destruction of bronchial walls throughout tracheobronchial tree -- DESTROYED BRONCHI May also be confined to single segment or lobe, usually on lower lobes [Types:] - Cylindrical - Fusiform (varicose) - Saccular (cystic) [Results from: ] - Conditions associated with repeated damage to bronchial walls with abnormal mucociliary clearance - Built-up mucus puts extra pressure on the airway walls - Secondary infection, characterized by inflammation and leukocytic accumulations 3. **Cyanosis** [Definition:] bluish discoloration of skin and mucous membranes [Caused by:] - Desaturation with oxygen - Reduced hemoglobin level [Types:] - Central: decreased oxygen saturation of hemoglobin in arterial blood, best observed in buccal mucous membranes and lips - Peripheral: slowed blood circulation of fingers and toes, best visualized by examining nail bed area 4. **Acute respiratory distress syndrome (ARDS)** [Definition:] non cardiogenic pulmonary edema (excess fluid builds up in alveoli) that quickly leads to acute respiratory failure Also known as: - Shock lung - Stiff lung - White lung - Wet lung Difficult to diagnose and if not treated in 48h death might occur **[\*Surfactant:]** fluid secreted by cells of alveoli that helps to reduce surface tensions of pulmonary fluids. Contributes to elastic properties of pulmonary tissue, preventing alveoli from collapsing 5. **Asthma** [Definition:] chronic inflammation airway disorder [Characterized by:] - Airflow obstruction - Airway hyperresponsiveness to multiple stimuli Type of COPD = chronic obstructive pulmonary disease 6. **Chronic bronchitis** [Definition:] excessive production of tracheobronchial mucus, chronic cough and airflow obstruction 7. **Chronic hypoxia** [Definition:] not enough oxygen for long period of time. Causes kidneys produce erythropoietin which leads to RBC production and polycythemia (high number of RBCs) Hgb high -- oxygen low =\> cyanosis is evident 8. **Cor pulmonale** [Definition:] Right heart becomes enlarged or strained due to high blood pressure in lungs affecting the structure or function of lungs or associated structures [Course of disease:] - Lung disease occurs first -\> consequences for right side of heart - Cor pulmonale occurs at end of lung diseases that cause chronic hypoxia - Chronic hypoxia causes pulmonary arteriole vasoconstriction =\> increased lung pressure - Increased lung pressure =\> right side of heart works harder, becomes enlarged and may eventually fail 9. **Emphysema** [Definition:] abnormal, permanent enlargement of acini & destruction of alveolar walls. Form of COPD Acini = terminal portions of respiratory bronchioles and alveoli [Results in:] airflow limitation due to lack of lung tendency to return to original size 10. **Influenza** (flu, grippe) [Definition:] acute, highly contagious viral infection of respiratory tract 11. **Pneumonia** [Definition:] acute infection of lung parenchyma (functional tissue of lung involved in gas exchange) that impairs gas exchange [Classified by:] - Etiology - Location - Type 12. **Pneumothorax** [Definition:] air in pleural cavity that leads to partial or complete lung collapse [Classification: ] - Traumatic: further classified as open or closed - Spontaneous: (also considered closed pneumothorax) common among older patients with chronic pulmonary disease. May occur in young, healthy patients, usually tall young males - Tension: life threatening condition that produces most severe symptoms and it can happen when blood flow back to the heart is blocked or slowed down. 13. **Pulmonary edema** [Definition:] accumulation of fluid in extravascular spaces of lung. It's a common complication of cardiovascular disorders 14. **Pulmonary embolism (=clot, did it again at cardiovascular system)** [Definition:] obstruction of pulmonary arterial bed (arteries, arterioles, and capillaries) by dislodged thrombus, heart valve growth or foreign substance Possibly fatal with massive emboli **DON'T CONFUSE:** [Clot (thrombus):] solid mass of blood that forms in blood vessel or heart, usually stays in one place [Embolus:] when a part of a clot breaks off and travels through bloodstream. Can also be air, fat or bacteria 15. **Pulmonary hypertension:** [Definition:] blood pressure in pulmonary arteries becomes abnormally high [Occurs:] for reasons other than aging or altitude (altitude = υψόμετρο) [Classification:] - Primary: increased PAP (pulmonary artery pressure) and increased pulmonary vascular resistance (with no obvious cause). Most common in women 20-40 y.o. - Secondary: resulting from existing cardiac or pulmonary disease, or both 16. **Severe acute respiratory syndrome (SARS)** [Definition:] life-threatening viral infection Not highly contagious when protective measures are used Incubation period 2-7 days 17. **Tuberculosis** [Definition:] lung infection (mycobacterium tuberculosis) [Characteristics: ] - pulmonary infiltrates (clusters of immune cells in lungs) - formation of granulomas (hardened areas of inflammation) - caseation (tissue breaks down and has a diff. consistency) - fibrosis (scarring) - cavitation (hollow spaces in lung) May be acute or chronic Prognosis excellent with proper treatment and compliance (following instructions) 18. **Upper respiratory tract infection** (common cold / acute coryza) [Definition:] acute, afebrile (without fever) viral infection [Causes:] inflammation of upper respiratory tract [Can lead to]: second bacterial infections, although a cold is not harmful **NEUROLOGIC -- WEEK 3** **GCS** (Glasgow coma scale): [Measures:] - Motor response - Verbal response - Eye opening response To assess person's level of consciousness after a brain injury  1. **Cerebral edema** [Definition:] increased fluid content of brain tissue [Leads to:] increased intracellular or extracellular fluid volume [Caused by:] - Initial injury to brain tissue - Cerebral ischemia (reduced blood flow in brain) - Hypoxia (low oxygen levels) - Hypercapnia (high CO2 levels) 2. **Paresis** [Definition:] partial loss of motor function (paralysis) and muscle power (weakness) [Can result from disfunction of:] - Upper motor neurons (in cerebral cortex, subcortical white matter, internal capsule, brain stem or spinal cord) - Lower motor neurons (in brain stem motor nuclei and anterior horn of spinal cord) or possibly with axons to skeletal muscles - Motor units affecting muscle fibers or neuromuscular junction 3. **Dementia:** [Definition:] loss of more than one intellectual or cognitive function [Problems with: ] - General knowledge - Information - Alertness - Recent memory - Long -- term memory - Reasoning - Concept formulation - Abstraction (conceptual thinking) - Language use [Caused by:] defect in network of neurons in brain [Classified by:] - Amnestic -- memory - Intentional -- regulate actions and behavior - Cognitive -- thinking, reasoning and problem-solving [5 As of Dementia:] - Amnesia: memory loss, particularly short-term memory - Agnosia: forgetting purpose of familiar objects - Apraxia: forgetting how to perform familiar activities - Apathy: lack of concern for lost abilities - Aphasia: lack of sensible speech or being mute 4. **Altzheimer's disease** [Definition:] degenerative disorder of cerebral cortex (frontal lobe and hippocampus), primary progressive form of dementia More than half of all cases of dementia Has poor diagnosis 5. **Amyotrophic lateral sclerosis** (ALS) or **Lou Gehrig disease** [Definition:] chronic, progressively weakening disease, motor neuron disease [Causes:] muscular atrophy [Ages:] 40-60, commonly in men 6. **Cerebral aneurysm** [Definition:] weakness in wall of cerebral artery that causes localized dilation. Usually arises at arterial junction in circle of Willis (bottom of brain). Commonly ruptures without warning resulting in **subarachnoid hemorrhage** [Severity of rupture:] graded according to signs and symptoms [Commonly:] women, late 40s - mid 50s 7. **Subarachnoid hemorrhage** [Definition:] bleeding in space between brain and membrane that covers it (meninges) [Symptoms: ] - Change in level of consciousness - Sudden severe headache - Cranial nerve deficits - Hypertension may cause microaneurysms and tiny arterioles to rupture in brain - =\> pressure on adjacent arterioles and causing them to burst =\> more bleeding [Caused by:] trauma =\> subarachnoid hemorrhage =\> more pressure on brain tissue 8. **Lyme disease** [Definition:] multisystemic disorder [Caused by:] bacteria Borrelia burgdorferi, from deer ticks [3 stages:] - Early localized stage (red rash and flulike symptoms) - Early disseminated stage (neurologic and cardiac abnormalities) - Late stage (arthritis, chronic neurologic problems) 9. **Meningitis** [Definition:] inflammation of brain and spinal cord meninges (dura mater, arachnoid and pia mater) [Resulting from:] bacterial infection 10. **Migraine headache** [Definition:] throbbing, vascular (pounding) headache that usually appears in childhood and commonly recurs throughout adulthood [Classified by aura:] - Common migraine -- no aura (80% of cases) - Classic migraine -- with aura (20% of cases) Aura = temporary warning signs that occur before headache More common in women 11. **Multiple sclerosis:** [Definition:] chronic disease, demyelination of white matter (neuron axons) of brain and spinal cord with period of exacerbation and remission Major cause of chronic disability in young adults ages 20-40 [Common in:] - Women - Urban populations (in city) - Upper socioeconomic groups 12. **Myasthenia gravis:** [Definition:] immune system produces antibodies that block or destroy receptors at neuromuscular junction =\> prevents muscle contraction. Affects muscles innervated by cranial nerves (on head) [Causes: ] - Sporadic but progressive weakness - Abnormal fatigability of striated (skeletal) muscles [Exacerbated by:] exercise and repeated movement [Common in:] - Women 20-40 y.o. - Men older than 40 y.o. 13. **Parkinson's disease** [Definition:] degenerative disease which produces progressive muscle rigidity, akinesia and involuntary tremor [Caused by:] - Loss of dopamine -- producing neurons [Dopamine:] essential for smooth coordinated muscle movement 14. **Seizure disorder** = epilepsy [Definition:] abnormal electrical discharges of neurons in the brain Commonly begins at early childhood or after age of 65 [Symptoms: ] - paroxysmal events - seizures [Types of seizures:] - focal (partial) -- begin at one part of brain - generalized -- affect both sides of brain Can be controlled with compliance to prescribed treatment 15. **Stroke** [Definition:] sudden disruption of cerebral circulation (blood vessels supplying the brain) in one or more blood vessels [Symptoms according to:] - Affected artery - Severity of damage - Extent of collateral circulation [Types:] - Ischemic: blood clot blocking a vessel - Hemorrhagic: caused by burst blood vessel [Affects:] - Stroke in one hemisphere -- features on opposite side of body - Stroke that damages cranial nerves -- affects structures on same side Rapid identification is crucial (ischemic or hemorrhagic) for proper treatment 16. **West Nile encephalitis** [Definition:] vector -- borne infectious disease (transmitted through insects) that causes primarily encephalitis (inflammation of brain) [Caused by:] West Nile virus [Causes:] yellow fever and malaria [Mortality:] rages from 3% - 15% (higher among elderly population) 17. **Clinical depression** [Definition:] serious medical condition that affects thoughts, mood, feelings, behavior and physical health, interferes with ability to function [Types:] - Dysthymia (long-term low mood) - Major depression - Premenstrual dysmorphic disorder (women before period) - Postpartum depression - Seasonal affective disorder **Role of neurotransmitters:** Chemical messengers released into synapses between neurons to carry messages [Affect:] - Behavior - Mood - Thought Norepinephrine and Serotonin: neurotransmitters that play role in depression, they cause depression if low in brain areas **GASTROINTESTINAL -- WEEK 4** 1. **Nausea** [Definition:] urge to vomit, may occur with or without vomiting [Characteristics:] - Increased salivation - Diminished functional activities of stomach - Altered small intestinal motility May be stimulated by high brain centers (emotions) 2. **Cirrhosis** [Definition:] chronic disease, liver becomes scarred and damaged (diffuse destruction and fibrotic regeneration of hepatic cells [Characteristics:] - Damages liver tissue - Normal vasculature 3. **Budd-Chiari syndrome** [Definition:] flow of blood out of liver is blocked, blockage at any point in veins of liver [Cause:] anything except cardiac [Improve outcome by:] prompt diagnosis and treatment 4. **Wilson disease** [Definition:] genetic disorder that prevents body from removing extra copper =\> copper build up in liver, brain, eyes and other organs Without treatment, high copper levels can cause life-threatening organ damage 5. **Alpha-1 antitrypsin deficiency** [Definition:] hereditary genetic disorder which may lead to development of lung and/or liver disease Most common genetic cause of liver disease in children Adults can be affected too and may develop lung conditions such as emphysema (enlargement of acini) as well as liver problems 6. **Colorectal cancer** [Definition:] slow-growing cancer that starts in inner layer of intestinal tract. Commonly begins as a polyp [Signs and symptoms:] depend on location of tumor Potentially curable if diagnosed early 7. **Crohn's disease** [Definition:] slowly spreading, progressive inflammatory bowel disease [Involves:] - Any part of GI tract - Usually proximal portion of colon - May affect terminal ileum (last part of small intestine) Extends through all layers of the intestinal wall Fibrotic thickening of the bowel wall and narrowing of the lumen 8. **Diverticular disease** [Definition:] bulging pouches (diverticula) in GI wall (especially large intestine) that push mucosal lining though surrounding muscle [Classification:] - Diverticulosis: when diverticula are present but don't cause any symptoms - Diverticulitis: diverticula are inflamed, may cause potentially fatal obstruction (blockage), infection or hemorrhage 9. **Gastroesophageal reflux disease (GERD)** [Definition:] backflow of gastric or duodenal contents (or both) into esophagus and past the lower esophageal sphincter without burping or vomit [Causes:] acute epigastric pain usually after meals 10. **Hepatitis, nonviral** [Definition:] inflammation of liver [Caused by:] exposure to certain chemicals or drugs [Complete recovery usually but may cause:] - Fulminating hepatitis (liver failure) - Cirrhosis (chronic hepatitis infections) 11. **Hepatitis, viral** [Definition:] common liver infection that causes hepatic cell destruction, necrosis and autolysis [Types:] differentiated by causative virus and mode of transmission - Type-A: highly contagious, from ingestion of contaminated food or water - Type-B: through contact with contaminated blood, secretions and feces - Type-C: though shared needles and blood transfusions - Type-D: cannot exist without hepatitis B; possibly severe and can lead to rapid hepatitis - Type-E: associated with recent travel to endemic area 12. **Irritable bowel syndrome (IBS)** [Definition:] mild condition that has no anatomic abnormality or inflammatory component 13. **Pancreatitis** [Definition:] inflammation of the pancreas [Forms:] acute or chronic [Prognosis:] - Good -- when associated with biliary tract disease - Poor -- when associated with alcoholism Mortality as high as 60% (with necrosis and hemorrhage) 14. **Peptic ulcer disease** [Definition:] open lesions (ulcers) in the mucosal membrane of stomach or duodenum [Types:] acute or chronic Commonly seen in women 15. **Esophageal varices** [Definition:] swollen, twisted veins in submucosa of lower esophagus First sign of portal hypertension (elevated pressure in portal vein due to liver disease) [Can cause: ] - Massive hematemesis (vomiting of blood) requiring emergency care to control hemorrhage and prevent hypovolemic shock (loss of significant amount of fluid of blood) 16. **Cholecystitis** [Definition:] gallbladder becomes inflamed How? Calculus (gallstone) becomes lodged in the cystic duct, causing painful gallbladder distention [May be:] acute or chronic 17. **Intestinal obstruction** [Definition:] partial or complete blockage of the lumen in the small or large bowel. Small bowel obstruction is more common and usually more serious [Complete obstruction:] if untreated, can cause death within hours due to shock and vascular collapse [More likely to occur:] - After abdominal surgery - Persons with congenital bowel deformities - 60% caused by postoperative adhesions [Result in:] - Small intestine -- metabolic alkalosis from dehydration and loss of gastric hydrochloric acid - Large intestine -- slow dehydration and loss of intestinal alkaline fluids, resulting metabolic acidosis 18. **Ulcerative colitis** [Definition:] inflammatory disease that affects the mucosa of the colon and rectum It usually starts in the rectum and sigmoid colon, rarely reaching the terminal ileum due to a weak ileocecal valve. [Symptoms: ] - Edema -- leading to mucosal friability - Ulcerations - Damages large intestine's mucosal and submucosal layers [Cycles between:] exacerbation and remission **MUSCULOSKELETAL -- WEEK 5** 1. **Altered bone density** [Types: ] - Excess bone resorption that occurs during normal resorption and formation phases of bone remodeling (osteoporosis) - Decreased estrogen production during early menopause, leading to diminished osteoblastic activity and loss of bone mass - Vitamin D deficiency and inadequate calcium absorption during childhood, while prevents normal bone calcification 2. **Muscle atrophy** [Definition:] decrease in size of muscle tissue or cell [May occur:] - After prolonged inactivity from bed rest or trauma (casting) - When local nerve damage makes movement impossible - When illness robs muscles of needed nutrients 3. **Bone cancer** [Types:] Osseous bone tumors & Non-osseous bone tumors - Osseous bone tumors: Arise from bony structure itself Include: - Osteogenic sarcomas (most common) - Parosteal osteogenic sarcomas - Chondrosarcomas (chondroblastic sarcoma) - Malignant giant cell tumors - Non-osseous bone tumors: Arise from hematopoietic, vascular and neural tissues Include: - Ewing's sarcomas - Fibrosarcomas (fibroblastic sarcomas) - Multiple myelomas - Chordomas 4. **Herniated disc** [Definition:] soft gel-like center of intervertebral disk (nucleus pulposus) pushes through a crack or tear in tougher outer layer of disk (anulus fibrosus) & irritate or compress nerves About 90% in lumbar and lumbosacral regions at L4,L5 or S1 5. **Sciatica** [Definition:] pain that radiates from lower back down the back of the leg due to sciatic nerve compression [How to detect:] Clinician lifts the leg of a supine patient and then dorsiflexing the ankle. If patient feels back pain, it's called "positive straight leg raising sign" which indicates sciatica 6. **Osteoarthritis** [Definition:] chronic condition causing breakdown of joint cartilage and formation of reactive new bone (it's a response from the body to attempt to repair the joint by forming new bone) Usually affects weight-bearing joints - Heberden's nodes: small, pea sized growths that occur on the joint closest to the tip of the finger (distal interphalangeal joint) - Bouchard's nodes: small bony growths that appear on the middle joint of the finger 7. **Osteomyelitis** [Definition:] bone infection characterized by progressive inflammatory reaction that destroys the integrity of interior bone structure [Due to:] bacteria from surface of skin that invade - In children: rapidly growing areas of bone are more susceptible - In adults: diabetes is a common presisposing factor - Prosthetic joints also at risk of infection [Most common bacterium:] Staphylococcus aureus, the common skin flora [Treatment:] intraosseous or hematologic antibiotic treatment is essential [Diabetes is a major risk factor for osteomyelitis:] - Impaired wound healing - Diminished immunity - Decreased circulation =\> which increases susceptibility of bone to infection particularly in lower extremities 8. **Osteoporosis** [Definition:] metabolic bone disorder in which rate of bone resorption accelerates while rate of bone formation slows =\> loss of bone mass Affected bones become abnormally vulnerable to fractures [Types:] - Primary (commonly called postmenopausal osteoporosis) - Secondary (other causes) 9. **Bone formation and resorption** [Organic portion] = osteoid that acts as matrix or framework for mineral portion [Bone-forming cells] = osteoblasts that produce the osteoid matrix [Mineral portion:] consists of calcium and other minerals and it hardens the osteoid matrix Large bone cells reshape mature bones by resorbing the mineral and organic components. However in osteoporosis, osteoblasts continue to produce bone but resorption by osteoclasts exceeds bone formation [Types of bones:] - Cortical (solid) - Trabecular (mesh-like): undergoes effects of osteoporosis before cortical and is most susceptible to fracture. Located in wrist, hip and vertebrae 10. **Rhabdomyolysis** [Definition:] rapid breakdown of muscle fibers - If the cause is treated early, recovery is usually good - If untreated, it can lead to kidney failure 11. **Myoglobin** [Definition:] protein located in striated muscles of vertebrates [Structure:] made of one chain with a site that binds oxygen, using a heme group [MB gene:] encoding myoglobin in humans [Function:] - Oxygen storage in muscle - Bind and release oxygen depending on oxygen concentration in cell - Supplies oxygen to myocytes - Hemostasis of NITRIC OXIDE - Detoxification of reactive oxygen species It's the reason muscles have a red colour 12. **Osteosarcoma** [Definition:] highly aggressive malignant bone tumor usually occuring during periods of bone growth [Location:] usually in extremeties of long bones near metaphyseal growth plates [Usually appears:] in bones that have the fastest bone growth (femur, upper tibia or fibula, humerus) 13. **Osteonecrosis of the jaw** [Definition:] medication-related osteonecrosis of the jaw (MRONJ) is a severe adverse drug reaction Consists of progressive bone destruction in maxillofacial region of patients [Pharmacological agents that cause this:] - Antiresorptive (including bisphosphonates BPs and receptor activator of nuclear factor kappa-B ligand inhibitors) - Antiangiogenic (prevent growth of new blood vessels =\> affecting bone healing) **HEMATOLOGIC DISORDERS -- WEEK 6** 1. **RBC deficiency (anemia)** [Definition:] reduced production or destruction of red blood cells, marked by hypoxia, triggers release of erythropoietin Hypoxia= increased tissue demand for oxygen Erythropoietin= hormone for activation of RBCs production in bone marrow 2. **RBC excess (polycythemia)** [Definition:] abnormal increased production of RBCs, marked by chronic tissue hypoxia, triggers increased erythropoietin release 3. **WBC deficiency (leukopenia)** [Definition:] suppressed production of leukocytes (white blood cells) in bone marrow. Alters body's defense mechanism and increases risk of infection =\> leukopenia [May be: ] - Congenital - Acquired (drugs, radiation, prolonged stress, systemic disease, viral infection) [Mostly affects:] neutrophils (predominant type of granular leukocytes, or granulocyte) =\> results in neutropenia 4. **WBC excess (leukocytosis)** [Definition:] initiated by inflammatory response or infection, triggers cellular response of phagocytic cells to site of injury or infection Mostly pathogenic leukocytes commonly associated with cancer and bone marrow disorders 5. **Anemia, folic acid (vitamin B9) deficiency** [Definition:] common, slowly progressive, megaloblastic anemia marked by prodaction of few, large, deformed RBCs because of vitamin B9 deficiency B9 = vitamin crucial for RBCs normal production [Mostly seen in:] - Infants - Adolescents (teenagers) - Pregnant and lactating females - Alcoholics - Elderly - Those with malignant diseases - Those with intestinal diseases 6. **Anemia, pernicious** [Definition:] most common type of megaloblastic anemia, characterized by lack of intrinsic factor (which is needed to absorb vitamin B12) and breakdown of RBCs Manifestations subside with treatment, some neurologic deficits may be permanent! [Symptoms:] - Gastric polyps - Stomach cancer - Hypokalemia (low levels of K+ only during first week of treatment) - Permanent CNS symptoms 7. **Disseminated intravascular coagulation (DIC)** [Definition:] clot formation which blocks blood flow to organs [Results in: ] - Small blood vessels get blocked - Tissue damage & organ failure (due to lack of blood flow) - Uses up clotting factors & platelets (=\> no new clots when needed) - Triggers breakdown of clots - =\> Severe bleeding! Early detection is crucial [Causes:] - Sepsis - Trauma - Obstetric complications - Malignancies - Vascular disorders - Toxins - Liver disease - Heatstroke Prognosis depends on it as well as the severity of the hemorrhage and treatment underlying disease 8. **Hodgkin's disease (lymphoma, type of cancer)** [Definition:] neoplastic (tumor-forming) disorder that arises from single node or group of nodes [Causes:] painless swelling of lymph nodes, spleen and other lymphoid tissue [Results from:] abnormal growth of blood cells in lymphatic system Good prognosis with appropriate treatment, with about 90% of patients surviving for at least 5 years 9. **Leukemia** [Definition:] group of malignant disorders characterized by abnormal proliferation of WBC precursors or blasts in bone marrow or lymph tissue. [Blasts accumulate in:] - Peripheral blood - Bone marrow - Bone tissues [Classified as acute or chronic:] (and lympoid or myeloid) - [Acute lympholytic leukemia (ALL):] abnormal growth of lymphotic precursors (immature lymphoblasts) - [Acute myelogenous leukemia (AML):] rapid accumulation of myeloid precursors (immature myeloblasts) - [Chronic lymphocytic leukemia (CLL):] uncontrollable spread of small, abnormal lymphocytes in lymphoid tissue, blood and bone marrow - [Chronic myelogenous leukemia (CML):] abnormal overgrowth of granulocytic -- precursors (myeloblasts, promyelocytes, metamyelocytes and myelocytes) in bone marrow, blood and body tissues 10. **Non-Hodgkin's lymphoma** [Definition:] malignant lymphoma (cancer) originating in lymph glands and other lymphoid tissues 11. **Thalassemia** [Definition:] hereditary group of hemolytic anemias (body makes fewer healthy RBCs and less hemoglobin than normal) [Beta-thalassemia:] - Most common type - Occurs as major (Cooley's anemia) and minor (Alpha-thalassemia just involves different part of hemoglobin) 12. **Sickle cell disease** [Definition:] congenital hemolytic anemia resulting from defective hemoglobin molecules (abnormal hemoglobin S) [Cause:] genetic factor that causes red blood cells in early 20s and few lived to middle age [Life expectancy today:] age 45 with 40% to 50% of patients living into their 50s [Occurs:] - Primarly in African and Mediterranean descent - Also affects populations like Puerto Rico, Turkey, India and Middle East [Results from:] - Substitution of amino acid valine -\> for glutamic acid in hemoglobin S gene - Becomes insoluble during hypoxia - These blood cells become rigid, rough and elongated and cause hemolysis - Altered cells pile up in capillaries and smalled blood vessels -\> blood more viscous Hemolysis= cell breaks apart and release of hemoglobin in bloodstream [Causes: ] - Pain - Tissue ischemia (damage) - Oran infractions [Each patient has different:] - Hypoxic threshold - Different factors that trigger sickle cell crisis (like illness, exposure to cold, stress, acidosis, dehydration) Blood vessel blockage =\> anoxic changes that lead to further sickling and obstruction 13. **Malaria and SCD** [Definition:] malaria parasites invade normal RBCs and rearrange their contnent. [How: ] - Parasites breed and produce proteins that make RBCs sticky - These blood cells explode and release parasites capable of infecting other RBCs. [People with SCT (trait) are not as affected by malaria compared to those with normal hemoglobin:] - They have 50-90% fewer parasites than people with normal hemoglobin - Get rid of parasites faster - Lower hospital admissions - Milder cases of malaria - Lower rated of blood transfusions - Less likely to die from malaria - Less likely to get bacteremia (blood infection) [Why:] - The misshapen hemoglobin of SCT affects a parasite's ability to complete this cycle - Parasite triggers SCT hemoglobin to sickle - Immune system then clears infected RBCs before parasite can complete its life cycle and infect other blood cells =\> fewer parasites and milder illness **IMMUNOLOGIC DISORDERS -- WEEK 7** **Humoral immunity / B-cell immunity** [Definition:] when foreign substances (antigens) invade the body, B-lymphocytes secrete antibodies that attack the antigen. Also called Antibody-mediated response Requires CD4 cells to accomplish destruction of antigen =\> HIV attacks CD4 and B-cell immunity is inactivated **Cell-mediated immunity / T-cell immunity** When foreign substances invade body, CD4 and CD8 T lymphocytes (T helper and cytotoxic T cells) directly attack antigen [Requires] CD4 cells to accomplish destraction of antigen =\> HIV attacks CD4 cells and T-cell immunity is inactivated 1. **Autoimmune reactions** [Definition:] body's normal defenses become self-destructive recognizing self-antigens as foreign. [Cause:] unclear but may result from combination of factors - Genetic - Hormonal - Environmental [Characterized by:] - B-cell hyperactivity (may be related to T cell abnormalities) - Hyper-gammaglobulinemia (excess antibody production) 2. **Hypersensitivity** [Definition:] exaggerated or inappropriate response occuring on second exposure to antigen leading to inflammation and destruction of healthy tissue [Reactions may be:] - Immediate - Delayed (most severe days after exposure [Types:] - Type I: mediated by immunoglobulin (Ig) E (allergic reaction such as anaphylaxis) - Type II: tissue specific, mediated by IgG or IgM (cytotoxic hypersensitivity such as transfusion reactions - Type III: immune complex, mediated by IgG or IgM (immune complex mediated reactions such as illness) - Type IV: T-cell mediated (direct-cell mediated or delayed-type hypersensitivity, such as viral hepatitis or allergic contact dermatitis) 3. **Aquired immunodeficiency syndrome (AIDS)** [Definition:] gradual destruction of T-cell immunity, causing weakened immune system -\> more likely for patient to get infections and cancer [Contracted through:] - Blood transmission of HIV - Body-fluid transmission HIV HIV = human immunosufficiency virus [Diagnosis:] based on HIV status and presence of \>200 CD4+ T cells per cubic millimeter of blood (mm3) 4. **Allergic rhinitis** [Definition:] reaction to airborne (inhaled) allergens, most common allergic reaction Rhinitis (inflammation of the nasal mucous membrane) and conjuctivitis (inflammation of conjuctiva-eyes) may occur seasonally or year-round 5. **Anaphylaxis** [Definition:] acute, potentially life-threatening type I (immediate) hypersensitivity reaction marked by sudden onset of rapidly progressive urticaria (skin rash) and respiratory distress [Occurs:] in minutes or up to 1 hour after antigen exposure 6. **Rheumatoid arthritis** [Definition:] chronic systemic autoimmune inflammatory disease of connective tissue that attacks primarly peripheral joind and surrounding muscles, tendons, ligaments and blood vessels [Characteristics: ] - Type III hypersensitivity reaction - Includes bried improvements and unexpected flare-ups - Many complications if left untreated - 3 times more common in women than men [Patho tips:] - Inflammation in joint lining & immune cells damage cartilage and bone - Abnormal tissue (pannus) grows and destroys cartilage and bone =\> joint damage worsens - Scar tissue forms, misaligning the joint. Deformities and stiffness occur - Scar tissue hardens into bone, fusing the joint. No movement possible 7. **Systemic lupus erythematosus** [Definition:] chronic inflammatory autoimmune disorder of connective tissue affecting multiple organs. [Characteristics:] - Type III hypersensitivity reaction - Includes bried improvements and unexpected flare-ups - Affects more women than men 8. **Ankylosis spondylitis** [Definition:] autoimmune, chronic, progressive inflammatory bone disease that primarly affects sacroiliac, apophyseal and costovertebral joints along with adjacent soft tissue Usually begins in sacroiliac joint -\> progresses to lumbar, thoracic and cervical regions of spine (goes upwards) [Worsening of bone and cartilage:] can lead to formation of fibrous tissue and eventual fusion of spine or peripheral joints 9. **Avascular necrosis** [Definition:] death of bone tissue. Painful bone condition that gets worse over time and can affect mobility [Occurs when:] soething cuts off blood flow to one of your bones [Causes:] - Broken bones - Dislocated hips - Radiation therapy - Alcohol misuse [Treatment:] surgery (sometimes joint replacement) to easy pain and improve mobility 10. **Gaucher disease** [Definition:] genetic, metabolic disorder where fat-laden Gaucher cells build up in areas like spleen, liver and bone marrow. Most common lysosomal storage disorders [Genetics:] both parents must carry the disease [Caused by:] glucocerebrosidase (GCase), enzyme that breaks down fatty chemical in body called glucocerebroside [Characteristics:] - Gaucher cells are a type of scavenger cell (macrophages). - They fill up with unprocessed glucocerebroside. - These cells build up in the spleen, liver, and bone marrow. - This buildup leads to organ inflammation and problems with how they work. 11. **Atopic dermatitis -- Eczema** [Deinition:] chronic skin disorder characterized by superficial skin inflammation and intense itching Typically begins during infancy or early childhood **ENDOCRINE DISORDERS -- WEEK 8** 1. **Adrenal crisis (Addisonian crisis)** [Definition:] possible in primary or secondary adrenal hypofuntion and involves critical deficiency of mineralocorticoids and glucocorticoids (cortisol) [Occurs:] after acute stress, sepsis, trauma, surgery or omission (παράβλεψη) of steroid therapy in patients with chronic adrenal insufficiency 2. **Cushing's syndrome** [Definition:] cluster of clinical abnormalities caused by excessive corticotropin (high levels of cortisol) pituitary corticotropin excess! Accounts for 80% of endogenous cases (endogenous = the body itself) One symptom is Buffalo Bump! ACTH =\> Cortisol =\> Cushing's Syndrome 3. **Diabetes insipidus** [Definition:] disorder of water metabolism resulting from deficiency of antidiuretic hormone (ADH/vasopressin) [Two types:] - Pituitary diabetes insipidus -- caused by deficiency of vasopressin - Nephrogenic diabetes insipidus -- caused by resistance of renal tubules to vasopressin (even if it is produced in normal amounts) [Characterized by:] - Excessive fluid intake - Polyuria 4. **Diabetes mellitus** [Definition:] chronic disorder of carbohydrate metabolism with subsequent alteration of protein and fat metabolism [Characterized by hyperglycemia resulting from:] - Lack of insulin - Lack of insulin effect - Or both [General classifications:] - Type 1 -- absolute insulin insufficiency - Type 2 -- insulin resistance with varying degree of insulin secretory defects - Pre-diabetes -- blood glucose levels higher than normal but not high enough to be diagnosed with type 2 diabetes - Gestational (pregnancy-related) diabete 5. **Hyperthyroidism** [Definition:] metabolic imbalance that results from overproduction of thyroid hormone also called thyrotoxicosis [Most common form:] Graves' disease [Thyroid storm:] acute severe exacerbation of thyrotoxicosis which is a medical emergency, possibly life-threatening cardiac, hepatic or renal consequences occur 6. **Grave's disease** [Definition:] increased thyroxine (T4) production causes enlargement of thyroid gland (goiter) and multiple system changes [Explanation:] TSH tries to slow down T3/T4 production BUT TSIs make the thyroid produce T3/T4 uncontrollably so thyroid gets bigger 7. **Hypothyroidism** [Definition:] results from hypothalamic, pituitary or thyroid insufficiency or resistance to thyroid hormone Can progress to life-threatening myxedema coma 8. **Myxedema** [Definition:] dermatologic changes that occur in hypothyroidism and occasionally hyperthyroidism. It's the deposition of mucopolysaccharides in the dermis which results in swelling of the affected area. [Pretibial myxedema:] when skin changes occur in hyperthyroidism, mostly in Graves' disease 9. **Myxedema coma (myxedema crisis)** [Definition:] rare, life-threatening clinical condition that represents severe hypothyroidism with physiologic decompensation. [Occurs in patients:] - With long-standing undiagnosed hypothyroidism - Most often precipitated by infection - Cerebrovascular disease - Heart failure - Trauma - Drug therapy 10. **Thyroid cancer (thyroid carcinoma)** [Definition:] most common endocrine malignancy in all age groups, especially people who have undergone radiation treatment of the neck area [3 main types:] - Papillary - Follicular - Medullary - (Anaplastic) 11. **Buffalo bump** [Definition:] hump behind shoulders, buildup of fat. It is a sign of lipodystrophy, which is a medical term for a problem upon the process of how the body makes, uses and sores fat. Mostly a Cushing's Syndrome symptom! 12. **Addison's disease (primary adrenal insufficiency)** [Definition:] adrenal glands fail to produce enough cortisol & aldosterone Addison's ≠ Cushing's [Oral manifestations: ] Endocrine and immune dysfunction - Mucosal pigmentation - Tongue discoloration - Infections (e.g. oral candititis) Comorbidities (presence of one or more diseases alongside a primary condition) - APS1 -- oral canditiasis - APS1 -- hypoparathyroidism, short dental roots, enamel hypoplasia/dysplasia, enamel opacities, hypodontia - Anemia -- pallor (χλωμάδα) of mucosa - Diabetes mellitus -- periodontal disease, oral candidiasis - Vitiligo -- depigmentation of oral mucosa - Celiac disease -- xerostomia, dry lips, mucosal ulcerations, sialadentitis, aphtous stomatitis, dental enamel defects, gingival bleeding (Celiac disease=abnormal reaction to gluten) **RENAL DISORDERS -- WEEK 9** 1. **Acute renal failure** [Definition:] sudden interruption of renal function Caused by: - Obstruction - Poor circulation - Underlying kidney disease [Classified as:] - Prerenal - Intrarenal - Postrenal [3 distinct phases:] - Oliguric (small production of urine) - Diuretic (large amounts of diluted urine) - Recovery (gradually back to normal) Usually reversible with treatment [Untreated may progress to:] - End-stage renal disease - Prerenal azotemia = increase in nitrogen-containing compounds (e.g. urea and creatinine) in blood due to reduced blood flow to kidneys - Death 2. **Acute tubular necrosis (ATN) / acute tubulointerstitial nephritis** [Definition:] destroys the tubular segment of the nephron [Causes: ] - Uremia = more nitrogen in blood than normal from protein breakdown - Renal injury 3. **Bladder cancer** [May develop:] - On surface of bladder wall (benign or malignant papillomas) - Grow within bladder wall (generally more virulent) and quickly invade underlying muscles [Most common type:] transitional cell carcinoma, arising from transitional epithelium of mucous membrane [Less common types:] - Adenocarcinomas - Epidermoid carcinomas - Squamous cell carcinomas - Sarcomas - Tumors in bladder diverticula - Carcinoma in situ (cancer that hasn't invaded surrounding structures) [Early stages:] asymptomatic 4. **Chronic renal failure** [Definition:] usually end result of gradual tissue destruction and loss of renal function. Also results from rapidly progressing disease of sudden onset that destroys nephron and causes irreversible kidney damage [Progress:] - Few symptoms until less than 25% of glomerular filtration remains - Normal parenchyma (functional tissue) then worsens rapidly - Symptoms worsen as renal function decreases Fatal without treatment 5. **Glomerulonephritis** [Definition:] bilateral inflammation of glomeruli that's acute or chronic [Most rare type:] Goodpasture's syndrome Could be bilateral inflammation = it can occur at both sides of body or organ system Could follow streptococcal infection in certain susceptible individuals! **[Acute post-streptococcal glomerulonephritis:]** results from immune response that occurs in glomerulus - Streptococcal infection of throat begins - Antibodies that body forms against streptococcal organisms attack glomeruli membranes and cause inflammation - Glomerular injury occurs as a result of inflammatory process [Glomerular injury causes: ] - Increased permeability of glomerular capillaries and proteins - RBCs seep out of capillary blood into tubule fluid that becomes urine [Symptoms: ] - Proteins are lost from blood - Colloid oncotic pressure decreases (plasma proteins pressure) - Edema results [Signs: ] - Proteinuria - Hematuria - Edema Hypertension also occurs due to high renin secretion in kidney injury! 6. **Hydronephrosis** [Definition:] abnormal dilation of the renal pelvis and the calyces of one or both kidneys [Caused by:] obstruction of urine flow in the genitourinary tract (build up of urine causes renal pelvis to swell up) 7. **Polycystic kidney disease (PKD)** [Definition:] disorder characterized by multiple bilateral grapelike clusters of fluid-filled cysts that enlarge the kidneys, compressing and eventually replacing functioning renal tissue Affects males and females the equally [3 forms:] - Autosomal dominant polycystic kidney disease (ADPKD) -- most common type, inherited, accounts for about 10% of all cases of end-stage renal disease in US - Autosomal recessive PKD -- another inherited form, it's a rare form that can exhibit symptoms when a fetus is still in the womb - Acquired cystic kidney disease -- isn't inherited and tends to occur in the later stages of life, associated with long-term kidney problems, especially kidney failure and is prevalent in patients who have been receiving dialysis for a long period of time Dialysis= helps kidney's filtering function to remove waste, toxins and excess fluids 8. **Pyelonephritis** [Definition:] acute pyelonephritis is a sudden inflammation cause by bacteria that primarily affects the interstitial area and the renal pelvis or less commonly the renal tubules. One of the most common renal diseases and may affect one or both kidneys [In females:] most common probably because of the shorter female urethra and the proximity of external urethral orifice to vagina and rectum =\> bacteria reach bladder more easily [In males:] may occur due to - lack of antibacterial prostatic secretions, normally produced in males - prostate enlargement that obstructs urine flow 9. **Renal calculi - stones (nephrolithiasis)** [Definition:] stones can form anywhere in the urinary tract, most commonly in renal pelvis or calyx. May vary in size and may be solitary or multiple [Major types are:] - Calcium oxalate & Calcium phosphate: 75-80% - Struvite (magnesium, ammonium, phosphate): 15% - Uric acid: 7% 10. **Renovascular hypertension** [Definition:] occurs when systemic blood pressure increases due to intrarenal atherosclerosis or stenosis of major renal arteries or their branches. Most common type of secondary hypertension Intrarenal atherosclerosis = build-up of fatty deposits (plaques) -\> blockage of vessels Secondary hypertension = high blood pressure caused by underlying medical condition Partial or complete stenosis resulting in blood pressure elevation May be malignant of benign!  Angiotensin II stimulates the adrenal cortex to secrete aldosterone, which causes the nephrons to reabsorb sodium and water into bloodstream, elevating blood volume and pressure further =\> worsening symptoms for people who have renovascular hypertension 11. **Lower urinary tract infection (UTI) / cystitis** [Definition:] localized bacterial infection in the bladder. Bladder and urethra become inflamed and edematous causing specific symptoms [More common in females:] one in 5 women reports having had a UTI in their life **INTEGUMENTARY DISORDERS -- WEEK 10** 1. **Primary lesions** [Definition:] appear on previously healthy skin in response to disease or external irritation [Classified as:] - Macules - Papules - Plaques - Patches - Nodules - Tumors - Wheals - Comedos - Cysts - Vesicles - Pustules - Bullae 2. **Secondary lesions (modified lesions)** [Result from:] - Rupture - Mechanical irritation - Extension - Invasion - Normal or abnormal healing of primary lesions [Classified as:] - Atrophy - Erosion - Uclers - Scales - Crusts - Excoriation - Fissures - Lichenification - Scars 3. **Acne** [Definition:] chronic inflammatory disease of sebaceous glands usually associated with a high rate of sebum secretion [Occurs in areas that contain sebaceous glands:] - Face - Neck - Chest - Back - Shoulders [2 types of acne:] - Inflammatory: in which hair follicle is blocked by sebum causing bacteria to grow and eventually rupture the follicle (pimples) - Non-inflammatory: in which follicle doesn't rupture but remains dilated (blackheads and whiteheads) 4. **Contact dermatitis** [Definition: ] - Sharply border inflammation of the skin resulting from contact with an irritating chemical or atopic allergen (a substance producing an allergic reaction in the skin) - Irritation of the skin resulting from contact with concentrated substances to which skin is sensitive [Skin sensitivity to:] - Perfumes - Soaps - Chemicals - Metals and alloys (e.g. nickle used in jewelry) 5. **Basal cell carcinoma (basal cell epithelioma)** [Definition:] slow-growing destructive skin tumor that accounts for more than 50% of all cancers [Happens when:] basal cells in skin's lower layer grow abnormally. These cells don't mature or form normal skin properly, instead they keep dividing uncontrollably leading to lump or mass 6. **Cellulitis** [Definition:] infection of dermis or subcutaneous layer of skin possibly resulting from skin damage (bite or wound) [May cause:] - Fever - Erythema (redness of the skin) - Lymphangitis (inflammation of lymphatic vessels) 7. **Herpes zoster / Shingles** [Definition:] acute inflammation caused by infection with *herpesvirus varicella-zoster* (chickenpox virus) [Produces:] - Localized vesicular skin lesions - Severe neuralgic pain in peripheral areas [Complete recovery for most patients (usually occurs in adults) but possible:] - Scarring - Vision impairment (with corneal damage) - Persistent neuralgia (nerve pain) **Ramsay Hunt Syndrome:** specific complication of Herpes Zoster that occurs when virus affects facial nerve near the ear 8. **Malignant melanoma** [Definition:] neoplasm (όγκος) which arises from melanocytes and is characterized by enlargement of skin lesion or nevus (mole) [Accompanied by:] - Color - Inflammation - Soreness - Itching - Ulceration - Bleeding - Textural changes [Common sites:] - Head and neck (men) - Legs (women) - Back (those exposed to excessive sunlight) [Classified as:] - Superficial spreading melanoma - Nodular malignant melanoma - Lentigo maligna melanoma - Acral-lentiginous melanoma [Statistics:] - Increased incidence (up to 50% in past 20 years) suggests earlier detection - About 10 times more common among white populations [Tips to look for:] - Asymmetry: is the mole irregular in shape? - Border: is the border irregular, notched or poorly defined? - Color: does the color vary, for example, between shades of brown, red, white, blue or black? - Diameter: is the diameter more than 6 mm? 9. **Psoriasis** [Definition:] chronic, recurrent disease characterized by epidermal proliferation with recurring partial remissions and exacerbations Flare-ups commonly related to specific systemic and environmental factors but may be unpredictable Exfoliate or erythrodermic psoriasis signifies wide-spread involvement 10. **Squamous cell carcinoma** [Definition:] invasive tumor with metastatic (can spread) potential that arises from keratinizing epidermal cells Occur most commonly in fair-skinned white men older than age 60 Higher incidence with outdoor employment or reaction or residence in sunny, warm climate 11. **Pressure ulcers (sores, bedsores)** [Definition:] localized areas of cellular necrosis that occur most often in the skin and subcutaneous tissue over bony prominences [These ulcers may be:] - Superficial (caused by local skin irritation with subsequent surface breakdown - Deep (originating in underlying tissue): commonly remain undetected until they penetrate the skin but by then they usually have caused subcutaneous damage **REPRODUCTIVE & GENETIC DISORDERS -- WEEK 11** 1.