Patho Exam 1 PDF

decreased nutrients to the tissues- ISCHEMIA Nosocomial: infection acquired while in a hospital setting Know the hypersensitivities and examples of each Type 1, IgE mediated: –Immediate response –Local or systemic –Allergen activate IgE which bind to mast cells –At next...

decreased nutrients to the tissues- ISCHEMIA Nosocomial: infection acquired while in a hospital setting Know the hypersensitivities and examples of each Type 1, IgE mediated: –Immediate response –Local or systemic –Allergen activate IgE which bind to mast cells –At next exposure, the antigen binds with the surface IgE, releasing mediators and triggering the complement system –Examples: hay fever, food allergies, and anaphylaxis –Treatment: epinephrine, antihistamines, corticosteroids, and desensitizing injection Type 2, cytotoxic hypersensitivity reaction: –IgG or IgM type antibodies that react to foreign tissue of cells –Lysis of blood cells occurs because of the activation of the complement –Usually immediate responses –Examples: Blood transfusion reaction and erythroblastosis fetalis –Treatment: Ensuring blood compatibility, administering medication to prevent maternal antibody development Type 3, immune complex-mediated hypersensitivity reaction: - Circulating antigen-antibody complexes accumulate and are deposited in the tissue - Usually immediate response - Triggers the complement system and inflammation - Example Autoimmune conditions (e.g. systemic lupus erythematosus) - Treatment: is disease specific  Type 4, delayed hypersensitivity reaction: - Cell-mediated rather than antibody-mediated involving the T cells - Delayed response - Examples: tuberculin skin testing, transplant reactions, poison ivy and contact dermatitis - Treatment: is disease specific Know the types of prevention Tertiary prevention: Management of chronic diseases, and rehabilitation support services to slow down the progression of diseases Secondary prevention: Health assessment and screening to facilitate early identification of chronic diseases Primary prevention: Health promotion, advisory, and counseling services and educational programmes to drive lifestyle changes for the prevention of chronic diseases Known a lot about hypertension: Hypertension, also known as high blood pressure, is a condition where the pressure in your blood vessels is consistently too high. Hypertension is common but can be serious if left untreated. It can increase the risk of other health problems, such as heart disease, stroke, and kidney disease. People with high blood pressure may not feel symptoms, so the only way to know if you have it is to get your blood pressure checked.  Know the types of shock: - Cardiogenic: When the heart can't pump blood effectively, often due to heart problems or a heart attack - (answer on exam, likely) Hypovolemic: When there's not enough blood volume - Neurogenic: When the nervous system is damaged, such as from a spinal cord injury, head trauma, anesthesia, stress, or severe pain - Anaphylactic: Caused by an allergic reaction - Septic: Caused by infections - Obstructive: When something outside of the heart prevents it from pumping enough blood Know the caution mnemonic: C: Change in bowel or bladder habits, such as diarrhea, constipation, blood in stool or urine, or changes in urine color A: A sore that doesn't heal, or that grows, becomes more painful, or doesn't improve over time U: Unusual bleeding or discharge T: Thickening or lump in the breasts, testicles, or elsewhere I: Indigestion or difficulty swallowing O: Obvious change in the size, color, shape, or thickness of a wart, mole, or mouth sore N: Nagging cough or persistent hoarseness Cleft palate is an example of multifactorial inheritance Other examples include cancers of the breast, ovaries, bowel, prostate, and skin, high blood pressure, high cholesterol, diabetes, and coronary artery disease  Know the Turner’s vs Klinefelter’s syndrome - Klinefelter syndrome (KS) is a genetic condition that occurs when a male is born with an extra X chromosome. XXY or XXXY; features of Klinefelter syndrome include some mental impairment, usually sterile, some breast development, high pitched voice, small testes. - Turner syndrome is a genetic disorder that affects females when they are born with a missing or abnormal X chromosome. It's one of the most common chromosomal disorders in girls and can cause a variety of symptoms, including short stature, infertility, Congenital heart defects, and ear and hearing problems - Down syndrome is when DNA fragments are displaced or lost, thus altering genetic information. Features of down syndrome include small head and flat facial profile, development stages are delayed, and hands are small and have a single palmar crease. Know what the purpose of the TNM scale is for diagnosing cancer The TNM (tumor, node, and metastasis) staging system helps doctors determine the size and spread of cancer in a patient's body. T: Describes the size of the primary tumor and whether it has spread into nearby tissue. N: Number of nearby lymph nodes that have cancer and how far the cancer has spread to them. M: Whether the cancer has spread from the primary tumor to other parts of the body, also known as metastasis.  Know the types of necrosis and example of each: - Liquefaction necrosis refers to the process by which dead cells liquefy under the influence of certain cell enzymes. Example: Cerebellum or brain infarction - Coagulative necrosis occurs when the cell proteins are altered or denatured and the cells retain some form for a time after death. Example: kidney - Fat necrosis occurs when fatty tissue is broken down into fatty acids in the presence of infection or certain enzymes. Example: mesentery or pancreas - Caseous necrosis is a form of coagulation necrosis in which a thick, yellowish, “cheesy” substance forms. Example: Lung - Dry gangrene is often caused by coagulative necrosis, in which the tissue dries, shrinks, and blackens. Example: dry gangrene of a toe - Wet gangrene is a result of liquefaction causing the tissue to become cold, swollen, and black. Example: wet gangrene of a foot Know your med term a. itis = inflammation b. oma = tumor c. tomy = to cut out, incision d. arthro = joint e. litho = stone f. arthritis = inflammation of a joint g. lithology = study of stones h. lithotomy = removing a stone i.myocardium = muscle (myo) of the heart (cardia) j.tachycardia = fast (tach – swift/speed) heart k. cardiomyopathy = diseased muscle of the heart l. appendectomy = to cut out the appendix m. appendicitis = inflammation of the appendix n. dermatitis = inflammation of the skin o. antibiotic = against a living thing p. sarcoma = cancerous/malignant tumor of the flesh q. patho = diseased r. ology = to study s. pathology = study of diseases t. pathologist = a specialist that studies diseases Know the types of gangrene and necrosis: - Liquefaction necrosis refers to the process by which dead cells liquefy under the influence of certain cell enzymes. Example: Cerebellum, stroke, or brain infarction - Coagulative necrosis occurs when the cell proteins are altered or denatured and the cells retain some form for a time after death. Example: kidney - Fat necrosis occurs when fatty tissue is broken down into fatty acids in the presence of infection or certain enzymes. Example: mesentery or pancreas - Caseous necrosis is a form of coagulation necrosis in which a thick, yellowish, “cheesy” substance forms. Example: Lung (tuberculosis) - Dry gangrene is often caused by coagulative necrosis, in which the tissue dries, shrinks, and blackens. Example: dry gangrene of a toe - Wet gangrene is a result of liquefaction causing the tissue to become cold, swollen, and black. Example: wet gangrene of a foot - Gas gangrene is the gas inside the tissue. Example: foot. Bacterial invasion contributed to a diagnosis Know the types of cellular adaptations  - Atrophy: Individual cells get smaller– if sufficient number entire organ shrinks. Causes: Decrease in workload, pressure, use, blood supply, nutrition, hormonal stimulation & nervous stimulation Example: brain (alzheimer) - Hypertrophy: individual cells get bigger. Causes: High blood pressure or Resistance exercise. Example: muscles. - Hyperplasia: increase in # of cells (increased cell division). Example: Benign prostatic hyperplasia and Foot callus - Metaplasia: Reversible replace of one mature cell type by another cell type(can be less differentiated). Causes: Chronic irritation or inflammation. Examples: Bronchus (air pollutants) - Dysplasia: Abnormal change in size, shape & organization of mature cells (not adaptive). Example: Cervical dysplasia (pap smears check for dysplasia as it is an early sign of cervical cancer). - Neoplasia: Uncontrolled and excessive growth. Examples: Any cancerous growth/ tumor Know the definition of pathophysiology Pathophysiology is the study of the disorder or breakdown of the human body’s function. Know benign and malignant tumors Benign: Slow growing Well-defined Capsule Not invasive Well differentiated Low mitotic index No metastasis Malignant: Fast growing Not encapsulated Invade locally Poorly differentiated Hi mitotic index Able to metastasize Know the anemias Pernicious: Autoimmune: –anti-IF or anti-parietal cell antibodies Manifestations: –bleeding gums, diarrhea, impaired smell, loss of deep tendon reflexes, anorexia, personality or memory changes, positive Babinski’s sign, stomatitis, paresthesia, and unsteady gait Diagnosis: –CBC, serum B12 levels, Antibody presence, gastric analysis, folate – (Schilling’s test, bone marrow biopsy) Treatment: injectable B12–Bypass GI tract absorption - Macrocytic Megaloblastic: Folate and VitB12 are required for DNA synthesis – Leads to decreased maturation & cell division –Become anemic –large red cells Decreased intake from diet –Stores in body vary (folate few months, B12 few years) In VitB12 deficiency may be caused by a lack of intrinsic factor (binds to VitB12 and enables the ileum to absorb) –Causes: Gastric dysfunction Celiac sprue Autoimmune(anti-IF or anti-parietal cell antibodies) –Pernicious Anemia –May see myelin breakdown & neurological complications - Macrocytic Aplastic Anemia Pancytopenia:– Bone marrow depression of all blood cells –damage to PSC Causes: – insidious, other anemias, autoimmune, medications, medical treatments, viruses, cancer, and genetic Onset may be insidious or sudden & severe Manifestations: –Anemia (e.g., weakness, pallor, dyspnea) – Leukocytopenia (e.g., recurrent infections) –Thrombocytopenia (e.g., bleeding) Diagnosis: – complete blood count and bone marrow biopsy Treatment: – identify and manage underlying cause, oxygen therapy, infection control & treatment, bleeding precautions, blood transfusions, and bone marrow transplants Sickle Cell Anemia Autosomal recessive inheritance–Abnormal Hemoglobin “S” (one AA substitution)–Trait is both HgbS and HgbA (normal)–Disease/Anemia is homozygous SS HgbS causes the RBC to become abnormally shaped/sickled under low oxygen conditions–Abnormal RBC’s carry less oxygen and clog vessels–Causing tissue hypoxia and ischemia More common in people of African and Mediterranean descent–Also seen in people from South and Central America, the Caribbean, and the Middle East Manifestations: –Appear as early as 6 months of age –Sickle cell crisis Painful episodes that can last for hours to days Pain is caused by tissue ischemia and necrosis Triggered by dehydration, stress, infection, high altitudes, and fever –Include: abdominal pain, bone pain, dyspnea, delayed growth and development, fatigue, fever, jaundice, pallor, tachycardia, skin ulcers, angina, excessive thirst, frequent urination, priapism, and vision impairment  Diagnosis: –CBC, sickle solubility (screen), hemoglobin electrophoresis, CMP Life expectancy improving with better management Treatment: –No cure, palliative EXCEPTION: Stem cell or bone marrow transplant Gene therapy under research –Avoid triggers –Medications (e.g., Hydrea[hydroxyurea]) –Other strategies: oxygen therapy, hydration, pain management, infection control, vaccinations, blood transfusions, bone marrow transplants, genetic counseling Hemolytic Anemia Excessive erythrocyte destruction Reticulocyte production index is high Causes: –idiopathic, autoimmune, genetics, infections, blood transfusion reactions, and blood incompatibility in the neonate Several types:–hemoglobinopathies (sickle cell anemia), thalassemia, RBC membrane or enzyme defects, immune (erythroblastosis fetalis) and non-immune hemolytic Anemia Know hodgkins vs nonhodgkins Lymphomas Cancers originate in lymphatic system– Affects WBC’s as well Most common hematologic cancer in the US Two main types: – Hodgkin lymphoma: B Cells – Non-Hodgkin lymphoma: B Cells, T Cells, NK Cells Hodgkin Lymphoma Lesser common of the two Solid tumors with the presence of Reed-Sternberg cells  Typically originate in the lymph nodes of the upper body Several subtypes Amenable to cure Manifestations – painless enlarged lymph nodes, weight loss, fever, night sweats, pruritus, coughing, difficulty breathing, chest pain, recurrent Diagnosis:– Physical examination, presence of Reed-Sternberg cells in a lymph node biopsy, CBC, chest X-rays, CT-scan,MRI,PET scan, and bone marrow biopsy Treatment: – chemotherapy, radiation, and surgery Non-Hodgkin Lymphoma More common Poor prognosis Many different types Similar to Hodgkin manifestations, staging, and treatment Different in the spread and diagnosis Can originate in the T or B cells No Reed-Sternberg cells Know the types of leukemia: Leukemia Manifestations: –leukopenia, leukocytosis, anemia, thrombocytopenia, lymphadenopathy, joint swelling, bone pain, weight loss, anorexia, hepatomegaly, splenomegaly, and central nervous system dysfunction Diagnosis:–H&P , CBC with a peripheral blood smear, and bone marrow biopsy Treatment: –chemotherapy and bone marrow transplant Chronic Myeloid Leukemia – Affects primarily adults – Responds poorly to chemotherapy, but the prognosis is improved with allogenic bone marrow transplant Acute lymphocytic leukemia: -B lymphocytes -Young children -The best prognosis is found in children between 1 and 9 years of age; infants and adolescents respond less positively to chemotherapy. The more rapid the response to drugs, the more positive the outlook. Acute myelogenous (or myelocytic) leukemia: -Granulocytic stem cells -Adults Chronic lymphocytic leukemia: - B lymphocytes -Adults >50 years -The prognosis is often related to the WBC count and the proportion of blast cells present at the time of diagnosis. Chronic myelogenous leukemia: -Granulocytic stem cells -Adults 30–50 years Acute monocytic leukemia: - Monocytes - Adults -Chemotherapy is less successful in adults with AML, although remissions may be achieved. Hairy cell leukemia: -B lymphocytes -Males >50 years Know the hemoglobin structure: Globin group: Surrounded by the four heme groups Heme groups: Ring-like organic compounds called porphyrins with an iron atom attached Protein chains: Two alpha chains and two beta chains, each with a heme group Know where hematopoiesis occurs in children and in adults: Hematopoiesis How is it regulated? –Via “hormones” or growth factors: Received from other body cells Act as signals to hematopoietic tissue MANY growth factors exist  Are both general and specific growth factors to make certain cell types -Via apoptosis: Normal life span of cell; “programmed” cell death Good to remove aged and defective cells Where does it occur? –Embryonic stage : Yolk sac & AGM (aorta-gonads mesonephros) Up to about 6 weeks gestational age –Fetus: Liver and spleen Peaks at about 6 months gestation –Newborn: bone marrow in all bones –Adult: Bone marrow in axial skeleton Supplemented by spleen & liver if problem with marrow–Called “extramedullary” hematopoiesis–Marrow is in the middle or medulla of the bone Know that HIV effects CD4 cells and macrophages- on the exam it will give macrophages as a choice but DO NOT pick it- the answer is T cells bc CD4 cells are a type of T cell Know manifestations of lupus specifically the malar rash Manifestations of lupus include skin rashes (malar rash), Fatigue, abdominal pain, and joint pain Know the stages of general adaptation syndrome- alarm, resistance, and exhaustion  Alarm reaction The body's initial response to stress, which can include a sudden burst of energy, increased heart rate and breathing rate, and higher glucose levels. For example, if someone hears a rustling noise in the bushes while hiking and realizes it's a bear, their hypothalamus sends a distress signal to the pituitary glands, which release glucocorticoids. The glucocorticoids then trigger the adrenal glands to release adrenaline and cortisol. Resistance The body's resistance to stress is maximized during this stage. For example, the hiker might still be alert as they enter the resistance stage after running away from the bear. Exhaustion The body's ability to adapt to stress is exhausted during this final stage, and death can sometimes occur. If the stress that triggered GAS isn't resolved, it can lead to physical and mental health problems. Know what maladaptive and adaptive coping mechanisms are and examples of each Adaptive coping mechanisms: - actions that help people manage their emotions and work through stress in a healthy way. - Examples: sleep, planning, exercise, and talking. Maladaptive coping mechanisms: - can be counterproductive and harmful to a person's well-being. - Examples: drinking, drugs and isolation. Know DiGeorge Syndrome is a lack of T cells and is an example of primary immunodeficiency Know that sarcoma and carcinoma are terms that indicate something is cancerous