pathology wk 6

What main issue makes urinary system disorders particularly important to embalmers?

The associated accumulation of nitrogen in body tissues, which increases formaldehyde demand.

How does nitrogen accumulation affect formaldehyde demand during embalming?

Higher levels of nitrogen in the tissues create a higher formaldehyde demand.

In addition to decomposition, what causes nitrogenous waste accumulation in human remains?

Proper dysfunction or failure of the urinary system.

What secondary issues can urinary system disorders produce that complicate embalming?

Edematous tissues laden with microbial agents, which increase decomposition rates and retard fluid distribution/diffusion.

What is uremia?

A urinary system disorder caused by the retention in the blood of nitrogenous waste products normally excreted in urine.

What two visual and olfactory signs indicate uremia to an embalmer?

A strong odor and possible yellow discoloration of the tissues.

How does uremia affect tissue moisture and formaldehyde demand?

It greatly increases formaldehyde demand and commonly presents both dehydration and edema.

What embalming fluid choice should be used if yellow discoloration from uremia is present?

The embalmer should err on the side of caution and use a jaundice fluid rather than a high index fluid.

What is acute glomerulonephritis characterized by clinically?

Sudden onset of blood and protein in the urine accompanied by salt and water retention.

What cellular and structural changes occur in the glomerulus during acute glomerulonephritis?

An increase in epithelial/endothelial cells, heavy presence of neutrophils and monocytes, and thickening of capillary walls.

What physiological symptoms result from the cellular changes in acute glomerulonephritis?

Excess protein in urine, blood in urine, edema, and high blood pressure.

What are potential etiologies or causes of acute glomerulonephritis?

Streptococcal throat infection, skin infection, hepatitis, diabetes, or intravenous drug use.

How is acute glomerulonephritis treated depending on etiology?

With antibiotics.

How are urinary tract infections (UTIs) typically categorized?

By the specific portion of the urinary tract that is affected.

Which common microorganisms cause urinary tract infections?

Neisseria gonorrhea, Chlamydia trachomatis, Escherichia coli, Proteus species, and Pseudomonas species.

What is the difference between pyelitis and pyelonephritis?

Pyelitis is inflammation of the renal pelvis and calyces; pyelonephritis is an inflammatory disorder of the nephrons caused by renal infection.

What is the common term for pyelonephritis and what regions does it infect?

Kidney infection, affecting both the renal pelvis and the remainder of the kidney.

What is ureteritis and what structures does it affect?

Inflammation of one or both ureters, which connect the kidneys to the urinary bladder.

What are the two main causes of ureteritis?

Spread of infection from the kidneys to the bladder, or defective nerves controlling ureter function.

How does damage to the nerve supply of a ureter cause ureteritis?

It causes the muscular layers of the ureter to malfunction, slowing urine flow.

What is cystitis versus interstitial cystitis?

Cystitis is any inflammation of the urinary bladder; interstitial cystitis is a recurring condition with pain in the bladder and pelvic region.

What are the symptoms of interstitial cystitis?

Urgent need to urinate up to 60 times a day and increasing pain as the bladder fills or empties.

What structural changes occur in the bladder wall over time with interstitial cystitis?

The bladder wall becomes irritated or scarred, and pinpoint bleeding appears from recurrent irritation.

Why are antibiotics ineffective for interstitial cystitis?

Because interstitial cystitis is idiopathic.

What is the cure status for interstitial cystitis?

There is currently no cure.

What is urethritis and what structure does it involve?

An inflammatory condition of the urethra, the tube carrying urine out of the body from the bladder.

Who is more likely to develop urethritis: men or women?

Women are far more likely than men to develop urethritis.

Which sexually transmitted pathogens cause urethritis?

Neisseria gonorrhea, Chlamydia, and herpes simplex virus.

What are the symptoms of STI-related urethritis?

Painful urination and a yellow-green discharge of pus from the urethra.

Is hydronephrosis considered a primary disease?

No, it is a condition that occurs as part of a disease, not a disease itself.

What causes hydronephrosis?

A kidney becoming distended due to a backup of urine.

What is the difference between bilateral and unilateral hydronephrosis?

Bilateral involves both kidneys; unilateral involves a single kidney.

What conditions or factors cause or accompany hydronephrosis?

Pregnancy, obstruction of the renal system, backflow of urine from bladder to ureter/kidney, and kidney stones.

Do symptoms always appear in unilateral hydronephrosis?

No, unilateral hydronephrosis may occasionally present no signs or symptoms.

What is nephrolithiasis?

A condition in which one or more kidney stones (renal calculi) are present in the urinary system.

What substances overconcentrate in urine to form kidney stones?

Calcium, oxalates, phosphates, and carbonate.

When do kidney stones typically begin causing pain and where is it felt?

When they move down the ureter, causing pain starting in the abdominal flank leading to the groin.

What populations or patient histories show increased risk for kidney stones?

Premature infants, individuals with family history, and people with a history of more than two stone episodes.

What is polycystic kidney disease?

An inherited disorder characterized by bilateral, grapelike clusters of cysts replacing normal renal tissue.

How do polycystic cysts impact kidney function?

They enlarge the kidneys externally, compressing internal nephrons and disrupting blood filtration and urine production.

What features characterize renal cell carcinoma?

Lack of early warning signs, diverse clinical manifestations, and resistance to radiation and chemotherapy.

Where in the kidney does renal cell carcinoma typically originate?

In the epithelium of the proximal renal tubule.

Where does renal cell carcinoma frequently metastasize?

Lungs, soft tissues, bone, liver, and brain.

Why does renal cell carcinoma have a high mortality rate?

Due to its rapid metastasis combined with resistance to conventional treatments.

What cancer type typically causes carcinoma of the urinary bladder?

Transitional cell carcinomas.

In what parts of the urinary tract can transitional cell carcinomas appear?

Renal pelvis, ureter, bladder, or urethra.

How is bladder cancer categorized structurally and invasively?

As low grade vs. high grade, and superficial vs. muscle invasive.

What rare primary tumors and other cancer types occur in the urinary bladder?

Small cell carcinoma, lymphoma, sarcoma, adenocarcinomas, squamous cell carcinomas, leiomyosarcomas, and rhabdomyosarcomas.

What is one of the only initial signs of bladder cancer?

Painless hematuria (blood in the urine).

What is renal failure and what are its two forms?

The loss of kidney function; classified as acute or chronic.

What causes acute renal failure?

Sudden drop in blood pressure (trauma, surgery, septic shock, hemorrhage, burns, dehydration), renal artery blockage/narrowing, or severe infections.

How does chronic renal failure differ from acute renal failure?

Acute is sudden and reversible; chronic is slowly progressive and rarely reversible.

What is dialysis?

Diffusion of blood across a semipermeable membrane to remove toxic materials and maintain fluid, electrolyte, and acid-base balance.

When is dialysis utilized clinically?

For kidney failure, or in emergency situations to quickly remove drugs or poisons.

What are the four significant postmortem conditions associated with urinary system diseases?

Edema, uremia, dehydration, and odor.

What general chemical and volume requirements are needed for embalming urinary disease cases?

Astringent embalming chemicals and copious amounts of arterial embalming fluid.

What two effects do nitrogenous compounds from uremia have on embalming?

They neutralize formaldehyde (increasing formaldehyde demand) and alter protein structures (inhibiting cross-linking).

How can postmortem edema and odor from urinary diseases be reduced during embalming?

Through aggressive arterial embalming techniques.

How does the textbook classify respiratory system disorders instead of location?

Categorized as either pathological or microbiological.

What traditionally defines upper vs lower respiratory diseases?

Upper involves nose, throat, and trachea; lower involves bronchi and lungs.

What is the difference between rhinitis and sinusitis?

Rhinitis is nasal irritation/inflammation; sinusitis is inflammation of any/all four skull sinus cavities opening into nasal passages.

What shared symptoms characterize rhinitis and sinusitis?

Runny nose, itching, sneezing, stuffy nose (congestion), and eye itching.

What is the primary cause of chronic rhinitis?

An allergy commonly referred to as hay fever.

What is pharyngitis vs laryngitis, and what happens when combined?

Pharyngitis is throat inflammation; laryngitis is voice box inflammation. Combined, they cause a sore throat and loss of voice.

What common respiratory infections feature pharyngitis and laryngitis as symptoms?

The common cold and strep throat.

Which two viruses most commonly cause the common cold?

Rhinoviruses and coronaviruses.

Why can the body never build complete immunity to the common cold?

Because over 200 different viruses cause cold symptoms.

How does age affect the frequency of the common cold?

Children get 6–10 colds/year due to low resistance; adults over 60 get 1 or fewer per year.

When do cold symptoms begin and what secondary infections can occur?

Symptoms begin 2–3 days post-infection; secondary bacterial infections can affect middle ears or sinuses.

What is tracheitis and its most common bacterial cause?

Inflammation/bacterial infection of the trachea causing windpipe blockage, most often caused by Staphylococcus aureus.

Why does tracheitis usually require hospitalization?

Airway blockage requires insertion of an endotracheal breathing tube.

What are the clinical signs of tracheitis?

Deep barking cough, crowing sounds on inhalation, high fever, breathing difficulty, and intercostal retractions.

What is bronchitis and how is chronic bronchitis defined?

Inflammation of the main lung airways (bronchi); chronic requires mucus cough most days for at least 3 months per year.

What occurs in the bronchi during an asthma attack?

Hypersensitive bronchial linings get irritated and swell shut, reducing airflow.

What posture and sound are characteristic of asthma?

Hunching forward to inhale, accompanied by shortness of breath and wheezing.

In which age group does asthma occur more frequently?

Children.

What is pneumonia and how are its cases categorized?

Inflammation/infection of lungs; categorized by infection site and causative agent.

What is the difference between lobar pneumonia and bronchial pneumonia?

Lobar affects a single lung lobe; bronchial affects smaller areas across several lobes.

What is pleurisy and what is empyema?

Pleurisy is inflammation of lung pleurae; empyema is pus accumulation within pleural exudate.

What are hemorrhagic pleurisy and pleural adhesions?

Hemorrhagic is blood in the pleural space; adhesions occur when fibrous material binds pleura to diaphragm/chest wall.

What are the signs and symptoms of pleurisy?

Stabbing pain, worsening pain on deep breath, chills, cough, fever, pale/anxious face, guarding/lying on affected side.

Why did the WHO declare tuberculosis a global emergency?

Global breakdown in health services, spread of HIV/AIDS, and emergence of multidrug-resistant strains.

How does the tuberculosis bacterium survive harsh environments?

It possesses a waxy coat that withstands extreme environmental changes.

How is tuberculosis transmitted and what does multidrug-resistant mean?

Spread through air; multidrug-resistant strains resist all major anti-TB drugs.

What is atelectasis?

Loss of lung volume ("incomplete expansion") from inadequate airspace expansion, preventing gas exchange.

What is the difference between obstructive and nonobstructive atelectasis?

Obstructive (most common) results from blocked trachea/bronchi; nonobstructive results from pleura contact loss, compression, surfactant loss, or scarring.

What structural changes and physical signs occur in emphysema?

Desiccated/torn alveolar walls and air trapped at bronchiole ends cause a barrel chest and pursed-lip breathing.

What primary conditions bring on secondary emphysema?

Infections, long-term smoking, or pneumoconiosis.

What causes a lung abscess and what condition frequently leads to it?

Infected/inflamed pus-filled lung tissue, frequently caused by inhaling bacteria from periodontal gum disease.

What happens when a lung abscess ruptures?

It creates an air-and-fluid cavity in the lung, or causes empyema if it ruptures into the pleural space.

What is pneumoconiosis and what are its four most common mineral sources?

Respiratory inflammation from mineral dust; common sources are coal dust, silica, asbestos, and beryllium.

How do lung macrophages contribute to tissue damage in pneumoconiosis?

They release hazardous chemicals attempting to destroy trapped dust, forming fibrous masses.

Why can pneumoconiosis affect non-workers outside occupational settings?

Family members exposed to dust carryover develop increased frequency of cancers and lymphatic damage.

What major disease context is frequently complicated by respiratory fungal infections?

Complications of AIDS.

What are three common fungal diseases of the respiratory system?

Histoplasmosis, aspergillosis, and coccidioidomycosis.

What genetic mutation causes cystic fibrosis and what is the average terminal age?

Mutations in the CFTR gene; terminal in most cases at an average age of 20.

What physiological defect causes thick mucus in cystic fibrosis?

Defective cells fail to release chloride, causing a salt imbalance and thick mucus production.

What organs are obstructed by mucus in cystic fibrosis patients?

Lungs (causing infection), pancreas, and intestines (blocking digestive enzymes).

What is a respiratory polyp and where is it most commonly found?

A pedicled tumor attached by a blood-supplying stem, most common in nose/throat of patients with chronic allergies/sinusitis.

Why are large respiratory polyps often surgically removed?

They bleed easily, can become malignant, and interfere with breathing.