UTA Patho Final

Hyperplasia

Increased multiplication of cells

Rheumatoid Arthritis VS. Osteoarthritis

RA occurs all over body, in younger peopleworse in the morning, requires a blood test

OA worse at night and occurs in older people, wear down of protective cartilage

Opportunistic deseases seen in AIDS patients

Thrush, Pneumoctstis pnemonia (PCP), Cytomegalovirus (CMV), Kaposi Sarcoma (Causes lesions)

What can cause bloody diarrhea?

Dysentery, IBS, Crohn's

Lymohademopathy

enlarged lymph nodes bc of infection or cancer

Hypersplenism

overactive spleen-WBC, RBC, platelets get eaten

S/S anemia, leukopenia, thrombocytopenia, pancytopenia

Spleenomegaly

enlargment of the spleen

causes: increased hemolysis of RBC

Chronic venous insufficiency (CVI)

ploppy veins and valves, poor venous return,

S/S edema, brown skin, breaks in skin that cant heal bc can't get though edema

Polycythemia Vera

Blood cancer that causes an overproduction of RBC making blood thick and sludgy treated by donating blood

Deep vein thrombosis (DVT)

Caused by virchow's triad

S/S swelling, redness, warm

Virchow's Triad

Venous stasis- Hypercoaguability- vascular wall injury

Pulmonary Embolism

S/S SOB bloody sputum, right heart backflow

Arterial insufficiency

Plaque build up,hardening of walls

etiology: genetics, lack of exercise, diet, alcoholism, smoking

Peripheral Arterial disease (PAD)

Narrowed blood vessels cause lack of blood flow

S/S Pain, Paresthesia (prickly burning), Pallor (unhealthily pale)

Terratogenic influences on pregnant woman

drugs, alcohol

Alternative name for Down syndrome

Trisomy 21

3 single gene disorders

autosomal recessive, autosomal dominant,

sex-linked

Carcinoma

malignant epithelium (Skin cancer)

Dysplasia

abnormal growth of cells, tissues, bone, or an organ

McCardle's disease

a glycogen storage disease

S/S Muscle pain, weakness,cramps, exercise intolerance

Beriberi disease

Lack of thiamine (B1)causing problems with Memory and parasthesia

etiology: alcoholism, poor diet

S/S SOB, swollen legs, pain

Sickle cell anemia

Autosomal recessive disease

mutates RBC C shaped

S/S SOB, fatigue, ischemia esp, in joints

Metaplasia

Reversible replacement of one differentiated cell type with another

Kwashiorkor

protein malnutrition from diet

S/S swollen belly in children, frequent infection

Sarcoma

malignant connective tissue (bones, soft tissue)

Hypertrophy

abnormal enlargement of a body part or organ

Wernicke sydrome

B1 thiamine deficiency due to alcoholism

Venous stasis from congestion causes

increased hydrostatic pressure leading to:

edema

varicose veins(twisted veins)

S/S of Edema

dry tight skin, brownish discoloration, venous ulcers

CVI factors

Age, inherited predisposition, obesity, pregnancy, poor muscle tone from immobility

Thrombophlebitis

inflammation and swelling of vein from clot(DVT)

Virchow's Triad is present in people who

Sit for long periods

have casts

pregnant

obese

on diuretic medication

have preexisiting problems such as circulation, clotting probs

Pulmonary Embolism S/S

Can occur due to DVT

chest pain

SOB

hemoptysis

shock

Treating venous probs (DVT,PE)

mobility

hydration

elevate legs

blood thinners

Systolic pressure

Diastolic pressure

-Pressure on arteries when heart is contracting and ejecting blood

-Pressure when heart is resting

Good perfusion

110/60, pulses can be felt, palpable arteries, nail blanching, normal organ function

Arteriosclerosis

chronic disease of arterial system

Arteriosclerosis etiology

HTN, smoking,diabetes, infectin, high cholesteral, microscopic damage,

Atherosclerosis

fat deposits in wall causing inflammation and coagulatory response

Patho of aterio disease

Ischemic pain(increase with exertion)

pale,cool skin

delayed healing

altered level of consciousness

Peripheral arterial disease (PAD)

commonly applies to legs but any arterial disease outside of the heart

Venous thrombi

Block flow toward heart

Etiology for Hypertension

Atherosclerosis

Overactive sympathetic nervous system

Overactive RAAS

Overactive sympathetic system patho

Over-relase of epinephrine by cariac symp nerve fibers---Over stimulates beta receptors of heart muscle which INCREASES HR and contractility

resulting in GREATER CARDIAC OUTPUT

larger volume of blood in peripheral arteries lead to sustained increased BP

Damage done by Hypertension

Neuological (loss of funtion in brain due to ischemia)

Renal (spilling of blood or protein into urine eventually leading to renal failure)

Cardiovascular (increased workload stiffens arteries leading to high BP)

hematuria

blood in urine due to high pressures

proteinuria

protein found in urine due to high pressure

Aneurysms

dilated or out-pouching of arterial vessel wall from

weakened arterial walls

injury to the intima allowing blood to seep into arterial muscles and tissues

Aneurysm S/S

if leaks or ruptures in brain

weakness on one side of the body

change in level of consciousness

headache

How to prevent HTN/ arterial disease

manage stress, smoking, alcohol

Lower LDL and HDL

exercise

increase good fat

Beta-blockers to help sympathetic overactivity

ACE inhibitor to help RAAS overactivity

RUQ contains

liver&gall bladder, part of pancreas, part of transverse colon

LUQ contains

part of stomach, spleen, part of transverse colon

RLQ contains

cecum, appendix, part of ascending colon

LLQ contains

Part of descending colon, sigmoid colon

Umbilical region contains

lower duodenum, jejunum, ileum

epigastric area contains

pyloric area of stomach, duodenum, art of pancreas

Gastroesophageal reflux disorder (GERD)

reflux of hydrochloric acid and pepsin from stomach into esophagus--due to relaxation of lower esophageal sphinctor

Barrett's esophagus

Tissue in esophagus becomes dysplastic (precancerous) due to GERD

Hiatal heria

stomach herniates through the diaphragm causing GERD, dysphagia (difficulty swallowing)

Gastritis

inflammation of gastric tissue can cause erosion

S/S pain, burning, bleeding

acute gastritis

results from overuse of NSAIDS (suppress protective prostaglandins) or ETOH (alcohol)

heals once offending agent is removed

Chronic gastritis (atrophic gastritis)

Autoimmune etiology

occurs in elderly

DEVELOP pernicious anemia

Peptic Ulcer disease (PUD)

inflammation of stomach and proximal duodenum mucosal lining allowing acid to ulcerate underlying tissue causing ULCERS

Causes of PUD

ASA(aspirin)

NSAID ALl DECREASE PROSTAGLANDINS

Chronic steroids

Heavy alcohol use

chronic disease such as liver,CKD,diabetes

Psychological stress

H.Pylori

Heliobacter Pylori

bacteria ingested that burrows past mucous lining and attatches to epithelial cells

S/Spain after eating

GI bleeding

Treated by antiacids and eradicated by antibiotics

Colorectal cancer

S/S blood in stool

changes in bowel habits

TX if confined to polyp- polypectomy

if widespread removal of part of colon leading to colostomy

Inflammatory bowl disease

inflamm of lining and walls of intestines

Crohn's disease

ulcerative colitis

Fistula

abnormal channels or connection of organs

Crohn's disease (small intestines)

Transmural involvement (all layers of bowl are inflamed )

Patchy pattern

S/S malabsorption, bloody diarrhea, abdominal cramps, weight loss

Ulcerative colitis (large intestine colon disease)

Ulcers begin in rectum and progress into entire colon

confluent segments of inflamed tissue

do not extrend beyond submucosa

S/S main difference-- dehydration

not at risk for malnutrition

Patho of an intestinal obstruction

Obstruction- buildup of fluid and gas proxima; to obst.- adbominal distention

S/S colicky abdominal pain

constipation

causes of bowl obstruction

adhesions (scaring)

hernia

tumor

intussusception ( telescope portion of bowel cutting blood)

volvulus (tortion)

paralytic ileus (loss of motion)

Paralytic illus caused by

post anesthesia, abdominal surgery. electrolyte imbalance, spinal trauma

Diverticulum/ diverticulosis

herniation of mucosa from muscle layer of intestine protruding out

No symtoms

Diverticulitis

inflammation and pain of diverticula

S/S LLQ pain, feve, leukocytosis

abscess formation, rupture

TX increase fiber, avoid seeds/nuts, anitbiotics'

UGI

bleeding from upper GI

esophagus, stomach, deodenum

S/S hematemesis( vomit)

frank bleeding (brown color, partially digested)

Occult bleeding (trace amount from chronic bleeding)

LGI

bleeding from lower GI

jejunum, ileum. colon

IBD, diverticulitis, neoplasms

Hematochezia

blood in the stool

Jaundice

alteration in bilirubin cycle where it gets deposited in various places manifesting as yellow-green skin

Prehepatic, hepatic, posthepatic

Prehepatic Jaundice

increased unconjugated bilirubin which occurs when hemolysis rate is faster then livers ability to process bilirubin

hemolytic anemia( decreased RBC bc of destruction) or erythroblastosis fetalis

Posthepatic jaundice (obstructive)

Increased conjugated bilirubin(direct bilirubin) problem with bilirubin making into intestines due to obstruction or inflammation (ex:tumor)

backs up and leaks from liver cells into circulation

Makes stool grey

Hepatic jaundice

increased unconj bili from cirrhosis or hepatitis so liver cannot conjuate and conjuate bili is low

Prehepatic Blood test

bili serum- high

Indirect (unconjugated bili)- high

direct bili-normal

posthepatic blood test

bili serum- high

Indirect (unconjugated bili)- normal

direct bili- high

hepatic blood test

bili serum-high or norm

Indirect (unconjugated bili)- high

direct bili-low

Cholecystitis

inflammation of gall bladder caused by stones

from cholesterol increase

dehydration

S/S pain in RUQ

biliary colic (spasms of GB and bile ducts) worse after high fat meal

nausea/vomiting

posthepatic jaundice

risk factors female, fat, forty, fertile, fair

starvation

obesity

Labs: high direct bili

leukocytosis

Acute Pancreatitis

escape of pancreatic enzyme into pancreas and surrounding causing AUTODIGESTION

Pancreatic cancer

S/S pain, jaundice, weightloss

Hepatits

inflammation of the liver from autoimmune probs, microbs, idiopathic

S/S aching, fatigue, malaise, Nausea, vomiting, jaundice

viral hepatitis

HAV,

fever, malaise, jaundice

mild transmitted externally (oysters)

HBV, HCV,

transmitted parenterally (outside gut)

IV abuse, recieving blood, sexually

insidious

Cirrhosis

end stage irreversible liver disease

MAinly from alcohol abuse

toxic reaction to drugs

viral hepatitis

primary bili cirrhosis

cirrhosis patho

Diminished hepatocyte function leading to

-nutritional problems (glyconeogenesis, glycogenolysis)

-protein depletion probs (low protein lead to ascites(B-T abdomen) and less clotting factor

-metabolism probs incuding ammonia, drugs, hormones

-Portal HTN

Hempatic encephalopathy

result of cirrhosis- cannot metabloize ammonia leading to toxic levels in CNS leading to brain inflammation

S/S

lack of mental awareness, confusion, coma

Asterixis

liver flap-- flapping tremor of hands as result of cirrhosis

Ascites

increased back pressure into portal veins-increased hydrostatic pressure- fluid into abdominal cavity

Splenomegaly

shunting of blood into splenic vein enlarges spleen

develops hypersplenism (breakdown of RBC, WBC, thrombocytes

Varices

enlarged, thin walled veins

worse in esophagus bc it can easily rupture and bleed to death

Tests for Cirrhosis

check bilirubin levels

elevated serum liver enzymes check

Treatment for liver disease

enhance nutrition, no alcohol,

give diuretics to move T-B

IV albumin

control ammoina

protect against infection, trauma,

liver transplant

WHen HR is faster than normal

SNS fight or flight (epinephrine secreted binds to beta receptors)

Hyperkalemia causing hyopolarization

SA, AV node glitches