AHHHHHH patho final

idiopathic

cause unknown

iatrogenic

unintended result from unwanted diagnosis or therapeutic procedure

syndrome

group of co-occuring signs and symptoms with unknwon etiology

latent period

time taken by particle to reproduce inside host. no signs or symptoms yet

prodromal period

early signs or symptoms of an illness or heath problems that appear before the major signs or symptoms start

convalescence

time spent recovering

remission

diminution of the seriousness or intensity of disease or pain; a temporary recovery.

sequela

a condition which is the consequence of a previous disease or injury.

reliability vs calidity

reliability is the test's ability to give the same results in repeated measurements. validity is the degree in which the results are true (accuracy)

sensitivity vs specificity

sensitivity: testing the presence of. specificity: able to test the absence of the person condition

tertiary prevention

rehabilitation, preventing complication and improving quality of life

secondary prevention

screening of at risk individual, control of risk factors and early intervention

primary prevention

health promotion and addressing risk factors, social and genetic factors of the healthy population

allostasis

ability to adapt to challenges.

alarm reaction

fight or flight due to stressful stimulus. hypotalamus axis activations

stage of resistance

increased activity of the nervou system and the endocrine systms to return the body to hemostasis. al

allostatic state

the bodys attempting to restore homeostasis

state of exhaustion

point where the body can no longer return to homeostasis

allostatic overload

cost of body's organs and tissues for an excessive or ineffectively

catecholamines

norepinephrine and epinephrine

norepinephrine

constricts blood vessels, raises BP, reduces gastric secretion, increases night and far vision by dilating pupils

epinephrine

enhances heart contractility, increases cardiac output, bronchodilation, increases release of glucose from liver, and increases glucose levels

cortisol

aka stress hormone, energy burst. affects protein metabolism and promotes appetite and food seeking behaviors. has anti-inflammatory effects

aldosterone

primary mineralocorticoid, promoting reabsorption of sodium and water in kidney. regulates blood volume and blood pressure

endorphins and enkephalins

endogenous opioids that raise pain threshold. produces euphoria and sedation

oxytocin

produced during childbirth, lactation, and sex. calming effect, promoting human bonding and reduces stress

immune cytokines

secreted by macrophages in response to stress. Enhances immune system response however prolonged stress can supress immune function

types of reversible cellular injuries

cellular accumulations and cellular adaptationsi

irreversible cellular injuries

necrosis, apoptosis, and cellular aging

causes of ischemia and hypoxia

nutritional deficiencies, infectious and immunologic responses, chemical injuries, physical and mechanical injuries, radiation induced injuries

hypoxia leads to hydropic swelling, process?

decrease in ATP production --> less potassium move out, more sodium move into cell --> intracellular osmotic pressure --> cellular swelling

excess accumulations of cell could consist of

normal substances, pigments/minerals, and denatured/misfolded proteins

cellular accumulation diseases

lysosomal storage disease (Gaucher disease) and pigmentation

adaptive cellular responses

normal, atrophy, hypertrophy, hyperplasia, metaplasia, dysplasia

four types of necrosis

coagulative, liquefactive, fat necrosis, and caseous necrosis

coagulative necrosis

prolonged ischemia. black, dry, hard. typically toes and fingers. like myocardium infraction

liquefactive

quicker death, breakdown of tissue, increased liquefactive tissue --> WBC accumulation in abscessf or CNS

fat necrosis

tissue with increased fat content, like liver, leading to trauma to breast. White and chalky

caseous necrosis

in the lungs caused by tuberculosis. compared to cheese

necrosis depends on tissue

coagulative --> heat
liquefactive --> brain
fat --> pancreas
caseous --> lung

gangrene

cellular death in a large area of tissue due to interruption of blood supply to a particular part of the body

dry gangrene

form of coagulative necrosis characterized by blackened, dry, wrinkled tissue separated by a line of demarcation from healthy tissue

wet gangrene

form of liquefactive necrosis, that develops quickly. Often found in internal organs and can be fatal

gas gangrene

results for infection of necrotic tissue by anaerobic bacteria (clostridium) rice krispy sound POP

apoptosis

type of cell death, that's not always a pathologic process. NO INFLAMMATION. may be inhibited by signals external or internal to the cell triggering intracellular cascades. activates cellular response

internal signals may induce apoptosis

withdrawal of survival signals that normally supress apoptotic pathways --> self destruct

extracellular signals

such as fas ligand, bind to the cell and trigger death cascade through activation of death receptor

somatic death

death of the entire organism. no inflammation or immunologic response occurs prior to death.

why do muscles stiffen during death? tissue breakdown?

influx of calcium throughout the body after death. release of lytic enzymes in body tissues: postmortem autolysis

macule

small 1-2 cm, flat, palpations. dont fell it, just color changes (ex. freckles)

patch

greater than 2 cm. lighter color, hypopigmentation like vitiligo. more common in darker skin but can happen to anybody

papule

patch. 1-2 cm, raised example pole

plaque

>2cm, raisedve/elevated, 2 almost close together

vesicle

small,

bulla

big blister, 2+ cm. ex. Steven Johnson syndrome or burns

pustule

1-2 cm, raised, pus filled, coloration. ex. acne

secondary lesions

excoriation, lichenification, scar

diffuse

scattered all over

discrete

seperated, distincy

confluent

running into each other, squished together

imetigo

from staphylococci. small cluster vesicles that open up and leak up honey colored crust

syphilis

treponema pallidum, like STI, manifest with skin lesion. Tx was IM antibiotic (penicillin)

cutaneous abscess

localized collection of pus in the skin. treatment is incision with drainage. and oral antibiotic if MRSA

impetigo treatment

topical antibiotic (mupriocin)

common skin viral conditions

verrucae, herpes, chicken pox, herpes zoster

verrucae

common warts, bumpy appearence. typically on adolescent hands, can freeze and cut off

herpes simplex (oral/genital)

oral: cold sores, in times of stress
genital: STI, reoccurring outbreak with no cure but can suppress and and shorten outbreaks
treatment with antiviral may reduce severity/dysfunction, preventing recurrence

fungal infectious conditions

tinea corporis, tinea cruris, tinea pedis, tinea unguis

skin preparation drugs

isopropyl alcohol, povidone-iodine, chlorhexidine

topical antipruritic drugs

antihistamines, corticosteroids

corticosteroids

anti-inflammatory effects, antipruritic effects

topical medications

nitro-bid

treatment of pressure injuries

keep area clean, dry, and free from infection or further pressure; cover with nonstick dressing, irrigate as needed; maintain fluid and protein stores; vitamin supplements, avoiding general infection

prevention of pressure injuries

frequent turning every 2 hours, get person out of bed and into chair, keep vulnerable areas clean and dry, keep bed coverings off feet. use pillows to float heels

braden scale measure

sensory perception, moisture, activity, mobility, nutrition, and friction/shear

wound care drugs

oral vitamin C helps with collagen synthesis and oral zinc.

topical wound care drugs

used to prepare wound bed for healing, remove nonviable tissue, antibacterial

dakin solution

topical anti-infective used to prevent or treat tissue infection. used for wound debridement for pressure ulcers.
adverse effects: severe redness or irritation of treated skin, pain, or swelling
use: applied to wounds as an irrigation or cleanser and to moisten dressings

iodosorb

topical anti-infective, used to clean wounds and promote healing of wounds. absorbs fluids and removes exudate, slough, and debris. Promotes a moist healing environment
adverse effects: allergic reactions
do not use in patients who are sensitive to iodine.

santyl

topical debriding agent. used to debride chronic dermal ulcers or severe burns. enzymes selectively removes necrotic issue and does not harm normal tissue.
adverse effects: pain, burning, and temporary redness or irritation to skin around affected area
may increase risk for serious infections
use: apply 2 mm thick layer to whole wound bed only

medihoney

topical anti-infective and topical debriding agent. used to clean and promotes a moist environment. has antibacterial properties.
use: apply 3 mm layer directly to entire wound bed or primary dressing
no adverse effects

silver sulfadiazine

topical anti-infective. used to prevent or treat infection at the site of second and third degree burns. used for wound debridement for pressure ulcers.
use: apply 2mm layer directly to entire wound bed
adverse effects: pain, burning, and itching

parathyroid hormone

increases serum calcium. increases bone resorption, increases calcium reabsorption from renal tubules. Increases absorption of calcium in intestine

calcitonin

decreases serum calcium. inhibits bone resorption, decreases calcium resorption from renal tubules

stages of bone healing

hematoma formation, fibrocartilage formation, callus formation, ossification, consolidation/remodeling

healing time varies with

fracture location, severity of the fracture, nutritional status/health status

complications of fractures

delayed healing, nonunion, malunion deformity, nerovascular injury, osteonecrosis, compartment syndrome, osteomyelitis, deep vein thrombosis, pulmonary embolus, fat emboli syndrome

avascular necrosis

lack of blood supply to an area of bone tissue leads to necrosis. Occurs after a fracture or dislocation interrupts normal blood blood. also associated with alcohol and corticosteroids (long term leads to vasoconstriction)

6 P's

pain out of proportion, paralysis, paresthesia, pallor, pulselessness, polar

compartment syndrome

bleeding or swelling in a soft tissue compartment causes increased pressure because fasciae that enclose the compartment do not stretch . If tissue pressure exceeds intravascular pressure, blood vessels will collapse. this leads to hypoxia of the tissue.

treatment of compartment syndrome

emergent surgery to alleviate tissue pressure and restore blood flow. Notify physician immediately if you suspect compartment syndrome

osteomyelitis

severe pyogenic infection of bone and local tissue. organisms reach bone through bloodstream, adjacent soft tissues or direct introduction of organism into bone. if not treated necrosis. treatment is 4-6 weeks of antibiotics

DVT

deep vein thrombosis. redness, swelling, and pain in one extremity

DVT can lead to

pulmonary embolism. clot breaks loose and it travels the lodges in the lungsf

fat emboli syndrome

fat particles released from bone marrow (esp. from fractured pelvis or long bones) into blood stream and lodges in lung vascularity

treatment of fat emboli syndrome

supportive care - IV fluids, ventilatory support. prevention by early reduction and immobilization of fractures

osteoporosis

porous bone, unknown etiology. Most common metabolic disease and occurs when rate of bone resorption is greater than bone formation, decreasing density of trabecular bone

ACCESS

alcohol use, corticosteroid use, calcium low, estrogen low, smoking, sedentary lifestyle

CDEFGS

calcium, vitamin D, exercise, prevent falls, gain weight, and stop smoking

osteoporosis treatment

calcium, vitamin D supplements, weight bearing exercise, bisphosphate (inhibit osteoclast), estrogen replacement, calcitonin