Trigger 6, RAD PATHO: Incognita

Sir Kharl's Hand-Outs

pathology

pathology

The study of diseases that can cause abnormalities in the structure or function of various organ system.

disease

• Pattern of the body’s response to some form of injury that causes variation of normal conditions.

• Disturbance in the function or structure of the human body.

• Congenital and Hereditary

• Inflammatory

• Degenerative

• Metabolic process

• Traumatic

• Neoplastic

Pathologic process can be defined as following:

etiology

study of the cause of a disease

• Viruses

• Bacteria

• Trauma

• Heat

• Chemical agents

• Poor nutrition

causes of a diseases:

iatrogenic

diseases caused by physicians or their treatment

nosocomial

infections at the acute care facility

community acquired

infections that develop outside the healthcare facility

idiophatic

underlying cause if unknown

acute

quick onset and last for a short period

chronic

diseases may manifest more slowly and last for a very long time

• multiple sclerosis

• diabetes mellitus experiencing hypoglycemia or hyperglycemia

examples of chronic disease:

diagnosis

the identification of a disease an individual is believed to have

prognosis

Predicted course and outcome of the disease

morphology

structure of cells or tissue

epidemiology

the investigation of disease in large groups

inflammation

initial response of body tissues to local injury

• Dialiation of arterioles, capillaries, and venules (hyperemia)

• Heat and redness

• Venules and capillaries become abnormally permeable (allowing exudate in the surrounding tissue)

• Swelling produces pressure on sensitive nerve endings (Pain)

• Fever. common in inflammatory conditions

process of inflammation:

• Rubor (redness)

• Calor (heat)

• Tumor (Swelling)

• Dolor (pain)

• Loss of function

clinical signs of acute inflammation:

altered (changed)

if an inflammation occurs, the blood flow and vascular permeabilty is what?

edema

accumulation of abnormal amounts of fluid in the intercellular tissue spaces or body cavities

localized

this edema is an inflammatory reaction

anasarca

generalized edema occurs with pronounced swelling of subcutaneous tissues throughout the body

elephantiasis

local obstruction of lymphatic drainage (filariasis)

ischemia

refers to an interference with the blood supply to an organ or part of an organ

atherosclerosis

narrowing or arterial structures

• narrowing of arterial structures (atherosclerosis)

• thrombotic or embolic occlusion

ischemia may be cause by:

• ganglion cells

• myocardial cells

what cells undergo irreversable damage if deprived of their blood supply for 3 to 5 minutes?

anemic or cyanotic

ischemia is commonly seen in, what type of patients?

infarct

localized area of ischemic necrosis within a tissue or organ produced by occlusion of either its arterial supply or its venous drainage.

necrosis

tissue death that maybe caused by lack of blood supply

gangrene

condition that results from death of tissue due to lack of blood supply

hemorrhage

• rupture of blood vessels

• trauma, atherosclerosis, an inflammatory or neoplastic erosion of vessels

hematoma

hemorrhage

• trapped blood within the body tissues

petechiae

hemorrhage

• minimal hemorrhages into the skin, mucous membranes, or serosal surface

purpura

hemorrhage

• slightly larger hemorrhages

ecchymosis

hemorrhage

• larger (greater than 1 to 2 cm) subcutaneous hematoma

atrophy

alterations of cell growth

• reduction in the size or number of cells in an organ or tissue

hypoplasia

alterations of cell growth

• underdevelopment

aplasia

alterations of cell growth

• failure to develop

hypertrophy

alterations of cell growth

• increase in the size of cells in an organ or tissue

hyperplasia

alterations of cell growth

• increase number of cells

metaplasia

alterations of cell growth

• conversion of one cell type into another cell type that is not normal for that tissue

dysplasia

alterations of cell growth

• loss of uniformity of individual cells and heir architectural orientation

neoplasia

• Latin words meaning “New Growth” (Tumor)

• Abnormal proliferation of cells

• Can be Benign or Malignant

• Cells acts as parasites, competing with normal cells and tissues for their metabolic needs

cachexia

• tumor cells flourish

• the patient becomes weak and emaciated (thin)

weak and emaciated

a patient with cachexia becomes, what?

tumor

greek word “oncos,” means?

oncology

study of neoplasms (tumor)

• parenchyma

• supporting stroma

what are the basic components of tumors?

parenchyma

basic component of tumor

• organ or tissue

• made up of proliferating neoplastic cells

• determines how the tumor behaves

supporting stroma

basic component of tumor

• tissue

• made up of connective tissue, blood vessels, and possibly lymphatic vessels

• determines how the tumor is named

benign tumor

• Resemble the cells of origin in structure and function

• Remain localized

• Can be surgically removed

malignant tumor

• cancer

• Invades and destroys adjacent structures and spread to distant sites (metastasize)

• poorly differentiated (may be impossible to determine which organ they originate)

cancer

latin word karnikos meaning “crab” (has fingerlike projections)

carcinoma

a malignant tumor affecting epithelial tissues, skin, and mucous membranes lining body cavities

sarcoma

• highly malignant tumors arising from connective tissues such as bone, muscle, and cartilage

• less common than carcinoma, but tend to spread more rapidly

carcinogens

substance that promotes carcinogenesis

carcinogenesis

formation of cancer

metastasis

the spread of malignant cancer cells resulting in a secondary tumor distant from the primary lesion

• seedling (diffuse spread)

• lyphatic spread

• hematogenous spread

malignant neoplasms disseminate to distant sites by one of three ways:

seedling (diffuse spread) within the body

a way of disseminating of malignant neoplasms to a distant site

• Cancerous cells travel to a distant site or distant organ system

• Neoplasms invade body cavities

• GIT to the peritoneum to distant sites

lyphatic spread

a way of disseminating of malignant neoplasms to a distant site

• major metastatic route of carcinomas (lung and breast)

• depends on the site and natural lymphatic drainage (sentinel node)

hematogenous spread

a way of disseminating of malignant neoplasms to a distant site

• Invasion of the circulatory system

• complex process involving several steps

• Invade and penetrate blood vessels, travel as neoplastic emboli, can be trapped in small vessels

• Certain types of cancer appear more often as metastases from other areas rather than originating in a given organ

surgically removed

what is the appropriate theraphy for a localized tumor?

radiation theraphy

what is the appropriate theraphy for a hodgkin’s disease?

hormonal theraphy

what is the appropriate theraphy for a prostate cancer?

refers to the size and extent of the main tumor

what does T mean in the TNM system?

primary tumor

the main tumor is usually called as, what?

• refers to the number of nearby lymph nodes that have cancer

what does N mean in the TNM system?

no lymph nodes containing cancer cells

in the TNM system, 0 N means?

lots of lymph nodes containing cancer cells

in the TNM system, 3 N means?

refers to whether the cancer has metastasized.

what does M mean in the TNM system?

the cancer hasn't spread

in the TNM system, 0 M means?

the cancer has spread

in the TNM system, 1 M means?

in situ

abnormal cells are present but have not spread to nearby tissue.

localized

cancer is limited to the place where it started, with no sign that it has spread.

regional

cancer has spread to nearby lymph nodes, tissues, or organs.

distant

cancer has spread to distant parts of the body.

unknown

there is not enough information to figure out the stage

grading of malignant tumor

• assesses aggressiveness or degree of malignancy

• indicates its biological behaviour

• allows prediction of its responsiveness to therapeutic agents

• how abnormal the tumor cells and the tumor tissue look under a microscope

grade 1

grading of malignant tumor

• the cancer cells look very similar to normal cells and are growing slowly

• well differentiated, low grade

grade 2

grading of malignant tumor

• the cells look unlike to normal cells and are growing more quickly than normal

• moderately differentiated, intermediate grade

grade 3

grading of malignant tumor

• the cells look very abnormal to normal cells and are growing quickly

• poorly differentiated, high grade

grade 4

grading of malignant tumor

• tumors tend to grow rapidly and spread faster

• undifferentiated, high grade

GX

grading of malignant tumor

• means that the grade can't be assessed.

• It is also called undetermined grade.

hereditary disease

• Passed from one generation to the next

• Reflects abnormality in the DNA

• Enzyme deficiency

• Mutations – alterations in DNA structure

• May become permanent if they affect gonadal cells

albinism

absence of pigmentation

phenylketonuria

build up of phenylalanine

autosomal dominant disorders

• transmitted from one generation to the next

• heterozygous

achondroplasia

autosomal dominant disorder

• dwarfism

neurofibromatosis

autosomal dominant disorder

• tumors of the nervous system

marfan’s syndrome

autosomal dominant disorder

• disorder of the connective tissue

Familial Hypercholesterolemia

autosomal dominant disorder

• high levels of LDL (low-density lipoprotein) in the blood

autosomal recessive disorders

• Homozygous for the defective gene

• Close intermarriage

cystic fibrosis

autosomal recessive disorder

• affects cells that produce mucus, sweat, and digestive juices

tay-sachs disease

autosomal recessive disorder

• absence of a vital enzyme called hexosaminidase-A (Hex-A)

acquired immunodeficiency syndrome

• Commonly affects young homosexual men, IV drug abusers, hemophiliacs, and in recipients of transfusions

• Characterized by a profound and sustained impairment of cellular immunity that results in recurrent or sequectial oppurtunistic infections and particularly aggressive form of Kaposi’s sarcoma

• Affects the skin and causes an ulcerated hemorrhagic dermatitis

• Small bowel metastasis can produce reddish or bluish red nodules

• Attributable to infection with retroviruses (HIV)

• Pulmonary infections are common in patients with AIDS

• Pneumocystis Carinii Pneumonia (usually fatal if untreated)

• GI manifestations

pulmonary infections

these infections are common in patients with AIDS