Patho Final

Pancytopenia

reduction or absence of all three types of blood cells

Erythrocytosis

 a condition where there is a high concentration of red blood cells in the blood

Leukocytosis

increased levels of WBC

Metastasis

Is the spread of cancer cells from the site of the original tumor to distant tissues and organs through the body.

isotonic solution

Same osmolality or concentration of particles (285 mOsm/kg) as the intracellular fluid (ICF) or extracellular fluid (ECF)

hypotonic solution

Lower concentration; more dilute than body fluids

hypertonic solution

Concentration of more than 285–294 mOsm/kg

Diffusion

A solute is moved from an area of greater concentration to an area of lesser concentration

active transport

Requires life, biologic activity, and cell’s expenditure of metabolic energy by means of ATP, Occurs only across living membranes that flow “uphill.” (Think Na+ and K+)

Osmosis

Water moves “down” a concentration gradient across a semipermeable membrane

Filtration

Water and solutes move through a membrane because of a greater pushing pressure (force) on one side of the membrane than on the other side.

Pallor Mortis

pale skin

Algor Mortis

reduced temperature

Rigor Mortis

muscle stiffening

Livor Mortis

purple skin discoloration

Hypoxemia

Low oxygen levels in the blood

Hypercapnia

increased carbon dioxide (CO2) in the arterial blood

Hyperresonance

a loud, low-pitched sound produced when a doctor taps on a patient's chest wall during a lung exam

Peritonitis

inflammation of the peritoneum (serous membrane surrounding the organs of the abdomen and lining the abdominopelvic cavity)

Ascites

buildup of fluid in the peritoneal cavity

Laceration

Tear or rip resulting when tensile strength of skin or tissue is exceeded

Avulsion

A complete separation of a tendon or ligament from its bony attachment site

Keloid

Irregularly shaped, elevated, progressively enlarging scar; grows beyond boundaries of wound; caused by excessive collagen formation during healing

Abrasion

partial thickness wound caused by damage to the skin. It can be superficial involving only the epidermis to deep, involving the deep dermis, usually involve minimal bleeding

Fracture

partial or complete breaks in a bone that occur when a force is applied that's stronger than the bone can withstand

Dehiscence

wound pulls apart at the suture line, occurs 5-12 days after suture

Granuloma

a cluster of cells that forms when the body's immune system attempts to isolate a harmful substance it can't eliminate, typically made of WBC

Autoimmunity

occurs when the body's immune system mistakenly attacks healthy cells, tissues, or organs

Urticaria

also known as hives, is a skin condition that causes raised, itchy bumps that can be red or flesh-colored

Ecchymosis

a discoloration of the skin resulting from bleeding underneath, typically caused by bruising

Virulence

The capacity to cause severe disease; for example, measles virus is of low virulence; rabies virus is highly virulent

Communicability

The ability to spread from one individual to others and cause disease

Opportunistic

infections caused by organisms that normally don't cause disease, but become pathogenic when the body's immune system is weakened

Vector

a living organism that carries and spreads disease-causing pathogens from one host to another

Incubation

The period from initial exposure to the infectious agent and the onset of the first symptoms; during this time, the microorganisms have entered the individual, undergone initial colonization, and begun multiplying but are at insufficient numbers to cause symptoms. This period may last from several hours to years prodromal phase

Homeostasis

the body's ability to maintain a stable internal environment, even when external conditions change

Allostasis

the process of maintaining stability through change (Talked about this during the stress unit)

Rhabdomyoma

is an extremely rare benign tumor of striated muscle that generally occurs in the tongue, neck muscles, larynx, uvula, nasal cavity, axilla, vulva, and heart. These tumors are usually treated by surgical excision and typically do not recur.

Nutrigenomic

the study of how food and genes interact to affect a person's health and risk of disease

Adrenarche

Before puberty, there also is an increase in adrenal androgen in both sexes or a natural process that marks the beginning of sexual maturation in children, and is characterized by the maturation of the adrenal glands

Gonadarche

the beginning of puberty, when the gonads start to change

Thelarche

maturation of the reproductive organs

Menarche

first menstruation

Cryptorchidism

Failure of the testes to descend through the inguinal canal

Nystagmus

an involuntary unilateral or bilateral rapid, rhythmic oscillatory movement of the eyes

Strabismus

one eye deviates from the other when the person is looking at an object This is caused by a weak or hypertonic muscle in one eye

Diplopia

double vision

Presbyopia

Loss of accommodation with advancing age

Aphasia

Loss of comprehension or production of language

Apraxia

the complete inability to perform purposeful or skilled motor acts in the absence of paralysis, sensory loss, abnormal posture and tone, abnormal involuntary movement, incoordination, or inattentiveness

Akinesia

a decrease in voluntary and associated movements, the loss of voluntary muscle movement

Bradykinesia

slowness of voluntary movements, slow or delayed movement, or a progressive reduction in the amplitude of movement

Paroxysmal dyskinesia

abnormal, involuntary movements that occur as spasms, a rare group of movement disorders that cause brief, recurring episodes of involuntary movements

Tardive dyskinesia

the involuntary movement of the face, trunk, and extremities,  a chronic condition that causes involuntary, repetitive movements in the body as a result of prolonged medication use

Empyema

the presence of pus in the pleural space (infected pleural effusion); it usually occurs because of lymphatic drainage from sites of bacterial pneumonia

Bradypnea

breathing rate is abnormally slow, usually below 12 breaths per minute for adults

Tachypnea

rapid and shallow breathing that's faster than normal

Kussmal’s respirations

a medical emergency that involves a pattern of rapid, deep, and labored breathing

paroxysmal nocturnal dyspnea

occurs with pulmonary or cardiac disease, waking the individual while sleeping, gasping for air

Melena

black, tarry stools that indicate bleeding in the upper gastrointestinal (GI) tract

Cachexia

a complex metabolic syndrome associated with basic illness and is characterized by the loss of muscle with or without loss of fat mass

Hematochezia

Fresh, bright red blood passed from rectum

Hematemesis

Bloody vomitus; either fresh, bright red blood or dark grainy digested blood with “coffee grounds” appearance

Ligaments

tough, fibrous tissues that connect bone to bone to form joints, allowing for a range of motion

Tendons

a tough band of tissue that connects muscle to bone

Bursitis

inflammation of a bursa, are sacs lined with synovial membrane and filled with synovial fluid, is caused by repeated trauma

Rhabdomyolysis

the rapid breakdown of muscle that causes the release of intracellular contents, including the protein pigment myoglobin, into the extracellular space and bloodstream

Epicondylopathy

is inflammation of a tendon where it attaches to a bone

• Tennis elbow - lateral epicondylitis

• Goldfer’s elbow - medial epicondylitis

Osteosarcoma

the most common primary malignant bone tumor in children and young adults, most common malignant bone-forming tumor

Pneumothorax

the presence of air or gas in the pleural space. It is caused by a rupture in either the visceral pleura or the parietal pleura or both

pleural effusion

fluid accumulation in the pleural space

Atelectasis

the collapse of lung tissue

Gynecomastia

the overdevelopment of breast tissue in a male. It appears more during certain ages of hormonal change such as birth, adolescence, and old age

Immunization - HPV

• Strongly associated with cancer and cervical dysplasia

• Transferred through sexual contact

• Vaccine at age 11 or 12, two vaccinations given 5 months apart

Immunization - Hepatitis

• Found in feces, bile and sera (A)

• Vaccine at 1 year old

• Sexually transmitted from mother to baby (B) aggressively vaccinated by maternal HIV infection and blood transfusions 

• (C) no vax

• Hep D and E no vax

• E is common in Asian and african countries

Immunization - Rotavirus

• Leading cause of sever diarrhea in infants

• Vaccinations in newborns, 2 doses

Immunization - HIB

Hemophilus influenzae type B vaccination for children 5 and older

Potassium

3.5-5.0 mEq/L

Sodium

135-145 mEq/L

Calcium

9.0-10.5mg/dL

Phosphate

2.5-4.5mg/dL ( with hypo level at < 2.0 and hyper at > 4.7)

Magnesium

1.5-3.0mg/dL

pH

7.35-7.45

PaCo2

35-45 mmHg

PaO2

80-100 mmHG

HCO3

21-28mEq/L

Allergy Tests

• Food challenges

• Skin tests

• Lab tests for IgE

Tests of Reproductive Function

• Hormonal assays

• Laparascope

• Radiographic studies

• Needle biopsy

• Pap test

• Mammogram

• Fertility tests

  • Male - tested to determine the number, amount, structure, and motility of sperm and obstruction along the reproductive tract

  • Female - tested to determine whether the reproductive tract is patent to allow for the passage of ovum and sperm, ovulation is normal, the endometrium is responding normally to hormones, tumors or infections are present in reproductive tissues

Tests of Nervous system structure and function

• Skull and spine roentgenograms (x-ray images)

• Computed tomographic scan (noninvasive)

• Magnetic resonance imaging

  • Magnetic resonance angiography

• Positron-emission tomographic scan

  • Radioactive substance

• Cerebral angiography (dye)

• Single photon emission computed tomography (SPECT)

• Myelography (dye)

• Echoencephalography (ultrasound)

• Electroencephalography (brain waves)

• Evoked potentials (stimulus activated)

• Cerebral spinal fluid analysis (L3 or L4)

• Magnetoencephalography (MEG)

Tests of Bone function

• Gait analysis

• Serum calcium and phosphorus

• Imaging studies

  • Radiograph

  • Computed tomography (CT)

  • Dual-energy computed tomography (DECT)

  • Magnetic resonance imaging (MRI)

  • Magnetic resonance arthrography (MRA)

  • Positron emission tomography (PET)

  • MRI-PET

• Bone scanning

• Dual-photon absorptiometry (DXA)

• Serum bone-specific alkaline phosphatase (BAP): marker of bone formation

• Bone resorption evaluation

  • Urinary and serum measurements of cross-linked N-terminal telopeptides (NTx) a product of osteoclast bone resorption, specific for bone collagen alone

Tests of joint function

• Arthrography - inject dye into the joint

• Arthroscopy - directly visualizes a joint through an arthroscope

• MRI - produces images of body tissues through the use of electromagnetic (radio) waves

• Synovial fluid analysis - normal fluid is sterile; abnormal blood (hemarthrosis), bacteria (disease), fragments and tissue (inflammation or wear and tear)

Tests of Muscular function

• Serum creatine kinase - increased when muscles are diseased or damaged

• Myoglobin - detecable in urine with acute muscle damage

• Electromyogram (EMG)

  • Uses sensitive needle electrodes to help differentiate muscle diseases from peripheral nerve and neuromuscular junction disorders

• Muscle biopsy

• Complex myography - noninvasive way to gather information on the mechanical characteristics of muscle

• Genetics - molecular genetics, DNA libraries, genetic proves, and gene localization

Effects of hormones in the regulation of blood pressure

• Epinephrine and norepinephrine - cause vasoconstriction

• ADH - increases blood volume

• Angiotensin II - vasoconstrictor

• Nitric Oxide, prostaglandins, endothelium-derived relaxing factor - vasodilation

Tests of Cardiovascular function

• Cardiac and coronary artery evaluations

  • Chest X-ray - examine the size and contour of the heart and related structures

  • Electrocardiography - serial 12-lead ECGs establish the presence of myocardial ischemia and infarction or conduction defects and dysrhythmias

  • Echocardiography - is the most effective and widely used noninvasive modality for evaluating the structures of the heart

  • Stress testing - aka exercise testing, elicits signs and symptoms of heart disease and coronary artery disease taht may not appear at rest, most include the injection of a radiotracer

  • Computed tomography (CT) - single-photon emission computed tomography (SPECT) evaluates coronary artery disease and myocardial ischemia during stress testing

  • Magnetic resonance imaging (MRI) - Depicts the anatomy and physiology of the great blood vessels and myocardium in three dimensions

  • Technetium scanning - provides “hot spot” using nuclear scanning

  • Electrophysiology - provides an in-depth evaluation of electrical conduction

  • Catheterization with angiography - an invasive procedure of fluoroscopy and strict sterile techniques into the heart. Angiography: fluoroscopically visualizes the coronary arteries

• Systemic vascular evaluations

  • Analysis of adequate flow rates, vascular obstructions, and structural defects

  • Arterial pressure pulse waveform analysis - pulsation of carotid artery can be drawn as a waveform plotting pressure against time

  • Doppler ultrasonography - uses a microphone that amplifies and records the sounds made by blood flowing in the peripheral vessels

  • CT and MRI - provide information about the great vessels

  • Venography and arteriography - radiopaque dye can be injected through intravenous or intraarterial catheters to allow for the visualization of the internal structure, diameter, and patency of veins and arteries

Tests of Pulmonary Function

• Spirometry - measures volume and flow of air inhaled and exhaled and plotted against time during different maneuvers

• Pulmonary diffusing capacity - measures the gas diffusion rate across the alveolocapillary membrane

• Residual volume

• Oximetry

• Capnography

• Functional reserve capacity (FRC)

• Total lung capacity 

• Arterial blood gas analysis - determines pH and oxygen and CO2 concentrations

• Thoracic imaging techniques

  • Chest radiography, CT, MRI, PET, Ultrasonography

Tests of Digestive function

• Gastrointestinal tract

  • Radiographs using contrast media such as barium or iodine-containing compounds: image outlines the gastrointestinal lumen, biliary tree and pancreatic ducts, fistulae and arteriovenous systems

  • Computed tomographic (CT) scanning: is used to diagnose intestinal lesions and pancreatic or hepatic tumors or cysts

  • Ultrasonic scanning: is a safe, simple, and relatively inexpensive technique used to detect gallstones and intraabdominal masses, particularly abscesses

  • Fiberoptic endoscopy, using flexible endoscopes: allows the direct visualization of the gastrointestinal tract

    • A biopsy channel allows tissue sampling and suction can be applied to remove gastrointestinal secretions or blood

  • Analysis of stool, gastric secretions, tissue, and plasma: offers important clues to infection, malabsorption syndromes, ulcerative lesions, and tumor growth

  • Magnetic resonance (MR)

• Liver tests

  • Nuclear imaging is useful after liver transplantation

  • Elevated plasma level of liver enzymes: Is associated with many liver diseases from the release of cytoplasmic enzymes into circulation when damage to the hepatocyte occurs

    • Aminotransferases and lactat dehydogenase (LDH), aspartate transaminase (AST), alanine transaminase (ALT)

    • Elevation of conjugated bilirubin levels

    • Prolonged prothrombin times (lack of vitamin K)

    • Diminished plasma proteins, such as albumin and globulins

  • Biopsies: help confirm some diagnoses

• Gallbladder tests

  • Various imaging techniques such as those listed under GI tract

  • Malfunction causes changes

    • Both the conjugated and total serum bilirubin values are elevated

    • Urine urobilinogen is increased

    • Stools are clay colored

    • Jaundice develops

    • Vitamin K not absorbed then fat absorption can be impaired and the prothrombin time prolonged

    • White cell count is elevated with inflammation of the gallbladder

• Exocrine pancreas

  • Serum lipase and urinary amylase: significant measures of pancreatic injury

  • Inflammation or obstruction: early increase in serum amylase levels

Tests of Renal function

• Concept of clearance - renal clearance techniques determine how much of a substance can be cleared from the blood by the kidneys during a given unit of time. Permits an indirect measure of GFR, tubular secretion, tubular reabsorption and renal blood flow

• Clearance and GFR

  • GFR - the best estimate for the functioning of renal tissue. Clears insulin from the plasma, creatinine provides a good estimate of GFR only one blood sample is required in addition to a 24-hour volume of urine

  • Para-aminohippuric acid (PAH) clearance is used to determine renal plasma flow and blood flow

• Blood tests

  • Plasma creatinine concentration

  • Plasma cystatin C concentration

  • Blood urea nitrogen (BUN)

• Urinalysis

  • Urine color

  • Urine pH

  • Specific gravity - estimated measure of the solute concentration of urine (Normal - 1.016-1.022)

  • Urine Sediment - RBCs, casts, crystals, WBCs

  • Reagent strips (dipsticks)

Active Immunity

produced by the body's own immune system ex:vaccines

Passive Immunity

produced by an outside source ex: mother-baby antibodies

IgG

• Most abundant class (80% - 85%)

  • transported across placenta

  • Accounts for most of the protective activity

  • 4 classes: