module 3 patho

pernicious/megaloblastic anemia + treatment

megaloblasts

vitamin B12 deficiency

oral supplements and b12 injections

what is the most common cause of vitamin b12

etiology

• autoimmune reaction, chronic gastritis, inflammatory

sickle cell anemia

• recessive inherited characteristic

• abnormal hemoglobin formation (deoxygenated)

• disk→crescent/sickle shape when O2 levels are low = less life span

• cell membrane is damaged leading to hemolysis

problem w/ sickel cell anemia

• obstruction of small blood vessels by RBC’s. causing thrombus formation (blood clots), causing infarction → necrosis

treatment for sickle cell

• hydroxyurea (oral chemo)

• b9/folic acid

• bone marrow transplant

leukemia

• leukocyte are undifferentiated = immature

• multiply uncontrollably in bone marrow which causes infiltration in organs

acute leukemia

• high proportion of immature non-functional cells in bone marrow

• sudden

• primarily in children & young adults

chronic leukemia

• higher proportion of mature cells but may have lower functionality

• mild signs, better prognosis

• older people

multiple myeloma

neoplastic disease that causes increased production of malignant plasma cells that replace and erode bone marrow

• tumours, loss of bone, bone pain

hodgkin lymphoma vs non-hodgkin lymphoma

hodgkin - single lymph node then spreads, defective t lymphocytes with less lymphocytes

non - widespread with multiple nodes, b-lymphocytes

UTI

urinary tract infection

• most ascending

• e-coli

cystitis

inflammation of the bladder

• capacity reduced

• pain , pain while peeing, peeing at night, clodu w odour

pyelonephritis

• inflammation of the renal pelvis and medulla

• may involve 1 or both kidneys

• recurrency can cause failure and necrosis

• dull aching pain, fever

• antibiotics, cranberry juice

glomeulonephirtis / acute post streptococcal

beta hemolytic streptococcal (GAS) infection

acute/chronic renal failure

scarring of kidneys

urolithiasis

concentrated urine (salt)

accumulates causing infection

and immobility, causing nephrosis

nephrosis

swelling of one or both kidneys caused by a buildup of urine that cannot properly drain into the bladder

hydronephrosis

• secondary problem

• urine filled dilatation of renal pelvis

• atrophy of kidney due to urinary outflow obstruction → infection —> necrosis → failure

renal cell carcinoma

• hypernephroma

• PRIMARY tumour

• painless, metastasized

wilms tumour (nephroblastoma)

very common in children 3-5 years

Adult Polycystic Kidney Disease

genetic

fluid filled cysts

bilateral, causing chronic renal failure

acute vs chronic failure

acute - sudden, reversible

chronic - gradual loss, irreversible

no pee (auria), less urine (oliguria), nitrogenous waste

hiatus hernia

part of the stomach is elevated and protrudes through opening in diaphragm into thoracic cavity

• shorter esophagus, pressure in abdomen, weakness of diaphragm

sliding vs rolling hernia

sliding - stomach & GE junction protrudes

rolling - fundus of stomach moves up

peptic ulcer

exposed to acid due to pepsin secretion

• hemmorhage

gallstones

masses of solid or calculi in bile, cholestrol, or bilirubin (pigment)

jaundice

yellowing skin resulting from high levels of bilirubin in blood

pre vs intra vs post heptatuc jaundice (type of bilirubin?)

pre - unconjugated bilirubin

intra - bilirubin of both types

post - conjugated bilirubin

hepatitis

inflation of liver

hepatitis B

untreated can lead to long-term mild infection, cirrhosis, or hepatic cancer

cirrhosis

alcohol, cronic hepatitis

diverticular disease

sigmoid colon

herniation

cryptorchidism

undescended testes

m/c in premature & low birth weight infants’

inferitility and malignancy

hydrocele

accumulation of excessive fluid

cystic mass in scrotum

varicocele

dilation of veins in the pampiniform plexus of veins (veins draining the testes) on left side

BPH benign prostatic hypertrophy/hyperplasia

age related common diseasw, non malignant enlargement of prostate gland

compression of urethra which can cause dribbling and uti’s

testicular carcinoma

germ cell tumours, rare

enlargement of testicles, hard masses

diabetes mellitus

deficit of insulin secretion by islets of langerhans or insulin esistance

abnormal metabolism of macronolecules

high glucose levels

3 p’s of diabetes

polyuria, polydipsia, polyphagia

diabetes insipidus

deficit of ADPH/vasopressin

unable to concentrate the urine

diabetes insipidus 2 types

neurogenic/central - synthesis or release of ADH

nephrogenic - do not respond to ADH

goiter

enlargement of thyroid gland

hypo/hyper

low iodine excessive stim of TSH

hypothyroidism - hashimoto’s thyroiditis

destructuve autoimmune disorder

hypothyroidism - myxedema

severe hypothydoism in adulys

hypothyroidism - cretinism

in children

adrenal - pheochromocytoma

benign tumour of the medulla

secretes epinephrine and norepinephrine

adrenal - cushing’s syndrome

hypercortisolism

adrenal - addison’s disease

deficit of glucocorticoids, mineralocorticoids, androgens

• hypoglycemia

endometriosis

endometrial tissue outside uterus

endometrioma

cyst filled with old blood in ovary - chocolate cyst

leiomyoma (fibroids)

begnign tumours of smooth muscle, common, asymptomic if small

ovarian cysts

fluid filled sacs in ovaries, benign, pain

Polycystic Ovarian Disease

large ovaries with multiple cystsm causing abnormalities in hormones, ovulation doesnt occur

cervical carcinoma

STD’s, early sx, asymptomatic

Transient Ischemic Attack

mini stroke

• temporary localized reduction of blood flow in brain

• recovery within 24 hours

• warn of potential stroke/CVA

CVA/stroke

infarction (ncerosis by lack of o2) of brain tissue resulting from lack of blood

total occlusion of cerebral blood vessels

3 types of cva/stroke

1. atheroma - gradual

2. embolus - sudden (due to tumour, air, infection)

3. hemmorhage - sudden

Cerebral Aneurysm

• dilation in artery, multiple (weak→bulge→compression of structures)

• mostlt iccur at circle of willis

what does cerebral aneurysm rupture into

the subarachnoid space & csf → high pressure in skull

• loss of vision, consciousness

meningitis

inflammation of meninges of brain and spinal cord

• microbes (e. coli) reach brain via blood, inflammatory response

encephalitis

infection of the parenchymal or connective tissue in the brain or spinal cord

• west nile

• herpes

• ticks

inflammation→necrosis→loss of function

contusion

bruising of brain tissue with rupture of small blood vessels

compound fractures

brain tissue exposed to environment, risk of infection

depressed skull fractures

displacement of piece of bone below skull

pressing into brain tissue

increases ICP

basilar fracture

leaking of CSF through ears and nose

countrecoup injury

injury occurring on the side opposite the initial head impact by bouncing off skull

hematoma

collection of blood in tissue from ruptured blood vessels

hydrocephalus

water on the brain

CSF accumulating compressing brain tissue and blood vessels

enlarged brain

noncimmunicating hydrocephalus

flow of CSF blocked

communicating hydrocephalus

absorption of CSF impaired

spina bifida

neural tube defects

multifactorial

spina bifida occulta

spinal process does not fuse

spina bifida - meningocele

herniation of the meninges & CSF

spina bifida - myelomeningocele

most serious,

herniation of spinal cord, meninges, csf

neuro impairment

multiple sclerosis

progressive demyelination of neyrons of the brain, spinal cord, and cranial nerves

forms plaques

parkinsons disease

degenerative disease

affects motor loss due to loss of neurons in basal nuclei

low dipamine secretion