Part 1 Chiropractic Boards: Pathology -- Organ Systems, Respiratory, GI/GU, Blood/Lymph, & Endocrine Disorders

What condition has patchy thickening, atheroma's (fatty streaks) of subintimal wall (medium/large arteries), where the arterial wall becomes thick & loses its elasticity with dystrophic calcification (thrombus)?

Arteriosclerosis/Atherosclerosis

What are 8 risk factors of Arteriosclerosis/Atherosclerosis?

1) HTN

2) increased serum lipids & LDL (>160)

3) Smoking

4) Diabetes mellitus

5) morbid obesity

6) >65 y/o

7) Familial Type III hyperlipoproteinemia

8) Males, or females increased rate after menopause

What are the 2 main causes for Arteriosclerosis/Atherosclerosis?

Ischemic heart Disease & Cerebrovascular disease

What is the acronym to pick up on a stroke? How many hours does stroke need to be treated before it's a major cause of death?

FAST

- Face

- Arm

- Speech

- Time

(take baby Aspirin on way to hospital; within 5 hours)

What type of Arteriosclerosis/Atherosclerosis is calcified tunica media in medium sized arteries such as the femoral, radial, and uterine?

Monckeberg

What type of Arteriosclerosis/Atherosclerosis is proliferation intima of the small vessels and obliterates the artery?

Obliterans

What type of Arteriosclerosis/Atherosclerosis is of the extremties?

Peripheral

Which artery involved with Arteriosclerosis/Atherosclerosis demonstrates atherosclerotic aneurysms & cholesterol embolism?

Aorta

What is a localized dilation in the wall of an artery, vein, or heart, and can be anywhere?

Aneurysm

What is the MC central aneurysm? MC peripheral aneurysm?

MC central = Aorta (abdominal)

MC peripheral = Popliteal (bilateral)

What is longitudinal cleavage of the arterial media by a column of blood, "tearing pain", with acute onset (retrosternal)?

Dissecting Aneurysm

What is the MC dissecting aneurysm location? 70% of patients have what other condition that can lead to this?

Abdominal aorta

70% of patients have HTN

What type of aneurysm can be asymptomatic, but can show lumbar vertebral pressure?

Abdominal Aortic aneurysm

Which artery involved with Arteriosclerosis/Atherosclerosis includes BERRY aneurysms, subarachnoid & intracerebral hemorrhage, and hereditary?

Circle of Willis

What artery in the Circle of Willis is MC to have Berry aneurysms? What age group is this MC in?

Anterior communicating artery

Younger males

Which artery involved with Arteriosclerosis/Atherosclerosis demonstrates chronic cerebral ischemia, strokes, transient ischemic attacks (TIAs)?

Internal carotid artery

Which artery involved with Arteriosclerosis/Atherosclerosis demonstrates cerebellar & brain stem ischemia & infarction?

Vertebrobasilar artery

Which artery involved with Arteriosclerosis/Atherosclerosis demonstrates myocardial infarction, chronic myocardial ischemia, angina, chronic heart failure, arrhythmias, & heart block?

Coronary artery

Which artery involved with Arteriosclerosis/Atherosclerosis demonstrates intestinal ischemia & infarction (ischemic colitis)?

Celiac & mesenteric

Which artery involved with Arteriosclerosis/Atherosclerosis demonstrates renal artery stenosis, renovascular hypertension, renal ischemia & infarct?

Renal artery

Which artery involved with Arteriosclerosis/Atherosclerosis demonstrates peripheral vascular disease, intermittent claudication, gangrene?

Iliofemoral artery

What condition is characteristic with a patient waking up with a throbbing headache, typically the occipital region, with sustained elevation of system arterial blood pressure (diastole above 90mm), with 50% of individuals having blood pressure over 140/90?

HTN

What type of HTN occurs over 40 years old with etiology unkown?

Essential HTN

What type of HTN is caused by Na retention & increased peripheral resistance?

Secondary HTN

What type of HTN is earliest phase of HTN?

Benign HTN

What type of HTN is papilledema, retinal hemorrhages, exudates, b/p usually 200/150 mm Hg, fibrinoid necrosis of unica media, intimal fibrosis, narrowing vessels, acute ischemia to tissue vessel feeds?

Malignant HTN

What hypertensive disease is systemic hypertension causing increased work on the left ventricle and causing hypertrophy and eventual failure?

Hypertensive heart disease

What hypertensive disease is decrease in GFR, fibrosis, loss of nephrons, and eventual renal failure?

Hypertensive renal diseaese

What hypertensive disease has thrombosis and strokes?

Hypertensive cerebral disease

What hypertensive disease demonstrates papilledema, retinal hemorrhages, fluffy exudates (cotton wool spots)?

Hypertensive renal disease

What is congenital failure of closure between the pulmonary artery & aorta (up to 80% premature)?

Patent Ductus Arteriosus (PDA)

What is increased right ventricular secondary to lung malfunction, including Emphysema, chronic bronchitis, cystic fibrosis?

Cor Pulmonale

What are the 4 features of Tetralogy of Fallot?

1) Dextrorotation of the aotra

2) Right ventricular hypertrophy

3) Intraventricular septal defect

4) Pulmonary artery stenosis

DRIP

What 2 valves of the heart is affected by rheumatic fever? Which is typically involved first?

MITRAL & Aortic

- mitral typically involved first

What type of anemia has small cells w/o much color, iron deficiency, and chronic hemorrhaging (cancer, ulcers, gastritis)?

Microcytic Hyperchromic anemia

How do you test for Hemorrhage?

GUIAC test

- Occult = hidden blood

- Frank = seen blood

What type of anemia is pernicious, resulting in a loss of parietal cells, decreased Vit B12 (cobalamin/cobalt) absorption, Reticulocytotic development, and Posterolateral sclerosis end stage (glove & stocking paralysis), with Folate (B9/folic acid) deficiency?

Macrocytic normochromic

What is the triphasic color change?

Pallor, cyanosis, rubor

What is seen in the esophagus with portal hypertension?

Esophageal varices

What causes ulcerations in the stomach?

H. pylori

What is a condition that affects the large intestine (colon) and causes problems with passing stool, missing Meissner's & Auerbach's plexus?

Hirshsprung's

What deficiency is seen in macrocytic normochromic anemia?

B12 (& folate)

What type of embolism is seen with deep sea diving?

Air emboli

What is the MC form of non-ischemic cardiomyopathy with gradual cardiac failure w/ hypertrophy/dilation of the heart?

Idiopathic dilated cardiomyopathy (DCM)

What is the major cause of Idiopathic dilated cardiomyopathy (DCM)? What are some other causes?

VIRAL MYOCARDITIS (coxsackievirus)

-- others include hemochromatosis, chromic anemia, alcoholism, sarcoidosis, & 3rd trimester pregnancy

What condition has heavy muscular hyper-contracting heart caused through congenital, Friedreich's Ataxia, glycogen storage disease, or infants of diabetic mothers?

Hypertrophic diastolic disorder

What condition has diastole & left ventricular filling impeded, caused by amyloidosis, radiation-induced fibrosis, and is found in children?

Restrictive diastolic disorder

What are 2 conditions that can occur due to acute oxygen deficiency to tissue? Which one does NOT have tissue death?

1) Angina (NO tissue death)

2) Myocardial Infarctions

What type of angina is due to activity, emotional excitement, or other increased cardiac work?

Typical or Stable

What types of angina is close to an MI with increased frequency and prolonged duration?

Unstable or Crescendo

What types of angina occurs at REST and is a coronary artery spasm?

Prinzmetal

What is ischemic heart disease, with the death of tissue releases enzyme?

Myocardial Infarction

What kind of Myocardial Infarction is full or nearly full thickness of the ventricular wall?

Transmural infarct

What kind of Myocardial Infarction is inner 1/3 or at most 1/2 of the ventricular?

Subendocardial infarct

What is impaired esophageal peristalsis and lower esophageal sphincter contraction, with dysphagia for solid & liquids, chest pain, and regurgitation and nocturnal cough?

Achalasia

What is the mucosal membrane across lumen, thought of like the "webs in your pipes", and a triad of post-cricoid dysphagia, iron-deficiency anemia, and esophageal webbing?

Plummer Vinson (Paterson-Kelly)

What is the varicosities in the esophagus from Portal HTN?

Esophageal varices

What is incompetence of the lower esophageal sphincter that results in gastric contents and Barrett's?

Gastroesophageal (GERD)

What is outpouching of the mucosa & submucosa posteriorly that fills with food, with possible regurgitation when bending or lying down?

Esophageal Diverticula (Zenker's)

What condition is laceration of the distal esophagus & proximal stomach during vomiting, retching, or hiccups with Hemorrhage seen in Alcoholics?

Mallory-Weiss

NOTE: Mallory is an alcoholic

What ulcers are the MC, located at the beginning of the small intestine with burning or gnawing pain and vomiting?

Duodenal ulcers

What ulcers are located along the lesser curvature of the stomach cause by H. Pylori & NSAIDS?

Gastric ulcers

Where does cancer of the stomach occur most frequently at with Unexplained weight loss & unrelenting pain?

Greater curvature

What 3 conditions may have unexplained weight loss?

1) Cancer

2) DM

3) AIDS

What condition has skip lesions?

Cronh's

What is the primary concern with ulcerative colitis?

Malabsorption

What characteristic cell is seen in Alcoholic hepatitis?

Mallory bodies

What is inflammation of the liver?

Hepatitis

What is a condition in which your liver is scarred and permanently damaged, and is secondary to chronic alcohol abuse and known as "fatty liver"?

Cirrhosis

The liver provides a fertile bed for what?

Blood-borne metastases

What is a pouch or sac through a defect?

Diverticulum

What is the presence of diverticula but shows NO inflammation?

Diverticulosis

What is the inflammation of diverticular mucosa with severe abdominal pain, fever, nausea, and change in bowel habits?

Diverticulitis

What is an inflammatory bowel disease affects the innermost lining of the colon with mucosal ulcerations & watery stool that is episodic, with bloody diarrhea, and fever?

Ulcerative Colitis

What disease has gas & distention with pencil-thin stools that has episodic diarrhea, fever, and anorexia?

Irritable Bowel Syndrome

What chronic disease of the digestive tract shows skip lesions in the distal ileum or colon with chronic diarrhea, fever, and anorexia?

Crohn's (Regional Enteritis)

What disease is congenital absence of Meissner's & Auerbach's autonomic plexus, involving the colon but could be fatal if not diagnosed in infancy?

Hirschsprung's (Congenital megacolon)

What disease is hereditary & immune reaction with chronic intestinal malabsorption causing mucosal damage due to gluten (wheat) intolerance and will show steatorrhea?

Celiac Disease (Nontropical Sprue, Gluten Enteropathy, Celiac Sprue)

What disease is a mucosal abnormality in the small bowel leading to multiple nutritional deficiencies, with the triad of sore tongue, diarrhea, and weight loss?

Topical Sprue

What disease is a small bowel infection that is progressive & fatal with lymph obstruction, seen in 30-60 y/o males and other symptoms such as anemia, weight loss, skin pigmentation, diarrhea, joint symptoms, severe malabsorption, abdominal pain, cough, and pleuritic pain?

Whipple's Disease

What disease is an aggressive peptic ulcer or tumor that can perforate through the lining due to too much gastric acid?

Zollinger-Ellison

What disease is an autosomal disease found in the ascending colon producing polyps?

Gardener's Syndrome

What is the most common cancer death in both males and womens?

Lung cancer

What is the infection of the lung, alveolar spaces, and/or interstitial tissue, affecting 2 million people a year?

Pneumonia

What is the MC cause of pneumonia, caused by consolidation and streptococcus pneumonia?

Bacterial pneumonia

What is the MC type of bacterial pneumonia?

Lobar pneumonia

What type of pneumonia has gradual onset with increased lymphocytes?

Viral Pneumonia

What is the MC atypical pneumonia (lack of exudate; Eaton Agent)?

Mycoplasmal Pneumonia

What type of pneumonia is debilitated patients and alcoholics with red currant jelly sputum?

Klebsiella (Friedlander's)

What type of pneumonia is common in patients with AIDS?

Pneumocystis carinii pneumonia

What type of pneumonia has rusty sputum?

Pneumococcal pneumonia

What tumor starts at the top part of the lung (apex) and affects the brachial plexus?

Pancoast Tumor

What condition has ptosis, miosis, & anhydrosis?

Horner's

What are 4 causes of Horner's syndrome?

1) Whiplash

2) Smoking

3) Asbestos

4) Pancoast tumor

What is increased resistance to airflow during forced expiration (prolonged expiration)?

COPD

(Chronic Obstructive Pulmonary Disease)

What type of COPD is long-term inflammation of the bronchi and is known as a blue bloater, chronic cough, sputum that is blood-streaked, wheezing, and dyspnea?

Chronic Bronchitis

What type of COPD is a condition where the airways narrow and swell, producing extra mucus and with characteristic features such as Curschmann's spirals, Charcot's Laden Crystals, thick sputum, and bronchial spasm?

Asthma

What type of COPD is "bronchiolitis" from tobacco smoke & air pollution?

Small Airway Disease

What is a long-term condition where the airways of the lungs become widened, leading to a build-up of excess mucus that can make the lungs more vulnerable to infection, is a "dead lung", irreversible, focal bronchial dilation with infection & necrosis of tissue?

Bronchiestasis

What lung condition can have clubbing of the nails?

Lung cancer